Sample records for quality problems caused

  1. Causes of Indoor Air Quality Problems in Schools: Summary of Scientific Research. Revised Edition.

    ERIC Educational Resources Information Center

    Bayer, Charlene W.; Crow, Sidney A.; Fischer, John

    Understanding the primary causes of indoor air quality (IAQ) problems and how controllable factors--proper heating, ventilation and air-conditioning (HVAC) system design, allocation of adequate outdoor air, proper filtration, effective humidity control, and routine maintenance--can avert problems may help all building owners, operators, and…

  2. Collaborative problem solving with a total quality model.

    PubMed

    Volden, C M; Monnig, R

    1993-01-01

    A collaborative problem-solving system committed to the interests of those involved complies with the teachings of the total quality management movement in health care. Deming espoused that any quality system must become an integral part of routine activities. A process that is used consistently in dealing with problems, issues, or conflicts provides a mechanism for accomplishing total quality improvement. The collaborative problem-solving process described here results in quality decision-making. This model incorporates Ishikawa's cause-and-effect (fishbone) diagram, Moore's key causes of conflict, and the steps of the University of North Dakota Conflict Resolution Center's collaborative problem solving model.

  3. Causes of Indoor Air Quality Problems in Schools: Summary of Scientific Research

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

    Bayer, C.W.

    2001-02-22

    In the modern urban setting, most individuals spend about 80% of their time indoors and are therefore exposed to the indoor environment to a much greater extent than to the outdoors (Lebowitz 1992). Concomitant with this increased habitation in urban buildings, there have been numerous reports of adverse health effects related to indoor air quality (IAQ) (sick buildings). Most of these buildings were built in the last two decades and were constructed to be energy-efficient. The quality of air in the indoor environment can be altered by a number of factors: release of volatile compounds from furnishings, floor and wallmore » coverings, and other finishing materials or machinery; inadequate ventilation; poor temperature and humidity control; re-entrainment of outdoor volatile organic compounds (VOCs); and the contamination of the indoor environment by microbes (particularly fungi). Armstrong Laboratory (1992) found that the three most frequent causes of IAQ are (1) inadequate design and/or maintenance of the heating, ventilation, and air-conditioning (HVAC) system, (2) a shortage of fresh air, and (3) lack of humidity control. A similar study by the National Institute for Occupational Safety and Health (NIOSH 1989) recognized inadequate ventilation as the most frequent source of IAQ problems in the work environment (52% of the time). Poor IAQ due to microbial contamination can be the result of the complex interactions of physical, chemical, and biological factors. Harmful fungal populations, once established in the HVAC system or occupied space of a modern building, may episodically produce or intensify what is known as sick building syndrome (SBS) (Cummings and Withers 1998). Indeed, SBS caused by fungi may be more enduring and recalcitrant to treatment than SBS from multiple chemical exposures (Andrae 1988). An understanding of the microbial ecology of the indoor environment is crucial to ultimately resolving many IAQ problems. The incidence of SBS related to

  4. School Attendance Problems: Using the TQM Tools To Identify Root Causes.

    ERIC Educational Resources Information Center

    Weller, L. David

    2000-01-01

    Deming's principles and TQM problem-solving tools and techniques can be used to solve noninstructional problems such as vandalism, dropouts, and student absenteeism. This case study presents a model for principals to apply to identify root causes, resolve problems, and provide quality outcomes (at reduced cost) in noninstructional areas. (Contains…

  5. Problem of quality assurance during metal constructions welding via robotic technological complexes

    NASA Astrophysics Data System (ADS)

    Fominykh, D. S.; Rezchikov, A. F.; Kushnikov, V. A.; Ivashchenko, V. A.; Bogomolov, A. S.; Filimonyuk, L. Yu; Dolinina, O. N.; Kushnikov, O. V.; Shulga, T. E.; Tverdokhlebov, V. A.

    2018-05-01

    The problem of minimizing the probability for critical combinations of events that lead to a loss in welding quality via robotic process automation is examined. The problem is formulated, models and algorithms for its solution are developed. The problem is solved by minimizing the criterion characterizing the losses caused by defective products. Solving the problem may enhance the quality and accuracy of operations performed and reduce the losses caused by defective product

  6. Causes of Indoor Air Quality Problems in Schools: Summary of Scientific Research.

    ERIC Educational Resources Information Center

    Bayer, Charlene W.; Crow, Sidney A.; Fischer, John

    Research show that one in five U.S. schools has indoor air quality (IAQ) problems; 36 percent have inadequate heating, ventilation, and air conditioning (HVAC) systems; and there appears to be a correlation between IAQs and the proportion of a school's students coming from low-income households. This report examines the IAQ issue in U.S. public…

  7. Strategies in Forecasting Outcomes in Ethical Decision-making: Identifying and Analyzing the Causes of the Problem

    PubMed Central

    Beeler, Cheryl K.; Antes, Alison L.; Wang, Xiaoqian; Caughron, Jared J.; Thiel, Chase E.; Mumford, Michael D.

    2010-01-01

    This study examined the role of key causal analysis strategies in forecasting and ethical decision-making. Undergraduate participants took on the role of the key actor in several ethical problems and were asked to identify and analyze the causes, forecast potential outcomes, and make a decision about each problem. Time pressure and analytic mindset were manipulated while participants worked through these problems. The results indicated that forecast quality was associated with decision ethicality, and the identification of the critical causes of the problem was associated with both higher quality forecasts and higher ethicality of decisions. Neither time pressure nor analytic mindset impacted forecasts or ethicality of decisions. Theoretical and practical implications of these findings are discussed. PMID:20352056

  8. Assessing the Quality of Problems in Problem-Based Learning

    ERIC Educational Resources Information Center

    Sockalingam, Nachamma; Rotgans, Jerome; Schmidt, Henk

    2012-01-01

    This study evaluated the construct validity and reliability of a newly devised 32-item problem quality rating scale intended to measure the quality of problems in problem-based learning. The rating scale measured the following five characteristics of problems: the extent to which the problem (1) leads to learning objectives, (2) is familiar, (3)…

  9. Predicting Causes of Data Quality Issues in a Clinical Data Research Network.

    PubMed

    Khare, Ritu; Ruth, Byron J; Miller, Matthew; Tucker, Joshua; Utidjian, Levon H; Razzaghi, Hanieh; Patibandla, Nandan; Burrows, Evanette K; Bailey, L Charles

    2018-01-01

    Clinical data research networks (CDRNs) invest substantially in identifying and investigating data quality problems. While identification is largely automated, the investigation and resolution are carried out manually at individual institutions. In the PEDSnet CDRN, we found that only approximately 35% of the identified data quality issues are resolvable as they are caused by errors in the extract-transform-load (ETL) code. Nonetheless, with no prior knowledge of issue causes, partner institutions end up spending significant time investigating issues that represent either inherent data characteristics or false alarms. This work investigates whether the causes (ETL, Characteristic, or False alarm) can be predicted before spending time investigating issues. We trained a classifier on the metadata from 10,281 real-world data quality issues, and achieved a cause prediction F1-measure of up to 90%. While initially tested on PEDSnet, the proposed methodology is applicable to other CDRNs facing similar bottlenecks in handling data quality results.

  10. Understanding Heart Valve Problems and Causes

    MedlinePlus

    ... and conditions that can cause valve problems: Infective endocarditis Injury Rheumatic fever These conditions can cause one ... Surgery? Recovery Milestones Checklist | Spanish What Is Infective Endocarditis? | Spanish Interactive Treatment Guide Infographic: What Everyone Should ...

  11. Fact Sheet on Avoiding Indoor Air Quality Problems During Flood Cleanup

    EPA Pesticide Factsheets

    This fact sheet discusses problems caused by microbial growth, and other effects of flooding, on indoor air quality and the steps you can take to lessen these effects. This focuses on residential flood cleanup, but it applies to other building types.

  12. The Root Cause of the Overheating Problem

    NASA Technical Reports Server (NTRS)

    Liou, Meng-Sing

    2017-01-01

    Previously we identified the receding flow, where two fluid streams recede from each other, as an open numerical problem, because all well-known numerical fluxes give an anomalous temperature rise, thus called the overheating problem. This phenomenon, although presented in several textbooks, and many previous publications, has scarcely been satisfactorily addressed and the root cause of the overheating problem not well understood. We found that this temperature rise was solely connected to entropy rise and proposed to use the method of characteristics to eradicate the problem. However, the root cause of the entropy production was still unclear. In the present study, we identify the cause of this problem: the entropy rise is rooted in the pressure flux in a finite volume formulation and is implanted at the first time step. It is found theoretically inevitable for all existing numerical flux schemes used in the finite volume setting, as confirmed by numerical tests. This difficulty cannot be eliminated by manipulating time step, grid size, spatial accuracy, etc, although the rate of overheating depends on the flux scheme used. Finally, we incorporate the entropy transport equation, in place of the energy equation, to ensure preservation of entropy, thus correcting this temperature anomaly. Its applicability is demonstrated for some relevant 1D and 2D problems. Thus, the present study validates that the entropy generated ab initio is the genesis of the overheating problem.

  13. [Problems caused by poisonous tropical marine animals].

    PubMed

    Lääveri, Tinja; Räisänen-Sokolowski, Anne; Jama, Timo

    2014-01-01

    A Finnish physician encounters problems caused by tropical marine animals either during her/his own travelling or while treating travelers who have returned home. Certain species of medusae and cone shells as well as the stings by some fish species are life-threateningly poisonous. A person stung or bitten by any of the most dangerous species must immediately be admitted to the hospital. Foreign material remaining in tissues after stings by echinoderms and spiky fish may cause problems months after the actual injury. The injuries become easily infected, and antimicrobial drug therapy must thus cover gram-negative rod-shaped bacteria as well.

  14. Little Evidence That Time in Child Care Causes Externalizing Problems During Early Childhood in Norway

    PubMed Central

    Zachrisson, Henrik Daae; Dearing, Eric; Lekhal, Ratib; Toppelberg, Claudio O.

    2012-01-01

    Associations between maternal reports of hours in child care and children’s externalizing problems at 18 and 36 months of age were examined in a population-based Norwegian sample (n = 75,271). Within a sociopolitical context of homogenously high-quality child care, there was little evidence that high quantity of care causes externalizing problems. Using conventional approaches to handling selection bias and listwise deletion for substantial attrition in this sample, more hours in care predicted higher problem levels, yet with small effect sizes. The finding, however, was not robust to using multiple imputation for missing values. Moreover, when sibling and individual fixed-effects models for handling selection bias were used, no relation between hours and problems was evident. PMID:23311645

  15. Guidance for modeling causes and effects in environmental problem solving

    USGS Publications Warehouse

    Armour, Carl L.; Williamson, Samuel C.

    1988-01-01

    Environmental problems are difficult to solve because their causes and effects are not easily understood. When attempts are made to analyze causes and effects, the principal challenge is organization of information into a framework that is logical, technically defensible, and easy to understand and communicate. When decisionmakers attempt to solve complex problems before an adequate cause and effect analysis is performed there are serious risks. These risks include: greater reliance on subjective reasoning, lessened chance for scoping an effective problem solving approach, impaired recognition of the need for supplemental information to attain understanding, increased chance for making unsound decisions, and lessened chance for gaining approval and financial support for a program/ Cause and effect relationships can be modeled. This type of modeling has been applied to various environmental problems, including cumulative impact assessment (Dames and Moore 1981; Meehan and Weber 1985; Williamson et al. 1987; Raley et al. 1988) and evaluation of effects of quarrying (Sheate 1986). This guidance for field users was written because of the current interest in documenting cause-effect logic as a part of ecological problem solving. Principal literature sources relating to the modeling approach are: Riggs and Inouye (1975a, b), Erickson (1981), and United States Office of Personnel Management (1986).

  16. Parent Beliefs about the Causes of Learning and Developmental Problems among Children with Autism Spectrum Disorder: Results from a National Survey

    PubMed Central

    Lindly, Olivia J.; Sinche, Brianna

    2017-01-01

    This study aimed to assess variation in parent beliefs about causes of learning and developmental problems in U.S. children with autism spectrum disorder, using data from a nationally-representative survey. Results showed that beliefs about a genetic/hereditary cause of learning/developmental problems were most common, but nearly as many parents believed in exposure causes. 40% of parents had no definite causal beliefs. On multivariate analysis, parents who were non-white, publicly-insured or poor were more likely than other parents to endorse exposure causes, or less likely to endorse genetic causes, compared to other parents. Further research should assess how these beliefs modify health care quality or services utilization. PMID:27611353

  17. [Quality of data on deaths from external causes in a medium-sized city in Minas Gerais State, Brazil].

    PubMed

    Melo, Cristiane Magalhães de; Bevilacqua, Paula Dias; Barletto, Marisa; França, Elisabeth Barboza

    2014-09-01

    This study aimed to assess the quality of data on deaths from external causes in Viçosa, Minas Gerais State, Brazil, from 2000 to 2009, and the completeness of the Mortality Information System (SIM). The data were obtained from the SIM of the Municipal Health Department, municipal police enquiries, and local newspaper articles, resulting in a databank with 495 deaths from external causes. The results showed a high proportion of deaths with indeterminate intent (21%) in the SIM, suggesting problems with quality of information. Comparison of data from the SIM and police department detected problems with coverage in the SIM (21%) and thus in the official statistics on mortality from accidents and violence. The results emphasize the importance of searches in other data sources to upgrade the SIM and expand its coverage, and especially the need for studies to identify and analyze problems faced by small and medium-sized cities in the production of mortality data.

  18. Eliminating Problems Caused by Multicollinearity: A Warning.

    ERIC Educational Resources Information Center

    Kennedy, Peter E.

    1982-01-01

    Explains why an econometric practice introduced by J.C. Soper cannot eliminate the problems caused by multicollinearity. The author suggests that it can be a useful technique in that it forces researchers to pay more attention to the specifications of their models. (AM)

  19. Thinking can cause forgetting: memory dynamics in creative problem solving.

    PubMed

    Storm, Benjamin C; Angello, Genna; Bjork, Elizabeth Ligon

    2011-09-01

    Research on retrieval-induced forgetting has shown that retrieval can cause the forgetting of related or competing items in memory (Anderson, Bjork, & Bjork, 1994). In the present research, we examined whether an analogous phenomenon occurs in the context of creative problem solving. Using the Remote Associates Test (RAT; Mednick, 1962), we found that attempting to generate a novel common associate to 3 cue words caused the forgetting of other strong associates related to those cue words. This problem-solving-induced forgetting effect occurred even when participants failed to generate a viable solution, increased in magnitude when participants spent additional time problem solving, and was positively correlated with problem-solving success on a separate set of RAT problems. These results implicate a role for forgetting in overcoming fixation in creative problem solving. (c) 2011 APA, all rights reserved.

  20. Quality assurance strategies for investigating IAQ problems

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

    Collett, C.W.; Ross, J.A.; Sterling, E.M.

    Thousands of buildings have now been investigated throughout North America and western Europe. The evaluative strategies and protocols used by various investigators have been described in the scientific and protocols used by various investigators have been described in the scientific and technical literature, including those used by government agencies, private consultants, researchers, and physicians. Review of these strategies shows a consistency and commonly in approach, despite differences in terminology and organization. Most of the published protocols recognize the need to employ a multidisciplinary approach to the evaluation of indoor environmental problems, an approach that views buildings as complex, dynamic systems.more » The multidisciplinary approaches advocated by investigators gather information about the physical building (architectural), the mechanical systems that control indoor environmental conditions (engineering), the type and extent of occupant health and comfort concerns (medical), the objective quality of the air (industrial hygiene) and the occupants subjective perceptions of conditions in their work environment (social science). These components have generally been organized into a series of steps or phases, with each phase extending the information gathered from the preceding phase until a point when the causes of problems may be identified.« less

  1. What Causes Care Coordination Problems? A Case for Microanalysis

    PubMed Central

    Zachary, Wayne; Maulitz, Russell Charles; Zachary, Drew A.

    2016-01-01

    Introduction: Care coordination (CC) is an important fulcrum for pursuing a range of health care goals. Current research and policy analyses have focused on aggregated data rather than on understanding what happens within individual cases. At the case level, CC emerges as a complex network of communications among providers over time, crossing and recrossing many organizational boundaries. Micro-level analysis is needed to understand where and how CC fails, as well as to identify best practices and root causes of problems. Coordination Process Diagramming: Coordination Process Diagramming (CPD) is a new framework for representing and analyzing CC arcs at the micro level, separating an arc into its participants and roles, communication structure, organizational structures, and transitions of care, all on a common time line. Conclusion: Comparative CPD analysis across a sample of CC arcs identifies common CC problems and potential root causes, showing the potential value of the framework. The analyses also suggest intervention strategies that could be applied to attack the root causes of CC problems, including organizational changes, education and training, and additional health information technology development. PMID:27563685

  2. Environmental problems caused by Istanbul subway excavation and suggestions for remediation

    NASA Astrophysics Data System (ADS)

    Ocak, Ibrahim

    2009-10-01

    Many environmental problems caused by subway excavations have inevitably become an important point in city life. These problems can be categorized as transporting and stocking of excavated material, traffic jams, noise, vibrations, piles of dust mud and lack of supplies. Although these problems cause many difficulties, the most pressing for a big city like Istanbul is excavation, since other listed difficulties result from it. Moreover, these problems are environmentally and regionally restricted to the period over which construction projects are underway and disappear when construction is finished. Currently, in Istanbul, there are nine subway construction projects in operation, covering approximately 73 km in length; over 200 km to be constructed in the near future. The amount of material excavated from ongoing construction projects covers approximately 12 million m3. In this study, problems—primarily, the problem with excavation waste (EW)—caused by subway excavation are analyzed and suggestions for remediation are offered.

  3. Auditing and Evaluating Quality: Questions and Problems

    ERIC Educational Resources Information Center

    Vostrikov, A.

    2004-01-01

    For many Russian universities, improving the quality of education has become a central problem. Colleges and universities that have traditionally enjoyed high academic authority are not especially concerned about it; they are more concerned about the problems of financing and their own development. But for relatively young educational institutions…

  4. Classifying Wildfire Causes in the USDA Forest Service: Problems and Alternatives

    Treesearch

    Linda R. Donoghue

    1982-01-01

    Discusses problems associated with fire-cause data on USDA Forest Service wildfire reports, traces the historical development of wildfire-cause categories, and presents the pros and cons of retaining current wildfire-cause reporting systems or adopting new systems.

  5. Self-consciousness, friendship quality, and adolescent internalizing problems

    PubMed Central

    Bowker, Julie C.; Rubin, Kenneth H.

    2013-01-01

    The correlates between public and private self-consciousness and internalizing difficulties were examined during early adolescence. Friendship quality was assessed as a possible moderator of the relation between self-consciousness and maladjustment. One hundred and thirty-seven young adolescents (N = 87 girls; M age = 13.98 years) reported on their self-consciousness, internalizing problems, and the quality of their best friendship. Results indicated stronger associations between private self-consciousness and internalizing correlates than between public self-consciousness and internalizing problems, suggesting that private self-consciousness may be a stronger risk factor during adolescence. Contrary to expectations, evidence revealed that positive friendship quality may exacerbate some difficulties associated with self-consciousness. Results pertaining to friendship quality add to the growing literature on the ways in which friendships can contribute to adjustment difficulties. PMID:19998530

  6. How to Diagnose Solutions to a Quality of Care Problem

    PubMed Central

    Silver, Samuel A.; McQuillan, Rory F.; Weizman, Adam V.; Thomas, Alison; Chertow, Glenn M.; Nesrallah, Gihad; Chan, Christopher T.; Bell, Chaim M.

    2016-01-01

    To change a particular quality of care outcome within a system, quality improvement initiatives must first understand the causes contributing to the outcome. After the causes of a particular outcome are known, changes can be made to address these causes and change the outcome. Using the example of home dialysis (home hemodialysis and peritoneal dialysis), this article within this Moving Points feature on quality improvement will provide health care professionals with the tools necessary to analyze the steps contributing to certain outcomes in health care quality and develop ideas that will ultimately lead to their resolution. The tools used to identify the main contributors to a quality of care outcome will be described, including cause and effect diagrams, Pareto analysis, and process mapping. We will also review common change concepts and brainstorming activities to identify effective change ideas. These methods will be applied to our home dialysis quality improvement project, providing a practical example that other kidney health care professionals can replicate at their local centers. PMID:27016495

  7. Identifying and attributing common data quality problems: temperature and precipitation observations in Bolivia and Peru

    NASA Astrophysics Data System (ADS)

    Hunziker, Stefan; Gubler, Stefanie; Calle, Juan; Moreno, Isabel; Andrade, Marcos; Velarde, Fernando; Ticona, Laura; Carrasco, Gualberto; Castellón, Yaruska; Oria Rojas, Clara; Brönnimann, Stefan; Croci-Maspoli, Mischa; Konzelmann, Thomas; Rohrer, Mario

    2016-04-01

    Assessing climatological trends and extreme events requires high-quality data. However, for many regions of the world, observational data of the desired quality is not available. In order to eliminate errors in the data, quality control (QC) should be applied before data analysis. If the data still contains undetected errors and quality problems after QC, a consequence may be misleading and erroneous results. A region which is seriously affected by observational data quality problems is the Central Andes. At the same time, climatological information on ongoing climate change and climate risks are of utmost importance in this area due to its vulnerability to meteorological extreme events and climatic changes. Beside data quality issues, the lack of metadata and the low station network density complicate quality control and assessment, and hence, appropriate application of the data. Errors and data problems may occur at any point of the data generation chain, e.g. due to unsuitable station configuration or siting, poor station maintenance, erroneous instrument reading, or inaccurate data digitalization and post processing. Different measurement conditions in the predominantly conventional station networks in Bolivia and Peru compared to the mostly automated networks e.g. in Europe or Northern America may cause different types of errors. Hence, applying QC methods used on state of the art networks to Bolivian and Peruvian climate observations may not be suitable or sufficient. A comprehensive amount of Bolivian and Peruvian maximum and minimum temperature and precipitation in-situ measurements were analyzed to detect and describe common data quality problems. Furthermore, station visits and reviews of the original documents were done. Some of the errors could be attributed to a specific source. Such information is of great importance for data users, since it allows them to decide for what applications the data still can be used. In ideal cases, it may even allow to

  8. Using Problem-solving Therapy to Improve Problem-solving Orientation, Problem-solving Skills and Quality of Life in Older Hemodialysis Patients.

    PubMed

    Erdley-Kass, Shiloh D; Kass, Darrin S; Gellis, Zvi D; Bogner, Hillary A; Berger, Andrea; Perkins, Robert M

    2017-08-24

    To determine the effectiveness of Problem-Solving Therapy (PST) in older hemodialysis (HD) patients by assessing changes in health-related quality of life and problem-solving skills. 33 HD patients in an outpatient hemodialysis center without active medical and psychiatric illness were enrolled. The intervention group (n = 15) received PST from a licensed social worker for 6 weeks, whereas the control group (n = 18) received usual care treatment. In comparison to the control group, patients receiving PST intervention reported improved perceptions of mental health, were more likely to view their problems with a positive orientation and were more likely to use functional problem-solving methods. Furthermore, this group was also more likely to view their overall health, activity limits, social activities and ability to accomplish desired tasks with a more positive mindset. The results demonstrate that PST may positively impact mental health components of quality of life and problem-solving coping among older HD patients. PST is an effective, efficient, and easy to implement intervention that can benefit problem-solving abilities and mental health-related quality of life in older HD patients. In turn, this will help patients manage their daily living activities related to their medical condition and reduce daily stressors.

  9. Relationship Between Sleep Problems and Quality of Life in Children With ADHD.

    PubMed

    Yürümez, Esra; Kılıç, Birim Günay

    2016-01-01

    The purpose of this study is to assess the sleep behaviors, sleep problems and frequency, and relationship with psychiatric comorbidities in ADHD Combined type and to evaluate the effect of sleep problems on quality of life. Forty-six boys, aged 7 to 13 years, with ADHD-combined type and 31 healthy boys were included. ADHD children were never treated for sleep or psychiatric disorders. Intelligence quotient (IQ) test scores were minimum 80, body mass index were normal and did not have medical disorders. Parents completed Children's Sleep Habits Questionnaire, Conners' Parent Rating Scale and The Pediatric Quality of Life Inventory (PedsQL) and participants were asked about sleep behaviors and were administered PedsQL and Schedule for Affective Disorders and Schizophrenia. The frequency of sleep problems in ADHD is 84.8%, higher than the control group (p = .002). Evaluating PedsQL scores, the quality of life is worse in physical, psychosocial health, and total life quality (p < .05). ADHD group with sleep problems have more night wakings than control group with sleep problems (p = .02). The comorbidity do not increase sleep problems. The frequency of parasomnias is increased in group with learning disorders (p = .05). The results of this study, which controls for a number of possible confounders found in previous examinations of ADHD and sleep, support the results of a number of other studies that have found an increased overall prevalence of parent-reported sleep disturbances in children with ADHD compared with healthy control participants. As the ADHD group have more night wakings than the control group through the night, it is thought that night wakings that cause a partitioned sleep may be important signs seen in ADHD. That could be suggested by two hypotheses. First one is that, daytime sleepiness is more common in ADHD and those children present excessive hyperactivity during the day to stay awake and the second one is the improvement of ADHD signs when the

  10. Using ecotechnology to address water quality and wetland habitat loss problems in the Mississippi basin: a hierarchical approach.

    PubMed

    Day, John W; Yañéz Arancibia, Alejandro; Mitsch, William J; Lara-Dominguez, Ana Laura; Day, Jason N; Ko, Jae-Young; Lane, Robert; Lindsey, Joel; Lomeli, David Zarate

    2003-12-01

    Human activities are affecting the environment at continental and global scales. An example of this is the Mississippi basin where there has been a large scale loss of wetlands and water quality deterioration over the past century. Wetland and riparian ecosystems have been isolated from rivers and streams. Wetland loss is due both to drainage and reclamation, mainly for agriculture, and to isolation from the river by levees, as in the Mississippi delta. There has been a decline in water quality due to increasing use of fertilizers, enhanced drainage and the loss of wetlands for cleaning water. Water quality has deteriorated throughout the basin and high nitrogen in the Mississippi river is causing a large area of hypoxia in the Gulf of Mexico adjacent to the Mississippi delta. Since the causes of these problems are distributed over the basin, the solution also needs to be distributed over the basin. Ecotechnology and ecological engineering offer the only ecologically sound and cost-effective method of solving these problems. Wetlands to promote nitrogen removal, mainly through denitrification but also through burial and plant uptake, offer a sound ecotechnological solution. At the level of the Mississippi basin, changes in farming practices and use of wetlands for nitrogen assimilation can reduce nitrogen levels in the River. There are additional benefits of restoration of wetland and riverine ecosystems, flood control, reduction in public health threats, and enhanced wildlife and fisheries. At the local drainage basin level, the use of river diversions in the Mississippi delta can address both problems of coastal land loss and water quality deterioration. Nitrate levels in diverted river water are rapidly reduced as water flows through coastal watersheds. At the local level, wetlands are being used to treat municipal wastewater. This is a cost-effective method, which results in improved water quality, enhanced wetland productivity and increased accretion. The

  11. Perceptions of Neighborhood Problems and Health-Related Quality of Life

    ERIC Educational Resources Information Center

    Hill, Erin M.; Shepherd, Daniel; Welch, David; Dirks, Kim N.; McBride, David

    2012-01-01

    This article examines the association between perceptions of neighborhood problems and health-related quality of life (HRQOL) in a sample of New Zealand residents (n = 692). A modified version of the Neighborhood Problems Scale (originally developed by Steptoe and Feldman, 2001) and the World Health Organization Quality of Life (WHOQOL-BREF) were…

  12. 49 CFR 40.199 - What problems always cause a drug test to be cancelled?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false What problems always cause a drug test to be cancelled? 40.199 Section 40.199 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Problems in Drug Tests § 40.199 What problems always cause a drug test to be cancelled? (a...

  13. [Allergies, an increasing public health problem: causes and consequences].

    PubMed

    de Weck, A

    2000-01-01

    Allergies due to IgE immunoglobulins and belonging to the atopic syndrome, such as asthma, allergic rhinitis and atopic eczema have increased in prevalence three times during the past 20-30 years in most industrialized countries. The causes of that increase are still much debated but seem to be related to multiple changes in the environment. Our recent studies on dog atopy indicate that the interaction of a dominant gene responsible for high IgE production but with variable expression, according to several environmental factors acting during infancy, could explain observations made in man. Allergic diseases have become an important portion of public health costs, amounting to approximately 200 billions French Francs in the European Community. Early and adequate care for the about 20% of allergic patients which are severely affected, as well setting up a systematic prevention policy would have a moderating influence on the increasing costs, and would achieve improvements in the quality of life of allergic patients. Appropriate measures include fostering medical and political awareness about the problem's urgency, the formation of an appropriate body of specialists and an Allergological education at all levels, as well as the definition of a screening and care providing policy taking in account existing medical structures.

  14. Relations between hydrology, water quality, and taste-and-odor causing organisms and compounds in Lake Houston, Texas, April 2006-September 2008

    USGS Publications Warehouse

    Beussink, Amy M.; Graham, Jennifer L.

    2011-01-01

    biovolume occurred during July-September of each year, when temperatures were larger than 27 degrees Celsius and water residence times were longer than 400 days. In contrast, actinomycetes bacteria were most abundant during non-summer and when water residence times were less than 100 days, reflecting the close association between these organisms and transport of suspended sediments. Geosmin and 2-methylisoborneol are the taste-and-odor causing compounds most commonly produced by cyanobacteria and actinomycetes bacteria. Geosmin was detected more frequently (62 percent of samples) than 2-methylisoborneol (29 percent of samples) in Lake Houston. Geosmin exceeded the human detection threshold (10 nanograms per liter) only once during the study period and 2-methylisoborneol exceeded the human detection threshold twice. Manganese is a naturally occurring trace element that can occasionally cause taste-andodor problems in drinking water. Manganese concentrations exceeded the human detection threshold (about 50 micrograms per liter) in about 50 percent of samples collected near the surface and 84 percent of samples collected near the bottom. The cyanotoxin microcystin was detected relatively infrequently (16 percent of samples) and at small concentrations (less than or equal to 0.2 micrograms per liter). The abundance of the taste-and-odor causing organisms cyanobacteria and actinomycetes bacteria in Lake Houston was coupled with inflow events and subsequent changes in water-quality conditions. Cyanobacterial biovolume (biomass) in Lake Houston was largest during warm periods with little inflow and relatively small turbidity values. In contrast, actinomycetes bacteria were most abundant following inflow events when turbidity was relatively large. Severe taste-and-odor problems were not observed during the study period, precluding quantification of the hydrologic and water-quality conditions associated with large concentrations of taste-and-odor causing compounds and development of

  15. Stepfamily Relationship Quality and Children's Internalizing and Externalizing Problems.

    PubMed

    Jensen, Todd M; Lippold, Melissa A; Mills-Koonce, Roger; Fosco, Gregory M

    2017-03-07

    The stepfamily literature is replete with between-group analyses by which youth residing in stepfamilies are compared to youth in other family structures across indicators of adjustment and well-being. Few longitudinal studies examine variation in stepfamily functioning to identify factors that promote the positive adjustment of stepchildren over time. Using a longitudinal sample of 191 stepchildren (56% female, mean age = 11.3 years), the current study examines the association between the relationship quality of three central stepfamily dyads (stepparent-child, parent-child, and stepcouple) and children's internalizing and externalizing problems concurrently and over time. Results from path analyses indicate that higher levels of parent-child affective quality are associated with lower levels of children's concurrent internalizing and externalizing problems at Wave 1. Higher levels of stepparent-child affective quality are associated with decreases in children's internalizing and externalizing problems at Wave 2 (6 months beyond baseline), even after controlling for children's internalizing and externalizing problems at Wave 1 and other covariates. The stepcouple relationship was not directly linked to youth outcomes. Our findings provide implications for future research and practice. © 2017 Family Process Institute.

  16. Emotional Problems, Quality of Life, and Symptom Burden in Patients With Lung Cancer.

    PubMed

    Morrison, Eleshia J; Novotny, Paul J; Sloan, Jeff A; Yang, Ping; Patten, Christi A; Ruddy, Kathryn J; Clark, Matthew M

    2017-09-01

    Lung cancer is associated with a greater symptom burden than other cancers, yet little is known about the prevalence of emotional problems and how emotional problems may be related to the physical symptom burden and quality of life in newly diagnosed patients with lung cancer. This study aimed to identify the patient and disease characteristics of patients with lung cancer experiencing emotional problems and to examine how emotional problems relate to quality of life and symptom burden. A total of 2205 newly diagnosed patients with lung cancer completed questionnaires on emotional problems, quality of life, and symptom burden. Emotional problems at diagnosis were associated with younger age, female gender, current cigarette smoking, current employment, advanced lung cancer disease, surgical or chemotherapy treatment, and a lower Eastern Cooperative Oncology Group performance score. Additionally, strong associations were found between greater severity of emotional problems, lower quality of life, and greater symptom burden. Certain characteristics place patients with lung cancer at greater risk for emotional problems, which are associated with a reduced quality of life and greater symptom burden. Assessment of the presence of emotional problems at the time of lung cancer diagnosis provides the opportunity to offer tailored strategies for managing negative mood, and for improving the quality of life and symptom burden management of patients with lung cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. The quality of life of adolescents with menstrual problems.

    PubMed

    Nur Azurah, Abdul Ghani; Sanci, Lena; Moore, Elya; Grover, Sonia

    2013-04-01

    To date, very few publications have examined the health related quality of life (HRQL) in the younger population with menstrual problems, despite their high prevalence in adolescent girls. We describe the health-related quality of life (HRQL) among adolescents with menstrual problems and identified factors that have an impact on it. The study was a questionnaire study (using PedsQL 4.0) of adolescents aged 13-18 referred to a tertiary gynecology center for menstrual problems between June 2009 and August 2010. One hundred eighty-four adolescents completed the questionnaires. The mean age was 15.10 ± 1.49 with the mean body mass index (BMI) of 22.83 ± 4.82 kg/m(2). The most common menstrual problems seen in the clinic were dysmenorrhea (38.6%) followed by heavy bleeding (33.6%), oligomenorrhea (19.6%), and amenorrhea (8.2%). The mean overall score was 70.40 ± 16.36 with 42.3% having a score below 1 standard deviation (SD) from the norms. Adolescents with dysmenorrhea had the poorest score in physical function, whereas those with amenorrhea had the lowest score in psychosocial function. Maternal parenting style, parental anxiety, adolescents' ill-health behavior, and BMI have been found to have impact on the girls' quality of life (QoL). Although menstrual problems are not life threatening, they can pose a significant impact on the quality of life of these patients. Identification of these impacts might lead to the recognition of potential services or education to improve this. Understanding the characteristics that predict QoL may help a clinician identify patients who are risk for poor QoL. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. All rights reserved.

  18. Instructional Qualities of a Successful Mathematical Problem-Solving Class.

    ERIC Educational Resources Information Center

    Santos-Trigo, Manuel

    1998-01-01

    Describes activities that have been successfully implemented by an expert during a mathematical problem-solving course. Focuses on the identification of the qualities of these problems used to promote the development of student strategies and values that reflect mathematical practice in the classroom. Contains 17 references. (ASK)

  19. Strategies for Limiting Engineers' Potential Liability for Indoor Air Quality Problems.

    PubMed

    von Oppenfeld, Rolf R; Freeze, Mark E; Sabo, Sean M

    1998-10-01

    Engineers face indoor air quality (IAQ) issues at the design phase of building construction as well as during the investigation and mitigation of potential indoor air pollution problems during building operation. IAQ issues that can be identified are "building-related illnesses" that may include problems of volatile organic compounds (VOCs). IAQ issues that cannot be identified are termed "sick building syndrome." Frequently, microorganism-caused illnesses are difficult to confirm. Engineers who provide professional services that directly or indirectly impact IAQ face significant potential liability to clients and third parties when performing these duties. Potential theories supporting liability claims for IAQ problems against engineers include breach of contract and various common law tort theories such as negligence and negligent misrepresentation. Furthermore, an increasing number of federal, state, and local regulations affect IAQ issues and can directly increase the potential liability of engineers. A duty to disclose potential or actual air quality concerns to third parties may apply for engineers in given circumstances. Such a duty may arise from judicial precedent, the Model Guide for Professional Conduct for Engineers, or the Code of Ethics for Engineers. Practical strategies engineers can use to protect themselves from liability include regular training and continuing education in relevant regulatory, scientific, and case law developments; detailed documentation and recordkeeping practices; adequate insurance coverage; contractual indemnity clauses; contractual provisions limiting liability to the scope of work performed; and contractual provisions limiting the extent of liability for engineers' negligence. Furthermore, through the proper use of building materials and construction techniques, an engineer or other design professional can effectively limit the potential for IAQ liability.

  20. Accountability and Other CAUSES of Total Quality Management.

    ERIC Educational Resources Information Center

    Aamot, Karen; Piotrowski, Craig

    1995-01-01

    Describes Total Quality Management (TQM) techniques implemented at Waukesha County Technical College (Wisconsin). The CAUSES program focuses on customers, accountability, understanding, self-improvement, education, and searching. Describes application of TQM to the fixed-asset team project. Four figures are included. (LMI)

  1. Quality Tools and TRIZ Based Quality Improvement Case Study at PT ‘X’ A Plastic Moulding Manufacturing Industry

    NASA Astrophysics Data System (ADS)

    Wirawan, Christina; Chandra, Fory

    2016-02-01

    Theory of Inventive Problem Solving (TRIZ) is a creative encouraging problem solving method. TRIZ is prepared by Altshuller for product design. Altshuller prepared contradiction matrix and suggestion to solve contradictions usually occur in product design. This paper try to combine TRIZ with quality tools such as Pareto and Fault Tree Analysis (FTA) to solve contradiction in quality improvement problem, neither than product design problem. Pareto used to identify defect priority, FTA used to analysis and identify root cause of defect. When there is contradiction in solving defect causes, TRIZ used to find creative problem solving. As a case study, PT ’X’, a plastic molding manufacturing industry was taken. PT ‘X’ using traditional press machine to produce plastic thread cone. There are 5 defect types that might occur in plastic thread cone production, incomplete form, dirty, mottle, excessive form, rugged. Research about quality improvement effort using DMAIC at PT ‘X’ have been done by Fory Candra. From this research, defect types, priority, root cause from FTA, recommendation from FMEA. In this research, from FTA reviewed, contradictions found among causes troublesome quality improvement efforts. TRIZ used to solve the contradictions and quality improvement effort can be made effectively.

  2. Citrus Quality Control: An NMR/MRI Problem-Based Experiment

    ERIC Educational Resources Information Center

    Erhart, Sarah E.; McCarrick, Robert M.; Lorigan, Gary A.; Yezierski, Ellen J.

    2016-01-01

    An experiment seated in an industrial context can provide an engaging framework and unique learning opportunity for an upper-division physical chemistry laboratory. An experiment that teaches NMR/MRI through a problem-based quality control of citrus products was developed. In this experiment, using a problem-based learning (PBL) approach, students…

  3. Understanding the Causes and Management of Problem Behaviour in Zimbabwean Schools: Teacher Perceptions

    ERIC Educational Resources Information Center

    Chitiyo, Morgan; Chitiyo, George; Chitiyo, Jonathan; Oyedele, Victoria; Makoni, Richard; Fonnah, Davidson; Chipangure, Luke

    2014-01-01

    Problem behaviour continues to present a challenge for school-teachers worldwide. Since school-teachers around the globe have different conceptualisations of what constitutes problem behaviour, the purpose of this study was to examine the perceptions of Zimbabwean school-teachers about their perceived causes of problem behaviour among students in…

  4. Globalization causes a world of health problems.

    PubMed

    Abell, H

    1998-01-01

    Many countries in Asia, Africa, Latin America, and the Caribbean offer substantial tax breaks to foreign corporations that set up shops in free-trade zones and waive environmental regulations and repress trade unions to further induce this practice. Workers in these shops--mainly women--perform repetitive machine-based motions, are exposed to toxic chemicals and unsafe equipment, and face dangerously high production quotas. Health problems caused by these working conditions include headache and dizziness, fatigue, anemia, forgetfulness, stomach pains, respiratory problems, hypertension, heart disease, and allergies. Water and air pollution and dumping of hazardous waste affect the health of entire communities. Since free-trade zones are a permanent feature of the global economy, organizing to protect workers and communities assumes critical importance. Groups such as the Border Committee of Women Workers in Mexico are providing workers with skills and support to make demands such as better treatment of pregnant workers. International labor, environmental, and public health advocates can support such efforts by providing assistance to worker-controlled organizations and pressuring governments to enforce laws intended to protect workers and their communities.

  5. Energy Problems and Environmental Concern

    ERIC Educational Resources Information Center

    Train, Russell E.

    1973-01-01

    Discusses problems encountered in energy extraction and consumption, involving nuclear power plant construction, environmental consequences of energy systems, and energy conservation ethics. Indicates that the increasing concern over environmental quality is not the true cause of present energy problems. (CC)

  6. Thinking Can Cause Forgetting: Memory Dynamics in Creative Problem Solving

    ERIC Educational Resources Information Center

    Storm, Benjamin C.; Angello, Genna; Bjork, Elizabeth Ligon

    2011-01-01

    Research on retrieval-induced forgetting has shown that retrieval can cause the forgetting of related or competing items in memory (Anderson, Bjork, & Bjork, 1994). In the present research, we examined whether an analogous phenomenon occurs in the context of creative problem solving. Using the Remote Associates Test (RAT; Mednick, 1962), we…

  7. Teaching Mathematical Word Problem Solving: The Quality of Evidence for Strategy Instruction Priming the Problem Structure

    ERIC Educational Resources Information Center

    Jitendra, Asha K.; Petersen-Brown, Shawna; Lein, Amy E.; Zaslofsky, Anne F.; Kunkel, Amy K.; Jung, Pyung-Gang; Egan, Andrea M.

    2015-01-01

    This study examined the quality of the research base related to strategy instruction priming the underlying mathematical problem structure for students with learning disabilities and those at risk for mathematics difficulties. We evaluated the quality of methodological rigor of 18 group research studies using the criteria proposed by Gersten et…

  8. Teaching mathematical word problem solving: the quality of evidence for strategy instruction priming the problem structure.

    PubMed

    Jitendra, Asha K; Petersen-Brown, Shawna; Lein, Amy E; Zaslofsky, Anne F; Kunkel, Amy K; Jung, Pyung-Gang; Egan, Andrea M

    2015-01-01

    This study examined the quality of the research base related to strategy instruction priming the underlying mathematical problem structure for students with learning disabilities and those at risk for mathematics difficulties. We evaluated the quality of methodological rigor of 18 group research studies using the criteria proposed by Gersten et al. and 10 single case design (SCD) research studies using criteria suggested by Horner et al. and the What Works Clearinghouse. Results indicated that 14 group design studies met the criteria for high-quality or acceptable research, whereas SCD studies did not meet the standards for an evidence-based practice. Based on these findings, strategy instruction priming the mathematics problem structure is considered an evidence-based practice using only group design methodological criteria. Implications for future research and for practice are discussed. © Hammill Institute on Disabilities 2013.

  9. Using Verbal Protocol Data to Reflect the Quality of Problem Representation in Solving Algebra Word Problems.

    ERIC Educational Resources Information Center

    Bull, Elizabeth Kay

    The goal of this study was to find a way to quantify three criteria of representational quality, described by Greeno, so that it would be possible to examine statistically the relationship between representational quality and other variables related to problem solution. The sample consisted of 18 college students, 84 percent of whom had…

  10. Do causes of stress differ in their association with problem drinking by sex in Korean adolescents?

    PubMed

    Choi, Jae-Woo; Park, Eun-Cheol; Kim, Jae-Hyun; Park, So-Hee

    2017-01-01

    Previous studies have focused mainly on whether stress causes present drinking or excessive drinking. However, few studies have been conducted on the relationship between stress and problem drinking in adolescents. The objective of this study was to examine the stress level and the cause of stress related to problem drinking behavior according to sex among Korean youth. Data for this study were pooled from cross-sectional data collected annually from 2007 through 2012 from the Korea Youth Risk Behavior Web-based Survey. A representative sample of 442,113 students from 800 randomly selected middle and high schools in Korea were included. Multiple logistic regression models were used in the analysis. Both male and female students with extremely high stress were more likely to engage in problem drinking than were students with no stress (odds ratios [OR], 1.73 in males and 1.41 in females). The major causes of stress in male students that were associated with problem drinking were conflict with a teacher, trouble with parents, and peer relationships (ORs, 2.47, 1.72, and 1.71, respectively), whereas there are no statistically significant association between causes of stress and problem drinking among female students. Considering stress level, Male students with extremely high stress level were associated with problem drinking regardless of causes of stress, while Female students who felt extremely high levels of stress were more likely to engage in problem drinking due to stress from a conflict with parents, peer relationships, appearance, and financial difficulty (ORs, 1.53, 1.53, 1.46, and 1.47, respectively). Adolescents who engage in problem drinking may be affected by different causes of stress according to sex. Thus, appropriate approaches that reflect sex differences will be helpful to alleviate problem drinking in adolescents and educational authorities need to arrange more effective education program for drinking given positive associations between drinking

  11. Learning from patients: Identifying design features of medicines that cause medication use problems.

    PubMed

    Notenboom, Kim; Leufkens, Hubert Gm; Vromans, Herman; Bouvy, Marcel L

    2017-01-30

    Usability is a key factor in ensuring safe and efficacious use of medicines. However, several studies showed that people experience a variety of problems using their medicines. The purpose of this study was to identify design features of oral medicines that cause use problems among older patients in daily practice. A qualitative study with semi-structured interviews on the experiences of older people with the use of their medicines was performed (n=59). Information on practical problems, strategies to overcome these problems and the medicines' design features that caused these problems were collected. The practical problems and management strategies were categorised into 'use difficulties' and 'use errors'. A total of 158 use problems were identified, of which 45 were categorized as use difficulties and 113 as use error. Design features that contributed the most to the occurrence of use difficulties were the dimensions and surface texture of the dosage form (29.6% and 18.5%, respectively). Design features that contributed the most to the occurrence of use errors were the push-through force of blisters (22.1%) and tamper evident packaging (12.1%). These findings will help developers of medicinal products to proactively address potential usability issues with their medicines. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  12. Longitudinal effects of sibling relationship quality on adolescent problem behavior: a cross-ethnic comparison.

    PubMed

    Buist, Kirsten L; Paalman, Carmen H; Branje, Susan J T; Deković, Maja; Reitz, Ellen; Verhoeven, Marjolein; Meeus, Wim H J; Koot, Hans M; Hale, William W

    2014-04-01

    The aim of the present study was to examine whether adolescents of Moroccan and Dutch origin differ concerning sibling relationship quality and to examine whether the associations between quality of the sibling relationship and level and change in externalizing and internalizing problem behavior are comparable for Moroccan and Dutch adolescents. Five annual waves of questionnaire data on sibling support and conflict as well as externalizing problems, anxiety and depression were collected from 159 ethnic Moroccan adolescents (Mage = 13.3 years) and from 159 ethnic Dutch adolescents (Mage = 13.0 years). Our findings demonstrated significant mean level differences between the Moroccan and Dutch sample in sibling relationship quality, externalizing problems, and depression, with Moroccan adolescents reporting higher sibling relationship quality and less problem behavior. However, effects of sibling relationship quality on externalizing problems, anxiety, and depression were similar for the Moroccan and Dutch samples. Sibling support was not related to level of externalizing problems, nor to changes in externalizing problems, anxiety, and depression. Additionally, more sibling conflict was related to a higher starting level of and faster decreases in problem behaviors. Our results support the ethnic equivalence model, which holds that the influence of family relationships is similar for different ethnic groups. Moreover, sibling support and conflict affect both the level and the fluctuations in problem behavior over time in specific ethnic groups similarly. Implications for future studies and interventions are subsequently discussed.

  13. Health-related quality of life and emotional problems in children surviving brain tumor treatment: A descriptive study of 2 cohorts.

    PubMed

    Dessens, Arianne B; van Herwerden, Michael C; Aarsen, Femke K; Birnie, Erwin; Catsman-Berrevoets, Coriene E

    2016-08-01

    The survival of childhood brain tumors has improved in the past 30 years, but acquired brain injury due to damage caused by tumor invasion and side effects of different treatment modalities frequently occurs. This study focused on residual impairments, health-related quality of life (HRQoL), and emotional and behavioral problems in 2 cohorts of survivors diagnosed and treated for various types of brain tumors. Survivors in the 2004 cohort visited the Erasmus Medical Centre for standardized follow-up between 2003 and 2004, and in the 2014 cohort, between 2012 and 2014. Data of neurologically impairments of all children were extracted from medical records. Parents and survivors filled out questionnaires on quality of life and emotional and behavioral problems. In both cohorts, approximately 55% of the survivors displayed neurologic impairments. In comparison with the healthy reference group, a reduced parent-reported quality of life was found on the Motor, Cognition, and Autonomy (Cohort 2004) scales. Comparison between the cohorts showed that parents in the 2004 cohort reported a higher HRQoL on the Motor and Cognitive functioning scales. In the 2014 cohort, children reported less negative emotions than healthy children. No increase in emotional or behavioral problems were reported by children in both cohorts, whereas parents reported problems in social functioning and isolation related to a delay in emotional development. Children surviving brain tumor treatment have a reduced quality of life. The authors therefore recommend regular screening of HRQoL and emotional and behavioral problems and referral to specific aftercare.

  14. Dispositional Mindfulness and Memory Problems: The Role of Perceived Stress and Sleep Quality

    PubMed Central

    Brisbon, Nicholas M.; Lachman, Margie E.

    2016-01-01

    There is a growing body of evidence exploring the beneficial effects of mindfulness on stress, sleep quality, and memory, though the mechanisms involved are less certain. The present study explored the roles of perceived stress and sleep quality as potential mediators between dispositional mindfulness and subjective memory problems. Data were from a Boston area subsample of the Midlife in the United States study (MIDUS-II) assessed in 2004–2006, and again approximately one year later (N=299). As expected, higher dispositional mindfulness was associated with lower perceived stress and better sleep quality. There was no direct association found between mindfulness and subjective memory problems, however, there was a significant indirect effect through perceived stress, although not with sleep quality. The present findings suggest that perceived stress may play a mediating role between dispositional mindfulness and subjective memory problems, in that those with higher mindfulness generally report experiencing less stress than those with lower mindfulness, which may be protective of memory problems in everyday life. PMID:28344682

  15. Dispositional Mindfulness and Memory Problems: The Role of Perceived Stress and Sleep Quality.

    PubMed

    Brisbon, Nicholas M; Lachman, Margie E

    2017-04-01

    There is a growing body of evidence exploring the beneficial effects of mindfulness on stress, sleep quality, and memory, though the mechanisms involved are less certain. The present study explored the roles of perceived stress and sleep quality as potential mediators between dispositional mindfulness and subjective memory problems. Data were from a Boston area subsample of the Midlife in the United States study (MIDUS-II) assessed in 2004-2006, and again approximately one year later (N=299). As expected, higher dispositional mindfulness was associated with lower perceived stress and better sleep quality. There was no direct association found between mindfulness and subjective memory problems, however, there was a significant indirect effect through perceived stress, although not with sleep quality. The present findings suggest that perceived stress may play a mediating role between dispositional mindfulness and subjective memory problems, in that those with higher mindfulness generally report experiencing less stress than those with lower mindfulness, which may be protective of memory problems in everyday life.

  16. Indoor air quality: A psychosocial perspective

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

    Boxer, P.A.

    1990-05-01

    The incidence of indoor air quality problems has increased dramatically over the past decade. Investigation of these problems has yielded a definitive cause in only one third of the cases. Psychosocial factors may play a key role in the development and propagation of symptoms attributed to poor indoor air quality. Guidelines for managing indoor air quality problems from the organizational perspective are based upon psychosocial principles and elements of risk perception.

  17. Relationships between undergraduates' argumentation skills, conceptual quality of problem solutions, and problem solving strategies in introductory physics

    NASA Astrophysics Data System (ADS)

    Rebello, Carina M.

    This study explored the effects of alternative forms of argumentation on undergraduates' physics solutions in introductory calculus-based physics. A two-phase concurrent mixed methods design was employed to investigate relationships between undergraduates' written argumentation abilities, conceptual quality of problem solutions, as well as approaches and strategies for solving argumentative physics problems across multiple physics topics. Participants were assigned via stratified sampling to one of three conditions (control, guided construct, or guided evaluate) based on gender and pre-test scores on a conceptual instrument. The guided construct and guided evaluate groups received tasks and prompts drawn from literature to facilitate argument construction or evaluation. Using a multiple case study design, with each condition serving as a case, interviews were conducted consisting of a think-aloud problem solving session paired with a semi-structured interview. The analysis of problem solving strategies was guided by the theoretical framework on epistemic games adapted by Tuminaro and Redish (2007). This study provides empirical evidence that integration of written argumentation into physics problems can potentially improve the conceptual quality of solutions, expand their repertoire of problem solving strategies and show promise for addressing the gender gap in physics. The study suggests further avenues for research in this area and implications for designing and implementing argumentation tasks in introductory college physics.

  18. 49 CFR 40.203 - What problems cause a drug test to be cancelled unless they are corrected?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false What problems cause a drug test to be cancelled unless they are corrected? 40.203 Section 40.203 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Problems in Drug Tests § 40.203 What problems cause a drug test to be...

  19. Parental Sleep Quality and Behavior Problems of Children with Autism

    ERIC Educational Resources Information Center

    Mihaila, Iulia; Hartley, Sigan L.

    2018-01-01

    This study explored the impact of parental sleep quality on the experience of behavior problems by children with autism spectrum disorder. A 14-day daily diary was used in a sample of 176 mother-father couples. Dyadic multilevel models were conducted to examine the between-person and within-person effects of previous-night sleep quality on…

  20. Coping and social problem solving correlates of asthma control and quality of life.

    PubMed

    McCormick, Sean P; Nezu, Christine M; Nezu, Arthur M; Sherman, Michael; Davey, Adam; Collins, Bradley N

    2014-02-01

    In a sample of adults with asthma receiving care and medication in an outpatient pulmonary clinic, this study tested for statistical associations between social problem-solving styles, asthma control, and asthma-related quality of life. These variables were measured cross sectionally as a first step toward more systematic application of social problem-solving frameworks in asthma self-management training. Recruitment occurred during pulmonology clinic service hours. Forty-four adults with physician-confirmed diagnosis of asthma provided data including age, gender, height, weight, race, income, and comorbid conditions. The Asthma Control Questionnaire, the Mini Asthma Quality of Life Questionnaire (Short Form), and peak expiratory force measures offered multiple views of asthma health at the time of the study. Maladaptive coping (impulsive and careless problem-solving styles) based on transactional stress models of health were assessed with the Social Problem-Solving Inventory-Revised: Short Form. Controlling for variance associated with gender, age, and income, individuals reporting higher impulsive-careless scores exhibited significantly lower scores on asthma control (β = 0.70, p = 0.001, confidence interval (CI) [0.37-1.04]) and lower asthma-related quality of life (β = 0.79, p = 0.017, CI [0.15-1.42]). These findings suggest that specific maladaptive problem-solving styles may uniquely contribute to asthma health burdens. Because problem-solving coping strategies are both measureable and teachable, behavioral interventions aimed at facilitating adaptive coping and problem solving could positively affect patient's asthma management and quality of life.

  1. Improving the quality of mass produced maps

    USGS Publications Warehouse

    Simley, J.

    2001-01-01

    Quality is critical in cartography because key decisions are often made based on the information the map communicates. The mass production of digital cartographic information to support geographic information science has now added a new dimension to the problem of cartographic quality, as problems once limited to small volumes can now proliferate in mass production programs. These problems can also affect the economics of map production by diverting a sizeable portion of production cost to pay for rework on maps with poor quality. Such problems are common to general industry-in response, the quality engineering profession has developed a number of successful methods to overcome these problems. Two important methods are the reduction of error through statistical analysis and addressing the quality environment in which people work. Once initial and obvious quality problems have been solved, outside influences periodically appear that cause adverse variations in quality and consequently increase production costs. Such errors can be difficult to detect before the customer is affected. However, a number of statistical techniques can be employed to detect variation so that the problem is eliminated before significant damage is caused. Additionally, the environment in which the workforce operates must be conductive to quality. Managers have a powerful responsibility to create this environment. Two sets of guidelines, known as Deming's Fourteen Points and ISO-9000, provide models for this environment.

  2. Internalizing Problems among Cyberbullying Victims and Moderator Effects of Friendship Quality

    ERIC Educational Resources Information Center

    Aoyama, Ikuko; Saxon, Terrill F.; Fearon, Danielle D.

    2011-01-01

    Purpose: The purpose of this paper is to examine the relationship between cyberbullying victimization and internalizing problems among the youth. Moderator effects of a friendship quality were also investigated to examine if higher friendship quality moderated the negative effects of cyberbullying on psychological states of students.…

  3. Assessment and mitigation of power quality problems for PUSPATI TRIGA Reactor (RTP)

    NASA Astrophysics Data System (ADS)

    Zakaria, Mohd Fazli; Ramachandaramurthy, Vigna K.

    2017-01-01

    An electrical power systems are exposed to different types of power quality disturbances. Investigation and monitoring of power quality are necessary to maintain accurate operation of sensitive equipment especially for nuclear installations. This paper will discuss the power quality problems observed at the electrical sources of PUSPATI TRIGA Reactor (RTP). Assessment of power quality requires the identification of any anomalous behavior on a power system, which adversely affects the normal operation of electrical or electronic equipment. A power quality assessment involves gathering data resources; analyzing the data (with reference to power quality standards) then, if problems exist, recommendation of mitigation techniques must be considered. Field power quality data is collected by power quality recorder and analyzed with reference to power quality standards. Normally the electrical power is supplied to the RTP via two sources in order to keep a good reliability where each of them is designed to carry the full load. The assessment of power quality during reactor operation was performed for both electrical sources. There were several disturbances such as voltage harmonics and flicker that exceeded the thresholds. To reduce these disturbances, mitigation techniques have been proposed, such as to install passive harmonic filters to reduce harmonic distortion, dynamic voltage restorer (DVR) to reduce voltage disturbances and isolate all sensitive and critical loads.

  4. Math Problems for Water Quality Control Personnel, Student Workbook. Second Edition.

    ERIC Educational Resources Information Center

    Delvecchio, Fred; Brutsch, Gloria

    This document is the student workbook for a course in mathematics for water quality control personnel. This version contains complete problems, answers and references. Problems are arranged alphabetically by treatment process. Charts, graphs, and drawings represent data forms an operator might see in a plant containing information necessary for…

  5. Problem Solving Teams in a Total Quality Management Environment.

    ERIC Educational Resources Information Center

    Towler, Constance F.

    1993-01-01

    Outlines the problem-solving team training process used at Harvard University (Massachusetts), including the size and formation of teams, roles, and time commitment. Components of the process are explained, including introduction to Total Quality Management (TQM), customer satisfaction, meeting management, Parker Team Player Survey, interactive…

  6. Exploring the relationship between quality of life and mental health problems in children: implications for measurement and practice.

    PubMed

    Sharpe, Helen; Patalay, Praveetha; Fink, Elian; Vostanis, Panos; Deighton, Jessica; Wolpert, Miranda

    2016-06-01

    Quality of life is typically reduced in children with mental health problems. Understanding the relationship between quality of life and mental health problems and the factors that moderate this association is a pressing priority. This was a cross-sectional study involving 45,398 children aged 8-13 years from 880 schools in England. Self-reported quality of life was assessed using nine items from the KIDSCREEN-10 and mental health was assessed using the Me and My School Questionnaire. Demographic information (gender, age, ethnicity, socio-economic status) was also recorded. Quality of life was highest in children with no problems and lowest in children with both internalising and externalising problems. There was indication that quality of life may be reduced in children with internalising problems compared with externalising problems. Approximately 12 % children with mental health problems reported high quality of life. The link between mental health and quality of life was moderated by gender and age but not by socio-economic status or ethnicity. This study supports previous work showing mental health and quality of life are related but not synonymous. The findings have implications for measuring quality of life in child mental health settings and the need for approaches to support children with mental health problems that are at particular risk of poor quality of life.

  7. Quality of life of people with mental health problems: a synthesis of qualitative research

    PubMed Central

    2012-01-01

    Purpose To identify the domains of quality of life important to people with mental health problems. Method A systematic review of qualitative research undertaken with people with mental health problems using a framework synthesis. Results We identified six domains: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope and hopelessness. Firstly, symptoms or ‘ill-being’ were an intrinsic aspect of quality of life for people with severe mental health problems. Additionally, a good quality of life was characterised by the feeling of being in control (particularly of distressing symptoms), autonomy and choice; a positive self-image; a sense of belonging; engagement in meaningful and enjoyable activities; and feelings of hope and optimism. Conversely, a poor quality life, often experienced by those with severe mental health difficulties, was characterized by feelings of distress; lack of control, choice and autonomy; low self-esteem and confidence; a sense of not being part of society; diminished activity; and a sense of hopelessness and demoralization. Conclusions Generic measures fail to address the complexity of quality of life measurement and the broad range of domains important to people with mental health problems. PMID:23173689

  8. Quality Education Improvement: Yemen and the Problem of the "Brain Drain"

    ERIC Educational Resources Information Center

    Muthanna, Abdulghani

    2015-01-01

    This paper presents an overview of the problems that hinder improvement of the quality of education in Yemen, with a particular focus on higher education institutions. It discusses in particular the problem of the brain drain and why this phenomenon is occurring in Yemen. Semi-structured interviews with three professors at higher education…

  9. On the Problems of Asking for a Definition of Quality in Education

    ERIC Educational Resources Information Center

    Wittek, Line; Kvernbekk, Tone

    2011-01-01

    In this article we discuss the problems of asking for a definition of quality in education from a philosophy of language perspective. We take the concept of quality as it appears in higher education discourse as our example. More specifically we discuss the possibility of obtaining a precise, unified definition of quality by addressing the problem…

  10. The Profile of Creativity and Proposing Statistical Problem Quality Level Reviewed From Cognitive Style

    NASA Astrophysics Data System (ADS)

    Awi; Ahmar, A. S.; Rahman, A.; Minggi, I.; Mulbar, U.; Asdar; Ruslan; Upu, H.; Alimuddin; Hamda; Rosidah; Sutamrin; Tiro, M. A.; Rusli

    2018-01-01

    This research aims to reveal the profile about the level of creativity and the ability to propose statistical problem of students at Mathematics Education 2014 Batch in the State University of Makassar in terms of their cognitive style. This research uses explorative qualitative method by giving meta-cognitive scaffolding at the time of research. The hypothesis of research is that students who have field independent (FI) cognitive style in statistics problem posing from the provided information already able to propose the statistical problem that can be solved and create new data and the problem is already been included as a high quality statistical problem, while students who have dependent cognitive field (FD) commonly are still limited in statistics problem posing that can be finished and do not load new data and the problem is included as medium quality statistical problem.

