40 CFR 51.368 - Public information and consumer protection.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... The SIP shall include a plan for informing the public on an ongoing basis throughout the life of the I/M program of the air quality problem, the requirements of Federal and State law, the role of motor vehicles in the air quality problem, the need for and benefits of an inspection program, how to maintain a...

Quality of life in adolescents and adults with CHARGE syndrome.

PubMed

Hartshorne, Nancy; Hudson, Alexandra; MacCuspie, Jillian; Kennert, Benjamin; Nacarato, Tasha; Hartshorne, Timothy; Blake, Kim

2016-08-01

Health-related Quality of Life and the Impact of Childhood Neurologic Disability Scale were collected for 53 patients with CHARGE syndrome aged 13-39 years with a mean academic level of 4th grade. The most prevalent new and ongoing issues included bone health issues, sleep apnea, retinal detachment, anxiety, and aggression. Sleep issues were significantly correlated with anxiety, self-abuse, conduct problems, and autistic-like behaviors. Problems with overall health, behavior, and balance most affected the number of social activities in the individual's life. Sensory impairment most affected relationships with friends. Two contrasting case studies are presented and demonstrate that the quality of life exists on a broad spectrum in CHARGE syndrome, just as its physical features range from mild to very severe. A multitude of factors, including those beyond the physical manifestations, such as anxiety and sleep problems, influence quality of life and are important areas for intervention. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

[Evaluation of external quality assurance in accordance with sect. 137 SGB V at the Carl Gustav Carus university hospital in Dresden].

PubMed

Petzold, Thomas; Steinwitz, Adrienne; Schmitt, Jochen; Eberlein-Gonska, Maria

2013-01-01

Obligatory external quality assurance is an established method used to ensure the quality of inpatient care in Germany. The comprehensive approach is unique in international comparison. In addition to the statutory requirement, the health insurance funds require this form of external quality control in order to foster quality-based competition between hospitals. Ever since its introduction, healthcare providers have scrutinised the effects of the mandatory use of this survey. The study was based on all patients in the University Hospital Dresden, for whom a quality assurance sheet (n = 45,639) had to be recorded between 2003 and 2011. The documentation of these sheets was carried out by specially trained personnel. For each performance area, the duration of the documentation quality sheets was assessed, and a descriptive analysis of all quality assurance sheets was conducted. In the presence of statistical significance the so-called "Structured Dialogues" were analysed. Over the whole period, 167 statistically noticeable problems occurred. Nine of these have been rated as noticeable problems in medical quality by the specialised working groups of the project office quality assurance (PGSQS) at the Saxon State Medical Association (SLÄK). The remaining 158 statistical anomalies included 25 documentation errors; 96 were classified as statistically significant, and only 37 were marked to indicate that re-observation by the PGSQS was required. The total effort estimate for the documentation of quality assurance sheets was approximately 1,420 working days in the observation period. As far as the quality of patient care is concerned, the results can be considered positive because only a small number of quality indicators indicate noticeable qualitative problems. This statement is based primarily on the comparison of the groups of Saxony and Germany, which are included in the quality report of external quality assurance in accordance with sect. 137 SGB V. The majority of noticeable statistical problems were due to documentation errors. Other noticeable statistical problems that are medically indicated, but without effect on the extramural care to patients, recurrently occur with the respective quality indicators. Examples include the postoperative mobility indicators of the implementation of endoprostheses which cannot be used to draw conclusions about patient outcomes. Information on the quality of life as well as the post-hospital course of disease would be important in this context, but is still lacking. The use of external quality assurance data in accordance with sect. 137 SGB V for evaluation research has so far been handled quite restrictively. Thus, in-depth analyses on the quality of treatment cannot be derived. Copyright © 2013. Published by Elsevier GmbH.

Development of an expert system for power quality advisement using CLIPS 6.0

NASA Technical Reports Server (NTRS)

Chandrasekaran, A.; Sarma, P. R. R.; Sundaram, Ashok

1994-01-01

Proliferation of power electronic devices has brought in its wake both deterioration in and demand for quality power supply from the utilities. The power quality problems become apparent when the user's equipment or systems maloperate or fail. Since power quality concerns arise from a wide variety of sources and the problem fixes are better achieved from the expertise of field engineers, development of an expert system for power quality advisement seems to be a very attractive and cost-effective solution for utility applications. An expert system thus developed gives an understanding of the adverse effects of power quality related problems on the system and could help in finding remedial solutions. The paper reports the design of a power quality advisement expert system being developed using CLIPS 6.0. A brief outline of the power quality concerns is first presented. A description of the knowledge base is next given and details of actual implementation include screen output from the program.

Equity and Access: All Students Are Mathematical Problem Solvers

ERIC Educational Resources Information Center

Franz, Dana Pompkyl; Ivy, Jessica; McKissick, Bethany R.

2016-01-01

Often mathematical instruction for students with disabilities, especially those with learning disabilities, includes an overabundance of instruction on mathematical computation and does not include high-quality instruction on mathematical reasoning and problem solving. In fact, it is a common misconception that students with learning disabilities…

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.

The impact of older person's frailty on the care-related quality of life of their informal caregiver over time: results from the TOPICS-MDS project.

PubMed

Oldenkamp, Marloes; Hagedoorn, Mariët; Wittek, Rafael; Stolk, Ronald; Smidt, Nynke

2017-10-01

To examine the impact of changes in an older person's frailty on the care-related quality of life of their informal caregiver. Five research projects in the TOPICS-MDS database with data of both older person and informal caregiver at baseline and after 12 months follow-up were selected. Frailty was measured in five health domains (functional limitations, psychological well-being, social functioning, health-related quality of life, self-rated health). Care-related quality of life was measured with the Care-Related Quality of Life instrument (CarerQoL-7D), containing two positive (fulfilment, perceived support) and five negative dimensions (relational problems, mental health problems, physical health problems, financial problems, problems combining informal care with daily activities). 660 older person/caregiver couples were included. Older persons were on average 79 (SD 6.9) years of age, and 61% was female. Caregivers were on average 65 (SD 12.6) years of age, and 68% was female. Results of the multivariable linear and logistic regression analyses showed that an increase in older person's frailty over time was related to a lower total care-related quality of life of the caregiver, and to more mental and physical health problems, and problems with combining informal care with daily activities at follow-up. A change in the older person's psychological well-being was most important for the caregiver's care-related quality of life, compared to the other health domains. Health professionals observing decreasing psychological well-being of an older person and increasing hours of informal care provision should be aware of the considerable problems this may bring to their informal caregiver, and should tailor interventions to support informal caregivers according to their specific needs and problems.

The Effectiveness of the Higher Education Quality Assessment System: Problems and Countermeasures in China

ERIC Educational Resources Information Center

Guangli, Zhou

2016-01-01

The effectiveness of the higher education quality assessment system is essentially a matter of policy evaluation. On the macro level, such a system refers to external quality assessment, which includes government evaluation, quality certification, and university rankings. Depending on the degree of government intervention, the external quality…

Environmental Quality Management in the United States in the 1980s and Beyond: An Appraisal.

ERIC Educational Resources Information Center

Bower, Blair T.

1984-01-01

Presents an overview of: (1) the institutional context of the environmental pollution sector of environmental quality management (EQM); accomplishments and problems in some representative subsectors (including water quality, soil erosion, air quality, and hazardous wastes); and (3) future prospects. Also considers role of government and…

Quality of life in ostomy patients: a qualitative study.

PubMed

Dabirian, Aazam; Yaghmaei, Farideh; Rassouli, Maryam; Tafreshi, Mansoureh Zagheri

2010-12-21

Therapeutic procedures may not only treat disease but also affect patient quality of life. Therefore, quality of life should be measured in order to assess the impact of disease and therapeutic procedures. To identify clients' problems, it is necessary to assess several dimensions of quality of life, including physical, spiritual, economic, and social aspects. In this regard, we conducted a qualitative study to explore quality of life and its dimensions in ostomy patients referred to the Iranian Ostomy Association. Fourteen patients were interviewed about their quality of life dimensions by purposeful sampling. Data were gathered by semistructured interviews and analyzed using the content analysis method. Nine main themes emerged using this approach, including physical problems related to colostomy, impact of colostomy on psychological functioning, social and family relationships, travel, nutrition, physical activity, and sexual function, as well as religious and economic issues. The findings of the study identified a number of challenges in quality of life for patients with ostomy. The results can be used by health care providers to create a supportive environment that promotes better quality of life for their ostomy patients.

Quality of life in ostomy patients: a qualitative study

PubMed Central

Dabirian, Aazam; Yaghmaei, Farideh; Rassouli, Maryam; Tafreshi, Mansoureh Zagheri

2011-01-01

Purpose Therapeutic procedures may not only treat disease but also affect patient quality of life. Therefore, quality of life should be measured in order to assess the impact of disease and therapeutic procedures. To identify clients’ problems, it is necessary to assess several dimensions of quality of life, including physical, spiritual, economic, and social aspects. In this regard, we conducted a qualitative study to explore quality of life and its dimensions in ostomy patients referred to the Iranian Ostomy Association. Methods Fourteen patients were interviewed about their quality of life dimensions by purposeful sampling. Data were gathered by semistructured interviews and analyzed using the content analysis method. Results Nine main themes emerged using this approach, including physical problems related to colostomy, impact of colostomy on psychological functioning, social and family relationships, travel, nutrition, physical activity, and sexual function, as well as religious and economic issues. Conclusion The findings of the study identified a number of challenges in quality of life for patients with ostomy. The results can be used by health care providers to create a supportive environment that promotes better quality of life for their ostomy patients. PMID:21311696

Improving Audio Quality in Distance Learning Applications.

ERIC Educational Resources Information Center

Richardson, Craig H.

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

Commercial jet fuel quality control

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

Strauss, K.H.

1995-05-01

The paper discusses the purpose of jet fuel quality control between the refinery and the aircraft. It describes fixed equipment, including various types of filters, and the usefulness and limitations of this equipment. Test equipment is reviewed as are various surveillance procedures. These include the Air Transport Association specification ATA 103, the FAA Advisory Circular 150/5230-4, the International Air Transport Association Guidance Material for Fuel Quality Control and Fuelling Service and the Guidelines for Quality Control at Jointly Operated Fuel Systems. Some past and current quality control problems are briefly mentioned.

40 CFR 35.588 - Award limitations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Tribe or Intertribal Consortium meets the applicable quality assurance and quality control requirements... Intertribal Consortium agrees to include a discussion of how the work performed under section 106 addressed water quality problems on Tribal lands in the annual report required under § 35.515(d). (5) After an...

40 CFR 35.588 - Award limitations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Tribe or Intertribal Consortium meets the applicable quality assurance and quality control requirements... Intertribal Consortium agrees to include a discussion of how the work performed under section 106 addressed water quality problems on Tribal lands in the annual report required under § 35.515(d). (5) After an...

Guidelines for software inspections

NASA Technical Reports Server (NTRS)

1983-01-01

Quality control inspections are software problem finding procedures which provide defect removal as well as improvements in software functionality, maintenance, quality, and development and testing methodology is discussed. The many side benefits include education, documentation, training, and scheduling.

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…

Parents' Guide to School Indoor Air Quality.

ERIC Educational Resources Information Center

Healthy Schools Network, Inc., Albany, NY.

This parents' guide presents articles on school indoor air pollution, children's health and the symptoms of indoor air pollution, and how schools can improve their air quality. Also included are tips on what to do if the school ignores air quality problems, and some examples of what school districts should be doing to improve their air quality.…

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…

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.

The influence of handling qualities on safety and survivability

NASA Technical Reports Server (NTRS)

Anderson, S. B.

1977-01-01

The relationship of handling qualities to safety and survivability of military aircraft is examined which includes the following: (1) a brief discussion of the philosophy used in the military specifications for treatment of degraded handling qualities, (2) an examination of several example handling qualities problem areas which influence safety and survivability; and (3) a movie illustrating the potential dangers of inadequate handling qualities features.

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

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.

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, selenium, and gross-alpha activity that exceed drinking-water standards. Suspected problems include possible contamination of the aquifer by oil-field brines and drilling fluids, pesticides, industrial chemicals, septic-tank effluent, fertilizers, and leakage from sewage systems and underground tanks used for storage of hydrocarbons. There are four major components of the Central Oklahoma aquifer project. The first component is the collection and analysis of existing information, including chemical, hydrologic, and land-use data. The second component is the geohydrologic and geochemical investigations of the aquifer flow system. The third component is the sampling for a wide variety of inorganic, organic, and radioactive constituents as part a regional survey that will produce a consistent set of data among all ground-water pilot projects. These data can be used to: (1) Define regional ground-water quality within the Central Oklahoma aquifer, and (2) compare water quality in the Central Oklahoma aquifer to the water quality in the other ground-water study units of the NAWQA program. The fourth component is topical studies that will address, in more detail, some of the major water-quality issues pertaining to the aquifer.

Developing a quality assurance program for online services.

PubMed Central

Humphries, A W; Naisawald, G V

1991-01-01

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

Developing a quality assurance program for online services.

PubMed

Humphries, A W; Naisawald, G V

1991-07-01

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

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.

[Quality of life in institutionalized elderly people of Medellín].

PubMed

Estrada, Alejandro; Cardona, Doris; Segura, Angela María; Chavarriaga, Lina Marcela; Ordóñez, Jaime; Osorio, Jorge Julián

2011-01-01

Many factors contribute to the deteriorating quality of life of elderly people living in care institutions. Some of these problems are a consequence of few contacts with relatives and friends, and being alone with a feeling of isolation. The conditions of quality of life are explored for elderly people living in care institutions. In a cross sectional study, 276 subjects were selected from 39 long term institutions located in the city of Medellín, Colombia. The sex ratio was female: male 60:40% with a mean age of 79.2 ± 8.0. Elderly subjects with cognitive problems or not living in the institution were excluded. The World Health Organization Quality of Life of Older Adults (WHOQOL-OLD) questionnaire was applied; in additional, capacity and cognitive functional scales of Pfeffer, the anxiety scale of Goldberg, and the Geriatric Depression Scale of Yesavage were administered. Mininutritional assessment scales and complementary questionnaires about demographics, health perception, social support system were also included. The information was analyzed using the Mann Whitney U test, Kruskal Wallis test, Pearson correlation and multiple linear regression method. Most (71%) considered themselves autonomous for undertaking daily, habitual activities. Other statistics included the following: 45.7% with depression, 33.0% with anxiety, 28.3% with functional problems, and 54.3% at risk of malnutrition. A negative quality-of-life assessment was associated with the following factors: female, diabetes, depression, anxiety and high functional capacity. A positive quality-of-life assessment was associated with individuals who voluntarily came to the institution. Quality of life for elderly people living in care institutions can become deteriorated when they are not capable to do the usual activities necessary for daily living. Exacerbating factors included sex, symptoms of depression, anxiety, or perceived mistreatment by their families.

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.

Does quantity generate quality? Testing the fundamental principle of brainstorming.

PubMed

Muñoz Adánez, Alfredo

2005-11-01

The purpose of this work is to test the chief principle of brainstorming, formulated as "quantity generates quality." The study is included within a broad program whose goal is to detect the strong and weak points of creative techniques. In a sample of 69 groups, containing between 3 and 8 members, the concurrence of two commonly accepted criteria was established as a quality rule: originality and utility or value. The results fully support the quantity-quality relation (r = .893): the more ideas produced to solve a problem, the better quality of the ideas. The importance of this finding, which supports Osborn's theory, is discussed, and the use of brainstorming is recommended to solve the many open problems faced by our society.

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.

Improving the Quality of Evidence-Based Writing Entries in Electronic Portfolios

ERIC Educational Resources Information Center

Denton, David W.

2012-01-01

The problem investigated in this study was whether entries written to an electronic portfolio by preservice teachers improved in quality after an intervention was deployed. The study also compared portfolio metadata to writing quality scores to determine whether there was a relationship. Participants included a convenience sample of 11…

How to Recognize a Quality Technical Education Program.

ERIC Educational Resources Information Center

Doty, Charles R.

Criteria for the evaluation of quality technical educational programs must be identified if follow-up studies are to be effective. Current research shows that problems in the development of such criteria include the tendency to evaluate programs on the basis of organizational structure rather than on the quality of the instructional program…

The Trouble with Color.

ERIC Educational Resources Information Center

Merchant, David

1999-01-01

Discusses problems with color quality in Web sites. Topics include differences in monitor settings, including contrast; amount of video RAM; user preference settings; browser-safe colors; cross-platform readability; and gamma values. (LRW)

Environmental Education.

ERIC Educational Resources Information Center

Bandhu, Desh, Ed.; Aulakh, G. S., Ed.

In India, environmental education (EE) is introduced at various levels. Goals of this country's EE programs include: improving the quality of environment to create awareness among the people on environmental problems and conservation; developing skills to solve environmental problems; creating the necessary atmosphere for citizen participation in…

Quantity and quality in forest research. Invited papers delivered at the 19th world congress of the International Union of Forest Research Organizations; 1990 August 5-11; Montreal, Canada.

Treesearch

Rolfe A. Leary

1991-01-01

Five papers are included that address aspects of quality in forest research. Topics cover (1) the need for a logic of inquiry, illustrated by examining forest fire policy in Western North America, (2) alternative criteria for judging the simplicity of forest models, (3) the identification and analysis of problems and the importance that scientists develop good problem...

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.

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.

Representation of People with Intellectual Disabilities in Randomised Controlled Trials on Antipsychotic Treatment for Behavioural Problems

ERIC Educational Resources Information Center

Scheifes, A.; Stolker, J. J.; Egberts, A. C. G.; Nijman, H. L. I.; Heerdink, E. R.

2011-01-01

Background: Behavioural problems are common in people with intellectual disability (ID) and are often treated with antipsychotics. Aim: To establish the frequency and characteristics of people with ID included in randomised controlled trials (RCTs) on antipsychotic treatment for behavioural problems, and to investigate the quality of these RCTs.…

A methodology model for quality management in a general hospital.

PubMed

Stern, Z; Naveh, E

1997-01-01

A reappraisal is made of the relevance of industrial modes of quality management to the issues of medical care. Analysis of the nature of medical care, which differentiates it from the supplier-client relationships of industry, presents the main intrinsic characteristics, which create problems in application of the industrial quality management approaches to medical care. Several examples are the complexity of the relationship between the medical action and the result obtained, the client's nonacceptance of economic profitability as a value in his medical care, and customer satisfaction biased by variable standards of knowledge. The real problems unique to hospitals are addressed, and a methodology model for their quality management is offered. Included is a sample of indicator vectors, measurements of quality care, cost of medical care, quality of service, and human resources. These are based on the trilogy of planning quality, quality control, and improving quality. The conclusions confirm the inadequacy of industrial quality management approaches for medical institutions and recommend investment in formulation of appropriate concepts.

Research investigations in and demonstrations of remote sensing applications to urban environmental problems

NASA Technical Reports Server (NTRS)

Hidalgo, J. U.

1975-01-01

The applicability of remote sensing to transportation and traffic analysis, urban quality, and land use problems is discussed. Other topics discussed include preliminary user analysis, potential uses, traffic study by remote sensing, and urban condition analysis using ERTS.

Methodology for stereoscopic motion-picture quality assessment

NASA Astrophysics Data System (ADS)

Voronov, Alexander; Vatolin, Dmitriy; Sumin, Denis; Napadovsky, Vyacheslav; Borisov, Alexey

2013-03-01

Creating and processing stereoscopic video imposes additional quality requirements related to view synchronization. In this work we propose a set of algorithms for detecting typical stereoscopic-video problems, which appear owing to imprecise setup of capture equipment or incorrect postprocessing. We developed a methodology for analyzing the quality of S3D motion pictures and for revealing their most problematic scenes. We then processed 10 modern stereo films, including Avatar, Resident Evil: Afterlife and Hugo, and analyzed changes in S3D-film quality over the years. This work presents real examples of common artifacts (color and sharpness mismatch, vertical disparity and excessive horizontal disparity) in the motion pictures we processed, as well as possible solutions for each problem. Our results enable improved quality assessment during the filming and postproduction stages.

Soil agroecosystem health: current challenges and future opportunities

USDA-ARS?s Scientific Manuscript database

Soil health is a broad concept that emphasizes the ecological importance of soils, including sustained plant and animal productivity, human health, and environmental quality. In the United States, soil degradation and associated water quality problems have been widely documented. Improvement and mai...

Breathing Easier.

ERIC Educational Resources Information Center

Smolkin, Rachel

2003-01-01

Describes use of Environmental Protection Agency's Tools for Schools tool kit to improve indoor air quality aimed specifically at eliminating asthma triggers such as dust mites and mold. Includes several examples of school district efforts to reduce or eliminate student health problems associated with poor indoor air quality. (PKP)

Are disease severity, sleep-related problems, and anxiety associated with work functioning in patients with obstructive sleep apnoea?

PubMed

Timkova, Vladimira; Nagyova, Iveta; Reijneveld, Sijmen A; Tkacova, Ruzena; van Dijk, Jitse P; Bültmann, Ute

2018-04-17

To examine whether Obstructive Sleep Apnoea severity, sleep-related problems, and anxiety are associated with work functioning in Obstructive Sleep Apnoea patients, when controlled for age, gender and type of occupation. To investigate whether anxiety moderates the associations between sleep-related problems and work functioning. We included 105 Obstructive Sleep Apnoea patients (70% male; mean age 46.62 ± 9.79 years). All patients completed the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Beck Anxiety Inventory, and the Work Role Functioning Questionnaire-2.0. Obstructive Sleep Apnoea-severity, poor nighttime sleep quality, and anxiety were univariately associated with impaired work functioning. Multivariate analyzes revealed that poor perceived sleep quality was more strongly associated with work functioning than sleep efficiency and daily disturbances. Anxiety was strongly associated with impaired work functioning. After adding anxiety, the explained variance in work functioning increased from 20% to 25%. Anxiety moderated the association between low and medium levels of nighttime sleep quality problems and work functioning. Poor perceived sleep quality and anxiety were strongly associated with impaired work functioning in Obstructive Sleep Apnoea patients. These findings may help to optimize management, standard treatment, and work functioning in people with Obstructive Sleep Apnoea when confirmed in longitudinal studies. Implications for Rehabilitation Studies show an impairment of functional status, including work functioning, in obstructive sleep apnea patients. Aside from physical disorders, obstructive sleep apnea patients often experience mental problems, such as anxiety. As many people with obstructive sleep apnea are undiagnosed, our results demonstrate to employers and healthcare professionals the need to encourage patients for obstructive sleep apnea screening, especially in the situation of impaired work functioning, increased anxiety, and poor sleep quality. The associations between obstructive sleep apnea, sleep and anxiety might increase the awareness of health professionals towards optimizing diagnostic accuracy and standard treatment.

[Modern problems of maintenance of hygienic safety of drinking water consumption at the regional level].

PubMed

Tulakin, A V; Tsyplakova, G V; Ampleeva, G P; Kozyreva, O N; Pivneva, O S; Trukhina, G M

Problems of hygienic reliability of the drinking water use in regions of the Russian Federation are observed in the article. The optimization of the water use was shown must be based on the bearing in mind of regional peculiarities of the shaping of water quality of groundwater and surface sources of the water use, taking into account of the effectiveness of regional water protection programs, programs for water treatment, coordination of the activity of economic entities and oversight bodies in the management of water quality on the basis of socio-hygienic monitoring. Regional problems requiring hygienic justification and accounting, include such issues as complex hydrological, hydrogeological, climatic and geographical conditions, pronouncement of the severity of anthropogenic pollution of sources of water supply, natural conditions of the shaping of water quality, efficiency of the water treatment. There is need in the improvement of the problems of the water quality monitoring, including with the use of computer technology, which allows to realize regional hygienic monitoring and spatial-temporal analysis of the water quality, to model the water quality management, to predict conditions of the water use by population in regions taking into account peculiarities of the current health situation. In the article there is shown the practicability of the so-called complex concept of multiple barriers suggesting the combined use of chemical oxidation and physical methods of the preparation of drinking water. It is required the further development of legislation for the protection of water bodies from pollution with the bigging up the status of sanitary protection zones; timely revision of the regulatory framework, establishing sanitary-epidemiological requirements to potable water and drinking water supply. The problem of the provision of the population with safe drinking water requires complex solution within the framework of the implementation of target programs adopted at the Federal and regional levels.

Information needs related to extension service and community outreach.

PubMed

Bottcher, Robert W

2003-06-01

Air quality affects everyone. Some people are affected by air quality impacts, regulations, and technological developments in several ways. Stakeholders include the medical community, ecologists, government regulators, industries, technology providers, academic professionals, concerned citizens, the news media, and elected officials. Each of these groups may perceive problems and opportunities differently, but all need access to information as it is developed. The diversity and complexity of air quality problems contribute to the challenges faced by extension and outreach professionals who must communicate with stakeholders having diverse backgrounds. Gases, particulates, biological aerosols, pathogens, and odors all require expensive and relatively complex technology to measure and control. Economic constraints affect the ability of regulators and others to measure air quality, and industry and others to control it. To address these challenges, while communicating air quality research results and concepts to stakeholders, three areas of information needs are evident. (1) A basic understanding of the fundamental concepts regarding air pollutants and their measurement and control is needed by all stakeholders; the Extension Specialist, to be effective, must help people move some distance up the learning curve. (2) Each problem or set of problems must be reasonably well defined since comprehensive solution of all problems simultaneously may not be feasible; for instance, the solution of an odor problem associated with animal production may not address atmospheric effects due to ammonia emissions. (3) The integrity of the communication process must be preserved by avoiding prejudice and protectionism; although stakeholders may seek to modify information to enhance their interests, extension and outreach professionals must be willing to present unwelcome information or admit to a lack of information. A solid grounding in fundamental concepts, careful and fair problem definition, and a resolute commitment to integrity and credibility will enable effective communication of air quality information to and among diverse stakeholders.

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

Clean the Air and Breathe Easier.

ERIC Educational Resources Information Center

Guevin, John

1997-01-01

Failure to prevent indoor air quality problems or act promptly can result in increased chances for long- or short-term health problems for staff and students, reduced productivity, faster plant deterioration, and strained school-community relations. Basic pollution control measures include source management, local exhausts, ventilation, exposure…

Association Between Internet Use and Sleep Problems in Adolescents.

PubMed

Ekinci, Özalp; Çelik, Tanju; Savaş, Nazan; Toros, Fevziye

2014-06-01

Sleep problems are commonly encountered in adolescents. It has been shown that electronic media have a negative influence on the sleep quality and daytime functioning in adolescents. This study aims to investigate the association between internet use and sleep problems in adolescents. A total of 1212 adolescents were recruited to the study. Self-report study questionnaire included two main parts: Young's Internet Addiction Scale (IAS) and a semi-structured inquiry on sleep habits/problems. Of the study sample, 16% (n=198) reported their sleep quality as bad or very bad. One-fourth of the sample reported using internet everyday and 27% of them reported spending more than one hour when online. The mean IAS total score was 35.56±13.87. Adolescents with a higher IAS score reported getting to bed later in the night, needing more time to fall asleep and having an increased number of awakenings in the night than the adolescents with lower IAS score (p=.001). They were also found to have higher frequencies of several sleep problems including difficulty in initiating and sustaining sleep, difficulty in waking up and feelings of sleepiness in day. In addition, sleep quality of them was worse when compared to the adolescents with a lower IAS score (p=.001). Problematic sleep habits and sleep problems were found to be more frequent in adolescents with a higher IAS total score. Health care providers must be aware of the possible negative impact of excessive and uncontrolled internet use on adolescents' sleep habits.

A shared computer-based problem-oriented patient record for the primary care team.

PubMed

Linnarsson, R; Nordgren, K

1995-01-01

1. INTRODUCTION. A computer-based patient record (CPR) system, Swedestar, has been developed for use in primary health care. The principal aim of the system is to support continuous quality improvement through improved information handling, improved decision-making, and improved procedures for quality assurance. The Swedestar system has evolved during a ten-year period beginning in 1984. 2. SYSTEM DESIGN. The design philosophy is based on the following key factors: a shared, problem-oriented patient record; structured data entry based on an extensive controlled vocabulary; advanced search and query functions, where the query language has the most important role; integrated decision support for drug prescribing and care protocols and guidelines; integrated procedures for quality assurance. 3. A SHARED PROBLEM-ORIENTED PATIENT RECORD. The core of the CPR system is the problem-oriented patient record. All problems of one patient, recorded by different members of the care team, are displayed on the problem list. Starting from this list, a problem follow-up can be made, one problem at a time or for several problems simultaneously. Thus, it is possible to get an integrated view, across provider categories, of those problems of one patient that belong together. This shared problem-oriented patient record provides an important basis for the primary care team work. 4. INTEGRATED DECISION SUPPORT. The decision support of the system includes a drug prescribing module and a care protocol module. The drug prescribing module is integrated with the patient records and includes an on-line check of the patient's medication list for potential interactions and data-driven reminders concerning major drug problems. Care protocols have been developed for the most common chronic diseases, such as asthma, diabetes, and hypertension. The patient records can be automatically checked according to the care protocols. 5. PRACTICAL EXPERIENCE. The Swedestar system has been implemented in a primary care area with 30,000 inhabitants. It is being used by all the primary care team members: 15 general practitioners, 25 district nurses, and 10 physiotherapists. Several years of practical experience of the CPR system shows that it has a positive impact on quality of care on four levels: 1) improved clinical follow-up of individual patients; 2) facilitated follow-up of aggregated data such as practice activity analysis, annual reports, and clinical indicators; 3) automated medical audit; and 4) concurrent audit. Within that primary care area, quality of care has improved substantially in several aspects due to the use of the CPR system [1].

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.

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.

The baby or the bath water? Lessons learned from the National Action Alliance for Suicide Prevention Research Prioritization Task Force literature review.

PubMed

Davis Molock, Sherry; Heekin, Janet M; Matlin, Samantha G; Barksdale, Crystal L; Gray, Ekwenzi; Booth, Chelsea L

2014-09-01

The Research Prioritization Task Force of the National Action Alliance for Suicide Prevention conducted a comprehensive literature review of suicide prevention/intervention trials to assess the quality of the scientific evidence. A literature "review of reviews" was conducted by searching the most widely used databases for mental health and public health research. The quality of the reviews was evaluated using the Revised Assessment of Multiple Systematic Reviews system; the quality of the scientific evidence for the suicide preventions/interventions was assessed using U.S. Preventive Services Task Force criteria. The reviews were limited to peer-reviewed publications with human subjects published in English. Ninety-eight systematic reviews and 45 primary sources on suicide prevention/interventions published between January 2000 and September 2012 were evaluated. The results suggest that the quality of both the systematic reviews and the scientific evidence for suicide preventions/interventions were mixed. The majority of the systematic reviews and prevention/interventions were evaluated as fair to poor in quality. There are many promising suicide prevention/intervention trials, but research findings are often inconclusive because of methodologic problems. Methodologic problems across systematic reviews include not conducting hand searches, not surveying gray literature, and being unable to aggregate data across studies. Methodologic problems with the scientific quality of the prevention/intervention trials include paucity of information on sample demographic characteristics, poorly defined outcomes, and excluding actively suicidal participants. Suggestions for ways to improve the quality of the systematic reviews and suicide preventions/interventions are provided. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

Vocational Education for China's Ethnic Minorities

ERIC Educational Resources Information Center

Qian, Minhui

2013-01-01

This article analyzes the current status and problems of vocational education for China's ethnic minorities. It concludes that these problems have both universal areas in common with China's overall education situation and individual characteristics; they also have both extrinsic and intrinsic qualities. The universal areas include the extrinsic…

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

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.

Implications of Fuel-Efficient Vehicles on Ride Quality and Passenger Acceptance : Workshop Proceedings, Woods Hole, Massachusetts, September 6-8, 1978

DOT National Transportation Integrated Search

1979-08-01

Four workshops were conducted under the auspices of the Transportation Research Board. The topics of discussion included ride quality and passenger acceptance problems associated with enhanced fuel efficiency of automobiles (Group A) and aircraft (Gr...

Problem Solving-based Learning Materials on Fraction for Training Creativity of Elementary School Students

NASA Astrophysics Data System (ADS)

Widhitama, Y. N.; Lukito, A.; Khabibah, S.

2018-01-01

The aim of this research is to develop problem solving based learning materials on fraction for training creativity of elementary school students. Curriculum 2006 states that mathematics should be studied by all learners starting from elementary level in order for them mastering thinking skills, one of them is creative thinking. To our current knowledge, there is no such a research topic being done. To promote this direction, we initiate by developing learning materials with problem solving approach. The developed materials include Lesson Plan, Student Activity Sheet, Mathematical Creativity Test, and Achievement Test. We implemented a slightly modified 4-D model by Thiagajan et al. (1974) consisting of Define, Design, Development, and Disseminate. Techniques of gathering data include observation, test, and questionnaire. We applied three good qualities for the resulted materials; that is, validity, practicality, and effectiveness. The results show that the four mentioned materials meet the corresponding criteria of good quality product.

Association between work role stressors and sleep quality.

PubMed

Iwasaki, S; Deguchi, Y; Inoue, K

2018-05-17

Work-related stressors are associated with low sleep quality. However, few studies have reported an association between role stressors and sleep quality. To elucidate the association between role stressors (including role conflict and ambiguity) and sleep quality. Cross-sectional study of daytime workers whose sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Work-related stressors, including role stressors, were assessed using the Generic Job Stress Questionnaire (GJSQ). The association between sleep quality and work-related stressors was investigated by logistic regression analysis. A total of 243 participants completed questionnaires were received (response rate 71%); 86 participants reported poor sleep quality, based on a global PSQI score ≥6. Multivariable logistic regression analysis revealed that higher role ambiguity was associated with global PSQI scores ≥6, and that role conflict was significantly associated with sleep problems, including sleep disturbance and daytime dysfunction. These results suggest that high role stress is associated with low sleep quality, and that this association should be considered an important determinant of the health of workers.

Quality data collection and management technology of aerospace complex product assembly process

NASA Astrophysics Data System (ADS)

Weng, Gang; Liu, Jianhua; He, Yongxi; Zhuang, Cunbo

2017-04-01

Aiming at solving problems of difficult management and poor traceability for discrete assembly process quality data, a data collection and management method is proposed which take the assembly process and BOM as the core. Data collection method base on workflow technology, data model base on BOM and quality traceability of assembly process is included in the method. Finally, assembly process quality data management system is developed and effective control and management of quality information for complex product assembly process is realized.

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.

Managing Strategic Change through TQM: Learning from Failure.

ERIC Educational Resources Information Center

Redman, Tom; Grieves, Jim

1999-01-01

Case study of a manufacturing firm that implemented total quality management (TQM) found that the initiative may have failed because the company was undergoing rapid, radical structural change. Other problems included short-term focus, communication problems, and employee concerns about job security. TQM may be more compatible with continuous…

Problems of Excess Capacity

NASA Technical Reports Server (NTRS)

Douglas, G.

1972-01-01

The problems of excess capacity in the airline industry are discussed with focus on the following topics: load factors; fair rate of return on investment; service-quality rivalry among airlines; pricing (fare) policies; aircraft production; and the impacts of excess capacity on operating costs. Also included is a discussion of the interrelationships among these topics.

Problem-Solving Therapy for Depression in Adults: A Systematic Review

ERIC Educational Resources Information Center

Gellis, Zvi D.; Kenaley, Bonnie

2008-01-01

Objectives: This article presents a systematic review of the evidence on problem-solving therapy (PST) for depressive disorders in noninstitutionalized adults. Method: Intervention studies using randomized controlled designs are included and methodological quality is assessed using a standard set of criteria from the Cochrane Collaborative Review…

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…

[Relations between problems on sleeping and suicidal behaviors in middle school students].

PubMed

Chen, Jing; Wan, Yuhui; Sun, Ying; Tao, Fangbiao

2014-02-01

To understand the epidemiological characteristics and possible associations between sleeping problems and suicidal behaviors among middle school students. A total of 13 817 middle school students were selected in Shenyang,Xinxiang, Chongqing and Guangzhou cities and cluster sampling method was used. Questionnaires would include information on demographics, quality of sleep, psychopathological status and suicidal behaviors. Pittsburgh Sleep Quality index (PSQI) and Adolescent Multidimensional Sub-health Questionnaire (MSQA) were used to assess the quality of sleep and psychosomatic symptoms, respectively. Rates on sleeping problems and suicidal behaviors were compared in students with specific characteristics. Effects related to sleeping problems and suicidal behaviors were analyzed, using the multivariate logistic regression model. The overall prevalence of problems related to sleeping among middle school students was 26.5%. 28.2% of the girls and 35.2% of senior students reported as having more sleeping problems. Rates on suicide related ideation, planning and attempts were 16.6%, 9.6% and 4.7% , respectively. Girls reported more suicide ideation than boys. However, no gender differences were found in suicide planning or attempted suicide. It also suggested that the incidence of the suicidal behavior among students with sleeping problems was significantly higher than students without sleeping problems. Data from Multivariable logistic regression analysis showed that sleeping problems appeared as independent risk factors on suicidal behavior. Higher PSQI scores seemed coincide with the increased risk of suicidal behaviors. Students having sleeping time less than 5 hours per day showed higher risk of suicidal behaviors. Problems on sleeping seemed a strong risk factor for suicidal behaviors among middle school students. Improvement on the quality of sleep and reasonable arrangement of sleeping time could help prevent related suicidal behaviors among middle school students.

21 CFR 900.4 - Standards for accreditation bodies.

Code of Federal Regulations, 2014 CFR

2014-04-01

... image quality, or upon request by FDA, the accreditation body shall review a facility's clinical images... review by the accreditation body demonstrates that a problem does exist with respect to image quality or... program shall: (i) Include requirements for clinical image review and phantom image review; (ii) Ensure...

21 CFR 900.4 - Standards for accreditation bodies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... image quality, or upon request by FDA, the accreditation body shall review a facility's clinical images... review by the accreditation body demonstrates that a problem does exist with respect to image quality or... program shall: (i) Include requirements for clinical image review and phantom image review; (ii) Ensure...

21 CFR 900.4 - Standards for accreditation bodies.

Code of Federal Regulations, 2012 CFR

2012-04-01

... image quality, or upon request by FDA, the accreditation body shall review a facility's clinical images... review by the accreditation body demonstrates that a problem does exist with respect to image quality or... program shall: (i) Include requirements for clinical image review and phantom image review; (ii) Ensure...

21 CFR 900.4 - Standards for accreditation bodies.

Code of Federal Regulations, 2013 CFR

2013-04-01

... image quality, or upon request by FDA, the accreditation body shall review a facility's clinical images... review by the accreditation body demonstrates that a problem does exist with respect to image quality or... program shall: (i) Include requirements for clinical image review and phantom image review; (ii) Ensure...

Quality in the Operational Air Force: A Case of Misplaced Emphasis

DTIC Science & Technology

1994-05-01

other quality advocates of the era. These men included Joseph Juran, Armand Feigenbaum, Kaoru Ishikawa , and Genichi Taguchi. Juran contributed disciplined...planning theories, while Feigenbaum felt that producing quality could actually reduce production costs. In addition, Ishikawa and Taguchi lent...statistically based problem solving techniques, but the more modem approaches of Ishikawa , Taguchi and others. The operative concept of TQM is ’continuous

Public Policy on Ground-Water Quality Protection. Proceedings of a National Conference (Virginia Polytechnic Inst. and State University, Blacksburg, Virginia, April 13-16, 1977).

