Sample records for quality practical application

  1. A Study on Students' Satisfaction Based on Quality Standards of Accreditation in Higher Education

    ERIC Educational Resources Information Center

    Neelaveni, C.; Manimaran S.

    2015-01-01

    Quality standards are evaluated by the Higher Educational Institutions by self evaluation at different levels and are also assessed by external agencies. Application of quality standards in administrative practices have been associated with the quality of higher education. To improve the quality of administrative practices, evaluation scales are…

  2. Quality in the pharmaceutical industry - A literature review.

    PubMed

    Haleem, Reham M; Salem, Maissa Y; Fatahallah, Faten A; Abdelfattah, Laila E

    2015-10-01

    The aim of this study is to:a.Highlight the most important guidelines and practices of quality in the pharmaceutical industry.b.Organize such guidelines and practices to create a guide to pave the way for other researchers who would like to dig deeper into these guidelines and practices. A review was conducted of 102 publications; 56 publications were concerned with the pharmaceutical quality directly while 46 publications were concerned with the general quality practices. The content of those sources was analyzed and the following themes were identified:a.Research theme 1: Guidelines of the pharmaceutical quality.b.Research theme 2: General practices recently applied in the pharmaceutical industry. The following guidelines were identified and reviewed: WHO guidelines, FDA guidelines, EU guidelines and ICH guidelines in the research theme I. In research theme II; the following topics were identified and reviewed: quality risk management, quality by design, corrective actions and preventive actions, process capability analysis, Six Sigma, process analytical technology, lean manufacturing, total quality management, ISO series and HACCP. Upon reviewing the previously highlighted guidelines and the practices that are widely applied in the pharmaceutical industry, it was noticed that there is an abundant number of papers and articles that explain the general guidelines and practices but the literature lack those describing application; case studies of the pharmaceutical factories applying those guidelines and significance of those guidelines and practices. It is recommended that the literature would invest more in the area of application and significance of guidelines and practices. New case studies should be done to prove the feasibility of such practices.

  3. Stand development and silviculture in bottomland hardwoods

    Treesearch

    J. Steven Meadows

    1993-01-01

    Silviculture for the production of high-quality timber in southern bottomland hardwood forests involves the application of environmentally sound practices in order to enhance the growth and quality of both individual trees and stands. To accomplish this purpose, silvicultural practices are typically used to regulate stand density, species composition, and stem quality...

  4. Quality in the pharmaceutical industry – A literature review

    PubMed Central

    Haleem, Reham M.; Salem, Maissa Y.; Fatahallah, Faten A.; Abdelfattah, Laila E.

    2013-01-01

    Objectives The aim of this study is to:a.Highlight the most important guidelines and practices of quality in the pharmaceutical industry.b.Organize such guidelines and practices to create a guide to pave the way for other researchers who would like to dig deeper into these guidelines and practices. Design A review was conducted of 102 publications; 56 publications were concerned with the pharmaceutical quality directly while 46 publications were concerned with the general quality practices. The content of those sources was analyzed and the following themes were identified:a.Research theme 1: Guidelines of the pharmaceutical quality.b.Research theme 2: General practices recently applied in the pharmaceutical industry. Main outcome measures The following guidelines were identified and reviewed: WHO guidelines, FDA guidelines, EU guidelines and ICH guidelines in the research theme I. In research theme II; the following topics were identified and reviewed: quality risk management, quality by design, corrective actions and preventive actions, process capability analysis, Six Sigma, process analytical technology, lean manufacturing, total quality management, ISO series and HACCP. Results Upon reviewing the previously highlighted guidelines and the practices that are widely applied in the pharmaceutical industry, it was noticed that there is an abundant number of papers and articles that explain the general guidelines and practices but the literature lack those describing application; case studies of the pharmaceutical factories applying those guidelines and significance of those guidelines and practices. Conclusions It is recommended that the literature would invest more in the area of application and significance of guidelines and practices. New case studies should be done to prove the feasibility of such practices. PMID:26594110

  5. Revisiting the Procedures for the Vector Data Quality Assurance in Practice

    NASA Astrophysics Data System (ADS)

    Erdoğan, M.; Torun, A.; Boyacı, D.

    2012-07-01

    Immense use of topographical data in spatial data visualization, business GIS (Geographic Information Systems) solutions and applications, mobile and location-based services forced the topo-data providers to create standard, up-to-date and complete data sets in a sustainable frame. Data quality has been studied and researched for more than two decades. There have been un-countable numbers of references on its semantics, its conceptual logical and representations and many applications on spatial databases and GIS. However, there is a gap between research and practice in the sense of spatial data quality which increases the costs and decreases the efficiency of data production. Spatial data quality is well-known by academia and industry but usually in different context. The research on spatial data quality stated several issues having practical use such as descriptive information, metadata, fulfillment of spatial relationships among data, integrity measures, geometric constraints etc. The industry and data producers realize them in three stages; pre-, co- and post data capturing. The pre-data capturing stage covers semantic modelling, data definition, cataloguing, modelling, data dictionary and schema creation processes. The co-data capturing stage covers general rules of spatial relationships, data and model specific rules such as topologic and model building relationships, geometric threshold, data extraction guidelines, object-object, object-belonging class, object-non-belonging class, class-class relationships to be taken into account during data capturing. And post-data capturing stage covers specified QC (quality check) benchmarks and checking compliance to general and specific rules. The vector data quality criteria are different from the views of producers and users. But these criteria are generally driven by the needs, expectations and feedbacks of the users. This paper presents a practical method which closes the gap between theory and practice. Development of spatial data quality concepts into developments and application requires existence of conceptual, logical and most importantly physical existence of data model, rules and knowledge of realization in a form of geo-spatial data. The applicable metrics and thresholds are determined on this concrete base. This study discusses application of geo-spatial data quality issues and QA (quality assurance) and QC procedures in the topographic data production. Firstly we introduce MGCP (Multinational Geospatial Co-production Program) data profile of NATO (North Atlantic Treaty Organization) DFDD (DGIWG Feature Data Dictionary), the requirements of data owner, the view of data producers for both data capturing and QC and finally QA to fulfil user needs. Then, our practical and new approach which divides the quality into three phases is introduced. Finally, implementation of our approach to accomplish metrics, measures and thresholds of quality definitions is discussed. In this paper, especially geometry and semantics quality and quality control procedures that can be performed by the producers are discussed. Some applicable best-practices that we experienced on techniques of quality control, defining regulations that define the objectives and data production procedures are given in the final remarks. These quality control procedures should include the visual checks over the source data, captured vector data and printouts, some automatic checks that can be performed by software and some semi-automatic checks by the interaction with quality control personnel. Finally, these quality control procedures should ensure the geometric, semantic, attribution and metadata quality of vector data.

  6. Preface to QoIS 2009

    NASA Astrophysics Data System (ADS)

    Comyn-Wattiau, Isabelle; Thalheim, Bernhard

    Quality assurance is a growing research domain within the Information Systems (IS) and Conceptual Modeling (CM) disciplines. Ongoing research on quality in IS and CM is highly diverse and encompasses theoretical aspects including quality definition and quality models, and practical/empirical aspects such as the development of methods, approaches and tools for quality measurement and improvement. Current research on quality also includes quality characteristics definitions, validation instruments, methodological and development approaches to quality assurance during software and information systems development, quality monitors, quality assurance during information systems development processes and practices, quality assurance both for data and (meta)schemata, quality support for information systems data import and export, quality of query answering, and cost/benefit analysis of quality assurance processes. Quality assurance is also depending on the application area and the specific requirements in applications such as health sector, logistics, public sector, financial sector, manufacturing, services, e-commerce, software, etc. Furthermore, quality assurance must also be supported for data aggregation, ETL processes, web content management and other multi-layered applications. Quality assurance is typically requiring resources and has therefore beside its benefits a computational and economical trade-off. It is therefore also based on compromising between the value of quality data and the cost for quality assurance.

  7. Quality control of colonoscopy procedures: a prospective validated method for the evaluation of professional practices applicable to all endoscopic units.

    PubMed

    Coriat, R; Pommaret, E; Chryssostalis, A; Viennot, S; Gaudric, M; Brezault, C; Lamarque, D; Roche, H; Verdier, D; Parlier, D; Prat, F; Chaussade, S

    2009-02-01

    To produce valid information, an evaluation of professional practices has to assess the quality of all practices before, during and after the procedure under study. Several auditing techniques have been proposed for colonoscopy. The purpose of this work is to describe a straightforward original validated method for the prospective evaluation of professional practices in the field of colonoscopy applicable in all endoscopy units without increasing the staff work load. Pertinent quality-control criteria (14 items) were identified by the endoscopists at the Cochin Hospital and were compatible with: findings in the available literature; guidelines proposed by the Superior Health Authority; and application in any endoscopy unit. Prospective routine data were collected and the methodology validated by evaluating 50 colonoscopies every quarter for one year. The relevance of the criteria was assessed using data collected during four separate periods. The standard checklist was complete for 57% of the colonoscopy procedures. The colonoscopy procedure was appropriate according to national guidelines in 94% of cases. These observations were particularly noteworthy: the quality of the colonic preparation was insufficient for 9% of the procedures; complete colonoscopy was achieved for 93% of patients; and 0.38 adenomas and 0.045 carcinomas were identified per colonoscopy. This simple and reproducible method can be used for valid quality-control audits in all endoscopy units. In France, unit-wide application of this method enables endoscopists to validate 100 of the 250 points required for continuous medical training. This is a quality-control tool that can be applied annually, using a random month to evaluate any changes in routine practices.

  8. Quality of Life. Volume II: Application to Persons with Disabilities.

    ERIC Educational Resources Information Center

    Schalock, Robert L., Ed.; Siperstein, Gary N., Ed.

    This volume summarizes current policies and programmatic practices that are influencing the quality of life of persons with mental retardation and developmental disabilities. Part 1, "Service Delivery Application," contains: "Using Person-Centered Planning To Address Personal Quality of Life" (John Butterworth and others); "The Aftermath of…

  9. 9 CFR 355.43 - Scope and applicability of rules of practice.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...; INSPECTION, CERTIFICATION, AND IDENTIFICATION AS TO CLASS, QUALITY, QUANTITY, AND CONDITION Mule Meat and Animal Food, Mule Meat By-Product § 355.43 Scope and applicability of rules of practice. The rules of...

  10. 9 CFR 355.43 - Scope and applicability of rules of practice.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...; INSPECTION, CERTIFICATION, AND IDENTIFICATION AS TO CLASS, QUALITY, QUANTITY, AND CONDITION Mule Meat and Animal Food, Mule Meat By-Product § 355.43 Scope and applicability of rules of practice. The rules of...

  11. 9 CFR 355.43 - Scope and applicability of rules of practice.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...; INSPECTION, CERTIFICATION, AND IDENTIFICATION AS TO CLASS, QUALITY, QUANTITY, AND CONDITION Mule Meat and Animal Food, Mule Meat By-Product § 355.43 Scope and applicability of rules of practice. The rules of...

  12. 9 CFR 355.43 - Scope and applicability of rules of practice.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...; INSPECTION, CERTIFICATION, AND IDENTIFICATION AS TO CLASS, QUALITY, QUANTITY, AND CONDITION Mule Meat and Animal Food, Mule Meat By-Product § 355.43 Scope and applicability of rules of practice. The rules of...

  13. Quality Assurance: Adapting SERVQUAL to Measure the Perceived Quality of Pre-Service Teachers' Teaching Practice Experience

    ERIC Educational Resources Information Center

    Oliver, Henry; Koeberg, Jeremy

    2013-01-01

    This article describes a work in progress study which extends traditional quality assurance mechanisms through the application of the SERVQUAL instrument. It assesses the difference between pre-service teacher expectations and actual experience during a Teaching Practice period. Anecdotal evidence points to students being the recipients of poor…

  14. [Post-marketing reevaluation for potential quality risk and quality control in clinical application of traditional Chinese medicines].

    PubMed

    Li, Hong-jiao; He, Li-yun; Liu, Bao-yan

    2015-06-01

    The effective quality control in clinical practices is an effective guarantee for the authenticity and scientificity of the findings. The post-marketing reevaluation for traditional Chinese medicines (TCM) focuses on the efficacy, adverse reaction, combined medication and effective dose of drugs in the market by expanded clinical trials, and requires a larger sample size and a wider range of patients. Therefore, this increases the difficulty of quality control in clinical practices. With the experience in quality control in clinical practices for the post-marketing reevaluation for Kangbingdu oral for cold, researchers in this study reviewed the study purpose, project, scheme design and clinical practice process from an overall point of view, analyzed the study characteristics of the post-marketing reevaluation for TCMs and the quality control risks, designed the quality control contents with quality impacting factors, defined key review contents and summarized the precautions in clinical practices, with the aim to improve the efficiency of quality control of clinical practices. This study can provide reference to clinical units and quality control-related personnel in the post-marketing reevaluation for TCMs.

  15. Translating Behavioral Science into Practice: A Framework to Determine Science Quality and Applicability for Police Organizations.

    PubMed

    McClure, Kimberley A; McGuire, Katherine L; Chapan, Denis M

    2018-05-07

    Policy on officer-involved shootings is critically reviewed and errors in applying scientific knowledge identified. Identifying and evaluating the most relevant science to a field-based problem is challenging. Law enforcement administrators with a clear understanding of valid science and application are in a better position to utilize scientific knowledge for the benefit of their organizations and officers. A recommended framework is proposed for considering the validity of science and its application. Valid science emerges via hypothesis testing, replication, extension and marked by peer review, known error rates, and general acceptance in its field of origin. Valid application of behavioral science requires an understanding of the methodology employed, measures used, and participants recruited to determine whether the science is ready for application. Fostering a science-practitioner partnership and an organizational culture that embraces quality, empirically based policy, and practices improves science-to-practice translation. © 2018 American Academy of Forensic Sciences.

  16. An evaluative review of questionnaires recommended for the assessment of quality of life and symptom severity in women with urinary incontinence.

    PubMed

    Hewison, Ann; McCaughan, Dorothy; Watt, Ian

    2014-11-01

    To provide an up-to-date assessment of the quality of commonly recommended questionnaires for measuring symptom severity and quality of life in women with urinary incontinence and also to consider their application to practice. Urinary incontinence is a common problem for women. In addition to various physical symptoms, there is a known effect on quality of life. Psychometrically robust questionnaires are reported to be the best way to measure an individual's perceptions of symptom severity and quality of life, and a number of different ones are recommended for use in international and national guidance, which can be confusing for clinicians. Moreover, there are concerns over the applicability of some of these instruments in clinical practice. An evaluative review was carried out examining selected questionnaires measuring symptom severity and/or quality of life. Selection of questionnaires for inclusion in the review was based on the recommendations of evidence-based guidance, followed by systematic scrutiny of the characteristics of the individual recommended questionnaires. Thirteen questionnaires were included in the review, of which three appeared to 'outperform' the remainder in terms of their psychometric properties and other characteristics. This review provides the most up-to-date and comprehensive analysis of the quality and applicability of the included questionnaires and offers the practitioner advice on which to select for use in practice. This review aims to help the practitioner choose a questionnaire based on a sound evaluation of the quality of the questionnaire and its applicability to the clinical setting. © 2013 John Wiley & Sons Ltd.

  17. 7 CFR 1466.20 - Application for contracts and selecting applications.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... concerning soil, water and air quality; wildlife habitat; and ground and surface water conservation; (vi... include water conservation or irrigation efficiency practices, the State Conservationist will give... conservation practices; (ii) The magnitude of the expected environmental benefits resulting from the...

  18. 7 CFR 1466.20 - Application for contracts and selecting applications.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... concerning soil, water and air quality; wildlife habitat; and ground and surface water conservation; (vi... include water conservation or irrigation efficiency practices, the State Conservationist will give... conservation practices; (ii) The magnitude of the expected environmental benefits resulting from the...

  19. 7 CFR 1466.20 - Application for contracts and selecting applications.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... concerning soil, water and air quality; wildlife habitat; and ground and surface water conservation; (vi... include water conservation or irrigation efficiency practices, the State Conservationist will give... conservation practices; (ii) The magnitude of the expected environmental benefits resulting from the...

  20. An Overview of Total Quality Management (TQM) practice in Construction Sector

    NASA Astrophysics Data System (ADS)

    Likita, A. J.; Zainun, N. Y.; Rahman, I. Abdul; Awal, A. S. M. Abdul; Alias, A. R.; Rahman, M. Q. Abdul; Ghazali, F. E. Mohamed

    2018-04-01

    In construction sector TQM can be termed as a philosophy which guides construction professionals on the proper execution of construction projects in terms of quality. The aim of this paper is to discuss on quality management practice in construction sector. This paper evaluated five previous researches and the findings were discussed to find a conclusion of TQM practise in construction sector. The study found that TQM had been successfully practice in construction sector at Saudi Arabia, India, US and South Africa. Application of Artificial Neural Network (ANN) help to improve the implementation of TQM in construction sector. In conclusion, quality management practices will give better control of processes in construction sector.

  1. Teaching quality improvement.

    PubMed

    Murray, Marry Ellen; Douglas, Stephen; Girdley, Diana; Jarzemsky, Paula

    2010-08-01

    Practicing nurses are required to engage in quality improvement work as a part of their clinical practice, but few undergraduate nursing education programs offer course work and applied experience in this area. This article presents a description of class content and teaching strategies, assignments, and evaluation strategies designed to achieve the Quality and Safety Education in Nursing competencies related to quality improvement and interdisciplinary teams. Students demonstrate their application of the quality improvement process by designing and implementing a small-scale quality improvement project that they report in storyboard format on a virtual conference Web site.

  2. Management Practices. U.S. Companies Improve Performance through Quality Efforts. Report to the Honorable Donald Ritter, House of Representatives.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. National Security and International Affairs Div.

    The General Accounting Office (GAO) examined the impact of formal total quality management (TQM) practices on the performance of 20 selected U.S. companies that were among the highest-scoring applicants in 1988 and 1989 for the Malcolm Baldridge National Quality Award. Several key indicators used by companies to measure performance were analyzed.…

  3. Suitability of Public Records for Evaluating Health Effects of Treated Sewage Sludge in North Carolina

    PubMed Central

    Keil, Alexander; Wing, Steven; Lowman, Amy

    2011-01-01

    BACKGROUND Exposure to potentially harmful agents because of waste disposal practices is receiving increased attention. Treated sewage sludge (TSS), or biosolid material, is the solid waste generated during domestic sewage treatment after it has undergone processes to reduce the number of pathogens and vector attractants. Application of TSS to land, which is the most common method for disposal, is promoted as a soil amendment and fertilizer. Few studies have examined the effects of land application on the health and quality of life of neighboring populations. We describe and summarize publicly available records that could be used to study the public health impact of practices associated with land application in North Carolina. METHODS We abstracted public records from the North Carolina Department of Natural Resources Division of Water Quality, to determine the following activities associated with land application of TSS in 8 counties in central North Carolina: the process for obtaining permits, reported applications, violations, documented concerns of residents, and penalties assessed. RESULTS The Division of Water Quality routinely collects records of permits and approvals for land application of TSS, amounts applied, and reported pollutant levels. Documentation was useful in summarizing land application practices, but lack of standardization in reporting was a concern. Research into the public health impacts of the land application program is hindered by inconsistency in documenting inspections and resident concerns. LIMITATIONS We were not able to validate state records with direct observation of land application of TSS. CONCLUSIONS Records from the Division of Water Quality would be of limited use in epidemiologic studies of the health effects of land application of biosolids. Information about locations, amounts, and dates of application are relevant to exposure potential, but additional information is needed for health investigations. PMID:21721493

  4. Suitability of public records for evaluating health effects of treated sewage sludge in North Carolina.

    PubMed

    Keil, Alexander; Wing, Steven; Lowman, Amy

    2011-01-01

    Exposure to potentially harmful agents because of waste disposal practices is receiving increased attention. Treated sewage sludge (TSS), or biosolid material, is the solid waste generated during domestic sewage treatment after it has undergone processes to reduce the number of pathogens and vector attractants. Application of TSS to land, which is the most common method for disposal, is promoted as a soil amendment and fertilizer. Few studies have examined the effects of land application on the health and quality of life of neighboring populations. We describe and summarize publicly available records that could be used to study the public health impact of practices associated with land application in North Carolina. We abstracted public records from the North Carolina Department of Natural Resources Division of Water Quality, to determine the following activities associated with land application of TSS in 8 counties in central North Carolina: the process for obtaining permits, reported applications, violations, documented concerns of residents, and penalties assessed. The Division of Water Quality routinely collects records of permits and approvals for land application of TSS, amounts applied, and reported pollutant levels. Documentation was useful in summarizing land application practices, but lack of standardization in reporting was a concern. Research into the public health impacts of the land application program is hindered by inconsistency in documenting inspections and resident concerns. We were not able to validate state records with direct observation of land application of TSS. Records from the Division of Water Quality would be of limited use in epidemiologic studies of the health effects of land application of biosolids. Information about locations, amounts, and dates of application are relevant to exposure potential, but additional information is needed for health investigations.

  5. Practical Approaches to Quality Improvement for Radiologists.

    PubMed

    Kelly, Aine Marie; Cronin, Paul

    2015-10-01

    Continuous quality improvement is a fundamental attribute of high-performing health care systems. Quality improvement is an essential component of health care, with the current emphasis on adding value. It is also a regulatory requirement, with reimbursements increasingly being linked to practice performance metrics. Practice quality improvement efforts must be demonstrated for credentialing purposes and for certification of radiologists in practice. Continuous quality improvement must occur for radiologists to remain competitive in an increasingly diverse health care market. This review provides an introduction to the main approaches available to undertake practice quality improvement, which will be useful for busy radiologists. Quality improvement plays multiple roles in radiology services, including ensuring and improving patient safety, providing a framework for implementing and improving processes to increase efficiency and reduce waste, analyzing and depicting performance data, monitoring performance and implementing change, enabling personnel assessment and development through continued education, and optimizing customer service and patient outcomes. The quality improvement approaches and underlying principles overlap, which is not surprising given that they all align with good patient care. The application of these principles to radiology practices not only benefits patients but also enhances practice performance through promotion of teamwork and achievement of goals. © RSNA, 2015.

  6. [THE VIRTUAL CYTOLOGIC SLIDES FOR EXTERNAL EVALUATION OF QUALITY OF IMPLEMENTATION OF CYTOLOGIC ANALYSES IN CLINICAL DIAGNOSTIC LABORATORIES: POSSIBILITIES AND PERSPECTIVES].

    PubMed

    Djangirova, T V; Shabalova, I P; Pronichev, A N; Polyakov, E V

    2015-08-01

    The article considers application of technology of analysis of cytological slides in external quality control of clinical diagnostic laboratories. The advantages of virtual slides are demonstrated against other applied technologies of external evaluation of quality i.e. slide plate and digital micro-photography. The conditions of formation of virtual slides for external evaluation of quality of clinical diagnostic laboratories. The technology of their application is described. The success of practical application of considered technology in the Federal system of external evaluation of quality is emphasized.

  7. Applications of Quality Management in Language Education

    ERIC Educational Resources Information Center

    Heyworth, Frank

    2013-01-01

    This review examines applications of quality management (QM) in language education. QM approaches have been adapted from methodologies developed in industrial and commercial settings, and these are briefly described. Key aspects of QM in language education are the definition of purpose, descriptions of principles and practice, including various…

  8. Nuclear Technology. Course 31: Quality Assurance Practices. Module 31-5, Nonconforming Materials.

    ERIC Educational Resources Information Center

    Pritchard, Jim; Espy, John

    This fifth in a series of eight modules for a course titled Quality Assurance Practices describes the essential elements of a nonconforming material control system, including purpose and application. The module follows a typical format that includes the following sections: (1) introduction, (2) module prerequisites, (3) objectives, (4) notes to…

  9. Record of Assessment Moderation Practice (RAMP): Survey Software as a Mechanism of Continuous Quality Improvement

    ERIC Educational Resources Information Center

    Johnson, Genevieve Marie

    2015-01-01

    In higher education, assessment integrity is pivotal to student learning and satisfaction, and, therefore, a particularly important target of continuous quality improvement. This paper reports on the preliminary development and application of a process of recording and analysing current assessment moderation practices, with the aim of identifying…

  10. Counseling Outcome Research: Making Practical Choices for Real-World Applications.

    ERIC Educational Resources Information Center

    Granello, Darcy H.; Granello, Paul F.

    The incorporation of published outcome data into clinical practice plays a significant role in determining appropriate treatment interventions and the efficacy of various modalities. If practitioners are willing to conduct their own outcome research, the results will enhance the quality of care for clients and improve the quality of information…

  11. Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice

    DTIC Science & Technology

    2015-03-24

    in the pursuit of quality nursing care is as important to military healthcare as it is in the civilian sector. Description: The Advancing...information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services , Directorate for Information...identify gaps in practice, apply principles of evidence-based practice (EBP), and advance scientific applications in the pursuit of quality nursing

  12. Apollo experience report: Reliability and quality assurance

    NASA Technical Reports Server (NTRS)

    Sperber, K. P.

    1973-01-01

    The reliability of the Apollo spacecraft resulted from the application of proven reliability and quality techniques and from sound management, engineering, and manufacturing practices. Continual assessment of these techniques and practices was made during the program, and, when deficiencies were detected, adjustments were made and the deficiencies were effectively corrected. The most significant practices, deficiencies, adjustments, and experiences during the Apollo Program are described in this report. These experiences can be helpful in establishing an effective base on which to structure an efficient reliability and quality assurance effort for future space-flight programs.

  13. [Clinical application evaluation of Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine].

    PubMed

    Liu, Yu-Qi; Liu, Meng-Yu; Li, Chun; Shi, Nan-Nan; Wang, Yue-Xi; Wang, Li-Ying; Zhao, Xue-Yao; Kou, Shuang; Han, Xue-Jie; Wang, Yan-Ping

    2017-09-01

    This study is to assess the Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine in clinical application and provide evidence for further guideline revision. The assessment was divided into applicability assessment and practicability assessment. The applicability assessment based on questionnaire survey and the traditional Chinese medicine (TCM) practitioners were asked to independently fill the Questionnaire for Applicability Assessment on the Guidelines for Diagnosis and Treatment in Traditional Chinese Medicine. The practicability assessment was based on prospective case investigation and analysis method and the TCM practitioners-in-charge filled the Case Investigation Questionnaire for Practicability Assessment on the Guidelines for Diagnosis and Treatment in Traditional Chinese Medicine. The data were analyzed in descriptive statistics. 151 questionnaires were investigated for applicability assessment and 1 016 patients were included for practicability assessment. The results showed that 88.74% of them were familiar with the guidelines and 45.70% used them. The guidelines quality and related items were similar in applicability assessment and practicability assessment, and scored highly as more than 85.00% except the "recuperating and prevention". The results suggested that the quality of Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine was high and could better guide the clinical practice. The "recuperating and prevention" part should be improved and the evidence data should be included in future guideline revision, so that the clinical utilization rate could be increased. Copyright© by the Chinese Pharmaceutical Association.

  14. A Quality Classroom: Quality Teaching Tools That Facilitate Student Success.

    ERIC Educational Resources Information Center

    Cooke, Brian

    This presentation described practical applications and quality tools for educators that are based on original classroom research and the theories of motivation, learning, profound knowledge, systems thinking, and service quality advanced by Karl Albrecht, William Glasser, and W. Edwards Deming. The presentation was conducted in a way that…

  15. Skinner Meets Piaget on the Reggio Playground: Practical Synthesis of Applied Behavior Analysis and Developmentally Appropriate Practice Orientations

    ERIC Educational Resources Information Center

    Warash, Bobbie; Curtis, Reagan; Hursh, Dan; Tucci, Vicci

    2008-01-01

    We focus on integrating developmentally appropriate practices, the project approach of Reggio Emilia, and a behavior analytic model to support a quality preschool environment. While the above practices often are considered incompatible, we have found substantial overlap and room for integration of these perspectives in practical application. With…

  16. Effectiveness of best management practices that have application to forest roads: a literature synthesis

    Treesearch

    Pamela J. Edwards; Frederica Wood; Robin L. Quinlivan

    2016-01-01

    Literature describing the effectiveness of best management practices (BMPs) applicable to forest roads is reviewed and synthesized. Effectiveness is considered from the perspective of protecting water quality and water resources. Both paved and unpaved forest roads are considered, but BMPs that involve substantial engineering are not considered. Some of the BMPs...

  17. Licorice Production and Manufacturing: All-Sorts of Practical Applications for Statistics

    ERIC Educational Resources Information Center

    Watson, Jane; Skalicky, Jane; Fitzallen, Noleine; Wright, Suzie

    2009-01-01

    Among the practical applications of statistics is the collection of data from manufacturing processes. Often collected in the form of a time series, data collected from a series of measurements show the variation in those measurements, such as mass of a product manufactured. Limits are set for quality control and if these are exceeded then a…

  18. Promoting and evaluating scientific rigour in qualitative research.

    PubMed

    Baillie, Lesley

    2015-07-15

    This article explores perspectives on qualitative research and the variety of views concerning rigour in the research process. Evaluating and ensuring the quality of research are essential considerations for practitioners who are appraising evidence to inform their practice or research. Several criteria and principles for evaluating quality in qualitative research are presented, recognising that their application in practice is influenced by the qualitative methodology used. The article examines a range of techniques that a qualitative researcher can use to promote rigour and apply it to practice.

  19. Quality assessment of recent evidence-based clinical practice guidelines for management of type 2 diabetes mellitus in adults using the AGREE II instrument.

    PubMed

    Anwer, Muhammad A; Al-Fahed, Ousama B; Arif, Samir I; Amer, Yasser S; Titi, Maher A; Al-Rukban, Mohammed O

    2018-02-01

    Type 2 diabetes mellitus (T2DM) is a worldwide and national public health problem that has a great impact on the population in Saudi Arabia. High-quality clinical practice guidelines (CPGs) are cornerstones in improving the health care provided for patients with diabetes. This study evaluated the methodological rigour, transparency, and applicability of recently published CPGs. Our group conducted a systematic search for recently published CPGs for T2DM. The searching and screening for Source CPGs were guided by tools from the ADAPTE methods with specific inclusion/exclusion criteria. Five reviewers using the second version of the Appraisal of Guidelines for Research and Evaluation (AGREE II) Instrument independently assessed the quality of the retrieved Source CPGs. Domains of Scope and purpose and Clarity of presentation received the highest scores in all CPGs. Most of the assessed CPGs (86%) were considered with high overall quality and were recommended for use. Rigour of development and applicability domains were together highest in 3 CPGs (43%). The overall high quality of DM CPGs published in the last 3 years demonstrated the continuous development and improvement in CPG methodologies and standards. Health care professionals should consider the quality of any CPG for T2DM before deciding to use it in their daily clinical practice. Three CPGs have been identified, using the AGREE criteria, as high-quality and trustworthy. Ideally, the resources provided by the AGREE trust including the AGREE II Instrument should be used by a clinician to scan through the large number of published T2DM CPGs to identify the CPGs with high methodological quality and applicability. © 2017 John Wiley & Sons, Ltd.

  20. Total Quality Management in Higher Education: Clearing the Hurdles. A Survey on Strategies for Implementing Quality Management Practices in Higher Education. A GOAL/QPC Application Report.

    ERIC Educational Resources Information Center

    Seymour, Daniel

    Based on a survey of Quality Management (QM) practitioners at 21 colleges, this study presents the 10 most difficult implementation hurdles to QM in higher education and a set of hurdle-clearing strategies. The hurdles are: (1) lack of time to implement QM; (2) perception that QM is something for janitorial and housing staffs but not applicable to…

  1. Quality health care in the European Union thanks to competition law.

    PubMed

    Fornaciari, Diego

    2010-01-01

    There are many biases concerning the application of competition law in health care. Quality concerns can however be integrated into competition law analysis. The aim of this paper is to identify the links between the application of competition law in the European Union and the right to quality health care and to point out the problems that arise when integrating quality concerns in competition law analysis. Guidelines must be issued and competition authorities must work together with institutions that have expertise in the field of health care quality measurement in order to integrate these dimensions in competition practice.

  2. The Bobath concept - a model to illustrate clinical practice.

    PubMed

    Michielsen, Marc; Vaughan-Graham, Julie; Holland, Ann; Magri, Alba; Suzuki, Mitsuo

    2017-12-17

    The model of Bobath clinical practice provides a framework identifying the unique aspects of the Bobath concept in terms of contemporary neurological rehabilitation. The utilisation of a framework to illustrate the clinical application of the Bobath concept provides the basis for a common understanding with respect to Bobath clinical practice, education, and research. The development process culminating in the model of Bobath clinical practice is described. The use of the model in clinical practice is illustrated using two cases: a client with a chronic incomplete spinal cord injury and a client with a stroke. This article describes the clinical application of the Bobath concept in terms of the integration of posture and movement with respect to the quality of task performance, applying the Model of Bobath Clinical Practice. Facilitation, a key aspect of Bobath clinical practice, was utilised to positively affect motor control and perception in two clients with impairment-related movement problems due to neurological pathology and associated activity limitations and participation restrictions - the outcome measures used to reflect the individual clinical presentation. Implications for Rehabilitation The model of Bobath clinical practice provides a framework identifying the unique aspects of the Bobath-concept. The model of Bobath clinical practice provides the basis for a common understanding with respect to Bobath clinical practice, education, and research. The clinical application of the Bobath-concept highlights the integration of posture and movement with respect to the quality of task performance. Facilitation, a key aspect of Bobath clinical practice, positively affects motor control, and perception.

  3. [Progress in methodological characteristics of clinical practice guideline for osteoarthritis].

    PubMed

    Xing, D; Wang, B; Lin, J H

    2017-06-01

    At present, several clinical practice guidelines for the treatment of osteoarthritis have been developed by institutes or societies. The ultimate purpose of developing clinical practice guidelines is to formulate the process in the treatment of osteoarthritis effectively. However, the methodologies used in developing clinical practice guidelines may place an influence on the transformation and application of that in treating osteoarthritis. The present study summarized the methodological features of individual clinical practice guideline and presented the tools for quality evaluation of clinical practice guideline. The limitations of current osteoarthritis guidelines of China are also indicated. The review article might help relevant institutions improve the quality in developing guide and clinical transformation.

  4. Canadian Association of Gastroenterology policy on the application for, and implementation of, clinical practice guidelines

    PubMed Central

    Singh, Harminder; Leontiadis, Grigorios I; Hookey, Lawrence; Enns, Robert; Bistritz, Lana; Rioux, Louis-Charles; Hope, Louise; Sinclair, Paul

    2014-01-01

    An important mandate of the Canadian Association of Gastroenterology (CAG), as documented in the Association’s governance policies, is to optimize the care of patients with digestive disorders. Clinical practice guidelines are one means of achieving this goal. The benefits of timely, high-quality and evidenced-based recommendations include: Enhancing the professional development of clinical members through education and dissemination of synthesized clinical research;Improving patient care provided by members by providing focus on quality and evidence;Creating legislative environments that favour effective clinical practice;Enhancing the clinical care provided to patients with digestive disease by nongastroenterologists; andIdentifying areas that require further information or research to improve clinical care.The present document provides the foundation required to ensure that clinical practice guidelines produced by the CAG are necessary, appropriate, credible and applicable. These recommendations should be adhered to as closely as possible to obtain CAG endorsement. PMID:25314352

  5. Canadian Association of Gastroenterology policy on the application for, and implementation of, clinical practice guidelines.

    PubMed

    Singh, Harminder; Leontiadis, Grigorios I; Hookey, Lawrence; Enns, Robert; Bistritz, Lana; Rioux, Louis-Charles; Hope, Louise; Sinclair, Paul

    2014-10-01

    An important mandate of the Canadian Association of Gastroenterology (CAG), as documented in the Association's governance policies, is to optimize the care of patients with digestive disorders. Clinical practice guidelines are one means of achieving this goal. The benefits of timely, high-quality and evidenced-based recommendations include: Enhancing the professional development of clinical members through education and dissemination of synthesized clinical research; Improving patient care provided by members by providing focus on quality and evidence; Creating legislative environments that favour effective clinical practice; Enhancing the clinical care provided to patients with digestive disease by nongastroenterologists; and Identifying areas that require further information or research to improve clinical care. The present document provides the foundation required to ensure that clinical practice guidelines produced by the CAG are necessary, appropriate, credible and applicable. These recommendations should be adhered to as closely as possible to obtain CAG endorsement.

  6. 7 CFR 1466.1 - Applicability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS ENVIRONMENTAL QUALITY INCENTIVES PROGRAM General Provisions... promote agricultural production, forest management, and environmental quality as compatible goals, and to... program are achieved by planning and implementing conservation practices on eligible land. (b) EQIP is...

  7. 7 CFR 1466.1 - Applicability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS ENVIRONMENTAL QUALITY INCENTIVES PROGRAM General Provisions... promote agricultural production, forest management, and environmental quality as compatible goals, and to... program are achieved by planning and implementing conservation practices on eligible land. (b) EQIP is...

  8. Total Quality Management: Public Sector Applications for Training Programs.

    ERIC Educational Resources Information Center

    Davis, David S.

    Total quality management (TQM) is based on the fundamental philosophy that it is always more effective to do something right the first time than it is to correct deficiencies. It seeks to improve quality and increase customer satisfaction by restructuring traditional management and organizational practices. Common characteristics of TQM include…

  9. Announcement—guidance document for acquiring reliable data in ecological restoration projects

    USGS Publications Warehouse

    Stapanian, Martin A.; Rodriguez, Karen; Lewis, Timothy E.; Blume, Louis; Palmer, Craig J.; Walters, Lynn; Schofield, Judith; Amos, Molly M.; Bucher, Adam

    2016-01-01

    The Laurentian Great Lakes are undergoing intensive ecological restoration in Canada and the United States. In the United States, an interagency committee was formed to facilitate implementation of quality practices for federally funded restoration projects in the Great Lakes basin. The Committee's responsibilities include developing a guidance document that will provide a common approach to the application of quality assurance and quality control (QA/QC) practices for restoration projects. The document will serve as a “how-to” guide for ensuring data quality during each aspect of ecological restoration projects. In addition, the document will provide suggestions on linking QA/QC data with the routine project data and hints on creating detailed supporting documentation. Finally, the document will advocate integrating all components of the project, including QA/QC applications, into an overarching decision-support framework. The guidance document is expected to be released by the U.S. EPA Great Lakes National Program Office in 2017.

  10. Measuring management's perspective of data quality in Pakistan's Tuberculosis control programme: a test-based approach to identify data quality dimensions.

    PubMed

    Ali, Syed Mustafa; Anjum, Naveed; Kamel Boulos, Maged N; Ishaq, Muhammad; Aamir, Javariya; Haider, Ghulam Rasool

    2018-01-16

    Data quality is core theme of programme's performance assessment and many organizations do not have any data quality improvement strategy, wherein data quality dimensions and data quality assessment framework are important constituents. As there is limited published research about the data quality specifics that are relevant to the context of Pakistan's Tuberculosis control programme, this study aims at identifying the applicable data quality dimensions by using the 'fitness-for-purpose' perspective. Forty-two respondents pooled a total of 473 years of professional experience, out of which 223 years (47%) were in TB control related programmes. Based on the responses against 11 practical cases, adopted from the routine recording and reporting system of Pakistan's TB control programme (real identities of patient were masked), completeness, accuracy, consistency, vagueness, uniqueness and timeliness are the applicable data quality dimensions relevant to the programme's context, i.e. work settings and field of practice. Based on a 'fitness-for-purpose' approach to data quality, this study used a test-based approach to measure management's perspective and identified data quality dimensions pertinent to the programme and country specific requirements. Implementation of a data quality improvement strategy and achieving enhanced data quality would greatly help organizations in promoting data use for informed decision making.

  11. Sealed-cell nickel-cadmium battery applications manual

    NASA Technical Reports Server (NTRS)

    Scott, W. R.; Rusta, D. W.

    1979-01-01

    The design, procurement, testing, and application of aerospace quality, hermetically sealed nickel-cadmium cells and batteries are presented. Cell technology, cell and battery development, and spacecraft applications are emphasized. Long term performance is discussed in terms of the effect of initial design, process, and application variables. Design guidelines and practices are given.

  12. [Quality and compliance with Clinical Practice Guidelines of Chronic Noncommunicable Diseases in primary care].

    PubMed

    Poblano-Verástegui, Ofelia; Vieyra-Romero, Waldo I; Galván-García, Ángel F; Fernández-Elorriaga, María; Rodríguez-Martínez, Antonia I; Saturno-Hernández, Pedro J

    2017-01-01

    To assess the quality and compliance of clinical practice guidelines (CPG) applicable to chronic non-communicable diseases (CNCD) in primary healthcare (CS), and views of staff on the barriers, facilitators and their use. 18 valued CPG with AGREEII, 3 are selected to develop indicators and assess compliance using lot quality acceptance sample (LQAS, standard 75 / 95% threshold 40 / 75% respectively, α:0. 05, β:0. 10) on 5 CS. 70 professionals surveyed about knowledge and use of CPG. Average quality of the CPG was 57.2%; low rating in domains: "Applicability" (<25%), "Stakeholder involvement" (43.5%) and "Rigour of development" (55.0%). Compliance in CS ranges from 39 to 53.4%. Professionals show uneven knowledge of CPG; 44 to 45% (according to CPG), they declare that they are not used, they identify as main barriers the lack of training, and their difficult accessibility and management. The quality and implementation of evaluated CPG is deficient constituting an opportunity of improvement in health services.

  13. Measuring impact of JAMA Dermatology Practice Gaps section on training in US dermatology residency programs.

    PubMed

    Britton, Kristina M; Stratman, Erik J

    2013-07-01

    JAMA Dermatology Practice Gaps commentaries are intended to aid in the interpretation of the literature to make it more practical and applicable to daily patient care. Practice Gaps commentaries have had an impact on physician clinical practice and dermatology residency curricula. To assess the impact of JAMA Dermatology Practice Gaps commentaries on dermatology residency training programs in the United States, including journal club discussions and local quality improvement activities. A web-based questionnaire of 17 questions was sent via e-mail to US dermatology residency program directors (PDs) in February 2012. Program director report of incorporating Practice Gaps themes and discussions into resident journal club activities, clinical practice, quality improvement activities, or research projects in the residency programs, as a result of a Practice Gaps commentary. Of the 114 surveys distributed to US dermatology residency PDs, 48 were completed (42% response rate). Sixty percent of PDs reported familiarity with the Practice Gaps section of JAMA Dermatology, and 56% discuss these commentaries during resident journal club activities. Quality improvement and research projects have been initiated as a result of Practice Gaps commentaries. Practice Gaps commentaries are discussed during most dermatology residency journal club activities. Practice Gaps have had an impact on physician practice and dermatology residency curricula and can serve as a tool for enhanced continuing medical education and quality improvement initiatives.

  14. A comprehensive clinical assessment tool to inform policy and practice: applications of the minimum data set.

    PubMed

    Mor, Vincent

    2004-04-01

    The Minimum Data Set (MDS) for nursing home (NH) resident assessment, designed to assess elders functional status and care needs, exemplifies how the information needs of clinical practice are congruent with those of research. Building on a review of the published literature, this article describes the development of the MDS, its reliability and validity testing, as well as the variety of different policy and research uses to which it has been applied. Interrater reliability of items and internal consistency of MDS summary scales is generally good to excellent. Validation studies reveal good correspondence to research quality instruments for cognition, activities of daily living, and diagnoses with more variable results for vision, pain, mood, and behavior scales. To date, no consistent evidence suggests that applications of MDS data for case-mix reimbursement and quality indicator monitoring systematically bias the data. Although facility variation in data quality could compromise some applications, creation of the MDS as a clinical tool for care planning provides an example of how assessment tools with clinical use can be used in administrative databases for research and policy applications.

  15. Quality - Inexpensive if a way of life.

    NASA Technical Reports Server (NTRS)

    Grau, D.

    1972-01-01

    NASA major projects require phased planning. The participation of persons charged with maintaining the proper quality during the last two of four phases has become accepted practice. Current objectives are concerned with the application of quality assurance techniques during the second phase. It is pointed out that quality must be emphasized during the entire engineering process, starting with the selection of the components.

  16. [Measurement and health economic evaluation of informal care].

    PubMed

    Zrubka, Zsombor

    2017-09-01

    Informal care is non-financed care outside the realm of formal healthcare, which represents an increasing challenge for aging societies. Informal care has frequently been neglected in health economic analyses, while in recent years its coverage has increased considerably in the international scientific literature. This review summarizes the methodology of the health-economic assessment of informal care, including the objective and subjective metrics of caregiver burden, its financial and non-financial valuation and practical applications, with special emphasis on the introduction of care-related quality of life instruments (e.g. Care Related Quality of Life - CarerQoL instrument). Care-related quality of life is a different entity from health-related quality of life, the two cannot be combined, so their joint evaluation requires multi-criteria decision analysis methods. Therefore, it is important to determine the societal preferences of care-related quality of life versus health-related quality of life, and map the relationship of care-related quality of life with time. The local validation of tools measuring care-related quality of life, its more widespread practical application and the analysis of its effect on decision making are also important part of the future research agenda. Orv Hetil. 2017; 158(35): 1363-1372.

  17. Developing and Validating Technological Pedagogical Content Knowledge-Practical (TPACK-Practical) through the Delphi Survey Technique

    ERIC Educational Resources Information Center

    Yeh, Yi-Fen; Hsu, Ying-Shao; Wu, Hsin-Kai; Hwang, Fu-Kwun; Lin, Tzu-Chiang

    2014-01-01

    Technological pedagogical content knowledge TPACK refers to the knowledge set that teachers currently use to further improve the quality of their teaching and assist their students in learning. Several TPACK models have been proposed, either for discussing TPACK's possible composition or its practical applications. Considering that…

  18. 40 CFR 52.2630 - Prevention of significant deterioration of air quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... Skie, EPA, dated May 18, 1989, Charles A. Collins, Administrator of the Air Quality Divisions stated: * * * The Division, will, as a matter of practice, utilize the “Guideline on Air Quality Models” as revised, including Supplement A, in all PSD permit application reviews. The Division will utilize any future...

  19. 40 CFR 122.44 - Establishing limitations, standards, and other permit conditions (applicable to State NPDES...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... CWA; (6) Ensure consistency with the requirements of a Water Quality Management plan approved by EPA..., or controls a pollutant or practice not limited in the permit. (d) Water quality standards and State... quality standards established under section 303 of the CWA, including State narrative criteria for water...

  20. Practical Applications of Space Systems, Supporting Paper 7: Environmental Quality.

    ERIC Educational Resources Information Center

    National Academy of Sciences - National Research Council, Washington, DC. Assembly of Engineering.

    This report summarizes the findings of one of fourteen panels that studied progress in space science applications and defined user needs potentially capable of being met by space-system applications. The study was requested by the National Aeronautics and Space Administration (NASA) and was conducted by the Space Applications Board. The panels…

  1. High Performing Colleges. The Malcolm Baldrige National Quality Award as a Framework for Improving Higher Education. Volume I: Theory and Concepts [and] Volume II: Case and Practice.

    ERIC Educational Resources Information Center

    Seymour, Daniel, Ed.; And Others

    This publication provides research-based discussion in 20 chapters of possible extension of the Malcolm Baldrige National Quality Award to honor high performing colleges. Chapters are organized into two volumes, the first exploring a broad range of issues from a scholarly point of view and the second emphasizing the practical application of a…

  2. Effect of pooled comparative information on judgments of quality

    PubMed Central

    Baumgart, Leigh A.; Bass, Ellen J.; Voss, John D.; Lyman, Jason A.

    2015-01-01

    Quality assessment is the focus of many health care initiatives. Yet it is not well understood how the type of information used in decision support tools to enable judgments of quality based on data impacts the accuracy, consistency and reliability of judgments made by physicians. Comparative pooled information could allow physicians to judge the quality of their practice by making comparisons to other practices or other specific populations of patients. In this study, resident physicians were provided with varying types of information derived from pooled patient data sets: quality component measures at the individual and group level, a qualitative interpretation of the quality measures using percentile rank, and an aggregate composite quality score. 32 participants viewed thirty quality profiles consisting of information applicable to the practice of thirty de-identified resident physicians. Those provided with quality component measures and a qualitative interpretation of the quality measures (rankings) judged quality of care more similarly to experts and were more internally consistent compared to participants who were provided with quality component measures alone. Reliability between participants was significantly less for those who were provided with a composite quality score compared to those who were not. PMID:26949581

  3. Fronting Integrated Scientific Web Applications: Design Features and Benefits for Regulatory Environments

    EPA Science Inventory

    Integrated decision support systems for regulatory applications benefit from standardindustry practices such as code reuse, test-driven development, and modularization. Theseapproaches make meeting the federal government’s goals of transparency, efficiency, and quality assurance ...

  4. Interactive Videodisc in Vocational Education. ERIC Digest No. 105.

    ERIC Educational Resources Information Center

    Kerka, Sandra

    Interactive videodisc (IVD) offers a combination of media with practical applications in vocational education. IVD is superior to videotapes and other media in quality, applicability, and effectiveness. IVD can be used in different settings and for a variety of instructional applications. Although not appropriate for every learning situation, IVD…

  5. An Application of Total Quality Principles in Transforming the Culture of Classrooms

    ERIC Educational Resources Information Center

    Algozzine, Bob; Audette, Robert H.; Marr, Mary Beth; Algozzine, Kate

    2005-01-01

    During the 1990s, many public schools began to apply the principles of Total Quality Management. As they moved ahead, they discovered that most of the separate principles that comprise Total Quality Management are not new to public education. Theories and practices using similar and related ideas have been championed by educators for generations.…

  6. White-collar productivity and quality issues; Proceedings of the Symposium on Productivity and Quality: Strategies for Improving Operations in Government and Industry, Washington, DC, September 25, 26, 1984

    NASA Technical Reports Server (NTRS)

    Gerard, M. (Editor); Edwards, P. W. (Editor)

    1985-01-01

    Techniques for improving the productivity of white-collar workers while maintaining high product quality are examined in reviews and reports. The emphasis is on the application of strategies developed in the private sector to government-agency and aerospace-industry operations. Topics discussed include international competition, organizational attitudes and orientation, management practices, education and training, renewing large organizations, encouraging innovation, national initiatives, employee involvement, management involvement, and applications of new technology.

  7. Evidence-based dentistry: a model for clinical practice.

    PubMed

    Faggion, Clóvis M; Tu, Yu-Kang

    2007-06-01

    Making decisions in dentistry should be based on the best evidence available. The objective of this study was to demonstrate a practical procedure and model that clinicians can use to apply the results of well-conducted studies to patient care by critically appraising the evidence with checklists and letter grade scales. To demonstrate application of this model for critically appraising the quality of research evidence, a hypothetical case involving an adult male with chronic periodontitis is used as an example. To determine the best clinical approach for this patient, a four-step, evidence-based model is demonstrated, consisting of the following: definition of a research question using the PICO format, search and selection of relevant literature, critical appraisal of identified research reports using checklists, and the application of evidence. In this model, the quality of research evidence was assessed quantitatively based on different levels of quality that are assigned letter grades of A, B, and C by evaluating the studies against the QUOROM (Quality of Reporting Meta-Analyses) and CONSORT (Consolidated Standards of Reporting Trials) checklists in a tabular format. For this hypothetical periodontics case, application of the model identified the best available evidence for clinical decision making, i.e., one randomized controlled trial and one systematic review of randomized controlled trials. Both studies showed similar answers for the research question. The use of a letter grade scale allowed an objective analysis of the quality of evidence. A checklist-driven model that assesses and applies evidence to dental practice may substantially improve dentists' decision making skill.

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

    Mills, G.J.; Brown, G.G.; Waterman, D.D.

    The feasibility of prestressing commercial boron/epoxy and graphite/epoxy prepreg material to higher strengths and lower property dispersions is demonstrated. Its practical application as an on-line process for improving quality levels is possible with minor modifications to current experimental practice. The mechanics of the bendstressing method affects a controlled alteration in the fiber defect content to the extent that composite improvements can be achieved approaching the inherent fiber quality with dispersions in properties reduced to the 1 to 2% range. (Author, modified-PL)

  9. Land application of domestic wastewater in Florida--statewide assessment of impact on ground-water quality

    USGS Publications Warehouse

    Franks, Bernard J.

    1981-01-01

    In Florida domestic waste water is being applied to the land for disposal and reuse. State and Federal regulations favor land-application methods over other advanced waste water treatment practices. Despite the increasing use of this alternative technology, little is known about localized effects on groundwater quality. This report documents the extent of land-application practices in Florida and summarizes case study information on some of the more adequately monitored site throughout the State. More than 2,500 sites in Florida are permitted by the Department of Environmental Regulation for applying domestic waste water to the land. The majority (more than 1,700 sites), classified as infiltration ponds, are concentrated in central and southern Florida. More than 560 sites classified as drainfields, and more than 250 sites classified as irrigation sites, are located primarily in central Florida. An estimated 150 million gallons per day of domestic waste water, after required secondary treatment, are applied to Florida soils. Despite the large numbers of sites and the considerable volume of waste water utilized, little is known about potential impact on groundwater quality. At the few sites where observation wells have been drilled and local groundwater quality monitored, no significant deterioration of water quality has been detected. (USGS)

  10. Hop powdery mildew control through alteration of spring pruning practices

    USDA-ARS?s Scientific Manuscript database

    Since 1997, Podosphaera macularis, the causal agent of hop powdery mildew, has become a recurrent threat to hops in the Pacific Northwest because of the potential to reduce cone yield and quality. Disease management practices often involve preventative fungicide applications, but alternative approac...

  11. 22 CFR 96.40 - Fee policies and procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices... application, a written schedule of expected total fees and estimated expenses and an explanation of the... connection with a Convention adoption: (1) Home study. The expected total fees and estimated expenses for...

  12. 22 CFR 96.40 - Fee policies and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices... application, a written schedule of expected total fees and estimated expenses and an explanation of the... connection with a Convention adoption: (1) Home study. The expected total fees and estimated expenses for...

  13. Air Quality Programs and Provisions of the Intermodal Surface Transportation Efficiency Act of 1991

    DOT National Transportation Integrated Search

    2012-11-01

    The US DOT sponsored Dynamic Mobility Applications (DMA) program seeks to identify, develop, and deploy applications that leverage the full potential of connected vehicles, travelers and infrastructure to enhance current operational practices and tra...

  14. The genomic applications in practice and prevention network.

    PubMed

    Khoury, Muin J; Feero, W Gregory; Reyes, Michele; Citrin, Toby; Freedman, Andrew; Leonard, Debra; Burke, Wylie; Coates, Ralph; Croyle, Robert T; Edwards, Karen; Kardia, Sharon; McBride, Colleen; Manolio, Teri; Randhawa, Gurvaneet; Rasooly, Rebekah; St Pierre, Jeannette; Terry, Sharon

    2009-07-01

    The authors describe the rationale and initial development of a new collaborative initiative, the Genomic Applications in Practice and Prevention Network. The network convened by the Centers for Disease Control and Prevention and the National Institutes of Health includes multiple stakeholders from academia, government, health care, public health, industry and consumers. The premise of Genomic Applications in Practice and Prevention Network is that there is an unaddressed chasm between gene discoveries and demonstration of their clinical validity and utility. This chasm is due to the lack of readily accessible information about the utility of most genomic applications and the lack of necessary knowledge by consumers and providers to implement what is known. The mission of Genomic Applications in Practice and Prevention Network is to accelerate and streamline the effective integration of validated genomic knowledge into the practice of medicine and public health, by empowering and sponsoring research, evaluating research findings, and disseminating high quality information on candidate genomic applications in practice and prevention. Genomic Applications in Practice and Prevention Network will develop a process that links ongoing collection of information on candidate genomic applications to four crucial domains: (1) knowledge synthesis and dissemination for new and existing technologies, and the identification of knowledge gaps, (2) a robust evidence-based recommendation development process, (3) translation research to evaluate validity, utility and impact in the real world and how to disseminate and implement recommended genomic applications, and (4) programs to enhance practice, education, and surveillance.

  15. Support and Strategies for Change Among Small Patient-Centered Medical Home Practices

    PubMed Central

    Scholle, Sarah Hudson; Asche, Stephen E.; Morton, Suzanne; Solberg, Leif I.; Tirodkar, Manasi A.; Jaén, Carlos Roberto

    2013-01-01

    PURPOSE We aimed to determine the motivations and barriers facing small practices that seek to adopt the patient-centered medical home (PCMH) model, as well as the type of help and strategies they use. METHODS We surveyed lead physicians at practices with fewer than 5 physicians, stratified by state and level of National Committee for Quality Assurance PCMH recognition, using a Web-based survey with telephone, fax, and mail follow-up. The response rate was 59%, yielding a total sample of 249 practices from 23 states. RESULTS Improving quality and patient experience were the strongest motivations for PCMH implementation; time and resources were the biggest barriers. Most practices participated in demonstration projects or received financial rewards for PCMH, and most received training or other kinds of help. Practices found training and help related to completing the PCMH application to be the most useful. Training for patients was both less common and less valued. The most commonly used strategies for practice transformation were staff training, systematizing processes of care, and quality measurement/goal setting. The least commonly endorsed strategy was involving patients in quality improvement. Practices with a higher level of PCMH recognition were more likely to have electronic health records, to report barriers, and to use measurement-based quality improvement strategies. CONCLUSIONS To spread the adoption of the PCMH model among small practices, financial support, practical training, and other help are likely to continue to be important. Few practices involved patients in their implementation, so it would be helpful to test the impact of greater patient involvement in the PCMH. PMID:23690387

  16. ESIP Information Quality Cluster (IQC)

    NASA Technical Reports Server (NTRS)

    Ramapriyan, H. K.; Peng, Ge; Moroni, David F.

    2016-01-01

    The Information Quality Cluster (IQC) within the Federation of Earth Science Information Partners (ESIP) was initially formed in 2011 and has evolved significantly over time. The current objectives of the IQC are to: 1. Actively evaluate community data quality best practices and standards; 2. Improve capture, description, discovery, and usability of information about data quality in Earth science data products; 3. Ensure producers of data products are aware of standards and best practices for conveying data quality, and data providers distributors intermediaries establish, improve and evolve mechanisms to assist users in discovering and understanding data quality information; and 4. Consistently provide guidance to data managers and stewards on how best to implement data quality standards and best practices to ensure and improve maturity of their data products. The activities of the IQC include: 1. Identification of additional needs for consistently capturing, describing, and conveying quality information through use case studies with broad and diverse applications; 2. Establishing and providing community-wide guidance on roles and responsibilities of key players and stakeholders including users and management; 3. Prototyping of conveying quality information to users in a more consistent, transparent, and digestible manner; 4. Establishing a baseline of standards and best practices for data quality; 5. Evaluating recommendations from NASA's DQWG in a broader context and proposing possible implementations; and 6. Engaging data providers, data managers, and data user communities as resources to improve our standards and best practices. Following the principles of openness of the ESIP Federation, IQC invites all individuals interested in improving capture, description, discovery, and usability of information about data quality in Earth science data products to participate in its activities.