  11. 49 CFR 40.203 - What problems cause a drug test to be cancelled unless they are corrected?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false What problems cause a drug test to be cancelled... What problems cause a drug test to be cancelled unless they are corrected? (a) As the MRO, when a... the CCF, you must cancel the test unless the flaw is corrected. (d) The following are correctable...

  12. Classroom Quality at Pre-kindergarten and Kindergarten and Children’s Social Skills and Behavior Problems

    PubMed Central

    Broekhuizen, Martine L.; Mokrova, Irina L.; Burchinal, Margaret R.; Garrett-Peters, Patricia T.

    2016-01-01

    Focusing on the continuity in the quality of classroom environments as children transition from preschool into elementary school, this study examined the associations between classroom quality in pre-kindergarten and kindergarten and children’s social skills and behavior problems in kindergarten and first grade. Participants included 1175 ethnically-diverse children (43% African American) living in low-wealth rural communities of the US. Results indicated that children who experienced higher levels of emotional and organizational classroom quality in both pre-kindergarten and kindergarten demonstrated better social skills and fewer behavior problems in both kindergarten and first grade comparing to children who did not experience higher classroom quality. The examination of the first grade results indicated that the emotional and organizational quality of pre-kindergarten classrooms was the strongest predictor of children’s first grade social skills and behavior problems. The study results are discussed from theoretical, practical, and policy perspectives. PMID:26949286

  13. Addressing the Wicked Problem of Quality in Higher Education: Theoretical Approaches and Implications

    ERIC Educational Resources Information Center

    Krause, Kerri-Lee

    2012-01-01

    This article explores the wicked problem of quality in higher education, arguing for a more robust theorising of the subject at national, institutional and local department level. The focus of the discussion rests on principles for theorising in more rigorous ways about the multidimensional issue of quality. Quality in higher education is proposed…

  14. Problems of Accreditation and Quality Assurance of Engineering Education in Developing Countries.

    ERIC Educational Resources Information Center

    Bordia, Surek

    2001-01-01

    Discusses the relationship between funding, management, and quality assurance in engineering education in developing countries. Presents a few case studies on problems of accreditation and quality assessment in larger developing countries such as India and the Philippines, and also in very small developing countries such as Papua New Guinea, Fiji,…

  15. [Quality of information analysis on basic causes of neonatal deaths recorded in the Mortality Information System: a study in Maceió, Alagoas State, Brazil, 2001-2002].

    PubMed

    Pedrosa, Linda Délia C O; Sarinho, Silvia W; Ordonha, Manoelina R

    2007-10-01

    Analysis of the quality of information on basic causes of neonatal deaths in Brazil is crucially important, since it allows one to estimate how many deaths are avoidable and provide support for policies to decrease neonatal mortality. The current study aimed to evaluate the reliability and validity of the Mortality Information System (MIS) for discriminating between basic causes of neonatal deaths and defining percentages of reducible causes. The basic causes of early neonatal deaths in hospitals in Maceió, Alagoas State, were analyzed, and the causes recorded in medical records were compared to the MIS data in order to measure reliability and validity. The modified SEADE Foundation and Wigglesworth classifications were compared to analyze the capacity for reduction of neonatal mortality. Maternal causes predominated in the medical records, as compared to respiratory disorders on the death certificates and in the MIS. The percentage of avoidable deaths may be much higher than observed from the MIS, due to imprecision in completing death certificates. Based on the MIS, the greatest problems are in early diagnosis and treatment of neonatal causes. However, the results show that the most pressing problems relate to failures in prenatal care and lack of control of diseases.

  16. Perceived Causes of Mental Health Problems and Help-Seeking Behavior among University Students in Ethiopia

    ERIC Educational Resources Information Center

    Alemu, Yirgalem

    2014-01-01

    The study examined perceived causes of mental health problems and professional help-seeking behavior among university students in Ethiopia. Data were collected from 370 students from four randomly selected colleges. The results revealed that the majority of the participants were able to recognize major mental health problems such as schizophrenia…

  17. Integrating participatory engagement and scientific research to inform causes and solutions to water problems in the River Njoro Watershed Kenya.

    NASA Astrophysics Data System (ADS)

    Jenkins, M.

    2012-12-01

    Over the course of 9 years, an international multidisciplinary team of US and Kenyan scientists under the Sustainable Management of Rural Watersheds (SUMAWA) Project, based at Egerton University in Kenya, worked with Kenyan public agencies to apply a variety of participatory methods and outreach activities combined with land use mapping, hydrologic and water system modeling, and other scientific tools and evaluations to investigate and identify solutions to declining water quantity and quality problems affecting communities and environmental and productive sectors in the River Njoro Watershed in Kenya. Traditional participatory rural appraisal techniques were modified to engage low income, informal, and tribal communities in identification of local services, benefits, and groups linked to water and riparian resources and collect their perceptions of water-related problems, priorities, and solution options throughout the watershed. Building on this foundation of insights, information, and engagement on water issues with local communities and other stakeholders, the project designed a research agenda aimed at creating shared scientific understanding of the causes of identified problems and developing and testing promising interventions to address community and stakeholder priority concerns. This presentation will share lessons from the SUMAWA experience of using a problem-driven, solution-oriented, community-based watershed approach to address water resource problems at local scale in a semi-arid African developing country setting.

  18. GEE-WIS Anchored Problem Solving Using Real-Time Authentic Water Quality Data

    NASA Astrophysics Data System (ADS)

    Young, M.; Wlodarczyk, M. S.; Branco, B.; Torgersen, T.

    2002-05-01

    GEE-WIS scientific problem solving consists of observing, hypothesizing, synthesis, argument building and reasoning, in the context of analysis, representation, modeling and sense-making of real-time authentic water quality data. Geoscience Environmental Education - Web-accessible Instrumented Systems, or GEE-WIS, an NSF Geoscience Education grant, has established a set of companion websites that stream real-time data from two campus retention ponds for research and use in secondary and undergraduate water quality lessons. We have targeted scientific problem solving skills because of the nature of the GEE-WIS environment, but further because they are central to state and federal efforts to establish science education curriculum standards and are at the core of performance-based testing. We have used a design experiment process to create and test two Anchored Instruction scenario problems. Customization such as that done through a design process, is acknowledged to be a fundamental component of educational research from an ecological psychology perspective. Our efforts have shared core design elements with other NSF water quality projects. Our method involves the analysis of student written scenario responses for level of scientific problem solving using a qualitative scoring rubric designed from participation in a related NSF project, SCALE (Synergy Communities: Aggregating Learning about Education). Student solutions of GEE-WIS anchor problems from Fall 2001 and Spring 2002 will be summarized. Implications are drawn for those interested in making secondary and high education geoscience more realistic and more motivating for students through the use of real-time authentic data via Internet.

  19. A New Model for Solving Time-Cost-Quality Trade-Off Problems in Construction

    PubMed Central

    Fu, Fang; Zhang, Tao

    2016-01-01

    A poor quality affects project makespan and its total costs negatively, but it can be recovered by repair works during construction. We construct a new non-linear programming model based on the classic multi-mode resource constrained project scheduling problem considering repair works. In order to obtain satisfactory quality without a high increase of project cost, the objective is to minimize total quality cost which consists of the prevention cost and failure cost according to Quality-Cost Analysis. A binary dependent normal distribution function is adopted to describe the activity quality; Cumulative quality is defined to determine whether to initiate repair works, according to the different relationships among activity qualities, namely, the coordinative and precedence relationship. Furthermore, a shuffled frog-leaping algorithm is developed to solve this discrete trade-off problem based on an adaptive serial schedule generation scheme and adjusted activity list. In the program of the algorithm, the frog-leaping progress combines the crossover operator of genetic algorithm and a permutation-based local search. Finally, an example of a construction project for a framed railway overpass is provided to examine the algorithm performance, and it assist in decision making to search for the appropriate makespan and quality threshold with minimal cost. PMID:27911939

  20. Association of Changes in Diet Quality with Total and Cause-Specific Mortality

    PubMed Central

    Sotos-Prieto, Mercedes; Bhupathiraju, Shilpa N.; Mattei, Josiemer; Fung, Teresa T.; Li, Yanping; Pan, An; Willett, Walter C.; Rimm, Eric B.; Hu, Frank B.

    2017-01-01

    BACKGROUND Few studies have evaluated the relationship between changes in diet quality over time and the risk of death. METHODS We used Cox proportional-hazards models to calculate adjusted hazard ratios for total and cause-specific mortality among 47,994 women in the Nurses’ Health Study and 25,745 men in the Health Professionals Follow-up Study from 1998 through 2010. Changes in diet quality over the preceding 12 years (1986–1998) were assessed with the use of the Alternate Healthy Eating Index–2010 score, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score. RESULTS The pooled hazard ratios for all-cause mortality among participants who had the greatest improvement in diet quality (13 to 33% improvement), as compared with those who had a relatively stable diet quality (0 to 3% improvement), in the 12-year period were the following: 0.91 (95% confidence interval [CI], 0.85 to 0.97) according to changes in the Alternate Healthy Eating Index score, 0.84 (95 CI%, 0.78 to 0.91) according to changes in the Alternate Mediterranean Diet score, and 0.89 (95% CI, 0.84 to 0.95) according to changes in the DASH score. A 20-percentile increase in diet scores (indicating an improved quality of diet) was significantly associated with a reduction in total mortality of 8 to 17% with the use of the three diet indexes and a 7 to 15% reduction in the risk of death from cardiovascular disease with the use of the Alternate Healthy Eating Index and Alternate Mediterranean Diet. Among participants who maintained a high-quality diet over a 12-year period, the risk of death from any cause was significantly lower — by 14% (95% CI, 8 to 19) when assessed with the Alternate Healthy Eating Index score, 11% (95% CI, 5 to 18) when assessed with the Alternate Mediterranean Diet score, and 9% (95% CI, 2 to 15) when assessed with the DASH score — than the risk among participants with consistently low diet scores over time. CONCLUSIONS

  1. Impact of problem finding on the quality of authentic open inquiry science research projects

    NASA Astrophysics Data System (ADS)

    Labanca, Frank

    2008-11-01

    Problem finding is a creative process whereby individuals develop original ideas for study. Secondary science students who successfully participate in authentic, novel, open inquiry studies must engage in problem finding to determine viable and suitable topics. This study examined problem finding strategies employed by students who successfully completed and presented the results of their open inquiry research at the 2007 Connecticut Science Fair and the 2007 International Science and Engineering Fair. A multicase qualitative study was framed through the lenses of creativity, inquiry strategies, and situated cognition learning theory. Data were triangulated by methods (interviews, document analysis, surveys) and sources (students, teachers, mentors, fair directors, documents). The data demonstrated that the quality of student projects was directly impacted by the quality of their problem finding. Effective problem finding was a result of students using resources from previous, specialized experiences. They had a positive self-concept and a temperament for both the creative and logical perspectives of science research. Successful problem finding was derived from an idiosyncratic, nonlinear, and flexible use and understanding of inquiry. Finally, problem finding was influenced and assisted by the community of practicing scientists, with whom the students had an exceptional ability to communicate effectively. As a result, there appears to be a juxtaposition of creative and logical/analytical thought for open inquiry that may not be present in other forms of inquiry. Instructional strategies are suggested for teachers of science research students to improve the quality of problem finding for their students and their subsequent research projects.

  2. Quality of Rapport as a Setting Event for Problem Behavior: Assessment and Intervention

    ERIC Educational Resources Information Center

    McLaughlin, Darlene Magito; Carr, Edward G.

    2005-01-01

    Relationship quality (rapport) between people with developmental disabilities and their caregivers has long been suggested as an important variable influencing the likelihood of problem behavior. However, to date, the association between rapport and problem behavior has not been systematically investigated. The authors evaluated a multimethod…

  3. Analysis of Station Quality Issues from EarthScope's Transportable Array

    NASA Astrophysics Data System (ADS)

    Pfeifer, C.; Barstow, N.; Busby, R.; Hafner, K.

    2008-12-01

    160 of the first 400 Earthscope USARRY transportable array (TA) stations have completed their first two-year deployment and are being moved to their next locations. Over the past 4 years the majority of stations have run with few interruptions in the transfer of real time data to the Array Network Facility (ANF) at the Univ of CA San Diego and near real time data to the IRIS Data Management System (DMS). The combination of telemetered data and dedicated people reviewing the waveforms and state of health data have revealed several conditions that can affect the data quality or cause loss of data. The data problems fall into three broad categories; station power, equipment malfunction, and communication failures. Station power issues have been implicated in several types of noise seen in the seismic data (as well as causing station failures and resultant data gaps). The most common type of equipment problem that has been found to degrade data quality is caused by sensor problems, and has affected all 3 types of sensors used in the TA to varying degrees. While communication problems can cause real time data loss, they do not cause a degradation of the quality of the data, and any gaps in the real time data due solely to communications problems are filled in later with the continuous data recorded to disk at each TA station. Over the past 4 years the TA team has recognized a number of noise sources and have made several design changes to minimize the effects on data quality. Design/procedural changes include: stopping water incursion into the stations, power conditioning, changing mass re-center voltage thresholds. Figures that demonstrate examples are provided. Changes have created better data quality and improved the station performance. Vigilance and deployment of service teams to reestablish communications, replace noisy sensors, and troubleshoot problems is also key to maintaining the high-quality TA network.

  4. [Quality assessment in anesthesia].

    PubMed

    Kupperwasser, B

    1996-01-01

    Quality assessment (assurance/improvement) is the set of methods used to measure and improve the delivered care and the department's performance against pre-established criteria or standards. The four stages of the self-maintained quality assessment cycle are: problem identification, problem analysis, problem correction and evaluation of corrective actions. Quality assessment is a measurable entity for which it is necessary to define and calibrate measurement parameters (indicators) from available data gathered from the hospital anaesthesia environment. Problem identification comes from the accumulation of indicators. There are four types of quality indicators: structure, process, outcome and sentinel indicators. The latter signal a quality defect, are independent of outcomes, are easier to analyse by statistical methods and closely related to processes and main targets of quality improvement. The three types of methods to analyse the problems (indicators) are: peer review, quantitative methods and risks management techniques. Peer review is performed by qualified anaesthesiologists. To improve its validity, the review process should be explicited and conclusions based on standards of practice and literature references. The quantitative methods are statistical analyses applied to the collected data and presented in a graphic format (histogram, Pareto diagram, control charts). The risks management techniques include: a) critical incident analysis establishing an objective relationship between a 'critical' event and the associated human behaviours; b) system accident analysis, based on the fact that accidents continue to occur despite safety systems and sophisticated technologies, checks of all the process components leading to the impredictable outcome and not just the human factors; c) cause-effect diagrams facilitate the problem analysis in reducing its causes to four fundamental components (persons, regulations, equipment, process). Definition and implementation

  5. Sleep-related problems in common medical conditions.

    PubMed

    Parish, James M

    2009-02-01

    Common medical problems are often associated with abnormalities of sleep. Patients with chronic medical disorders often have fewer hours of sleep and less restorative sleep compared to healthy individuals, and this poor sleep may worsen the subjective symptoms of the disorder. Individuals with lung disease often have disturbed sleep related to oxygen desaturations, coughing, or dyspnea. Both obstructive lung disease and restrictive lung diseases are associated with poor quality sleep. Awakenings from sleep are common in untreated or undertreated asthma, and cause sleep disruption. Gastroesophageal reflux is a major cause of disrupted sleep due to awakenings from heartburn, dyspepsia, acid brash, coughing, or choking. Patients with chronic renal disease commonly have sleep complaints often due to insomnia, insufficient sleep, sleep apnea, or restless legs syndrome. Complaints related to sleep are very common in patients with fibromyalgia and other causes of chronic pain. Sleep disruption increases the sensation of pain and decreases quality of life. Patients with infectious diseases, including acute viral illnesses, HIV-related disease, and Lyme disease, may have significant problems with insomnia and hypersomnolence. Women with menopause have from insomnia, sleep-disordered breathing, restless legs syndrome, or fibromyalgia. Patients with cancer or receiving cancer therapy are often bothered by insomnia or other sleep disturbances that affect quality of life and daytime energy. The objective of this article is to review frequently encountered medical conditions and examine their impact on sleep, and to review frequent sleep-related problems associated with these common medical conditions.

  6. The quality of medical death certification of cause of death in hospitals in rural Bangladesh: impact of introducing the International Form of Medical Certificate of Cause of Death.

    PubMed

    Hazard, Riley H; Chowdhury, Hafizur Rahman; Adair, Tim; Ansar, Adnan; Quaiyum Rahman, A M; Alam, Saidul; Alam, Nurul; Rampatige, Rasika; Streatfield, Peter Kim; Riley, Ian Douglas; Lopez, Alan D

    2017-10-02

    Accurate and timely data on cause of death are critically important for guiding health programs and policies. Deaths certified by doctors are implicitly considered to be reliable and accurate, yet the quality of information provided in the international Medical Certificate of Cause of Death (MCCD) usually varies according to the personnel involved in certification, the diagnostic capacity of the hospital, and the category of hospitals. There are no published studies that have analysed how certifying doctors in Bangladesh adhere to international rules when completing the MCCD or have assessed the quality of clinical record keeping. The study took place between January 2011 and April 2014 in the Chandpur and Comilla districts of Bangladesh. We introduced the international MCCD to all study hospitals. Trained project physicians assigned an underlying cause of death, assessed the quality of the death certificate, and reported the degree of certainty of the medical records provided for a given cause. We examined the frequency of common errors in completing the MCCD, the leading causes of in-hospital deaths, and the degree of certainty in the cause of death data. The study included 4914 death certificates. 72.9% of medical records were of too poor quality to assign a cause of death, with little difference by age, hospital, and cause of death. 95.6% of death certificates did not indicate the time interval between onset and death, 31.6% required a change in sequence, 13.9% required to include a new diagnosis, 50.7% used abbreviations, 41.5% used multiple causes per line, and 33.2% used an ill-defined condition as the underlying cause of death. 99.1% of death certificates had at least one error. The leading cause of death among adults was stroke (15.8%), among children was pneumonia (31.7%), and among neonates was birth asphyxia (52.8%). Physicians in Bangladeshi hospitals had difficulties in completing the MCCD correctly. Physicians routinely made errors in death

  7. Impact of financial burden of cancer on survivors' quality of life.

    PubMed

    Fenn, Kathleen M; Evans, Suzanne B; McCorkle, Ruth; DiGiovanna, Michael P; Pusztai, Lajos; Sanft, Tara; Hofstatter, Erin W; Killelea, Brigid K; Knobf, M Tish; Lannin, Donald R; Abu-Khalaf, Maysa; Horowitz, Nina R; Chagpar, Anees B

    2014-09-01

    Little is known about the relationship between the financial burden of cancer and the physical and emotional health of cancer survivors. We examined the association between financial problems caused by cancer and reported quality of life in a population-based sample of patients with cancer. Data from the 2010 National Health Interview Survey (NHIS) were analyzed. A multivariable regression model was used to examine the relationship between the degree to which cancer caused financial problems and the patients' reported quality of life. Of 2,108 patients who answered the survey question, "To what degree has cancer caused financial problems for you and your family?," 8.6% reported "a lot," whereas 69.6% reported "not at all." Patients who reported "a lot" of financial problems as a result of cancer care costs were more likely to rate their physical health (18.6% v 4.3%, P < .001), mental health (8.3% v 1.8%, P < .001), and satisfaction with social activities and relationships (11.8% v 3.6%, P < .001) as poor compared to those with no financial hardship. On multivariable analysis controlling for all of the significant covariates on bivariate analysis, the degree to which cancer caused financial problems was the strongest independent predictor of quality of life. Patients who reported that cancer caused "a lot" of financial problems were four times less likely to rate their quality of life as "excellent," "very good," or "good" (odds ratio = 0.24; 95% CI, 0.14 to 0.40; P < .001). Increased financial burden asa result of cancer care costs is the strongest independent predictor of poor quality of life among cancer survivors. Copyright © 2014 by American Society of Clinical Oncology.

  8. Relationships between Undergraduates' Argumentation Skills, Conceptual Quality of Problem Solutions, and Problem Solving Strategies in Introductory Physics

    ERIC Educational Resources Information Center

    Rebello, Carina M.

    2012-01-01

    This study explored the effects of alternative forms of argumentation on undergraduates' physics solutions in introductory calculus-based physics. A two-phase concurrent mixed methods design was employed to investigate relationships between undergraduates' written argumentation abilities, conceptual quality of problem solutions, as well…

  9. How the causes, consequences and solutions for problem gambling are reported in Australian newspapers: a qualitative content analysis.

    PubMed

    Miller, Helen E; Thomas, Samantha L; Robinson, Priscilla; Daube, Mike

    2014-12-01

    To inform public health approaches to problem gambling by examining how the news media covers problem gambling, with a particular focus on the causes, consequences and solutions to problem gambling, and the 'actors' and sources who influence media coverage. A qualitative content analysis guided by framing theory analysed coverage of problem gambling in Australian newspapers in the period 1 July 2011 to 30 June 2012. Solutions to problem gambling were more frequently discussed than causes and consequences. A focus on the responsibility of individuals was preferred to reporting that focused on broader social, ecological, and industry determinants of problem gambling. Reporting was highly politicised, with politicians frequently quoted and political issues frequently discussed. In contrast, the community sector, health professionals and problem gamblers were rarely quoted. This analysis has revealed the need for a more proactive, coordinated approach to the media by both public health researchers and health groups. The establishment of a gambling-specific coalition to push for evidence-based reform is recommended. © 2014 Public Health Association of Australia.

  10. Using Creative Problem Solving (TRIZ) in Improving the Quality of Hospital Services

    PubMed Central

    LariSemnani, Behrouz; Far, Rafat Mohebbi; Shalipoor, Elham; Mohseni, Mohammad

    2015-01-01

    TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients’ expectations from what seemingly is seen (the design of the hospital) and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design), accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients’ satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering), 25 (self-service), 35 (parameter changes), and 2 (taking out). Furthermore, in addition to these four principles, principle No. 24 (intermediary) was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ’ needs. PMID:25560360

  11. Using creative problem solving (TRIZ) in improving the quality of hospital services.

    PubMed

    LariSemnani, Behrouz; Mohebbi Far, Rafat; Shalipoor, Elham; Mohseni, Mohammad

    2014-08-14

    TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients' expectations from what seemingly is seen (the design of the hospital) and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design), accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients' satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering), 25 (self-service), 35 (parameter changes), and 2 (taking out). Furthermore, in addition to these four principles, principle No. 24 (intermediary) was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ' needs.

  12. Internet-Based Recording Service Solves Maintenance Reporting Problems.

    ERIC Educational Resources Information Center

    Noah, Marilyn

    2001-01-01

    Details the response to a health threat caused by illegal wastewater disposal in Wisconsin. Traces the identification of the problem, ordinances and policies adopted to guide the remedy, and subsequent monitoring of environmental quality. (DDR)

  13. [Continuous quality improvement in anesthesia].

    PubMed

    Gaitini, L; Vaida, S; Madgar, S

    1998-01-01

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

  14. Epidemiological Comparisons of Problems and Positive Qualities Reported by Adolescents in 24 Countries

    ERIC Educational Resources Information Center

    Rescorla, Leslie; Achenbach, Thomas M.; Ivanova, Masha Y.; Dumenci, Levent; Almqvist, Fredrik; Bilenberg, Niels; Bird, Hector; Broberg, Anders; Dobrean, Anca; Dopfner, Manfred; Erol, Nese; Forns, Maria; Hannesdottir, Helga; Kanbayashi, Yasuko; Lambert, Michael C.; Leung, Patrick; Minaei, Asghar; Mulatu, Mesfin S.; Novik, Torunn S.; Oh, Kyung-Ja; Roussos, Alexandra; Sawyer, Michael; Simsek, Zeynep; Steinhausen, Hans-Christoph; Weintraub, Sheila; Metzke, Christa Winkler; Wolanczyk, Tomasz; Zilber, Nelly; Zukauskiene, Rita; Verhulst, Frank

    2007-01-01

    In this study, the authors compared ratings of behavioral and emotional problems and positive qualities on the Youth Self-Report (T. M. Achenbach & L. A. Rescorla, 2001) by adolescents in general population samples from 24 countries (N = 27,206). For problem scales, country effect sizes (ESs) ranged from 3% to 9%, whereas those for gender and age…

  15. Cerebral visual impairment in children: Causes and associated ophthalmological problems.

    PubMed

    Pehere, Niranjan; Chougule, Pratik; Dutton, Gordon N

    2018-06-01

    The aim of this study is to identify common causes, associated ophthalmological abnormalities, and systemic comorbidities in children in Andhra Pradesh, India, with cerebral visual impairment (CVI). A retrospective review of case records of all children aged <16 years with diagnosis of CVI seen between January 2016 and December 2016 was carried out. Data were collected for their age, gender, cause of CVI, refraction, accommodation, anterior and posterior segment examination findings, and systemic problems. A total of 124 patients were identified and studied (80 boys and 44 girls, mean age 5.23 years, 44.8% aged <2 years). The most common causes of CVI were hypoxic-ischemic encephalopathy (HIE) (34.4%), undetermined etiology (32.8%), neonatal seizures, and infantile spasms (16% each). The most common presenting complaints were poor vision (76%) and squint (11.2%). Profound visual impairment was seen in 88.8%, and 11.2% had high functioning CVI. Fifty-eight (46.4%) patients had significant refractive errors, 40 (32.25%) had strabismus, 4 (3.2%) had visually significant cataract, and 40 (32%) had optic atrophy. Motor delay was observed in 39.5%, speech delay was evident in 22.4%, and cognitive delay in 16%. HIE is the most common cause (one-third) of CVI in our population, and the majority of them presented at age <2 years (44.8%) with profound visual impairment (88.8%). A significant number of them have treatable ophthalmic conditions such as refractive errors (46.4%), accommodative insufficiency (12.1%), and cataract (3.2%), and more than one-third of them also have delay in other areas of development.

  16. The Association between Preschool Classroom Quality and Children's Social-Emotional Problems

    ERIC Educational Resources Information Center

    Mohamed, Ahmed Hassan Hemdan; Marzouk, Samah Abd Al Fatah Mohamed

    2016-01-01

    This study examined the association between early childhood classroom quality and preschool children's social skills and emotional problems. Teachers completed the Early Childhood Environmental Rating Scale-Revised (ECERS-R) and the Devereux Early Childhood Assessment-Clinical Form (DECA-C). Participants included 141 preschool children from 10…

  17. Availability and quality of cause-of-death data for estimating the global burden of injuries

    PubMed Central

    Harrison, James E; Shahraz, Saeid; Fingerhut, Lois A

    2010-01-01

    Abstract Objective To assess the availability and quality of global death registration data used for estimating injury mortality. Methods The completeness and coverage of recent national death registration data from the World Health Organization mortality database were assessed. The quality of data on a specific cause of injury death was judged high if fewer than 20% of deaths were attributed to any of several partially specified causes of injury, such as “unspecified unintentional injury”. Findings Recent death registration data were available for 83 countries, comprising 28% of the global population. They included most high-income countries, most countries in Latin America and several in central Asia and the Caribbean. Categories commonly used for partially specified external causes of injury resulting in death included “undetermined intent,” “unspecified mechanism of unintentional injury,” “unspecified road injury” and “unspecified mechanism of homicide”. Only 20 countries had high-quality data. Nevertheless, because the partially specified categories do contain some information about injury mechanisms, reliable estimates of deaths due to specific external causes of injury, such as road injury, suicide and homicide, could be derived for many more countries. Conclusion Only 20 countries had high-quality death registration data that could be used for estimating injury mortality because injury deaths were frequently classified using imprecise partially specified categories. Analytical methods that can derive national estimates of injury mortality from alternative data sources are needed for countries without reliable death registration systems. PMID:21076564

  18. How Root Cause Analysis Can Improve the Value Methodology

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

    Wixson, James Robert

    2002-05-01

    Root cause analysis (RCA) is an important methodology that can be integrated with the VE Job Plan to generate superior results from the VE Methodology. The point at which RCA is most appropriate is after the function analysis and FAST Model have been built and functions for improvement have been chosen. These functions are then subjected to a simple, but, rigorous RCA to get to the root cause of their deficiencies, whether it is high cost/poor value, poor quality, or poor reliability. Once the most probable causes for these problems have been arrived at, better solutions for improvement can bemore » developed in the creativity phase because the team better understands the problems associated with these functions.« less

  19. Source Emissions in Multipollutant Air Quality Management

    EPA Science Inventory

    Human activities and natural processes that emit pollutants into the ambient atmosphere are the underlying cause of all air quality problems. In a technical sense, we refer to these activities and processes as pollutant sources. Although air quality management is usually concerne...

  20. The Quality of High School Students' Problem Solving from an Expertise Development Perspective

    ERIC Educational Resources Information Center

    Elvira, Quincy; Imants, Jeroen; deMaeyer, Sven; Segers, Mien

    2015-01-01

    The ability to solve problems is a key skill and is essential to our day-to-day lives, at home, at school and at work. The present study explores the quality of managerial problem-solving of participants who are in secondary education. We studied 10th, 11th, and 12th graders following a business track in the Netherlands. Participants were asked to…

  1. Overlapping genetic and environmental influences among men's alcohol consumption and problems, romantic quality and social support.

    PubMed

    Salvatore, J E; Prom-Wormley, E; Prescott, C A; Kendler, K S

    2015-08-01

    Alcohol consumption and problems are associated with interpersonal difficulties. We used a twin design to assess in men the degree to which genetic or environmental influences contributed to the covariance between alcohol consumption and problems, romantic quality and social support. The sample included adult male-male twin pairs (697 monozygotic and 487 dizygotic) for whom there were interview-based data on: alcohol consumption (average monthly alcohol consumption in the past year); alcohol problems (lifetime alcohol dependence symptoms); romantic conflict and warmth; friend problems and support; and relative problems and support. Key findings were that genetic and unique environmental factors contributed to the covariance between alcohol consumption and romantic conflict; genetic factors contributed to the covariance between alcohol problems and romantic conflict; and common and unique environmental factors contributed to the covariance between alcohol problems and friend problems. Recognizing and addressing the overlapping genetic and environmental influences that alcohol consumption and problems share with romantic quality and other indicators of social support may have implications for substance use prevention and intervention efforts.

  2. [Problems with Using Hospital Quality Reports as a Secondary Data Source for Health Services Research in Germany].

    PubMed

    Kraska, R A; de Cruppe, W; Geraedts, M

    2017-07-01

    Background Since 2005, German hospitals are required by law to publish structured quality reports (QRs). Because of the detailed data basis, the QRs are being increasingly used for secondary data analyses in health services research. Up until now, methodological difficulties that can cause distorted results of the analyses have essentially been overlooked. The aim of this study is to systematically list the methodological problems associated with using QR and to suggest solution strategies. Methods The QRs from 2006-2012 form the basis of the analyses and were aggregated in a database using an individualized data linkage procedure. Thereafter, a correlation analysis between a quality indicator and the staffing of hospitals was conducted, serving as an example for both cross-sectional as well as longitudinal studies. The resulting methodological problems are described qualitatively and quantitatively, and potential solutions are derived from the statistical literature. Results In each reporting year, 2-15% of the hospitals delivered no QR. In 2-16% of the QRs, it is not recognizable whether a report belongs to a hospital network or a single location. In addition, 6-66% of the location reports falsely contain data from the hospital network. 10% of the hospitals changed their institution code (IC), in 5% of the cases, the same "IC-location-number-combination" was used for different hospitals over the years. Therefore, 10-20% of the QRs cannot be linked with the IC as key variable. As a remedy for the linking of QR, the combination of the IC, the address and the number of beds represents a suitable solution. Using this solution, hospital network reports, location reports and missing reports can be identified and considered in an analysis. Conclusions Secondary data analyses with quality reports provide a high potential for error due to the inconsistent data base and the problems of the data linkage procedure. These can distort calculated parameters and limit the

  3. Social acceptance and quality of life of leprosy patient

    NASA Astrophysics Data System (ADS)

    Eyanoer, P. C.

    2018-03-01

    Some of the leprosy patients facing problems in many aspects such as social, economic, cultural and national security. Both the debilitating effects and disfigurements of leprosy, the society tends to stigmatize negatively those suffering from leprosy. The impact of negative stigma on society causes depression and problems in workplace cause difficulty in patient’s daily life. Neuropathic pain disturbs the quality of life of leprosy patients which could become so severe and significant. The neuropathic pain will lower their productivity which later caused difficulties in finding a job. This study was an analytical observational study to identify the correlation between neuropathic pain and quality of life in Leprosy Hospital of Scanning in Medan Belawan. The result showed that there is a correlation between neuropathic pain and disruption of quality of life (p=0.017). In conclusion, the milder the neuropathic pain experienced by persons with leprosy, the less the quality of life will be disturbed.

  4. The relationship of sleep problems to life quality and depression

    PubMed Central

    Sarıarslan, Hacı A.; Gulhan, Yıldırım B.; Unalan, Demet; Basturk, Mustafa; Delibas, Senol

    2015-01-01

    Objective: To identify the level of depression, the level of life quality, and the relationship between these, in patients applying to sleep centers for various sleep problems. Methods: This cross-sectional study included 229 patients who applied for polysomnography at sleeping centers under supervision of the Neurology and Chest Diseases Clinics of Kayseri Education and Research Hospital, Kayseri, Turkey between June and August 2013. The data collection tools were a socio-demographical data form, Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life Scale (WHOQOL-BREF). For statistical analyses, the Student t-test, Kruskal-Wallis-variant analysis, and chi-square tests were used. Significance level was considered as p<0.05. Results: In our study, patients who were older aged, married, not working, and who had a chronic disease, and a severe depressive symptom were observed to have significantly poorer sleep quality. While patients with any chronic disease had significantly higher scores for total PSQI and depression, their physical, mental, and social WHOQOL-BREF scores were significantly lower. The PSQI total scores, and depression scores of the smoking patients were significantly higher for physical, mental, and social WHOQOL-BREF fields. There was a positive correlation between PSQI scores and BDI scores while there was a negative correlation among BDI, PSQI, and WHOQOL-BREF life quality sub-scale scores. Conclusions: Sleep quality was significantly poorer in patients who were older aged, married, not working, and who had a chronic disease, and a severe depressive symptom. There was a significantly negative correlation among depression, sleep quality, and life quality, while there was a significantly positive correlation between life quality and depression. PMID:26166591

  5. An Investigation Into HPLC Data Quality Problems

    NASA Technical Reports Server (NTRS)

    Hooker, Stanford B.; VanHeukelem, Laurie

    2011-01-01

    This report summarizes the analyses and results produced by a five-member investigative team of Government, university, and industry experts, established by NASA HQ. The team examined data quality problems associated with high performance liquid chromatography (HPLC) analyses of pigment concentrations in seawater samples produced by the San Diego State University (SDSU) Center for Hydro-Optics and Remote Sensing (CHORS). This report shows CHORS did not validate the methods used before placing them into service to analyze field samples for NASA principal investigators (PIs), even though the HPLC literature contained easily accessible method validation procedures, and the importance of implementing them, more than a decade ago. In addition, there were so many sources of significant variance in the CHORS methodologies, that the HPLC system rarely operated within performance criteria capable of producing the requisite data quality. It is the recommendation of the investigative team to a) not correct the data, b) make all the data that was temporarily sequestered available for scientific use, and c) label the affected data with an appropriate warning, e.g., "These data are not validated and should not be used as the sole basis for a scientific result, conclusion, or hypothesis--independent corroborating evidence is required."

  6. Math Problems for Water Quality Control Personnel, Instructor's Manual. Second Edition.

    ERIC Educational Resources Information Center

    Delvecchio, Fred; Brutsch, Gloria

    This document is the instructor's manual for a course in mathematics for water quality control personnel. It is designed so a program may be designed for a specific facility. The problem structures are arranged alphabetically by treatment process. Charts, graphs and/or drawings representing familiar data forms contain the necessary information to…

  7. Adolescent Sleepiness: Causes and Consequences.

    PubMed

    Hansen, Shana L; Capener, Dale; Daly, Christopher

    2017-09-01

    Insufficient sleep duration and poor sleep quality are common among adolescents. The multidimensional causes of insufficient sleep duration and poor sleep quality include biological, health-related, environmental, and lifestyle factors. The most common direct consequence of insufficient and/or poor sleep quality is excessive daytime sleepiness, which may contribute to poor academic performance, behavioral health problems, substance use, and drowsy driving. Evaluation of sleepiness includes a detailed sleep history and sleep diary, with polysomnography only required for the assessment of specific sleep disorders. Management involves encouraging healthy sleep practices such as having consistent bed and wake times, limiting caffeine and electronics at night before bed, and eliminating napping, in addition to treating any existing sleep or medical disorders. [Pediatr Ann. 2017;46(9):e340-e344.]. Copyright 2017, SLACK Incorporated.

  8. Mitigation of Power Quality Problems in Grid-Interactive Distributed Generation System

    NASA Astrophysics Data System (ADS)

    Bhende, C. N.; Kalam, A.; Malla, S. G.

    2016-04-01

    Having an inter-tie between low/medium voltage grid and distributed generation (DG), both exposes to power quality (PQ) problems created by each other. This paper addresses various PQ problems arise due to integration of DG with grid. The major PQ problems are due to unbalanced and non-linear load connected at DG, unbalanced voltage variations on transmission line and unbalanced grid voltages which severely affect the performance of the system. To mitigate the above mentioned PQ problems, a novel integrated control of distribution static shunt compensator (DSTATCOM) is presented in this paper. DSTATCOM control helps in reducing the unbalance factor of PCC voltage. It also eliminates harmonics from line currents and makes them balanced. Moreover, DSTATCOM supplies the reactive power required by the load locally and hence, grid need not to supply the reactive power. To show the efficacy of the proposed controller, several operating conditions are considered and verified through simulation using MATLAB/SIMULINK.

  9. Work stressors, sleep quality, and alcohol-related problems across deployment: A parallel process latent growth modeling approach among Navy members.

    PubMed

    Bravo, Adrian J; Kelley, Michelle L; Hollis, Brittany F

    2017-10-01

    This study examined how work stressors were associated with sleep quality and alcohol-related problems among U.S. Navy members over the course of deployment. Participants were 101 U.S. Navy members assigned to an Arleigh Burke-class destroyer who experienced an 8-month deployment after Operational Enduring Freedom/Operation Iraqi Freedom. Approximately 6 weeks prior to deployment, 6 weeks after deployment, and 6 months reintegration, participants completed measures that assessed work stressors, sleep quality, and alcohol-related problems. A piecewise latent growth model was conducted in which the structural paths assessed if work stressors influenced sleep quality or its growth over time, and in turn if sleep quality influenced alcohol-related problems intercepts or growth over time. A significant indirect effect was found such that increases in work stressors from pre- to postdeployment predicted decreases in sleep quality, which in turn were associated with increases in alcohol-related problems from pre- to postdeployment. These effects were maintained from postdeployment through the 6-month reintegration. Findings suggest that work stressors may have important implications for sleep quality and alcohol-related problems. Positive methods of addressing stress and techniques to improve sleep quality are needed as both may be associated with alcohol-related problems among current Navy members. Copyright © 2016 John Wiley & Sons, Ltd.

  10. 49 CFR 40.269 - What problems cause an alcohol test to be cancelled unless they are corrected?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... cancelled unless they are corrected? 40.269 Section 40.269 Transportation Office of the Secretary of... Testing § 40.269 What problems cause an alcohol test to be cancelled unless they are corrected? As a BAT or STT, or employer, you must cancel an alcohol test if any of the following problems occur, unless...

  11. [Risks and health problems caused by the use of video terminals].

    PubMed

    Tamez González, Silvia; Ortiz-Hernández, Luis; Martínez-Alcántara, Susana; Méndez-Ramírez, Ignacio

    2003-01-01

    To evaluate the association between video display terminal (VDT) use and health hazards, occupational risks, and psychosocial factors, in newspaper workers. A cross-sectional study was conducted in 1998 in a representative sample (n = 68) drawn from a population of 218 VDT operators in Mexico City. Data were collected using a self-administered questionnaire. Data were confirmed by performing physical examinations. The research hypothesis was that both the current and cumulative use of VDT are associated with visual, musculoskeletal system, and skin illnesses, as well as with fatigue and mental or psychosomatic disorders. Occupational health hazards were assessed (visual problems, postural risks, sedentary work, computer mouse use, excessive heat, and overcrowding), as well as psychosocial factors related to work organization (psychological demands, work control, and social support). Prevalence ratios were adjusted for confounding variables like age, sex and schooling. Women were more likely than men to have upper extremity musculoskeletal disorders (MSD), dermatitis, and seborrheic eczema. VDT use was associated with neuro-visual fatigue, upper extremity MSD, dermatitis, and seborrheic eczema. Computer mouse use and postural risks were significantly associated with health problems. Psychosocial factors were mainly associated with mental problems, psychosomatic disorders, and fatigue. Intense use of video screens has been found to cause musculoskeletal disorders of the hand. The diversification of tasks and control of labor processes itself had a protective effect against psychosomatic disorders and pathological fatigue.

  12. MATERNAL INTERACTION QUALITY MODERATES EFFECTS OF PRENATAL MATERNAL EMOTIONAL SYMPTOMS ON GIRLS' INTERNALIZING PROBLEMS.

    PubMed

    Endendijk, Joyce J; De Bruijn, Anouk T C E; Van Bakel, Hedwig J A; Wijnen, Hennie A A; Pop, Victor J M; Van Baar, Anneloes L

    2017-09-01

    The role of mother-infant interaction quality is studied in the relation between prenatal maternal emotional symptoms and child behavioral problems. Healthy pregnant, Dutch women (N = 96, M = 31.6, SD = 3.3) were allocated to the "exposed group" (n = 46), consisting of mothers with high levels of prenatal feelings of anxiety and depression, or the "low-exposed group" (n = 50), consisting of mothers with normal levels of depressive or anxious symptoms during pregnancy. When the children (49 girls, 47 boys) were 23 to 60 months of age (M = 39.0, SD = 9.6), parents completed the Child Behavior Checklist (T.M. Achenbach & L.A. Rescorla, ), and mother-child interaction quality during a home visit was rated using the Emotional Availability Scales. There were no differences in mother-child interaction quality between the prenatally exposed and low-exposed groups. Girls exposed to high prenatal emotional symptoms showed more internalizing problems, if maternal interaction quality was less optimal. No significant effects were found for boys. © 2017 Michigan Association for Infant Mental Health.

  13. Child Reactivity Moderates the Over-Time Association between Mother-Child Conflict Quality and Externalizing Problems

    ERIC Educational Resources Information Center

    Nelson, Jackie A.

    2015-01-01

    Constructive parent-child conflict interactions that teach children to problem-solve and negotiate can enhance children's social adjustment. This paper identifies constructive and destructive qualities of mother-child conflict and explores whether child temperament moderated associations with changes in externalizing problems over time. One…

  14. Parent Beliefs about the Causes of Learning and Developmental Problems among Children with Autism Spectrum Disorder: Results from a National Survey

    ERIC Educational Resources Information Center

    Zuckerman, Katharine E.; Lindly, Olivia J.; Sinche, Brianna

    2016-01-01

    This study aimed to assess variation in parent beliefs about causes of learning and developmental problems in U.S. children with autism spectrum disorder, using data from a nationally representative survey. Results showed that beliefs about a genetic/hereditary cause of learning/developmental problems were most common, but nearly as many parents…

  15. Indoor air quality and health problems associated with damp floor coverings.

    PubMed

    Tuomainen, Anneli; Seuri, Markku; Sieppi, Anne

    2004-04-01

    To study the relationship between a high incidence of bronchial asthma among employees working in an office building and an indoor air problem related to the degradation of polyvinyl chloride (PVC) floor coverings in the building. The indoor air measurements and results of renovations are also described. Employees' symptoms were surveyed by a questionnaire, and the incidence of asthma was calculated from the medical records for 1997-2000. The quality of indoor air was assessed by microbial sampling and by investigation of the building for possible moisture damage. Indoor air was sampled for volatile organic compounds (VOCs) through Tenax adsorbent tubes. In situ volatile emission measurements from the concrete floor were performed via the field and laboratory emission cell (FLEC) method. In an office with approximately 150 employees, eight new cases of asthma were found in 4 years. In addition, the workers complained of respiratory, conjunctival and nasal symptoms. Emissions indicating the degradation of plastic floor coverings (e.g. 2-ethyl-1-hexanol, 1-butanol) were found in the indoor air and floor material samples. The plastic floor coverings, adhesives and the levelling layers were carefully removed from 12 rooms. The VOCs had diffused into the underlying concrete slabs. The concrete was warmed to remove the diffused VOCs from these areas. After the repairs the concentrations of the VOCs indicating the degradation of PVC, decreased, as did the prevalence of the employees' symptoms and several asthma patients' need for medication. The workers in the office building complained of several respiratory, conjunctival and dermal symptoms. The incidence of adult-onset asthma was approximately nine-times higher than that among Finns employed in similar work. The most probable single cause of the indoor air problem was the degradation of the plastic floor coverings.

  16. Eco-innovative design approach: Integrating quality and environmental aspects in prioritizing and solving engineering problems

    NASA Astrophysics Data System (ADS)

    Chakroun, Mahmoud; Gogu, Grigore; Pacaud, Thomas; Thirion, François

    2014-09-01

    This study proposes an eco-innovative design process taking into consideration quality and environmental aspects in prioritizing and solving technical engineering problems. This approach provides a synergy between the Life Cycle Assessment (LCA), the nonquality matrix, the Theory of Inventive Problem Solving (TRIZ), morphological analysis and the Analytical Hierarchy Process (AHP). In the sequence of these tools, LCA assesses the environmental impacts generated by the system. Then, for a better consideration of environmental aspects, a new tool is developed, the non-quality matrix, which defines the problem to be solved first from an environmental point of view. The TRIZ method allows the generation of new concepts and contradiction resolution. Then, the morphological analysis offers the possibility of extending the search space of solutions in a design problem in a systematic way. Finally, the AHP identifies the promising solution(s) by providing a clear logic for the choice made. Their usefulness has been demonstrated through their application to a case study involving a centrifugal spreader with spinning discs.

  17. SCREENING TO IDENTIFY AND PREVENT URBAN STORM WATER PROBLEMS: ESTIMATING IMPERVIOUS AREA ACCURATELY AND INEXPENSIVELY

    EPA Science Inventory

    Complete identification and eventual prevention of urban water quality problems pose significant monitoring, "smart growth" and water quality management challenges. Uncontrolled increase of impervious surface area (roads, buildings, and parking lots) causes detrimental hydrologi...

  18. Male infertility: an overview of causes and treatment options.

    PubMed

    Leaver, Rachel Busuttil

    2016-10-13

    It is estimated that 3.5 million people in the UK, that is one in every seven couples, have fertility problems. In the past, it was assumed that the cause always lay with the woman. However, developments in science brought a greater understanding of the process of sperm production and conception. It is now known that up to 30% of fertility problems may be because of the man alone and up to 90% of these are down to low sperm count or low sperm quality or both. This paper offers a review of the causes and potential factors that affect male fertility together with an overview of diagnosis, investigation and current treatment options for these men.

  19. Reciprocal and Complementary Sibling Interactions, Relationship Quality and Socio-Emotional Problem Solving

    ERIC Educational Resources Information Center

    Karos, Leigh Karavasilis; Howe, Nina; Aquan-Assee, Jasmin

    2007-01-01

    Associations between reciprocal and complementary sibling interactions, sibling relationship quality, and children's socio-emotional problem solving were examined in 40 grade 5-6 children (M age = 11.5 years) from middle class, Caucasian, Canadian families using a multi-method approach (i.e. interviews, self-report questionnaires, daily diary…

  20. 49 CFR 40.267 - What problems always cause an alcohol test to be cancelled?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... always cause an alcohol test to be cancelled? As an employer, a BAT, or an STT, you must cancel an alcohol test if any of the following problems occur. These are “fatal flaws.” You must inform the DER that... the case of a screening test conducted on a saliva ASD or a breath tube ASD: (1) The STT or BAT reads...

  1. Investigation of the Perceived Causes of Pre-Service Physics Teachers' Problems Encountered in School Experience

    ERIC Educational Resources Information Center

    Körhasan, Nilüfer Didis; Didis, M. Gözde

    2015-01-01

    This study investigates a group of pre-service physics teachers' perceptions about the causes of problems in school experience through the attribution theory. The participants were thirteen pre-service physics teachers from a public university in Turkey. Data were collected through the interviews by requesting the participants to reflect their own…

  2. Quality Training and Learning in Aviation: Problems of Alignment

    NASA Technical Reports Server (NTRS)

    Moore, Phillip J.; Lehrer, Henry R.; Telfer, Ross A.

    2001-01-01

    The challenge of producing training programs that lead to quality learning outcomes is ever present in aviation, especially when economic and regulatory pressures are brought into the equation. Previous research by Telfer & Moore (1997) indicates the importance of appropriate alignment of beliefs about learning across all levels of an organization from the managerial level, through the instructor/check and training level, to the pilots and other crew. This paper argues for a central focus on approaches to learning and training that encourage understanding, problem solving and application. Recent research in the area is emphasized as are methods and techniques for enhancing deeper learning.

  3. Causes of cine image quality deterioration in cardiac catheterization laboratories.

    PubMed

    Levin, D C; Dunham, L R; Stueve, R

    1983-10-01

    Deterioration of cineangiographic image quality can result from malfunctions or technical errors at a number of points along the cine imaging chain: generator and automatic brightness control, x-ray tube, x-ray beam geometry, image intensifier, optics, cine camera, cine film, film processing, and cine projector. Such malfunctions or errors can result in loss of image contrast, loss of spatial resolution, improper control of film optical density (brightness), or some combination thereof. While the electronic and photographic technology involved is complex, physicians who perform cardiac catheterization should be conversant with the problems and what can be done to solve them. Catheterization laboratory personnel have control over a number of factors that directly affect image quality, including radiation dose rate per cine frame, kilovoltage or pulse width (depending on type of automatic brightness control), cine run time, selection of small or large focal spot, proper object-intensifier distance and beam collimation, aperture of the cine camera lens, selection of cine film, processing temperature, processing immersion time, and selection of developer.

  4. Role of occupational health services in the assessment and management of indoor air quality problems.

    PubMed

    Carrer, Paolo; Muzi, Giacomo

    2011-01-01

    The role of the occupational health services in the assessment and management of indoor air quality (IAQ) problems in non-industrial sectors (offices, banks, etc.) has been discussed by experts of the ICOH Scientific Committee on IAQ and Health and has been proposed as follow: 1. Collaboration in risk assessment--risk management; 2. Questionnaire survey; 3. Health surveillance (only when periodical health surveillance is already performed for other risks or when specific clinical examination of workers is required); 4. Health promotion (programs for a better IAQ management). A team approach with cooperation between medical and technical experts is recommended in the assessment and management of indoor air quality problems.

  5. The Youth Employment Problem--Dimensions, Causes and Consequences. Research on Youth Employment and Employability Development. Youth Knowledge Development Report 2.9.

    ERIC Educational Resources Information Center

    Freeman, Richard B.; And Others

    This collection of papers on the youth employment problem consists of 15 papers that cover the dimensions, causes, and consequences of youth unemployment and that also focus on problems in measuring the extent of the problem, the dynamic aspects of youth labor force participation, and problems associated with adequately assessing the consequences…

  6. Total Quality Management Analysis of LAMPS MK 1 Aviation Maintenance Data

    DTIC Science & Technology

    1992-06-05

    Qualit Control? The Japanese Way by Dr. Kaoru Ishikawa translated by David J. Lu offers the Japanese version of Total Quality Management. Dr...causes to an effect or problem. It is called the Ishikawa Diagram after its inventor Kaoru Ishikawa , a pioneer in quality control. The name fishbone...pathways involved. 2) Cause and Effect Diagram (also known as an Ishikawa Diagram or a Fishbone Diagram). This diagram used to identify the causes, and

  7. Parent's Guide to School Indoor Air Quality. Revised

    ERIC Educational Resources Information Center

    Healthy Schools Network, Inc., 2012

    2012-01-01

    Air pollution is air pollution, indoors or out. Good indoor air quality (IAQ) contributes to a favorable learning environment for students, protects health, and supports the productivity of school personnel. In schools in poor repair, leaky roofs and crumbling walls have caused additional indoor air quality problems, including contamination with…

  8. Causes of corneal graft failure in India.

    PubMed

    Dandona, L; Naduvilath, T J; Janarthanan, M; Rao, G N

    1998-09-01

    The success of corneal grafting in visual rehabilitation of the corneal blind in India depends on survival of the grafts. Understanding the causes of graft failure may help reduce the risk of failure. We studied these causes in a series of 638 graft failures at our institution. Multivariate logistic regression analysis was used to evaluate the association of particular causes of graft failure with indications for grafting, socioeconomic status, age, sex, host corneal vascularization, donor corneal quality, and experience of surgeon. The major causes of graft failure were allograft rejection (29.2%), increased intraocular pressure (16.9%), infection excluding endophthalmitis (15.4%), and surface problems (12.7%). The odds of infection causing graft failure were significantly higher in patients of lower socioeconomic status (odds ratio 2.45, 95% CI 1.45-4.15). Surface problems as a cause of graft failure was significantly associated with grafts done for corneal scarring or for regrafts (odds ratio 3.36, 95% CI 1.80-6.30). Increased intraocular pressure as a cause of graft failure had significant association with grafts done for aphakic or pseudophakic bullous keratopathy, congenital conditions or glaucoma, or regrafts (odds ratio 2.19, 95% CI 1.25-3.84). Corneal dystrophy was the indication for grafting in 12 of the 13 cases of graft failure due to recurrence of host disease. Surface problems, increased intraocular pressure, and infection are modifiable risk factors that are more likely to cause graft failure in certain categories of patients in India. Knowledge about these associations can be helpful in looking for and aggressively treating these modifiable risk factors in the at-risk categories of corneal graft patients. This can possibly reduce the chance of graft failure.

  9. Sexual Functioning, Beliefs About Sexual Functioning and Quality of Life of Women with Infertility Problems.

    PubMed

    Agustus, Prathibha; Munivenkatappa, Manjula; Prasad, Padmini

    2017-01-01

    The study was conducted in the background of paucity of studies examining the sexual and psychosocial functioning of women with infertility. The study explored sexual functioning in women with infertility problems, their beliefs about sexuality and their quality of life. A single group exploratory design with non-probability purposive sampling was used. A total of 30 participants diagnosed with primary infertility were included in the study. The data were obtained by individual administration of the following tools: Semi-structured interview schedule, Female Sexual Functioning Inventory, Sexual Dysfunctional Beliefs Questionnaire, World Health Organization Quality of Life Scale - BREF Version and General Health Questionnaire-12. The data obtained were analyzed using descriptive statistics and non-parametric tests. About half of the participants had sexual dysfunction. Pain-related problems were most commonly reported (50%). Factors contributing to dysfunction included inadequate knowledge about sex, sexual stimulation and sexual communication. Along with inadequate self-image, negative childhood experiences, financial difficulties and marital discord in parents influenced the perception of self. Majority of the women had dysfunctional beliefs about sexuality (56%), and greater beliefs were found to be in the domain of sexual conservatism. The overall quality of life was poor, and 56% of women experienced psychological distress. There was significant positive correlation between sexual conservatism and experience of pain and overall sexual functioning. Women with infertility bear dysfunctional beliefs and suffer from problems in sexual functioning, have low quality of life and high psychological distress.

  10. Early Childhood Educators' Meta-Cognitive Knowledge of Problem-Solving Strategies and Quality of Childcare Curriculum Implementation

    ERIC Educational Resources Information Center

    Kim, Yeon Ha

    2016-01-01

    This study aims to explore the impact of early childhood educators' meta-cognitive knowledge on the quality of their childcare curriculum implementation, and to gain insights regarding successful problem-solving strategies associated with early education and care. Early childhood educators' implementation of general problem-solving strategies in…

  11. Important knowledge gaps among pastoralists on causes and treatment of udder health problems in livestock in southern Ethiopia: results of qualitative investigation.

    PubMed

    Amenu, Kebede; Szonyi, Barbara; Grace, Delia; Wieland, Barbara

    2017-10-23

    Ethiopia has high prevalences of udder health problems including clinical and subclinical mastitis across production systems in different livestock species. Previous studies on udder health problems have largely focused on identification of mastitis causing microbial pathogens and associated risk factors. However, relatively little is known about the knowledge and beliefs of livestock keepers regarding udder health problems. An understanding of the beliefs on the other hand would facilitate effective communication between livestock keepers and animal health professionals. Therefore, this study aimed at exploring the knowledge and belief surrounding the causes, clinical signs and treatments for udder health problems in (agro-) pastoral communities in southern Ethiopia using qualitative investigation. The result showed that udder health problem, locally known as 'dhukkuba muchaa', which translates to 'disease of teats', was classified into three main types: (1) tick infestation (dirandisa), (2) swelling of udder often with pus discharge (nyaqarsa) and (3) acute mastitis caused by evil eye (buda) with 'bloody milk'. Tick infestation was perceived to directly cause mechanical damage to udder tissue or to resulting in swelling leading to nyaqarsa. Our analysis also revealed the strong misperception that acute and severe swelling of udder was caused by evil eye. According to the pastoralists, cows with large udders in the late pregnancy are prone to evil eye infliction upon giving birth. The pastoralists often treat udder health problems by combining both modern and traditional methods. Removal of ticks by hand and acarcide application were the preferred methods for limiting tick infestation while swelling and evil eye cases were treated with antibiotics (e.g. oxytetracycline). The study also revealed that specific herbs, only known by the herbalists, were used for traditional treatment of udder health. Although this information could not be divulged at the time, it

  12. Root Cause Analysis of Quality Defects Using HPLC-MS Fingerprint Knowledgebase for Batch-to-batch Quality Control of Herbal Drugs.

    PubMed

    Yan, Binjun; Fang, Zhonghua; Shen, Lijuan; Qu, Haibin

    2015-01-01

    The batch-to-batch quality consistency of herbal drugs has always been an important issue. To propose a methodology for batch-to-batch quality control based on HPLC-MS fingerprints and process knowledgebase. The extraction process of Compound E-jiao Oral Liquid was taken as a case study. After establishing the HPLC-MS fingerprint analysis method, the fingerprints of the extract solutions produced under normal and abnormal operation conditions were obtained. Multivariate statistical models were built for fault detection and a discriminant analysis model was built using the probabilistic discriminant partial-least-squares method for fault diagnosis. Based on multivariate statistical analysis, process knowledge was acquired and the cause-effect relationship between process deviations and quality defects was revealed. The quality defects were detected successfully by multivariate statistical control charts and the type of process deviations were diagnosed correctly by discriminant analysis. This work has demonstrated the benefits of combining HPLC-MS fingerprints, process knowledge and multivariate analysis for the quality control of herbal drugs. Copyright © 2015 John Wiley & Sons, Ltd.

  13. Summary of Documentation for DYNA3D-ParaDyn's Software Quality Assurance Regression Test Problems

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

    Zywicz, Edward

    The Software Quality Assurance (SQA) regression test suite for DYNA3D (Zywicz and Lin, 2015) and ParaDyn (DeGroot, et al., 2015) currently contains approximately 600 problems divided into 21 suites, and is a required component of ParaDyn’s SQA plan (Ferencz and Oliver, 2013). The regression suite allows developers to ensure that software modifications do not unintentionally alter the code response. The entire regression suite is run prior to permanently incorporating any software modification or addition. When code modifications alter test problem results, the specific cause must be determined and fully understood before the software changes and revised test answers can bemore » incorporated. The regression suite is executed on LLNL platforms using a Python script and an associated data file. The user specifies the DYNA3D or ParaDyn executable, number of processors to use, test problems to run, and other options to the script. The data file details how each problem and its answer extraction scripts are executed. For each problem in the regression suite there exists an input deck, an eight-processor partition file, an answer file, and various extraction scripts. These scripts assemble a temporary answer file in a specific format from the simulation results. The temporary and stored answer files are compared to a specific level of numerical precision, and when differences are detected the test problem is flagged as failed. Presently, numerical results are stored and compared to 16 digits. At this accuracy level different processor types, compilers, number of partitions, etc. impact the results to various degrees. Thus, for consistency purposes the regression suite is run with ParaDyn using 8 processors on machines with a specific processor type (currently the Intel Xeon E5530 processor). For non-parallel regression problems, i.e., the two XFEM problems, DYNA3D is used instead. When environments or platforms change, executables using the current source code and

  14. Mapping online transportation service quality and multiclass classification problem solving priorities

    NASA Astrophysics Data System (ADS)

    Alamsyah, Andry; Rachmadiansyah, Imam

    2018-03-01

    Online transportation service is known for its accessibility, transparency, and tariff affordability. These points make online transportation have advantages over the existing conventional transportation service. Online transportation service is an example of disruptive technology that change the relationship between customers and companies. In Indonesia, there are high competition among online transportation provider, hence the companies must maintain and monitor their service level. To understand their position, we apply both sentiment analysis and multiclass classification to understand customer opinions. From negative sentiments, we can identify problems and establish problem-solving priorities. As a case study, we use the most popular online transportation provider in Indonesia: Gojek and Grab. Since many customers are actively give compliment and complain about company’s service level on Twitter, therefore we collect 61,721 tweets in Bahasa during one month observations. We apply Naive Bayes and Support Vector Machine methods to see which model perform best for our data. The result reveal Gojek has better service quality with 19.76% positive and 80.23% negative sentiments than Grab with 9.2% positive and 90.8% negative. The Gojek highest problem-solving priority is regarding application problems, while Grab is about unusable promos. The overall result shows general problems of both case study are related to accessibility dimension which indicate lack of capability to provide good digital access to the end users.