ERIC Educational Resources Information Center

Kerns, Waldon R., Ed.

This publication contains the papers presented at a National Conference on Ground Water Quality Protection Policy held in April of 1977. Paper titles include: (1) Magnitude of the Ground-Water Contamination Problem; (2) Limited Degredation as a Ground-Water Quality Policy; (3) Surface and Subsurface Mining: Policy Implications; (4) Oil Well…

Effective Documentation Tools

NASA Technical Reports Server (NTRS)

Sleboda, Claire

1997-01-01

Quality assurance programs provide a very effective means to monitor and evaluate medical care. Quality assurance involves: (1) Identify a problem; (2) Determine the source and nature of the problem; (3) Develop policies and methods to effect improvement; (4) Implement those polices; (5) Monitor the methods applied; and (6) Evaluate their effectiveness. Because this definition of quality assurance so closely resembles the Nursing Process, the health unit staff was able to use their knowledge of the nursing process to develop many forms which improve the quality of patient care. These forms include the NASA DFRC Service Report, the occupational injury form (Incident Report), the patient survey (Pre-hospital Evaluation/Care Report), the Laboratory Log Sheet, the 911 Run Sheet, and the Patient Assessment Stamp. Examples and steps which are followed to generate these reports are described.

COLLABORATIVE RESEARCH ON URBAN BEST MANAGEMENT PRACTICES

EPA Science Inventory

Storm driven wet weather flow (WWF) which includes combined sewer and sanitary sewer overflows and stormwater discharges are a leading cause of water-quality impairment. Problem constituents in WWF include pathogens, solids, nutrients, and toxicants. New technologies to control...

Watershed modeling and monitoring for assessing nutrient ...

EPA Pesticide Factsheets

Presentation for the American Water Works Association Water Sustainability Conference. The presentation highlights latest results from water quality trading research conducted by ORD using the East Fork Watershed in Southwestern Ohio as a case study. The watershed has a nutrient enrichment problem that is creating harmful algal blooms in a reservoir used for drinking water and recreation. Innovative modeling and monitoring is combined to understand how to best manage this water quality problem and costs associated with this endeavor. The presentation will provide an overview of the water quality trading feasibility research. The research includes the development and evaluation of innovative modeling and monitoring approaches to manage watersheds for nutrient pollution using a whole systems approach.

Improving the Quality of Home Health Care for Children With Medical Complexity.

PubMed

Nageswaran, Savithri; Golden, Shannon L

2017-08-01

The objectives of this study are to describe the quality of home health care services for children with medical complexity, identify barriers to delivering optimal home health care, and discuss potential solutions to improve home health care delivery. In this qualitative study, we conducted 20 semistructured in-depth interviews with primary caregivers of children with medical complexity, and 4 focus groups with 18 home health nurses. During an iterative analysis process, we identified themes related to quality of home health care. There is substantial variability between home health nurses in the delivery of home health care to children. Lack of skills in nurses is common and has serious negative health consequences for children with medical complexity, including hospitalizations, emergency room visits, and need for medical procedures. Inadequate home health care also contributes to caregiver burden. A major barrier to delivering optimal home health care is the lack of training of home health nurses in pediatric care and technology use. Potential solutions for improving care include home health agencies training nurses in the care of children with medical complexity, support for nurses in clinical problem solving, and reimbursement for training nurses in pediatric home care. Caregiver-level interventions includes preparation of caregivers about: providing medical care for their children at home and addressing problems with home health care services. There are problems in the quality of home health care delivered to children with medical complexity. Training nurses in the care of children with medical complexity and preparing caregivers about home care could improve home health care quality. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The Fragrant Chemist

ERIC Educational Resources Information Center

Ward, P.

1973-01-01

The chemist plays an important role in perfumery. There are scientific problems involved in relating odour to structure, including analysis of essential oils, quality control, and synthetic chemistry. (DF)

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 by lifetime co-occurring substance use disorders. Implications for clinicians, health care utilization, and public health issues are discussed.

Promising Long-Term Health-Related Quality of Life After High-Dose-Rate Brachytherapy Boost for Localized Prostate Cancer

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

Wahlgren, Thomas; Nilsson, Sten; Lennernaes, Bo

2007-11-01

Purpose: To explore the long-term general and disease-specific health-related quality of life (HRQOL) >5 years after combined radiotherapy for localized prostate cancer, including a high-dose-rate brachytherapy boost and hormonal deprivation therapy. Methods and Materials: Of 196 eligible patients with localized prostate cancer (Stage T1-T3a) consecutively treated with curative radiotherapy at our institution between June 1998 and August 2000, 182 (93%) completed the European Organization for Research and Treatment of Cancer Quality of Life questionnaires QLQ-C30 and QLQ-PR25, including specific questions on fecal incontinence >5 years after treatment in September 2005. A comparison with age-matched normative data was done, as wellmore » as a longitudinal analysis using HRQOL data from a previous study. Results: The analysis included 158 nonrecurrent patients. Comparisons made with normative data showed that physical and role functioning were significantly better statistically and social functioning was significantly worse. Diarrhea and sleep disturbances were more pronounced and pain less pronounced than in a normal male population. The longitudinal analysis of disease-specific HRQOL showed that urinary urgency and erectile problems persisted 5 years after treatment, and nocturia and hormonally dependent symptoms had declined significantly, with a statistically significant difference. Fecal incontinence was recognized by 25% of patients, of whom 80% considered it a minor problem. Conclusion: More than 5 years after combined radiotherapy, irritative urinary problems and erectile dysfunction remain concerns, although severe bowel disturbance and fecal incontinence seem to be minor problems. Longitudinally, a decline mainly in hormonally dependent symptoms was seen. Minor differences in general HRQOL compared with normative data were observed, possibly including 'response shift' effects.« less

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.

[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 of corrective measures, based on the findings of the two previous stages, are the third step of the evaluation cycle. The Hawthorne effect is an outcome improvement, before the implementation of any corrective actions. Verification of the implemented actions is the final and mandatory step closing the evaluation cycle.

Hierarchic Extensions in the Static and Dynamic Analysis of Elastic Beams. Ph.D. Thesis, 1990 Final Report, May 1990

NASA Technical Reports Server (NTRS)

Watson, Robert A.

1991-01-01

Approximate solutions of static and dynamic beam problems by the p-version of the finite element method are investigated. Within a hierarchy of engineering beam idealizations, rigorous formulations of the strain and kinetic energies for straight and circular beam elements are presented. These formulations include rotating coordinate system effects and geometric nonlinearities to allow for the evaluation of vertical axis wind turbines, the motivating problem for this research. Hierarchic finite element spaces, based on extensions of the polynomial orders used to approximate the displacement variables, are constructed. The developed models are implemented into a general purpose computer program for evaluation. Quality control procedures are examined for a diverse set of sample problems. These procedures include estimating discretization errors in energy norm and natural frequencies, performing static and dynamic equilibrium checks, observing convergence for qualities of interest, and comparison with more exacting theories and experimental data. It is demonstrated that p-extensions produce exponential rates of convergence in the approximation of strain energy and natural frequencies for the class of problems investigated.

Feminist Heuristics: Transforming the Foundation of Food Quality and Safety Assurance Systems

ERIC Educational Resources Information Center

Kimura, Aya Hirata

2012-01-01

Food safety and quality assurance systems have emerged as a key mechanism of food governance in recent years and are also popular among alternative agrofood movements, such as the organic and fair trade movements. Rural sociologists have identified many problems with existing systems, including corporate cooptation, the marginalization of small…

Biodiversity, air quality and human health

Treesearch

David J. Nowak; Sarah Jovan; Christina Branquinho; Sofia Augusto; Manuel C. Ribeiro; Conor E. Kretsch

2015-01-01

Air pollution is a significant problem in cities across the world. It affects human health and well-being, ecosystem health, crops, climate, visibility and human-made materials. Health effects related to air pollution include its impact on the pulmonary, cardiac, vascular and neurological systems (Section 2). Trees affect air quality through a number of means (Section...

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…

Measurement tools for mental health problems and mental well-being in people with severe or profound intellectual disabilities: A systematic review.

PubMed

Flynn, Samantha; Vereenooghe, Leen; Hastings, Richard P; Adams, Dawn; Cooper, Sally-Ann; Gore, Nick; Hatton, Chris; Hood, Kerry; Jahoda, Andrew; Langdon, Peter E; McNamara, Rachel; Oliver, Chris; Roy, Ashok; Totsika, Vasiliki; Waite, Jane

2017-11-01

Mental health problems affect people with intellectual disabilities (ID) at rates similar to or in excess of the non-ID population. People with severe ID are likely to have persistent mental health problems. In this systematic review (PROSPERO 2015:CRD42015024469), we identify and evaluate the methodological quality of available measures of mental health problems or well-being in individuals with severe or profound ID. Electronic searches of ten databases identified relevant publications. Two reviewers independently reviewed titles and abstracts of retrieved records (n=41,232) and full-text articles (n=573). Data were extracted and the quality of included papers was appraised. Thirty-two papers reporting on 12 measures were included. Nine measures addressed a broad spectrum of mental health problems, and were largely observational. One physiological measure of well-being was included. The Aberrant Behavior Checklist, Diagnostic Assessment for the Severely Handicapped Scale-II and Mood, Interest and Pleasure Questionnaire are reliable measures in this population. However, the psychometric properties of six other measures were only considered within a single study - indicating a lack of research replication. Few mental health measures are available for people with severe or profound ID, particularly lacking are tools measuring well-being. Assessment methods that do not rely on proxy reports should be explored further. Copyright © 2017 Elsevier Ltd. All rights reserved.

Science educators' perceptions of problems facing science education: A report of five surveys

NASA Astrophysics Data System (ADS)

Gallagher, James Joseph; Yager, Robert E.

Five groups of science educators representing faculty at graduate institutions, graduate students, teachers, supervisors, and leadership conferees were surveyed concerning their perceptions of current problems facing science education. A total of 144 participants provided an average of 4.7 responses. The responses were tabulated using an emergent set of categories that resulted in six major groupings, i.e. conceptual, organizational, teacher; related, student-related, university, and societal. The category with the most problems identified was in the area of conceptual problems. University related problems and organizational problems were the next two most frequently mentioned categories for problems. Specific problems in all categories most often cited include the following:1confusion and uncertainty in goals and objectives;2lack of vision and leadership in schools and universities;3absence of a theoretical base for science education;4poor quality teacher education programs;5inappropriate avenues for continuing education of teachers; limited dialogue between researchers and practitioners; declining enrollments; poor quality teaching and counseling; insufficient programs in science for the wide spectrum of students; and public and parental apathy towards science.

Sleep Complaints in Older Blacks: Do Demographic and Health Indices Explain Poor Sleep Quality and Duration?

PubMed Central

Gamaldo, Alyssa A.; Gamaldo, Charlene E.; Allaire, Jason C.; Aiken-Morgan, Adrienne T.; Salas, Rachel E.; Szanton, Sarah; Whitfield, Keith E.

2014-01-01

Objective: To examine the relationship between measures of sleep quality and the presence of commonly encountered comorbid and sociodemographic conditions in elderly Black subjects. Method: Analyses included participants from the Baltimore Study of Black Aging (BSBA; n = 450; mean age 71.43 years; SD 9.21). Pittsburgh Sleep Quality Index (PSQI) measured overall sleep pattern and quality. Self-reported and objective measures of physical and mental health data and demographic information were collected for all participants. Results: Sociodemographic and comorbid health factors were significantly associated with sleep quality. Results from regression analyses revealed that older age, current financial strain, interpersonal problems, and stress were unique predictors of worse sleep quality. Sleep duration was significantly correlated with age, depressive affect, interpersonal problems, and stress; only age was a unique significant predictor. While participants 62 years or younger had worse sleep quality with increasing levels of stress, there was no significant relationship between sleep quality and stress for participants 81 years and older. Conclusions: Several potential mechanisms may explain poor sleep in urban, community dwelling Blacks. Perceived stressors, including current financial hardship or hardship experienced for an extended time period throughout the lifespan, may influence sleep later in life. Citation: Gamaldo AA, Gamaldo CE, Allaire JC, Aiken-Morgan AT, Salas RE, Szanton S, Whitfield KE. Sleep complaints in older blacks: do demographic and health indices explain poor sleep quality and duration? J Clin Sleep Med 2014;10(7):725-731. PMID:25024649

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.

Supervising community health workers in low-income countries – a review of impact and implementation issues

PubMed Central

Hill, Zelee; Dumbaugh, Mari; Benton, Lorna; Källander, Karin; Strachan, Daniel; Asbroek, Augustinus ten; Tibenderana, James; Kirkwood, Betty; Meek, Sylvia

2014-01-01

Background Community health workers (CHWs) are an increasingly important component of health systems and programs. Despite the recognized role of supervision in ensuring CHWs are effective, supervision is often weak and under-supported. Little is known about what constitutes adequate supervision and how different supervision strategies influence performance, motivation, and retention. Objective To determine the impact of supervision strategies used in low- and middle-income countries and discuss implementation and feasibility issues with a focus on CHWs. Design A search of peer-reviewed, English language articles evaluating health provider supervision strategies was conducted through November 2013. Included articles evaluated the impact of supervision in low- or middle-income countries using a controlled, pre-/post- or observational design. Implementation and feasibility literature included both peer-reviewed and gray literature. Results A total of 22 impact papers were identified. Papers were from a range of low- and middle-income countries addressing the supervision of a variety of health care providers. We classified interventions as testing supervision frequency, the supportive/facilitative supervision package, supervision mode (peer, group, and community), tools (self-assessment and checklists), focus (quality assurance/problem solving), and training. Outcomes included coverage, performance, and perception of quality but were not uniform across studies. Evidence suggests that improving supervision quality has a greater impact than increasing frequency of supervision alone. Supportive supervision packages, community monitoring, and quality improvement/problem-solving approaches show the most promise; however, evaluation of all strategies was weak. Conclusion Few supervision strategies have been rigorously tested and data on CHW supervision is particularly sparse. This review highlights the diversity of supervision approaches that policy makers have to choose from and, while choices should be context specific, our findings suggest that high-quality supervision that focuses on supportive approaches, community monitoring, and/or quality assurance/problem solving may be most effective. PMID:24815075

Quality of life in stoma patients.

PubMed

Nugent, K P; Daniels, P; Stewart, B; Patankar, R; Johnson, C D

1999-12-01

Patients with stomas face many difficulties both physical and psychological. Little is known about the long-term problems and the impact on patient lifestyle of a permanent stoma. This study was designed to address the problems faced by patients with stomas. Patients were identified from the Stoma Care Department records for the years 1985 to 1992 and were contacted by mail. A questionnaire was designed to assess postoperative care, quality of life issues, and equipment problems. Responses were recorded on either a visual analog scale, a choice of yes-or-no alternatives, or by selection from a list of responses. A total of 542 eligible patients were contacted, and 391 replies were received. Major stomal problems included rashes (51 percent), leakage (36 percent), and ballooning (90 percent of patients with ileostomy). The majority of patients experienced some change in lifestyle (80 percent), and more than 40 percent of patients had problems with their sex lives. Many patients cope extremely well with a stoma; however, some patients experience considerable difficulty and distress. Improved preoperative assessment and counseling with longer follow-up by the stoma department would be helpful in the management of these patients and probably would contribute to improvement in the quality of their lives.

The Quality Assurance Project assists the vitamin A capsule program in Antique Province, Philippines.

PubMed

Blumenfeld, S

1994-01-01

Vitamin A deficiency remains an important problem in some parts of the Philippines. The Department of Health, with assistance from the Helen Keller Institute (HKI), established a vitamin A supplementation program in Antique Province providing for the administration of vitamin A capsules to malnourished children. Although the HKI cut off its assistance in 1992, continuation of the capsule supplementation program was an element of the National Nutrition Plan for 1992-96, and remains an element of the Antique Provincial health services program under the Philippines' devolved health services scheme. The Quality Assurance Program (QAP) in May 1993 began helping the Provincial Health Office improve the quality of the vitamin A program. A systems analysis was first undertaken to identify significant deviations from provider performance standards which had been adapted by the province from Nutrition Service guidelines. Many problems were observed, including lack of knowledge of the high-priority categories of children, incomplete counseling, and frequent mistakes in determining children's nutritional status. The provincial health office staff recommended that six of the province's seventeen municipalities participate in the quality improvement effort. The intent of the QAP staff was not only to help the provincial staff improve the quality of its vitamin A program by resolving some immediate operational problems, but to provide the health care workers with a quality improvement experience that they would intuitively transfer to other programs for which they were responsible. The coaching/facilitating approach of modern quality management allowed health workers to explore their own approaches to solving the problems chosen.

Solving the competitive facility location problem considering the reactions of competitor with a hybrid algorithm including Tabu Search and exact method

NASA Astrophysics Data System (ADS)

Bagherinejad, Jafar; Niknam, Azar

2018-03-01

In this paper, a leader-follower competitive facility location problem considering the reactions of the competitors is studied. A model for locating new facilities and determining levels of quality for the facilities of the leader firm is proposed. Moreover, changes in the location and quality of existing facilities in a competitive market where a competitor offers the same goods or services are taken into account. The competitor could react by opening new facilities, closing existing ones, and adjusting the quality levels of its existing facilities. The market share, captured by each facility, depends on its distance to customer and its quality that is calculated based on the probabilistic Huff's model. Each firm aims to maximize its profit subject to constraints on quality levels and budget of setting up new facilities. This problem is formulated as a bi-level mixed integer non-linear model. The model is solved using a combination of Tabu Search with an exact method. The performance of the proposed algorithm is compared with an upper bound that is achieved by applying Karush-Kuhn-Tucker conditions. Computational results show that our algorithm finds near the upper bound solutions in a reasonable time.

The indoor air we breathe.

PubMed Central

Oliver, L C; Shackleton, B W

1998-01-01

Increasingly recognized as a potential public health problem since the outbreak of Legionnaire's disease in Philadelphia in 1976, polluted indoor air has been associated with health problems that include asthma, sick building syndrome, multiple chemical sensitivity, and hypersensitivity pneumonitis. Symptoms are often nonspecific and include headache, eye and throat irritation, chest tightness and shortness of breath, and fatigue. Air-borne contaminants include commonly used chemicals, vehicular exhaust, microbial organisms, fibrous glass particles, and dust. Identified causes include defective building design and construction, aging of buildings and their ventilation systems, poor climate control, inattention to building maintenance. A major contributory factor is the explosion in the use of chemicals in building construction and furnishing materials over the past four decades. Organizational issues and psychological variables often contribute to the problem and hinder its resolution. This article describes the health problems related to poor indoor air quality and offers solutions. Images p398-a p399-a PMID:9769764

Obesity

MedlinePlus

... quality of life include: Depression Disability Sexual problems Shame and guilt Social isolation Lower work achievement Prevention ... as fruits, vegetables and whole grains. Avoid saturated fat and limit sweets and alcohol. Eat three regular ...

Sleep problems: an emerging global epidemic? Findings from the INDEPTH WHO-SAGE study among more than 40,000 older adults from 8 countries across Africa and Asia.

PubMed

Stranges, Saverio; Tigbe, William; Gómez-Olivé, Francesc Xavier; Thorogood, Margaret; Kandala, Ngianga-Bakwin

2012-08-01

To estimate the prevalence of sleep problems and the effect of potential correlates in low-income settings from Africa and Asia, where the evidence is lacking. Cross-sectional. Community-wide samples from 8 countries across Africa and Asia participating in the INDEPTH WHO-SAGE multicenter collaboration during 2006-2007. The participating sites included rural populations in Ghana, Tanzania, South Africa, India, Bangladesh, Vietnam, and Indonesia, and an urban area in Kenya. There were 24,434 women and 19,501 men age 50 yr and older. N/A. Two measures of sleep quality, over the past 30 days, were assessed alongside a number of sociodemographic variables, measures of quality of life, and comorbidities. Overall, 16.6% of participants reported severe/extreme nocturnal sleep problems, with a striking variation across the 8 populations, ranging from 3.9% (Purworejo, Indonesia and Nairobi, Kenya) to more than 40.0% (Matlab, Bangladesh). There was a consistent pattern of higher prevalence of sleep problems in women and older age groups. In bivariate analyses, lower education, not living in partnership, and poorer self-rated quality of life were consistently associated with higher prevalence of sleep problems (P < 0.001). In multivariate logistic regression analyses, limited physical functionality or greater disability and feelings of depression and anxiety were consistently strong, independent correlates of sleep problems, in both women and men, across the 8 sites (P < 0.001). A large number of older adults in low-income settings are currently experiencing sleep problems, which emphasizes the global dimension of this emerging public health issue. This study corroborates the multifaceted nature of sleep problems, which are strongly linked to poorer general well-being and quality of life, and psychiatric comorbidities.

75 FR 27514 - Approval and Promulgation of Implementation Plans and Designation of Areas for Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

... vehicular traffic are also subject to increased ozone levels because wind carries ozone and its precursors... ozone triggers a variety of health problems including aggravated asthma, reduced lung capacity, and... is called the design value (DV). The DV indicates the severity of the ozone problem in an area; it is...

Family Income Dynamics, Early Childhood Education and Care, and Early Child Behavior Problems in Norway

ERIC Educational Resources Information Center

Zachrisson, Henrik D.; Dearing, Eric

2015-01-01

The sociopolitical context of Norway includes low poverty rates and universal access to subsidized and regulated Early Childhood Education and Care (ECEC). In this context, the association between family income dynamics and changes in early child behavior problems was investigated, as well as whether high-quality ECEC buffers children from the…

Community Development, Problems and Prospects. Proceedings of a Commonwealth Conference, University Park, Pennsylvania, March 7-9, 1965.

ERIC Educational Resources Information Center

Buck, Roy C., Ed.; Rath, Robert A., Ed.

Conference papers on community development problems and prospects deal with needs, methods, objectives, resources, and the role of universities, with particular reference to urban areas. Concerns include deficiencies in knowledge, leadership, government, and the quality of urban life; land use and urban design; principles of economic development…

How to reduce scientific irreproducibility: the 5-year reflection.

PubMed

Fiala, Clare; Diamandis, Eleftherios P

2017-10-26

We discuss in depth six causes of scientific irreproducibility and their ramifications for the clinical sciences: fraud, unfounded papers published by prominent authorities, bias, technical deficiencies, fragmented science and problems with big data. Some proposed methods to combat this problem are briefly described, including an effort to replicate results from some high impact papers and a proposal that authors include detailed preclinical data in papers with supposedly high translational value. We here advocate for a 5-year reflection on papers with seemingly high clinical/translational potential, published alongside the original paper where authors reflect on the quality, reproducibility and impact of their findings. These reflections can be used as a benchmark for credibility, and begin a virtuous cycle of improving the quality of published findings in the literature.

Aircraft model prototypes which have specified handling-quality time histories

NASA Technical Reports Server (NTRS)

Johnson, S. H.

1976-01-01

Several techniques for obtaining linear constant-coefficient airplane models from specified handling-quality time histories are discussed. One technique, the pseudodata method, solves the basic problem, yields specified eigenvalues, and accommodates state-variable transfer-function zero suppression. The method is fully illustrated for a fourth-order stability-axis small-motion model with three lateral handling-quality time histories specified. The FORTRAN program which obtains and verifies the model is included and fully documented.

Report of the DOD-University Forum Working Group on Engineering and Science Education.

DTIC Science & Technology

1983-07-01

high priority to strengthening our national base of scientific and technical personnel. That included im- mediate emphasis on training people in the...4 - DOD Requirements for Civilian Engineering and Scientific Personnel .. 5 - DOD Requirements for Military Engineering and Scientific ...15 - The Problem is Quality ................ o................. ...... 15 - The Quality of Engineering and Scientific Personnel in

Callous-Unemotional Traits, Behavior Disorders, and the Student-Teacher Relationship in Elementary School Students

ERIC Educational Resources Information Center

Crum, Kathleen I.; Waschbusch, Daniel A.; Willoughby, Michael T.

2016-01-01

Mental health research demonstrates that children with conduct problems (CP) and callous-unemotional (CU) traits differ in important ways from children with CP alone, including differences in primary caregiver attachment quality. This research suggests CU may also influence the quality of attachment between children with CP and their teachers.…

A multiple objective optimization approach to quality control

NASA Technical Reports Server (NTRS)

Seaman, Christopher Michael

1991-01-01

The use of product quality as the performance criteria for manufacturing system control is explored. The goal in manufacturing, for economic reasons, is to optimize product quality. The problem is that since quality is a rather nebulous product characteristic, there is seldom an analytic function that can be used as a measure. Therefore standard control approaches, such as optimal control, cannot readily be applied. A second problem with optimizing product quality is that it is typically measured along many dimensions: there are many apsects of quality which must be optimized simultaneously. Very often these different aspects are incommensurate and competing. The concept of optimality must now include accepting tradeoffs among the different quality characteristics. These problems are addressed using multiple objective optimization. It is shown that the quality control problem can be defined as a multiple objective optimization problem. A controller structure is defined using this as the basis. Then, an algorithm is presented which can be used by an operator to interactively find the best operating point. Essentially, the algorithm uses process data to provide the operator with two pieces of information: (1) if it is possible to simultaneously improve all quality criteria, then determine what changes to the process input or controller parameters should be made to do this; and (2) if it is not possible to improve all criteria, and the current operating point is not a desirable one, select a criteria in which a tradeoff should be made, and make input changes to improve all other criteria. The process is not operating at an optimal point in any sense if no tradeoff has to be made to move to a new operating point. This algorithm ensures that operating points are optimal in some sense and provides the operator with information about tradeoffs when seeking the best operating point. The multiobjective algorithm was implemented in two different injection molding scenarios: tuning of process controllers to meet specified performance objectives and tuning of process inputs to meet specified quality objectives. Five case studies are presented.

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.

The Longitudinal Association Between Poor Sleep Quality and Cyberbullying, Mediated by Anger.

PubMed

Erreygers, Sara; Vandebosch, Heidi; Vranjes, Ivana; Baillien, Elfi; De Witte, Hans

2018-01-09

Adolescents tend to go to bed later and sleep less as they grow older, although their need for sleep stays the same throughout adolescence. Poor sleep has negative consequences on personal and interpersonal functioning, including increased aggressive tendencies. With adolescents' social life increasingly including interactions via digital media, these interactions may also become more aggressive when adolescents' sleep problems increase. One of the ways in which online aggression may be enacted is through cyberbullying. Although previous research has examined the role of sleep disruptions in offline bullying, the role of sleep in cyberbullying has not yet been addressed. Therefore, this study examines the longitudinal effect of poor sleep quality on later cyberbullying behavior. Thirteen- to fourteen-year-old adolescents completed self-report measures on sleep quality, anger, cyberbullying perpetration, and frequency of digital media use. Because one of the pathways through which sleep is proposed to be linked to aggression is an affective pathway, namely via angry affect, a mediation model of poor sleep quality predicting cyberbullying via feelings of anger was tested. Results from structural equation modeling and a bootstrap test indicated that poor sleep quality was indeed indirectly associated with later cyberbullying behavior through heightened feelings of anger, even when taking the effects of the use of digital media and previous cyberbullying behavior into account. This finding provides support for the proposed affective pathway linking sleep problems to aggression. As sleep problems and anger seem to play a predicting role in cyberbullying behavior, suggestions for cyberbullying intervention and prevention strategies are formulated.

Water Resources Research Grant Program Project Descriptions: Fiscal Year 1988

USGS Publications Warehouse

Lew, Melvin; McCoy, Beverly M.

1989-01-01

This report contains information on the 38 new projects funded by the U.S. Geological Survey's Water Resources Research Grant Program in fiscal year 1988 and on 11 projects completed during the year. For the new projects, the report gives the grant number, project title, performing organization, principal investigator(s), project duration, and a project description that includes: (1) identification of water-related problems and problem-solution approach, (2) contribution to problem solution, (3) objectives, and (4) approach. The 38 projects include 14 in the area of ground-water quality problems, 10 in the science and technology of water-quality management, 4 in climate variability and the hydrologic cycle, 7 in institutional change in water-resources management, and 3 in miscellaneous water-resources management problems. For the 11 completed projects, the report gives the grant number, project title, performing organization, principal investigator(s), starting date, date of receipt of final report, and an abstract of the final report. Each project description provides the information needed to obtain a copy of the final report. The report also contains tables showing (1) proposals received according to area of research interest, (2) grant awards and funding according to area of research interest, (3) proposals received according to type of submitting organization, and (4) awards and funding according to type of organization.

Sleep Duration, Sleep Quality, Body Mass Index, and Waist Circumference among Young Adults from 24 Low- and Middle-Income and Two High-Income Countries

PubMed Central

Peltzer, Karl; Pengpid, Supa

2017-01-01

Obesity and its comorbidities have emerged as a leading public health concern. The aim of this study was to explore the relationship between body mass index (BMI), waist circumference (WC) and sleep patterns, including duration and disturbances. A cross-sectional questionnaire survey and anthropometric measurements were conducted with undergraduate university students that were randomly recruited in 26 universities in 24 low- and middle-income and two high-income countries. The sample included 18,211 (42.1% male and 57.9% female, mean age 21.0 in male and 20.7 years in female students) undergraduate university students. The overall BMI was a mean of 22.5 kg/m2 for men and 22.0 kg/m2 for women, and the mean WC was 78.4 cm for men and 73.8 cm for women. More than 39% of the students reported short sleep duration (≤6 h/day) and over 30% reported moderate to extreme sleep problems. In a linear multivariable regression, adjusted for sociodemographic and lifestyle factors, short sleep duration was positively associated with BMI in both men and women, and was positively associated with WC among women but not among men. Sleep quality or problems among men were not associated with BMI, while among women mild sleep problems were inversely associated with BMI, and poor sleep quality or problems were positively associated with WC both among men and women. The study confirmed an association between short sleep duration and increased BMI and, among women, increased WC, and an association between poor sleep quality and increased WC but not BMI. Further, differences in the association between sleep characteristics and BMI and WC were found by region and country income. PMID:28587107

Sleep Duration, Sleep Quality, Body Mass Index, and Waist Circumference among Young Adults from 24 Low- and Middle-Income and Two High-Income Countries.

PubMed

Peltzer, Karl; Pengpid, Supa

2017-05-26

Obesity and its comorbidities have emerged as a leading public health concern. The aim of this study was to explore the relationship between body mass index (BMI), waist circumference (WC) and sleep patterns, including duration and disturbances. A cross-sectional questionnaire survey and anthropometric measurements were conducted with undergraduate university students that were randomly recruited in 26 universities in 24 low- and middle-income and two high-income countries. The sample included 18,211 (42.1% male and 57.9% female, mean age 21.0 in male and 20.7 years in female students) undergraduate university students. The overall BMI was a mean of 22.5 kg/m² for men and 22.0 kg/m² for women, and the mean WC was 78.4 cm for men and 73.8 cm for women. More than 39% of the students reported short sleep duration (≤6 h/day) and over 30% reported moderate to extreme sleep problems. In a linear multivariable regression, adjusted for sociodemographic and lifestyle factors, short sleep duration was positively associated with BMI in both men and women, and was positively associated with WC among women but not among men. Sleep quality or problems among men were not associated with BMI, while among women mild sleep problems were inversely associated with BMI, and poor sleep quality or problems were positively associated with WC both among men and women. The study confirmed an association between short sleep duration and increased BMI and, among women, increased WC, and an association between poor sleep quality and increased WC but not BMI. Further, differences in the association between sleep characteristics and BMI and WC were found by region and country income.

Water pollution in Pakistan and its impact on public health--a review.

PubMed

Azizullah, Azizullah; Khattak, Muhammad Nasir Khan; Richter, Peter; Häder, Donat-Peter

2011-02-01

Water pollution is one of the major threats to public health in Pakistan. Drinking water quality is poorly managed and monitored. Pakistan ranks at number 80 among 122 nations regarding drinking water quality. Drinking water sources, both surface and groundwater are contaminated with coliforms, toxic metals and pesticides throughout the country. Various drinking water quality parameters set by WHO are frequently violated. Human activities like improper disposal of municipal and industrial effluents and indiscriminate applications of agrochemicals in agriculture are the main factors contributing to the deterioration of water quality. Microbial and chemical pollutants are the main factors responsible exclusively or in combination for various public health problems. This review discusses a detailed layout of drinking water quality in Pakistan with special emphasis on major pollutants, sources of pollution and the consequent health problems. The data presented in this review are extracted from various studies published in national and international journals. Also reports released by the government and non-governmental organizations are included. Copyright © 2010 Elsevier Ltd. All rights reserved.

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)…

"Rheum to Improve": Quality Improvement in Outpatient Rheumatology.

PubMed

Chow, Shirley L; Shojania, Kaveh G

2017-09-01

The commitment to improve care processes and patient outcomes is a professional mandate for clinicians and is also seen as an operational priority for institutions. Quality improvement now figures in the accreditation of training programs, specialty examinations, and hospital scorecards. Rheumatologists have traditionally focused primarily on quality problems such as guideline adherence; however, improvement goals should also include other aspects of care that are helpful to patients and are professionally rewarding for practitioners. This review makes use of improvement projects in outlining tangible tools rheumatologists can use to resolve quality concerns in their practices.

The Pharmacological Management of Oppositional Behaviour, Conduct Problems, and Aggression in Children and Adolescents With Attention-Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder: A Systematic Review and Meta-Analysis. Part 2: Antipsychotics and Traditional Mood Stabilizers

PubMed Central

Pringsheim, Tamara; Hirsch, Lauren; Gardner, David; Gorman, Daniel A

2015-01-01

Objective: Attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) are among the most common psychiatric diagnoses in childhood. Aggression and conduct problems are a major source of disability and a risk factor for poor long-term outcomes. Methods: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) of antipsychotics, lithium, and anticonvulsants for aggression and conduct problems in youth with ADHD, ODD, and CD. Each medication was given an overall quality of evidence rating based on the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Eleven RCTs of antipsychotics and 7 RCTs of lithium and anticonvulsants were included. There is moderate-quality evidence that risperidone has a moderate-to-large effect on conduct problems and aggression in youth with subaverage IQ and ODD, CD, or disruptive behaviour disorder not otherwise specified, with and without ADHD, and high-quality evidence that risperidone has a moderate effect on disruptive and aggressive behaviour in youth with average IQ and ODD or CD, with and without ADHD. Evidence supporting the use of haloperidol, thioridazine, quetiapine, and lithium in aggressive youth with CD is of low or very-low quality, and evidence supporting the use of divalproex in aggressive youth with ODD or CD is of low quality. There is very-low-quality evidence that carbamazepine is no different from placebo for the management of aggression in youth with CD. Conclusion: With the exception of risperidone, the evidence to support the use of antipsychotics and mood stabilizers is of low quality. PMID:25886656

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.

Parent-Child Relations, Conduct Problems and Cigarette Use in Adolescence: Examining the Role of Genetic and Environmental Factors on Patterns of Behavior

ERIC Educational Resources Information Center

Shelton, Katherine H.; Harold, Gordon T.; Fowler, Tom A.; Rice, Frances J.; Neale, Michael C.; Thapar, Anita; van den Bree, Marianne B. M.

2008-01-01

This study investigated genetic and environmental influences on the associations between mother-child relationship quality (warmth and hostility) and adolescent conduct problems and cigarette use. Participants included 601 mothers and adolescent twin pairs (aged 12-17 years). Mothers and adolescents provided separate reports of mother-to-child…

Health problems and stress in Information Technology and Business Process Outsourcing employees.

PubMed

Padma, V; Anand, N N; Gurukul, S M G Swaminatha; Javid, S M A Syed Mohammed; Prasad, Arun; Arun, S

2015-04-01

Stress is high in software profession because of their nature of work, target, achievements, night shift, over work load. 1. To study the demographic profile of the employees. 2. To access the level of job stress and quality of life of the respondents. 3. To study in detail the health problems of the employees. All employees working in IT and BPO industry for more than two years were included into the study. A detailed questionnaire of around 1000 IT and BPO employees including their personal details, stress score by Holmes and Rahe to assess the level of stress and master health checkup profile were taken and the results were analysed. Around 56% had musculoskeletal symptoms. 22% had newly diagnosed hypertension,10% had diabetes, 36% had dyslipidemia, 54% had depression, anxiety and insomnia, 40% had obesity. The stress score was higher in employees who developed diabetes, hypertension and depression. Early diagnosis of stress induced health problems can be made out by stress scores, intense lifestyle modification, diet advice along with psychological counselling would reduce the incidence of health problems in IT sector and improve the quality of work force.

Health problems and stress in Information Technology and Business Process Outsourcing employees

PubMed Central

Padma, V.; Anand, N. N.; Gurukul, S. M. G. Swaminatha; Javid, S. M. A. Syed Mohammed; Prasad, Arun; Arun, S.

2015-01-01

Stress is high in software profession because of their nature of work, target, achievements, night shift, over work load. 1. To study the demographic profile of the employees. 2. To access the level of job stress and quality of life of the respondents. 3. To study in detail the health problems of the employees. All employees working in IT and BPO industry for more than two years were included into the study. A detailed questionnaire of around 1000 IT and BPO employees including their personal details, stress score by Holmes and Rahe to assess the level of stress and master health checkup profile were taken and the results were analysed. Around 56% had musculoskeletal symptoms. 22% had newly diagnosed hypertension,10% had diabetes, 36% had dyslipidemia, 54% had depression, anxiety and insomnia, 40% had obesity. The stress score was higher in employees who developed diabetes, hypertension and depression. Early diagnosis of stress induced health problems can be made out by stress scores, intense lifestyle modification, diet advice along with psychological counselling would reduce the incidence of health problems in IT sector and improve the quality of work force. PMID:26015763

[Witch hunt and hypotheses loss].

PubMed

Köhler, Dieter

2015-12-01

At this time randomized controlled studies (RCT) in clinical trials usually have high quality. But this quality is only true for the included patients (intrinsic validity). It is common to generalize the results to more or less similar patients. This inductive method is prohibited in epistemology what is known for 250 years (D Hume, K R Popper). Therefore the external validity for the data of RCT is low. To solve this problem additional clinical and pathophysiological based data are necessary to generalize the results. Unfortunately RCT show less quality in their premises. This is partly due to the influence of the pharmaceutical industry. A loss of universality of the hypothesis for RCT decreases basically the extrinsic validity. The articles describe this problem with examples. © Georg Thieme Verlag KG Stuttgart · New York.

Depression and associated factors in older adults in South Africa.

PubMed

Peltzer, Karl; Phaswana-Mafuya, Nancy

2013-01-18

Late-life depression is an important public health problem because of its devastating consequences. The study aims to investigate the prevalence and associated factors of self-reported symptom-based depression in a national sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE wave 1) in 2008. We conducted a national population-based cross-sectional study with a probability sample of 3,840 individuals aged 50 years or above in South Africa in 2008. The questionnaire included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements as well as questions on depression symptoms in the past 12 months. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables, and depression. The overall prevalence of symptom-based depression in the past 12 months was 4.0%. In multivariable analysis, functional disability, lack of quality of life, and chronic conditions (angina, asthma, arthritis, and nocturnal sleep problems) were associated with self-reported depression symptoms in the past 12 months. Self-reported depression in older South Africans seems to be a public health problem calling for appropriate interventions to reduce occurrence. Factors identified to be associated with depression, including functional disability, lack of quality of life, and chronic conditions (angina, asthma, arthritis, and nocturnal sleep problems), can be used to guide interventions. The identified protective and risk factors can help in formulating public health care policies to improve quality of life among older adults.