  17. The anatomy and art of writing a successful grant application: a practical step-by-step approach.

    PubMed

    Gholipour, Ali; Lee, Edward Y; Warfield, Simon K

    2014-12-01

    Writing a compelling grant application is a skill that is crucial to conducting high-quality and high-impact scientific research. A successful grant proposal provides the resources necessary to foster activity in an important area of investigation. A concise and practical overview of the anatomy and art of grant writing is provided in this article, along with citations to resources that are particularly useful for junior investigators.

  18. 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.

  19. Good manufacturing practices for medicinal products for human use.

    PubMed

    Gouveia, Bruno G; Rijo, Patrícia; Gonçalo, Tânia S; Reis, Catarina P

    2015-01-01

    At international and national levels, there are public and private organizations, institutions and regulatory authorities, who work and cooperate between them and with Pharmaceutical Industry, in order to achieve a consensus of the guidelines and laws of the manufacturing of medicinal products for human use. This article includes an explanation of how operate and cooperate these participants, between them and expose the current regulations, following the line of European Community/European Economic Area, referencing, wherever appropriate, the practiced guidelines, outside of regulatory action of space mentioned. In this way, it is intended to achieve quality, security and effectiveness exceptional levels in the manufacturing of health products. Good Manufacturing Practice aim the promotion of the human health and consequently, to the improvement of quality of life. For achieve the proposed objectives, it is necessary to ensure the applicability of the presented concepts and show the benefits arising from this applicability.

  20. Good manufacturing practices for medicinal products for human use

    PubMed Central

    Gouveia, Bruno G.; Rijo, Patrícia; Gonçalo, Tânia S.; Reis, Catarina P.

    2015-01-01

    At international and national levels, there are public and private organizations, institutions and regulatory authorities, who work and cooperate between them and with Pharmaceutical Industry, in order to achieve a consensus of the guidelines and laws of the manufacturing of medicinal products for human use. This article includes an explanation of how operate and cooperate these participants, between them and expose the current regulations, following the line of European Community/European Economic Area, referencing, wherever appropriate, the practiced guidelines, outside of regulatory action of space mentioned. In this way, it is intended to achieve quality, security and effectiveness exceptional levels in the manufacturing of health products. Good Manufacturing Practice aim the promotion of the human health and consequently, to the improvement of quality of life. For achieve the proposed objectives, it is necessary to ensure the applicability of the presented concepts and show the benefits arising from this applicability. PMID:25883511

  1. On multidisciplinary research on the application of remote sensing to water resources problems

    NASA Technical Reports Server (NTRS)

    1972-01-01

    This research is directed toward development of a practical, operational remote sensing water quality monitoring system. To accomplish this, five fundamental aspects of the problem have been under investigation during the past three years. These are: (1) development of practical and economical methods of obtaining, handling and analyzing remote sensing data; (2) determination of the correlation between remote sensed imagery and actual water quality parameters; (3) determination of the optimum technique for monitoring specific water pollution parameters and for evaluating the reliability with which this can be accomplished; (4) determination of the extent of masking due to depth of penetration, bottom effects, film development effects, and angle falloff, and development of techniques to eliminate or minimize them; and (5) development of operational procedures which might be employed by a municipal, state or federal agency for the application of remote sensing to water quality monitoring, including space-generated data.

  2. Advancing Kinesiology through Improved Peer Review

    ERIC Educational Resources Information Center

    Knudson, Duane V.; Morrow, James R., Jr.; Thomas, Jerry R.

    2014-01-01

    Peer review of scholarship is essential to journal quality, evidence, knowledge advancement, and application of that knowledge in any field. This commentary summarizes recent literature on issues related to peer-review quality and current review practice in kinesiology and provides recommendations to improve peer review in kinesiology journals. We…

  3. Novel/non-conventional manure application practices to minimize environmental impacts

    USDA-ARS?s Scientific Manuscript database

    Livestock manure can supply essential crop nutrients and contribute to improved soil quality. However, conventional surface broadcast application can result in adverse environmental effects from NH3 volatilization, odor, and runoff losses of nutrients and pathogens. Incorporation of manure by tillag...

  4. Storm Water Management Model Applications Manual

    EPA Science Inventory

    The EPA Storm Water Management Model (SWMM) is a dynamic rainfall-runoff simulation model that computes runoff quantity and quality from primarily urban areas. This manual is a practical application guide for new SWMM users who have already had some previous training in hydrolog...

  5. From Research to Practice: The Application of Research Results to Program Improvement across After-School, Camp, and Community Recreation Programs

    ERIC Educational Resources Information Center

    Bennett, Troy

    2016-01-01

    Academic researchers dedicated to contributing to quality improvement in professional practice need to find more effective ways to bridge the gap between research and practice. Bridging the gap requires understanding what encourages the use of research findings by practitioners and what discourages it, as well as understanding how practitioners…

  6. Cryopreservation in fish: current status and pathways to quality assurance and quality control in repository development

    PubMed Central

    Torres, Leticia; Hu, E.; Tiersch, Terrence R.

    2017-01-01

    Cryopreservation in aquatic species in general has been constrained to research activities for more than 60 years. Although the need for application and commercialisation pathways has become clear, the lack of comprehensive quality assurance and quality control programs has impeded the progress of the field, delaying the establishment of germplasm repositories and commercial-scale applications. In this review we focus on the opportunities for standardisation in the practices involved in the four main stages of the cryopreservation process: (1) source, housing and conditioning of fish; (2) sample collection and preparation; (3) freezing and cryogenic storage of samples; and (4) egg collection and use of thawed sperm samples. In addition, we introduce some key factors that would assist the transition to commercial-scale, high-throughput application. PMID:26739583

  7. Where do they come from and where do they go: implications of geographic origins of medical students.

    PubMed

    Pretorius, Richard W; Lichter, Michael I; Okazaki, Goroh; Sellick, John A

    2010-10-01

    Can prior places of residence listed on a medical school application predict where a physician will practice in midcareer? Geographic data were analyzed for a cohort of 399 graduates from a single U.S. medical school. Applicants with origins in the local region had a 40.4% to 49.5% probability of practicing locally in midcareer--an increased likelihood of 6.1 to 7.3 (P < .001) by bivariate analysis. In a logistic regression analysis, residence at birth (odds ratio [OR] = 2.6, P = .019) and at college graduation (OR = 2.8, P = .001) were significant predictors of midcareer practice location, but residence at high school graduation and on application to medical school were not. Midcareer practice location is related to geographic origins. Using multiple indicators of geographic origins available at the time of application can allow admissions committees to make higher-quality decisions.

  8. Screening for important unwarranted variation in clinical practice: a triple-test of processes of care, costs and patient outcomes.

    PubMed

    Partington, Andrew; Chew, Derek P; Ben-Tovim, David; Horsfall, Matthew; Hakendorf, Paul; Karnon, Jonathan

    2017-03-01

    Objective Unwarranted variation in clinical practice is a target for quality improvement in health care, but there is no consensus on how to identify such variation or to assess the potential value of initiatives to improve quality in these areas. This study illustrates the use of a triple test, namely the comparative analysis of processes of care, costs and outcomes, to identify and assess the burden of unwarranted variation in clinical practice. Methods Routinely collected hospital and mortality data were linked for patients presenting with symptoms suggestive of acute coronary syndromes at the emergency departments of four public hospitals in South Australia. Multiple regression models analysed variation in re-admissions and mortality at 30 days and 12 months, patient costs and multiple process indicators. Results After casemix adjustment, an outlier hospital with statistically significantly poorer outcomes and higher costs was identified. Key process indicators included admission patterns, use of invasive diagnostic procedures and length of stay. Performance varied according to patients' presenting characteristics and time of presentation. Conclusions The joint analysis of processes, outcomes and costs as alternative measures of performance inform the importance of reducing variation in clinical practice, as well as identifying specific targets for quality improvement along clinical pathways. Such analyses could be undertaken across a wide range of clinical areas to inform the potential value and prioritisation of quality improvement initiatives. What is known about the topic? Variation in clinical practice is a long-standing issue that has been analysed from many different perspectives. It is neither possible nor desirable to address all forms of variation in clinical practice: the focus should be on identifying important unwarranted variation to inform actions to reduce variation and improve quality. What does this paper add? This paper proposes the comparative analysis of processes of care, costs and outcomes for patients with similar diagnoses presenting at alternative hospitals, using linked, routinely collected data. This triple test of performance indicators extracts maximum value from routine data to identify priority areas for quality improvement to reduce important and unwarranted variations in clinical practice. What are the implications for practitioners? The proposed analyses need to be applied to other clinical areas to demonstrate the general application of the methods. The outputs can then be validated through the application of quality improvement initiatives in clinical areas with identified important and unwarranted variation. Validated frameworks for the comparative analysis of clinical practice provide an efficient approach to valuing and prioritising actions to improve health service quality.

  9. Opening the black box of ethics policy work: evaluating a covert practice.

    PubMed

    Frolic, Andrea; Drolet, Katherine; Bryanton, Kim; Caron, Carole; Cupido, Cynthia; Flaherty, Barb; Fung, Sylvia; McCall, Lori

    2012-01-01

    Hospital ethics committees (HECs) and ethicists generally describe themselves as engaged in four domains of practice: case consultation, research, education, and policy work. Despite the increasing attention to quality indicators, practice standards, and evaluation methods for the other domains, comparatively little is known or published about the policy work of HECs or ethicists. This article attempts to open the "black box" of this health care ethics practice by providing two detailed case examples of ethics policy reviews. We also describe the development and application of an evaluation strategy to assess the quality of ethics policy review work, and to enable continuous improvement of ethics policy review processes. Given the potential for policy work to impact entire patient populations and organizational systems, it is imperative that HECs and ethicists develop clearer roles, responsibilities, procedural standards, and evaluation methods to ensure the delivery of consistent, relevant, and high-quality ethics policy reviews.

  10. Promoting good health research practice in low- and middle-income countries

    PubMed Central

    Mahendradhata, Yodi; Nabieva, Jamila; Ahmad, Riris Andono; Henley, Patricia; Launois, Pascal; Merle, Corinne; Maure, Christine; Horstick, Olaf; Elango, Varalakshmi

    2016-01-01

    Background Good clinical practice (GCP) guidelines have been the source of improvement in the quality of clinical trials; however, there are limitations to the application of GCP in the conduct of health research beyond industry-sponsored clinical trials. The UNICEF/UNDP/World Bank/WHO Special Program for Research and Training in Tropical Disease is promoting good practice in all health research involving human through the Good Health Research Practice (GHRP) training program initiative. Objective To report the results of piloting the GHRP training program and formulate further steps to harness GHRP for promoting good practices in all health research involving human, particularly in low- and middle-income countries (LMICs). Design The objective of this training is to impart knowledge and skills for the application of ethical and quality principles to the design, conduct, recording, and reporting of health research involving human participants based on the level of risk, to ensure a fit-for-purpose quality system. This has been formulated into five sequential modules to be delivered in a 4-day course. Four courses have been organized in the pilot phase (2014–2015). The courses have been evaluated and assessed based on course feedback (quantitative and qualitative data) collected during course implementation and qualitative email-based pre- and post-course evaluation. Results Participants were highly satisfied with the course content and its organization. The relevance and applicability of the course content resulted in positive feedback and an articulated willingness to adapt and disseminate the course. Action points to strengthen the training program have been identified, and showed the imminent need to develop a consensus with a broader range of key stakeholders on the final set of GHRP standards and means for implementation. Conclusions There is an urgent need to harness the momentum to promote high-quality and ethical health research in LMICs through scaling up GHRP training and further development of GHRP principles into international standards. PMID:27498965

  11. Assessing primary care data quality.

    PubMed

    Lim, Yvonne Mei Fong; Yusof, Maryati; Sivasampu, Sheamini

    2018-04-16

    Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

  12. Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: a systematic review and Delphi estimation of mortality effect

    PubMed Central

    2011-01-01

    Background Annually over 520,000 newborns die from neonatal sepsis, and 60,000 more from tetanus. Estimates of the effect of clean birth and postnatal care practices are required for evidence-based program planning. Objective To review the evidence for clean birth and postnatal care practices and estimate the effect on neonatal mortality from sepsis and tetanus for the Lives Saved Tool (LiST). Methods We conducted a systematic review of multiple databases. Data were abstracted into standard tables and assessed by GRADE criteria. Where appropriate, meta-analyses were undertaken. For interventions with low quality evidence but a strong GRADE recommendation, a Delphi process was conducted. Results Low quality evidence supports a reduction in all-cause neonatal mortality (19% (95% c.i. 1–34%)), cord infection (30% (95% c.i. 20–39%)) and neonatal tetanus (49% (95% c.i. 35–62%)) with birth attendant handwashing. Very low quality evidence supports a reduction in neonatal tetanus mortality with a clean birth surface (93% (95% c.i. 77-100%)) and no relationship between a clean perineum and tetanus. Low quality evidence supports a reduction of neonatal tetanus with facility birth (68% (95% c.i. 47-88%). No relationship was found between birth place and cord infections or sepsis mortality. For postnatal clean practices, all-cause mortality is reduced with chlorhexidine cord applications in the first 24 hours of life (34% (95% c.i. 5–54%, moderate quality evidence) and antimicrobial cord applications (63% (95% c.i. 41–86%, low quality evidence). One study of postnatal maternal handwashing reported reductions in all-cause mortality (44% (95% c.i. 18–62%)) and cord infection ((24% (95% c.i. 5-40%)). Given the low quality of evidence, a Delphi expert opinion process was undertaken. Thirty experts reached consensus regarding reduction of neonatal sepsis deaths by clean birth practices at home (15% (IQR 10–20)) or in a facility (27% IQR 24–36)), and by clean postnatal care practices (40% (IQR 25–50)). The panel estimated that neonatal tetanus mortality was reduced by clean birth practices at home (30% (IQR(20–30)), or in a facility (38% (IQR 34–40)), and by clean postnatal care practices (40% (IQR 30–50)). Conclusion According to expert opinion, clean birth and particularly postnatal care practices are effective in reducing neonatal mortality from sepsis and tetanus. Further research is required regarding optimal implementation strategies. PMID:21501428

  13. Food Sanitation and Safety Self-Assessment Instrument for School Nutrition Programs.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento.

    Like food-service establishments, child nutrition programs are responsible for preserving the quality and wholesomeness of food. Proper food-handling practices prevent contamination and job-related accidents. Application of the evaluation instrument presented in this document to individual programs helps to define proper practices, assess the…

  14. Impact of long-term tillage and manure application on soil physical properties

    USDA-ARS?s Scientific Manuscript database

    Soil physical properties play an integral role in maintaining soil quality for sustainable agricultural practices. Agronomic practices such as tillage systems and organic amendments have been shown to influence soil physical properties. Thus, a study was conducted to evaluate effects of long-term ma...

  15. Putting Writing Research into Practice: Applications for Teacher Professional Development

    ERIC Educational Resources Information Center

    Troia, Gary A., Ed.; Shankland, Rebecca K., Ed.; Heintz, Anne, Ed.

    2010-01-01

    What are the most effective methods for teaching writing across grade levels and student populations? What kind of training do teachers need to put research-validated methods into practice? This unique volume combines the latest writing research with clear-cut recommendations for designing high-quality professional development efforts. Prominent…

  16. 75 FR 22810 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-30

    ... System (EHRDS)--practice application and profile update system; Use: In 2008, the Secretary of the... new demonstration initiative using Medicare waiver authority to reward the delivery of high-quality... system was first developed with the intention of having practices applying to participate in Phase 2 of...

  17. 75 FR 41487 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-16

    ...: Electronic Health Records Demonstration System (EHRDS)--practice application and profile update system; Use... reward the delivery of high-quality care supported by the adoption and use of electronic health records... demonstration system was first developed with the intention of having practices applying to participate in Phase...

  18. An ethnographic exploration of influences on prescribing in general practice: why is there variation in prescribing practices?

    PubMed

    Grant, Aileen; Sullivan, Frank; Dowell, Jon

    2013-06-21

    Prescribing is a core activity for general practitioners, yet significant variation in the quality of prescribing has been reported. This suggests there may be room for improvement in the application of the current best research evidence. There has been substantial investment in technologies and interventions to address this issue, but effect sizes so far have been small to moderate. This suggests that prescribing is a decision-making process that is not sufficiently understood. By understanding more about prescribing processes and the implementation of research evidence, variation may more easily be understood and more effective interventions proposed. An ethnographic study in three Scottish general practices with diverse organizational characteristics. Practices were ranked by their performance against Audit Scotland prescribing quality indicators, incorporating established best research evidence. Two practices of high prescribing quality and one practice of low prescribing quality were recruited. Participant observation, formal and informal interviews, and a review of practice documentation were employed. Practices ranked as high prescribing quality consistently made and applied macro and micro prescribing decisions, whereas the low-ranking practice only made micro prescribing decisions. Macro prescribing decisions were collective, policy decisions made considering research evidence in light of the average patient, one disease, condition, or drug. Micro prescribing decisions were made in consultation with the patient considering their views, preferences, circumstances and other conditions (if necessary).Although micro prescribing can operate independently, the implementation of evidence-based, quality prescribing was attributable to an interdependent relationship. Macro prescribing policy enabled prescribing decisions to be based on scientific evidence and applied consistently where possible. Ultimately, this influenced prescribing decisions that occur at the micro level in consultation with patients. General practitioners in the higher prescribing quality practices made two different 'types' of prescribing decision; macro and micro. Macro prescribing informs micro prescribing and without a macro basis to draw upon the low-ranked practice had no effective mechanism to engage with, reflect on and implement relevant evidence. Practices that recognize these two levels of decision making about prescribing are more likely to be able to implement higher quality evidence.

  19. An ethnographic exploration of influences on prescribing in general practice: why is there variation in prescribing practices?

    PubMed Central

    2013-01-01

    Background Prescribing is a core activity for general practitioners, yet significant variation in the quality of prescribing has been reported. This suggests there may be room for improvement in the application of the current best research evidence. There has been substantial investment in technologies and interventions to address this issue, but effect sizes so far have been small to moderate. This suggests that prescribing is a decision-making process that is not sufficiently understood. By understanding more about prescribing processes and the implementation of research evidence, variation may more easily be understood and more effective interventions proposed. Methods An ethnographic study in three Scottish general practices with diverse organizational characteristics. Practices were ranked by their performance against Audit Scotland prescribing quality indicators, incorporating established best research evidence. Two practices of high prescribing quality and one practice of low prescribing quality were recruited. Participant observation, formal and informal interviews, and a review of practice documentation were employed. Results Practices ranked as high prescribing quality consistently made and applied macro and micro prescribing decisions, whereas the low-ranking practice only made micro prescribing decisions. Macro prescribing decisions were collective, policy decisions made considering research evidence in light of the average patient, one disease, condition, or drug. Micro prescribing decisions were made in consultation with the patient considering their views, preferences, circumstances and other conditions (if necessary). Although micro prescribing can operate independently, the implementation of evidence-based, quality prescribing was attributable to an interdependent relationship. Macro prescribing policy enabled prescribing decisions to be based on scientific evidence and applied consistently where possible. Ultimately, this influenced prescribing decisions that occur at the micro level in consultation with patients. Conclusion General practitioners in the higher prescribing quality practices made two different ‘types’ of prescribing decision; macro and micro. Macro prescribing informs micro prescribing and without a macro basis to draw upon the low-ranked practice had no effective mechanism to engage with, reflect on and implement relevant evidence. Practices that recognize these two levels of decision making about prescribing are more likely to be able to implement higher quality evidence. PMID:23799906

  20. School Development Applications in Turkey

    ERIC Educational Resources Information Center

    Hosgörür, Vural

    2014-01-01

    This study aims to define and explain the establishment, functioning and problems of school development management teams (SDMTs), similar to quality circles used in total quality management practices, for the purposes of continuous development and improvement of schools on the basis of the planned school development model. This is a qualitative…

  1. Evaluating, interpreting, and communicating performance of hydrologic/water quality models considering intended use: A review and recommendations

    USDA-ARS?s Scientific Manuscript database

    Previous publications have outlined recommended practices for hydrologic and water quality (H/WQ) modeling, but none have formulated comprehensive guidelines for the final stage of modeling applications, namely evaluation, interpretation, and communication of model results and the consideration of t...

  2. Applying Services Marketing Principles to Postgraduate Supervision

    ERIC Educational Resources Information Center

    Dann, Stephen

    2008-01-01

    Purpose: The paper aims to describe the application of two key service quality frameworks for improving the delivery of postgraduate research supervision. The services quality frameworks are used to identify key areas of overlap between services marketing practice and postgraduate supervision that can be used by the supervisor to improve research…

  3. DEVELOPMENT OF GUIDELINES FOR CALIBRATING, VALIDATING, AND EVALUATING HYDROLOGIC AND WATER QUALITY MODELS: ASABE ENGINEERING PRACTICE 621

    USDA-ARS?s Scientific Manuscript database

    Information to support application of hydrologic and water quality (H/WQ) models abounds, yet modelers commonly use arbitrary, ad hoc methods to conduct, document, and report model calibration, validation, and evaluation. Consistent methods are needed to improve model calibration, validation, and e...

  4. [Clinical practice guidelines in Peru: evaluation of its quality using the AGREE II instrument].

    PubMed

    Canelo-Aybar, Carlos; Balbin, Graciela; Perez-Gomez, Ángela; Florez, Iván D

    2016-01-01

    To evaluate the methodological quality of clinical practice guidelines (CPGs) put into practice by the Peruvian Ministry of Health (MINSA), 17 CPGs from the ministry, published between 2009 and 2014, were independently evaluated by three methodologic experts using the AGREE II instrument. The score of AGREE II domains was low and very low in all CPGs: scope and purpose (medium, 44%), clarity of presentation (medium, 47%), participation of decision-makers (medium, 8%), methodological rigor (medium, 5%), applicability (medium, 5%), and editorial independence (medium, 8%). In conclusion, the methodological quality of CPGs implemented by the MINSA is low. Consequently, its use could not be recommended. The implementation of the methodology for the development of CPGs described in the recentlypublished CPG methodological preparation manual in Peru is a pressing need.

  5. 21 CFR 26.79 - Territorial application.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Territorial application. 26.79 Section 26.79 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS...

  6. Strategic environmental assessment in tourism planning - Extent of application and quality of documentation

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

    Carvalho Lemos, Clara, E-mail: clara@sc.usp.br; Fischer, Thomas B., E-mail: fischer@liverpool.ac.uk; Pereira Souza, Marcelo, E-mail: mps@usp.br

    Strategic environmental assessment (SEA) has been applied throughout the world in different sectors and in various ways. This paper reports on results of a PhD research on SEA applied to tourism development planning, reflecting the situation in mid-2010. First, the extent of tourism specific SEA application world-wide is established. Then, based on a review of the quality of 10 selected SEA reports, good practice, as well as challenges, trends and opportunities for tourism specific SEA are identified. Shortcomings of SEA in tourism planning are established and implications for future research are outlined. - Highlights: Black-Right-Pointing-Pointer The extent of tourism specificmore » SEA practice is identified. Black-Right-Pointing-Pointer Selected SEA/Tourism reports are evaluated. Black-Right-Pointing-Pointer SEA application to tourism planning is still limited. Black-Right-Pointing-Pointer A number of shortcomings can be pointed out.« less

  7. Assessing the impacts of sustainable agricultural practices for water quality improvements in the Vouga catchment (Portugal) using the SWAT model.

    PubMed

    Rocha, João; Roebeling, Peter; Rial-Rivas, María Ermitas

    2015-12-01

    The extensive use of fertilizers has become one of the most challenging environmental issues in agricultural catchment areas. In order to reduce the negative impacts from agricultural activities and to accomplish the objectives of the European Water Framework Directive we must consider the implementation of sustainable agricultural practices. In this study, we assess sustainable agricultural practices based on reductions in N-fertilizer application rates (from 100% to 0%) and N-application methods (single, split and slow-release) across key agricultural land use classes in the Vouga catchment, Portugal. The SWAT model was used to relate sustainable agricultural practices, agricultural yields and N-NO3 water pollution deliveries. Results show that crop yields as well as N-NO3 exportation rates decrease with reductions in N-application rates and single N-application methods lead to lower crop yields and higher N-NO3 exportation rates as compared to split and slow-release N-application methods. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Proposal of quality indicators for cardiac rehabilitation after acute coronary syndrome in Japan: a modified Delphi method and practice test.

    PubMed

    Ohtera, Shosuke; Kanazawa, Natsuko; Ozasa, Neiko; Ueshima, Kenji; Nakayama, Takeo

    2017-01-27

    Cardiac rehabilitation is underused and its quality in practice is unclear. A quality indicator is a measurable element of clinical practice performance. This study aimed to propose a set of quality indicators for cardiac rehabilitation following an acute coronary event in the Japanese population and conduct a small-size practice test to confirm feasibility and applicability of the indicators in real-world clinical practice. This study used a modified Delphi technique (the RAND/UCLA appropriateness method), a consensus method which involves an evidence review, a face-to-face multidisciplinary panel meeting and repeated anonymous rating. Evidence to be reviewed included clinical practice guidelines available in English or Japanese and existing quality indicators. Performance of each indicator was assessed retrospectively using medical records at a university hospital in Japan. 10 professionals in cardiac rehabilitation for the consensus panel. In the literature review, 23 clinical practice guidelines and 16 existing indicators were identified to generate potential indicators. Through the consensus-building process, a total of 30 indicators were assessed and finally 13 indicators were accepted. The practice test (n=39) revealed that 74% of patients underwent cardiac rehabilitation. Median performance of process measures was 93% (IQR 46-100%). 'Communication with the doctor who referred the patient to cardiac rehabilitation' and 'continuous participation in cardiac rehabilitation' had low performance (32% and 38%, respectively). A modified Delphi technique identified a comprehensive set of quality indicators for cardiac rehabilitation. The single-site, small-size practice test confirmed that most of the proposed indicators were measurable in real-world clinical practice. However, some clinical processes which are not covered by national health insurance in Japan had low performance. Further studies will be needed to clarify and improve the quality of care in cardiac rehabilitation. 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/.

  9. 7 CFR 1466.1 - Applicability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... promote agricultural production, forest management, and environmental quality as compatible goals, and to... program are achieved by planning and implementing conservation practices on eligible land. (b) EQIP is...

  10. 7 CFR 1466.1 - Applicability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... promote agricultural production, forest management, and environmental quality as compatible goals, and to... program are achieved by planning and implementing conservation practices on eligible land. (b) EQIP is...

  11. 7 CFR 1466.1 - Applicability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... promote agricultural production, forest management, and environmental quality as compatible goals, and to... program are achieved by planning and implementing conservation practices on eligible land. (b) EQIP is...

  12. Human factors systems approach to healthcare quality and patient safety

    PubMed Central

    Carayon, Pascale; Wetterneck, Tosha B.; Rivera-Rodriguez, A. Joy; Hundt, Ann Schoofs; Hoonakker, Peter; Holden, Richard; Gurses, Ayse P.

    2013-01-01

    Human factors systems approaches are critical for improving healthcare quality and patient safety. The SEIPS (Systems Engineering Initiative for Patient Safety) model of work system and patient safety is a human factors systems approach that has been successfully applied in healthcare research and practice. Several research and practical applications of the SEIPS model are described. Important implications of the SEIPS model for healthcare system and process redesign are highlighted. Principles for redesigning healthcare systems using the SEIPS model are described. Balancing the work system and encouraging the active and adaptive role of workers are key principles for improving healthcare quality and patient safety. PMID:23845724

  13. Smartphone applications: potential tools for use in preparing for CCRN certification examinations.

    PubMed

    Curran, Claire

    2014-06-01

    Recent advances in smartphone technology now allow clinicians to use commercially produced applications when studying for nursing certification examinations. The quality of currently available CCRN review applications varies in this first generation of products. Most are limited to multiple-choice practice questions, although a few have additional elements such as study guides and reference charts. Weaknesses found in the applications evaluated include poorly written and edited content, questions limited to rote memorization rather than application and analysis of knowledge, and content too basic or outside the scope of experienced critical care nursing practice. A list of important factors for consumers to consider before purchase is provided. ©2014 American Association of Critical-Care Nurses.

  14. Cooper-Harper Experience Report for Spacecraft Handling Qualities Applications

    NASA Technical Reports Server (NTRS)

    Bailey, Randall E.; Jackson, E. Bruce; Bilimoria, Karl D.; Mueller, Eric R.; Frost, Chad R.; Alderete, Thomas S.

    2009-01-01

    A synopsis of experience from the fixed-wing and rotary-wing aircraft communities in handling qualities development and the use of the Cooper-Harper pilot rating scale is presented as background for spacecraft handling qualities research, development, test, and evaluation (RDT&E). In addition, handling qualities experiences and lessons-learned from previous United States (US) spacecraft developments are reviewed. This report is intended to provide a central location for references, best practices, and lessons-learned to guide current and future spacecraft handling qualities RDT&E.

  15. Mobile-Based Applications and Functionalities for Self-Management of People Living with HIV.

    PubMed

    Mehraeen, Esmaeil; Safdari, Reza; Mohammadzadeh, Niloofar; Seyedalinaghi, Seyed Ahmad; Forootan, Siavash; Mohraz, Minoo

    2018-01-01

    Due to the chronicity of HIV/AIDS and the increased number of people living with HIV (PLWH), these people need the innovative and practical approaches to take advantage of high-quality healthcare services. The objectives of this scoping review were to identify the mobile-based applications and functionalities for self-management of people living with HIV. We conducted a comprehensive search of PubMed, Scopus, Science direct, Web of Science and Embase databases for literature published from 2010 to 2017. Screening, data abstraction, and methodological quality assessment were done in duplicate. Our search identified 10 common mobile-based applications and 8 functionalities of these applications for self-management of people living with HIV. According to the findings, "text-messaging" and "reminder" applications were more addressed in reviewed articles. Moreover, the results indicated that "medication adherence" was the common functionality of mobile-based applications for PLWH. Inclusive evidence supports the use of text messaging as a mobile-based functionality to improve medication adherence and motivational messaging. Future mobile-based applications in the healthcare industry should address additional practices such as online chatting, social conversations, physical activity intervention, and supply chain management.

  16. Summary of strategies for planning Productivity Improvement and Quality Enhancement (PIQE)

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The Summary of NASA Strategies for Productivity Improvement and Quality Enhancement respond to NASA's eighth top goal: Establish NASA as a leader in the development and application of advanced technology and management practices which contribute to significant increases in both Agency and national productivity. The Strategies provide the framework for development of the agency-wide Productivity Improvement and Quality Enhancement (PIQE) Plans.

  17. Best Practices for Validating Hazard Control

    EPA Science Inventory

    Provides information on the application of Hazard Assessment Critical Control Points analysis to manging building water quality, and information on molecular assay options for detecting pathogens in water.

  18. Environmental Monitoring Curriculum System and Application-Oriented Training

    ERIC Educational Resources Information Center

    Wang, Jing-Ping; Wang, Xin-Hong

    2016-01-01

    Through building the environmental monitoring curriculum system for application-oriented talents, the comprehensive design and practice were constructed from the syllabus, textbooks, web-based courses, top-quality courses, test paper bank, open laboratory and scientific research etc. The aims are to promote environmental science professional,…

  19. 47 CFR 1.1309 - Application amendments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Application amendments. 1.1309 Section 1.1309 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Procedures Implementing the... quality of the human environment (see § 1.1308(c)). The period of thirty (30) days may be extended upon a...

  20. Expanding Role of Data Science and Bioinformatics in Drug Discovery and Development.

    PubMed

    Fingert, Howard J

    2018-01-01

    Numerous barriers have been identified which detract from successful applications of clinical trial data and platforms. Despite the challenges, opportunities are growing to advance compliance, quality, and practical applications through top-down establishment of guiding principles, coupled with bottom-up approaches to promote data science competencies among data producers. Recent examples of successful applications include modern treatments for hematologic malignancies, developed with support from public-private partnerships, guiding principles for data-sharing, standards for protocol designs and data management, digital technologies, and quality analytics. © 2017 American Society for Clinical Pharmacology and Therapeutics.

  1. Big Data Analytic, Big Step for Patient Management and Care in Puerto Rico.

    PubMed

    Borrero, Ernesto E

    2018-01-01

    This letter provides an overview of the application of big data in health care system to improve quality of care, including predictive modelling for risk and resource use, precision medicine and clinical decision support, quality of care and performance measurement, public health and research applications, among others. The author delineates the tremendous potential for big data analytics and discuss how it can be successfully implemented in clinical practice, as an important component of a learning health-care system.

  2. Best Management Practices for Silvicultural Chemicals and the Science Behind Them

    Treesearch

    Jerry L. Michael

    2004-01-01

    Silvicultural chemicals include fertilizers and pesticides applied for forest management. All states east of the Rockies have at least some form of silvicultural chemical best management practices (SCBMPs) and it is widely accepted that SCBMPs effect someprotection of water quality. All SCBMPs recommend handling and application precautions and a minimum width...

  3. Telemedicine for Access to Quality Care on Medical Practice and Continuing Medical Education in a Global Arena

    ERIC Educational Resources Information Center

    Rafiq, Azhar; Merrell, Ronald C.

    2005-01-01

    Health care practices continue to evolve with technological advances integrating computer applications and patient information management into telemedicine systems. Telemedicine can be broadly defined as the use of information technology to provide patient care and share clinical information from one geographic location to another. Telemedicine…

  4. Application of Total Quality Management System in Thai Primary Schools

    ERIC Educational Resources Information Center

    Prueangphitchayathon, Setthiya; Tesaputa, Kowat; Somprach, Kanokorn

    2015-01-01

    The present study seeks to develop a total quality management (TQM) system that can be applied to primary schools. The approach focuses on customer orientation, total involvement of all constituencies and continuous improvement. TQM principles were studied and synthesized according to case studies of the best practices in 3 primary schools (small,…

  5. Le qualita espressive del linguaggio orale: Il simbolismo fonetico (The Expressive Qualities of Oral Language: Phonetic Symbolism).

    ERIC Educational Resources Information Center

    Cavaliere, Roberto

    1988-01-01

    Discusses a study of the expressive qualities of oral language. Results suggest that there is a natural rather than an arbitrary relationship between words and their meanings. Practical applications of this theory of phonetic symbolism in the area of commercial advertising are presented. (CFM)

  6. Practical application of air-quality research incorporated in CMHC's research house.

    PubMed Central

    Rafuse, J

    1995-01-01

    The Canada Mortgage and Housing Corporation has been looking at ways to improve indoor air quality since 1984 and now hopes to interest house designers and manufacturers in the results of its research. Its flagship project has been the construction of a proto-type research house for environmentally hypersensitive people. PMID:7736379

  7. Air Pollution, A Scientists' Institute for Public Information Workbook.

    ERIC Educational Resources Information Center

    Nadler, Allen A.; And Others

    Documentation is given on the known and potential effects of air pollution on human health, weather conditions, and biosphere. Practical applications of this information are discussed, with special reference to the Federal Air Quality Act and to the planning of urban expressways. Problems in defining standards of air quality are discussed.…

  8. Quality Matters™: An Educational Input in an Ongoing Design-Based Research Project

    ERIC Educational Resources Information Center

    Adair, Deborah; Shattuck, Kay

    2015-01-01

    Quality Matters (QM) has been transforming established best practices and online education-based research into an applicable, scalable course level improvement process for the last decade. In this article, the authors describe QM as an ongoing design-based research project and an educational input for improving online education.

  9. Clinical practice guideline development manual: a quality-driven approach for translating evidence into action.

    PubMed

    Rosenfeld, Richard M; Shiffman, Richard N

    2009-06-01

    Guidelines translate best evidence into best practice. A well-crafted guideline promotes quality by reducing health-care variations, improving diagnostic accuracy, promoting effective therapy, and discouraging ineffective-or potentially harmful-interventions. Despite a plethora of published guidelines, methodology is often poorly defined and varies greatly within and among organizations. This manual describes the principles and practices used successfully by the American Academy of Otolaryngology-Head and Neck Surgery to produce quality-driven, evidence-based guidelines using efficient and transparent methodology for action-ready recommendations with multidisciplinary applicability. The development process, which allows moving from conception to completion in 12 months, emphasizes a logical sequence of key action statements supported by amplifying text, evidence profiles, and recommendation grades that link action to evidence. As clinical practice guidelines become more prominent as a key metric of quality health care, organizations must develop efficient production strategies that balance rigor and pragmatism. Equally important, clinicians must become savvy in understanding what guidelines are-and are not-and how they are best utilized to improve care. The information in this manual should help clinicians and organizations achieve these goals.

  10. Quality assessment of osteoporosis clinical practice guidelines for physical activity and safe movement: an AGREE II appraisal.

    PubMed

    Armstrong, James Jacob; Rodrigues, Isabel Braganca; Wasiuta, Tom; MacDermid, Joy C

    2016-01-01

    Many osteoporosis clinical practice guidelines are published, and the extent to which physical activity and safe movement is addressed varies. To better inform clinical decision-making, a quality assessment and structured analysis of recommendations was undertaken. Guideline quality varied substantially, and improvement is necessary in physical activity and safe movement recommendations. The purpose of the present study is to survey available osteoporosis clinical practice guidelines (CPGs) containing physical activity and safe movement recommendations in order to assess the methodological quality with which they were developed. An analysis of the various physical activity and safe movement recommendations was conducted to determine variability between CPGs. An online literature search revealed 19 CPGs meeting our inclusion criteria. Three independent scorers evaluated CPG quality using the Appraisal of Guidelines for Research and Evaluation version II (AGREE II) instrument. Two separate individuals used a standard table to extract relevant recommendations. Intra-reviewer AGREE II score agreement ranged from fair to good (intra-class correlation coefficient (ICC) = 0.34 to 0.65). The quality of the 19 included CPGs was variable (AGREE sub-scores: 14 to 100%). CPGs scored higher in the "scope and purpose" and "clarity of presentation" domains. They scored the lowest in "applicability" and "editorial independence." Four CPGs were classified as high quality, ten average quality, and five low quality. Most CPGs recommended weight-bearing, muscle-strengthening, and resistance exercises. Information on exercise dosage, progression, and contraindications was often absent. Immobility and movements involving spinal flexion and/or torsion were discouraged. There were several high-quality CPGs; however, variability in quality and lack of specific parameters for implementation necessitates caution and critical examination by readers. CPG development groups should pay special attention to the clinical applicability of their CPGs as well as fully disclosing conflicts of interest. CPGs were in general an agreement regarding safe physical activity and safe movement recommendations. However, recommendations were often vague and the more specific recommendations were inconsistent between CPGs.

  11. Broiler litter management effects on the nutrient composition of the litter

    USDA-ARS?s Scientific Manuscript database

    Application of poultry litter as a fertilizer source is a common practice in agriculture production. However, potential water quality concerns as a result of over application of poultry litter has risen as a major environmental issue in states with substantial poultry production. Fundamental to the ...

  12. Collaborative Documentation in Mental Health: Applications to Rehabilitation Counseling

    ERIC Educational Resources Information Center

    Sheehan, Lindsay; Lewicki, Todd

    2016-01-01

    Purpose: In this article, the emerging practice of collaborative documentation (CD) in community mental health care and its applications to rehabilitation counseling were explored. CD has the potential to promote greater client empowerment, clinical transparency, and documentation efficiency and quality; however, the CD process is not well…

  13. Application of Strategic Management Principles as Tool to Improve Quality of Construction Technological Process

    NASA Astrophysics Data System (ADS)

    Kluchnikova, O.; Pobegaylov, O.

    2017-11-01

    The article focuses on the basic theory and practical aspects of the strategic management improving in terms of enhancing the quality of a technological process: these aspects have been proven experimentally by their introduction in company operations. The authors have worked out some proposals aimed at the selection of an optimal supplier for building companies as well as the algorithm for the analysis and optimization of a construction company basing on scientific and practical research as well as on the experimental data obtained in the experiment.

  14. Utilization of building information modeling in infrastructure’s design and construction

    NASA Astrophysics Data System (ADS)

    Zak, Josef; Macadam, Helen

    2017-09-01

    Building Information Modeling (BIM) is a concept that has gained its place in the design, construction and maintenance of buildings in Czech Republic during recent years. This paper deals with description of usage, applications and potential benefits and disadvantages connected with implementation of BIM principles in the preparation and construction of infrastructure projects. Part of the paper describes the status of BIM implementation in Czech Republic, and there is a review of several virtual design and construction practices in Czech Republic. Examples of best practice are presented from current infrastructure projects. The paper further summarizes experiences with new technologies gained from the application of BIM related workflows. The focus is on the BIM model utilization for the machine control systems on site, quality assurance, quality management and construction management.

  15. Using Quality Management Systems to Improve Test Development and Standards and to Promote Good Practice: A Case Study of Testing Italian as a Foreign Language

    ERIC Educational Resources Information Center

    Grego Bolli, Giuliana

    2014-01-01

    This article discusses the problem of quality in the production of language tests in the context of Italian language examinations. The concept of quality is closely related to the application of stated standards and related procedures. These standards, developed over the last thirty years, are mainly related to the concepts of the accountability…

  16. School in a Box in Low Resource Primary School in Mozambique: Practical Application of Zone of Proximal Development in Teacher Training with Mobile Technology

    ERIC Educational Resources Information Center

    O'Sullivan, Linda; Seabra, N. Miguel

    2016-01-01

    The new Sustainable Development Goals call for quality education for all. This study aims to examine the role of mobile educational technology, through the School in a Box intervention, particularly in supporting teachers skills in achieving quality education, in the context of a public primary school in Mozambique. Quality education is examined…

  17. Development of reference practices for the calibration and validation of atmospheric composition satellites

    NASA Astrophysics Data System (ADS)

    Lambert, Jean-Christopher; Bojkov, Bojan

    The Committee on Earth Observation Satellites (CEOS)/Working Group on Calibration and Validation (WGCV) is developing a global data quality strategy for the Global Earth Obser-vation System of Systems (GEOSS). In this context, CEOS WGCV elaborated the GEOSS Quality Assurance framework for Earth Observation (QA4EO, http://qa4eo.org). QA4EO en-compasses a documentary framework and a set of ten guidelines, which describe the top-level approach of QA activities and key requirements that drive the QA process. QA4EO is appli-cable virtually to all Earth Observation data. Calibration and validation activities are a cornerstone of the GEOSS data quality strategy. Proper uncertainty assessment of the satellite measurements and their derived data products is essential, and needs to be continuously monitored and traceable to standards. As a practical application of QA4EO, CEOS WGCV has undertaken to establish a set of best practices, methodologies and guidelines for satellite calibration and validation. The present paper reviews current developments of best practices and guidelines for the vali-dation of atmospheric composition satellites. Aimed as a community effort, the approach is to start with current practices that could be improved with time. The present review addresses current validation capabilities, achievements, caveats, harmonization efforts, and challenges. Terminologies and general principles of validation are reminded. Going beyond elementary def-initions of validation like the assessment of uncertainties, the specific GEOSS context requires considering also the validation of individual service components and against user requirements.

  18. A Patient Record-Filing System for Family Practice

    PubMed Central

    Levitt, Cheryl

    1988-01-01

    The efficient storage and easy retrieval of quality records are a central concern of good family practice. Many physicians starting out in practice have difficulty choosing a practical and lasting system for storing their records. Some who have established practices are installing computers in their offices and finding that their filing systems are worn, outdated, and incompatible with computerized systems. This article describes a new filing system installed simultaneously with a new computer system in a family-practice teaching centre. The approach adopted solved all identifiable problems and is applicable in family practices of all sizes.

  19. [Factors influencing the quality of clinical practice guidelines in ovarian cancer].

    PubMed

    Castillo-Londoño, J S; Medina-Torres, Y A; Sandoval-Salinas, C; Buitrago-Gutierrez, G; Torres-Ibargüen, M Z; Gonzalez-Rangel, A L

    To identify the characteristics of the published clinical practice guidelines for the management of epithelial ovarian cancer that suggest a good methodological quality. A literature review was performed on 25 clinical practice guidelines for epithelial ovarian cancer that were identified in different databases (MEDLINE, Guidelines International Network, National Guidelines Clearing house) published between 2007 and 2014. The quality of the guidelines was evaluated using the Appraisal of Guidelines Research and Evaluation II tool. Descriptive and bivariate analyses were performed to assess the association between the quality of the guidelines and of some of their features and their developers. Just under half (48%) of the guidelines were rated as low quality. Scientific societies or independent centres and private funding, or under-reporting the source of funding, were statistically associated with lower quality of clinical practice guidelines (P<.01). The guidelines developed by National Program Guidelines had a median of consistently higher scores in all domains of the Appraisal of Guidelines Research and Evaluation II, with significant differences in the definition of scope and objectives, the participation of stakeholders, the methodological rigour of development, and applicability to the context. Features such as the nature of the developer and funding of the guidelines are predictors of quality that should be taken into account prior to the use of the recommendations of a document. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Results of the 2013 Association of Residents in Radiation Oncology career planning survey of practicing physicians in the United States.

    PubMed

    Mattes, Malcolm D; Golden, Daniel W; Mohindra, Pranshu; Kharofa, Jordan

    2014-08-01

    The goal of this study was to develop insights about the job application process for graduating radiation oncology residents from the perspective of those involved in hiring. In May and June 2013, a nationwide electronic survey was sent to 1,671 practicing radiation oncologists in academic and private practice settings. Descriptive statistics are reported. In addition, subgroup analysis was performed. Surveys were completed by 206 physicians. Ninety-six percent were willing to hire individuals directly from residency. Participants believed that the first half of the fourth postgraduate year is the most appropriate time for residents to begin networking and the beginning of the fifth postgraduate year is the most appropriate time to begin contacting practices in pursuit of employment. Seventy percent began interviewing 4 to 9 months before the job start date, and 84% interviewed ≤6 candidates per available position. The 5 most important factors to participants when evaluating prospective candidates were (from most to least important) work ethic, personality, interview impression, experience in intensity-modulated radiation therapy, and flexibility. Factors that participants believed should be most important to candidates when evaluating practices included a collegial environment; emphasis on best patient care; quality of equipment, physics, dosimetry, and quality assurance; quality of the support staff and facility; and a multidisciplinary approach to patient care. Those in academics rated research-related factors higher than those in private practice, who rated business-related factors higher. The perspectives of practicing physicians on the job application process are documented to provide a comprehensive resource for current and future residents and employers. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. Implementation science theories to inform efforts for de-implementation of urologic oncology care practices resulting in overuse and misuse.

    PubMed

    Nielsen, Matthew E; Birken, Sarah A

    2018-05-01

    The field of implementation science has been conventionally applied in the context of increasing the application of evidence-based practices into clinical care, given evidence of underusage of appropriate interventions in many settings. Increasingly, however, there is recognition of the potential for similar frameworks to inform efforts to reduce the application of ineffective or potentially harmful practices. In this article, we provide some examples of clinical scenarios in which the quality problem may be overuse and misuse, and review relevant theories and frameworks that may inform improvement activities. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. [Application of bioassay in quality control of Chinese materia medica-taking Radix Isatidis as an example].

    PubMed

    Yan, Dan; Ren, Yongshen; Luo, Jiaoyang; Li, Hanbing; Feng, Xue; Xiao, Xiaohe

    2010-10-01

    Bioassay, which construct the characteristics consistents with Chinese medical science, is the core mode and methods for the quality control of Chinese materia medica. Taking the bioassay of Radix Isatidis as an example, the contribution, status and application of bioassay in the quality control of Chinese materia medica were introduced in this article, and two key issue (the selection of reference and measurement methods) in the process of establishing bioassay were also explained. This article expects to provide a reference for the development and improvement of the bioassay of Chinese materia medica in a practical manipulation level.

  3. [Quality of life in dysphonia].

    PubMed

    Rosanowski, F; Grässel, E; Hoppe, U; Köllner, V

    2009-09-01

    Quality of life is multidimensional and comprises physical, emotional, and social aspects. It has always been the implicit focus of medical work. However, since the 1980s it has been possible to measure it explicitly. Quality of life is impaired in dysphonic patients; this finding is supported by specific studies on self-reported physical, emotional, and social well-being. For practical application of these data, it is recommended to measure all three domains. From a therapeutic point of view, verbal intervention following the PLISSIT model (permission, limited information, special suggestions, intensive therapy) has been proven to enhance patient satisfaction. Therefore, this clinical procedure is recommended for routine application in dysphonic patients.

  4. Designing nursing excellence through a National Quality Forum nurse scholar program.

    PubMed

    Neumann, Julie A; Brady-Schluttner, Katherine A; Attlesey-Pries, Jacqueline M; Twedell, Diane M

    2010-01-01

    Closing the knowledge gap for current practicing nurses in the Institute of Medicine (IOM) core competencies is critical to providing safe patient care. The National Quality Forum (NQF) nurse scholar program is one organization's journey to close the gap in the IOM core competencies in a large teaching organization. The NQF nurse scholar program is positioned to provide a plan to assist current nurses to accelerate their learning about quality improvement, evidence-based practice, and informatics, 3 of the core competencies identified by the IOM, and focus on application of skills to NQF nurse-sensitive measures. Curriculum outline, educational methodologies, administrative processes, and aims of the project are discussed.

  5. Comparative analysis of structural concrete Quality Assurance practices on nine nuclear and three fossil fuel power plant construction projects. Final summary report

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

    Willenbrock, J.H.; Thomas, H.R. Jr.; Burati, J.J. Jr.

    1978-12-01

    A summary of two reports, COO/4120-1 and COO/4120-2, is given. A comparative analysis was made of the Quality Assurance practices related to the structural concrete phase on nine nuclear and three fossil fuel power plant projects which are (or have been) under construction in the United States in the past ten years. For the nuclear projects the analysis identified the response of each Quality Assurance program to the applicable criteria of 10 CFR Part 50, Appendix B as well as to the pertinent regulatory requirements and industry standards. For the fossil projects the analysis identified the response of each Qualitymore » Assurance program to criteria similar to those which were applicable in the nuclear situation. The major emphasis was placed on the construction aspects of the structural concrete phase of each project. The engineering and design aspects were examined whenever they interfaced with the construction aspects.« less

  6. Systematic evaluation of clinical practice guidelines for pharmacogenomics.

    PubMed

    Beckett, Robert D; Kisor, David F; Smith, Thomas; Vonada, Brooke

    2018-06-01

    To systematically assess methodological quality of pharmacogenomics clinical practice guidelines. Guidelines published through 2017 were reviewed by at least three independent reviewers using the AGREE II instrument, which consists of 23 items grouped into 6 domains and 2 items representing an overall assessment. Items were assessed on a seven-point rating scale, and aggregate quality scores were calculated. 31 articles were included. All guidelines were published as peer-reviewed articles and 90% (n = 28) were endorsed by professional organizations. Mean AGREE II domain scores (maximum score 100%) ranged from 46.6 ± 11.5% ('applicability') to 78.9 ± 11.4% ('clarity of presentation'). Median overall quality score was 72.2% (IQR: 61.1-77.8%). Quality of pharmacogenomics guidelines was generally high, but variable, for most AGREE II domains.

  7. [Audiovisual telecommunication by multimedia technology in HNO medicine. ISDN--internet--ATM].

    PubMed

    Plinkert, P K; Plinkert, B; Kurek, R; Zenner, H P

    2000-11-01

    Telemedicine includes all medical activities in diagnosis, therapeutics, or social medicine undertaken by means of an electronic transfer medium, enabling the transmission of visual and acoustic information over long distances to doctors not personally present at the place of the requested consultation. Most experience with telemedicine applications has been gained in the field of diagnosis (teleconsultation, teleradiology, telepathology) and is expanding to quality control and quality assurance. Decisive for each form of application is its availability, practicability, cost, safety, and especially quality of audiovisual transmission. For telesurgical applications, particularly the use of minimally invasive techniques in otorhinolaryngology, head, and neck surgery, the high quality transmission of audiovisual data in real time is necessary. Rapid expansion and further developments in transmission technologies and networks in the last decade have created several technologies with increased quality and costs. In this paper, we tested different transmission media for audiovisual telecommunication--integrated services digital network (ISDN), Internet, and asynchronous transfer mode (ATM)--using real time video transmission of typical operations in otorhinolaryngology. Their applications, costs, and future perspectives are discussed.

  8. Best Practices in Hiring: Addressing Unconscious Bias

    NASA Astrophysics Data System (ADS)

    Simpson, Caroline E.

    2012-01-01

    Research has shown that implementing certain hiring practices will increase diversity in the workplace while enhancing academic quality. All of these practices rely on addressing the issue of 'unconscious bias.' A brief overview of unconscious bias--what it is, how it works, and simple measures to counter it--will be presented. Successful strategies, actions, and recommendations for implementing best recruiting and hiring practices, which have been proven to enhance academic excellence by ensuring a deep and diverse applicant pool, will also be presented.

  9. Surgical Process Improvement: Impact of a Standardized Care Model With Electronic Decision Support to Improve Compliance With SCIP Inf-9.

    PubMed

    Cook, David J; Thompson, Jeffrey E; Suri, Rakesh; Prinsen, Sharon K

    2014-01-01

    The absence of standardization in surgical care process, exemplified in a "solution shop" model, can lead to unwarranted variation, increased cost, and reduced quality. A comprehensive effort was undertaken to improve quality of care around indwelling bladder catheter use following surgery by creating a "focused factory" model within the cardiac surgical practice. Baseline compliance with Surgical Care Improvement Inf-9, removal of urinary catheter by the end of surgical postoperative day 2, was determined. Comparison of baseline data to postintervention results showed clinically important reductions in the duration of indwelling bladder catheters as well as marked reduction in practice variation. Following the intervention, Surgical Care Improvement Inf-9 guidelines were met in 97% of patients. Although clinical quality improvement was notable, the process to accomplish this-identification of patients suitable for standardized pathways, protocol application, and electronic systems to support the standardized practice model-has potentially greater relevance than the specific clinical results. © 2013 by the American College of Medical Quality.

  10. Factual Approach in Decision Making - the Prerequisite of Success in Quality Management

    NASA Astrophysics Data System (ADS)

    Kučerová, Marta; Škůrková Lestyánszka, Katarína

    2013-12-01

    In quality management system as well as in other managerial systems, effective decisions must be always based on the data and information analysis, i.e. based on facts, in accordance with the factual approach principle in quality management. It is therefore necessary to measure and collect the data and information about processes. The article presents the results of a conducted survey, which was focused on application of factual approach in decision making. It also offers suggestions for improvements of application of the principle in business practice. This article was prepared using the research results of VEGA project No. 1/0229/08 "Perspectives of the quality management development in relation to the requirements of market in the Slovak Republic".

  11. A solution quality assessment method for swarm intelligence optimization algorithms.

    PubMed

    Zhang, Zhaojun; Wang, Gai-Ge; Zou, Kuansheng; Zhang, Jianhua

    2014-01-01

    Nowadays, swarm intelligence optimization has become an important optimization tool and wildly used in many fields of application. In contrast to many successful applications, the theoretical foundation is rather weak. Therefore, there are still many problems to be solved. One problem is how to quantify the performance of algorithm in finite time, that is, how to evaluate the solution quality got by algorithm for practical problems. It greatly limits the application in practical problems. A solution quality assessment method for intelligent optimization is proposed in this paper. It is an experimental analysis method based on the analysis of search space and characteristic of algorithm itself. Instead of "value performance," the "ordinal performance" is used as evaluation criteria in this method. The feasible solutions were clustered according to distance to divide solution samples into several parts. Then, solution space and "good enough" set can be decomposed based on the clustering results. Last, using relative knowledge of statistics, the evaluation result can be got. To validate the proposed method, some intelligent algorithms such as ant colony optimization (ACO), particle swarm optimization (PSO), and artificial fish swarm algorithm (AFS) were taken to solve traveling salesman problem. Computational results indicate the feasibility of proposed method.

  12. Gelatin-Filtered Consomme: A Practical Demonstration of the Freezing and Thawing Processes

    ERIC Educational Resources Information Center

    Lahne, Jacob B.; Schmidt, Shelly J.

    2010-01-01

    Freezing is a key food processing and preservation technique widely used in the food industry. Application of best freezing and storage practices extends the shelf-life of foods for several months, while retaining much of the original quality of the fresh food. During freezing, as well as its counterpart process, thawing, a number of critical…

  13. Video Use in Teacher Education: A Survey of Teacher-Educators' Practices across Disciplines

    ERIC Educational Resources Information Center

    Arya, Poonam; Christ, Tanya; Chiu, Ming Ming

    2016-01-01

    Video methods utilize tenets of high quality teacher education and support education students' learning and application of learning to teaching practices. However, how frequently video is used in teacher education, and in what ways is unknown. Therefore, this study used survey data to identify the extent to which 94 teacher-educators used video in…

  14. Reviews of theoretical frameworks: Challenges and judging the quality of theory application.

    PubMed

    Hean, Sarah; Anderson, Liz; Green, Chris; John, Carol; Pitt, Richard; O'Halloran, Cath

    2016-06-01

    Rigorous reviews of available information, from a range of resources, are required to support medical and health educators in their decision making. The aim of this article is to highlight the importance of a review of theoretical frameworks specifically as a supplement to reviews that focus on a synthesis of the empirical evidence alone. Establishing a shared understanding of theory as a concept is highlighted as a challenge and some practical strategies to achieving this are presented. This article also introduces the concept of theoretical quality, arguing that a critique of how theory is applied should complement the methodological appraisal of the literature in a review. We illustrate the challenge of establishing a shared meaning of theory through reference to experiences of an on-going review of this kind conducted in the field of interprofessional education (IPE) and use a high scoring paper selected in this review to illustrate how theoretical quality can be assessed. In reaching a shared understanding of theory as a concept, practical strategies that promote experiential and practical ways of knowing are required in addition to more propositional ways of sharing knowledge. Concepts of parsimony, testability, operational adequacy and empirical adequacy are explored as concepts that establish theoretical quality. Reviews of theoretical frameworks used in medical education are required to inform educational practice. Review teams should make time and effort to reach a shared understanding of the term theory. Theory reviews, and reviews more widely, should add an assessment of theory application to the protocol of their review method.

  15. Effects of tillage and application rate on atrazine transport to subsurface drainage: Evaluation of RZWQM using a six-year field study

    USDA-ARS?s Scientific Manuscript database

    Well-tested agricultural system models can improve our understanding of the water quality effects of management practices under different conditions. The Root Zone Water Quality Model (RZWQM) has been tested under a variety of conditions. However, the current model’s ability to simulate pesticide tr...