  15. Associations of Perceived Sibling and Parent-Child Relationship Quality with Internalizing and Externalizing Problems: Comparing Indian and Dutch Early Adolescents

    ERIC Educational Resources Information Center

    Buist, Kirsten L.; Verhoeven, Marjolein; Hoksbergen, René; ter Laak, Jan; Watve, Sujala; Paranjpe, Analpa

    2017-01-01

    The aims of the present study were (a) to examine whether Dutch and Indian early adolescents differ concerning sibling and parent-child relationship quality and externalizing and internalizing problems, and (b) to compare the associations between sibling and parent-child relationship quality and externalizing and internalizing problems for Indian…

  16. Shiftwork-Mediated Disruptions of Circadian Rhythms and Sleep Homeostasis Cause Serious Health Problems

    PubMed Central

    Duan, Pengfei

    2018-01-01

    Shiftwork became common during the last few decades with the growing demands of human life. Despite the social inactivity and irregularity in habits, working in continuous irregular shifts causes serious health issues including sleep disorders, psychiatric disorders, cancer, and metabolic disorders. These health problems arise due to the disruption in circadian clock system, which is associated with alterations in genetic expressions. Alteration in clock controlling genes further affects genes linked with disorders including major depression disorder, bipolar disorder, phase delay and phase advance sleep syndromes, breast cancer, and colon cancer. A diverse research work is needed focusing on broad spectrum changes caused by jet lag in brain and neuronal system. This review is an attempt to motivate the researchers to conduct advanced studies in this area to identify the risk factors and mechanisms. Its goal is extended to make the shift workers aware about the risks associated with shiftwork. PMID:29607311

  17. Fear of abandonment as a mediator of the relations between divorce stressors and mother-child relationship quality and children's adjustment problems.

    PubMed

    Wolchik, Sharlene A; Tein, Jenn-Yun; Sandler, Irwin N; Doyle, Kathryn W

    2002-08-01

    This study examines whether fear of abandonment mediates the prospective relations between divorce stressors and mother-child relationship quality and adjustment problems of children of divorce. Participants were 216 children, ages 8-12, and their primary residential mothers. Children reported on divorce stressors and fear of abandonment; mothers and children reported on mother-child relationship quality and internalizing and externalizing problems. Structural equation models indicated that Time 1 fear of abandonment mediated the relation between Time 1 divorce stressors and Time 2 internalizing and externalizing problems. Time 1 fear of abandonment also mediated the relation between Time 1 mother-child relationship quality and Time 2 internalizing and externalizing problems. Implications of these results for understanding variability in children's postdivorce adjustment problems and interventions for divorced families are discussed.

  18. Sexual Functioning, Beliefs About Sexual Functioning and Quality of Life of Women with Infertility Problems

    PubMed Central

    Agustus, Prathibha; Munivenkatappa, Manjula; Prasad, Padmini

    2017-01-01

    Background: The study was conducted in the background of paucity of studies examining the sexual and psychosocial functioning of women with infertility. Aims: The study explored sexual functioning in women with infertility problems, their beliefs about sexuality and their quality of life. Settings and Design: A single group exploratory design with non-probability purposive sampling was used. A total of 30 participants diagnosed with primary infertility were included in the study. Materials and Methods: The data were obtained by individual administration of the following tools: Semi-structured interview schedule, Female Sexual Functioning Inventory, Sexual Dysfunctional Beliefs Questionnaire, World Health Organization Quality of Life Scale − BREF Version and General Health Questionnaire-12. The data obtained were analyzed using descriptive statistics and non-parametric tests. Results: About half of the participants had sexual dysfunction. Pain-related problems were most commonly reported (50%). Factors contributing to dysfunction included inadequate knowledge about sex, sexual stimulation and sexual communication. Along with inadequate self-image, negative childhood experiences, financial difficulties and marital discord in parents influenced the perception of self. Majority of the women had dysfunctional beliefs about sexuality (56%), and greater beliefs were found to be in the domain of sexual conservatism. The overall quality of life was poor, and 56% of women experienced psychological distress. There was significant positive correlation between sexual conservatism and experience of pain and overall sexual functioning. Conclusion: Women with infertility bear dysfunctional beliefs and suffer from problems in sexual functioning, have low quality of life and high psychological distress. PMID:29142451

  19. What causes addiction problems? Environmental, biological and constitutional explanations in press portrayals from four European welfare societies.

    PubMed

    Hellman, Matilda; Majamäki, Maija; Rolando, Sara; Bujalski, Michał; Lemmens, Paul

    2015-03-01

    Press items (N = 1327) about addiction related problems were collected from politically independent daily newspapers in Finland, Italy, the Netherlands, and Poland from 1991, 1998, and 2011. A synchronized qualitative coding was performed for discerning the descriptions of the genesis to the problems in terms of described causes to and reasons for why they occur. Environmental explanations were by far the most common and they varied most between the materials. The analysis documents how the portrayals include traces of their contextual origin, relating to different media tasks and welfare cultural traditions. Meaning-based differences were also assigned to the kind of problems that held the most salience in the press reporting. A general worry over societal change is tied into the explanations of accumulating addiction problems and underpins the press reporting in all countries.

  20. On Q: Causing Quality in Higher Education.

    ERIC Educational Resources Information Center

    Seymour, Daniel T.

    This book presents college and university education as a quality-oriented service with students, parents, and legislators as customers demanding quality. It attempts to blend the concept of strategic management of quality in industry with the latest thinking on the administration of higher education. The first chapter discusses the importance of…

  1. Differential susceptibility effects: the interaction of negative emotionality and sibling relationship quality on childhood internalizing problems and social skills.

    PubMed

    Morgan, Judith K; Shaw, Daniel S; Olino, Thomas M

    2012-08-01

    Whereas socialization influences in early childhood have been linked to children's emerging internalizing problems and prosocial behavior, relatively few studies have examined how NE might moderate such associations in both advantageous and maladaptive ways. Furthermore, more research is needed to evaluate the impact of sibling relationships as an influential socialization influence on these child outcomes. In the current study we examined how NE might differentially moderate the associations between quality of relationships with siblings and both internalizing problems and social skills at school entry. NE moderated the effects of positive and destructive sibling relationship quality on child internalizing problems. Specifically, for boys high on NE, more positive sibling relationship quality predicted fewer internalizing problems, but more destructive sibling conflict predicted more internalizing problems. NE also moderated the effects of destructive sibling conflict on child social skills. For boys high on NE, destructive sibling conflict predicted fewer social skills. Boys high on NE appear to show greater susceptibility to the effects of sibling socialization on child outcomes, relative to boys low on NE. The implications of these interactions are discussed with respect to differential susceptibility theory.

  2. Differential Susceptibility Effects: The Interaction of Negative Emotionality and Sibling Relationship Quality on Childhood Internalizing Problems and Social Skills

    PubMed Central

    Shaw, Daniel S.; Olino, Thomas M.

    2012-01-01

    Whereas socialization influences in early childhood have been linked to children’s emerging internalizing problems and prosocial behavior, relatively few studies have examined how NE might moderate such associations in both advantageous and maladaptive ways. Furthermore, more research is needed to evaluate the impact of sibling relationships as an influential socialization influence on these child outcomes. In the current study we examined how NE might differentially moderate the associations between quality of relationships with siblings and both internalizing problems and social skills at school entry. NE moderated the effects of positive and destructive sibling relationship quality on child internalizing problems. Specifically, for boys high on NE, more positive sibling relationship quality predicted fewer internalizing problems, but more destructive sibling conflict predicted more internalizing problems. NE also moderated the effects of destructive sibling conflict on child social skills. For boys high on NE, destructive sibling conflict predicted fewer social skills. Boys high on NE appear to show greater susceptibility to the effects of sibling socialization on child outcomes, relative to boys low on NE. The implications of these interactions are discussed with respect to differential susceptibility theory. PMID:22366882

  3. Causes and Remedies for Errors in International Forest Products Trade Data: Examples from the Hardwood Trade Statistics

    Treesearch

    William G. Luppold; William G. Luppold

    1995-01-01

    The quality of data concerning international hardwood products trade declined in the 1980s because of several problems associated with the collection and processing of individual export transaction records. This note examines the source, impact, and remedies for data problems caused by data screening procedures, nonreporting, recording errors, and alternative...

  4. Indoor Air Quality in Schools: Clean Air Is Good Business.

    ERIC Educational Resources Information Center

    Guarneiri, Michele A.

    2003-01-01

    Describes the effect of poor indoor air quality (IAQ) on student health, the cost of safeguarding good IAQ, the cause of poor IAQ in schools, how to tell whether a school has an IAQ problem, and how the U.S. Environmental Protection Agency can help schools improve indoor air quality though the use of their free "Indoor Air Quality Tools for…

  5. The Quality of Registration of Clinical Trials: Still a Problem

    PubMed Central

    Viergever, Roderik F.; Karam, Ghassan; Reis, Andreas; Ghersi, Davina

    2014-01-01

    Introduction The benefits of clinical trials registration include improved transparency on clinical trials for healthcare workers and patients, increased accountability of trialists, the potential to address publication bias and selective reporting, and possibilities for research collaboration and prioritization. However, poor quality of information in registered records of trials has been found to undermine these benefits in the past. Trialists' increasing experience with trial registration and recent developments in registration systems may have positively affected data quality. This study was conducted to investigate whether the quality of registration has improved. Methods We repeated a study from 2009, using the same methods and the same research team. A random sample of 400 records of clinical trials that were registered between 01/01/2012 and 01/01/2013 was taken from the International Clinical Trials Registry Platform (ICTRP) and assessed for the quality of information on 1) contact details, 2) interventions and 3) primary outcomes. Results were compared to the equivalent assessments from our previous study. Results There was a small and not statistically significant increase from 81.0% to 85.5% in the percentage of records that provided a name of a contact person. There was a significant increase from 68.7% to 74.9% in the number of records that provided either an email address or a telephone number. There was a significant increase from 44.2% to 51.9% in the number of intervention arms that were complete in registering intervention specifics. There was a significant increase from 38.2% to 57.6% in the number of primary outcomes that were specific measures with a meaningful timeframe. Approximately half of all trials continued to be retrospectively registered. Discussion There have been small but significant improvements in the quality of registration since 2009. Important problems with quality remain and continue to constitute an impediment to the

  6. Effect of the patient-to-patient communication model on dysphagia caused by total laryngectomy.

    PubMed

    Tian, L; An, R; Zhang, J; Sun, Y; Zhao, R; Liu, M

    2017-03-01

    The study aimed to evaluate the effect of a patient-to-patient communication model on dysphagia in laryngeal cancer patients after total laryngectomy. Sixty-five patients who had undergone total laryngectomy were randomly divided into three groups: a routine communication group, a patient communication group (that received the patient-to-patient communication model) and a physician communication group. Questionnaires were used to compare quality of life and swallowing problems among all patient groups. The main factors causing dysphagia in total laryngectomy patients were related to fear and mental health. The patient communication group had improved visual analogue scale scores at one week after starting to eat. Quality of life in swallowing disorders questionnaire scores were significantly higher in the patient communication and physician communication groups than in the routine communication group. In addition, swallowing problems were much more severe in patients educated to high school level and above than in others. The patient-to-patient communication model can be used to resolve swallowing problems caused by psychological factors in total laryngectomy patients.

  7. Cause-and-effect mapping of critical events.

    PubMed

    Graves, Krisanne; Simmons, Debora; Galley, Mark D

    2010-06-01

    Health care errors are routinely reported in the scientific and public press and have become a major concern for most Americans. In learning to identify and analyze errors health care can develop some of the skills of a learning organization, including the concept of systems thinking. Modern experts in improving quality have been working in other high-risk industries since the 1920s making structured organizational changes through various frameworks for quality methods including continuous quality improvement and total quality management. When using these tools, it is important to understand systems thinking and the concept of processes within organization. Within these frameworks of improvement, several tools can be used in the analysis of errors. This article introduces a robust tool with a broad analytical view consistent with systems thinking, called CauseMapping (ThinkReliability, Houston, TX, USA), which can be used to systematically analyze the process and the problem at the same time. Copyright 2010 Elsevier Inc. All rights reserved.

  8. The problem of fuzzy cause-specific death rates in mortality context analysis: the case of Panama City.

    PubMed

    Bock, S; Gans, P

    1993-05-01

    In studies of mortality, small and fluctuating numbers of deaths are problems which are caused by infrequent reporting and small spatial unit reporting. To use Panama City as an example, the paper will introduce a Monte Carlo simulation which allows for the analysis of mortality even with small absolute numbers. In addition, Panama City will be used as an example where good medical care is available in every city district, so that social class differences between the districts have a negligible effect on most cause-specific death rates and infant mortality.

  9. Oral impacts on quality of life and problem-oriented attendance among South East London adults.

    PubMed

    Gaewkhiew, Piyada; Bernabé, Eduardo; Gallagher, Jennifer E; Klass, Charlotte; Delgado-Angulo, Elsa K

    2017-04-26

    Dental care seeking behaviour is often driven by symptoms. The value of oral health related quality of life (OHRQoL) measures to predict utilisation of dental services is unknown. This study aims to explore the association between OHRQoL and problem-oriented dental attendance among adults. We analysed cross-sectional data for 705 adults, aged 16 years and above, living in three boroughs of Inner South East London. Data were collected during structured interviews at home. The short form of the Oral Health Impact Profile (OHIP-14) was used to assess the frequency of oral impacts on daily life in the last year. Problem-oriented attendance was defined based on time elapsed since last visit (last 6 months) and reason for that visit (trouble with teeth). The association between OHIP-14 (total and domain) scores and problem-oriented attendance was tested in logistic regression models adjusting for participants' sociodemographic characteristics. Problem-oriented attenders had a higher OHIP-14 total score than regular attenders (6.73 and 3.73, respectively). In regression models, there was a positive association between OHIP-14 total score and problem-oriented attendance. The odds of visiting the dentist for trouble with teeth were 1.07 greater (95% Confidence Interval: 1.04-1.10) per unit increase in the OHIP-14 total score, after adjustment for participants' sociodemographic characteristics. In subsequent analysis by OHIP-14 domains, greater scores in all domains but handicap were significantly associated with problem-oriented attendance. This study shows that oral impacts on quality of life are associated with recent problem-oriented dental attendance among London adults. Six of the seven domains in the OHIP-14 questionnaire were also associated with dental visits for trouble with teeth.

  10. Crying without a cause and being easily upset in two-year-olds: heritability and predictive power of behavioral problems.

    PubMed

    Groen-Blokhuis, Maria M; Middeldorp, Christel M; M van Beijsterveldt, Catharina E; Boomsma, Dorret I

    2011-10-01

    In order to estimate the influence of genetic and environmental factors on 'crying without a cause' and 'being easily upset' in 2-year-old children, a large twin study was carried out. Prospective data were available for ~18,000 2-year-old twin pairs from the Netherlands Twin Register. A bivariate genetic analysis was performed using structural equation modeling in the Mx software package. The influence of maternal personality characteristics and demographic and lifestyle factors was tested to identify specific risk factors that may underlie the shared environment of twins. Furthermore, it was tested whether crying without a cause and being easily upset were predictive of later internalizing, externalizing and attention problems. Crying without a cause yielded a heritability estimate of 60% in boys and girls. For easily upset, the heritability was estimated at 43% in boys and 31% in girls. The variance explained by shared environment varied between 35% and 63%. The correlation between crying without a cause and easily upset (r = .36) was explained both by genetic and shared environmental factors. Birth cohort, gestational age, socioeconomic status, parental age, parental smoking behavior and alcohol use during pregnancy did not explain the shared environmental component. Neuroticism of the mother explained a small proportion of the additive genetic, but not of the shared environmental effects for easily upset. Crying without a cause and being easily upset at age 2 were predictive of internalizing, externalizing and attention problems at age 7, with effect sizes of .28-.42. A large influence of shared environmental factors on crying without a cause and easily upset was detected. Although these effects could be specific to these items, we could not explain them by personality characteristics of the mother or by demographic and lifestyle factors, and we recognize that these effects may reflect other maternal characteristics. A substantial influence of genetic factors

  11. Quality Assessment of Medical Apps that Target Medication-Related Problems.

    PubMed

    Loy, John Shiguang; Ali, Eskinder Eshetu; Yap, Kevin Yi-Lwern

    2016-10-01

    The advent of smartphones has enabled a plethora of medical apps for disease management. As of 2012, there are 40,000 health care-related mobile apps available in the market. Since most of these medical apps do not go through any stringent quality assessment, there is a risk of consumers being misinformed or misled by unreliable information. In this regard, apps that target medication-related problems (MRPs) are not an exception. There is little information on what constitutes quality in apps that target MRPs and how good the existing apps are. To develop a quality assessment tool for evaluating apps that target MRPs and assess the quality of such apps available in the major mobile app stores (iTunes and Google Play). The top 100 free and paid apps in the medical categories of iTunes and Google Play stores (total of 400 apps) were screened for inclusion in the final analysis. English language apps that targeted MRPs were downloaded on test devices to evaluate their quality. Apps intended for clinicians, patients, or both were eligible for evaluation. The quality assessment tool consisted of 4 sections (appropriateness, reliability, usability, privacy), which determined the overall quality of the apps. Apps that fulfilled the inclusion criteria were classified based on the presence of any 1 or more of the 5 features considered important for apps targeting MRPs (monitoring, interaction checker, dose calculator, medication information, medication record). Descriptive statistics and Mann-Whitney tests were used for analysis. Final analysis was based on 59 apps that fulfilled the study inclusion criteria. Apps with interaction checker (66.9%) and monitoring features (54.8%) had the highest and lowest overall qualities. Paid apps generally scored higher for usability than free apps (P = 0.006) but lower for privacy (P = 0.003). Half of the interaction checker apps were unable to detect interactions with herbal medications. Blood pressure and heart rate monitoring apps

  12. Preventing Indoor Air Quality Problems in Educational Facilities: Guidelines for Hot, Humid Climates. Revised.

    ERIC Educational Resources Information Center

    Odom, J. David; DuBose, George

    This manual addresses the errors that occur during new construction that subsequently contribute to indoor air quality (IAQ) problems in newly constructed buildings in hot and humid climates, and offers guidelines for preventing them during the design and construction phases. It defines the roles and responsibilities of the design team, the…

  13. Effect of genes, environment, and lifetime co-occurring disorders on health-related quality of life in problem and pathological gamblers.

    PubMed

    Scherrer, Jeffrey F; Xian, Hong; Shah, Kamini R; Volberg, Rachel; Slutske, Wendy; Eisen, Seth A

    2005-06-01

    Problem and pathological gambling are associated with many impairments in quality of life, including financial, family, legal, and social problems. Gambling disorders commonly co-occur with other psychiatric disorders, such as alcoholism and depression. Although these consequences and correlates have been reported, little is known about the health-related functional impairment associated with gambling. To model differences in the health-related quality of life (HRQoL) among non-problem gamblers, problem gamblers, and pathological gamblers after controlling for lifetime co-occurring substance use disorders, psychiatric disorders, sociodemographics, and genetic and family environmental influences. Cohort and co-twin studies. Nationally distributed community sample. Male twin members of the Vietnam Era Twin Registry: 53 pathological gamblers, 270 subclinical problem gamblers, and 1346 non-problem gamblers (controls). We obtained HRQoL data, via the 8-Item Short-Form Health Survey, from all participants. Data from a subset of twin pairs discordant for gambling behavior was used to control for genetic and family environmental effects on HRQoL and problem gambling. Main Outcome Measure Health-related quality of life. Results from adjusted logistic regression analyses suggest little difference across groups in the physical domains of the health survey; however, for each mental health domain, pathological gamblers had lower HRQoL scores than problem gamblers (P<.05), who in turn had lower scores than non-problem gamblers (P<.05). After controlling for genes and family environment, no significant differences existed between the non-problem gambling twins and their problem or pathological gambling brothers, but adjusted co-twin analyses resulted in statistically significant differences in 4 of 8 subscales. Pathological and problem gambling are associated with significant decrements in HRQoL. This association is partly explained by genetic and family environmental effects and

  14. Problem of data quality and the limitations of the infrastructure approach

    NASA Astrophysics Data System (ADS)

    Behlen, Fred M.; Sayre, Richard E.; Rackus, Edward; Ye, Dingzhong

    1998-07-01

    The 'Infrastructure Approach' is a PACS implementation methodology wherein the archive, network and information systems interfaces are acquired first, and workstations are installed later. The approach allows building a history of archived image data, so that most prior examinations are available in digital form when workstations are deployed. A limitation of the Infrastructure Approach is that the deferred use of digital image data defeats many data quality management functions that are provided automatically by human mechanisms when data is immediately used for the completion of clinical tasks. If the digital data is used solely for archiving while reports are interpreted from film, the radiologist serves only as a check against lost films, and another person must be designated as responsible for the quality of the digital data. Data from the Radiology Information System and the PACS were analyzed to assess the nature and frequency of system and data quality errors. The error level was found to be acceptable if supported by auditing and error resolution procedures requiring additional staff time, and in any case was better than the loss rate of a hardcopy film archive. It is concluded that the problem of data quality compromises but does not negate the value of the Infrastructure Approach. The Infrastructure Approach should best be employed only to a limited extent, and that any phased PACS implementation should have a substantial complement of workstations dedicated to softcopy interpretation for at least some applications, and with full deployment following not long thereafter.

  15. The Effect of an Education Program Utilising PRECEDE Model on the Quality of Life in Patients with Type 2 Diabetes

    ERIC Educational Resources Information Center

    Taghdisi, M. H.; Borhani, M.; Solhi, M.; Afkari, M. E.; Hosseini, F.

    2012-01-01

    Background and objective: The problems caused by diabetes have direct and indirect impacts on the quality of life of diabetic patients. An increase of these problems means a decrease in a patient's quality of life. This study was conducted to assess the effect of the educational programme based on the precede model in promoting quality of life of…

  16. Coping, problem solving, depression, and health-related quality of life in patients receiving outpatient stroke rehabilitation.

    PubMed

    Visser, Marieke M; Heijenbrok-Kal, Majanka H; Spijker, Adriaan Van't; Oostra, Kristine M; Busschbach, Jan J; Ribbers, Gerard M

    2015-08-01

    To investigate whether patients with high and low depression scores after stroke use different coping strategies and problem-solving skills and whether these variables are related to psychosocial health-related quality of life (HRQOL) independent of depression. Cross-sectional study. Two rehabilitation centers. Patients participating in outpatient stroke rehabilitation (N=166; mean age, 53.06±10.19y; 53% men; median time poststroke, 7.29mo). Not applicable. Coping strategy was measured using the Coping Inventory for Stressful Situations; problem-solving skills were measured using the Social Problem Solving Inventory-Revised: Short Form; depression was assessed using the Center for Epidemiologic Studies Depression Scale; and HRQOL was measured using the five-level EuroQol five-dimensional questionnaire and the Stroke-Specific Quality of Life Scale. Independent samples t tests and multivariable regression analyses, adjusted for patient characteristics, were performed. Compared with patients with low depression scores, patients with high depression scores used less positive problem orientation (P=.002) and emotion-oriented coping (P<.001) and more negative problem orientation (P<.001) and avoidance style (P<.001). Depression score was related to all domains of both general HRQOL (visual analog scale: β=-.679; P<.001; utility: β=-.009; P<.001) and stroke-specific HRQOL (physical HRQOL: β=-.020; P=.001; psychosocial HRQOL: β=-.054, P<.001; total HRQOL: β=-.037; P<.001). Positive problem orientation was independently related to psychosocial HRQOL (β=.086; P=.018) and total HRQOL (β=.058; P=.031). Patients with high depression scores use different coping strategies and problem-solving skills than do patients with low depression scores. Independent of depression, positive problem-solving skills appear to be most significantly related to better HRQOL. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. CAUSES OF PROBLEMS IN ANALYZING PE SAMPLES

    EPA Science Inventory

    The U.S. EPA's Environmental Monitoring Systems Laboratory in Las Vegas (EMSL-LV), is responsible for overseeing quality assurance of EPA's Superfund Contract Laboratory Program. n part, this oversight role involves examining QA data provided by the labs in order to investigate p...

  18. Differences in the Rates of Reading Problems in the United States and Japan: A Search for Causes.

    ERIC Educational Resources Information Center

    Furukawa, James M.; Sakamoto, Takahiko

    It is estimated that approximately 15% of the school children in the United States have reading problems, while only about 1% of students in Japan have such difficulties. A joint study was conducted by researchers in the two countries to identify possible causes for this difference. Subjects were 61 Japanese kindergarten students in an urban…

  19. Behavior problems of children in foster care: Associations with foster mothers' representations, commitment, and the quality of mother-child interaction.

    PubMed

    Dubois-Comtois, Karine; Bernier, Annie; Tarabulsy, George M; Cyr, Chantal; St-Laurent, Diane; Lanctôt, Anne-Sophie; St-Onge, Janie; Moss, Ellen; Béliveau, Marie-Julie

    2015-10-01

    This study investigated different environmental and contextual factors associated with maltreated children's adjustment in foster care. Participants included 83 children (52 boys), ages 1-7 years, and their foster caregivers. Quality of interaction with the foster caregiver was assessed from direct observation of a free-play situation; foster caregiver attachment state of mind and commitment toward the child were assessed using two interviews; disruptive behavior symptoms were reported by foster caregivers. Results showed that quality of interaction between foster caregivers and children were associated with behavior problems, such that higher-quality interactions were related to fewer externalizing and internalizing problems. Foster caregivers' state of mind and commitment were interrelated but not directly associated with behavior problems of foster children. Type of placement moderated the association between foster caregiver commitment and foster child behavior problems. Whereas greater foster caregiver commitment was associated with higher levels of adjustment for children in foster families (kin and non-kin), this was not the case in foster-to-adopt families. Finally, the associations between foster child behavior problems and history of maltreatment and placement related-risk conditions fell below significance after considering child age and quality of interaction with the foster caregiver. Findings underscore the crucial contribution of the foster caregiver-child relationship to fostering child adjustment and, thereby, have important implications for clinical services offered to this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. SCREENING TO IDENTIFY AND PREVENT URBAN STORM WATER PROBLEMS: ESTIMATING IMPERVIOUS AREA ACCURATELY AND CHEAPLY

    EPA Science Inventory

    Complete identification and eventual prevention of urban/suburban water quality problems pose significant monitoring challenges. Uncontrolled growth of impervious surfaces (roads, buildings and parking) causes detrimental hydrologic changes, stream channel erosion, habitat degra...

  1. Six Sigma Approach to Improve Stripping Quality of Automotive Electronics Component – a case study

    NASA Astrophysics Data System (ADS)

    Razali, Noraini Mohd; Murni Mohamad Kadri, Siti; Con Ee, Toh

    2018-03-01

    Lacking of problem solving skill techniques and cooperation between support groups are the two obstacles that always been faced in actual production line. Inadequate detail analysis and inappropriate technique in solving the problem may cause the repeating issues which may give impact to the organization performance. This study utilizes a well-structured six sigma DMAIC with combination of other problem solving tools to solve product quality problem in manufacturing of automotive electronics component. The study is concentrated at the stripping process, a critical process steps with highest rejection rate that contribute to the scrap and rework performance. The detail analysis is conducted in the analysis phase to identify the actual root cause of the problem. Then several improvement activities are implemented and the results show that the rejection rate due to stripping defect decrease tremendously and the process capability index improved from 0.75 to 1.67. This results prove that the six sigma approach used to tackle the quality problem is substantially effective.

  2. The Role of Marital Quality and Spousal Support in Behaviour Problems of Children with and without Intellectual Disability

    ERIC Educational Resources Information Center

    Wieland, N.; Baker, B. L.

    2010-01-01

    Background: Children with intellectual disability (ID) have been found to be at an increased risk for developing behavioural problems. The purpose of this study was to examine the relationship between the marital domain, including marital quality and spousal support, and behaviour problems in children with and without ID. Methods: The relationship…

  3. 49 CFR 40.201 - What problems always cause a drug test to be cancelled and may result in a requirement for...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... cancelled and may result in a requirement for another collection? 40.201 Section 40.201 Transportation... TESTING PROGRAMS Problems in Drug Tests § 40.201 What problems always cause a drug test to be cancelled and may result in a requirement for another collection? As the MRO, you must cancel a drug test when a...

  4. Why Bother with Beliefs? Examining Relationships between Race/Ethnicity, Parental Beliefs about Causes of Child Problems, and Mental Health Service Use

    ERIC Educational Resources Information Center

    Yeh, May; McCabe, Kristen; Hough, Richard L.; Lau, Anna; Fakhry, Fatme; Garland, Ann

    2005-01-01

    In this study, the authors examined the role of parental beliefs about the causes of child problems in predicting later mental health service use in a large, diverse population of at-risk youths. Study hypotheses were that parental beliefs consistent with biopsychosocial causes would be associated with later mental health service use;…

  5. Quality of data in multiethnic health surveys.

    PubMed Central

    Pasick, R. J.; Stewart, S. L.; Bird, J. A.; D'Onofrio, C. N.

    2001-01-01

    OBJECTIVE: There has been insufficient research on the influence of ethno-cultural and language differences in public health surveys. Using data from three independent studies, the authors examine methods to assess data quality and to identify causes of problematic survey questions. METHODS: Qualitative and quantitative methods were used in this exploratory study, including secondary analyses of data from three baseline surveys (conducted in English, Spanish, Cantonese, Mandarin, and Vietnamese). Collection of additional data included interviews with investigators and interviewers; observations of item development; focus groups; think-aloud interviews; a test-retest assessment survey; and a pilot test of alternatively worded questions. RESULTS: The authors identify underlying causes for the 12 most problematic variables in three multiethnic surveys and describe them in terms of ethnic differences in reliability, validity, and cognitive processes (interpretation, memory retrieval, judgment formation, and response editing), and differences with regard to cultural appropriateness and translation problems. CONCLUSIONS: Multiple complex elements affect measurement in a multiethnic survey, many of which are neither readily observed nor understood through standard tests of data quality. Multiethnic survey questions are best evaluated using a variety of quantitative and qualitative methods that reveal different types and causes of problems. PMID:11889288

  6. Indoor Air Quality Problem Solving Tool

    EPA Pesticide Factsheets

    Use the IAQ Problem Solving Tool to learn about the connection between health complaints and common solutions in schools. This resource provides an easy, step-by-step process to start identifying and resolving IAQ problems found at your school.

  7. 49 CFR 40.201 - What problems always cause a drug test to be cancelled and may result in a requirement for...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false What problems always cause a drug test to be cancelled and may result in a requirement for another collection? 40.201 Section 40.201 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Problems in Drug Tests § 40.201 Wha...

  8. Utility-based quality of life in mothers of children with behaviour problems: A population-based study.

    PubMed

    Le, Ha Nd; Gulenc, Alisha; Gold, Lisa; Sarkadi, Anna; Ukoumunne, Obioha C; Bayer, Jordana; Wake, Melissa; Hiscock, Harriet

    2016-12-01

    To examine the relationship between mothers' health-related quality of life (HRQoL) and child behaviour problems at age 2 years. To investigate whether the relationship between maternal HRQoL and child behaviour problems is independent of maternal mental health. Cross-sectional survey nested within a population-level, cluster randomised trial, which aims to prevent early child behaviour problems. One hundred and sixty mothers of 2-year-old children, in nine local government areas in Victoria, Australia. HRQoL was measured using the Assessment of Quality of Life 6D and child behaviour was measured using the child behaviour checklist (CBCL/1.5-5 years). Maternal mental health was measured using the Depression Anxiety Stress Scale. Data were collected at child age 2 years; demographic data were collected at child age 8 months. HRQoL was lower for mothers with children that had borderline/clinical behaviour problems compared to those with children without problems (mean difference -0.14, 95% confidence interval (CI): -0.16 to -0.12, P < 0.001). The finding did not markedly change when adjusting for household income, financial security, child gender, child temperament and intervention group status at child age 8 months (mean difference -0.12, 95% CI: -0.15 to -0.09, P < 0.001), but did attenuate when additionally adjusting for concurrent maternal mental health (mean difference -0.03, 95% CI: -0.05 to -0.02, P < 0.001). Child behaviour problems were associated with lower maternal HRQoL. Child behaviour problems prevention programmes could consider this association with maternal HRQoL and be designed to improve and report both mothers' and their child's health and wellbeing. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  9. Feeding problems of infants and toddlers

    PubMed Central

    Bernard-Bonnin, Anne-Claude

    2006-01-01

    OBJECTIVE To propose a diagnostic and therapeutic approach to feeding problems in early childhood. QUALITY OF EVIDENCE Articles were retrieved through a MEDLINE search from January 1990 to December 2005 using the MeSH terms eating disorders, infant, and child. Recommended practice is based mainly on levels II and III evidence. MAIN MESSAGE Feeding problems are classified under structural abnormalities, neurodevelopmental disabilities, and behavioural disorders, with overlap between categories. A medical approach also needs an evaluation of diet and an assessment of the interaction between parent and child. Treating medical or surgical conditions, increasing caloric intake, and counseling about general nutrition can alleviate mild to moderate problems. More complicated cases should be referred to multidisciplinary teams. Behavioural therapy aims to foster appropriate behaviour and discourage maladaptive behaviour. CONCLUSION Feeding problems in early childhood often have multifactorial causes and a substantial behavioural component. Family physicians have a key role in detecting problems, offering advice, managing mildly to moderately severe cases, and referring more complicated cases to multidisciplinary teams. PMID:17279184

  10. Comparison of Decisions Quality of Heuristic Methods with Limited Depth-First Search Techniques in the Graph Shortest Path Problem

    NASA Astrophysics Data System (ADS)

    Vatutin, Eduard

    2017-12-01

    The article deals with the problem of analysis of effectiveness of the heuristic methods with limited depth-first search techniques of decision obtaining in the test problem of getting the shortest path in graph. The article briefly describes the group of methods based on the limit of branches number of the combinatorial search tree and limit of analyzed subtree depth used to solve the problem. The methodology of comparing experimental data for the estimation of the quality of solutions based on the performing of computational experiments with samples of graphs with pseudo-random structure and selected vertices and arcs number using the BOINC platform is considered. It also shows description of obtained experimental results which allow to identify the areas of the preferable usage of selected subset of heuristic methods depending on the size of the problem and power of constraints. It is shown that the considered pair of methods is ineffective in the selected problem and significantly inferior to the quality of solutions that are provided by ant colony optimization method and its modification with combinatorial returns.

  11. [Current situations and problem analysis of influencing factors of traditional Chinese medicine tablets on forming quality].

    PubMed

    Li, Yan-Nian; Wu, Zhen-Feng; Wan, Na; Li, Yuan-Hui; Li, Hui-Ting; Yang, Ming

    2018-04-01

    The compressibility of tablets is the essential operating unit during the preparation of traditional Chinese medicine tablets, as well as a complicated process. Therefore, it is of great significance to comprehensively study the influencing factors on the formation process. This paper aimed to review the evaluation methods for the tablet forming quality and highlight the effects of material powder properties, excipients and preparation technology on the quality of traditional Chinese medicine tablets on the basis of relevant literatures. Furthermore, the common problems in tablet forming process are also analyzed to provide useful references for the development of tablet forming quality of traditional Chinese medicines. Copyright© by the Chinese Pharmaceutical Association.

  12. Mexico City air quality research initiative. Volume 2, Problem definition, background, and summary of prior research

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

    Not Available

    1994-06-01

    Air pollution in Mexico City has increased along with the growth of the city, the movement of its population, and the growth of employment created by industry. The main cause of pollution in the city is energy consumption. Therefore, it is necessary to take into account the city`s economic development and its prospects when considering the technological relationships between well-being and energy consumption. Air pollution in the city from dust and other particles suspended in the air is an old problem. However, pollution as we know it today began about 50 years ago with the growth of industry, transportation, andmore » population. The level of well-being attained in Mexico City implies a high energy use that necessarily affects the valley`s natural air quality. However, the pollution has grown so fast that the City must act urgently on three fronts: first, following a comprehensive strategy, transform the economic foundation of the city with nonpolluting activities to replace the old industries, second, halt pollution growth through the development of better technologies; and third, use better fuels, emission controls, and protection of wooded areas.« less

  13. Modelling voltage sag mitigation using dynamic voltage restorer and analyzing power quality issue

    NASA Astrophysics Data System (ADS)

    Ismail, Nor Laili; Hidzir, Hizrin Dayana Mohd; Thanakodi, Suresh; Nazar, Nazatul Shiema Moh; Ibrahim, Pungut; Ali, Che Ku Muhammad Sabri Che Ku

    2018-02-01

    Power quality problem which are arise due to a fault or a pulsed load can have caused an interruption of critical load. The modern power systems are becoming more sensitive to the quality of the power supplied by the utility company. Voltage sags and swells, flicker, interruptions, harmonic distortion and other distortion to the sinusoidal waveform are the examples of the power quality problems. The most affected due to these problems is industrial customers who use a lot of sensitive equipment. There has suffered a huge loss to these problems. Resulting of broken or damage equipment if voltage sag exceeds the sensitive threshold of the equipment. Thus, device such as Static Synchronous Compensator (STATCOM) and Dynamic Voltage Restorer (DVR) has been created to solve this problem among users. DVR is a custom power device that most effective and efficient. This paper intended to report the DVR operations during voltage sag compensation.

  14. [Cause-of-death statistics and ICD, quo vadis?

    PubMed

    Eckert, Olaf; Vogel, Ulrich

    2018-07-01

    The International Statistical Classification of Diseases and Related Health Problems (ICD) is the worldwide binding standard for generating underlying cause-of-death statistics. What are the effects of former revisions of the ICD on underlying cause-of-death statistics and which opportunities and challenges are becoming apparent in a possible transition process from ICD-10 to ICD-11?This article presents the calculation of the exploitation grade of ICD-9 and ICD-10 in the German cause-of-death statistics and quality of documentation. Approximately 67,000 anonymized German death certificates are processed by Iris/MUSE and official German cause-of-death statistics are analyzed.In addition to substantial changes in the exploitation grade in the transition from ICD-9 to ICD-10, regional effects become visible. The rate of so-called "ill-defined" conditions exceeds 10%.Despite substantial improvement of ICD revisions there are long-known deficits in the coroner's inquest, filling death certificates and quality of coding. To make better use of the ICD as a methodological framework for mortality statistics and health reporting in Germany, the following measures are necessary: 1. General use of Iris/MUSE, 2. Establishing multiple underlying cause-of-death statistics, 3. Introduction of an electronic death certificate, 4. Improvement of the medical assessment of cause of death.Within short time the WHO will release the 11th revision of the ICD that will provide additional opportunities for the development of underlying cause-of-death statistics and their use in science, public health and politics. A coordinated effort including participants in the process and users is necessary to meet the related challenges.

  15. Quality Circles: Involvement, Problem-Solving, and Recognition.

    ERIC Educational Resources Information Center

    Moretz, H. Lynn

    1983-01-01

    The media production department of Central Piedmont Community College (CPCC) began quality circle meetings in January 1981 after studying the process of quality circles and obtaining the understanding and support of the college administration. A quality circle is a small group of people doing similar work who voluntarily meet on a regular basis to…

  16. Warm Dry Weather Conditions Cause of 2016 Fort McMurray Wild Forest Fire and Associated Air Quality

    NASA Astrophysics Data System (ADS)

    de Azevedo, S. C.; Singh, R. P.; da Silva, E. A., Sr.

    2016-12-01

    The climate change is evident from the increasing temperature around the world, day to day life and increasing frequency of natural hazards. The warm and dry conditions are the cause of frequent forest fires around the globe. Forest fires severely affect the air quality and human health. Multi sensor satellites and dense network of ground stations provide information about vegetation health, meteorological, air quality and atmospheric parameters. We have carried out detailed analysis of satellite and ground data of wild forest fire that occurred in May 2016 in Fort McMurray, Alberta, Canada. This wild forest fire destroyed 10 per cent of Fort McMurray's housing and forced more than 90,000 people to evacuate the surrounding areas. Our results show that the warm and dry conditions with low rainfall were the cause of Fort McMurray wild fire. The air quality parameters (particulate matter, CO, ozone, NO2, methane) and greenhouse gases measured from Atmospheric Infrared Sounder (AIRS) satellite show enhanced levels soon after the forest fire. The emissions from the forest fire affected health of population living in surrounding areas up to 300 km radius.

  17. [From gene to disease; genetic causes of hearing loss and visual impairment sometimes accompanied by vestibular problems (Usher syndrome)].

    PubMed

    Pennings, R J E; Kremer, H; Deutman, A F; Kimberling, W J; Cremers, C W R J

    2002-12-07

    Usher syndrome is an autosomal recessively inherited disease, characterised by sensorineural hearing loss, tapetoretinal degeneration and in some cases vestibular problems. Based on the clinical heterogeneity, the disease can be classified into three clinical types (I, II and III), which have their own genetic subtypes (Usher 1A-Usher IG, Usher 2A-Usher 2C and Usher 3). The majority of the Usher type I cases are caused by mutations in the MYO7A gene (Usher 1B) while mutations in the USH2A gene (Usher 2A) are the cause of most cases of type II. Usher syndrome type III, caused by mutations in the USH3 gene, is frequently seen only in Finland.

  18. Gifted Middle School Students' Achievement and Perceptions of Science Classroom Quality during Problem-Based Learning

    ERIC Educational Resources Information Center

    Horak, Anne K.; Galluzzo, Gary R.

    2017-01-01

    The purpose of this study was to explore the effect of problem-based learning (PBL) on student achievement and students' perceptions of classroom quality. A group of students taught using PBL and a comparison group of students taught using traditional instruction were studied. A total of 457 students participated in the study. Pre- and…

  19. Lower limb atherosclerotic disease causes various deteriorations of patients' health-related quality of life.

    PubMed

    Koivunen, Kirsi; Lukkarinen, Hannele

    2006-12-01

    Lower limb atherosclerotic disease (LLAD) is a worldwide health problem. Approximately 100,000 Finns have LLAD. Currently, a large number of health-related quality of life (HRQoL) studies are available, but we still have scant comprehensive information of HRQoL of patients with LLAD. The aim was to describe the HRQoL of women and men with LLAD in relation to the age- and sex-matched general population. In addition, the purpose was to study which demographic and relevant clinical and psychologic factors are connected with HRQoL of patients with LLAD. Patients with LLAD (N = 180, 62 women and 118 men) were recruited to participate in this study in the Clinic of Surgery, Oulu University Hospital, from 2001 to 2004. The control sample consisted of an age- and sex-matched general population (N = 2126; 1081 women and 1045 men). The HRQoL of the women and men with LLAD was evaluated using the Nottingham Health Profile (NHP) instrument, in relation to an age- and sex-matched general population (N = 2126) as well as demographic and relevant clinical and psychologic factors. The HRQoL of men was significantly (P < .05) poorer on all dimensions of the NHP instrument in the age groups 55 to 74 years. HRQoL was also clearly affected in the youngest age group of men on the dimensions of pain (P < .05) and mobility (P < .05) and further in the oldest age group on the dimension of energy (P < .05). The HRQoL of women with LLAD was only significantly poorer (P < .05) on the dimension of pain in the age group of 65 to 74 years than the HRQoL of age-matched Finnish women. The most emphasized relationships between poor HRQoL and the demographic, relevant clinical and psychologic factors were male sex, lack of exercise, retirement, a short painless walking distance, other atherosclerotic disease, poor subjective health status, problems with ability to cope at home, problems with the treatment of illness, and sex life. Male patients with LLAD had poorer HRQoL than the corresponding

  20. Decreased health-related quality of life in patients with diabetic foot problems.

    PubMed

    Sothornwit, Jin; Srisawasdi, Gulapar; Suwannakin, Atchara; Sriwijitkamol, Apiradee

    2018-01-01

    The aim of this study was to investigate health-related quality of life (HRQoL) in patients with diabetic foot problems and compare the HRQoL between diabetic patients with: 1) diabetic foot problems (DF), including diabetic foot ulcer (DFU) or amputation (AMPU); 2) other diabetic complications (COM), such as diabetic retinopathy (DR), end-stage renal disease (ESRD), or coronary artery disease (CAD); and 3) no diabetic complication (CON). A total of 254 diabetic patients were studied in a cross-sectional setting. HRQoL was evaluated using Thai version of the Euro Quality of Life Questionnaire (EuroQoL), with five dimensions and five-level scale (EQ-5D-5L). Utility scores were calculated using time trade-off methods. A total of 141 patients in the DF group (98 DFU and 43 AMPU groups), 82 in the COM group (27 DR, 28 ESRD, and 27 CAD groups), and 31 in the CON group were interviewed. The mean age was 63.2±12.1 years, body mass index was 24.9±4.7 kg/m 2 , mean hemoglobin A1c was 7.7±2.1%, duration of diabetes was 13.1±9.9 years, and the mean utility scores were 0.799±0.25. After having DF, 21% of patients had lost their jobs. The COM group had lower utility scores than the CON group. Among the diabetic complications, the DF group had the lowest mean utility scores as compared to the COM and CON groups (0.703±0.28 in the DF group, 0.903±0.15 in the COM group, and 0.961±0.06 in the CON group, P <0.01). There was no difference in the mean utility scores between DFU and AMPU groups. Patients in the DF group reported moderate-to-severe problem in all dimensions more than the other groups. DF have the greatest negative impact on HRQoL. Therefore, diabetic foot care should be emphasized in clinical practice to prevent foot complications.

  1. Can hospital audit teams identify case management problems, analyse their causes, identify and implement improvements? A cross-sectional process evaluation of obstetric near-miss case reviews in Benin.

    PubMed

    Borchert, Matthias; Goufodji, Sourou; Alihonou, Eusèbe; Delvaux, Thérèse; Saizonou, Jacques; Kanhonou, Lydie; Filippi, Véronique

    2012-10-11

    Obstetric near-miss case reviews are being promoted as a quality assurance intervention suitable for hospitals in low income countries. We introduced such reviews in five district, regional and national hospitals in Benin, West Africa. In a cross-sectional study we analysed the extent to which the hospital audit teams were able to identify case management problems (CMPs), analyse their causes, agree on solutions and put these solutions into practice. We analysed case summaries, women's interview transcripts and audit minutes produced by the audit teams for 67 meetings concerning one woman with near-miss complications each. We compared the proportion of CMPs identified by an external assessment team to the number found by the audit teams. For the latter, we described the CMP causes identified, solutions proposed and implemented by the audit teams. Audit meetings were conducted regularly and were well attended. Audit teams identified half of the 714 CMPs; they were more likely to find managerial ones (71%) than the ones relating to treatment (30%). Most identified CMPs were valid. Almost all causes of CMPs were plausible, but often too superficial to be of great value for directing remedial action. Audit teams suggested solutions, most of them promising ones, for 38% of the CMPs they had identified, but recorded their implementation only for a minority (8.5%). The importance of following-up and documenting the implementation of solutions should be stressed in future audit interventions. Tools facilitating the follow-up should be made available. Near-miss case reviews hold promise, but their effectiveness to improve the quality of care sustainably and on a large scale still needs to be established.

  2. Can hospital audit teams identify case management problems, analyse their causes, identify and implement improvements? A cross-sectional process evaluation of obstetric near-miss case reviews in Benin

    PubMed Central

    2012-01-01

    Background Obstetric near-miss case reviews are being promoted as a quality assurance intervention suitable for hospitals in low income countries. We introduced such reviews in five district, regional and national hospitals in Benin, West Africa. In a cross-sectional study we analysed the extent to which the hospital audit teams were able to identify case management problems (CMPs), analyse their causes, agree on solutions and put these solutions into practice. Methods We analysed case summaries, women’s interview transcripts and audit minutes produced by the audit teams for 67 meetings concerning one woman with near-miss complications each. We compared the proportion of CMPs identified by an external assessment team to the number found by the audit teams. For the latter, we described the CMP causes identified, solutions proposed and implemented by the audit teams. Results Audit meetings were conducted regularly and were well attended. Audit teams identified half of the 714 CMPs; they were more likely to find managerial ones (71%) than the ones relating to treatment (30%). Most identified CMPs were valid. Almost all causes of CMPs were plausible, but often too superficial to be of great value for directing remedial action. Audit teams suggested solutions, most of them promising ones, for 38% of the CMPs they had identified, but recorded their implementation only for a minority (8.5%). Conclusions The importance of following-up and documenting the implementation of solutions should be stressed in future audit interventions. Tools facilitating the follow-up should be made available. Near-miss case reviews hold promise, but their effectiveness to improve the quality of care sustainably and on a large scale still needs to be established. PMID:23057707

  3. Sorting and recycling of domestic waste. Review of occupational health problems and their possible causes.

    PubMed

    Poulsen, O M; Breum, N O; Ebbehøj, N; Hansen, A M; Ivens, U I; van Lelieveld, D; Malmros, P; Matthiasen, L; Nielsen, B H; Nielsen, E M

    1995-05-19

    In order to reduce the strain on the environment from the deposition of waste in landfills and combustion at incineration plants, several governments throughout the industrialized world have planned greatly increased recycling of domestic waste by the turn of the millennium. To implement the plans, new waste recycling facilities are to be built and the number of workers involved in waste sorting and recycling will increase steadily during the next decade. Several studies have reinforced the hypothesis that exposure to airborne microorganisms and the toxic products thereof are important factors causing a multitude of health problems among workers at waste sorting and recycling plants. Workers at transfer stations, landfills and incineration plants may experience an increased risk of pulmonary disorders and gastrointestinal problems. High concentrations of total airborne dust, bacteria, faecal coliform bacteria and fungal spores have been reported. The concentrations are considered to be sufficiently high to cause adverse health effects. In addition, a high incidence of lower back injuries, probably due to heavy lifting during work, has been reported among workers at landfills and incineration plants. Workers involved in manual sorting of unseparated domestic waste, as well as workers at compost plants experience more or less frequent symptoms of organic dust toxic syndrome (ODTS) (cough, chest-tightness, dyspnoea, influenza-like symptoms such as chills, fever, muscle ache, joint pain, fatigue and headache), gastrointestinal problems such as nausea and diarrhoea, irritation of the skin, eye and mucous membranes of the nose and upper airways, etc. In addition cases of severe occupational pulmonary diseases (asthma, alveolitis, bronchitis) have been reported. Manual sorting of unseparated domestic waste may be associated with exposures to large quantities of airborne bacteria and endotoxin. Several work functions in compost plants can result in very high exposure to

  4. The role of marital quality and spousal support in behaviour problems of children with and without intellectual disability.

    PubMed

    Wieland, Natalie; Baker, B L

    2010-07-01

    Children with intellectual disability (ID) have been found to be at an increased risk for developing behavioural problems. The purpose of this study was to examine the relationship between the marital domain, including marital quality and spousal support, and behaviour problems in children with and without ID. The relationship between the marital domain and child behaviour problems was examined in 132 families of 6-year-olds with and without ID. Using hierarchical regression, these relationships were also studied over time from child ages 6-8 years. Child behaviour problems were assessed with mother-reported Child Behavior Checklist. The marital domain was measured using the Dyadic Adjustment Scale-7 and the Spousal Support and Agreement Scale. Mother-reported parenting stress and observed parenting practices were tested as potential mediators of the relationship between the marital domain and child behaviour problems. Mean levels of the marital domain were not significantly different between typically developing (TD) and ID groups, but there were significantly greater levels of variance in reported marital quality in the ID group at ages 6, 7 and 8. The marital domain score at child age 6 years predicted child behaviour problems at age 8 for the TD group only. This predictive relationship appeared to be a unidirectional effect, as child behaviour problems at age 6 were not found to predict levels of the marital domain at age 8. Parenting stress partially mediated this relationship for the TD group. The marital domain may have a greater impact on behavioural outcomes for TD children. Implications for future research and interventions are discussed.

  5. Longitudinal Associations between Externalizing Problems and Student-Teacher Relationship Quality for Young Children with ASD

    ERIC Educational Resources Information Center

    Eisenhower, Abbey S.; Blacher, Jan; Bush Hurst, Hillary

    2015-01-01

    The associations between student-teacher relationship (STR) quality and externalizing behavior problems in school were examined among 166 children with ASD (82% boys, ages 4-7 years) across three assessments over a 1.5-year period; IQs in the sample range from 50 to 139 (M = 88.7). Unlike other non-ASD populations, the association between STR…

  6. The population problem: conceptions and misconceptions.

    PubMed

    Berelson, B

    1971-01-01

    Only 1 in about 110 sex acts results in a conception and 1 in 270 in a live birth. Of all conceptions, 40% result in live births, 5% in stillbirths, and 55% never develop. 1/3 of all known conceptions ends in abortion, spontaneous or induced. It appears that the population problem depends on a small fraction of the potential. Misconceptions of the problem are corrected, and it is emphasized that while no social problem facing the U.S. would be easier with a larger population, demographic factors do not cause all of the other problems. Increasing numbers are not as important as the rate of increase (2% annually worldwide). Today's population problem has been caused by a decreased death rate, not an increased birthrate. There are 2 kinds of countries in the world today: those with a high standard of living and low fertility and those with a low standard of living and high fertility. Most of the uninformed women of the world would not choose to have large numbers of children if they had a choice. Population density is not a problem in itself. Experts disagree, but it is improbable that large numbers of people will die of starvation in the next few decades. Environmental deterioration is more the result of modern economic and technological practices than of demographic factors. Efforts at fertility control are not aimed at minorities in this country and elsewhere. The poor are discriminated against in access to family planning services and abortion. Moslems of developing countries have higher fertility rates than Roman Catholics in developed countries. There would be many social costs if the U.S. were to achieve zero population growth in the near future. The population problem has implications for the future quality of life.

  7. Relations of parenting quality, interparental conflict, and overnights with mental health problems of children in divorcing families with high legal conflict.

    PubMed

    Sandler, Irwin N; Wheeler, Lorey A; Braver, Sanford L

    2013-12-01

    The current study examined the associations between child mental health problems and the quality of maternal and paternal parenting, and how these associations were moderated by three contextual factors: quality of parenting by the other parent, interparental conflict, and the number of overnights parents had with the child. Data for the current study came from a sample of divorcing families who are in high legal conflict over developing or maintaining a parenting plan following divorce. Analyses revealed that the associations between child mental health problems and positive maternal and paternal parenting were moderated by the quality of parenting provided by the other parent and by the number of overnights children spent with parents, but not by the level of interparental conflict. When parenting by the other parent and number of overnights were considered together in the same model, only number of overnights moderated the relations between parenting and child-behavior problems. The results support the proposition that the well-being of children in high-conflict divorcing families is better when they spend adequate time with at least one parent who provides high-quality parenting.

  8. Relations of Parenting Quality, Interparental Conflict, and Overnights with Mental Health Problems of Children in Divorcing Families with High Legal Conflict

    PubMed Central

    Sandler, Irwin N.; Wheeler, Lorey A.; Braver, Sanford L.

    2013-01-01

    The current study examined the associations between child mental health problems and the quality of maternal and paternal parenting, and how these associations were moderated by three contextual factors, quality of parenting by the other parent, interparental conflict, and the number of overnights parents had with the child. Data for the current study come from a sample of divorcing families who are in high legal conflict over developing or maintaining a parenting plan following divorce. Analyses revealed that the associations between child mental health problems and positive maternal and paternal parenting were moderated by the quality of parenting provided by the other parent and by the number of overnights children spent with parents, but not by the level of interparental conflict. When both parenting by the other parent and number of overnights were considered in the same model, only number of overnights moderated the relations between parenting and child behavior problems. The results support the proposition that the well-being of children in high conflict divorcing families is better when they spend adequate time with at least one parent who provides high quality parenting. PMID:24098960

  9. Fuel cells provide a revenue-generating solution to power quality problems

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

    King, J.M. Jr.

    Electric power quality and reliability are becoming increasingly important as computers and microprocessors assume a larger role in commercial, health care and industrial buildings and processes. At the same time, constraints on transmission and distribution of power from central stations are making local areas vulnerable to low voltage, load addition limitations, power quality and power reliability problems. Many customers currently utilize some form of premium power in the form of standby generators and/or UPS systems. These include customers where continuous power is required because of health and safety or security reasons (hospitals, nursing homes, places of public assembly, air trafficmore » control, military installations, telecommunications, etc.) These also include customers with industrial or commercial processes which can`t tolerance an interruption of power because of product loss or equipment damage. The paper discusses the use of the PC25 fuel cell power plant for backup and parallel power supplies for critical industrial applications. Several PC25 installations are described: the use of propane in a PC25; the use by rural cooperatives; and a demonstration of PC25 technology using landfill gas.« less

  10. Benchmarking strategies for measuring the quality of healthcare: problems and prospects.

    PubMed

    Lovaglio, Pietro Giorgio

    2012-01-01

    Over the last few years, increasing attention has been directed toward the problems inherent to measuring the quality of healthcare and implementing benchmarking strategies. Besides offering accreditation and certification processes, recent approaches measure the performance of healthcare institutions in order to evaluate their effectiveness, defined as the capacity to provide treatment that modifies and improves the patient's state of health. This paper, dealing with hospital effectiveness, focuses on research methods for effectiveness analyses within a strategy comparing different healthcare institutions. The paper, after having introduced readers to the principle debates on benchmarking strategies, which depend on the perspective and type of indicators used, focuses on the methodological problems related to performing consistent benchmarking analyses. Particularly, statistical methods suitable for controlling case-mix, analyzing aggregate data, rare events, and continuous outcomes measured with error are examined. Specific challenges of benchmarking strategies, such as the risk of risk adjustment (case-mix fallacy, underreporting, risk of comparing noncomparable hospitals), selection bias, and possible strategies for the development of consistent benchmarking analyses, are discussed. Finally, to demonstrate the feasibility of the illustrated benchmarking strategies, an application focused on determining regional benchmarks for patient satisfaction (using 2009 Lombardy Region Patient Satisfaction Questionnaire) is proposed.

  11. Understanding sleep problems in children with epilepsy: Associations with quality of life, Attention-Deficit Hyperactivity Disorder and maternal emotional symptoms.

    PubMed

    Ekinci, Ozalp; Isik, Uğur; Gunes, Serkan; Ekinci, Nuran

    2016-08-01

    This study aimed to (1) compare sleep problems between children and adolescents with epilepsy and non-epileptic controls, and (2) examine whether there is an association between sleep problems and quality of life, Attention-Deficit Hyperactivity Disorder (ADHD) and mothers' emotional symptoms. Fifty-three patients from a cohort of epilepsy (aged 7-18 years) and 28 controls with minor medical problems (aged 7-18 years) were included. Parents completed Children's Sleep Habits Questionnaire (CSHQ) and Kinder Lebensqualitätsfragebogen: Children's Quality of Life Questionnaire-revised (KINDL-R) for patients and controls. Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) parent and teacher forms were used to assess ADHD symptoms for patients. Mothers of the patients completed Beck Depression Inventory and State-Trait Anxiety Inventory (STAI). Neurology clinic charts were reviewed for the epilepsy-related variables. Children with epilepsy had a higher CSHQ Total score than the control group. Those with a CSHQ score >56 (which indicates moderate to severe sleep problems) had lower scores on KINDL-R. Parent-rated T-DSM-IV-S Total and Hyperactivity-Impulsivity scores, STAI trait and Beck scores were found to be higher in those with a CSHQ score >56. Significant positive correlations were found between CSHQ Total score and T-DSM-IV-S, STAI trait and Beck scores. Binary logistic regression analysis revealed that T-DSM-IV-S Total, Inattention and Hyperactivity-Impulsivity scores were significantly associated with a higher CSHQ Total score. None of the epilepsy-related variables were found to be related with the CSHQ Total score. Among children with epilepsy, sleep problems lead to a poor quality of life. The link between sleep problems and psychiatric symptoms must be conceptualized as a bilateral relationship. ADHD appears to be the strongest predictor of sleep problems. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights

  12. Seed germination test for toxicity evaluation of compost: Its roles, problems and prospects.

    PubMed

    Luo, Yuan; Liang, Jie; Zeng, Guangming; Chen, Ming; Mo, Dan; Li, Guoxue; Zhang, Difang

    2018-01-01

    Compost is commonly used for the growth of plants and the remediation of environmental pollution. It is important to evaluate the quality of compost and seed germination test is a powerful tool to examine the toxicity of compost, which is the most important aspect of the quality. Now the test is widely adopted, but the main problem is that the test results vary with different methods and seed species, which limits the development and application of it. The standardization of methods and the modelization of seeds can contribute to solving the problem. Additionally, according to the probabilistic theory of seed germination, the error caused by the analysis and judgment methods of the test results can be reduced. Here, we reviewed the roles, problems and prospects of the seed germination test in the studies of compost. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Motility problems in the intellectually challenged child, adolescent, and young adult.

    PubMed

    Martinelli, Massimo; Staiano, Annamaria

    2011-12-01

    Gastrointestinal (GI) motility problems represent an important cause of morbidity and sometimes mortality in patients affected by developmental disorders. This article describes motility disorders in Down syndrome, cerebral palsy, familial dysautonomia, and Williams syndrome. These problems do not often receive appropriate attention, either because priority is given to other medical aspects of the disorder, or because of the inability of affected children to communicate their symptoms. A better approach to the diagnosis and treatment of GI disorders is required to improve quality of life and minimize morbidity and mortality among patients with developmental disorders.

  14. Total Quality Training: The Quality Culture and Quality Trainer.

    ERIC Educational Resources Information Center

    Thomas, Brian

    This book examines the application of total quality management (TQM) principles to training and development. It contains 10 chapters on the following topics: the quality revolution (the nature of and rationale for quality); major barriers to achieving quality (supplier-led approaches, problems with customers, throughput orientation, variable…

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

    PubMed

    Eklund, J A

    1999-01-01

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

  16. In Defense of Educators: The Problem of Idea Quality, Not "Teacher Quality"

    ERIC Educational Resources Information Center

    Hirsch, E. D., Jr.