The motivation paradox: higher psychosocial problem levels in severely mentally ill patients are associated with less motivation for treatment.

PubMed

Mulder, Cornelis L; Jochems, E; Kortrijk, H E

2014-04-01

Lack of motivation for treatment makes a subgroup of patients with severe mental illness (SMI) difficult to engage in psychiatric treatment. Such difficult-to-engage patients may also be the most in need of treatment. We hypothesized that the level of psychosocial problems would be inversely related to motivation for treatment. Cross-sectional study in two independent samples. The first sample (n = 294) included SMI patients who participated in a randomized controlled trial and were assessed using the Health of the Nation Outcome Scales (HoNOS) and self-rated and clinician-rated motivation-for-treatment scales. The second sample (n = 1,170) included SMI patients who were treated in Assertive Outreach Teams and were routinely assessed with the HoNOS and a motivation-for-treatment scale. In both samples, patients also self-rated their quality of life. In both samples, patients with HoNOS scores of 16 and higher had lower motivation scores on all motivation scales than patients with lower HoNOS scores, and also a lower quality of life. A motivation paradox seems inherent to this association between higher psychosocial problems levels, less motivation for treatment, and lower quality of life. Such a paradox has clinical relevance, as it may provide an ethical basis for outreach services which aim to engage marginally motivated SMI patients with severe psychosocial problems into mental health care.

Evaluation of Genetic Algorithm Concepts Using Model Problems. Part 2; Multi-Objective Optimization

NASA Technical Reports Server (NTRS)

Holst, Terry L.; Pulliam, Thomas H.

2003-01-01

A genetic algorithm approach suitable for solving multi-objective optimization problems is described and evaluated using a series of simple model problems. Several new features including a binning selection algorithm and a gene-space transformation procedure are included. The genetic algorithm is suitable for finding pareto optimal solutions in search spaces that are defined by any number of genes and that contain any number of local extrema. Results indicate that the genetic algorithm optimization approach is flexible in application and extremely reliable, providing optimal results for all optimization problems attempted. The binning algorithm generally provides pareto front quality enhancements and moderate convergence efficiency improvements for most of the model problems. The gene-space transformation procedure provides a large convergence efficiency enhancement for problems with non-convoluted pareto fronts and a degradation in efficiency for problems with convoluted pareto fronts. The most difficult problems --multi-mode search spaces with a large number of genes and convoluted pareto fronts-- require a large number of function evaluations for GA convergence, but always converge.

Did Better Colleges Bring Better Jobs? Estimating the Effects of College Quality on Initial Employment for College Graduates in China

ERIC Educational Resources Information Center

Yu, Li

2017-01-01

The unemployment problem of college students in China has drawn much attention from academics and society. Using the 2011 College Student Labor Market (CSLM) survey data from Tsinghua University, this paper estimated the effects of college quality on initial employment, including employment status and employment unit ownership for fresh college…

[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 elaborated. Copyright© by the Chinese Pharmaceutical Association.

How to Begin a Quality Improvement Project.

PubMed

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

2016-05-06

Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management. Stakeholder mapping and analysis are useful tools at this stage, and these are reviewed to help identify individuals who might have a vested interest in the project. Physician engagement is a particularly important component of project success, and the knowledge that patients/caregivers can offer as members of a quality improvement team should not be overlooked. After a team is formed, an improvement framework helps to organize the scientific process of system change. Common quality improvement frameworks include Six Sigma, Lean, and the Model for Improvement. These models are contrasted, with a focus on the Model for Improvement, because it is widely used and applicable to a variety of quality of care problems without advanced training. It involves three steps: setting aims to focus improvement, choosing a balanced set of measures to determine if improvement occurs, and testing new ideas to change the current process. These new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained by testing changes and reflecting on their effect. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). This provides an example that kidney health care professionals can use to begin their own quality improvement projects. Copyright © 2016 by the American Society of Nephrology.

How to Begin a Quality Improvement Project

PubMed Central

Harel, Ziv; McQuillan, Rory; Weizman, Adam V.; Thomas, Alison; Chertow, Glenn M.; Nesrallah, Gihad; Bell, Chaim M.; Chan, Christopher T.

2016-01-01

Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management. Stakeholder mapping and analysis are useful tools at this stage, and these are reviewed to help identify individuals who might have a vested interest in the project. Physician engagement is a particularly important component of project success, and the knowledge that patients/caregivers can offer as members of a quality improvement team should not be overlooked. After a team is formed, an improvement framework helps to organize the scientific process of system change. Common quality improvement frameworks include Six Sigma, Lean, and the Model for Improvement. These models are contrasted, with a focus on the Model for Improvement, because it is widely used and applicable to a variety of quality of care problems without advanced training. It involves three steps: setting aims to focus improvement, choosing a balanced set of measures to determine if improvement occurs, and testing new ideas to change the current process. These new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained by testing changes and reflecting on their effect. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). This provides an example that kidney health care professionals can use to begin their own quality improvement projects. PMID:27016497

Patient safety is not enough: targeting quality improvements to optimize the health of the population.

PubMed

Woolf, Steven H

2004-01-06

Ensuring patient safety is essential for better health care, but preoccupation with niches of medicine, such as patient safety, can inadvertently compromise outcomes if it distracts from other problems that pose a greater threat to health. The greatest benefit for the population comes from a comprehensive view of population needs and making improvements in proportion with their potential effect on public health; anything less subjects an excess of people to morbidity and death. Patient safety, in context, is a subset of health problems affecting Americans. Safety is a subcategory of medical errors, which also includes mistakes in health promotion and chronic disease management that cost lives but do not affect "safety." These errors are a subset of lapses in quality, which result not only from errors but also from systemic problems, such as lack of access, inequity, and flawed system designs. Lapses in quality are a subset of deficient caring, which encompasses gaps in therapeutics, respect, and compassion that are undetected by normative quality indicators. These larger problems arguably cost hundreds of thousands more lives than do lapses in safety, and the system redesigns to correct them should receive proportionately greater emphasis. Ensuring such rational prioritization requires policy and medical leaders to eschew parochialism and take a global perspective in gauging health problems. The public's well-being requires policymakers to view the system as a whole and consider the potential effect on overall population health when prioritizing care improvements and system redesigns.

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.

Associations among everyday stress, critical life events, and sexual problems.

PubMed

Bodenmann, Guy; Ledermann, Thomas; Blattner, Denise; Galluzzo, Claudia

2006-07-01

This study addresses the question of how stress is linked to sexual problems among women and men in close relationships. Psychological symptoms, relationship quality, internal daily stress (i.e., originating within the couple such as conflicts, worry for the partner), external daily stress (i.e., stress arising outside the couple such as job stress, stressful relatives, and so forth), and critical life events were examined with regard to their association with different sexual problems. The results support the hypotheses that (1) there is an incremental effect of stress on sexual problems after controlling for psychological symptoms and relationship quality, and that (2) it is primarily internal daily stress and in some cases critical life events rather than external daily stress that are related to sexual problems, particularly hypoactive sexual desire in women and men, sexual aversion in women, vaginismus in women, and premature ejaculation in men. Our findings indicate that the treatment of these sexual problems should address relationship issues and include a focus on helping individuals improve their stress management skills within their couple relationship.

An Analysis of the Status of Curriculum Reform and Textbook Production in Indonesia.

ERIC Educational Resources Information Center

Theisen, Gary; And Others

Curriculum reform in Indonesia during the past 2 decades has been marked by several themes. These themes include an increased emphasis on educational outcomes, greater standardization in instructional practices, improved teacher quality, and increased locally relevant curricula. Some problems recognized include an overloading of instructional time…

Remote sensing applications of wildland fire and air quality in China

Treesearch

John J. Qu; Xianjun Hao; Yongqiang Liu; Allen R. Riebau; Haoruo Yi; Xianlin Qin

2009-01-01

As one of the most populous and geographically largest countries, China faces many problems including industrial growth, economic sustainability, food security, climate change, and air pollution. Interwoven with these challenges,...

Problem solving, loneliness, depression levels and associated factors in high school adolescents.

PubMed

Sahin, Ummugulsum; Adana, Filiz

2016-01-01

To determine problem solving, loneliness, depression levels and associated factors in high school adolescents. This cross-sectional study was conducted in a city west of Turkey (Bursa) in a public high school and the population was 774 and the sampling was 394 students. Students to be included in the study were selected using the multiple sampling method. A personal Information Form with 23 questions, Problem Solving Inventory (PSI), Loneliness Scale (UCLA), Beck Depression Inventory (BDI) were used as data collection tools in the study. Basic statistical analyses, t-test, Kruskall Wallis-H, One Way Anova and Pearson Correlation test were used to evaluate the data. Necessary permissions were obtained from the relevant institution, students, parents and the ethical committee. The study found significant differences between "problem solving level" and family type, health assessment, life quality and mothers', fathers' siblings' closeness level; between "loneliness level" and gender, family income, health assessment, life quality and mothers', fathers', siblings' closeness level; between "depression level" and life quality, family income, fathers' closeness level. Unfavorable socio-economic and cultural conditions can have an effect on the problem solving, loneliness and depression levels of adolescents. Providing structured education to adolescents at risk under school mental health nursing practices is recommended.

The Pharmacological Management of Oppositional Behaviour, Conduct Problems, and Aggression in Children and Adolescents With Attention-Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder: A Systematic Review and Meta-Analysis. Part 1: Psychostimulants, Alpha-2 Agonists, and Atomoxetine

PubMed Central

Pringsheim, Tamara; Hirsch, Lauren; Gardner, David; Gorman, Daniel A

2015-01-01

Objective: Children with attention-deficit hyperactivity disorder (ADHD) may have oppositional behaviour, conduct problems, and aggression. These symptoms vary in severity, and may be related to a comorbid diagnosis of oppositional defiant disorder (ODD) or conduct disorder (CD). Critical evaluation of the efficacy of ADHD medications may guide the clinician regarding the usefulness of medications for these symptoms. Method: We performed a systematic review and meta-analysis of psychostimulants, alpha-2 agonists, and atomoxetine for oppositional behaviour, conduct problems, and aggression in youth with ADHD, ODD, and CD. The quality of evidence for medications was rated using the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Two systematic reviews and 20 randomized controlled trials were included. There is high-quality evidence that psychostimulants have a moderate-to-large effect on oppositional behaviour, conduct problems, and aggression in youth with ADHD, with and without ODD or CD. There is very-low-quality evidence that clonidine has a small effect on oppositional behaviour and conduct problems in youth with ADHD, with and without ODD or CD. There is moderate-quality evidence that guanfacine has a small-to-moderate effect on oppositional behaviour in youth with ADHD, with and without ODD. There is high-quality evidence that atomoxetine has a small effect on oppositional behaviour in youth with ADHD, with and without ODD or CD. Conclusions: Evidence indicates that psychostimulants, alpha-2 agonists, and atomoxetine can be beneficial for disruptive and aggressive behaviours in addition to core ADHD symptoms; however, psychostimulants generally provide the most benefit. PMID:25886655

The pharmacological management of oppositional behaviour, conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder: a systematic review and meta-analysis. Part 1: psychostimulants, alpha-2 agonists, and atomoxetine.

PubMed

Pringsheim, Tamara; Hirsch, Lauren; Gardner, David; Gorman, Daniel A

2015-02-01

Children with attention-deficit hyperactivity disorder (ADHD) may have oppositional behaviour, conduct problems, and aggression. These symptoms vary in severity, and may be related to a comorbid diagnosis of oppositional defiant disorder (ODD) or conduct disorder (CD). Critical evaluation of the efficacy of ADHD medications may guide the clinician regarding the usefulness of medications for these symptoms. We performed a systematic review and meta-analysis of psychostimulants, alpha-2 agonists, and atomoxetine for oppositional behaviour, conduct problems, and aggression in youth with ADHD, ODD, and CD. The quality of evidence for medications was rated using the Grading of Recommendations Assessment, Development and Evaluation approach. Two systematic reviews and 20 randomized controlled trials were included. There is high-quality evidence that psychostimulants have a moderate-to-large effect on oppositional behaviour, conduct problems, and aggression in youth with ADHD, with and without ODD or CD. There is very-low-quality evidence that clonidine has a small effect on oppositional behaviour and conduct problems in youth with ADHD, with and without ODD or CD. There is moderate-quality evidence that guanfacine has a small-to-moderate effect on oppositional behaviour in youth with ADHD, with and without ODD. There is high-quality evidence that atomoxetine has a small effect on oppositional behaviour in youth with ADHD, with and without ODD or CD. Evidence indicates that psychostimulants, alpha-2 agonists, and atomoxetine can be beneficial for disruptive and aggressive behaviours in addition to core ADHD symptoms; however, psychostimulants generally provide the most benefit.

Set-up of a decision support system to support sustainable development of the Laguna de Bay, Philippines.

PubMed

Nauta, Tjitte A; Bongco, Alicia E; Santos-Borja, Adelina C

2003-01-01

Over recent decades, population expansion, deforestation, land conversion, urbanisation, intense fisheries and industrialisation have produced massive changes in the Laguna de Bay catchment, Philippines. The resulting problems include rapid siltation of the lake, eutrophication, inputs of toxics, flooding problems and loss of biodiversity. Rational and systematic resolution of conflicting water use and water allocation interests is now urgently needed in order to ensure sustainable use of the water resources. With respect to the competing and conflicting pressures on the water resources, the Laguna Lake Development Authority (LLDA) needs to achieve comprehensive management and development of the area. In view of these problems and needs, the Government of the Netherlands was funding a two-year project entitled 'Sustainable Development of the Laguna de Bay Environment'.A comprehensive tool has been developed to support decision-making at catchment level. This consists of an ArcView GIS-database linked to a state-of-the-art modelling suite, including hydrological and waste load models for the catchment area and a three-dimensional hydrodynamic and water quality model (Delft3D) linked to a habitat evaluation module for the lake. In addition, MS Office based tools to support a stakeholder analysis and financial and economic assessments have been developed. The project also focused on technical studies relating to dredging, drinking water supply and infrastructure works. These aimed to produce technically and economically feasible solutions to water quantity and quality problems. The paper also presents the findings of a study on the development of polder islands in the Laguna de Bay, addressing the water quantity and quality problems and focusing on the application of the decision support system.

Effects of a Problem-Solving Intervention (COPE) on Quality of Life for Patients with Advanced Cancer on Clinical Trials and their Caregivers: Simultaneous Care Educational Intervention (SCEI): Linking Palliation and Clinical Trials

PubMed Central

Carducci, Michael; Loscalzo, Matthew J.; Linder, John; Greasby, Tamara; Beckett, Laurel A.

2011-01-01

Abstract Context Patients on investigational clinical trials and their caregivers experience poor quality of life (QOL), which declines as the disease progresses. Objective To examine the effect of a standardized cognitive–behavioral problem-solving educational intervention on the QOL of patients enrolled on investigational clinical trials and their caregivers. Design Prospective, multi-institution, randomized trial. QOL was measured repeatedly over 6 months. Participants Patients were simultaneously enrolled onto phase 1, 2, or 3 Institutional Review Board (IRB)-approved cancer clinical trials. Intervention Intervention arm dyads participated in three conjoint educational sessions during the first month, learning the COPE problem solving model. Nonintervention arm dyads received usual care. Outcome Measures Global QOL was measured by the City of Hope Quality of Life Instruments for Patients or Caregivers; problem solving skills were measured by the Social Problem Solving Inventory-Revised. Results The results are reported using the CONSORT statement. The analytic data set included 476 dyads including 1596 patient data points and 1576 care giver data points. Patient QOL showed no significant difference in the rate of change between the intervention and usual care arms (p = 0.70). Caregiver QOL scores in the intervention arm declined, but at less than half the rate in the control arm (p = 0.02). Conclusions The COPE intervention enabled the average caregiver to come much closer to stable QOL over the 6-month follow-up. Future studies should enroll subjects much earlier in the cancer illness trajectory, a common patient/caregiver theme. The maximum effect was seen in caregivers who completed the 6-month follow-up, suggesting that the impact may increase over time. PMID:21413846

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.

Scripted Collaboration in Serious Gaming for Complex Learning: Effects of Multiple Perspectives when Acquiring Water Management Skills

ERIC Educational Resources Information Center

Hummel, Hans G. K.; van Houcke, Jasper; Nadolski, Rob J.; van der Hiele, Tony; Kurvers, Hub; Lohr, Ansje

2011-01-01

This paper examines how learning outcomes from playing serious games can be enhanced by including scripted collaboration in the game play. We compared the quality of advisory reports, that students in the domain of water management had to draw up for an authentic case problem, both before and after collaborating on the problem with (virtual) peer…

Quality of life in head and neck cancer survivors: a cross-sectional survey.

PubMed

Chaukar, Devendra A; Walvekar, Rohan R; Das, Ashok K; Deshpande, Mandar S; Pai, Prathamesh S; Chaturvedi, Pankaj; Kakade, Anagha; D'Cruz, Anil K

2009-01-01

Head and neck cancer (HNC) survivors have substantial psychological distress in addition to treatment-related side effects. This study examines the long-term quality of life (QOL) of HNC survivors in a busy tertiary care center. A prospective, cross-sectional survey was conducted studying 212 HNC survivors 1 year after completion of their treatment at a tertiary cancer center. Quality of life assessments were performed using the 2 standardized health-related QOL questionnaires: The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and The Quality of Life Questionnaire Head and Neck Cancer Module. The overall global QOL rating for the study cohort was satisfactory. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 scores showed that the domains where most patients faired poorly included financial difficulties (54%), appetite loss (36%), fatigue (33%), and cough (30%). The Quality of Life Questionnaire Head and Neck Cancer Module scale identified the domains with poor scores to be dry mouth (64%), dental problems (42%), sticky saliva (40%), cough (39%), and problems with mouth opening (32%). Patients with early-stage tumors and those treated with surgery alone had significantly better QOL scores when compared with advanced stage tumors and patients receiving either radiation alone or multimodality treatment, respectively. Quality of life questionnaires provide a medium for patients to effectively communicate with their physician in a busy tertiary care facility and provide an insight into the physical, psychological, and social problems affecting our patients which can then direct future interventions.

The North East Regional Conference on Quality Educational Standards in Teaching. Summary Findings (Albany, March 7-8, 1969). QuEST Report Series, #1.

ERIC Educational Resources Information Center

American Federation of Teachers, Washington, DC.

This booklet reports a workshop conference sponsored by the American Federation of Teachers (AFT) Council for Quality Educational Standards in Teaching (QuEST) to involve delegates from locals in clarifying and solving professional problems. Summary of the workshop on "The Diffuclut Child" includes description of the effects of disruptive children…

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.

Research design in end-of-life research: state of science.

PubMed

George, Linda K

2002-10-01

The volume of research on end-of-life care, death, and dying has exploded during the past decade. This article reviews the conceptual and methodological adequacy of end-of-life research to date, focusing on limitations of research to date and ways of improving future research. A systematic search was conducted to identify the base of end-of-life research. Approximately 400 empirical articles were identified and are the basis of this review. Although much has been learned from research to date, limitations in the knowledge base are substantial. The most fundamental problems identified are conceptual and include failure to define dying; neglect of the distinctions among quality of life, quality of death, and quality of end-of-life care. Methodologically, the single greatest problem is the lack of longitudinal studies that cover more than the time period immediately before death. Gaps in the research base include insufficient attention to psychological and spiritual issues, the prevalence of psychiatric disorder and the effectiveness of the treatment of such disorders among dying persons, provider and health system variables, social and cultural diversity, and the effects of comorbidity on trajectories of dying.

Selection and application of microbial source tracking tools for water-quality investigations

USGS Publications Warehouse

Stoeckel, Donald M.

2005-01-01

Microbial source tracking (MST) is a complex process that includes many decision-making steps. Once a contamination problem has been defined, the potential user of MST tools must thoroughly consider study objectives before deciding upon a source identifier, a detection method, and an analytical approach to apply to the problem. Regardless of which MST protocol is chosen, underlying assumptions can affect the results and interpretation. It is crucial to incorporate tests of those assumptions in the study quality-control plan to help validate results and facilitate interpretation. Detailed descriptions of MST objectives, protocols, and assumptions are provided in this report to assist in selection and application of MST tools for water-quality investigations. Several case studies illustrate real-world applications of MST protocols over a range of settings, spatial scales, and types of contamination. Technical details of many available source identifiers and detection methods are included as appendixes. By use of this information, researchers should be able to formulate realistic expectations for the information that MST tools can provide and, where possible, successfully execute investigations to characterize sources of fecal contamination to resource waters.

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

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.

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 reserved.

Evolutions of Advanced Stamping CAE — Technology Adventures and Business Impact on Automotive Dies and Stamping

NASA Astrophysics Data System (ADS)

Wang, Chuantao (C. T.)

2005-08-01

In the past decade, sheet metal forming and die development has been transformed to a science-based and technology-driven engineering and manufacturing enterprise from a tryout-based craft. Stamping CAE, especially the sheet metal forming simulation, as one of the core components in digital die making and digital stamping, has played a key role in this historical transition. The stamping simulation technology and its industrial applications have greatly impacted automotive sheet metal product design, die developments, die construction and tryout, and production stamping. The stamping CAE community has successfully resolved the traditional formability problems such as splits and wrinkles. The evolution of the stamping CAE technology and business demands opens even greater opportunities and challenges to stamping CAE community in the areas of (1) continuously improving simulation accuracy, drastically reducing simulation time-in-system, and improving operationalability (friendliness), (2) resolving those historically difficult-to-resolve problems such as dimensional quality problems (springback and twist) and surface quality problems (distortion and skid/impact lines), (3) resolving total manufacturability problems in line die operations including blanking, draw/redraw, trim/piercing, and flanging, and (4) overcoming new problems in forming new sheet materials with new forming techniques. In this article, the author first provides an overview of the stamping CAE technology adventures and achievements, and industrial applications in the past decade. Then the author presents a summary of increasing manufacturability needs from the formability to total quality and total manufacturability of sheet metal stampings. Finally, the paper outlines the new needs and trends for continuous improvements and innovations to meet increasing challenges in line die formability and quality requirements in automotive stamping.

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.

Draft framework for watershed-based trading

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

NONE

1996-05-30

Effluent trading is an innovative way for water quality agencies and community stakeholders to develop common-sense, cost-effective solutions for water quality problems in their watersheds. Trading can allow communities to grow and prosper while retaining their commitment to water quality. The bulk of this framework discusses effluent trading in watersheds. Remaining sections discuss transactions that, while not technically fulfilling the definition of `effluent` trade, do involve the exchange of valued water quality or other ecological improvements between partners responding to market initiatives. This document therefore includes activities such as trades within a facility (intra-plant trading) and wetland mitigation banking, effluentmore » trading/watersheds/watershed management/water quality protection/water quality management.« less

[Application progress on near infrared spectroscopy in quality control and process monitoring of traditional Chinese medicine].

PubMed

Li, Wenlong; Qu, Haibin

2017-01-25

The industry of traditional Chinese medicine (TCM) encounters problems like quality fluctuation of raw materials and unstandardized production process. Near infrared (NIR) spectroscopy technology is widely used in quality control of TCM because of its abundant information, fast and nondestructive characters. The main applications include quantitative analysis of Chinese medicinal materials, intermediates and Chinese patent medicines; the authenticity of TCM, species, origins and manufacturers; monitoring and control of the extraction, alcohol precipitation, column chromatography and blending process. This article reviews the progress on the application of NIR spectroscopy technology in TCM field. In view of the problems existing in the application, the article proposes that the standardization of NIR analysis method should be developed according to specific characteristics of TCM, which will promote the application of NIR technology in the TCM industry.

A non-linear optimization programming model for air quality planning including co-benefits for GHG emissions.

PubMed

Turrini, Enrico; Carnevale, Claudio; Finzi, Giovanna; Volta, Marialuisa

2018-04-15

This paper introduces the MAQ (Multi-dimensional Air Quality) model aimed at defining cost-effective air quality plans at different scales (urban to national) and assessing the co-benefits for GHG emissions. The model implements and solves a non-linear multi-objective, multi-pollutant decision problem where the decision variables are the application levels of emission abatement measures allowing the reduction of energy consumption, end-of pipe technologies and fuel switch options. The objectives of the decision problem are the minimization of tropospheric secondary pollution exposure and of internal costs. The model assesses CO 2 equivalent emissions in order to support decision makers in the selection of win-win policies. The methodology is tested on Lombardy region, a heavily polluted area in northern Italy. Copyright © 2017 Elsevier B.V. All rights reserved.

[Physical and technical quality assurance in German breast cancer screening: progress report of the Reference Center Muenster after three years].

PubMed

Sommer, A; Girnus, R; Wendt, B; Czwoydzinski, J; Wüstenbecker, C; Heindel, W; Lenzen, H

2009-05-01

German breast cancer screening is monitored by a large physical quality assurance program. This report refers to the first experiences of the Reference Center (RC) Muenster after three years of the technical quality control of digital and analog mammography units (MU). This paper also shows whether the presently used quality assurance (QA) method is able to ensure that the MUs in the screening program are functioning without any serious problems. RC Muenster supervises 95 units (May 2008). The daily, weekly and monthly quality assurance of these units is controlled by web-based QA software named "MammoConrol" and developed by RC Muenster. The annual QA for the units must be conducted in the form of an on-site inspection by medical physics experts of the RC and is scored by an objective ranking system. The results of these QA routines were evaluated and analyzed for this paper. During the period from 3/1/2006 to 5/31/2008, 8 % of the analog systems and 1 % of the digital systems exhibited problems in the daily QA. For 9 % of the analog MUs and 17 % of the digital MUs, failures appeared in the monthly QA. In the annual control, 86.7 % of the analog units exhibited slight problems and 13.3 % had serious problems. With respect to the digital units, 12 % were without any defects, 58 % had slight problems, 27 % had serious failures and 3 % had to be reported to the responsible authorities and were temporarily shut down. The special quality control requirements for German breast cancer screening, including annual on-site checks of the units, have shown in the last three years that QA with a high monitoring standard can be ensured for a large number of decentralized MUs. The currently used QA method sufficiently ensures that the screening program is technically safe. Further studies must show whether the density and focus of the QA measures must be reconfigured.

Determinants of Marital Quality in an Arranged Marriage Society

PubMed Central

Allendorf, Keera

2013-01-01

Drawing on a uniquely large number of items on marital quality, this study explores the determinants of marital quality in Chitwan Valley, Nepal. Marital quality is measured with five dimensions identified through exploratory factor analysis, including satisfaction, communication, togetherness, problems, and disagreements. Gender, education, and spouse choice emerge as the most important determinants of these dimensions of marital quality. Specifically, men, those with more schooling, and those who participated in the choice of their spouse have higher levels of marital quality. By contrast, caste, occupation, age at marriage, marital duration, and number of children have little to no association with marital quality. While gender, education, and spouse choice emerge as key determinants of marital quality in this context, the majority of variation in marital quality remains unexplained. PMID:23146598

Mind wandering, sleep quality, affect and chronotype: an exploratory study.

PubMed

Carciofo, Richard; Du, Feng; Song, Nan; Zhang, Kan

2014-01-01

Poor sleep quality impairs cognition, including executive functions and concentration, but there has been little direct research on the relationships between sleep quality and mind wandering or daydreaming. Evening chronotype is associated with poor sleep quality, more mind wandering and more daydreaming; negative affect is also a mutual correlate. This exploratory study investigated how mind wandering and daydreaming are related to different aspects of sleep quality, and whether sleep quality influences the relationships between mind wandering/daydreaming and negative affect, and mind wandering/daydreaming and chronotype. Three surveys (Ns = 213; 190; 270) were completed with Chinese adults aged 18-50, including measures of sleep quality, daytime sleepiness, mind wandering, daydreaming, chronotype and affect (positive and negative). Higher frequencies of mind wandering and daydreaming were associated with poorer sleep quality, in particular with poor subjective sleep quality and increased sleep latency, night-time disturbance, daytime dysfunction and daytime sleepiness. Poor sleep quality was found to partially mediate the relationships between daydreaming and negative affect, and mind wandering and negative affect. Additionally, low positive affect and poor sleep quality, in conjunction, fully mediated the relationships between chronotype and mind wandering, and chronotype and daydreaming. The relationships between mind wandering/daydreaming and positive affect were also moderated by chronotype, being weaker in those with a morning preference. Finally, while daytime sleepiness was positively correlated with daydream frequency, it was negatively correlated with a measure of problem-solving daydreams, indicating that more refined distinctions between different forms of daydreaming or mind wandering are warranted. Overall, the evidence is suggestive of a bi-directional relationship between poor sleep quality and mind wandering/daydreaming, which may be important in attempts to deal with sleep problems and improve sleep quality. These findings and further research on this topic may also have implications for definitions and theories of mind wandering and daydreaming.

Mind Wandering, Sleep Quality, Affect and Chronotype: An Exploratory Study

PubMed Central

Carciofo, Richard; Du, Feng; Song, Nan; Zhang, Kan

2014-01-01

Poor sleep quality impairs cognition, including executive functions and concentration, but there has been little direct research on the relationships between sleep quality and mind wandering or daydreaming. Evening chronotype is associated with poor sleep quality, more mind wandering and more daydreaming; negative affect is also a mutual correlate. This exploratory study investigated how mind wandering and daydreaming are related to different aspects of sleep quality, and whether sleep quality influences the relationships between mind wandering/daydreaming and negative affect, and mind wandering/daydreaming and chronotype. Three surveys (Ns = 213; 190; 270) were completed with Chinese adults aged 18–50, including measures of sleep quality, daytime sleepiness, mind wandering, daydreaming, chronotype and affect (positive and negative). Higher frequencies of mind wandering and daydreaming were associated with poorer sleep quality, in particular with poor subjective sleep quality and increased sleep latency, night-time disturbance, daytime dysfunction and daytime sleepiness. Poor sleep quality was found to partially mediate the relationships between daydreaming and negative affect, and mind wandering and negative affect. Additionally, low positive affect and poor sleep quality, in conjunction, fully mediated the relationships between chronotype and mind wandering, and chronotype and daydreaming. The relationships between mind wandering/daydreaming and positive affect were also moderated by chronotype, being weaker in those with a morning preference. Finally, while daytime sleepiness was positively correlated with daydream frequency, it was negatively correlated with a measure of problem-solving daydreams, indicating that more refined distinctions between different forms of daydreaming or mind wandering are warranted. Overall, the evidence is suggestive of a bi-directional relationship between poor sleep quality and mind wandering/daydreaming, which may be important in attempts to deal with sleep problems and improve sleep quality. These findings and further research on this topic may also have implications for definitions and theories of mind wandering and daydreaming. PMID:24609107

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.

MANAGEMENT OF COMBINED SEWER OVERFLOW: RESEARCH PROGRAM CAPSTONE

EPA Science Inventory

Combined-sewer overflow (CSO) is a mixture of urban storm drainage, municipal-industrial wastewater, and subterranean infiltration. Untreated discharges of CSOs have caused substantial pollution impacts on the quality of receiving-water bodies. Problem constituents include visi...

MANAGEMENT OF COMBINED SEWER OVERFLOW RESEARCH PROGRAM CAPSTONE

EPA Science Inventory

Combined-sewer overflow (CSO) is a mixture of urban storm drainage, municipal-industrial wastewater, and subterranean infiltration. Untreated discharges of CSOs have caused substantial pollution impacts on the quality of receiving-water bodies. Problem constituents include ...

How good is Google? The quality of otolaryngology information on the internet.

PubMed

Pusz, Max D; Brietzke, Scott E

2012-09-01

To assess the quality of the information a patient (parent) may encounter using a Google search for typical otolaryngology ailments. Cross-sectional study. Tertiary care center. A Google keyword search was performed for 10 common otolaryngology problems including ear infection, hearing loss, tonsillitis, and so on. The top 10 search results for each were critically examined using the 16-item (1-5 scale) standardized DISCERN instrument. The DISCERN instrument was developed to assess the quality and comprehensiveness of patient treatment choice literature. A total of 100 Web sites were assessed. Of these, 19 (19%) were primarily advertisements for products and were excluded from DISCERN scoring. Searches for more typically chronic otolaryngic problems (eg, tinnitus, sleep apnea, etc) resulted in more biased, advertisement-type results than those for typically acute problems (eg, ear infection, sinus infection, P = .03). The search for "sleep apnea treatment" produced the highest scoring results (mean overall DISCERN score = 3.49, range = 1.81-4.56), and the search for "hoarseness treatment" produced the lowest scores (mean = 2.49, range = 1.56-3.56). Results from major comprehensive Web sites (WebMD, EMedicinehealth.com, Wikipedia, etc.) scored higher than other Web sites (mean DISCERN score = 3.46 vs 2.48, P < .001). There is marked variability in the quality of Web site information for the treatment of common otolaryngologic problems. Searches on more chronic problems resulted in a higher proportion of biased advertisement Web sites. Larger, comprehensive Web sites generally provided better information but were less than perfect in presenting complete information on treatment options.

Person-related factors associated with work participation in employees with health problems: a systematic review.

PubMed

de Wit, Mariska; Wind, Haije; Hulshof, Carel T J; Frings-Dresen, Monique H W

2018-07-01

The objective of this systematic review was to explore and provide systematically assessed information about the association between person-related factors and work participation of people with health problems. The research question was: what is the association between selected person-related factors and work participation of workers with health problems? A systematic review was carried out in PubMed and PsycINFO to search for original papers published between January 2007 and February 2017. The risk of bias of the studies included was assessed using quality assessment tools from the Joanna Briggs Institute. The quality of evidence was assessed using the GRADE framework for prognostic studies. In total, 113 studies were included, all of which addressed the association between person-related factors and work participation. The factors positively associated with work participation were positive expectations regarding recovery or return to work, optimism, self-efficacy, motivation, feelings of control, and perceived health. The factors negatively associated with work participation were fear-avoidance beliefs, perceived work-relatedness of the health problem, and catastrophizing. Different coping strategies had a negative or a positive relationship with work participation. The results of this review provide more insight into the associations between different cognitions and perceptions and work participation. The results of this study suggest that person-related factors should be considered by occupational- and insurance physicians when they diagnose, evaluate or provide treatment to employees. Further research is required to determine how these physicians could obtain and apply such information and whether its application leads to a better quality of care.

Child behavior and sibling relationship quality: A cross-lagged analysis.

PubMed

Pike, Alison; Oliver, Bonamy R

2017-03-01

Bidirectional associations between sibling relationships and children's problem behaviors are robust, and links with prosocial behavior have also been reported. Using cross-lagged models, we were able to conservatively test temporal directions of links between positive and negative aspects of sibling relationships and children's prosocial behavior and conduct problems across a 3-year time span in middle childhood. The Avon Longitudinal Study of Parents and Children (ALSPAC; http://www.bristol.ac.uk/alspac/researchers/data-access/data-dictionary/) is an ongoing population-based study designed to investigate the effects of a wide range of factors on children's health and development. For the purposes of the current analyses, we included 2,043 ALSPAC families who had just 1 older sibling as well as the target child, with an age gap of no more than 5 years. Mothers reported about the quality of the sibling relationship and both children's prosocial behavior and conduct problems when the target child was 4 years of age and again when the target child was 7 years old. Confirming our hypothesis, individual child behavior was predictive of sibling relationship quality, and sibling relationship quality was predictive of later child behavior, providing robust evidence of bidirectionality for both prosocial behavior and conduct problems. It would be consistent to expect that an improvement in either sibling relationship quality or individual children's behavior could have a positive spill over effect. We also found evidence of older sibling dominance in the domain of prosocial behavior and the positive aspects of sibling interaction. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Child Behavior and Sibling Relationship Quality: A Cross-Lagged Analysis

PubMed Central

2016-01-01

Bidirectional associations between sibling relationships and children’s problem behaviors are robust, and links with prosocial behavior have also been reported. Using cross-lagged models, we were able to conservatively test temporal directions of links between positive and negative aspects of sibling relationships and children’s prosocial behavior and conduct problems across a 3-year time span in middle childhood. The Avon Longitudinal Study of Parents and Children (ALSPAC; http://www.bristol.ac.uk/alspac/researchers/data-access/data-dictionary/) is an ongoing population-based study designed to investigate the effects of a wide range of factors on children’s health and development. For the purposes of the current analyses, we included 2,043 ALSPAC families who had just 1 older sibling as well as the target child, with an age gap of no more than 5 years. Mothers reported about the quality of the sibling relationship and both children’s prosocial behavior and conduct problems when the target child was 4 years of age and again when the target child was 7 years old. Confirming our hypothesis, individual child behavior was predictive of sibling relationship quality, and sibling relationship quality was predictive of later child behavior, providing robust evidence of bidirectionality for both prosocial behavior and conduct problems. It would be consistent to expect that an improvement in either sibling relationship quality or individual children’s behavior could have a positive spill over effect. We also found evidence of older sibling dominance in the domain of prosocial behavior and the positive aspects of sibling interaction. PMID:27797540

Status of surface-water modeling in the U.S. Geological Survey

USGS Publications Warehouse

Jennings, Marshall E.; Yotsukura, Nobuhiro

1979-01-01

The U.S. Geological Survey is active in the development and use of models for the analysis of various types of surface-water problems. Types of problems for which models have been, or are being developed, include categories such as the following: (1)specialized hydraulics, (2)flow routing in streams, estuaries, lakes, and reservoirs, (3) sedimentation, (4) transport of physical, chemical, and biological constituents, (5) surface exchange of heat and mass, (6) coupled stream-aquifer flow systems, (7) physical hydrology for rainfall-runoff relations, stream-system simulations, channel geometry, and water quality, (8) statistical hydrology for synthetic streamflows, floods, droughts, storage, and water quality, (9) management and operation problems, and (10) miscellaneous hydrologic problems. Following a brief review of activities prior to 1970, the current status of surface-water modeling is given as being in a developmental, verification, operational, or continued improvement phase. A list of recently published selected references, provides useful details on the characteristics of models.

Hypnosis Intervention Effects on Sleep Outcomes: A Systematic Review.

PubMed

Chamine, Irina; Atchley, Rachel; Oken, Barry S

2018-02-15

Sleep improvement is a promising target for preventing and modifying many health problems. Hypnosis is considered a cost-effective and safe intervention with reported benefits for multiple health conditions. There is a growing body of research assessing the efficacy of hypnosis for various health conditions in which sleep was targeted as a primary or secondary outcome. This review aimed to investigate the effects of hypnosis interventions on sleep, to describe the hypnotic procedures, and to evaluate potential adverse effects of hypnosis. We reviewed studies (prior to January 2017) using hypnosis in adults for sleep problems and other conditions comorbid with sleep problems, with at least one sleep outcome measure. Randomized controlled trials and other prospective studies were included. One hundred thirty-nine nonduplicate abstracts were screened, and 24 of the reviewed papers were included for qualitative analysis. Overall, 58.3% of the included studies reported hypnosis benefit on sleep outcomes, with 12.5% reporting mixed results, and 29.2% reporting no hypnosis benefit; when only studies with lower risk of bias were reviewed the patterns were similar. Hypnosis intervention procedures were summarized and incidence of adverse experiences assessed. Hypnosis for sleep problems is a promising treatment that merits further investigation. Available evidence suggests low incidence of adverse events. The current evidence is limited because of few studies assessing populations with sleep complaints, small samples, and low methodological quality of the included studies. Our review points out some beneficial hypnosis effects on sleep but more high-quality studies on this topic are warranted. © 2018 American Academy of Sleep Medicine

PHIT for Duty, a Personal Health Intervention Tool for Psychological Health and Traumatic Brain Injury

DTIC Science & Technology

2014-04-01

of this project is to help prevent psychological disorders in high-risk individuals with early symptoms of stress, depression , substance use, and...questionnaires in five domains (i.e., stress, anxiety, sleep quality, depression , and alcohol use). An expert system, called the intelligent virtual...problems mentioned were depression , anxiety and sleep issues. Additional post deployment health problems discussed include stress, aggression, social

Quality of herbal medicines: challenges and solutions.