  16. A Construal of the Understanding Level of Quality Assurance by Internal Stakeholders in Two Malaysian Universities

    ERIC Educational Resources Information Center

    Njie, Baboucarr; Asimiran, Soaib

    2016-01-01

    The "understanding" in terms of interpretation of quality assurance is essential for the acceptance, theorizing and the practical application of the methods proposed by it. A great deal of research papers have often pointed to the lack of understanding, among others, as the reason behind the inadequate nature of implementing quality…

  17. Family Quality of Life: Moving from Measurement to Application

    ERIC Educational Resources Information Center

    Zuna, Nina I.; Turnbull, Ann; Summers, Jean Ann

    2009-01-01

    Noting the absence of sound theoretical underpinnings for family quality of life (FQoL) research and work, the authors note that, to guide FQoL practice, research findings must be schematically organized so as to enable practitioners to implement empirical findings effectively. One way to meet this goal is to introduce a theoretical model that…

  18. Management of common gastrointestinal disorders: quality criteria based on patients' views and practice guidelines

    PubMed Central

    Jones, Roger; Hunt, Claire; Stevens, Richard; Dalrymple, Jamie; Driscoll, Richard; Sleet, Sarah; Smith, Jonathan Blanchard

    2009-01-01

    Background Although gastrointestinal disorders are common in general practice, clinical guidelines are not always implemented, and few patient-generated quality criteria are available to guide management. Aim To develop quality criteria for the management of four common gastrointestinal disorders: coeliac disease, gastro-oesophageal reflux disease (GORD), inflammatory bowel disease, and irritable bowel syndrome. Design of study Qualitative study including thematic analysis of transcripts from patient focus groups and content analysis of published clinical practice guidelines. Emergent themes were synthesised by a consensus panel, into quality criteria for each condition. Setting Community-based practice in England, UK. Methods Fourteen focus groups were conducted (four for coeliac disease, irritable bowel syndrome, and inflammatory bowel disease, and two for GORD) involving a total of 93 patients (64 females, 29 males; mean age 55.4 years). Quality criteria were based on patients' views and expectations, synthesised with an analysis of clinical practice guidelines. Results A chronic disease management model was developed for each condition. Key themes included improving the timeliness and accuracy of diagnosis, appropriate use of investigations, better provision of information for patients, including access to patient organisations, better communication with, and access to, secondary care providers, and structured follow-up and regular review, particularly for coeliac disease and inflammatory bowel disease. Conclusion This study provides a model for the development of quality markers for chronic disease management in gastroenterology, which is likely to be applicable to other chronic conditions. PMID:19520018

  19. Clinical Nurse Leader Integration Into Practice: Developing Theory To Guide Best Practice.

    PubMed

    Bender, Miriam

    2016-01-01

    Numerous policy bodies have identified the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards. Although there is growing evidence of improved care environment and patient safety and quality outcomes after redesigning care delivery microsystems to integrate CNL practice, significant variation in CNL implementation has been noted across reports, making it difficult to causally link CNL practice to reported outcomes. This variability reflects the overall absence in the literature of a well-defined CNL theoretical framework to help guide standardized application in practice. To address this knowledge gap, an interpretive synthesis with a grounded theory analysis of CNL narratives was conducted to develop a theoretical model for CNL practice. The model clarifies CNL practice domains and proposes mechanisms by which CNL-integrated care delivery microsystems improve health care quality. The model highlights the need for a systematic approach to CNL implementation including a well-thought out strategy for care delivery redesign; a consistent, competency-based CNL workflow; and sustained macro-to-micro system leadership support. CNL practice can be considered an effective approach to organizing nursing care that maximizes the scope of nursing to influence the ways care is delivered by all professions within a clinical microsystem. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Good Practices in Model‐Informed Drug Discovery and Development: Practice, Application, and Documentation

    PubMed Central

    Burghaus, R; Cosson, V; Cheung, SYA; Chenel, M; DellaPasqua, O; Frey, N; Hamrén, B; Harnisch, L; Ivanow, F; Kerbusch, T; Lippert, J; Milligan, PA; Rohou, S; Staab, A; Steimer, JL; Tornøe, C; Visser, SAG

    2016-01-01

    This document was developed to enable greater consistency in the practice, application, and documentation of Model‐Informed Drug Discovery and Development (MID3) across the pharmaceutical industry. A collection of “good practice” recommendations are assembled here in order to minimize the heterogeneity in both the quality and content of MID3 implementation and documentation. The three major objectives of this white paper are to: i) inform company decision makers how the strategic integration of MID3 can benefit R&D efficiency; ii) provide MID3 analysts with sufficient material to enhance the planning, rigor, and consistency of the application of MID3; and iii) provide regulatory authorities with substrate to develop MID3 related and/or MID3 enabled guidelines. PMID:27069774

  1. [Clinical application evaluation of Guidelines for the Diagnosis and Treatment of Common Diseases of Pediatrics in Traditional Chinese Medicine].

    PubMed

    Liu, Meng-Yu; Yang, Wei; Wang, Li-Ying; Zhao, Xue-Yao; Wang, Yue-Xi; Liu, Yu-Qi; Han, Xue-Jie; Lv, Ai-Ping

    2017-09-01

    Clinical application evaluation research of Guidelines for the Diagnosis and Treatment of Common Diseases of Pediatrics in Traditional Chinese Medicine intends to evaluate the quality level and clinical application of the guideline. A questionnaire and prospective case survey methods were used to evaluate the applicability evaluation based on the clinician questionnaire and the application evaluation based on clinical case observation. The applicability evaluation, familiarity and utilization rate of doctors' guidelines were 85.06%, 62.76%; Sort by technical grade, intermediate grade doctors have a higher familiarity rate and utilization rate, while the junior grade doctor's is lower; Guide quality level of applicability evaluation, other items' rational percentage are better than 96% except the items of health preserving and prevention and other treatment is relatively low; Items' applicable percentage of applicability evaluation are more than 91% except the item of guide simplicity. Comprehensive applicability evaluation, The percentage of the guideline applicable to clinical practice accounted for 94.94%. The consistency rate of syndrome differentiation and clinical application is more than 96% in addition to prescription medication, other treatments and health preserving and prevention of the guidelines apply consistency of application evaluation. The percentage of good treatment effect accounted for 92.96% of application effect evaluation. The safety percentage is 99.89% and economy is 97.45%. The research shows that of Guidelines for the Diagnosis and Treatment of Common Diseases of Pediatrics in Traditional Chinese Medicine quality level is good and is basically applicable to pediatric clinical practice which can be used as a standardized recommendation of pediatric common diseases' treatment specification. A small part of the guidelines are not applicable and need to be further consummated. Health preserving and prevention and other treatment of the guideline need to be revised. Copyright© by the Chinese Pharmaceutical Association.

  2. 'How to know what you need to do': a cross-country comparison of maternal health guidelines in Burkina Faso, Ghana and Tanzania.

    PubMed

    Baker, Ulrika; Tomson, Göran; Somé, Mathias; Kouyaté, Bocar; Williams, John; Mpembeni, Rose; Massawe, Siriel; Blank, Antje; Gustafsson, Lars L; Eriksen, Jaran

    2012-04-13

    Initiatives to raise the quality of care provided to mothers need to be given priority in Sub Saharan Africa (SSA). The promotion of clinical practice guidelines (CPGs) is a common strategy, but their implementation is often challenging, limiting their potential impact. Through a cross-country perspective, this study explored CPGs for maternal health in Burkina Faso, Ghana, and Tanzania. The objectives were to compare factors related to CPG use including their content compared with World Health Organization (WHO) guidelines, their format, and their development processes. Perceptions of their availability and use in practice were also explored. The overall purpose was to further the understanding of how to increase CPGs' potential to improve quality of care for mothers in SSA. The study was a multiple case study design consisting of cross-country comparisons using document review and key informant interviews. A conceptual framework to aid analysis and discussion of results was developed, including selected domains related to guidelines' implementability and use by health workers in practice in terms of usability, applicability, and adaptability. The study revealed few significant differences in content between the national guidelines for maternal health and WHO recommendations. There were, however, marked variations in the format of CPGs between the three countries. Apart from the Ghanaian and one of the Tanzanian CPGs, the levels of both usability and applicability were assessed as low or medium. In all three countries, the use of CPGs by health workers in practice was perceived to be limited. Our cross-country study suggests that it is not poor quality of content or lack of evidence base that constitute the major barrier for CPGs to positively impact on quality improvement in maternal care in SSA. It rather emphasises the need to prioritise the format of guidelines to increase their usability and applicability and to consider these attributes together with implementation strategies as integral to their development processes.

  3. Appraising the methodological quality of the clinical practice guideline for diabetes mellitus using the AGREE II instrument: a methodological evaluation.

    PubMed

    Radwan, Mahmoud; Akbari Sari, Ali; Rashidian, Arash; Takian, Amirhossein; Abou-Dagga, Sanaa; Elsous, Aymen

    2017-02-01

    To evaluate the methodological quality of the Palestinian Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Methodological evaluation. A cross-cultural adaptation framework was followed to translate and develop a standardised Translated Arabic Version of the AGREE II. Palestinian Primary Healthcare Centres. Sixteen appraisers independently evaluated the Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Methodological quality of diabetic guideline. The Translated Arabic Version of the AGREE II showed an acceptable reliability and validity. Internal consistency ranged between 0.67 and 0.88 (Cronbach's α). Intra-class coefficient among appraisers ranged between 0.56 and 0.88. The quality of this guideline is low. Both domains 'Scope and Purpose' and 'Clarity of Presentation' had the highest quality scores (66.7% and 61.5%, respectively), whereas the scores for 'Applicability', 'Stakeholder Involvement', 'Rigour of Development' and 'Editorial Independence' were the lowest (27%, 35%, 36.5%, and 40%, respectively). The findings suggest that the quality of this Clinical Practice Guideline is disappointingly low. To improve the quality of current and future guidelines, the AGREE II instrument is extremely recommended to be incorporated as a gold standard for developing, evaluating or updating the Palestinian Clinical Practice Guidelines. Future guidelines can be improved by setting specific strategies to overcome implementation barriers with respect to economic considerations, engaging of all relevant end-users and patients, ensuring a rigorous methodology for searching, selecting and synthesising the evidences and recommendations, and addressing potential conflict of interests within the development group.

  4. [Algorithms of artificial neural networks--practical application in medical science].

    PubMed

    Stefaniak, Bogusław; Cholewiński, Witold; Tarkowska, Anna

    2005-12-01

    Artificial Neural Networks (ANN) may be a tool alternative and complementary to typical statistical analysis. However, in spite of many computer applications of various ANN algorithms ready for use, artificial intelligence is relatively rarely applied to data processing. This paper presents practical aspects of scientific application of ANN in medicine using widely available algorithms. Several main steps of analysis with ANN were discussed starting from material selection and dividing it into groups, to the quality assessment of obtained results at the end. The most frequent, typical reasons for errors as well as the comparison of ANN method to the modeling by regression analysis were also described.

  5. The OA System of College - - Design of the Teaching Quality Monitoring Subsystem

    NASA Astrophysics Data System (ADS)

    Wu, Hongjuan; Ying, Hong; Jiang, Youyi; Yan, Pei

    According to the drawbacks of traditional teaching quality monitoring subsystems and based on the achievements of practical research in the teaching quality monitoring administration in College, this paper provides a design of overall structure of teaching quality monitoring subsystem, that is more suitable for colleges' management. This new system is endowed with the same features as .NET application programes: easy to extend, easy to maintain, flexible, convenient, and it let enterprises, students' parents and excellent graduates participate in teaching quality monitoring administration, have significant effect to ensure the quality of talent training in colleges.

  6. Applying Quality by Design Concepts to Pharmacy Compounding.

    PubMed

    Timko, Robert J

    2015-01-01

    Compounding of medications is an important part of the practice of the pharmacy profession. Because compounded medications do not have U.S. Food and Drug Administration approval, a pharmacist has the responsibility to ensure that compounded medications are of suitable quality, safety, and efficacy. The Federal Government and numerous states have updated their laws and regulations regarding pharmacy compounding as a result of recent quality issues. Compounding pharmacists are expected to follow good preparation prodecures in their compounding practices in much the same way pharmaceutical manufacturers are required to follow Current Good Manufacturing Procedures as detailed in the United States Code of Federal Regulations. Application of Quality by Design concepts to the preparation process for a compounded medication can help in understanding the potential pitfalls and the means to mitigate their impact. The goal is to build quality into the compounding process to ensure that the resultant compounded prescription meets the human or animal patients' requirements.

  7. Integrating water quality responses to best management practices in Portugal.

    PubMed

    Fonseca, André; Boaventura, Rui A R; Vilar, Vítor J P

    2018-01-01

    Nutrient nonpoint pollution has a significant impact on water resources worldwide. The main challenge of this work was to assess the application of best management practices in agricultural land to comply with water quality legislation for surface waters. The Hydrological Simulation Program-FORTRAN was used to evaluate water quality of Ave River in Portugal. Best management practices (infiltration basin) (BMP) were applied to agricultural land (for 3, 6, 9, 12, and 15% area) with removal efficiencies of 50% for fecal coliforms and 30% for nitrogen, phosphorus, and biochemical oxygen demand. The inflow of water quality constituents was reduced for all scenarios, with fecal coliforms achieving the highest reduction between 5.8 and 28.9% and nutrients and biochemical oxygen demand between 2 and 13%. Biochemical oxygen demand and orthophosphates concentrations achieved a good water quality status according to the European Legislation for scenarios of BMP applied to 3 and 12% agricultural area, respectively. Fecal coliform levels in Ave River basin require further treatment to fall below the established value in the abovementioned legislation. This study shows that agricultural watersheds such as Ave basins demand special attention in regard to nonpoint pollution sources effects on water quality and nutrient loads.

  8. A Practical and Portable Solids-State Electronic Terahertz Imaging System

    PubMed Central

    Smart, Ken; Du, Jia; Li, Li; Wang, David; Leslie, Keith; Ji, Fan; Li, Xiang Dong; Zeng, Da Zhang

    2016-01-01

    A practical compact solid-state terahertz imaging system is presented. Various beam guiding architectures were explored and hardware performance assessed to improve its compactness, robustness, multi-functionality and simplicity of operation. The system performance in terms of image resolution, signal-to-noise ratio, the electronic signal modulation versus optical chopper, is evaluated and discussed. The system can be conveniently switched between transmission and reflection mode according to the application. A range of imaging application scenarios was explored and images of high visual quality were obtained in both transmission and reflection mode. PMID:27110791

  9. 40 CFR 451.21 - Effluent limitations attainable by the application of the best practicable control technology...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS... as video cameras, digital scanning sonar, and upweller systems; monitoring of sediment quality...

  10. 40 CFR 451.21 - Effluent limitations attainable by the application of the best practicable control technology...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS... as video cameras, digital scanning sonar, and upweller systems; monitoring of sediment quality...

  11. 40 CFR 451.21 - Effluent limitations attainable by the application of the best practicable control technology...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS... as video cameras, digital scanning sonar, and upweller systems; monitoring of sediment quality...

  12. Practical applications of space systems. [environmental quality and resources management

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The study was conducted to provide an opportunity for knowledgeable users to express their needs for information or services which might or might not be met by space systems, and to relate the present and potential capabilities of space systems to their needs. The needs, accomplishments to date, and future possibilities in the applications of space systems for providing food and energy, while at the same time improving and safeguarding the physical environment and the quality of life, are presented. Organizing the usage of these space systems capabilities is also discussed.

  13. Chronic disease management for depression in US medical practices: results from the Health Tracking Physician Survey.

    PubMed

    Zafar, Waleed; Mojtabai, Ramin

    2011-07-01

    Chronic care model (CCM) envisages a multicomponent systematic remodeling of ambulatory care to improve chronic diseases management. Application of CCM in primary care management of depression has traditionally lagged behind the application of this model in management of other common chronic illnesses. In past research, the use of CCM has been operationalized by measuring the use of evidence-based organized care management processes (CMPs). To compare the use of CMPs in treatment of depression with the use of these processes in treatment of diabetes and asthma and to examine practice-level correlates of this use. Using data from the 2008 Health Tracking Physician Survey, a nationally representative sample of physicians in the United States, we compared the use of 5 different CMPs: written guidelines in English and other languages for self-management, availability of staff to educate patients about self-management, availability of nurse care managers for care coordination, and group meetings of patients with staff. We further examined the association of practice-level characteristics with the use of the 5 CMPs for management of depression. CMPs were more commonly used for management of diabetes and asthma than for depression. The use of CMPs for depression was more common in health maintenance organizations [adjusted odds ratios (AOR) ranging from 2.45 to 5.98 for different CMPs], in practices that provided physicians with feedback regarding quality of care to patients (AOR range, 1.42 to 1.69), and in practices with greater use of clinical information technology (AOR range, 1.06 to 1.11). The application of CMPs in management of depression continues to lag behind other common chronic conditions. Feedbacks on quality of care and expanded use of information technology may improve application of CMPs for depression care in general medical settings.

  14. Standardization of Good Manufacturing Practice-compliant production of bone marrow-derived human mesenchymal stromal cells for immunotherapeutic applications.

    PubMed

    Wuchter, Patrick; Bieback, Karen; Schrezenmeier, Hubert; Bornhäuser, Martin; Müller, Lutz P; Bönig, Halvard; Wagner, Wolfgang; Meisel, Roland; Pavel, Petra; Tonn, Torsten; Lang, Peter; Müller, Ingo; Renner, Matthias; Malcherek, Georg; Saffrich, Rainer; Buss, Eike C; Horn, Patrick; Rojewski, Markus; Schmitt, Anita; Ho, Anthony D; Sanzenbacher, Ralf; Schmitt, Michael

    2015-02-01

    Human mesenchymal stem or stromal cells (MSCs) represent a potential resource not only for regenerative medicine but also for immunomodulatory cell therapies. The application of different MSC culture protocols has significantly hampered the comparability of experimental and clinical data from different laboratories and has posed a major obstacle for multicenter clinical trials. Manufacturing of cell products for clinical application in the European Community must be conducted in compliance with Good Manufacturing Practice and requires a manufacturing license. In Germany, the Paul-Ehrlich-Institut as the Federal Authority for Vaccines and Biomedicines is critically involved in the approval process. This report summarizes a consensus meeting between researchers, clinicians and regulatory experts on standard quality requirements for MSC production. The strategy for quality control testing depends on the product's cell composition, the manufacturing process and the indication and target patient population. Important quality criteria in this sense are, among others, the immunophenotype of the cells, composition of the culture medium and the risk for malignant transformation, as well as aging and the immunosuppressive potential of the manufactured MSCs. This position paper intends to provide relevant information to interested parties regarding these criteria to foster the development of scientifically valid and harmonized quality standards and to support approval of MSC-based investigational medicinal products. Copyright © 2015 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  15. Research philosophy in pharmacy practice: necessity and relevance.

    PubMed

    Winit-Watjana, Win

    2016-12-01

    Pharmacy practice has gradually evolved with the paradigm shifted towards patient-focused practice or medicines optimisation. The advancement of pharmacy-related research has contributed to this progression, but the philosophy of research remained unexplored. This review was thus aimed to outline the succinct concept of research philosophy and its application in pharmacy practice research. Research philosophy has been introduced to offer an alternative way to think about problem-driven research that is normally conducted. To clarify the research philosophy, four research paradigms, i.e. positivism (or empiricism), postpositivism (or realism), interpretivism (or constructivism) and pragmatism, are investigated according to philosophical realms, i.e. ontology, epistemology, axiology and logic of inquiry. With the application of research philosophy, some examples of quantitative and qualitative research were elaborated along with the conventional research approach. Understanding research philosophy is crucial for pharmacy researchers and pharmacists, as it underpins the choice of methodology and data collection. The review provides the overview of research philosophy and its application in pharmacy practice research. Further discussion on this vital issue is warranted to help generate quality evidence for pharmacy practice. © 2016 Royal Pharmaceutical Society.

  16. Vegetable Grafting: The Implications of a Growing Agronomic Imperative for Vegetable Fruit Quality and Nutritive Value

    PubMed Central

    Kyriacou, Marios C.; Rouphael, Youssef; Colla, Giuseppe; Zrenner, Rita; Schwarz, Dietmar

    2017-01-01

    Grafting has become an imperative for intensive vegetable production since chlorofluorocarbon-based soil fumigants were banned from use on grounds of environmental protection. Compelled by this development, research into rootstock–scion interaction has broadened the potential applications of grafting in the vegetable industry beyond aspects of soil phytopathology. Grafting has been increasingly tapped for cultivation under adverse environs posing abiotic and biotic stresses to vegetable crops, thus enabling expansion of commercial production onto otherwise under-exploited land. Vigorous rootstocks have been employed not only in the open field but also under protected cultivation where increase in productivity improves distribution of infrastructural and energy costs. Applications of grafting have expanded mainly in two families: the Cucurbitaceae and the Solanaceae, both of which comprise major vegetable crops. As the main drives behind the expansion of vegetable grafting have been the resistance to soilborne pathogens, tolerance to abiotic stresses and increase in yields, rootstock selection and breeding have accordingly conformed to the prevailing demand for improving productivity, arguably at the expense of fruit quality. It is, however, compelling to assess the qualitative implications of this growing agronomic practice for human nutrition. Problems of impaired vegetable fruit quality have not infrequently been associated with the practice of grafting. Accordingly, the aim of the current review is to reassess how the practice of grafting and the prevalence of particular types of commercial rootstocks influence vegetable fruit quality and, partly, storability. Physical, sensorial and bioactive aspects of quality are examined with respect to grafting for watermelon, melon, cucumber, tomato, eggplant, and pepper. The physiological mechanisms at play which mediate rootstock effects on scion performance are discussed in interpreting the implications of grafting for the configuration of vegetable fruit physicochemical quality and nutritive value. PMID:28553298

  17. Clinical practice guideline development manual: A quality-driven approach for translating evidence into action

    PubMed Central

    Rosenfeld, Richard M.; Shiffman, Richard N.

    2010-01-01

    Background Guidelines translate best evidence into best practice. A well-crafted guideline promotes quality by reducing healthcare variations, improving diagnostic accuracy, promoting effective therapy, and discouraging ineffective – or potentially harmful – interventions. Despite a plethora of published guidelines, methodology is often poorly defined and varies greatly within and among organizations. Purpose This manual describes the principles and practices used successfully by the American Academy of Otolaryngology – Head and Neck Surgery to produce quality-driven, evidence-based guidelines using efficient and transparent methodology for action-ready recommendations with multi-disciplinary applicability. The development process, which allows moving from conception to completion in twelve months, emphasizes a logical sequence of key action statements supported by amplifying text, evidence profiles, and recommendation grades that link action to evidence. Conclusions As clinical practice guidelines become more prominent as a key metric of quality healthcare, organizations must develop efficient production strategies that balance rigor and pragmatism. Equally important, clinicians must become savvy in understanding what guidelines are – and are not – and how they are best utilized to improve care. The information in this manual should help clinicians and organizations achieve these goals. PMID:19464525

  18. [Discussion on logistics management of medical consumables].

    PubMed

    Deng, Sutong; Wang, Miao; Jiang, Xiali

    2011-09-01

    Management of medical consumables is an important part of modern hospital management. In modern medical behavior, drugs and medical devices act directly on the patient, and are important factors affecting the quality of medical practice. With the increasing use of medical materials, based on practical application, this article proposes the management model of medical consumables, and discusses the essence of medical materials logistics management.

  19. 77 FR 22691 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-17

    ... statute provides that the Institute will not develop a dollars-per-quality-life-year estimate as a... have practical utility; How the quality, utility, and clarity of the information to be collected may be... plan sponsors of calculating the average number of lives covered for the applicable policy year or plan...

  20. Practices and Exploration on Competition of Molecular Biological Detection Technology among Students in Food Quality and Safety Major

    ERIC Educational Resources Information Center

    Chang, Yaning; Peng, Yuke; Li, Pengfei; Zhuang, Yingping

    2017-01-01

    With the increasing importance in the application of the molecular biological detection technology in the field of food safety, strengthening education in molecular biology experimental techniques is more necessary for the culture of the students in food quality and safety major. However, molecular biology experiments are not always in curricula…

  1. Environmental impacts of in-house windrow composting of broiler litter prior to land application in subtropical/semi-arid conditions

    USDA-ARS?s Scientific Manuscript database

    Land application to crop and pasture land is a common and effective method of utilizing the resource value of poultry litter. In-house windrow composting of litter is an emerging management practice with the potential to mitigate water quality and nuisance odor concerns associated with land applica...

  2. Impacts of agricultural management practices on soil quality in Europe and China - an assessment within the framework of the EU iSQAPER project

    NASA Astrophysics Data System (ADS)

    Alaoui, Abdallah; Schwilch, Gudrun; Barão, Lúcia; Basch, Gottlieb; Sukkel, Wijnand; Lemesle, Julie; Ferreira, Carla; Garcia-Orenes, Fuensanta; Morugan, Alicia; Mataix, Jorge; Kosmas, Costas; Glavan, Matjaž; Tóth, Brigitta; Petrutza Gate, Olga; Lipiec, Jerzy; Reintam, Endla; Xu, Minggang; Di, Jiaying; Fan, Hongzhu; Geissen, Violette

    2017-04-01

    Agricultural soils are under a wide variety of pressures, including from increasing global demand for food associated with population growth, changing diets, land degradation, and associated productivity reductions potentially exacerbated by climate change. To manage the use of agricultural soils well, decision-makers need science-based, easily applicable, and cost-effective tools for assessing soil quality and soil functions. Since a practical assessment of soil quality requires the integrated consideration of key soil properties and their variations in space and time, providing such tools remains a challenging task. This study aims to assess the impact of innovative agricultural management practices on soil quality in 14 study sites across Europe (10) and China (4), covering the major pedo-climatic zones. The study is part of the European H2020 project iSQAPER, which involves 25 partners across Europe and China and is coordinated by Wageningen University, The Netherlands. iSQAPER is aimed at interactive soil quality assessment in Europe and China for agricultural productivity and environmental resilience. The study began with a thorough literature analysis to inform the selection of indicators for the assessment of soil structure and soil functions. A manual was then developed in order to standardize and facilitate the task of inventorying soil quality and management practices at the case study sites. The manual provides clear and precise instructions on how to assess the 11 selected soil quality indicators based on a visual soil assessment methodology. A newly developed infiltrometer was used to easily assess the soil infiltration capacity in the field and investigate hydrodynamic flow processes. Based on consistent calibration, the infiltrometer enables reliable prediction of key soil hydraulic properties. The main aim of this inventory is to link agricultural management practices to the soil quality status at the case study sites, and to identify innovative practices that have improved soil quality. The inventory and the scoring of soil quality are done together with land users at each study site. The idea is to compare the soil quality on a farm where management practices have changed 3 or more years ago with that on a control farm where practices have not changed, with both farms located in the same pedo-climatic zone and having comparable soil conditions. The case study partners were requested to identify at least 3 newly adopted management practices (or combinations thereof) and 3 related control farms. First results show that among 88 sets of paired plots, 60 pairs (68 %) show a positive impact of innovative agricultural management practices on soil quality. 18 pairs (21 %) do not show any difference in soil quality between soils under innovative practices and soils in the control plots, and the remaining 10 plots (11 %) show an inverse effect. The non-detectable effect of the innovative practices on soil quality are due to type of tillage management, soil type and fertility that mask the effect of management practices on soil and also due to time of the assessment. This assessment will be repeated in the coming years, with the aim of providing sound data on soil quality and its improvement through innovative management practices across Europe and China.

  3. Strengthening radiopharmacy practice in IAEA Member States.

    PubMed

    Duatti, Adriano; Bhonsle, Uday

    2013-05-01

    Radiopharmaceuticals are essential components of nuclear medicine procedures. Without radiopharmaceuticals nuclear medicine procedures cannot be performed. Therefore it could be said that 'No radiopharmaceutical-no nuclear medicine.' A good radiopharmacy practice supports nuclear medicine activities by producing radiopharmaceuticals that are safe and are of the required quality in a consistent way. As with any medicinal product, radiopharmaceuticals are required to be produced under carefully controlled conditions and are tested for their quality, prior to the administration to patients, using validated standard operating procedures. These procedures are based on the principles of Good Manufacturing Practice (GMP). The GMP principles are based on scientific knowledge and applicable regulatory requirements and guidance related to radiopharmaceutical productions and use. The International Atomic Energy Agency (IAEA) is committed to promote, in the Member States (MS), a rational and practical approach for the implementation of GMP for compounding or manufacturing of diagnostic or therapeutic radiopharmaceuticals. To pursue this goal the IAEA has developed various mechanisms and collaborations with individual experts in the field and with relevant national and international institutions or organizations. IAEA's activities in promoting radiopharmaceutical science include commissioning expert advice in the form of publications on radiopharmaceutical production, quality control and usage, producing technical guidance on production and regulatory aspects related to new radiopharmaceuticals, creating guidance documentation for self or internal audits of radiopharmaceutical production facilities, producing guidance on implementation of Quality Management System and GMP in radiopharmacy, assisting in creation of specific radiopharmaceutical monographs for the International Pharmacopoeia, and developing radiopharmacy-related human resource capabilities in MS through individual and regional training courses and education programs. IAEA strongly supports development of clinical nuclear medicine services by assisting MS in setting up reliable Radiopharmaceutical production facilities for single photon emission computed tomography, positron emission tomography, and for therapeutic applications. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Clinical Nurse Specialists Guide Staff Nurses to Promote Practice Accountability Through Peer Review.

    PubMed

    Semper, Julie; Halvorson, Betty; Hersh, Mary; Torres, Clare; Lillington, Linda

    2016-01-01

    The aim of the study was to describe the clinical nurse specialist role in developing and implementing a staff nurse education program to promote practice accountability using peer review principles. Peer review is essential for professional nursing practice demanding a significant culture change. Clinical nurse specialists in a Magnet-designated community hospital were charged with developing a staff nurse peer review education program. Peer review is a recognized mechanism of professional self-regulation to ensure delivery of quality care. The American Nurses Association strongly urges incorporating peer review in professional nursing practice models. Clinical nurse specialists play a critical role in educating staff nurses about practice accountability. Clinical nurse specialists developed an education program guided by the American Nurses Association's principles of peer review. A baseline needs assessment identified potential barriers and learning needs. Content incorporated tools and strategies to build communication skills, collaboration, practice change, and peer accountability. The education program resulted in increased staff nurse knowledge about peer review and application of peer review principles in practice. Clinical nurse specialists played a critical role in helping staff nurses understand peer review and its application to practice. The clinical nurse specialist role will continue to be important in sustaining the application of peer review principles in practice.

  5. Improved quality and more attractive work by applying EBM in disability evaluations: a qualitative survey.

    PubMed

    Hoving, Jan L; Kok, Rob; Ketelaar, Sarah M; Smits, Paul B A; van Dijk, Frank J H; Verbeek, Jos H

    2016-02-29

    The uptake of evidence in practice by physicians, even if they are trained in the systematic method of evidence-based medicine (EBM), remains difficult to improve. The aim of this study was to explore perceptions and experiences of physicians doing disability evaluations regarding motivators and preconditions for the implementation of EBM in daily practice. This qualitative study was nested in a cluster randomized controlled trial (Trial registration NTR1767; 20-apr-2009) evaluating the effects of training in EBM. The 45 physicians that participated received a comprehensive 6-months training program in EBM of which the last course day included audio-recorded interviews in groups. During these interviews participating physicians discussed perceptions and experiences regarding EBM application in daily practice. In an iterative process we searched for common motivators or preconditions for the implementation of EBM. Three main concepts or themes emerged after analyzing the transcriptions of the discussions: 1) improved quality of physicians' actions, such as clients benefiting from the application of EBM; 2) improved work attractiveness of physicians; and 3) preconditions that have to be met in order to work in an evidence-based manner including professional competence, facilitating material conditions and organizational support and demands. Physicians trained in EBM are motivated to use EBM because they perceive it as a factor improving the quality of their work and making their work more attractive. In addition to personal investments and gains, organizational support should further facilitate the uptake of evidence in practice.

  6. Quality Measures in Orthopaedic Sports Medicine: A Systematic Review.

    PubMed

    Abrams, Geoffrey D; Greenberg, Daniel R; Dragoo, Jason L; Safran, Marc R; Kamal, Robin N

    2017-10-01

    To report the current quality measures that are applicable to orthopaedic sports medicine physicians. Six databases were searched with a customized search term to identify quality measures relevant to orthopaedic sports medicine surgeons: MEDLINE/PubMed, EMBASE, the National Quality Forum (NQF) Quality Positioning System (QPS), the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC), the Physician Quality Reporting System (PQRS) database, and the American Academy of Orthopaedic Surgeons (AAOS) website. Results were screened by 2 Board-certified orthopaedic surgeons with fellowship training in sports medicine and dichotomized based on sports medicine-specific or general orthopaedic (nonarthroplasty) categories. Hip and knee arthroplasty measures were excluded. Included quality measures were further categorized based on Donabedian's domains and the Center for Medicare and Medicaid (CMS) National Quality Strategy priorities. A total of 1,292 quality measures were screened and 66 unique quality measures were included. A total of 47 were sports medicine-specific and 19 related to the general practice of orthopaedics for a fellowship-trained sports medicine specialist. Nineteen (29%) quality measures were collected within PQRS, with 5 of them relating to sports medicine and 14 relating to general orthopaedics. AAOS Clinical Practice Guidelines (CPGs) comprised 40 (60%) of the included measures and were all within sports medicine. Five (8%) additional measures were collected within AHRQ and 2 (3%) within NQF. Most quality measures consist of process rather than outcome or structural measures. No measures addressing concussions were identified. There are many existing quality measures relating to the practice of orthopaedic sports medicine. Most quality measures are process measures described within PQRS or AAOS CPGs. Knowledge of quality measures are important as they may be used to improve care, are increasingly being used to determine physician reimbursement, and can inform future quality measure development efforts. Published by Elsevier Inc.

  7. Triangulated Proxy Reporting: a technique for improving how communication partners come to know people with severe cognitive impairment.

    PubMed

    Lyons, Gordon; De Bortoli, Tania; Arthur-Kelly, Michael

    2017-09-01

    This paper explains and demonstrates the pilot application of Triangulated Proxy Reporting (TPR); a practical technique for enhancing communication around people who have severe cognitive impairment (SCI). An introduction explains SCI and how this impacts on communication; and consequently on quality of care and quality of life. This is followed by an explanation of TPR and its origins in triangulation research techniques. An illustrative vignette explicates its utility and value in a group home for a resident with profound multiple disabilities. The Discussion and Conclusion sections propose the wider application of TPR for different cohorts of people with SCIs, their communication partners and service providers. TPR presents as a practical technique for enhancing communication interactions with people who have SCI. The paper demonstrates the potential of the technique for improving engagement amongst those with profound multiple disabilities, severe acquired brain injury and advanced dementia and their partners in and across different care settings. Implications for Rehabilitation Triangulated Proxy Reporting (TPR) shows potential to improve communications between people with severe cognitive impairments and their communication partners. TPR can lead to improved quality of care and quality of life for people with profound multiple disabilities, very advanced dementia and severe acquired brain injury, who otherwise are very difficult to support. TPR is a relatively simple and inexpensive technique that service providers can incorporate into practice to improving communications between clients with severe cognitive impairments, their carers and other support professionals.

  8. CALL FOR PAPERS: 13th International Conference on Force and Mass Measurement

    NASA Astrophysics Data System (ADS)

    1992-01-01

    10 14 May 1993, Helsinki Fair Centre, Finland Scope of the Conference The Conference reports and reviews the state of the art and future trends in force and mass measurements in science and industry. Emphasis is on the applications of new methods, current problems in calibration and quality control, as well as on advancements in new sensor technologies and industrial application of force and mass measurements. Main Themes and Topics 1. The state of the art and development trends in force and mass measurements Development and stability of high level mass standards Mass comparators and force standard machine New research topics in mass and force 2. Calibration and quality control Calibration methods Estimation of uncertainties and classification of accuracies Relations between calibration, testing and quality control Requirements for quality control Verification of weighing instruments and their main devices 3. Application of force and mass measurements Automatic weighing Mass flow measurements Quality control in process industry Sensor technologies Practical applications Special applications in industry, trade, etc. Deadline for submission of abstracts: 30 June 1992. For further information please contact: Finnish Society of Automation, Asemapäällikönkatu 12C, SF-00520 HELSINKI, Finland Phone: Int. +3580 1461 644, Fax: Int. +3580 1461 650

  9. Connecting congregations: technology resources influence parish nurse practice.

    PubMed

    Zerull, Lisa M; Near, Kelly K; Ragon, Bart; Farrell, Sarah P

    2009-01-01

    This descriptive pilot study evaluated the influence of health resource information education and the use of Web-based communication technology on the professional practice of the parish nurse in the congregational setting. Five parish nurse participants from varied denominations in rural and nonrural Virginia received a laptop computer, printer, video projector, and webcam along with high-speed Internet access in each congregational setting. The nurses attended two group education sessions that incorporated computer applications and training in accessing and using quality health information resources and communication applications such as a group "chat" software and webcam to communicate with others through high-speed Internet access. Qualitative analysis from semistructured interviews of nurses confirmed that participants found the project to be beneficial in terms of awareness, education, and applicability of technology use in parish nurse practice. Quantitative data from preproject and postproject surveys found significant differences in nurses' abilities and confidence with technology use and application. Findings showed that the knowledge and experience gained from this study enhanced parish nurse practice and confidence in using technology for communication, health education, and counseling.

  10. Pilot Study Evaluating a Practice-Based Learning and Improvement Curriculum Focusing on the Development of System-Level Quality Improvement Skills

    PubMed Central

    Tomolo, Anne M; Lawrence, Renée H; Watts, Brook; Augustine, Sarah; Aron, David C; Singh, Mamta K

    2011-01-01

    Background We developed a practice-based learning and improvement (PBLI) curriculum to address important gaps in components of content and experiential learning activities through didactics and participation in systems-level quality improvement projects that focus on making changes in health care processes. Methods We evaluated the impact of our curriculum on resident PBLI knowledge, self-efficacy, and application skills. A quasi-experimental design assessed the impact of a curriculum (PBLI quality improvement systems compared with non-PBLI) on internal medicine residents' learning during a 4-week ambulatory block. We measured application skills, self-efficacy, and knowledge by using the Systems Quality Improvement Training and Assessment Tool. Exit evaluations assessed time invested and experiences related to the team projects and suggestions for improving the curriculum. Results The 2 groups showed differences in change scores. Relative to the comparison group, residents in the PBLI curriculum demonstrated a significant increase in the belief about their ability to implement a continuous quality improvement project (P  =  .020), comfort level in developing data collection plans (P  =  .010), and total knowledge scores (P < .001), after adjusting for prior PBLI experience. Participants in the PBLI curriculum also demonstrated significant improvement in providing a more complete aim statement for a proposed project after adjusting for prior PBLI experience (P  =  .001). Exit evaluations were completed by 96% of PBLI curriculum participants who reported high satisfaction with team performance. Conclusion Residents in our curriculum showed gains in areas fundamental for PBLI competency. The observed improvements were related to fundamental quality improvement knowledge, with limited gain in application skills. This suggests that while heading in the right direction, we need to conceptualize and structure PBLI training in a way that integrates it throughout the residency program and fosters the application of this knowledge and these skills. PMID:22379523

  11. Pilot study evaluating a practice-based learning and improvement curriculum focusing on the development of system-level quality improvement skills.

    PubMed

    Tomolo, Anne M; Lawrence, Renée H; Watts, Brook; Augustine, Sarah; Aron, David C; Singh, Mamta K

    2011-03-01

    We developed a practice-based learning and improvement (PBLI) curriculum to address important gaps in components of content and experiential learning activities through didactics and participation in systems-level quality improvement projects that focus on making changes in health care processes. We evaluated the impact of our curriculum on resident PBLI knowledge, self-efficacy, and application skills. A quasi-experimental design assessed the impact of a curriculum (PBLI quality improvement systems compared with non-PBLI) on internal medicine residents' learning during a 4-week ambulatory block. We measured application skills, self-efficacy, and knowledge by using the Systems Quality Improvement Training and Assessment Tool. Exit evaluations assessed time invested and experiences related to the team projects and suggestions for improving the curriculum. The 2 groups showed differences in change scores. Relative to the comparison group, residents in the PBLI curriculum demonstrated a significant increase in the belief about their ability to implement a continuous quality improvement project (P  =  .020), comfort level in developing data collection plans (P  =  .010), and total knowledge scores (P < .001), after adjusting for prior PBLI experience. Participants in the PBLI curriculum also demonstrated significant improvement in providing a more complete aim statement for a proposed project after adjusting for prior PBLI experience (P  =  .001). Exit evaluations were completed by 96% of PBLI curriculum participants who reported high satisfaction with team performance. Residents in our curriculum showed gains in areas fundamental for PBLI competency. The observed improvements were related to fundamental quality improvement knowledge, with limited gain in application skills. This suggests that while heading in the right direction, we need to conceptualize and structure PBLI training in a way that integrates it throughout the residency program and fosters the application of this knowledge and these skills.

  12. Clinical practice guidelines in hypertension: a review.

    PubMed

    Álvarez-Vargas, Mayita Lizbeth; Galvez-Olortegui, José Kelvin; Galvez-Olortegui, Tomas Vladimir; Sosa-Rosado, José Manuel; Camacho-Saavedra, Luis Arturo

    2015-10-23

    The aim of this study is the methodological evaluation of Clinical Practice Guidelines (CPG) in hypertension. This is the first in a series of review articles, analysis, assessment in methodology and content of clinical practice guidelines in Cardiology. Of all clinical practice guidelines, three were selected and the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was used to assess each guide. The guidelines obtained the lowest score in the domain of applicability (mean 43.8%); while the highest score was for clarity of presentation (mean 81.5%). The lowest percentage was found in the applicability domain (European guideline) and the highest of all scores was found in two domains: scope and purpose, and clarity of presentation (Canadian guideline). Assessing the quality of the clinical practice guidelines analyzed, the Canadian is one with the best scores obtained by applying the AGREE II instrument, and it is advised to be used without modifications.

  13. Quality Improvement With Discrete Event Simulation: A Primer for Radiologists.

    PubMed

    Booker, Michael T; O'Connell, Ryan J; Desai, Bhushan; Duddalwar, Vinay A

    2016-04-01

    The application of simulation software in health care has transformed quality and process improvement. Specifically, software based on discrete-event simulation (DES) has shown the ability to improve radiology workflows and systems. Nevertheless, despite the successful application of DES in the medical literature, the power and value of simulation remains underutilized. For this reason, the basics of DES modeling are introduced, with specific attention to medical imaging. In an effort to provide readers with the tools necessary to begin their own DES analyses, the practical steps of choosing a software package and building a basic radiology model are discussed. In addition, three radiology system examples are presented, with accompanying DES models that assist in analysis and decision making. Through these simulations, we provide readers with an understanding of the theory, requirements, and benefits of implementing DES in their own radiology practices. Copyright © 2016 American College of Radiology. All rights reserved.

  14. Variation in Protein Origin and Utilization: Research and Clinical Application.

    PubMed

    Paddon-Jones, Douglas; Coss-Bu, Jorge A; Morris, Claudia R; Phillips, Stuart M; Wernerman, Jan

    2017-04-01

    Muscle health can be rapidly compromised in clinical environments. Modifiable strategies to preserve metabolic homeostasis in adult patient populations include physical activity and pharmacologic support; however, optimizing dietary practices, or more specifically protein intake, is a necessary prerequisite for any other treatment strategy to be fully effective. Simply increasing protein intake is a well-intentioned but often unfocused strategy to protect muscle health in an intensive care setting. Protein quality is a frequently overlooked factor with the potential to differentially influence health outcomes. Quality can be assessed by a variety of techniques, with digestible indispensable amino acid score being the current and most comprehensive technique endorsed by the Food and Agriculture Organization. In practical terms, animal-based proteins are consistently scored higher in quality compared with incomplete proteins, regardless of the assessment method. Consequently, choosing parenteral and/or enteral feeding options that contain high-quality proteins, rich in the branched-chain amino acid leucine, may help establish a dietary framework with the potential to support clinical practice and improve health outcomes in critically ill patients.

  15. Recent practices on wastewater reuse in Turkey.

    PubMed

    Tanik, A; Ekdal, A; Germirli Babuna, F; Orhon, D

    2005-01-01

    Reuse of wastewater for irrigational purposes in agriculture has been a widely applied practice all around the world compared to such applications in industries. In most of the developing countries, high costs of wastewater treatment stimulate the direct reuse of raw or partly treated effluent in irrigation despite the socio-cultural objections in some countries regarding religious rituals towards consuming wastewater. In Turkey, reuse applications in agriculture have been in use by indirect application by means of withdrawing water from the downstream end of treatment plants. Such practices affected the deterioration of surface water resources due to the lack of water quality monitoring and control. However, more conscious and planned reuse activities in agriculture have recently started by the operation of urban wastewater treatment plants. Turkey does not face any severe water scarcity problems for the time being, but as the water resources show the signs of water quality deterioration it seems to be one of the priority issues in the near future. The industrial reuse activities are only at the research stage especially in industries consuming high amounts of water. In-plant control implementation is the preferred effort of minimizing water consumption in such industries. The current reuse activities are outlined in the article forming an example from a developing country.

  16. 4R Water Quality Impacts: An Assessment and Synthesis of Forty Years of Drainage Nitrogen Losses.

    PubMed

    Christianson, L E; Harmel, R D

    2015-11-01

    The intersection of agricultural drainage and nutrient mobility in the environment has led to multiscale water quality concerns. This work reviewed and quantitatively analyzed nearly 1,000 site-years of subsurface tile drainage nitrogen (N) load data to develop a more comprehensive understanding of the impacts of 4R practices (application of the right source of nutrients, at the right rate and time, and in the right place) within drained landscapes across North America. Using drainage data newly compiled in the "Measured Annual Nutrient loads from AGricultural Environments" (MANAGE) database, relationships were developed across N application rates for nitrate N drainage loads and corn ( L.) yields. The lack of significant differences between N application timing or application method was inconsistent with the current emphasis placed on application timing, in particular, as a water quality improvement strategy ( = 0.934 and 0.916, respectively). Broad-scale analyses such as this can help identify major trends for water quality, but accurate implementation of the 4R approach will require site-specific knowledge to balance agronomic and environmental goals. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  17. [Quality control in herbal supplements].

    PubMed

    Oelker, Luisa

    2005-01-01

    Quality and safety of food and herbal supplements are the result of a whole of different elements as good manufacturing practice and process control. The process control must be active and able to individuate and correct all possible hazards. The main and most utilized instrument is the hazard analysis critical control point (HACCP) system the correct application of which can guarantee the safety of the product. Herbal supplements need, in addition to standard quality control, a set of checks to assure the harmlessness and safety of the plants used.

  18. Sensor-Based Optimization Model for Air Quality Improvement in Home IoT

    PubMed Central

    Kim, Jonghyuk

    2018-01-01

    We introduce current home Internet of Things (IoT) technology and present research on its various forms and applications in real life. In addition, we describe IoT marketing strategies as well as specific modeling techniques for improving air quality, a key home IoT service. To this end, we summarize the latest research on sensor-based home IoT, studies on indoor air quality, and technical studies on random data generation. In addition, we develop an air quality improvement model that can be readily applied to the market by acquiring initial analytical data and building infrastructures using spectrum/density analysis and the natural cubic spline method. Accordingly, we generate related data based on user behavioral values. We integrate the logic into the existing home IoT system to enable users to easily access the system through the Web or mobile applications. We expect that the present introduction of a practical marketing application method will contribute to enhancing the expansion of the home IoT market. PMID:29570684

  19. Sensor-Based Optimization Model for Air Quality Improvement in Home IoT.

    PubMed

    Kim, Jonghyuk; Hwangbo, Hyunwoo

    2018-03-23

    We introduce current home Internet of Things (IoT) technology and present research on its various forms and applications in real life. In addition, we describe IoT marketing strategies as well as specific modeling techniques for improving air quality, a key home IoT service. To this end, we summarize the latest research on sensor-based home IoT, studies on indoor air quality, and technical studies on random data generation. In addition, we develop an air quality improvement model that can be readily applied to the market by acquiring initial analytical data and building infrastructures using spectrum/density analysis and the natural cubic spline method. Accordingly, we generate related data based on user behavioral values. We integrate the logic into the existing home IoT system to enable users to easily access the system through the Web or mobile applications. We expect that the present introduction of a practical marketing application method will contribute to enhancing the expansion of the home IoT market.

  20. Academy of nutrition and dietetics: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in sports nutrition and dietetics.

    PubMed

    Steinmuller, Patricia L; Kruskall, Laura J; Karpinski, Christine A; Manore, Melinda M; Macedonio, Michele A; Meyer, Nanna L

    2014-04-01

    Sports nutrition and dietetics addresses relationships of nutrition with physical activity, including weight management, exercise, and physical performance. Nutrition plays a key role in the prevention and treatment of obesity and chronic disease and for maintenance of health, and the ability to engage in physical activity, sports, and other aspects of physical performance. Thus, the Sports, Cardiovascular, and Wellness Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed the Revised 2014 Standards of Practice and Standards of Professional Performance as a resource for Registered Dietitian Nutritionists working in sports nutrition and dietetics to assess their current skill levels and to identify areas for further professional development in this emerging practice area. The revised document reflects advances in sports nutrition and dietetics practice since the original standards were published in 2009 and replaces those standards. The Standards of Practice represents the four steps in the Nutrition Care Process as applied to the care of patients/clients. The Standards of Professional Performance covers six standards of professional performance: quality in practice, competence and accountability, provision of services, application of research, communication and application of knowledge, and utilization and management of resources. Within each standard, specific indicators provide measurable action statements that illustrate how the standards can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for Registered Dietitian Nutritionists working in sports nutrition and dietetics. The Standards of Practice and Standards of Professional Performance are complementary resources for Registered Dietitian Nutritionists in sports nutrition and dietetics practice. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  1. Deterministic compressive sampling for high-quality image reconstruction of ultrasound tomography.

    PubMed

    Huy, Tran Quang; Tue, Huynh Huu; Long, Ton That; Duc-Tan, Tran

    2017-05-25

    A well-known diagnostic imaging modality, termed ultrasound tomography, was quickly developed for the detection of very small tumors whose sizes are smaller than the wavelength of the incident pressure wave without ionizing radiation, compared to the current gold-standard X-ray mammography. Based on inverse scattering technique, ultrasound tomography uses some material properties such as sound contrast or attenuation to detect small targets. The Distorted Born Iterative Method (DBIM) based on first-order Born approximation is an efficient diffraction tomography approach. One of the challenges for a high quality reconstruction is to obtain many measurements from the number of transmitters and receivers. Given the fact that biomedical images are often sparse, the compressed sensing (CS) technique could be therefore effectively applied to ultrasound tomography by reducing the number of transmitters and receivers, while maintaining a high quality of image reconstruction. There are currently several work on CS that dispose randomly distributed locations for the measurement system. However, this random configuration is relatively difficult to implement in practice. Instead of it, we should adopt a methodology that helps determine the locations of measurement devices in a deterministic way. For this, we develop the novel DCS-DBIM algorithm that is highly applicable in practice. Inspired of the exploitation of the deterministic compressed sensing technique (DCS) introduced by the authors few years ago with the image reconstruction process implemented using l 1 regularization. Simulation results of the proposed approach have demonstrated its high performance, with the normalized error approximately 90% reduced, compared to the conventional approach, this new approach can save half of number of measurements and only uses two iterations. Universal image quality index is also evaluated in order to prove the efficiency of the proposed approach. Numerical simulation results indicate that CS and DCS techniques offer equivalent image reconstruction quality with simpler practical implementation. It would be a very promising approach in practical applications of modern biomedical imaging technology.

  2. A survey of quality assurance practices in biomedical open source software projects.

    PubMed

    Koru, Günes; El Emam, Khaled; Neisa, Angelica; Umarji, Medha

    2007-05-07

    Open source (OS) software is continuously gaining recognition and use in the biomedical domain, for example, in health informatics and bioinformatics. Given the mission critical nature of applications in this domain and their potential impact on patient safety, it is important to understand to what degree and how effectively biomedical OS developers perform standard quality assurance (QA) activities such as peer reviews and testing. This would allow the users of biomedical OS software to better understand the quality risks, if any, and the developers to identify process improvement opportunities to produce higher quality software. A survey of developers working on biomedical OS projects was conducted to examine the QA activities that are performed. We took a descriptive approach to summarize the implementation of QA activities and then examined some of the factors that may be related to the implementation of such practices. Our descriptive results show that 63% (95% CI, 54-72) of projects did not include peer reviews in their development process, while 82% (95% CI, 75-89) did include testing. Approximately 74% (95% CI, 67-81) of developers did not have a background in computing, 80% (95% CI, 74-87) were paid for their contributions to the project, and 52% (95% CI, 43-60) had PhDs. A multivariate logistic regression model to predict the implementation of peer reviews was not significant (likelihood ratio test = 16.86, 9 df, P = .051) and neither was a model to predict the implementation of testing (likelihood ratio test = 3.34, 9 df, P = .95). Less attention is paid to peer review than testing. However, the former is a complementary, and necessary, QA practice rather than an alternative. Therefore, one can argue that there are quality risks, at least at this point in time, in transitioning biomedical OS software into any critical settings that may have operational, financial, or safety implications. Developers of biomedical OS applications should invest more effort in implementing systemic peer review practices throughout the development and maintenance processes.

  3. Exploration of multidimensional interactive classroom teaching for CCD principle and application course

    NASA Astrophysics Data System (ADS)

    Fu, Xinghu; Tan, Ailing; Zhang, Baojun; Fu, Guangwei; Bi, Weihong

    2017-08-01

    The CCD principle and application course is professional and comprehensive. It involves many subject contents. The course content includes eight aspects. In order to complete the teaching tasks within a limited time, improve the classroom teaching quality and prompt students master the course content faster and better, so the multidimensional interactive classroom teaching is proposed. In the teaching practice, the interactive relationship between the frontier science, scientific research project, living example and classroom content is researched detailedly. Finally, it has been proved practically that the proposed multidimensional interactive classroom teaching can achieved good teaching effect.

  4. Production of high-quality marketing applications: strategies for biotechnology companies working with contract research organizations.

    PubMed

    Hecker, Sandra J; Preston, Christopher; Foote, MaryAnn

    2003-01-01

    Many biotechnology and pharmaceutical companies use clinical research organizations (CROs) to assist in the writing and preparation of clinical documents intended for submission to health authorities. Start-up companies often require the expertise of a CRO to prepare their first regulatory documents. Larger or more experienced companies often require CRO staff to assist at times of multiple simultaneous submissions. The timely production of high-quality new drug marketing applications requires close collaborations between the drug company and the CRO. The views of both CRO and industry in ensuring best practices are discussed.

  5. Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Oncology Nutrition.

    PubMed

    Charuhas Macris, Paula; Schilling, Karen; Palko, Raymond

    2018-04-01

    Oncology nutrition encompasses nutrition care for individuals along the cancer care continuum. Nutrition is a vital component of prevention, treatment, and healthy survivorship. The practice of an oncology registered dietitian nutritionist (RDN) reflects the setting and population served with diverse cancer diagnoses, including expanded roles and responsibilities reflecting the RDN's interests and organization's activities. Provision of nutrition services in oncology requires that RDNs have advanced knowledge in the focus area of oncology nutrition. Thus, the Oncology Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance as tools for RDNs currently in practice or interested in working in oncology nutrition, to address their current skill level and to identify areas for additional professional development in this practice area. The Standards of Practice address and apply the Nutrition Care Process and workflow elements, which are screening, assessment, diagnosis, intervention, evaluation/monitoring, and discharge planning and transitions of care. The Standards of Professional Performance consist of the following six domains of professionalism including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements and describe three skill levels (competent, proficient, and expert) for RDNs working in oncology nutrition. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  6. Comparative analysis of structural concrete quality assurance practices on nine nuclear power plant construction projects. Final report

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

    Willenbrock, J.H.; Thomas, H.R. Jr.; Burati, J.L. Jr.

    1978-06-01

    The basic objective of this research effort was to perform a comparative analysis of the Quality Assurance practices related to the structural concrete phase on nine nuclear power plant projects which are (or have been) under construction in the United States in the past ten years. This analysis identified the response of each Quality Assurance program to the applicable criteria of 10 CFR Part 50, Appendix B as well as to the pertinent regulatory requirements and industry standards. The major emphasis was placed on the construction aspects of the structural concrete phase of each project. The engineering and design aspectsmore » were examined whenever they interfaced with the construction aspects. For those aspects of the Quality Assurance system which can be considered managerial in nature (i.e., organizational relationships, types of Quality Assurance programs, corrective action procedures, etc.) an attempt has been made to present the alternative approaches that were identified. For those aspects of the Quality Assurance system which are technical in nature (i.e., the frequency of testing for slump, compressive strength, etc.) an attempt has been made to present a comparative analysis between projects and in relation to the recommended or mandated practices presented in the appropriate industry codes and standards.« less

  7. Commentary: A call to leadership: the role of the academic medical center in driving sustainable health system improvement through performance measurement.

    PubMed

    Nedza, Susan M

    2009-12-01

    As the government attempts to address the high cost of health care in the United States, the issues being confronted include variations in the quality of care administered and the inconsistent application of scientifically proven treatments. To improve quality, methods of measurement and reporting with rewards or, eventually, penalties based on performance, must be developed. To date, well-intentioned national policy initiatives, such as value-based purchasing, have focused primarily on the measurement of discrete events and on attempts to construct incentives. While important, the current approach alone cannot improve quality, ensure equitability, decrease variability, and optimize value. Additional thought-leadership is required, both theoretical and applied. Academic medical centers' (AMCs') scholarly and practical participation is needed. Although quality cannot be sustainably improved without measurement, the existing measures alone do not ensure quality. There is not enough evidence to support strong measure development and, further, not enough insight regarding whether the existing measures have their intended effect of enhancing health care delivery that results in quality outcomes for patients. Perhaps the only way that the United States health care system will achieve a standard of quality care is through the strong embrace, effective engagement, intellectual insights, educational contributions, and practical applications in AMCs. Quality will never be achieved through public policies or national initiatives alone but instead through the commitment of the academic community to forward the science of performance measurement and to ensure that measurement leads to better health outcomes for our nation.

  8. A capacity-building conceptual framework for public health nutrition practice.

    PubMed

    Baillie, Elizabeth; Bjarnholt, Christel; Gruber, Marlies; Hughes, Roger

    2009-08-01

    To describe a conceptual framework to assist in the application of capacity-building principles to public health nutrition practice. A review of the literature and consideration of the determinants of effective public health nutrition practice has been used to inform the development of a conceptual framework for capacity building in the context of public health nutrition practice. The limited literature supports a greater integration and application of capacity-building strategies and principles in public health nutrition practice, and that this application should be overt and strategic. A framework is proposed that identifies a number of determinants of capacity for effective public health nutrition action. The framework represents the key foundations for building capacity including leadership, resourcing and intelligence. Five key strategic domains supported by these foundation elements, including partnerships, organisational development, project management quality, workforce development and community development, are proposed. This framework can be used to assist the systematic assessment, development and evaluation of capacity-building activity within public health nutrition practice. Capacity building is a strategy within public health nutrition practice that needs to be central to public health nutrition intervention management. The present paper defines, contextualises and outlines a framework for integrating and making explicit the importance of capacity building within public health nutrition practice at many levels.

  9. QA/QC in the laboratory

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

    Hood, F.C.

    1992-05-01

    Quality assurance and quality control (QA/QC) of analytical chemistry laboratory activities are essential to the validity and usefulness of resultant data. However, in themselves, conventional QA/QC measures will not always ensure that fraudulent data are not generated. Conventional QA/QC measures are based on the assumption that work will be done in good faith; to assure against fraudulent practices, QA/QC measures must be tailored to specific analyses protocols in anticipation of intentional misapplication of those protocols. Application of specific QA/QC measures to ensure against fraudulent practices result in an increased administrative burden being placed on the analytical process; accordingly, in keepingmore » with graded QA philosophy, data quality objectives must be used to identify specific points of concern for special control to minimize the administrative impact.« less

  10. QA/QC in the laboratory. Session F

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

    Hood, F.C.