    2017-01-01

    People who emphasize teaching quality and the central importance of teachers are right to do so. Where some go wrong is in thinking that teacher quality is an innate characteristic. The effectiveness of a teacher is not some inherent competence, as the phrase "teacher quality" suggests. Teacher effectiveness is contextual. Why has the…

  17. Towards High-Quality Reflective Learning amongst Law Undergraduate Students: Analysing Students' Reflective Journals during a Problem-Based Learning Course

    ERIC Educational Resources Information Center

    Rué, Joan; Font, Antoni; Cebrián, Gisela

    2013-01-01

    There is wide agreement that problem-based learning is a key strategy to promote individual abilities for "learning how to learn". This paper presents the main contributions that reflective journals and the problem-based learning approach can make to foster professional knowledge and quality learning in higher education. Thirty-six…

  18. Musculoskeletal system problems and quality of life of mothers of children with cerebral palsy with different levels of disability.

    PubMed

    Kavlak, Erdoğan; Altuğ, Filiz; Büker, Nihal; Şenol, Hande

    2015-01-01

    The objective of this study is to investigate musculoskeletal system problems and quality of life of mothers of children with cerebral palsy with different levels of disability. 100 children (37 girls and 63 boys) with cerebral palsy (CP) and their mothers were included in this study. Functional levels of children with CP were assessed by using the Gross Motor Function Classification System (GMFCS) and the Pediatric Functional Independence Measure (WeeFIM). Quality of life of mothers regarding health was assessed by using the Nottingham Health Profile (NHP). Musculoskeletal system problems of mothers were assessed by using the Neck Disability Index (NDI) and the Roland-Morris Disability Questionnaire (RMDQ). No statistical significance was found when GMFCS levels of children with CP and the NHP, DASH-T, RMDQ, NDI and the BAE values of mothers were compared in an inter-group way (p> 0.05). When the NHP parameters and the existence of lower and arm pains of mothers were compared with their BAI, NDI, RMDQ and DASH-T scores, a statistically significant relationship was found among them (p< 0.05). As functional levels of children with CP get worse, upper extremity, lower back and neck problems and anxiety levels of mothers increase and this situation negatively affects mothers' quality of life.

  19. Dealing with the Criterion Problem by Measuring the Quality and Quantity of Creative Activity and Accomplishment

    ERIC Educational Resources Information Center

    Paek, Sue Hyeon; Runco, Mark A.

    2017-01-01

    The criterion problem was one of the focal points of early studies of creativity, but several useful criteria have been developed in the last few decades. The investigation reported here represents additional progress. This report (a) describes a new quality of creative achievement index for each domain of the Creative Activity and Accomplishment…

  20. Problems with using the normal distribution--and ways to improve quality and efficiency of data analysis.

    PubMed

    Limpert, Eckhard; Stahel, Werner A

    2011-01-01

    The gaussian or normal distribution is the most established model to characterize quantitative variation of original data. Accordingly, data are summarized using the arithmetic mean and the standard deviation, by mean ± SD, or with the standard error of the mean, mean ± SEM. This, together with corresponding bars in graphical displays has become the standard to characterize variation. Here we question the adequacy of this characterization, and of the model. The published literature provides numerous examples for which such descriptions appear inappropriate because, based on the "95% range check", their distributions are obviously skewed. In these cases, the symmetric characterization is a poor description and may trigger wrong conclusions. To solve the problem, it is enlightening to regard causes of variation. Multiplicative causes are by far more important than additive ones, in general, and benefit from a multiplicative (or log-) normal approach. Fortunately, quite similar to the normal, the log-normal distribution can now be handled easily and characterized at the level of the original data with the help of both, a new sign, x/, times-divide, and notation. Analogous to mean ± SD, it connects the multiplicative (or geometric) mean mean * and the multiplicative standard deviation s* in the form mean * x/s*, that is advantageous and recommended. The corresponding shift from the symmetric to the asymmetric view will substantially increase both, recognition of data distributions, and interpretation quality. It will allow for savings in sample size that can be considerable. Moreover, this is in line with ethical responsibility. Adequate models will improve concepts and theories, and provide deeper insight into science and life.

  1. Walking Problems

    MedlinePlus

    ... as Parkinson's disease Diseases such as arthritis or multiple sclerosis Vision or balance problems Treatment of walking problems depends on the cause. Physical therapy, surgery, or mobility aids may help.

  2. Reproducibility of Mammography Units, Film Processing and Quality Imaging

    NASA Astrophysics Data System (ADS)

    Gaona, Enrique

    2003-09-01

    The purpose of this study was to carry out an exploratory survey of the problems of quality control in mammography and processors units as a diagnosis of the current situation of mammography facilities. Measurements of reproducibility, optical density, optical difference and gamma index are included. Breast cancer is the most frequently diagnosed cancer and is the second leading cause of cancer death among women in the Mexican Republic. Mammography is a radiographic examination specially designed for detecting breast pathology. We found that the problems of reproducibility of AEC are smaller than the problems of processors units because almost all processors fall outside of the acceptable variation limits and they can affect the mammography quality image and the dose to breast. Only four mammography units agree with the minimum score established by ACR and FDA for the phantom image.

  3. Guidelines for Controlling Indoor Air Quality Problems Associated with Kilns, Copiers, and Welding in Schools. Technical Bulletin.

    ERIC Educational Resources Information Center

    Turner, Ronald W.; And Others

    Guidelines for controlling indoor air quality problems associated with kilns, copiers, and welding in schools are provided in this document. Individual sections on kilns, duplicating equipment, and welding operations contain information on the following: sources of contaminants; health effects; methods of control; ventilation strategies; and…

  4. Rotation length based on a time series analysis of timber degrade cause by oak borers

    Treesearch

    Richard P. Guyette; Rose-Marie Muzika; Aaron Stevenson

    2007-01-01

    Recent outbreaks of red oak borer (Enaphalodes rufulus Haldeman) are causing unprecedented economic devaluation of red oak timber in many areas of the Ozarks in the Midwestern United States. Managers have few guidelines for coping with this problem in the long-term. Here we present a retrospective analysis of degrade in wood quality and value focused...

  5. The integration of FMEA with other problem solving tools: A review of enhancement opportunities

    NASA Astrophysics Data System (ADS)

    Ng, W. C.; Teh, S. Y.; Low, H. C.; Teoh, P. C.

    2017-09-01

    Failure Mode Effect Analysis (FMEA) is one the most effective and accepted problem solving (PS) tools for most of the companies in the world. Since FMEA was first introduced in 1949, practitioners have implemented FMEA in various industries for their quality improvement initiatives. However, studies have shown that there are drawbacks that hinder the effectiveness of FMEA for continuous quality improvement from product design to manufacturing. Therefore, FMEA is integrated with other PS tools such as inventive problem solving methodology (TRIZ), Quality Function Deployment (QFD), Root Cause Analysis (RCA) and seven basic tools of quality to address the drawbacks. This study begins by identifying the drawbacks in FMEA. A comprehensive literature review on the integration of FMEA with other tools is carried out to categorise the integrations based on the drawbacks identified. The three categories are inefficiency of failure analysis, psychological inertia and neglect of customers’ perspective. This study concludes by discussing the gaps and opportunities in the integration for future research.

  6. Environmental Problems, Causes, and Solutions: An Open Question

    ERIC Educational Resources Information Center

    Negev, Maya; Garb, Yaakov; Biller, Roni; Sagy, Gonen; Tal, Alon

    2010-01-01

    In a national evaluation of environmental literacy in Israel, (Negev, Sagy, Garb, Salzberg, & Tal, 2008), the authors included both multiple choice questions and open questions. In this article the authors describe the qualitative analysis of the answers to an open question regarding a local environmental problem. Most participants specified…

  7. Decreased health-related quality of life in patients with diabetic foot problems

    PubMed Central

    Sothornwit, Jin; Srisawasdi, Gulapar; Suwannakin, Atchara; Sriwijitkamol, Apiradee

    2018-01-01

    Purpose The aim of this study was to investigate health-related quality of life (HRQoL) in patients with diabetic foot problems and compare the HRQoL between diabetic patients with: 1) diabetic foot problems (DF), including diabetic foot ulcer (DFU) or amputation (AMPU); 2) other diabetic complications (COM), such as diabetic retinopathy (DR), end-stage renal disease (ESRD), or coronary artery disease (CAD); and 3) no diabetic complication (CON). Patients and methods A total of 254 diabetic patients were studied in a cross-sectional setting. HRQoL was evaluated using Thai version of the Euro Quality of Life Questionnaire (EuroQoL), with five dimensions and five-level scale (EQ-5D-5L). Utility scores were calculated using time trade-off methods. Results A total of 141 patients in the DF group (98 DFU and 43 AMPU groups), 82 in the COM group (27 DR, 28 ESRD, and 27 CAD groups), and 31 in the CON group were interviewed. The mean age was 63.2±12.1 years, body mass index was 24.9±4.7 kg/m2, mean hemoglobin A1c was 7.7±2.1%, duration of diabetes was 13.1±9.9 years, and the mean utility scores were 0.799±0.25. After having DF, 21% of patients had lost their jobs. The COM group had lower utility scores than the CON group. Among the diabetic complications, the DF group had the lowest mean utility scores as compared to the COM and CON groups (0.703±0.28 in the DF group, 0.903±0.15 in the COM group, and 0.961±0.06 in the CON group, P<0.01). There was no difference in the mean utility scores between DFU and AMPU groups. Patients in the DF group reported moderate-to-severe problem in all dimensions more than the other groups. Conclusion DF have the greatest negative impact on HRQoL. Therefore, diabetic foot care should be emphasized in clinical practice to prevent foot complications. PMID:29563821

  8. Benchmarking Strategies for Measuring the Quality of Healthcare: Problems and Prospects

    PubMed Central

    Lovaglio, Pietro Giorgio

    2012-01-01

    Over the last few years, increasing attention has been directed toward the problems inherent to measuring the quality of healthcare and implementing benchmarking strategies. Besides offering accreditation and certification processes, recent approaches measure the performance of healthcare institutions in order to evaluate their effectiveness, defined as the capacity to provide treatment that modifies and improves the patient's state of health. This paper, dealing with hospital effectiveness, focuses on research methods for effectiveness analyses within a strategy comparing different healthcare institutions. The paper, after having introduced readers to the principle debates on benchmarking strategies, which depend on the perspective and type of indicators used, focuses on the methodological problems related to performing consistent benchmarking analyses. Particularly, statistical methods suitable for controlling case-mix, analyzing aggregate data, rare events, and continuous outcomes measured with error are examined. Specific challenges of benchmarking strategies, such as the risk of risk adjustment (case-mix fallacy, underreporting, risk of comparing noncomparable hospitals), selection bias, and possible strategies for the development of consistent benchmarking analyses, are discussed. Finally, to demonstrate the feasibility of the illustrated benchmarking strategies, an application focused on determining regional benchmarks for patient satisfaction (using 2009 Lombardy Region Patient Satisfaction Questionnaire) is proposed. PMID:22666140

  9. The Impact of Coexisting Emotional and Conduct Problems on Family Functioning and Quality of Life Among Adolescents With ADHD.

    PubMed

    Schei, Jorun; Jozefiak, Thomas; Nøvik, Torunn Stene; Lydersen, Stian; Indredavik, Marit S

    2016-05-01

    The aim of this study was to assess the impact of self-reported emotional and conduct problems on family functioning and quality of life (QoL) among adolescents with ADHD. The ADHD group (N = 194) was divided into the following groups: without additional emotional or conduct problems, with emotional problems, with conduct problems, and with both problem types. The cross-sectional study included parent and adolescent reports. Adolescents with ADHD and both problem types reported significantly lower QoL and family functioning than all other ADHD groups. Parents reported better QoL for the ADHD group without additional problems, but similar family functioning for all groups. A higher level of coexisting psychiatric problems had a significant impact on adolescents' reports of family functioning and QoL. However, coexisting problems showed no association with parent reports of family functioning. Adolescents with ADHD might add important information in clinical assessment. © The Author(s) 2013.

  10. PACS quality control and automatic problem notifier

    NASA Astrophysics Data System (ADS)

    Honeyman-Buck, Janice C.; Jones, Douglas; Frost, Meryll M.; Staab, Edward V.

    1997-05-01

    One side effect of installing a clinical PACS Is that users become dependent upon the technology and in some cases it can be very difficult to revert back to a film based system if components fail. The nature of system failures range from slow deterioration of function as seen in the loss of monitor luminance through sudden catastrophic loss of the entire PACS networks. This paper describes the quality control procedures in place at the University of Florida and the automatic notification system that alerts PACS personnel when a failure has happened or is anticipated. The goal is to recover from a failure with a minimum of downtime and no data loss. Routine quality control is practiced on all aspects of PACS, from acquisition, through network routing, through display, and including archiving. Whenever possible, the system components perform self and between platform checks for active processes, file system status, errors in log files, and system uptime. When an error is detected or a exception occurs, an automatic page is sent to a pager with a diagnostic code. Documentation on each code, trouble shooting procedures, and repairs are kept on an intranet server accessible only to people involved in maintaining the PACS. In addition to the automatic paging system for error conditions, acquisition is assured by an automatic fax report sent on a daily basis to all technologists acquiring PACS images to be used as a cross check that all studies are archived prior to being removed from the acquisition systems. Daily quality control is preformed to assure that studies can be moved from each acquisition and contrast adjustment. The results of selected quality control reports will be presented. The intranet documentation server will be described with the automatic pager system. Monitor quality control reports will be described and the cost of quality control will be quantified. As PACS is accepted as a clinical tool, the same standards of quality control must be established

  11. The quality-value proposition in health care.

    PubMed

    Feazell, G Landon; Marren, John P

    2003-01-01

    Powerful forces are converging in US health care to finally cause recognition of the inherently logical relationship between quality and money. The forces, or marketplace "drivers," which are converging to compel recognition of the relationship between cost and quality are: (1) the increasing costs of care; (2) the recurrence of another medical malpractice crisis; and (3) the recognition inside and outside of health care that quality is inconsistent and unacceptable. It is apparent that hospital administrators, financial officers, board members, and medical staff leadership do not routinely do two things: (1) relate quality to finance; and (2) appreciate the intra-hospital structural problems that impede quality attainment. This article discusses these factors and offers a positive method for re-structuring quality efforts and focusing the hospital and its medical staff on quality. The simple but compelling thesis of the authors is that health care must immediately engage in the transformation to making quality of medical care the fundamental business strategy of the organization.

  12. Spatiotemporal influence of temperature, air quality, and urban environment on cause-specific mortality during hazy days.

    PubMed

    Ho, Hung Chak; Wong, Man Sing; Yang, Lin; Shi, Wenzhong; Yang, Jinxin; Bilal, Muhammad; Chan, Ta-Chien

    2018-03-01

    Haze is an extreme weather event that can severely increase air pollution exposure, resulting in higher burdens on human health. Few studies have explored the health effects of haze, and none have investigated the spatiotemporal interaction between temperature, air quality and urban environment that may exacerbate the adverse health effects of haze. We investigated the spatiotemporal pattern of haze effects and explored the additional effects of temperature, air pollution and urban environment on the short-term mortality risk during hazy days. We applied a Poisson regression model to daily mortality data from 2007 through 2014, to analyze the short-term mortality risk during haze events in Hong Kong. We evaluated the adverse effect on five types of cause-specific mortality after four types of haze event. We also analyzed the additional effect contributed by the spatial variability of urban environment on each type of cause-specific mortality during a specific haze event. A regular hazy day (lag 0) has higher all-cause mortality risk than a day without haze (odds ratio: 1.029 [1.009, 1.049]). We have also observed high mortality risks associated with mental disorders and diseases of the nervous system during hazy days. In addition, extreme weather and air quality contributed to haze-related mortality, while cold weather and higher ground-level ozone had stronger influences on mortality risk. Areas with a high-density environment, lower vegetation, higher anthropogenic heat, and higher PM 2.5 featured stronger effects of haze on mortality than the others. A combined influence of haze, extreme weather/air quality, and urban environment can result in extremely high mortality due to mental/behavioral disorders or diseases of the nervous system. In conclusion, we developed a data-driven technique to analyze the effects of haze on mortality. Our results target the specific dates and areas with higher mortality during haze events, which can be used for development of

  13. Simple Solutions to Complex Problems: Moral Panic and the Fluid Shift from "Equity" to "Quality" in Education

    ERIC Educational Resources Information Center

    Mockler, Nicole

    2014-01-01

    Education is increasingly conceptualised by governments and policymakers in western democracies in terms of productivity and human capital, emphasising elements of individualism and competition over concerns around democracy and equity. More and more, solutions to intransigent educational problems related to equity are seen in terms of quality and…

  14. Gender-Related Quality of Parent-Child Interactions and Early Adolescent Problem Behaviors: Exploratory Study with Midwestern Samples

    ERIC Educational Resources Information Center

    Spoth, Richard; Neppl, Tricia; Goldberg-Lillehoj, Catherine; Jung, Tony; Ramisetty-Mikler, Suhasini

    2006-01-01

    This article reports two exploratory studies testing a model guided by a social interactional perspective, positing an inverse relation between the quality of parent-child interactions and adolescent problem behaviors. It addresses mixed findings in the literature related to gender differences. Study 1 uses cross-sectional survey data from…

  15. Group problems in problem-based learning.

    PubMed

    Hendry, Graham D; Ryan, Greg; Harris, Jennifer

    2003-11-01

    Successful small-group learning in problem-based learning (PBL) educational programmes relies on functional group processes. However, there has been limited research on PBL group problems, and no studies have been conducted on problems as perceived by both students and tutors in the same educational context. The authors investigated PBL group problems in a graduate-entry medical programme, and report the most common group problems, and those that hinder students' learning the most. The possible causes of individual quietness and dominant behaviour, and potential influences that group problems may have on the tutorial process are summarized in an exploratory model of PBL group dysfunction that could be used to guide further research. Specifically, there is a need for further evidence on which to base guidelines for tutors and students to effectively manage group problems.

  16. Quality of ground water in Idaho

    USGS Publications Warehouse

    Yee, Johnson J.; Souza, William R.

    1987-01-01

    The major aquifers in Idaho are categorized under two rock types, sedimentary and volcanic, and are grouped into six hydrologic basins. Areas with adequate, minimally adequate, or deficient data available for groundwater-quality evaluations are described. Wide variations in chemical concentrations in the water occur within individual aquifers, as well as among the aquifers. The existing data base is not sufficient to describe fully the ground-water quality throughout the State; however, it does indicate that the water is generally suitable for most uses. In some aquifers, concentrations of fluoride, cadmium, and iron in the water exceed the U.S. Environmental Protection Agency's drinking-water standards. Dissolved solids, chloride, and sulfate may cause problems in some local areas. Water-quality data are sparse in many areas, and only general statements can be made regarding the areal distribution of chemical constituents. Few data are available to describe temporal variations of water quality in the aquifers. Primary concerns related to special problem areas in Idaho include (1) protection of water quality in the Rathdrum Prairie aquifer, (2) potential degradation of water quality in the Boise-Nampa area, (3) effects of widespread use of drain wells overlying the eastern Snake River Plain basalt aquifer, and (4) disposal of low-level radioactive wastes at the Idaho National Engineering Laboratory. Shortcomings in the ground-water-quality data base are categorized as (1) multiaquifer sample inadequacy, (2) constituent coverage limitations, (3) baseline-data deficiencies, and (4) data-base nonuniformity.

  17. Predictive value of general movements' quality in low-risk infants for minor neurological dysfunction and behavioural problems at preschool age.

    PubMed

    Bennema, Anne N; Schendelaar, Pamela; Seggers, Jorien; Haadsma, Maaike L; Heineman, Maas Jan; Hadders-Algra, Mijna

    2016-03-01

    General movement (GM) assessment is a well-established tool to predict cerebral palsy in high-risk infants. Little is known on the predictive value of GM assessment in low-risk populations. To assess the predictive value of GM quality in early infancy for the development of the clinically relevant form of minor neurological dysfunction (complex MND) and behavioral problems at preschool age. Prospective cohort study. A total of 216 members of the prospective Groningen Assisted Reproductive Techniques (ART) cohort study were included in this study. ART did not affect neurodevelopmental outcome of these relatively low-risk infants born to subfertile parents. GM quality was determined at 2 weeks and 3 months. At 18 months and 4 years, the Hempel neurological examination was used to assess MND. At 4 years, parents completed the Child Behavior Checklist; this resulted in the total problem score (TPS), internalizing problem score (IPS), and externalizing problem score (EPS). Predictive values of definitely (DA) and mildly (MA) abnormal GMs were calculated. DA GMs at 2 weeks were associated with complex MND at 18 months and atypical TPS and IPS at 4 years (all p<0.05). Sensitivity and positive predictive value of DA GMs at 2 weeks were rather low (13%-60%); specificity and negative predictive value were excellent (92%-99%). DA GMs at 3 months occurred too infrequently to calculate prediction. MA GMs were not associated with outcome. GM quality as a single predictor for complex MND and behavioral problems at preschool age has limited clinical value in children at low risk for developmental disorders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Adolescent Problem Behavior and Problem Driving in Young Adulthood

    ERIC Educational Resources Information Center

    Bingham, C. Raymond; Shope, Jean T.

    2004-01-01

    Motor vehicle crashes are the leading cause of death among drivers younger than age 35, making problem driving behavior among young drivers a significant public concern. Effective intervention requires a better understanding of the antecedents of problem driving. Problem behavior theory, social control theory, and Kandel's model of substance use…

  19. A Study of the Causes of Physical and Emotional Problems Encountered by Older Women Returning to Secretarial Employment After A Prolonged Absence. Final Report.

    ERIC Educational Resources Information Center

    Lloyd, Glenna G.

    The problem of this study was to identify the cause of the physical and emotional problems encountered by older women who have returned to work after a prolonged absence. Such information, it was believed, would be valuable to business and educational institutions in retraining or updating prospective secretarial employees. Data for the study were…

  20. Family Emotional Climate and Sibling Relationship Quality: Influences on Behavioral Problems and Adaptation in Preschool-Aged Children

    ERIC Educational Resources Information Center

    Modry-Mandell, Kerri L.; Gamble, Wendy C.; Taylor, Angela R.

    2007-01-01

    We examined the impact of family emotional climate and sibling relationship quality on behavioral problems and adaptation in preschool-aged children. Participants were 63 mothers with a preschool-aged child enrolled in a Southern Arizona Head Start Program. Siblings were identified as children closest in age to target child. Mothers of…

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

    PubMed

    Carrer, Paolo; Wolkoff, Peder

    2018-04-12

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

  2. A comprehensive model for diagnosing the causes of individual medical performance problems: skills, knowledge, internal, past and external factors (SKIPE).

    PubMed

    Norfolk, Tim; Siriwardena, A Niroshan

    2013-01-01

    This discussion paper describes a new and comprehensive model for diagnosing the causes of individual medical performance problems: SKIPE (skills, knowledge, internal, past and external factors). This builds on a previous paper describing a unifying theory of clinical practice, the RDM-p model, which captures the primary skill sets required for effective medical performance (relationship, diagnostics and management), and the professionalism that needs to underpin them. The SKIPE model is currently being used, in conjunction with the RDM-p model, for the in-depth assessment and management of doctors whose performance is a cause for concern.

  3. Problems with Using the Normal Distribution – and Ways to Improve Quality and Efficiency of Data Analysis

    PubMed Central

    Limpert, Eckhard; Stahel, Werner A.

    2011-01-01

    Background The Gaussian or normal distribution is the most established model to characterize quantitative variation of original data. Accordingly, data are summarized using the arithmetic mean and the standard deviation, by ± SD, or with the standard error of the mean, ± SEM. This, together with corresponding bars in graphical displays has become the standard to characterize variation. Methodology/Principal Findings Here we question the adequacy of this characterization, and of the model. The published literature provides numerous examples for which such descriptions appear inappropriate because, based on the “95% range check”, their distributions are obviously skewed. In these cases, the symmetric characterization is a poor description and may trigger wrong conclusions. To solve the problem, it is enlightening to regard causes of variation. Multiplicative causes are by far more important than additive ones, in general, and benefit from a multiplicative (or log-) normal approach. Fortunately, quite similar to the normal, the log-normal distribution can now be handled easily and characterized at the level of the original data with the help of both, a new sign, x/, times-divide, and notation. Analogous to ± SD, it connects the multiplicative (or geometric) mean * and the multiplicative standard deviation s* in the form * x/s*, that is advantageous and recommended. Conclusions/Significance The corresponding shift from the symmetric to the asymmetric view will substantially increase both, recognition of data distributions, and interpretation quality. It will allow for savings in sample size that can be considerable. Moreover, this is in line with ethical responsibility. Adequate models will improve concepts and theories, and provide deeper insight into science and life. PMID:21779325

  4. An integrated view of data quality in Earth observation

    PubMed Central

    Yang, X.; Blower, J. D.; Bastin, L.; Lush, V.; Zabala, A.; Masó, J.; Cornford, D.; Díaz, P.; Lumsden, J.

    2013-01-01

    Data quality is a difficult notion to define precisely, and different communities have different views and understandings of the subject. This causes confusion, a lack of harmonization of data across communities and omission of vital quality information. For some existing data infrastructures, data quality standards cannot address the problem adequately and cannot fulfil all user needs or cover all concepts of data quality. In this study, we discuss some philosophical issues on data quality. We identify actual user needs on data quality, review existing standards and specifications on data quality, and propose an integrated model for data quality in the field of Earth observation (EO). We also propose a practical mechanism for applying the integrated quality information model to a large number of datasets through metadata inheritance. While our data quality management approach is in the domain of EO, we believe that the ideas and methodologies for data quality management can be applied to wider domains and disciplines to facilitate quality-enabled scientific research. PMID:23230156

  5. An integrated view of data quality in Earth observation.

    PubMed

    Yang, X; Blower, J D; Bastin, L; Lush, V; Zabala, A; Masó, J; Cornford, D; Díaz, P; Lumsden, J

    2013-01-28

    Data quality is a difficult notion to define precisely, and different communities have different views and understandings of the subject. This causes confusion, a lack of harmonization of data across communities and omission of vital quality information. For some existing data infrastructures, data quality standards cannot address the problem adequately and cannot fulfil all user needs or cover all concepts of data quality. In this study, we discuss some philosophical issues on data quality. We identify actual user needs on data quality, review existing standards and specifications on data quality, and propose an integrated model for data quality in the field of Earth observation (EO). We also propose a practical mechanism for applying the integrated quality information model to a large number of datasets through metadata inheritance. While our data quality management approach is in the domain of EO, we believe that the ideas and methodologies for data quality management can be applied to wider domains and disciplines to facilitate quality-enabled scientific research.

  6. Strategy to identify the causes and to solve a sludge granulation problem in methanogenic reactors: application to a full-scale plant treating cheese wastewater.

    PubMed

    Macarie, Hervé; Esquivel, Maricela; Laguna, Acela; Baron, Olivier; El Mamouni, Rachid; Guiot, Serge R; Monroy, Oscar

    2017-08-26

    Granulation of biomass is at the basis of the operation of the most successful anaerobic systems (UASB, EGSB and IC reactors) applied worldwide for wastewater treatment. Despite of decades of studies of the biomass granulation process, it is still not fully understood and controlled. "Degranulation/lack of granulation" is a problem that occurs sometimes in anaerobic systems resulting often in heavy loss of biomass and poor treatment efficiencies or even complete reactor failure. Such a problem occurred in Mexico in two full-scale UASB reactors treating cheese wastewater. A close follow-up of the plant was performed to try to identify the factors responsible for the phenomenon. Basically, the list of possible causes to a granulation problem that were investigated can be classified amongst nutritional, i.e. related to wastewater composition (e.g. deficiency or excess of macronutrients or micronutrients, too high COD proportion due to proteins or volatile fatty acids, high ammonium, sulphate or fat concentrations), operational (excessive loading rate, sub- or over-optimal water upflow velocity) and structural (poor hydraulic design of the plant). Despite of an intensive search, the causes of the granulation problems could not be identified. The present case remains however an example of the strategy that must be followed to identify these causes and could be used as a guide for plant operators or consultants who are confronted with a similar situation independently of the type of wastewater. According to a large literature based on successful experiments at lab scale, an attempt to artificially granulate the industrial reactor biomass through the dosage of a cationic polymer was also tested but equally failed. Instead of promoting granulation, the dosage caused a heavy sludge flotation. This shows that the scaling of such a procedure from lab to real scale cannot be advised right away unless its operability at such a scale can be demonstrated.

  7. Types, Problems and Their Causes, and Solutions to the Offences against the Environmental Laws by Probationers in Maha Sarakham Province

    ERIC Educational Resources Information Center

    Wanlu, Somchai; Singseewo, Adisak; Suksringarm, Paitool

    2015-01-01

    This study aimed to explore types, problems and their causes, and solutions to the offences against the environmental laws of probationers in Maha Sarakham Province. The study comprised 2 phases: Phase 1 was a study of types of the offences against the environmental laws: and phase 2 was an interview with 25 people directly dealing with the…

  8. AN EVALUATION OF THE INTERACTION BETWEEN QUALITY OF ATTENTION AND NEGATIVE REINFORCEMENT WITH CHILDREN WHO DISPLAY ESCAPE-MAINTAINED PROBLEM BEHAVIOR

    PubMed Central

    Gardner, Andrew W; Wacker, David P; Boelter, Eric W

    2009-01-01

    The choice-making behavior of 2 typically developing children who engaged in problem behavior maintained by negative reinforcement was evaluated within a concurrent-operants assessment that varied the quality of attention across free-play and demand conditions. The results demonstrated that it was possible to bias responding towards academic demands for both participants by providing high-quality attention, despite the continuous availability of negative reinforcement. The current study extended brief clinical methods with typically developing children and demonstrated how different qualities of attention provided across concurrent schedules could bias responding. PMID:19949522

  9. Quality of life in men diagnosed with anogenital warts*

    PubMed Central

    de Camargo, Caio Cavassan; D'Elia, Maria Paula Barbieri; Miot, Helio Amante

    2017-01-01

    Anogenital warts are a worldwide public health problem. They consist of epithelial proliferations caused by HPV, whose transmission occurs mainly through sexual intercourse. In this study, we evaluated their impact on the quality of life of adult males. We interviewed 88 men in an outpatient clinic for sexually transmitted diseases at a Brazilian public institution, using the DLQI-BRA questionnaire. Most patients (81%) presented mild or no impairment of quality of life. The main dimensions affected were sex life, symptoms, and embarrassment. The low impact on quality of life may well justify the delay in seeking medical treatment, favoring the spread of the disease. PMID:29186268

  10. A Logistic Life Cycle Cost-Benefit Analysis of Power Quality Management in the Avionics Repair Facility

    DTIC Science & Technology

    1998-06-01

    quality management can have on the intermediate level of maintenance. Power quality management is a preventative process that focuses on identifying and correcting problems that cause bad power. Using cost-benefit analysis we compare the effects of implementing a power quality management program at AIMD Lemoore and AIMD Fallon. The implementation of power quality management can result in wide scale logistical support changes in regards to the life cycle costs of maintaining the DoD’s current inventory

  11. Ground-water quality atlas of Wisconsin

    USGS Publications Warehouse

    Kammerer, Phil A.

    1981-01-01

    This report summarizes data on ground-water quality stored in the U.S. Geological Survey's computer system (WATSTORE). The summary includes water quality data for 2,443 single-aquifer wells, which tap one of the State's three major aquifers (sand and gravel, Silurian dolomite, and sandstone). Data for dissolved solids, hardness, alkalinity, calcium, magnesium, sodium, potassium, iron, manganese, sulfate, chloride, fluoride, and nitrate are summarized by aquifer and by county, and locations of wells for which data are available 1 are shown for each aquifer. Calcium, magnesium, and bicarbonate (the principal component of alkalinity) are the major dissolved constituents in Wisconsin's ground water. High iron concentrations and hardness cause ground-water quality problems in much of the State. Statewide ,summaries of trace constituent (selected trace metals; arsenic, boron, and organic carbon) concentrations show that these constituents impair water quality in only a few isolated wells.

  12. Diagnosing plant problems

    Treesearch

    Cheryl A. Smith

    2008-01-01

    Diagnosing Christmas tree problems can be a challenge, requiring a basic knowledge of plant culture and physiology, the effect of environmental influences on plant health, and the ability to identify the possible causes of plant problems. Developing a solution or remedy to the problem depends on a proper diagnosis, a process that requires recognition of a problem and...

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  14. Methods for Ensuring High Quality of Coding of Cause of Death. The Mortality Register to Follow Southern Urals Populations Exposed to Radiation.

    PubMed

    Startsev, N; Dimov, P; Grosche, B; Tretyakov, F; Schüz, J; Akleyev, A

    2015-01-01

    To follow up populations exposed to several radiation accidents in the Southern Urals, a cause-of-death registry was established at the Urals Center capturing deaths in the Chelyabinsk, Kurgan and Sverdlovsk region since 1950. When registering deaths over such a long time period, quality measures need to be in place to maintain quality and reduce the impact of individual coders as well as quality changes in death certificates. To ensure the uniformity of coding, a method for semi-automatic coding was developed, which is described here. Briefly, the method is based on a dynamic thesaurus, database-supported coding and parallel coding by two different individuals. A comparison of the proposed method for organizing the coding process with the common procedure of coding showed good agreement, with, at the end of the coding process, 70  - 90% agreement for the three-digit ICD -9 rubrics. The semi-automatic method ensures a sufficiently high quality of coding by at the same time providing an opportunity to reduce the labor intensity inherent in the creation of large-volume cause-of-death registries.

  15. Quality of Work Life: Theoretical and Methodological Problems, and Presentation of a New Model and Measuring Instrument

    ERIC Educational Resources Information Center

    Martel, Jean-Pierre; Dupuis, Gilles

    2006-01-01

    Purpose: Ever since the concept of Quality of Work Life (QWL) was first used over 30 years ago, a range of definitions and theoretical constructs have succeeded each other with the aim of mitigating the many problems facing the concept. A historical overview of the concept of QWL is presented here. Given the lack of consensus concerning the…

  16. Nondestructive inspection of nuts for food quality and safety using NIRS (abstract)

    USDA-ARS?s Scientific Manuscript database

    Mold infection and insect infestation are significant postharvest problems for processors of nuts. Fungal disease causes direct loss of product or reduced value due to the lower-quality grade of the chest-nut lot. In most cases, fungal infection is not detectable using traditional sorting techniques...

  17. A multi-model evaluation of aerosols over South Asia: common problems and possible causes

    NASA Astrophysics Data System (ADS)

    Pan, X.; Chin, M.; Gautam, R.; Bian, H.; Kim, D.; Colarco, P. R.; Diehl, T. L.; Takemura, T.; Pozzoli, L.; Tsigaridis, K.; Bauer, S.; Bellouin, N.

    2015-05-01

    Atmospheric pollution over South Asia attracts special attention due to its effects on regional climate, water cycle and human health. These effects are potentially growing owing to rising trends of anthropogenic aerosol emissions. In this study, the spatio-temporal aerosol distributions over South Asia from seven global aerosol models are evaluated against aerosol retrievals from NASA satellite sensors and ground-based measurements for the period of 2000-2007. Overall, substantial underestimations of aerosol loading over South Asia are found systematically in most model simulations. Averaged over the entire South Asia, the annual mean aerosol optical depth (AOD) is underestimated by a range 15 to 44% across models compared to MISR (Multi-angle Imaging SpectroRadiometer), which is the lowest bound among various satellite AOD retrievals (from MISR, SeaWiFS (Sea-Viewing Wide Field-of-View Sensor), MODIS (Moderate Resolution Imaging Spectroradiometer) Aqua and Terra). In particular during the post-monsoon and wintertime periods (i.e., October-January), when agricultural waste burning and anthropogenic emissions dominate, models fail to capture AOD and aerosol absorption optical depth (AAOD) over the Indo-Gangetic Plain (IGP) compared to ground-based Aerosol Robotic Network (AERONET) sunphotometer measurements. The underestimations of aerosol loading in models generally occur in the lower troposphere (below 2 km) based on the comparisons of aerosol extinction profiles calculated by the models with those from Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) data. Furthermore, surface concentrations of all aerosol components (sulfate, nitrate, organic aerosol (OA) and black carbon (BC)) from the models are found much lower than in situ measurements in winter. Several possible causes for these common problems of underestimating aerosols in models during the post-monsoon and wintertime periods are identified: the aerosol hygroscopic growth and formation of

  18. Do Carpets Impair Indoor Air Quality and Cause Adverse Health Outcomes: A Review.

    PubMed

    Becher, Rune; Øvrevik, Johan; Schwarze, Per E; Nilsen, Steinar; Hongslo, Jan K; Bakke, Jan Vilhelm

    2018-01-23

    Several earlier studies have shown the presence of more dust and allergens in carpets compared with non-carpeted floors. At the same time, adverse effects of carpeted floors on perceived indoor air quality as well as worsening of symptoms in individuals with asthma and allergies were reported. Avoiding extensive carpet use in offices, schools, kindergartens and bedrooms has therefore been recommended by several health authorities. More recently, carpet producers have argued that former assessments were obsolete and that modern rugs are unproblematic, even for those with asthma and allergies. To investigate whether the recommendation to be cautious with the use of carpets is still valid, or whether there are new data supporting that carpet flooring do not present a problem for indoor air quality and health, we have reviewed the literature on this matter. We have not found updated peer reviewed evidence that carpeted floor is unproblematic for the indoor environment. On the contrary, also more recent data support that carpets may act as a repository for pollutants which may become resuspended upon activity in the carpeted area. Also, the use of carpets is still linked to perception of reduced indoor air quality as well as adverse health effects as previously reported. To our knowledge, there are no publications that report on deposition of pollutants and adverse health outcomes associated with modern rugs. However, due to the three-dimensional structure of carpets, any carpet will to some extent act like a sink. Thus, continued caution should still be exercised when considering the use of wall-to-wall carpeted floors in schools, kindergartens and offices, as well as in children's bedrooms unless special needs indicate that carpets are preferable.

  19. Root-Cause Analysis of Persistently High Maternal Mortality in a Rural District of Indonesia: Role of Clinical Care Quality and Health Services Organizational Factors.

    PubMed

    Mahmood, Mohammad Afzal; Mufidah, Ismi; Scroggs, Steven; Siddiqui, Amna Rehana; Raheel, Hafsa; Wibdarminto, Koentijo; Dirgantoro, Bernardus; Vercruyssen, Jorien; Wahabi, Hayfaa A

    2018-01-01

    Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants. Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays. The root causes were found in poor quality of care, which caused hospital to be unprepared to manage deteriorating patients. In hospital, poor implementation of standard operating procedures was rooted in inadequate skills, lack of forward planning, ineffective communication, and unavailability of essential services. In primary care, root causes included inadequate risk management, referrals to facilities where needed services are not available, and lack of coordination between primary healthcare and hospitals. There is an urgent need for a shift in focus to quality of care through knowledge, skills, and support for consistent application of protocols, making essential services available, effective risk assessment and management, and facilitating timely referrals to facilities that are adequately equipped.

  20. Causes of Deafness: Retrospection and Omens.

    ERIC Educational Resources Information Center

    Champie, Joan

    1996-01-01

    This study reviewed records of several American schools for the deaf in the 19th century concerning the stated causes of deafness given by parents. The high rate of adventitious deafness is noted. Stated causes are categorized into: fevers, inflammations, medicines/poisons, trauma, heat/cold, ear problems, nervous system problems, head/neck…

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

    PubMed Central

    2018-01-01

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

  2. Efforts To Solve Quality Problems. Background Paper No. 36.

    ERIC Educational Resources Information Center

    Smith, Michael J.; And Others

    Producing goods and services of high quality is not expensive, but correcting poor quality costs U.S. companies as much as 20 percent of sales revenues annually. One survey reported that only 1 out of 300 U.S. companies involved management and engineering staff in quality training. The tendency is to have a quality control department, separate…

  3. The Quality Control of Data in a Clinical Database System—The Patient Identification Problem *

    PubMed Central

    Lai, J. Chi-Sang; Covvey, H.D.; Sevcik, K.C.; Wigle, E.D.

    1981-01-01

    Ensuring the accuracy of patient identification and the linkage of records with the appropriate patient owner is the first level of quality control of data in a clinical database system. Without a unique patient identifier, the fact that patient identity may be recorded at different places and times means that multiple identities may be associated with a given patient and new records associated with any of these identities. Even when a unique patient identifier is utilized, errors introduced in the data handling process can result in the same problems. The outcome is that the retrieval request for a given record may fail, or an erroneously identified record may be retrieved. We have studied each of the ways this fundamental problem occurs and propose a solution based on record linkage techniques to detect errors of this type. Specifically, we propose a patient identification scheme for the situation where no unique health identifier is available and detail a method to find patient records with erroneous identifiers.

  4. [Discussion on agricultural product quality and safety problem from ecological view].

    PubMed

    Xiao, Ming; Dong, Nan; Lyu, Xin

    2015-08-01

    There are many different perspectives about the sustainable agriculture, which had been proposed since the last three decades in the world. While China's ecologists and agronomists proposed a similar concept named 'ecological agriculture'. Although ecological agriculture in China has achieved substantial progress, including theory, models and supporting technologies nearly several decades of practice and development, its application guidance still is not yet clear. The organic agriculture model proposed by European Union is popular, but it is limited in the beneficiary groups and the social and ecological responsibility. In this context, the article based on an ecological point of view, analyzed the shortcomings of ecological imbalance caused by a single mode of agricultural production and the negative impact on the quality of agricultural products, and discussed the core values of ecological agriculture. On this basis, we put forward the concept of sustainable security of agricultural products. Based on this concept, an agricultural platform was established under the healthy ecosysphere environment, and from this agricultural platform, agricultural products could be safely and sustainably obtained. Around the central value of the concept, we designed the agricultural sustainable and security production model. Finally, we compared the responsibility, benefiting groups, agronomic practices selection and other aspects of sustainable agriculture with organic agriculture, and proved the advancement of sustainable agricultural model in agricultural production quality and safety.

  5. Dysphagia, malnutrition and gastrointestinal problems in patients with mitochondrial disease caused by the m3243A>G mutation.

    PubMed

    de Laat, P; Zweers, H E E; Knuijt, S; Smeitink, J A M; Wanten, G J A; Janssen, M C H

    2015-01-01

    Previous research has shown that dysphagia and gastrointestinal problems occur frequently in carriers of the m.3243A>G mutation; however, the exact frequency and severity have not been determined. We hypothesise that adult carriers have an increased risk for malnutrition. In this observational study we evaluated the presence of gastrointestinal problems and dysphagia in 92 carriers of the m.3243A>G mutation. The severity of the general disease involvement was classified using the Newcastle Mitochondrial Disease Adult Scale (NMDAS). Gastrointestinal involvement, dysphagia and the risk for malnutrition were scored using the Gastrointestinal Symptoms Questionnaire and the Malnutrition Universal Screening Tool. Gastrointestinal symptoms and anthropometrics were compared with healthy controls. Our results show that the height, weight and body mass index (BMI) of these carriers were lower than the national average (p < 0.05). Seventy-nine carriers (86%) suffered from at least one gastrointestinal symptom, mainly flatulence or hard stools. Both frequency and severity of symptoms were significantly increased compared with reference data of healthy Dutch adults. Of the carriers, 45% reported (mostly mild) dysphagia. Solid foods cause more problems than liquids. A negative correlation between BMI and heteroplasmy levels in urinary epithelial cells (UEC) was present (Spearman correlation coefficient = - 0.319, p = 0.003). Dysphagia and gastrointestinal problems, especially constipation, are common symptoms in the total m.3243A>G carriers cohort and are not related to heteroplasmy levels in UEC or disease severity. The severity of gastrointestinal problems as well as overall disease severity is associated with an increased risk for malnutrition.

  6. Employability Skills, Personal Qualities, and Early Employment Problems of Entry-Level Auditors: Perspectives from Employers, Lecturers, Auditors, and Students

    ERIC Educational Resources Information Center

    Lim, Yet-Mee; Lee, Teck Heang; Yap, Ching Seng; Ling, Chui Ching

    2016-01-01

    The authors examine the issue of employability of university accounting students from the perspectives of accounting firm employers, junior auditors, accounting lecturers, and accounting students. Areas of investigation include perceived importance of employability skills and desirable personal qualities; and early employment problems encountered…

  7. Improving Reference Service: The Case for Using a Continuous Quality Improvement Method.

    ERIC Educational Resources Information Center

    Aluri, Rao

    1993-01-01

    Discusses the evaluation of library reference service; examines problems with past evaluations, including the lack of long-term planning and a systems perspective; and suggests a method for continuously monitoring and improving reference service using quality improvement tools such as checklists, cause and effect diagrams, Pareto charts, and…

  8. Effects of musculoskeletal system problems on quality of life and depression in students preparing for university entrance exam.

    PubMed

    Kitiş, Ali; Büker, Nihal; Ünal, Ayse; Şavkın, Raziye

    2017-07-01

    This study was planned to investigate the relationship between musculoskeletal problems, depression, and quality of life in students preparing for university entrance exams. A total of 180 students were included in the study, 104 were female (57.77%), and 76 were male (42.22%). Students were reached through the cram schools ("dershane") in Denizli. Musculoskeletal system problems, depression status, and quality of life were determined with the Musculoskeletal-Postural Discomfort Scale (MDS), Boratav Depression Screen Scale (Bordepta), and Short Form-36 (SF-36), respectively. Demographic data, daily study, and sleep duration were also recorded. Students have moderate musculoskeletal discomfort. Musculoskeletal disorders and depressive symptoms are more observed in female students than male students ( P = 0.000). The SF-36 results were significantly negatively correlated with the MDS and Bordepta scores. A significant positive correlation was found between musculoskeletal disorders and depression status (r = 0.351, P = 0.000). Sleep duration was negatively correlated with the MDS and Bordepta (r = -0.209, P = 0.005; r = -0.148, P = 0.047, respectively) and positively correlated with the SF-36 role limitation/emotional and social functioning subscales (r = 0.225, P = 0.002 and r = 0.191, P = 0.010 respectively). Musculoskeletal problems and depression status negatively affects general health status especially in female students who are preparing for university entrance examinations. Students should be informed about musculoskeletal problems by healthcare professionals and the study room, tables, and chairs should be arranged ergonomically. Further studies might be determined that why musculoskeletal disorders and depression status are more widely among female students.

  9. New directions: Future approaches to the standardized assessment of airborne pollutants affecting environmental quality

    NASA Astrophysics Data System (ADS)

    Nehr, Sascha; Franzen-Reuter, Isabelle; Kucejko, Catharina

    2017-10-01

    Man-made activities have caused unexampled changes of our environment during the last two centuries. Due to emissions of a vast number of pollutants the composition of the Earth's atmosphere is continuously changing, and the consequences for humans and for ecosystems are only partly understood at present. Once released to the atmosphere, the emitted substances undergo physical and chemical degradation. Many of the substances detected in ambient air are toxic or carcinogenic and might cause respiratory and cardiovascular diseases. Furthermore, air pollutants are influencing acidification, eutrophication, global warming, and biodiversity. Therefore soil quality, water quality, air quality, ecosystem exposure to pollutant deposition, biodiversity, and climate change are coupled problems (Schlesinger, 1997; Steffen et al., 2005; Ehlers et al., 2006; Rockström et al., 2009).

  10. Bruxism is unlikely to cause damage to the periodontium: findings from a systematic literature assessment.

    PubMed

    Manfredini, Daniele; Ahlberg, Jari; Mura, Rossano; Lobbezoo, Frank

    2015-04-01

    This paper systematically reviews the MEDLINE and SCOPUS literature to answer the following question: Is there any evidence that bruxism may cause periodontal damage per se? Clinical studies on humans, assessing the potential relationship between bruxism and periodontal lesions (i.e., decreased attachment level, bone loss, tooth mobility/migration, altered periodontal perception) were eligible. Methodologic shortcomings were identified by the adoption of the Critical Appraisal Skills Program quality assessment, mainly concerning the internal validity of findings according to an unspecific bruxism diagnosis. The six included articles covered a high variability of topics, without multiple papers on the same argument. Findings showed that the only effect of bruxism on periodontal structures was an increase in periodontal sensation, whereas a relationship with periodontal lesions was absent. Based on the analysis of Hill criteria, the validity of causation conclusions was limited, mainly owing to the absence of a longitudinal evaluation of the temporal relationship and dose-response effects between bruxism and periodontal lesions. Despite the scarce quantity and quality of the literature that prevents sound conclusions on the causal link between bruxism and the periodontal problems assessed in this review, it seems reasonable to suggest that bruxism cannot cause periodontal damage per se. It is also important to emphasize, however, that because of methodologic problems, particularly regarding sleep bruxism assessment, more high-quality studies (e.g., randomized controlled trials) are needed to further clarify this issue.

  11. Do Carpets Impair Indoor Air Quality and Cause Adverse Health Outcomes: A Review

    PubMed Central

    Becher, Rune; Øvrevik, Johan; Schwarze, Per E.; Nilsen, Steinar; Hongslo, Jan K.; Bakke, Jan Vilhelm

    2018-01-01

    Several earlier studies have shown the presence of more dust and allergens in carpets compared with non-carpeted floors. At the same time, adverse effects of carpeted floors on perceived indoor air quality as well as worsening of symptoms in individuals with asthma and allergies were reported. Avoiding extensive carpet use in offices, schools, kindergartens and bedrooms has therefore been recommended by several health authorities. More recently, carpet producers have argued that former assessments were obsolete and that modern rugs are unproblematic, even for those with asthma and allergies. To investigate whether the recommendation to be cautious with the use of carpets is still valid, or whether there are new data supporting that carpet flooring do not present a problem for indoor air quality and health, we have reviewed the literature on this matter. We have not found updated peer reviewed evidence that carpeted floor is unproblematic for the indoor environment. On the contrary, also more recent data support that carpets may act as a repository for pollutants which may become resuspended upon activity in the carpeted area. Also, the use of carpets is still linked to perception of reduced indoor air quality as well as adverse health effects as previously reported. To our knowledge, there are no publications that report on deposition of pollutants and adverse health outcomes associated with modern rugs. However, due to the three-dimensional structure of carpets, any carpet will to some extent act like a sink. Thus, continued caution should still be exercised when considering the use of wall-to-wall carpeted floors in schools, kindergartens and offices, as well as in children’s bedrooms unless special needs indicate that carpets are preferable. PMID:29360764

  12. Healthcare quality improvement -- policy implications and practicalities.

    PubMed

    Esain, Ann Elizabeth; Williams, Sharon J; Gakhal, Sandeep; Caley, Lynne; Cooke, Matthew W

    2012-01-01

    This article aims to explore quality improvement (QI) at individual, group and organisational level. It also aims to identify restraining forces using formative evaluation and discuss implications for current UK policy, particularly quality, innovation, productivity and prevention. Learning events combined with work-based projects, focusing on individual and group responses are evaluated. A total of 11 multi-disciplinary groups drawn from NHS England healthcare Trusts (self-governing operational groups) were sampled. These Trusts have different geographic locations and participants were drawn from primary, secondary and commissioning arms. Mixed methods: questionnaires, observations and reflective accounts were used. The paper finds that solution versus problem identification causes confusion and influences success. Time for problem solving to achieve QI was absent. Feedback and learning structures are often not in place or inflexible. Limited focus on patient-centred services may be related to past assumptions regarding organisational design, hence assumptions and models need to be understood and challenged. The authors revise the Plan, Do, Study; Act (PDSA) model by adding an explicit problem identification step and hence avoiding solution-focused habits; demonstrating the need for more formative evaluations to inform managers and policy makers about healthcare QI processes. - Although UK-centric, the quality agenda is a USA and European theme, findings may help those embarking on this journey or those struggling with QI.

  13. Radio speech communication problems reported in a survey of military pilots.

    PubMed

    Lahtinen, Taija M M; Huttunen, Kerttu H; Kuronen, Pentti O; Sorri, Martti J; Leino, Tuomo K

    2010-12-01

    Despite technological advances in conveying information, speech communication is still a key safety factor in aviation. Effective radio communication is necessary, for example, in building and maintaining good team situation awareness. However, little has been reported concerning the prevalence and nature of radio communication problems in everyday working environments in military aviation. We surveyed Finnish Defense Forces pilots regarding the prevalence of radio speech communication problems. Of the 225 pilots contacted, 75% replied to our survey. Altogether 138 of the respondents were fixed-wing pilots and 31 were helicopter pilots. Problems in radio communication occurred, on average, during 14% of flight time. The most prevalent problems were multiple speakers on the same radio frequency band causing overlapping speech, missing acknowledgments, high background noise especially during helicopter operations, and technical problems. Of the respondents, 18% (31 pilots) reported having encountered at least one potentially dangerous event caused by problems in radio communication during their military aviation career. If the employer were to offer extra hearing protection, such as custom-made ear plugs, 93% of the pilots indicated that they would use it. Communication can be a flight safety factor especially during intense air combat exercises and other information-loaded flights. During these situations, communication should be clear and focused on the most essential information. So, training and technical improvements are necessary for better communication. High quality radio speech communication also improves operational effectiveness in military aviation.

  14. Root-Cause Analysis of Persistently High Maternal Mortality in a Rural District of Indonesia: Role of Clinical Care Quality and Health Services Organizational Factors

    PubMed Central

    Mufidah, Ismi; Scroggs, Steven; Siddiqui, Amna Rehana; Raheel, Hafsa; Wibdarminto, Koentijo; Dirgantoro, Bernardus; Vercruyssen, Jorien

    2018-01-01

    Background Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants. Method Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays. Findings The root causes were found in poor quality of care, which caused hospital to be unprepared to manage deteriorating patients. In hospital, poor implementation of standard operating procedures was rooted in inadequate skills, lack of forward planning, ineffective communication, and unavailability of essential services. In primary care, root causes included inadequate risk management, referrals to facilities where needed services are not available, and lack of coordination between primary healthcare and hospitals. Conclusion There is an urgent need for a shift in focus to quality of care through knowledge, skills, and support for consistent application of protocols, making essential services available, effective risk assessment and management, and facilitating timely referrals to facilities that are adequately equipped. PMID:29682538

  15. HACCP-based quality risk management approach to udder health problems on dairy farms

    PubMed Central

    2009-01-01

    Against the background of prevailing udder health problems on dairy farms, this paper discusses a new approach to mastitis control. Current udder health control programmes, such as the 'five-point plan', are highlighted and their drawbacks indicated. The concept and principles of hazard analysis critical control points (HACCP) are introduced. The eight core elements of this concept are dealt with by using the example of a dairy herd with a mastitis problem due to Staphylococcus aureus. The various steps to be taken in the development of a HACCP-based quality risk management programme are illustrated through the application of core elements. Finally, it is shown that the HACCP key words, structure, organisation, planning, communication and formalisation; which do not frequently appear in conventional herd health and production management programmes can contribute to better udder health. The role of the veterinarian can be paramount and of added value, if he/she is willing to invest in new knowledge and skills, such as the HACCP concept, farm economics, animal nutrition, and particularly the role of coach to the dairy farmer in the implementation of preventative measures in relation to udder health. PMID:22082372

  16. HACCP-based quality risk management approach to udder health problems on dairy farms.

    PubMed

    Noordhuizen, Jptm; Cannas da Silva, J

    2009-04-01

    Against the background of prevailing udder health problems on dairy farms, this paper discusses a new approach to mastitis control. Current udder health control programmes, such as the 'five-point plan', are highlighted and their drawbacks indicated. The concept and principles of hazard analysis critical control points (HACCP) are introduced. The eight core elements of this concept are dealt with by using the example of a dairy herd with a mastitis problem due to Staphylococcus aureus. The various steps to be taken in the development of a HACCP-based quality risk management programme are illustrated through the application of core elements. Finally, it is shown that the HACCP key words, structure, organisation, planning, communication and formalisation; which do not frequently appear in conventional herd health and production management programmes can contribute to better udder health. The role of the veterinarian can be paramount and of added value, if he/she is willing to invest in new knowledge and skills, such as the HACCP concept, farm economics, animal nutrition, and particularly the role of coach to the dairy farmer in the implementation of preventative measures in relation to udder health.

  17. A pilot study of routine immunization data quality in Bunza Local Government area: causes and possible remedies.

    PubMed

    Omoleke, Semeeh Akinwale; Tadesse, Menberu Getachew

    2017-01-01

    As a result of poor quality administrative data for routine immunisation (RI) in Nigeria, the real coverage of RI remains unknown, constituting a setback in curtailing vaccine preventable diseases (VPDs). Consequently, the purpose of this pilot study is to identify source(s) and evaluate the magnitude of poor data quality as well as propose recommendations to address the problem. The authors conducted a cross-sectional study in which 5 out of the 22 health facilities providing routine immunization services in Bunza Local Government Area (LGA), Kebbi State, Nigeria, were selected for data quality assessment. The reported coverage of RI in August and September, 2016 was the primary element of evaluation in the selected Health Facilities (HFs). Administered questionnaires were adapted from WHO Data Quality Assurance and RI monitoring tools to generate data from the HFs, as well as standardised community survey tool for household surveys. Data inconsistency was detected in 100% of the selected HFs. Maximum difference between HF monthly summary and RI registration book for penta 3 data quality report analysis was 820% and 767% in MCH Bunza and PHC Balu respectively. However, a minimum difference of 3% was observed at Loko Dispensary. Maximum difference between HF summary and RI registration for measles was 614% at MCH Bunza and 43% minimum difference at Loko. In contrast to the administrative coverage, 60-80% of the children sampled from households were either not immunised or partially immunised. Further, the main sources of poor data quality include heavy workload on RI providers, over-reliance on administrative coverage report, and lack of understanding of the significance of high data quality by RI providers. Substantial data discrepancies were observed in RI reports from all the Health Facilities which is indicative of poor data quality at the LGA level. Community surveys also revealed an over-reporting from administrative coverage data. Consequently, efforts

  18. A pilot study of routine immunization data quality in Bunza Local Government area: causes and possible remedies

    PubMed Central

    Omoleke, Semeeh Akinwale; Tadesse, Menberu Getachew

    2017-01-01

    Introduction As a result of poor quality administrative data for routine immunisation (RI) in Nigeria, the real coverage of RI remains unknown, constituting a setback in curtailing vaccine preventable diseases (VPDs). Consequently, the purpose of this pilot study is to identify source(s) and evaluate the magnitude of poor data quality as well as propose recommendations to address the problem. Methods The authors conducted a cross-sectional study in which 5 out of the 22 health facilities providing routine immunization services in Bunza Local Government Area (LGA), Kebbi State, Nigeria, were selected for data quality assessment. The reported coverage of RI in August and September, 2016 was the primary element of evaluation in the selected Health Facilities (HFs). Administered questionnaires were adapted from WHO Data Quality Assurance and RI monitoring tools to generate data from the HFs, as well as standardised community survey tool for household surveys. Results Data inconsistency was detected in 100% of the selected HFs. Maximum difference between HF monthly summary and RI registration book for penta 3 data quality report analysis was 820% and 767% in MCH Bunza and PHC Balu respectively. However, a minimum difference of 3% was observed at Loko Dispensary. Maximum difference between HF summary and RI registration for measles was 614% at MCH Bunza and 43% minimum difference at Loko. In contrast to the administrative coverage, 60-80% of the children sampled from households were either not immunised or partially immunised. Further, the main sources of poor data quality include heavy workload on RI providers, over-reliance on administrative coverage report, and lack of understanding of the significance of high data quality by RI providers. Conclusion Substantial data discrepancies were observed in RI reports from all the Health Facilities which is indicative of poor data quality at the LGA level. Community surveys also revealed an over-reporting from administrative

  19. Evaluating Quality Circles in a College of Further Education. Manchester Monographs 31.

    ERIC Educational Resources Information Center

    Atkinson, Tim

    Quality circles (QCs) are small volunteer groups of workers who meet weekly with a trained leader operating to a strict code of conduct. They use techniques of brainstorming, cause and effect classification, pareto analysis, and presentation to consider work-related problems and recommend solutions to management. QCs have been tried in educational…

  20. Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: a systematic review.

    PubMed

    Vonk-Klaassen, Sylvia M; de Vocht, Hilde M; den Ouden, Marjolein E M; Eddes, Eric Hans; Schuurmans, Marieke J

    2016-01-01

    Many long-term ostomates are 'out-of-sight' of healthcare, and it is unknown how ostomates deal with ostomy-related problems and how these problems affect their quality of life (QOL). The aim is to examine patient-related studies describing ostomy-related problems and their impact on the perceived QOL of long-term colostomates. The electronic databases PubMed (MEDLINE), CINAHL, Cochrane Library and PsycINFO were systematically searched. All studies were included in which ostomy-specific QOL was measured using validated multidimensional instruments. Of the 6447 citations identified, 14 prevailingly descriptive cross-sectional studies were included. Three different validated multidimensional instruments for measuring QOL in ostomates were used (EORTC C30/CR38, MCOHQOLQO, Stoma QOL Questionnaire). All studies demonstrated that living with a colostomy influences the overall QOL negatively. The ostomy-related problems described included sexual problems, depressive feelings, gas, constipation, dissatisfaction with appearance, change in clothing, travel difficulties, feeling tired and worry about noises. In conclusion, all 14 studies gave an indication of the impact of ostomy-related problems on the perceived QOL and demonstrated that a colostomy influences the QOL negatively. There is a wide range of ostomy-specific QOL scores, and there seem to be higher QOL scores in the studies where the MCOHQOLQO instrument was used. The MCOHQOLQO and the Stoma QOL Questionnaire gave the most detailed information about which ostomy-related problems were experienced. This review adds knowledge about the impact of stoma-related problems on QOL of long-term ostomates, but more research has to be conducted, to detect ostomy-related problems and especially possible care needs.

  1. A cognitive-behavioral and mindfulness-based group sleep intervention improves behavior problems in at-risk adolescents by improving perceived sleep quality.