PubMed

Zhang, Junhua; Wider, Barbara; Shang, Hongcai; Li, Xuemei; Ernst, Edzard

2012-01-01

The popularity of herbal medicines has risen worldwide. This increase in usage renders safety issues important. Many adverse events of herbal medicines can be attributed to the poor quality of the raw materials or the finished products. Different types of herbal medicines are associated with different problems. Quality issues of herbal medicines can be classified into two categories: external and internal. In this review, external issues including contamination (e.g. toxic metals, pesticides residues and microbes), adulteration and misidentification are detailed. Complexity and non-uniformity of the ingredients in herbal medicines are the internal issues affecting the quality of herbal medicines. Solutions to the raised problems are discussed. The rigorous implementation of Good Agricultural and Collection Practices (GACP) and Good Manufacturing Practices (GMP) would undoubtedly reduce the risk of external issues. Through the use of modern analytical methods and pharmaceutical techniques, previously unsolved internal issues have become solvable. Standard herbal products can be manufactured from the standard herbal extracts. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

LQAS usefulness in an emergency department.

PubMed

de la Orden, Susana Granado; Rodríguez-Rieiro, Cristina; Sánchez-Gómez, Amaya; García, Ana Chacón; Hernández-Fernández, Tomás; Revilla, Angel Abad; Escribano, Dolores Vigil; Pérez, Paz Rodríguez

2008-01-01

This paper aims to explore lot quality assurance sampling (LQAS) applicability and usefulness in the evaluation of quality indicators in a hospital emergency department (ED) and to determine the degree of compliance with quality standards according to this sampling method. Descriptive observational research in the Hospital General Universitario Gregorio Marañón (HGUGM) emergency department (ED). Patients older than 15 years, diagnosed with dyspnoea, chest pain, urinary tract colic or bronchial asthma attending the HGUGM ED from December 2005 to May 2006, and patients admitted during 2005 with exacerbation of chronic obstructive pulmonary disease or acute meningitis were included in the study. Sample sizes were calculated using LQAS. Different quality indicators, one for each process, were selected. The upper (acceptable quality level (AQL)) and lower thresholds (rejectable quality level (RQL)) were established considering risk alpha = 5 per cent and beta = 20 per cent, and the minimum number of observations required was calculated. It was impossible to reach the necessary sample size for bronchial asthma and urinary tract colic patients. For chest pain, acute exacerbation of chronic obstructive pulmonary disease, and acute meningitis, quality problems were detected. The lot was accepted only for the dyspnoea indicator. The usefulness of LQAS to detect quality problems in the management of health processes in one hospital's ED. The LQAS could complement traditional sampling methods.

Water Resources Research Grant Program project descriptions, fiscal year 1987

USGS Publications Warehouse

,

1987-01-01

This report contains information on the 34 new projects funded by the United States Geological Survey 's Water Resources Research Grant Program in fiscal year 1987 and on 3 projects completed during the year. For the new projects, the report gives the grant number, project title, performing organization, principal investigator(s), and a project description that includes: (1) identification of water related problems and problem-solution approach (2) contribution to problem solution, (3) objectives, and (4) approach. The 34 projects include 12 in the area of groundwater quality problems, 12 in the science and technology of water quality management, 1 in climate variability and the hydrologic cycle, 4 in institutional change in water resources management, and 5 in surface water management. For the three completed projects, the report furnishes the grant number; project title; performing organization; principal investor(s); starting data; data of receipt of final report; and an abstract of the final report. Each project description provides the information needed to obtain a copy of the final report. The report contains tables showing: (1) proposals received according to area of research interest, (2) grant awards and funding according to area of research interest, (3) proposals received according to type of submitting organization, and (4) awards and funding according to type of organization. (Author 's abstract)

Project-based teaching in health informatics: a course on health care quality improvement.

PubMed

Moehr, J R; Berenji, G R; Green, C J; Kagolovsky, Y

2001-01-01

Teaching the skills and knowledge required in health informatics [1] is a challenge because the skill of applying knowledge in real life requires practice. We relate the experience with introducing a practice component to a course in "Health Care Quality Improvement". Working health care professionals were invited to bring an actual quality problem from their place of work and to work alongside students in running the problem through a quality improvement project lifecycle. Multiple technological and process oriented teaching innovations were employed including project sessions in observation rooms, video recording of these sessions, generation of demonstration examples and distance education components. Both students and their collaborators from the work place developed proficiency in applying quality improvement methods as well as in experiencing the realities of group processes, information gaps and organizational constraints. The principles used to achieve high involvement of the whole class, the employed resources and technical support are described. The resulting academic and practical achievements are discussed in relation to the alternative instructional modalities, and with respect to didactic implications for similar endeavors and beyond to other fields such as systems engineering.

Using Community-Based Participatory Research to Identify Environmental Justice Issues in an Inner-City Community and Inform Urban Planning.

PubMed

Mansyur, Carol Leler; Jeng, Hueiwang Anna; Holloman, Erica; DeBrew, Linwood

2016-01-01

The Southeast CARE Coalition has been using community-based participatory research to examine environmental degradation in the Southeast Community, Newport News, Virginia. A survey was developed to collect assessment data. Up to 66% of respondents were concerned about environmental problems in their community. Those with health conditions were significantly more likely to identify specific environmental problems. The top 5 environmental concerns included coal dust, air quality, crime, water quality, and trash. The community-based participatory research process is building community capacity and participation, providing community input into strategic planning, and empowering community members to take control of environmental justice issues in their community.

Organizational management practices for achieving software process improvement

NASA Technical Reports Server (NTRS)

Kandt, Ronald Kirk

2004-01-01

The crisis in developing software has been known for over thirty years. Problems that existed in developing software in the early days of computing still exist today. These problems include the delivery of low-quality products, actual development costs that exceed expected development costs, and actual development time that exceeds expected development time. Several solutions have been offered to overcome out inability to deliver high-quality software, on-time and within budget. One of these solutions involves software process improvement. However, such efforts often fail because of organizational management issues. This paper discusses business practices that organizations should follow to improve their chances of initiating and sustaining successful software process improvement efforts.

The effect of ice skating on psychological well-being and sleep quality of children with visual or hearing impairment.

PubMed

Dursun, Onur Burak; Erhan, Süleyman Erim; Ibiş, Esra Özhan; Esin, Ibrahim Selcuk; Keleş, Sadullah; Şirinkan, Ahmet; Yörük, Özgür; Acar, Ethem; Beyhun, Nazim Ercument

2015-01-01

Physical exercise and sports have a key role in preventing physical and psychiatric problems in children. However, children with a disability often experience difficulty participating in physical activity due to a lack of suitable opportunities. Participation in an accessible sport is particularly important for these children, but studies examining which sports are beneficial for which disability groups are rare. In this study, we assessed the effects of ice skating on the psychological well-being, self-concept, and sleep quality of children with hearing or visual impairment. Forty students (20 visually impaired and 20 hearing impaired) aged 8-16 were included in a regular ice skating programme for three months. We examined the sleep quality, self-concept, and behavioural and emotional states of the children before and after participating in the programme. There was a significant improvement in self-concept, behavioural and emotional problems, and sleep quality (p < 0.05 for each) of the children with hearing impairment. Although the sleep quality (p = 0.019) and emotional problem scores (p = 0.000) of the visually impaired children improved; self-concept, peer relations and hyperactivity scores of these children worsened (p < 0.05 for each). Ice skating is one of the popular sport alternatives that gives children the opportunity to exercise and have fun together. The results of this study revealed that regular ice skating programmes may have positive effects on the psychological well-being of children with hearing impairment. Despite some positive effects, caution must be use when including visually impaired children in ice skating programmes. Generalization of the study's outcomes is limited as the study group were residential students enrolled in special education institutions for children who are blind or deaf. Ice skating is a community-based sport and a popular leisure activity that can also have benefits for people with disabilities. Ice skating and children with hearing impairment: Self-concept, behavioural and emotional problems, and sleep quality of the children with hearing impairment significantly improved after ice skating. Ice skating programmes may be considered as a rehabilitation alternative for children with hearing impairment. Ice skating and children with visual impairment: Caution must be use when including children with visual impairment in ice skating programmes because of possible negative psychological outcomes. Balance exercises before starting the practices on ice should be considered for preventing some possible negative outcomes in children with visual impairment.

Effect of self-acupressure for symptom management: a systematic review.

PubMed

Song, Hyun Jin; Seo, Hyun-Ju; Lee, Heeyoung; Son, Heejeong; Choi, Sun Mi; Lee, Sanghun

2015-02-01

To assess the efficacy and safety of self-administered acupressure to alleviate symptoms of various health problems, including allergic disease, cancer, respiratory disease, dysmenorrhea, perceived stress, insomnia, and sleep disturbances. We searched core, Korean, Chinese, and Japanese databases, including Ovid-MEDLINE, Ovid-EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), six representative electronic Korean medical databases, China National Knowledge Infrastructure (CNKI), and Japan Science and Technology Information Aggregator (J-STAGE). We included randomized controlled trials (RCTs) and quasi-RCTs that examined disease-specific effects or symptom relief, adverse reactions, and quality-of-life (QOL) for self-administered acupressure. Data collection and assessment of the methodological quality of the included studies were conducted by two independent reviewers. Eight RCTs and two quasi-RCTs showed positive effects and safety of self-acupressure therapy in clinically diverse populations. Quality assessment revealed moderate quality for the RCTs, with 50% or more of the trials assessed as presenting a low risk of bias in seven domains. All of the selected 10 studies reported positive effects for primary outcomes of self-acupressure therapy for symptom management, including significant improvements in symptom scores in allergic disease, nausea and vomiting in cancer, symptom scores in respiratory disease, pain symptoms in dysmenorrhea, and stress/fatigue scores and sleep disturbances in healthy people. Our findings suggest that self-administered acupressure shows promise to alleviate the symptoms of various health problems. Therefore, further research with larger samples and methodologically well-designed RCTs is required to establish the efficacy of self-administered acupressure. Copyright © 2014 Elsevier Ltd. All rights reserved.

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.

Space Life Support Technology Applications to Terrestrial Environmental Problems

NASA Technical Reports Server (NTRS)

Schwartzkopf, Steven H.; Sleeper, Howard L.

1993-01-01

Many of the problems now facing the human race on Earth are, in fact, life support issues. Decline of air Quality as a result of industrial and automotive emissions, pollution of ground water by organic pesticides or solvents, and the disposal of solid wastes are all examples of environmental problems that we must solve to sustain human life. The technologies currently under development to solve the problems of supporting human life for advanced space missions are extraordinarily synergistic with these environmental problems. The development of these technologies (including both physicochemical and bioregenerative types) is increasingly focused on closing the life support loop by removing and recycling contaminants and wastes to produce the materials necessary to sustain human life. By so doing, this technology development effort also focuses automatically on reducing resupply logistics requirements and increasing crew safety through increased self-sufficiency. This paper describes several technologies that have been developed to support human life in space and illustrates the applicability of the technologies to environmental problems including environmental remediation and pollution prevention.

42 CFR 422.503 - General provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... activities, the furnishing of services, the quality improvement program, and the administrative and... program, including but not limited to reporting potential issues, investigating issues, conducting self... raised, investigating potential compliance problems as identified in the course of self-evaluations and...

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.

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.

Quality circles in a department of dietetics.

PubMed

Treadwell, D D; Klein, J A

1984-06-01

Quality circles can be an excellent approach to managerial effectiveness in the 1980s. For the Department of Dietetics at Miami Valley Hospital, Dayton , Ohio, quality circles have demonstrated excellent return on investment. Their many benefits include increased productivity, improved employee satisfaction and morale, and cost savings. In order to ensure success, the team needs to be selected carefully and trained thoroughly in problem-solving techniques. Initial meetings should be directed to defining the objectives and code of conduct as well as establishing a trusting environment in which to grow and develop.

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.

Quality of Living: Environmental Viewpoints. Make Up Your Own Mind, Book 3.

ERIC Educational Resources Information Center

Pollis, Adamantia, Ed.

This book is the third in a series of discussion materials, this issue being part of an action project to increase environmental awareness. Over 60 readings are included that cover a wide variety of opinions and interpretations of specific environmental problems and related philosophic issues. Examples of topics discussed include population, land…

Diabetes Care and Treatment Project: A Joslin Telemedicine Initiative

DTIC Science & Technology

2007-10-31

measures include clinical data (e.g. HbA1c , blood pressure, quality of life questionnaires) and secondary outcome measures include economic data (e.g...elevated HbA1c (³ 8.5%). Over 12-months we will measure HbA1c , office BP, and scores on the Problem Areas in Diabetes (PAID) questionnaire and Center

Consequences of Team Charter Quality: Teamwork Mental Model Similarity and Team Viability in Engineering Design Student Teams

ERIC Educational Resources Information Center

Conway Hughston, Veronica

2014-01-01

Since 1996 ABET has mandated that undergraduate engineering degree granting institutions focus on learning outcomes such as professional skills (i.e. solving unstructured problems and working in teams). As a result, engineering curricula were restructured to include team based learning--including team charters. Team charters were diffused into…

Water flow algorithm decision support tool for travelling salesman problem

NASA Astrophysics Data System (ADS)

Kamarudin, Anis Aklima; Othman, Zulaiha Ali; Sarim, Hafiz Mohd

2016-08-01

This paper discuss about the role of Decision Support Tool in Travelling Salesman Problem (TSP) for helping the researchers who doing research in same area will get the better result from the proposed algorithm. A study has been conducted and Rapid Application Development (RAD) model has been use as a methodology which includes requirement planning, user design, construction and cutover. Water Flow Algorithm (WFA) with initialization technique improvement is used as the proposed algorithm in this study for evaluating effectiveness against TSP cases. For DST evaluation will go through usability testing conducted on system use, quality of information, quality of interface and overall satisfaction. Evaluation is needed for determine whether this tool can assists user in making a decision to solve TSP problems with the proposed algorithm or not. Some statistical result shown the ability of this tool in term of helping researchers to conduct the experiments on the WFA with improvements TSP initialization.

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

NASA Technical Reports Server (NTRS)

1972-01-01

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

Air Quality in Megacities: Lessons Learned from Mexico City Field Measurements

NASA Astrophysics Data System (ADS)

Molina, L. T.

2014-12-01

More than half of the world's population now lives in urban areas because of the opportunities for better jobs, access to city services, cultural and educational activities, and a desire for more stimulating human interaction. At the same time, many of these urban centers are expanding rapidly, giving rise to the phenomenon of megacities. In recent decades air pollution has become not only one of the most important environmental problems of megacities, but also presents serious consequences to human health and ecosystems and economic costs to society. Although the progress to date in combating air pollution problems in developed and some developing world megacities has been impressive, many challenges remain including the need to improve air quality while simultaneously mitigating climate change. This talk will present the results and the lessons learned from field measurements conducted in Mexico City Metropolitan Area - one of the world's largest megacities - over the past decade. While each city has its own unique circumstances, the need for an integrated assessment approach in addressing complex environmental problems is the same. There is no single strategy in solving air pollution problems in megacities; a mix of policy measures based on sound scientific findings will be necessary to improve air quality, protect public health, and mitigate climate change.

Real-world implications of apathy among older adults: Independent associations with activities of daily living and quality of life.

PubMed

Tierney, Savanna M; Woods, Steven Paul; Weinborn, Michael; Bucks, Romola S

2018-03-13

Apathy is common in older adults and has been linked to adverse health outcomes. The current study examined whether apathy contributes to problems managing activities of daily living (ADLs) and lower quality of life (QoL) in older adults. Participants included 83 community-dwelling older adults. Apathy was assessed using a composite of the self and family-rating scales from the Frontal Systems Behavioral Scale (FrSBe). A knowledgeable informant completed the Activities of Daily Living Questionnaire (ADLQ), and participants completed the World Health Organization Quality of Life (WHOQol) scale. Nominal logistic regressions controlling for age, anxiety and depression symptoms, chronic medical conditions, and global cognition revealed that higher levels of apathy were significantly associated with a wide range of mild ADL problems. In parallel, a multiple linear regression indicated that greater apathy was significantly associated with lower QoL independent of ADL problems, anxious and depressive symptomology, chronic medical conditions, global cognition and age. Findings suggest that apathy confers an increased risk of problems in the independent management of daily activities and poorer well-being among community-dwelling older adults. Neurobehavioral and pharmacological interventions to improve apathy may have beneficial effects on the daily lives of older adults.

Oral health assessment and mouth care for children and young people receiving palliative care. Part one.

PubMed

Sargeant, Stephanie; Chamley, Carol

2013-03-01

This is the first part of two articles exploring oral health problems and treatments for children receiving palliative care, successful management of which can improve considerably the quality of life for this group of children and young people. Part one includes an adapted oral health assessment tool for use in children and young people with complex and palliative healthcare needs that has the potential to help nurses identify and monitor oral health problems and prevent or minimise oral problems from developing. Part two--to be published next month--focuses on basic oral hygiene and the management of specific oral health problems.

Workplace interventions to prevent work disability in workers on sick leave.

PubMed

van Vilsteren, Myrthe; van Oostrom, Sandra H; de Vet, Henrica C W; Franche, Renée-Louise; Boot, Cécile R L; Anema, Johannes R

2015-10-05

Work disability has serious consequences for individuals as well as society. It is possible to facilitate resumption of work by reducing barriers to return to work (RTW) and promoting collaboration with key stakeholders. This review was first published in 2009 and has now been updated to include studies published up to February 2015. To determine the effectiveness of workplace interventions in preventing work disability among sick-listed workers, when compared to usual care or clinical interventions. We searched the Cochrane Work Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO databases on 2 February 2015. We included randomised controlled trials (RCTs) of workplace interventions that aimed to improve RTW for disabled workers. We only included studies where RTW or conversely sickness absence was reported as a continuous outcome. Two review authors independently extracted data and assessed risk of bias of the studies. We performed meta-analysis where possible, and we assessed the quality of evidence according to GRADE criteria. We used standard methodological procedures expected by Cochrane. We included 14 RCTs with 1897 workers. Eight studies included workers with musculoskeletal disorders, five workers with mental health problems, and one workers with cancer. We judged six studies to have low risk of bias for the outcome sickness absence.Workplace interventions significantly improved time until first RTW compared to usual care, moderate-quality evidence (hazard ratio (HR) 1.55, 95% confidence interval (CI) 1.20 to 2.01). Workplace interventions did not considerably reduce time to lasting RTW compared to usual care, very low-quality evidence (HR 1.07, 95% CI 0.72 to 1.57). The effect on cumulative duration of sickness absence showed a mean difference of -33.33 (95% CI -49.54 to -17.12), favouring the workplace intervention, high-quality evidence. One study assessed recurrences of sick leave, and favoured usual care, moderate-quality evidence (HR 0.42, 95% CI 0.21 to 0.82). Overall, the effectiveness of workplace interventions on work disability showed varying results.In subgroup analyses, we found that workplace interventions reduced time to first and lasting RTW among workers with musculoskeletal disorders more than usual care (HR 1.44, 95% CI 1.15 to 1.82 and HR 1.77, 95% CI 1.37 to 2.29, respectively; both moderate-quality evidence). In studies of workers with musculoskeletal disorders, pain also improved (standardised mean difference (SMD) -0.26, 95% CI -0.47 to -0.06), as well as functional status (SMD -0.33, 95% CI -0.58 to -0.08). In studies of workers with mental health problems, there was a significant improvement in time until first RTW (HR 2.64, 95% CI 1.41 to 4.95), but no considerable reduction in lasting RTW (HR 0.79, 95% CI 0.54 to 1.17). One study of workers with cancer did not find a considerable reduction in lasting RTW (HR 0.88, 95% CI 0.53 to 1.47).In another subgroup analysis, we did not find evidence that offering a workplace intervention in combination with a cognitive behavioural intervention (HR 1.93, 95% CI 1.27 to 2.93) is considerably more effective than offering a workplace intervention alone (HR 1.35, 95% CI 1.01 to 1.82, test for subgroup differences P = 0.17).Workplace interventions did not considerably reduce time until first RTW compared with a clinical intervention in workers with mental health problems in one study (HR 2.65, 95% CI 1.42 to 4.95, very low-quality evidence). We found moderate-quality evidence that workplace interventions reduce time to first RTW, high-quality evidence that workplace interventions reduce cumulative duration of sickness absence, very low-quality evidence that workplace interventions reduce time to lasting RTW, and moderate-quality evidence that workplace interventions increase recurrences of sick leave. Overall, the effectiveness of workplace interventions on work disability showed varying results. Workplace interventions reduce time to RTW and improve pain and functional status in workers with musculoskeletal disorders. We found no evidence of a considerable effect of workplace interventions on time to RTW in workers with mental health problems or cancer.We found moderate-quality evidence to support workplace interventions for workers with musculoskeletal disorders. The quality of the evidence on the effectiveness of workplace interventions for workers with mental health problems and cancer is low, and results do not show an effect of workplace interventions for these workers. Future research should expand the range of health conditions evaluated with high-quality studies.

The Integration of Marketing in Post-Secondary Vocational Education.

ERIC Educational Resources Information Center

O'Connor, Patrick J.; And Others

Marketing can solve problems postsecondary vocational educators face related to enrollment, professional contribution, image, and program quality. Postsecondary vocational education should be aggressively marketed because of its expanding growth and mission. Postsecondary institutions are using various marketing strategies, including activities…

The commuter rail circulator network design problem : formulation, solution methods, and applications

DOT National Transportation Integrated Search

2007-08-01

Commuter rail is increasingly popular as a means to introduce rail transportation to metropolitan transportation systems. The long-term benefits of commuter rail include the addition of capacity to the transportation system, providing a quality commu...

Issues in Water Quality Trading: Perspectives on the Market-Based Approach

EPA Science Inventory

Market mechanisms and incentives can play an important role in addressing environmental problems. Potential advantages of using market-based approaches include reducing the costs of meeting environmental goals and encouraging innovation. One market mechanism that has been promo...

TOXICITY TESTS FOR SEDIMENT QUALITY ASSESSMENTS

EPA Science Inventory

Toxic sediments have contributed to a wide-variety of environmental problems around the world. The observed effects include direct toxic effects to aquatic life, bio-magnification of toxicants in the food chain, and economic impacts. This chapter discusses the use of toxicity...

Strategies for Hard Times in Higher Education.

ERIC Educational Resources Information Center

Desfosses, Louis R.

1996-01-01

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

Effect of leucine-to-methionine substitutions on the diffraction quality of histone chaperone SET/TAF-Ibeta/INHAT crystals.

PubMed

Senda, Miki; Muto, Shinsuke; Horikoshi, Masami; Senda, Toshiya

2008-10-01

One of the most frequent problems in crystallization is poor quality of the crystals. In order to overcome this obstacle several methods have been utilized, including amino-acid substitutions of the target protein. Here, an example is presented of crystal-quality improvement by leucine-to-methionine substitutions. A variant protein with three amino-acid substitutions enabled improvement of the crystal quality of the histone chaperone SET/TAF-Ibeta/INHAT when combined with optimization of the cryoconditions. This procedure improved the resolution of the SET/TAF-Ibeta/INHAT crystals from around 5.5 to 2.3 A without changing the crystallization conditions.

On the road again: patient perspectives on commuting for palliative care.

PubMed

Pesut, Barbara; Robinson, Carole A; Bottorff, Joan L; Fyles, Gillian; Broughton, Sandra

2010-06-01

The aim of this research project was to gain an understanding of the experiences of rural cancer patients who commute to an urban cancer center for palliative care. The study utilized a mixed method design. Fifteen individuals with a palliative designation participated in semi-structured interviews and filled out the Problems and Needs in Palliative Care Questionnaire. Qualitative findings included three major themes: cultures of rural life and care, strategies for commuting, and the effects of commuting. Participants valued their rural lifestyles and gained significant support from their communities. Strategies included preparing for the trip with particular attention to pain management, making the most of time, and maintaining significant relationships. Establishing a routine helped to offset the anxiety of commuting. Commuting was costly but the quality of life and supportive relationships obtained through treatment were significant benefits. Questionnaire data suggested that participants were experiencing a number of problems but few indicated they desired more professional attention to those problems. Rural lifestyles are often an important part of overall well-being and commuting for care is both costly and complex. Health care providers should assist individuals to weigh the relative contributions of staying in their rural locale versus commuting for care to their overall quality of life. Palliative-care individuals in this study indicated a number of ongoing problems but were not inclined to seek further assistance from health care providers in addressing those problems. Clinicians should actively inquire about problems and further research is needed to understand why patients are reluctant to seek help.

Study of generic quality of life in patients operated on for post-prostatectomy incontinence.

PubMed

Holm, Henriette Veiby; Fosså, Sophie D; Hedlund, Hans; Dahl, Alv A

2013-09-01

The relationship between urological and psychosocial variables, and generic quality of life in patients operated on for post-prostatectomy incontinence has hardly been studied, and our aim was to investigate this relationship. Patients who had an artificial urinary sphincter AMS800 (n = 100) implanted between January 2002 and June 2010 were invited to complete a mailed questionnaire covering demographic data including work ability, urinary and sexual function, anxiety/depression, and generic quality of life. Poor quality of life was defined as a score <40 on either the physical or the mental Short Form 12 summary scales. Of 85 compliant patients, 30 (35%) reported poor generic quality of life and 55 (65%) reported better quality of life at a median follow-up time of 26 months (range 6-104 months). The poor quality of life group showed significantly more overall urinary and sexual problems, and more men had undergone surgical revisions compared with the better quality of life group. Levels of anxiety and depression were significantly higher, and work ability was lower in the poor quality of life group. In multivariate logistic regression models, increased level of depression and impaired work ability, inability to reach orgasm, and not recommending the operation remained significantly associated with poor quality of life. Poor generic quality of life after surgery for post-prostatectomy incontinence is more strongly associated with reduced work ability and depression rather than urinary and sexual problems. © 2013 The Japanese Urological Association.

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.

[Employee assistance program].

PubMed

Shima, Satoru; Tanaka, Katsutoshi; Ohba, Sayo

2002-03-01

Recently the EAP has received much attention in Japan. The first EAP service in the US was conducted by employees who had recovered from alcohol problems. In the early days EAP providers focused on addiction, but mainly after 1980 they expanded their service areas to include mental health, marital problems, legal problems and financial problems. In Japan the EAP was first received attention as a counseling resource outside the workplace where employees could seek professional help confidentially, but the main reasons why this system now interests employers are as a risk-management tool and an outsourcing of mental health services, since the growing number of mental health cases in the workplace has been a big issue for employers. Two movements have also contributed to more recognition of the EAP: one is guidelines on compensation for mental health cases in the workplace and the other is guidelines on mental health promotion in the workplace. There are four types of EAP systems: internal EAP, external EAP, combination EAP, and consortium EAP. EAP core technology consists of 8 functions including problem identification, Crisis intervention, Short-term intervention, Consultation with work organization leader. The literature on cost-benefit analysis of the EAP is very limited. Although the available data suggest that the EAP is highly cost-effective, further studies are needed with the sufficient statistical quality. In Japan the most important issues in the EAP are the standardization and quality assurance of EAP services. For this purpose development of a good educational system for EAP professionals is needed.

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.

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

PubMed

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

2008-10-01

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

Creation of a synthetic indicator of quality of care as a clinical management standard in primary care.

PubMed

Coma, Ermengol; Ferran, Manel; Méndez, Leonardo; Iglesias, Begoña; Fina, Francesc; Medina, Manuel

2013-12-01

The development of electronic medical records has allowed the creation of new quality indicators in healthcare. Among them, synthetic indicators facilitate global interpretation of results and comparisons between professionals. A healthcare quality standard (EQA, the Catalan acronym for Estàndard de Qualitat Assistencial) was constructed to serve as a synthetic indicator to measure the quality of care provided by primary care professionals in Catalonia (Spain). The project phases were to establish the reference population; select health problems to be included; define, select and deliberate about subindicators; and construct and publish the EQA. Construction of the EQA involved 107 healthcare professionals, and 91 health problems were included. In addition, 133 experts were consulted, who proposed a total of 339 indicators. After systematic paired comparison, 61 indicators were selected to create the synthetic indicator. The EQA is now calculated on a monthly basis for more than 8000 healthcare professionals using an automated process that extracts data from electronic medical records; results are published on a follow-up website. Along with the use of the online EQA results tool, there has been an ongoing improvement in most of the quality of care indicators. Creation of the EQA has proven to be useful for the measurement of the quality of care of primary care services. Also an improvement trend over 5 years is shown across most of the measured indicators. The online version of this article (doi:10.1186/2193-1801-2-51) contains supplementary material, which is available to authorized users.

Perceived Neighborhood Safety Is Associated with Poor Sleep Health among Gay, Bisexual, and Other Men Who Have Sex with Men in Paris, France.

PubMed

Duncan, Dustin T; Park, Su Hyun; Goedel, William C; Kreski, Noah T; Morganstein, Jace G; Hambrick, H Rhodes; Jean-Louis, Girardin; Chaix, Basile

2017-06-01

Recent studies have examined sleep health among men who have sex with men (MSM), but no studies have examined associations of neighborhood characteristics and sleep health among this population. The purpose of this study was to examine associations between perceived neighborhood safety and sleep health among a sample of MSM in Paris, France. We placed broadcast advertisements on a popular smartphone application for MSM in October 2016 to recruit users in the Paris (France) metropolitan area (n = 580). Users were directed to complete a web-based survey, including previously used items measuring perceptions of neighborhood safety, validated measures of sleep health, and socio-demographics. Modified Poisson models were used to estimate risk ratios (RRs) and 95% confidence intervals (CI) for the associations between perceived neighborhood safety and the following outcomes: (1) poor sleep quality, (2) short sleep duration, and (3) self-reported sleep problems. Poor sleep health was common in our sample; e.g., 30.1% reported poor sleep quality and 44.7% reported problems falling asleep. In multivariate regression models, perceived neighborhood safety was associated with poor sleep quality, short sleep duration, and having sleep problems. For example, reporting living in a neighborhood perceived as unsafe during the daytime (vs. safe) was associated with poor sleep quality (aRR, 1.60; 95% CI, 1.01, 2.52), short sleep duration (aRR, 1.92; 95% CI, 1.26, 2.94), problems falling asleep (aRR, 1.57; 95% CI, 1.17, 2.11), and problems staying awake in the daytime (aRR, 2.16; 95% CI, 1.05, 4.43). Interventions to increase neighborhood safety may improve sleep health among MSM.

Ergonomics, quality and continuous improvement--conceptual and empirical relationships in an industrial context.

PubMed

Eklund, J

1997-10-01

This paper reviews the literature comparing the fields of ergonomics and quality, mainly in an industrial context, including mutual influences, similarities and differences. Relationships between ergonomics and the factors: work conditions, product design, ISO 9000, continuous improvements and TQM are reviewed in relation to the consequence, application, and process domains. The definitions of ergonomics and quality overlap substantially. Quality deficiencies, human errors and ergonomics problems often have the same cause, which in many cases can be traced to the design of work, workplace and environment e.g. noise, light, postures, loads, pace and work content. In addition, the possibility of performing to a high standard at work is an important prerequisite for satisfaction and well-being. Contradictions between the two fields have been identified in the view of concepts such as standardization, reduction of variability and copying of best practice, requiring further research. The field of quality would gain by incorporating ergonomics knowledge, especially in the areas of work design and human capability, since these factors are decisive for human performance and also therefore the performance of the systems involved. The field of ergonomics, on the other hand, would benefit from developing a stronger emphasis on methodologies and structures for improvement processes, including a clearer link with leadership and company strategies. Just as important is a further development of practicable participative ergonomics methods and tools for use at workplaces by the workers themselves, in order to integrate the top-down and the bottom-up processes and achieve better impact. Using participative processes for problem-solving and continuous improvement, focusing ergonomics and quality jointly has a great potential for improving working conditions and quality results simultaneously, and satisfying most of the interested parties.

Requirements for significant problem reporting and trend analysis

NASA Technical Reports Server (NTRS)

1988-01-01

This handbook supplements policies, requirements, and procedures of NMI 8070.3 to ensure that NASA management at each organizational level is: fully aware of trends affecting both the level of safety and the potential for mission success established for both NASA manned space programs and its supporting institutions; fully and independently informed of problems that represent significant risk to the safety of all personnel (including the general populace) and to the success of a mission or operation through a program mechanism herein defined as Significant Problem Reporting; and in full agreement with the level of elimination of these problems through the closed-loop accounting of corrective actions. The requirements of this handbook are supportive of the agency's safety, reliability, maintainability, and quality assurance (SRM&QA) program objectives and are applicable to all organizational elements of NASA connected with or supporting developmental or operational manned space program/projects (including associated payloads) and the related institutional facilities.

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

Genetic Algorithms Applied to Multi-Objective Aerodynamic Shape Optimization

NASA Technical Reports Server (NTRS)

Holst, Terry L.

2004-01-01

A genetic algorithm approach suitable for solving multi-objective optimization problems is described and evaluated using a series of aerodynamic shape optimization problems. Several new features including two variations of a binning selection algorithm and a gene-space transformation procedure are included. The genetic algorithm is suitable for finding pareto optimal solutions in search spaces that are defined by any number of genes and that contain any number of local extrema. A new masking array capability is included allowing any gene or gene subset to be eliminated as decision variables from the design space. This allows determination of the effect of a single gene or gene subset on the pareto optimal solution. Results indicate that the genetic algorithm optimization approach is flexible in application and reliable. The binning selection algorithms generally provide pareto front quality enhancements and moderate convergence efficiency improvements for most of the problems solved.

Genetic Algorithms Applied to Multi-Objective Aerodynamic Shape Optimization

NASA Technical Reports Server (NTRS)

Holst, Terry L.

2005-01-01

A genetic algorithm approach suitable for solving multi-objective problems is described and evaluated using a series of aerodynamic shape optimization problems. Several new features including two variations of a binning selection algorithm and a gene-space transformation procedure are included. The genetic algorithm is suitable for finding Pareto optimal solutions in search spaces that are defined by any number of genes and that contain any number of local extrema. A new masking array capability is included allowing any gene or gene subset to be eliminated as decision variables from the design space. This allows determination of the effect of a single gene or gene subset on the Pareto optimal solution. Results indicate that the genetic algorithm optimization approach is flexible in application and reliable. The binning selection algorithms generally provide Pareto front quality enhancements and moderate convergence efficiency improvements for most of the problems solved.

Microbial production of isoquinoline alkaloids as plant secondary metabolites based on metabolic engineering research.

PubMed

Sato, Fumihiko; Kumagai, Hidehiko

2013-01-01

Plants produce a variety of secondary metabolites that possess strong physiological activities. Unfortunately, however, their production can suffer from a variety of serious problems, including low levels of productivity and heterogeneous quality, as well as difficulty in raw material supply. In contrast, microorganisms can be used to produce their primary and some of their secondary metabolites in a controlled environment, thus assuring high levels of efficiency and uniform quality. In an attempt to overcome the problems associated with secondary metabolite production in plants, we developed a microbial platform for the production of plant isoquinoline alkaloids involving the unification of the microbial and plant metabolic pathways into a single system. The potential applications of this system have also been discussed.

Microbial production of isoquinoline alkaloids as plant secondary metabolites based on metabolic engineering research

PubMed Central

SATO, Fumihiko; KUMAGAI, Hidehiko

2013-01-01

Plants produce a variety of secondary metabolites that possess strong physiological activities. Unfortunately, however, their production can suffer from a variety of serious problems, including low levels of productivity and heterogeneous quality, as well as difficulty in raw material supply. In contrast, microorganisms can be used to produce their primary and some of their secondary metabolites in a controlled environment, thus assuring high levels of efficiency and uniform quality. In an attempt to overcome the problems associated with secondary metabolite production in plants, we developed a microbial platform for the production of plant isoquinoline alkaloids involving the unification of the microbial and plant metabolic pathways into a single system. The potential applications of this system have also been discussed. PMID:23666088

DO HERBAL AGENTS HAVE A PLACE IN THE TREATMENT OF SLEEP PROBLEMS IN LONG-TERM CARE?

PubMed Central

Shimazaki, Mark; Martin, Jennifer L.

2007-01-01

Sleep disruption is common in the long-term care setting. This paper discusses the available literature on two herbal approaches to sleep problems in long-term care. The largest body of evidence exists for the use of the dietary/herbal supplements valerian and melatonin. While these agents appear to have a modest positive effect on sleep quality among older adults, most studies were small in size and included only subjective assessments of sleep quality. In addition, it is unclear whether these agents pose risks to long-term care residents due to potential drug interactions. Additional research is needed prior to making conclusive recommendations about the use of these interventions for sleep in the long-term care setting. PMID:17498609

Managing Academic Libraries with Fewer Resources.

ERIC Educational Resources Information Center

Riggs, Donald E.

1992-01-01

A discussion of academic library management during retrenchment looks at a variety of issues, including staffing needs in the labor-intensive library environment, acquisitions budgeting, interlibrary cooperation (ownership vs. access to resources), entrepreneurship and strategic planning for problem solving, and use of total quality management…

Developing Evidence & Gathering Data about Teacher Education Program Quality

ERIC Educational Resources Information Center

American Association of State Colleges and Universities, 2007

2007-01-01

Linking teacher practice to pupil outcomes has proven challenging for teacher educators. Methodological problems occur when linking individual teacher actions with subsequent pupil performance, including substantial intervening variables, questions about appropriate measures of student learning, issues regarding the lack of test standardization…

AN ELECTRIFYING NEW SOLUTION TO AN OLD PROBLEM?

EPA Science Inventory

The adverse health effects of particles have been linked to many factors, including particle size. The U.S. Environmental Protection Agency (EPA) first issued National Ambient Air QualityStandards (NAAQS) for particular matter (PM) in 1971, amended the standards in 1987 for part...

Water Quality Pollution, Treatment and Control in Contemporary and Future Environmental Education.

ERIC Educational Resources Information Center

Zoller, Uri

1988-01-01

Deals with the issue of water education, including problems, what should be done, what can be done, and what to do. Presents two curricular units on water and two interdisciplinary, environmentally oriented courses for use in Israel. (YP)

National Health Insurance and Health Education: Strategies for Change.

ERIC Educational Resources Information Center

Dwore, Richard B.