    1992-05-01

    Quality assurance and quality control (QA/QC) of analytical chemistry laboratory activities are essential to the validity and usefulness of resultant data. However, in themselves, conventional QA/QC measures will not always ensure that fraudulent data are not generated. Conventional QA/QC measures are based on the assumption that work will be done in good faith; to assure against fraudulent practices, QA/QC measures must be tailored to specific analyses protocols in anticipation of intentional misapplication of those protocols. Application of specific QA/QC measures to ensure against fraudulent practices result in an increased administrative burden being placed on the analytical process; accordingly, in keepingmore » with graded QA philosophy, data quality objectives must be used to identify specific points of concern for special control to minimize the administrative impact.« less

  11. Evaluation of the theory-based Quality Improvement in Physical Therapy (QUIP) programme: a one-group, pre-test post-test pilot study.

    PubMed

    Rutten, Geert M; Harting, Janneke; Bartholomew, L Kay; Schlief, Angelique; Oostendorp, Rob A B; de Vries, Nanne K

    2013-05-25

    Guideline adherence in physical therapy is far from optimal, which has consequences for the effectiveness and efficiency of physical therapy care. Programmes to enhance guideline adherence have, so far, been relatively ineffective. We systematically developed a theory-based Quality Improvement in Physical Therapy (QUIP) programme aimed at the individual performance level (practicing physiotherapists; PTs) and the practice organization level (practice quality manager; PQM). The aim of the study was to pilot test the multilevel QUIP programme's effectiveness and the fidelity, acceptability and feasibility of its implementation. A one-group, pre-test, post-test pilot study (N = 8 practices; N = 32 PTs, 8 of whom were also PQMs) done between September and December 2009. Guideline adherence was measured using clinical vignettes that addressed 12 quality indicators reflecting the guidelines' main recommendations. Determinants of adherence were measured using quantitative methods (questionnaires). Delivery of the programme and management changes were assessed using qualitative methods (observations, group interviews, and document analyses). Changes in adherence and determinants were tested in the paired samples T-tests and expressed in effect sizes (Cohen's d). Overall adherence did not change (3.1%; p = .138). Adherence to three quality indicators improved (8%, 24%, 43%; .000 ≤ p ≤ .023). Adherence to one quality indicator decreased (-15.7%; p = .004). Scores on various determinants of individual performance improved and favourable changes at practice organizational level were observed. Improvements were associated with the programme's multilevel approach, collective goal setting, and the application of self-regulation; unfavourable findings with programme deficits. The one-group pre-test post-test design limits the internal validity of the study, the self-selected sample its external validity. The QUIP programme has the potential to change physical therapy practice but needs considerable revision to induce the ongoing quality improvement process that is required to optimize overall guideline adherence. To assess its value, the programme needs to be tested in a randomized controlled trial.

  12. Potential application of machine vision technology to saffron (Crocus sativus L.) quality characterization.

    PubMed

    Kiani, Sajad; Minaei, Saeid

    2016-12-01

    Saffron quality characterization is an important issue in the food industry and of interest to the consumers. This paper proposes an expert system based on the application of machine vision technology for characterization of saffron and shows how it can be employed in practical usage. There is a correlation between saffron color and its geographic location of production and some chemical attributes which could be properly used for characterization of saffron quality and freshness. This may be accomplished by employing image processing techniques coupled with multivariate data analysis for quantification of saffron properties. Expert algorithms can be made available for prediction of saffron characteristics such as color as well as for product classification. Copyright © 2016. Published by Elsevier Ltd.

  13. The Kubler-Ross model, physician distress, and performance reporting.

    PubMed

    Smaldone, Marc C; Uzzo, Robert G

    2013-07-01

    Physician performance reporting has been proposed as an essential component of health-care reform, with the aim of improving quality by providing transparency and accountability. Despite strong evidence demonstrating regional variation in practice patterns and lack of evidence-based care, public outcomes reporting has been met with resistance from medical professionals. Application of the Kubler-Ross 'five stages of grief' model--a conceptual framework consisting of a series of emotional stages (denial, anger, bargaining, depression, and acceptance) inspired by work with terminally ill patients--could provide some insight into why physicians are reluctant to accept emerging quality-reporting mechanisms. Physician-led quality-improvement initiatives are vital to contemporary health-care reform efforts and applications in urology, as well as other medical disciplines, are currently being explored.

  14. The PEACE project review of clinical instruments for hospice and palliative care.

    PubMed

    Hanson, Laura C; Scheunemann, Leslie P; Zimmerman, Sheryl; Rokoske, Franziska S; Schenck, Anna P

    2010-10-01

    Hospice and palliative care organizations are expanding their use of standardized instruments and other approaches to measure quality. We undertook a systematic review and evaluation of published patient-level instruments for potential application in hospice and palliative care clinical quality measurement. We searched prior reviews and computerized reference databases from 1990 through February 2007 for studies of instruments relevant to physical, psychological, social, cultural, spiritual, or ethical aspects of palliative care, or measuring prognosis, function or continuity of care. Publications were selected for full review if they provided evidence of psychometric properties or practical application of an instrument tested in or appropriate for a hospice or palliative care population. Selected instruments were evaluated and scored for scientific soundness and potential application in clinical quality measurement. The search found 1427 publications, with 229 selected for full manuscript review. Manuscripts provided information on 129 instruments which were evaluated using a structured scoring guide for psychometric properties. Thirty-nine instruments scoring near or above the 75th percentile were recommended. Most instruments covered multiple domains or focused on care for physical symptoms, psychological or social aspects of care. Few instruments were available to measure cultural aspects of care, structure and process of care, and continuity of care. Numerous patient-level instruments are available to measure physical, psychological and social aspects of palliative care with adequate evidence for scientific soundness and practical clinical use for quality improvement and research. Other aspects of palliative care may benefit from further instrument development research.

  15. Best Practices in Overset Grid Generation

    NASA Technical Reports Server (NTRS)

    Gomez, Reynaldo J., III

    2002-01-01

    Accurate geometry + high quality grids are necessary for an accurate solution. Other requirements include a) Verified/validated solver with appropriate physics b) Convergence criteria consistent with application: 1) Aerodynamics - forces and moments; 2) Heat transfer - maximum and minimum heat transfer coefficients.

  16. Bioretention for highway stormwater quality improvement in Texas : final report.

    DOT National Transportation Integrated Search

    2013-04-01

    This final report summarizes five years worth of work in evaluating the applicability and performance of : bioretention best management practices (BMPs) for highway environments in Texas. Within the five-year time frame, : the research team did a ...

  17. Building Assessment Survey and Evaluation Study: Summarized Data - Test Space Pollutant Sources

    EPA Pesticide Factsheets

    information collected regarding sources that may have potential impact on the building in terms of indoor air quality including sources such as past or current water damage, pesticide application practices, special use spaces, etc.

  18. Practical implications of pre-employment nurse assessments.

    PubMed

    Kuthy, James E; Ramon, Cheree; Gonzalez, Ronald; Biddle, Dan A

    2013-01-01

    Hiring nurses is a difficult task that can have serious repercussions for medical facilities. If nurses without proper skills are hired, patients can suffer from insufficient quality of care and potentially life-threatening conditions. Nurse applicants' technical knowledge is extremely important to avoid negative outcomes; however, there are soft skills that factor into their success, such as bedside manner, personality, communication, and decision making. In order for medical facilities to select and maintain high-performing nurse staff, hiring managers must incorporate evaluations for these types of skills in their hiring process. The current study focused on using content/criterion-related validation design to create assessments by which nurse applicants can be evaluated for both technical knowledge/skills and soft skills. The study included participation of more than 876 nursing staff members. To rank applicants on divergent skills, 3 assessment types were investigated, resulting in the creation of an assessment with 3 components. The clinical, situational, and behavioral components that were created measure applicants' job knowledge, interpersonal competency in medical facility-related situations, and aspects of personality and behavior, respectively. Results indicate that using the assessment can predict 45% of a nurse applicant's future job performance. Practical implications include hiring and maintaining a higher quality of nurses and decreased hiring costs.

  19. Poor Documentation of Inflammatory Bowel Disease Quality Measures in Academic, Community, and Private Practice.

    PubMed

    Feuerstein, Joseph D; Castillo, Natalia E; Siddique, Sana S; Lewandowski, Jeffrey J; Geissler, Kathy; Martinez-Vazquez, Manuel; Thukral, Chandrashekhar; Leffler, Daniel A; Cheifetz, Adam S

    2016-03-01

    Quality measures are used to standardize health care and monitor quality of care. In 2011, the American Gastroenterological Association established quality measures for inflammatory bowel disease (IBD), but there has been limited documentation of compliance from different practice settings. We reviewed charts from 367 consecutive patients with IBD seen at academic practices, 217 patients seen at community practices, and 199 patients seen at private practices for compliance with 8 outpatient measures. Records were assessed for IBD history, medications, comorbidities, and hospitalizations. We also determined the number of patient visits to gastroenterologists in the past year, whether patients had a primary care physician at the same institution, and whether they were seen by a specialist in IBD or in conjunction with a trainee, and reviewed physician demographics. A univariate and multivariate statistical analysis was performed to determine which factors were associated with compliance of all core measures. Screening for tobacco abuse was the most frequently assessed core measure (89.6% of patients; n = 701 of 783), followed by location of IBD (80.3%; n = 629 of 783), and assessment for corticosteroid-sparing therapy (70.8%; n = 275 of 388). The least-frequently evaluated measures were pneumococcal immunization (16.7% of patients; n = 131 of 783), bone loss (25%; n = 126 of 505), and influenza immunization (28.7%; n = 225 of 783). Only 5.8% of patients (46 of 783) had all applicable core measures documented (24 in academic practice, none in clinical practice, and 22 in private practice). In the multivariate model, year of graduation from fellowship (odds ratio [OR], 2.184; 95% confidence interval [CI], 1.522-3.134; P < .001), year of graduation from medical school (OR, 0.500; 95% CI, 0.352-0.709; P < .001), and total number of comorbidities (OR, 1.089; 95% CI, 1.016-1.168; P = .016) were associated with compliance with all core measures. We found poor documentation of IBD quality measures in academic, clinical, and private gastroenterology practices. Interventions are necessary to improve reporting of quality measures. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  20. Quality Assessment of Clinical Practice Guidelines for Respiratory Diseases in China: A Systematic Appraisal.

    PubMed

    Jiang, Mei; Liao, Li-Yue; Liu, Xiao-Qing; He, Wei-Qun; Guan, Wei-Jie; Chen, Hao; Li, Yi-Min

    2015-09-01

    There has been a significant increase in the publication of clinical practice guidelines (CPGs) for respiratory diseases in China. However, little is known about the quality and potential impacts of these CPGs. Our objective was to critically evaluate the quality of Chinese CPGs for respiratory diseases that were published in peer-reviewed medical journals. A systematic search of scientific literature published between 1979 and 2013 was undertaken to identify and select CPGs that were related to respiratory diseases. Four Chinese databases (the Chinese Biomedical Literature database [CBM], the China National Knowledge Infrastructure [CNKI], the VIP database, and the WANFANG database) were used. The quality of eligible guidelines was assessed independently by four reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. The overall agreement among reviewers was evaluated using an intraclass correlation coefficient. A total of 109 guidelines published in 27 medical journals from 1979 to 2013 were evaluated. The overall agreement among reviewers was considered good (intraclass correlation coefficient, 0.838; 95% CI, 0.812-0.862). The scores of the six AGREE domains were low: 57.3% for scope and purpose (range, 4.2%-80.5%), 23.8% for stakeholder involvement (range, 2.8%-54.2%), 7.7% for rigor of development (range, 0%-27.1%), 59.8% for clarity and presentation (range, 22.2%-80.6%), 10.9% for applicability (range, 0%-22.9%), and 0.6% for editorial independence (range, 0%-16.7%). Scores for all guidelines were below 60%, and only three guidelines (2.8%) were recommended for clinical practice with modifications. The quality of the guidelines was low, and stakeholder involvement, rigor of development, applicability, and editorial independence should be considered in the future development of CPGs for respiratory diseases in China.

  1. Why Physics in Medicine?

    PubMed

    Samei, Ehsan; Grist, Thomas M

    2018-05-18

    Despite its crucial role in the development of new medical imaging technologies, in clinical practice, physics has primarily been involved in the technical evaluation of technologies. However, this narrow role is no longer adequate. New trajectories in medicine call for a stronger role for physics in the clinic. The movement toward evidence-based, quantitative, and value-based medicine requires physicists to play a more integral role in delivering innovative precision care through the intentional clinical application of physical sciences. There are three aspects of this clinical role: technology assessment based on metrics as they relate to expected clinical performance, optimized use of technologies for patient-centered clinical outcomes, and retrospective analysis of imaging operations to ensure attainment of expectations in terms of quality and variability. These tasks fuel the drive toward high-quality, consistent practice of medical imaging that is patient centered, evidence based, and safe. While this particular article focuses on imaging, this trajectory and paradigm is equally applicable to the multitudes of the applications of physics in medicine. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  2. Organization, management, implementation and value of ehr implementation in a solo pediatric practice.

    PubMed

    Cooper, Jeffrey D

    2004-01-01

    This case study-based on this practice's application for the 2003 HIMSS Davies Award for Primary Care-describes the processes, costs and benefits of the implementation of an EHR in a solo practice. The organization, management and value of an EHR implementation is described, as well as a description of the physician's 15 business objectives, which shows how each objective was met and to what degree and gives specific financial data. An EHR that is implemented in a small practice improves quality of patient care, office efficiency and patient safety. A small practice can realize significant ROI from an EHR.

  3. Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Diabetes Care.

    PubMed

    Davidson, Patricia; Ross, Tamara; Castor, Chimene

    2018-05-01

    There are 30.3 million people with diabetes and 86 million with prediabetes in the United States, underscoring the growing need for comprehensive diabetes care and nutrition for the management of diabetes and diabetes-related conditions. Management of diabetes is also critical for the prevention of diabetes-related complications such as cardiovascular and renal disease. The Diabetes Care and Education Dietetic Practice Group along with the Academy of Nutrition and Dietetics Quality Management Committee have updated the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitian Nutritionists (RDNs) in Diabetes Care. The SOP and SOPP for RDNs in Diabetes Care provide indicators that describe three levels of practice: competent, proficient, and expert. The SOP utilizes the Nutrition Care Process and clinical workflow elements for care and management of those with diabetes and prediabetes. The SOPP describes six domains that focus on professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Specific indicators outlined in the SOP and SOPP depict how these standards apply to practice. The SOP and SOPP are complementary resources for RDNs caring for individuals with diabetes or specializing in diabetes care or practicing in other diabetes-related areas, including research. The SOP and SOPP are intended to be used for RDN self-evaluation for ensuring competent practice and for determining potential education and training needs for advancement to a higher practice level in a variety of settings. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  4. Assessment of man's thermal comfort in practice

    PubMed Central

    Fanger, P. O.

    1973-01-01

    Fanger, P. O. (1973).British Journal of Industrial Medicine,30, 313-324. Assessment of man's thermal comfort in practice. A review is given of existing knowledge regarding the conditions for thermal comfort. Both physiological and environmental comfort conditions are discussed. Comfort criteria are shown diagrammatically, and their application is illustrated by numerous practical examples. Furthermore, the effect on the comfort conditions of age, adaptation, sex, seasonal and circadian rhythm, and unilateral heating or cooling of the body is discussed. The term `climate monotony' is considered. A method is recommended for the evaluation of the quality of thermal environments in practice. Images PMID:4584998

  5. Implementing high-performance work practices in healthcare organizations: qualitative and conceptual evidence.

    PubMed

    McAlearney, Ann Scheck; Robbins, Julie; Garman, Andrew N; Song, Paula H

    2013-01-01

    Studies across industries suggest that the systematic use of high-performance work practices (HPWPs) may be an effective but underused strategy to improve quality of care in healthcare organizations. Optimal use of HPWPs depends on how they are implemented, yet we know little about their implementation in healthcare. We conducted 67 key informant interviews in five healthcare organizations, each considered to have exemplary work practices in place and to deliver high-quality care, as part of an extensive study of HPWP use in healthcare. We analyzed interview transcripts inductively and deductively to examine why and how organizations implement HPWPs. We used an evidence-based model of complex innovation adoption to guide our exploration of factors that facilitate HPWP implementation. We found considerable variability in interviewees' reasons for implementing HPWPs, including macro-organizational (strategic level) and micro-organizational (individual level) reasons. This variability highlighted the complex context for HPWP implementation in many organizations. We also found that our application of an innovation implementation model helped clarify and categorize facilitators of HPWP implementation, thus providing insight on how these factors can contribute to implementation effectiveness. Focusing efforts on clarifying definitions, building commitment, and ensuring consistency in the application of work practices may be particularly important elements of successful implementation.

  6. How to adapt existing evidence-based clinical practice guidelines: a case example with smoking cessation guidelines in Canada

    PubMed Central

    Selby, Peter; Hunter, Katie; Rogers, Jess; Lang-Robertson, Kelly; Soklaridis, Sophie; Chow, Virginia; Tremblay, Michèle; Koubanioudakis, Denise; Dragonetti, Rosa; Hussain, Sarwar; Zawertailo, Laurie

    2017-01-01

    Objective To develop and encourage the adoption of clinical practice guidelines (CPGs) for smoking cessation in Canada by engaging stakeholders in the adaptation of existing high-quality CPGs using principles of the ADAPTE framework. Methods An independent expert body in guideline review conducted a review and identified six existing CPGs, which met a priori criteria for quality and potential applicability to the local context. Summary statements were extracted and assigned a grade of recommendation and level of evidence by a second expert panel. Regional knowledge exchange brokers recruited additional stakeholders to build a multidisciplinary network of over 800 clinicians, researchers and decision-makers from across Canada. This interprofessional network and other stakeholders were offered various opportunities to provide input on the guideline both online and in person. We actively encouraged end-user input into the development and adaptation of the guidelines to ensure applicability to various practice settings and to promote adoption. Results The final guideline contained 24 summary statements along with supporting clinical considerations, across six topic area sections. The guideline was adopted by various provincial/territorial and national government and non-governmental organisations. Conclusions This method can be applied in other jurisdictions to adapt existing high-quality smoking cessation CPGs to the local context and to facilitate subsequent adoption by various stakeholders. PMID:29102984

  7. Strategies for Hard Times in Higher Education.

    ERIC Educational Resources Information Center

    Desfosses, Louis R.

    1996-01-01

    Planning and management strategies used in the private sector have practical applications for higher education in a period of systemic and organizational stress. Promising strategies include organizational delayering; employee empowerment; boundless thinking, problem-solving teams; accelerated processes; quality management and improvement; and…

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

    Osmanlioglu, Ahmet Erdal

    Pre-treatment of radioactive waste is the first step in waste management program that occurs after waste generation from various applications in Turkey. Pre-treatment and characterization practices are carried out in Radioactive Waste Management Unit (RWMU) at Cekmece Nuclear Research and Training Center (CNRTC) in Istanbul. This facility has been assigned to take all low-level radioactive wastes generated by nuclear applications in Turkey. The wastes are generated from research and nuclear applications mainly in medicine, biology, agriculture, quality control in metal processing and construction industries. These wastes are classified as low- level radioactive wastes. Pre-treatment practices cover several steps. In thismore » paper, main steps of pre-treatment and characterization are presented. Basically these are; collection, segregation, chemical adjustment, size reduction and decontamination operations. (author)« less

  9. International Conference on Harmonisation; guidance on Q10 Pharmaceutical Quality System; availability. Notice.

    PubMed

    2009-04-08

    The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "Q10 Pharmaceutical Quality System." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance describes a model for an effective quality management system for the pharmaceutical industry, referred to as the Pharmaceutical Quality System. The guidance is intended to provide a comprehensive approach to an effective pharmaceutical quality system that is based on International Organization for Standardization (ISO) concepts, includes applicable good manufacturing practice (GMP) regulations and complements ICH guidances on "Q8 Pharmaceutical Development" and "Q9 Quality Risk Management."

  10. Medicinal herbs and phytochitodeztherapy in oncology.

    PubMed

    Treskunov, Karp; Treskunova, Olga; Komarov, Boris; Goroshetchenko, Alex; Glebov, Vlad

    2003-01-01

    Application of clinical phytology in treatment of oncology diseases was limited by intensive development of chemical pharmaceuticals and surgery. The authors had set the task to develop the computer database for phytotherapy application. The database included full information on patient's clinical status (identified diseases, symptoms, syndromes) and applied phytotherapy treatment. Special attention was paid to the application of phyto preparations containing chitosan. The computer database contains information on 2335 patients. It supports reliable data on efficiency of phytotherapy in general and allows to evaluate the efficiency of some particular medicinal herbs and to develop efficient complex phyto preparations for treatment of specific diseases. The application of phytotherapy in treatment of oncology patients confirmed the positive effect on patient's quality of life. In conclusion it should be emphasized that the present situation of practical application of phytotherapy could be considered as unacceptable because of absence of necessary knowledge and practical experience in using phytotherapy in outpatient clinics, hospitals and medicinal centers.

  11. Quality management in European screening laboratories in blood establishments: A view of current approaches and trends.

    PubMed

    Pereira, Paulo; Westgard, James O; Encarnação, Pedro; Seghatchian, Jerard; de Sousa, Gracinda

    2015-04-01

    The screening laboratory has a critical role in the post-transfusion safety. The success of its targets and efficiency depends on the management system used. Even though the European Union directive 2002/98/EC requires a quality management system in blood establishments, its requirements for screening laboratories are generic. Complementary approaches are needed to implement a quality management system focused on screening laboratories. This article briefly discusses the current good manufacturing practices and good laboratory practices, as well as the trends in quality management system standards. ISO 9001 is widely accepted in some European Union blood establishments as the quality management standard, however this is not synonymous of its successful application. The ISO "risk-based thinking" is interrelated with the quality risk-management process of the EuBIS "Standards and criteria for the inspection of blood establishments". ISO 15189 should be the next step on the quality assurance of a screening laboratory, since it is focused on medical laboratory. To standardize the quality management systems in blood establishments' screening laboratories, new national and European claims focused on technical requirements following ISO 15189 is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Clinical practice guidelines in breast cancer

    PubMed Central

    Tyagi, N. Kumar; Dhesy-Thind, S.

    2018-01-01

    Background A number of clinical practice guidelines (cpgs) concerning breast cancer (bca) screening and management are available. Here, we review the strengths and weaknesses of cpgs from various professional organizations and consensus groups with respect to their methodologic quality, recommendations, and implementability. Methods Guidelines from four groups were reviewed with respect to two clinical scenarios: adjuvant ovarian function suppression (ofs) in premenopausal women with early-stage estrogen receptor–positive bca, and use of sentinel lymph node biopsy (slnb) after neoadjuvant chemotherapy (nac) for locally advanced bca. Guidelines from the American Society of Clinical Oncology (asco); Cancer Care Ontario’s Program in Evidence Based Care (cco’s pebc); the U.S. National Comprehensive Cancer Network (nccn); and the St. Gallen International Breast Cancer Consensus Conference were reviewed by two independent assessors. Guideline methodology and applicability were evaluated using the agree ii tool. Results The quality of the cpgs was greatest for the guidelines developed by asco and cco’s pebc. The nccn and St. Gallen guidelines were found to have lower scores for methodologic rigour. All guidelines scored poorly for applicability. The recommendations for ofs were similar in three guidelines. Recommendations by the various organizations for the use of slnb after nac were contradictory. Conclusions Our review demonstrated that cpgs can be heterogeneous in methodologic quality. Low-quality cpg implementation strategies contribute to low uptake of, and adherence to, bca cpgs. Further research examining the barriers to recommendations—such as intrinsic guideline characteristics and the needs of end users—is required. The use of bca cpgs can improve the knowledge-to-practice gap and patient outcomes.

  13. Status and future of disease protection and grape berry quality alteration by micro-organisms in viticulture.

    PubMed

    Otoguro, M; Suzuki, S

    2018-06-16

    Grapevine is one of the most widely grown fruit crops in the world. At present, however, there is much concern regarding chemical pollution in viticulture due to the application of chemical fungicides and fertilizers. One viticultural practice to resolve this issue is the application of micro-organisms to grapevine as a substitute for chemicals. Some micro-organisms act as an enhancer of grape berry quality as well as a suppresser of disease in grapevine through their antagonistic ability and/or systemic resistance inducing ability. Herein, we review current and prospective applications of micro-organisms in viticulture. In this review, we evaluate the applicability of micro-organisms in viticulture. Micro-organisms can improve grape berry quality through grapevine disease protection and grape berry quality alteration. Because the use of micro-organisms to protect grapevine from plant diseases is safer than the use of chemical fungicides, the use of biofungicides in viticulture is expected to be enhanced by the increasing consumer concern towards chemical fungicides. Micro-organisms also modify plant secondary metabolites for use as flavours, pharmaceuticals and food additives. Studies of micro-organisms that promote polyphenol, anthocyanin and aroma compound biosynthesis are in progress with an eye to improving grape berry quality. © 2018 The Society for Applied Microbiology.

  14. Underground Test Area Quality Assurance Project Plan Nevada National Security Site, Nevada, Revision 0

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

    Irene Farnham

    This Quality Assurance Project Plan (QAPP) provides the overall quality assurance (QA) program requirements and general quality practices to be applied to the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Underground Test Area (UGTA) Sub-Project (hereafter the Sub-Project) activities. The requirements in this QAPP are consistent with DOE Order 414.1C, Quality Assurance (DOE, 2005); U.S. Environmental Protection Agency (EPA) Guidance for Quality Assurance Project Plans for Modeling (EPA, 2002); and EPA Guidance on the Development, Evaluation, and Application of Environmental Models (EPA, 2009). The QAPP Revision 0 supersedes DOE--341, Underground Test Area Quality Assurancemore » Project Plan, Nevada Test Site, Nevada, Revision 4.« less

  15. The development and validation of a meta-tool for quality appraisal of public health evidence: Meta Quality Appraisal Tool (MetaQAT).

    PubMed

    Rosella, L; Bowman, C; Pach, B; Morgan, S; Fitzpatrick, T; Goel, V

    2016-07-01

    Most quality appraisal tools were developed for clinical medicine and tend to be study-specific with a strong emphasis on risk of bias. In order to be more relevant to public health, an appropriate quality appraisal tool needs to be less reliant on the evidence hierarchy and consider practice applicability. Given the broad range of study designs used in public health, the objective of this study was to develop and validate a meta-tool that combines public health-focused principles of appraisal coupled with a set of design-specific companion tools. Several design methods were used to develop and validate the tool including literature review, synthesis, and validation with a reference standard. A search of critical appraisal tools relevant to public health was conducted; core concepts were collated. The resulting framework was piloted during three feedback sessions with public health practitioners. Following subsequent revisions, the final meta-tool, the Meta Quality Appraisal Tool (MetaQAT), was then validated through a content analysis of appraisals conducted by two groups of experienced public health researchers (MetaQAT vs generic appraisal form). The MetaQAT framework consists of four domains: relevancy, reliability, validity, and applicability. In addition, a companion tool was assembled from existing critical appraisal tools to provide study design-specific guidance on validity appraisal. Content analysis showed similar methodological and generalizability concerns were raised by both groups; however, the MetaQAT appraisers commented more extensively on applicability to public health practice. Critical appraisal tools designed for clinical medicine have limitations for use in the context of public health. The meta-tool structure of the MetaQAT allows for rigorous appraisal, while allowing users to simultaneously appraise the multitude of study designs relevant to public health research and assess non-standard domains, such as applicability. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Using evidence-based practice to create a venous access team: the Venous Access Task Force of the Children's Hospital of Denver.

    PubMed

    MacPhee, Maura

    2002-12-01

    The following article is an example of evidence-based practice applied to an institutional Quality Improvement (QI) project. QI originated in the 1980s and is best associated with the work of W. Deming (1986). It is also known as Continuous Quality Improvement, because a major principle of this approach is constant improvement of services or products. This improvement process contains other critical components: scientific method, employee participation and teamwork, accountable leadership, appropriate training and ongoing education, and client focus (Demming, 1986). QI has been globally successful and has helped transform American industry, including health care services. The following clinically based project illustrates the application of QI concepts and evidence-based practice to enhance outcomes. Copyright 2002, Elsevier Science (USA). All rights reserved.

  17. Informatics application provides instant research to practice benefits.

    PubMed Central

    Bowles, K. H.; Peng, T.; Qian, R.; Naylor, M. D.

    2001-01-01

    A web-based research information system was designed to enable our research team to efficiently measure health related quality of life among frail older adults in a variety of health care settings (home care, nursing homes, assisted living, PACE). The structure, process, and outcome data is collected using laptop computers and downloaded to a SQL database. Unique features of this project are the ability to transfer research to practice by instantly sharing individual and aggregate results with the clinicians caring for these elders and directly impacting the quality of their care. Clinicians can also dial in to the database to access standard queries or receive customized reports about the patients in their facilities. This paper will describe the development and implementation of the information system. The conference presentation will include a demonstration and examples of research to practice benefits. PMID:11825156

  18. Experimenting Design and Implementation of an Educational Services Management System Based on ISO/IEC 20000 Standard

    NASA Astrophysics Data System (ADS)

    Lezcano, Jean-Marc; Adachihara, Hatsuo; Prunier, Marc

    European higher education organizations are encouraged to implement quality management practices. Existing quality standards and frameworks do not capitalize an important set of best practices addressing educational services delivery. The ISO/IEC 20000 standard, elaborated from IT service management issues, is widening its field of application and may represent an interesting alternative. A specific approach is needed to apprehend the particular nature of educational services, consider the systemic cooperating roles of educational system and learning system, and define ISO/IEC 20000 vocabulary and concepts adapted to the domain. ISO/IEC 20000 may provide an answer to European Standard Guideline compliance and improve educational services management. The current experimentation is expected to cast light on the complexity, practicality and effectiveness of the use of ISO/IEC 20000 in a first field of "non IT" services.

  19. Polymerase Chain Reaction/Rapid Methods Are Gaining a Foothold in Developing Countries.

    PubMed

    Ragheb, Suzan Mohammed; Jimenez, Luis

    Detection of microbial contamination in pharmaceutical raw materials and finished products is a critical factor to guarantee their safety, stability, and potency. Rapid microbiological methods-such as polymerase chain reaction-have been widely applied to clinical and food quality control analysis. However, polymerase chain reaction applications to pharmaceutical quality control have been rather slow and sporadic. Successful implementation of these methods in pharmaceutical companies in developing countries requires important considerations to provide sensitive and robust assays that will comply with good manufacturing practices. In recent years several publications have encouraged the application of molecular techniques in the microbiological assessment of pharmaceuticals. One of these techniques is polymerase chain reaction (PCR). The successful application of PCR in the pharmaceutical industry in developing countries is governed by considerable factors and requirements. These factors include the setting up of a PCR laboratory and the choice of appropriate equipment and reagents. In addition, the presence of well-trained analysts and establishment of quality control and quality assurance programs are important requirements. The pharmaceutical firms should take into account these factors to allow better chances for regulatory acceptance and wide application of this technique. © PDA, Inc. 2014.

  20. Big data analytics to improve cardiovascular care: promise and challenges.

    PubMed

    Rumsfeld, John S; Joynt, Karen E; Maddox, Thomas M

    2016-06-01

    The potential for big data analytics to improve cardiovascular quality of care and patient outcomes is tremendous. However, the application of big data in health care is at a nascent stage, and the evidence to date demonstrating that big data analytics will improve care and outcomes is scant. This Review provides an overview of the data sources and methods that comprise big data analytics, and describes eight areas of application of big data analytics to improve cardiovascular care, including predictive modelling for risk and resource use, population management, drug and medical device safety surveillance, disease and treatment heterogeneity, precision medicine and clinical decision support, quality of care and performance measurement, and public health and research applications. We also delineate the important challenges for big data applications in cardiovascular care, including the need for evidence of effectiveness and safety, the methodological issues such as data quality and validation, and the critical importance of clinical integration and proof of clinical utility. If big data analytics are shown to improve quality of care and patient outcomes, and can be successfully implemented in cardiovascular practice, big data will fulfil its potential as an important component of a learning health-care system.

  1. Quality Control of the Print with the Application of Statistical Methods

    NASA Astrophysics Data System (ADS)

    Simonenko, K. V.; Bulatova, G. S.; Antropova, L. B.; Varepo, L. G.

    2018-04-01

    The basis for standardizing the process of offset printing is the control of print quality indicators. The solution of this problem has various approaches, among which the most important are statistical methods. Practical implementation of them for managing the quality of the printing process is very relevant and is reflected in this paper. The possibility of using the method of constructing a Control Card to identify the reasons for the deviation of the optical density for a triad of inks in offset printing is shown.

  2. [The comprehensive approach to ensure the quality of forensic medical examination of a cadaver].

    PubMed

    Mel'nikov, O V; Mal'tsev, A E; Petrov, S B; Petrov, B A

    2015-01-01

    The objective of the present work was to estimate the effectiveness of the comprehensive monitoring system designed to enhance the quality of forensic medical expertise for determining the cause of death in the hanging cases. It was shown that the practical application of the algorithmization and automated quality control system improves the effectiveness of forensic medical examination of the cadavers in the hanging cases. The system performs the control, directing, and teaching functions. Moreover, it allows to estimate the completeness of the examination of the cadaver.

  3. Academy of Nutrition and Dietetics: Standards of professional performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Sustainable, Resilient, and Healthy Food and Water Systems.

    PubMed

    Tagtow, Angie; Robien, Kim; Bergquist, Erin; Bruening, Meg; Dierks, Lisa; Hartman, Barbara E; Robinson-O'Brien, Ramona; Steinitz, Tamara; Tahsin, Bettina; Underwood, Teri; Wilkins, Jennifer

    2014-03-01

    Sustainability is the ability of a system to be maintained over the long term. Resilience is the ability of a system to withstand disturbances and continue to function in a sustainable manner. Issues of sustainability and resilience apply to all aspects of nutrition and dietetics practice, can be practiced at both the program and systems level, and are broader than any one specific practice setting or individual intervention. Given an increasing need to apply principles of sustainability and resilience to nutrition and dietetics practice, as well as growing interest among the public and by Registered Dietitian Nutritionists of health issues related to food and water systems, the Hunger and Environmental Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed the Standards of Professional Performance as a tool for Registered Dietitian Nutritionists working in sustainable, resilient, and healthy food and water systems to assess their current skill levels and to identify areas for further professional development in this emerging practice area. This Standards of Professional Performance document covers six standards of professional performance: quality in practice, competence and accountability, provision of services, application of research, communication and application of knowledge, and utilization and management of resources. Within each standard, specific indicators provide measurable action statements that illustrate how sustainable, resilient, and healthy food and water systems principles can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for Registered Dietitian Nutritionists working in sustainable, resilient, and healthy food and water systems. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  4. Topical Reports: Sustainable Design for Schools.

    ERIC Educational Resources Information Center

    Fox, Anne W.

    This document presents several reports on the practical applications of sustainable design and schools; it includes information about student performance and sustainable design features involving lighting, acoustics, air quality, and student well-being. Three case studies (Washington's Bainbridge Island School District, Texas' Roy Lee Walker…

  5. Hydro-physical Characteristics of Selected Media Used for Containerized Agriculture Systems

    USDA-ARS?s Scientific Manuscript database

    Containerized plant production represents an extremely intensive agricultural practice with large amounts of water and fertilizer application. Hydro-physical characteristics such as water infiltration, texture and structure, particle size distribution affect the quality of the media used in containe...

  6. Evaluating Green/Gray Infrastructure for CSO/Stormwater Control

    EPA Science Inventory

    The NRMRL is conducting this project to evaluate the water quality and quantity benefits of a large-scale application of green infrastructure (low-impact development/best management practices) retrofits in an entire subcatchment. It will document ORD's effort to demonstrate the e...

  7. Quality assessment of clinical practice guidelines for eosinophilic esophagitis using the AGREE II instrument.

    PubMed

    Lucendo, Alfredo J; Arias, Ángel; Redondo-González, Olga; Molina-Infante, Javier

    2017-04-01

    High-quality evidence-based clinical practice guidelines can guide diagnosis and treatment to optimize outcomes. We aimed to systematically review the quality of international guidelines on eosinophilic esophagitis (EoE). MEDLINE and Scopus databases were searched for appropriate guidelines up to 2016. Two gastroenterologists and two methodologists independently evaluated the documents using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Amongst the 25 records initially retrieved, four guidelines developed by recognized scientific organizations met inclusion criteria. AGREE II results varied widely across domains, but none achieved an overall assessment score of over 60%. Scope and purpose (61.82 ± 19.24%), clarity of presentation (57.13 ± 40.56%) and editorial independence (93.75 ± 1.69%) showed the highest mean rating, whereas stakeholder involvement (28.82 ± 11.19%), rigor of development (32.29 ± 12.02%) and applicability (21.62 ± 7.14%) did not reach quality thresholds. Intraclass correlation coefficients for agreement was excellent among appraisers (0.903), between gastroenterologists and methodologists (0.878) and for each individual guideline (0.838 to 0.955). Clinical practice guidelines for EoE vary significantly in quality, are invariably limited and currently, none can be 'strongly recommended'.

  8. Evidence-Based Advances in Reptile Medicine.

    PubMed

    Mitchell, Mark A; Perry, Sean M

    2017-09-01

    Evidence-based medicine allows veterinarians to practice high-quality medicine, because the basis for all decision making is quantitative, objective, and reproducible. Case reports and case series are limited in their scope and application. Cross-sectional studies, likewise, cannot provide answers to specific variable testing with a temporal application. It is essential for the reptile specialty to expand into case-control studies, cohort studies, and experimental/intervention studies. Unfortunately, much of the reptile literature remains limited to descriptive studies. This article reviews current evidence-based topics in reptile medicine and shares how everyone practicing in the field can contribute to improving this specialty. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Implementation of BMP Strategies for Adaptation to Climate Change and Land Use Change in a Pasture-Dominated Watershed

    PubMed Central

    Chiang, Li-Chi; Chaubey, Indrajeet; Hong, Nien-Ming; Lin, Yu-Pin; Huang, Tao

    2012-01-01

    Implementing a suite of best management practices (BMPs) can reduce non-point source (NPS) pollutants from various land use activities. Watershed models are generally used to evaluate the effectiveness of BMP performance in improving water quality as the basis for watershed management recommendations. This study evaluates 171 management practice combinations that incorporate nutrient management, vegetated filter strips (VFS) and grazing management for their performances in improving water quality in a pasture-dominated watershed with dynamic land use changes during 1992–2007 by using the Soil and Water Assessment Tool (SWAT). These selected BMPs were further examined with future climate conditions (2010–2069) downscaled from three general circulation models (GCMs) for understanding how climate change may impact BMP performance. Simulation results indicate that total nitrogen (TN) and total phosphorus (TP) losses increase with increasing litter application rates. Alum-treated litter applications resulted in greater TN losses, and fewer TP losses than the losses from untreated poultry litter applications. For the same litter application rates, sediment and TP losses are greater for summer applications than fall and spring applications, while TN losses are greater for fall applications. Overgrazing management resulted in the greatest sediment and phosphorus losses, and VFS is the most influential management practice in reducing pollutant losses. Simulations also indicate that climate change impacts TSS losses the most, resulting in a larger magnitude of TSS losses. However, the performance of selected BMPs in reducing TN and TP losses was more stable in future climate change conditions than in the BMP performance in the historical climate condition. We recommend that selection of BMPs to reduce TSS losses should be a priority concern when multiple uses of BMPs that benefit nutrient reductions are considered in a watershed. Therefore, the BMP combination of spring litter application, optimum grazing management and filter strip with a VFS ratio of 42 could be a promising alternative for use in mitigating future climate change. PMID:23202767

  10. Implementing resilience engineering for healthcare quality improvement using the CARE model: a feasibility study protocol.

    PubMed

    Anderson, J E; Ross, A J; Back, J; Duncan, M; Snell, P; Walsh, K; Jaye, P

    2016-01-01

    Resilience engineering (RE) is an emerging perspective on safety in complex adaptive systems that emphasises how outcomes emerge from the complexity of the clinical environment. Complexity creates the need for flexible adaptation to achieve outcomes. RE focuses on understanding the nature of adaptations, learning from success and increasing adaptive capacity. Although the philosophy is clear, progress in applying the ideas to quality improvement has been slow. The aim of this study is to test the feasibility of translating RE concepts into practical methods to improve quality by designing, implementing and evaluating interventions based on RE theory. The CARE model operationalises the key concepts and their relationships to guide the empirical investigation. The settings are the Emergency Department and the Older Person's Unit in a large London teaching hospital. Phases 1 and 2 of our work, leading to the development of interventions to improve the quality of care, are described in this paper. Ethical approval has been granted for these phases. Phase 1 will use ethnographic methods, including observation of work practices and interviews with staff, to understand adaptations and outcomes. The findings will be used to collaboratively design, with clinical staff in interactive design workshops, interventions to improve the quality of care. The evaluation phase will be designed and submitted for ethical approval when the outcomes of phases 1 and 2 are known. Study outcomes will be knowledge about the feasibility of applying RE to improve quality, the development of RE theory and a validated model of resilience in clinical work which can be used to guide other applications. Tools, methods and practical guidance for practitioners will also be produced, as well as specific knowledge of the potential effectiveness of the implemented interventions in emergency and older people's care. Further studies to test the application of RE at a larger scale will be required, including studies of other healthcare settings, organisational contexts and different interventions.

  11. Practical application of a patient satisfaction survey.

    PubMed

    Margo, K L; Margo, G M

    1990-01-01

    Patient satisfaction surveys are a practical method for studying one aspect of quality of care in an HMO. This report details the use of a patient satisfaction survey for this purpose. The focus is on the instrument chosen and the type of analyses carried out. Despite the interest and potential usefulness of the data obtained, the organizational response to the study can be the rate-limiting factor for using the findings. In general, the method can be used for periodic monitoring and as a valid method for detecting or confirming suspected trouble spots in the system. To be successful, the data must be interpreted in the spirit of a shared commitment to quality care.

  12. Application of target costing in machining

    NASA Astrophysics Data System (ADS)

    Gopalakrishnan, Bhaskaran; Kokatnur, Ameet; Gupta, Deepak P.

    2004-11-01

    In today's intensely competitive and highly volatile business environment, consistent development of low cost and high quality products meeting the functionality requirements is a key to a company's survival. Companies continuously strive to reduce the costs while still producing quality products to stay ahead in the competition. Many companies have turned to target costing to achieve this objective. Target costing is a structured approach to determine the cost at which a proposed product, meeting the quality and functionality requirements, must be produced in order to generate the desired profits. It subtracts the desired profit margin from the company's selling price to establish the manufacturing cost of the product. Extensive literature review revealed that companies in automotive, electronic and process industries have reaped the benefits of target costing. However target costing approach has not been applied in the machining industry, but other techniques based on Geometric Programming, Goal Programming, and Lagrange Multiplier have been proposed for application in this industry. These models follow a forward approach, by first selecting a set of machining parameters, and then determining the machining cost. Hence in this study we have developed an algorithm to apply the concepts of target costing, which is a backward approach that selects the machining parameters based on the required machining costs, and is therefore more suitable for practical applications in process improvement and cost reduction. A target costing model was developed for turning operation and was successfully validated using practical data.

  13. The role of organizational research in implementing evidence-based practice: QUERI Series

    PubMed Central

    Yano, Elizabeth M

    2008-01-01

    Background Health care organizations exert significant influence on the manner in which clinicians practice and the processes and outcomes of care that patients experience. A greater understanding of the organizational milieu into which innovations will be introduced, as well as the organizational factors that are likely to foster or hinder the adoption and use of new technologies, care arrangements and quality improvement (QI) strategies are central to the effective implementation of research into practice. Unfortunately, much implementation research seems to not recognize or adequately address the influence and importance of organizations. Using examples from the U.S. Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI), we describe the role of organizational research in advancing the implementation of evidence-based practice into routine care settings. Methods Using the six-step QUERI process as a foundation, we present an organizational research framework designed to improve and accelerate the implementation of evidence-based practice into routine care. Specific QUERI-related organizational research applications are reviewed, with discussion of the measures and methods used to apply them. We describe these applications in the context of a continuum of organizational research activities to be conducted before, during and after implementation. Results Since QUERI's inception, various approaches to organizational research have been employed to foster progress through QUERI's six-step process. We report on how explicit integration of the evaluation of organizational factors into QUERI planning has informed the design of more effective care delivery system interventions and enabled their improved "fit" to individual VA facilities or practices. We examine the value and challenges in conducting organizational research, and briefly describe the contributions of organizational theory and environmental context to the research framework. Conclusion Understanding the organizational context of delivering evidence-based practice is a critical adjunct to efforts to systematically improve quality. Given the size and diversity of VA practices, coupled with unique organizational data sources, QUERI is well-positioned to make valuable contributions to the field of implementation science. More explicit accommodation of organizational inquiry into implementation research agendas has helped QUERI researchers to better frame and extend their work as they move toward regional and national spread activities. PMID:18510749

  14. A Critical Review of the Quality of Cough Clinical Practice Guidelines.

    PubMed

    Jiang, Mei; Guan, Wei-Jie; Fang, Zhang-Fu; Xie, Yan-Qing; Xie, Jia-Xing; Chen, Hao; Wei, Dang; Lai, Ke-Fang; Zhong, Nan-Shan

    2016-10-01

    Clinical practice guidelines (CPGs) have been developed to provide health-care practitioners with the best possible evidence, but the quality of these CPGs varies greatly. The goal of this study was to systematically evaluate the quality of cough CPGs and identify gaps limiting evidence-based practice. Systematic searches were conducted to identify cough CPGs in guideline databases, developers' Websites, and Medline. Four reviewers independently evaluated eligible guidelines by using the Appraisal of Guidelines for Research and Evaluation II assessment tool. Agreement among reviewers was measured by using the intraclass correlation coefficient. The number of recommendations, strength of recommendation, and levels of evidence were determined. Fifteen cough CPGs were identified. An overall high degree of agreement among reviewers was observed (intraclass correlation coefficient, 0.82 [95% CI, 0.79-0.85]). The quality ranged from good to acceptable in the scope and purpose (mean, 72%; range, 54%-93%) and clarity and presentation (mean, 68%; range, 50%-90%) domains but not in stakeholder involvement (mean, 36%; range, 18%-90%), rigor of development (mean, 36%; range, 9%-93%), applicability (mean, 23%; range, 9%-83%), and editorial independence domains (mean, 24%; range, 0-96%). Seven guidelines (46.7%) were considered "strongly recommended" or "recommended with modifications" for clinical practice. More than 70% of recommendations were based on nonrandomized studies (Level C, 30.4%) and expert opinion (Level D, 41.3%). The quality of cough CPGs is variable, and recommendations are largely based on low-quality evidence. There is significant room for improvement to develop high-quality guidelines, which urgently warrants first-class research to minimize the vital gaps in the evidence for formulation of cough CPGs. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  15. A comparative analysis of the dissemination of best practice measures for key populations.

    PubMed

    Lundy, Jennifer; Santangelo, Jennifer; Rogers, Patrick; Kuehn, Lynn; Christensen, Sharon; Bournique, Judy; Mekhjian, Hagop; Kamal, Jyoti

    2008-11-06

    In collaboration with the department of Quality and Operations Improvement, Clinical Applications and the Information Warehouse, we have leveraged available Information Warehouse data to build a Best Practice Compliance Measurement Dashboard. This tool combines information from our operating room charting system, our order entry system and coding information from the patient billing and management system to provide 'previous day', data on a patients current course of treatment.

  16. High Reliability Organization and Applicability to the Battlefield to Reduce Errors Associated with Combat Casualty Care

    DTIC Science & Technology

    2016-06-10

    I placed on the search engine: “English language,” “5 years.” Journal categories included core clinical journals , dental journals , MEDLINE, and...Army) AE Adverse event AHRQ Agency for Healthcare Research and Quality AHS Army Health System AMEDD Army Medical Department CPQ Clinical Practice...harm to a patient (Joint Commission 2015). Clinical Quality Management: A systematic, organized , multidisciplinary approach to the ongoing

  17. An Ounce of Application Is Worth a Ton of Abstraction. A Practical Guide to Implementing Total Quality Management.

    ERIC Educational Resources Information Center

    Crouch, J. Michael

    This book explains how to implement a Total Quality Management (TQM) program within an organization focusing in particular on ways to sustain the effort. Part 1 of five offers an overview of the TQM approach and the rationale for adopting it. Topics of discussion include signs of the need for change, what TQM is and what it is not, the basics of…

  18. [The Role of Nursing Education in the Advancement of the Nursing Profession].

    PubMed

    Chang Yeh, Mei

    2017-02-01

    The present article discusses the role of nursing education in the advancement of the nursing profession in the context of the three facets of knowledge: generation, dissemination, and application. Nursing is an applied science and the application of knowledge in practice is the ultimate goal of the nursing profession. The reform of the healthcare delivery model requires that nurses acquire and utilize evidence-based clinical knowledge, critical thinking, effective communication, and team collaboration skills in order to ensure the quality of patient care and safety. Therefore, baccalaureate education has become the minimal requirement for pre-licensure nursing education. Schools of nursing are responsible to cultivate competent nurses to respond to the demands on the nursing workforce from the healthcare system. Attaining a master's education in nursing helps cultivate Advanced Practice Registered Nurses (APRNs) to further expand the roles and functions of the nursing profession in order to promote the quality of care in clinical practice. Nursing faculty and scholars of higher education institutions generate nursing knowledge and develop professional scholarship through research. Attaining a doctoral education in nursing cultivates faculties and scholars who will continually generate and disseminate nursing knowledge into the future.

  19. [ISO 9001certification of a quality management system in a clinical investigation center].

    PubMed

    Chesnais, Jimmy; Fougerou-Leurent, Claire; Laforest, Claire; Renault, Alain; Bellissant, Eric; Laviolle, Bruno

    2018-05-03

    Beyond the application of legal requirements, clinical trials must have a permanent approach of quality control. The clinical investigation centers (CICs) are academic structures of clinical research certified by the French National institute of health and medical research (Inserm) and whose functioning relies on recommendations of good practice. It is important to accompany this standardization of practices by the implementation of a quality management system. This article presents the process that enabled the CIC of Rennes to become certified ISO 9001 by French standards association (Afnor) certification in May, 2016. The application of the fundamental principles of the standard ISO 9001 in the domain of clinical research is approached. The problem of the perimeter for the certification and the related process mapping are exposed. The activities of methodology, management and analysis of clinical studies were chosen for the initial certification of the CIC of Rennes. The perspectives for the extension of the perimeter of certification are also approached at the end of article. Copyright © 2018 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  20. Developing a quality assurance program for online services.

    PubMed Central

    Humphries, A W; Naisawald, G V

    1991-01-01

    A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas. PMID:1909197

  1. Developing a quality assurance program for online services.

    PubMed

    Humphries, A W; Naisawald, G V

    1991-07-01

    A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas.

  2. Irrigated mountain meadow fertilizer application timing effects on overland flow water quality.

    PubMed

    White, Shawn K; Brummer, Joe E; Leininger, Wayne C; Frasier, Gary W; Waskom, Reagan M; Bauder, Troy A

    2003-01-01

    Nonpoint-source pollution from agricultural activities is currently the leading cause of degradation of waterways in the United States. Applying best management practices to flood-irrigated mountain meadows may improve agricultural runoff and return flow water quality. Prior research has focused on fertilizer use for increased hay yields, while few studies have investigated the environmental implications of this practice. We examined the effects of fertilizer application timing on overland flow water quality from an irrigated mountain meadow near Gunnison, Colorado. Application of 40 kg phosphorus (P) and 19 kg nitrogen (N) ha(-1) using monoammonium phosphate (11-52-0, N-P-K) fertilizer to plots in the fall significantly reduced concentrations of reactive P and ammonium N in irrigation overland flow compared with early or late spring fertilization. Reactive P loading was 9 to almost 16 times greater when fertilizer was applied in the early or late spring, respectively, compared with in the fall. Ammonium N followed a similar trend with early spring loading more than 18 times greater and late spring loading more than 34 times greater than loads from fall-fertilized plots. Losses of 45% of the applied P and more than 17% of the N were measured in runoff when fertilizer was applied in the late spring. These results, coupled with those from previous studies, suggest that mountain meadow hay producers should apply fertilizer in the fall, especially P-based fertilizers, to improve hay yields, avoid economic losses from loss of applied fertilizers, and reduce the potential for impacts to water quality.

  3. Bio-analytical applications of microbial fuel cell-based biosensors for onsite water quality monitoring.

    PubMed

    ElMekawy, A; Hegab, H M; Pant, D; Saint, C P

    2018-01-01

    Globally, sustainable provision of high-quality safe water is a major challenge of the 21st century. Various chemical and biological monitoring analytics are presently utilized to guarantee the availability of high-quality water. However, these techniques still face some challenges including high costs, complex design and onsite and online limitations. The recent technology of using microbial fuel cell (MFC)-based biosensors holds outstanding potential for the rapid and real-time monitoring of water source quality. MFCs have the advantages of simplicity in design and efficiency for onsite sensing. Even though some sensing applications of MFCs were previously studied, e.g. biochemical oxygen demand sensor, recently numerous research groups around the world have presented new practical applications of this technique, which combine multidisciplinary scientific knowledge in materials science, microbiology and electrochemistry fields. This review presents the most updated research on the utilization of MFCs as potential biosensors for monitoring water quality and considers the range of potentially toxic analytes that have so far been detected using this methodology. The advantages of MFCs over established technology are also considered as well as future work required to establish their routine use. © 2017 The Society for Applied Microbiology.

  4. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project.

    PubMed

    2003-02-01

    International interest in clinical practice guidelines has never been greater but many published guidelines do not meet the basic quality requirements. There have been renewed calls for validated criteria to assess the quality of guidelines. To develop and validate an international instrument for assessing the quality of the process and reporting of clinical practice guideline development. The instrument was developed through a multi-staged process of item generation, selection and scaling, field testing, and refinement procedures. 100 guidelines selected from 11 participating countries were evaluated independently by 194 appraisers with the instrument. Following refinement the instrument was further field tested on three guidelines per country by a new set of 70 appraisers. The final version of the instrument contained 23 items grouped into six quality domains with a 4 point Likert scale to score each item (scope and purpose, stakeholder involvement, rigour of development, clarity and presentation, applicability, editorial independence). 95% of appraisers found the instrument useful for assessing guidelines. Reliability was acceptable for most domains (Cronbach's alpha 0.64-0.88). Guidelines produced as part of an established guideline programme had significantly higher scores on editorial independence and, after the publication of a national policy, had significantly higher quality scores on rigour of development (p<0.005). Guidelines with technical documentation had higher scores on that domain (p<0.0001). This is the first time an appraisal instrument for clinical practice guidelines has been developed and tested internationally. The instrument is sensitive to differences in important aspects of guidelines and can be used consistently and easily by a wide range of professionals from different backgrounds. The adoption of common standards should improve the consistency and quality of the reporting of guideline development worldwide and provide a framework to encourage international comparison of clinical practice guidelines.

  5. Ask the right question: a critical step for practicing evidence-based laboratory medicine.

    PubMed

    Price, Christopher P; Christenson, Robert H

    2013-07-01

    The purpose of laboratory medicine is to facilitate better decision making in clinical practice and healthcare delivery. Decision making implies an unresolved issue, problem or unmet need. The most important criterion for any investigation to be of value in clinical practice is that it addresses an unmet need. The different ways in which laboratory investigations are utilized in patient care can be represented in the form of questions. It is important that these questions are articulated to highlight the variables that will impact on the effectiveness of the investigation in the scenario being considered. These variables include the characteristics of the patient (or population) and clinical setting, the nature of the decision and action taken on receipt of the test result and the expected outcome. Asking a question is the first step of the evidence-based laboratory medicine (EBLM) cycle, the other steps being acquiring the evidence, critically appraising the evidence, applying the evidence and auditing use of the evidence. Getting the question right determines the quality of the whole process, thus, defines the quality in practice of laboratory medicine. Whilst the main focus of the EBLM cycle is to provide a strong evidence base for use in clinical practice, it is clear that the five steps are equally applicable in commissioning, delivery and audit (performance management) of services. Asking the right question is crucial to improving the quality of evidence, and practice, in laboratory medicine, and should be used in routine laboratory medicine practice and management throughout healthcare.

  6. [Applications of the hospital statistics management system].

    PubMed

    Zhai, Hong; Ren, Yong; Liu, Jing; Li, You-Zhang; Ma, Xiao-Long; Jiao, Tao-Tao

    2008-01-01

    The Hospital Statistics Management System is built on an Office Automation Platform of Shandong provincial hospital system. Its workflow, role and popedom technologies are used to standardize and optimize the management program of statistics in the total quality control of hospital statistics. The system's applications have combined the office automation platform with the statistics management in a hospital and this provides a practical example of a modern hospital statistics management model.

  7. An Acuity Tool for Heart Failure Case Management: Quantifying Workload, Service Utilization, and Disease Severity.

    PubMed

    Kilgore, Matthew D

    The cardiology service line director at a health maintenance organization (HMO) in Washington State required a valid, reliable, and practical means for measuring workloads and other productivity factors for six heart failure (HF) registered nurse case managers located across three geographical regions. The Kilgore Heart Failure Case Management (KHFCM) Acuity Tool was systematically designed, developed, and validated to measure workload as a dependent function of the number of heart failure case management (HFCM) services rendered and the duration of times spent on various care duties. Research and development occurred at various HMO-affiliated internal medicine and cardiology offices throughout Western Washington. The concepts, methods, and principles used to develop the KHFCM Acuity Tool are applicable for any type of health care professional aiming to quantify workload using a high-quality objective tool. The content matter, scaling, and language on the KHFCM Acuity Tool are specific to HFCM settings. The content matter and numeric scales for the KHFCM Acuity Tool were developed and validated using a mixed-method participant action research method applied to a group of six outpatient HF case managers and their respective caseloads. The participant action research method was selected, because the application of this method requires research participants to become directly involved in the diagnosis of research problems, the planning and execution of actions taken to address those problems, and the implementation of progressive strategies throughout the course of the study, as necessary, to produce the most credible and practical practice improvements (; ; ; ). Heart failure case managers served clients with New York Heart Association Functional Class III-IV HF (), and encounters were conducted primarily by telephone or in-office consultation. A mix of qualitative and quantitative results demonstrated a variety of quality improvement outcomes achieved by the design and practice application of the KHFCM Acuity Tool. Quality improvement outcomes included a more valid reflection of encounter times and demonstration of the KHFCM Acuity Tool as a reliable, practical, credible, and satisfying tool for reflecting HF case manager workloads and HF disease severity. The KHFCM Acuity Tool defines workload simply as a function of the number of HFCM services performed and the duration of time spent on a client encounter. The design of the tool facilitates the measure of workload, service utilization, and HF disease characteristics, independently from the overall measure of acuity, so that differences in individual case manager practice, as well as client characteristics within sites, across sites, and potentially throughout annual seasons, can be demonstrated. Data produced from long-term applications of the KHFCM Acuity Tool, across all regions, could serve as a driver for establishing systemwide HFCM productivity benchmarks or standards of practice for HF case managers. Data produced from localized applications could serve as a reference for coordinating staffing resources or developing HFCM productivity benchmarks within individual regions or sites.