    PubMed

    Blake, Matthew J; Snoep, Lian; Raniti, Monika; Schwartz, Orli; Waloszek, Joanna M; Simmons, Julian G; Murray, Greg; Blake, Laura; Landau, Elizabeth R; Dahl, Ronald E; Bootzin, Richard; McMakin, Dana L; Dudgeon, Paul; Trinder, John; Allen, Nicholas B

    2017-12-01

    The aim of this study was to test whether a cognitive-behavioral and mindfulness-based group sleep intervention would improve behavior problems in at-risk adolescents, and whether these improvements were specifically related to improvements in sleep. Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (female = 60%; mean age = 14.48, range 12.04-16.31 years) who had high levels of sleep problems and anxiety symptoms. Participants were randomized into either a sleep improvement intervention (n = 63) or an active control "study skills" intervention (n = 60). Participants completed sleep and behavior problems questionnaires, wore an actiwatch and completed a sleep diary for five school nights, both before and after the intervention. Parallel multiple mediation models showed that postintervention improvements in social problems, attention problems, and aggressive behaviors were specifically mediated by moderate improvements in self-reported sleep quality on school nights, but were not mediated by moderate improvements in actigraphy-assessed sleep onset latency or sleep diary-measured sleep efficiency on school nights. This study provides evidence, using a methodologically rigorous design, that a cognitive-behavioral and mindfulness-based group sleep intervention improved behavior problems in at-risk adolescent by improving perceived sleep quality on school nights. These findings suggest that sleep interventions could be directed towards adolescents with behavior problems. This study was part of The SENSE Study (Sleep and Education: learning New Skills Early). URL: ACTRN12612001177842; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12612001177842&isBasic=True. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Cause of vocal fold scar.

    PubMed

    Allen, Jacqui

    2010-12-01

    The prolonged debilitation, loss of income, and decrement in quality of life caused by vocal fold scar is exacerbated by our inability to successfully treat this difficult problem. As technology focuses on developing innovative treatments, we need to fully appreciate and understand the mechanisms giving rise to glottal scar, on both a macroscopic and microscopic level. This review examines recent literature pertaining to the gross and molecular mechanisms which give rise to vocal fold scar. Mechanisms of vocal fold scar production have been examined in both macroscopic and microscopic detail. Trauma and injury involving any aspect of the lamina propria, particularly the deeper layers, may result in epithelial tethering and scar formation. At the molecular level, early inflammatory cytokines activate and recruit fibroblasts which then drive the fibrotic cascade. Transforming growth factor-β enhances fibrosis and is balanced by tissue matrix metalloproteinases and hepatocyte growth factor activity. Molecular signaling offers novel opportunities to intervene in scar formation. New work investigating the cause of vocal fold scar identifies complex molecular processes leading to fibrosis in the lamina propria. Improved mechanistic understanding offers insight into prevention strategies and possible targets for antifibrotic therapies that may help prevent or treat this debilitating condition.

  3. Identification of mitochondrial genome-encoded small RNAs related to egg quality deterioration caused by post-ovulatory aging in rainbow trout

    USDA-ARS?s Scientific Manuscript database

    Numerous factors have been reported to affect rainbow trout egg quality, among which, post-ovulatory aging is one of the most significant causes as reared rainbow trout do not usually volitionally oviposit the ovulated eggs. Frequent examination of the stock is therefore required in order to reduce...

  4. [Critical reflexion on quality improvement and networking].

    PubMed

    Adler, R

    2012-06-06

    Qualitiy-control and networking are two issues of debate in modern medicine. The origin of these terms is not to be found in medicine, but rather in industry. However their naive transfer to the field of medicine causes damage. It is relatively easy to test industrial products for their quality. Dealing with meaningful medical problems is far too complex. Simple data such as blood pressure, HbA1c, etc. may be assessed. The only means of quality-control of complex medical situations and actions are ward rounds by attending physicians, case presentations at staff meetings, etc. Issues of clinical quality-control are discussed on the basis of the history of an aged couple. Furthermore a personal clinical experience illustrates how doctors create a useful network with other physicians and how they eliminate "useless" colleagues from their network. Economists should have no influence or impact whatsoever on the quality-control and networking of physicians.

  5. A Nationwide Cross-Sectional Survey of Sleep-Related Problems in Japanese Visually Impaired Patients: Prevalence and Association with Health-Related Quality of Life

    PubMed Central

    Tamura, Norihisa; Sasai-Sakuma, Taeko; Morita, Yuko; Okawa, Masako; Inoue, Shigeru; Inoue, Yuichi

    2016-01-01

    Study Objectives: This questionnaire-based cross-sectional study was conducted (1) to estimate the prevalence of sleep-related problems, and (2) to explore factors associated with lower physical/mental quality of life (QOL), particularly addressing sleep-related problems among Japanese visually impaired people. Methods: This nationwide questionnaire-based survey was administered to visually impaired individuals through the Japan Federation of the Blind. Visually impaired individuals without light perception (LP) (n = 311), those with LP (n = 287), and age-matched and gender-matched controls (n = 615) were eligible for this study. Study questionnaires elicited demographic information, and information about visual impairment status, sleep-related problems, and health-related quality of life. Results: Visually impaired individuals with and without LP showed higher prevalence rates of irregular sleep-wake patterns and difficulty maintaining sleep than controls (34.7% and 29.4% vs. 15.8%, 60.1% and 46.7% vs. 26.8%, respectively; p < 0.001). These sleep-related problems were observed more frequently in visually impaired individuals without LP than in those with LP. Non-restorative sleep or excessive daytime sleepiness was associated with lower mental/physical QOL in visually impaired individuals with LP and in control subjects. However, visually impaired individuals without LP showed irregular sleep-wake pattern or difficulty waking up at the desired time, which was associated with lower mental/physical QOL. Conclusions: Sleep-related problems were observed more frequently in visually impaired individuals than in controls. Moreover, the rates of difficulties were higher among subjects without LP. Sleep-related problems, especially circadian rhythm-related ones, can be associated with lower mental/physical QOL in visually impaired individuals without LP. Citation: Tamura N, Sasai-Sakuma T, Morita Y, Okawa M, Inoue S, Inoue Y. A nationwide cross-sectional survey of sleep

  6. The prevalence of foot problems in older women: a cause for concern.

    PubMed

    Dawson, Jill; Thorogood, Margaret; Marks, Sally-Anne; Juszczak, Ed; Dodd, Chris; Lavis, Grahame; Fitzpatrick, Ray

    2002-06-01

    Painful feet are an extremely common problem amongst older women. Such problems increase the risk of falls and hamper mobility. The aetiology of painful and deformed feet is poorly understood. Data were obtained during a pilot case-control study about past high heel usage in women, in relation to osteoarthritis of the knee. A total of 127 women aged 50-70 were interviewed (31 cases, 96 controls); case-control sets were matched for age. The following information was obtained about footwear: (1) age when first wore shoes with heels 1, 2 and 3 inches high; (2) height of heels worn for work; (3) maximum height of heels worn regularly for work, going out socially and for dancing, in 10-year age bands. Information about work-related activities and lifetime occupational history was gathered using a Life-Grid. The interview included a foot inspection. Foot problems, particularly foot arthritis, affected considerably more cases than controls (45 per cent versus 16 per cent, p = 0.001) and was considered a confounder. Cases were therefore excluded from subsequent analyses. Amongst controls, the prevalence of any foot problems was very high (83 per cent). All women had regularly worn one inch heels and few (8 per cent) had never worn 2 inch heels. Foot problems were significantly associated with a history of wearing relatively lower heels. Few work activities were related to foot problems; regular lifting was associated with foot pain (p = 0.03). Most women in this age-group have been exposed to high-heeled shoes over many years, making aetiological research difficult in this area. Foot pain and deformities are widespread. The relationship between footwear, occupational activities and foot problems is a complex one that deserves considerably more research.

  7. Diet Quality Scores and Prediction of All-Cause, Cardiovascular and Cancer Mortality in a Pan-European Cohort Study

    PubMed Central

    Lassale, Camille; Gunter, Marc J.; Romaguera, Dora; Peelen, Linda M.; Van der Schouw, Yvonne T.; Beulens, Joline W. J.; Freisling, Heinz; Muller, David C.; Ferrari, Pietro; Huybrechts, Inge; Fagherazzi, Guy; Boutron-Ruault, Marie-Christine; Affret, Aurélie; Overvad, Kim; Dahm, Christina C.; Olsen, Anja; Roswall, Nina; Tsilidis, Konstantinos K.; Katzke, Verena A.; Kühn, Tilman; Buijsse, Brian; Quirós, José-Ramón; Sánchez-Cantalejo, Emilio; Etxezarreta, Nerea; Huerta, José María; Barricarte, Aurelio; Bonet, Catalina; Khaw, Kay-Tee; Key, Timothy J.; Trichopoulou, Antonia; Bamia, Christina; Lagiou, Pagona; Palli, Domenico; Agnoli, Claudia; Tumino, Rosario; Fasanelli, Francesca; Panico, Salvatore; Bueno-de-Mesquita, H. Bas; Boer, Jolanda M. A.; Sonestedt, Emily; Nilsson, Lena Maria; Renström, Frida; Weiderpass, Elisabete; Skeie, Guri; Lund, Eiliv; Moons, Karel G. M.; Riboli, Elio; Tzoulaki, Ioanna

    2016-01-01

    Scores of overall diet quality have received increasing attention in relation to disease aetiology; however, their value in risk prediction has been little examined. The objective was to assess and compare the association and predictive performance of 10 diet quality scores on 10-year risk of all-cause, CVD and cancer mortality in 451,256 healthy participants to the European Prospective Investigation into Cancer and Nutrition, followed-up for a median of 12.8y. All dietary scores studied showed significant inverse associations with all outcomes. The range of HRs (95% CI) in the top vs. lowest quartile of dietary scores in a composite model including non-invasive factors (age, sex, smoking, body mass index, education, physical activity and study centre) was 0.75 (0.72–0.79) to 0.88 (0.84–0.92) for all-cause, 0.76 (0.69–0.83) to 0.84 (0.76–0.92) for CVD and 0.78 (0.73–0.83) to 0.91 (0.85–0.97) for cancer mortality. Models with dietary scores alone showed low discrimination, but composite models also including age, sex and other non-invasive factors showed good discrimination and calibration, which varied little between different diet scores examined. Mean C-statistic of full models was 0.73, 0.80 and 0.71 for all-cause, CVD and cancer mortality. Dietary scores have poor predictive performance for 10-year mortality risk when used in isolation but display good predictive ability in combination with other non-invasive common risk factors. PMID:27409582

  8. Grain dormancy and light quality effects on germination in the model grass Brachypodium distachyon

    USDA-ARS?s Scientific Manuscript database

    Lack of seed dormancy in cereal crops such as barley and wheat is a common problem affecting farming areas around the world, causing losses in yield and quality due to pre-harvest sprouting. Control of seed dormancy has been investigated extensively using various approaches in different species incl...

  9. Peer problems mediate the relationship between developmental coordination disorder and behavioral problems in school-aged children.

    PubMed

    Wagner, Matthias Oliver; Bös, Klaus; Jascenoka, Julia; Jekauc, Darko; Petermann, Franz

    2012-01-01

    The aim of this study was to gain insights into the relationship between developmental coordination disorder, peer problems, and behavioral problems in school-aged children where both internalizing and externalizing behavioral problems were considered. We assumed that the relationship between developmental coordination disorder and internalizing/externalizing problems in school-aged children is mediated by peer problems and tested the hypothesis that a greater degree of motor impairment causes a greater degree of peer problems and thus a greater degree of internalizing or externalizing problems. Seventy boys and girls aged between 5 and 11 years were examined using the Movement Assessment Battery for Children 2 and the Intelligence and Developmental Scales. The results of path analysis showed that the relationship between developmental coordination disorder and internalizing/externalizing problems in school-aged children is mediated at least in part by peer problems. However, the cross-sectional design of the study does not provide conclusive evidence for a cause-effect relationship and only allows for the conservative prognosis that a greater degree of motor impairment may cause a greater degree of peer problems and thus a greater degree of internalizing/externalizing problems. Nevertheless, the results of this study emphasize the importance of being well-integrated in their peer group especially for children with developmental coordination disorder. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Quality improvement primer part 1: Preparing for a quality improvement project in the emergency department.

    PubMed

    Chartier, Lucas B; Cheng, Amy H Y; Stang, Antonia S; Vaillancourt, Samuel

    2018-01-01

    Emergency medicine (EM) providers work in a fast-paced and often hectic environment that has a high risk for patient safety incidents and gaps in the quality of care. These challenges have resulted in opportunities for frontline EM providers to play a role in quality improvement (QI) projects. QI has developed into a mature field with methodologies that can dramatically improve the odds of having a successful project with a sustainable impact. However, this expertise is not yet commonly taught during professional training. In this first of three articles meant as a QI primer for EM clinicians, we will introduce QI methodology and strategic planning using a fictional case study as an example. We will review how to identify a QI problem, define components of an effective problem statement, and identify stakeholders and core change team members. We will also describe three techniques used to perform root cause analyses-Ishikawa diagrams, Pareto charts and process mapping-and how they relate to preparing for a QI project. The next two papers in this series will focus on the execution of the QI project itself using rapid-cycle testing and on the evaluation and sustainability of QI projects.

  11. Relationships between parental sleep quality, fatigue, cognitions about infant sleep, and parental depression pre and post-intervention for infant behavioral sleep problems.

    PubMed

    Hall, Wendy A; Moynihan, Melissa; Bhagat, Radhika; Wooldridge, Joanne

    2017-04-04

    Maternal and paternal depression has been associated with infants' behavioral sleep problems. Behavioral sleep interventions, which alter parental cognitions about infant sleep, have improved infant sleep problems. This study reports relationships between parental depression, fatigue, sleep quality, and cognitions about infant sleep pre and post-intervention for a behavioral sleep problem. This secondary analysis of data from Canadian parents (n = 455), with healthy infants aged 6-to-8-months exposed to a behavioral sleep intervention, examined baseline data and follow-up data from 18 or 24 weeks post intervention (group teaching or printed material) exposure. Parents reported on sleep quality, fatigue, depression, and cognitions about infant sleep. Data were analyzed using Pearson's r and stepwise regression analysis. Parents' fatigue, sleep quality, sleep cognitions, and depression scores were correlated at baseline and follow-up. At baseline, sleep quality (b = .52, 95% CI .19-.85), fatigue (b = .48, 95% CI .33-.63), doubt about managing infant sleep (b = .44, 95% CI .19-.69), and anger about infant sleep (b = .69, 95% CI .44-.94) were associated with mothers' depression. At baseline, fathers' depression related to sleep quality (b = .42, 95% CI .01-.83), fatigue (b = .47, 95% CI .32-.63), and doubt about managing infant sleep (b = .50, 95% CI .24-.76). At follow-up, mothers' depression was associated with sleep quality (b = .76, 95% CI .41-1.12), fatigue (b = .25, 95% CI .14-.37), doubt about managing infant sleep (b = .44, 95% CI .16-.73), sleep anger (b = .31, 95% CI .02-.59), and setting sleep limits (b = -.22, 95% CI -.41-[-.03]). At follow-up, fathers' depression related to sleep quality (b = .84, 95% CI .46-1.22), fatigue (b = .31, 95% CI .17-.45), sleep doubt (b = .34, 95% CI .05-.62), and setting sleep limits (b = .25, 95% CI .01-.49). Mothers' and fathers' cognitions about infant

  12. Vulvovaginitis: causes and management.

    PubMed Central

    Pierce, A M; Hart, C A

    1992-01-01

    Over a period of 33 months in a paediatric accident and emergency department, the clinical pattern and possible causes of vulvovaginitis were studied prospectively in 200 girls presenting with genital discharge, irritation, pain, or redness. The major causes were poor hygiene and threadworms. The suspicion of sexual abuse arose in a few girls but no organisms of sexually transmitted disease were found. Urinary symptoms were common but only 20 patients had a significant bacteriuria and 40 had sterile pyuria. Specific skin problems occurred in 28 cases. Simple measures to improve hygiene and treatment of threadworms gave effective relief. Genital irritation caused urinary symptoms with no clinical evidence of infection, and it is advised that antibiotic treatment should await urine culture. Specific skin problems require help from a dermatologist. The possibility of sexual abuse must be considered especially if the vulvovaginitis is persistent or recurrent after adequate treatment. PMID:1580682

  13. Study of twenty preparations of human albumin solution which failed in quality control testing due to elevated sodium content, a poor internal quality control at manufacturing unit.

    PubMed

    Prasad, J P; Madhu, Y; Singh, Surinder; Soni, G R; Agnihotri, N; Singh, Varsha; Kumar, Pradeep; Jain, Nidhi; Prakash, Anu; Singh, Varun

    2016-11-01

    Current study is conducted in our laboratory due to failure in quality control testing of twenty batches of Human Albumin solution in which sodium content is higher than the prescribed limit. These batches are received in short duration from indigenous manufacturer and is the first incident of failure of Human albumin preparation in sodium content of manufacturer. On request of manufacturer, study is conducted to rule out the cause. Repeat testing of each out of specification batch is conducted and a trend analysis is drawn between our findings and manufacturer's results, also study of trend analysis of manufacturer for the last one year. Trend analysis data indicated towards poor consistency of batches with major shift at various time intervals in sodium content of human albumin preparation. Further analysis rule out that non-traceable quality of standard used in the internal quality control testing by manufacturer is the root cause of the problem. Copyright © 2016 International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

  14. Soil problems in China and its lessons for other developing countries

    NASA Astrophysics Data System (ADS)

    Chen, N.; Widjajanto, D. W.; Zheng, Y.

    2018-01-01

    With the rapid growth of economy in China for more than 35 years since 1980, the soils in China experienced severe chances featured in high input of chemical fertilizers indeed of organic fertilizers to pursue high yield for the ever-growing population and the increase of life style and in high input of a large amount of metals especially cadmium from manure and atmospheric deposition. The shift of fertilizer application pattern and the high-yield output greatly change the soil quality, of which soil acidification is one of the main problems. Soil acidification and high cadmium input not only caused pollution on the soil but also contaminated the food. Cadmium with high percentage based on the strict soil quality standard (cadmium 0.3 mg/kg for soil, 0.2 mg/kg for rice grain). This paper will elucidate the soil pollution process in China during this 35 years and evaluate the soil and food problem properly and it may give a lesson for other developing countries when they are pave the way of modernization.

  15. Inequity and health. Is malnutrition really caused by poor nutrition?

    PubMed

    Bharmal, F Y

    2000-08-01

    To look at inequities leading to malnutrition and from the wider picture to find root causes and deal with them in order to alleviate malnutrition. Literature review. The health of the population is adversely affected by the inequities in the country. Women and children being most vulnerable are worst affected. The prevalence of Protein Energy Malnutrition (P.E.M.) in children under five years of age is 51 percent. Such a magnitude of malnutrition in a country, where availability of food per capita is more than adequate, points towards the fact that the inequities within the country are at the root of the problem. Poor income is not the only predictor of malnutrition, gender, urban-rural differences in access, utilization and quality of health care also influence health. In addition, there are some underlying factors such as illiteracy, unawareness of the mother about healthy behaviors, lack of decision-making power of women, along with deep-rooted cultural values of a patriarchal system. Malnutrition is caused by a multitude of factors, some of which are biological, others are environmental, cultural or social. Education of the invisible half of the population, who actually look after the children and the family, is an important strategy to alleviate this problem.

  16. Mathematical Problems in Synthetic Aperture Radar

    NASA Astrophysics Data System (ADS)

    Klein, Jens

    2010-10-01

    This thesis is concerned with problems related to Synthetic Aperture Radar (SAR). The thesis is structured as follows: The first chapter explains what SAR is, and the physical and mathematical background is illuminated. The following chapter points out a problem with a divergent integral in a common approach and proposes an improvement. Numerical comparisons are shown that indicate that the improvements allow for a superior image quality. Thereafter the problem of limited data is analyzed. In a realistic SAR-measurement the data gathered from the electromagnetic waves reflected from the surface can only be collected from a limited area. However the reconstruction formula requires data from an infinite distance. The chapter gives an analysis of the artifacts which can obscure the reconstructed images due to this problem. Additionally, some numerical examples are shown that point to the severity of the problem. In chapter 4 the fact that data is available only from a limited area is used to propose a new inversion formula. This inversion formula has the potential to make it easier to suppress artifacts due to limited data and, depending on the application, can be refined to a fast reconstruction formula. In the penultimate chapter a solution to the problem of left-right ambiguity is presented. This problem exists since the invention of SAR and is caused by the geometry of the measurements. This leads to the fact that only symmetric images can be obtained. With the solution from this chapter it is possible to reconstruct not only the even part of the reflectivity function, but also the odd part, thus making it possible to reconstruct asymmetric images. Numerical simulations are shown to demonstrate that this solution is not affected by stability problems as other approaches have been. The final chapter develops some continuative ideas that could be pursued in the future.

  17. Blast vibration damage to water supply well - water quality and quantity

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

    Matheson, G.M.; Miller, D.K.

    1997-05-01

    Possible impacts to the water quality and production capacity of ground water supply wells by blasting is a common cause of complaints for blasting contractors, mining companies, and local regulatory authorities. The major complaints of changes in well water quality include; turbidity; discolored water (red, brown, black, yellow and milky water), and nitrate and/or coliform contamination. The major complaints for changes in well water production capacity include: loss of quantity production, air in water and/or water lines, damage to pump, and damage to well screen or borehole. The review of research and common causes of these problems indicates that mostmore » of these complaints are not related to blasting and can be shown to be related to either environmental factors, poor well construction, or wells whose elements required repair or replacement prior to blasting. The paper reviews each of the complaints cited and provides the probable causes of the observed condition and discusses their relation to blasting.« less

  18. Severe interpersonal violence against children in sport: Associated mental health problems and quality of life in adulthood.

    PubMed

    Vertommen, Tine; Kampen, Jarl; Schipper-van Veldhoven, Nicolette; Uzieblo, Kasia; Van Den Eede, Filip

    2018-02-01

    In a recent large-scale prevalence study of interpersonal violence (IV) against child athletes in the Netherlands and Belgium we found that 9% of adult respondents who participated in organized sports before the age of 18 had experienced severe psychological violence, 8% severe physical violence, and 6% severe sexual violence in various sport settings. While the general literature has repeatedly shown that exposure to IV during childhood is associated with mental health problems in adulthood and to a lesser extent with reduced quality of life (QOL), these relationships have not been demonstrated in (former) athletes. Thus, the current study aims to assess the association of severe childhood IV in sport and adult wellbeing. Depression, anxiety, and somatization were assessed in the same general population sample (N = 4043) using the Brief Symptom Inventory (BSI-18) and QOL with the World Health Organization Quality of Life questionnaire (WHOQOL-Brèf). The association between severe IV in sport and adult wellbeing was investigated using multiple linear regression while controlling for demographics, recent life events, and relatives' psychological problems. We found severe sexual, physical, and psychological childhood IV in sport to be associated with more adult psychological distress and reduced QOL. Polyvictimization shows the strongest correlation with poorer wellbeing and QOL. Recent life events, relatives' psychological problems, marital status, and level of education were significant covariates in the psychological symptoms and QOL assessed. We hope that these new insights prompt sport administrators to implement broad spectrum child protection measures and raise the awareness of mental health professionals about the necessity to also screen for adverse childhood experiences in the sport context. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Problem music and self-harming.

    PubMed

    North, Adrian C; Hargreaves, David J

    2006-10-01

    Academics and protest groups have claimed that "problem music" (hard rock, hip hop/rap, & punk) causes self-injurious thoughts/behaviors among fans. In this study we investigated whether the relationship is mediated by self-esteem, delinquency, and conservatism; and whether first exposure to problem music preceded self-injurious thoughts. A liking for problem music was associated with four of the five self-injurious measures, although these significant relationships were weakened (into nonsignificance in the case of two self-injurious measures) when the mediating variables were included. Listening to problem music did not precede self-injurious thoughts. Problem music is associated with self-injurious thoughts and behaviors, but this relationship is mediated by other factors and the former does not seem to cause the latter.

  20. MapReduce Based Parallel Bayesian Network for Manufacturing Quality Control

    NASA Astrophysics Data System (ADS)

    Zheng, Mao-Kuan; Ming, Xin-Guo; Zhang, Xian-Yu; Li, Guo-Ming

    2017-09-01

    Increasing complexity of industrial products and manufacturing processes have challenged conventional statistics based quality management approaches in the circumstances of dynamic production. A Bayesian network and big data analytics integrated approach for manufacturing process quality analysis and control is proposed. Based on Hadoop distributed architecture and MapReduce parallel computing model, big volume and variety quality related data generated during the manufacturing process could be dealt with. Artificial intelligent algorithms, including Bayesian network learning, classification and reasoning, are embedded into the Reduce process. Relying on the ability of the Bayesian network in dealing with dynamic and uncertain problem and the parallel computing power of MapReduce, Bayesian network of impact factors on quality are built based on prior probability distribution and modified with posterior probability distribution. A case study on hull segment manufacturing precision management for ship and offshore platform building shows that computing speed accelerates almost directly proportionally to the increase of computing nodes. It is also proved that the proposed model is feasible for locating and reasoning of root causes, forecasting of manufacturing outcome, and intelligent decision for precision problem solving. The integration of bigdata analytics and BN method offers a whole new perspective in manufacturing quality control.

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

    PubMed

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

    1995-12-01

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

  2. An Examination of the Effects of Children's Gender and Behavioral Problems on the Quality of Teacher-Children Relationships

    ERIC Educational Resources Information Center

    Koca, Fatih

    2016-01-01

    The goal of the study was to examine and provide exploratory findings regarding the effects of child gender, gender socialization perspective, and child behavioral problems (i.e., internalizing and externalizing) on the quality of teacher-child relationship. Gender socialization perspective posits that girls tend to be more develop relationships…

  3. The Profile Quality of Pond In Kendal Regency to Diversification Aquaculture

    NASA Astrophysics Data System (ADS)

    Ayuniar, Ligar Novi; Hidayat, Jafron Wasiq

    2018-02-01

    Water quality, particularly coastal areas, is systematically tropogenic. The decline in water quality is caused by industrial waste pollution, soil erosion carried by the river, and the depletion of mangrove areas. The decrease of water quality can affect the fishery cultivation activities that exist in the region. It also affects the quality of the cultivated fish. Fish cultivated in ponds with poor water quality can be harmful to the health of the people who consume the fish. One effort to manage the feasibility of pond waters is by identifying the quality. The purpose of this research is to know the profile of pond water quality and to know the diversity potential of aquaculture. Based on the nature of the problem this research is a field research, while the purpose of this study is descriptive and explanatory research. The method used in this research is research by using survey method. Aquatic profile results are essential to improve the quality and quantity of Fisheries, especially in diversifying fisheries.

  4. Table - Impacts of the Proposed Transport Rule on Counties with Monitors Projected to have Ozone and/or Fine Particle Air Quality Problems

    EPA Pesticide Factsheets

    This table shows the impacts of the proposed Transport Rule on Counties with Monitors Projected to have Ozone and/or Fine Particle Air Quality Problems, both with and without the Cross-State Air Pollution Rule.

  5. Pharmacological interventions for sleepiness and sleep disturbances caused by shift work.

    PubMed

    Liira, Juha; Verbeek, Jos H; Costa, Giovanni; Driscoll, Tim R; Sallinen, Mikael; Isotalo, Leena K; Ruotsalainen, Jani H

    2015-02-01

    Shift work results in sleep-wake disturbances, which cause sleepiness during night shifts and reduce sleep length and quality in daytime sleep after the night shift. In its serious form it is also called shift work sleep disorder. Various pharmacological products are used to ameliorate symptoms of sleepiness or poor sleep length and quality. To evaluate the effects of pharmacological interventions to reduce sleepiness or to improve alertness at work and decrease sleep disturbances whilst of work, or both, in workers undertaking shift work. We searched CENTRAL, MEDLINE, EMBASE, PubMed and PsycINFO up to 20 September 2013 and ClinicalTrials.gov up to July 2013. We also screened reference lists of included trials and relevant reviews. We included all eligible randomised controlled trials (RCTs), including cross-over RCTs, of pharmacological products among workers who were engaged in shift work (including night shifts) in their present jobs and who may or may not have had sleep problems. Primary outcomes were sleep length and sleep quality while of work, alertness and sleepiness, or fatigue at work. Two authors independently selected studies, extracted data and assessed risk of bias in included trials. We performed meta-analyses where appropriate. We included 15 randomised placebo-controlled trials with 718 participants. Nine trials evaluated the effect of melatonin and two the effect of hypnotics for improving sleep problems. One trial assessed the effect of modafinil, two of armodafinil and one examined caffeine plus naps to decrease sleepiness or to increase alertness.

  6. Understanding Adult Age Differences in the Frequency of Problems With Friends.

    PubMed

    Schlosnagle, Leo; Strough, JoNell

    2017-01-01

    We investigated characteristics of younger and older adults' friendships. Younger (N = 39) and older (N = 39) adults completed measures pertaining to a specific friend they had (i.e., contact frequency, positive friendship quality, and negative friendship quality) and their frequency of problems with friends in general. Older adults reported fewer problems with friends in general, and fewer negative friendship qualities, less frequent contact, and more positive friendship qualities with a specific friend than younger adults. Contact frequency, positive friendship quality, and negative friendship quality with a specific friend were related to frequency of problems with friends in general, but only contact frequency was a significant mediator of the relation between age and frequency of problems with friends in general. Results show that characteristics of a specific friendship relate to problems with friends in general, and that contact frequency with a specific friend mediates the relation between age and problems with friends in general. Implications are discussed. © The Author(s) 2016.

  7. [LIGHT POLLUTION AS THE HYGIENIC PROBLEM].

    PubMed

    Kaptsov, V A; Gerasev, V F; Deynego, V N

    2015-01-01

    Mass introduction of lighting devices according to the concept of "maximum coverage area" and multistoried buildings of cities gave rise to light pollution, which became a problem for astronomers, ecologists and hygienists. Analysis of modern lighting devices and installations has shown that about 30-45% of the luminous flux becomes the light pollution. Night lighting of cities causes both direct and indirect damage to the environment, leads to unnecessary energy wastes. So in the USA due to excessive light there is wasted about 2 million barrels of oil per day. Light pollution affects the human hormonal system, causing various health disorders, such as insomnia and depression as a consequence. The light pollution through the ganglion cells of the retina affects the synthesis of melatonin by the pineal gland (epiphysis) and contributes to its calcification, which greatly affects the human psyche. At present, many countries have been paying much state attention to this problem via delivery of national documents and change of the concept of the designing of lighting devices and installations. The essence of this concept--to shine with a preset quality of light only in the right place at the specified time interval. This reduces the light pollution, saves energy and increases the environmental safety of lighting. There is presented an example of a technical solution to reduce the light pollution in the application of the light panel in the form of the gradient of the light guide generator project development.

  8. The role of context in preschool learning: a multilevel examination of the contribution of context-specific problem behaviors and classroom process quality to low-income children's approaches to learning.

    PubMed

    Domínguez, Ximena; Vitiello, Virginia E; Fuccillo, Janna M; Greenfield, Daryl B; Bulotsky-Shearer, Rebecca J

    2011-04-01

    Research suggests that promoting adaptive approaches to learning early in childhood may help close the gap between advantaged and disadvantaged children. Recent research has identified specific child-level and classroom-level variables that are significantly associated with preschoolers' approaches to learning. However, further research is needed to understand the interactive effects of these variables and determine whether classroom-level variables buffer the detrimental effects of child-level risk variables. Using a largely urban and minority sample (N=275) of preschool children, the present study examined the additive and interactive effects of children's context-specific problem behaviors and classroom process quality dimensions on children's approaches to learning. Teachers rated children's problem behavior and approaches to learning and independent assessors conducted classroom observations to assess process quality. Problem behaviors in structured learning situations and in peer and teacher interactions were found to negatively predict variance in approaches to learning. Classroom process quality domains did not independently predict variance in approaches to learning. Nonetheless, classroom process quality played an important role in these associations; high emotional support buffered the detrimental effects of problem behavior, whereas high instructional support exacerbated them. The findings of this study have important implications for classroom practices aimed at helping children who exhibit problem behaviors. Copyright © 2010 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  9. Research on Holographic Evaluation of Service Quality in Power Data Network

    NASA Astrophysics Data System (ADS)

    Wei, Chen; Jing, Tao; Ji, Yutong

    2018-01-01

    With the rapid development of power data network, the continuous development of the Power data application service system, more and more service systems are being put into operation. Following this, the higher requirements for network quality and service quality are raised, in the actual process for the network operation and maintenance. This paper describes the electricity network and data network services status. A holographic assessment model was presented to achieve a comprehensive intelligence assessment on the power data network and quality of service in the operation and maintenance on the power data network. This evaluation method avoids the problems caused by traditional means which performs a single assessment of network performance quality. This intelligent Evaluation method can improve the efficiency of network operation and maintenance guarantee the quality of real-time service in the power data network..

  10. A Guide to the Librarian's Responsibility in Achieving Quality in Lighting and Ventilation.

    ERIC Educational Resources Information Center

    Mason, Ellsworth

    1967-01-01

    Quality, not intensity, is the keystone to good library lighting. The single most important problem in lighting is glare caused by extremely intense centers of light. Multiple interfiling of light rays is a factor required in library lighting. A fixture that diffuses light well is basic when light emerges from the fixture. It scatters widely,…

  11. Precipitation data in a mountainous catchment in Honduras: quality assessment and spatiotemporal characteristics

    NASA Astrophysics Data System (ADS)

    Westerberg, I.; Walther, A.; Guerrero, J.-L.; Coello, Z.; Halldin, S.; Xu, C.-Y.; Chen, D.; Lundin, L.-C.

    2010-08-01

    An accurate description of temporal and spatial precipitation variability in Central America is important for local farming, water supply and flood management. Data quality problems and lack of consistent precipitation data impede hydrometeorological analysis in the 7,500 km2 Choluteca River basin in central Honduras, encompassing the capital Tegucigalpa. We used precipitation data from 60 daily and 13 monthly stations in 1913-2006 from five local authorities and NOAA's Global Historical Climatology Network. Quality control routines were developed to tackle the specific data quality problems. The quality-controlled data were characterised spatially and temporally, and compared with regional and larger-scale studies. Two gap-filling methods for daily data and three interpolation methods for monthly and mean annual precipitation were compared. The coefficient-of-correlation-weighting method provided the best results for gap-filling and the universal kriging method for spatial interpolation. In-homogeneity in the time series was the main quality problem, and 22% of the daily precipitation data were too poor to be used. Spatial autocorrelation for monthly precipitation was low during the dry season, and correlation increased markedly when data were temporally aggregated from a daily time scale to 4-5 days. The analysis manifested the high spatial and temporal variability caused by the diverse precipitation-generating mechanisms and the need for an improved monitoring network.

  12. Relationship between Hydrodynamic Conditions and Water Quality in Landscape Water Body

    NASA Astrophysics Data System (ADS)

    Kang, Mengxin; Tian, Yimei; Zhang, Haiya; Wang, Dehong

    2018-01-01

    The urban landscape water usually lacks necessary water cycle and water speed is closed to zero, which easily lead to eutrophication in water system and deterioration of water quality. Therefore, understanding the impact of water circulation on the water quality is of great significance. With that significance, this research has been done to investigate the relationship between hydrodynamic conditions and water quality of urban landscape water based on adopted water quality indexes such as chemical oxygen demand (COD), total nitrogen (TN), total phosphorus (TP) and nitrogen-ammonia (NH3-N). Moreover, MIKE 21 model is used to simulate the hydrodynamics and water quality under different cases in an urban landscape lake. The results of simulation show that water circulation system could effectively improve current speeds, reduce the proportion of stagnation area, and solve the problem of water quality deterioration caused by reclaimed water in the lake.

  13. Problem-focused coping and self-efficacy as correlates of quality of life and severity of fibromyalgia in primary fibromyalgia patients.

    PubMed

    Alok, Ragini; Das, Siddharth Kumar; Agarwal, Girdhar Gopal; Tiwari, Sarvada Chand; Salwahan, Latika; Srivastava, Ragini

    2014-09-01

    Patients with fibromyalgia syndrome (FMS) often experience problems such as poor quality of life (QoL), loss of self-efficacy (SE), inappropriate coping behavior, and chronic widespread pain along with other symptoms. Recent studies have indicated that sense of SE and effective coping strategies (CSs) are the crux on which the management of chronic pain and enrichment of QoL of FMS patients depend. Realizing the importance of this subject for the rehabilitation of the people with FMS, this study aimed at analyzing the correlation between severity of FMS, and QoL, SE, and CSs among the patients of FMS. One hundred patients with fibromyalgia (FM) and 100 control subjects were studied. Fibromyalgia Impact Questionnaire-Revised, Quality of Life Scale, Arthritis Self-efficacy Scale, and COPE Scales for CSs were administered to both the groups. Significantly lower SE, poor QoL, and less use of CSs were reported by FM patients (P < 0.01) vis-à-vis healthy people. Problem-focused coping (r = 0.27, P < 0.01) and SE (r = 0.20, P < 0.05) were found to be significantly and positively associated with QoL. Components of Fibromyalgia Impact Questionnaire-Revised, namely, pain, function, and symptoms, were found to be significantly and negatively associated with problem-focused coping (P < 0.05), SE (P < 0.01), and QoL (P < 0.01). This study confirms that problem-focused CSs and SE are important correlates of QoL and severity of FM in Indian as well as other populations.

  14. Driver's workload comparison in waste collection vehicle routing problem

    NASA Astrophysics Data System (ADS)

    Benjamin, Aida Mauziah; Abdul-Rahman, Syariza

    2016-10-01

    This paper compares the workload of the drivers for a waste collection benchmark problem. The problem involves ten data sets with different number of customers to be served and different number of disposal facilities available. Previous studies proposed a heuristic algorithm, namely Different Initial Customer (DIC) to solve the problem by constructing initial vehicles routes for the drivers with two main objectives; to minimize the total distance travelled and to minimize the total number of vehicles needed to collect the waste. The results from DIC compared well with other solutions in the literature. However, the balance of the workload among the vehicle drivers is not considered in the solutions. Thus in this paper, we evaluate the quality of the solutions in terms of the total number of customers served by each driver. Then the computational result is compared in terms of the total distance travelled which have been presented in a previous study. Comparison results show that the workload of the drivers are unbalance in terms of these two factors that may cause dissatisfaction among the drivers as well as to the managament.

  15. Case histories of building material problems caused by condensation at an enclosed swimming pool and an enclosed ice rink

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

    VanGeem, M.G.; Farahmandpour, K.; Gajda, J.

    1999-07-01

    Enclosed swimming pools and ice rinks in winter climates have the potential for high indoor relative humidities and cold building materials. These elements can contribute to condensation and premature deterioration of building materials. Case histories are provided for an enclosed swimming pool and an enclosed ice rink with condensation problems. An evaluation was performed after roof leaks were reported at a recently constructed indoor swimming pool in a Chicago suburb. After a preliminary inspection, it was evident that the reported leaks were related to building moisture problems rather than a roof leak. Exterior brick masonry exhibited heavy efflorescence in themore » area of the swimming pools, and water streaks were visible on the exterior walls below the eaves. The evaluation included laboratory testing, a visual inspection, field tests and measurements, and analyses for condensation potential. Results of the evaluation indicated the presence of condensed moisture as a direct cause of the observed water stains, and masonry efflorescence. Recommended corrective actions developed. A 54-year-old enclosed ice rink in New England was under investigation to determine the cause of a deteriorated wood deck roof. The building did not have dehumidification or air handling systems, and was heated only when occupied. The evaluation included visual inspection and analyses for condensation potential. Results of the evaluation indicated condensation within the wood decking and insulation during winter months, and high relative humidities that prohibited drying during the spring, summer, and fall. These conditions, over an extended number of years, resulted in decay of the wood decking.« less

  16. Problems of quality and equity in pain management: exploring the role of biomedical culture.

    PubMed

    Crowley-Matoka, Megan; Saha, Somnath; Dobscha, Steven K; Burgess, Diana J

    2009-10-01

    To explore how social scientific analyses of the culture of biomedicine may contribute to advancing our understanding of ongoing issues of quality and equity in pain management. Drawing upon the rich body of social scientific literature on the culture of biomedicine, we identify key features of biomedical culture with particular salience for pain management. We then examine how these cultural features of biomedicine may shape key phases of the pain management process in ways that have implications not just for quality, but for equity in pain management as well. We bring together a range of literatures in developing our analysis, including literatures on the culture of biomedicine, pain management and health care disparities. We surveyed the relevant literatures to identify and inter-relate key features of biomedical culture, key phases of the pain management process, and key dimensions of identified problems with suboptimal and inequitable treatment of pain. We identified three key features of biomedical culture with critical implications for pain management: 1) mind-body dualism; 2) a focus on disease vs illness; and 3) a bias toward cure vs care. Each of these cultural features play a role in the key phases of pain management, specifically pain-related communication, assessment and treatment decision-making, in ways that may hinder successful treatment of pain in general -- and of pain patients from disadvantaged groups in particular. Deepening our understanding of the role of biomedical culture in pain management has implications for education, policy and research as part of ongoing efforts to ameliorate problems in both quality and equity in managing pain. In particular, we suggest that building upon the existing the cultural competence movement in medicine to include fostering a deeper understanding of biomedical culture and its impact on physicians may be useful. From a policy perspective, we identify pain management as an area where the need for a shift to a

  17. Causes of deaths data, linkages and big data perspectives.

    PubMed

    Rey, Grégoire; Bounebache, Karim; Rondet, Claire

    2018-07-01

    The study of cause-specific mortality data is one of the main sources of information for public health monitoring. In most industrialized countries, when a death occurs, it is a legal requirement that a medical certificate based on the international form recommended by World Health Organization's (WHO) is filled in by a physician. The physician reports the causes of death that directly led or contributed to the death on the death certificate. The death certificate is then forwarded to a coding office, where each cause is coded, and one underlying cause is defined, using the rules of the International Classification of Diseases and Related Health Problems, now in its 10th Revision (ICD-10). Recently, a growing number of countries have adopted, or have decided to adopt, the coding software Iris, developed and maintained by an international consortium 1 . This whole standardized production process results in a high and constantly increasing international comparability of cause-specific mortality data. While these data could be used for international comparisons and benchmarking of global burden of diseases, quality of care and prevention policies, there are also many other ways and methods to explore their richness, especially when they are linked with other data sources. Some of these methods are potentially referring to the so-called "big data" field. These methods could be applied both to the production of the data, to the statistical processing of the data, and even more to process these data linked to other databases. In the present note, we depict the main domains in which this new field of methods could be applied. We focus specifically on the context of France, a 65 million inhabitants country with a centralized health data system. Finally we will insist on the importance of data quality, and the specific problematics related to death certification in the forensic medicine domain. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All

  18. Problems Caused by Microbes and Treatment Strategies Monitoring and Preventing Reservoir Souring Using Molecular Microbiological Methods (MMM)

    NASA Astrophysics Data System (ADS)

    Gittel, Antje

    The injection of seawater during the process of secondary oil recovery in offshore oilfields supplies huge amounts of sulphate to the prokaryotic reservoir communities. Together with the presence of oil organics and their degradation products as electron donors, this facilitates the enrichment and growth of sulphate-reducing prokaryotes (SRP) in the reservoir, as well as in pipings and top-side installations (Sunde and Torsvik, 2005; Vance and Thrasher, 2005). The activity of SRP causes severe economic problems due to the reactivity and toxicity of the produced hydrogen sulphide (H2S), one of the major problems being reservoir souring. Besides the use of broad-spectrum biocides or inhibitors for sulphate reduction, the addition of nitrate effectively decreased the net production of H2S in model column studies (Myhr et al., 2002; Hubert et al., 2005; Dunsmore et al., 2006) and field trials (Telang et al., 1997; Bødtker et al., 2008). The mechanisms by which nitrate addition might affect souring control are (i) the stimulation of heterotrophic nitrate-reducing bacteria (hNRB) that outcompete SRP for electron donors, (ii) the activity of nitrate-reducing, sulphide-oxidising bacteria (NR-SOB), and (iii) the inhibition of SRP by the production of nitrite and nitrous oxides (Sunde and Torsvik, 2005; Hubert and Voordouw, 2007).

  19. Quality Control in Title I Evaluation: Problems and Approaches.

    ERIC Educational Resources Information Center

    Hansen, Joe B.

    Educational program evalaution is subject to many difficulties. Problems with evaluation include such conceptual problems as: (1) understanding of decisions to be made; (2) adequate definition; (3) consensus on values and criteria; (4) coordination among administrative levels; and (5) use of an appropriate evaluation model. Technical problems…

  20. Beliefs of people taking antidepressants about the causes of their own depression.

    PubMed

    Read, John; Cartwright, Claire; Gibson, Kerry; Shiels, Christopher; Magliano, Lorenza

    2015-03-15

    The beliefs of people receiving treatment about the causes of their own mental health problems are researched less often than the causal beliefs of the public, but have important implications for relationships with prescribers, treatment choices and recovery. An online survey on a range of beliefs about depression, and experiences with antidepressants, was completed by 1829 New Zealand adults prescribed anti-depressants in the preceding five years, 97.4% of whom proceeded to take antidepressants. Six of 17 beliefs about the causes of their own depression were endorsed by more than half the sample: chemical imbalance, family stress, work stress, heredity, relationship problems and distressing events in childhood. There were some marked differences in content, structure and level of conviction of beliefs about one׳s own depression and the sample׳s previously published beliefs about depression in general. There were also significant differences between the beliefs of demographic groupings. Regression analyses revealed that self-reported effectiveness of the antidepressants was positively associated with bio-genetic causal beliefs. The quality of the relationship with the prescribing doctor was positively related to a belief in chemical imbalance as a cause and negatively related to a belief in unemployment as a cause. The convenience sample may have been biased towards a favourable view of bio-genetic explanations, since 83% reported that the medication reduced their depression. People experiencing depression hold complex, multifactorial and idiosyncratic sets of beliefs about the causes of their own depression, apparently based at least in part on their own life experiences and circumstances. Exploring those beliefs may enhance the doctor-patient relationship and selection of appropriate treatment modality. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Water Quality Monitor

    NASA Technical Reports Server (NTRS)

    1982-01-01

    An automated water quality monitoring system was developed by Langley Research Center to meet a need of the Environmental Protection Agency (EPA). Designed for unattended operation in water depths up to 100 feet, the system consists of a subsurface buoy anchored in the water, a surface control unit (SCU) and a hydrophone link for acoustic communication between buoy and SCU. Primary functional unit is the subsurface buoy. It incorporates 16 cells for water sampling, plus sensors for eight water quality measurements. Buoy contains all the electronic equipment needed for collecting and storing sensor data, including a microcomputer and a memory unit. Power for the electronics is supplied by a rechargeable nickel cadmium battery that is designed to operate for about two weeks. Through hydrophone link the subsurface buoy reports its data to the SCU, which relays it to land stations. Link allows two-way communications. If system encounters a problem, it automatically shuts down and sends alert signal. Sequence of commands sent via hydrophone link causes buoy to release from anchor and float to the surface for recovery.

  2. [Quality of life in patients with age-related macular degeneration - medical and social problem].

    PubMed

    Muzyka-Woźniak, Maria; Misiuk-Hojło, Marta; Wesolowska, Alicja

    2011-01-01

    Age-related macular degeneration (AMD) is a leading cause of blindness over the age of 50 in western countries. People with AMD are suffering from serious vision-related disability and their social life is compromised. The aim of our study was to assess quality of life (QoL) in patients with exudative AMD. The study group was 100 patients treated for AMD, the control group were 30 age and sex matched subjects without ophthalmic disorders. Patients were treated with anti-VEGF therapy, by means of National Eye Institute Visual Function Questionnaire (NEI VFQ-25). As well as visual function, the NEI-VFQ investigates social functioning, mental health and dependency. There was statistically significant difference in QoL overall score between study group and control group. Patients with AMD obtained 51.1 (+/- 20.5 ) overall score, control group reached 83.7 (+/- 11.7) overall score, p = 0.001. Detailed analysis of study group revealed low acceptance of the disease and strong dependency. QoL in patients with AMD assessed with NEI VFQ-25, is significantly impaired. Low quality of life and difficulties in performing daily activities point at the need of formal psychological and social care.

  3. Analysis of disruptive events and precarious situations caused by interaction with neurosurgical microscope.

    PubMed

    Eivazi, Shahram; Afkari, Hoorieh; Bednarik, Roman; Leinonen, Ville; Tukiainen, Markku; Jääskeläinen, Juha E

    2015-07-01

    Developments in micro-neurosurgical microscopes have improved operating precision and ensured the quality of outcomes. Using the stereoscopic magnified view, however, necessitates frequent manual adjustments to the microscope during an operation. This article reports on an investigation of the interaction details concerning a state-of-the-art micro-neurosurgical microscope. The video data from detailed observations of neurosurgeons' interaction patterns with the microscope were analysed to examine disruptive events caused by adjusting the microscope. The primary findings show that interruptions caused by adjusting the microscope handgrips and mouth switch prolong the surgery time up to 10%. Surgeons, we observed, avoid interaction with the microscope's controls, settings, and configurations by working at the edge of the view, operating on a non-focused view, and assuming unergonomic body postures. The lack of an automatic method for adjusting the microscope is a major problem that causes interruptions during micro-neurosurgery. From this understanding of disruptive events, we discuss the opportunities and limitations of interactive technologies that aim to reduce the frequency or shorten the duration of interruptions caused by microscope adjustment.

  4. Estimated Under-Five Deaths Associated with Poor-Quality Antimalarials in Sub-Saharan Africa

    PubMed Central

    Renschler, John P.; Walters, Kelsey M.; Newton, Paul N.; Laxminarayan, Ramanan

    2015-01-01

    Many antimalarials sold in sub-Saharan Africa are poor-quality (falsified, substandard, or degraded), and the burden of disease caused by this problem is inadequately quantified. In this article, we estimate the number of under-five deaths caused by ineffective treatment of malaria associated with consumption of poor-quality antimalarials in 39 sub-Saharan countries. Using Latin hypercube sampling our estimates were calculated as the product of the number of private sector antimalarials consumed by malaria-positive children in 2013; the proportion of private sector antimalarials consumed that were of poor-quality; and the case fatality rate (CFR) of under-five malaria-positive children who did not receive appropriate treatment. An estimated 122,350 (interquartile range [IQR]: 91,577–154,736) under-five malaria deaths were associated with consumption of poor-quality antimalarials, representing 3.75% (IQR: 2.81–4.75%) of all under-five deaths in our sample of 39 countries. There is considerable uncertainty surrounding our results because of gaps in data on case fatality rates and prevalence of poor-quality antimalarials. Our analysis highlights the need for further investigation into the distribution of poor-quality antimalarials and the need for stronger surveillance and regulatory efforts to prevent the sale of poor-quality antimalarials. PMID:25897068

  5. On the Causes of Effects

    ERIC Educational Resources Information Center

    Dawid, A. Philip; Faigman, David L.; Fienberg, Stephen E.

    2015-01-01

    We welcome Professor Pearl's comment on our original article, Dawid et al. Our focus there on the distinction between the "Effects of Causes" (EoC) and the "Causes of Effects" (CoE) concerned two fundamental problems, one a theoretical challenge in statistics and the other a practical challenge for trial courts. In this…

  6. Mutations Affecting the SAND Domain of DEAF1 Cause Intellectual Disability with Severe Speech Impairment and Behavioral Problems

    PubMed Central

    Vulto-van Silfhout, Anneke T.; Rajamanickam, Shivakumar; Jensik, Philip J.; Vergult, Sarah; de Rocker, Nina; Newhall, Kathryn J.; Raghavan, Ramya; Reardon, Sara N.; Jarrett, Kelsey; McIntyre, Tara; Bulinski, Joseph; Ownby, Stacy L.; Huggenvik, Jodi I.; McKnight, G. Stanley; Rose, Gregory M.; Cai, Xiang; Willaert, Andy; Zweier, Christiane; Endele, Sabine; de Ligt, Joep; van Bon, Bregje W.M.; Lugtenberg, Dorien; de Vries, Petra F.; Veltman, Joris A.; van Bokhoven, Hans; Brunner, Han G.; Rauch, Anita; de Brouwer, Arjan P.M.; Carvill, Gemma L.; Hoischen, Alexander; Mefford, Heather C.; Eichler, Evan E.; Vissers, Lisenka E.L.M.; Menten, Björn; Collard, Michael W.; de Vries, Bert B.A.

    2014-01-01

    Recently, we identified in two individuals with intellectual disability (ID) different de novo mutations in DEAF1, which encodes a transcription factor with an important role in embryonic development. To ascertain whether these mutations in DEAF1 are causative for the ID phenotype, we performed targeted resequencing of DEAF1 in an additional cohort of over 2,300 individuals with unexplained ID and identified two additional individuals with de novo mutations in this gene. All four individuals had severe ID with severely affected speech development, and three showed severe behavioral problems. DEAF1 is highly expressed in the CNS, especially during early embryonic development. All four mutations were missense mutations affecting the SAND domain of DEAF1. Altered DEAF1 harboring any of the four amino acid changes showed impaired transcriptional regulation of the DEAF1 promoter. Moreover, behavioral studies in mice with a conditional knockout of Deaf1 in the brain showed memory deficits and increased anxiety-like behavior. Our results demonstrate that mutations in DEAF1 cause ID and behavioral problems, most likely as a result of impaired transcriptional regulation by DEAF1. PMID:24726472

  7. Optimum profit model considering production, quality and sale problem

    NASA Astrophysics Data System (ADS)

    Chen, Chung-Ho; Lu, Chih-Lun

    2011-12-01

    Chen and Liu ['Procurement Strategies in the Presence of the Spot Market-an Analytical Framework', Production Planning and Control, 18, 297-309] presented the optimum profit model between the producers and the purchasers for the supply chain system with a pure procurement policy. However, their model with a simple manufacturing cost did not consider the used cost of the customer. In this study, the modified Chen and Liu's model will be addressed for determining the optimum product and process parameters. The authors propose a modified Chen and Liu's model under the two-stage screening procedure. The surrogate variable having a high correlation with the measurable quality characteristic will be directly measured in the first stage. The measurable quality characteristic will be directly measured in the second stage when the product decision cannot be determined in the first stage. The used cost of the customer will be measured by adopting Taguchi's quadratic quality loss function. The optimum purchaser's order quantity, the producer's product price and the process quality level will be jointly determined by maximising the expected profit between them.

  8. Quality of Life of Country Families in Four Eastern Kentucky Counties: Change and Persistent Problems, 1961 and 1973. RS-46.

    ERIC Educational Resources Information Center

    Coughenour, C. Milton

    Change and persistent problems in the quality of life of open-country families (n=317) in four eastern Kentucky counties (Harlan, Perry, Whitley, and Wolfe) were examined via comparison of data derived from surveys of household heads in 1961 and 1973. The 1961 survey provided data on occupations, income, level of living, and opinions re: the…

  9. Making stillbirths visible: a systematic review of globally reported causes of stillbirth.

    PubMed

    Reinebrant, H E; Leisher, S H; Coory, M; Henry, S; Wojcieszek, A M; Gardener, G; Lourie, R; Ellwood, D; Teoh, Z; Allanson, E; Blencowe, H; Draper, E S; Erwich, J J; Frøen, J F; Gardosi, J; Gold, K; Gordijn, S; Gordon, A; Heazell, Aep; Khong, T Y; Korteweg, F; Lawn, J E; McClure, E M; Oats, J; Pattinson, R; Pettersson, K; Siassakos, D; Silver, R M; Smith, Gcs; Tunçalp, Ö; Flenady, V

    2018-01-01

    Stillbirth is a global health problem. The World Health Organization (WHO) application of the International Classification of Diseases for perinatal mortality (ICD-PM) aims to improve data on stillbirth to enable prevention. To identify globally reported causes of stillbirth, classification systems, and alignment with the ICD-PM. We searched CINAHL, EMBASE, Medline, Global Health, and Pubmed from 2009 to 2016. Reports of stillbirth causes in unselective cohorts. Pooled estimates of causes were derived for country representative reports. Systems and causes were assessed for alignment with the ICD-PM. Data are presented by income setting (low, middle, and high income countries; LIC, MIC, HIC). Eighty-five reports from 50 countries (489 089 stillbirths) were included. The most frequent categories were Unexplained, Antepartum haemorrhage, and Other (all settings); Infection and Hypoxic peripartum (LIC), and Placental (MIC, HIC). Overall report quality was low. Only one classification system fully aligned with ICD-PM. All stillbirth causes mapped to ICD-PM. In a subset from HIC, mapping obscured major causes. There is a paucity of quality information on causes of stillbirth globally. Improving investigation of stillbirths and standardisation of audit and classification is urgently needed and should be achievable in all well-resourced settings. Implementation of the WHO Perinatal Mortality Audit and Review guide is needed, particularly across high burden settings. HR, SH, SHL, and AW were supported by an NHMRC-CRE grant (APP1116640). VF was funded by an NHMRC-CDF (APP1123611). Urgent need to improve data on causes of stillbirths across all settings to meet global targets. Background and methods Nearly three million babies are stillborn every year. These deaths have deep and long-lasting effects on parents, healthcare providers, and the society. One of the major challenges to preventing stillbirths is the lack of information about why they happen. In this study, we

  10. Sexual problems in people with refractory epilepsy.

    PubMed

    Henning, Oliver J; Nakken, Karl O; Træen, Bente; Mowinckel, Petter; Lossius, Morten

    2016-08-01

    Sexual dysfunction is an important but often neglected aspect of epilepsy. The objective of this study was to explore the prevalence and types of sexual problems in patients with epilepsy and compare the results with similar data obtained from a representative sample of the general population. At the National Centre for Epilepsy in Norway, 171 of 227 consecutive adult inpatients and outpatients with epilepsy (response rate: 75.3%) and their neurologists participated in a questionnaire study about epilepsy and sexuality. The results were compared with data available from 594 adult Norwegians who had completed the same questionnaire. Patients with epilepsy had a significantly higher prevalence of sexual problems (women: 75.3% vs. 12.0%; men: 63.3% vs. 9.6%). The most commonly reported problems (>30%) were reduced sexual desire, orgasm problems, erection problems, and vaginal dryness. The patients reported considerable dissatisfaction regarding sexual functioning. Significantly more sexual problems were found in patients of both sexes with reduced quality of life and in women with symptoms of depression. We found no significant association between sexual problems and age of epilepsy onset, type of epilepsy, or use of enzyme-inducing antiepileptic drugs. Whereas age at sexual debut did not differ between the patients with epilepsy and the general population, men with epilepsy had a lower number of partners during the last 12months, and the proportion of women with a low frequency of intercourse was higher in the group with epilepsy. In conclusion, sexual problems are significantly greater in Norwegian patients with epilepsy than in the general adult population. As no single epilepsy type or treatment could be identified as a specific predisposing factor, it seems likely that there are multiple causes underlying our results, including both organic and psychosocial factors. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Water Pollution (Causes, Mechanisms, Solution).

    ERIC Educational Resources Information Center

    Strandberg, Carl

    Written for the general public, this book illustrates the causes, status, problem areas, and prediction and control of water pollution. Water pollution is one of the most pressing issues of our time and the author communicates the complexities of this problem to the reader in common language. The purpose of the introductory chapter is to show what…

  12. What Causes Menstrual Irregularities?

    MedlinePlus

    ... epilepsy or mental health problems Common causes of heavy or prolonged menstrual bleeding include: 2 , 7 Adolescence ( ... ovulation) Polycystic ovary syndrome (PCOS) (bleeding irregular but heavy) Uterine fibroids (benign growths of uterine muscle) Endometrial ...

  13. Solving TSP problem with improved genetic algorithm

    NASA Astrophysics Data System (ADS)

    Fu, Chunhua; Zhang, Lijun; Wang, Xiaojing; Qiao, Liying

    2018-05-01

    The TSP is a typical NP problem. The optimization of vehicle routing problem (VRP) and city pipeline optimization can use TSP to solve; therefore it is very important to the optimization for solving TSP problem. The genetic algorithm (GA) is one of ideal methods in solving it. The standard genetic algorithm has some limitations. Improving the selection operator of genetic algorithm, and importing elite retention strategy can ensure the select operation of quality, In mutation operation, using the adaptive algorithm selection can improve the quality of search results and variation, after the chromosome evolved one-way evolution reverse operation is added which can make the offspring inherit gene of parental quality improvement opportunities, and improve the ability of searching the optimal solution algorithm.

  14. Sleep problems in Dravet syndrome: a modifiable comorbidity.

    PubMed

    Licheni, Shane H; Mcmahon, Jacinta M; Schneider, Amy L; Davey, Margot J; Scheffer, Ingrid E

    2018-02-01

    Many children with severe developmental and epileptic encephalopathies experience significant sleep disturbance, causing major disruption to the family's quality of life. We aimed to determine the frequency and nature of sleep problems in individuals with Dravet syndrome. The Sleep Disturbance Scale for Children and a seizure questionnaire were distributed to the parents/guardians of 96 patients with Dravet syndrome. Sixteen patients had two nights of home oximetry. Fifty-seven out of 96 questionnaires were completed. Forty-three out of 57 (75%) individuals had sleep problems. Twenty-five out of 57 (44%) individuals had an abnormal total sleep score, with difficulty initiating and maintaining sleep (22 out of 57, 39%), sleep-wake transition disorders (20 out of 57, 35%), and sleep breathing disorders (19 out of 57, 33%). Twenty-two out of 57 (39%) individuals took medication to assist sleep, predominantly melatonin (n=14). Thirty out of 57 (53%) recently had nocturnal seizures. Overnight oximetry showed 14 out of 16 (88%) had a higher oxygen desaturation index (>3%), and six out of 16 (38%) had higher mean pulse rates than normative values. Home oximetry was normal or inconclusive in all patients. Seventy-five per cent of individuals with Dravet syndrome had sleep problems, highlighting the importance of routinely assessing sleep and initiating appropriate behavioural and pharmacological interventions to improve the patient and family's quality of life. A high oxygen desaturation index and mean pulse rates on pulse oximetry may reflect unrecognized nocturnal seizures. More than 70% of patients with Dravet syndrome have sleep problems. Difficulty initiating and maintaining sleep was most common, particularly in those older than 20 years. Second most common were sleep-wake transition disorders, affecting more than 50% of those younger than 5 years. Sleep breathing disorders were a frequent problem across all age groups. Oximetry was not diagnostic of sleep

  15. Quality management: reduction of waiting time and efficiency enhancement in an ENT-university outpatients' department

    PubMed Central

    Helbig, Matthias; Helbig, Silke; Kahla-Witzsch, Heike A; May, Angelika

    2009-01-01

    Background Public health systems are confronted with constantly rising costs. Furthermore, diagnostic as well as treatment services become more and more specialized. These are the reasons for an interdisciplinary project on the one hand aiming at simplification of planning and scheduling patient appointments, on the other hand at fulfilling all requirements of efficiency and treatment quality. Methods As to understanding procedure and problem solving activities, the responsible project group strictly proceeded with four methodical steps: actual state analysis, analysis of causes, correcting measures, and examination of effectiveness. Various methods of quality management, as for instance opinion polls, data collections, and several procedures of problem identification as well as of solution proposals were applied. All activities were realized according to the requirements of the clinic's ISO 9001:2000 certified quality management system. The development of this project is described step by step from planning phase to inauguration into the daily routine of the clinic and subsequent control of effectiveness. Results Five significant problem fields could be identified. After an analysis of causes the major remedial measures were: installation of a patient telephone hotline, standardization of appointment arrangements for all patients, modification of the appointments book considering the reason for coming in planning defined working periods for certain symptoms and treatments, improvement of telephonic counselling, and transition to flexible time planning by daily updates of the appointments book. After implementation of these changes into the clinic's routine success could be demonstrated by significantly reduced waiting times and resulting increased patient satisfaction. Conclusion Systematic scrutiny of the existing organizational structures of the outpatients' department of our clinic by means of actual state analysis and analysis of causes revealed the necessity

  16. Low physical activity and high screen time can increase the risks of mental health problems and poor sleep quality among Chinese college students.