1980-01-01

The concept of National Health Insurance (NHI) as one of several strategies for resolving health problems in the U.S. is discussed. NHI goals include comprehensive health care, quality health care, efficient delivery systems, phased-in benefits, and consumer representation. (JD)

Self-reported health status and access to health services in a sample of prisoners in Italy

PubMed Central

2011-01-01

Background Self-reported health status in underserved population of prisoners has not been extensively explored. The purposes of this cross-sectional study were to assess self-reported health, quality of life, and access to health services in a sample of male prisoners of Italy. Methods A total of 908 prisoners received a self-administered anonymous questionnaire pertaining on demographic and detention characteristics, self-reported health status and quality of life, access to health services, lifestyles, and participation to preventive, social, and rehabilitation programs. A total of 650 prisoners agreed to participate in the study and returned the questionnaire. Results Respectively, 31.6% and 43.5% of prisoners reported a poor perceived health status and a poor quality of life, and 60% admitted that their health was worsened or greatly worsened during the prison stay. Older age, lower education, psychiatric disorders, self-reported health problems on prison entry, and suicide attempts within prison were significantly associated with a perceived worse health status. At the time of the questionnaire delivery, 30% of the prisoners self-reported a health problem present on prison entry and 82% present at the time of the survey. Most frequently reported health problems included dental health problems, arthritis or joint pain, eye problems, gastrointestinal diseases, emotional problems, and high blood pressure. On average, prisoners encountered general practitioners six times during the previous year, and the frequency of medical encounters was significantly associated with older age, sentenced prisoners, psychiatric disorders, and self-reported health problems on prison entry. Conclusions The findings suggest that prisoners have a perceived poor health status, specific care needs and health promotion programs are seldom offered. Programs for correction of risk behaviour and prevention of long-term effects of incarceration on prisoners' health are strongly needed. PMID:21726446

Vehicle Routing Problem Using Genetic Algorithm with Multi Compartment on Vegetable Distribution

NASA Astrophysics Data System (ADS)

Kurnia, Hari; Gustri Wahyuni, Elyza; Cergas Pembrani, Elang; Gardini, Syifa Tri; Kurnia Aditya, Silfa

2018-03-01

The problem that is often gained by the industries of managing and distributing vegetables is how to distribute vegetables so that the quality of the vegetables can be maintained properly. The problems encountered include optimal route selection and little travel time or so-called TSP (Traveling Salesman Problem). These problems can be modeled using the Vehicle Routing Problem (VRP) algorithm with rating ranking, a cross order based crossing, and also order based mutation mutations on selected chromosomes. This study uses limitations using only 20 market points, 2 point warehouse (multi compartment) and 5 vehicles. It is determined that for one distribution, one vehicle can only distribute to 4 market points only from 1 particular warehouse, and also one such vehicle can only accommodate 100 kg capacity.

Quality Assessment of TPB-Based Questionnaires: A Systematic Review

PubMed Central

Oluka, Obiageli Crystal; Nie, Shaofa; Sun, Yi

2014-01-01

Objective This review is aimed at assessing the quality of questionnaires and their development process based on the theory of planned behavior (TPB) change model. Methods A systematic literature search for studies with the primary aim of TPB-based questionnaire development was conducted in relevant databases between 2002 and 2012 using selected search terms. Ten of 1,034 screened abstracts met the inclusion criteria and were assessed for methodological quality using two different appraisal tools: one for the overall methodological quality of each study and the other developed for the appraisal of the questionnaire content and development process. Both appraisal tools consisted of items regarding the likelihood of bias in each study and were eventually combined to give the overall quality score for each included study. Results 8 of the 10 included studies showed low risk of bias in the overall quality assessment of each study, while 9 of the studies were of high quality based on the quality appraisal of questionnaire content and development process. Conclusion Quality appraisal of the questionnaires in the 10 reviewed studies was successfully conducted, highlighting the top problem areas (including: sample size estimation; inclusion of direct and indirect measures; and inclusion of questions on demographics) in the development of TPB-based questionnaires and the need for researchers to provide a more detailed account of their development process. PMID:24722323

Self-Organizing Hierarchical Particle Swarm Optimization with Time-Varying Acceleration Coefficients for Economic Dispatch with Valve Point Effects and Multifuel Options

NASA Astrophysics Data System (ADS)

Polprasert, Jirawadee; Ongsakul, Weerakorn; Dieu, Vo Ngoc

2011-06-01

This paper proposes a self-organizing hierarchical particle swarm optimization (SPSO) with time-varying acceleration coefficients (TVAC) for solving economic dispatch (ED) problem with non-smooth functions including multiple fuel options (MFO) and valve-point loading effects (VPLE). The proposed SPSO with TVAC is the new approach optimizer and good performance for solving ED problems. It can handle the premature convergence of the problem by re-initialization of velocity whenever particles are stagnated in the search space. To properly control both local and global explorations of the swarm during the optimization process, the performance of TVAC is included. The proposed method is tested in different ED problems with non-smooth cost functions and the obtained results are compared to those from many other methods in the literature. The results have revealed that the proposed SPSO with TVAC is effective in finding higher quality solutions for non-smooth ED problems than many other methods.

Regulatory approaches for addressing dissolved oxygen concerns at hydropower facilities

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

Peterson, Mark J.; Cada, Glenn F.; Sale, Michael J.

Low dissolved oxygen (DO) concentrations are a common water quality problem downstream of hydropower facilities. At some facilities, structural improvements (e.g. installation of weir dams or aerating turbines) or operational changes (e.g., spilling water over the dam) can be made to improve DO levels. In other cases, structural and operational approaches are too costly for the project to implement or are likely to be of limited effectiveness. Despite improvements in overall water quality below dams in recent years, many hydropower projects are unable to meet state water quality standards for DO. Regulatory agencies in the U.S. are considering or implementingmore » dramatic changes in their approach to protecting the quality of the Nation’s waters. New policies and initiatives have emphasized flexibility, increased collaboration and shared responsibility among all parties, and market-based, economic incentives. The use of new regulatory approaches may now be a viable option for addressing the DO problem at some hydropower facilities. This report summarizes some of the regulatory-related options available to hydropower projects, including negotiation of site-specific water quality criteria, use of biological monitoring, watershed-based strategies for the management of water quality, and watershed-based trading. Key decision points center on the health of the local biological communities and whether there are contributing impacts (i.e., other sources of low DO effluents) in the watershed. If the biological communities downstream of the hydropower project are healthy, negotiation for site-specific water quality standards or biocriteria (discharge performance criteria based on characteristics of the aquatic biota) might be pursued. If there are other effluent dischargers in the watershed that contribute to low DO problems, watershed-scale strategies and effluent trading may be effective. This report examines the value of regulatory approaches by reviewing their use in other« less

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.

Short- and long-term health consequences of sleep disruption.

PubMed

Medic, Goran; Wille, Micheline; Hemels, Michiel Eh

2017-01-01

Sleep plays a vital role in brain function and systemic physiology across many body systems. Problems with sleep are widely prevalent and include deficits in quantity and quality of sleep; sleep problems that impact the continuity of sleep are collectively referred to as sleep disruptions. Numerous factors contribute to sleep disruption, ranging from lifestyle and environmental factors to sleep disorders and other medical conditions. Sleep disruptions have substantial adverse short- and long-term health consequences. A literature search was conducted to provide a nonsystematic review of these health consequences (this review was designed to be nonsystematic to better focus on the topics of interest due to the myriad parameters affected by sleep). Sleep disruption is associated with increased activity of the sympathetic nervous system and hypothalamic-pituitary-adrenal axis, metabolic effects, changes in circadian rhythms, and proinflammatory responses. In otherwise healthy adults, short-term consequences of sleep disruption include increased stress responsivity, somatic pain, reduced quality of life, emotional distress and mood disorders, and cognitive, memory, and performance deficits. For adolescents, psychosocial health, school performance, and risk-taking behaviors are impacted by sleep disruption. Behavioral problems and cognitive functioning are associated with sleep disruption in children. Long-term consequences of sleep disruption in otherwise healthy individuals include hypertension, dyslipidemia, cardiovascular disease, weight-related issues, metabolic syndrome, type 2 diabetes mellitus, and colorectal cancer. All-cause mortality is also increased in men with sleep disturbances. For those with underlying medical conditions, sleep disruption may diminish the health-related quality of life of children and adolescents and may worsen the severity of common gastrointestinal disorders. As a result of the potential consequences of sleep disruption, health care professionals should be cognizant of how managing underlying medical conditions may help to optimize sleep continuity and consider prescribing interventions that minimize sleep disruption.

Short- and long-term health consequences of sleep disruption

PubMed Central

Medic, Goran; Wille, Micheline; Hemels, Michiel EH

2017-01-01

Sleep plays a vital role in brain function and systemic physiology across many body systems. Problems with sleep are widely prevalent and include deficits in quantity and quality of sleep; sleep problems that impact the continuity of sleep are collectively referred to as sleep disruptions. Numerous factors contribute to sleep disruption, ranging from lifestyle and environmental factors to sleep disorders and other medical conditions. Sleep disruptions have substantial adverse short- and long-term health consequences. A literature search was conducted to provide a nonsystematic review of these health consequences (this review was designed to be nonsystematic to better focus on the topics of interest due to the myriad parameters affected by sleep). Sleep disruption is associated with increased activity of the sympathetic nervous system and hypothalamic–pituitary–adrenal axis, metabolic effects, changes in circadian rhythms, and proinflammatory responses. In otherwise healthy adults, short-term consequences of sleep disruption include increased stress responsivity, somatic pain, reduced quality of life, emotional distress and mood disorders, and cognitive, memory, and performance deficits. For adolescents, psychosocial health, school performance, and risk-taking behaviors are impacted by sleep disruption. Behavioral problems and cognitive functioning are associated with sleep disruption in children. Long-term consequences of sleep disruption in otherwise healthy individuals include hypertension, dyslipidemia, cardiovascular disease, weight-related issues, metabolic syndrome, type 2 diabetes mellitus, and colorectal cancer. All-cause mortality is also increased in men with sleep disturbances. For those with underlying medical conditions, sleep disruption may diminish the health-related quality of life of children and adolescents and may worsen the severity of common gastrointestinal disorders. As a result of the potential consequences of sleep disruption, health care professionals should be cognizant of how managing underlying medical conditions may help to optimize sleep continuity and consider prescribing interventions that minimize sleep disruption. PMID:28579842

Parental palliative cancer: psychosocial adjustment and health-related quality of life in adolescents participating in a German family counselling service

PubMed Central

2012-01-01

Background Parental palliative disease is a family affair, however adolescent's well-being and coping are still rarely considered. The objectives of this paper were a) to identify differences in psychosocial adjustment and health-related quality of life (HRQoL) among adolescents and young adults with parents suffering from palliative cancer or cancers in other disease stages, b) to relate psychosocial adjustment and health-related quality of life to adolescent coping, and c) to explore significant mediator and predictor variables. Methods Cross-sectional data were derived from a multi-site research study of families before child-centered counselling. N=86 adolescents and young adults were included, their mean age 13.78 years (sd 2.45), 56% being female. Performed analyses included ANCOVA, multiple linear regression, and mediation analysis. Results Adolescents with parents suffering from palliative cancers reported significantly less total psychosocial problems, and better overall HRQoL. There were no significant group differences regarding coping frequency and efficacy. Our set of coping items significantly mediated the effect of parental disease stage on psychosocial problems and HRQoL. Further, parental disease status and general family functioning predicted psychosocial problems (R2adj =.390) and HRQoL (R2adj =.239) best. Conclusion The study indicates distress among adolescents throughout the entire parental disease process. Our analysis suggests that counselling services could offer supportive interventions which focus particularly on adolescent coping as well as family functioning. PMID:23110440

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

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.

Societal costs of underage drinking.

PubMed

Miller, Ted R; Levy, David T; Spicer, Rebecca S; Taylor, Dexter M

2006-07-01

Despite minimum-purchase-age laws, young people regularly drink alcohol. This study estimated the magnitude and costs of problems resulting from underage drinking by category-traffic crashes, violence, property crime, suicide, burns, drownings, fetal alcohol syndrome, high-risk sex, poisonings, psychoses, and dependency treatment-and compared those costs with associated alcohol sales. Previous studies did not break out costs of alcohol problems by age. For each category of alcohol-related problems, we estimated fatal and nonfatal cases attributable to underage alcohol use. We multiplied alcohol-attributable cases by estimated costs per case to obtain total costs for each problem. Underage drinking accounted for at least 16% of alcohol sales in 2001. It led to 3,170 deaths and 2.6 million other harmful events. The estimated $61.9 billion bill (relative SE = 18.5%) included $5.4 billion in medical costs, $14.9 billion in work loss and other resource costs, and $41.6 billion in lost quality of life. Quality-of-life costs, which accounted for 67% of total costs, required challenging indirect measurement. Alcohol-attributable violence and traffic crashes dominated the costs. Leaving aside quality of life, the societal harm of $1 per drink consumed by an underage drinker exceeded the average purchase price of $0.90 or the associated $0.10 in tax revenues. Recent attention has focused on problems resulting from youth use of illicit drugs and tobacco. In light of the associated substantial injuries, deaths, and high costs to society, youth drinking behaviors merit the same kind of serious attention.

Less reduction of psychosocial problems among adolescents with unmet communication needs.

PubMed

Jager, Margot; Reijneveld, Sijmen A; Almansa, Josue; Metselaar, Janneke; Knorth, Erik J; De Winter, Andrea F

2017-04-01

Patient-professional communication has been suggested to be a major determinant of treatment outcomes in psychosocial care for children and adolescents. However, the mechanisms involved are largely unknown and no longitudinal studies have been performed. Our aim was, therefore, to assess over the course of 1 year, the impact of patient-centered communication on psychosocial problems of adolescents in psychosocial care, including the routes mediating this impact. We obtained data on 315 adolescents, aged 12-18 years, enrolled in child and adolescent social or mental health care. We assessed patient-centered communication by comparing the needs and experiences of adolescents with regard to three aspects of communication: affective quality, information provision, and shared decision-making. Changes in psychosocial problems comprised those reported by adolescents and their parents between baseline and 1 year thereafter. Potential mediators were treatment adherence, improvement of understanding, and improvement in self-confidence. We found a relationship between unmet needs for affective quality, information provision, and shared decision-making and less reduction of psychosocial problems. The association between the unmet need to share in decision-making and less reduction of psychosocial problems were partially mediated by less improvement in self-confidence (30 %). We found no mediators regarding affective quality and information provision. Our findings confirm that patient-centered communication is a major determinant of treatment outcomes in psychosocial care for adolescents. Professionals should be aware that tailoring their communication to individual patients' needs is vital to the effectiveness of psychosocial care.

Associations between living arrangements and health-related quality of life of urban elderly people: a study from China.

PubMed

Sun, Xiaojie; Lucas, Henry; Meng, Qingyue; Zhang, Yaoguang

2011-04-01

This study aimed to compare health-related quality of life (HRQOL) for elderly men and women in three mutually exclusive living arrangements: living alone, living only with spouse, and non-empty-nesters. It also examined whether such living arrangements and other factors relating to social interaction have an independent influence on HRQOL after controlling for other variables. The data were drawn from China's 4th National Household Health Survey (NHHS) conducted in 2008. The final sample included 9,711 urban elderly people of 60 years and above. The EQ-5D inventory was used to measure health-related quality of life. The proportions of non-empty-nested men and women both changed following a 'U'-shaped curve with the increasing age. Controlling for other variables not including social interaction indicators, "living alone" was a significant predictor of reporting problems on Mobility, Pain/Discomfort and Anxiety/Depression. After introducing social interaction indicators, urban older adults 'having close contact with neighbors every week' had lower odds of problems on all five EQ-5D indicators, those 'having close contact with friends and relatives' had lower odds of problems on Mobility, Pain/Discomfort and Anxiety/Depression, and those 'taking part in social activities every week' had lower odds of problems on all dimensions but Anxiety/Depression. In addition, after introducing social interaction indicators, the odds of reported problems on the three dimensions increased obviously. This study suggests that the most vulnerable urban older adults are those who live entirely on their own. Frequent social interaction may buffer the negative effect of living alone on HRQOL of older adults. Policies that attempt to build harmonious neighborhoods, extend older adults' social network and encourage them to take part in social activities should be considered by the policy-makers in the future.

The quality of rivers: From pristine stage to global pollution

NASA Astrophysics Data System (ADS)

Meybeck, Michel; Helmer, Richard

1989-12-01

River water quality is highly variable by nature due to environmental conditions such as basin lithology, vegetation and climate. In small watersheds spatial variations extend over orders of magnitude for most major elements and nutrients, while this variability is an order of magnitude lower for major basins. A standard river water for use as reference is therefore not applicable. As a consequence natural waters can possibly be unfit for various human uses, even including drinking. The Water Quality (WQ) concept has greatly evolved since the beginning of the century in accordance with expanding water uses and analytical developments. Even in well developed countries the dissolved heavy metal measurements in rivers are not very reliable while dissolved organic micro-pollutants are even rarely analysed routinely. Major WQ problems have been identified according to river basin size, including organic pollution, salinity, total suspended solids, heavy metals, eutrophication, nitrate, organic micro-pollutants, acidification. They generally occurred in this order over a period of about 100 years in the industrialized countries. Historical records of WQ are rare but can be established indirectly through studies of lake sediments. When proper control action is taken at an early stage, numerous examples of WQ recovery have been found in rivers for most of the common pollution problems. Future WQ problems will mostly derive from mine tailings and toxic waste disposal in both developed and developing countries, industrial accidents and organic micropollutants which emerge faster than our analytical capacities. The newly industrializing countries will face all the above-mentioned problems within a very short time period without having the means to cope with them one at a time. River studies point out the global alteration of the biogeochemical cycles of many major elements and nutrients (S, Na, K, N, P). For heavy metals such as lead, present estimates of global river loads emphasize the role of interim storage on land, thus delaying downstream pollution problems.

Distress Tolerance Links Sleep Problems with Stress and Health in Homeless.

PubMed

Reitzel, Lorraine R; Short, Nicole A; Schmidt, Norman B; Garey, Lorra; Zvolensky, Michael J; Moisiuc, Alexis; Reddick, Carrie; Kendzor, Darla E; Businelle, Michael S

2017-11-01

We examined associations between sleep problems, distress intolerance, and perceived stress and health in a convenience sample of homeless adults. Participants (N = 513, 36% women, Mage = 44.5 ±11.9) self-reported sleep adequacy, sleep duration, unintentional sleep during the daytime, distress tolerance, urban stress, and days of poor mental health and days of poor physical health over the last month. The indirect effects of sleep problems on stress and health through distress tolerance were examined using a non-parametric, bias-corrected bootstrapping procedure. Sleep problems were prevalent (eg, 13.0 ±11.4 days of inadequate sleep and 4.7 ±7.9 days of unintentionally falling asleep during the preceding month). Distress intolerance partially accounted for the associations of inadequate sleep and unintentionally falling asleep, but not sleep duration, with urban stress and more days of poor mental and physical health. Many homeless individuals endure sleep problems. Given the connections between sleep and morbidity and mortality, results further support the need for more attention directed toward facilitating improvements in sleep quality to improve the quality of life of homeless adults, potentially including attention to improving distress tolerance skills.

A Norwegian prospective study of preterm mother–infant interactions at 6 and 18 months and the impact of maternal mental health problems, pregnancy and birth complications

PubMed Central

Misund, Aud R; Bråten, Stein; Nerdrum, Per; Pripp, Are Hugo; Diseth, Trond H

2016-01-01

Objective Pregnancy, birth and health complications, maternal mental health problems following preterm birth and their possible impact on early mother–infant interaction at 6 and 18 months corrected age (CA) were explored. Predictors of mother–infant interaction at 18 months CA were identified. Design and methods This prospective longitudinal and observational study included 33 preterm mother–infant (<33 gestational age (GA)) interactions at 6 and 18 months CA from a socioeconomic low-risk, middle-class sample. The Parent–Child Early Relational Assessment (PCERA) scale was used to assess the mother–infant interaction. Results ‘Bleeding in pregnancy’ predicted lower quality in preterm mother–infant interaction in 6 PCERA scales, while high ‘maternal trait anxiety’ predicted higher interactional quality in 2 PCERA scales and ‘family size’ predicted lower interactional quality in 1 PCERA scale at 18 months CA. Mothers with symptoms of post-traumatic stress reactions, general psychological distress and anxiety at 2 weeks postpartum (PP) showed significantly better outcome than mothers without symptoms in 6 PCERA subscales at 6 months CA and 2 PCERA subscales at 18 months CA. Conclusions Our study detected a correspondence between early pregnancy complications and lower quality of preterm mother–infant interaction, and an association between high levels of maternal mental health problems and better quality in preterm mother–infant interaction. PMID:27147380

Sexual Function Across Aging.

PubMed

Clayton, Anita H; Harsh, Veronica

2016-03-01

Women experience multiple changes in social and reproductive statuses across the life span which can affect sexual functioning. Various phases of the sexual response cycle may be impacted and can lead to sexual dysfunction. Screening for sexual problems and consideration of contributing factors such as neurobiology, reproductive life events, medical problems, medication use, and depression can help guide appropriate treatment and thereby improve the sexual functioning and quality of life of affected women. Treatment options include psychotropic medications, hormone therapy, and psychotherapy.

The associations of indoor environment and psychosocial factors on the subjective evaluation of Indoor Air Quality among lower secondary school students: a multilevel analysis.

PubMed

Finell, E; Haverinen-Shaughnessy, U; Tolvanen, A; Laaksonen, S; Karvonen, S; Sund, R; Saaristo, V; Luopa, P; Ståhl, T; Putus, T; Pekkanen, J

2017-03-01

Subjective evaluation of Indoor Air Quality (subjective IAQ) reflects both building-related and psychosocial factors, but their associations have rarely been studied other than on the individual level in occupational settings and their interactions have not been assessed. Therefore, we studied whether schools' observed indoor air problems and psychosocial factors are associated with subjective IAQ and their potential interactions. The analysis was performed with a nationwide sample (N = 195 schools/26946 students) using multilevel modeling. Two datasets were merged: (i) survey data from students, including information on schools' psychosocial environment and subjective IAQ, and (ii) data from school principals, including information on observed indoor air problems. On the student level, school-related stress, poor teacher-student relationship, and whether the student did not easily receive help from school personnel, were significantly associated with poor subjective IAQ. On the school level, observed indoor air problem (standardized β = -0.43) and poor teacher-student relationship (standardized β = -0.22) were significant predictors of poor subjective IAQ. In addition, school-related stress was associated with poor subjective IAQ, but only in schools without observed indoor air problem (standardized β = -0.44). © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Running With the Pack: Teen Peer-Relationship Qualities as Predictors of Adult Physical Health

PubMed Central

Allen, Joseph P.; Uchino, Bert N.; Hafen, Christopher A.

2015-01-01

This study assessed qualities of adolescent peer relationships as long-term predictors of physical health quality in adulthood. In an intensive multimethod, multireporter study of a community sample of 171 individuals assessed repeatedly from the ages of 13 to 27 years, physical health quality in adulthood was robustly predicted by independent reports of early-adolescent close-friendship quality and by a pattern of acquiescence to social norms in adolescent peer relationships. Predictions remained after accounting for numerous potential confounds, including prior health problems, concurrent body mass index, anxious and depressive symptoms, personality characteristics, adolescent-era financial adversity, and adolescent-era physical attractiveness. These findings have important implications for understanding the unique intensity of peer relationships in adolescence. PMID:26290522

Urban Renewal Mega Projects and Residents' Quality of Life: Evidence from Historical Religious Center of Mashhad Metropolis.

PubMed

Forouhar, Amir; Hasankhani, Mahnoosh

2018-04-01

Urban decay is the process by which a historical city center, or an old part of a city, falls into decrepitude and faces serious problems. Urban management, therefore, implements renewal mega projects with the goal of physical and functional revitalization, retrieval of socioeconomic capacities, and improving of quality of life of residents. Ignoring the complexities of these large-scale interventions in the old and historical urban fabrics may lead to undesirable consequences, including an additional decline of quality of life. Thus, the present paper aims to assess the impact of renewal mega projects on residents' subjective quality of life, in the historical religious district of the holy city of Mashhad (Samen District). A combination of quantitative and qualitative methods of impact assessment, including questionnaires, semi-structured personal interviews, and direct observation, is used in this paper. The results yield that the Samen Renewal Project has significantly reduced the resident's subjective quality of life, due to its undesirable impacts on physical, socio-cultural, and economic environments.

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.

Hydrology and water quality of Park Lake, south-central Wisconsin

USGS Publications Warehouse

Kammerer, P.A.

1996-01-01

Park Lake extends to the northeast from the village of Pardeeville in Columbia County (fig. 1). Local residents perceive water-quality problems in the lake that include excessive algae and aquatic plant growth. Algae and plant growth in a lake are controlled, in part, by the availability of phosphorus in the water. However, no measurements of phosphorus enter- ing the lake or of other factors that affect lake-water quality had been made, and available data on water quality were limited to 2 years of measurements at one site in the lake in 1986- 87. To obtain the data and in- formation needed to address the water-quality problems at Park Lake and to develop a management plan that would limit the input of phosphorus to the lake, the U.S. Geologi- cal Survey, in cooperation with the Park Lake Management District, studied the hydrology of the lake and collected data needed to determine sources and amount of phosphorus en- tering the lake. This Fact Sheet summarizes the results of that study. Data collected during the study were published in a separate report (Holmstrom and others, 1994, p. 70-85).

Three Australian whistleblowing sagas: lessons for internal and external regulation.

PubMed

Faunce, Thomas A; Bolsin, Stephen N C

2004-07-05

The protracted and costly investigations into Camden and Campbelltown hospitals (New South Wales), The Canberra Hospital (Australian Capital Territory), and King Edward Memorial Hospital (Western Australia) recently uncovered significant problems with quality and safety at these institutions. Each investigation arose after whistleblowers alerted politicians directly, having failed to resolve the problems using existing intra-institutional structures. None of the substantiated problems had been uncovered or previously resolved by extensive accreditation or national safety and quality processes; in each instance, the problems were exacerbated by a poor institutional culture of self-regulation, error reporting or investigation. Even after substantiation of their allegations, the whistleblowers, who included staff specialists, administrators and nurses, received little respect and support from their institutions or professions. Increasing legislative protections indicate the role of whistleblowers must now be formally acknowledged and incorporated as a "last resort" component in clinical-governance structures. Portable digital technology, if adequately funded and institutionally supported, may help to transform the conscience-based activity of whistleblowing into a culture of self-reporting, linked to personal and professional development.

Workplace mental health: An international review of guidelines.

PubMed

Memish, Kate; Martin, Angela; Bartlett, Larissa; Dawkins, Sarah; Sanderson, Kristy

2017-08-01

The aim of this systematic review was to determine the quality and comprehensiveness of guidelines developed for employers to detect, prevent, and manage mental health problems in the workplace. An integrated approach that combined expertise from medicine, psychology, public health, management, and occupational health and safety was identified as a best practice framework to assess guideline comprehensiveness. An iterative search strategy of the grey literature was used plus consultation with experts in psychology, public health, and mental health promotion. Inclusion criteria were documents published in English and developed specifically for employers to detect, prevent, and manage mental health problems in the workplace. A total of 20 guidelines met these criteria and were reviewed. Development documents were included to inform quality assessment. This was performed using the AGREE II rating system. Our results indicated that low scores were often due to a lack of focus on prevention and rather a focus on the detection and treatment of mental health problems in the workplace. When prevention recommendations were included they were often individually focused and did not include practical tools or advice to implement. An inconsistency in language, lack of consultation with relevant population groups in the development process and a failure to outline and differentiate between the legal/minimum requirements of a region were also observed. The findings from this systematic review will inform translation of scientific evidence into practical recommendations to prevent mental health problems within the workplace. It will also direct employers, clinicians, and policy-makers towards examples of best-practice guidelines. Copyright © 2017 Elsevier Inc. All rights reserved.

Aircraft model prototypes which have specified handling-quality time histories

NASA Technical Reports Server (NTRS)

Johnson, S. H.

1978-01-01

Several techniques for obtaining linear constant-coefficient airplane models from specified handling-quality time histories are discussed. The pseudodata method solves the basic problem, yields specified eigenvalues, and accommodates state-variable transfer-function zero suppression. The algebraic equations to be solved are bilinear, at worst. The disadvantages are reduced generality and no assurance that the resulting model will be airplane like in detail. The method is fully illustrated for a fourth-order stability-axis small motion model with three lateral handling quality time histories specified. The FORTRAN program which obtains and verifies the model is included and fully documented.

The impact of the night float system on internal medicine residency programs.

PubMed

Trontell, M C; Carson, J L; Taragin, M I; Duff, A

1991-01-01

To study the design, method of implementation, perceived benefits, and problems associated with a night float system. Self-administered questionnaire completed by program directors, which included both structured and open-ended questions. The answers reflect resident and student opinions as well as those of the program directors, since program directors regularly obtain feedback from these groups. The 442 accredited internal medicine residency programs listed in the 1988-89 Directory of Graduate Medical Education Programs. Of the 442 programs, 79% responded, and 30% had experience with a night float system. The most frequent methods for initiating a night float system included: decreasing elective time (42.3%), hiring more residents (26.9%), creating a non-teaching service (12.5%), and reallocating housestaff time (9.6%). Positive effects cited include decreased fatigue, improved housestaff morale, improved recruiting, and better attitude toward internal medicine training. The quality of medical care was considered the same or better by most programs using it. The most commonly cited problems were decreased continuity of care, inadequate teaching of the night float team, and miscommunication. Residency programs using a night float system usually observe a positive effect on housestaff morale, recruitment, and working hours and no detrimental effect on the quality of patient care. Miscommunication and inadequate learning experience for the night float team are important potential problems. This survey suggests that the night float represents one solution to reducing resident working hours.

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.

Air Quality Guide for Ozone

MedlinePlus

... outdoors. Note: If you don't have an air conditioner, staying inside with the windows closed may be dangerous in extremely hot weather. In these cases, seek alternative shelter. Key Facts to Know About Ozone: Ozone in the air we breathe can cause serious health problems, including ...

Living in the Environment: A Sourcebook for Environmental Education.

ERIC Educational Resources Information Center

Sytnik, K. M.; And Others

This document presents a survey of ideas concerning environmental issues and educational efforts to improve the quality of life. Chapter one, "Environmental Education for Understanding and Solving Environmental Problems," includes sections on the relationship between cultural heritage and the environment, and methodologies in…

Catalogers and Competition.

ERIC Educational Resources Information Center

Howden, Norman

1987-01-01

Reports the results of a literature review and a survey of catalogers which were conducted to study the problem of the decline in quantity and quality of applications for entry-level cataloging jobs. Factors studied included: competition between types of library professionals, automation, library education, the women's movement, and library…

Four Sides to Every Story: Creating Effective Multimedia Business Simulations.

ERIC Educational Resources Information Center

Graham, William; Legere, Sylvie M.

1998-01-01

Discusses the goal-based design concepts used to build a CD-ROM-based course for senior executives at Andersen Consulting. Topics include quality management; continuous improvement; problem-centered learning; video storytelling; feedback; multimedia learning environments; course organization; and possible future applications. (Author/LRW)

Doctoral Education in Nursing: Future Directions

ERIC Educational Resources Information Center

Downs, Florence S.

1978-01-01

Problems that confront nursing education and the quality of doctoral preparation are discussed in this article and include the steep rise in requests from nurses for admission into doctoral programs and tight university budgets; other concerns are the development of scholars and sharing research findings. (TA)

Workplace High Tech Spurs Retraining Efforts.

ERIC Educational Resources Information Center

Davis, Dwight B.

1984-01-01

Discusses who should provide training for displaced workers who need new skills. Areas examined include: (1) the need for retraining; (2) current corporate efforts; (3) agreements in the automotive industry; (4) job quality; (5) the federal government's role; and (6) federal legislation related to the problem. (JN)

The quality of antimalarials available in Yemen

PubMed Central

Abdo-Rabbo, Ahmed; Bassili, Amal; Atta, Hoda

2005-01-01

Background Malaria has always been a major public health problem in Yemen. Several studies in developing countries have demonstrated ineffective and poor quality drugs including antimalarials. Therefore, quality assessment of antimalarial drugs is of crucial importance. This study aimed to assess the quality of antimalarials (chloroquine and sulfadoxine/pyrimethamine) available in Yemen and to determine whether the quality of these products was related to the level of the distribution chain at which the samples were collected or related to the manufacturers. Methods Four samples from each antimalarial product were collected from each of the various levels of the distribution chain. One sample was kept with the research team. Two were tested at Sana'a and Aden Drug Quality Control Laboratories. The fourth was sent to the Centre for Quality Assurance of Medicines in Potchefstroom, South Africa, for analysis. Quality indicators measured were the content of the active ingredient and dissolution rate (for tablets only) in comparison to standard specifications for these products in the relevant pharmacopoeia. Results The results identified several problems of sub-standard products within the drug distribution chain. They included high and low failures in ingredient content for chloroquine tablets and chloroquine syrup. There was some dissolution failure for chloroquine tablets, and high sulfadoxine/pyrimethamine tablets dissolution failures. Failures with the dissolution of the pyrimethamine were found at most of the collection points. No clear relationship neither between the quality products and the level of the distribution chain, nor between locally manufactured and imported products was observed. Conclusion There are sub-standard antimalarial products circulating within the drug distribution chains in the country, which will have serious implications on the reduced therapeutic effectiveness and on the development of drug resistance. This appears to be due to non-compliance with Good Manufacturing Practice guidelines by manufacturers in the production of the antimalarials. PMID:15987508

Adaptivity and smart algorithms for fluid-structure interaction

NASA Technical Reports Server (NTRS)

Oden, J. Tinsley

1990-01-01

This paper reviews new approaches in CFD which have the potential for significantly increasing current capabilities of modeling complex flow phenomena and of treating difficult problems in fluid-structure interaction. These approaches are based on the notions of adaptive methods and smart algorithms, which use instantaneous measures of the quality and other features of the numerical flowfields as a basis for making changes in the structure of the computational grid and of algorithms designed to function on the grid. The application of these new techniques to several problem classes are addressed, including problems with moving boundaries, fluid-structure interaction in high-speed turbine flows, flow in domains with receding boundaries, and related problems.

Index of surface-water records, part 12, Pacific slope basins in Washington and upper Columbia River basin, to September 30, 1948

USGS Publications Warehouse

,

1949-01-01

The groundwater resources of Wood County, Wisconsin, are described. Groundwater is pumped only from wells drilled in Precambrian rock in the northern two-thirds of the county. The generally low permeability of this rock limits the availability of groundwater in this area. Saturated deposits of sand and gravel yield more than 500 gal/min to wells in the southern part of the county. Background groundwater quality and indicators of groundwater-quality problems, such as elevated concentrations of nitrate, chloride, hardness, and iron, are compared by aquifer for the entire county. An elevated concentration of iron is the major water quality problem in the county. Results of water quality analysis from observation wells drilled next to abandoned landfills throughout the county indicate that groundwater in the immediate vicinity of these landfills has been affected by leachate. The report includes maps of the thickness and saturated thickness of unconsolidated deposits, a water-table map, and tables of aquifer-production and well-production data from about 1,500 drillers ' well-construction reports. (USGS)

Devices for Ambulatory Monitoring of Sleep-Associated Disorders in Children with Neurological Diseases.

PubMed

Ulate-Campos, Adriana; Tsuboyama, Melissa; Loddenkemper, Tobias

2017-12-25

Good sleep quality is essential for a child's wellbeing. Early sleep problems have been linked to the later development of emotional and behavioral disorders and can negatively impact the quality of life of the child and his or her family. Sleep-associated conditions are frequent in the pediatric population, and even more so in children with neurological problems. Monitoring devices can help to better characterize sleep efficiency and sleep quality. They can also be helpful to better characterize paroxysmal nocturnal events and differentiate between nocturnal seizures, parasomnias, and obstructive sleep apnea, each of which has a different management. Overnight ambulatory detection devices allow for a tolerable, low cost, objective assessment of sleep quality in the patient's natural environment. They can also be used as a notification system to allow for rapid recognition and prompt intervention of events like seizures. Optimal monitoring devices will be patient- and diagnosis-specific, but may include a combination of modalities such as ambulatory electroencephalograms, actigraphy, and pulse oximetry. We will summarize the current literature on ambulatory sleep devices for detecting sleep disorders in children with neurological diseases.

An Artificial Intelligence System to Predict Quality of Service in Banking Organizations

PubMed Central

Popovič, Aleš

2016-01-01

Quality of service, that is, the waiting time that customers must endure in order to receive a service, is a critical performance aspect in private and public service organizations. Providing good service quality is particularly important in highly competitive sectors where similar services exist. In this paper, focusing on banking sector, we propose an artificial intelligence system for building a model for the prediction of service quality. While the traditional approach used for building analytical models relies on theories and assumptions about the problem at hand, we propose a novel approach for learning models from actual data. Thus, the proposed approach is not biased by the knowledge that experts may have about the problem, but it is completely based on the available data. The system is based on a recently defined variant of genetic programming that allows practitioners to include the concept of semantics in the search process. This will have beneficial effects on the search process and will produce analytical models that are based only on the data and not on domain-dependent knowledge. PMID:27313604

An Artificial Intelligence System to Predict Quality of Service in Banking Organizations.

PubMed

Castelli, Mauro; Manzoni, Luca; Popovič, Aleš

2016-01-01

Quality of service, that is, the waiting time that customers must endure in order to receive a service, is a critical performance aspect in private and public service organizations. Providing good service quality is particularly important in highly competitive sectors where similar services exist. In this paper, focusing on banking sector, we propose an artificial intelligence system for building a model for the prediction of service quality. While the traditional approach used for building analytical models relies on theories and assumptions about the problem at hand, we propose a novel approach for learning models from actual data. Thus, the proposed approach is not biased by the knowledge that experts may have about the problem, but it is completely based on the available data. The system is based on a recently defined variant of genetic programming that allows practitioners to include the concept of semantics in the search process. This will have beneficial effects on the search process and will produce analytical models that are based only on the data and not on domain-dependent knowledge.

River water pollution condition in upper part of Brantas River and Bengawan Solo River

NASA Astrophysics Data System (ADS)

Roosmini, D.; Septiono, M. A.; Putri, N. E.; Shabrina, H. M.; Salami, I. R. S.; Ariesyady, H. D.

2018-01-01

Wastewater and solid waste from both domestic and industry have been known to give burden on river water quality. Most of river water quality problem in Indonesia has start in the upper part of river due to anthropogenic activities, due to inappropriate land use management including the poor wastewater infrastructure. Base on Upper Citarum River Water pollution problem, it is interesting to study the other main river in Java Island. Bengawan Solo River and Brantas River were chosen as the sample in this study. Parameters assessed in this study are as follows: TSS, TDS, pH, DO, and hexavalent chromium. The status of river water quality are assess using STORET method. Based on (five) parameters, STORET value showed that in Brantas River, Pagerluyung monitoring point had the worst quality relatively compared to other monitoring point in Brantas River with exceeding copper, lead and tin compared to the stream standard in East Java Provincial Regulation No. 2 in 2008. Brantas River was categorized as lightly polluted river based on monitoring period 2011-2015 in 5 monitoring points, namely Pendem, Sengguruh, Kademangan, Meritjan and Kertosono.

Regulation and its role in the prevention of building-associated illness.