  8. Current Applications and Future Perspectives of the Use of 3D Printing in Anatomical Training and Neurosurgery

    PubMed Central

    Baskaran, Vivek; Štrkalj, Goran; Štrkalj, Mirjana; Di Ieva, Antonio

    2016-01-01

    3D printing is a form of rapid prototyping technology, which has led to innovative new applications in biomedicine. It facilitates the production of highly accurate three dimensional objects from substrate materials. The inherent accuracy and other properties of 3D printing have allowed it to have exciting applications in anatomy education and surgery, with the specialty of neurosurgery having benefited particularly well. This article presents the findings of a literature review of the Pubmed and Web of Science databases investigating the applications of 3D printing in anatomy and surgical education, and neurosurgery. A number of applications within these fields were found, with many significantly improving the quality of anatomy and surgical education, and the practice of neurosurgery. They also offered advantages over existing approaches and practices. It is envisaged that the number of useful applications will rise in the coming years, particularly as the costs of this technology decrease and its uptake rises. PMID:27445707

  9. Current Applications and Future Perspectives of the Use of 3D Printing in Anatomical Training and Neurosurgery.

    PubMed

    Baskaran, Vivek; Štrkalj, Goran; Štrkalj, Mirjana; Di Ieva, Antonio

    2016-01-01

    3D printing is a form of rapid prototyping technology, which has led to innovative new applications in biomedicine. It facilitates the production of highly accurate three dimensional objects from substrate materials. The inherent accuracy and other properties of 3D printing have allowed it to have exciting applications in anatomy education and surgery, with the specialty of neurosurgery having benefited particularly well. This article presents the findings of a literature review of the Pubmed and Web of Science databases investigating the applications of 3D printing in anatomy and surgical education, and neurosurgery. A number of applications within these fields were found, with many significantly improving the quality of anatomy and surgical education, and the practice of neurosurgery. They also offered advantages over existing approaches and practices. It is envisaged that the number of useful applications will rise in the coming years, particularly as the costs of this technology decrease and its uptake rises.

  10. Using cytology to increase small animal practice revenue.

    PubMed

    Hodges, Joanne

    2013-11-01

    Diagnostic cytology is a useful, noninvasive test with practical foundations in high-quality medicine and applications to practice building. Cytology will generate practice revenue whether assessed in-house or sent to a clinical pathologist. Thorough in-house evaluation is adequate in some cases, but expert opinion is important in many cases. Specimen slides should at least be reviewed in-house for assessment of cellularity and potential artifacts before submission to a reference laboratory. Reference laboratories also provide special stains and advanced molecular diagnostics to help further characterize many neoplastic processes, search for organisms, identify pigments, and address other important aspects of the lesion. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Clinical Practice Guideline Development Manual, Third Edition: a quality-driven approach for translating evidence into action.

    PubMed

    Rosenfeld, Richard M; Shiffman, Richard N; Robertson, Peter

    2013-01-01

    Guidelines translate best evidence into best practice. A well-crafted guideline promotes quality by reducing health care variations, improving diagnostic accuracy, promoting effective therapy, and discouraging ineffective-or potentially harmful-interventions. Despite a plethora of published guidelines, methodology is often poorly defined and varies greatly within and among organizations. The third edition of this manual describes the principles and practices used successfully by the American Academy of Otolaryngology--Head and Neck Surgery Foundation to produce quality-driven, evidence-based guidelines using efficient and transparent methodology for actionable recommendations with multidisciplinary applicability. The development process emphasizes a logical sequence of key action statements supported by amplifying text, action statement profiles, and recommendation grades linking action to evidence. New material in this edition includes standards for trustworthy guidelines, updated classification of evidence levels, increased patient and public involvement, assessing confidence in the evidence, documenting differences of opinion, expanded discussion of conflict of interest, and use of computerized decision support for crafting actionable recommendations. As clinical practice guidelines become more prominent as a key metric of quality health care, organizations must develop efficient production strategies that balance rigor and pragmatism. Equally important, clinicians must become savvy in understanding what guidelines are--and are not--and how they are best used to improve care. The information in this manual should help clinicians and organizations achieve these goals.

  12. AGREEing on Canadian cardiovascular clinical practice guidelines.

    PubMed

    Stone, James A; Austford, Leslie; Parker, John H; Gledhill, Norm; Tremblay, Guy; Arthur, Heather M

    2008-10-01

    The use of clinical practice guidelines (CPGs), particularly the routine implementation of evidence-based cardiovascular health maintenance and disease management recommendations, affords both expert and nonexpert practitioners the opportunity to achieve better, and at least theoretically similar, patient outcomes. However, health care practitioners are often stymied in their efforts to follow even well-researched and well-written CPGs as a consequence of contradictory information. The purposeful integration and harmonization of Canadian cardiovascular CPGs, regardless of their specific risk factor or clinical management focus, is critical to their widespread acceptance and implementation. This level of cooperation and coordination among CPG groups and organizations would help to ensure that their clinical practice roadmaps (ie, best practice recommendations) contain clear, concise and complementary, rather than contradictory, patient care information. Similarly, the application of specific tools intended to improve the quality of CPGs, such as the Appraisal of Guidelines for Research and Evaluation (AGREE) assessment tool, may also lead to improvements in CPG quality and potentially enhance their acceptance and implementation.

  13. GMP in blood collection and processing.

    PubMed

    Wagstaff, W

    1998-01-01

    The principles of Good Manufacturing Practice have, in the main, been universally developed for the guidance of the pharmaceutical industry rather than for transfusion services. However, these rules and guides are increasingly being adapted for use in blood centres, in the production of labile blood components and of plasma for fractionation. The guide for pharmaceutical industries produced by the commission of the European Communities is used as a model here, the nine basic requirements being those applicable to Quality Management, personnel, premises and equipment, document, production, Quality Control, contract manufacture and analysis, complaints and product recall, and self-inspection. Though having more direct application to the production laboratory preparing blood components, the majority of these requirements and principles are also directly applicable to all of the activities involved in blood collection.

  14. Assessing the practice of biomedical ontology evaluation: Gaps and opportunities.

    PubMed

    Amith, Muhammad; He, Zhe; Bian, Jiang; Lossio-Ventura, Juan Antonio; Tao, Cui

    2018-04-01

    With the proliferation of heterogeneous health care data in the last three decades, biomedical ontologies and controlled biomedical terminologies play a more and more important role in knowledge representation and management, data integration, natural language processing, as well as decision support for health information systems and biomedical research. Biomedical ontologies and controlled terminologies are intended to assure interoperability. Nevertheless, the quality of biomedical ontologies has hindered their applicability and subsequent adoption in real-world applications. Ontology evaluation is an integral part of ontology development and maintenance. In the biomedicine domain, ontology evaluation is often conducted by third parties as a quality assurance (or auditing) effort that focuses on identifying modeling errors and inconsistencies. In this work, we first organized four categorical schemes of ontology evaluation methods in the existing literature to create an integrated taxonomy. Further, to understand the ontology evaluation practice in the biomedicine domain, we reviewed a sample of 200 ontologies from the National Center for Biomedical Ontology (NCBO) BioPortal-the largest repository for biomedical ontologies-and observed that only 15 of these ontologies have documented evaluation in their corresponding inception papers. We then surveyed the recent quality assurance approaches for biomedical ontologies and their use. We also mapped these quality assurance approaches to the ontology evaluation criteria. It is our anticipation that ontology evaluation and quality assurance approaches will be more widely adopted in the development life cycle of biomedical ontologies. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. What can we learn from field experiments about the development of SOC and GHG emissions under different management practices?

    NASA Astrophysics Data System (ADS)

    Spiegel, Heide; Lehtinen, Taru; Schlatter, Norman; Haslmayr, Hans-Peter; Baumgarten, Andreas; ten Berge, Hein

    2015-04-01

    Successful agricultural management practices are required to maintain or enhance soil quality; at the same time climate change mitigation is becoming increasingly important. Within the EU project CATCH-C we analysed the effects of different agricultural practices not only on crop productivity, but also on soil quality indicators (e.g. soil organic carbon (SOC)) and climate change (CC) mitigation indicators (e.g. CO2, CH4, N2O emissions). European data sets and associated literature, mainly from long-term experiments were evaluated. This evaluation of agricultural management practices was carried out comparing a set of improved ("best") and often applied ("current") management practices. Positive and negative effects occurred when best management practices are adopted. As expected, none of the investigated practices could comply with all objectives simultaneously, i.e. maintaining high yields, mitigating climate change and improving chemical, physical and biological soil quality. The studied soil management practices "non-inversion tillage", "organic fertilisation" (application of farm yard manure, slurry, compost) and "incorporation of crop residues" represent important management practices for farmers to increase SOC, thus improving soil quality. However, CO2 and, especially, N2O emissions may rise as well. The evaluation of CC mitigation is often limited by the lack of data from - preferably - continuous GHG emission measurements. Thus, more long-term field studies are needed to better assess the CO2, CH4 and, especially, N2O emissions following the above mentioned favorably rated MPs. Only if SOC and GHG emissions are measured in the same field experiments, it will be possible to compute overall balances of necessary CO2-C equivalent emissions. CATCH-C is funded within the 7th Framework Programme for Research, Technological Development and Demonstration, Theme 2 - Biotechnologies, Agriculture & Food. (Grant Agreement N° 289782).

  16. The extent, quality and impact of patient and public involvement in primary care research: a mixed methods study.

    PubMed

    Blackburn, Steven; McLachlan, Sarah; Jowett, Sue; Kinghorn, Philip; Gill, Paramjit; Higginbottom, Adele; Rhodes, Carol; Stevenson, Fiona; Jinks, Clare

    2018-01-01

    In the UK, more patients go to primary care than other parts of the health service. Therefore it is important for research into primary care to include the insights and views of people who receive these services. To explore the extent, quality and impact of patient and public involvement (PPI) in primary care research, we examined documents of 200 projects and surveyed 191 researchers.We found that about half of studies included PPI to develop research ideas and during the study itself. Common activities included designing study materials, advising on methods, and managing the research. Some studies did not undertake the PPI activities initially planned and funded for. PPI varied by study design, health condition and study population. We found pockets of good practice: having a PPI budget, supporting PPI contributors, and PPI informing recruitment issues. However, good practice was lacking in other areas. Few projects offered PPI contributors training, used PPI to develop information for participants about study progress and included PPI to advise on publishing findings.Researchers reported beneficial impacts of PPI. Most impact was reported when the approach to PPI included more indicators of good practice. The main cost of PPI for researchers was their time. Many reported difficulties providing information about PPI.In partnership with PPI contributors, we have used these findings to develop:a new Cost and Consequences Framework for PPI highlighting financial and non-financial costs, benefits and harms of PPIFifteen co-produced recommendations to improve the practice and delivery of PPI. Background: To improve the lives of patients in primary care requires the involvement of service users in primary care research. We aimed to explore the extent, quality and impact of patient and public involvement (PPI) in primary care research. Methods: We extracted information about PPI from grant applications, reports and an electronic survey of researchers of studies funded by the NIHR School for Primary Care Research (SPCR). We applied recognised quality indicators to assess the quality of PPI and assessed its impact on research. Results: We examined 200 grant applications and reports of 181 projects. PPI was evident in the development of 47 (24%) grant applications. 113 (57%) grant applications included plans for PPI during the study, mostly in study design, oversight, and dissemination. PPI during projects was reported for 83 (46%) projects, including designing study materials and managing the research. We identified inconsistencies between planned and reported PPI. PPI varied by study design, health condition and study population.Of 46 (24%) of 191 questionnaires completed, 15 reported PPI activity. Several projects showed best practice according to guidelines, in terms of having a PPI budget, supporting PPI contributors, and PPI informing recruitment issues. However few projects offered PPI contributors training, used PPI to develop information for participants about study progress, and had PPI in advising on dissemination.Beneficial impacts of PPI in designing studies and writing participant information was frequently reported. Less impact was reported on developing funding applications, managing or carrying out the research. The main cost of PPI for researchers was their time. Many researchers found it difficult to provide information about PPI activities.Our findings informed:a new Cost and Consequences Framework for PPI in primary care research highlighting financial and non-financial costs, plus the benefits and harms of PPIFifteen co-produced recommendations to improve PPI in research and within the SPCR. Conclusions: The extent, quality and impact of PPI in primary care research is inconsistent across research design and topics. Pockets of good practice were identified making a positive impact on research. The new Cost and Consequences Framework may help others assess the impact of PPI.

  17. Increasing the relevance of research to health care managers: hospital CEO imperatives for improving quality and lowering costs.

    PubMed

    Alexander, Jeffrey A; Hearld, Larry R; Jiang, H Joanna; Fraser, Irene

    2007-01-01

    Evidence-based management assumes that available research evidence is consistent with the problems and decision-making conditions faced by those who will utilize this evidence in practice. This article attempts to identify how hospital leaders view key determinants of hospital quality and costs, as well as the fundamental ways these leaders "think" about solutions to quality and cost issues in their organizations. The objective of this analysis is to better inform the research agenda and approaches pursued by health services research so that this research reflects the "realities" of practice in hospitals. We conducted a series of semistructured interviews with a convenience sample of eight hospital and three health system leaders. Questions focused on current and future challenges facing hospitals as they relate to hospital quality, costs, and efficiency, and potential solutions to those challenges. Nine major organizational and managerial factors emerged from the interviews, including staffing, evidence-based practice, information technology, data availability and benchmarking, and leadership. Hospital leaders tend to think about these factors systemically and consider process-related factors as the important drivers of cost and quality. The results suggest a need to expand the methods utilized by health services researchers to make their research more relevant to health care managers. Expanding research methods to reflect the systemic way that managers view the challenges and solutions facing their organizations may enhance the application of research findings into management practice. Finally, better communication is needed between the research and practice communities. Researchers must learn to think more like managers if their research is to be relevant, and managers must learn to more effectively communicate their issues with the research community and frame their problems in researchable terms.

  18. [Watershed water environment pollution models and their applications: a review].

    PubMed

    Zhu, Yao; Liang, Zhi-Wei; Li, Wei; Yang, Yi; Yang, Mu-Yi; Mao, Wei; Xu, Han-Li; Wu, Wei-Xiang

    2013-10-01

    Watershed water environment pollution model is the important tool for studying watershed environmental problems. Through the quantitative description of the complicated pollution processes of whole watershed system and its parts, the model can identify the main sources and migration pathways of pollutants, estimate the pollutant loadings, and evaluate their impacts on water environment, providing a basis for watershed planning and management. This paper reviewed the watershed water environment models widely applied at home and abroad, with the focuses on the models of pollutants loading (GWLF and PLOAD), water quality of received water bodies (QUAL2E and WASP), and the watershed models integrated pollutant loadings and water quality (HSPF, SWAT, AGNPS, AnnAGNPS, and SWMM), and introduced the structures, principles, and main characteristics as well as the limitations in practical applications of these models. The other models of water quality (CE-QUAL-W2, EFDC, and AQUATOX) and watershed models (GLEAMS and MIKE SHE) were also briefly introduced. Through the case analysis on the applications of single model and integrated models, the development trend and application prospect of the watershed water environment pollution models were discussed.

  19. Medical Information Exchange: Pattern of Global Mobile Messenger Usage among Otolaryngologists.

    PubMed

    Siegal, Gil; Dagan, Elad; Wolf, Michael; Duvdevani, Shay; Alon, Eran E

    2016-11-01

    Information technology has revolutionized health care. However, the development of dedicated mobile health software has been lagging, leading to the use of general mobile applications to fill in the void. The use of such applications has several legal, ethical, and regulatory implications. We examined the experience and practices governing the usage of a global mobile messenger application (WhatsApp) for mobile health purposes in a national cohort of practicing otolaryngologists in Israel, a known early adaptor information technology society. Cross-sectional data were collected from practicing otolaryngologists and otolaryngology residents via self-administered questionnaire. The questionnaire was composed of a demographic section, a section surveying the practices of mobile application use, mobile health application use, and knowledge regarding institutional policies governing the transmission of medical data. The sample included 22 otolaryngology residents and 47 practicing otolaryngologists. Of the physicians, 83% worked in academic centers, and 88% and 40% of the physicians who worked in a hospital setting or a community clinic used WhatsApp for medical use, respectively. Working with residents increased the medical usage of WhatsApp from 50% to 91% (P = .006). Finally, 72% were unfamiliar with any institutional policy regarding the transfer of medical information by personal smartphones. Mobile health is becoming an integral part of modern medical systems, improving accessibility, efficiency, and possibly quality of medical care. The need to incorporate personal mobile devices in the overall information technology standards, guidelines, and regulation is becoming more acute. Nonetheless, practices must be properly instituted to prevent unwanted consequences. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  20. 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.

  1. Total quality management in blood transfusion.

    PubMed

    Smit-Sibinga, C T

    2000-01-01

    Quality management is an ongoing development resulting in consistency products and services and ever increasing customer satisfaction. The ultimum is Total Quality Management. Quality systems and quality management in transfusion medicine have gained considerable attention since the outbreak of the AIDS epidemic. Where product orientation has long been applied through quality control, Good Manufacturing Practice (GMP) principles were introduced, shifting the developments in the direction of process orientation. Globally, and particularly in the more industrialised world people and system orientation has come along with the introduction of the ISO9001 concept. Harmonisation and a degree of uniformity are needed to implement a universally applicable Quality System and related Quality Management. Where the American Association of Blood Banks (AABB) is the professional organisation with the most extensive experience in quality systems in blood transfusion, the European Union and the Council of Europe now are in the process to design a quality system and management applicable to a larger variety of countries, based on a hybrid of current GMP and ISO9001 principles. The International Federation of Red Cross and Red Crescent Societies has developed a more universally to implement Quality Manual, with a pilot project in Honduras. It is recommendable to harmonise the various designs and bring the approaches under one common denominator.

  2. Evaluation of the theory-based Quality Improvement in Physical Therapy (QUIP) programme: a one-group, pre-test post-test pilot study

    PubMed Central

    2013-01-01

    Background Guideline adherence in physical therapy is far from optimal, which has consequences for the effectiveness and efficiency of physical therapy care. Programmes to enhance guideline adherence have, so far, been relatively ineffective. We systematically developed a theory-based Quality Improvement in Physical Therapy (QUIP) programme aimed at the individual performance level (practicing physiotherapists; PTs) and the practice organization level (practice quality manager; PQM). The aim of the study was to pilot test the multilevel QUIP programme’s effectiveness and the fidelity, acceptability and feasibility of its implementation. Methods A one-group, pre-test, post-test pilot study (N = 8 practices; N = 32 PTs, 8 of whom were also PQMs) done between September and December 2009. Guideline adherence was measured using clinical vignettes that addressed 12 quality indicators reflecting the guidelines’ main recommendations. Determinants of adherence were measured using quantitative methods (questionnaires). Delivery of the programme and management changes were assessed using qualitative methods (observations, group interviews, and document analyses). Changes in adherence and determinants were tested in the paired samples T-tests and expressed in effect sizes (Cohen’s d). Results Overall adherence did not change (3.1%; p = .138). Adherence to three quality indicators improved (8%, 24%, 43%; .000 ≤ p ≤ .023). Adherence to one quality indicator decreased (−15.7%; p = .004). Scores on various determinants of individual performance improved and favourable changes at practice organizational level were observed. Improvements were associated with the programme’s multilevel approach, collective goal setting, and the application of self-regulation; unfavourable findings with programme deficits. The one-group pre-test post-test design limits the internal validity of the study, the self-selected sample its external validity. Conclusions The QUIP programme has the potential to change physical therapy practice but needs considerable revision to induce the ongoing quality improvement process that is required to optimize overall guideline adherence. To assess its value, the programme needs to be tested in a randomized controlled trial. PMID:23705912

  3. Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 Standards of Practice and Standards of Professional Performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition.

    PubMed

    Kent, Pamela S; McCarthy, Maureen P; Burrowes, Jerrilynn D; McCann, Linda; Pavlinac, Jessie; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Kruger, Sarah; Byham-Gray, Laura; Pace, Rory C; Hannahs, Valarie; Benner, Debbie

    2014-09-01

    Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition. Copyright © 2014 Academy of Nutrition and Dietetics and the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  4. Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition.

    PubMed

    Kent, Pamela S; McCarthy, Maureen P; Burrowes, Jerrilynn D; McCann, Linda; Pavlinac, Jessie; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Kruger, Sarah; Byham-Gray, Laura; Pace, Rory C; Hannahs, Valarie; Benner, Debbie

    2014-09-01

    Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition. Copyright © 2014 Academy of Nutrition and Dietetics and the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  5. Evaluating radiographers' diagnostic accuracy in screen-reading mammograms: what constitutes a quality study?

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

    Debono, Josephine C, E-mail: josephine.debono@bci.org.au; Poulos, Ann E; Westmead Breast Cancer Institute, Westmead, New South Wales

    The aim of this study was to first evaluate the quality of studies investigating the diagnostic accuracy of radiographers as mammogram screen-readers and then to develop an adapted tool for determining the quality of screen-reading studies. A literature search was used to identify relevant studies and a quality evaluation tool constructed by combining the criteria for quality of Whiting, Rutjes, Dinnes et al. and Brealey and Westwood. This constructed tool was then applied to the studies and subsequently adapted specifically for use in evaluating quality in studies investigating diagnostic accuracy of screen-readers. Eleven studies were identified and the constructed toolmore » applied to evaluate quality. This evaluation resulted in the identification of quality issues with the studies such as potential for bias, applicability of results, study conduct, reporting of the study and observer characteristics. An assessment of the applicability and relevance of the tool for this area of research resulted in adaptations to the criteria and the development of a tool specifically for evaluating diagnostic accuracy in screen-reading. This tool, with further refinement and rigorous validation can make a significant contribution to promoting well-designed studies in this important area of research and practice.« less

  6. Production system with process quality control: modelling and application

    NASA Astrophysics Data System (ADS)

    Tsou, Jia-Chi

    2010-07-01

    Over the past decade, there has been a great deal of research dedicated to the study of quality and the economics of production. In this article, we develop a dynamic model which is based on the hypothesis of a traditional economic production quantity model. Taguchi's cost of poor quality is used to evaluate the cost of poor quality in the dynamic production system. A practical case from the automotive industry, which uses the Six-sigma DMAIC methodology, is discussed to verify the proposed model. This study shows that there is an optimal value of quality investment to make the production system reach a reasonable quality level and minimise the production cost. Based on our model, the management can adjust its investment in quality improvement to generate considerable financial return.

  7. [VR and AR Applications in Medical Practice and Education].

    PubMed

    Hsieh, Min-Chai; Lin, Yu-Hsuan

    2017-12-01

    As technology advances, mobile devices have gradually turned into wearable devices. Furthermore, virtual reality (VR), augmented reality (AR), and mixed reality (MR) are being increasingly applied in medical fields such as medical education and training, surgical simulation, neurological rehabilitation, psychotherapy, and telemedicine. Research results demonstrate the ability of VR, AR, and MR to ameliorate the inconveniences that are often associated with traditional medical care, reduce incidents of medical malpractice caused by unskilled operations, and reduce the cost of medical education and training. What is more, the application of these technologies has enhanced the effectiveness of medical education and training, raised the level of diagnosis and treatment, improved the doctor-patient relationship, and boosted the efficiency of medical execution. The present study introduces VR, AR, and MR applications in medical practice and education with the aim of helping health professionals better understand the applications and use these technologies to improve the quality of medical care.

  8. [Application of fingerprint chromatogram in quality control of Shen-Mai injection].

    PubMed

    Shi, Xian-zhe; Yang, Jun; Zhao, Chun-xia; Xiong, Jian-hui; Xu, Guo-wang

    2002-07-01

    The theory and practice of traditional Chinese medicine require some comprehensive methods to assess quality of the Chinese herbal medication. Fingerprint chromatogram is one of the feasible approaches to evaluate the quality of Chinese herbal medication. So the fingerprint chromatogram of Shen-Mai injection was established by using reversed-phase high performance liquid chromatography. The chromatographic conditions were as follows: a Hypersil C18 column was used; the mobile phase was composed of water (A) and acetontrile (B) with linear gradient elution (0-50 min, 5%-95% B, volume fraction); the flow rate was 1.0 mL/min and the UV absorbance detection was set at 202 nm. The peak-area ratios of twenty-three fingerprint peaks and internal standard (diphenyl) were taken as the criteria for quality control. The quality differences in various batches and various manufacturers of Shen-Mai injections were investigated by projection discriminance based on principal component analysis. The results show the method developed is convenient, reliable and applicable for the quality control analysis of Shen-Mai injection.

  9. Improving patient care trajectories: an innovative quasi-experimental research method for health services.

    PubMed

    Campos, Eneida Rached; Moreira-Filho, Djalma de Carvalho; Silva, Marcos Tadeu Nolasco da

    2018-05-01

    Scores to predict treatment outcomes have earned a well-deserved place in healthcare practice. However, when used to help achieve excellence in the care of a given disease, scores should also take into account organizational and social aspects. This article aims to create scores to obtain key variables and its application in the management of care of a given disease. We present a method called Epidemiological Planning for Patient Care Trajectory (PELC) and its application in a research of HIV pediatric patients. This case study is presented by means of two studies. The first study deals with the development of the method PELC. The second is HIV Pediatric case-control study based on PELC method. HIV pediatric research - the first practical PELC application - found these four key variables to the individual quality level care trajectories: adherence to ART, attending at least one appointment with the otolaryngologist, attending at least one appointment with social services, and having missed one or more routine appointments. We believe PELC method can be used in researches about any kind of care trajectories, contributing to quality level advancements in health services, with emphasis on patient safety and equity in healthcare.

  10. Improving secondary prevention screening in clinical encounters using mhealth among prelicensure master's entry clinical nursing students.

    PubMed

    FitzGerald, Leah Z; Rorie, Anne; Salem, Benissa E

    2015-04-01

    To determine the feasibility and acceptability of a mHealth application among nursing students for health promotion and secondary prevention health recommendations for hospitalized adult patients. A pretest-posttest design with a convenience sample of 169 prelicensure master's entry clinical nursing students in a large urban public university. Survey questions assessed intention to use, perceived usefulness, perceived ease of use, subjective norm, voluntariness, clinical area relevance, output quality, and result demonstrability of the United States Preventive Services Task Force (USPSTF) evidence-based practice guidelines via the mHealth application. Descriptive statistics and frequencies were used to explore sociodemographics; paired t-tests were used to evaluate pre- and posttest differences. Pre- and posttest significant differences (p < .01) were found between intention to use, perceived usefulness, subjective norm, voluntariness, image, clinical relevance, result demonstrability, and output quality (p < .02). Ease use of a mHealth application was not significantly different. These findings highlight the need to integrate evidence-based practice tools using mHealth technology among prelicensure master's entry clinical nursing students in order to engage and foster translational learning and improve dissemination of secondary prevention screening guidelines among hospitalized patients. © 2015 Sigma Theta Tau International.

  11. Mixed-methods research in pharmacy practice: recommendations for quality reporting. Part 2.

    PubMed

    Hadi, Muhammad Abdul; Alldred, David Phillip; Closs, S José; Briggs, Michelle

    2014-02-01

    This is the second of two papers that explore the use of mixed-methods research in pharmacy practice. This paper discusses the rationale, applications, limitations and challenges of conducting mixed-methods research. As with other research methods, the choice of mixed-methods should always be justified because not all research questions require a mixed-methods approach. Mixed-methods research is particularly suitable when one dataset may be inadequate in answering the research question, an explanation of initial results is required, generalizability of qualitative findings is desired or broader and deeper understanding of a research problem is necessary. Mixed-methods research has its own challenges and limitations, which should be considered carefully while designing the study. There is a need to improve the quality of reporting of mixed-methods research. A framework for reporting mixed-methods research is proposed, for researchers and reviewers, with the intention of improving its quality. Pharmacy practice research can benefit from research that uses both 'numbers' (quantitative) and 'words' (qualitative) to develop a strong evidence base to support pharmacy-led services. © 2013 Royal Pharmaceutical Society.

  12. MO-DE-207-04: Imaging educational program on solutions to common pediatric imaging challenges

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

    Krishnamurthy, R.

    This imaging educational program will focus on solutions to common pediatric imaging challenges. The speakers will present collective knowledge on best practices in pediatric imaging from their experience at dedicated children’s hospitals. The educational program will begin with a detailed discussion of the optimal configuration of fluoroscopes for general pediatric procedures. Following this introduction will be a focused discussion on the utility of Dual Energy CT for imaging children. The third lecture will address the substantial challenge of obtaining consistent image post -processing in pediatric digital radiography. The fourth and final lecture will address best practices in pediatric MRI includingmore » a discussion of ancillary methods to reduce sedation and anesthesia rates. Learning Objectives: To learn techniques for optimizing radiation dose and image quality in pediatric fluoroscopy To become familiar with the unique challenges and applications of Dual Energy CT in pediatric imaging To learn solutions for consistent post-processing quality in pediatric digital radiography To understand the key components of an effective MRI safety and quality program for the pediatric practice.« less

  13. Review of Virtual Reality Treatment in Psychiatry: Evidence Versus Current Diffusion and Use.

    PubMed

    Mishkind, Matthew C; Norr, Aaron M; Katz, Andrea C; Reger, Greg M

    2017-09-18

    This review provides an overview of the current evidence base for and clinical applications of the use of virtual reality (VR) in psychiatric practice, in context of recent technological developments. The use of VR in psychiatric practice shows promise with much of the research demonstrating clinical effectiveness for conditions including post-traumatic stress disorder, anxiety and phobias, chronic pain, rehabilitation, and addictions. However, more research is needed before the use of VR is considered a clinical standard of practice in some areas. The recent release of first generation consumer VR products signals a change in the viability of further developing VR systems and applications. As applications increase so will the need for good quality research to best understand what makes VR effective, and when VR is not appropriate for clinical services. As the field progresses, it is hopeful that the flexibility afforded by this technology will yield superior outcomes and a better understanding of the underlying mechanisms impacting those outcomes.

  14. Analysis of Food Contaminants, Residues, and Chemical Constituents of Concern

    NASA Astrophysics Data System (ADS)

    Ismail, Baraem; Reuhs, Bradley L.; Nielsen, S. Suzanne

    The food chain that starts with farmers and ends with consumers can be complex, involving multiple stages of production and distribution (planting, harvesting, breeding, transporting, storing, importing, processing, packaging, distributing to retail markets, and shelf storing) (Fig. 18.1). Various practices can be employed at each stage in the food chain, which may include pesticide treatment, agricultural bioengineering, veterinary drug administration, environmental and storage conditions, processing applications, economic gain practices, use of food additives, choice of packaging material, etc. Each of these practices can play a major role in food quality and safety, due to the possibility of contamination with or introduction (intentionally and nonintentionally) of hazardous substances or constituents. Legislation and regulation to ensure food quality and safety are in place and continue to develop to protect the stakeholders, namely farmers, consumers, and industry. [Refer to reference (1) for information on regulations of food contaminants and residues.

  15. Ammonia emissions from land application of manures

    USDA-ARS?s Scientific Manuscript database

    Ammonia volatilization can be a major nitrogen (N) loss process for surface-applied manures. There is concern that current manure management practices are contributing to ammonia losses in the Mid-Atlantic region with subsequent reductions in air quality and increases in N losses to streams and est...

  16. Improving Audio Quality in Distance Learning Applications.

    ERIC Educational Resources Information Center

    Richardson, Craig H.

    This paper discusses common causes of problems encountered with audio systems in distance learning networks and offers practical suggestions for correcting the problems. Problems and discussions are divided into nine categories: (1) acoustics, including reverberant classrooms leading to distorted or garbled voices, as well as one-dimensional audio…

  17. 7 CFR 58.127 - Facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of equipment. Culinary steam used in direct contact with milk or dairy products shall be free from... used wherever applicable to insure a satisfactory and safe steam supply. Culinary steam shall comply with the 3-A Accepted Practices for a Method of Producing Steam of Culinary Quality, number 609. This...

  18. Summary Article: IEA HPP Annex 36: Quality Installation / Quality Maintenance Sensitivity Studies

    DOE PAGES

    Hourahan, Glenn; Domanski, Piotr; Baxter, Van D.

    2015-01-30

    The outcome from this Annex activity clearly identifies that poorly designed, installed, and/or maintained heat pumps operate inefficiently and waste considerable energy compared to their as-designed potential. Additionally, it is clear that small faults for a given field-observed practice are significant, that some attribute deviations (in various equipment applications and geographical locations) have a larger impact than others, and that multiple faults or deviations have a cumulative impact on heat pump performance.

  19. If patient-reported outcome measures are considered key health-care quality indicators, who is excluded from participation?

    PubMed

    Kroll, Thilo; Wyke, Sally; Jahagirdar, Deepa; Ritchie, Karen

    2014-10-01

    Patient-reported outcome measures have received increasing attention with regard to ensuring quality improvement across the health service. However, there is a risk that people with disabilities and low literacy are systematically excluded from the development of these measures as well as their application in clinical practice. This editorial highlights some of these risks and the potential consequences of exclusion for these groups. © 2012 John Wiley & Sons Ltd.

  20. Overview and technical and practical aspects for use of geostatistics in hazardous-, toxic-, and radioactive-waste-site investigations

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

    Bossong, C.R.; Karlinger, M.R.; Troutman, B.M.

    1999-10-01

    Technical and practical aspects of applying geostatistics are developed for individuals involved in investigation at hazardous-, toxic-, and radioactive-waste sites. Important geostatistical concepts, such as variograms and ordinary, universal, and indicator kriging, are described in general terms for introductory purposes and in more detail for practical applications. Variogram modeling using measured ground-water elevation data is described in detail to illustrate principles of stationarity, anisotropy, transformations, and cross validation. Several examples of kriging applications are described using ground-water-level elevations, bedrock elevations, and ground-water-quality data. A review of contemporary literature and selected public domain software associated with geostatistics also is provided, asmore » is a discussion of alternative methods for spatial modeling, including inverse distance weighting, triangulation, splines, trend-surface analysis, and simulation.« less

  1. Feasibility of 48 quality indicators in ambulatory care in Germany: a cross-sectional observational study.

    PubMed

    de Cruppé, Werner; Kleudgen, Susanne; Diel, Franziska; Burgdorf, Friederike; Geraedts, Max

    2015-01-01

    The National Association of Statutory Health Insurance Physicians develops quality indicators (QIs) for ambulatory care in Germany. This study explores the feasibility of a total of 48 QIs. Cross-sectional observational study with primary data collection in writing from medical practices in 10 specialist fields of outpatient care. "Feasibility" covers 7 criteria for indicator assessment and data collection: applicability, availability, retrievability, complexity, relevance, reliability, and acceptance. A questionnaire consisting of 10 questions was used to evaluate these feasibility criteria for each indicator. Survey results were subjected to descriptive analysis. The analyzed sample comprises 103 participants who have been working as practice-based physicians for an average of 13 years. 40% only keep electronic medical records and 2% only paper records, and the rest uses both. The rating of QIs in the field-specific QI sets shows the following mean values: 67% of the participants consider the QIs assigned to them as corresponding to their practice care mandate. Data on these QIs deemed to be applicable are collected by 94% of respondents, documented by 91%, and by 51% electronically. 58% of the data required for the denominator, and 38% for the numerator are retrievable from the practice management system. The time required to access data on a QI is more than 30minutes for 84% of respondents, and 67% consider the effort involved as unacceptable. The rating received was 61% for the relevance of QIs to the assessment of a practitioner's own quality of health care, 69% for the estimated reliability of data collection, and 58% for the acceptance of being evaluated via QIs. In order to improve the feasibility of QI-based practice assessments it will be necessary to a) fine-tune the selection of QIs for the respective groups of specialist, b) to promote the use of computerized practice management systems, and c) integrate effective and user-friendly retrieval functions in the software. Another aspect to be explored is how the acceptance of QI-based practice evaluations can be improved in individual specialist fields. Copyright © 2015. Published by Elsevier GmbH.

  2. Quality in applied science

    NASA Astrophysics Data System (ADS)

    Sten, T.

    1993-12-01

    Science is in many senses a special kind of craft and only skilled craftsmen are able to distinguish good work from bad. Due to the variation in approaches, methods and even philosophical basis, it is nearly impossible to derive a general set of quality criteria for scientific work outside specific research traditions. Applied science introduces a new set of quality criteria having to do with the application of results in practical situations and policy making. A scientist doing basic research relates mainly to the scientific community of which he is a member, while in applied contract research the scientist has to consider the impact of his results both for the immediate users and upon interest groups possibly being affected. Application thus raises a whole new set of requirements having to do with business ethics, policy consequences and societal ethics in general.

  3. Pitch-informed solo and accompaniment separation towards its use in music education applications

    NASA Astrophysics Data System (ADS)

    Cano, Estefanía; Schuller, Gerald; Dittmar, Christian

    2014-12-01

    We present a system for the automatic separation of solo instruments and music accompaniment in polyphonic music recordings. Our approach is based on a pitch detection front-end and a tone-based spectral estimation. We assess the plausibility of using sound separation technologies to create practice material in a music education context. To better understand the sound separation quality requirements in music education, a listening test was conducted to determine the most perceptually relevant signal distortions that need to be improved. Results from the listening test show that solo and accompaniment tracks pose different quality requirements and should be optimized differently. We propose and evaluate algorithm modifications to better understand their effects on objective perceptual quality measures. Finally, we outline possible ways of optimizing our separation approach to better suit the requirements of music education applications.

  4. NASA Earth Observation Systems and Applications for Public Health and Air Quality Models and Decisions Support

    NASA Technical Reports Server (NTRS)

    Estes, Sue; Haynes, John; Omar, Ali

    2013-01-01

    Health and Air Quality providers and researchers need environmental data to study and understand the geographic, environmental, and meteorological differences in disease. Satellite remote sensing of the environment offers a unique vantage point that can fill in the gaps of environmental, spatial, and temporal data for tracking disease. This presentation will demonstrate the need for collaborations between multi-disciplinary research groups to develop the full potential of utilizing Earth Observations in studying health. Satellite earth observations present a unique vantage point of the earth's environment from space, which offers a wealth of health applications for the imaginative investigator. The presentation is directly related to Earth Observing systems and Global Health Surveillance and will present research results of the remote sensing environmental observations of earth and health applications, which can contribute to the public health and air quality research. As part of NASA approach and methodology they have used Earth Observation Systems and Applications for Public Health and Air Quality Models to provide a method for bridging gaps of environmental, spatial, and temporal data for tracking disease. This presentation will provide an overview of projects dealing with infectious diseases, water borne diseases and air quality and how many environmental variables effect human health. This presentation will provide a venue where the results of both research and practice using satellite earth observations to study weather and it's role in public health research.

  5. NASA Earth Observation Systems and Applications for Public Health and Air Quality Models and Decisions Support

    NASA Technical Reports Server (NTRS)

    Estes, Sue; Haynes, John; Omar, Ali

    2012-01-01

    Health and Air Quality providers and researchers need environmental data to study and understand the geographic, environmental, and meteorological differences in disease. Satellite remote sensing of the environment offers a unique vantage point that can fill in the gaps of environmental, spatial, and temporal data for tracking disease. This presentation will demonstrate the need for collaborations between multi-disciplinary research groups to develop the full potential of utilizing Earth Observations in studying health. Satellite earth observations present a unique vantage point of the earth's environment from space, which offers a wealth of health applications for the imaginative investigator. The presentation is directly related to Earth Observing systems and Global Health Surveillance and will present research results of the remote sensing environmental observations of earth and health applications, which can contribute to the public health and air quality research. As part of NASA approach and methodology they have used Earth Observation Systems and Applications for Public Health and Air Quality Models to provide a method for bridging gaps of environmental, spatial, and temporal data for tracking disease. This presentation will provide an overview of projects dealing with infectious diseases, water borne diseases and air quality and how many environmental variables effect human health. This presentation will provide a venue where the results of both research and practice using satellite earth observations to study weather and it's role in public health research.

  6. [Lung function tests: the pneumologist and ambulatory care].

    PubMed

    Reis Ferreira, J M

    2004-01-01

    Lung function testing (LFT) has been standardized and greatly improved in the last three decades, but its relative complexity has driven to recent sistematization and standardization of its applicability in the office and in primary care. In memorian of Prof António Couto, and of his outstanding role in the promotion of LFT in Potyugal, this conference deals with the definition of office spirometry, its application range, and the essential steps for the performance, in acceptable quality and reproducibility conditioms. The role of the specialist in promoting this method, and his support to possible spirometry performers, is aimed as an important request in the success of the practical and used technique in family practice and primary health care.

  7. Quality control in gastrointestinal surgery.

    PubMed

    Ramírez-Barba, Ector Jaime; Arenas-Moya, Diego; Vázquez-Guerrero, Arturo

    2011-01-01

    We analyzed the Mexican legal framework, identifying the vectors that characterize quality and control in gastrointestinal surgery. Quality is contemplated in the health protection rights determined according to the Mexican Constitution, established in the general health law and included as a specific goal in the actual National Development Plan and Health Sector Plan. Quality control implies planning, verification and application of corrective measures. Mexico has implemented several quality strategies such as certification of hospitals and regulatory agreements by the General Salubrity Council, creation of the National Health Quality Committee, generation of Clinical Practice Guidelines and the Certification of Medical Specialties, among others. Quality control in gastrointestinal surgery must begin at the time of medical education and continue during professional activities of surgeons, encouraging multidisciplinary teamwork, knowledge, abilities, attitudes, values and skills that promote homogeneous, safe and quality health services for the Mexican population.

  8. [Systemic validation of clinical practice guidelines: the AGREE network].

    PubMed

    Hannes, K; Van Royen, P; Aertgeerts, B; Buntinx, F; Ramaekers, D; Chevalier, P

    2005-12-01

    Over recent decades, the number of available clinical practice guidelines has enormously grown. Guidelines should meet specific quality criteria to ensure good quality. There is a growing need for the developement of a set of criteria to ensure that potential biases inherent in guideline development have been properly addressed and that the recommendations for practice are valid and reliable. The AGREE-collaboration is an international network that developed an instrument to critically appraise the methodological quality of guidelines. AGREE promotes a clear strategy to produce, disseminate and evaluate guidelines of high quality. In the first phase of the international project the AGREE-instrument was tested in 11 different countries. Based on this experience the instrument was refined and optimised. In the second phase it was disseminated, promoted and evaluated in 18 participating countries. Belgium was one of them. The Belgian partner in the AGREE-project developed 3 workshops and established 13 validation committees to validate guidelines from Belgian developer groups. We collected 33 questionnaires from participants of the workshops and the validation committees, in which we asked for primary experiences and information on the usefulness and applicability of the instrument. We were also interested in the shortcomings of the instrument and potential strategies to bridge them. More efforts should be made to train methodological experts to gain certain skills for a critical appraisal of clinical practice guidelines. Promoting the AGREE-instrument will lead to a broader knowledge and use of quality criteria in guideline development and appraisal. The development and dissemination of an international list of criteria to appraise the quality of guidelines will stimulate the development of methodologically sound guidelines. International comparisons between existing guidelines will lead to a better collaboration between guideline developers throughout the world.

  9. Among nurses, how does education level impact professional values? A systematic review.

    PubMed

    Sibandze, B T; Scafide, K N

    2018-03-01

    Professional nursing values have been acknowledged globally as the foundation of daily nursing care practice. Understanding how nurses identify, comprehend and apply their professional nursing values is an important step towards improving nursing practice and patient care quality. Research has demonstrated that nurses' professional values are cultivated during prelicensure academic education. The aim of this systematic review was to determine how level of education affects professional nursing values of clinical practising nurses. A systematic search of quantitative research published through December 2015 was performed in the following five electronic databases: CINAHL, Cochrane Library, MEDLINE, Web of Science and Religion and Philosophy Collection. The search was not limited to country of origin. The studies were assessed for methodological quality using established criteria. Of 1501 articles identified through the literature search, only seven studies met the inclusion criteria with the majority being of good to high quality. Most of the studies found registered nurses pursuing a bachelor of science in nursing or higher had a greater awareness and application of professional values than nurses with lower levels of academic or non-academic education. Nurses with higher education also embraced professional values as fundamental for quality nursing care practice. Health and academic institutions should support nurses through quality continuing and higher education that reinforces professional values, thus improving the quality of patient care. The level of nurses' education appears to play an important role in developing both an awareness and an integration of professional values into practice. More research is needed to discover methods that may be used to promote nurses' professional values among nurses already practising clinically. © 2017 International Council of Nurses.

  10. Towards practical implementation of biophotonics-based solutions for cost-effective monitoring of food quality control (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Meglinski, Igor; Popov, Alexey; Bykov, Alexander

    2017-03-01

    Biophotonics-based diagnostic and imaging modalities have been widely used in various applications associated with the non-invasive imaging of the internal structure of a range biological media from a range of cells cultures to biological tissues. With the fast growing interest in food securities there remains strong demand to apply reliable and cost effective biophotonics-based technologies for rapid screening of freshness, internal defects and quality of major agricultural products. In current presentation the results of application of optical coherence tomography (OCT) and encapsulated optical bio-sensors for quantitative assessment of freshness of agricultural products, such as meat and sea foods, are presented, and their further perspectives are discussed.

  11. Quality Factor Effect on the Wireless Range of Microstrip Patch Antenna Strain Sensors

    PubMed Central

    Daliri, Ali; Galehdar, Amir; Rowe, Wayne S. T.; John, Sabu; Wang, Chun H.; Ghorbani, Kamran

    2014-01-01

    Recently introduced passive wireless strain sensors based on microstrip patch antennas have shown great potential for reliable health and usage monitoring in aerospace and civil industries. However, the wireless interrogation range of these sensors is limited to few centimeters, which restricts their practical application. This paper presents an investigation on the effect of circular microstrip patch antenna (CMPA) design on the quality factor and the maximum practical wireless reading range of the sensor. The results reveal that by using appropriate substrate materials the interrogation distance of the CMPA sensor can be increased four-fold, from the previously reported 5 to 20 cm, thus improving considerably the viability of this type of wireless sensors for strain measurement and damage detection. PMID:24451457

  12. Quality factor effect on the wireless range of microstrip patch antenna strain sensors.

    PubMed

    Daliri, Ali; Galehdar, Amir; Rowe, Wayne S T; John, Sabu; Wang, Chun H; Ghorbani, Kamran

    2014-01-02

    Recently introduced passive wireless strain sensors based on microstrip patch antennas have shown great potential for reliable health and usage monitoring in aerospace and civil industries. However, the wireless interrogation range of these sensors is limited to few centimeters, which restricts their practical application. This paper presents an investigation on the effect of circular microstrip patch antenna (CMPA) design on the quality factor and the maximum practical wireless reading range of the sensor. The results reveal that by using appropriate substrate materials the interrogation distance of the CMPA sensor can be increased four-fold, from the previously reported 5 to 20 cm, thus improving considerably the viability of this type of wireless sensors for strain measurement and damage detection.

  13. Spatial multiobjective optimization of agricultural conservation practices using a SWAT model and an evolutionary algorithm.

    PubMed

    Rabotyagov, Sergey; Campbell, Todd; Valcu, Adriana; Gassman, Philip; Jha, Manoj; Schilling, Keith; Wolter, Calvin; Kling, Catherine

    2012-12-09

    Finding the cost-efficient (i.e., lowest-cost) ways of targeting conservation practice investments for the achievement of specific water quality goals across the landscape is of primary importance in watershed management. Traditional economics methods of finding the lowest-cost solution in the watershed context (e.g.,(5,12,20)) assume that off-site impacts can be accurately described as a proportion of on-site pollution generated. Such approaches are unlikely to be representative of the actual pollution process in a watershed, where the impacts of polluting sources are often determined by complex biophysical processes. The use of modern physically-based, spatially distributed hydrologic simulation models allows for a greater degree of realism in terms of process representation but requires a development of a simulation-optimization framework where the model becomes an integral part of optimization. Evolutionary algorithms appear to be a particularly useful optimization tool, able to deal with the combinatorial nature of a watershed simulation-optimization problem and allowing the use of the full water quality model. Evolutionary algorithms treat a particular spatial allocation of conservation practices in a watershed as a candidate solution and utilize sets (populations) of candidate solutions iteratively applying stochastic operators of selection, recombination, and mutation to find improvements with respect to the optimization objectives. The optimization objectives in this case are to minimize nonpoint-source pollution in the watershed, simultaneously minimizing the cost of conservation practices. A recent and expanding set of research is attempting to use similar methods and integrates water quality models with broadly defined evolutionary optimization methods(3,4,9,10,13-15,17-19,22,23,25). In this application, we demonstrate a program which follows Rabotyagov et al.'s approach and integrates a modern and commonly used SWAT water quality model(7) with a multiobjective evolutionary algorithm SPEA2(26), and user-specified set of conservation practices and their costs to search for the complete tradeoff frontiers between costs of conservation practices and user-specified water quality objectives. The frontiers quantify the tradeoffs faced by the watershed managers by presenting the full range of costs associated with various water quality improvement goals. The program allows for a selection of watershed configurations achieving specified water quality improvement goals and a production of maps of optimized placement of conservation practices.

  14. Quality of clinical practice guidelines of lower extremity venous ulcers.

    PubMed

    Rumbo-Prieto, José María; Arantón-Areosa, Luis; Palomar-Llatas, Federico; Romero-Martín, Manuel

    The clinical variability and professional uncertainty in the prevention and treatment of lower extremity venous ulcers (VU) has as a main consequence, the fact that patients can be subjected to diagnostic and therapeutic tests, sometimes of dubious utility, these may even be harmful to the health of the patient and that, at other times, certain procedures or processes that may be appropriate to the patient's situation and needs may be omitted. It is for this reason that a series of specific documents called clinical practice guidelines for the approach of VU (CPG-VU) have been created, with the aim of improving the effectiveness and quality of care, reducing unjustified variability and establishing homogeneous criteria for its handling. Nevertheless, the literature shows that not all CPGs have the same methodological and evidence-drawing criteria. Many of them are of poor scientific quality and editorial rigor. This implies that CPGs should be periodically reviewed and updated based on the most current evidence and their quality contrasted with validated instruments such as AGREE-II. After an analysis of the quality of six CPG-VU available today, it has been possible to identify what guidelines are recommended for its implementation in the practice of care, which should be modified to improve their applicability and development of the evidence. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  15. Optimum Landscape Allocation of Conservation Practices for Water Quality and Ecosystem Service Valuation

    NASA Astrophysics Data System (ADS)

    Dalzell, B. J.; Pennington, D.; Nelson, E.; Mulla, D.; Polasky, S.; Taff, S.

    2012-12-01

    This study links a spatially-explicit biophysical model (SWAT) with an economic model (InVEST) to identify the economically optimum allocation of conservation practices on the landscape. Combining biophysical and economic analysis allows assessment of the benefits and costs of alternative policy choices through consideration of direct costs and benefits as measured by market transactions as well as non-market benefits and costs from changes in environmental conditions that lead to changes in the provision of ecosystem services. When applied to an agricultural watershed located in South-Central Minnesota, this approach showed that: (1) some modest gains (20% improvement, relative to baseline conditions) in water quality can be achieved without diminishing current economic returns, but that (2) more dramatic reductions in sediment and phosphorus required to meet water quality goals (50% reductions in loadings) will require transitioning land from row crops into perennial vegetation. This shift in land cover will result in a reduction in economic returns unless non-market ecosystem services are also valued. Further results showed that traditional best management practices such as conservation tillage and reduced fertilizer application rates are not sufficient to achieve water quality goals by themselves. Finally, if crop prices drop to pre-2007 levels or valuation of ecosystem services increases, then achieving water quality goals can occur with less of an economic impact to the watershed.

  16. Lasers for industrial production processing: tailored tools with increasing flexibility

    NASA Astrophysics Data System (ADS)

    Rath, Wolfram

    2012-03-01

    High-power fiber lasers are the newest generation of diode-pumped solid-state lasers. Due to their all-fiber design they are compact, efficient and robust. Rofin's Fiber lasers are available with highest beam qualities but the use of different process fiber core sizes enables the user additionally to adapt the beam quality, focus size and Rayleigh length to his requirements for best processing results. Multi-mode fibers from 50μm to 600μm with corresponding beam qualities of 2.5 mm.mrad to 25 mm.mrad are typically used. The integrated beam switching modules can make the laser power available to 4 different manufacturing systems or can share the power to two processing heads for parallel processing. Also CO2 Slab lasers combine high power with either "single-mode" beam quality or higher order modes. The wellestablished technique is in use for a large number of industrial applications, processing either metals or non-metallic materials. For many of these applications CO2 lasers remain the best choice of possible laser sources either driven by the specific requirements of the application or because of the cost structure of the application. The actual technical properties of these lasers will be presented including an overview over the wavelength driven differences of application results, examples of current industrial practice as cutting, welding, surface processing including the flexible use of scanners and classical optics processing heads.

  17. Evaluating natural antimicrobials for food application, in natural antimicrobials for food safety and quality

    USDA-ARS?s Scientific Manuscript database

    The microflora of foods is of practical significance to producers, processors and consumers. Food manufacturers and distributors are responding to consumers’ demand for food products that are safe, fresher and convenient for use. In some cases foods may be improperly processed and/or contaminated wi...

  18. 78 FR 52909 - Consumer Financial Protection Bureau Notice of Availability of Final Environmental Assessment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-27

    ...: [email protected] . Mail/Hand Delivery/Courier: Michael Davis, Project Manager, Consumer Financial... application of best management practices (BMP) to minimize short term air quality and noise impact during... of Final Environmental Assessment (FINAL EA) and a Finding of No Significant Impact (FONSI) for...

  19. Climate Change Vulnerability Assessments: Four Case Studies of Water Utility Practices (External Review Draft)

    EPA Science Inventory

    EPA has released this draft document solely for the purpose of pre-dissemination peer review under applicable information quality guidelines. This document has not been formally disseminated by EPA. It does not represent and should not be construed to represent any Agency policy ...

  20. Spatialised Metaphors of Practice: How Teacher Educators Engage with Professional Standards for Teachers

    ERIC Educational Resources Information Center

    Ryan, Mary; Bourke, Terri

    2018-01-01

    Pre-service teacher educators, both nationally and internationally, must negotiate a plethora of expectations including using Professional Standards to enhance teacher quality. In Australia, the recent Teacher Education Ministerial Advisory Group (TEMAG) report highlighted weak application of Standards in Initial Teacher Education (ITE). However,…

  1. Manure storage capacity and application timing influence watershed-level nutrient losses

    USDA-ARS?s Scientific Manuscript database

    Current concerns over water quality requires best management practices for land-applied manure. One important strategy is to apply manure at right timing, which though is often greatly affected by manure generation and storage capacities in a given watershed. This study was to test the hypotheses: (...

  2. Business Administration Scale for Family Child Care, BAS

    ERIC Educational Resources Information Center

    Talan, Teri N.; Bloom, Paula Jorde

    2009-01-01

    The "BAS for Family Child Care" is the first valid and reliable tool for measuring and improving the overall quality of business and professional practices in family child care settings. It is applicable for multiple uses, including program self-improvement, technical assistance and monitoring, training, research and evaluation, and public…

  3. Business Administration Scale for Family Child Care (BAS). Second Edition

    ERIC Educational Resources Information Center

    Talan, Teri N.; Bloom, Paula Jorde

    2018-01-01

    The "Business Administration Scale for Family Child Care" (BAS) is the first valid and reliable tool for measuring and improving the overall quality of business and professional practices in family child care settings. It is applicable for multiple uses, including program self-improvement, technical assistance and monitoring, training,…

  4. Composted manure application promotes long-term invasion of semi-arid rangeland by Bromus tectorum

    USDA-ARS?s Scientific Manuscript database

    Composted organic matter derived from sewage treatment facilities or livestock manure from feedlots is often applied to rangelands of western North America to increase soil fertility, forage production, forage quality, and soil carbon (C) storage. This practice can have a number of undesirable side ...

  5. Examining the Quality of Technology Implementation in STEM Classrooms: Demonstration of an Evaluative Framework

    ERIC Educational Resources Information Center

    Parker, Caroline E.; Stylinski, Cathlyn D.; Bonney, Christina R.; Schillaci, Rebecca; McAuliffe, Carla

    2015-01-01

    Technology applications aligned with science, technology, engineering, and math (STEM) workplace practices can engage students in real-world pursuits but also present dramatic challenges for classroom implementation. We examined the impact of teacher professional development focused on incorporating these workplace technologies in the classroom.…

  6. [Application of spaced retrieval training on patients with dementia].

    PubMed

    Wu, Hua-Shan; Lin, Li-Chan

    2012-10-01

    Dementia causes semantic and episodic memory impairments that limit patients' activities of daily living (ADL) and increase caregiver burden. Spaced retrieval training uses repetitive retrieval to strengthen cognitive and motor skills intuitively in mild / moderate dementia patients who retain preserved implicit / non-declarative memory. This article describes and discusses the operative mechanism, influencing variables, and practical applications of spaced retrieval training. We hope this article increases professional understanding and application of this training approach to improve dementia patient ADL and improve quality of life for both caregivers and patients.

  7. Stem cell bioprocessing: fundamentals and principles

    PubMed Central

    Placzek, Mark R.; Chung, I-Ming; Macedo, Hugo M.; Ismail, Siti; Mortera Blanco, Teresa; Lim, Mayasari; Min Cha, Jae; Fauzi, Iliana; Kang, Yunyi; Yeo, David C.L.; Yip Joan Ma, Chi; Polak, Julia M.; Panoskaltsis, Nicki; Mantalaris, Athanasios

    2008-01-01

    In recent years, the potential of stem cell research for tissue engineering-based therapies and regenerative medicine clinical applications has become well established. In 2006, Chung pioneered the first entire organ transplant using adult stem cells and a scaffold for clinical evaluation. With this a new milestone was achieved, with seven patients with myelomeningocele receiving stem cell-derived bladder transplants resulting in substantial improvements in their quality of life. While a bladder is a relatively simple organ, the breakthrough highlights the incredible benefits that can be gained from the cross-disciplinary nature of tissue engineering and regenerative medicine (TERM) that encompasses stem cell research and stem cell bioprocessing. Unquestionably, the development of bioprocess technologies for the transfer of the current laboratory-based practice of stem cell tissue culture to the clinic as therapeutics necessitates the application of engineering principles and practices to achieve control, reproducibility, automation, validation and safety of the process and the product. The successful translation will require contributions from fundamental research (from developmental biology to the ‘omics’ technologies and advances in immunology) and from existing industrial practice (biologics), especially on automation, quality assurance and regulation. The timely development, integration and execution of various components will be critical—failures of the past (such as in the commercialization of skin equivalents) on marketing, pricing, production and advertising should not be repeated. This review aims to address the principles required for successful stem cell bioprocessing so that they can be applied deftly to clinical applications. PMID:19033137

  8. Stem cell bioprocessing: fundamentals and principles.

    PubMed

    Placzek, Mark R; Chung, I-Ming; Macedo, Hugo M; Ismail, Siti; Mortera Blanco, Teresa; Lim, Mayasari; Cha, Jae Min; Fauzi, Iliana; Kang, Yunyi; Yeo, David C L; Ma, Chi Yip Joan; Polak, Julia M; Panoskaltsis, Nicki; Mantalaris, Athanasios

    2009-03-06

    In recent years, the potential of stem cell research for tissue engineering-based therapies and regenerative medicine clinical applications has become well established. In 2006, Chung pioneered the first entire organ transplant using adult stem cells and a scaffold for clinical evaluation. With this a new milestone was achieved, with seven patients with myelomeningocele receiving stem cell-derived bladder transplants resulting in substantial improvements in their quality of life. While a bladder is a relatively simple organ, the breakthrough highlights the incredible benefits that can be gained from the cross-disciplinary nature of tissue engineering and regenerative medicine (TERM) that encompasses stem cell research and stem cell bioprocessing. Unquestionably, the development of bioprocess technologies for the transfer of the current laboratory-based practice of stem cell tissue culture to the clinic as therapeutics necessitates the application of engineering principles and practices to achieve control, reproducibility, automation, validation and safety of the process and the product. The successful translation will require contributions from fundamental research (from developmental biology to the 'omics' technologies and advances in immunology) and from existing industrial practice (biologics), especially on automation, quality assurance and regulation. The timely development, integration and execution of various components will be critical-failures of the past (such as in the commercialization of skin equivalents) on marketing, pricing, production and advertising should not be repeated. This review aims to address the principles required for successful stem cell bioprocessing so that they can be applied deftly to clinical applications.