    PubMed

    Wu, Xiaoyan; Tao, Shuman; Zhang, Yukun; Zhang, Shichen; Tao, Fangbiao

    2015-01-01

    To test the independent and interactive associations of physical activity (PA) and screen time (ST) with self-reported mental health and sleep quality among Chinese college students. Data were collected in October, 2013. The gender, age, residential background, body mass index (BMI), perceived family economy and perceived study burden were obtained from a total of 4747 college students (41.6% males and 58.4% females). The outcomes were self-reported PA status, ST, anxiety, depression, psychopathological symptoms and sleep quality. Analyses were conducted with logistic regression models. Overall, 16.3%, 15.9% and 17.3% of the students had psychological problems, such as anxiety, depression and psychopathological symptoms, respectively. The prevalence of poor sleep quality was 9.8%. High ST was significantly positively associated with anxiety (OR=1.38, 95%CI: 1.15-1.65), depression (OR=1.76, 95%CI: 1.47-2.09), psychopathological symptoms (OR=1.69, 95%CI: 1.43-2.01) and poor sleep quality (OR=1.32, 95%CI: 1.06-1.65). High PA was insignificantly negatively associated with anxiety, depression, psychopathological symptoms and poor sleep. Low PA and high ST were independently and interactively associated with increased risks of mental health problems and poor sleep quality (p<0.05 for all). Interventions are needed to reduce ST and increase PA in the lifestyles of young people. Future research should develop and measure the impacts of interventions and their potential consequences on sleep, health, and well being.

  17. Computerization in industry causes problems for people with reading and writing difficulties (dyslexia).

    PubMed

    Knutsson, A

    1986-01-01

    For 10 years computerization in industry has advanced at a rapid pace. A problem which has not received attention is that of people with reading and writing difficulties who experience severe problems when they have to communicate with a computer monitor screen. These individuals are often embarrassed by their difficulties and conceal them from their fellow workers. A number of case studies are described which show the form the problems can take. In one case, an employee was compelled to move from department to department as each was computerized in turn. Computers transform a large number of manual tasks in industry into jobs which call for reading and writing skills. Better education at elementary school and at the workplace in connection with computerization are the most important means of overcoming this problem. Moreover, computer programs could be written in a more human way.

  18. Psychological Problems, Protective Factors and Health-Related Quality of Life in Youth Affected by Violence: The Burden of the Multiply Victimised

    ERIC Educational Resources Information Center

    Schlack, Robert; Ravens-Sieberer, Ulrike; Petermann, Franz

    2013-01-01

    This study investigates self-rated mental health in terms of psychological problems, protective factors and health-related quality of life (HRQOL) in a nationally representative sample of adolescents (n = 6813) aged 11-17 involved in violence with varying frequency. Using MANCOVA and ANCOVA, youth with single and multiple histories of violent…

  19. 1976 water-quality data in Bear Creek basin, Medford, Oregon

    USGS Publications Warehouse

    McKenzie, Stuart W.; Wittenberg, Loren A.

    1977-01-01

    The U.S. Geological Survey, in cooperation with the Rogue Valley Council of Governments, is studying surface-water-quality problems and their causes in the Bear Creek basin of southwestern Oregon. Two specific areas of investigation include: measurements of the quality and quantity of water in the irrigation canals and drainage system and the diel (during a 24-hour period) variation of water-quality parameters in the main stem of Bear Creek. The irrigation and drainage study involves 25 sites in canals and natural drainageways. One hundred thirty-three samples were collected for analysis, and discharge was determined at the time of collection. The diel study includes six sites on Bear Creek. On August 23-24, four parameters were monitored at all six sites during a 24-hour period.

  20. A framework for the evaluation of air pollution caused by motor vehicles

    NASA Astrophysics Data System (ADS)

    Elawej, Khalifa A. K.

    This research investigated the problem of air pollution caused by vehicles in the city of Tripoli, Libya. This also included the identification of the socioeconomic and institutional factors which have contributed to the increased severity of the air pollution problem. The issues addressed included legal, institutional and technical aspects. A descriptive method was applied in which a case study approach was adopted. Primary data were collected through personal interviews with responsible people in relevant institutions, including EGA, GTL and ATD, complemented by questionnaires and direct observations. The data collected from the interviews and questionnaires were analysed using Excel and SPSS software.Owing to the lack of data on vehicular emissions in the study area, an inventory of the annual vehicular emissions in the city was made through the application of COPERT.4 software which is widely used for calculating vehicular emissions. This inventory covered the period from 2005 to 2010. Laboratory Mobile was also used to measure the concentration of vehicular emissions in the city centre of Tripoli, and compared with the vehicular concentrations in Sheffield, UK, for the same period.A framework was developed and validated to evaluate the air pollution caused by vehicles in Tripoli. The findings from the research showed that there has been a dramatic increase in the quantity of vehicle emissions in the city, highlighting the extent of the problem. Some influencing factors which have made a significant contribution to the occurrence and increased severity of traffic air pollution in Tripoli include: the increase in the vehicle fleet, the quality and quantity of the fuel consumed, insufficient public transportation, a shortage of public awareness, and deficiencies in the relevant legislation. Obstacles facing the responsible institutions include a lack of capable and qualified staff, and a shortage of necessary equipment for monitoring and addressing traffic

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

    PubMed

    Roche, B G; Sommer, C

    1995-01-01

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

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

    PubMed

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

    2012-01-01

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

  3. When Poor Indoor Air Causes a Crisis.

    ERIC Educational Resources Information Center

    Spencer, Robert D.

    1998-01-01

    An air quality problem originating with a steam leak in an improperly maintained heating system resulted in unanticipated expenses of $420,000 for the Lakeview (Michigan) School District. Indoor air quality complaints require immediate investigation and action; clear communication to parents, staff, and media representatives; competent…

  4. Combining FMEA with DEMATEL models to solve production process problems.

    PubMed

    Tsai, Sang-Bing; Zhou, Jie; Gao, Yang; Wang, Jiangtao; Li, Guodong; Zheng, Yuxiang; Ren, Peng; Xu, Wei

    2017-01-01

    Failure mode and effects analysis (FMEA) is an analysis tool for identifying and preventing flaws or defects in products during the design and process planning stage, preventing the repeated occurrence of problems, reducing the effects of these problems, enhancing product quality and reliability, saving costs, and improving competitiveness. However, FMEA can only analyze one influence factor according to its priority, rendering this method ineffective for systems containing multiple FMs whose effects are simultaneous or interact with one another. Accordingly, when FMEA fails to identify the influence factors and the factors being influenced, the most crucial problems may be placed in lower priority or remain unresolved. Decision-Making Trial and Evaluation Laboratory (DEMATEL) facilitates the determination of cause and effect factors; by identifying the causal factors that should be prioritized, prompt and effective solutions to core problems can be derived, thereby enhancing performance. Using the photovoltaic cell manufacturing industry in China as the research target, the present study combined FMEA with DEMATEL to amend the flaws of FMEA and enhance its effectiveness. First, FMEA was used to identify items requiring improvement. Then, DEMATEL was employed to examine the interactive effects and causal relationships of these items. Finally, the solutions to the problems were prioritized. The proposed method effectively combined the advantages of FMEA and DEMATEL to facilitate the identification of core problems and prioritization of solutions in the Chinese photovoltaic cell industry.

  5. Controlling urban air pollution caused by households: uncertainty, prices, and income.

    PubMed

    Chávez, Carlos A; Stranlund, John K; Gómez, Walter

    2011-10-01

    We examine the control of air pollution caused by households burning wood for heating and cooking in the developing world. Since the problem is one of controlling emissions from nonpoint sources, regulations are likely to be directed at household choices of wood consumption and combustion technologies. Moreover, these choices are subtractions from, or contributions to, the pure public good of air quality. Consequently, the efficient policy design is not independent of the distribution of household income. Since it is unrealistic to assume that environmental authorities can make lump sum income transfers part of control policies, efficient control of air pollution caused by wood consumption entails a higher tax on wood consumption and a higher subsidy for more efficient combustion technologies for higher income households. Among other difficulties, implementing a policy to promote the adoption of cleaner combustion technologies must overcome the seemingly paradoxical result that efficient control calls for higher technology subsidies for higher income households. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. A Nationwide Cross-Sectional Survey of Sleep-Related Problems in Japanese Visually Impaired Patients: Prevalence and Association with Health-Related Quality of Life.

    PubMed

    Tamura, Norihisa; Sasai-Sakuma, Taeko; Morita, Yuko; Okawa, Masako; Inoue, Shigeru; Inoue, Yuichi

    2016-12-15

    This questionnaire-based cross-sectional study was conducted (1) to estimate the prevalence of sleep-related problems, and (2) to explore factors associated with lower physical/mental quality of life (QOL), particularly addressing sleep-related problems among Japanese visually impaired people. This nationwide questionnaire-based survey was administered to visually impaired individuals through the Japan Federation of the Blind. Visually impaired individuals without light perception (LP) (n = 311), those with LP (n = 287), and age-matched and gender-matched controls (n = 615) were eligible for this study. Study questionnaires elicited demographic information, and information about visual impairment status, sleep-related problems, and health-related quality of life. Visually impaired individuals with and without LP showed higher prevalence rates of irregular sleep-wake patterns and difficulty maintaining sleep than controls (34.7% and 29.4% vs. 15.8%, 60.1% and 46.7% vs. 26.8%, respectively; p < 0.001). These sleep-related problems were observed more frequently in visually impaired individuals without LP than in those with LP. Non-restorative sleep or excessive daytime sleepiness was associated with lower mental/physical QOL in visually impaired individuals with LP and in control subjects. However, visually impaired individuals without LP showed irregular sleep-wake pattern or difficulty waking up at the desired time, which was associated with lower mental/physical QOL. Sleep-related problems were observed more frequently in visually impaired individuals than in controls. Moreover, the rates of difficulties were higher among subjects without LP. Sleep-related problems, especially circadian rhythm-related ones, can be associated with lower mental/physical QOL in visually impaired individuals without LP. © 2016 American Academy of Sleep Medicine

  7. Moderating effect of self-efficacy on the relation between behavior problems in persons with dementia and the distress they cause in caregivers.

    PubMed

    Nogales-González, C; Romero-Moreno, R; Losada, A; Márquez-González, M; Zarit, S H

    2015-01-01

    Behavioral and psychological symptoms in dementia (BPSD) are the principal sources of stress in caregivers. The aim of the present work is to analyze the moderating effect of self-efficacy for managing BPSD on the distress these problems generate in family caregivers. The participants were 231 family caregivers of people with dementia. We assessed the frequency and caregiver distress associated with three dimensions of BPSD (depressive, disruptive and memory problems). In addition, we assessed the moderating effect of self-efficacy for dealing with BPSD in the relationship between the dementia patient's frequency of BPSD and caregiver distress through hierarchical regression analyses, one for each of the dimensions of BPSD. We found a moderating effect of self-efficacy on the relation between the frequency of BPSD and the distress in caregivers for the dimensions of depressive and disruptive behaviors. Caregivers having to deal with a high frequency of behavior problems but with high levels of self-efficacy presented significantly lower levels of distress associated with depressive and disruptive behavior problems compared to those caregivers with low levels of self-efficacy. No differences in the effects of self-efficacy were found for distress levels of caregivers who dealt with low frequency of BPSD. Also, we did not find a moderating effect of self-efficacy on the relation between the frequency of memory problems and caregivers' distress. The results suggest that self-efficacy for managing BPSD attenuates the relation between the frequency of behavior problems – both disruptive and depressive – and the distress they cause in caregivers.

  8. Accounting for failure: risk-based regulation and the problems of ensuring healthcare quality in the NHS

    PubMed Central

    Beaussier, Anne-Laure; Demeritt, David; Griffiths, Alex; Rothstein, Henry

    2016-01-01

    In this paper, we examine why risk-based policy instruments have failed to improve the proportionality, effectiveness, and legitimacy of healthcare quality regulation in the National Health Service (NHS) in England. Rather than trying to prevent all possible harms, risk-based approaches promise to rationalise and manage the inevitable limits of what regulation can hope to achieve by focusing regulatory standard-setting and enforcement activity on the highest priority risks, as determined through formal assessments of their probability and consequences. As such, risk-based approaches have been enthusiastically adopted by healthcare quality regulators over the last decade. However, by drawing on historical policy analysis and in-depth interviews with 15 high-level UK informants in 2013–2015, we identify a series of practical problems in using risk-based policy instruments for defining, assessing, and ensuring compliance with healthcare quality standards. Based on our analysis, we go on to consider why, despite a succession of failures, healthcare regulators remain committed to developing and using risk-based approaches. We conclude by identifying several preconditions for successful risk-based regulation: goals must be clear and trade-offs between them amenable to agreement; regulators must be able to reliably assess the probability and consequences of adverse outcomes; regulators must have a range of enforcement tools that can be deployed in proportion to risk; and there must be political tolerance for adverse outcomes. PMID:27499677

  9. Accounting for failure: risk-based regulation and the problems of ensuring healthcare quality in the NHS.

    PubMed

    Beaussier, Anne-Laure; Demeritt, David; Griffiths, Alex; Rothstein, Henry

    2016-05-18

    In this paper, we examine why risk-based policy instruments have failed to improve the proportionality, effectiveness, and legitimacy of healthcare quality regulation in the National Health Service (NHS) in England. Rather than trying to prevent all possible harms, risk-based approaches promise to rationalise and manage the inevitable limits of what regulation can hope to achieve by focusing regulatory standard-setting and enforcement activity on the highest priority risks, as determined through formal assessments of their probability and consequences. As such, risk-based approaches have been enthusiastically adopted by healthcare quality regulators over the last decade. However, by drawing on historical policy analysis and in-depth interviews with 15 high-level UK informants in 2013-2015, we identify a series of practical problems in using risk-based policy instruments for defining, assessing, and ensuring compliance with healthcare quality standards. Based on our analysis, we go on to consider why, despite a succession of failures, healthcare regulators remain committed to developing and using risk-based approaches. We conclude by identifying several preconditions for successful risk-based regulation: goals must be clear and trade-offs between them amenable to agreement; regulators must be able to reliably assess the probability and consequences of adverse outcomes; regulators must have a range of enforcement tools that can be deployed in proportion to risk; and there must be political tolerance for adverse outcomes.

  10. On the look-up tables for the critical heat flux in tubes (history and problems)

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

    Kirillov, P.L.; Smogalev, I.P.

    1995-09-01

    The complication of critical heat flux (CHF) problem for boiling in channels is caused by the large number of variable factors and the variety of two-phase flows. The existence of several hundreds of correlations for the prediction of CHF demonstrates the unsatisfactory state of this problem. The phenomenological CHF models can provide only the qualitative predictions of CHF primarily in annular-dispersed flow. The CHF look-up tables covered the results of numerous experiments received more recognition in the last 15 years. These tables are based on the statistical averaging of CHF values for each range of pressure, mass flux and quality.more » The CHF values for regions, where no experimental data is available, are obtained by extrapolation. The correction of these tables to account for the diameter effect is a complicated problem. There are ranges of conditions where the simple correlations cannot produce the reliable results. Therefore, diameter effect on CHF needs additional study. The modification of look-up table data for CHF in tubes to predict CHF in rod bundles must include a method which to take into account the nonuniformity of quality in a rod bundle cross section.« less

  11. Beyond memory problems: multiple obstacles to health and quality of life in older people seeking help for subjective memory complaints.

    PubMed

    Rotenberg Shpigelman, Shlomit; Sternberg, Shelley; Maeir, Adina

    2017-08-29

    Preliminary evidence suggests that older people who seek medical help for subjective memory complaints (SMC) may be at risk for depression, poor quality of life (QoL), and functional limitations. This study aims to: (1) further investigate bio-psycho-social characteristics, participation in personally meaningful activities and QoL of help-seekers; and (2) examine the relationship of these characteristics to QoL, and explore the unique contribution of participation to QoL. Cognitive, meta-cognitive, emotional, social, participation, and QoL measures were used to compare 51 help-seekers referred from geriatric clinics to 40 age-matched controls who did not seek help for memory problems. Help-seekers exhibited lower participation and QoL, had lower mean cognitive scores, reported more memory mistakes and negative memory-beliefs, more depression, worse self-efficacy, and less positive social interaction than non-help-seekers. Quality of life in help-seekers was significantly correlated with most variables. Participation contributed to the explained variance of QoL in help-seekers, beyond that accounted for by cognition and emotional status. Help-seekers with SMC exhibited a complex health condition that includes not only SMC, but also objective memory impairment, depression, functional restrictions, negative memory beliefs, low perception of memory abilities, reduced self-efficacy and insufficient social interactions, all associated with lower QoL. This multi-faceted condition should be considered in the treatment of help-seekers. Implications for Rehabilitation Older people who seek help for subjective memory complaints may be facing a larger problem involving bio-psycho-social factors, affecting participation in meaningful activities and quality of life. Quality of life may be improved via treatment of depression, functional restrictions, memory beliefs, self-efficacy, and positive social interactions. Participation in meaningful activities is an especially important

  12. Power Quality Improvement by Unified Power Quality Conditioner Based on CSC Topology Using Synchronous Reference Frame Theory

    PubMed Central

    Dharmalingam, Rajasekaran; Dash, Subhransu Sekhar; Senthilnathan, Karthikrajan; Mayilvaganan, Arun Bhaskar; Chinnamuthu, Subramani

    2014-01-01

    This paper deals with the performance of unified power quality conditioner (UPQC) based on current source converter (CSC) topology. UPQC is used to mitigate the power quality problems like harmonics and sag. The shunt and series active filter performs the simultaneous elimination of current and voltage problems. The power fed is linked through common DC link and maintains constant real power exchange. The DC link is connected through the reactor. The real power supply is given by the photovoltaic system for the compensation of power quality problems. The reference current and voltage generation for shunt and series converter is based on phase locked loop and synchronous reference frame theory. The proposed UPQC-CSC design has superior performance for mitigating the power quality problems. PMID:25013854

  13. Power quality improvement by unified power quality conditioner based on CSC topology using synchronous reference frame theory.

    PubMed

    Dharmalingam, Rajasekaran; Dash, Subhransu Sekhar; Senthilnathan, Karthikrajan; Mayilvaganan, Arun Bhaskar; Chinnamuthu, Subramani

    2014-01-01

    This paper deals with the performance of unified power quality conditioner (UPQC) based on current source converter (CSC) topology. UPQC is used to mitigate the power quality problems like harmonics and sag. The shunt and series active filter performs the simultaneous elimination of current and voltage problems. The power fed is linked through common DC link and maintains constant real power exchange. The DC link is connected through the reactor. The real power supply is given by the photovoltaic system for the compensation of power quality problems. The reference current and voltage generation for shunt and series converter is based on phase locked loop and synchronous reference frame theory. The proposed UPQC-CSC design has superior performance for mitigating the power quality problems.

  14. Problem-Solving Therapy During Outpatient Stroke Rehabilitation Improves Coping and Health-Related Quality of Life: Randomized Controlled Trial.

    PubMed

    Visser, Marieke M; Heijenbrok-Kal, Majanka H; Van't Spijker, Adriaan; Lannoo, Engelien; Busschbach, Jan J V; Ribbers, Gerard M

    2016-01-01

    This study investigated whether problem-solving therapy (PST) is an effective group intervention for improving coping strategy and health-related quality of life (HRQoL) in patients with stroke. In this multicenter randomized controlled trial, the intervention group received PST as add-on to standard outpatient rehabilitation, the control group received outpatient rehabilitation only. Measurements were performed at baseline, directly after the intervention, and 6 and 12 months later. Data were analyzed using linear-mixed models. Primary outcomes were task-oriented coping as measured by the Coping Inventory for Stressful Situations and psychosocial HRQoL as measured by the Stroke-Specific Quality of Life Scale. Secondary outcomes were the EuroQol EQ-5D-5L utility score, emotion-oriented and avoidant coping as measured by the Coping Inventory for Stressful Situations, problem-solving skills as measured by the Social Problem Solving Inventory-Revised, and depression as measured by the Center for Epidemiological Studies Depression Scale. Included were 166 patients with stroke, mean age 53.06 years (SD, 10.19), 53% men, median time poststroke 7.29 months (interquartile range, 4.90-10.61 months). Six months post intervention, the PST group showed significant improvement when compared with the control group in task-oriented coping (P=0.008), but not stroke-specific psychosocial HRQoL. Furthermore, avoidant coping (P=0.039) and the utility value for general HRQoL (P=0.034) improved more in the PST group than in the control after 6 months. PST seems to improve task-oriented coping but not disease-specific psychosocial HRQoL after stroke >6-month follow-up. Furthermore, we found indications that PST may improve generic HRQoL recovery and avoidant coping. URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2509. Unique identifier: CNTR2509. © 2015 American Heart Association, Inc.

  15. Trading a Problem-solving Task

    NASA Astrophysics Data System (ADS)

    Matsubara, Shigeo

    This paper focuses on a task allocation problem, especially cases where the task is to find a solution in a search problem or a constraint satisfaction problem. If the search problem is hard to solve, a contractor may fail to find a solution. Here, the more computational resources such as the CPU time the contractor invests in solving the search problem, the more a solution is likely to be found. This brings about a new problem that a contractee has to find an appropriate level of the quality in a task achievement as well as to find an efficient allocation of a task among contractors. For example, if the contractee asks the contractor to find a solution with certainty, the payment from the contractee to the contractor may exceed the contractee's benefit from obtaining a solution, which discourages the contractee from trading a task. However, solving this problem is difficult because the contractee cannot ascertain the contractor's problem-solving ability such as the amount of available resources and knowledge (e.g. algorithms, heuristics) or monitor what amount of resources are actually invested in solving the allocated task. To solve this problem, we propose a task allocation mechanism that is able to choose an appropriate level of the quality in a task achievement and prove that this mechanism guarantees that each contractor reveals its true information. Moreover, we show that our mechanism can increase the contractee's utility compared with a simple auction mechanism by using computer simulation.

  16. Detecting effects of the indicated prevention Programme for Externalizing Problem behaviour (PEP) on child symptoms, parenting, and parental quality of life in a randomized controlled trial.

    PubMed

    Hanisch, Charlotte; Freund-Braier, Inez; Hautmann, Christopher; Jänen, Nicola; Plück, Julia; Brix, Gabriele; Eichelberger, Ilka; Döpfner, Manfred

    2010-01-01

    Behavioural parent training is effective in improving child disruptive behavioural problems in preschool children by increasing parenting competence. The indicated Prevention Programme for Externalizing Problem behaviour (PEP) is a group training programme for parents and kindergarten teachers of children aged 3-6 years with externalizing behavioural problems. To evaluate the effects of PEP on child problem behaviour, parenting practices, parent-child interactions, and parental quality of life. Parents and kindergarten teachers of 155 children were randomly assigned to an intervention group (n = 91) and a nontreated control group (n = 64). They rated children's problem behaviour before and after PEP training; parents also reported on their parenting practices and quality of life. Standardized play situations were video-taped and rated for parent-child interactions, e.g. parental warmth. In the intention to treat analysis, mothers of the intervention group described less disruptive child behaviour and better parenting strategies, and showed more parental warmth during a standardized parent-child interaction. Dosage analyses confirmed these results for parents who attended at least five training sessions. Children were also rated to show less behaviour problems by their kindergarten teachers. Training effects were especially positive for parents who attended at least half of the training sessions. CBCL: Child Behaviour Checklist; CII: Coder Impressions Inventory; DASS: Depression anxiety Stress Scale; HSQ: Home-situation Questionnaire; LSS: Life Satisfaction Scale; OBDT: observed behaviour during the test; PCL: Problem Checklist; PEP: prevention programme for externalizing problem behaviour; PPC: Parent Problem Checklist; PPS: Parent Practices Scale; PS: Parenting Scale; PSBC: Problem Setting and Behaviour checklist; QJPS: Questionnaire on Judging Parental Strains; SEFS: Self-Efficacy Scale; SSC: Social Support Scale; TRF: Caregiver-Teacher Report Form.

  17. The air quality and health impacts of domestic trans-boundary pollution in various regions of China.

    PubMed

    Gu, Y; Yim, S H L

    2016-12-01

    Air pollution is one of the most pressing environmental problems in China. Literature has reported that outdoor air pollution leads to adverse health problems every year in China. Recent measurement studies found the important regional nature of particulates in China. Trans-boundary air pollution within China has yet to be fully understood. This study aimed to comprehensively understand the processes of domestic trans-boundary air pollution in China and to apportion the impacts of emissions in different regions on air quality and public health. We applied a state-of-the-art air quality model to simulate air quality in China and then adapted a form of integrated concentration-response function for China to estimate the resultant amount of premature mortality due to exposures to PM 2.5 . Our findings show that domestic trans-boundary impacts (TBI), on average, account for 27% of the total PM 2.5 in China. We estimated that outdoor air pollution caused ~870,000 (95% CI: 130,000-1500,000) premature mortalities in China in 2010, of which on average 18% are attributed to TBI. Among all the regions, North China is the largest contributor to TBI due to 41% of the health impacts of its emissions occurring in other regions. Taiwan (TW) is the smallest contributor to TBI occurring in China, contributing 2% of the national TBI, while TBI causes 22% of the premature mortalities due to outdoor air pollution in TW. Our findings pinpoint the significant impacts of TBI on public health in China, indicating the need for cross-region cooperation to mitigate the air quality impacts and the nation's resultant health problems. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Mutations affecting the SAND domain of DEAF1 cause intellectual disability with severe speech impairment and behavioral problems.

    PubMed

    Vulto-van Silfhout, Anneke T; Rajamanickam, Shivakumar; Jensik, Philip J; Vergult, Sarah; de Rocker, Nina; Newhall, Kathryn J; Raghavan, Ramya; Reardon, Sara N; Jarrett, Kelsey; McIntyre, Tara; Bulinski, Joseph; Ownby, Stacy L; Huggenvik, Jodi I; McKnight, G Stanley; Rose, Gregory M; Cai, Xiang; Willaert, Andy; Zweier, Christiane; Endele, Sabine; de Ligt, Joep; van Bon, Bregje W M; Lugtenberg, Dorien; de Vries, Petra F; Veltman, Joris A; van Bokhoven, Hans; Brunner, Han G; Rauch, Anita; de Brouwer, Arjan P M; Carvill, Gemma L; Hoischen, Alexander; Mefford, Heather C; Eichler, Evan E; Vissers, Lisenka E L M; Menten, Björn; Collard, Michael W; de Vries, Bert B A

    2014-05-01

    Recently, we identified in two individuals with intellectual disability (ID) different de novo mutations in DEAF1, which encodes a transcription factor with an important role in embryonic development. To ascertain whether these mutations in DEAF1 are causative for the ID phenotype, we performed targeted resequencing of DEAF1 in an additional cohort of over 2,300 individuals with unexplained ID and identified two additional individuals with de novo mutations in this gene. All four individuals had severe ID with severely affected speech development, and three showed severe behavioral problems. DEAF1 is highly expressed in the CNS, especially during early embryonic development. All four mutations were missense mutations affecting the SAND domain of DEAF1. Altered DEAF1 harboring any of the four amino acid changes showed impaired transcriptional regulation of the DEAF1 promoter. Moreover, behavioral studies in mice with a conditional knockout of Deaf1 in the brain showed memory deficits and increased anxiety-like behavior. Our results demonstrate that mutations in DEAF1 cause ID and behavioral problems, most likely as a result of impaired transcriptional regulation by DEAF1. Copyright © 2014 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  19. Ten tools of continuous quality improvement: a review and case example of hospital discharge.

    PubMed

    Ziegenfuss, J T; McKenna, C K

    1995-01-01

    Concepts and methods of continuous quality improvement have been endorsed by quality specialists in American Health care, and their use has convinced CEOs that industrial methods can make a contribution to health and medical care. For all the quality improvement publications, there are still few that offer a clear, concise definition and an explanation of the primary tools for teaching purposes. This report reviews ten continuous quality improvement methods including: problem solving cycle, affinity diagrams, cause and effect diagrams, Pareto diagrams, histograms, bar charts, control charts, scatter diagrams, checklists, and a process decision program chart. These do not represent an exhaustive list, but a set of commonly used tools. They are applied to a case study of bed utilization in a university hospital.

  20. Dependability of technical items: Problems of standardization

    NASA Astrophysics Data System (ADS)

    Fedotova, G. A.; Voropai, N. I.; Kovalev, G. F.

    2016-12-01

    This paper is concerned with problems blown up in the development of a new version of the Interstate Standard GOST 27.002 "Industrial product dependability. Terms and definitions". This Standard covers a wide range of technical items and is used in numerous regulations, specifications, standard and technical documentation. A currently available State Standard GOST 27.002-89 was introduced in 1990. Its development involved a participation of scientists and experts from different technical areas, its draft was debated in different audiences and constantly refined, so it was a high quality document. However, after 25 years of its application it's become necessary to develop a new version of the Standard that would reflect the current understanding of industrial dependability, accounting for the changes taking place in Russia in the production, management and development of various technical systems and facilities. The development of a new version of the Standard makes it possible to generalize on a terminological level the knowledge and experience in the area of reliability of technical items, accumulated over a quarter of the century in different industries and reliability research schools, to account for domestic and foreign experience of standardization. Working on the new version of the Standard, we have faced a number of issues and problems on harmonization with the International Standard IEC 60500-192, caused first of all by different approaches to the use of terms and differences in the mentalities of experts from different countries. The paper focuses on the problems related to the chapter "Maintenance, restoration and repair", which caused difficulties for the developers to harmonize term definitions both with experts and the International Standard, which is mainly related to differences between the Russian concept and practice of maintenance and repair and foreign ones.

  1. Causes of Incivility in Iranian Nursing Students: A Qualitative Study

    PubMed Central

    Rad, Mostafa; Ildarabadi, Es-hagh; Moharreri, Fatemeh; Moonaghi, Hossein Karimi

    2016-01-01

    Background: Incivility among nursing students is a common academic problem. Knowing the causes of students’ incivility will enable the faculty members and academic institutions to select correct strategies to deal with this problem. This study was conducted to explore the causes of incivility among nursing students from both educators’ and students’ points of view. Methods: gThis qualitative content analysis study was applied in order to explore experiences and insights of 17 nursing lecturers and 9 nursing students who were selected through purposeful sampling and interviewed on the causes of incivility. Participants were selected among students and lecturers of nursing schools in Khorasan Razavi. The inclusion criteria for the students were having passed one educational term and for the lecturers having one year experience of teaching respectively. Data gathering was done using deep semi-structured interviews starting from March 2014 to March 2015. Results: Three main categories extracted from the data were student related factors, teacher related factors, and organizational factors. Non-educational engagement, attracting attentions, lack of motivation, students’ personality, and lack of experience were the subcategories of student related factors. Subcategories of teacher related factors included lack of skills, teachers’ personal qualities, lack of experience, and incivility of teachers. Finally, the subcategories of organizational factors included no evaluation system for teachers and lack of understanding the organizational rules and regulations. Conclusion: The results of this study indicated that factors related to students, teachers, and organization may lead to nursing students’ incivility and clarified its dimensions. In order to develop a civil environment in nursing college, managers and educators’ awareness should be promoted via various ways such as workshops. PMID:26793730

  2. Risk-based decision making to manage water quality failures caused by combined sewer overflows

    NASA Astrophysics Data System (ADS)

    Sriwastava, A. K.; Torres-Matallana, J. A.; Tait, S.; Schellart, A.

    2017-12-01

    Regulatory authorities set certain environmental permit for water utilities such that the combined sewer overflows (CSO) managed by these companies conform to the regulations. These utility companies face the risk of paying penalty or negative publicity in case they breach the environmental permit. These risks can be addressed by designing appropriate solutions such as investing in additional infrastructure which improve the system capacity and reduce the impact of CSO spills. The performance of these solutions is often estimated using urban drainage models. Hence, any uncertainty in these models can have a significant effect on the decision making process. This study outlines a risk-based decision making approach to address water quality failure caused by CSO spills. A calibrated lumped urban drainage model is used to simulate CSO spill quality in Haute-Sûre catchment in Luxembourg. Uncertainty in rainfall and model parameters is propagated through Monte Carlo simulations to quantify uncertainty in the concentration of ammonia in the CSO spill. A combination of decision alternatives such as the construction of a storage tank at the CSO and the reduction in the flow contribution of catchment surfaces are selected as planning measures to avoid the water quality failure. Failure is defined as exceedance of a concentration-duration based threshold based on Austrian emission standards for ammonia (De Toffol, 2006) with a certain frequency. For each decision alternative, uncertainty quantification results into a probability distribution of the number of annual CSO spill events which exceed the threshold. For each alternative, a buffered failure probability as defined in Rockafellar & Royset (2010), is estimated. Buffered failure probability (pbf) is a conservative estimate of failure probability (pf), however, unlike failure probability, it includes information about the upper tail of the distribution. A pareto-optimal set of solutions is obtained by performing mean

  3. Remote quality monitoring in the banana chain

    PubMed Central

    Jedermann, Reiner; Praeger, Ulrike; Geyer, Martin; Lang, Walter

    2014-01-01

    Quality problems occurring during or after sea transportation of bananas in refrigerated containers are mainly caused by insufficient cooling and non-optimal atmospheric conditions, but also by the heat generated by respiration activity. Tools to measure and evaluate these effects can largely help to reduce losses along the banana supply chain. The presented green life model provides a tool to predict the effect of deviating temperature, relative humidity, and CO2 and O2 gas concentrations on the storage stability of bananas. A second thermal model allows evaluation of the cooling efficiency, the effect of changes in packaging and stowage and the amount of respiration heat from the measured temperature curves. Spontaneous ripening causes higher respiration heat and CO2 production rate. The resulting risk for creation of hot spots increases in positions in which the respiration heat exceeds the available cooling capacity. In case studies on the transport of bananas from Costa Rica to Europe, we validated the models and showed how they can be applied to generate automated warning messages for containers with reduced banana green life or with temperature problems and also for remote monitoring of the ripening process inside the container. PMID:24797132

  4. Remote quality monitoring in the banana chain.

    PubMed

    Jedermann, Reiner; Praeger, Ulrike; Geyer, Martin; Lang, Walter

    2014-06-13

    Quality problems occurring during or after sea transportation of bananas in refrigerated containers are mainly caused by insufficient cooling and non-optimal atmospheric conditions, but also by the heat generated by respiration activity. Tools to measure and evaluate these effects can largely help to reduce losses along the banana supply chain. The presented green life model provides a tool to predict the effect of deviating temperature, relative humidity, and CO2 and O2 gas concentrations on the storage stability of bananas. A second thermal model allows evaluation of the cooling efficiency, the effect of changes in packaging and stowage and the amount of respiration heat from the measured temperature curves. Spontaneous ripening causes higher respiration heat and CO2 production rate. The resulting risk for creation of hot spots increases in positions in which the respiration heat exceeds the available cooling capacity. In case studies on the transport of bananas from Costa Rica to Europe, we validated the models and showed how they can be applied to generate automated warning messages for containers with reduced banana green life or with temperature problems and also for remote monitoring of the ripening process inside the container.

  5. Reinventing Teaching and Testing: Quality Learning for Quality Employment.

    ERIC Educational Resources Information Center

    Cooke, Brian P.

    To succeed in today's competitive global markets, organizations are hiring responsible problem solvers and collaborative "associates" who improve productivity, assure quality service, and contribute creatively. These organizations demand employees who are skilled at learning to learn, listening, communicating, problem solving, teamwork,…

  6. Internet addiction, sleep and health-related life quality among obese individuals: a comparison study of the growing problems in adolescent health.

    PubMed

    Eliacik, Kayi; Bolat, Nurullah; Koçyiğit, Cemil; Kanik, Ali; Selkie, Ellen; Yilmaz, Huseyin; Catli, Gonul; Dundar, Nihal Olgac; Dundar, Bumin Nuri

    2016-12-01

    The rapid rise in the global prevalence of obesity suggests that environmental factors may be responsible. The increased use of technology is associated with increased rates of obesity due to declines in physical activity and significant sedentary life style. Internet addiction is also a growing health issue associated with diminished physical activity and poor sleep quality as well as various health problems. The purpose of this study was to determine associations between Internet addiction and adolescent obesity-related problems. In this case-control study, 71 adolescents with obesity were recruited from the outpatient clinic at Tepecik Teaching Hospital and Katip Celebi University Hospital, Department of Pediatric Endocrinology in Izmir, Turkey. The control group consisted of 64 non-obese adolescents that were matched with patients in the study group by age and gender. All subjects completed socio-demographic forms, an Internet addiction scale, the Pediatric Quality of Life Inventory, the Pittsburgh Sleep Quality Index, and the Epworth Sleepiness Scale. Adolescents with obesity were significantly more likely to have Internet addiction (p = 0.002), lower quality of life (p < 0.001), and higher daytime sleepiness (p = 0.008). Moreover, binary regression analysis showed that Internet addiction and less physical activity were associated with increased odds of obesity. The results indicated a significant association between Internet addiction and obesity. Health practitioners should take possible Internet addiction, online activities, and physical activities into consideration in follow-up of obese adolescents. In addition to pharmacologic therapies and dietary interventions, providing behavioral therapy targeting healthy Internet use may be promising to reduce the effects of obesity in adolescence.

  7. Total Quality Management in Construction

    DTIC Science & Technology

    1993-08-01

    1989. I Ishikawa , Kaoru . Guide to Quality Control. White Plains, New York: Asian Productivity Organization, 1982. 5 Kelso, Frank B. II, Admiral...category are explored to determine the most significant causes which produce the effect. Figure 24 shows a typical cause-and effect diagram. Kaoru ... Ishikawa describes cause-and-effect diagrams as I an effective tool "to clearly illustrate the various causes I affecting quality by sorting out and relating

  8. The footwear factory's assembly sector: opposing organizational structure and quality from the ergonomic work analysis.

    PubMed

    Silva, Kláudia M M N; Coelho, Bernardo G P; Junior, Josemir V S; Faria, Luiz F M; Dutra, Ludmila; Alvarenga, Marília; Roggini, Renan; Echternach, Eliza Helena de Oliveira

    2012-01-01

    Data from 2006 indicated that Brazilian footwear leather industry was composed of approximately 9,488 formally registered establishments, considering the leather industry, footwear and leather goods. It was responsible for 211,582 people employed. However, in spite of having many employees, this kind of organization found several problems when analyzed from the ergonomics view. With this premise, then, in order to identify bottlenecks and other engineering problems that could cause discomfort and motivation lack among workers, leading directly to the loss of the product quality, the assembly sector of women's shoes factory was characterized.

  9. Do Demographic Factors, School Functioning, and Quality of Student-Teacher Relationships as Rated by Teachers Predict Internalising and Externalising Problems among Norwegian Schoolchildren?

    ERIC Educational Resources Information Center

    Drugli, May Britt; Klokner, Christian; Larsson, Bo

    2011-01-01

    The present study explored the association between child internalising and externalising problems in schools and demographic factors (sex and age), school functioning (academic performance and adaptive functioning) and teacher-reported student-teacher relationship quality in a cross-sectional study using structural equation modelling. The study…

  10. Colored Traveling Salesman Problem.

    PubMed

    Li, Jun; Zhou, MengChu; Sun, Qirui; Dai, Xianzhong; Yu, Xiaolong

    2015-11-01

    The multiple traveling salesman problem (MTSP) is an important combinatorial optimization problem. It has been widely and successfully applied to the practical cases in which multiple traveling individuals (salesmen) share the common workspace (city set). However, it cannot represent some application problems where multiple traveling individuals not only have their own exclusive tasks but also share a group of tasks with each other. This work proposes a new MTSP called colored traveling salesman problem (CTSP) for handling such cases. Two types of city groups are defined, i.e., each group of exclusive cities of a single color for a salesman to visit and a group of shared cities of multiple colors allowing all salesmen to visit. Evidences show that CTSP is NP-hard and a multidepot MTSP and multiple single traveling salesman problems are its special cases. We present a genetic algorithm (GA) with dual-chromosome coding for CTSP and analyze the corresponding solution space. Then, GA is improved by incorporating greedy, hill-climbing (HC), and simulated annealing (SA) operations to achieve better performance. By experiments, the limitation of the exact solution method is revealed and the performance of the presented GAs is compared. The results suggest that SAGA can achieve the best quality of solutions and HCGA should be the choice making good tradeoff between the solution quality and computing time.

  11. Improving Quality of Shoe Soles Product using Six Sigma

    NASA Astrophysics Data System (ADS)

    Jesslyn Wijaya, Athalia; Trusaji, Wildan; Akbar, Muhammad; Ma’ruf, Anas; Irianto, Dradjad

    2018-03-01

    A manufacture in Bandung produce kind of rubber-based product i.e. trim, rice rollers, shoe soles, etc. After penetrating the shoe soles market, the manufacture has met customer with tight quality control. Based on the past data, defect level of this product was 18.08% that caused the manufacture’s loss of time and money. Quality improvement effort was done using six sigma method that included phases of define, measure, analyse, improve, and control (DMAIC). In the design phase, the object’s problem and definition were defined. Delphi method was also used in this phase to identify critical factors. In the measure phase, the existing process stability and sigma quality level were measured. Fishbone diagram and failure mode and effect analysis (FMEA) were used in the next phase to analyse the root cause and determine the priority issues. Improve phase was done by designing alternative improvement strategy using 5W1H method. Some improvement efforts were identified, i.e. (i) modifying design of the hanging rack, (ii) create pantone colour book and check sheet, (iii) provide pedestrian line at compound department, (iv) buying stop watch, and (v) modifying shoe soles dies. Some control strategies for continuous improvement were proposed such as SOP or reward and punishment system.

  12. Side Effects: Nerve Problems (Peripheral Neuropathy)

    Cancer.gov

    Nerve problems, such as peripheral neuropathy, can be caused by cancer treatment. Learn about signs and symptoms of nerve changes. Find out how to prevent or manage nerve problems during cancer treatment.

  13. Use of enzymes to minimize the rheological dough problems caused by high levels of damaged starch in starch-gluten systems.

    PubMed

    Barrera, Gabriela N; León, Alberto E; Ribotta, Pablo D

    2016-05-01

    During wheat milling, starch granules can experience mechanical damage, producing damaged starch. High levels of damaged starch modify the physicochemical properties of wheat flour, negatively affecting the dough behavior as well as the flour quality and cookie and bread making quality. The aim of this work was to evaluate the effect of α-amylase, maltogenic amylase and amyloglucosidase on dough rheology in order to propose alternatives to reduce the issues related to high levels of damaged starch. The dough with a high level of damaged starch became more viscous and resistant to deformations as well as less elastic and extensible. The soluble fraction of the doughs influenced the rheological behavior of the systems. The α-amylase and amyloglucosidase reduced the negative effects of high damaged starch contents, improving the dough rheological properties modified by damaged starch. The rheological behavior of dough with the higher damaged-starch content was related to a more open gluten network arrangement as a result of the large size of the swollen damaged starch granules. We can conclude that the dough rheological properties of systems with high damaged starch content changed positively as a result of enzyme action, particularly α-amylase and amyloglucosidase additions, allowing the use of these amylases and mixtures of them as corrective additives. Little information was reported about amyloglucosidase activity alone or combined with α-amylase. The combinations of these two enzymes are promising to minimize the negative effects caused by high levels of damaged starch on product quality. More research needs to be done on bread quality combining these two enzymes. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

  14. Family quality of life and ASD: the role of child adaptive functioning and behavior problems.

    PubMed

    Emily, Gardiner; Grace, Iarocci

    2015-04-01

    The family is the key support network for children with autism spectrum disorder (ASD), in many cases into adulthood. The Family Quality of Life (FQOL) construct encompasses family satisfaction with both internal and external dynamics, as well as support availability. Therefore, although these families face considerable risk in raising a child with a disability, the FQOL outcome is conceptualized as representative of a continuum of family adaptation. This study examined the role of child characteristics, including adaptive functioning and behaviour problems, in relation to FQOL. Eighty-four caregivers of children and adolescents (range = 6-18 years) with ASD participated, completing questionnaires online and by telephone. Adaptive functioning, and specifically daily living skills, emerged as a significant predictor of FQOL satisfaction, after accounting for behavioural and demographic characteristics, including child age, gender, perceived disability severity, and behavioural problems, as well as family income. Furthermore, there were significant differences across each domain of FQOL when groups were separated by daily living skill functioning level ('low,' 'moderately low,' and 'adequate'). The results suggest that intervention strategies targeting daily living skills will likely have beneficial effects for both individual and family well-being, and may reduce family support demands. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

  15. A Public Health Approach to Addressing Arthritis in Older Adults: The Most Common Cause of Disability

    PubMed Central

    Helmick, Charles G.; Brady, Teresa J.

    2012-01-01

    Arthritis is highly prevalent and is the leading cause of disability among older adults in the United States owing to the aging of the population and increases in the prevalence of risk factors (e.g., obesity). Arthritis will play a large role in the health-related quality of life, functional independence, and disability of older adults in the upcoming decades. We have emphasized the role of the public health system in reducing the impact of this large and growing public health problem, and we have presented priority public health actions. PMID:22390506

  16. Loss of labour productivity caused by disease and health problems: what is the magnitude of its effect on Spain's economy?

    PubMed

    Oliva-Moreno, Juan

    2012-10-01

    The aim of this study is to estimate the economic impact of the non-medical costs of diseases and accidents in Spain. Its main premise sustains the idea that in addition to the number of deaths, the loss of quality of life and the pain suffered by patients and their family members as a result of diseases and accidents, there are other indicators that provide us with a better understanding of their socioeconomic impact. Our analysis provides estimates of the loss of labour productivity in Spain as a result of health problems in 2005. Our main finding suggests an estimated loss amounting to over 37,969 millions euros, of which 9,136 millions euros are due to premature deaths, 18,577 millions to permanent disability and 10,255 millions to temporary disability. The loss in labour productivity due to accidents and health problems was estimated to a figure equivalent to nearly 4.2% of the Gross Domestic Product of Spain in 2005. This study underscores the strong economic impact of non-medical costs of diseases. In addition, it stresses the need for better information systems for collecting data that is relevant to the topic at hand.

  17. Acids in combination with sodium dodecyl sulfate caused quality deterioration of fresh-cut iceberg lettuce during storage in modified atmosphere package.

    PubMed

    Guan, Wenqiang; Huang, Lihan; Fan, Xuetong

    2010-10-01

    Recent studies showed that sodium acid sulfate (SAS) and levulinic acid (LA) in combination with sodium dodecyl sulfate (SDS) was effective in inactivating human pathogens on Romaine lettuce. The present study investigated the effects of LA and SAS in combination with SDS (as compared with citric acid and chlorine) on the inactivation of E. coli O157:H7 and sensory quality of fresh-cut Iceberg lettuce in modified atmosphere packages during storage at 4 °C. Results showed that LA (0.5% to 3%) and SAS (0.25% to 0.75%) with 0.05% SDS caused detrimental effects on visual quality and texture of lettuce. LA- and SAS-treated samples were sensorially unacceptable due to development of sogginess and softening after 7 and 14 d storage. It appears that the combined treatments caused an increase in the respiration rate of fresh-cut lettuce as indicated by higher CO(2) and lower O(2) in modified atmosphere packages. On the positive side, the acid treatments inhibited cut edge browning of lettuce pieces developed during storage. LA (0.5%), SAS (0.25%), and citric acid (approximately 0.25%) in combination with SDS reduced population of E. coli OH157:H7 by 0.41, 0.87, and 0.58 log CFU/g, respectively, while chlorine achieved a reduction of 0.94 log CFU/g without damage to the lettuce. Therefore, compared to chlorine, LA and SAS in combination with SDS have limited commercial value for fresh-cut Iceberg lettuce due to quality deterioration during storage.

  18. Improving Histopathology Laboratory Productivity: Process Consultancy and A3 Problem Solving.

    PubMed

    Yörükoğlu, Kutsal; Özer, Erdener; Alptekin, Birsen; Öcal, Cem

    2017-01-01

    The ISO 17020 quality program has been run in our pathology laboratory for four years to establish an action plan for correction and prevention of identified errors. In this study, we aimed to evaluate the errors that we could not identify through ISO 17020 and/or solve by means of process consulting. Process consulting is carefully intervening in a group or team to help it to accomplish its goals. The A3 problem solving process was run under the leadership of a 'workflow, IT and consultancy manager'. An action team was established consisting of technical staff. A root cause analysis was applied for target conditions, and the 6-S method was implemented for solution proposals. Applicable proposals were activated and the results were rated by six-sigma analysis. Non-applicable proposals were reported to the laboratory administrator. A mislabelling error was the most complained issue triggering all pre-analytical errors. There were 21 non-value added steps grouped in 8 main targets on the fish bone graphic (transporting, recording, moving, individual, waiting, over-processing, over-transaction and errors). Unnecessary redundant requests, missing slides, archiving issues, redundant activities, and mislabelling errors were proposed to be solved by improving visibility and fixing spaghetti problems. Spatial re-organization, organizational marking, re-defining some operations, and labeling activities raised the six sigma score from 24% to 68% for all phases. Operational transactions such as implementation of a pathology laboratory system was suggested for long-term improvement. Laboratory management is a complex process. Quality control is an effective method to improve productivity. Systematic checking in a quality program may not always find and/or solve the problems. External observation may reveal crucial indicators about the system failures providing very simple solutions.

  19. Physical activity is associated with the physical, psychological, social and environmental quality of life in people with mental health problems in a low resource setting.

    PubMed

    Vancampfort, Davy; Van Damme, Tine; Probst, Michel; Firth, Joseph; Stubbs, Brendon; Basangwa, David; Mugisha, James

    2017-12-01

    There is a growing recognition of the importance of encouraging patients with mental health problems to become more active as an efficacious strategy to reduce the disability-associated burden. The aim of the current study was to investigate if there are differences in quality of life (QoL) outcomes between people with mental health problems that do and do not meet the recommendations of 150min per week of physical activity. 109 (36♀) Ugandan in- and outpatients (mean age = 34.2 ± 10.2 years) (depression = 7, bipolar disorder = 31, schizophrenia = 21, alcohol use disorder = 50) completed the Physical Activity Vital Sign (PAVS) method and World Health Organization Quality of Life Assessment brief version. Those who did not achieve the minimum physical activity recommendations as assessed by the PAVS (n = 63) had a lower physical, psychological, social and environmental QoL. The current data offer further evidence that the PAVS method might be an important risk identification tool in people with mental health problems. The feasibility and acceptability of the PAVS may help promote the importance of physical activity assessment and prescription as a core part of the treatment of mental health problems in LMICs. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Mitigating the Problem of Unmeasured Outcomes in Quality Reports

    PubMed Central

    Glazer, Jacob; McGuire, Thomas; Normand, Sharon-Lise T.

    2009-01-01

    Quality reports or profiles of health care providers are inevitably based on only a measurable subset of the “outputs” of the organization. Hospitals, for example, are being profiled on their mortality in the cardiac area but not in some other areas where mortality does not seem to be the appropriate measure of quality. If inputs used for outputs included in the profile also affect outputs outside the scope of the profile, it can be taken into account in constructing a profile of the measured outputs. This paper presents a theory for how such a commonality in production should be taken into account in designing a profile for a hospital or other health care provider. We distinguish between “conventional” weights in a quality profile, and “optimal” weights that take into account a commonality in the production process. The basic idea is to increase the weights on discharges for which output is measured that use inputs that are important to other discharges whose outputs are not included in the profile. PMID:20490360

  1. Diabetic Eye Problems

    MedlinePlus

    ... damage your eyes. The most common problem is diabetic retinopathy. It is a leading cause of blindness in ... You need a healthy retina to see clearly. Diabetic retinopathy damages the tiny blood vessels inside your retina. ...

  2. Combining FMEA with DEMATEL models to solve production process problems

    PubMed Central

    Tsai, Sang-Bing; Zhou, Jie; Gao, Yang; Wang, Jiangtao; Li, Guodong; Zheng, Yuxiang; Ren, Peng; Xu, Wei

    2017-01-01

    Failure mode and effects analysis (FMEA) is an analysis tool for identifying and preventing flaws or defects in products during the design and process planning stage, preventing the repeated occurrence of problems, reducing the effects of these problems, enhancing product quality and reliability, saving costs, and improving competitiveness. However, FMEA can only analyze one influence factor according to its priority, rendering this method ineffective for systems containing multiple FMs whose effects are simultaneous or interact with one another. Accordingly, when FMEA fails to identify the influence factors and the factors being influenced, the most crucial problems may be placed in lower priority or remain unresolved. Decision-Making Trial and Evaluation Laboratory (DEMATEL) facilitates the determination of cause and effect factors; by identifying the causal factors that should be prioritized, prompt and effective solutions to core problems can be derived, thereby enhancing performance. Using the photovoltaic cell manufacturing industry in China as the research target, the present study combined FMEA with DEMATEL to amend the flaws of FMEA and enhance its effectiveness. First, FMEA was used to identify items requiring improvement. Then, DEMATEL was employed to examine the interactive effects and causal relationships of these items. Finally, the solutions to the problems were prioritized. The proposed method effectively combined the advantages of FMEA and DEMATEL to facilitate the identification of core problems and prioritization of solutions in the Chinese photovoltaic cell industry. PMID:28837663

  3. Parental Problem-Solving Abilities and the Association of Sickle Cell Disease Complications with Health-related Quality of Life for School-age Children

    PubMed Central

    Barakat, Lamia P.; Daniel, Lauren C.; Smith, Kelsey; Robinson, M. Renée; Patterson, Chavis A.

    2013-01-01

    Children with sickle cell disease (SCD) are at risk for poor health-related quality of life (HRQOL). The current analysis sought to explore parent problem-solving abilities/skills as a moderator between SCD complications and HRQOL to evaluate applicability to pediatric SCD. At baseline, 83 children ages 6–12 years and their primary caregiver completed measures of the child HRQOL. Primary caregivers also completed a measure of social problem-solving. A SCD complications score was computed from medical record review. Parent problem-solving abilities significantly moderated the association of SCD complications with child self-report psychosocial HRQOL (p = .006). SCD complications had a direct effect on parent proxy physical and psychosocial child HRQOL. Enhancing parent problem-solving abilities may be one approach to improve HRQOL for children with high SCD complications; however, modification of parent perceptions of HRQOL may require direct intervention to improve knowledge and skills involved in disease management. PMID:24222378

  4. Parental problem-solving abilities and the association of sickle cell disease complications with health-related quality of life for school-age children.

    PubMed

    Barakat, Lamia P; Daniel, Lauren C; Smith, Kelsey; Renée Robinson, M; Patterson, Chavis A

    2014-03-01

    Children with sickle cell disease (SCD) are at risk for poor health-related quality of life (HRQOL). The current analysis sought to explore parent problem-solving abilities/skills as a moderator between SCD complications and HRQOL to evaluate applicability to pediatric SCD. At baseline, 83 children ages 6-12 years and their primary caregiver completed measures of child HRQOL. Primary caregivers also completed a measure of social problem-solving. A SCD complications score was computed from medical record review. Parent problem-solving abilities significantly moderated the association of SCD complications with child self-report psychosocial HRQOL (p = .006). SCD complications had a direct effect on parent proxy physical and psychosocial child HRQOL. Enhancing parent problem-solving abilities may be one approach to improve HRQOL for children with high SCD complications; however, modification of parent perceptions of HRQOL may require direct intervention to improve knowledge and skills involved in disease management.

  5. Handling qualities related to stall/spin accidents of supersonic fighter aircraft

    NASA Technical Reports Server (NTRS)

    Anderson, S. B.

    1984-01-01

    This paper reviews the handling qualities which influence the high angle of attack (AOA) behavior of supersonic fighter aircraft in order to obtain a clearer understanding of the causes of stall/spin accidents. The results show that, because modern fighters suffer more serious consequences when control is lost, good handling qualities are essential for safe operation at high AOA. Relaxed static stability used on some fighter aircraft can result in control problems at high AOA owing to inertia coupling and the difficulty of a recovery from a deep stall. Indications are that the use of departure/spin resistance and an automatic spin prevention system will greatly improve the safety record for modern supersonic fighters.

  6. Problem Gambling Family Impacts: Development of the Problem Gambling Family Impact Scale.

    PubMed

    Dowling, N A; Suomi, A; Jackson, A C; Lavis, T

    2016-09-01

    Although family members of problem gamblers frequently present to treatment services, problem gambling family impacts are under-researched. The most commonly endorsed items on a new measure of gambling-related family impacts [Problem Gambling Family Impact Measure (PG-FIM: Problem Gambler version)] by 212 treatment-seeking problem gamblers included trust (62.5 %), anger (61.8 %), depression or sadness (58.7 %), anxiety (57.7 %), distress due to gambling-related absences (56.1 %), reduced quality time (52.4 %), and communication breakdowns (52.4 %). The PG-FIM (Problem Gambler version) was comprised of three factors: (1) financial impacts, (2) increased responsibility impacts, and (3) psychosocial impacts with good psychometric properties. Younger, more impulsive, non-electronic gaming machine (EGM) gamblers who had more severe gambling problems reported more financial impacts; non-EGM gamblers with poorer general health reported more increased responsibility impacts; and more impulsive non-EGM gamblers with more psychological distress and higher gambling severity reported more psychosocial impacts. The findings have implications for the development of interventions for the family members of problem gamblers.

  7. A new statistical framework to assess structural alignment quality using information compression

    PubMed Central

    Collier, James H.; Allison, Lloyd; Lesk, Arthur M.; Garcia de la Banda, Maria; Konagurthu, Arun S.

    2014-01-01

    Motivation: Progress in protein biology depends on the reliability of results from a handful of computational techniques, structural alignments being one. Recent reviews have highlighted substantial inconsistencies and differences between alignment results generated by the ever-growing stock of structural alignment programs. The lack of consensus on how the quality of structural alignments must be assessed has been identified as the main cause for the observed differences. Current methods assess structural alignment quality by constructing a scoring function that attempts to balance conflicting criteria, mainly alignment coverage and fidelity of structures under superposition. This traditional approach to measuring alignment quality, the subject of considerable literature, has failed to solve the problem. Further development along the same lines is unlikely to rectify the current deficiencies in the field. Results: This paper proposes a new statistical framework to assess structural alignment quality and significance based on lossless information compression. This is a radical departure from the traditional approach of formulating scoring functions. It links the structural alignment problem to the general class of statistical inductive inference problems, solved using the information-theoretic criterion of minimum message length. Based on this, we developed an efficient and reliable measure of structural alignment quality, I-value. The performance of I-value is demonstrated in comparison with a number of popular scoring functions, on a large collection of competing alignments. Our analysis shows that I-value provides a rigorous and reliable quantification of structural alignment quality, addressing a major gap in the field. Availability: http://lcb.infotech.monash.edu.au/I-value Contact: arun.konagurthu@monash.edu Supplementary information: Online supplementary data are available at http://lcb.infotech.monash.edu.au/I-value/suppl.html PMID:25161241

  8. Century-scale perspective on water quality in selected river basins of the conterminous United States

    USGS Publications Warehouse

    Stets, Edward G.; Kelly, Valerie J.; Broussard, Whitney P.; Smith, Thor E.; Crawford, Charles G.

    2012-01-01

    Nutrient pollution in the form of excess nitrogen and phosphorus inputs is a well-known cause of water-quality degradation that has affected water bodies across the Nation throughout the 20th century. The recognition of excess nutrients as pollution developed later than the recognition of other water-quality problems, such as waterborne illness, industrial pollution, and organic wastes. Nevertheless, long-term analysis of nutrient pollution is fundamental to our understanding of the current magnitude of the problem, as well the origins and the effects. This report describes the century-scale changes in water quality across a range streams in order to place current water-quality concerns in historical context and presents this history on a national scale as well as for selected river reaches. The primary focus is on nutrient pollution, but the development and societal responses to other water-quality problems also are considered. Land use and agriculture in the selected river reaches also are analyzed to consider how these factors may relate to nutrient pollution. Finally, the availability of relevant nutrient and inorganic carbon data are presented for the selected river reaches. Sources of these data included Federal agencies, State-level reports, municipal public works facilities, public health surveys, and sanitary surveys. The availability of these data extends back more than a century for most of the selected river reaches and suggests that there is a tremendous opportunity to document the development of nutrient pollution in these river reaches.