PubMed

Besch, E L

1989-01-01

Many groups have as their common goal the maintenance of acceptable indoor air quality, which protects occupants from adverse health effects and discomfort, but no one group possesses the interest or expertise to deal with all of the IAQ issues. Nonetheless, conclusions can be made regarding available alternatives to mitigate indoor air quality problems, including building-associated illness. It has been suggested that congressional action is needed in three areas related to BAI and IAQ: Recognition that controlling outdoor air only--even if "health based"--will not result in substantial improvement of public health; Definition of responsibilities for achieving healthful indoor environments; and Resolution of jurisdictional disputes between various federal agencies. Through their studies of buildings whose occupants complained of building-associated illness, NIOSH and others have concluded that inadequate supply and distribution of outdoor air to indoor spaces are the most common causes of SBS. Nonetheless, there are no reports of follow-up studies which confirm that the recommended ventilation upgrades actually solved the IAQ problems. Other reports indicate that maintenance, energy management, and air distribution are as important as ventilation rate. Corrective action, therefore, should include these issues. Systematic research directed toward providing cost-effective and innovative solutions should be the driving force. Rather than regulation, governments should assist in funding the necessary research, providing educational, technical and legal assistance, and developing policy options directed at reducing indoor air pollutants. In those cases where the specific causes of IAQ problems can be identified, remedial actions should be immediately implemented utilizing available technology. It has been suggested that "sick buildings" resulted from too much emphasis on efficency and safety and not enough on occupant health and well-being. Because health has been defined as "a state of complete physical, mental and social well-being not merely the absence of disease or infirmity," greater emphasis should be given to the concept of control and maintenance of healthy indoor environments (i.e., "healthy buildings") through utilization of quality assurance measures. Also, human response, system performance, and service factors should be utilized to assure an acceptable building performance. Finally, building designers, contractors, owners, managers, and operators must be knowledgeable regarding indoor air quality problems and their consequences and work together to build and maintain healthy buildings. This includes developing training, education, monitoring, and preventive maintenance programs to assure accountability for the proper management of the building systems. The certification (or licensing) of those responsible for providing indoor air quality has been suggested.

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.

Childhood maltreatment and adulthood poor sleep quality: a longitudinal study.

PubMed

Abajobir, Amanuel A; Kisely, Steve; Williams, Gail; Strathearn, Lane; Najman, Jake M

2017-08-01

Available evidence from cross-sectional studies suggests that childhood maltreatment may be associated with a range of sleep disorders. However, these studies have not controlled for potential individual-, familial- and environmental-level confounders. To determine the association between childhood maltreatment and lower sleep quality after adjusting for potential confounders. Data for the present study were obtained from a pre-birth cohort study of 3778 young adults (52.6% female) of the Mater Hospital-University of Queensland Study of Pregnancy follow up at a mean age of 20.6 years. The Mater Hospital-University of Queensland Study of Pregnancy is a prospective Australian pre-birth cohort study of mothers consecutively recruited during their first obstetric clinic visit at Brisbane's Mater Hospital in 1981-1983. Participants completed the Pittsburgh Sleep Quality Index at the 21-year follow up. We linked this dataset to agency-recorded substantiated cases of childhood maltreatment. A series of separate logistic regression models was used to test whether childhood maltreatment predicted lower sleep quality after adjustment for selected confounders. Substantiated physical abuse significantly predicted lower sleep quality in males. Single and multiple forms of childhood maltreatment, including age of maltreatment and number of substantiations, did not predict lower sleep quality in either gender in both crude and adjusted models. Not being married, living in a residential problem area, cigarette smoking and internalising were significantly associated with lower sleep quality in a fully adjusted model for the male-female combined sample. Childhood maltreatment does not appear to predict young adult poor sleep quality, with the exception of physical abuse for males. While childhood maltreatment has been found to predict a range of mental health problems, childhood maltreatment does not appear to predict sleep problems occurring in young adults. Poor sleep quality was accounted for by concurrent social disadvantage, cigarette smoking and internalising. © 2017 Royal Australasian College of Physicians.

Customer and household matching: resolving entity identity in data warehouses

NASA Astrophysics Data System (ADS)

Berndt, Donald J.; Satterfield, Ronald K.

2000-04-01

The data preparation and cleansing tasks necessary to ensure high quality data are among the most difficult challenges faced in data warehousing and data mining projects. The extraction of source data, transformation into new forms, and loading into a data warehouse environment are all time consuming tasks that can be supported by methodologies and tools. This paper focuses on the problem of record linkage or entity matching, tasks that can be very important in providing high quality data. Merging two or more large databases into a single integrated system is a difficult problem in many industries, especially in the wake of acquisitions. For example, managing customer lists can be challenging when duplicate entries, data entry problems, and changing information conspire to make data quality an elusive target. Common tasks with regard to customer lists include customer matching to reduce duplicate entries and household matching to group customers. These often O(n2) problems can consume significant resources, both in computing infrastructure and human oversight, and the goal of high accuracy in the final integrated database can be difficult to assure. This paper distinguishes between attribute corruption and entity corruption, discussing the various impacts on quality. A metajoin operator is proposed and used to organize past and current entity matching techniques. Finally, a logistic regression approach to implementing the metajoin operator is discussed and illustrated with an example. The metajoin can be used to determine whether two records match, don't match, or require further evaluation by human experts. Properly implemented, the metajoin operator could allow the integration of individual databases with greater accuracy and lower cost.

Traditional and nontraditional evaluations of student outcomes in a practical final examination of veterinary radiology.

PubMed

Koskinen, Heli I

2010-01-01

The Faculty of Veterinary Medicine at the University of Helsinki recognized the lack of systems to measure the quality of education. At the department level, this meant lack of systems to measure the quality of students' outcomes. The aim of this article was to compare the quality of outcomes of a final examination in veterinary radiology by calculating the correlations between traditional (quantitative scores traditionally given by veterinary teachers) and nontraditional (qualitative Structure of the Observed Learning Outcome, or SOLO, method) grading results. Evaluation of the quality of the questions is also included. The results indicate that SOLO offers criteria for quality evaluation, especially for questions. A correlation of 0.60 (p<0.01) existed between qualitative and quantitative estimations, and a correlation of 0.79 (p<0.01) existed between evaluators, both using traditional scores. Two suggestions for a better system to evaluate quality in the future: First, development of problem-solving skills during the learning process should also be assessed. Second, both the scoring of factual correctness of answers (knowledge) and the grammatical structure of an answer and the quality of presentation should be included in the quality evaluation process.

Intensive Care and its Discontents: Psychiatric Illness in the Critically Ill.

PubMed

Hashmi, Ali M; Han, Jin Y; Demla, Vishal

2017-09-01

Critically ill patients can develop a host of cognitive and psychiatric complaints during their intensive care unit (ICU) stay, many of which persist for weeks or months following discharge from the ICU and can seriously affect their quality of life, including their ability to return to work. This article describes some common psychiatric problems encountered by clinicians in the ICU, including their assessment and management. A comprehensive approach is needed to decrease patient suffering, improve morbidity and mortality, and ensure that critically ill patients can return to the highest quality of life after an ICU stay. Copyright © 2017 Elsevier Inc. All rights reserved.

Systematic Review of Universal Resilience-Focused Interventions Targeting Child and Adolescent Mental Health in the School Setting.

PubMed

Dray, Julia; Bowman, Jenny; Campbell, Elizabeth; Freund, Megan; Wolfenden, Luke; Hodder, Rebecca K; McElwaine, Kathleen; Tremain, Danika; Bartlem, Kate; Bailey, Jacqueline; Small, Tameka; Palazzi, Kerrin; Oldmeadow, Christopher; Wiggers, John

2017-10-01

To examine the effect of universal, school-based, resilience-focused interventions on mental health problems in children and adolescents. Eligible studies were randomized controlled trials (RCTs) of universal, school-based interventions that included strategies to strengthen a minimum of 3 internal resilience protective factors, and included an outcome measure of mental health problems in children and adolescents aged 5 to 18 years. Six databases were searched from 1995 to 2015. Results were pooled in meta-analyses by mental health outcome (anxiety symptoms, depressive symptoms, hyperactivity, conduct problems, internalizing problems, externalizing problems, and general psychological distress), for all trials (5-18 years). Subgroup analyses were conducted by age (child: 5-10 years; adolescent: 11-18 years), length of follow-up (short: post-≤12 months; long: >12 months), and gender (narrative). A total of 57 included trials were identified from 5,984 records, with 49 contributing to meta-analyses. For all trials, resilience-focused interventions were effective relative to a control in reducing 4 of 7 outcomes: depressive symptoms, internalizing problems, externalizing problems, and general psychological distress. For child trials (meta-analyses for 6 outcomes), interventions were effective for anxiety symptoms and general psychological distress. For adolescent trials (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. For short-term follow-up, interventions were effective for 2 of 7 outcomes: depressive symptoms and anxiety symptoms. For long-term follow-up (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. The findings may suggest most promise for using universal resilience-focused interventions at least for short-term reductions in depressive and anxiety symptoms for children and adolescents, particularly if a cognitive-behavioral therapy-based approach is used. The limited number of trials providing data amenable for meta-analysis for some outcomes and subgroups, the variability of interventions, study quality, and bias mean that it is not possible to draw more specific conclusions. Identifying what intervention qualities (such as number and type of protective factor) achieve the greatest positive effect per mental health problem outcome remains an important area for future research. Systematic Review of Universal Resilience Interventions Targeting Child and Adolescent Mental Health in the School Setting; http://dx.doi.org/10.1186/s13643-015-0172-6; PROSPERO CRD42015025908. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

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.

Quality of systematic reviews in pediatric oncology--a systematic review.

PubMed

Lundh, Andreas; Knijnenburg, Sebastiaan L; Jørgensen, Anders W; van Dalen, Elvira C; Kremer, Leontien C M

2009-12-01

To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. We identified eligible systematic reviews through a systematic search of the literature. Data on clinical and methodological characteristics of the included systematic reviews were extracted. The methodological quality of the included systematic reviews was assessed using the overview quality assessment questionnaire, a validated 10-item quality assessment tool. We compared the methodological quality of systematic reviews published in regular journals with that of Cochrane systematic reviews. We included 117 systematic reviews, 99 systematic reviews published in regular journals and 18 Cochrane systematic reviews. The average methodological quality of systematic reviews was low for all ten items, but the quality of Cochrane systematic reviews was significantly higher than systematic reviews published in regular journals. On a 1-7 scale, the median overall quality score for all systematic reviews was 2 (range 1-7), with a score of 1 (range 1-7) for systematic reviews in regular journals compared to 6 (range 3-7) in Cochrane systematic reviews (p<0.001). Most systematic reviews in the field of pediatric oncology seem to have serious methodological flaws leading to a high risk of bias. While Cochrane systematic reviews were of higher methodological quality than systematic reviews in regular journals, some of them also had methodological problems. Therefore, the methodology of each individual systematic review should be scrutinized before accepting its results.

PatientsLikeMe® Online Epilepsy Community: Patient characteristics and predictors of poor health-related quality of life.

PubMed

de la Loge, Christine; Dimova, Svetlana; Mueller, Knut; Phillips, George; Durgin, Tracy L; Wicks, Paul; Borghs, Simon

2016-10-01

The online PatientsLikeMe® Epilepsy Community allows patients with epilepsy to record, monitor, and share their demographic, disease, and treatment characteristics, providing valuable insights into patient perceptions and understanding of epilepsy. The objective of this retrospective analysis was to characterize the profile of users and their disease and identify factors predictive of poor health-related quality of life (HRQoL), while assessing the platform's potential in providing patient-reported data for research purposes. Data recorded (January 2010-November 2011) by Epilepsy Community members, with an epilepsy diagnosis and who reported >1 seizure, included the following: sociodemographic and disease characteristics, treatments, symptoms, side effects perceived as medication-related, seizure occurrence, and standardized questionnaires (Quality of Life in Epilepsy Inventory [QOLIE-31/P], EuroQoL 5-Dimensions Scale, 3 Levels [EQ-5D-3L], and Hospital Anxiety and Depression Scale [HADS]). Univariate and multivariate logistic regressions were conducted to identify predictors of poor HRQoL. During the study period, the Epilepsy Community comprised 3073 patients, of whom 71.5% were female, had a mean age of 37.8years, and had a mean epilepsy duration of 17.7years. The most frequently reported moderate/severe symptoms (n=2135) included memory problems (60.2%), problems concentrating (53.8%), and fatigue (50.0%). Medication-related side effects (n=639) included somnolence (23.2%), fatigue (17.2%), and memory impairment (13.8%). The QOLIE-31/P scores (n=1121) were significantly worse in patients who experienced a recent seizure. For QOLIE-31/P, highly predictive factors for poor HRQoL included the following: mild/moderate problems concentrating, depression, memory problems, treatment side effects, occurrence of tonic-clonic seizures, and epilepsy duration ≤1year. For EQ-5D-3L, highly predictive factors for poor HRQoL included the following: pain, depression, and comorbidities. Patients on newer AEDs were less likely to report poor HRQoL (QOLIE-31/P). These findings move further towards supporting the feasibility and usefulness of collecting real-world, anonymized data recorded by patients online. The data provide insights into factors impacting HRQoL, suggesting that a holistic treatment approach beyond seizure control should be considered in epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

The quality of hospital-based antenatal care in Istanbul.

PubMed

Turan, Janet Molzan; Bulut, Ayşpen; Nalbant, Hacer; Ortayli, Nuriye; Akalin, A Arzu Koloğlu

2006-03-01

The aim of this study was to gather comprehensive data from three hospitals in Istanbul, Turkey, in order to gain in-depth understanding of the quality of antenatal care in this setting. The Bruce-Jain framework for quality of care was adapted for use in evaluating antenatal care. Methods included examination of hospital records, in-depth interviews, exit questionnaires, and structured observations. The study revealed deficiencies in the quality of antenatal care being delivered at the study hospitals in all six elements of the quality-of-care framework. The technical content of visits varied greatly among the hospitals, and an overuse of technology was accompanied by neglect of some essential components of antenatal care. Although at the private hospital some problems with the technical content of care were identified, client satisfaction was higher there, where the care included good interpersonal relations, information provision, and continuity. Providers at all three hospitals felt constrained by heavy patient loads and a lack of resources. Multifaceted approaches are needed to improve the quality of antenatal care in this setting.

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…

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 drugs for sleepiness are used. Usage of standardized and valid diagnostic criteria, exclusion of adolescence, gender, socioeconomic level, primary sleep problems, medical disorders and low IQ level, making allowances for effect of comorbidities and having compared with the control group are the important methodological features of this study. The most important limitation of this study is small sample size that makes the findings less generalizable to other groups of children with ADHD, and another one is not having used objective measurements together with subjective measurements. In conclusion, these results underscore the importance of screening all children who have a symptom constellation suggestive of ADHD for sleep problems that may either play a causative role or exacerbate the clinical appearance of ADHD in a given child. Correct evaluation and treatment of sleep problems increase the life quality of family and child and also decrease the severity of ADHD symptoms. © The Author(s) 2013.

Field-Testing for Ozone: Analyzing Air Quality in Your Hometown.

ERIC Educational Resources Information Center

Lee, Judy; DeRulle, Joyce

1995-01-01

Describes a project designed to teach students how to measure ground-level ozone and determine ozone concentrations. Enables students to research the effects of ozone exposure and discuss ways to clean up the problem. Includes an activity based on the oxidation capability of ozone. (JRH)

Evaluating the Economic and Social Benefits of Nutrient Reductions in Coastal New England Waters

EPA Science Inventory

New England’s coastal social-ecological systems are subject to chronic environmental problems, including water quality degradation. Researchers at EPA’s Office of Research and Development (ORD) Atlantic Ecology Division (AED) are piloting an effort to further understand how reduc...

CORMIX: AN EXPERT SYSTEM FOR MIXING ZONE ANALYSIS

EPA Science Inventory

United States water quality policy includes the concept of a fixing zone, a limited area where initial dilution of a discharge occurs. urrent practice in mixing zone analysis is plagued by a number of problems--mixing zone definitions vary widely, there is a diversity of discharg...

Teacher Burnout: Stylish Fad or Profound Problem.

ERIC Educational Resources Information Center

Cunningham, William G.

1982-01-01

Evidence suggests that teacher burnout has significant impact on the quality of education and on teacher job satisfaction. Its causes include job stress and organizational structures or professional relationships. Reduction of burnout may come from such strategies as increased teacher role differentiation, greater teacher support, and improved…

A Study On School Practice Of Students In Field Teaching Master Of Arts Without Thesis

NASA Astrophysics Data System (ADS)

Guzel, Hatice

2007-04-01

Teacher training and the quality of the trained teachers include a large number of problems about the education system and practices that are constantly on agenda in Turkey. Teacher candidates should be well trained in order to possess certain qualifications.

Libraries and Learning.

ERIC Educational Resources Information Center

Gee, E. Gordon; Breivik, Patricia Senn

Quality education in an information society must include skills related to the accessing and evaluating of pertinent information for problem solving. Moving beyond the practice of using reserve material, lectures, and textbooks predominant in most college teaching today would be a step towards producing independent learners more likely to use the…

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

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.

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.

A practical guide to assessing clinical decision-making skills using the key features approach.

PubMed

Farmer, Elizabeth A; Page, Gordon

2005-12-01

This paper in the series on professional assessment provides a practical guide to writing key features problems (KFPs). Key features problems test clinical decision-making skills in written or computer-based formats. They are based on the concept of critical steps or 'key features' in decision making and represent an advance on the older, less reliable patient management problem (PMP) formats. The practical steps in writing these problems are discussed and illustrated by examples. Steps include assembling problem-writing groups, selecting a suitable clinical scenario or problem and defining its key features, writing the questions, selecting question response formats, preparing scoring keys, reviewing item quality and item banking. The KFP format provides educators with a flexible approach to testing clinical decision-making skills with demonstrated validity and reliability when constructed according to the guidelines provided.

Software Past, Present, and Future: Views from Government, Industry and Academia

NASA Technical Reports Server (NTRS)

Holcomb, Lee; Page, Jerry; Evangelist, Michael

2000-01-01

Views from the NASA CIO NASA Software Engineering Workshop on software development from the past, present, and future are presented. The topics include: 1) Software Past; 2) Software Present; 3) NASA's Largest Software Challenges; 4) 8330 Software Projects in Industry Standish Groups 1994 Report; 5) Software Future; 6) Capability Maturity Model (CMM): Software Engineering Institute (SEI) levels; 7) System Engineering Quality Also Part of the Problem; 8) University Environment Trends Will Increase the Problem in Software Engineering; and 9) NASA Software Engineering Goals.

The entrepreneurial revolution in health care delivery.

PubMed

Silver, A D

1987-06-01

The rapid changes in the health marketplace have opened the door for entrepreneurs. The author shows how entrepreneurs seek previously unthought of solutions to problems and through a team effort increase corporate value. According to the author, there is a specific profile of the successful entrepreneur. The qualities of the entrepreneur and the managers that work with them, therefore, are discussed in detail. Finally, several examples of problems in health care that present entrepreneurial opportunities are presented. The author includes scenarios for taking advantage of these opportunities.

[Evaluation on methodological problems in reports concerning quantitative analysis of syndrome differentiation of diabetes mellitus].

PubMed

Chen, Bi-Cang; Wu, Qiu-Ying; Xiang, Cheng-Bin; Zhou, Yi; Guo, Ling-Xiang; Zhao, Neng-Jiang; Yang, Shu-Yu

2006-01-01

To evaluate the quality of reports published in recent 10 years in China about quantitative analysis of syndrome differentiation for diabetes mellitus (DM) in order to explore the methodological problems in these reports and find possible solutions. The main medical literature databases in China were searched. Thirty-one articles were included and evaluated by the principles of clinical epidemiology. There were many mistakes and deficiencies in these articles, such as clinical trial designs, diagnosis criteria for DM, standards of syndrome differentiation of DM, case inclusive and exclusive criteria, sample size and estimation, data comparability and statistical methods. It is necessary and important to improve the quality of reports concerning quantitative analysis of syndrome differentiation of DM in light of the principles of clinical epidemiology.

[Colonoscopy for early detection and prevention of colorectal cancer].

PubMed

Niv, Yaron

2010-08-01

Colonoscopy has a limited success in the prevention of colorectal cancer of the right colon. Thus, there is place for improvement. The potential reasons for colonoscopy failure are the different biology of polyps on the right side of the colon or procedure quality. Preparation, withdrawal time, detection of all polyps and their removal using the best technique will overcome this problem. Furthermore, the implementation of a computerized database and report that includes quality assurance fields, will improve colonoscopy success rates.

Automated quality control for stitching of textile articles

NASA Technical Reports Server (NTRS)

Miller, Jeffrey L. (Inventor); Markus, Alan (Inventor)

1999-01-01

Quality control for stitching of a textile article is performed by measuring thread tension in the stitches as the stitches are being made, determining locations of the stitches, and generating a map including the locations and stitching data derived from the measured thread tensions. The stitching data can be analyzed, off-line or in real time, to identify defective stitches. Defective stitches can then be repaired. Real time analysis of the thread tensions allows problems such as broken needle threads to be corrected immediately.

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.

Genetic Algorithm for Optimization: Preprocessor and Algorithm

NASA Technical Reports Server (NTRS)

Sen, S. K.; Shaykhian, Gholam A.

2006-01-01

Genetic algorithm (GA) inspired by Darwin's theory of evolution and employed to solve optimization problems - unconstrained or constrained - uses an evolutionary process. A GA has several parameters such the population size, search space, crossover and mutation probabilities, and fitness criterion. These parameters are not universally known/determined a priori for all problems. Depending on the problem at hand, these parameters need to be decided such that the resulting GA performs the best. We present here a preprocessor that achieves just that, i.e., it determines, for a specified problem, the foregoing parameters so that the consequent GA is a best for the problem. We stress also the need for such a preprocessor both for quality (error) and for cost (complexity) to produce the solution. The preprocessor includes, as its first step, making use of all the information such as that of nature/character of the function/system, search space, physical/laboratory experimentation (if already done/available), and the physical environment. It also includes the information that can be generated through any means - deterministic/nondeterministic/graphics. Instead of attempting a solution of the problem straightway through a GA without having/using the information/knowledge of the character of the system, we would do consciously a much better job of producing a solution by using the information generated/created in the very first step of the preprocessor. We, therefore, unstintingly advocate the use of a preprocessor to solve a real-world optimization problem including NP-complete ones before using the statistically most appropriate GA. We also include such a GA for unconstrained function optimization problems.

Hybrid water flow-like algorithm with Tabu search for traveling salesman problem

NASA Astrophysics Data System (ADS)

Bostamam, Jasmin M.; Othman, Zulaiha

2016-08-01

This paper presents a hybrid Water Flow-like Algorithm with Tabu Search for solving travelling salesman problem (WFA-TS-TSP).WFA has been proven its outstanding performances in solving TSP meanwhile TS is a conventional algorithm which has been used since decades to solve various combinatorial optimization problem including TSP. Hybridization between WFA with TS provides a better balance of exploration and exploitation criteria which are the key elements in determining the performance of one metaheuristic. TS use two different local search namely, 2opt and 3opt separately. The proposed WFA-TS-TSP is tested on 23 sets on the well-known benchmarked symmetric TSP instances. The result shows that the proposed WFA-TS-TSP has significant better quality solutions compared to WFA. The result also shows that the WFA-TS-TSP with 3-opt obtained the best quality solution. With the result obtained, it could be concluded that WFA has potential to be further improved by using hybrid technique or using better local search technique.

Raman Spectroscopy for In-Line Water Quality Monitoring — Instrumentation and Potential

PubMed Central

Li, Zhiyun; Deen, M. Jamal; Kumar, Shiva; Selvaganapathy, P. Ravi

2014-01-01

Worldwide, the access to safe drinking water is a huge problem. In fact, the number of persons without safe drinking water is increasing, even though it is an essential ingredient for human health and development. The enormity of the problem also makes it a critical environmental and public health issue. Therefore, there is a critical need for easy-to-use, compact and sensitive techniques for water quality monitoring. Raman spectroscopy has been a very powerful technique to characterize chemical composition and has been applied to many areas, including chemistry, food, material science or pharmaceuticals. The development of advanced Raman techniques and improvements in instrumentation, has significantly improved the performance of modern Raman spectrometers so that it can now be used for detection of low concentrations of chemicals such as in-line monitoring of chemical and pharmaceutical contaminants in water. This paper briefly introduces the fundamentals of Raman spectroscopy, reviews the development of Raman instrumentations and discusses advanced and potential Raman techniques for in-line water quality monitoring. PMID:25230309

The potential of crowdsourcing to improve patient-centered care.

PubMed

Weiner, Michael

2014-01-01

Crowdsourcing (CS) is the outsourcing of a problem or task to a crowd. Although patient-centered care (PCC) may aim to be tailored to an individual's needs, the uses of CS for generating ideas, identifying values, solving problems, facilitating research, and educating an audience represent powerful roles that can shape both allocation of shared resources and delivery of personalized care and treatment. CS can often be conducted quickly and at relatively low cost. Pitfalls include bias, risks of research ethics, inadequate quality of data, inadequate metrics, and observer-expectancy effect. Health professionals and consumers in the US should increase their attention to CS for the benefit of PCC. Patients' participation in CS to shape health policy and decisions is one way to pursue PCC itself and may help to improve clinical outcomes through a better understanding of patients' perspectives. CS should especially be used to traverse the quality-cost curve, or decrease costs while preserving or improving quality of care.

Raman spectroscopy for in-line water quality monitoring--instrumentation and potential.

PubMed

Li, Zhiyun; Deen, M Jamal; Kumar, Shiva; Selvaganapathy, P Ravi

2014-09-16

Worldwide, the access to safe drinking water is a huge problem. In fact, the number of persons without safe drinking water is increasing, even though it is an essential ingredient for human health and development. The enormity of the problem also makes it a critical environmental and public health issue. Therefore, there is a critical need for easy-to-use, compact and sensitive techniques for water quality monitoring. Raman spectroscopy has been a very powerful technique to characterize chemical composition and has been applied to many areas, including chemistry, food, material science or pharmaceuticals. The development of advanced Raman techniques and improvements in instrumentation, has significantly improved the performance of modern Raman spectrometers so that it can now be used for detection of low concentrations of chemicals such as in-line monitoring of chemical and pharmaceutical contaminants in water. This paper briefly introduces the fundamentals of Raman spectroscopy, reviews the development of Raman instrumentations and discusses advanced and potential Raman techniques for in-line water quality monitoring.

Life quality of patients who underwent breast reconstruction after prophylactic mastectomy: systematic review.

PubMed

Aygin, Dilek; Cengiz, Hande

2018-05-02

Prophylactic mastectomy is used to reduce the incidence of breast cancer in women with genetic predisposition and family history of breast cancer, and the rate of application is increased nowadays. Chronic pain, body image, and sexuality may negatively affect quality of life, while patients generally have increased quality of life and satisfaction after prophylactic mastectomy. The aim of this study is the evaluation of the results of the studies about quality of life of patients who underwent breast reconstruction after prophylactic mastectomy. For the 1996-2016 literature, we searched the databases of Scopus, Science Direct, PubMed, EBSCO, Cochrane, Medline Complete, Ovid, Springer Link, Google Academic, Taylor & Francis, PsychINFO databases. For the gray literature, National Thesis Center and ULAKBIM databases were searched. Seven studies complying with the criteria were included in the review. Seven studies included in this study aimed to investigate the effect of prophylactic mastectomy on breast pain, numbness, sexuality and quality of life. When the studies were reviewed, we were found that the majority of the patients were satisfied with the results of the procedure, although the body image perception and pain/ movement/ perception and sexual problems were experienced after the breast surgery. While overall satisfaction with cosmetic results was high, most women were not satisfied with the softness of the reconstructed breasts, and had problems with breast hardness, numbness and sex. Therefore, it is very important to inform the patients about the complications that may develop after the operation, while there is not enough data about the importance of informing the patients before the operation.

Suggestions for better data presentation in papers: an experience from a comprehensive study on national and sub-national trends of overweight and obesity.

PubMed

Djalalinia, Shirin; Kelishadi, Roya; Qorbani, Mostafa; Peykari, Niloofar; Kasaeian, Amir; Saeedi Moghaddam, Sahar; Gohari, Kimiya; Larijani, Bagher; Farzadfar, Farshad

2014-12-01

The importance of data quality whether in collection, analysis or presenting stage is a tangible and undeniable scientific fact and the main objects of researches implementation. This paper aims at explaining the main problems of the Iranian scientific papers for providing better data in the field of national and sub-national prevalence, incidence estimates and trends of obesity and overweight. To assess and evaluate papers, we systematically followed an approved standard protocol. Retrieval of studies was performed through Thomson Reuters Web of Science, PubMed, and Scopus, as well as Iranian databases including Irandoc, Scientific Information Database (SID), and IranMedex. Using GBD (Global Burden of Diseases) validated quality assessment forms to assess the quality and availability of data in papers, we considered the following four main domains: a) Quality of studies, b) Quality report of the results, c) Responsiveness of corresponding authors, and d) Diversity in study settings. We retrieved 3,253 records; of these 1,875 were from international and 1378 from national databases. After refining steps, 129 (3.97%) papers remained related to our study domain. More than 51% of relevant papers were excluded because of poor quality of studies. The number of reported total population and points of data were 22,972 and 29 for boys, and 38,985 and 47 for girls, respectively. For all measures, missing values and diversities in studies' setting limited our ability to compare and analyze the results. Moreover, we had some serious problems in contacting the corresponding authors for complementary information necessary (Receptiveness: 17.9%). As the present paper focused on the main problems of Iranian scientific papers and proposed suggestions, the results will have implications for better policy making.

Quality issues with malaria rapid diagnostic test accessories and buffer packaging: findings from a 5-country private sector project in Africa.

PubMed

Harvey, Steven A; Incardona, Sandra; Martin, Nina; Lussiana, Cristina; Streat, Elizabeth; Dolan, Stephanie; Champouillon, Nora; Kyabayinze, Daniel J; Mugerwa, Robert; Nakanwagi, Grace; Njoki, Nancy; Rova, Ratsimandisa; Cunningham, Jane

2017-04-20

Use of antigen-detecting malaria rapid diagnostic tests (RDTs) has increased exponentially over the last decade. WHO's Global Malaria Programme, FIND, and other collaborators have established a quality assurance scheme to guide product selection, lot verification, transport, storage, and training procedures. Recent concerns over the quality of buffer packaging and test accessories suggest a need to include these items in product assessments. This paper describes quality problems with buffer and accessories encountered in a project promoting private sector RDT use in five African countries and suggests steps to avoid or more rapidly identify and resolve such problems. Private provider complaints about RDT buffer vials and kit accessories were collected during supervisory visits, and a standard assessment process was developed. Using 100 tests drawn from six different lots produced by two manufacturers, lab technicians visually assessed alcohol swab packaging, blood transfer device (BTD) usability, and buffer appearance, then calculated mean blood volume from 10 BTD transfers and mean buffer volume from 10 individual buffer vials. WHO guided complaint reporting and follow-up with manufacturers. Supervisory visits confirmed user reports of dry alcohol swabs, poorly functioning BTDs, and non-uniform volumes of buffer. Lot testing revealed further evidence of quality problems, leading one manufacturer to replace buffer vials and accessories for 40,000 RDTs. In December 2014, WHO issued an Information Notice for Users regarding variable buffer volumes in single-use vials and recommended against procurement of these products until defects were addressed. Though not necessarily comprehensive or generalizable, the findings presented here highlight the need for extending quality assessment to all malaria RDT test kit contents. Defects such as those described in this paper could reduce test accuracy and increase probability of invalid, false positive, or false negative results. Such deficiencies could undermine provider confidence in RDTs, prompting a return to presumptive treatment or reliance on poor quality microscopy. In partial response to this experience, WHO, FIND, and other project partners have developed guidance on documenting, troubleshooting, reporting, and resolving such problems when they occur.

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…

The relation between Internet and social media use and the demographic and clinical parameters, quality of life, depression, cognitive function and sleep quality in hemodialysis patients: social media and hemodialysis.

PubMed

Afsar, Baris

2013-01-01

There are very few studies in the literature investigating the Internet use in hemodialysis (HD) patients. However, no study examined the relationship between Internet and social media use and quality of life, depression, cognitive function and sleep problems in HD patients. The study is cross-sectional in design. All patients underwent history taking; physical examination; laboratory analysis and quality of life (by a short form of the Medical Outcomes Study), depression (by the Beck Depression Inventory), cognitive function (by the Standardized Mini Mental State Examination) and sleep problems (by the Pittsburgh Sleep Quality Index) evaluation. In total, 134 HD patients (male/female: 73/61, age: 53.0 ± 13.4 years) were included. Patients with mail, Facebook and Twitter accounts were younger, were less depressive, had better quality of life, had higher cognitive function and were more educated compared to patients who did not have these accounts. Patients with Internet-based research about their disease were less depressive, had better quality of life and sleep quality, had higher cognitive function and were more educated compared to patients who did not have Internet-based research. Internet and social media use was closely related with quality of life, depression, cognitive function and education in HD patients. Studies are needed on whether Internet use under the supervision of health care professionals will improve clinical outcomes, adherence, quality of life, depression and decision making in HD patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Local extinction of dragonfly and damselfly populations in low- and high-quality habitat patches.

PubMed

Suhonen, Jukka; Hilli-Lukkarinen, Milla; Korkeamäki, Esa; Kuitunen, Markku; Kullas, Johanna; Penttinen, Jouni; Salmela, Jukka

2010-08-01

Understanding the risk of extinction of a single population is an important problem in both theoretical and applied ecology. Local extinction risk depends on several factors, including population size, demographic or environmental stochasticity, natural catastrophe, or the loss of genetic diversity. The probability of local extinction may also be higher in low-quality sink habitats than in high-quality source habitats. We tested this hypothesis by comparing local extinction rates of 15 species of Odonata (dragonflies and damselflies) between 1930-1975 and 1995-2003 in central Finland. Local extinction rates were higher in low-quality than in high-quality habitats. Nevertheless, for the three most common species there were no differences in extinction rates between low- and high-quality habitats. Our results suggest that a good understanding of habitat quality is crucial for the conservation of species in heterogeneous landscapes.

Core components of a comprehensive quality assurance program in anatomic pathology.

PubMed

Nakhleh, Raouf E

2009-11-01

In this article the core components of a comprehensive quality assurance and improvement plan are outlined. Quality anatomic pathology work comes with focus on accurate, timely, and complete reports. A commitment to continuous quality improvement and a systems approach with a persistent effort helps to achieve this end. Departments should have a quality assurance and improvement plan that includes a risk assessment of real and potential problems facing the laboratory. The plan should also list the individuals responsible for carrying out the program with adequate resources, a defined timetable, and annual assessment for progress and future directions. Quality assurance monitors should address regulatory requirements and be organized by laboratory division (surgical pathology, cytology, etc) as well as 5 segments (preanalytic, analytic, postanalytic phases of the test cycle, turn-around-time, and customer satisfaction). Quality assurance data can also be used to evaluate individual pathologists using multiple parameters with peer group comparison.

Running With the Pack: Teen Peer-Relationship Qualities as Predictors of Adult Physical Health.

PubMed

Allen, Joseph P; Uchino, Bert N; Hafen, Christopher A

2015-10-01

This study assessed qualities of adolescent peer relationships as long-term predictors of physical health quality in adulthood. In an intensive multimethod, multireporter study of a community sample of 171 individuals assessed repeatedly from the ages of 13 to 27 years, physical health quality in adulthood was robustly predicted by independent reports of early-adolescent close-friendship quality and by a pattern of acquiescence to social norms in adolescent peer relationships. Predictions remained after accounting for numerous potential confounds, including prior health problems, concurrent body mass index, anxious and depressive symptoms, personality characteristics, adolescent-era financial adversity, and adolescent-era physical attractiveness. These findings have important implications for understanding the unique intensity of peer relationships in adolescence. © The Author(s) 2015.

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.

State of Health and Quality of Life of Women at Advanced Age

PubMed Central

Pinkas, Jarosław; Gujski, Mariusz; Humeniuk, Ewa; Raczkiewicz, Dorota; Bejga, Przemysław; Owoc, Alfred; Bojar, Iwona

2016-01-01

Background Evaluation of the state of health, quality of life, and the relationship between the level of the quality of life and health status in a group of women at an advanced age (90 years of age and older) in Poland. Material/Methods The study was conducted in 2014 in an all-Polish sample of 870 women aged 90 years and older. The research instruments were: the authors’ questionnaire and several standardized tests: Katz Index of Independence in Activities of Daily Living (Katz ADL), Abbreviated Mental Test Score (AMTS), and the World Health Organization Quality of Life (WHOQOL)-BREF. The results of the study were statistically analyzed using significant t-test for mean and regression analysis. Results The majority of women at an advanced age suffered from chronic pain (76%) and major geriatric problems such as hypoacusis (81%), visual disturbances (69%) and urinary incontinence (60%); the minority of women at an advanced age suffered from falls and fainting (39%), stool incontinence (17%), severe functional impairment (24%), and cognitive impairment (10%). On a scale of 1 to 5, women at an advanced age assessed positively for overall quality of life (mean 3.3), social relationships (3.5), and environment (3.2), but negatively for general health, physical health, and psychological health (2.7, 2.7, and 2.8, respectively). The presence of chronic pain and geriatric problems, including urinary and stool incontinences, falls and faint ing, visual disturbances and hypoacusis, significantly decreased overall quality of life; general health, physical health, psychological health, social relationships, and environment. Overall quality of life, general health, physical health, psychological health, social relationships, and environment was correlated with functional and cognitive impairments. Conclusions Quality of life of women at an advanced age decreased if chronic pain, major geriatric problems, or functional or cognitive impairments occurred. PMID:27580565

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.

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.

Quality of life in patients with Parkinson's disease: development of a questionnaire.

PubMed Central

de Boer, A G; Wijker, W; Speelman, J D; de Haes, J C

1996-01-01

OBJECTIVES--To develop and test a questionnaire for measuring quality of life in patients with Parkinson's disease. METHODS--An item pool was developed based on the experience of patients with Parkinson's disease and of neurologists; medical literature on the problems of patients with Parkinson's disease; and other quality of life questionnaires. To reduce the item pool, 13 patients identified items that were a problem to them and rated their importance. Items which were most often chosen and rated most important were included in the Parkinson's disease quality of life questionnaire (PDQL). The PDQL consists of 37 items. To evaluate the discriminant validity of the PDQL three groups of severity of disease were compared. To test for convergent validity, the scores of the PDQL were tested for correlation with standard indices of quality of life. RESULTS--The PDQL was filled out by 384 patients with Parkinson's disease. It consisted of four subscales: parkinsonian symptoms, systemic symptoms, emotional functioning, and social functioning. The internal-consistency reliability coefficients of the PDQL subscales were high (0.80-0.87). Patients with higher disease severity had significantly lower quality of life on all PDQL subscales (P < 0.05). Almost all PDQL subscales correlated highly (P < 0.001) with the corresponding scales of the standard quality of life indices. CONCLUSION--The PDQL is a relevant, reliable, and valid measure of the quality of life of patients with Parkinson's disease. Images PMID:8676165

Professional Staff Contributions to Student Retention and Success in Higher Education

ERIC Educational Resources Information Center

Roberts, Jenny

2018-01-01

Student attrition remains a persistent problem within the Australian higher education sector. Contributing factors include financial, reputational and quality issues, which can pose significant risks for a university's sustainability. Institutional culture is fundamental to decisions student make about withdrawing or remaining in higher education.…

Early Predictors of Psychopathology and Competence in Children.