  9. The Applicability of Lean and Six Sigma Techniques to Clinical and Translational Research

    PubMed Central

    Schweikhart, Sharon A.; Dembe, Allard E

    2010-01-01

    Background Lean and Six Sigma are business management strategies commonly used in production industries to improve process efficiency and quality. During the past decade, these process improvement techniques increasingly have been applied outside of the manufacturing sector, for example, in health care and in software development. This article concerns the potential use of Lean and Six Sigma to improve the processes involved in clinical and translational research. Improving quality, avoiding delays and errors, and speeding up the time to implementation of biomedical discoveries are prime objectives of the NIH Roadmap for Biomedical Research and the NIH Clinical and Translational Science Award (CTSA) program. Methods This article presents a description of the main principles, practices, and methodologies used in Lean and Six Sigma. Available literature involving applications of Lean and Six Sigma to health care, laboratory science, and clinical and translational research is reviewed. Specific issues concerning the use of these techniques in different phases of translational research are identified. Results Examples are provided of Lean and Six Sigma applications that are being planned at a current CTSA site, which could potentially be replicated elsewhere. We describe how different process improvement approaches are best adapted for particularly translational research phases. Conclusions Lean and Six Sigma process improvement methodologies are well suited to help achieve NIH’s goal of making clinical and translational research more efficient and cost-effective, enhancing the quality of the research, and facilitating the successful adoption of biomedical research findings into practice. PMID:19730130

  10. The applicability of Lean and Six Sigma techniques to clinical and translational research.

    PubMed

    Schweikhart, Sharon A; Dembe, Allard E

    2009-10-01

    Lean and Six Sigma are business management strategies commonly used in production industries to improve process efficiency and quality. During the past decade, these process improvement techniques increasingly have been applied outside the manufacturing sector, for example, in health care and in software development. This article concerns the potential use of Lean and Six Sigma in improving the processes involved in clinical and translational research. Improving quality, avoiding delays and errors, and speeding up the time to implementation of biomedical discoveries are prime objectives of the National Institutes of Health (NIH) Roadmap for Medical Research and the NIH's Clinical and Translational Science Award program. This article presents a description of the main principles, practices, and methods used in Lean and Six Sigma. Available literature involving applications of Lean and Six Sigma to health care, laboratory science, and clinical and translational research is reviewed. Specific issues concerning the use of these techniques in different phases of translational research are identified. Examples of Lean and Six Sigma applications that are being planned at a current Clinical and Translational Science Award site are provided, which could potentially be replicated elsewhere. We describe how different process improvement approaches are best adapted for particular translational research phases. Lean and Six Sigma process improvement methods are well suited to help achieve NIH's goal of making clinical and translational research more efficient and cost-effective, enhancing the quality of the research, and facilitating the successful adoption of biomedical research findings into practice.

  11. Consensus on best practice standards for Fracture Liaison Service in the Asia-Pacific region.

    PubMed

    Chan, Ding-Cheng Derrick; Chang, Lo-Yu; Akesson, Kristina E; Mitchell, Paul; Chen, Chung-Hwan; Michael Lewiecki, E; Lee, Joon Kiong; Lau, Tang Ching; Songpatanasilp, Thawee; Lee, Kin Bong; Kim, Kwang Joon; Chen, Jung-Fu; Huang, Ko-En; Gau, Yih-Lan; Chang, Yin-Fan; Ebeling, Peter; Xia, Weibo; Yu, Wei; Suzuki, Atsushi; Hew, Fen Lee; Mercado-Asis, Leilani B; Chung, Yoon-Sok; Tsai, Keh-Sung; Lin, Gau-Tyan; Yang, Rong-Sen; Wu, Chih-Hsing

    2018-05-12

    The Fracture Liaison Service (FLS) Consensus Meeting endorsed by the International Osteoporosis Foundation (IOF), Asian Federation of Osteoporosis Societies (AFOS), and Asia Pacific Osteoporosis Foundation (APOF) was hosted by the Taiwanese Osteoporosis Association on October 14, 2017. International and domestic experts reviewed the 13 Best Practice Framework (BPF) standards and concluded that all standards were generally applicable in the Asia-Pacific region and needed only minor modifications to fit the healthcare settings in the region. To review and generate consensus on best practices of fracture liaison service (FLS) in the Asia-Pacific (AP) region. In October 2017, the Taiwanese Osteoporosis Association (TOA) invited experts from the AP region (n = 23), the Capture the Fracture Steering Committee (n = 2), and the USA (n = 1) to join the AP region FLS Consensus Meeting in Taipei. After two rounds of consensus generation, the recommendations on the 13 Best Practice Framework (BPF) standards were reported and reviewed by the attendees. Experts unable to attend the on-site meeting reviewed the draft, made suggestions, and approved the final version. Because the number of FLSs in the region is rapidly increasing, experts agreed that it was timely to establish consensus on benchmark quality standards for FLSs in the region. They also agreed that the 13 BPF standards and the 3 levels of standards were generally applicable, but that some clarifications were necessary. They suggested, for example, that patient and family education be incorporated into the current standards and that communication with the public to promote FLSs be increased. The consensus on the 13 BPF standards reviewed in this meeting was that they were generally applicable and required only a few advanced clarifications to increase the quality of FLSs in the region.

  12. [Cultural adaptation of the Brazilian version of the Godin-Shephard Leisure-Time Physical Activity Questionnaire].

    PubMed

    São-João, Thaís Moreira; Rodrigues, Roberta Cunha Matheus; Gallani, Maria Cecilia Bueno Jayme; Miura, Cinthya Tamie de Passos; Domingues, Gabriela de Barros Leite; Godin, Gaston

    2013-06-01

    To conduct the cultural adaptation of the Brazilian version of the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) and to assess its content validity, practicability, acceptability and reliability. The stages of translation, synthesis, back translation, expert committee review and pre-test were carried out, followed by the evaluation of the practicability, acceptability and reliability (test-retest). The judges assessed its semantic, idiomatic, conceptual, cultural and metabolic equivalences. The adapted version was submitted to the pre-test (n = 20), and test-retest (n = 80), in healthy individuals and in those suffering from cardiovascular disease in Limeira, SP, Southeastern Brazil, between 2010 and 2011. The proportion of agreement of the committee of judges was assessed using the Content Validity Index. Reliability was assessed by the criterion of stability, with 15 days between applications. Practicability was evaluated by the time spent interviewing and acceptability was estimated as the percentage of unanswered items and the proportion of patients who responded to all items. The translated version of the questionnaire showed evidence of appropriate semantic-idiomatic, conceptual, cultural and metabolic equivalence, with substitutions of several physical activities more appropriate to the Brazilian population. The practicability analysis showed short time needed for the application of the instrument (mean 3.0 minutes). As for acceptability, all patients answered 100% of the items. The test-retest analysis suggested that stability was good (Intraclass Correlation Coefficient value of 0.84). The Brazilian version of the questionnaire showed satisfactory measures of the qualities in question. Its application to diverse populations in future studies is recommended in order to provide robust measures of these qualities.

  13. An application of Landsat and computer technology to potential water pollution from soil erosion

    NASA Technical Reports Server (NTRS)

    Campbell, W. J.

    1981-01-01

    Agricultural activity has been recognized as the primary source of nonpoint source water pollution. Water quality planners have needed information that is timely, accurate, easily reproducible, and relatively inexpensive to utilize to implement 'Best Management Practices' for water quality. In this paper, a case study shows how the combination of satellite data, which can give accurate land-cover/land-use information, and a computerized geographic information system, can assess nonpoint pollution at a regional scale and be cost effective.

  14. Getting past widgets and digits: the fundamental transformation of the foundations of nursing practice.

    PubMed

    Porter-O'Grady, Tim

    2014-01-01

    Health reform and transformation now call for the creation of a new landscape for nursing practice based on intentional translation application of value-driven measures of service, quality, and price. Nursing is a central driver in the effective recalibration of health care within the rubric of health transformation under the aegis of the Patient Protection and Affordable Care Act. Increasingly relying on a growing digital infrastructure, the nursing profession must now reframe both its practice foundations and patterns of practice to reflect emerging value-driven, health-grounded service requisites. Specific nursing responses are suggested, which position nursing to best coordinate, integrate, and facilitate health delivery in the emerging value-driven service environment.

  15. Good cell culture practices &in vitro toxicology.

    PubMed

    Eskes, Chantra; Boström, Ann-Charlotte; Bowe, Gerhard; Coecke, Sandra; Hartung, Thomas; Hendriks, Giel; Pamies, David; Piton, Alain; Rovida, Costanza

    2017-12-01

    Good Cell Culture Practices (GCCP) is of high relevance to in vitro toxicology. The European Society of Toxicology In Vitro (ESTIV), the Center for Alternatives for Animal Testing (CAAT) and the In Vitro Toxicology Industrial Platform (IVTIP) joined forces to address by means of an ESTIV 2016 pre-congress session the different aspects and applications of GCCP. The covered aspects comprised the current status of the OECD guidance document on Good In Vitro Method Practices, the importance of quality assurance for new technological advances in in vitro toxicology including stem cells, and the optimized implementation of Good Manufacturing Practices and Good Laboratory Practices for regulatory testing purposes. General discussions raised the duality related to the difficulties in implementing GCCP in an academic innovative research framework on one hand, and on the other hand, the need for such GCCP principles in order to ensure reproducibility and robustness of in vitro test methods for toxicity testing. Indeed, if good cell culture principles are critical to take into consideration for all uses of in vitro test methods for toxicity testing, the level of application of such principles may depend on the stage of development of the test method as well as on the applications of the test methods, i.e., academic innovative research vs. regulatory standardized test method. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Reducing microbial contamination in storm runoff from high use areas on California coastal dairies.

    PubMed

    Lewis, D J; Atwill, E R; Lennox, M S; Pereira, M D G; Miller, W A; Conrad, P A; Tate, K W

    2009-01-01

    High use areas are a fundamental part of California coastal dairies and grazing livestock ranches as feeding areas, nurseries, and sick pens. High stocking densities and daily use in these areas lead to soil surfaces devoid of vegetation and covered in manure, with high potential for manure transport during winter rains to receiving waters regulated for shellfish harvesting and recreation. We characterized the association between California's Mediterranean climate and a series of existing and proposed management practices on fecal coliform bacteria (FCB) transport from high use areas on dairies and ranches. Results from 351 storm runoff samples collected below 35 high-use areas indicate that removal of cattle during winter, locating high use areas on level ground, application of straw and seeding, and vegetative buffer strip implementation were significantly associated with FCB concentration and load reductions. These results complement our findings for reductions of specific pathogens in runoff from these areas. These findings have practical significance because they document surface water quality benefits that the studied management practices provide in application on working farms and ranches. This direction is critical and timely for on-farm management efforts seeking to reduce microbial pollution in runoff and comply with indicator bacteria water quality criteria.

  17. Multiple Interactive Pollutants in Water Quality Trading

    NASA Astrophysics Data System (ADS)

    Sarang, Amin; Lence, Barbara J.; Shamsai, Abolfazl

    2008-10-01

    Efficient environmental management calls for the consideration of multiple pollutants, for which two main types of transferable discharge permit (TDP) program have been described: separate permits that manage each pollutant individually in separate markets, with each permit based on the quantity of the pollutant or its environmental effects, and weighted-sum permits that aggregate several pollutants as a single commodity to be traded in a single market. In this paper, we perform a mathematical analysis of TDP programs for multiple pollutants that jointly affect the environment (i.e., interactive pollutants) and demonstrate the practicality of this approach for cost-efficient maintenance of river water quality. For interactive pollutants, the relative weighting factors are functions of the water quality impacts, marginal damage function, and marginal treatment costs at optimality. We derive the optimal set of weighting factors required by this approach for important scenarios for multiple interactive pollutants and propose using an analytical elasticity of substitution function to estimate damage functions for these scenarios. We evaluate the applicability of this approach using a hypothetical example that considers two interactive pollutants. We compare the weighted-sum permit approach for interactive pollutants with individual permit systems and TDP programs for multiple additive pollutants. We conclude by discussing practical considerations and implementation issues that result from the application of weighted-sum permit programs.

  18. International Watershed Technology: Improving Water Quality and Quantity at the Local, Basin, and Regional Scales

    USGS Publications Warehouse

    Tollner, Ernest W.; Douglas-Mankin, Kyle R.

    2017-01-01

    This article introduces the five papers in the “International Watershed Technology” collection. These papers were selected from 60 technical presentations at the fifth biennial ASABE 21st Century Watershed Technology Conference and Workshop: Improving the Quality of Water Resources at Local, Basin, and Regional Scales, held in Quito, Ecuador, on 3-9 December 2016. The conference focused on solving spatial and temporal water quality and quantity problems and addressed topics such as watershed management in developing countries, aquatic ecology and ecohydrology, ecosystem services, climate change mitigation strategies, flood forecasting, remote sensing, and water resource policy and management. While diverse, the presentation topics reflected the continuing evolution of the “data mining” and “big data” themes of past conferences related to geospatial data applications, with increasing emphasis on practical solutions. The papers selected for this collection represent applications of spatial data analyses toward practical ends with a theme of “tools and techniques for sustainability.” The papers address a range of topics, including the matching of crops with water availability, and assessing the environmental impacts of agricultural production. The papers identify some of the latest tools and techniques for improving sustainability in watershed resource management that are relevant to both developing and developed countries.

  19. Quality appraisal of clinical practice guidelines on the use of physiotherapy in rheumatoid arthritis: a systematic review.

    PubMed

    Hurkmans, Emalie J; Jones, Anamaria; Li, Linda C; Vliet Vlieland, Theodora P M

    2011-10-01

    To assess the quality of guidelines published in peer-reviewed literature concerning the role of physiotherapy in the management of patients with RA. A systematic literature search for clinical practice guidelines that included physiotherapy interventions was performed in four electronic databases. We assessed the quality of the selected guidelines using the appraisal of guidelines for research and evaluation (AGREE) instrument. In addition, the recommendations of guidelines with the highest quality scores were summarized. Eight clinical practice guidelines fulfilled the inclusion criteria. Scope/purpose was the most often adequately addressed AGREE domain (in seven of the eight guidelines) and applicability the least (in two of the eight guidelines). Based on the AGREE domain scores, six guidelines could be recommended or strongly recommended for clinical use. Five out of these six (strongly) recommended guidelines included a recommendation on exercise therapy and/or patient education, with these interventions being recommended in every case. Transcutaneous electrical nerve stimulation and thermotherapy were recommended in four of these six guidelines. US, thermotherapy, low-level laser therapy, massage, passive mobilization and balneotherapy were addressed in one or two of these six guidelines. Six of eight clinical practice guidelines addressing physiotherapy interventions were recommended or strongly recommended according to the AGREE instrument. In general, guideline recommendations on physiotherapy intervention, from both the recommended guidelines as well as from the not recommended guidelines, lacked detail concerning mode of delivery, intensity, frequency and duration.

  20. Applicability of market-based instruments for safeguarding water quality in coastal waterways: Case study for Darwin Harbour, Australia

    NASA Astrophysics Data System (ADS)

    Greiner, Romy

    2014-02-01

    Water pollution of coastal waterways is a complex problem due to the cocktail of pollutants and multiplicity of polluters involved and pollution characteristics. Pollution control therefore requires a combination of policy instruments. This paper examines the applicability of market-based instruments to achieve effective and efficient water quality management in Darwin Harbour, Northern Territory, Australia. Potential applicability of instruments is examined in the context of biophysical and economic pollution characteristics, and experience with instruments elsewhere. The paper concludes that there is potential for inclusion of market-based instruments as part of an instrument mix to safeguard water quality in Darwin Harbour. It recommends, in particular, expanding the existing licencing system to include quantitative pollution limits for all significant point polluters; comprehensive and independent pollution monitoring across Darwin Harbour; public disclosure of water quality and emissions data; positive incentives for landholders in the Darwin Harbour catchment to improve land management practices; a stormwater offset program for greenfield urban developments; adoption of performance bonds for developments and operations which pose a substantial risk to water quality, including port expansion and dredging; and detailed consideration of a bubble licensing scheme for nutrient pollution. The paper offers an analytical framework for policy makers and resource managers tasked with water quality management in coastal waterways elsewhere in Australia and globally, and helps to scan for MBIs suitable in any given environmental management situation.

  1. Comprehensive Performance Study of Magneto Cantilevers as a Candidate Model for Biological Sensors used in Lab-on-a-Chip Applications

    PubMed Central

    Saberkari, Hamidreza; Ghavifekr, Habib Badri; Shamsi, Mousa

    2015-01-01

    In recent years, demand for biological sensors which are capable of fast and accurate detection of minor amounts of pathogens in real-time form has been intensified. Acoustic wave (AW) devices whose performance is determined by mass sensitivity parameters and quality factor are used in biological sensors as platforms with high quality. Yet, current AW devices are facing many challenges such as the low value of their quality factor in practical applications and also their difficulty to use in liquids. The main focus of this article is to study on the magnetostrictive sensors which include milli/microcantilever (MSMC) type. In comparison with AW devices, MSMC has a lot of advantages; (1) its actuation and sensing unit is wirelessly controlled. (2) Its fabrication process is easy. (3) It works well in liquids. (4) It has a high-quality factor (in the air > 500). Simulation results demonstrate that the amount of quality factor depends on environment properties (density and viscosity), MSMC geometry, and its resonant behavior of harmonic modes. PMID:26120566

  2. Wellbeing Understanding in High Quality Healthcare Informatics and Telepractice.

    PubMed

    Fiorini, Rodolfo A; De Giacomo, Piero; L'Abate, Luciano

    2016-01-01

    The proper use of healthcare informatics technology and multidimensional conceptual clarity are fundamental to create and boost outstanding clinical and telepractice results. Avoiding even terminology ambiguities is mandatory for high quality of care service. For instance, well-being or wellbeing is a different way to write the same concept only, or there is a good deal of ambiguity around the meanings of these terms the way they are written. In personal health, healthcare and healthcare informatics, this kind of ambiguity and lack of conceptual clarity has been called out repeatedly over the past 50 years. It is time to get the right, terse scenario. We present a brief review to develop and achieve ultimate wellbeing understanding for practical high quality healthcare informatics and telepractice application. This article presents an innovative point of view on deeper wellbeing understanding towards its increased clinical effective application.

  3. A sequential factorial analysis approach to characterize the effects of uncertainties for supporting air quality management

    NASA Astrophysics Data System (ADS)

    Wang, S.; Huang, G. H.; Veawab, A.

    2013-03-01

    This study proposes a sequential factorial analysis (SFA) approach for supporting regional air quality management under uncertainty. SFA is capable not only of examining the interactive effects of input parameters, but also of analyzing the effects of constraints. When there are too many factors involved in practical applications, SFA has the advantage of conducting a sequence of factorial analyses for characterizing the effects of factors in a systematic manner. The factor-screening strategy employed in SFA is effective in greatly reducing the computational effort. The proposed SFA approach is applied to a regional air quality management problem for demonstrating its applicability. The results indicate that the effects of factors are evaluated quantitatively, which can help decision makers identify the key factors that have significant influence on system performance and explore the valuable information that may be veiled beneath their interrelationships.

  4. Identifying and Promoting Best Practices in Residency Application and Selection in a Complex Academic Health Network.

    PubMed

    Bandiera, Glen; Abrahams, Caroline; Ruetalo, Mariela; Hanson, Mark D; Nickell, Leslie; Spadafora, Salvatore

    2015-12-01

    Medical education institutions have a social mandate to produce a diverse physician workforce that meets the public's needs. Recent reports have framed the admission process outcome of undergraduate and postgraduate medical education (UGME and PGME) programs as a key determinant of the collective contributions graduating cohorts will make to society, creating a sense of urgency around the issue of who gets accepted. The need for evidence-informed residency application and selection processes is growing because of the increasing size and diversity of the applicant pool and the need for equity, fairness, social accountability, and health human resource planning. The selection literature, however, is dominated by a UGME focus and emphasizes determination of desirable qualities of future physicians and selection instrument reliability and validity. Gaps remain regarding PGME selection, particularly the creation of specialty-specific selection criteria, suitable outcome measures, and reliable selection systems.In this Perspective, the authors describe the University of Toronto's centralized approach to defining system-level best practices for residency application and selection. Over the 2012-2013 academic year, the Best Practices in Application and Selection working group reviewed relevant literature and reports, consulted content experts, surveyed local practices, and conducted iterative stakeholder consultations on draft recommendations. Strong agreement arose around the resulting 13 principles and 24 best practices, which had either empirical support or face validity. These recommendations, which are shared in this article, have been adopted by the university's PGME advisory committee and will inform a national initiative to improve trainees' transition from UGME to PGME in Canada.

  5. Improving opioid safety practices in primary care: protocol for the development and evaluation of a multifaceted, theory-informed pilot intervention for healthcare providers

    PubMed Central

    Leece, Pamela; Buchman, Daniel Z; Hamilton, Michael; Timmings, Caitlyn; Shantharam, Yalnee; Moore, Julia; Furlan, Andrea D

    2017-01-01

    Introduction In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. Methods and analysis Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians. The intervention uses practical educational and self-assessment tools to provide prescribers with feedback on their current knowledge and practices, and resources to improve their practice. The evaluation approach uses a pretest and post-test design and includes both quantitative and qualitative methods at baseline and 6 months. We will recruit a purposive sample of approximately 10 family physicians in Ontario from diverse practice settings, who currently treat patients with long-term opioid therapy for chronic pain. Quantitative data will be analysed using basic descriptive statistics, and qualitative data will be analysed using the Framework Method. Ethics and dissemination The University Health Network Research Ethics Board approved this study. Dissemination plan includes publications, conference presentations and brief stakeholder reports. This evidence-informed, theory-driven intervention has implications for national application of opioid quality improvement tools in primary care settings. We are engaging experts and end users in advisory and stakeholder roles throughout our project to increase its national relevance, application and sustainability. The performance measures could be used as the basis for health system quality improvement indicators to monitor opioid prescribing. Additionally, the methods and approach used in this study could be adapted for other opioid guidelines, or applied to other areas of preventive healthcare and clinical guideline implementation processes. PMID:28446522

  6. Statistical efficiency of adaptive algorithms.

    PubMed

    Widrow, Bernard; Kamenetsky, Max

    2003-01-01

    The statistical efficiency of a learning algorithm applied to the adaptation of a given set of variable weights is defined as the ratio of the quality of the converged solution to the amount of data used in training the weights. Statistical efficiency is computed by averaging over an ensemble of learning experiences. A high quality solution is very close to optimal, while a low quality solution corresponds to noisy weights and less than optimal performance. In this work, two gradient descent adaptive algorithms are compared, the LMS algorithm and the LMS/Newton algorithm. LMS is simple and practical, and is used in many applications worldwide. LMS/Newton is based on Newton's method and the LMS algorithm. LMS/Newton is optimal in the least squares sense. It maximizes the quality of its adaptive solution while minimizing the use of training data. Many least squares adaptive algorithms have been devised over the years, but no other least squares algorithm can give better performance, on average, than LMS/Newton. LMS is easily implemented, but LMS/Newton, although of great mathematical interest, cannot be implemented in most practical applications. Because of its optimality, LMS/Newton serves as a benchmark for all least squares adaptive algorithms. The performances of LMS and LMS/Newton are compared, and it is found that under many circumstances, both algorithms provide equal performance. For example, when both algorithms are tested with statistically nonstationary input signals, their average performances are equal. When adapting with stationary input signals and with random initial conditions, their respective learning times are on average equal. However, under worst-case initial conditions, the learning time of LMS can be much greater than that of LMS/Newton, and this is the principal disadvantage of the LMS algorithm. But the strong points of LMS are ease of implementation and optimal performance under important practical conditions. For these reasons, the LMS algorithm has enjoyed very widespread application. It is used in almost every modem for channel equalization and echo cancelling. Furthermore, it is related to the famous backpropagation algorithm used for training neural networks.

  7. Bringing quality improvement into the intensive care unit.

    PubMed

    McMillan, Tracy R; Hyzy, Robert C

    2007-02-01

    During the last several years, many governmental and nongovernmental organizations have championed the application of the principles of quality improvement to the practice of medicine, particularly in the area of critical care. To review the breadth of approaches to quality improvement in the intensive care unit, including measures such as mortality and length of stay, and the use of protocols, bundles, and the role of large, multiple-hospital collaboratives. Several agencies have participated in the application of the quality movement to medicine, culminating in the development of standards such as the intensive care unit core measures of the Joint Commission on Accreditation of Healthcare Organizations. Although "zero defects" may not be possible in all measurable variables of quality in the intensive care unit, several measures, such as catheter-related bloodstream infections, can be significantly reduced through the implementation of improved processes of care, such as care bundles. Large, multiple-center, quality improvement collaboratives, such as the Michigan Keystone Intensive Care Unit Project, may be particularly effective in improving the quality of care by creating a "bandwagon effect" within a geographic region. The quality revolution is having a significant effect in the critical care unit and is likely to be facilitated by the transition to the electronic medical record.

  8. Evaluation of agricultural best-management practices in the Conestoga River headwaters, Pennsylvania; effects of nutrient management on quality of surface runoff at a small carbonate-rock site near Ephrate, Pennsylvania, 1984-90

    USGS Publications Warehouse

    Hall, D.W.; Lietman, P.L.; Koerkle, E.J.

    1997-01-01

    The U.S. Geological Survey and the Pennsylvania Department of Environmental Protection conducted a study from 1984 to 1990 to determine theeffects of the implementation and practice of nutrient management [an agricultural best-management practice (BMP)] on the quality of surface runoff and ground water at a 55-acre crop and livestock farm in carbonate terrain nearEphrata, Pa. Implementation of nutrient management at Field-Site 2 resulted in application decreases of 33 percent for nitrogen and 29 percent for phosphorus. There wereno significant changes in nitrogen or phosphorusloads for a given amount of runoff from the pre-BMP to the post-BMP periods. However, less than 2 percent of the applied nutrients weredischarged with runoff throughout the study period.After the implementation of nutrient management, statistically significant decreases in concentrations of nitrate in ground-water samples occurred at threeof the four wells monitored throughout the pre- and post-BMP periods. The largest decreases in nitrate concentrations occurred at wells where samples hadthe largest nitrate concentrations prior to nutrient management. Changes in nitrogen applications to the contributing areas of five wells were correlated with nitrate concentrations of the well water. The correlations between the timing and amount of applied nitrogen and changes in ground-water quality met the four conditions that are characteristic of a cause-effect relation: an association, consistency, responsiveness, and a mechanism. Changes in ground-water nitrate concentrations lagged behind changes in loading of nitrogen fertilizers (primarily manure) by approximately 4 to 19 months.

  9. Estimating Legacy Soil Phosphorus Impacts on Phosphorus Loss in The Chesapeake Bay Watershed

    USDA-ARS?s Scientific Manuscript database

    Agricultural nutrient management is an issue due to phosphorus (P) loss from fields and water quality degradation. This is especially true in watersheds where a history of P application in excess of crop needs has resulted in elevated soil P (legacy P). As practices and policy are implemented in suc...

  10. The limnology of a Mississippi River alluvial plain oxbow lake following the application of conservation practices

    USDA-ARS?s Scientific Manuscript database

    From 1995 and 2011 Beasley Lake watershed near Indianola, MS, was subjected to a variety of conservation measures designed to reduce water velocity, erosion and discharge of sediment laden water. Water quality monitoring during the period indicated a number of long term trends and relationships bet...

  11. Tire Production and Pollution Control. Environmental Education Curriculum. Revised.

    ERIC Educational Resources Information Center

    Topeka Public Schools, KS.

    This unit was developed to introduce secondary students to the many facets of a typical, large manufacturing plant - the Topeka Goodyear Tire and Rubber Company - in an effort to increase awareness of sound environmental practices in industry. Its five major foci include the production of tires and quality control procedures; applications of…

  12. Adding Value to a Graduate Physiology Seminar by Focusing on Public Communication Skills

    ERIC Educational Resources Information Center

    LaRocca, Thomas J.; Justice, Jamie N.; Seals, Douglas R.; Martens, Christopher R.

    2016-01-01

    A major goal of graduate education is the development of students as "stewards of the discipline," scholars who can create and preserve knowledge and responsibly translate it through writing, teaching, and practical applications. These qualities are consistent with the American Physiological Society's list of professional skills for…

  13. Reduction in a commercial potato irrigation schedule during tuber bulking in Florida: Physiological, Yield, and Quality effects

    USDA-ARS?s Scientific Manuscript database

    Proper irrigation scheduling in potato (Solanum tuberosum L.) can lead to higher returns and more sustainable production practices when compared to systems that do not take plant water demand into account. In an attempt to reduce irrigation applications while minimizing yield reduction, we evaluated...

  14. The Needs of Faculty and Administrators: The Perspective of a Dean.

    ERIC Educational Resources Information Center

    Colaizzi, John L.

    1982-01-01

    Among the critical needs in pharmacy programs are: emphasis on quality of leadership, faculty, and student applicant pool; faculty research and scholarly activity; curricular balance and strength; and a suitable mix of practice sites. Colleges of pharmacy have the responsibility of ensuring the future economic viability of the profession. (MSE)

  15. Learning curves in health care.

    PubMed

    Waldman, J Deane; Yourstone, Steven A; Smith, Howard L

    2003-01-01

    This article explores the uses of learning curve theory in medicine. Though effective application of learning curve theory in health care can result in higher quality and lower cost, it is seldom methodically applied in clinical practice. Fundamental changes are necessary in the corporate culture of medicine in order to capitalize maximally on the benefits of learning.

  16. ISO 9000 and Malcolm Baldrige: In Training and Education. A Practical Application Guide.

    ERIC Educational Resources Information Center

    Russo, C. W. Russ

    This book is addressed to educators and work-place trainers interested in applying the Malcolm Baldrige award criteria and/or the International Organization for Standardization (ISO) 9000 training guidelines for program improvement. An initial section compares and contrasts the ISO standards and the Malcolm Baldrige National Quality Award…

  17. A Shared Experience: An Interdisciplinary Professional Doctorate in Health and Social Care

    ERIC Educational Resources Information Center

    Mcvicar, Andrew; Caan, Woody; Hillier, Dawn; Munn-Giddings, Carol; Ramon, Shulamit; Winter, Richard

    2006-01-01

    This paper describes the development of an innovative interprofessional doctorate in health and social care, within an academic framework designed explicitly to ensure that candidates must demonstrate qualities of cognitive application commensurate with doctoral study, yet must also meet the practice-focused outcomes of a professional doctorate.…

  18. [Implementation of clinical practice guidelines: how can we close the evidence-practice gap?].

    PubMed

    Muche-Borowski, Cathleen; Nothacker, M; Kopp, I

    2015-01-01

    Guidelines are intended as instruments of knowledge transfer to support decision-making by physicians, other health professionals and patients in clinical practice and thereby contribute to quality improvements in healthcare. To date they are an indispensable tool for healthcare. Their benefit for patients can only be seen in application, i.e. the implementation of guideline recommendations. For successful implementation, implementability and practicability play a crucial role and these characteristics can be influenced and should be promoted by the guideline development group. In addition, a force field analysis to identify barriers against and facilitators for the implementation of specific guideline recommendations from the perspective of physicians and patients is recommended to guide the development of an individual implementation strategy and the selection of appropriate interventions. However, implementation cannot be achieved by the guideline development group alone and a universal implementation strategy does not exist. Therefore, a process using theory, analysis, experience and shared responsibility of stakeholders in healthcare is recommended, with the aim to achieve sustainable behavioral change and improve the quality of care by guideline-oriented behavior.

  19. Using an expanded outcomes framework and continuing education evidence to improve facilitation of patient-centered medical home recognition and transformation.

    PubMed

    Van Hoof, Thomas J; Kelvey-Albert, Michele; Katz, Matthew; Lalime, Ken; Sacks, Ken; Meehan, Thomas P

    2014-01-01

    The patient-centered medical home is a model for delivering primary care in the United States. Primary care clinicians and their staffs require assistance in understanding the innovation and in applying it to practice. The purpose of this article is to describe and to critique a continuing education program that is relevant to, and will become more common in, primary care. A multifaceted educational strategy prepared 20 primary care private practices to achieve National Committee for Quality Assurance Level 3 recognition as Patient-Centered Medical Homes. Eighteen (90%) practices submitted an application to the National Committee for Quality Assurance. On the first submission attempt, 13 of 18 (72%) achieved Level 3 recognition and 5 (28%) achieved Level 1 recognition. An interactive multifaceted educational strategy can be successful in preparing primary care practices for Patient-Centered Medical Homes recognition, but the strategy may not ensure transformation. Future educational activities should consider an expanded outcomes framework and the evidence of effective continuing education to be more successful with recognition and transformation.

  20. Advances in diagnostic ultrasonography.

    PubMed

    Reef, V B

    1991-08-01

    A wide variety of ultrasonographic equipment currently is available for use in equine practice, but no one machine is optimal for every type of imaging. Image quality is the most important factor in equipment selection once the needs of the practitioner are ascertained. The transducer frequencies available, transducer footprints, depth of field displayed, frame rate, gray scale, simultaneous electrocardiography, Doppler, and functions to modify the image are all important considerations. The ability to make measurements off of videocassette recorder playback and future upgradability should be evaluated. Linear array and sector technology are the backbone of equine ultrasonography today. Linear array technology is most useful for a high-volume broodmare practice, whereas sector technology is ideal for a more general equine practice. The curved or convex linear scanner has more applications than the standard linear array and is equipped with the linear array rectal probe, which provides the equine practitioner with a more versatile unit for equine ultrasonographic evaluations. The annular array and phased array systems have improved image quality, but each has its own limitations. The new sector scanners still provide the most versatile affordable equipment for equine general practice.

  1. Applying openEHR's Guideline Definition Language to the SITS international stroke treatment registry: a European retrospective observational study.

    PubMed

    Anani, Nadim; Mazya, Michael V; Chen, Rong; Prazeres Moreira, Tiago; Bill, Olivier; Ahmed, Niaz; Wahlgren, Nils; Koch, Sabine

    2017-01-10

    Interoperability standards intend to standardise health information, clinical practice guidelines intend to standardise care procedures, and patient data registries are vital for monitoring quality of care and for clinical research. This study combines all three: it uses interoperability specifications to model guideline knowledge and applies the result to registry data. We applied the openEHR Guideline Definition Language (GDL) to data from 18,400 European patients in the Safe Implementation of Treatments in Stroke (SITS) registry to retrospectively check their compliance with European recommendations for acute stroke treatment. Comparing compliance rates obtained with GDL to those obtained by conventional statistical data analysis yielded a complete match, suggesting that GDL technology is reliable for guideline compliance checking. The successful application of a standard guideline formalism to a large patient registry dataset is an important step toward widespread implementation of computer-interpretable guidelines in clinical practice and registry-based research. Application of the methodology gave important results on the evolution of stroke care in Europe, important both for quality of care monitoring and clinical research.

  2. Assessing Program Learning Objectives to Improve Undergraduate Physics Education

    NASA Astrophysics Data System (ADS)

    Menke, Carrie

    2014-03-01

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

  3. Application of organic acids for plant protection against phytopathogens.

    PubMed

    Morgunov, Igor G; Kamzolova, Svetlana V; Dedyukhina, Emilia G; Chistyakova, Tatiana I; Lunina, Julia N; Mironov, Alexey A; Stepanova, Nadezda N; Shemshura, Olga N; Vainshtein, Mikhail B

    2017-02-01

    The basic tendency in the field of plant protection concerns with reducing the use of pesticides and their replacement by environmentally acceptable biological preparations. The most promising approach to plant protection is application of microbial metabolites. In the last years, bactericidal, fungicidal, and nematodocidal activities were revealed for citric, succinic, α-ketoglutaric, palmitoleic, and other organic acids. It was shown that application of carboxylic acids resulted in acceleration of plant development and the yield increase. Of special interest is the use of arachidonic acid in very low concentrations as an inductor (elicitor) of protective functions in plants. The bottleneck in practical applications of these simple, nontoxic, and moderately priced preparations is the absence of industrial production of the mentioned organic acids of required quality since even small contaminations of synthetic preparations decrease their quality and make them dangerous for ecology and toxic for plants, animals, and human. This review gives a general conception on the use of organic acids for plant protection against the most dangerous pathogens and pests, as well as focuses on microbiological processes for production of these microbial metabolites of high quality from available, inexpensive, and renewable substrates.

  4. Surgical innovation and quality assurance: Can we have both?

    PubMed

    Georgeson, Keith

    2015-06-01

    Innovation is the major force for progress in pediatric surgery. Most of the progress in surgery has evolved secondary to novel approaches developed by surgeons confronted with difficult pathologic conditions. Up to the present time, most surgical innovation has been practiced with few rules for guidance. Innovation to make surgical procedures more effective and less morbid is highly desirable. However, the absence of oversight has the potential to lead to unbridled human experimentation. The quality improvement movement in medicine is attempting to improve outcomes using evidence-based clinical pathways. Quality improvement aims to decrease the variation in therapeutic approaches by scientifically defining best practices. There is a significant potential for autonomous surgical innovators to clash with well-meaning proponents of quality improvement. A suggested remedy to encourage surgical innovators while protecting patients from unintended harm is for institutions to develop Surgical Innovation Committees to evaluate and give oversight to the early application of new techniques and devices. Scientific evaluation under the auspices of an IRB should follow when feasible. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Quality and safety aspects in histopathology laboratory

    PubMed Central

    Adyanthaya, Soniya; Jose, Maji

    2013-01-01

    Histopathology is an art of analyzing and interpreting the shapes, sizes and architectural patterns of cells and tissues within a given specific clinical background and a science by which the image is placed in the context of knowledge of pathobiology, to arrive at an accurate diagnosis. To function effectively and safely, all the procedures and activities of histopathology laboratory should be evaluated and monitored accurately. In histopathology laboratory, the concept of quality control is applicable to pre-analytical, analytical and post-analytical activities. Ensuring safety of working personnel as well as environment is also highly important. Safety issues that may come up in a histopathology lab are primarily those related to potentially hazardous chemicals, biohazardous materials, accidents linked to the equipment and instrumentation employed and general risks from electrical and fire hazards. This article discusses quality management system which can ensure quality performance in histopathology laboratory. The hazards in pathology laboratories and practical safety measures aimed at controlling the dangers are also discussed with the objective of promoting safety consciousness and the practice of laboratory safety. PMID:24574660

  6. Development and production of good manufacturing practice grade human embryonic stem cell lines as source material for clinical application.

    PubMed

    De Sousa, P A; Downie, J M; Tye, B J; Bruce, K; Dand, P; Dhanjal, S; Serhal, P; Harper, J; Turner, M; Bateman, M

    2016-09-01

    From 2006 to 2011, Roslin Cells Ltd derived 17 human embryonic stem cells (hESC) while developing (RCM1, RC-2 to -8, -10) and implementing (RC-9, -11 to -17) quality assured standards of operation in a facility operating in compliance with European Union (EU) directives and United Kingdom (UK) licensure for procurement, processing and storage of human cells as source material for clinical application, and targeted to comply with an EU Good Manufacturing Practice specification. Here we describe the evolution and specification of the facility, its operation and outputs, complementing hESC resource details communicated in Stem Cell Research Lab Resources. Copyright © 2016. Published by Elsevier B.V.

  7. Director of nursing and midwifery leadership: informed through the lens of critical social science.

    PubMed

    Solman, Annette

    2010-05-01

    Highlight the use of critical social science theories, practice development principles and a situational leadership framework within transformational leadership to inform Directors of Nursing and Midwifery (DoNM) practices as leaders. Healthcare is constantly changing, unpredictable, strives for quality service and cost containment, which can result in stress and crisis for healthcare workers. DoNM leadership is critical to supporting and leading staff through these complex times within healthcare. Understanding theories, frameworks and their application to real-world practice can assist in supporting individuals and teams to navigate through the changing healthcare environment. Blending critical social science theories with practice development principles and the situational leadership framework can assist the DoNM to enact transformational leadership to support the development of individuals and teams to meet the complex healthcare needs of patients within the clinical setting. IMPLICATIONS FOR NURSE MANAGEMENT: This article contributes through the practical application of critical social science theories, practice development principles and situational leadership framework within transformational leadership as an approach for enacting DoNM leadership. To further understand and develop in the role of the contemporary DoNM in leadership, these directors are encouraged to publish their work.

  8. Comprehensive nursing case management. An advanced practice model.

    PubMed

    Taylor, P

    1999-01-01

    Under managed care and capitated reimbursement systems, case management is a core strategy for providing high-quality, cost-effective care by decreasing fragmentation, enhancing quality, ensuring efficient use of resources, and containing costs. Although case management is used in various areas of the healthcare arena, it suffers from a lack of consensus regarding its definition, essential components, and appropriate application. The purpose of this paper is to examine the components and limitations of existing case management models, outline the competencies of an effective case manager, and present a model of advanced practice nursing case management that focuses on a continuum of care that integrates medical and psychosocial resources to promote optimal clinical fiscal outcomes and enables patients to work as partners with the healthcare team in facilitating and maintaining their physical and emotional well-being.

  9. Value-based medicine: concepts and application.

    PubMed

    Bae, Jong-Myon

    2015-01-01

    Global healthcare in the 21st century is characterized by evidence-based medicine (EBM), patient-centered care, and cost effectiveness. EBM involves clinical decisions being made by integrating patient preference with medical treatment evidence and physician experiences. The Center for Value-Based Medicine suggested value-based medicine (VBM) as the practice of medicine based upon the patient-perceived value conferred by an intervention. VBM starts with the best evidence-based data and converts it to patient value-based data, so that it allows clinicians to deliver higher quality patient care than EBM alone. The final goals of VBM are improving quality of healthcare and using healthcare resources efficiently. This paper introduces the concepts and application of VBM and suggests some strategies for promoting related research.

  10. Practical applications of nondestructive materials characterization

    NASA Astrophysics Data System (ADS)

    Green, Robert E., Jr.

    1992-10-01

    Nondestructive evaluation (NDE) techniques are reviewed for applications to the industrial production of materials including microstructural, physical, and chemical analyses. NDE techniques addressed include: (1) double-pulse holographic interferometry for sealed-package leak testing; (2) process controls for noncontact metals fabrication; (3) ultrasonic detections of oxygen contamination in titanium welds; and (4) scanning acoustic microscopy for the evaluation of solder bonds. The use of embedded sensors and emerging NDE concepts provides the means for controlling the manufacturing and quality of quartz crystal resonators, nickel single-crystal turbine blades, and integrated circuits. Advances in sensor technology and artificial intelligence algorithms and the use of embedded sensors combine to make NDE technology highly effective in controlling industrial materials manufacturing and the quality of the products.

  11. Value-based medicine: concepts and application

    PubMed Central

    Bae, Jong-Myon

    2015-01-01

    Global healthcare in the 21st century is characterized by evidence-based medicine (EBM), patient-centered care, and cost effectiveness. EBM involves clinical decisions being made by integrating patient preference with medical treatment evidence and physician experiences. The Center for Value-Based Medicine suggested value-based medicine (VBM) as the practice of medicine based upon the patient-perceived value conferred by an intervention. VBM starts with the best evidence-based data and converts it to patient value-based data, so that it allows clinicians to deliver higher quality patient care than EBM alone. The final goals of VBM are improving quality of healthcare and using healthcare resources efficiently. This paper introduces the concepts and application of VBM and suggests some strategies for promoting related research. PMID:25773441

  12. Assurance of Myeloid Growth Factor Administration in an Infusion Center: Pilot Quality Improvement Initiative.

    PubMed

    Ramirez, Pamela Maree; Peterson, Barry; Holtshopple, Christine; Borja, Kristina; Torres, Vincent; Valdivia-Peppers, Lucille; Harriague, Julio; Joe, Melanie D

    2017-12-01

    Four incident reports involving missed doses of myeloid growth factors (MGFs) triggered the need for an outcome-driven initiative. From March 1, 2015, to February 29, 2016, at University of California Irvine Health Chao Infusion Center, 116 of 3,300 MGF doses were missed (3.52%), including pegfilgrastim, filgrastim, and sargramostim. We hypothesized that with the application of Lean Six Sigma methodology, we would achieve our primary objective of reducing the number of missed MGF doses to < 0.5%. This quality improvement initiative was conducted at Chao Infusion Center as part of a Lean Six Sigma Green Belt Certification Program. Therefore, Lean Six Sigma principles and tools were used throughout each phase of the project. Retrospective and prospective medical record reviews and data analyses were performed to evaluate the extent of the identified problem and impact of the process changes. Improvements included systems applications, practice changes, process modifications, and safety-net procedures. Preintervention, 24 missed doses (20.7%) required patient supportive care measures, resulting in increased hospital costs and decreased quality of care. Postintervention, from June 8, 2016, to August 7, 2016, zero of 489 MGF doses were missed after 2 months of intervention ( P < .001). Chao Infusion Center reduced missed doses from 3.52% to 0%, reaching the goal of < 0.5%. The establishment of simplified and standardized processes with safety checks for error prevention increased quality of care. Lean Six Sigma methodology can be applied by other institutions to produce positive outcomes and implement similar practice changes.

  13. Stormwater runoff quality in correlation to land use and land cover development in Yongin, South Korea.

    PubMed

    Paule, M A; Memon, S A; Lee, B-Y; Umer, S R; Lee, C-H

    2014-01-01

    Stormwater runoff quality is sensitive to land use and land cover (LULC) change. It is difficult to understand their relationship in predicting the pollution potential and developing watershed management practices to eliminate or reduce the pollution risk. In this study, the relationship between LULC change and stormwater runoff quality in two separate monitoring sites comprising a construction area (Site 1) and mixed land use (Site 2) was analyzed using geographic information system (GIS), event mean concentration (EMC), and correlation analysis. It was detected that bare land area increased, while other land use areas such as agriculture, commercial, forest, grassland, parking lot, residential, and road reduced. Based on the analyses performed, high maximum range and average EMCs were found in Site 2 for most of the water pollutants. Also, urban areas and increased conversion of LULC into bare land corresponded to degradation of stormwater quality. Correlation analysis between LULC and stormwater quality showed the influence of different factors such as farming practices, geographical location, and amount of precipitation, vegetation loss, and anthropogenic activities in monitoring sites. This research found that GIS application was an efficient tool for monthly monitoring, validation and statistical analysis of LULC change in the study area.

  14. Effects of process parameters on the molding quality of the micro-needle array

    NASA Astrophysics Data System (ADS)

    Qiu, Z. J.; Ma, Z.; Gao, S.

    2016-07-01

    Micro-needle array, which is used in medical applications, is a kind of typical injection molded products with microstructures. Due to its tiny micro-features size and high aspect ratios, it is more likely to produce short shots defects, leading to poor molding quality. The injection molding process of the micro-needle array was studied in this paper to find the effects of the process parameters on the molding quality of the micro-needle array and to provide theoretical guidance for practical production of high-quality products. With the shrinkage ratio and warpage of micro needles as the evaluation indices of the molding quality, the orthogonal experiment was conducted and the analysis of variance was carried out. According to the results, the contribution rates were calculated to determine the influence of various process parameters on molding quality. The single parameter method was used to analyse the main process parameter. It was found that the contribution rate of the holding pressure on shrinkage ratio and warpage reached 83.55% and 94.71% respectively, far higher than that of the other parameters. The study revealed that the holding pressure is the main factor which affects the molding quality of micro-needle array so that it should be focused on in order to obtain plastic parts with high quality in the practical production.

  15. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1 : ASC software quality engineering practices version 1.0.

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

    Minana, Molly A.; Sturtevant, Judith E.; Heaphy, Robert

    2005-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in DOE/AL Quality Criteria (QC-1) as conformance to customer requirements and expectations. This quality plan defines the ASC program software quality practices and provides mappings of these practices to the SNL Corporate Process Requirements (CPR 1.3.2 and CPR 1.3.6) and the Department of Energy (DOE) document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines (GP&G). This quality plan identifies ASC management andmore » software project teams' responsibilities for cost-effective software engineering quality practices. The SNL ASC Software Quality Plan establishes the signatories commitment to improving software products by applying cost-effective software engineering quality practices. This document explains the project teams opportunities for tailoring and implementing the practices; enumerates the practices that compose the development of SNL ASC's software products; and includes a sample assessment checklist that was developed based upon the practices in this document.« less

  16. Evidence-based Medicine in Facial Plastic Surgery: Current State and Future Directions.

    PubMed

    Dedhia, Raj; Hsieh, Tsung-Yen; Tollefson, Travis T; Ishii, Lisa E

    2016-08-01

    Evidence-based medicine (EBM) encompasses the evaluation and application of best available evidence, incorporation of clinical experience, and emphasis on patient preference and values. Different scales are used to rate levels of evidence. Translating available data for interventions to clinical practice guidelines requires an assessment of both the quality of evidence and the strength of recommendation. Essential to the practice of EBM is evaluating the effectiveness of an intervention through outcome measures. This article discusses principles essential to EBM, resources commonly used in EBM practice, and the strengths and limitations of EBM in facial plastic and reconstructive surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. [Information, knowledge and healthcare practice: professionals participation as the key element of the gear].

    PubMed

    Adam, Paula; Permanyer-Miralda, Gaietà; Solà-Morales, Oriol; Canela-Soler, Jaume

    2010-02-01

    This article analyzes the role of ICT within the complicated gear between information, knowledge and healthcare practices, which particular focus on two specific cases: the digitalization process of the healthcare system and the application of knowledge into the healthcare practices. In both cases, international and local experiences suggest, and sometimes demonstrate the importance of the participation, capacity-building and empowerment of healthcare practitioners for the generation, transfer and use of information and knowledge empowered by the digital tools which should bring into the system better performance, more efficacy, efficiency, equity, equality, security, quality. 2010 Elsevier España S.L. All rights reserved.

  18. [Construction of NIRS-based total quality control system for compound Ejiao oral liquid and relative thinking].

    PubMed

    Zhang, Yan; Zhang, Lu; Tian, Shou-Sheng; Zhou, Xiang-Shan; Li, Wen-Long; Qu, Hai-Bin

    2016-10-01

    In this paper, near infrared spectroscopy (NIRS)-based total quality control system of compound Ejiao oral liquid is introduced briefly, including the quality control of raw traditional Chinese medicine (TCM) materials, monitoring and control of the extract and the alkaline precipitation technics, and also the inspection of finished products in both open bottle and non-opening modes. By analyzing and summing up the significance and difficulties, several important problems in the practical applications of NIRS technology are proposed, which will provide references for the similar studies of other TCM products. Copyright© by the Chinese Pharmaceutical Association.

  19. Criterion-based clinical audit in obstetrics: bridging the quality gap?

    PubMed

    Graham, W J

    2009-06-01

    The Millennium Development Goal 5 - reducing maternal mortality by 75% - is unlikely to be met globally and for the majority of low-income countries. At this time of heightened concern to scale-up services for mothers and babies, it is crucial that not only shortfalls in the quantity of care - in terms of location and financial access - are addressed, but also the quality. Reductions in maternal and perinatal mortality in the immediate term depend in large part on the timely delivery of effective practices in the management of life-threatening complications. Such practices require a functioning health system - including skilled and motivated providers engaged with the women and communities whom they serve. Assuring the quality of this system, the services and the care that women receive requires many inputs, including effective and efficient monitoring mechanisms. The purpose of this article is to summarise the practical steps involved in applying one such mechanism, criterion-based clinical audit (CBCA), and to highlight recent lessons from its application in developing countries. Like all audit tools, the ultimate worth of CBCA relates to the action it stimulates in the health system and among providers.

  20. Applications of turbidity monitoring to forest management in California.

    PubMed

    Harris, Richard R; Sullivan, Kathleen; Cafferata, Peter H; Munn, John R; Faucher, Kevin M

    2007-09-01

    Many California streams have been adversely affected by sedimentation caused by historic and current land uses, including timber harvesting. The impacts of timber harvesting and logging transportation systems on erosion and sediment delivery can be directly measured, modeled, or inferred from water quality measurements. California regulatory agencies, researchers, and land owners have adopted turbidity monitoring to determine effects of forest management practices on suspended sediment loads and water quality at watershed, project, and site scales. Watershed-scale trends in sediment discharge and responses to current forest practices may be estimated from data collected at automated sampling stations that measure turbidity, stream flow, suspended sediment concentrations, and other water quality parameters. Future results from these studies will provide a basis for assessing the effectiveness of modern forest practice regulations in protecting water quality. At the project scale, manual sampling of water column turbidity during high stream flow events within and downstream from active timber harvest plans can identify emerging sediment sources. Remedial actions can then be taken by managers to prevent or mitigate water quality impacts. At the site scale, manual turbidity sampling during storms or high stream flow events at sites located upstream and downstream from new, upgraded, or decommissioned stream crossings has proven to be a valuable way to determine whether measures taken to prevent post-construction erosion and sediment production are effective. Turbidity monitoring at the project and site scales is therefore an important tool for adaptive management. Uncertainty regarding the effects of current forest practices must be resolved through watershed-scale experiments. In the short term, this uncertainty will stimulate increased use of project and site-scale monitoring.

  1. An Evaluation of Web-Based Clinical Practice Guidelines for Managing Problems Associated with Cannabis Use

    PubMed Central

    Turner, Michael W; Rooke, Sally E; Langton, Julia M; Gates, Peter J

    2012-01-01

    Background Cannabis is the most widely used illicit substance, and multiple treatment options and avenues exist for managing its use. There has been an increase in the development of clinical practice guidelines (CPGs) to improve standards of care in this area, many of which are disseminated online. However, little is known about the quality and accessibility of these online CPGs. Objective The purpose of study 1 was to determine the extent to which cannabis-related CPGs disseminated online adhere to established methodological standards. The purpose of study 2 was to determine if treatment providers are familiar with these guidelines and to assess their perceived quality of these guidelines. Methods Study 1 involved a systematic search using the Google Scholar search engine and the National Drugs Sector Information Service (NDSIS) website of the Alcohol and Other Drugs Council of Australia (ADCA) to identify CPGs disseminated online. To be included in the current study, CPGs needed to be free of charge and provide guidance on psychological interventions for reducing cannabis use. Four trained reviewers independently assessed the quality of the 7 identified guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Study 2 assessed 166 Australian cannabis-use treatment providers’ (mean age = 45.47 years, SD 12.14) familiarity with and opinions of these 7 guidelines using an online survey. Treatment providers were recruited using online advertisements that directed volunteers to a link to complete the survey, which was posted online for 6 months (January to June 2012). Primary study outcomes included quality scores and rates of guideline familiarity, guideline use, and discovery methods. Results Based on the AGREE II, the quality of CPGs varied considerably. Across different reporting domains, adherence to methodological standards ranged from 0% to 92%. Quality was lowest in the domains of rigor of development (50%), applicability (46%), and editorial independence (30%). Although examination of AGREE II domain scores demonstrated that the quality of the 7 guidelines could be divided into 3 categories (high quality, acceptable to low quality, and very low quality), review of treatment providers’ quality perceptions indicated all guidelines fell into 1 category (acceptable quality). Based on treatment providers’ familiarity with and usage rates of the CPGs, a combination of peer/colleagues, senior professionals, workshops, and Internet dissemination was deemed to be most effective for promoting cannabis use CPGs. Lack of time, guideline length, conflicts with theoretical orientation, and prior content knowledge were identified as barriers to guideline uptake. Conclusions Developers of CPGs should improve their reporting of development processes, conflicts of interest, and CPGs’ applicability to practice, while remaining cognizant that long guidelines may deter implementation. Treatment providers need to be aware that the quality of cannabis-related CPGs varies substantially. PMID:23249447

  2. Helicity multiplexed broadband metasurface holograms.

    PubMed

    Wen, Dandan; Yue, Fuyong; Li, Guixin; Zheng, Guoxing; Chan, Kinlong; Chen, Shumei; Chen, Ming; Li, King Fai; Wong, Polis Wing Han; Cheah, Kok Wai; Pun, Edwin Yue Bun; Zhang, Shuang; Chen, Xianzhong

    2015-09-10

    Metasurfaces are engineered interfaces that contain a thin layer of plasmonic or dielectric nanostructures capable of manipulating light in a desirable manner. Advances in metasurfaces have led to various practical applications ranging from lensing to holography. Metasurface holograms that can be switched by the polarization state of incident light have been demonstrated for achieving polarization multiplexed functionalities. However, practical application of these devices has been limited by their capability for achieving high efficiency and high image quality. Here we experimentally demonstrate a helicity multiplexed metasurface hologram with high efficiency and good image fidelity over a broad range of frequencies. The metasurface hologram features the combination of two sets of hologram patterns operating with opposite incident helicities. Two symmetrically distributed off-axis images are interchangeable by controlling the helicity of the input light. The demonstrated helicity multiplexed metasurface hologram with its high performance opens avenues for future applications with functionality switchable optical devices.

  3. Helicity multiplexed broadband metasurface holograms

    PubMed Central

    Wen, Dandan; Yue, Fuyong; Li, Guixin; Zheng, Guoxing; Chan, Kinlong; Chen, Shumei; Chen, Ming; Li, King Fai; Wong, Polis Wing Han; Cheah, Kok Wai; Yue Bun Pun, Edwin; Zhang, Shuang; Chen, Xianzhong

    2015-01-01

    Metasurfaces are engineered interfaces that contain a thin layer of plasmonic or dielectric nanostructures capable of manipulating light in a desirable manner. Advances in metasurfaces have led to various practical applications ranging from lensing to holography. Metasurface holograms that can be switched by the polarization state of incident light have been demonstrated for achieving polarization multiplexed functionalities. However, practical application of these devices has been limited by their capability for achieving high efficiency and high image quality. Here we experimentally demonstrate a helicity multiplexed metasurface hologram with high efficiency and good image fidelity over a broad range of frequencies. The metasurface hologram features the combination of two sets of hologram patterns operating with opposite incident helicities. Two symmetrically distributed off-axis images are interchangeable by controlling the helicity of the input light. The demonstrated helicity multiplexed metasurface hologram with its high performance opens avenues for future applications with functionality switchable optical devices. PMID:26354497

  4. The research-practice gap: bridging the schism between eating disorder researchers and practitioners.

    PubMed

    Lilienfeld, Scott O; Ritschel, Lorie A; Lynn, Steven Jay; Brown, Amanda P; Cautin, Robin L; Latzman, Robert D

    2013-07-01

    The field of eating disorders (EDs) treatment has been beset by a marked disjunction between scientific evidence and clinical application. We describe the nature and scope of the research-practice gap in the ED field. We draw on surveys and broader literature to better understand the research-practice gap in ED treatment and reasons for resistance to evidence-based practice. We identify three sources of the research-practice gap: (1) attitudinal factors, (2) differences in the definition of "evidence," and (3) cognitive factors, especially naïve realism and confirmation bias. We affirm the role of science as a safeguard against human fallibility and as a means of bridging the research-practice gap, and delineate key principles of scientific thinking for ED researchers and practitioners. We conclude with proposals for narrowing the research-practice gap in ED treatment and enhancing the quality of interventions for ED clients. Copyright © 2013 Wiley Periodicals, Inc.