  9. Occupational noise-induced tinnitus: does it affect workers' quality of life?

    PubMed

    Muluk, Nuray Bayar; Oguztürk, Omer

    2008-02-01

    This prospective study aimed to investigate the quality of life of workers in a steel factory. The study group was composed of 16 male workers with tinnitus and 30 ears. Fifteen male workers without tinnitus and 30 ears were included into the control group. Workers were evaluated by questionnaire, pure-tone audiometry, and the SF-36 Health Survey. In the study group, tinnitus loudness levels (TLLs) were found. In the study group, the domains general mental health and role limitations owing to emotional problems were significantly lower than in the control group. Older age, industrial noise exposure over a long period, higher noise exposure during work, and hearing loss secondary to occupational noise caused workers to experience higher TLLs. Earheadings protected workers more than earplugs, and TLLs were lower. Important factors that affect workers' quality of life are maximum exposed noise levels, daily and total noise exposure time, and exposure to continuous noise. Occupational noise-induced tinnitus mainly causes emotional disability rather than physical disability. Emotionally impaired QOL results may be due to tinnitus-related psychological problems. Workers should have knowledge about the hazardous effects of noise. Periodic health checkups and regular seminars have great importance. Workers must be aware of other ototoxic factors, such as medications and noisy music. In the future, researchers should develop a screening method to detect those with a more hereditary affinity to hearing loss.

  10. The Organization of Schools as an Overlooked Source of Underqualified Teaching. Teaching Quality Policy Briefs. Number 7

    ERIC Educational Resources Information Center

    Center for the Study of Teaching and Policy, 2002

    2002-01-01

    The study reported in this policy brief focuses on one aspect of unequal distribution of quality teaching--out-of-field placement. In schools serving primarily low-income and/or minority students, out-of-field teaching is an acute problem and occurs even though the causes have little to do with the lack of certified teachers. Rather, school…

  11. Prevalence of mood and sleep problems in chronic skin diseases: a pilot study.

    PubMed

    Mostaghimi, Ladan

    2008-05-01

    The relationship between chronic skin problems and mood and sleep disorders merits more attention. Mood and sleep problems add to comorbidity of chronic skin diseases and affect patient compliance with dermatologic treatment. A pilot study was conducted to determine the prevalence of mood and sleep problems in participants with chronic skin diseases in outpatient dermatology clinics at the University of Wisconsin, Madison, using 4 self-assessment questionnaires. Study participants included willing adults with any skin problem of at least 6 months' duration. The participants were asked to complete the questionnaires, which included Current Life Functioning, Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI-II), and Beck Anxiety Inventory. In summary, 15 of 16 participants had poor sleep quality. Six participants had poor sleep quality without any mood problems (depression or anxiety). Mood problems worsened the quality of sleep and functioning. Nine of 16 participants (56.25%) reported mood problems (depression or anxiety). The results show a high prevalence of depression and anxiety and a very high prevalence of poor sleep quality. Considering the negative effect of comorbid psychiatric and sleep problems on treatment and prognosis of chronic skin diseases, this study demonstrates the need for further evaluation and eventual screening of all patients with chronic skin diseases for mood and sleep problems.

  12. Known TCP Implementation Problems

    NASA Technical Reports Server (NTRS)

    Paxson, Vern (Editor); Allman, Mark; Dawson, Scott; Fenner, William; Griner, Jim; Heavens, Ian; Lahey, K.; Semke, J.; Volz, B.

    1999-01-01

    This memo catalogs a number of known TCP implementation problems. The goal in doing so is to improve conditions in the existing Internet by enhancing the quality of current TCP/IP implementations. It is hoped that both performance and correctness issues can be resolved by making implementors aware of the problems and their solutions. In the long term, it is hoped that this will provide a reduction in unnecessary traffic on the network, the rate of connection failures due to protocol errors, and load on network servers due to time spent processing both unsuccessful connections and retransmitted data. This will help to ensure the stability of the global Internet. Each problem is defined as follows: Name of Problem The name associated with the problem. In this memo, the name is given as a subsection heading. Classification one or more problem categories for which the problem is classified: "congestion control", "performance", "reliability", "resource management". Description A definition of the problem, succinct but including necessary background material. Significance A brief summary of the sorts of environments for which the problem is significant.

  13. Collection of domestic waste. Review of occupational health problems and their possible causes.

    PubMed

    Poulsen, O M; Breum, N O; Ebbehøj, N; Hansen, A M; Ivens, U I; van Lelieveld, D; Malmros, P; Matthiasen, L; Nielsen, B H; Nielsen, E M

    1995-08-18

    During the last decade, a growing interest in recycling of domestic waste has emerged, and action plans to increase the recycling of domestic waste have been agreed by many governments. A common feature of these plans is the implementation of new systems and equipment for the collection of domestic waste which has been separated at source. However, only limited information exists on possible occupational health problems related to such new systems. Occupational accidents are very frequent among waste collectors. Based on current knowledge, it appears that the risk factors should be considered as an integrated entity, i.e. technical factors (poor accessibility to the waste, design of equipment) may act in concert with high working rate, visual fatigue due to poor illumination and perhaps muscle fatigue due to high work load. Musculoskeletal problems are also common among waste collectors. A good deal of knowledge has accumulated on mechanical load on the spine and energetic load on the cardio-pulmonary system in relation to the handling of waste bags, bins, domestic containers and large containers. However, epidemiologic studies with exposure classification based on field measurement are needed, both to further identify high risk work conditions and to provide a detailed basis for the establishment of occupational exposure limits for mechanical and energetic load particularly in relation to pulling, pushing and tilting of containers. In 1975, an excess risk for chronic bronchitis was reported for waste collectors in Geneva (Rufèner-Press et al., 1975) and data from the Danish Registry of Occupational Accidents and Diseases also indicate an excess risk for pulmonary problems among waste collectors compared with the total work force. Surprisingly few measurements of potentially hazardous airborne exposures have been performed, and the causality of work-related pulmonary problems among waste collectors is unknown. Recent studies have indicated that implementation of

  14. Self-Consciousness, Friendship Quality, and Adolescent Internalizing Problems

    ERIC Educational Resources Information Center

    Bowker, Julie C.; Rubin, Kenneth H.

    2009-01-01

    The correlates between public and private self-consciousness and internalizing difficulties were examined during early adolescence. Friendship quality was assessed as a possible moderator of the relation between self-consciousness and maladjustment. One hundred and thirty-seven young adolescents (N = 87 girls; M age = 13.98 years) reported on…

  15. Measuring quality in anatomic pathology.

    PubMed

    Raab, Stephen S; Grzybicki, Dana Marie

    2008-06-01

    This article focuses mainly on diagnostic accuracy in measuring quality in anatomic pathology, noting that measuring any quality metric is complex and demanding. The authors discuss standardization and its variability within and across areas of care delivery and efforts involving defining and measuring error to achieve pathology quality and patient safety. They propose that data linking error to patient outcome are critical for developing quality improvement initiatives targeting errors that cause patient harm in addition to using methods of root cause analysis, beyond those traditionally used in cytologic-histologic correlation, to assist in the development of error reduction and quality improvement plans.

  16. Social problem-solving, perceived stress, negative life events, depression and life satisfaction in psoriasis.

    PubMed

    Eskin, M; Savk, E; Uslu, M; Küçükaydoğan, N

    2014-11-01

    Psoriasis is a chronic dermatosis which may cause significant impairment of the patient's quality of life. The purpose of this study was to investigate the social problem-solving skills, perceived stress, negative life events, depression and life satisfaction in psoriasis patients. Data were gathered by means of questionnaires and clinical evaluations from 51 psoriatic patients and 51 matched healthy controls. Average disease duration was 16.47 years and average Psoriasis Area and Severity Index score was 3.67. Compared with the controls, the patients displayed lower social problem-solving skills. They displayed higher negative problem orientation and impulsive-careless problem-solving style scores than the controls. Patients tended also to show more avoidant problem-solving style and lower life satisfaction than controls. There was no difference between psoriatic patients and controls in terms of depression, perceived stress and negative life events. Higher social problem-solving skills were associated with lower depression, perceived stress and fewer numbers of negative life events but higher level of life satisfaction. The patient group largely included mild and moderate psoriatic cases. The findings of the study suggest that problem-solving training or therapy may be a suitable option for alleviating levels of psychological distress in patients suffering from psoriasis. © 2014 European Academy of Dermatology and Venereology.

  17. Mining problems caused by tectonic stress in Illinois basin

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

    Nelson, W.J.

    1991-08-01

    The Illinois basin coalfield is subject to a contemporary tectonic stress field in which the principal compressive stress axis ({sigma}1) is horizontal and strikes N60{degree}E to east-west. This stress is responsible for widespread development of kind zones and directional roof failures in mine headings driven perpendicular to {sigma}1. Also, small thrust faults perpendicular to {sigma}1 and joints parallel to {sigma}1 weaken the mine roof and occasionally admit water and gas to workings, depending upon geologic setting. The direction of magnitude of stress have been identified by a variety of techniques that can be applied both prior to mining and duringmore » development. Mining experience shows that the best method of minimizing stress-related problems is to drive mine headings at about 45 to {sigma}1.« less

  18. Environmental Protection: Federal Incentives Could Help Promote Land Use That Protects Air and Water Quality

    DTIC Science & Technology

    2001-10-01

    can over stimulate algae and plant growth, which can degrade coral reefs and important fish spawning habitats. In 2001, the U.S. Geological Survey... Oceanic and Atmospheric Administration NPDES National Pollutant Discharge Elimination System PAH polycyclic aromatic hydrocarbons SIP state...as a significant cause of coastal water quality problems, the acidification of streams and lakes, and the toxic contamination of fish and the birds

  19. Investigations of the quality of hospital electric power supply and the tolerance of medical electric devices to voltage dips.

    PubMed

    Hanada, Eisuke; Itoga, Shuuya; Takano, Kyoko; Kudou, Takato

    2007-06-01

    Medical devices driven by electric power have come to be commonly used in hospitals, and rapid changes of voltage or current can easily cause them to fail. A stable and high quality power supply is indispensable in order to maintain safety in the modern clinical setting. Therefore, we investigated the quality of the power supply in a hospital and determined the tolerance of 13 pieces of medical equipment to voltage dips. The results showed little distortion of the voltage wave. However, we found an approximately 7% momentary voltage dip caused by lightening and other problems, such as 2 to 5% periodic drops in voltage and voltage wave distortions caused by incorrect grounding. In a tolerance test, the settings of some medical devices were changed at the time of automatic reboot after a disturbance. For another device, trend information was initialized.

  20. Annoyance, Sleep and Concentration Problems due to Combined Traffic Noise and the Benefit of Quiet Side

    PubMed Central

    Bodin, Theo; Björk, Jonas; Ardö, Jonas; Albin, Maria

    2015-01-01

    Background: Access to a quiet side in one’s dwelling is thought to compensate for higher noise levels at the most exposed façade. It has also been indicated that noise from combined traffic sources causes more noise annoyance than equal average levels from either road traffic or railway noise separately. Methods: 2612 persons in Malmö, Sweden, answered to a residential environment survey including questions on outdoor environment, noise sensitivity, noise annoyance, sleep quality and concentration problems. Road traffic and railway noise was modeled using Geographic Information System. Results: Access to a quiet side, i.e., at least one window facing yard, water or green space, was associated with reduced risk of annoyance OR (95%CI) 0.47 (0.38–0.59), and concentration problems 0.76 (0.61–0.95). Bedroom window facing the same environment was associated to reduced risk of reporting of poor sleep quality 0.78 (0.64–1.00). Railway noise was associated with reduced risk of annoyance below 55 dB(A) but not at higher levels of exposure. Conclusions: Having a window facing a yard, water or green space was associated to a substantially reduced risk of noise annoyance and concentration problems. If this window was the bedroom window, sleeping problems were less likely. PMID:25642690

  1. Earthquake prognosis:cause for failure and ways for the problem solution

    NASA Astrophysics Data System (ADS)

    Kondratiev, O.

    2003-04-01

    Despite of the more than 50-years history of the development of the prognosis earthquake method this problem is yet not to be resolved. This makes one to have doubt in rightness of the chosen approaches retrospective search of the diverse earthquake precursors. It is obvious to speak of long-term, middle-term and short-term earthquake prognosis. They all have a probabilistic character and it would be more correct to consider them as related to the seismic hazard prognosis. In distinction of them, the problem of the operative prognosis is being discussed in report. The operative prognosis should conclude the opportune presenting of the seismic alarm signal of the place, time and power of the earthquake in order to take necessary measures for maximal mitigation of the catastrophic consequence of this event. To do this it is necessary to predict the earthquake location with accuracy of first dozens of kilometres, time of its occurrence with accuracy of the first days and its power with accuracy of the magnitude units. If the problem is formulated in such a way, it cannot principally be resolved in the framework of the concept of the indirect earthquake precursors using. It is necessary to pass from the concept of the passive observatory network to the concept of the object-oriented search of the potential source zones and direct information obtaining on the parameter medium changes within these zones in the process of the earthquake preparation and development. While formulated in this way, the problem becomes a integrated task for the planet and prospecting geophysics. To detect the source zones it is possible to use the method of the converted waves of earthquakes, for monitoring - seismic reflecting and method of the common point. Arrangement of these and possible other geophysical methods should be provided by organising the special integrated geophysic expedition of the rapid response on the occurred strong earthquakes and conducting purposeful investigation

  2. Using activity-based learning approach to enhance the quality of instruction in civil engineering in Indonesian universities

    NASA Astrophysics Data System (ADS)

    Priyono, Wena, Made; Rahardjo, Boedi

    2017-09-01

    Experts and practitioners agree that the quality of higher education in Indonesia needs to be improved significantly and continuously. The low quality of university graduates is caused by many factors, one of which is the poor quality of learning. Today's instruction process tends to place great emphasis only on delivering knowledge. To avoid the pitfalls of such instruction, e.g. passive learning, thus Civil Engineering students should be given more opportunities to interact with others and actively participate in the learning process. Based on a number of theoretical and empirical studies, one appropriate strategy to overcome the aforementioned problem is by developing and implementing activity-based learning approach.

  3. Theoretical framework of the causes of construction time and cost overruns

    NASA Astrophysics Data System (ADS)

    Ullah, K.; Abdullah, A. H.; Nagapan, S.; Suhoo, S.; Khan, M. S.

    2017-11-01

    Any construction practitioner fundamental goal is to complete the projects within estimated duration and budgets, and expected quality targets. However, time and cost overruns are regular and universal phenomenon in construction projects and the construction projects in Malaysia has no exemption from the problems of time overrun and cost overrun. In order to accomplish the successful completion of construction projects on specified time and within planned cost, there are various factors that should be given serious attention so that issues such as time and cost overrun can be addressed. This paper aims to construct a framework for the causes of time overrun and cost overrun in construction projects of Malaysia. Based on the relevant literature review, causative factors of time overrun and cost overrun in Malaysian construction projects are summarized and the theoretical frameworks of the causes of construction time overrun and cost overrun is constructed. The developed frameworks for construction time and cost overruns based on the existing literature will assist the construction practitioners to plan the efficient approaches for achieving successful completion of the projects.

  4. King Oedipus and the Problem Solving Process.

    ERIC Educational Resources Information Center

    Borchardt, Donald A.

    An analysis of the problem solving process reveals at least three options: (1) finding the cause, (2) solving the problem, and (3) anticipating potential problems. These methods may be illustrated by examining "Oedipus Tyrannus," a play in which a king attempts to deal with a problem that appears to be beyond his ability to solve, and…

  5. The role of failure/problems in engineering: A commentary of failures experienced - lessons learned

    NASA Technical Reports Server (NTRS)

    Ryan, R. S.

    1992-01-01

    The written version of a series of seminars given to several aerospace companies and three NASA centers are presented. The results are lessons learned through a study of the problems experienced in 35 years of engineering. The basic conclusion is that the primary cause of problems has not been mission technologies, as important as technology is, but the neglect of basic principles. Undergirding this is the lack of a systems focus from determining requirements through design, verification, and operations phases. Many of the concepts discussed are fundamental to total quality management (TQM) and can be used to augment this product enhanced philosophy. Fourteen principles are addressed with problems experienced and are used as examples. Included is a discussion of the implication of constraints, poorly defined requirements, and schedules. Design guidelines, lessons learned, and future tasks are listed. Two additional sections are included that deal with personal lessons learned and thoughts on future thrusts (TQM).

  6. A Review of Youth Employment Problems, Programs & Policies: Volume 2. Special Needs and Concentrated Problems.

    ERIC Educational Resources Information Center

    Vice President's Task Force on Youth Employment, Washington, DC.

    This series of nine reports reviews available information on the special needs and concentrated problems of youth employment. (It constitutes the second of a three-volume compendium; other volumes examine causes and dimensions of youth employment problems and analyze program experience--see note.) The effects of discrimination on minority youth…

  7. Nintendo related injuries and other problems: review.

    PubMed

    Jalink, Maarten B; Heineman, Erik; Pierie, Jean-Pierre E N; ten Cate Hoedemaker, Henk O

    2014-12-16

    To identify all reported cases of injury and other problems caused by using a Nintendo video gaming system. Review. Search of PubMed and Embase in June 2014 for reports on injuries and other problems caused by using a Nintendo gaming system. Most of the 38 articles identified were case reports or case series. Injuries and problems ranged from neurological and psychological to surgical. Traditional controllers with buttons were associated with tendinitis of the extensor of the thumb. The joystick on the Nintendo 64 controller was linked to palmar ulceration. The motion sensitive Wii remote was associated with musculoskeletal problems and various traumas. Most problems are mild and prevalence is low. The described injuries were related to the way the games are controlled, which varies according to the video game console. © Jalink et al 2014.

  8. Nintendo related injuries and other problems: review

    PubMed Central

    Heineman, Erik; Pierie, Jean-Pierre E N; ten Cate Hoedemaker, Henk O

    2014-01-01

    Objective To identify all reported cases of injury and other problems caused by using a Nintendo video gaming system. Design Review. Data sources and review methods Search of PubMed and Embase in June 2014 for reports on injuries and other problems caused by using a Nintendo gaming system. Results Most of the 38 articles identified were case reports or case series. Injuries and problems ranged from neurological and psychological to surgical. Traditional controllers with buttons were associated with tendinitis of the extensor of the thumb. The joystick on the Nintendo 64 controller was linked to palmar ulceration. The motion sensitive Wii remote was associated with musculoskeletal problems and various traumas. Conclusions Most problems are mild and prevalence is low. The described injuries were related to the way the games are controlled, which varies according to the video game console. PMID:25515525

  9. Assessment of Growth Problems in Adolescents

    PubMed Central

    Baker, F.W.

    1986-01-01

    Investigation of an adolescent growth problem consists of taking an adequate history and doing a complete physical examination. This procedure, along with a calculation of bone age and height/weight age, will allow family physicians to decide on the cause of the growth variance in most patients. Relatively simple studies can be done in the family physician's office to delineate the major causes of growth problems; the majority will be unrelated to the endocrine system. Further studies may be needed in a hospital-based setting. PMID:21267222

  10. Heat Problems.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    Heat problems and heat cramps related to jogging can be caused by fluid imbalances, medications, dietary insufficiency, vomiting or diarrhea, among other factors. If the condition keeps reoccurring, the advice of a physician should be sought. Some preventive measures that can be taken include: (1) running during the cooler hours of the day; (2)…

  11. Improving data quality in the linked open data: a survey

    NASA Astrophysics Data System (ADS)

    Hadhiatma, A.

    2018-03-01

    The Linked Open Data (LOD) is “web of data”, a different paradigm from “web of document” commonly used today. However, the huge LOD still suffers from data quality problems such as completeness, consistency, and accuracy. Data quality problems relate to designing effective methods both to manage and to retrieve information at various data quality levels. Based on review from papers and journals, addressing data quality requires some standards functioning to (1) identification of data quality problems, (2) assessment of data quality for a given context, and (3) correction of data quality problems. However, mostly the methods and strategies dealing with the LOD data quality were not as an integrative approach. Hence, based on those standards and an integrative approach, there are opportunities to improve the LOD data quality in the term of incompleteness, inaccuracy and inconsistency, considering to its schema and ontology, namely ontology refinement. Moreover, the term of the ontology refinement means that it copes not only to improve data quality but also to enrich the LOD. Therefore, it needs (1) a standard for data quality assessment and evaluation which is more appropriate to the LOD; (2) a framework of methods based on statistical relational learning that can improve the correction of data quality problems as well as enrich the LOD.

  12. Conquering common breast-feeding problems.

    PubMed

    Walker, Marsha

    2008-01-01

    Meeting mothers' personal breast-feeding goals depends on a number of factors, including the timely resolution of any problems she encounters. Nurses are often the first providers who interact with the mother during the perinatal period and are positioned to guide mothers through the prevention and solving of breast-feeding problems. Although many problems may be "common," failure to remedy conditions that cause pain, frustration, and anxiety can lead to premature weaning and avoidance of breast-feeding subsequent children. This article describes strategies and interventions to alleviate common problems that breast-feeding mothers frequently encounter.

  13. Mental Health, School Problems, and Social Networks: Modeling Urban Adolescent Substance Use

    ERIC Educational Resources Information Center

    Mason, Michael J.

    2010-01-01

    This study tested a mediation model of the relationship with school problems, social network quality, and substance use with a primary care sample of 301 urban adolescents. It was theorized that social network quality (level of risk or protection in network) would mediate the effects of school problems, accounting for internalizing problems and…

  14. Water quality of North Carolina streams

    USGS Publications Warehouse

    Harned, Douglas; Meyer, Dann

    1983-01-01

    Interpretation of water quality data collected by the U.S. Geological Survey and the North Carolina Department of Natural Resources and Community Development, for the Yadkin-Pee Dee River system, has identified water quality variations, characterized the current condition of the river in reference to water quality standards, estimated the degree of pollution caused by man, and evaluated long-term trends in concentrations of major dissolved constituents. Three stations, Yadkin River at Yadkin College (02116500), Rocky River near Norwood (02126000), and Pee Dee River near Rockingham (02129000) have been sampled over different periods of time beginning in 1906. Overall, the ambient water quality of the Yadkin-Pee Dee River system is satisfactory for most water uses. Iron and manganese concentrations are often above desirable levels, but they are not unusually high in comparison to other North Carolina streams. Lead concentrations also periodically rise above the recommended criterion for domestic water use. Mercury concentrations frequently exceed, and pH levels fall below, the recommended criteria for protection of aquatic life. Dissolved oxygen levels, while generally good, are lowest at the Pee Dee near Rockingham, due to the station 's location not far downstream from a lake. Suspended sediment is the most significant water quality problem of the Yadkin-Pee Dee River. The major cation in the river is sodium and the major anions are bicarbonate and carbonate. Eutrophication is currently a problem in the Yadkin-Pee Dee, particularly in High Rock Lake. An estimated nutrient and sediment balance of the system indicates that lakes along the Yadkin-Pee Dee River serve as a sink for sediment, ammonia, and phosphorus. Pollution makes up approximately 59% of the total dissolved solids load of the Yadkin River at Yadkin College, 43% for the Rocky River near Norwood, and 29% for the Pee Dee River near Rockingham. Statistically significant trends show a pattern of increasing

  15. Improvement of Meteorological Inputs for TexAQS-II Air Quality Simulations

    NASA Astrophysics Data System (ADS)

    Ngan, F.; Byun, D.; Kim, H.; Cheng, F.; Kim, S.; Lee, D.

    2008-12-01

    An air quality forecasting system (UH-AQF) for Eastern Texas, which is in operation by the Institute for Multidimensional Air Quality Studies (IMAQS) at the University of Houston, uses the Fifth-Generation PSU/NCAR Mesoscale Model MM5 model as the meteorological driver for modeling air quality with the Community Multiscale Air Quality (CMAQ) model. While the forecasting system was successfully used for the planning and implementation of various measurement activities, evaluations of the forecasting results revealed a few systematic problems in the numerical simulations. From comparison with observations, we observe some times over-prediction of northerly winds caused by inaccurate synoptic inputs and other times too strong southerly winds caused by local sea breeze development. Discrepancies in maximum and minimum temperature are also seen for certain days. Precipitation events, as well as clouds, are simulated at the incorrect locations and times occasionally. Model simulatednrealistic thunderstorms are simulated, causing sometimes cause unrealistically strong outflows. To understand physical and chemical processes influencing air quality measures, a proper description of real world meteorological conditions is essential. The objective of this study is to generate better meteorological inputs than the AQF results to support the chemistry modeling. We utilized existing objective analysis and nudging tools in the MM5 system to develop the MUltiscale Nest-down Data Assimilation System (MUNDAS), which incorporates extensive meteorological observations available in the simulated domain for the retrospective simulation of the TexAQS-II period. With the re-simulated meteorological input, we are able to better predict ozone events during TexAQS-II period. In addition, base datasets in MM5 such as land use/land cover, vegetation fraction, soil type and sea surface temperature are updated by satellite data to represent the surface features more accurately. They are key

  16. Study on the quality of FRP fishing vessel based on improved Fishbone Chart

    NASA Astrophysics Data System (ADS)

    Sui, J. H.; Yu, Y. F.; Du, Q. F.; Jiang, D. W.

    2018-01-01

    The construction quality of FRP fishing vessels influences their production, use and industry development. In order to explore the factors that affect the construction quality of FRP fishing vessels, key factors affecting the construction quality of FRP fishing vessels are determined based on the quality problems of FRP fishing vessels constructed. The improved Fishbone Chart is used to analyze the eight factors of “human, machine, material, process, environment, inspection, design and information”. Taking the factors that affect the construction quality of FRP fishing vessels as the central target, the eight influencing factors were condensed into five aspects and a composite Fishbone Chart is drawn. The Fishbone Chart is used as the basic model, the influencing factors are sorted, screened and discriminated, and the system model convenient for construction site management and control is established. Finally, the causes of poor construction of FRP fishing vessels are analyzed and discussed, and relevant suggestions are put forward.

  17. Dynamic Assessment of Water Quality Based on a Variable Fuzzy Pattern Recognition Model

    PubMed Central

    Xu, Shiguo; Wang, Tianxiang; Hu, Suduan

    2015-01-01

    Water quality assessment is an important foundation of water resource protection and is affected by many indicators. The dynamic and fuzzy changes of water quality lead to problems for proper assessment. This paper explores a method which is in accordance with the water quality changes. The proposed method is based on the variable fuzzy pattern recognition (VFPR) model and combines the analytic hierarchy process (AHP) model with the entropy weight (EW) method. The proposed method was applied to dynamically assess the water quality of Biliuhe Reservoir (Dailan, China). The results show that the water quality level is between levels 2 and 3 and worse in August or September, caused by the increasing water temperature and rainfall. Weights and methods are compared and random errors of the values of indicators are analyzed. It is concluded that the proposed method has advantages of dynamism, fuzzification and stability by considering the interval influence of multiple indicators and using the average level characteristic values of four models as results. PMID:25689998

  18. Dynamic assessment of water quality based on a variable fuzzy pattern recognition model.

    PubMed

    Xu, Shiguo; Wang, Tianxiang; Hu, Suduan

    2015-02-16

    Water quality assessment is an important foundation of water resource protection and is affected by many indicators. The dynamic and fuzzy changes of water quality lead to problems for proper assessment. This paper explores a method which is in accordance with the water quality changes. The proposed method is based on the variable fuzzy pattern recognition (VFPR) model and combines the analytic hierarchy process (AHP) model with the entropy weight (EW) method. The proposed method was applied to dynamically assess the water quality of Biliuhe Reservoir (Dailan, China). The results show that the water quality level is between levels 2 and 3 and worse in August or September, caused by the increasing water temperature and rainfall. Weights and methods are compared and random errors of the values of indicators are analyzed. It is concluded that the proposed method has advantages of dynamism, fuzzification and stability by considering the interval influence of multiple indicators and using the average level characteristic values of four models as results.

  19. Quelques problemes poses a la grammaire casuelle (Some Problems Regarding Case Grammar)

    ERIC Educational Resources Information Center

    Fillmore, Charles J.

    1975-01-01

    Discusses problems related to case grammar theory, including: the organizations of a case grammar; determination of semantic roles; definition and hierarchy of cases; cause-effect relations; and formalization and notation. (Text is in French.) (AM)

  20. Telephone Problem-Solving Treatment Improves Sleep Quality in Service Members With Combat-Related Mild Traumatic Brain Injury: Results From a Randomized Clinical Trial.

    PubMed

    Vuletic, S; Bell, K R; Jain, S; Bush, N; Temkin, N; Fann, J R; Stanfill, K E; Dikmen, S; Brockway, J A; He, F; Ernstrom, K; Raman, R; Grant, G; Stein, M B; Gahm, G A

    2016-01-01

    Evaluate sleep quality, its correlates, and the effect of telephone-based problem-solving treatment (PST) in active duty postdeployment service members with mild traumatic brain injury (mTBI) SETTING:: Randomized clinical trial. Active duty service members with combat-related mTBI. Education-only (EO) and PST groups (N = 178 each) received printed study materials and 12 educational brochures. The PST group additionally received up to 12 PST telephone calls addressing participant-selected issues. Outcomes were evaluated postintervention (6 months) and at 12 months. Pittsburgh Sleep Quality Index. Sleep quality was manifestly poor in both groups at baseline (Pittsburgh Sleep Quality Index = 12.5 ± 4). Overall sleep quality was significantly different between the PST and EO groups at 6 months (P = .003) but not at 12 months. Longitudinally, PST significantly improved sleep quality at 6 months (P = .001) but not over the follow-up. Low sleep quality was associated with concussion symptoms, pain, depression, and posttraumatic stress disorder at all time points (P < .0001). Sleep disorders, common in postdeployment service members with mTBI, are strongly associated with the presence of pain, posttraumatic stress disorder, and depression. Telephone-based PST may be an effective therapeutic approach for reducing sleep disorders in this population. Research should focus on maintenance of treatment gains.

  1. Indoor Air Quality in Schools: Understanding the Problem and Finding the Solution.

    ERIC Educational Resources Information Center

    Bacci, Geoff

    2002-01-01

    Describes issues and solutions involving indoor air quality in school. Includes indoor air quality action plans, the role of the environmental consultant, and resources available to help school districts develop an indoor air quality action plan. (PKP)

  2. Special Problems of People with Diabetes and Visual Impairment.

    ERIC Educational Resources Information Center

    Rosenthal, J. L.

    1993-01-01

    This article addresses the types of visual impairment caused by diabetes and the unique problems that people with diabetes and visual impairment face. Diabetic retinopathy, cataracts, glaucoma, and diabetic optic neuropathy are discussed as causes of visual impairment, and specific problems in basic living are identified, including diet,…

  3. Rumination decreases parental problem-solving effectiveness in dysphoric postnatal mothers.

    PubMed

    O'Mahen, Heather A; Boyd, Alex; Gashe, Caroline

    2015-06-01

    Postnatal depression is associated with poorer parenting quality, but there are few studies examining maternal-specific cognitive processes that may impact on parenting quality. In this study, we examined the impact of rumination on parental problem-solving effectiveness in dysphoric and non-dysphoric postnatal mothers. Fifty-nine mothers with a infant aged 12 months and under, 20 of whom had a Beck Depression Score II (BDI-II) score ≥ 14, and 39 who scored less than 14 on the BDI-II were randomly assigned to either a rumination or distraction condition. Problem-solving effectiveness was assessed post-induction with the "Postnatal Parental Problem-Solving Task" (PPST), which was adapted from the Means Ends Problem-solving task. Parental problem-solving confidence was also assessed. Dysphoric ruminating mothers exhibited poorer problem-solving effectiveness and poorer confidence regarding their problem-solving compared to dysphoric distracting, non-dysphoric distracting, and non-dysphoric ruminating mothers. A self-report measure of depressed mood was used. Rumination may be a key mechanism associated with both depressive mood and maternal parenting quality during the postnatal period. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  4. E-therapy for mental health problems: a systematic review.

    PubMed

    Postel, Marloes G; de Haan, Hein A; De Jong, Cor A J

    2008-09-01

    The widespread availability of the Internet offers opportunities for improving access to therapy for people with mental health problems. There is a seemingly infinite supply of Internet-based interventions available on the World Wide Web. The aim of the present study is to systematically assess the methodological quality of randomized controlled trials (RCTs) concerning e-therapy for mental health problems. Two reviewers independently assessed the methodological quality of the RCTs, based on a list of criteria for the methodological quality assessment as recommended by the Cochrane Back Review Group. The search yielded 14 papers that reported RCTs concerning e-therapy for mental-health problems. The methodological quality of studies included in this review was generally low. It is concluded that e-therapy may turn out to be an appropriate therapeutic entity, but the evidence needs to be more convincing. Recommendations are made concerning the method of reporting RCTs and the need to add some content items to an e-therapy study.

  5. On designing for quality

    NASA Technical Reports Server (NTRS)

    Vajingortin, L. D.; Roisman, W. P.

    1991-01-01

    The problem of ensuring the required quality of products and/or technological processes often becomes more difficult due to the fact that there is not general theory of determining the optimal sets of value of the primary factors, i.e., of the output parameters of the parts and units comprising an object and ensuring the correspondence of the object's parameters to the quality requirements. This is the main reason for the amount of time taken to finish complex vital article. To create this theory, one has to overcome a number of difficulties and to solve the following tasks: the creation of reliable and stable mathematical models showing the influence of the primary factors on the output parameters; finding a new technique of assigning tolerances for primary factors with regard to economical, technological, and other criteria, the technique being based on the solution of the main problem; well reasoned assignment of nominal values for primary factors which serve as the basis for creating tolerances. Each of the above listed tasks is of independent importance. An attempt is made to give solutions for this problem. The above problem dealing with quality ensuring an mathematically formalized aspect is called the multiple inverse problem.

  6. Common skin problems in children.

    PubMed

    Sethuraman, Gomathy; Bhari, Neetu

    2014-04-01

    Childhood dermatological problems contribute about one-third of all consultations in the setting of both pediatrics and dermatology outpatient services. Skin disorders in children may cause anxiety to parents. General Practitioners should be familiar with the common prevalent skin problems as immediate pediatric dermatology consultation may not be possible. Infections, infestations and dermatitis are the most prevalent diseases among Indian children. The scope of this review is to briefly highlight these common and other important dermatological problems in children.

  7. E-Quality in the Workplace: Quality Circles or Quality of Working Life Programs in the US.

    ERIC Educational Resources Information Center

    Savage, Grant T.; Romano, Richard

    Quality Circle (QC) and Quality of Working Life (QWL) in the United States are similar in that both stress participative decision making, preserve management's prerogative to have the final say, and are voluntary. QC and QWL programs differ, however, in that labor unions are more involved in QWLs; QCs deal only with technical problems related to…

  8. Selective Mutism: Causes and Interventions.

    ERIC Educational Resources Information Center

    Hultquist, Alan M.

    1995-01-01

    This article reviews the literature regarding the diagnostic criteria, causes, assessment, and treatment of selective mutism in school-age children. The most successful treatments have included various forms or combinations of behavior modification, though these may not address the underlying problem. (Author/DB)

  9. Problems caused by regulatory delays and lack of regulation

    NASA Astrophysics Data System (ADS)

    Reamer, Lynne A.

    1994-12-01

    An FDA perspective on some of the problems encountered during the device review process is described. Emphasis is placed on the need for communication and teamwork among all parties to make the system work. Manufacturers are encouraged to `Do it right the first time.' Pertinent questions are asked of the manufacturers and proposed solutions are presented. Day to day reality at FDA is described and document workload is revealed. Lack of regulation, or more appropriately, when less regulation is appropriate is discussed. FDA has distributed to manufacturers a new draft guidance document to help in the decisionmaking process and when to submit a 510(k) when modifications are made to a device. This and other mechanisms are in place at the FDA to streamline the review process. Manufacturers are cautioned about their decisions and to seek advice from qualified persons. FDA emphasizes that help is available and that when in doubt, call.

  10. Causes of unplanned hemodialysis initiation.

    PubMed

    Gomis Couto, A; Teruel Briones, J L; Fernández Lucas, M; Rivera Gorrin, M; Rodríguez Mendiola, N; Jiménez Álvaro, S; Quereda Rodríguez-Navarro, C

    2011-01-01

    Half of patients starting chronic hemodialysis used a transient vascular catheter as a vascular access (unplanned initiation). An objective of the Quality Management Group of the Spanish Society of Nephrology is to achieve that 80% of the patients starting hemodialysis do it with an arteriovenous fistula. We want to review the causes of non-planned hemodialysis nowadays. In 2010, 43 patients had started chronic hemodialysis in the Hospital Ramón y Cajal in Madrid (Spain). Mean age was 61 years, 79% were men, the most frequent cause of chronic renal disease was the diabetes (23%) and Charlson Comorbidity Index was 6.3 ± 2.6. The unplanned hemodialysis occurred in 20 patients (47%), without any differences with the 23 patients who began planned hemodialysis, in none of the clinical or demographic parameters analyzed. The main cause of unplanned hemodialysis was the acute exacerbation of chronic kidney disease stage 3 or 4, previously stable, secondary to an unforeseeable intercurrent process (8 patients, 40% of the cases). One patient began after a non-recovery acute renal failure and in other 6 patients, the reason of unplanned hemodialysis initiation was not attributable to the operation Health System (in 3 cases unknown kidney chronic disease and in the other 3 cases it was patient´s responsibility). Only in 5 cases (25%), the cause could be corrigible. Most causes of unplanned hemodialysis does not come from the healthcare organization and therefore not easy to resolve it. Consequently, the objective of the Quality Group will be difficult to be achieved.

  11. Optimal Planning and Problem-Solving

    NASA Technical Reports Server (NTRS)

    Clemet, Bradley; Schaffer, Steven; Rabideau, Gregg

    2008-01-01

    CTAEMS MDP Optimal Planner is a problem-solving software designed to command a single spacecraft/rover, or a team of spacecraft/rovers, to perform the best action possible at all times according to an abstract model of the spacecraft/rover and its environment. It also may be useful in solving logistical problems encountered in commercial applications such as shipping and manufacturing. The planner reasons around uncertainty according to specified probabilities of outcomes using a plan hierarchy to avoid exploring certain kinds of suboptimal actions. Also, planned actions are calculated as the state-action space is expanded, rather than afterward, to reduce by an order of magnitude the processing time and memory used. The software solves planning problems with actions that can execute concurrently, that have uncertain duration and quality, and that have functional dependencies on others that affect quality. These problems are modeled in a hierarchical planning language called C_TAEMS, a derivative of the TAEMS language for specifying domains for the DARPA Coordinators program. In realistic environments, actions often have uncertain outcomes and can have complex relationships with other tasks. The planner approaches problems by considering all possible actions that may be taken from any state reachable from a given, initial state, and from within the constraints of a given task hierarchy that specifies what tasks may be performed by which team member.

  12. Improving the yield and quality of DNA isolated from white-rot fungi.

    PubMed

    Kuhad, R C; Kapoor, R K; Lal, R

    2004-01-01

    A new simple method used to eliminate polysaccharides that cause problems during DNA isolation was established for 6 different white-rot fungi using 1% hexadecyltrimethylammonium bromide (CTAB) as wash buffer and followed by centrifugation. Variation in the DNA yield and quality was ascertained using precipitating agents, detergents and cell-wall-hydrolyzing chitinase. Considerable amount of exopolysaccharides from fungal biomass was removed with the use of 1% CTAB wash buffer followed by centrifugation. The DNA varied in terms of yield and quality. For the DNA extraction use of 2% SDS in extraction buffer worked best for Pycnoporus cinnabarinus, Cyathus bulleri, Cyathus striatus and Cyathus stercoreus, while 2% CTAB worked best for Phanerochaete chrysosporium and Pleurotus ostreatus. Elimination of phenol and use of absolute ethanol for precipitating DNA resulted in good yield and quality of DNA. This DNA was amenable to restriction endonuclease digestion.

  13. Known Data Problems | ECHO | US EPA

    EPA Pesticide Factsheets

    EPA manages a series of national information systems that include data flowing from staff in EPA and state/tribal/local offices. Given this fairly complex set of transactions, occasional problems occur with the migration of data into the national systems. This page is meant to explain known data quality problems with larger sets of data.

  14. Problem-solving tools for analyzing system problems. The affinity map and the relationship diagram.

    PubMed

    Lepley, C J

    1998-12-01

    The author describes how to use two management tools, an affinity map and a relationship diagram, to define and analyze aspects of a complex problem in a system. The affinity map identifies the key influencing elements of the problem, whereas the relationship diagram helps to identify the area that is the most important element of the issue. Managers can use the tools to draw a map of problem drivers, graphically display the drivers in a diagram, and use the diagram to develop a cause-and-effect relationship.

  15. Community Problems in Eight Northwestern Counties. Report No. 1 of a Series on Quality of Life and Development in Northwestern Wisconsin, January 1976.

    ERIC Educational Resources Information Center

    Lambert, Virginia

    As part of a study of the quality of life in northwestern Wisconsin, questions re: important problems, public services, and environmental concerns were asked of a sample of 150 people in each of 5 counties (Bayfield, Douglas, Price, Taylor, and Washburn) in 1974. Responses to similar questions asked in a 1973 study of Ashland, Burnett, and Rusk…

  16. Global magnitude of visual impairment caused by uncorrected refractive errors in 2004

    PubMed Central

    Pascolini, Donatella; Mariotti, Silvio P; Pokharel, Gopal P

    2008-01-01

    Abstract Estimates of the prevalence of visual impairment caused by uncorrected refractive errors in 2004 have been determined at regional and global levels for people aged 5 years and over from recent published and unpublished surveys. The estimates were based on the prevalence of visual acuity of less than 6/18 in the better eye with the currently available refractive correction that could be improved to equal to or better than 6/18 by refraction or pinhole. A total of 153 million people (range of uncertainty: 123 million to 184 million) are estimated to be visually impaired from uncorrected refractive errors, of whom eight million are blind. This cause of visual impairment has been overlooked in previous estimates that were based on best-corrected vision. Combined with the 161 million people visually impaired estimated in 2002 according to best-corrected vision, 314 million people are visually impaired from all causes: uncorrected refractive errors become the main cause of low vision and the second cause of blindness. Uncorrected refractive errors can hamper performance at school, reduce employability and productivity, and generally impair quality of life. Yet the correction of refractive errors with appropriate spectacles is among the most cost-effective interventions in eye health care. The results presented in this paper help to unearth a formerly hidden problem of public health dimensions and promote policy development and implementation, programmatic decision-making and corrective interventions, as well as stimulate research. PMID:18235892

  17. Managing Global Problems.

    ERIC Educational Resources Information Center

    Stanley, C. Maxwell

    The book examines the historical background of and accomplishments in seven global problem areas. It is hypothesized that effective management within today's framework is the only way to progress toward the political and economic order that is necessary to assure peace and security, justice, and human rights, and to improve the quality of life. It…

  18. Water quality of Bear Creek basin, Jackson County, Oregon

    USGS Publications Warehouse

    Wittenberg, Loren A.; McKenzie, Stuart W.

    1980-01-01

    Water-quality data identify surface-water-quality problems in Bear Creek basin, Jackson County, Oreg., where possible, their causes or sources. Irrigation and return-flow data show pastures are sources of fecal coliform and fecal streptococci bacteria and sinks for suspended sediment and nitrite-plus-nitrate nitrogen. Bear Creek and its tributaries have dissolved oxygen and pH values that do not meet State standards. Forty to 50% of the fecal coliform and fecal streptococci concentrations were higher than 1,000 bacteria colonies per 100 milliliters during the irrigation season in the lower two-thirds of the basin. During the irrigation season, suspended-sediment concentrations, average 35 milligrams per liter, were double those for the nonirrigation season. The Ashland sewage-treatment plant is a major source of nitrite plus nitrate, ammonia, and Kjeldahl nitrogen, and orthophosphate in Bear Creek. (USGS)

  19. Assessment of maternal health care quality: conceptual and methodologic issues.

    PubMed

    Lane, D S; Kelman, H R

    1975-10-01

    Past efforts in assessment of the quality of maternity care have been analyzed in order to develop an evaluation framework that will have utility and applicability beyond a specific program, population, or health discipline. Presently available evaluation approaches have focused attention on either "high risk" populations or upon women experiencing a complicated pregnancy or delivery. Quality has been defined as the extent to which normative or empirically derived standards of obstetrical care have been applied. An alternative approach is suggested which conceives of the pregnancy as a normal physiological event but with the potentiality of either causing or exacerbating social or health problems. Maternity care quality is viewed as the application of those necessary health and health-related services that are required to safeguard the health of the mother and offspring, minimize the noxious consequences of pre-existing or concurrent health hazards or conditions, and upgrade the health and social functioning of those women who require it. Additionally, the system of services should be functionally organized to optimize care. Indicators of quality are suggested which incorporate structural, process, and outcome variables, and which link medical and consumer criteria in a comprehensive community level approach to quality assessment.

  20. The Population Problem as Economic Disarticulation.

    ERIC Educational Resources Information Center

    Yapa, Lakshman S.

    1985-01-01

    Overpopulation exists when people lack the basic means of subsistence, or when there is massive and permanent unemployment. Population problems of developing countries are examined, and causes of high rates of fertility are discussed. The utilization of productive resources in solving population problems is also examined. (RM)

  1. Endophthalmitis caused by Fusarium: An emerging problem in patients with corneal trauma. A case series.

    PubMed

    Barrios Andrés, José Luis; López-Soria, Leyre Mónica; Alastruey Izquierdo, Ana; Echevarría Ecenarro, Jaime; Feijoó Lera, Raquel; Garrido Fierro, Jesus; Cabrerizo Nuñez, Francisco Javier; Canut Blasco, Andrés

    Although fortunately very rare in countries with a temperate climate, certain factors, such as clinical or pharmacological immunosuppression, may cause Fusarium-related fungal infections to become an emerging problem. Moreover, Fusarium is one of the most important etiological agents in exogenous endophthalmitis, which is often favored by the disruption of the epithelial barriers. The aim of this series of clinical cases is to identify characteristic clinical findings that may allow an early diagnosis and more efficient management of this ophthalmologic emergency. Three cases of endophthalmitis due to Fusarium solani and Fusarium oxysporum, diagnosed in 2009, 2010, and 2014 in patients from two different health regions belonging to the same health system and separated by around 43 miles, are presented. The Fusarium isolates were initially identified microscopically and the species subsequently confirmed by sequencing the elongation factor alpha (EFα) and internal transcribed spacers (ITS). Susceptibility to antifungal agents was determined using the EUCAST broth dilution method. Evolution was poor as two of the three patients progressed to phthisis bulbi despite surgical measures and broad-spectrum antifungal antibiotic therapy. It is essential to rapidly instigate multidisciplinary measures to combat suspected endophthalmitis due to Fusarium given the poor prognosis of this type of infection. Copyright © 2018 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Using Simulation Technique to overcome the multi-collinearity problem for estimating fuzzy linear regression parameters.

    NASA Astrophysics Data System (ADS)

    Mansoor Gorgees, Hazim; Hilal, Mariam Mohammed

    2018-05-01

    Fatigue cracking is one of the common types of pavement distresses and is an indicator of structural failure; cracks allow moisture infiltration, roughness, may further deteriorate to a pothole. Some causes of pavement deterioration are: traffic loading; environment influences; drainage deficiencies; materials quality problems; construction deficiencies and external contributors. Many researchers have made models that contain many variables like asphalt content, asphalt viscosity, fatigue life, stiffness of asphalt mixture, temperature and other parameters that affect the fatigue life. For this situation, a fuzzy linear regression model was employed and analyzed by using the traditional methods and our proposed method in order to overcome the multi-collinearity problem. The total spread error was used as a criterion to compare the performance of the studied methods. Simulation program was used to obtain the required results.

  3. Spinal cord injury - Symptoms and causes

    MedlinePlus

    ... are the leading cause of spinal cord injuries, accounting for almost half of new spinal cord injuries ... address these problems if they affect you. Respiratory system. Your injury may make it more difficult to ...

  4. Vulvovaginitis: Find the cause to treat it.

    PubMed

    Goje, Oluwatosin; Munoz, Jessian L

    2017-03-01

    Vulvar and vaginal disorders are among the most common problems seen in ambulatory care. The cause is usually infectious, but noninfectious causes should also be considered, and differentiating them can be challenging. Accurate diagnosis based on patient history, physical examination, and laboratory testing is necessary so that effective therapy can be chosen. Copyright © 2017 Cleveland Clinic.

  5. Image quality and dose differences caused by vendor-specific image processing of neonatal radiographs.

    PubMed

    Sensakovic, William F; O'Dell, M Cody; Letter, Haley; Kohler, Nathan; Rop, Baiywo; Cook, Jane; Logsdon, Gregory; Varich, Laura

    2016-10-01

    Image processing plays an important role in optimizing image quality and radiation dose in projection radiography. Unfortunately commercial algorithms are black boxes that are often left at or near vendor default settings rather than being optimized. We hypothesize that different commercial image-processing systems, when left at or near default settings, create significant differences in image quality. We further hypothesize that image-quality differences can be exploited to produce images of equivalent quality but lower radiation dose. We used a portable radiography system to acquire images on a neonatal chest phantom and recorded the entrance surface air kerma (ESAK). We applied two image-processing systems (Optima XR220amx, by GE Healthcare, Waukesha, WI; and MUSICA(2) by Agfa HealthCare, Mortsel, Belgium) to the images. Seven observers (attending pediatric radiologists and radiology residents) independently assessed image quality using two methods: rating and matching. Image-quality ratings were independently assessed by each observer on a 10-point scale. Matching consisted of each observer matching GE-processed images and Agfa-processed images with equivalent image quality. A total of 210 rating tasks and 42 matching tasks were performed and effective dose was estimated. Median Agfa-processed image-quality ratings were higher than GE-processed ratings. Non-diagnostic ratings were seen over a wider range of doses for GE-processed images than for Agfa-processed images. During matching tasks, observers matched image quality between GE-processed images and Agfa-processed images acquired at a lower effective dose (11 ± 9 μSv; P < 0.0001). Image-processing methods significantly impact perceived image quality. These image-quality differences can be exploited to alter protocols and produce images of equivalent image quality but lower doses. Those purchasing projection radiography systems or third-party image-processing software should be aware that image

  6. [The current problems of investigations into thanatogenesis and the causes of death considered in the articles published in the journal "Sudebno-meditsinskaya ekspertiza (Forensic Medical Expertise)" during the period from 2000 to 2014].

    PubMed

    Fetisov, V A; Gusarov, A A; Khabova, Z S; Baibarza, N V; Rudenko, I A

    2015-01-01

    The objective of the present work was the analysis of the scientometrical characteristics of the publication activity of the authors of the articles concerning the problems of investigations into thanatogenesis and the causes of death that were submitted for the publication in the journal "Sudebno-meditsinskaya ekspertiza" during the period from 2000 to 2014. The analysis was aimed at detecting the priority fields of research of interest not only for domestic but especially for foreign specialists. The study has revealed the most popular Russian-language and foreign journals that were most frequently cited by the authors of "Sudebno-meditsinskaya ekspertiza". It was shown that the largest number of publications were submitted by the research groups affiliated with the departments and other subdivisions of the practical expert institutions of Moscow, Sankt-Petersburg, Astrakhan, Krasnodar, Baku, and Krasnoyarsk. It is concluded that the further analysis and assessment of the research activities of specialist in forensic medical expertise with the use of scientometrical methods constitute the indispensable condition for the development and improvement of the quality of forensic medical expertise in the Russian Federation.

  7. Hydrology and quality of ground water in northern Thurston County, Washington

    USGS Publications Warehouse

    Dion, N.P.; Turney, G.L.; Jones, M.A.

    1994-01-01

    Northern Thurston County is underlain by as much as 1,000 feet of unconsolidated deposits of Pleistocene Age, that are of both glacial and nonglacial origin. Interpretation of 17 geelogic sections led to the delineation of 7 major geohydrologic units, 3 of which constitute aquifers in the area. Precipi- tation ranges from about 35 to 65 inches per year across the study area. Estimates of gross recharge from precipitation indicate that the ground-water system of the area receives about 25 inches per year. The net recharge to the system (recharge from precipitation minus withdrawals from wells) is the equivalent of about 23 inches per year. Ground water generally moves toward marine bodiesand to major surface drainage channels. Leakage from Lake St. Clair, which lies in a compound kettle within permeable glacial outwash, is almost 24 feet per year per unit area. Leakage from the lake may make up part of the water that discharges at McAllister Springs, north of the lake. Of the few water-quality problems encountered, the most widespread is seawater intrusion, which is caused by the activities of man. Most water-quality problems in the study area, however, are due to natural causes. Iron concentrations axe as large as 21,000 micrograms per liter, manganese concentrations are as large as 3,400 micrograms per liter, and connate seawater is present in ground water in the southern pan of the study area.

  8. Problems with provision: barriers to drinking water quality and public health in rural Tasmania, Australia.

    PubMed

    Whelan, Jessica J; Willis, Karen

    2007-01-01

    Access to safe drinking water is essential to human life and wellbeing, and is a key public health issue. However, many communities in rural and regional parts of Australia are unable to access drinking water that meets national standards for protecting human health. The aim of this research was to identify the key issues in and barriers to the provision and management of safe drinking water in rural Tasmania, Australia. Semi-structured interviews were conducted with key local government employees and public health officials responsible for management of drinking water in rural Tasmania. Participants were asked about their core public health duties, regulatory responsibilities, perceptions and management of risk, as well as the key barriers that may be affecting the provision of safe drinking water. This research highlights the effect of rural locality on management and safety of fresh water in protecting public health. The key issues contributing to problems with drinking water provision and quality identified by participants included: poor and inadequate water supply infrastructure; lack of resources and staffing; inadequate catchment monitoring; and the effect of competing land uses, such as forestry, on water supply quality. This research raises issues of inequity in the provision of safe drinking water in rural communities. It highlights not only the increasing need for greater funding by state and commonwealth government for basic services such as drinking water, but also the importance of an holistic and integrated approach to managing drinking water resources in rural Tasmania.

  9. Elementary School Teacher Candidates' Perceptions of Good Problems

    ERIC Educational Resources Information Center

    Lee, Ji-Eun; Kim, Kyoung-Tae

    2005-01-01

    This study describes a classroom action research activity regarding a group of elementary school teacher candidates' perceptions of good mathematics problems. A questionnaire containing 20 problems was given, and the candidates were asked to rate the quality of each problem on a 5-point scale. The results revealed that the majority of the teacher…

  10. Problem analysis of geotechnical well drilling in complex environment

    NASA Astrophysics Data System (ADS)

    Kasenov, A. K.; Biletskiy, M. T.; Ratov, B. T.; Korotchenko, T. V.

    2015-02-01

    The article examines primary causes of problems occurring during the drilling of geotechnical wells (injection, production and monitoring wells) for in-situ leaching to extract uranium in South Kazakhstan. Such a drilling problem as hole caving which is basically caused by various chemical and physical factors (hydraulic, mechanical, etc.) has been thoroughly investigated. The analysis of packing causes has revealed that this problem usually occurs because of insufficient amount of drilling mud being associated with small cross section downward flow and relatively large cross section upward flow. This is explained by the fact that when spear bores are used to drill clay rocks, cutting size is usually rather big and there is a risk for clay particles to coagulate.

  11. California's program: Indoor air problems aren't amenable to regulation

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

    Wesolowski, J.

    In 1982, California's legislature established an Indoor Air Quality Program (CIAQP) in the Department of Health Services to carry out research on the nature and extent of the indoor air problem (excluding industrial worksites), to find appropriate mitigation measures, and to promote and coordinate the efforts of other state agencies. Since indoor air problems usually are not amenable to regulatory solutions, regulatory authority was not included in the mandate. The program conducts research into a wide range of contaminants--radon, asbestos, formaldehyde, carbon monoxide, volatile organic compounds, environmental tobacco smoke (ETS), as well as into biological aerosols that cause such diseasesmore » as Legionnaires disease, tuberculosis, allergies, and asthma. Studies are also carried out to better understand the Sick Building Syndrome. The research includes field surveys to determine the exposure of the population to specific contaminants and experiments in the laboratory to develop protocols for reducing exposures. The research emphasizes measurement of exposure--concentration multiplied by the time a person is exposed--as opposed to measurement of concentration only.« less

  12. Body image and sexual problems in young women with breast cancer.

    PubMed

    Fobair, Pat; Stewart, Susan L; Chang, Subo; D'Onofrio, Carol; Banks, Priscilla J; Bloom, Joan R

    2006-07-01

    The purpose of this study was to determine the frequency of body image and sexual problems in the first months after treatment among women diagnosed with breast cancer at age 50 or younger. Breast cancer treatment may have severe effects on the bodies of younger women. Surgical treatment may be disfiguring, chemotherapy may cause abrupt menopause, and hormone replacement is not recommended. A multi-ethnic population-based sample of 549 women aged 22-50 who were married or in a stable unmarried relationship were interviewed within seven months of diagnosis with in situ, local, or regional breast cancer. Body image and sexual problems were experienced by a substantial proportion of women in the early months after diagnosis. Half of the 546 women experienced two or more body image problems some of the time (33%), or at least one problem much of the time (17%). Among sexually active women, greater body image problems were associated with mastectomy and possible reconstruction, hair loss from chemotherapy, concern with weight gain or loss, poorer mental health, lower self-esteem, and partner's difficulty understanding one's feelings. Among the 360 sexually active women, half (52%) reported having a little problem in two or more areas of sexual functioning (24%), or a definite or serious problem in at least one area (28%). Greater sexual problems were associated with vaginal dryness, poorer mental health, being married, partner's difficulty understanding one's feelings, and more body image problems, and there were significant ethnic differences in reported severity. Difficulties related to sexuality and sexual functioning were common and occurred soon after surgical and adjuvant treatment. Addressing these problems is essential to improve the quality of life of young women with breast cancer.

  13. Quality of Sleep and its Relationship to Quality of Life in Hemodialysis Patients

    PubMed Central

    Parvan, Kobra; lakdizaji, Sima; Roshangar, Fariborz; Mostofi, Mahtab

    2013-01-01

    Introduction: Despite many advances in the treatment of chronic renal failure, the quality of sleep in patients who suffer from this disease is at the risk. The high prevalence of sleep disorders in hemodialysis patients, which is concomitant with physical, behavioral, and psychological problems, has always affected these patients' quality of life (QOL). This study aimed to determine the relationship between quality of sleep and quality of life in hemodialysis patients. Methods: By using a descriptive and correlational design, this study was conducted on 245 hemodialysis patients in 2012. Patients were selected by convenience sampling from the hemodialysis ward of four training hospitals of Tabriz and Maragheh. Quality of sleep was measured by the Pittsburgh Sleep Quality Index (PSQI), and the quality of life for patients was measured by the Kidney Disease Quality Of Life questionnaire (KDQOL-SF). Results: 83.3% of hemodialysis patients had poor quality of sleep. Poor quality of life was significantly associated with poor quality of sleep. There was a significant negative correlation between global PSQI and important aspects of quality of life including physical health, symptoms and problems, the impact of kidney disease on daily life, burden of kidney disease, mental health, social support, and sexual function. Conclusion: The low quality of sleep in hemodialysis patients has an effect on the deterioration of their quality of life. Therefore, training, counseling, and advocacy programs should be developed to improve the patients' quality of sleep and quality of life, especially those with lower education level and income, and older people. PMID:25276738

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

    NASA Technical Reports Server (NTRS)

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

    2013-01-01

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

  15. A national and state profile of leading health problems and health care quality for US children: key insurance disparities and across-state variations.

    PubMed

    Bethell, Christina D; Kogan, Michael D; Strickland, Bonnie B; Schor, Edward L; Robertson, Julie; Newacheck, Paul W

    2011-01-01

    Parent/consumer-reported data is valuable and necessary for population-based assessment of many key child health and health care quality measures relevant to both the Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 and the Patient Protection and Affordable Care Act of 2010 (ACA). The aim of this study was to evaluate national and state prevalence of health problems and special health care needs in US children; to estimate health care quality related to adequacy and consistency of insurance coverage, access to specialist, mental health and preventive medical and dental care, developmental screening, and whether children meet criteria for having a medical home, including care coordination and family centeredness; and to assess differences in health and health care quality for children by insurance type, special health care needs status, race/ethnicity, and/or state of residence. National and state level estimates were derived from the 2007 National Survey of Children's Health (N = 91,642; children aged 0-17 years). Variations between children with public versus private sector health insurance, special health care needs, specific conditions, race/ethnicity, and across states were evaluated using multivariate logistic regression and/or standardized statistical tests. An estimated 43% of US children (32 million) currently have at least 1 of 20 chronic health conditions assessed, increasing to 54.1% when overweight, obesity, or being at risk for developmental delays are included; 19.2% (14.2 million) have conditions resulting in a special health care need, a 1.6 point increase since 2003. Compared with privately insured children, the prevalence, complexity, and severity of health problems were systematically greater for the 29.1% of all children who are publicly insured children after adjusting for variations in demographic and socioeconomic factors. Forty-five percent of all children in the United States scored positively on a minimal quality

  16. Genetic Algorithms for Multiple-Choice Problems

    NASA Astrophysics Data System (ADS)

    Aickelin, Uwe

    2010-04-01

    This thesis investigates the use of problem-specific knowledge to enhance a genetic algorithm approach to multiple-choice optimisation problems.It shows that such information can significantly enhance performance, but that the choice of information and the way it is included are important factors for success.Two multiple-choice problems are considered.The first is constructing a feasible nurse roster that considers as many requests as possible.In the second problem, shops are allocated to locations in a mall subject to constraints and maximising the overall income.Genetic algorithms are chosen for their well-known robustness and ability to solve large and complex discrete optimisation problems.However, a survey of the literature reveals room for further research into generic ways to include constraints into a genetic algorithm framework.Hence, the main theme of this work is to balance feasibility and cost of solutions.In particular, co-operative co-evolution with hierarchical sub-populations, problem structure exploiting repair schemes and indirect genetic algorithms with self-adjusting decoder functions are identified as promising approaches.The research starts by applying standard genetic algorithms to the problems and explaining the failure of such approaches due to epistasis.To overcome this, problem-specific information is added in a variety of ways, some of which are designed to increase the number of feasible solutions found whilst others are intended to improve the quality of such solutions.As well as a theoretical discussion as to the underlying reasons for using each operator,extensive computational experiments are carried out on a variety of data.These show that the indirect approach relies less on problem structure and hence is easier to implement and superior in solution quality.

  17. Account of an optical beam spreading caused by turbulence for the problem of partially coherent wavefield propagation through inhomogeneous absorbing media

    NASA Astrophysics Data System (ADS)

    Dudorov, Vadim V.; Kolosov, Valerii V.