ERIC Educational Resources Information Center

Sroufe, L. Alan; Egeland, Byron

A longitudinal investigation focused on the etiology of psychiatric and behavioral disorders in a sample of 190 children at risk for developmental problems. Data collection began during pregnancy and included assessments of: (1) parental personality, intelligence, and parenting attitudes; (2) parent-child interaction and relationship quality; (3)…

Thinking Globally, Acting Locally: Using the Local Environment to Explore Global Issues.

ERIC Educational Resources Information Center

Simmons, Deborah

1994-01-01

Asserts that water pollution is a global problem and presents statistics indicating how much of the world's water is threatened. Presents three elementary school classroom activities on water quality and local water resources. Includes a figure describing the work of the Global Rivers Environmental Education Network. (CFR)

Use of glucose oxidase to improve refrigerated dough quality

USDA-ARS?s Scientific Manuscript database

Refrigerated dough encompasses a wide range of products including bread, rolls, pastries and pizza crust and is a very popular choice for consumers. Two of the largest problems that occur during refrigerated dough storage are dough syruping and loss of dough strength. The goal of this study was to e...

Rural Youth: The Policy Agenda.

ERIC Educational Resources Information Center

Dey, Ian; Jentsch, Birgit

With the advent of a Scottish Parliament and a Minister and Parliamentary Committee for Rural Affairs, there is now a broad consensus that policies are needed to generate "quality jobs" for young people in rural Scotland. This agenda is politically appealing, since it addresses various rural problems, including retention of young people…

Odor and odorous chemical emissions from animal buildings: part 1 - project overview, collection methods, and quality control

USDA-ARS?s Scientific Manuscript database

Livestock facilities have historically generated public concerns due to their emissions of odorous air and various chemical pollutants. Odor emission factors and identification of principal odorous chemicals are needed to better understand the problem. Applications of odor emission factors include i...

Proposal for Implementation of Office of Educational Radio Services.

ERIC Educational Resources Information Center

Petrizzi, David M.; Wright, A. J.

Auburn University's radio station is being faced with providing quality public radio programing with inadequate resources, including money, personnel, and university support. This proposal is directed to the university community and discusses the university radio station's problems at three levels. At the federal level, concerns relate to…

How Well Do Researchers Report Their Measures? An Evaluation of Measurement in Published Educational Research.

ERIC Educational Resources Information Center

Whittington, Dale

1998-01-01

This study describes how much and in what ways authors of research studies fail to include adequate information about data collection. Results based on analysis of 220 articles from 22 journals show that the quality of measurement reporting continues to be a problem. (SLD)

Environmental Education . . . The Way of the Hula Hoop?

ERIC Educational Resources Information Center

Applegate, Warren

1974-01-01

Given is information on a federally funded environmental education program based on field experience and community awareness. Problem-solving methods were used to involve students in local environmental issues. Field experiences included trips to the mountains and seashore and community projects in water quality, recycling, and nature trail…

Medical Management of Constipation

PubMed Central

Portalatin, Meredith; Winstead, Nathaniel

2012-01-01

Constipation is a common clinical problem. Initial management of chronic constipation should include lifestyle maneuvers, and increased fiber and fluids. Polyethylene glycol, sodium picosulfate, bisacodyl, prucalopride, lubiprostone, and linaclotide were all more effective than placebo for treating chronic idiopathic constipation. Many commonly used agents lack quality evidence supporting their use. PMID:23449608

Teachers as Researchers: A "Fair Dinkum" Learning Legacy

ERIC Educational Resources Information Center

Comber, Barbara

2013-01-01

As educators encounter a policy landscape where increasingly the education lexicon includes keywords such as data, evidence, quality, and standards, it is interesting to revisit Garth Boomer's contribution regarding teachers as researchers. In "Fair Dinkum Teaching and Learning," Boomer (1985) clearly named at least two key problems that…

Minor Anomalies and Behavior in Different Home Environments.

ERIC Educational Resources Information Center

LaVeck, Beverly; And Others

This study presents research findings of a four year study intended to identify infant and family characteristics which, singly or in combination, predict developmental problems during preschool and school years. Predictors included a variety of measures of parental and neonatal biological conditions as well as measures of the quality of the…

Depressive symptoms, smoking, drinking, and quality of life among head and neck cancer patients.

PubMed

Duffy, Sonia A; Ronis, David L; Valenstein, Marcia; Fowler, Karen E; Lambert, Michael T; Bishop, Carol; Terrell, Jeffrey E

2007-01-01

The authors examined the relationship between depressive symptoms, smoking, problem drinking, and quality of life among 973 head and neck cancer patients who were surveyed and had their charts audited. Forty-six percent screened positive for depressive symptoms, 30% smoked, and 16% screened positive for problem drinking. Controlling for clinical and demographic variables, linear-regression analyses showed that depressive symptoms had a strong negative association with all 12 quality-of-life scales; smoking had a negative association on all but one of the quality-of-life scales; and problem drinking was not associated with any of the quality-of-life scales. Interventions targeting depression, smoking, and problem drinking need to be integrated into oncology clinics.

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.

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.

Increasing podiatry referrals for patients with inflammatory arthritis at a tertiary hospital in Singapore: A quality improvement project.

PubMed

Carter, K; Cheung, P P; Rome, K; Santosa, A; Lahiri, M

2017-06-01

Foot disease is highly prevalent in people with inflammatory arthritis and is often under-recognized. Podiatry intervention can significantly reduce foot pain and disability, with timely access being the key factor. The aim of this study was to plan and implement a quality improvement project to identify the barriers to, and improve, uptake of podiatry services among patients with inflammatory arthritis-related foot problems seen at a tertiary hospital in Singapore. A 6-month quality improvement program was conducted by a team of key stakeholders using quality improvement tools to identify, implement and test several interventions designed to improve uptake of podiatry services. The number of patients referred for podiatry assessment was recorded on a weekly basis by an experienced podiatrist. The criterion for appropriate referral to podiatry was those patients with current or previous foot problems such as foot pain, swelling and deformity. Interventions included education initiatives, revised workflow, development of national guidelines for inflammatory arthritis, local podiatry guidelines for the management of foot and ankle problems, routine use of outcome measures, and introduction of a fully integrated rheumatology-podiatry service with reduced cost package. Referral rates increased from 8% to 11%, and were sustained beyond the study period. Complete incorporation of podiatry into the rheumatology consultation as part of the multidisciplinary team package further increased referrals to achieve the target of full uptake of the podiatry service. Through a structured quality improvement program, referrals to podiatry increased and improved the uptake and acceptance of rheumatology-podiatry services. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Norwegian prospective study of preterm mother-infant interactions at 6 and 18 months and the impact of maternal mental health problems, pregnancy and birth complications.

PubMed

Misund, Aud R; Bråten, Stein; Nerdrum, Per; Pripp, Are Hugo; Diseth, Trond H

2016-05-04

Pregnancy, birth and health complications, maternal mental health problems following preterm birth and their possible impact on early mother-infant interaction at 6 and 18 months corrected age (CA) were explored. Predictors of mother-infant interaction at 18 months CA were identified. This prospective longitudinal and observational study included 33 preterm mother-infant (<33 gestational age (GA)) interactions at 6 and 18 months CA from a socioeconomic low-risk, middle-class sample. The Parent-Child Early Relational Assessment (PCERA) scale was used to assess the mother-infant interaction. 'Bleeding in pregnancy' predicted lower quality in preterm mother-infant interaction in 6 PCERA scales, while high 'maternal trait anxiety' predicted higher interactional quality in 2 PCERA scales and 'family size' predicted lower interactional quality in 1 PCERA scale at 18 months CA. Mothers with symptoms of post-traumatic stress reactions, general psychological distress and anxiety at 2 weeks postpartum (PP) showed significantly better outcome than mothers without symptoms in 6 PCERA subscales at 6 months CA and 2 PCERA subscales at 18 months CA. Our study detected a correspondence between early pregnancy complications and lower quality of preterm mother-infant interaction, and an association between high levels of maternal mental health problems and better quality in preterm mother-infant interaction. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Community violence concerns and adolescent sleep.

PubMed

Bagley, Erika J; Tu, Kelly M; Buckhalt, Joseph A; El-Sheikh, Mona

2016-03-01

The goal of this study was to examine links between concerns about community violence and objective and subjective sleep parameters in an adolescent sample. Sex was considered as a moderator of effects. The study used a cross-sectional design. The community-based sample included 252 adolescents (53% girls) with an average age of 15.79 years (SD = 0.81) from the Southeastern United States. The sample included 34% African American and 66% European American adolescents from a wide range of socioeconomic backgrounds. Adolescent-reported community violence concerns were assessed using a composite of 3 separate subscales that measured perceived community safety and threats of community and school violence. Sleep duration and quality were assessed using actigraphy, and subjective sleep problems and daytime sleepiness were measured with subscales of the School Sleep Habits Survey. Community violence predicted lower sleep efficiency, more long-wake episodes, and more sleep/wake problems and sleepiness. Sex-related moderation effects revealed that girls in the sample were more vulnerable to the effects of violence concerns on their objective sleep quality. Findings highlight the role of community violence concerns on adolescents' sleep, revealing that greater community violence concerns are linked with lower levels of actigraphy-based and subjective reports of sleep quality, particularly for adolescent girls. Consideration of the mechanisms by which violence concerns may affect sleep is discussed.

A Study of Clinical Profile and Quality of Life in Patients with Scabies at a Rural Tertiary Care Centre.

PubMed

Nair, Pragya Ashok; Vora, Rita Vipul; Jivani, Nidhi B; Gandhi, Shailee S

2016-10-01

Scabies is a contagious disease primarily related to poverty and overcrowding, it rapidly spreads from person to person specially in people with poor hygiene. We come across many patients from rural areas with scabies. In India the incidence ranges from 13% to 59% in rural and urban areas. Many people complain of sleep disturbances and affection of work and leisure activities due to itching. Very few studies are done in India about the affection of quality of life in such patients. To study the demographic details, clinical profile and quality of life in patients with scabies. A prospective, observational and cross-sectional study conducted at Department of Dermatology and Venereology, rural based tertiary care centre, Gujarat for a period of 6 months from March to August 2015, after ethical approval from the institute. Study included all patients with clinical features suggestive of scabies. The data including age, sex, occupation, education, socioeconomic status, complaints, past history, family history and clinical features along with the questionnaire for affection of quality of life were recorded in predesigned proforma and detailed analysis was done. Total of 102 newly diagnosed scabies patients attending skin OPD were included in the study. Out of 102 patients, 50.98% were males. The most common age group affected was 21-40 years, in 44.11% patients. Students were commonly affected with 41.17% followed by housewives with 20.58% cases. Most common lesion seen was papules in 84.3% followed by excoriations in 82.3% cases. Maximum 51.6% adults had small effect on quality of life while 62.5% children reported minimal effect on quality of life. Scabies is an important and commonly encountered health problem which is highly contagious and if not attended timely and adequately can affect the quality of life in the form of work affection, sleep disturbances and psychosocial problems in patients as well as its family members. This could be easily prevented if the patients of scabies are recognised and treated early and proper awareness is must to avoid recurrences. The profile of scabies patients helps in early recognition of scabies even at the peripheral centers.

Family Income Dynamics, Early Childhood Education and Care, and Early Child Behavior Problems in Norway

PubMed Central

Zachrisson, Henrik Daae; Dearing, Eric

2014-01-01

The sociopolitical context of Norway includes low poverty rates and universal access to subsidized and regulated Early Childhood Education and Care (ECEC). In this context, the association between family income dynamics and changes in early child behavior problems was investigated, as well as whether high quality ECEC buffers children from the effects of income dynamics. In a population-based sample (N = 75,296), within-family changes in income-to-needs predicted changes in externalizing and internalizing problems (from age 18 to 36 months), particularly for lower-income children. For internalizing problems, ECEC buffered the effect of income-to-needs changes. These findings lend further support to the potential benefits of ECEC for children from lower-income families. PMID:25345342

Inhibitory Control Mediates the Association between Perceived Stress and Secure Relationship Quality.

PubMed

Herd, Toria; Li, Mengjiao; Maciejewski, Dominique; Lee, Jacob; Deater-Deckard, Kirby; King-Casas, Brooks; Kim-Spoon, Jungmeen

2018-01-01

Past research has demonstrated negative associations between exposure to stressors and quality of interpersonal relationships among children and adolescents. Nevertheless, underlying mechanisms of this association remain unclear. Chronic stress has been shown to disrupt prefrontal functioning in the brain, including inhibitory control abilities, and evidence is accumulating that inhibitory control may play an important role in secure interpersonal relationship quality, including peer problems and social competence. In this prospective longitudinal study, we examine whether changes in inhibitory control, measured at both behavioral and neural levels, mediate the association between stress and changes in secure relationship quality with parents and peers. The sample included 167 adolescents (53% males) who were first recruited at age 13 or 14 years and assessed annually three times. Adolescents' inhibitory control was measured by their behavioral performance and brain activities, and adolescents self-reported perceived stress levels and relationship quality with mothers, fathers, and peers. Results suggest that behavioral inhibitory control mediates the association between perceived stress and adolescent's secure relationship quality with their mothers and fathers, but not their peers. In contrast, given that stress was not significantly correlated with neural inhibitory control, we did not further test the mediation path. Our results highlight the role of inhibitory control as a process through which stressful life experiences are related to impaired secure relationship quality between adolescents and their mothers and fathers.

Inhibitory Control Mediates the Association between Perceived Stress and Secure Relationship Quality

PubMed Central

Herd, Toria; Li, Mengjiao; Maciejewski, Dominique; Lee, Jacob; Deater-Deckard, Kirby; King-Casas, Brooks; Kim-Spoon, Jungmeen

2018-01-01

Past research has demonstrated negative associations between exposure to stressors and quality of interpersonal relationships among children and adolescents. Nevertheless, underlying mechanisms of this association remain unclear. Chronic stress has been shown to disrupt prefrontal functioning in the brain, including inhibitory control abilities, and evidence is accumulating that inhibitory control may play an important role in secure interpersonal relationship quality, including peer problems and social competence. In this prospective longitudinal study, we examine whether changes in inhibitory control, measured at both behavioral and neural levels, mediate the association between stress and changes in secure relationship quality with parents and peers. The sample included 167 adolescents (53% males) who were first recruited at age 13 or 14 years and assessed annually three times. Adolescents’ inhibitory control was measured by their behavioral performance and brain activities, and adolescents self-reported perceived stress levels and relationship quality with mothers, fathers, and peers. Results suggest that behavioral inhibitory control mediates the association between perceived stress and adolescent’s secure relationship quality with their mothers and fathers, but not their peers. In contrast, given that stress was not significantly correlated with neural inhibitory control, we did not further test the mediation path. Our results highlight the role of inhibitory control as a process through which stressful life experiences are related to impaired secure relationship quality between adolescents and their mothers and fathers. PMID:29535664

Enhanced Verification Test Suite for Physics Simulation Codes

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

Kamm, J R; Brock, J S; Brandon, S T

2008-10-10

This document discusses problems with which to augment, in quantity and in quality, the existing tri-laboratory suite of verification problems used by Los Alamos National Laboratory (LANL), Lawrence Livermore National Laboratory (LLNL), and Sandia National Laboratories (SNL). The purpose of verification analysis is demonstrate whether the numerical results of the discretization algorithms in physics and engineering simulation codes provide correct solutions of the corresponding continuum equations. The key points of this document are: (1) Verification deals with mathematical correctness of the numerical algorithms in a code, while validation deals with physical correctness of a simulation in a regime of interest.more » This document is about verification. (2) The current seven-problem Tri-Laboratory Verification Test Suite, which has been used for approximately five years at the DOE WP laboratories, is limited. (3) Both the methodology for and technology used in verification analysis have evolved and been improved since the original test suite was proposed. (4) The proposed test problems are in three basic areas: (a) Hydrodynamics; (b) Transport processes; and (c) Dynamic strength-of-materials. (5) For several of the proposed problems we provide a 'strong sense verification benchmark', consisting of (i) a clear mathematical statement of the problem with sufficient information to run a computer simulation, (ii) an explanation of how the code result and benchmark solution are to be evaluated, and (iii) a description of the acceptance criterion for simulation code results. (6) It is proposed that the set of verification test problems with which any particular code be evaluated include some of the problems described in this document. Analysis of the proposed verification test problems constitutes part of a necessary--but not sufficient--step that builds confidence in physics and engineering simulation codes. More complicated test cases, including physics models of greater sophistication or other physics regimes (e.g., energetic material response, magneto-hydrodynamics), would represent a scientifically desirable complement to the fundamental test cases discussed in this report. The authors believe that this document can be used to enhance the verification analyses undertaken at the DOE WP Laboratories and, thus, to improve the quality, credibility, and usefulness of the simulation codes that are analyzed with these problems.« less

[Construction of NIRS-based total quality control system for compound Ejiao oral liquid and relative thinking].

PubMed

Zhang, Yan; Zhang, Lu; Tian, Shou-Sheng; Zhou, Xiang-Shan; Li, Wen-Long; Qu, Hai-Bin

2016-10-01

In this paper, near infrared spectroscopy (NIRS)-based total quality control system of compound Ejiao oral liquid is introduced briefly, including the quality control of raw traditional Chinese medicine (TCM) materials, monitoring and control of the extract and the alkaline precipitation technics, and also the inspection of finished products in both open bottle and non-opening modes. By analyzing and summing up the significance and difficulties, several important problems in the practical applications of NIRS technology are proposed, which will provide references for the similar studies of other TCM products. Copyright© by the Chinese Pharmaceutical Association.

The measurement of quality of care in the Veterans Health Administration.

PubMed

Halpern, J

1996-03-01

The Veterans Health Administration (VHA) is committed to continual refinement of its system of quality measurement. The VHA organizational structure for quality measurement has three levels. At the national level, the Associate Chief Medical Director for Quality Management provides leadership, sets policy, furnishes measurement tools, develops and distributes measures of quality, and delivers educational programs. At the intermediate level, VHA has four regional offices with staff responsible for reviewing risk management data, investigating quality problems, and ensuring compliance with accreditation requirements. At the hospital level, staff reporting directly to the chief of staff or the hospital director are responsible for implementing VHA quality management policy. The Veterans Health Administration's philosophy of quality measurement recognizes the agency's moral imperative to provide America's veterans with care that meets accepted standards. Because the repair of faulty systems is more efficient than the identification of poor performers, VHA has integrated the techniques of total quality into a multifaceted improvement program that also includes the accreditation program and traditional quality assurance activities. VHA monitors its performance by maintaining adverse incident databases, conducting patient satisfaction surveys, contracting for external peer review of 50,000 records per year, and comparing process and outcome rates internally and when possible with external benchmarks. The near-term objectives of VHA include providing medical centers with a quality matrix that will permit local development of quality indicators, construction of a report card for VHA's customers, and implementing the Malcolm W. Baldrige system for quality improvement as the road map for systemwide continuous improvement. Other goals include providing greater access to data, creating a patient-centered database, providing real-time clinical decision support, and expanding the databases.

Modeling and water quality assessment during realisation of the coastal projects in Sochi region (Black sea coast of Russia)

NASA Astrophysics Data System (ADS)

Prokhoda-Shumskikh, L.

2012-04-01

Sochi region is the unique subtropical resort on the Black Sea coast of Russia. Nowadays due to Sochi is the capital of the Olympic game 2014, the government of the Russian Federation accepts the special federal program of Black Sea coast development. Program foresees the existing and creation of new coastal recreational and touristic complexes along the Russian Black Sea coast, such as complex of yacht harbors, water centers (aqua-centers), network of port localities and etc. These coastal projects are different, but the main problems of the environmental impact assessment are the same. The environmental impact and the relative damage should be assessed at the stage of construction as well as at the stage of operation. The key problem for the recreation coastal zone is water quality management. The port localities network as example is considered. To increase the accuracy and informative of forecasts for the coastal zone conditions the system-dynamic model has been developed, what allows to estimate the quality of the sea water, including that in the semi-enclosed coastal water areas with the limited water exchange. The model of water quality in the coastal zone includes the equations of deposit concentration changes and chemical substances evolution in the studied areas. The model incorporates joint description of cycles of two biogenic elements - nitrogen and phosphorus. The system is completely defined by the biogeochemical reactions. The sizes of such water areas allow the applying the full mixing and zero-dimensional models of water quality. The circulation of water inside the area is taken into account additionally. Water exchange in the semi-enclosed coastal water areas is defined by the discharge through the open parts of area border. The novelty of the offered model is its adaptation to the specific conditions of semi-enclosed coastal water areas. At the same time, the model contains details of the biogeochemical processes to complete modelling of the water quality. The developed system dynamics model is realized in the «PowerSim Studio» media. The data of natural measurements of water quality are applied for the model verification, and the correlated numerical results for the Russian Black Sea coast are presented. The main objective of the present paper is to present the actual examples, and to generalise the problems and to discuss the possible approaches of their solution.

Reintegration after bone marrow transplantation.

PubMed

Baker, F; Zabora, J; Polland, A; Wingard, J

1999-01-01

This study examines the problems of bone marrow transplantation (BMT) survivors in returning to "normal" life in the community after BMT. Before being released from The Johns Hopkins Oncology Center, 84 recipients of BMT were interviewed regarding their quality of life and psychosocial adaptation. Survivors were reinterviewed at 6 months, and at 1 year post-BMT, producing considerable qualitative data regarding their problems in living. Eighty-four patients who had received BMT completed qualitative interviews and standardized measures before treatment, before the return home, and at 6 and 12 months post-BMT. The interviews were subjected to a content analysis methodology to establish units and categories to examine the body of material. Content analysis of these interviews from the first year after BMT identified three areas of psychosocial morbidity; 1) physical problems, which included fatigue, appearance, troubles in eating, and physical restrictions; 2) psychological problems, which included fears about the future, sense of loss of control, anxiety, and depression; and 3) community reintegration problems, which included difficulty in returning to former social roles, separation from home, family, and friends, difficulty in resuming social relations, dealing with stigmatization, problems with family and children, and financial and employment difficulties. Identification of these problems for BMT survivors can be used to guide the development of specific materials and services to prepare recipients of BMTs and their families for life after the transplant. These qualitative results can also be used to direct the development of assessment tools to identify potential patient and family problems.

Intimate partner violence during pregnancy and behavioral problems in children and adolescents: a meta-analysis.

PubMed

Silva, Elisabete P; Lemos, Andrea; Andrade, Carlos H S; Ludermir, Ana B

2018-03-21

To evaluate the association of intimate partner violence during the gestational period and the development of externalizing and internalizing behavioral problems in children and adolescents. A meta-analysis of cohort and case-control studies was performed, using studies selected from electronic databases. Eligible studies included women who experienced intimate partner violence during pregnancy and their children's behavioral problems. These problems encompass two groups: externalizing problems (expressed by hyperactivity, aggressive and challenging behavior, and delinquency) and internalizing problems (represented by depressive moods, anxiety, and somatic symptoms). The risk of bias was assessed by the Newcastle-Ottawa Quality Assessment Scale (NOS) and the quality of evidence by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). RevMan 5.3 software was used for the meta-analysis. Of the 687 eligible articles, only seven met all inclusion criteria and consisted of 12,250 mother/child pairs. The age range of the assessed children varied from 10 months to 16 years. The odds of internalizing problems in children exposed to prenatal violence were two-fold higher (OR=2.10, 95% CI: 1.17-3.76) and that of externalizing problems were 1.9-fold higher (95% CI: 1.28-2.83), when compared to children of unexposed mothers. The results of this study are consistent with the hypothesis that women's exposure to intimate partner violence during pregnancy may be associated with behavioral problems of their children, emphasizing the need for greater understanding about the vulnerability of children to adversity in early ages. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

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…

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…

U.S. healthcare fix: leveraging the lessons from the food supply chain.

PubMed

Kumar, Sameer; Blair, John T

2013-01-01

U.S. healthcare costs consistently outpace inflation, causing growing problems of affordability. This trend cannot be sustained indefinitely. The purpose of this study is to use supply-chain tools for macro-level examination of the U.S. healthcare as a business system and identify options and best use practices. We compare the important and successful U.S. food industry to the essential but problematic U.S. healthcare industry. Supply chain strategies leading to food business operations success are examined and healthcare applications suggested. We emphasize "total cost of ownership" which includes all costs incurred by all stakeholders of U.S. healthcare, including maintenance and cleanup, not just the initial purchase price. U.S. hospitals and clinics can use supply chain strategies in a total cost of ownership framework to reduce healthcare costs while maintaining patient care quality. Supply chain strategies of resource pooling, mass customization, centralized logistics, specialization, postponement and continuous improvement that have been successfully used in the U.S. food industry should be more widely applied to the U.S. healthcare industry. New and growing areas of telemedicine and medical tourism should be included in the supply chain analysis of U.S. healthcare. Valid statistical analysis of results in all areas of U.S. healthcare is an important part of the process. U.S. healthcare industry problems are systematic operational and supply chain problems rather than problems with workforce or technology. Examination of the U.S. healthcare industry through a supply chain framework should lead to significant operational improvement in both prevention and treatment of acute and chronic ailments. A rational and unemotional reorganization of the U.S. healthcare system operations, using supply chain strategies, should help reduce healthcare costs while maintaining quality and increasing accessibility.

Evaluation of Arctic broadband surface radiation measurements

NASA Astrophysics Data System (ADS)

Matsui, N.; Long, C. N.; Augustine, J.; Halliwell, D.; Uttal, T.; Longenecker, D.; Niebergall, O.; Wendell, J.; Albee, R.

2012-02-01

The Arctic is a challenging environment for making in-situ surface radiation measurements. A standard suite of radiation sensors is typically designed to measure incoming and outgoing shortwave (SW) and thermal infrared, or longwave (LW), radiation. Enhancements may include various sensors for measuring irradiance in narrower bandwidths. Many solar radiation/thermal infrared flux sensors utilize protective glass domes and some are mounted on complex mechanical platforms (solar trackers) that keep sensors and shading devices trained on the sun along its diurnal path. High quality measurements require striking a balance between locating stations in a pristine undisturbed setting free of artificial blockage (such as from buildings and towers) and providing accessibility to allow operators to clean and maintain the instruments. Three significant sources of erroneous data in the Arctic include solar tracker malfunctions, rime/frost/snow deposition on the protective glass domes of the radiometers and operational problems due to limited operator access in extreme weather conditions. In this study, comparisons are made between the global and component sum (direct [vertical component] + diffuse) SW measurements. The difference between these two quantities (that theoretically should be zero) is used to illustrate the magnitude and seasonality of arctic radiation flux measurement problems. The problem of rime/frost/snow deposition is investigated in more detail for one case study utilizing both SW and LW measurements. Solutions to these operational problems that utilize measurement redundancy, more sophisticated heating and ventilation strategies and a more systematic program of operational support and subsequent data quality protocols are proposed.

Evaluation of arctic broadband surface radiation measurements

NASA Astrophysics Data System (ADS)

Matsui, N.; Long, C. N.; Augustine, J.; Halliwell, D.; Uttal, T.; Longenecker, D.; Nievergall, O.; Wendell, J.; Albee, R.

2011-08-01

The Arctic is a challenging environment for making in-situ radiation measurements. A standard suite of radiation sensors is typically designed to measure the total, direct and diffuse components of incoming and outgoing broadband shortwave (SW) and broadband thermal infrared, or longwave (LW) radiation. Enhancements can include various sensors for measuring irradiance in various narrower bandwidths. Many solar radiation/thermal infrared flux sensors utilize protective glass domes and some are mounted on complex mechanical platforms (solar trackers) that rotate sensors and shading devices that track the sun. High quality measurements require striking a balance between locating sensors in a pristine undisturbed location free of artificial blockage (such as buildings and towers) and providing accessibility to allow operators to clean and maintain the instruments. Three significant sources of erroneous data include solar tracker malfunctions, rime/frost/snow deposition on the instruments and operational problems due to limited operator access in extreme weather conditions. In this study, a comparison is made between the global and component sum (direct [vertical component] + diffuse) shortwave measurements. The difference between these two quantities (that theoretically should be zero) is used to illustrate the magnitude and seasonality of radiation flux measurement problems. The problem of rime/frost/snow deposition is investigated in more detail for one case study utilizing both shortwave and longwave measurements. Solutions to these operational problems are proposed that utilize measurement redundancy, more sophisticated heating and ventilation strategies and a more systematic program of operational support and subsequent data quality protocols.

Inverse models: A necessary next step in ground-water modeling

USGS Publications Warehouse

Poeter, E.P.; Hill, M.C.

1997-01-01

Inverse models using, for example, nonlinear least-squares regression, provide capabilities that help modelers take full advantage of the insight available from ground-water models. However, lack of information about the requirements and benefits of inverse models is an obstacle to their widespread use. This paper presents a simple ground-water flow problem to illustrate the requirements and benefits of the nonlinear least-squares repression method of inverse modeling and discusses how these attributes apply to field problems. The benefits of inverse modeling include: (1) expedited determination of best fit parameter values; (2) quantification of the (a) quality of calibration, (b) data shortcomings and needs, and (c) confidence limits on parameter estimates and predictions; and (3) identification of issues that are easily overlooked during nonautomated calibration.Inverse models using, for example, nonlinear least-squares regression, provide capabilities that help modelers take full advantage of the insight available from ground-water models. However, lack of information about the requirements and benefits of inverse models is an obstacle to their widespread use. This paper presents a simple ground-water flow problem to illustrate the requirements and benefits of the nonlinear least-squares regression method of inverse modeling and discusses how these attributes apply to field problems. The benefits of inverse modeling include: (1) expedited determination of best fit parameter values; (2) quantification of the (a) quality of calibration, (b) data shortcomings and needs, and (c) confidence limits on parameter estimates and predictions; and (3) identification of issues that are easily overlooked during nonautomated calibration.

Regional and supraregional biochemistry services in Scotland: a survey of hospital laboratory users.

PubMed Central

Murphy, M J; Dryburgh, F J; Shepherd, J

1994-01-01

AIM--To ascertain the views of Scottish hospital laboratory users on aspects of regional and supraregional biochemical services offered by the Institute of Biochemistry at Glasgow Royal Infirmary. METHODS--A questionnaire was circulated asking questions or inviting opinions under various headings, including current patterns of usage of the services provided, availability of information on specimen collection requirements and reference ranges, current arrangements for transport of specimens, turnaround times for delivery of reports, layout and content of request and report forms, quantity and quality of interpretive advice, potential changes in laboratory services, and overall impression of the services provided. Opportunities were provided for free text comment. The questionnaire was circulated in 1992 to heads of department in 23 Scottish hospital biochemistry laboratories. RESULTS--Twenty one replies were received. Services used widely included trace metals/vitamins (n = 20) and specialised endocrine tests (n = 19). Other services also used included specialised lipid tests (n = 13), toxicology (n = 12), thyroid function tests (n = nine), and tumour markers (n = eight). Fifteen laboratories used one or more of the services at least weekly. Most (n = 20) welcomed the idea of a handbook providing information on specimen collection and reference ranges. Nine identified loss of specimens as a problem. Other perceived problems included the absence of reference ranges from report forms, quantity and quality of interpretive advice, and turnaround times of some tests. Overall impressions of the service(s) offered were very good (n = 12); adequate (n = seven); poor (n = one). CONCLUSIONS--Useful information was obtained about patterns of use and transport arrangements. Areas identified as requiring follow up included provision of information, alternative ways of communicating reports, and improvement in quantity and quality of interpretive advice. PMID:8027390

Interventions for attention problems after pediatric traumatic brain injury: what is the evidence?

PubMed

Backeljauw, Barynia; Kurowski, Brad G

2014-09-01

To gain an understanding of the current state of the evidence for management of attention problems after traumatic brain injury (TBI) in children, determine gaps in the literature, and make recommendations for future research. TYPE: Focused systematic review. PubMed/Medline and PsychINFO databases were searched for relevant articles published in English during the last 20 years. Keywords included "attention" "attention deficit and disruptive behavior disorders," and "brain injuries." Studies were limited to children. Titles were examined first and eliminated based on lack of relevancy to attention problems after brain injury in children. This was followed by an abstract and full text review. Article quality was determined based on the US Preventative Services Task Force recommendations for evidence grading. Four pharmacologic and 10 cognitive therapy intervention studies were identified. These studies varied in level of evidence quality but were primarily nonrandomized or cohort studies. There are studies that demonstrate benefits of varying pharmacologic and cognitive therapies for the management of attention problems after TBI. However, there is a paucity of evidence available to definitively guide management of attention problems after pediatric TBI. Larger randomized, controlled trials and multicenter studies are needed to elucidate optimal treatment strategies in this population. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Metaheuristic optimisation methods for approximate solving of singular boundary value problems

NASA Astrophysics Data System (ADS)

Sadollah, Ali; Yadav, Neha; Gao, Kaizhou; Su, Rong

2017-07-01

This paper presents a novel approximation technique based on metaheuristics and weighted residual function (WRF) for tackling singular boundary value problems (BVPs) arising in engineering and science. With the aid of certain fundamental concepts of mathematics, Fourier series expansion, and metaheuristic optimisation algorithms, singular BVPs can be approximated as an optimisation problem with boundary conditions as constraints. The target is to minimise the WRF (i.e. error function) constructed in approximation of BVPs. The scheme involves generational distance metric for quality evaluation of the approximate solutions against exact solutions (i.e. error evaluator metric). Four test problems including two linear and two non-linear singular BVPs are considered in this paper to check the efficiency and accuracy of the proposed algorithm. The optimisation task is performed using three different optimisers including the particle swarm optimisation, the water cycle algorithm, and the harmony search algorithm. Optimisation results obtained show that the suggested technique can be successfully applied for approximate solving of singular BVPs.

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).

Developing quality indicators and auditing protocols from formal guideline models: knowledge representation and transformations.

PubMed

Advani, Aneel; Goldstein, Mary; Shahar, Yuval; Musen, Mark A

2003-01-01

Automated quality assessment of clinician actions and patient outcomes is a central problem in guideline- or standards-based medical care. In this paper we describe a model representation and algorithm for deriving structured quality indicators and auditing protocols from formalized specifications of guidelines used in decision support systems. We apply the model and algorithm to the assessment of physician concordance with a guideline knowledge model for hypertension used in a decision-support system. The properties of our solution include the ability to derive automatically context-specific and case-mix-adjusted quality indicators that can model global or local levels of detail about the guideline parameterized by defining the reliability of each indicator or element of the guideline.

Effectiveness of a Self Help Cognitive Behavioural Treatment Program for Problem Gamblers: A Randomised Controlled Trial.

PubMed

Oei, T P S; Raylu, N; Lai, W W

2018-06-01

The study aimed to strengthen the scarce literature on self-help treatments for Problem Gambling (PG) by comparing the effectiveness of a Self-Help Cognitive Behavioral Treatment (SHCBT) program (n = 23) with a 6-week Waitlist condition (n = 32) in problem gamblers. Participants were community volunteers with gambling problems and were randomly allocated to the Waitlist and treatment conditions. Results showed significant improvements at post-treatment in gambling behaviors including frequency of gambling, average amount gambled per day and PG symptoms as well as a number of gambling correlates including psychological states (e.g., depression, anxiety and stress), gambling cognitions, gambling urges, gambling related self-efficacy, satisfaction with life, and quality of life among those who completed the SHCBT program, when compared with the waitlist condition. The effect size (partial η 2 ) ranged from .25 to .57 for all assessed outcomes that showed significant improvement from pre- to post-treatment. It was concluded that a self-help CBT program can be beneficial for treating community problem gamblers.

Learning in and about rural places: Connections and tensions between students' everyday experiences and environmental quality issues in their community

NASA Astrophysics Data System (ADS)

Zimmerman, Heather Toomey; Weible, Jennifer L.

2017-03-01

Guided by sociocultural perspectives on the importance of place as a resource for learning, we investigated 14- and 15-year old students' understandings of their community and water quality during a school-based watershed unit. Methods included a theory-driven thematic analysis of field notes and video transcripts from four biology classrooms, a qualitative and quantitative analysis of 67 pairs of matched pre- and post-intervention mindmaps, and a content analysis of 73 student reflections. As they learned about water quality, learners recognized the relevance of the watershed's health to the health of their community. Students acknowledged the impacts of local economically driven activities (e.g., natural gas wells, application of agrichemicals) and leisure activities (e.g., boating, fishing) on the watershed's environmental health. As students learned in and about their watershed, they experienced both connections and tensions between their everyday experiences and the environmental problems in their community. The students suggested individual sustainability actions needed to address water quality issues; however, the students struggled to understand how to act collectively. Implications of rural experiences as assets to future environmental sciences learning are discussed as well as the implications of educational experiences that do not include an advocacy component when students uncover environmental health issues. We suggest further consideration is needed on how to help young people develop action-oriented science knowledge, not just inert knowledge of environmental problems, during place-based education units.

Associations of impaired sleep quality, insomnia, and sleepiness with epilepsy: A questionnaire-based case-control study.

PubMed

Im, Hee-Jin; Park, Seong-Ho; Baek, Shin-Hye; Chu, Min Kyung; Yang, Kwang Ik; Kim, Won-Joo; Yun, Chang-Ho

2016-04-01

The purpose of this study was to document the frequency of sleep problems including poor sleep quality, excessive daytime sleepiness, and insomnia in subjects with epilepsy compared with healthy controls and to determine the factors associated with these sleep disturbances. We recruited 180 patients with epilepsy (age: 43.2 ± 15.6 years, men: 50.0%) and 2836 healthy subjects (age: 44.5 ± 15.0 years, men: 49.8%). Sleep and the anxiety/mood profiles were measured using the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Goldberg Anxiety Scale, and Patient Health Questionnaire-9 depression scale. Associations of sleep problems with epilepsy and other factors were tested by multiple logistic regression analysis, adjusted for age, gender, body mass index, alcohol intake, smoking, perceived sleep insufficiency, and habitual snoring. Sleep disturbances were more common in the group with epilepsy than in the controls (53.3% vs. 25.5%; p<0.001). Poor sleep quality, excessive daytime sleepiness, and insomnia were significantly associated with epilepsy (odds ratio [95% confidence interval]: 3.52 [2.45-5.05], 2.10 [1.41-3.12], 5.91 [3.43-10.16], respectively). Depressive mood, anxiety, and perceived sleep insufficiency contributed to the presence of sleep disturbances. In the group with epilepsy, seizure remission for the past year related to a lower frequency of insomnia, whereas age, sex, type of epilepsy, and number of antiepileptic drugs were not correlated with sleep problems. Epilepsy was significantly associated with the higher frequency of sleep disturbances, which supports the importance of screening sleep problems in patients with epilepsy and providing available intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects.