  5. Managing the Quality of Experience in the Multimedia Internet of Things: A Layered-Based Approach †

    PubMed Central

    Floris, Alessandro; Atzori, Luigi

    2016-01-01

    This paper addresses the issue of evaluating the Quality of Experience (QoE) for Internet of Things (IoT) applications, with particular attention to the case where multimedia content is involved. A layered IoT architecture is firstly analyzed to understand which QoE influence factors have to be considered in relevant application scenarios. We then introduce the concept of Multimedia IoT (MIoT) and define a layered QoE model aimed at evaluating and combining the contributions of each influence factor to estimate the overall QoE in MIoT applications. Finally, we present a use case related to the remote monitoring of vehicles during driving practices, which is used to validate the proposed layered model, and we discuss a second use case for smart surveillance, to emphasize the generality of the proposed framework. The effectiveness in evaluating classes of influence factors separately is demonstrated. PMID:27918437

  6. Managing the Quality of Experience in the Multimedia Internet of Things: A Layered-Based Approach.

    PubMed

    Floris, Alessandro; Atzori, Luigi

    2016-12-02

    This paper addresses the issue of evaluating the Quality of Experience (QoE) for Internet of Things (IoT) applications, with particular attention to the case where multimedia content is involved. A layered IoT architecture is firstly analyzed to understand which QoE influence factors have to be considered in relevant application scenarios. We then introduce the concept of Multimedia IoT (MIoT) and define a layered QoE model aimed at evaluating and combining the contributions of each influence factor to estimate the overall QoE in MIoT applications. Finally, we present a use case related to the remote monitoring of vehicles during driving practices, which is used to validate the proposed layered model, and we discuss a second use case for smart surveillance, to emphasize the generality of the proposed framework. The effectiveness in evaluating classes of influence factors separately is demonstrated.

  7. Applicability of NASA contract quality management and failure mode effect analysis procedures to the USGS Outer Continental Shelf oil and gas lease management program

    NASA Technical Reports Server (NTRS)

    Dyer, M. K.; Little, D. G.; Hoard, E. G.; Taylor, A. C.; Campbell, R.

    1972-01-01

    An approach that might be used for determining the applicability of NASA management techniques to benefit almost any type of down-to-earth enterprise is presented. A study was made to determine the following: (1) the practicality of adopting NASA contractual quality management techniques to the U.S. Geological Survey Outer Continental Shelf lease management function; (2) the applicability of failure mode effects analysis to the drilling, production, and delivery systems in use offshore; (3) the impact on industrial offshore operations and onshore management operations required to apply recommended NASA techniques; and (4) the probable changes required in laws or regulations in order to implement recommendations. Several management activities that have been applied to space programs are identified, and their institution for improved management of offshore and onshore oil and gas operations is recommended.

  8. Using quality assessment tools to critically appraise ageing research: a guide for clinicians.

    PubMed

    Harrison, Jennifer Kirsty; Reid, James; Quinn, Terry J; Shenkin, Susan Deborah

    2017-05-01

    Evidence based medicine tells us that we should not accept published research at face value. Even research from established teams published in the highest impact journals can have methodological flaws, biases and limited generalisability. The critical appraisal of research studies can seem daunting, but tools are available to make the process easier for the non-specialist. Understanding the language and process of quality assessment is essential when considering or conducting research, and is also valuable for all clinicians who use published research to inform their clinical practice.We present a review written specifically for the practising geriatrician. This considers how quality is defined in relation to the methodological conduct and reporting of research. Having established why quality assessment is important, we present and critique tools which are available to standardise quality assessment. We consider five study designs: RCTs, non-randomised studies, observational studies, systematic reviews and diagnostic test accuracy studies. Quality assessment for each of these study designs is illustrated with an example of published cognitive research. The practical applications of the tools are highlighted, with guidance on their strengths and limitations. We signpost educational resources and offer specific advice for use of these tools.We hope that all geriatricians become comfortable with critical appraisal of published research and that use of the tools described in this review - along with awareness of their strengths and limitations - become a part of teaching, journal clubs and practice. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society.

  9. Quality assurance of nursing web sites: development and implications of the ALEU method.

    PubMed

    Cambil-Martín, Jacobo; Flynn, Maria; Villaverde-Gutiérrez, Carmen

    2011-09-01

    This article presents a study that evaluated the physical accessibility, readability, and usability of Spanish nursing Web sites and discusses the quality assurance issues raised, which are relevant to the wider nursing community. The Internet is recognized as an important source of health information for both nurses and the general public. Although it makes health-related information universally available, the wide variation in the overall quality of health Web sites is problematic. This raises many questions for the nursing profession: about what constitutes a good-quality Web site, about the nature of the information that nurses are finding and using to support their professional education, research, and clinical practice, and about the impact that Internet information ultimately has on health interactions and nursing care. The process of completing this small study showed that it is possible to usefully assess dimensions of Web site quality and suggested that it may be feasible to develop tools to help nurses evaluate national and international nursing Web sites. More research is needed to understand how nurses use the Internet to support their everyday professional practices, but the development and application of international Web site quality assurance tools may be important for maintaining professional nursing standards in the Internet age.

  10. Lyophilization process design space.

    PubMed

    Patel, Sajal Manubhai; Pikal, Michael J

    2013-11-01

    The application of key elements of quality by design (QbD), such as risk assessment, process analytical technology, and design space, is discussed widely as it relates to freeze-drying process design and development. However, this commentary focuses on constructing the Design and Control Space, particularly for the primary drying step of the freeze-drying process. Also, practical applications and considerations of claiming a process Design Space under the QbD paradigm have been discussed. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association.

  11. Development of quality indicators to evaluate antibiotic treatment of patients with community-acquired pneumonia in Indonesia.

    PubMed

    Farida, Helmia; Rondags, Angelique; Gasem, M Hussein; Leong, Katharina; Adityana, A; van den Broek, Peterhans J; Keuter, Monique; Natsch, Stephanie

    2015-04-01

    To develop an instrument for evaluating the quality of antibiotic management of patients with community-acquired pneumonia (CAP) applicable in a middle-income developing country. A previous study and Indonesian guidelines were reviewed to derive potential quality of care indicators (QIs). An expert panel performed a two-round Delphi consensus procedure on the QI's relevance to patient recovery, reduction of antimicrobial resistance and cost containment. Applicability in practice, including reliability, feasibility and opportunity for improvement, was determined in a data set of 128 patients hospitalised with CAP in Semarang, Indonesia. Fifteen QIs were selected by the consensus procedure. Five QIs did not pass feasibility criteria, because of inappropriate documentation, inefficient laboratory services or patient factors. Three QIs provided minor opportunity for improvement. Two QIs contradicted each other; one of these was considered not valid and excluded. A final set of six QIs was defined for use in the Indonesian setting. Using the Delphi method, we defined a list of QIs for assessing the quality of care, in particular antibiotic treatment, for CAP in Indonesia. For further improvement, a modified Delphi method that includes discussion, a sound medical documentation system, improvement of microbiology laboratory services, and multi-center applicability tests are needed to develop a valid and applicable QI list for the Indonesian setting. © 2014 John Wiley & Sons Ltd.

  12. Critical appraisal in the practice of laboratory medicine.

    PubMed

    Price, Christopher P; Christenson, Robert H

    2016-03-01

    Critical appraisal is a key skill employed across the spectrum of laboratory medicine practice. It underpins the use of information that is relevant, of good quality and is meaningful. Relevance is answering the right question for the right patient at the right time, with quality ensuring provision of the right information. Meaningful is making the right decisions in order to deliver the right outcomes. Critical appraisal is about minimizing the risk of bias or 'departures from trueness' in all of the facets of laboratory medicine practice. It can be summarized in four steps: (i) a clear understanding and articulation of the problem being addressed - whether it be an analytical challenge, individual patient care or policymaking; (ii) verifying the methodological approach employed; (iii) assuring the reliability of the results and (iv) ensuring the applicability and implications of the results. Reference is made to a number of checklists that can be used to assist in the process of critical appraisal. © The Author(s) 2015.

  13. A quality improvement initiative to reduce necrotizing enterocolitis across hospital systems.

    PubMed

    Nathan, Amy T; Ward, Laura; Schibler, Kurt; Moyer, Laurel; South, Andrew; Kaplan, Heather C

    2018-04-20

    Necrotizing enterocolitis (NEC) is a devastating intestinal disease in premature infants. Local rates of NEC were unacceptably high. We hypothesized that utilizing quality improvement methodology to standardize care and apply evidence-based practices would reduce our rate of NEC. A multidisciplinary team used the model for improvement to prioritize interventions. Three neonatal intensive care units (NICUs) developed a standardized feeding protocol for very low birth weight (VLBW) infants, and employed strategies to increase the use of human milk, maximize intestinal perfusion, and promote a healthy microbiome. The primary outcome measure, NEC in VLBW infants, decreased from 0.17 cases/100 VLBW patient days to 0.029, an 83% reduction, while the compliance with a standardized feeding protocol improved. Through reliable implementation of evidence-based practices, this project reduced the regional rate of NEC by 83%. A key outcome and primary driver of success was standardization across multiple NICUs, resulting in consistent application of best practices and reduction in variation.

  14. WHO Expert Committee on Specifications for Pharmaceutical Preparations.

    PubMed

    2003-01-01

    This report presents the recommendations of an international group of experts convened by the World Health Organization to consider matters concerning the quality assurance of pharmaceuticals and specifications for drug substances and dosage forms. Of particular relevance to drug regulatory authorities and pharmaceutical manufacturers, the report discusses activities related to the development of The International Pharmacopoeia and basic tests for pharmaceutical substances and dosage forms, as well as quality control of reference materials, good manufacturing practices (GMP), stability studies, inspection, hazard analysis, procurement, storage and other aspects of quality assurance of pharmaceuticals, and regulatory issues. The report is complemented by a number of annexes, including recommendations on the risk of transmitting animal spongiform encephalopathy agents via medicinal products, guidelines on GMP for pharmaceutical products, a model certificate for GMP and guidance on a GMP inspection report. The final annexes provide guidance on the application of Hazard Analysis and Critical Control Point (HACCP) method to pharmaceuticals, good storage practices and a procedure for assessing acceptability of pharmaceutical products for purchase by United Nations agencies.

  15. Research in action: using positive deviance to improve quality of health care

    PubMed Central

    Bradley, Elizabeth H; Curry, Leslie A; Ramanadhan, Shoba; Rowe, Laura; Nembhard, Ingrid M; Krumholz, Harlan M

    2009-01-01

    Background Despite decades of efforts to improve quality of health care, poor performance persists in many aspects of care. Less than 1% of the enormous national investment in medical research is focused on improving health care delivery. Furthermore, when effective innovations in clinical care are discovered, uptake of these innovations is often delayed and incomplete. In this paper, we build on the established principle of 'positive deviance' to propose an approach to identifying practices that improve health care quality. Methods We synthesize existing literature on positive deviance, describe major alternative approaches, propose benefits and limitations of a positive deviance approach for research directed toward improving quality of health care, and describe an application of this approach in improving hospital care for patients with acute myocardial infarction. Results The positive deviance approach, as adapted for use in health care, presumes that the knowledge about 'what works' is available in existing organizations that demonstrate consistently exceptional performance. Steps in this approach: identify 'positive deviants,' i.e., organizations that consistently demonstrate exceptionally high performance in the area of interest (e.g., proper medication use, timeliness of care); study the organizations in-depth using qualitative methods to generate hypotheses about practices that allow organizations to achieve top performance; test hypotheses statistically in larger, representative samples of organizations; and work in partnership with key stakeholders, including potential adopters, to disseminate the evidence about newly characterized best practices. The approach is particularly appropriate in situations where organizations can be ranked reliably based on valid performance measures, where there is substantial natural variation in performance within an industry, when openness about practices to achieve exceptional performance exists, and where there is an engaged constituency to promote uptake of discovered practices. Conclusion The identification and examination of health care organizations that demonstrate positive deviance provides an opportunity to characterize and disseminate strategies for improving quality. PMID:19426507

  16. Classification schemes for knowledge translation interventions: a practical resource for researchers.

    PubMed

    Slaughter, Susan E; Zimmermann, Gabrielle L; Nuspl, Megan; Hanson, Heather M; Albrecht, Lauren; Esmail, Rosmin; Sauro, Khara; Newton, Amanda S; Donald, Maoliosa; Dyson, Michele P; Thomson, Denise; Hartling, Lisa

    2017-12-06

    As implementation science advances, the number of interventions to promote the translation of evidence into healthcare, health systems, or health policy is growing. Accordingly, classification schemes for these knowledge translation (KT) interventions have emerged. A recent scoping review identified 51 classification schemes of KT interventions to integrate evidence into healthcare practice; however, the review did not evaluate the quality of the classification schemes or provide detailed information to assist researchers in selecting a scheme for their context and purpose. This study aimed to further examine and assess the quality of these classification schemes of KT interventions, and provide information to aid researchers when selecting a classification scheme. We abstracted the following information from each of the original 51 classification scheme articles: authors' objectives; purpose of the scheme and field of application; socioecologic level (individual, organizational, community, system); adaptability (broad versus specific); target group (patients, providers, policy-makers), intent (policy, education, practice), and purpose (dissemination versus implementation). Two reviewers independently evaluated the methodological quality of the development of each classification scheme using an adapted version of the AGREE II tool. Based on these assessments, two independent reviewers reached consensus about whether to recommend each scheme for researcher use, or not. Of the 51 original classification schemes, we excluded seven that were not specific classification schemes, not accessible or duplicates. Of the remaining 44 classification schemes, nine were not recommended. Of the 35 recommended classification schemes, ten focused on behaviour change and six focused on population health. Many schemes (n = 29) addressed practice considerations. Fewer schemes addressed educational or policy objectives. Twenty-five classification schemes had broad applicability, six were specific, and four had elements of both. Twenty-three schemes targeted health providers, nine targeted both patients and providers and one targeted policy-makers. Most classification schemes were intended for implementation rather than dissemination. Thirty-five classification schemes of KT interventions were developed and reported with sufficient rigour to be recommended for use by researchers interested in KT in healthcare. Our additional categorization and quality analysis will aid in selecting suitable classification schemes for research initiatives in the field of implementation science.

  17. Implementation and application of moving average as continuous analytical quality control instrument demonstrated for 24 routine chemistry assays.

    PubMed

    Rossum, Huub H van; Kemperman, Hans

    2017-07-26

    General application of a moving average (MA) as continuous analytical quality control (QC) for routine chemistry assays has failed due to lack of a simple method that allows optimization of MAs. A new method was applied to optimize the MA for routine chemistry and was evaluated in daily practice as continuous analytical QC instrument. MA procedures were optimized using an MA bias detection simulation procedure. Optimization was graphically supported by bias detection curves. Next, all optimal MA procedures that contributed to the quality assurance were run for 100 consecutive days and MA alarms generated during working hours were investigated. Optimized MA procedures were applied for 24 chemistry assays. During this evaluation, 303,871 MA values and 76 MA alarms were generated. Of all alarms, 54 (71%) were generated during office hours. Of these, 41 were further investigated and were caused by ion selective electrode (ISE) failure (1), calibration failure not detected by QC due to improper QC settings (1), possible bias (significant difference with the other analyzer) (10), non-human materials analyzed (2), extreme result(s) of a single patient (2), pre-analytical error (1), no cause identified (20), and no conclusion possible (4). MA was implemented in daily practice as a continuous QC instrument for 24 routine chemistry assays. In our setup when an MA alarm required follow-up, a manageable number of MA alarms was generated that resulted in valuable MA alarms. For the management of MA alarms, several applications/requirements in the MA management software will simplify the use of MA procedures.

  18. Data fusion in data scarce areas using a back-propagation artificial neural network model: a case study of the South China Sea

    NASA Astrophysics Data System (ADS)

    Wang, Zheng; Mao, Zhihua; Xia, Junshi; Du, Peijun; Shi, Liangliang; Huang, Haiqing; Wang, Tianyu; Gong, Fang; Zhu, Qiankun

    2018-06-01

    The cloud cover for the South China Sea and its coastal area is relatively large throughout the year, which limits the potential application of optical remote sensing. A HJ-charge-coupled device (HJ-CCD) has the advantages of wide field, high temporal resolution, and short repeat cycle. However, this instrument suffers from its use of only four relatively low-quality bands which can't adequately resolve the features of long wavelengths. The Landsat Enhanced Thematic Mapper-plus (ETM+) provides high-quality data, however, the Scan Line Corrector (SLC) stopped working and caused striping of remote sensed images, which dramatically reduced the coverage of the ETM+ data. In order to combine the advantages of the HJ-CCD and Landsat ETM+ data, we adopted a back-propagation artificial neural network (BP-ANN) to fuse these two data types for this study. The results showed that the fused output data not only have the advantage of data intactness for the HJ-CCD, but also have the advantages of the multi-spectral and high radiometric resolution of the ETM+ data. Moreover, the fused data were analyzed qualitatively, quantitatively and from a practical application point of view. Experimental studies indicated that the fused data have a full spatial distribution, multi-spectral bands, high radiometric resolution, a small difference between the observed and fused output data, and a high correlation between the observed and fused data. The excellent performance in its practical application is a further demonstration that the fused data are of high quality.

  19. Availability of High Quality TRMM Ground Validation Data from Kwajalein, RMI: A Practical Application of the Relative Calibration Adjustment Technique

    NASA Technical Reports Server (NTRS)

    Marks, David A.; Wolff, David B.; Silberstein, David S.; Tokay, Ali; Pippitt, Jason L.; Wang, Jianxin

    2008-01-01

    Since the Tropical Rainfall Measuring Mission (TRMM) satellite launch in November 1997, the TRMM Satellite Validation Office (TSVO) at NASA Goddard Space Flight Center (GSFC) has been performing quality control and estimating rainfall from the KPOL S-band radar at Kwajalein, Republic of the Marshall Islands. Over this period, KPOL has incurred many episodes of calibration and antenna pointing angle uncertainty. To address these issues, the TSVO has applied the Relative Calibration Adjustment (RCA) technique to eight years of KPOL radar data to produce Ground Validation (GV) Version 7 products. This application has significantly improved stability in KPOL reflectivity distributions needed for Probability Matching Method (PMM) rain rate estimation and for comparisons to the TRMM Precipitation Radar (PR). In years with significant calibration and angle corrections, the statistical improvement in PMM distributions is dramatic. The intent of this paper is to show improved stability in corrected KPOL reflectivity distributions by using the PR as a stable reference. Inter-month fluctuations in mean reflectivity differences between the PR and corrected KPOL are on the order of 1-2 dB, and inter-year mean reflectivity differences fluctuate by approximately 1 dB. This represents a marked improvement in stability with confidence comparable to the established calibration and uncertainty boundaries of the PR. The practical application of the RCA method has salvaged eight years of radar data that would have otherwise been unusable, and has made possible a high-quality database of tropical ocean-based reflectivity measurements and precipitation estimates for the research community.

  20. [A review on studies and applications of near infrared spectroscopy technique(NIRS) in detecting quality of hay].

    PubMed

    Ding, Wu-Rong; Gan, You-Min; Guo, Xu-Sheng; Yang, Fu-Yu

    2009-02-01

    The quality of hay can directly affect the price of hay and also livestock productivity. Many kinds of methods have been developed for detecting the quality of hay and the method of near infrared spectroscopy (NIRS) has been widely used with consideration of its fast, effective and nondestructive characteristics during detecting process. In the present paper, the feasibility and effectiveness of application of NIRS to detecting hay quality were expounded. Meanwhile, the advance in the study of using NIRS to detect chemical compositions, extent of incursion by epiphyte, amount of toxicant excreted by endogenetic epiphyte and some minim components that can not be detected by using chemical methods were also introduced detailedly. Based on the review of the progresses in using NIRS to detect the quality of hay, it can be concluded that using NIRS to detect hay quality can avoid the disadvantages of time wasting, complication and high cost when using traditional chemical method. And for better utilization of NIRS in practice, some more studies still need to be implemented to further perfect and improve the utilization of NIRS for detecting forage quality, and more accurate modes and systematic analysis software need to be established in times to come.

  1. TQM: A bibliography with abstracts. [total quality management

    NASA Technical Reports Server (NTRS)

    Gottlich, Gretchen L. (Editor)

    1992-01-01

    This document is designed to function as a special resource for NASA Langley scientists, engineers, and managers during the introduction and development of total quality management (TQM) practices at the Center. It lists approximately 300 bibliographic citations for articles and reports dealing with various aspects of TQM. Abstracts are also available for the majority of the citations. Citations are organized by broad subject areas, including case studies, customer service, senior management, leadership, communication tools, TQM basics, applications, and implementation. An introduction and indexes provide additional information on arrangement and availability of these materials.

  2. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan : ASC software quality engineering practices Version 3.0.

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

    Turgeon, Jennifer L.; Minana, Molly A.; Hackney, Patricia

    2009-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in the US Department of Energy/National Nuclear Security Agency (DOE/NNSA) Quality Criteria, Revision 10 (QC-1) as 'conformance to customer requirements and expectations'. This quality plan defines the SNL ASC Program software quality engineering (SQE) practices and provides a mapping of these practices to the SNL Corporate Process Requirement (CPR) 001.3.6; 'Corporate Software Engineering Excellence'. This plan also identifies ASC management's and themore » software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals. This SNL ASC Software Quality Plan establishes the signatories commitments to improving software products by applying cost-effective SQE practices. This plan enumerates the SQE practices that comprise the development of SNL ASC's software products and explains the project teams opportunities for tailoring and implementing the practices.« less

  3. Documentation of quality improvement exposure by internal medicine residency applicants.

    PubMed

    Kolade, Victor O; Sethi, Anuradha

    2016-01-01

    Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. To document the reporting of QI training or experience in residency applications. Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.

  4. Field Evidence Supporting Conventional Onion Curing Practices as a Strategy To Mitigate Escherichia coli Contamination from Irrigation Water.

    PubMed

    Wright, Daniel; Feibert, Erik; Reitz, Stuart; Shock, Clint; Waite-Cusic, Joy

    2018-03-01

    The Produce Safety Rule of the U.S. Food Safety Modernization Act includes restrictions on the use of agricultural water of poor microbiological quality. Mitigation options for poor water quality include the application of an irrigation-to-harvest interval of <4 days; however, dry bulb onion production includes an extended irrigation-to-harvest interval (<30 days). This study evaluated conventional curing practices for mitigating Escherichia coli contamination in a field setting. Well water inoculated with rifampin-resistant E. coli (1, 2, or 3 log CFU/mL) was applied to onion fields (randomized block design; n = 5) via drip tape on the final day of irrigation. Onions remained undisturbed for 7 days and were then lifted to the surface to cure for an additional 21 days before harvest. Water, onions, and soil were tested for presence of rifampin-resistant E. coli. One day after irrigation, 13.3% of onions (20 of 150) receiving the poorest quality water (3 log CFU/mL) tested positive for E. coli; this prevalence was reduced to 4% (6 of 150 onions) after 7 days. Regardless of inoculum level, E. coli was not detected on any onions beyond 15 days postirrigation. These results support conventional dry bulb onion curing practices as an effective strategy to mitigate microbiological concerns associated with poor quality irrigation water.

  5. A novel hydrogel electrolyte extender for rapid application of EEG sensors and extended recordings.

    PubMed

    Kleffner-Canucci, Killian; Luu, Phan; Naleway, John; Tucker, Don M

    2012-04-30

    Dense-array EEG recordings are now commonplace in research and gaining acceptance in clinical settings. Application of many sensors with traditional electrolytes is time consuming. Saline electrolytes can be used to minimize application time but recording duration is limited due to evaporation. In the present study, we evaluate a NIPAm (N-isopropyl acrylamide:acrylic acid) base electrolyte extender for use with saline electrolytes. Sensor-scalp impedances and EEG data quality acquired with the electrolyte extender are compared with those obtained for saline and an EEG electrolyte commonly used in clinical exams (Elefix). The results show that when used in conjunction with saline, electrode-scalp impedances and data across the EEG spectrum are comparable with those obtained using Elefix EEG paste. When used in conjunction with saline, the electrolyte extender permits rapid application of dense-sensor arrays and stable, high-quality EEG data to be obtained for at least 4.5 h. This is an enabling technology that will make benefits of dense-array EEG recordings practical for clinical applications. Copyright © 2011 Elsevier B.V. All rights reserved.

  6. Technical proficiency in cytopathology: assessment through external quality assurance.

    PubMed

    Cummings, M C; Greaves, J; Shukor, R A; Perkins, G; Ross, J

    2017-04-01

    To assess both the feasibility and value of conducting an external quality assurance programme concerning technical aspects of cytopathology laboratory practice, and the interest by laboratories in enrolling in such a programme. Six technical surveys, comprising staining exercises and questionnaires relating to laboratory practice, were distributed over a 4-year period to the approximately 220 laboratories enrolled in the RCPAQAP Cytopathology slide survey modules. Staining exercises using the Papanicolaou and Romanowsky techniques, the preparation of urine and body fluid specimens and immunocytochemistry on the cell block material were assessed. Accompanying relevant questionnaires were included, and one survey comprised a questionnaire alone concerning the collection of urinary tract and body fluid samples. Provision of an external cytopathology technical module was feasible for the RCPAQAP and participation rates (maximum of 87% per survey; average 68% for stained slides and 66% for questionnaires) were commendable, particularly considering these were optional undertakings with some exercises not applicable to all laboratories. The great majority of submitted slides were scored as satisfactory, and there was an especially high standard for the immunocytochemical staining exercise with 95% considered satisfactory, including 50.6% with a perfect score. Reasons for suboptimal scores were provided for potential quality improvement for interested laboratories. A wealth of information relating to laboratory practice was provided to the RCPAQAP which was collated and summarised for laboratory use. The provision of a technical module in cytopathology is both a feasible and valuable undertaking of interest to laboratories which should become standard practice for cytopathology external quality assurance providers. © 2016 John Wiley & Sons Ltd.

  7. Relationships between evidence-based practice, quality improvement and clinical error experience of nurses in Korean hospitals.

    PubMed

    Hwang, Jee-In; Park, Hyeoun-Ae

    2015-07-01

    This study investigated individual and work-related factors associated with nurses' perceptions of evidence-based practice (EBP) and quality improvement (QI), and the relationships between evidence-based practice, quality improvement and clinical errors. Understanding the factors affecting evidence-based practice and quality improvement activities and their relationships with clinical errors is important for designing strategies to promote evidence-based practice, quality improvement and patient safety. A cross-sectional survey was conducted with 594 nurses in two Korean teaching hospitals using the evidence-based practice Questionnaire and quality improvement scale developed in this study. Four hundred and forty-three nurses (74.6%) returned the completed survey. Nurses' ages and educational levels were significantly associated with evidence-based practice scores whereas age and job position were associated with quality improvement scores. There were positive, moderate correlations between evidence-based practice and quality improvement scores. Nurses who had not made any clinical errors during the past 12 months had significantly higher quality improvement skills scores than those who had. The findings indicated the necessity of educational support regarding evidence-based practice and quality improvement for younger staff nurses who have no master degrees. Enhancing quality improvement skills may reduce clinical errors. Nurse managers should consider the characteristics of their staff when implementing educational and clinical strategies for evidence-based practice and quality improvement. © 2013 John Wiley & Sons Ltd.

  8. Living With Diabetes in Appalachia: A Focus Group Study.

    PubMed

    Carpenter, Roger; Smith, Mary Jane

    This article presents an innovative holistic practice application based on evidence from a focus group study on managing diabetes. The purpose of this study addressed the research question: How do persons with type 2 diabetes describe ways of managing the challenge of living with diabetes? A second purpose was to link the findings on ways to manage diabetes to holistic nursing practice through story theory. Nine adults with type 2 diabetes living in rural West Virginia participated in 3 focus groups. Using content analysis, the study findings integrated themes with core qualities, and are as follows: living life as an evolving process is awakening to the present and doing it your way, being on guard is a vigilant ongoing responsibility, attending to bodily experience is awareness of body and facing life stress, and knowing the consequences is awareness of potential problems and taking charge. Merging the study findings with the concepts of story theory led to the development of an innovative practice application for managing diabetes. Managing diabetes in this practice application goes beyond problem-centeredness to a patient-centered approach, offering attention to individual preferences. Since managing diabetes is a major problem in Appalachia, there a need for innovative approaches. This study adds to the body of knowledge on how persons from Appalachia manage diabetes. In addition, it offers a story practice approach for managing diabetes-replacing a problem focus to a more holistic approach to practice leading to more meaningful and fulfilling outcomes.

  9. Assessing tolerance of longleaf pine understory herbaceous plants to herbicide applications in a container nursery

    Treesearch

    D. Paul Jackson; Scott A. Enebak; James West; Drew Hinnant

    2015-01-01

    Renewed efforts in longleaf pine (Pinus palustris Mill.) ecosystem restoration has increased interest in the commercial production of understory herbaceous species. Successful establishment of understory herbaceous species is enhanced when using quality nursery-grown plants that have a better chance of survival after outplanting. Nursery growing practices have not been...

  10. A Qualitative Review of Literature on Peer Review of Teaching in Higher Education: An Application of the SWOT Framework

    ERIC Educational Resources Information Center

    Thomas, Susan; Chie, Qiu Ting; Abraham, Mathew; Raj, Sony Jalarajan; Beh, Loo-See

    2014-01-01

    The issues of professional accountability, faculty member development, and enhancing higher education quality in universities are gaining importance. A strategy that could increase personal control over teaching practices in addition to improving professional development among faculty members is peer review of teaching (PRT). Five themes that are…

  11. "Now I Know My ABCDs": Asset-Based Community Development with School Children in Ethiopia

    ERIC Educational Resources Information Center

    Johnson Butterfield, Alice K.; Yeneabat, Mulu; Moxley, David P.

    2016-01-01

    Asset-based community development (ABCD) is a promising practice for communities to engage in self-determination through the efforts residents invest in identifying community assets, framing and documenting the issues communities face, and taking action to advance quality of life. The ABCD literature does not report on the application of ABCD…

  12. 21 CFR Appendix A to Subpart A of... - List of Applicable Laws, Regulations, and Administrative Provisions

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN MEDICAL DEVICE PRODUCT...://dg3.eudra.org.] Council Directive 65/65/EEC of 26 January 1965 on the approximation of provisions laid... extended, widened, and amended. Council Directive 75/319/EEC of 20 May 1975 on the approximation of...

  13. 21 CFR Appendix A to Subpart A of... - List of Applicable Laws, Regulations, and Administrative Provisions

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN MEDICAL DEVICE PRODUCT...://dg3.eudra.org.] Council Directive 65/65/EEC of 26 January 1965 on the approximation of provisions laid... extended, widened, and amended. Council Directive 75/319/EEC of 20 May 1975 on the approximation of...

  14. 21 CFR Appendix A to Subpart A of... - List of Applicable Laws, Regulations, and Administrative Provisions

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN MEDICAL DEVICE PRODUCT...://dg3.eudra.org.] Council Directive 65/65/EEC of 26 January 1965 on the approximation of provisions laid... extended, widened, and amended. Council Directive 75/319/EEC of 20 May 1975 on the approximation of...

  15. 21 CFR Appendix A to Subpart A of... - List of Applicable Laws, Regulations, and Administrative Provisions

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN MEDICAL DEVICE PRODUCT...://dg3.eudra.org.] Council Directive 65/65/EEC of 26 January 1965 on the approximation of provisions laid... extended, widened, and amended. Council Directive 75/319/EEC of 20 May 1975 on the approximation of...

  16. Swine manure application effects on ammonia volatilization, forage quality, and yield in the Pre-Amazon Region of Brazil

    USDA-ARS?s Scientific Manuscript database

    The use of swine manure as a nutrient source for pastures is increasingly common in Brazil, due to its low cost. However, this practice can cause nitrogen (N) losses in agricultural soil, where ammonia volatilization may be the main drawback, generating undesirable economic and environmental consequ...

  17. Education and Instability: Avoiding the Policy-Practice Gap in an Emerging Field

    ERIC Educational Resources Information Center

    Karpinska, Z. E.; Yarrow, Rachel; Gough, L. M. A.

    2007-01-01

    The imperative to provide education for communities affected by man-made or natural disaster has been strongly articulated. Since the mid 1990s, a growing body of literature and research has emerged in the fledgling field of "education and instability"; however, there is still a pressing need for high-quality, applicable research. The…

  18. Looping and Attachment in Early Childhood Education: How the Applications of Epigenetics Demand a Change

    ERIC Educational Resources Information Center

    Nitecki, Elena

    2017-01-01

    Increasing focus on the quality of childcare and Pre-K is calling attention to the circumstances of childcare and impact on the child's social and emotional health, specifically in terms of attachment. The early childhood profession recognizes that consistency in caregiving is essential for the child's attachment. Looping, the practice of keeping…

  19. 40 CFR 93.123 - Procedures for determining localized CO, PM10, and PM2.5 concentrations (hot-spot analysis).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... PM2.5 violations”) must be based on quantitative analysis using the applicable air quality models... either: (i) Quantitative methods that represent reasonable and common professional practice; or (ii) A...) The hot-spot demonstration required by § 93.116 must be based on quantitative analysis methods for the...

  20. Application of Trophic Magnification Factors (TMFs) Under the Water Framework Directive: Some Practical Advice on Selecting and Determining a TMF

    EPA Science Inventory

    Directive 2013/39/EU amending and updating the Water Framework Directive (2000/60/EC) and its Daughter Directive (the so-called EQS Directive: 2008/105/EC) sets Environmental Quality Standards for biota (EQSbiota) for a number of bioaccumulative chemicals which can pose a threat ...

  1. Application of trophic magnification factors (TMFs) under the Water Framework Directive: some practical advice on selecting and determining a TMF (poster)

    EPA Science Inventory

    Directive 2013/39/EU amending and updating the Water Framework Directive (2000/60/EC) and its Daughter Directive (the so-called EQS Directive: 2008/105/EC) sets Environmental Quality Standards for biota (EQSbiota) for a number of bioaccumulative chemicals which can pose a threat ...

  2. Alternative Methods for the Reduction of Evaporation: Practical Exercises for the Science Classroom

    ERIC Educational Resources Information Center

    Schouten, Peter; Putland, Sam; Lemckert, Charles J.; Parisi, Alfio V.; Downs, Nathan

    2012-01-01

    Across the world, freshwater is valued as the most critically important natural resource, as it is required to sustain the cycle of life. Evaporation is one of the primary environmental processes that can reduce the amount of quality water available for use in industrial, agricultural and household applications. The effect of evaporation becomes…

  3. Human Needs and Intellectual Disabilities: Applications for Person Centered Planning, Dual Diagnosis, and Crisis Intervention

    ERIC Educational Resources Information Center

    Reiss, Steven

    2009-01-01

    Human Needs and Intellectual Disabilities identifies the 12 human needs most relevant to the lives of people with intellectual disabilities, autism and related developmental disabilities. It includes detailed, practical suggestions for caregivers or parents interested in the happiness, quality of life, and self-determination of their loved ones or…

  4. Use of Mobile Applications for Hospital Discharge Letters: Improving Handover at Point of Practice

    ERIC Educational Resources Information Center

    Maher, Bridget; Drachsler, Hendrik; Kalz, Marco; Hoare, Cathal; Sorensen, Humphrey; Lezcano, Leonardo; Henn, Pat; Specht, Marcus

    2013-01-01

    Handover of patient care is a time of particular risk and it is important that accurate and relevant information is clearly communicated. The hospital discharge letter is an important part of handover. However, the quality of hospital discharge letters is variable and letters frequently omit important information. The Cork Letter-Writing…

  5. Audio/Audioconferencing in Support of Distance Education. Knowledge Series: A Topical, Start-Up Guide to Distance Education Practice and Delivery.

    ERIC Educational Resources Information Center

    Macmullen, Paul

    The main focus of this document is on audioconferencing, which in distance education contexts provides "virtual" interaction equivalent in quality to face-to-face, conventional classroom interaction. The applications of audiotape and audio broadcast are covered only briefly. Discussion first includes reasons for using audioconferencing…

  6. Mindfulness Practices for Accounting and Business Education: A New Perspective

    ERIC Educational Resources Information Center

    Borker, David R.

    2013-01-01

    For more than a decade, researchers in accounting and business education have focused on the concept of mindfulness as a source of ideas that contribute to transforming the classroom experience and the quality of student learning. This research is founded on the work of social scientists studying the general application of mindfulness to teaching…

  7. Integration of visual and motion cues for simulator requirements and ride quality investigation

    NASA Technical Reports Server (NTRS)

    Young, L. R.

    1976-01-01

    Practical tools which can extend the state of the art of moving base flight simulation for research and training are developed. Main approaches to this research effort include: (1) application of the vestibular model for perception of orientation based on motion cues: optimum simulator motion controls; and (2) visual cues in landing.

  8. 77 FR 28876 - Information Collections Being Submitted for Review and Approval to the Office of Management and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-16

    ... description of the applicant's organizational structure, and the names of its executives, officers, members of.... Title: Structure and Practices of the Video Relay Service Program, Second Report and Order and Order, CG... prevent fraud and abuse, and ensure quality service, in the provision of Internet-based forms of...

  9. Bond quality of phenol-based adhesives containing liquefied creosote-treated wood

    Treesearch

    Chung-Yun Hse; Feng Fu; Hui Pan

    2009-01-01

    Liquefaction of spent creosote-treated wood was studied to determine the technological practicability of its application in converting treated wood waste into resin adhesives. A total of 144 plywood panels were fabricated with experimental variables included 2 phenol to wood (P/W) ratios in liquefaction, 6 resin formulations (3 formaldehyde/liquefied wood (F/...

  10. Water quality impact assessment of agricultural Beneficial Management Practices (BMPs) simulated for a regional catchment in Quebec, Eastern Canada

    NASA Astrophysics Data System (ADS)

    Rousseau, Alain N.; Hallema, Dennis W.; Gumiere, Silvio J.; Savary, Stéphane; Hould Gosselin, Gabriel

    2014-05-01

    Water quality has become a matter of increasing concern over the past four decades as a result of the intensification of agriculture, and more particularly so in Canada where agriculture has evolved into the largest non-point source of surface water pollution. The Canadian WEBs project (Watershed Evaluation of Beneficial Management Practices, BMPs) was initiated in order to determine the efficiency of BMPs in improving the surface water quality of rural catchments, and the economic aspects related to their implementation on the same scale. In this contribution we use the integrated watershed modelling platform GIBSI (Gestion Intégrée des Bassins versants à l'aide d'un Système Informatisé) to evaluate the effects of various BMPs on sediment and nutrient yields and, in close relation to this, the surface water quality for the Beaurivage River catchment (718 km2) in Quebec, eastern Canada. A base scenario of the catchment is developed by calibrating the different models of the GIBSI platform, namely HYDROTEL for hydrology, the Revised Universal Soil Loss Equation (RUSLE) for soil erosion, the Erosion-Productivity Impact Calculator (EPIC) of the Soil and Water Assessment Tool (SWAT) for contaminant transport and fate, and QUAL2E for stream water quality. Four BMPs were analysed: (1) vegetated riparian buffer strips, (2) precision slurry application, (3) transition of all cereal and corn fields to grassland (grassland conversion), and (4) no-tillage on corn fields. Simulations suggest that riparian buffer strips and grassland conversion are more effective in terms of phosphorus, nitrogen and sediment load reduction than precision slurry application and no-tillage on corn fields. The results furthermore indicate the need for a more profound understanding of sediment dynamics in streams and on riparian buffer strips.

  11. Effect of the time of application of phosphorus fertilizer on yield and quality parameters of melon crop amended with winery waste compost.

    NASA Astrophysics Data System (ADS)

    Requejo Mariscal, María Isabel; Cartagena, María Carmen; Villena Gordo, Raquel; Arce Martínez, Augusto; Ribas Elcorobarrutia, Francisco; Jesús Cabello Cabello, María; Castellanos Serrano, María Teresa

    2016-04-01

    In Spain, drip irrigation systems are widely used for horticultural crop production. In drip irrigation systems, emitter clogging has been identified as one of the most important concerns. Clogging is closely related to the quality of the irrigation water and the structure of the emitter flow path, and occurs as a result of multiple physical, biological and chemical factors. So, the use of acid fertilizers (e.g. phosphoric acid) in these systems is common to avoid the emitter clogging. Moreover, in this country the use of exhausted grape marc compost as source of nutrients and organic matter has been identified as a good management option of soil fertility, especially in grape-growing areas with a large generation of wastes from the wine and distillery industries. The purpose of this work was to study the effect of the time of application of phosphorus fertilizer with fertirrigation in a melon crop amended with winery waste compost on yield and quality parameters. During two years, the melon crop was grown under field conditions and beside the control treatment, three doses of compost were applied: 6.7, 13.3 and 20.0 t ha-1. All the compost treatments received 120 kg ha-1 of phosphorus fertilizer (phosphoric acid) for the season varying the time of application: The first year phosphorus application started after male and female flowering, and the second year the application started before flowering. Yield and quality parameters were evaluated to assess the suitability of these practices. Acknowledgements: This project has been supported by INIA-RTA2010-00110-C03. Keywords: Phosphorus fertilizer, exhausted grape marc compost, melon crop, yield and quality parameters.

  12. Good laboratory practices for biochemical genetic testing and newborn screening for inherited metabolic disorders.

    PubMed

    2012-04-06

    Biochemical genetic testing and newborn screening are essential laboratory services for the screening, detection, diagnosis, and monitoring of inborn errors of metabolism or inherited metabolic disorders. Under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations, laboratory testing is categorized on the basis of the level of testing complexity as either waived (i.e., from routine regulatory oversight) or nonwaived testing (which includes tests of moderate and high complexity). Laboratories that perform biochemical genetic testing are required by CLIA regulations to meet the general quality systems requirements for nonwaived testing and the personnel requirements for high-complexity testing. Laboratories that perform public health newborn screening are subject to the same CLIA regulations and applicable state requirements. As the number of inherited metabolic diseases that are included in state-based newborn screening programs continues to increase, ensuring the quality of performance and delivery of testing services remains a continuous challenge not only for public health laboratories and other newborn screening facilities but also for biochemical genetic testing laboratories. To help ensure the quality of laboratory testing, CDC collaborated with the Centers for Medicare & Medicaid Services, the Food and Drug Administration, the Health Resources and Services Administration, and the National Institutes of Health to develop guidelines for laboratories to meet CLIA requirements and apply additional quality assurance measures for these areas of genetic testing. This report provides recommendations for good laboratory practices that were developed based on recommendations from the Clinical Laboratory Improvement Advisory Committee, with additional input from the Secretary's Advisory Committee on Genetics, Health, and Society; the Secretary's Advisory Committee on Heritable Disorders in Newborns and Children; and representatives of newborn screening laboratories. The recommended practices address the benefits of using a quality management system approach, factors to consider before introducing new tests, establishment and verification of test performance specifications, the total laboratory testing process (which consists of the preanalytic, analytic, and postanalytic phases), confidentiality of patient information and test results, and personnel qualifications and responsibilities for laboratory testing for inherited metabolic diseases. These recommendations are intended for laboratories that perform biochemical genetic testing to improve the quality of laboratory services and for newborn screening laboratories to ensure the quality of laboratory practices for inherited metabolic disorders. These recommendations also are intended as a resource for medical and public health professionals who evaluate laboratory practices, for users of laboratory services to facilitate their collaboration with newborn screening systems and use of biochemical genetic tests, and for standard-setting organizations and professional societies in developing future laboratory quality standards and practice recommendations. This report complements Good Laboratory Practices for Molecular Genetic Testing for Heritable Diseases and Conditions (CDC. Good laboratory practices for molecular genetic testing for heritable diseases and conditions. MMWR 2009;58 [No. RR-6]) to provide guidance for ensuring and improving the quality of genetic laboratory services and public health outcomes. Future recommendations for additional areas of genetic testing will be considered on the basis of continued monitoring and evaluation of laboratory practices, technology advancements, and the development of laboratory standards and guidelines.

  13. Biomedical applications of a real-time terahertz color scanner

    PubMed Central

    Schirmer, Markus; Fujio, Makoto; Minami, Masaaki; Miura, Jiro; Araki, Tsutomu; Yasui, Takeshi

    2010-01-01

    A real-time THz color scanner has the potential to further expand the application scope of THz spectral imaging based on its rapid image acquisition rate. We demonstrated three possible applications of a THz color scanner in the biomedical field: imaging of pharmaceutical tablets, human teeth, and human hair. The first application showed the scanner’s potential in total inspection for rapid quality control of pharmaceutical tablets moving on a conveyor belt. The second application demonstrated that the scanner can be used to identify a potential indicator for crystallinity of dental tissue. In the third application, the scanner was successfully used to visualize the drying process of wet hairs. These demonstrations indicated the high potential of the THz color scanner for practical applications in the biomedical field. PMID:21258472

  14. Development of the teaching simulator based on animated film to strengthening pedagogical competencies of prospective teachers

    NASA Astrophysics Data System (ADS)

    Fatimah, Siti; Setiawan, Wawan; Kusnendar, Jajang; Rasim, Junaeti, Enjun; Anggraeni, Ria

    2017-05-01

    Debriefing of pedagogical competence through both theory and practice which became a requirement for prospective teachers were through micro teaching and teaching practice program. But, some reports from the partner schools stated that the participants of teaching practice program have not well prepared on implementing the learning in the classroom because of lacking the debriefing. In line with the development of information technology, it is very possible to develop a media briefing of pedagogical competencies for prospective teachers through an application so that they can use it anytime and anywhere. This study was one answer to the problem of unpreparedness participants of the teaching practice program. This study developed a teaching simulator, which was an application for learning simulation with the animated film to enhance the professional pedagogical competence prospective teachers. By the application of this teaching simulator, students as prospective teacher could test their own pedagogic competence through learning models with different varied characteristics of students. Teaching Simulator has been equipped with features that allow users to be able to explore the quality of teaching techniques that they employ for the teaching and learning activities in the classroom. These features included the election approaches, the student's character, learning materials, questioning techniques, discussion, and evaluation. Teaching simulator application provided the ease of prospective teachers or teachers in implementing the development of lessons for practice in the classroom. Applications that have been developed to apply simulation models allow users to freely manage a lesson. Development of teaching simulator application was passed through the stages which include needs assessment, design, coding, testing, revision, improvement, grading, and packaging. The application of teaching simulator was also enriched with some real instructional video as a comparison for the user. Based on the two experts, the media expert and education expert, stated that the application of teaching simulator is feasible to be used as an instrument for the debriefing of students as potential participants of the teaching practice program. The results of the use of the application to the students as potential participants of teaching practice program, showed significant increases in the pedagogic competence. This study was presented at an international seminar and in the process of publishing in international reputated journals. Applications teaching simulator was in the process of registration to obtain the copyright of the Ministry of Justice and Human Rights. Debriefing for prospective teachers to use teaching simulator application could improve the mastery of pedagogy, give clear feedback, and perform repetitions at anytime.

  15. Innovation on Energy Power Technology (7)Development and Practical Application of Sodium-Sulfur Battery for Electric Energy Storage System

    NASA Astrophysics Data System (ADS)

    Rachi, Hideki

    Sodium-Sulfur battery (NAS battery), which has more than 3 times of energy density compared with the conventional lead-acid battery and can be compactly established, has a great installation effects as a distributed energy storage system in the urban area which consumes big electric power. For the power company, NAS battery contributes to the load leveling, the supply capability up at the peak period, the efficient operation of the electric power equipment and the reduction of the capital expenditure. And for the customer, it is possible to enjoy the reduction of the electricity charges by utilizing nighttime electric power and the securing of a security. The contribution to the highly sophisticated information society where the higher electric power quality is desired, mainly office buildings and factories by the progress of IT, is very big. Tokyo Electric Power Company (TEPCO) developed the elementary technology of NAS battery from 1984 and ended the development of practical battery which has long-term durability and the safety and the performance verification of the megawatt scale. Finally TEPCO accomplished the practical application and commercialization of the stationary energy storage technology by NAS battery. In this paper, we introduces about conquered problems until practical application and commercialization.

  16. Echocardiography Practice: Insights into Appropriate Clinical Use, Technical Competence and Quality Improvement Program

    PubMed Central

    Kossaify, Antoine; Grollier, Gilles

    2014-01-01

    Echocardiography accounts for nearly half of all cardiac imaging techniques. It is a widely available and adaptable tool, as well as being a cost-effective and mainly a non-invasive test. In addition, echocardiography provides extensive clinical data, which is related to the presence or advent of different modalities (tissue Doppler imaging, speckle tracking imaging, three-dimensional mode, contrast echo, etc.), different approaches (transesophageal, intravascular, etc.), and different applications (ie, heart failure/resynchronization studies, ischemia/stress echo, etc.). In view of this, it is essential to conform to criteria of appropriate use and to keep standards of competence. In this study, we sought to review and discuss clinical practice of echocardiography in light of the criteria of appropriate clinical use, also we present an insight into echocardiographic technical competence and quality improvement project. PMID:24516342

  17. Urban Stormwater Characterization, Control, and Treatment.

    PubMed

    Moore, Trisha L; Rodak, Carolyn M; Vogel, Jason R

    2017-10-01

    A summary of 246 studies published in 2016 on topics related to the characterization and management of urban stormwater runoff is presented in the following review. The review is structured along three major topical areas: (1) general characterization of stormwater quantity and quality; (2) engineered systems for stormwater control and treatment, including erosion and sediment control practices, constructed stormwater ponds and wetlands, bioretention, permeable pavement, greenroofs, and rainwater harvesting and (3) watershedscale application of stormwater treatment and control practices. Common research themes and needs highlighted throughout this review include efforts to better understand stormwater transport and treatment mechanisms and their representation in models, advancements to optimize the design of stormwater control measures to meet specific hydrologic and/or water quality targets, and increasing understanding of the biophysical and social factors that influence watershed-scale implementation of low impact development and other stormwater control measures.

  18. Uav Photogrammetry: a Practical Solution for Challenging Mapping Projects

    NASA Astrophysics Data System (ADS)

    Saadatseresht, M.; Hashempour, A. H.; Hasanlou, M.

    2015-12-01

    We have observed huge attentions to application of unmanned aerial vehicle (UAV) in aerial mapping since a decade ago. Though, it has several advantages for handling time/cost/quality issues, there are a dozen of challenges in working with UAVs. In this paper, we; as the Robotic Photogrammetry Research Group (RPRG), will firstly review these challenges then show its advantages in three special practical projects. For each project, we will share our experiences through description of the UAV specifications, flight settings and processing steps. At the end, we will illustrate final result of each project and show how this technology could make unbelievable benefits to clients including 3D city realistic model in decimetre level, ultra high quality map production in several centimetre level, and accessing to a high risk and rough relief area for mapping aims.

  19. Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

    PubMed Central

    2014-01-01

    Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945

  20. Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain.

    PubMed

    Rutten, Geert M; Harting, Janneke; Bartholomew, Leona K; Braspenning, Jozé C; van Dolder, Rob; Heijmans, Marcel Fgj; Hendriks, Erik Jm; Kremers, Stef Pj; van Peppen, Roland Ps; Rutten, Steven Tj; Schlief, Angelique; de Vries, Nanne K; Oostendorp, Rob Ab

    2014-01-15

    Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process.

  1. An appraisal of the 2012 American College of Rheumatology Guidelines for the Management of Gout.

    PubMed

    Nuki, George

    2014-03-01

    Appraisal of the 2012 American College of Rheumatology (ACR) Guidelines for the Management of Gout. The ACRs first clinical practice guidelines for the management of gout focus on recommendations for nonpharmacologic and pharmacologic approaches to hyperuricaemia and the treatment and prophylaxis of acute gouty arthritis. The RAND/UCLA appropriateness methodology employed assessed risks and benefits of alternative treatments for efficacy, safety and quality but not for cost-effectiveness. Novel recommendations include the use of either allopurinol or febuxostat for first-line urate-lowering drug therapy (ULT), screening for HLA-B*5801 prior to initiation of allopurinol in Asians at relatively high risk for allopurinol hypersensitivity, and the use of pegloticase for patients with severe, symptomatic, tophaceous gout refractory to, or intolerant of, appropriately dosed ULTs. Appraisal and comparison with other guidelines using Guidelines International Network and Appraisal of Guidelines, Research and Evaluation (AGREE II) criteria showed good scores for scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, editorial independence and, overall quality, but not for applicability. The ACR guidelines provide comprehensive, up-to-date, good-quality, evidence-based, expert consensus recommendations for the management of gout in clinical practice but score poorly for applicability. To improve the management of gout in the community a summary of key recommendations, criteria for audit and standards of care are now required.

  2. Service quality in health care.

    PubMed

    Kenagy, J W; Berwick, D M; Shore, M F

    1999-02-17

    Although US health care is described as "the world's largest service industry," the quality of service--that is, the characteristics that shape the experience of care beyond technical competence--is rarely discussed in the medical literature. This article illustrates service quality principles by analyzing a routine encounter in health care from a service quality point of view. This illustration and a review of related literature from both inside and outside health care has led to the following 2 premises: First, if high-quality service had a greater presence in our practices and institutions, it would improve clinical outcomes and patient and physician satisfaction while reducing cost, and it would create competitive advantage for those who are expert in its application. Second, many other industries in the service sector have taken service quality to a high level, their techniques are readily transferable to health care, and physicians caring for patients can learn from them.

  3. Tiger Team Assessment of the Ames Laboratory

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

    Not Available

    1992-03-01

    This report documents the Tiger Assessment of the Ames Laboratory (Ames), located in Ames, Iowa. Ames is operated for the US Department of Energy (DOE) by Iowa State University. The assessment was conducted from February 10 to March 5, 1992, under the auspices of the Office of Special Projects, Office of the Assistant Secretary of Environment, Safety and Health, Headquarters, DOE. The assessment was comprehensive, encompassing Environment, Safety, and Health (ES H) disciplines; management practices; and contractor and DOE self-assessments. Compliance with applicable Federal, State of Iowa, and local regulations; applicable DOE Orders; best management practices; and internal requirements atmore » Ames Laboratory were assessed. In addition, an evaluation of the adequacy and effectiveness of DOE and the site contractor's management of ES H/quality assurance program was conducted.« less

  4. Practical experience from the Office of Adolescent Health's large scale implementation of an evidence-based Teen Pregnancy Prevention Program.

    PubMed

    Margolis, Amy Lynn; Roper, Allison Yvonne

    2014-03-01

    After 3 years of experience overseeing the implementation and evaluation of evidence-based teen pregnancy prevention programs in a diversity of populations and settings across the country, the Office of Adolescent Health (OAH) has learned numerous lessons through practical application and new experiences. These lessons and experiences are applicable to those working to implement evidence-based programs on a large scale. The lessons described in this paper focus on what it means for a program to be implementation ready, the role of the program developer in replicating evidence-based programs, the importance of a planning period to ensure quality implementation, the need to define and measure fidelity, and the conditions necessary to support rigorous grantee-level evaluation. Published by Elsevier Inc.

  5. Supporting Collaborative Model and Data Service Development and Deployment with DevOps

    NASA Astrophysics Data System (ADS)

    David, O.

    2016-12-01

    Adopting DevOps practices for model service development and deployment enables a community to engage in service-oriented modeling and data management. The Cloud Services Integration Platform (CSIP) developed the last 5 years at Colorado State University provides for collaborative integration of environmental models into scalable model and data services as a micro-services platform with API and deployment infrastructure. Originally developed to support USDA natural resource applications, it proved suitable for a wider range of applications in the environmental modeling domain. While extending its scope and visibility it became apparent community integration and adequate work flow support through the full model development and application cycle drove successful outcomes.DevOps provide best practices, tools, and organizational structures to optimize the transition from model service development to deployment by minimizing the (i) operational burden and (ii) turnaround time for modelers. We have developed and implemented a methodology to fully automate a suite of applications for application lifecycle management, version control, continuous integration, container management, and container scaling to enable model and data service developers in various institutions to collaboratively build, run, deploy, test, and scale services within minutes.To date more than 160 model and data services are available for applications in hydrology (PRMS, Hydrotools, CFA, ESP), water and wind erosion prediction (WEPP, WEPS, RUSLE2), soil quality trends (SCI, STIR), water quality analysis (SWAT-CP, WQM, CFA, AgES-W), stream degradation assessment (SWAT-DEG), hydraulics (cross-section), and grazing management (GRAS). In addition, supporting data services include soil (SSURGO), ecological site (ESIS), climate (CLIGEN, WINDGEN), land management and crop rotations (LMOD), and pesticides (WQM), developed using this workflow automation and decentralized governance.

  6. Mindcontrol: A web application for brain segmentation quality control.

    PubMed

    Keshavan, Anisha; Datta, Esha; M McDonough, Ian; Madan, Christopher R; Jordan, Kesshi; Henry, Roland G

    2018-04-15

    Tissue classification plays a crucial role in the investigation of normal neural development, brain-behavior relationships, and the disease mechanisms of many psychiatric and neurological illnesses. Ensuring the accuracy of tissue classification is important for quality research and, in particular, the translation of imaging biomarkers to clinical practice. Assessment with the human eye is vital to correct various errors inherent to all currently available segmentation algorithms. Manual quality assurance becomes methodologically difficult at a large scale - a problem of increasing importance as the number of data sets is on the rise. To make this process more efficient, we have developed Mindcontrol, an open-source web application for the collaborative quality control of neuroimaging processing outputs. The Mindcontrol platform consists of a dashboard to organize data, descriptive visualizations to explore the data, an imaging viewer, and an in-browser annotation and editing toolbox for data curation and quality control. Mindcontrol is flexible and can be configured for the outputs of any software package in any data organization structure. Example configurations for three large, open-source datasets are presented: the 1000 Functional Connectomes Project (FCP), the Consortium for Reliability and Reproducibility (CoRR), and the Autism Brain Imaging Data Exchange (ABIDE) Collection. These demo applications link descriptive quality control metrics, regional brain volumes, and thickness scalars to a 3D imaging viewer and editing module, resulting in an easy-to-implement quality control protocol that can be scaled for any size and complexity of study. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  7. GAGG:ce single crystalline films: New perspective scintillators for electron detection in SEM.

    PubMed

    Bok, Jan; Lalinský, Ondřej; Hanuš, Martin; Onderišinová, Zuzana; Kelar, Jakub; Kučera, Miroslav

    2016-04-01

    Single crystal scintillators are frequently used for electron detection in scanning electron microscopy (SEM). We report gadolinium aluminum gallium garnet (GAGG:Ce) single crystalline films as a new perspective scintillators for the SEM. For the first time, the epitaxial garnet films were used in a practical application: the GAGG:Ce scintillator was incorporated into a SEM scintillation electron detector and it showed improved image quality. In order to prove the GAGG:Ce quality accurately, the scintillation properties were examined using electron beam excitation and compared with frequently used scintillators in the SEM. The results demonstrate excellent emission efficiency of the GAGG:Ce single crystalline films together with their very fast scintillation decay useful for demanding SEM applications. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. [Implementation of the technical requirements of the UNE-EN-ISO 15189 quality standard in a mycobacterial laboratory].