    2003-04-01

    The propagation problem for partially coherent wave fields in inhomogeneous media is considered in this work. The influence of refraction, inhomogeneity of gain medium properties and refraction parameter fluctuations on target characteristics of radiation are taken into consideration. Such problems arise in the study of laser propagation on atmosphere paths, under investigation of directional radiation pattern forming for lasers which gain media is characterized by strong fluctuation of dielectric constant and for lasers which resonator have an atmosphere area. The ray-tracing technique allows us to make effective algorithms for modeling of a partially coherent wave field propagation through inhomogeneous random media is presented for case when the influecne of an optical wave refraction, the influence of the inhomogeiety of radiaitn amplification or absorption, and also the influence of fluctuations of a refraction parameter on target radiation parameters are basic. Novelty of the technique consists in the account of the additional refraction caused by inhomogeneity of gain, and also in the method of an account of turbulent distortions of a beam with any initial coherence allowing to execute construction of effective numerical algorithms. The technique based on the solution of the equation for coherence function of the second order.

  18. An analysis of root cause identification and continuous quality improvement in public health H1N1 after-action reports.

    PubMed

    Singleton, Christa-Marie; Debastiani, Summer; Rose, Dale; Kahn, Emily B

    2014-01-01

    To identify the extent to which the Homeland Security Exercise and Evaluation Program's (HSEEP) After Action Report/Improvement Plan (AAR/IP) template was followed by public health entities and facilitated the identification of detailed corrective actions and continuous improvement. Data were drawn from the US H1N1 Public Health Emergency Response (PHER) federal grant awardees (n = 62). After action report/improvement plan text was examined to identify the presence of AAR/IP HSEEP elements and characterized as "minimally complete," "partially complete," or "complete." Corrective actions (CA) and recommendations within the IP focusing on performance deficits were coded as specific, measurable, and time-bound, and whether they were associated with a problem that met root cause criteria and whether the CA/recommendation was intended to address or fix the root cause. A total of 2619 CA/recommendations were identified. More than half (n = 1480, 57%) addressed root causes. Corrective actions/recommendations associated with complete AARs more frequently addressed root cause (58% vs 51%, χ = 9.1, P < 0.003) and were more specific (34% vs 23%, χ = 32.3, P < 0.0001), measurable (30% vs 18%, χ = 37.9, P < 0.0001), and time-bound (38% vs 15%, χ = 115.5, P < 0.0001) than partially complete AARs. The same pattern was not observed with completeness of IPs. Corrective actions and recommendations were similarly specific and measurable. Recommendations significantly addressed root cause more than CAs. Our analysis indicates a possible lack of awardee distinction between CA and recommendations in AARs. As HSEEP adapts to align with the 2011 National Preparedness Goal and National Preparedness System, future HSEEP documents should emphasize the importance of root cause analysis as a required element within AAR documents and templates in the exercise and real incident environment, as well as the need for specific and measurable CAs.

  19. Toward Modeling the Intrinsic Complexity of Test Problems

    ERIC Educational Resources Information Center

    Shoufan, Abdulhadi

    2017-01-01

    The concept of intrinsic complexity explains why different problems of the same type, tackled by the same problem solver, can require different times to solve and yield solutions of different quality. This paper proposes a general four-step approach that can be used to establish a model for the intrinsic complexity of a problem class in terms of…

  20. Recovery of condensate water quality in power generator's surface condenser

    NASA Astrophysics Data System (ADS)

    Kurniawan, Lilik Adib

    2017-03-01

    In PT Badak NGL Plant, steam turbines are used to drive major power generators, compressors, and pumps. Steam exiting the turbines is condensed in surface condensers to be returned to boilers. Therefore, surface condenser performance and quality of condensate water are very important. One of the recent problem was caused by the leak of a surface condenser of Steam Turbine Power Generator. Thesteam turbine was overhauled, leaving the surface condenser idle and exposed to air for more than 1.5 years. Sea water ingress due to tube leaks worsens the corrosionof the condenser shell. The combination of mineral scale and corrosion product resulting high conductivity condensate at outlet condenser when we restarted up, beyond the acceptable limit. After assessing several options, chemical cleaning was the best way to overcome the problem according to condenser configuration. An 8 hour circulation of 5%wt citric acid had succeed reducing water conductivity from 50 μmhos/cm to below 5 μmhos/cm. The condensate water, then meets the required quality, i.e. pH 8.3 - 9.0; conductivity ≤ 5 μmhos/cm, therefore the power generator can be operated normally without any concern until now.

  1. Breakdown Cause and Effect Analysis. Case Study

    NASA Astrophysics Data System (ADS)

    Biały, Witold; Ružbarský, Juraj

    2018-06-01

    Every company must ensure that the production process proceeds without interferences. Within this article, the author uses the term "interferences" in reference to unplanned stoppages caused by breakdowns. Unfortunately, usually due to machine operators' mistakes, machines break, which causes stoppages thus generating additional costs for the company. This article shows a cause and effect analysis of a breakdown in a production process. The FMEA as well as quality management tools: the Ishikawa diagram and Pareto chart were used for the analysis. Correction measures were presented which allowed for a significant reduction in the number of stoppages caused by breakdowns.

  2. Psychological problems, protective factors and health-related quality of life in youth affected by violence: the burden of the multiply victimised.

    PubMed

    Schlack, Robert; Ravens-Sieberer, Ulrike; Petermann, Franz

    2013-06-01

    This study investigates self-rated mental health in terms of psychological problems, protective factors and health-related quality of life (HRQOL) in a nationally representative sample of adolescents (n=6813) aged 11-17 involved in violence with varying frequency. Using MANCOVA and ANCOVA, youth with single and multiple histories of violent victimisation and violence perpetration were contrasted with non-involved comparisons. The results show that even low levels of violence involvement were associated with more problems, fewer protective factors and impaired HRQOL. Multiply victimised youth - not perpetrating victims - stood out with internalising, peer and hyperactivity/inattention problems. Discriminant function analysis separated non-involved from violence-affected youth, and multiply victimised from not multiply victimised youth. Externalising behaviours, family issues, male sex and school functioning predicted group separation on the first function (proportion variance explained 80.0%), while internalising and peer issues were predictive for the second function (PVE 14.2%). Implications for prevention, intervention and research are discussed. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  3. [Illness caused by water-based paints?].

    PubMed

    Birkeland, G; Zahlsen, K; Aas, K

    1994-08-20

    Illness caused by the indoor environment is a challenging and complicated field to investigate. Emissions from paints may contribute to the problems. Several components of water-based paints evaporate for a long time after painting, and some of them may affect human biology. We describe one patient who has experienced symptoms caused by water-based paint. Different reaction mechanisms may be involved, and these are discussed. Components which may elicit biological effects are listed and discussed. Physicians should be aware of the possibility that a few patients may suffer from illness caused by emissions from modern paints.

  4. Causes of Male Dropout Rate in Pakistan

    ERIC Educational Resources Information Center

    Ud Din, Muhammad Naseer; Dad, Hukam; Iqbal, Javid; Shah, Syed Shafqat Ali; Niazi, Muhammad Imran

    2011-01-01

    This study aimed to seek the cause of male students' dropout rate at the primary level of F.R. Peshawar. The main objectives of the study were: 1) to study the teacher problems and attitudes of the dropouts, 2) to determine the factors that cause dropouts, 3) to study the government's strategy of dropouts, and 4) to provide suggestions to overcome…

  5. Problems and hopes perceived by mothers, fathers and physicians of children receiving palliative care.

    PubMed

    Hill, Douglas L; Miller, Victoria A; Hexem, Kari R; Carroll, Karen W; Faerber, Jennifer A; Kang, Tammy; Feudtner, Chris

    2015-10-01

    The quality of shared decision making for children with serious illness may depend on whether parents and physicians share similar perceptions of problems and hopes for the child. (i) Describe the problems and hopes reported by mothers, fathers and physicians of children receiving palliative care; (ii) examine the observed concordance between participants; (iii) examine parental perceived agreement; and (iv) examine whether parents who identified specific problems also specified corresponding hopes, or whether the problems were left 'hopeless'. Seventy-one parents and 43 physicians were asked to report problems and hopes and perceived agreement for 50 children receiving palliative care. Problems and hopes were classified into eight domains. Observed concordance was calculated between parents and between each parent and the physicians. The most common problem domains were physical body (88%), quality of life (74%) and medical knowledge (48%). The most common hope domains were quality of life (88%), suffering (76%) and physical body (39%). Overall parental dyads demonstrated a high percentage of concordance (82%) regarding reported problem domains and a lower percentage of concordance on hopes (65%). Concordance between parents and physicians regarding specific children was lower on problem (65-66%) and hope domains (59-63%). Respondents who identified problems regarding a child's quality of life or suffering were likely to also report corresponding hopes in these domains (93 and 82%, respectively). Asking parents and physicians to talk about problems and hopes may provide a straightforward means to improve the quality of shared decision making for critically ill children. © 2013 John Wiley & Sons Ltd.

  6. Sleep quality in long haul truck drivers: A study on Iranian national data.

    PubMed

    Sadeghniiat-Haghighi, Khosro; Yazdi, Zohreh; Kazemifar, Amir-Mohammad

    2016-08-01

    Iran has a high rate of road traffic accidents. Poor quality of sleep brings about loss of attention, which is an important cause of road traffic accidents particularly in monotonous roads. The causes of poor quality of sleep in occupational drivers are multifactorial. The objective of the present study was to assess the prevalence of poor sleep quality among occupational drivers with rotating work schedules and analyze its different risk factors. 2200 professional long-haul truck drivers who had been referred to the Occupational Health Clinic for routine education course were invited. We obtained data from eight provinces from various parts of Iran during 2012-2013. Data were collected using a questionnaire including questions about demographic and job characteristics. Pittsburg Sleep Quality Index (PSQI) was used to assess drivers' sleep quality. Mean working (driving) time was (9.3±2.5) hours daily and (55.5 ± 18.29) hours weekly. About 23.5% of the drivers reported history of smoking, 14.5% had low job satisfaction and 60% had irregular work schedule. 16.4% of drivers had an accidents leading to injury during the past five years. The mean PSQI score was 4.2 ± 2.7; 54% had a PSQI>5 (poor quality of sleep). Multivariate logistic regression showed that smoking, job satisfaction, history of accidents, shift work and work hours per day were the most important risk factors for poor sleep quality. Results obtained from the current study showed a high prevalence of poor quality of sleep among professional drivers. It warrants more attention to this significant problem using some measures to improve working conditions in professional drivers, as well as health promotion interventions.

  7. The Impact of Skin Problems on the Quality of Life in Patients Treated with Anticancer Agents: A Cross-Sectional Study.

    PubMed

    Lee, Jaewon; Lim, Jin; Park, Jong Seo; Kim, Miso; Kim, Tae-Yong; Kim, Tae Min; Lee, Kyung-Hun; Keam, Bhumsuk; Han, Sae-Won; Mun, Je-Ho; Cho, Kwang Hyun; Jo, Seong Jin

    2017-12-14

    Patients treated with anticancer agents often experience a variety of treatment-related skin problems, which can impair their quality of life. In this cross-sectional study, Dermatology Life Quality Index (DLQI) and clinical information were evaluated in patients under active anticancer treatment using a questionnaire survey and their medical records review. Of 375 evaluated subjects with anticancer therapy, 136 (36.27%) and 114 (30.40%) were treated for breast cancer and colorectal cancer, respectively. We found that women, breast cancer, targeted agent use, and longer duration of anticancer therapy were associated with higher dermatology-specific QoL distraction. In addition, itching, dry skin, easy bruising, pigmentation, papulopustules on face, periungual inflammation, nail changes, palmoplantar lesions were associated with significantly higher DLQI scores. Periungual inflammation and palmoplantar lesions scored the highest DLQI. We believe our findings can be helpful to clinicians in counseling and managing the patients undergoing anticancer therapy.

  8. Clue Insensitivity in Remote Associates Test Problem Solving

    ERIC Educational Resources Information Center

    Smith, Steven M.; Sifonis, Cynthia M.; Angello, Genna

    2012-01-01

    Does spreading activation from incidentally encountered hints cause incubation effects? We used Remote Associates Test (RAT) problems to examine effects of incidental clues on impasse resolution. When solution words were seen incidentally 3-sec before initially unsolved problems were retested, more problems were resolved (Experiment 1). When…

  9. The interaction between nitrobenzene and Microcystis aeruginosa and its potential to impact water quality.

    PubMed

    Liu, Zhiquan; Cui, Fuyi; Ma, Hua; Fan, Zhenqiang; Zhao, Zhiwei; Hou, Zhenling; Liu, Dongmei; Jia, Xuebin

    2013-08-01

    The potential water quality problems caused by the interaction between nitrobezene (NB) and Microcystis aeruginosa was investigated by studying the growth inhibition, the haloacetic acids formation potential (HAAFP) and the secretion of microcystin-LR (MC-LR). The results showed that NB can inhibit the growth of M. aeruginosa, and the value of EC50 increased with the increase of initial algal density. Although NB can hardly react with chlorine to form HAAs, the presence of NB can enhance the HAAFP productivity. The secretion of the intracellular MC-LR is constant under the steady experimental conditions. However, the presence of NB can reduce the MC-LR productivity of M. aeruginosa. Overall, the increased disinfection risk caused by the interaction has more important effect on the safety of drinking water quality than the benefit of the decreased MC-LR productivity, and should be serious considered when the water contained NB and M. aeruginosa is used as drinking water source. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Turkish EFL Academicians' Problems Concerning Translation Activities and Practices, Attitudes towards the Use of Online and Printed Translation Tools, and Suggestions for Quality Translation Practice

    ERIC Educational Resources Information Center

    Zengin, Bugra; Kacar, Isil Gunseli

    2011-01-01

    This mixed method research study aimed to highlight the problems of EFL academicians concerning their current translation practices, their attitudes towards the use of various translation tools, and offer suggestions for more quality translation practices. Seventy-three EFL academicians from three Turkish universities participated in the study.…

  11. Acid Precipitation: Causes and Consequences.

    ERIC Educational Resources Information Center

    Babich, Harvey; And Others

    1980-01-01

    This article is the first of three articles in a series on the acid rain problem in recent years. Discussed are the causes of acid precipitation and its consequences for the abiotic and biotic components of the terrestrial and aquatic ecosystems, and for man-made materials. (Author/SA)

  12. Numerical Boundary Conditions for Computational Aeroacoustics Benchmark Problems

    NASA Technical Reports Server (NTRS)

    Tam, Chritsopher K. W.; Kurbatskii, Konstantin A.; Fang, Jun

    1997-01-01

    Category 1, Problems 1 and 2, Category 2, Problem 2, and Category 3, Problem 2 are solved computationally using the Dispersion-Relation-Preserving (DRP) scheme. All these problems are governed by the linearized Euler equations. The resolution requirements of the DRP scheme for maintaining low numerical dispersion and dissipation as well as accurate wave speeds in solving the linearized Euler equations are now well understood. As long as 8 or more mesh points per wavelength is employed in the numerical computation, high quality results are assured. For the first three categories of benchmark problems, therefore, the real challenge is to develop high quality numerical boundary conditions. For Category 1, Problems 1 and 2, it is the curved wall boundary conditions. For Category 2, Problem 2, it is the internal radiation boundary conditions inside the duct. For Category 3, Problem 2, they are the inflow and outflow boundary conditions upstream and downstream of the blade row. These are the foci of the present investigation. Special nonhomogeneous radiation boundary conditions that generate the incoming disturbances and at the same time allow the outgoing reflected or scattered acoustic disturbances to leave the computation domain without significant reflection are developed. Numerical results based on these boundary conditions are provided.

  13. Causal chain analysis and root causes: the GIWA approach.

    PubMed

    Belausteguigoitia, Juan Carlos

    2004-02-01

    The Global International Waters Assessment (GIWA) was created to help develop a priority setting mechanism for actions in international waters. Apart from assessing the severity of environmental problems in ecosystems, the GIWA's task is to analyze potential policy actions that could solve or mitigate these problems. Given the complex nature of the problems, understanding their root causes is essential to develop effective solutions. The GIWA provides a framework to analyze these causes, which is based on identifying the factors that shape human behavior in relation to the use (direct or indirect) of aquatic resources. Two sets of factors are analyzed. The first one consists of social coordination mechanisms (institutions). Faults in these mechanisms lead to wasteful use of resources. The second consists of factors that do not cause wasteful use of resources per se (poverty, trade, demographic growth, technology), but expose and magnify the faults of the first group of factors. The picture that comes out is that diagnosing simple generic causes, e.g. poverty or trade, without analyzing the case specific ways in which the root causes act and interact to degrade the environment, will likely ignore important links that may put the effectiveness of the recommended policies at risk. A summary of the causal chain analysis for the Colorado River Delta is provided as an example.

  14. Quality end-of-life care: A global perspective

    PubMed Central

    Singer, Peter A; Bowman, Kerry W

    2002-01-01

    Background Quality end-of-life care has emerged as an important concept in industrialized countries. Discussion We argue quality end-of-life care should be seen as a global public health and health systems problem. It is a global problem because 85 % of the 56 million deaths worldwide that occur annually are in developing countries. It is a public health problem because of the number of people it affects, directly and indirectly, in terms of the well being of loved ones, and the large-scale, population based nature of some possible interventions. It is a health systems problem because one of its main features is the need for better information on quality end-of-life care. We examine the context of end-of-life care, including the epidemiology of death and cross-cultural considerations. Although there are examples of success, we could not identify systematic data on capacity for delivering quality end-of-life care in developing countries. We also address a possible objection to improving end-of-life care in developing countries; many deaths are preventable and reduction of avoidable deaths should be the focus of attention. Conclusions We make three recommendations: (1) reinforce the recasting of quality end-of-life care as a global public health and health systems problem; (2) strengthen capacity to deliver quality end-of-life care; and (3) develop improved strategies to acquire information about the quality of end-of-life care. PMID:12139768

  15. [A strategy of constructing the technological system for quality control of Chinese medicine based on process control and management].

    PubMed

    Cheng, Yi-Yu; Qian, Zhong-Zhi; Zhang, Bo-Li

    2017-01-01

    The current situation, bottleneck problems and severe challenges in quality control technology of Chinese Medicine (CM) are briefly described. It is presented to change the phenomenon related to the post-test as the main means and contempt for process control in drug regulation, reverse the situation of neglecting the development of process control and management technology for pharmaceutical manufacture and reconstruct the technological system for quality control of CM products. The regulation and technology system based on process control and management for controlling CM quality should be established to solve weighty realistic problems of CM industry from the root causes, including backwardness of quality control technology, weakness of quality risk control measures, poor reputation of product quality and so on. By this way, the obstacles from poor controllability of CM product quality could be broken. Concentrating on those difficult problems and weak links in the technical field of CM quality control, it is proposed to build CMC (Chemistry, Manufacturing and Controls) regulation for CM products with Chinese characteristics and promote the regulation international recognition as soon as possible. The CMC technical framework, which is clinical efficacy-oriented, manufacturing manner-centered and process control-focused, was designed. To address the clinical characteristics of traditional Chinese medicine (TCM) and the production feature of CM manufacture, it is suggested to establish quality control engineering for CM manufacturing by integrating pharmaceutical analysis, TCM chemistry, TCM pharmacology, pharmaceutical engineering, control engineering, management engineering and other disciplines. Further, a theoretical model of quality control engineering for CM manufacturing and the methodology of digital pharmaceutical engineering are proposed. A technology pathway for promoting CM standard and realizing the strategic goal of CM internationalization is

  16. Algorithm design for automated transportation photo enforcement camera image and video quality diagnostic check modules

    NASA Astrophysics Data System (ADS)

    Raghavan, Ajay; Saha, Bhaskar

    2013-03-01

    Photo enforcement devices for traffic rules such as red lights, toll, stops, and speed limits are increasingly being deployed in cities and counties around the world to ensure smooth traffic flow and public safety. These are typically unattended fielded systems, and so it is important to periodically check them for potential image/video quality problems that might interfere with their intended functionality. There is interest in automating such checks to reduce the operational overhead and human error involved in manually checking large camera device fleets. Examples of problems affecting such camera devices include exposure issues, focus drifts, obstructions, misalignment, download errors, and motion blur. Furthermore, in some cases, in addition to the sub-algorithms for individual problems, one also has to carefully design the overall algorithm and logic to check for and accurately classifying these individual problems. Some of these issues can occur in tandem or have the potential to be confused for each other by automated algorithms. Examples include camera misalignment that can cause some scene elements to go out of focus for wide-area scenes or download errors that can be misinterpreted as an obstruction. Therefore, the sequence in which the sub-algorithms are utilized is also important. This paper presents an overview of these problems along with no-reference and reduced reference image and video quality solutions to detect and classify such faults.

  17. Assessment of groundwater quality and contamination problems ascribed to an abandoned uranium mine (Cunha Baixa region, Central Portugal)

    NASA Astrophysics Data System (ADS)

    Neves, O.; Matias, M. J.

    2008-02-01

    The assessment of groundwater quality and its environmental implications in the region of the abandoned Cunha Baixa uranium mine (Central Portugal) was carried out from 1995 to 2004. Shallow groundwater is the major water supply source for irrigation in the neighbourhood of Cunha Baixa village. Water samples from the mine site as well as from private wells were collected in order to identify the mining impact on water composition, the extent of contamination and the seasonal and temporal groundwater quality variations. Some of the sampled private wells contain waters having low pH (<4.5 5) and high values of EC, TDS, SO4, F, Ca, Mg, Al, Mn, Ni, U, Zn and 226Ra. The wells located through the ESE WSE groundwater flow path (1 km down gradient of the mining site) display the most contaminated water. In the summer season, the levels of SO4, Al, Mn, and U were 50 120 times higher than those registered for uncontaminated waters and exceeded the quality limits for irrigation purposes, presenting soil degradation risks. Nevertheless, this study indicates that groundwater contamination suffered a small decrease from 1999 to 2004. The bioaccumulation of toxic metals such as Al, Mn, and U within the food chain may cause a serious health hazard to the Cunha Baixa village inhabitants.

  18. Problems due to superheating of cryogenic liquids

    NASA Astrophysics Data System (ADS)

    Hands, B. A.

    1988-12-01

    Superheating can cause several problems in the storage of cryogenic liquids: stratification can cause unexpectedly high tank pressures or, in multicomponent liquids, rollover with its consequential high vaporization rate; geysering causes the rapid expulsion of static liquid from a vertical tube; chugging is a similar phenomenon observed when liquid flows through a reasonably well-insulated pipe.

  19. Fresh Groundwater Resources in Georgia and Management Problems

    NASA Astrophysics Data System (ADS)

    Gaprindashvili, George; Gaprindashvili, Merab

    2015-04-01

    Fresh water represents conditioned factor for human body's life. That's why the superiority of drinking water is recognized as human body's priority according to the international declarations. World is experiencing deficit of quality water. Natural Disasters caused by the pollution of the fresh groundwater is also very painful and acute, because it needed more time, more material and financial means for the liquidation of their results, and what the most important practically is, it is impossible to renew the initial natural conditions completely. All these conditions that the rational use of fresh groundwater passed by the interests of separate countries and became worldwide, international problem - fresh water became as considerable raw material for the worlds import and export. The fresh groundwater place the important role among the water recourses of Georgia. Their existing is considerably connected to the development of industry and agriculture, also with water supply issue of populated area. Groundwater management requires precise knowledge of sources (aquifers). Monitoring of Georgia's most important aquifers started many years ago and has provided large amount of data. This was interrupted at the beginning of the 1990s. It could be noted that fresh water existing in the country is distinguished with high quality. According to the mineralization and temperature parameters groundwater is generally divided into the following groups: 1) Fresh drinking waters (mineralization not exceeding 1.0 g/l); 2) Mineral waters (mineralization over 1.0 g/l); 3) Thermal waters -- healing (20˚C - 35˚C), Geothermal (40˚C - 108˚C). Below we present briefly review about the situation of fresh groundwater resources, started recovery of groundwater monitoring network and the analysis of the management problems.

  20. 48 CFR 8.711 - Quality complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Quality complaints. 8.711... Blind or Severely Disabled 8.711 Quality complaints. (a) When the quality of supplies or services... the appropriate central nonprofit agency. (b) When quality problems cannot be resolved by the Ability...

  1. Community Problems in Five West Central Counties. Report No. 7 of a Series on Quality of Life and Development in Northwestern Wisconsin, February 1976.

    ERIC Educational Resources Information Center

    Lambert, Virginia; Linn, Gary

    As part of a study on development and the quality of life in northwestern Wisconsin, questions concerning important problems, public services, and environmental issues were asked of samples of 150 people in each of 4 west central counties (Clark, Dunn, Eau Claire, and Polk) in 1974. Responses to similar questions asked in a 1973 study of St. Croix…

  2. Modernization Problems of Higher Education in Kyrgyzstan

    ERIC Educational Resources Information Center

    Dzhaparova, R.

    2005-01-01

    In this article, the author discusses and presents some modernization problems of Kyrgyzstan's higher education. These problems are: (1) The low quality of the services of professional education that are offered; (2) In the republic as a whole, the qualitative makeup of the corps of instructors is clearly deteriorating; (3) The services of…

  3. Morphologic Quality of DSMs Based on Optical and Radar Space Imagery

    NASA Astrophysics Data System (ADS)

    Sefercik, U. G.; Bayik, C.; Karakis, S.; Jacobsen, K.

    2011-09-01

    Digital Surface Models (DSMs) are representing the visible surface of the earth by the height corresponding to its X-, Y-location and height value Z. The quality of a DSM can be described by the accuracy and the morphologic details. Both depend upon the used input information, the used technique and the roughness of the terrain. The influence of the topographic details to the DSM quality is shown for the test fields Istanbul and Zonguldak. Zonguldak has a rough mountainous character with heights from sea level up to 1640m, while Istanbul is dominated by rolling hills going up to an elevation of 435m. DSMs from SPOT-5, the SRTM C-band height models and ASTER GDEM have been investigated. The DSMs have been verified with height models from large scale aerial photos being more accurate and including morphologic details. It was necessary to determine and respect shifts of the height models caused by datum problems and orientation of the height models. The DSM quality is analyzed depending upon the terrain inclination. The DSM quality differs for both test fields. The morphologic quality depends upon the point spacing of the analyzed DSMs and the terrain characteristics.

  4. Identifying problem and compulsive gamblers.

    PubMed Central

    van Es, R.

    2000-01-01

    OBJECTIVE: To present a meta-analysis of current research on the prevalence, identification, and treatment of problem and compulsive gamblers. QUALITY OF EVIDENCE: Problem and compulsive gambling was not a socio-scientific concern until the last two decades. Hence research on this topic is limited. The summary and analysis for this paper relied on computer searches of journal and news abstracts in addition to direct contact with organizations addressing the identification and treatment of compulsive gamblers. MAIN MESSAGE: An estimated 5% of those who gamble run into problems. About 1% of those who gamble are predicted to experience serious problems. Successful treatment of problem and compulsive gambling continues to be a challenge. Although cognitive therapy has been the favoured approach, a combination of several therapeutic approaches is advocated. CONCLUSIONS: Problem and compulsive gambling can present a real health threat. As with other addictions, treatment strategies continue to be a baffling social problem. Aware and informed physicians can have a pivotal role in the difficult process of identifying, acknowledging, and remediating problem and compulsive gambling. PMID:10907572

  5. Problem and pathological gambling in a sample of casino patrons.

    PubMed

    Fong, Timothy W; Campos, Michael D; Brecht, Mary-Lynn; Davis, Alice; Marco, Adrienne; Pecanha, Viviane; Rosenthal, Richard J

    2011-03-01

    Relatively few studies have examined gambling problems among individuals in a casino setting. The current study sought to examine the prevalence of gambling problems among a sample of casino patrons and examine alcohol and tobacco use, health status, and quality of life by gambling problem status. To these ends, 176 casino patrons were recruited by going to a Southern California casino and requesting that they complete an anonymous survey. Results indicated the following lifetime rates for at-risk, problem, and pathological gambling: 29.2, 10.7, and 29.8%. Differences were found with regards to gambling behavior, and results indicated higher rates of smoking among individuals with gambling problems, but not higher rates of alcohol use. Self-rated quality of life was lower among pathological gamblers relative to non-problem gamblers, but did not differ from at-risk or problem gamblers. Although subject to some limitations, our data support the notion of higher frequency of gambling problems among casino patrons and may suggest the need for increased interventions for gambling problems on-site at casinos.

  6. Commitments to Improve the Quality of Learning.

    ERIC Educational Resources Information Center

    Cross, K. Patricia

    For the nation as a whole, there is a moving bandwagon of educational change, clearly hitched to attempts to personalize and individualize instruction. The new emphases on the quality of learning appears to offer some potential solutions to two current problems: the twin problems of quality and equality in education. Traditional group-oriented…

  7. Selecting Health Care Improvement Projects: A Methodology Integrating Cause-and-Effect Diagram and Analytical Hierarchy Process.

    PubMed

    Testik, Özlem Müge; Shaygan, Amir; Dasdemir, Erdi; Soydan, Guray

    It is often vital to identify, prioritize, and select quality improvement projects in a hospital. Yet, a methodology, which utilizes experts' opinions with different points of view, is needed for better decision making. The proposed methodology utilizes the cause-and-effect diagram to identify improvement projects and construct a project hierarchy for a problem. The right improvement projects are then prioritized and selected using a weighting scheme of analytical hierarchy process by aggregating experts' opinions. An approach for collecting data from experts and a graphical display for summarizing the obtained information are also provided. The methodology is implemented for improving a hospital appointment system. The top-ranked 2 major project categories for improvements were identified to be system- and accessibility-related causes (45%) and capacity-related causes (28%), respectively. For each of the major project category, subprojects were then ranked for selecting the improvement needs. The methodology is useful in cases where an aggregate decision based on experts' opinions is expected. Some suggestions for practical implementations are provided.

  8. Vision Problems in Homeless Children.

    PubMed

    Smith, Natalie L; Smith, Thomas J; DeSantis, Diana; Suhocki, Marissa; Fenske, Danielle

    2015-08-01

    Vision problems in homeless children can decrease educational achievement and quality of life. To estimate the prevalence and specific diagnoses of vision problems in children in an urban homeless shelter. A prospective series of 107 homeless children and teenagers who underwent screening with a vision questionnaire, eye chart screening (if mature enough) and if vision problem suspected, evaluation by a pediatric ophthalmologist. Glasses and other therapeutic interventions were provided if necessary. The prevalence of vision problems in this population was 25%. Common diagnoses included astigmatism, amblyopia, anisometropia, myopia, and hyperopia. Glasses were required and provided for 24 children (22%). Vision problems in homeless children are common and frequently correctable with ophthalmic intervention. Evaluation by pediatric ophthalmologist is crucial for accurate diagnoses and treatment. Our system of screening and evaluation is feasible, efficacious, and reproducible in other homeless care situations.

  9. Quality in health care: what are the problems and what are the solutions?

    PubMed

    Shipon, D M; Nash, D B

    2000-10-01

    The health care industry must define quality as achieving "desired health outcomes" that are "consistent with current professional knowledge." Once a single definition is established, health care professionals can begin to measure quality and improve the process of health care in this country. Clinical variation and an increasing number of medical mistakes have contributed to rising health care costs and poor quality. Once the industry establishes what is wrong, it can begin to devise some solutions to improve the quality of health care. A six-step strategy to improve quality is suggested: increasing accountability at all levels of the industry, continuous quality improvement, standardization of medicine using guidelines, patient empowerment, improved access to health information through a centralized database, and the need for incentives for patients and medical professionals. Although many physicians are skeptical of such changes, the health care industry clearly must work together to address the issue of quality appropriately.

  10. Quality of groundwater resources in Afghanistan.

    PubMed

    Hayat, Ehsanullah; Baba, Alper

    2017-07-01

    Water is the main source of energy production and economy in Afghanistan where agriculture accounts for more than 50% of the country's gross domestic product (GDP). Access to safe drinking water is still a problem in the country, which has caused different health issues and even child mortality especially in rural areas. Groundwater is the main source of drinking water in the country. However, little knowledge is available about the quality of groundwater throughout the entire country, and its quality has not been investigated extensively yet like in other countries in the world. While most people think that consuming groundwater is a reliable and safe source of drinking water for health, the United Nations (UN) agencies report various kinds of waterborne diseases and even child mortalities due to drinking water quality in the country. In this article, significant geogenic and anthropogenic factors that play a vital role in groundwater contamination of the country are identified and explained. Different geogenic contaminations such as arsenic, fluoride, sulfate, and boron occur in several areas of Afghanistan that have a direct effect on human health. The water quality mapping for Afghanistan is completed for half of the country, which shows that groundwater is plagued by high levels of fluoride and arsenic in some areas. The water quality mapping of the other half of the country cannot be completed due to security concerns currently. Also, there are different kinds of waterborne diseases such as diarrhea, cholera, and dysentery that can be seen in different parts of the country because of anthropogenic activities which continuously deteriorate groundwater.

  11. Do Visual Processing Deficits Cause Problem on Response Time Task for Dyslexics?

    ERIC Educational Resources Information Center

    Sigmundsson, H.

    2005-01-01

    This study was set out to explore the prediction that dyslexics would be likely to have particular problems compared to control group, on response time task when 'driving' a car simulator. The reason for doing so stems from the fact that there is considerable body of research on visual processing difficulties manifested by dyslexics. The task was…

  12. Measuring health care process quality with software quality measures.

    PubMed

    Yildiz, Ozkan; Demirörs, Onur

    2012-01-01

    Existing quality models focus on some specific diseases, clinics or clinical areas. Although they contain structure, process, or output type measures, there is no model which measures quality of health care processes comprehensively. In addition, due to the not measured overall process quality, hospitals cannot compare quality of processes internally and externally. To bring a solution to above problems, a new model is developed from software quality measures. We have adopted the ISO/IEC 9126 software quality standard for health care processes. Then, JCIAS (Joint Commission International Accreditation Standards for Hospitals) measurable elements were added to model scope for unifying functional requirements. Assessment (diagnosing) process measurement results are provided in this paper. After the application, it was concluded that the model determines weak and strong aspects of the processes, gives a more detailed picture for the process quality, and provides quantifiable information to hospitals to compare their processes with multiple organizations.

  13. The Fall in Older Adults: Physical and Cognitive Problems.

    PubMed

    Laurence, Bernard Demanze; Michel, Lacour

    2017-01-01

    The aging of posture and balance function alters the quality of life in older people and causes serious problems in terms of public health and socio-economic costs for our modern societies. This article reviews the various causes of imbalance and dizziness in the elderly, and considers how to prevent falls, and how to rehabilitate a faller subject in order to regain a good quality of life. Two effective ways of intervention are discussed, emphasizing the crucial role of physical activity and cognitive stimulation, classic or using the latest technical advances in virtual reality and video games. Fall in the elderly result from aging mechanisms acting on both the sensorimotor and cognitive spheres. The structural and functional integrity of the peripheral sensory receptors and the musculoskeletal system deteriorate with age. The brain ages and the executive functions, memory, learning, cortical processing of information, sharing of attentional resources and concentration, are modified in the elderly. Psychological affective factors such as depression, anxiety and stress contribute also to speed up the sensorimotor and cognitive decline. The rehabilitation of the postural balance in the elderly must take into account all of these components. The aging of the population and the increased of lifespan are a challenge for our modern societies regarding the major health and socio-economic questions they raise. The fall in the elderly being one of the dramatic consequences of the aging equilibration function, it is therefore imperative to develop rehabilitation procedures of balance. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  14. Socioeconomic Status, Economic Problems, and Delinquency

    ERIC Educational Resources Information Center

    Agnew, Robert; Matthews, Shelley Keith; Bucher, Jacob; Welcher, Adria N.; Keyes, Corey

    2008-01-01

    Research indicates that the relationship between socioeconomic status (SES) and delinquency is not as strong as suggested by the leading crime theories. This article argues that such theories do not predict that SES in and of itself causes delinquency but rather that the economic problems associated with SES cause delinquency. Such problems…

  15. Personality traits, interpersonal problems and therapeutic alliance in early schizophrenia spectrum disorders.

    PubMed

    Johansen, Ragnhild; Melle, Ingrid; Iversen, Valentina Cabral; Hestad, Knut

    2013-11-01

    The quality of the therapeutic alliance is associated with engagement in- and thus important to the outcome of- treatment in schizophrenia. In non-psychotic disorders, general personality traits and individual patterns of interpersonal problems have been linked to the formation and quality of the therapeutic alliance. The role of these factors in relation to therapeutic alliance has not previously been explored in schizophrenia spectrum disorders. To investigate associations between personality traits, interpersonal problems and the quality of the therapeutic alliance in early schizophrenia spectrum disorders. Demographic and clinical characteristics including Positive and Negative Syndrome Scale (PANSS) scores were assessed in 42 patients. Personality traits and interpersonal problems were assessed with the NEO Five factor Inventory (NEO-FFI) and the circumplex model of the Inventory of Interpersonal Problems (IIP-64C). Therapeutic alliance was measured with the Working Alliance Inventory - short form (WAI-S). Patient WAI-S scores were predicted by IIP-64C Submissive/Hostile interpersonal problems, age and PANSS excitative symptoms. Therapist WAI-S scores were predicted by NEO-FFI Agreeableness and the PANSS insight item. Core traits of personality and dimensions of interpersonal problems are associated with both patients' and therapists' perceptions of the quality of the working alliance. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Approaching the Challenge of Student Retention through the Lens of Quality Control: A Conceptual Model of University Business Student Retention Utilizing Six Sigma

    ERIC Educational Resources Information Center

    Jenicke, Lawrence O.; Holmes, Monica C.; Pisani, Michael J.

    2013-01-01

    Student retention in higher education is a major issue as academic institutions compete for fewer students and face declining enrollments. A conceptual model of applying the quality improvement methodology of Six Sigma to the problem of undergraduate student retention in a college of business is presented. Improvement techniques such as cause and…

  17. Insulin pumps and insulin quality--requirements and problems.

    PubMed

    Brange, J; Havelund, S

    1983-01-01

    In developing insulin solution suitable for delivery devices the chemical and biological stability, as well as the physical stability, must be taken into consideration. Addition of certain mono- and disaccharides increases the physical stability of neutral insulin solutions, but concurrently the chemical and biological stability decrease to an unacceptable degree. Addition of Ca-ions in low concentrations offers a physiologically acceptable method for stabilizing neutral insulin solutions against heat precipitation without affecting the quality, including the chemical and biological stability.

  18. Empirical evaluation of humpback whale telomere length estimates; quality control and factors causing variability in the singleplex and multiplex qPCR methods.

    PubMed

    Olsen, Morten Tange; Bérubé, Martine; Robbins, Jooke; Palsbøll, Per J

    2012-09-06

    Telomeres, the protective cap of chromosomes, have emerged as powerful markers of biological age and life history in model and non-model species. The qPCR method for telomere length estimation is one of the most common methods for telomere length estimation, but has received recent critique for being too error-prone and yielding unreliable results. This critique coincides with an increasing awareness of the potentials and limitations of the qPCR technique in general and the proposal of a general set of guidelines (MIQE) for standardization of experimental, analytical, and reporting steps of qPCR. In order to evaluate the utility of the qPCR method for telomere length estimation in non-model species, we carried out four different qPCR assays directed at humpback whale telomeres, and subsequently performed a rigorous quality control to evaluate the performance of each assay. Performance differed substantially among assays and only one assay was found useful for telomere length estimation in humpback whales. The most notable factors causing these inter-assay differences were primer design and choice of using singleplex or multiplex assays. Inferred amplification efficiencies differed by up to 40% depending on assay and quantification method, however this variation only affected telomere length estimates in the worst performing assays. Our results suggest that seemingly well performing qPCR assays may contain biases that will only be detected by extensive quality control. Moreover, we show that the qPCR method for telomere length estimation can be highly precise and accurate, and thus suitable for telomere measurement in non-model species, if effort is devoted to optimization at all experimental and analytical steps. We conclude by highlighting a set of quality controls which may serve for further standardization of the qPCR method for telomere length estimation, and discuss some of the factors that may cause variation in qPCR experiments.

  19. Older people's perceptions of the quality of oral care in short-term care units: A cross-sectional study.

    PubMed

    Andersson, Maria; Wilde-Larsson, Bodil; Carlsson, Eva; Persenius, Mona

    2018-06-01

    There is a lack of knowledge about oral care among older people living in short-term care (STC) units and how the quality of oral care provided by nursing staff is perceived by the older people. To (i) describe person-related conditions among older people in STC, (ii) describe and compare perceptions of the quality of oral care (including perceptions of care received and the subjective importance of such care), within and between older people who have the ability to perform oral self-care and those who are dependent on help with oral care and (iii) examine the relationship between person-related conditions and the quality of oral care. A cross-sectional study was conducted with 391 older people in STC units in Sweden based on self-reported questionnaire and clinical assessments. The older people were assessed as having normal oral health (2%), moderate oral health problems (78%) or severe oral health problems (20%). When comparing older people's perceptions of quality of oral care in terms of perceived reality and subjective importance, significant differences appeared within and between groups. Psychological well-being had a significant relationship with perception of the quality of oral care (both perceived reality and subjective importance), and gender and oral health status had a significant relationship with subjective importance. Older people's perceptions of areas for improvement regarding quality of oral care is a new and important knowledge for nursing staff in STC units. Older people want personalised information regarding oral health and oral care. Registered Nurses who take the responsibility in nursing care for older people's oral health may avoid unnecessary suffering by older people caused by oral health problems. Older people's perspective is an important component for quality work and might lead to improvements in the quality of oral care in STC. © 2018 John Wiley & Sons Ltd.

  20. Unravelling the confusion caused by GASB, FASB accounting rules.

    PubMed

    Duis, T E

    1994-11-01

    Separate GASB and FASB accounting and financial reporting rules for governmental healthcare providers are producing confusion. Among other problems, they reduce the usefulness of aggregated data about the healthcare industry. This article addresses the inconsistencies of the various reporting standards and identified problems they can cause.

  1. Water quality modelling of Jadro spring.

    PubMed

    Margeta, J; Fistanic, I

    2004-01-01

    Management of water quality in karst is a specific problem. Water generally moves very fast by infiltration processes but far more by concentrated flows through fissures and openings in karst. This enables the entire surface pollution to be transferred fast and without filtration into groundwater springs. A typical example is the Jadro spring. Changes in water quality at the spring are sudden, but short. Turbidity as a major water quality problem for the karst springs regularly exceeds allowable standards. Former practice in problem solving has been reduced to intensive water disinfection in periods of great turbidity without analyses of disinfection by-products risks for water users. The main prerequisite for water quality control and an optimization of water disinfection is the knowledge of raw water quality and nature of occurrence. The analysis of monitoring data and their functional relationship with hydrological parameters enables establishment of a stochastic model that will help obtain better information on turbidity in different periods of the year. Using the model a great number of average monthly and extreme daily values are generated. By statistical analyses of these data possibility of occurrence of high turbidity in certain months is obtained. This information can be used for designing expert system for water quality management of karst springs. Thus, the time series model becomes a valuable tool in management of drinking water quality of the Jadro spring.

  2. 40 CFR 130.8 - Water quality report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... QUALITY PLANNING AND MANAGEMENT § 130.8 Water quality report. (a) Each State shall prepare and submit... quality data and problems identified in the 305(b) report, States develop water quality management (WQM... the 305(b) report should be analyzed through water quality management planning leading to the...

  3. The Papers Printing Quality Complex Assessment Algorithm Development Taking into Account the Composition and Production Technological Features

    NASA Astrophysics Data System (ADS)

    Babakhanova, Kh A.; Varepo, L. G.; Nagornova, I. V.; Babluyk, E. B.; Kondratov, A. P.

    2018-04-01

    Paper is one of the printing system key components causing the high-quality printed products output. Providing the printing companies with the specified printing properties paper, while simultaneously increasing the paper products range and volume by means of the forecasting methods application and evaluation during the production process, is certainly a relevant problem. The paper presents the printing quality control algorithm taking into consideration the paper printing properties quality assessment depending on the manufacture technological features and composition variation. The information system including raw material and paper properties data and making possible pulp and paper enterprises to select paper composition optimal formulation is proposed taking into account the printing process procedure peculiarities of the paper manufacturing with specified printing properties.

  4. Overt and subtle discrimination, subjective well-being and physical health-related quality of life in an obese sample.

    PubMed

    Magallares, Alejandro; Benito de Valle, Pilar; Irles, Jose Antonio; Jauregui-Lobera, Ignacio

    2014-10-27

    Obesity represents a serious health issue affecting millions of people in Western industrialized countries. The severity of the medical problems it causes is paralleled by the fact that obesity has become a social stigma that affects the psychological health-related quality of life of individuals with weight problems. Our study, with 111 obese patients of a Spanish hospital, focused specifically on how overt and subtle discrimination is related to subjective well-being (affect balance and life satisfaction) and physical health-related quality of life. It was shown that overt (r = -.28, p < .01 with affect balance; r = -.26, p < .01 with life satisfaction) and subtle discrimination (r = -.28, p < .01 with affect balance; r = -.27, p < .01 with life satisfaction) were negatively linked with subjective well-being, and that there was a negative correlation between overt discrimination and physical health-related quality of life (r = -.26, p < .01). Additionally, it was found that overt discrimination was a mediator variable in the relationship between physical health-related quality of life and subjective well-being using the Baron and Kenny procedure. Finally, it is discussed the relationship between discrimination, subjective well-being and physical health-related quality of life in obese people.

  5. Parasites that cause problems in Malaysia: soil-transmitted helminths and malaria parasites.

    PubMed

    Singh, B; Cox-Singh, J

    2001-12-01

    Malaysia is a developing country with a range of parasitic infections. Indeed, soil-transmitted helminths and malaria parasites continue to have a significant impact on public health in Malaysia. In this article, the prevalence and distribution of these parasites, the problems associated with parasitic infections, the control measures taken to deal with these parasites and implications for the future will be discussed.

  6. Weekly variations of discharge and groundwater quality caused by intermittent water supply in an urbanized karst catchment

    NASA Astrophysics Data System (ADS)

    Grimmeisen, Felix; Zemann, Moritz; Goeppert, Nadine; Goldscheider, Nico

    2016-06-01

    Leaky sewerage and water distribution networks are an enormous problem throughout the world, specifically in developing countries and regions with water scarcity. Especially in many arid and semi-arid regions, intermittent water supply (IWS) is common practice to cope with water shortage. This study investigates the combined influence of urban activities, IWS and water losses on groundwater quality and discusses the implications for water management. In the city of As-Salt (Jordan), local water supply is mostly based on groundwater from the karst aquifer that underlies the city. Water is delivered to different supply zones for 24, 48 or 60 h each week with drinking water losses of around 50-60%. Fecal contamination in groundwater, mostly originating from the likewise leaky sewer system is a severe challenge for the local water supplier. In order to improve understanding of the local water cycle and contamination dynamics in the aquifer beneath the city, a down gradient spring and an observation well were chosen to identify contaminant occurrence and loads. Nitrate, Escherichia coli, spring discharge and the well water level were monitored for 2 years. Autocorrelation analyses of time series recorded during the dry season revealed weekly periodicity of spring discharge (45 ± 3.9 L s-1) and NO3-N concentrations (11.4 ± 0.8 mg L-1) along with weekly varying E. coli levels partly exceeding 2.420 MPN 100 mL-1. Cross-correlation analyses demonstrate a significant and inverse correlation of nitrate and discharge variations which points to a periodic dilution of contaminated groundwater by freshwater from the leaking IWS being the principal cause of the observed fluctuations. Contaminant inputs from leaking sewers appear to be rather constant. The results reveal the distinct impact of leaking clean IWS on the local groundwater and subsequently on the local water supply and therefore demonstrate the need for action regarding the mitigation of groundwater contamination and

  7. Tackling a Local Problem.

    ERIC Educational Resources Information Center

    Cook, Martin

    1995-01-01

    Students studying water as a class project were concerned by levels of pollution at a nearby river and the local beach. They identified three environmental problems for research including sewage discharge, beach litter, and quality of swimming water. Research consisted of field trips which allowed for opportunities to improve skills in collecting…

  8. Satellite remote sensing of particulate matter air quality: the cloud-cover problem.

    PubMed

    Christopher, Sundar A; Gupta, Pawan

    2010-05-01

    Satellite assessments of particulate matter (PM) air quality that use solar reflectance methods are dependent on availability of clear sky; in other words, mass concentrations of PM less than 2.5 microm in aerodynamic diameter (PM2.5) cannot be estimated from satellite observations under cloudy conditions or bright surfaces such as snow/ice. Whereas most ground monitors measure PM2.5 concentrations on an hourly basis regardless of cloud conditions, space-borne sensors can only estimate daytime PM2.5 in cloud-free conditions, therefore introducing a bias. In this study, an estimate of this clear-sky bias is provided from monthly to yearly time scales over the continental United States. One year of the Moderate Resolution Imaging Spectroradiometer (MODIS) 550-nm aerosol optical depth (AOD) retrievals from Terra and Aqua satellites, collocated with 371 U.S. Environmental Protection Agency (EPA) ground monitors, have been analyzed. The results indicate that the mean differences between PM2.5 reported by ground monitors and PM2.5 calculated from ground monitors during the satellite overpass times during cloud-free conditions are less than +/- 2.5 microg m(-3), although this value varies by season and location. The mean differences are not significant as calculated by t tests (alpha = 0.05). On the basis of this analysis, it is concluded that for the continental United States, cloud cover is not a major problem for inferring monthly to yearly PM2.5 from space-borne sensors.

  9. Saturn S-2 problem resolution history report

    NASA Technical Reports Server (NTRS)

    Virgil, F. W.

    1971-01-01

    A summary of S-2 Program problems and the solutions that were implemented is presented. The problems occurred during a period starting with the initial design concepts and continuing through the launch of the tenth S-2 flight stage information is from nine separate disciplines: design, facilities, logistics, manufacturing, material, program management, quality assurance, safety, and tests.

  10. The vexing problem of thrombosis in long-term mechanical circulatory support.

    PubMed

    Mehra, Mandeep R; Stewart, Garrick C; Uber, Patricia A

    2014-01-01

    Durable left ventricular assist devices (LVADs) have not only enhanced longevity but also conferred sustained improvements in quality of life, symptom control, and functional capacity in patients with medically refractory advanced heart failure. Problems with device-related infection, bleeding, neurologic events, right-sided heart failure, and device malfunction have dominated the clinical care of patients living on mechanical support. Even as adoption of durable LVADs accelerated globally, we began to encounter a growing dilemma of pump malfunction caused by thrombosis. In early 2011, clinicians began to notice a spike in the incidence of pump thrombosis with the HeartMate II (Thoratec Corp, Pleasanton, CA) LVAD. By 2012, the problem of thrombosis in LVADs began to consume most of the scientific direction as centers and collaborative groups began to dissect this nascent phenomenon. In this perspective, we describe the magnitude and implications of pump thrombosis, discuss secular and management trends in this unique population, attempt to dissect the problem at its root, offer guidance on surveillance and therapeutic principles, and outline issues that deserve our immediate and collaborative attention. © 2014 International Society for Heart and Lung Transplantation Published by International Society for the Heart and Lung Transplantation All rights reserved.

  11. The reliability-quality relationship for quality systems and quality risk management.

    PubMed

    Claycamp, H Gregg; Rahaman, Faiad; Urban, Jason M

    2012-01-01

    Engineering reliability typically refers to the probability that a system, or any of its components, will perform a required function for a stated period of time and under specified operating conditions. As such, reliability is inextricably linked with time-dependent quality concepts, such as maintaining a state of control and predicting the chances of losses from failures for quality risk management. Two popular current good manufacturing practice (cGMP) and quality risk management tools, failure mode and effects analysis (FMEA) and root cause analysis (RCA) are examples of engineering reliability evaluations that link reliability with quality and risk. Current concepts in pharmaceutical quality and quality management systems call for more predictive systems for maintaining quality; yet, the current pharmaceutical manufacturing literature and guidelines are curiously silent on engineering quality. This commentary discusses the meaning of engineering reliability while linking the concept to quality systems and quality risk management. The essay also discusses the difference between engineering reliability and statistical (assay) reliability. The assurance of quality in a pharmaceutical product is no longer measured only "after the fact" of manufacturing. Rather, concepts of quality systems and quality risk management call for designing quality assurance into all stages of the pharmaceutical product life cycle. Interestingly, most assays for quality are essentially static and inform product quality over the life cycle only by being repeated over time. Engineering process reliability is the fundamental concept that is meant to anticipate quality failures over the life cycle of the product. Reliability is a well-developed theory and practice for other types of manufactured products and manufacturing processes. Thus, it is well known to be an appropriate index of manufactured product quality. This essay discusses the meaning of reliability and its linkages with quality

  12. Ground-water quality assessment of the central Oklahoma Aquifer, Oklahoma; project description

    USGS Publications Warehouse

    Christenson, S.C.; Parkhurst, D.L.

    1987-01-01

    In April 1986, the U.S. Geological Survey began a pilot program to assess the quality of the Nation's surface-water and ground-water resources. The program, known as the National Water-Quality Assessment (NAWQA) program, is designed to acquire and interpret information about a variety of water-quality issues. The Central Oklahoma aquifer project is one of three ground-water pilot projects that have been started. The NAWQA program also incudes four surface-water pilot projects. The Central Oklahoma aquifer project, as part of the pilot NAWQA program, will develop and test methods for performing assessments of ground-water quality. The objectives of the Central Oklahoma aquifer assessment are: (1) To investigate regional ground-water quality throughout the aquifer in the manner consistent with the other pilot ground-water projects, emphasizing the occurrence and distribution of potentially toxic substances in ground water, including trace elements, organic compounds, and radioactive constituents; (2) to describe relations between ground-water quality, land use, hydrogeology, and other pertinent factors; and (3) to provide a general description of the location, nature, and possible causes of selected prevalent water-quality problems within the study unit; and (4) to describe the potential for water-quality degradation of ground-water zones within the study unit. The Central Oklahoma aquifer, which includes in descending order the Garber Sandstone and Wellington Formation, the Chase Group, the Council Grove Group, the Admire Group, and overlying alluvium and terrace deposits, underlies about 3,000 square miles of central Oklahoma and is used extensively for municipal, industrial, commercial, and domestic water supplies. The aquifer was selected for study by the NAWQA program because it is a major source for water supplies in central Oklahoma and because it has several known or suspected water-quality problems. Known problems include concentrations of arsenic, chromium

  13. Methanol shutdowns cause anxiety

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

    Thomas, N.

    1996-10-23

    European methanol players face an anxious few weeks as unscheduled outages combine with planned turnarounds to make an increasingly tight market. Global markets are also described as tightening, with production problems widely reported in North America. Several European producers were in the middle of shutdown periods when problems at Condea`s 400,000-m.t./year unit at Wesseling, Germany reportedly caused production to run at only 50% of capacity. In addition, the methanol plant at the Leuna refinery is said to be operating at only 60% of capacity, and one producer has had to extend a turnaround period. River levels in Germany are alsomore » low, putting pressure on shipments from Rotterdam. {open_quotes}This is a very difficult situation and we`re living hand to mouth,{close_quotes} says one producer. Producer sources report bids from consumers up to DM280/m.t. T2 fob Rotterdam, but they are unable to obtain extra product. Derivatives makers may also face problems: One methyl tert-butyl ether producer predicts prices {open_quotes}may hit the roof{close_quotes} once feedstock sourcing problems hit home.« less

  14. Environmental impact of leachate characteristics on water quality.

    PubMed

    Cumar, Sampath Kumar Mandyam; Nagaraja, Balasubramanya

    2011-07-01

    Improper urbanization and industrialization are causing a critical stress on groundwater quality in urban areas of the developing countries. The present study under investigation describes the pollution caused by leachate from a waste management site in southwestern Bangalore city causing pollution of the surface water and groundwater reserves. The characterization of 20 groundwater samples and Haralukunte lake sample indicated high pollution of these water reserves by leachate entry into the groundwater and surface water sources. The study area focuses around the solid waste management site, carrying out bio-composting and vermi-composting of municipal solid waste. Further investigations on the severe health problems faced by the public in the study area has revealed a clear pointer towards the usage of polluted water for rearing live-stock, farming, and domestic activities. The characterization of the leachate with high values of BOD at 1,450 mg/l, TDS at 17,200 mg/l, nitrates at 240 mg/l, and MPN at 545/100 ml indicates a clear nuisance potential, which has been substantiated by the characterization of lake water sample with chlorides at 3,400 mg/l, TDS at 8,020 mg/l, and lead and cadmium at 0.18 and 0.08 mg/l, respectively. Analysis of groundwater samples shows alarming physicochemical values closer to the waste disposal site and relatively reduced values away from the source of the waste management site. Bureau of Indian Standards have been adapted as the benchmark for the analysis and validation of observed water quality criteria.

  15. Defect Analysis Of Quality Palm Kernel Meal Using Statistical Quality Control In Kernels Factory

    NASA Astrophysics Data System (ADS)

    Sembiring, M. T.; Marbun, N. J.

    2018-04-01

    The production quality has an important impact retain the totality of characteristics of a product or service to pay attention to its capabilities to meet the needs that have been established. Quality criteria Palm Kernel Meal (PKM) set Factory kernel is as follows: oil content: max 8.50%, water content: max 12,00% and impurity content: max 4.00% While the average quality of the oil content of 8.94%, the water content of 5.51%, and 8.45% impurity content. To identify the defective product quality PKM produced, then used a method of analysis using Statistical Quality Control (SQC). PKM Plant Quality Kernel shows the oil content was 0.44% excess of a predetermined maximum value, and 4.50% impurity content. With excessive PKM content of oil and dirt cause disability content of production for oil, amounted to 854.6078 kg PKM and 8643.193 kg impurity content of PKM. Analysis of the results of cause and effect diagram and SQC, the factors that lead to poor quality of PKM is Ampere second press oil expeller and hours second press oil expeller.

  16. Father Involvement and Behavior Problems among Preadolescents at Risk of Maltreatment

    PubMed Central

    Yoon, Susan; Bellamy, Jennifer L.; Kim, Wonhee; Yoon, Dalhee

    2018-01-01

    Although there is a well-established connection between father involvement and children’s positive behavioral development in general, this relation has been understudied in more vulnerable and high-risk populations. The aims of this study were to examine how the quantity (i.e., the amount of shared activities) and quality (i.e., perceived quality of the father-child relationship) of father involvement are differently related to internalizing and externalizing behavior problems among preadolescents at risk of maltreatment and test if these associations are moderated by father type and child maltreatment. A secondary data analysis was conducted using data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Generalized estimating equations analysis was performed on a sample of 499 preadolescents aged 12 years. The results indicated that higher quality of father involvement was associated with lower levels of internalizing and externalizing behavior problems whereas greater quantity of father involvement was associated with higher levels of internalizing and externalizing behavior problems. The positive association between the quantity of father involvement and behavior problems was stronger in adolescents who were physically abused by their father. The association between father involvement and behavior problems did not differ by the type of father co-residing in the home. The findings suggest that policies and interventions aimed at improving the quality of fathers’ relationships and involvement with their children may be helpful in reducing behavior problems in adolescents at risk of maltreatment. PMID:29491703

  17. Brief Report: Parent-Reported Problems Related to Communication, Behavior and Interests in Children with Autistic Disorder and Their Impact on Quality of Life.

    PubMed

    Øien, Roald; Eisemann, Martin R

    2016-01-01

    Parents of children with Autism spectrum disorders often report elevated levels of stress, depression and anxiety compared to parents of children with other developmental disorders. The present study investigated experiences of mothers of children with autistic disorder, both boys and girls. The results show that mothers report problems related to communication, behavior and interests of their child, which impact their quality of life. There were also differences between boys and girls.

  18. Dredging and Water Quality Problems in the Great Lakes. Volume 2. Appendices A1 to A19. Sampling Surveys with Separate Reports

    DTIC Science & Technology

    1969-01-01

    Ii necessary and Identity by block number) Dredging Water Quality Water Pollution M0 AUOTR ACT e-ausamtoj m wesem. et itp omea d Identtfy by block...nmuibeA) The present report presents the results of a study conducted by the Corps Engineers with cooperation of the Federal Water Pollution Control...areas of the Great Lakes, as well as to develop the most practical methods for management of pollution problems that may be identified as resulting

  19. Ambient air quality trends and driving factor analysis in Beijing, 1983-2007.

    PubMed

    Zhang, Ju; Ouyang, Zhiyun; Miao, Hong; Wang, Xiaoke

    2011-01-01

    The rapid development in Beijing, the capital of China, has resulted in serious air pollution problems. Meanwhile great efforts have been made to improve the air quality, especially since 1998. The variation in air quality under the interaction of pollution and control in this mega city has attracted much attention. We analyzed the changes in ambient air quality in Beijing since the 1980's using the Daniel trend test based on data from long-term monitoring stations. The results showed that different pollutants displayed three trends: a decreasing trend, an increasing trend and a flat trend. SO2, dustfall, B[a]P, NO2 and PM10 fit decreasing trend pattern, while NOx showed an increasing trend, and CO, ozone pollution, total suspended particulate (TSP), as well as Pb fit the flat trend. The cause of the general air pollution in Beijing has changed from being predominantly related to coal burning to mixed traffic exhaust and coal burning related pollution. Seasonally, the pollution level is typically higher during the heating season from November to the following March. The interaction between pollution sources change and implementation of air pollution control measures was the main driving factor that caused the variation in air quality. Changes of industrial structure and improved energy efficiency, the use of clean energy and preferred use of clean coal, reduction in pollution sources, and implementation of advanced environmental standards have all contributed to the reduction in air pollution, particularly since 1998.

  20. Basic issues related to quantity and quality of health care, and quality assurance in Indonesia.

    PubMed

    Jacobalis, S

    1989-01-01

    Issues and problems related to the needs for quantity and quality in health care have been presented. The need for quantity has been quite successfully addressed in the last 20 years. Better quality of health care is very much in the minds of policy makers, providers and the informed public. Quality assessment and assurance as a programmed and on-going process in individual hospitals is systematically promoted and developed. An accreditation system for hospitals is planned for the future. This paper has not been able to contribute anything of value to the current practice of quality assurance. The industrialized world has passed the stages Indonesia is now going through. To some Australian colleagues, this presentation perhaps has revealed that one of their closest neighbours is struggling hard to improve the quality of life of its people, despite the tremendous problems and constraints with which it is confronted. Australia has always provided a helping hand in this struggle.