    PubMed

    Guna Serrano, M del Remedio; Ocete Mochón, M Dolores; Lahiguera, M José; Bresó, M Carmen; Gimeno Cardona, Concepción

    2013-02-01

    The UNE-EN-ISO 15189:2007 standard defines the requirements for quality and competence that must be met by medical laboratories. These laboratories should use this international standard to develop their own quality management systems and to evaluate their own competencies; in turn, this standard will be used by accreditation bodies to confirm or recognize the laboratories' competence. In clinical microbiology laboratories, application of the standard implies the implementation of the technical and specific management requirements that must be met to achieve optimal quality when carrying out microbiological tests. In Spain, accreditation is granted by the Spanish Accreditation Body (Entidad Nacional de Acreditación). This review aims to discuss the practical application of the standard's technical requirements in mycobacterial laboratory. Firstly, we define the scope of accreditation. Secondly, we specify how the items of the standard on personnel management, control of equipment, environmental facilities, method validation, internal controls and customer satisfaction surveys were developed and implemented in our laboratory. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  9. Efficacy of Carcass Electrical Stimulation in Meat Quality Enhancement: A Review

    PubMed Central

    Adeyemi, Kazeem Dauda; Sazili, Awis Qurni

    2014-01-01

    The use of electrical stimulation (ES) as a management tool to improve meat quality and efficiency of meat processing is reviewed. The basis of the efficacy of ES is its ability to fast track postmortem glycolysis, which in turn stimulates myriad histological, physical, biochemical, biophysical and physiological changes in the postmortem muscle. Electrical stimulation hastens the onset and resolution of rigor mortis thereby reducing processing time and labor and plays a vital role in improving meat tenderness and other meat quality traits. However, ES may have negative impacts on some meat quality traits such as color stability and water holding capacity in some animals. Electrical stimulation is not an end in itself. In order to achieve the desired benefits from its application, the technique must be properly used in conjunction with various intricate antemortem, perimortem and postmortem management practices. Despite extensive research on ES, the fundamental mechanisms and the appropriate commercial applications remained obscured. In addition, muscles differ in their response to ES. Thus, elementary knowledge of the various alterations with respect to muscle type is needed in order to optimize the effectiveness of ES in the improvement of meat quality. PMID:25049973

  10. Robust and transferable quantification of NMR spectral quality using IROC analysis

    NASA Astrophysics Data System (ADS)

    Zambrello, Matthew A.; Maciejewski, Mark W.; Schuyler, Adam D.; Weatherby, Gerard; Hoch, Jeffrey C.

    2017-12-01

    Non-Fourier methods are increasingly utilized in NMR spectroscopy because of their ability to handle nonuniformly-sampled data. However, non-Fourier methods present unique challenges due to their nonlinearity, which can produce nonrandom noise and render conventional metrics for spectral quality such as signal-to-noise ratio unreliable. The lack of robust and transferable metrics (i.e. applicable to methods exhibiting different nonlinearities) has hampered comparison of non-Fourier methods and nonuniform sampling schemes, preventing the identification of best practices. We describe a novel method, in situ receiver operating characteristic analysis (IROC), for characterizing spectral quality based on the Receiver Operating Characteristic curve. IROC utilizes synthetic signals added to empirical data as "ground truth", and provides several robust scalar-valued metrics for spectral quality. This approach avoids problems posed by nonlinear spectral estimates, and provides a versatile quantitative means of characterizing many aspects of spectral quality. We demonstrate applications to parameter optimization in Fourier and non-Fourier spectral estimation, critical comparison of different methods for spectrum analysis, and optimization of nonuniform sampling schemes. The approach will accelerate the discovery of optimal approaches to nonuniform sampling experiment design and non-Fourier spectrum analysis for multidimensional NMR.

  11. Multicomponent Musculoskeletal Movement Assessment Tools: A Systematic Review and Critical Appraisal of Their Development and Applicability to Professional Practice.

    PubMed

    Bennett, Hunter; Davison, Kade; Arnold, John; Slattery, Flynn; Martin, Max; Norton, Kevin

    2017-10-01

    Multicomponent movement assessment tools have become commonplace to measure movement quality, proposing to indicate injury risk and performance capabilities. Despite popular use, there has been no attempt to compare the components of each tool reported in the literature, the processes in which they were developed, or the underpinning rationale for their included content. As such, the objective of this systematic review was to provide a comprehensive summary of current movement assessment tools and appraise the evidence supporting their development. A systematic literature search was performed using PRISMA guidelines to identify multicomponent movement assessment tools. Commonalities between tools and the evidence provided to support the content of each tool was identified. Each tool underwent critical appraisal to identify the rigor in which it was developed, and its applicability to professional practice. Eleven tools were identified, of which 5 provided evidence to support their content as assessments of movement quality. One assessment tool (Soccer Injury Movement Screen [SIMS]) received an overall score of above 65% on critical appraisal, with a further 2 tools (Movement Competency Screen [MCS] and modified 4 movement screen [M4-MS]) scoring above 60%. Only the MCS provided clear justification for its developmental process. The remaining 8 tools scored between 40 and 60%. On appraisal, the MCS, M4-MS, and SIMS seem to provide the most practical value for assessing movement quality as they provide the strongest reports of developmental rigor and an identifiable evidence base. In addition, considering the evidence provided, these tools may have the strongest potential for identifying performance capabilities and guiding exercise prescription in athletic and sport-specific populations.

  12. Increasing in-stream nitrogen concentrations under different bioenergy crop management practices in central Germany

    NASA Astrophysics Data System (ADS)

    Jomaa, Seifeddine; Thraen, Daniela; Rode, Michael

    2015-04-01

    Understanding how nitrogen fluxes respond to changes in land use and agriculture practices is crucial for improving instream water quality prediction. In central Germany, expansion of bioenergy crops such as maize and rape for ethanol production during the last decade led to increasing of fertilizer application rates. To examine the effect of these changes, surface water quality of a drinking water reservoir catchment was investigated for more than 30 years. The Weida catchment (99.5 km2) is part of the Elbe river basin and has a share of 67% agricultural land use with significant changes in agricultural practices within the investigation period. For the period 2004-2012, the share of maize and rape has been increased by 52% and 20%, respectively, for enhancing bioenergy production. To achieve our gaols, the semi-distributed hydrological water quality HYPE (Hydrological Predictions for the Environment) model was calibrated for discharge and inorganic nitrogen concentrations (IN) during the period 1997-2000.The model was validated successfully (with lowest performance of NSE = 0.78 and PBIAS = 3.74% for discharge) for three different periods 1983-1987, 1989-1996 and 2000-2003, which are charaterized by different fertilizer application rates. Results showed that the HYPE model reproduced reasonably well discharge and IN daily loads (with lowest NSE = 0.64 for IN-load). In addition, the HYPE model was evaluated successfully to predict the discharge and IN concentrations for the period 2004-2012, where detailed input data in terms of crops management (field-specific survey) have been considered. Land use and crop rotations scenarios, with high hypothetical percentage of acceptance by the farmers, revealed that continuous conversion of agricultural land into bioenergy crops, will most likely, lead to an enrichment of in-stream nitrogen, especially after spring storms.

  13. Burn injury models of care: A review of quality and cultural safety for care of Indigenous children.

    PubMed

    Fraser, Sarah; Grant, Julian; Mackean, Tamara; Hunter, Kate; Holland, Andrew J A; Clapham, Kathleen; Teague, Warwick J; Ivers, Rebecca Q

    2018-05-01

    Safety and quality in the systematic management of burn care is important to ensure optimal outcomes. It is not clear if or how burn injury models of care uphold these qualities, or if they provide a space for culturally safe healthcare for Indigenous peoples, especially for children. This review is a critique of publically available models of care analysing their ability to facilitate safe, high-quality burn care for Indigenous children. Models of care were identified and mapped against cultural safety principles in healthcare, and against the National Health and Medical Research Council standard for clinical practice guidelines. An initial search and appraisal of tools was conducted to assess suitability of the tools in providing a mechanism to address quality and cultural safety. From the 53 documents found, 6 were eligible for review. Aspects of cultural safety were addressed in the models, but not explicitly, and were recorded very differently across all models. There was also limited or no cultural consultation documented in the models of care reviewed. Quality in the documents against National Health and Medical Research Council guidelines was evident; however, description or application of quality measures was inconsistent and incomplete. Gaps concerning safety and quality in the documented care pathways for Indigenous peoples' who sustain a burn injury and require burn care highlight the need for investigation and reform of current practices. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  14. Development of the Veritas plot and its application in cardiac surgery: an evidence-synthesis graphic tool for the clinician to assess multiple meta-analyses reporting on a common outcome.

    PubMed

    Panesar, Sukhmeet S; Rao, Christopher; Vecht, Joshua A; Mirza, Saqeb B; Netuveli, Gopalakrishnan; Morris, Richard; Rosenthal, Joe; Darzi, Ara; Athanasiou, Thanos

    2009-10-01

    Meta-analyses may be prone to generating misleading results because of a paucity of experimental studies (especially in surgery); publication bias; and heterogeneity in study design, intervention and the patient population of included studies. When investigating a specific clinical or scientific question on which several relevant meta-analyses may have been published, value judgments must be applied to determine which analysis represents the most robust evidence. These value judgments should be specifically acknowledged. We designed the Veritas plot to explicitly explore important elements of quality and to facilitate decision-making by highlighting specific areas in which meta-analyses are found to be deficient. Furthermore, as a graphic tool, it may be more intuitive than when similar data are presented in a tabular or text format. The Veritas plot is an adaption of the radar plot, a graphic tool for the description of multiattribute data. Key elements of meta-analytical quality such as heterogeneity, publication bias and study design are assessed. Existing qualitative methods such as the Assessment of Multiple Systematic Reviews (AMSTAR) tool have been incorporated in addition to important considerations when interpreting surgical meta-analyses such as the year of publication and population characteristics. To demonstrate the potential of the Veritas plot to inform clinical practice, we apply the Veritas plot to the meta-analytical literature comparing the incidence of 30-day stroke in off-pump coronary artery bypass surgery and conventional coronary artery bypass surgery. We demonstrate that a visually-stimulating and practical evidence-synthesis tool can direct the clinician and scientist to a particular meta-analytical study to inform clinical practice. The Veritas plot is also cumulative and allowed us to assess the quality of evidence over time. We have presented a practical graphic application for scientists and clinicians to identify and interpret variability in meta-analyses. Although further validation of the Veritas plot is required, it may have the potential to contribute to the implementation of evidence-based practice.

  15. Practice Guideline Recommendations on Perioperative Fasting: A Systematic Review.

    PubMed

    Lambert, Eva; Carey, Sharon

    2016-11-01

    Traditionally, perioperative fasting consisted of being nil by mouth (NBM) from midnight before surgery and fasting postoperatively until recovery of bowel function. These outdated practices persist despite emerging evidence revealing that excessive fasting results in negative outcomes and delayed recovery. Various evidence-based, multimodal, enhanced recovery protocols incorporating minimized perioperative fasting have arisen to improve patient outcomes and streamline recovery, but implementation remains limited. This article aims to review current fasting guidelines, assess their quality, summarize relevant recommendations, and identify gaps in evidence. A systematic literature search of Medline and CINAHL and a manual search of relevant websites identified guidelines containing suitable grading systems and fasting recommendations. Guideline quality was assessed using the Appraisal of Guidelines Research and Evaluation (AGREE) tool. Grading systems were standardized to the American Society for Parenteral and Enteral Nutrition format and recommendations summarized based on grading and guideline quality. Nineteen guidelines were included. Rigor of development scores ranged from 29%-95%, with only 8 guidelines explicitly declaring the use of systematic methodology. Applicability scores were lowest, averaging 32%. Ten recommendation types were extracted and summarized. Strong and consistent evidence exists for the minimization of perioperative fasting, for a 2-hour preoperative fast after clear fluids, and for early recommencement of oral food and fluid intake postoperatively. This article presents several high-level recommendations ready for immediate implementation, while poorly graded and inconsistent recommendations reveal key areas for future research. Meanwhile, guideline quality requires improvement, especially regarding rigor of development and applicability, through systematic methodology, reporting transparency, and implementation strategies. © 2015 American Society for Parenteral and Enteral Nutrition.

  16. Adapting total quality management for general practice: evaluation of a programme.

    PubMed Central

    Lawrence, M; Packwood, T

    1996-01-01

    OBJECTIVE: Assessment of the benefits and limitations of a quality improvement programme based on total quality management principles in general practice over a period of one year (October 1993-4). DESIGN: Questionnaires to practice team members before any intervention and after one year. Three progress reports completed by facilitators at four month intervals. Semistructured interviews with a sample of staff from each practice towards the end of the year. SETTING: 18 self selected practices from across the former Oxford Region. Three members of each practice received an initial residential course and three one day seminars during the year. Each practice was supported by a facilitator from their Medical Audit Advisory Group. MEASURES: Extent of understanding and implementation of quality improvement methodology. Number, completeness, and evaluation of quality improvement projects. Practice team members' attitudes to and involvement in team working and quality improvement. RESULTS: 16 of the 18 practices succeeded in implementing the quality improvement methods. 48 initiatives were considered and staff involvement was broad. Practice members showed increased involvement in, and appreciation of, strategic planning and team working, and satisfaction from improved patients services. 11 of the practices intend to continue with the methodology. The commonest barrier expressed was time. CONCLUSION: Quality improvement programmes based on total quality management principles produce beneficial changes in service delivery and team working in most general practices. It is incompatible with traditional doctor centred practice. The methodology needs to be adapted for primary care to avoid quality improvement being seen as separate from routine activity, and to save time. PMID:10161529

  17. Aligning Practice to Policies: Changing the Culture to Recognize and Reward Teaching at Research Universities

    PubMed Central

    Dennin, Michael; Schultz, Zachary D.; Feig, Andrew; Finkelstein, Noah; Greenhoot, Andrea Follmer; Hildreth, Michael; Leibovich, Adam K.; Martin, James D.; Moldwin, Mark B.; O’Dowd, Diane K.; Posey, Lynmarie A.; Smith, Tobin L.; Miller, Emily R.

    2017-01-01

    Recent calls for improvement in undergraduate education within STEM (science, technology, engineering, and mathematics) disciplines are hampered by the methods used to evaluate teaching effectiveness. Faculty members at research universities are commonly assessed and promoted mainly on the basis of research success. To improve the quality of undergraduate teaching across all disciplines, not only STEM fields, requires creating an environment wherein continuous improvement of teaching is valued, assessed, and rewarded at various stages of a faculty member’s career. This requires consistent application of policies that reflect well-established best practices for evaluating teaching at the department, college, and university levels. Evidence shows most teaching evaluation practices do not reflect stated policies, even when the policies specifically espouse teaching as a value. Thus, alignment of practice to policy is a major barrier to establishing a culture in which teaching is valued. Situated in the context of current national efforts to improve undergraduate STEM education, including the Association of American Universities Undergraduate STEM Education Initiative, this essay discusses four guiding principles for aligning practice with stated priorities in formal policies: 1) enhancing the role of deans and chairs; 2) effectively using the hiring process; 3) improving communication; and 4) improving the understanding of teaching as a scholarly activity. In addition, three specific examples of efforts to improve the practice of evaluating teaching are presented as examples: 1) Three Bucket Model of merit review at the University of California, Irvine; (2) Evaluation of Teaching Rubric, University of Kansas; and (3) Teaching Quality Framework, University of Colorado, Boulder. These examples provide flexible criteria to holistically evaluate and improve the quality of teaching across the diverse institutions comprising modern higher education. PMID:29196430

  18. Lean thinking in emergency departments: concepts and tools for quality improvement.

    PubMed

    Bruno, Frances

    2017-10-12

    The lean approach is a viable framework for reducing costs and enhancing the quality of patient care in emergency departments (EDs). Reports on lean-inspired quality improvement initiatives are rapidly growing but there is little emphasis on the philosophy behind the processes, which is the essential ingredient in sustaining transformation. This article describes lean philosophy, also referred to as lean, lean thinking and lean healthcare, and its main concepts, to enrich the knowledge and vocabulary of nurses involved or interested in quality improvement in EDs. The article includes examples of lean strategies to illustrate their practical application in EDs. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  19. Assessing experience in the deliberate practice of running using a fuzzy decision-support system

    PubMed Central

    Roveri, Maria Isabel; Manoel, Edison de Jesus; Onodera, Andrea Naomi; Ortega, Neli R. S.; Tessutti, Vitor Daniel; Vilela, Emerson; Evêncio, Nelson

    2017-01-01

    The judgement of skill experience and its levels is ambiguous though it is crucial for decision-making in sport sciences studies. We developed a fuzzy decision support system to classify experience of non-elite distance runners. Two Mamdani subsystems were developed based on expert running coaches’ knowledge. In the first subsystem, the linguistic variables of training frequency and volume were combined and the output defined the quality of running practice. The second subsystem yielded the level of running experience from the combination of the first subsystem output with the number of competitions and practice time. The model results were highly consistent with the judgment of three expert running coaches (r>0.88, p<0.001) and also with five other expert running coaches (r>0.86, p<0.001). From the expert’s knowledge and the fuzzy model, running experience is beyond the so-called "10-year rule" and depends not only on practice time, but on the quality of practice (training volume and frequency) and participation in competitions. The fuzzy rule-based model was very reliable, valid, deals with the marked ambiguities inherent in the judgment of experience and has potential applications in research, sports training, and clinical settings. PMID:28817655

  20. The Relationship Between Focused Attention Meditation Practice Habits, Psychological Symptoms, and Quality of Life.

    PubMed

    Bilican, F Isil

    2016-12-01

    This study examined the relationship between focused attention meditation practice habits, psychological symptoms, and quality of life. The participants were 30 adults from New York, NY, practicing Ananda Marga spirituality. They were administered the Symptom Check List-90-R and the Quality of Life Index. The findings pointed out while Ananda Marga meditation practice habits were not associated with improvements in psychological symptoms, longer years in meditation practice was associated with improvements in overall, social and psychological/spiritual quality of life. Longer periods of meditation practice per session were related to lower levels of overall quality of life and economic quality of life.

  1. Chemistry and quality of Hibiscus (Hibiscus sabdariffa) for developing the natural-product industry in Senegal.

    PubMed

    Juliani, H R; Welch, C R; Wu, Q; Diouf, B; Malainy, D; Simon, J E

    2009-03-01

    The objectives of this study were to assess and improve the quality of the hibiscus calyces from Senegal over 2 production seasons (2004 to 2005), to develop and adapt new procedures for the determination of hibiscus anthocyanins and analysis of the 2 major ones, delphinidin-3-sambubioside and cyanidin-3-sambubioside. The foreign matter, total ashes, and acid insoluble ashes showed that the calyces harvested in 2005 were produced following hygienic practices, while the color assessment of the calyces and analysis of hibiscus active principles also showed higher amounts of anthocyanins in 2005. A protocol to measure anthocyanins by pH-differential UV-Vis spectrophotometry was adapted to measure the hibiscus anthocyanins from a water extract. The spectrophotometric method for quantitation of total anthocyanins showed a close correlation (r(2)= 0.82) when compared with the HPLC method, suggesting the use of the colorimetric method in quality control programs as an affordable alternative method to assess anthocyanin content in hibiscus. New and raised standards for the cleanliness and active principle content in hibiscus are also proposed. This study demonstrated that the implementation of a quality control program and the application of agricultural good practices in the production and processing of hibiscus calyces can lead to higher quality natural plant products.

  2. [Quality management (TQM) in public health-care (PHC): principles for cost-performance calculations and cost reductions with better quality].

    PubMed

    Bergholz, W

    2008-11-01

    In many high-tech industries, quality management (QM) has enabled improvements of quality by a factor of 100 or more, in combination with significant cost reductions. Compared to this, the application of QM methods in health care is in its initial stages. It is anticipated that stringent process management, embedded in an effective QM system will lead to significant improvements in health care in general and in the German public health service in particular. Process management is an ideal platform for controlling in the health care sector, and it will significantly improve the leverage of controlling to bring down costs. Best practice sharing in industry has led to quantum leap improvements. Process management will enable best practice sharing also in the public health service, in spite of the highly diverse portfolio of services that the public health service offers in different German regions. Finally, it is emphasised that "technical" QM, e.g., on the basis of the ISO 9001 standard is not sufficient to reach excellence. It is necessary to integrate soft factors, such as patient or employee satisfaction, and leadership quality into the system. The EFQM model for excellence can serve as proven tool to reach this goal.

  3. The NISTmAb Reference Material 8671 lifecycle management and quality plan.

    PubMed

    Schiel, John E; Turner, Abigail

    2018-03-01

    Comprehensive analysis of monoclonal antibody therapeutics involves an ever expanding cadre of technologies. Lifecycle-appropriate application of current and emerging techniques requires rigorous testing followed by discussion between industry and regulators in a pre-competitive space, an effort that may be facilitated by a widely available test metric. Biopharmaceutical quality materials, however, are often difficult to access and/or are protected by intellectual property rights. The NISTmAb, humanized IgG1κ Reference Material 8671 (RM 8671), has been established with the intent of filling that void. The NISTmAb embodies the quality and characteristics of a typical biopharmaceutical product, is widely available to the biopharmaceutical community, and is an open innovation tool for development and dissemination of results. The NISTmAb lifecyle management plan described herein provides a hierarchical strategy for maintenance of quality over time through rigorous method qualification detailed in additional submissions in the current publication series. The NISTmAb RM 8671 is a representative monoclonal antibody material and provides a means to continually evaluate current best practices, promote innovative approaches, and inform regulatory paradigms as technology advances. Graphical abstract The NISTmAb Reference Material (RM) 8671 is intended to be an industry standard monoclonal antibody for pre-competitive harmonization of best practices and designing next generation characterization technologies for identity, quality, and stability testing.

  4. Chemical and microbiological water quality of subsurface agricultural drains during a field trial of liquid dairy manure effluent application rate and varying tillage practices, Upper Tiffin Watershed, southeastern Michigan

    USGS Publications Warehouse

    Haack, Sheridan Kidd; Duris, Joseph W.

    2008-01-01

    A field trial was done in the Upper Tiffin River Watershed, in southeastern Michigan, to determine the influence of liquid dairy manure effluent (LDME) management practices on the quality of agricultural subsurface-drain water. Samples from subsurface drains were analyzed for nutrients, fecal-coliform and Escherichia coli (E. coli) bacteria, antibiotics, chemicals typically detected in wastewater, and the occurrence of genes indicating the presence of shiga-toxin-producing E. coli, or of bovine-specific Bacteroidetes bacteria. Samples were collected from November 2, 2006, to March 20, 2007, from eight subsurface drains under field plots that received no LDME and no tillage (controls) or received 4,000 or 8,000 gallons per acre (gal/acre) of LDME and either no tillage or two different types of tillage. The two types of tillage tested were (1) ground-driven, rotary, subsurface cultivation and (2) rolling-tine aeration. Samples were collected before LDME application and at 4 hours, and 1, 2, 6, 7, and 14 days post-application. Nutrient concentrations were high in subsurface-drain water throughout the field-trial period and could not be attributed to the field-trial LDME application. Of the 59 drain-water samples, including those collected before LDME application and control samples for each date, 56 had concentrations greater than the U.S. Environmental Protection Agency (USEPA), Ecoregion VI recommended surface-water criterion for total phosphorus, and all samples had concentrations greater than the recommended total nitrogen criterion. Nitrate + nitrite nitrogen concentration exceeded 20 milligrams per liter for every sample and contributed most to the total nitrogen concentrations. Substantial increases in drain-water concentrations of organic and ammonia nitrogen and total phosphorus were found for all treatments, including controls, at 14 days post-application after 0.84 inch of rainfall over 2 days. E. coli concentrations exceeded the USEPA recreational-water-quality single-sample criterion of 235 colony forming units per 100 milliliters in only 3 of 56 samples. Of these three samples, two were collected within 1 day post-LDME application from the treatment receiving 8,000 gal/acre LDME with no tillage (NT8000). The third sample was from the rolling-tine aerator treatment with 4,000 gal/acre LDME application rate after the first significant rainfall. Two wastewater chemicals and two bacterial genes (eaeA and stx1) detected in the LDME, but absent in field blank or pre-application samples, were detected in the 4-hour or 1-day postapplication NT8000 samples. No LDME-associated chemicals were detected in later samples from the NT8000 treatment, and none were detected in samples from other treatments after the first significant rainfall. Results of this field trial were somewhat equivocal with respect to the influence of LDME concentration and tillage practices on subsurface-drain water quality, both immediately after LDME application and in the longer term, after significant rainfall. Interpretation of study findings is limited by the fact that treatments were not replicated, and flow rate or discharge from the subsurface drains was not measured. Nevertheless, study results provide useful information about nutrient and bacteria concentrations in subsurface drains during the non-growing season. In addition, study results demonstrate some potential for the use of chemical and microbiological indicators of LDME transport to subsurface drains.

  5. 22 CFR 96.39 - Information disclosure and quality control practices.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Information disclosure and quality control... for Convention Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices § 96.39 Information disclosure and quality control practices. (a) The agency or...

  6. 22 CFR 96.39 - Information disclosure and quality control practices.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Information disclosure and quality control... for Convention Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices § 96.39 Information disclosure and quality control practices. (a) The agency or...

  7. 22 CFR 96.39 - Information disclosure and quality control practices.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Information disclosure and quality control... for Convention Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices § 96.39 Information disclosure and quality control practices. (a) The agency or...

  8. 22 CFR 96.39 - Information disclosure and quality control practices.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Information disclosure and quality control... for Convention Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices § 96.39 Information disclosure and quality control practices. (a) The agency or...

  9. 22 CFR 96.39 - Information disclosure and quality control practices.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Information disclosure and quality control... for Convention Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices § 96.39 Information disclosure and quality control practices. (a) The agency or...

  10. Implementation Science: Buzzword or Game Changer?

    PubMed

    Douglas, Natalie F; Campbell, Wenonah N; Hinckley, Jacqueline J

    2015-12-01

    The purpose of this supplement article is to provide a resource of pertinent information concerning implementation science for immediate research application in communication sciences and disorders. Key terminology related to implementation science is reviewed. Practical suggestions for the application of implementation science theories and methodologies are provided, including an overview of hybrid research designs that simultaneously investigate clinical effectiveness and implementation as well as an introduction to approaches for engaging stakeholders in the research process. A detailed example from education is shared to show how implementation science was utilized to move an intervention program for autism into routine practice in the public school system. In particular, the example highlights the value of strong partnership among researchers, policy makers, and frontline practitioners in implementing and sustaining new evidence-based practices. Implementation science is not just a buzzword. This is a new field of study that can make a substantive contribution in communication sciences and disorders by informing research agendas, reducing health and education disparities, improving accountability and quality control, increasing clinician satisfaction and competence, and improving client outcomes.

  11. Infusing informatics into interprofessional education: the iTEAM (Interprofessional Technology Enhanced Advanced practice Model) project.

    PubMed

    Skiba, Diane J; Barton, Amy J; Knapfel, Sarah; Moore, Gina; Trinkley, Katy

    2014-01-01

    The iTEAM goal is to prepare advanced practice nurses, physicians and pharmacists with the interprofessional (IP) core competencies (informatics, patient centric, quality-focused, evidence based care) to provide technology enhanced collaborative care by: offering technology enhanced learning opportunities through a required informatics course, advanced practice courses (team based experiences with both standardized and virtual patients) and team based clinical experiences including e-health experiences. The innovative features of iTEAM project will be achieved through use of social media strategies, a web accessible Electronic Health Records (EHRs) system, a Virtual Clinic/Hospital in Second Life, various e-health applications including traditional telehealth tools and consumer oriented tools such as patient portals, social media consumer groups and mobile health (m-health) applications for health and wellness functions. It builds upon the schools' rich history of IP education and includes clinical partners, such as the VA and other clinical sites focused on care for underserved patient populations.

  12. Long-term Effect of Pig Slurry Application on Soil Carbon Storage, Quality and Yield Sustainability in Murcia Region, Spain

    NASA Astrophysics Data System (ADS)

    Büyükkılıç Yanardaǧ, Asuman

    2013-04-01

    Sustainability of agriculture is now a major global concern, especially since the 1980s. Soil organic matter is very important in the proper functions of the soil, which is also a good indicator of soil quality. This is due to its influence on many of the chemical, physical, and biological processes that control the capacity of a soil to perform properly. Understanding of nutrient supply through organic matter mineralization in agricultural systems is essential for maintaining long-term quality and productivity. The composition of pig manure will have a profound impact on soil properties, quality and crop yield when used in agriculture. We studied the effects of pig slurry (PS) application as an organic fertilizer, trying to determine the optimum amount that can be added to the soil, and the effect on soil properties, quality, and productivity. We applied 3 different doses on silty loam soils: Single (D1), Double (D2), Triple (D3) and unfertilized plots (C) served as controls. Samples were collected at two different levels, surface (0-30 cm) and subsurface (30-60 cm). D1 application dose, which is the agronomic rate of N-requirement (170 kg N/ha/yr) (European Directive 91/676/CEE), is very appropriate in term of sustainable agriculture and also can improve physical, chemical and biological soil properties. Therefore that the long-term use of PS with low dose may necessarily enhance soil quality in the long term. There are many factors to be considered when attempting to assess the overall net impact of a management practice on productivity. Additions of pig manure to soils at agronomic rates (170 kg N ha-1 yr-1) to match crop nutrient requirements are expected to have a positive impact on soil productivity. Therefore, the benefits from the use of application depend on the management of PS, carbon and environmental quality. However, PS have high micronutrient contents, and for this reason the application of high doses can pollute soils and damage human, animal and plant health, which is not suitable in term of sustainable agriculture. Keywords: Management, Pig slurry, Productivity, Quality, Soil.

  13. Eventual sport performance level: What about the role of type of sport, perception of critical life events, and practice quality?

    PubMed

    Toering, Tynke

    2017-01-01

    The target article describes an interesting study, which provides some challenging findings regarding athletes' pathway to excellence. The suggested links between critical life events, need for success, personal characteristics, and eventual performance level make sense from a psychodynamic perspective. This commentary will discuss some critical points related to the application of the findings in talent identification and -development programs. These are (1) the possible effect of the selection of participants on the results (including the impact of dependence on others for team sport athletes and the opportunity for multiple medal attainment), (2) a lack of detail in the description of how the athletes approached the critical life events (the perception of an event may contribute more to development than the event itself), and (3) a lack of detail in the description of the practice process throughout development. Some interesting differences were found in the motivation for and approach to practice, but little detail was given about what the athletes exactly were doing at the time. The concept of self-regulated learning may be useful in explaining how super-elite athletes action their goals through quality practice. © 2017 Elsevier B.V. All rights reserved.

  14. A Scoping Review of Social Media Use in Social Work Practice.

    PubMed

    Chan, Chitat

    2016-01-01

    The trend of using social media in social work is increasing, but research which systematically reviews and evaluates their uses in actual practice is limited. This article reviews the social work literature to identify the uses, benefits, and limitations of social media in social work practice, and identifies current gaps in the literature to provide recommendations for future social work research. Articles in 64 social work journals published between 2000 and 2014 were screened and analyzed. The included articles (n = 20) were analyzed with particular reference to their level of evidence and ways of social media use. The methodological quality of the studies in this review was low, and this was consistent with the findings of recent systematic reviews of social media use in medical healthcare. The findings initially suggested that social media can potentially contribute to various social work processes, including: service user engagement, need assessment, intervention, and program evaluation. Limitations include lack of quality control, reliability, confidentiality, and privacy. In social work, the dominant research concern in social media is more about professional ethics than their application in intervention. Implications for research and practice are discussed.

  15. Evidence-based practice guidelines in OHS: are they agree-able?

    PubMed

    Hulshof, Carel; Hoenen, John

    2007-01-01

    The purpose of this study was to evaluate the acceptance, validity, reliability and feasibility of the AGREE (Appraisal of Guidelines and REsearch and Evaluation) instrument to assess the quality of evidence-based practice guidelines for occupational physicians. In total, 6 practice guidelines of the Netherlands Society of Occupational Medicine (NVAB) were appraised by 20 occupational health professionals and experts in guideline development or implementation. Although appraisers often disagreed on individual item scores, the internal consistency and interrater reliability for most domains was sufficient. The AGREE criteria were in general considered relevant and no major suggestions for additional items for use in the context of occupational health were brought up. The domain scores for the individual guidelines show a wide variety: 'applicability' had on average the lowest mean score (53%) while 'scope and purpose' had the highest one (87%). Low scores indicate where improvements are possible and necessary, e.g. by providing more information about the development. Key experts in occupational health report that AGREE is a relevant and easy to use instrument to evaluate quality aspects and the included criteria provide a good framework to develop or update evidence-based practice guidelines in the field of occupational health.

  16. Fatigue as a Driver of Overall Quality of Life in Cancer Patients.

    PubMed

    McCabe, Ryan M; Grutsch, James F; Braun, Donald P; Nutakki, Swetha B

    2015-01-01

    This manuscript describes an approach for analyzing large amounts of disparate clinical data to elucidate the most impactful factor(s) that relate to a meaningful clinical outcome, in this case, the quality of life of cancer patients. The relationships between clinical and quality of life variables were evaluated using the EORTC QLQ-C30 global health domain--a validated surrogate variable for overall cancer patient well-being. A cross-sectional study design was used to evaluate the determinants of global health in cancer patients who initiated treatment at two regional medical centers between January 2001 and December 2009. Variables analyzed included 15 EORTC QLQ-C30 scales, age at diagnosis, gender, newly diagnosed/ recurrent disease status, and stage. The decision tree algorithm, perhaps unfamiliar to practicing clinicians, evaluates the relative contribution of individual parameters in classifying a clinically meaningful functional endpoint, such as the global health of a patient. Multiple patient characteristics were identified as important contributors. Fatigue, in particular, emerged as the most prevalent indicator of cancer patients' quality of life in 16/23 clinically relevant subsets. This analysis allowed results to be stated in a clinically-intuitive, rule set format using the language and quantities of the Quality of Life (QoL) tool itself. By applying the classification algorithms to a large data set, identification of fatigue as a root factor in driving global health and overall QoL was revealed. The ability to practice mining of clinical data sets to uncover critical clinical insights that are immediately applicable to patient care practices is illustrated.

  17. Fatigue as a Driver of Overall Quality of Life in Cancer Patients

    PubMed Central

    McCabe, Ryan M.; Grutsch, James F.; Braun, Donald P.; Nutakki, Swetha B.

    2015-01-01

    Background This manuscript describes an approach for analyzing large amounts of disparate clinical data to elucidate the most impactful factor(s) that relate to a meaningful clinical outcome, in this case, the quality of life of cancer patients. The relationships between clinical and quality of life variables were evaluated using the EORTC QLQ-C30 global health domain—a validated surrogate variable for overall cancer patient well-being. Methods A cross-sectional study design was used to evaluate the determinants of global health in cancer patients who initiated treatment at two regional medical centers between January 2001 and December 2009. Variables analyzed included 15 EORTC QLQ-C30 scales, age at diagnosis, gender, newly diagnosed/ recurrent disease status, and stage. The decision tree algorithm, perhaps unfamiliar to practicing clinicians, evaluates the relative contribution of individual parameters in classifying a clinically meaningful functional endpoint, such as the global health of a patient. Findings Multiple patient characteristics were identified as important contributors. Fatigue, in particular, emerged as the most prevalent indicator of cancer patients’ quality of life in 16/23 clinically relevant subsets. This analysis allowed results to be stated in a clinically-intuitive, rule set format using the language and quantities of the Quality of Life (QoL) tool itself. Interpretation By applying the classification algorithms to a large data set, identification of fatigue as a root factor in driving global health and overall QoL was revealed. The ability to practice mining of clinical data sets to uncover critical clinical insights that are immediately applicable to patient care practices is illustrated. PMID:26070133

  18. [Handbook for the preparation of evidence-based documents. Tools derived from scientific knowledge].

    PubMed

    Carrión-Camacho, M R; Martínez-Brocca, M A; Paneque-Sánchez-Toscano, I; Valencia-Martín, R; Palomino-García, A; Muñoz-Durán, C; Tamayo-López, M J; González-Eiris-Delgado, C; Otero-Candelera, R; Ortega-Ruiz, F; Sobrino-Márquez, J M; Jiménez-García-Bóveda, R; Fernández-Quero, M; Campos-Pareja, A M

    2013-01-01

    This handbook is intended to be an accessible, easy-to-consult guide to help professionals produce or adapt Evidence-Based Documents. Such documents will help standardize both clinical practice and decision-making, the quality always being monitored in such a way that established references are complied with. Evidence-Based Health Care Committee, a member of "Virgen del Rocío" University Hospital quality structure, proposed the preparation of a handbook to produce Evidence-Based Documents including: a description of products, characteristics, qualities, uses, methodology of production, and application scope of every one of them. The handbook consists of seven Evidence-Based tools, one chapter on critical analysis methodology of scientific literature, one chapter with internet resources, and some appendices with different assessment tools. This Handbook provides general practitioners with a great opportunity to improve quality and as a guideline to standardize clinical healthcare, and managers with a strategy to promote and encourage the development of documents in an effort to reduce clinical practice variability, as well as giving patients the opportunity of taking part in planning their own care. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

  19. Integrating cobenefits produced with water quality BMPs into credits markets: Conceptualization and experimental illustration for EPRI's Ohio River Basin Trading

    NASA Astrophysics Data System (ADS)

    Liu, Pengfei; Swallow, Stephen K.

    2016-05-01

    This paper develops a method that incorporates the public value for environmental cobenefits when a conservation buyer can purchase water quality credits based on nonmarket valuation results. We demonstrate this approach through an experiment with adult students in a classroom laboratory environment. Our application contributes to the study of individual preference and willingness to pay for cobenefits associated with the production of water quality credits in relation to the Ohio River Basin Trading Project. We use three different methods to elicit individuals' willingness to pay (WTP), including (1) a hypothetical referendum, (2) a real referendum lacking incentive compatibility, and (3) a real choice with incentive compatibility. Methodologically, our WTP estimates suggest individuals are more sensitive to the cost changes and reveal the lowest value in the real choice with incentive compatibility. Practically, we find individuals value certain cobenefits and credits as public goods. Incorporating public value toward cobenefits may improve the overall efficiency of a water quality trading market. Based on our specification of a planner's welfare function, results suggest a substantial welfare improvement after identifying an optimal allocation of a buyer's budget across credits derived from agricultural management practices producing different portfolios of cobenefits.

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

    PubMed

    Lee, Hye-Seong; van Hout, Danielle

    2009-08-01

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

  1. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1: ASC software quality engineering practices, Version 2.0.

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

    Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  2. Improving Water Quality With Conservation Buffers

    NASA Astrophysics Data System (ADS)

    Lowrance, R.; Dabney, S.; Schultz, R.

    2003-12-01

    Conservation buffer technologies are new approaches that need wider application. In-field buffer practices work best when used in combination with other buffer types and other conservation practices. Vegetative barriers may be used in combination with edge-of-field buffers to protect and improve their function and longevity by dispersing runoff and encouraging sediment deposition upslope of the buffer. It's important to understand how buffers can be managed to help reduce nutrient transport potential for high loading of nutrients from manure land application sites, A restored riparian wetland buffer retained or removed at least 59 percent of the nitrogen and 66 percent of the phosphorus that entered from an adjacent manure land application site. The Bear Creek National Restoration Demonstration Watershed project in Iowa has been the site of riparian forest buffers and filter strips creation; constructed wetlands to capture tile flow; stream-bank bioengineering; in-stream structures; and controlling livestock grazing. We need field studies that test various widths of buffers of different plant community compositions for their efficacy in trapping surface runoff, reducing nonpoint source pollutants in subsurface waters, and enhancing the aquatic ecosystem. Research is needed to evaluate the impact of different riparian grazing strategies on channel morphology, water quality, and the fate of livestock-associated pathogens and antibiotics. Integrating riparian buffers and other conservation buffers into these models is a key objective in future model development.

  3. Best Practices for Optimizing DoD Contractor Safety and Occupational Health Program Performance

    DTIC Science & Technology

    2012-12-01

    such as Accident Prevention Plan (APP), Activity Hazard Analysis (AHA), Quality Assurance Surveillance Plans (QASP), etc. Contract administration...technology support, medical , and maintenance of equipment and facilities. The DoD Guidebook for the Acquisition of Services, provides acquisition...OSHA regulations and perform in accordance with an applicable accident prevention program that complies with State and Federal requirements. The

  4. The Terms of the Deal: A Quality Charter School Contract Defined. Authorizing Matters. Issue Brief

    ERIC Educational Resources Information Center

    Haft, William

    2009-01-01

    A contract is about commitment and responsibility. It is about the commitment that two or more parties make and the responsibility to deliver on those commitments. When school developers and authorizers turn a charter application into a contract, the relationship transforms: it shifts from aspiration to expectation and from theory to practice. The…

  5. Medical robotics: the impact on perioperative nursing practice.

    PubMed

    Francis, Paula; Winfield, Howard N

    2006-04-01

    Robotic technology and the increased use of minimally invasive surgery approaches is altering the environment in which operating room personnel work and affecting how nurses must care for patients. An understanding of the history of robotics, current applications of the technology, and perioperative nursing responsibilities is needed to assure quality patient care in the wake of continued advances in technology.

  6. Reliability Abstracts and Technical Reviews January - December 1970. Volume 10, Nos. 1-12; R70-14805 - R70-15438

    NASA Technical Reports Server (NTRS)

    1970-01-01

    Reliability Abstracts and Technical Reviews is an abstract and critical analysis service covering published and report literature on reliability. The service is designed to provide information on theory and practice of reliability as applied to aerospace and an objective appraisal of the quality, significance, and applicability of the literature abstracted.

  7. Staff Stress and Burnout in Intellectual Disability Services: Work Stress Theory and Its Application

    ERIC Educational Resources Information Center

    Devereux, Jason; Hastings, Richard; Noone, Steve

    2009-01-01

    Background: Staff in intellectual disability services can be at risk of stress and burnout at work. Given that staff well-being has implications for the quality of life of the staff themselves and people with intellectual disabilities themselves, this is an important research and practical topic. In this paper, we review work stress theories that…

  8. A Study of the Relationship between Quality of PBIS Implementation, School Context, and Academic and Behavioral Outcomes

    ERIC Educational Resources Information Center

    Mier, Matthew B.

    2017-01-01

    Positive Behavioral Interventions and Supports (PBIS) is a framework that has been employed in schools in order to promote not only improved behavioral outcomes but academic outcomes as well. PBIS has three core elements: use of a three-tiered prevention model, application of evidence-based practices, and creation of systems to support and sustain…

  9. Adapting clinical practice guidelines for diabetic retinopathy in Kenya: process and outputs.

    PubMed

    Mwangi, Nyawira; Gachago, Muchai; Gichangi, Michael; Gichuhi, Stephen; Githeko, Kibata; Jalango, Atieno; Karimurio, Jefitha; Kibachio, Joseph; Muthami, Lawrence; Ngugi, Nancy; Nduri, Carmichael; Nyaga, Patrick; Nyamori, Joseph; Zindamoyen, Alain Nazaire Mbongo; Bascaran, Covadonga; Foster, Allen

    2018-06-15

    The use of clinical practice guidelines envisages augmenting quality and best practice in clinical outcomes. Generic guidelines that are not adapted for local use often fail to produce these outcomes. Adaptation is a systematic and rigorous process that should maintain the quality and validity of the guideline, while making it more usable by the targeted users. Diverse skills are required for the task of adaptation. Although adapting a guideline is not a guarantee that it will be implemented, adaptation may improve acceptance and adherence to its recommendations. We describe the process used to adapt clinical guidelines for diabetic retinopathy in Kenya, using validated tools and manuals. A technical working group consisting of volunteers provided leadership. The process was intensive and required more time than anticipated. Flexibility in the process and concurrent health system activities contributed to the success of the adaptation. The outputs from the adaptation include the guidelines in different formats, point of care instruments, as well as tools for training, monitoring, quality assurance and patient education. Guideline adaptation is applicable and feasible at the national level in Kenya. However, it is labor- and time -intensive. It presents a valuable opportunity to develop several additional outputs that are useful at the point of care.

  10. Application of digital profile modeling techniques to ground-water solute transport at Barstow, California

    USGS Publications Warehouse

    Robson, Stanley G.

    1978-01-01

    This study investigated the use of a two-dimensional profile-oriented water-quality model for the simulation of head and water-quality changes through the saturated thickness of an aquifer. The profile model is able to simulate confined or unconfined aquifers with nonhomogeneous anisotropic hydraulic conductivity, nonhomogeneous specific storage and porosity, and nonuniform saturated thickness. An aquifer may be simulated under either steady or nonsteady flow conditions provided that the ground-water flow path along which the longitudinal axis of the model is oriented does not move in the aquifer during the simulation time period. The profile model parameters are more difficult to quantify than are the corresponding parameters for an areal-oriented water-fluality model. However, the sensitivity of the profile model to the parameters may be such that the normal error of parameter estimation will not preclude obtaining acceptable model results. Although the profile model has the advantage of being able to simulate vertical flow and water-quality changes in a single- or multiple-aquifer system, the types of problems to which it can be applied is limited by the requirements that (1) the ground-water flow path remain oriented along the longitudinal axis of the model and (2) any subsequent hydrologic factors to be evaluated using the model must be located along the land-surface trace of the model. Simulation of hypothetical ground-water management practices indicates that the profile model is applicable to problem-oriented studies and can provide quantitative results applicable to a variety of management practices. In particular, simulations of the movement and dissolved-solids concentration of a zone of degraded ground-water quality near Barstow, Calif., indicate that halting subsurface disposal of treated sewage effluent in conjunction with pumping a line of fully penetrating wells would be an effective means of controlling the movement of degraded ground water.

  11. Benefits of Enterprise Ontology for the Development of ICT-Based Value Networks

    NASA Astrophysics Data System (ADS)

    Albani, Antonia; Dietz, Jan L. G.

    The competitiveness of value networks is highly dependent on the cooperation between business partners and the interoperability of their information systems. Innovations in information and communication technology (ICT), primarily the emergence of the Internet, offer possibilities to increase the interoperability of information systems and therefore enable inter-enterprise cooperation. For the design of inter-enterprise information systems, the concept of business component appears to be very promising. However, the identification of business components is strongly dependent on the appropriateness and the quality of the underlying business domain model. The ontological model of an enterprise - or an enterprise network - as presented in this article, is a high-quality and very adequate business domain model. It provides all essential information that is necessary for the design of the supporting information systems, and at a level of abstraction that makes it also understandable for business people. The application of enterprise ontology for the identification of business components is clarified. To exemplify our approach, a practical case is taken from the domain of strategic supply network development. By doing this, a widespread problem of the practical application of inter-enterprise information systems is being addressed.

  12. Practical applications of surface analytic tools in tribology

    NASA Technical Reports Server (NTRS)

    Ferrante, J.

    1980-01-01

    Many of the currently, widely used tools available for surface analysis are described. Those which have the highest applicability for giving elemental and/or compound analysis for problems of interest in tribology and are truly surface sensitive (that is, less than 10 atomic layers) are presented. The latter group is evaluated in detail in terms of strengths and weaknesses. Emphasis is placed on post facto analysis of experiments performed under 'real' conditions (e.g., in air with lubricants). It is further indicated that such equipment could be used for screening and quality control.

  13. Incorporating individualized quality of life measures in the evaluation of pharmacy services: the IN*COMPASS framework.

    PubMed

    Funderburk, F R; Pathak, D S; Pleil, A M

    1998-01-01

    Quality of life is a fascinating field to researchers and practitioners alike. To some researchers, quality of life is of interest because it offers untold challenges in constructing instruments and capturing data necessary to answer key questions about health, disease, and treatment. For such researchers, quality of life is about statistical relationships among questions and about using questions to define the physical, social, and emotional domains of health. To other researchers, this field is about finding practical applications in policy and treatment decision making for the information provided by quality of life assessments. To these researchers, the focus of quality of life is on ways to apply knowledge of quality of life differences between groups with and without specific diseases or ways to use knowledge about how treatments affect the quality of life of various patient populations. To practitioners, quality of life is about treatment outcomes that impact individual patients' daily lives. It is the practitioner that Funderburk, Pleil, and Pathak are considering in their paper in this issue of Pharmacy Practice Management Quarterly. These authors give several important messages to practitioners seeking to serve their patients by incorporating quality of life into their practices. The key message in the paper is that to better understand and determine the impact of treatment on a patient's quality of life, it is critical to start with a baseline or reference point relevant to that patient. From that baseline or reference point, treatment decisions can be made and progress, in quality of life terms, can be evaluated. Critical questions in their framework, which is called the IN*COMPASS (Individualized Client Oriented Method for Preferred Alleviation of Sickness States) Approach, are "How are you now?" and "How would you like to be?" The authors do not endorse particular quality of life tools in their approach; rather they prescribe certain critical questions that must be answered if information captured by any quality of life tool is to be useful at the patient level. Readers should not be put off by the fancy acronym used in this paper; nor must readers be keen students of quality of life to appreciate its message. The IN*COMPASS approach is fundamental to good patient care and can be applied by practitioners with any level of understanding of and appreciation for quality of life assessments.

  14. Design choices made by target users for a pay-for-performance program in primary care: an action research approach.

    PubMed

    Kirschner, Kirsten; Braspenning, Jozé; Jacobs, J E Annelies; Grol, Richard

    2012-03-27

    International interest in pay-for-performance (P4P) initiatives to improve quality of health care is growing. Current programs vary in the methods of performance measurement, appraisal and reimbursement. One may assume that involvement of health care professionals in the goal setting and methods of quality measurement and subsequent payment schemes may enhance their commitment to and motivation for P4P programs and therefore the impact of these programs. We developed a P4P program in which the target users were involved in decisions about the P4P methods. For the development of the P4P program a framework was used which distinguished three main components: performance measurement, appraisal and reimbursement. Based on this framework design choices were discussed in two panels of target users using an adapted Delphi procedure. The target users were 65 general practices and two health insurance companies in the South of the Netherlands. Performance measurement was linked to the Dutch accreditation program based on three domains (clinical care, practice management and patient experience). The general practice was chosen as unit of assessment. Relative standards were set at the 25th percentile of group performance. The incentive for clinical care was set twice as high as the one for practice management and patient experience. Quality scores were to be calculated separately for all three domains, and for both the quality level and the improvement of performance. The incentive for quality level was set thrice as high as the one for the improvement of performance. For reimbursement, quality scores were divided into seven levels. A practice with a quality score in the lowest group was not supposed to receive a bonus. The additional payment grew proportionally for each extra group. The bonus aimed at was on average 5% to 10% of the practice income. Designing a P4P program for primary care with involvement of the target users gave us an insight into their motives, which can help others who need to discuss similar programs. The resulting program is in line with target users' views and assessments of relevance and applicability. This may enhance their commitment to the program as was indicated by the growing number of voluntary participants after a successfully performed field test during the procedure. The elements of our framework can be very helpful for others who are developing or evaluating a P4P program.

  15. Development and application of the microbial fate and transport module for the Agricultural Policy/Environmental eXtender (APEX) model

    NASA Astrophysics Data System (ADS)

    Hong, E.; Park, Y.; Muirhead, R.; Jeong, J.; Pachepsky, Y. A.

    2017-12-01

    Pathogenic microorganisms in recreational and irrigation waters remain the subject of concern. Water quality models are used to estimate microbial quality of water sources, to evaluate microbial contamination-related risks, to guide the microbial water quality monitoring, and to evaluate the effect of agricultural management on the microbial water quality. The Agricultural Policy/Environmental eXtender (APEX) is the watershed-scale water quality model that includes highly detailed representation of agricultural management. The APEX currently does not have microbial fate and transport simulation capabilities. The objective of this work was to develop the first APEX microbial fate and transport module that could use the APEX conceptual model of manure removal together with recently introduced conceptualizations of the in-stream microbial fate and transport. The module utilizes manure erosion rates found in the APEX. Bacteria survival in soil-manure mixing layer was simulated with the two-stage survival model. Individual survival patterns were simulated for each manure application date. Simulated in-stream microbial fate and transport processes included the reach-scale passive release of bacteria with resuspended bottom sediment during high flow events, the transport of bacteria from bottom sediment due to the hyporheic exchange during low flow periods, the deposition with settling sediment, and the two-stage survival. Default parameter values were available from recently published databases. The APEX model with the newly developed microbial fate and transport module was applied to simulate seven years of monitoring data for the Toenepi watershed in New Zealand. Based on calibration and testing results, the APEX with the microbe module reproduced well the monitored pattern of E. coli concentrations at the watershed outlet. The APEX with the microbial fate and transport module will be utilized for predicting microbial quality of water under various agricultural practices, evaluating monitoring protocols, and supporting the selection of management practices based on regulations that rely on fecal indicator bacteria concentrations.

  16. Quality assurance, an administrative means to a managerial end: Part I. A historical overview.

    PubMed

    Clark, G B

    1990-01-01

    Quality has become the hallmark of industrial excellence. Many diverse factors have heightened national concern about managing quality control throughout the health-care industry, including laboratory services. Industry-wide focus on quality control has created a need for an administrative program to evaluate its effectiveness. That program is medical quality assurance. Because of national and industry-wide concern, development of quality assurance theory has gained increasing importance in medical accreditation and management circles. Scrutiny of the application of quality assurance has become particularly prominent during accreditation inspections. Implementing quality assurance programs now demands more of already finite resources. The professional laboratory manager should understand how quality assurance has developed in the United States during the past 150 years. The well-informed manager should recognize why the health-care industry only recently began to develop its own expertise in quality assurance. It is also worthwhile to understand how heavily health care has relied on the lessons learned in the non-health-care sector. This three-part series will present information that will help in applying quality assurance more effectively as a management tool in the medical laboratory. This first part outlines the early industrial, socioeconomic, and medicolegal background of quality assurance. Terminology is defined with some distinction made between the terms management and administration. The second part will address current accreditation requirements. Special emphasis will be placed on the practical application of accreditation guidelines, providing a template for quality assurance methods in the medical laboratory. The third part will provide an overview of quality assurance as a total management tool with some suggestions for developing and implementing a quality assurance program.

  17. Compliance of systematic reviews articles in brain arteriovenous malformation with PRISMA statement guidelines: Review of literature.

    PubMed

    Akhigbe, T; Zolnourian, A; Bulters, D

    2017-05-01

    The knowledge of reporting compliance of systematic reviews with PRISMA guidelines may assist in improving the quality of secondary research in brain AVM management and subsequently application to patient population and clinical practice. This may allow researchers and clinicians to be equipped to appraise existing literatures based on known deficit to look for or expect. The objective of this study was to assess the compliance of systematic reviews and meta-analysis in the management of brain AVM. Systematic reviews and meta-analyses articles published in medical journals between 1st of May 2011 and 30th April 2016 (five-year period) were examined. Exclusion criteria were articles that were not systematic reviews and not meta-analyses, narrative literature reviews, historical literature reviews, animal studies, unpublished articles, commentaries and letter to the editor. Electronic database search performed through Medline PubMed on 20th September 2016. This systematic review examined seven systematic review articles on intracranial arteriovenous malformation compliance with PRISMA statement guidelines. The mean percentage of applicable PRISMA items across all studies was 74% (range 67-93%). Protocol registration and declaration, risk of bias and funding sources were the most poorly reported of the PRISMA items (14% each). A significant variance in the total percentages was evident between studies (67-93%). Systematic review reporting in medical literature is excessively variable and overall poor. As these papers are being published with increasing frequency, need to fully adhere to PRISMA statement guide for systematic review to ensure high-quality publications. Complete reporting of PRISMA items within systematic reviews in cerebral arteriovenous malformation enhance quality assessment, robust critical appraisal, better judgement and ultimately sound application to practice thereby improving research standards and patients care. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  18. A Framework for Comprehensive Health Terminology Systems in the United States

    PubMed Central

    Chute, Christopher G.; Cohn, Simon P.; Campbell, James R.

    1998-01-01

    Health care in the United States has become an information-intensive industry, yet electronic health records represent patient data inconsistently for lack of clinical data standards. Classifications that have achieved common acceptance, such as the ICD-9-CM or ICD, aggregate heterogeneous patients into broad categories, which preclude their practical use in decision support, development of refined guidelines, or detailed comparison of patient outcomes or benchmarks. This document proposes a framework for the integration and maturation of clinical terminologies that would have practical applications in patient care, process management, outcome analysis, and decision support. Arising from the two working groups within the standards community—the ANSI (American National Standards Institute) Healthcare Informatics Standards Board Working Group and the Computer-based Patient Records Institute Working Group on Codes and Structures—it outlines policies regarding 1) functional characteristics of practical terminologies, 2) terminology models that can broaden their applications and contribute to their sustainability, 3) maintenance attributes that will enable terminologies to keep pace with rapidly changing health care knowledge and process, and 4) administrative issues that would facilitate their accessibility, adoption, and application to improve the quality and efficiency of American health care. PMID:9824798

  19. Improving opioid safety practices in primary care: protocol for the development and evaluation of a multifaceted, theory-informed pilot intervention for healthcare providers.

    PubMed

    Leece, Pamela; Buchman, Daniel Z; Hamilton, Michael; Timmings, Caitlyn; Shantharam, Yalnee; Moore, Julia; Furlan, Andrea D

    2017-04-26

    In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians. The intervention uses practical educational and self-assessment tools to provide prescribers with feedback on their current knowledge and practices, and resources to improve their practice. The evaluation approach uses a pretest and post-test design and includes both quantitative and qualitative methods at baseline and 6 months. We will recruit a purposive sample of approximately 10 family physicians in Ontario from diverse practice settings, who currently treat patients with long-term opioid therapy for chronic pain. Quantitative data will be analysed using basic descriptive statistics, and qualitative data will be analysed using the Framework Method. The University Health Network Research Ethics Board approved this study. Dissemination plan includes publications, conference presentations and brief stakeholder reports. This evidence-informed, theory-driven intervention has implications for national application of opioid quality improvement tools in primary care settings. We are engaging experts and end users in advisory and stakeholder roles throughout our project to increase its national relevance, application and sustainability. The performance measures could be used as the basis for health system quality improvement indicators to monitor opioid prescribing. Additionally, the methods and approach used in this study could be adapted for other opioid guidelines, or applied to other areas of preventive healthcare and clinical guideline implementation processes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Measurement issues in the sonographic assessment of tennis elbow.

    PubMed

    Poltawski, Leon; Jayaram, Vijay; Watson, Tim

    2010-05-01

    Sonography is increasingly being used for assessment in tennis elbow research and clinical practice, but there are a lack of data regarding its validity, reliability, and responsiveness to change for this application. Studies using the modality were reviewed to establish current levels of evidence for these measurement properties. There is reasonable evidence regarding its validity for identifying tennis elbow tendinopathy, but a lack of data addressing its reliability and responsiveness. Practical issues affecting image quality are discussed, and recommendations for further investigation are suggested, to enhance the credible use of sonography with this debilitating condition.

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