PubMed

Gerhart, James I; Burns, John W; Post, Kristina M; Smith, David A; Porter, Laura S; Burgess, Helen J; Schuster, Erik; Buvanendran, Asokumar; Fras, Anne Marie; Keefe, Francis J

2017-06-01

Poor sleep quality among people with chronic low back pain appears to be related to worse pain, affect, poor physical function, and pain catastrophizing. The causal direction between poor sleep and pain remains an open question, however, as does whether sleep quality exerts effects on low back pain differently across the course of the day. This daily diary study examined lagged temporal associations between prior night sleep quality and subsequent day pain, affect, physical function and pain catastrophizing, the reverse lagged temporal associations between prior day pain-related factors and subsequent night sleep quality, and whether the time of day during which an assessment was made moderated these temporal associations. Chronic low back pain patients (n = 105) completed structured electronic diary assessments five times per day for 14 days. Items included patient ratings of their pain, affect, physical function, and pain catastrophizing. Collapsed across all observations, poorer sleep quality was significantly related to higher pain ratings, higher negative affect, lower positive affect, poorer physical function, and higher pain catastrophizing. Lagged analyses averaged across the day revealed that poorer prior night sleep quality significantly predicted greater next day patient ratings of pain, and poorer physical function and higher pain catastrophizing. Prior poorer night sleep quality significantly predicted greater reports of pain, and poorer physical function, and higher pain catastrophizing, especially during the early part of the day. Sleep quality × time of day interactions showed that poor sleepers reported high pain, and negative mood and low function uniformly across the day, whereas good sleepers reported relatively good mornings, but showed pain, affect and function levels comparable to poor sleepers by the end of the day. Analyses of the reverse causal pathway were mostly nonsignificant. Sleep quality appears related not only to pain intensity but also to a wide range of patient mood and function factors. A good night's sleep also appears to offer only temporary respite, suggesting that comprehensive interventions for chronic low back pain not only should include attention to sleep problems but also focus on problems with pain appraisals and coping.

Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects

PubMed Central

Gerhart, James I.; Burns, John W.; Post, Kristina M.; Smith, David A.; Porter, Laura S.; Burgess, Helen J.; Schuster, Erik; Buvanendran, Asokumar; Fras, Anne Marie; Keefe, Francis J.

2016-01-01

Background Poor sleep quality among people with chronic low back pain appears to be related to worse pain, affect, poor physical function and pain catastrophizing. The causal direction between poor sleep and pain remains an open question, however, as does whether sleep quality exerts effects on low back pain differently across the course of the day. Purpose This daily diary study examined lagged temporal associations between prior night sleep quality and subsequent day pain, affect, physical function and pain catastrophizing, the reverse lagged temporal associations between prior day pain-related factors and subsequent night sleep quality, and whether the time of day during which an assessment was made moderated these temporal associations. Methods Chronic low back pain patients (n = 105) completed structured electronic diary assessments five times per day for 14 days. Items included patient ratings of their pain, affect, physical function and pain catastrophizing. Results Collapsed across all observations, poorer sleep quality was significantly related to higher pain ratings, higher negative affect, lower positive affect, poorer physical function and higher pain catastrophizing. Lagged analyses averaged across the day revealed that poorer prior night sleep quality significantly predicted greater next day patient ratings of pain, and poorer physical function and higher pain catastrophizing. Prior poorer night sleep quality significantly predicted greater reports of pain, and poorer physical function, and higher pain catastrophizing, especially during the early part of the day. Sleep Quality × Time of Day interactions showed that poor sleepers reported high pain, and negative mood and low function uniformly across the day, whereas good sleepers reported relatively good mornings, but showed pain, affect and function levels comparable to poor sleepers by the end of the day. Analyses of the reverse causal pathway were mostly nonsignificant. Conclusions Sleep quality appears related not only to pain intensity but also to a wide range of patient mood and function factors. A good night’s sleep also appears to offer only temporary respite, suggesting that comprehensive interventions for chronic low back pain not only should include attention to sleep problems but also focus on problems with pain appraisals and coping. PMID:27844327

Quality information for quality use of medicines; 2nd International Conference, Kazan, 15-16 October 2010.

PubMed

Ziganshina, Lilia E; Menkes, David B; Herxheimer, Andrew

2011-01-01

Kazan hosted Russia's first international conference on medicines that was entirely independent of the pharmaceutical industry, attracting 414 participants from 9 countries and 20 regions of the Russian Federation. The meeting was greeted and endorsed by world leaders in pharmaceutical information, policy and regulation. Delegates discussed the professional and social problems arising from unethical drug promotion, including compromised evidence from clinical trials and consequent impairments in health service delivery. The Conference adopted a resolution prioritizing policy development and health system needs, notably including the development of clinical pharmacology. A website documents conference materials and provides an interface for future collaboration: http://evidenceupdate-tatarstan.ru/confer.

Veterinary Aspects of Bird of Prey Reproduction.

PubMed

Bailey, Tom A; Lierz, Michael

2017-05-01

Captive breeding has contributed to successful restoration of many species of birds of prey. Avicultural techniques pioneered by raptor breeders include double clutching, direct fostering, cross-fostering, hatch and switch, hacking, imprinting male and female falcons for semen collection, and artificial insemination techniques. However, reproductive failure occurs related to management problems, including hygiene measures, food quality issues, breeding flock structure, or individual health issues of breeding birds. These may result in non-egg laying females, low-quality eggs, or infertile eggs caused by male infertility. Veterinary care of breeding collections is extremely important. This article provides an overview of veterinary involvement in raptor breeding projects. Copyright © 2016 Elsevier Inc. All rights reserved.

Relationship between sleep quality and mental health according to demographics of 850 patients with chronic obstructive pulmonary disease.

PubMed

Eslaminejad, Alireza; Safa, Mitra; Ghassem Boroujerdi, Fatemeh; Hajizadeh, Farzaneh; Pashm Foroush, Maryam

2017-10-01

We aimed to study sleep problems in hospitalized chronic obstructive pulmonary disease patients and assess the relationship of sleep quality with mental health and demographics of patients. Our study sample consisted of 850 chronic obstructive pulmonary disease patients hospitalized in Masih Daneshvari Hospital. Demographic data were collected and the Pittsburgh Sleep Quality and mental health questionnaires were filled out for patients. The results showed that 5.9 percent were suffering from severe sleep problems, while 4.7 percent had severe mental problems. A strong positive correlation was found between the total scores of mental health and sleep quality ( p < 0.01). The prevalence of sleep and mental health problems was higher in females compared to males. Mental health and sleep quality play important roles in quality of life of chronic obstructive pulmonary disease patients.

Identifying the Gaps in Practice for Combating Lead in Drinking Water in Hong Kong

PubMed Central

Lee, Wai Ling; Jia, Jie; Bao, Yani

2016-01-01

Excessive lead has been found in drinking water in Hong Kong in tests carried out in 2015. Investigations have identified that the problem in public rental housing estates was caused by the problematic solders used in the plumbing, and recommendations on enhancing the quality control system and strengthening the relevant water quality standards have been proposed. The cause for the same problem happening in other premises where soldering has not been adopted for water pipe connections is left unidentified. Considering the unidentified cause and the recommendations made, this study aims to identify the gaps in practice followed in Hong Kong for safeguarding the water quality of new installations. A holistic review of governing ordinances and regulations, products and materials used and the testing and commissioning requirements adopted in Hong Kong and elsewhere in the world were conducted. Based on international practices and parametric analysis, it was found that there are gaps in practices followed in Hong Kong, which are directly and indirectly leading to the lead-in-water crisis. Recommendations for improvement in the quality control system, and the water quality standards including the allowable lead content and leaching limit for products and materials and the testing and commissioning requirements on plumbing installations have been made. The review and the identified gaps would become useful reference for countries in strengthening their relevant water quality standards. PMID:27706062

Identifying the Gaps in Practice for Combating Lead in Drinking Water in Hong Kong.

PubMed

Lee, Wai Ling; Jia, Jie; Bao, Yani

2016-09-30

Excessive lead has been found in drinking water in Hong Kong in tests carried out in 2015. Investigations have identified that the problem in public rental housing estates was caused by the problematic solders used in the plumbing, and recommendations on enhancing the quality control system and strengthening the relevant water quality standards have been proposed. The cause for the same problem happening in other premises where soldering has not been adopted for water pipe connections is left unidentified. Considering the unidentified cause and the recommendations made, this study aims to identify the gaps in practice followed in Hong Kong for safeguarding the water quality of new installations. A holistic review of governing ordinances and regulations, products and materials used and the testing and commissioning requirements adopted in Hong Kong and elsewhere in the world were conducted. Based on international practices and parametric analysis, it was found that there are gaps in practices followed in Hong Kong, which are directly and indirectly leading to the lead-in-water crisis. Recommendations for improvement in the quality control system, and the water quality standards including the allowable lead content and leaching limit for products and materials and the testing and commissioning requirements on plumbing installations have been made. The review and the identified gaps would become useful reference for countries in strengthening their relevant water quality standards.

The adaption of coal quality to furnace structure

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

Zhang, Z.; Shun, X.

1996-12-31

This paper gives the research result of coal quality adaption to furnace structure. The designing of a furnace is based on the coal quality that the furnace would fire. If the coal fired in the furnace differs from the design coal, there would be a lot of problems such as flame stability, coal burn-out rate and slagging problem for the furnace during its operation. In order to know the adaptional range of coal quality for an existing furnace the authors had chosen three different furnaces and 18 kinds of coals in their research work. To understand the coal combustion characteristicsmore » they introduce different indexes to show different processes of coal combustion. These indexes include Fz index which demonstrates the coal combustion based on its utility analyzed result, flame stability index, combustion characteristic index and char burn-out index which are based on the analyzed result of thermogravimetric characteristic. As a furnace is built up and set into operation its flame stability, burn-out rate and ash deposition are definite. If a furnace`s fuel changes its structure characteristics and operation condition will change. A relation between coal quality to furnace structure is based on a lot of regressional analysis results of existing furnaces and their fuels. Based on this relation the adaption of coal quality for a furnace are defined and the kinds of coal furnace fired are optimized to its design fuel.« less

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.

Systematic overview of economic evaluations of health-related rehabilitation.

PubMed

Howard-Wilsher, Stephanie; Irvine, Lisa; Fan, Hong; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

2016-01-01

Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

NIOSH testimony on indoor air quality: Selected references before the Subcommittee on Superfund, Ocean and Water Protection, Committee on Environment and Public Works, United States Senate by J. Donald Millar, May 26, 1989

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

Not Available

1989-09-01

The National Institute for Occupational Safety and Health (NIOSH) has compiled the document in response to an increasing number of requests for information about indoor air quality (IAQ), including sick building syndrome. Included in the publication are: NIOSH Congressional testimony that describes the NIOSH IAQ investigations program and summarizes the results of NIOSH research and findings on IAQ problems, NIOSH guidance for conducting indoor air quality investigations, NIOSH journal article on evaluating building ventilation systems, and list of non-NIOSH publications on indoor air quality. As the Federal agency responsible for conducting research and making recommendations for occupational safety and healthmore » standards, NIOSH limits its IAQ activities to the occupational environment. The U.S. Environmental Protection Agency (EPA) also conducts an IAQ program and can be contacted for information regarding both occupational and non-occupational settings.« less

How to Assess Quality of Research in Iran, From Input to Impact? Introduction of Peer-Based Research Evaluation Model in Iran.

PubMed

Ebadifar, Asghar; Baradaran Eftekhari, Monir; Owlia, Parviz; Habibi, Elham; Ghalenoee, Elham; Bagheri, Mohammad Reza; Falahat, Katayoun; Eltemasi, Masoumeh; Sobhani, Zahra; Akhondzadeh, Shahin

2017-11-01

Research evaluation is a systematic and objective process to measure relevance, efficiency and effectiveness of research activities, and peer review is one of the most important tools for assessing quality of research. The aim of this study was introducing research evaluation indicators based on peer reviewing. This study was implemented in 4 stages. A list of objective-oriented evaluation indicators were designed in 4 axes, including; governance and leadership, structure, knowledge production and research impact. The top 10% medical sciences research centers (RCs) were evaluated based on peer review. Adequate equipment and laboratory instruments, high quality research publication and national or international cooperation were the main strengths in medical sciences RCs and the most important weaknesses included failure to adhere to strategic plans, parallel actions in similar fields, problems in manpower recruitment, knowledge translation & exchange (KTE) in service providers and policy makers' levels. Peer review evaluation can improve the quality of research.

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

Validation of Toolkit After-Death Bereaved Family Member Interview.

PubMed

Teno, J M; Clarridge, B; Casey, V; Edgman-Levitan, S; Fowler, J

2001-09-01

The purpose of this study was to examine the reliability and validity of the Toolkit After-Death Bereaved Family Member Interview to measure quality of care at the end of life from the unique perspective of family members. The survey included proposed problem scores (a count of the opportunity to improve the quality of care) and scales. Data were collected through a retrospective telephone survey with a family member who was interviewed between 3 and 6 months after the death of the patient. The setting was an outpatient hospice service, a consortium of nursing homes, and a hospital in New England. One hundred fifty-six family members from across these settings participated. The 8 proposed domains of care, as represented by problem scores or scales, were based on a conceptual model of patient-focused, family-centered medical care. The survey design emphasized face validity in order to provide actionable information to health care providers. A correlational and factor analysis was undertaken of the 8 proposed problem scores or scales. Cronbach's alpha scores varied from 0.58 to 0.87, with two problem scores (each of which had only 3 survey items) having a low alpha of 0.58. The mean item-to-total correlations for the other problem scores varied from 0.36 to 0.69, and the mean item-to-item correlations were between 0.32 and 0.70. The proposed problem scores or scales, with the exception of closure and advance care planning, demonstrated a moderate correlation (i.e., from 0.44 to 0.52) with the overall rating of satisfaction (as measured by a five-point, "excellent" to "poor" scale). Family members of persons who died with hospice service reported fewer problems in each of the six domains of medical care, gave a higher rating of the quality of care, and reported higher self-efficacy in caring for their loved ones. These results indicate that 7 of the 8 proposed problem scores or scales demonstrated psychometric properties that warrant further testing. The domain of closure demonstrated a poor correlation with overall satisfaction and requires further work. This survey could provide information to help guide quality improvement efforts to enhance the care of the dying.

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

[Development and current status of atmospheric pollution].

PubMed

Elichegaray, C; Bouallala, S; Maitre, A; Ba, M

2009-02-01

Air quality is a public health issue and this article includes a reminder of the related causes and issues and a description of the monitoring of ambient air quality in France. It also provides a review of major developments in recent years of the pollutants measured. Emissions of major air pollutants have declined significantly since the 1970s, and this is reflected in an overall improvement in the quality of ambient air. Nevertheless, various forms of air pollution remain a concern (in the case of photochemical pollution) and health data show that air pollution is still a cause of morbidity and mortality. The fight against air pollution must remain a priority and requires multi-pollutant and multi-effect approaches. The National Health and Environment Program adopted during the Grenelle environment stakeholder consultation processes includes targets for reducing human exposure to air pollution, especially particulate matter, as well as measures to improve indoor air quality. In a context dominated by the struggle against the emission of greenhouse gases, problems of air quality should not be underestimated and policies relating to climate protection must be taken into account.

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.

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

Quality of life of adult men with Duchenne muscular dystrophy in the Netherlands: implications for care.

PubMed

Pangalila, Robert F; van den Bos, Geertrudis A M; Bartels, Bart; Bergen, Michael P; Kampelmacher, Mike J; Stam, Henk J; Roebroeck, Marij E

2015-02-01

To assess quality of life of adults with Duchenne muscular dystrophy in the Netherlands and to identify domains and major problems influencing quality of life. Cross-sectional. Seventy-nine men aged ≥ 20 years with Duchenne muscular dystrophy. The Medical Outcome Study Short Form-36 (SF-36), World Health Organization Quality of Life - BREF (WHOQOL-BREF) and an interview were used to assess quality of life and problems. Compared with Dutch general population reference values, the SF-36 domains scores were lower on all domains except mental health and role limitations due to emotional problems. On the WHOQOL-BREF the social relationships domain score was lower. Main problems were intimate relationships, work, leisure, transport and meaningfulness of life. Seventy-three percent stated overall quality of life as "(very) good". The SF-36 domains mental health (rs 0.53, p < 0.001) and vitality (rs 0.49, p < 0.001) had the strongest associations with overall quality of life. Adult men with Duchenne muscular dystrophy assess their health status as low in the physical, but not in the mental, domains. Experienced problems are mainly in the area of participation. They are generally satisfied with their overall quality of life.

The German and Japanese health care systems: an international comparison using an input-output model.

PubMed

Rump, A; Schöffski, O

2016-12-01

The German and Japanese health care systems have common roots, but have evolved differently. Whereas the German system is often considered as expensive and poorly efficient, people in Japan are viewed as healthy and health care as comparatively cheap. In this study, we compared the quality, the effectiveness and efficiency of the German and Japanese health care systems. This study includes comparative health care data analysis. The quality and effectiveness of the German and Japanese health care systems were analyzed using an input-output model including 12 countries based on health indicators published by the OECD. Besides the invested resources, a risk-related input dimension was used for risk adjustment. The efficiency of the systems was assessed by relating the average output to the health expenses per capita. Health risks seem qualitatively different in Germany and Japan, but at the aggregate level, lifestyle does not seem to be an outstanding explanatory factor for health outcome differences between both countries. For investments in health resources, Germany is in a top position, whereas in the international comparison, the outcome is rather poor. The resources invested in Japan are also high, but slightly less than in Germany, whereas on average, the outcome is better. However, in the international comparison, resources as well as results in Japan show a very high variability. Relating the average output to the health expenses per capita indicates that on the average, the health care system in Japan is more efficient than in Germany. Germany and Japan have a quality problem with their health care systems. In Germany there is a transmission failure from structural to outcome quality that might be related to coordination problems between the outpatient and inpatient sector. Japan shows an unbalanced system that may be suspected to have a quality problem as a whole. As the development of the remuneration system including quality requirements is under the direct responsibility and guidance of the Ministry of Health in Japan, the issue might however be more easily solved in Japan than in Germany. Although on average, health care seems more efficient in Japan than in Germany, taking into account health as well as long-term care expenses and uncertainties related to exchange rate adjustments, the higher efficiency of the Japanese system becomes questionable. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The mediating role of perceived peer support in the relation between quality of attachment and internalizing problems in adolescence: a longitudinal perspective.

PubMed

Pace, Ugo; Zappulla, Carla; Di Maggio, Rosanna

2016-10-01

The study was aimed to verify, from a longitudinal perspective, whether perceived peer support would mediate the relationship between attachment and internalizing problems. Longitudinal participants included 482 adolescents (245 boys) aged 14-15 years in Wave 1 and 17-18 years in Wave 2. Participants in Wave 1 completed the Relationship Questionnaire, and those in Wave 2 completed the Social Support Questionnaire and the Youth Self-Report. Results showed that secure attachment positively predicted high levels of perceived peer support and negatively predicted internalizing problems, whereas fearful and preoccupied attachment negatively predicted perceived peer support and positively predicted internalizing problems. The mediation models showed that perceived peer support partially mediated the relationship between secure attachment and internalizing problems as well as between preoccupied attachment and internalizing problems and between fearful attachment and internalizing problems. Our results confirm the role of subjective perception of peer support in contributing to the prediction of internalizing problems beyond attachment styles.

Combinatorial optimization problem solution based on improved genetic algorithm

NASA Astrophysics Data System (ADS)

Zhang, Peng

2017-08-01

Traveling salesman problem (TSP) is a classic combinatorial optimization problem. It is a simplified form of many complex problems. In the process of study and research, it is understood that the parameters that affect the performance of genetic algorithm mainly include the quality of initial population, the population size, and crossover probability and mutation probability values. As a result, an improved genetic algorithm for solving TSP problems is put forward. The population is graded according to individual similarity, and different operations are performed to different levels of individuals. In addition, elitist retention strategy is adopted at each level, and the crossover operator and mutation operator are improved. Several experiments are designed to verify the feasibility of the algorithm. Through the experimental results analysis, it is proved that the improved algorithm can improve the accuracy and efficiency of the solution.

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.

Early Student-Teacher Relationships of Children With and Without Intellectual Disability: Contributions of Behavioral, Social, and Self-Regulatory Competence

PubMed Central

Eisenhower, Abbey S.; Baker, Bruce L.; Blacher, Jan

2011-01-01

We investigated the student-teacher relationships (STRs) of 6-year-old children with (n=58) and without (n=82) intellectual disability (ID). We also examined early (age 3) and concurrent (age 6) child behavioral, self-regulatory, and social characteristics as predictors of age 6 STR quality. Children with ID experienced significantly poorer relationships with their teachers, marked by less closeness and more conflict and dependency, compared to typically-developing children. This group difference was not accounted for entirely by IQ differences. The relation between ID status and STR quality was fully mediated by four age 6 child variables: mother- and teacher-reported behavior problems and mother- and teacher-reported social skills. The quality of children’s relationships with teachers was also predicted by child characteristics as early as age 3, including early behavior problems, self-regulation, and behavior during parent-child interactions. The relation of ID status to STR quality at age 6 was fully mediated by children’s self-regulatory abilities at age 3. Our findings demonstrate the importance of child behavioral and social characteristics in predicting relationships with teachers for children with and without ID. PMID:21490876

Environmental urban runoff monitoring

NASA Astrophysics Data System (ADS)

Yu, Byunggu; Behera, Pradeep K.; Kim, Seon Ho; Ramirez Rochac, Juan F.; Branham, Travis

2010-04-01

Urban stormwater runoff has been a critical and chronic problem in the quantity and quality of receiving waters, resulting in a major environmental concern. To address this problem engineers and professionals have developed a number of solutions which include various monitoring and modeling techniques. The most fundamental issue in these solutions is accurate monitoring of the quantity and quality of the runoff from both combined and separated sewer systems. This study proposes a new water quantity monitoring system, based on recent developments in sensor technology. Rather than using a single independent sensor, we harness an intelligent sensor platform that integrates various sensors, a wireless communication module, data storage, a battery, and processing power such that more comprehensive, efficient, and scalable data acquisition becomes possible. Our experimental results show the feasibility and applicability of such a sensor platform in the laboratory test setting.

[Health-related quality of life evaluation of elderly aged 65 years and over living at home].

PubMed

Jalenques, I; Auclair, C; Rondepierre, F; Gerbaud, L; Tourtauchaux, R

2015-06-01

To assess health-related quality of life in French adults aged 65 years and over, living at home, with a specific self-administered questionnaire, the LEIPAD, cross-culturally adapted in French. Elderly completed socio-demographic and medical questionnaires, a questionnaire about negative life events during the last 12 months and the LEIPAD. Data of 195 subjects (mean age: 72.6 years, men: 56.5%) were analyzed. The response rates to the LEIPAD scales were superior to 90%. Elderly reported on the whole a good health-related quality of life. Age had a negative effect on quality on life, which deteriorates over years. Age was correlated to the scales "Physical function", "Self-care", "Cognitive functioning" and "Sexual functioning". Elderly hospitalized in the last year had worse quality of life with a significant difference for "Physical function" scale. The number of health problems was positively correlated to "Physical function" scale. Elderly declaring at least one health problem had worse quality of life for this scale. Problems in couple, materials and financial problems had also negative effects on health-related quality of life. Our study highlights a good health-related quality of life for the majority of these adults aged 65 years and over, as well as the negative effect of age, health, couple, materials and financial problems on their quality of life. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

77 FR 30087 - Air Quality Designations for the 2008 Ozone National Ambient Air Quality Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-21

...This rule establishes initial air quality designations for most areas in the United States, including areas of Indian country, for the 2008 primary and secondary national ambient air quality standards (NAAQS) for ozone. The designations for several counties in Illinois, Indiana, and Wisconsin that the EPA is considering for inclusion in the Chicago nonattainment area will be designated in a subsequent action, no later than May 31, 2012. Areas designated as nonattainment are also being classified by operation of law according to the severity of their air quality problems. The classification categories are Marginal, Moderate, Serious, Severe, and Extreme. The EPA is establishing the air quality thresholds that define the classifications in a separate rule that the EPA is signing and publishing in the Federal Register on the same schedule as these designations. In accordance with that separate rule, six nonattainment areas in California are being reclassified to a higher classification.

Digitalizing historical high resolution water level data: Challenges and opportunities

NASA Astrophysics Data System (ADS)

Holinde, Lars; Hein, Hartmut; Barjenbruch, Ulrich

2017-04-01

Historical tide-gauge data offer the opportunities for determining variations in key characteristics for water level data and the analyses of past extreme events (storm surges). These information are important for calculating future trends and scenarios. But there are challenges involved due to the extensive effort needed to digitalize gauge sheets and quality control the resulting historical data. Based on these conditions, two main sources for inaccuracies in historical time series can be identified. First are several challenges due to the digitalization of the historical data, e.g. general quality of the sheets, multiple crossing lines of the observed water levels and additional comments on the sheet describing problems or additional information during the measurements. Second are problems during the measurements themselves. These can include the incorrect positioning of the sheets, trouble with the tide-gauge and maintenance. Errors resulting from these problems can be e.g. flat lines, discontinuities and outlier. Especially, the characterization of outliers has to be conducted carefully, to distinguish between real outliers and the appearance of extreme events. Methods for the quality control process involve the use of statistics, machine learning and neural networks. These will be described and applied to three different time series from tide gauge stations at the cost of Lower Saxony, Germany. Resulting difficulties and outcomes of the quality control process will be presented and explained. Furthermore, we will present a first glance at analyses for these time series.

A Non-bipartite Propensity Score Analysis of the Effects of Teacher-Student Relationships on Adolescent Problem and Prosocial Behavior.

PubMed

Obsuth, Ingrid; Murray, Aja Louise; Malti, Tina; Sulger, Philippe; Ribeaud, Denis; Eisner, Manuel

2017-08-01

Previous research suggests a link between the quality of teacher-student relationships and the students' behavioral outcomes; however, the observational nature of past studies makes it difficult to attribute a causal role to the quality of these relationships. In the current study, therefore, we used a propensity score analysis approach to evaluate whether students who were matched on their propensity to experience a given level of relationship quality but differed on their actual relationship quality diverged on their concurrent and subsequent problem and prosocial behavior. Student/self, teacher, and parent- (only waves 1-3) reported data from 8 waves of the Zurich Project on the Social Development of Children and Youths (z-proso), a longitudinal study of Swiss youth among a culturally diverse sample of 7- to 15-year-olds were utilized. The initial sample included 1483 (49.4 % female) students for whom information relevant for this study was available. The sample represented families from around 80 different countries, from across all the continents; with approximately 42 % of the female primary caregivers having been born in Switzerland. Following successful matching, we found that students who reported better relationships with their teachers and whose teachers reported better relationships with them evidenced fewer problem behaviors concurrently and up to 4 years later. There was also evidence for an analogous effect in predicting prosocial behavior. The implications of these findings are discussed in relation to prevention and intervention practices.

Safety, Tolerability and Efficacy of Drugs for Treating Behavioural Insomnia in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review with Methodological Quality Assessment.

PubMed

Anand, Shweta; Tong, Henry; Besag, Frank M C; Chan, Esther W; Cortese, Samuele; Wong, Ian C K

2017-06-01

A large proportion of paediatric patients with attention-deficit/hyperactivity disorder (ADHD) have associated sleep problems which not only affect the child's wellbeing but also impact family functioning. Management of sleep problems is consequently an important aspect of overall ADHD management in paediatric patients. Although some drugs are being used off-label for the management of paediatric insomnia, there is scant clinical evidence supporting their use. Our aim was to identify and assess the quality of published studies reporting the safety, tolerability and efficacy of drugs used for treating behavioural insomnia in children with ADHD. After an initial screen to determine which drugs were most commonly used, we conducted a systematic review of English-language publications from searches of PubMed, EMBASE, PsycINFO and two trial register databases to February 2017, using keywords 'clonidine', 'melatonin', 'zolpidem', 'eszopiclone', 'L-theanine', 'guanfacine', 'ADHD', 'sleep disorder' and 'children'. For quality assessment of included studies, we used the CONSORT checklist for randomised control trials (RCTs) and the Downs and Black checklist for non-RCTs. Twelve studies were included. Two case series for clonidine, two RCTs and four observational studies for melatonin and one RCT each for zolpidem, eszopiclone, L-theanine and guanfacine. Of the 12 included studies, only one on eszopiclone scored excellent for quality. The quality of the rest of the studies varied from moderate to low. For clonidine, melatonin and L-theanine, improvements in sleep-onset latency and total sleep duration were reported; however, zolpidem, eszopiclone and guanfacine failed to show any improvement when compared with placebo. Clonidine, melatonin, L-theanine, eszopiclone and guanfacine were well tolerated with mild to moderate adverse events; zolpidem was associated with neuropsychiatric adverse effects. There is generally poor evidence for prescribing drugs for behavioural insomnia in children with ADHD. Further controlled studies are warranted.

The impact of learned resourcefulness on quality of life in type II diabetic patients: a cross-sectional correlational study.

PubMed

Huang, Chiung-Yu; Perng, Shoa-Jen; Chen, Hisu-Fung; Lai, Chien-Yu

2008-12-01

It is well recognized that patients with diabetes encounter a host of daily self-care issues, including controlling blood sugar and preventing and managing complications, which impact significantly upon quality of life. Studies have indicated that learned resourcefulness has a potentially positive effect in dealing with psychosocial and health problems. The purpose of this study was to test the relationship between learned resourcefulness and quality of life in type II diabetic patients. The mediating and moderating effects of learned resourcefulness on the relationship between metabolic control and quality of life of diabetic patients was also examined. This cross-sectional and correlational study included a convenience sample of 131 type II diabetic patients recruited from three hospitals in southern Taiwan. Data were collected through questionnaires, which included the Rosenbaum's Self Control Schedule and World Health Organization's Quality of Life (Short Version). Multiple regression techniques were used to analyze outcome predictors. Study findings include identification of a mediating effect of learned resourcefulness between metabolic control and quality of life. While most DM patients were not satisfied with their health, we found that those with greater learned resourcefulness enjoyed a better quality of life. Learned resourcefulness, gender, and HbA1C explained 35.2% of variance in DM patient quality of life. Male diabetic patients enjoyed a better quality of life than females, even though levels of learned resourcefulness between the two groups were not significantly different. Results indicate that poor metabolic control of diabetic patients has a detrimental effect on quality of life, and when diabetic patients use more self-control skills, they may achieve better quality of life. Results suggest that nurses who use cognitive behavior coping strategies (resourcefulness) may help diabetic patients achieve better metabolic control and promote better quality of life.

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

Efroymson, Rebecca Ann; Dale, Virginia H; Kline, Keith L

Indicators of the environmental sustainability of biofuel production, distribution, and use should be selected, measured, and interpreted with respect to the context in which they are used. These indicators include measures of soil quality, water quality and quantity, greenhouse-gas emissions, biodiversity, air quality, and vegetation productivity. Contextual considerations include the purpose for the sustainability analysis, the particular biofuel production and distribution system (including supply chain, management aspects, and system viability), policy conditions, stakeholder values, location, temporal influences, spatial scale, baselines, and reference scenarios. Recommendations presented in this paper include formulating the problem for particular analyses, selecting appropriate context-specific indicators ofmore » environmental sustainability, and developing indicators that can reflect multiple environmental properties at low cost within a defined context. In addition, contextual considerations such as technical objectives, varying values and perspectives of stakeholder groups, and availability and reliability of data need to be understood and considered. Sustainability indicators for biofuels are most useful if adequate historical data are available, information can be collected at appropriate spatial and temporal scales, organizations are committed to use indicator information in the decision-making process, and indicators can effectively guide behavior toward more sustainable practices.« less

PROVING SOLUTIONS FOR A BETTER TOMORROW: A PROGRESS REPORT ON U.S. EPA'S DRINKING WATER TREATMENT TECHNOLOGY DEMONSTRATIONS IN ECUADOR, MEXICO AND CHINA (EPA/600/F-98/008)

EPA Science Inventory

This publication describes the progress of USEPA's Drinking Water Treatment Demonstration projects currently underway in Ecuador, Mexico and China. Material includes descriptions of problems faced and approaches used to improve water quality.

Water Conservation and Reuse. Instructor Guide. Working for Clean Water: An Information Program for Advisory Committees.

ERIC Educational Resources Information Center

Pennsylvania State Univ., Middletown. Inst. of State and Regional Affairs.

Described is a learning session on water conservation intended for citizen advisory groups interested in water quality planning. Topics addressed in this instructor's manual include water conservation needs, benefits, programs, technology, and problems. These materials are components of the Working for Clean Water Project. (Author/WB)

The Correlation between Children's Personal Behavioural Characteristics and Indicators of Children's Attachment to Their Mother or Father, Respectively.

ERIC Educational Resources Information Center

Cugmas, Zlatka

1998-01-01

Analyzed relationships between the quality of parental attachment and preschool children's behavioral characteristics, including social skills, productivity, behavior problems, neurosis, anxiety and self-evaluation. Found a positive relationship between parental attachment and the child's adaptation, but failed to confirm the hypothesis regarding…

Development of Creative Potential of Cinema Tourism

ERIC Educational Resources Information Center

Dzhandzhugazova, Elena A.; Ilinaa, Elena L.; Latkin, Aleksander N.; Koshelevava, Anna I.

2016-01-01

The relevance of the problem indicated in the article is caused by the fact that under current conditions it is necessary to offer high-quality and demanded tourist products, formed at the combination of various industries on the basis of wide application of creative potential of different industries, including tourism and cinema, a harmonious…

Teaching Large Classes in Higher Education. How To Maintain Quality with Reduced Resources.

ERIC Educational Resources Information Center

Gibbs, Graham, Ed.; Jenkins, Alan, Ed.

This publication seeks to give practical assistance to teachers and administrators responsible for teaching large classes at collges and universities in the United Kingdom. Areas covered include class size, problems related to learning and teaching, teaching strategies in specific disciplines, field study experience and other subjects. The 12…

Dropout Prevention in Appalachia: Lessons for the Nation.

ERIC Educational Resources Information Center

Campbell Communications, Inc., Bethesda, MD.

The Appalachian Regional Commission (ARC), in its efforts to improve the economy and quality of life in the Appalachian Region, has identified high school dropouts as a major stumbling block to the area's economic growth. Findings of ARC-sponsored research on dropouts include the following: (1) high school dropouts are a serious problem in…

77 FR 69679 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-20

... Sponsoring ETP Holder for the Sponsored Participant, including, among other things, criteria related to order... surrounding ports or port fees and that the Exchange is not aware of any problems that port users would have... gateway software and hardware enhancements and resources dedicated to gateway development, quality...

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.

The influence of a central vacuum system on quality life in patients with house dust-associated allergic rhinitis.

PubMed

Naguwa, S M; Gershwin, M E

2001-01-01

Indoor pollution is one of the most common problems addressed by allergists and troublesome for their patients. Although a large variety of products are available for removing such pollutants, including house dust, there is a relative paucity of data on the effectiveness of such devices. In many cases, central vacuum systems are recommended, particularly in new homes. To specifically address the question of whether a central vacuum system produces an improvement in the well characterized domains of Juniper Rhinoconjunctivitis Quality of Life Questionnaire, we selected 25 individuals with a history of documented type I hypersensitivity to house dust. Each of these individuals used either a Beam Central Vacuum System or their own conventional vacuum for a period of 3 months. At the end of this period, the individual switched over to the opposite limb of the study for 3 additional months. Interestingly, in all seven domains of the evaluation, including activity, sleep, nonnasal symptoms, practical problems, nasal symptoms, eye symptoms and emotions, use of the central vacuum proved to be superior.

Five years' experience in a (really) rural teleradiology practice. Was it worth it? The successes and the failures

NASA Astrophysics Data System (ADS)

Telepak, Robert J.; Freede, Emily; Jaramillo, Richard E.; Alverson, Dale C.

1998-07-01

During the past 5 years (1992 - 1997) the Department of Radiology of the University of New Mexico Health Sciences Center has developed an active teleradiology program. Contracts are in place to provide both routine and emergency image interpretations 24 hours per day, every day of the year. Several rural hospitals are served as well as the Navajo Indian Health Service. Areas of success: include significantly improved radiologic service to the rural sites, specialty consultations to general radiologists, successful teaching of teleradiology practice to radiology residents and staff, good diagnostic quality images, a small but real profit, improved quality assurance for the rural sites, and no significant medical-legal problems. Failures include: significant telecommunications problems, lack of acceptance and utilization by some of the rural sites, poor QA compliance by some sites, a long period of disappointing technical support by equipment vendors, and slow acceptance of DICOM by equipment manufacturers. The successes outweigh the failures. We would do it again -- but somewhat differently. We offer advice to institutions developing a new rural teleradiology operation.

Sleep disturbances among medical students: a global perspective.

PubMed

Azad, Muhammad Chanchal; Fraser, Kristin; Rumana, Nahid; Abdullah, Ahmad Faris; Shahana, Nahid; Hanly, Patrick J; Turin, Tanvir Chowdhury

2015-01-15

Medical students carry a large academic load which could potentially contribute to poor sleep quality above and beyond that already experienced by modern society. In this global literature review of the medical students' sleep experience, we find that poor sleep is not only common among medical students, but its prevalence is also higher than in non-medical students and the general population. Several factors including medical students' attitudes, knowledge of sleep, and academic demands have been identified as causative factors, but other potential mechanisms are incompletely understood. A better understanding about the etiology of sleep problems in medical trainees is essential if we hope to improve the overall quality of medical students' lives, including their academic performance. Sleep self-awareness and general knowledge appear insufficient in many studied cohorts, so increasing education for students might be one beneficial intervention. We conclude that there is ample evidence for a high prevalence of the problem, and research in this area should now expand towards initiatives to improve general sleep education for medical students, identify students at risk, and target them with programs to improve sleep. © 2015 American Academy of Sleep Medicine.

THE ROLE OF PSYCHOLOGICAL FEATURES IN MANAGEMENT OF PATIENTS WITH TYPE 1 DIABETES (CASE REPORT).

PubMed

Dunicheva, M; Zagorovskaya, T; Patrakeeva, E

2018-04-01

Studies have shown that effective diabetes management (and also self-management) can delay or prevent the micro- and macrovascular complications. But sometimes the way of achieving optimal glycemic control can affect quality of patient's life resulting in different fears and other psychological problems. Our clinical case demonstrates type 1 diabetes (T1D) patient with frequent episodes of hypoglycemia, including severe hypoglycemia, and various psychosocial problems. It confirms the importance of doctor's communication skills and necessity of constant collaboration with psychologist in organization of diabetes care.

Local ROI Reconstruction via Generalized FBP and BPF Algorithms along More Flexible Curves.

PubMed

Yu, Hengyong; Ye, Yangbo; Zhao, Shiying; Wang, Ge

2006-01-01

We study the local region-of-interest (ROI) reconstruction problem, also referred to as the local CT problem. Our scheme includes two steps: (a) the local truncated normal-dose projections are extended to global dataset by combining a few global low-dose projections; (b) the ROI are reconstructed by either the generalized filtered backprojection (FBP) or backprojection-filtration (BPF) algorithms. The simulation results show that both the FBP and BPF algorithms can reconstruct satisfactory results with image quality in the ROI comparable to that of the corresponding global CT reconstruction.

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

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.

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

Approach path control for powered-lift STOL aircraft

NASA Technical Reports Server (NTRS)

Clymer, D. J.; Flora, C. C.

1973-01-01

A flight control system concept is defined for approach flightpath control of an augmentor wing (or similar) powered-lift STOL configuration. The proposed STOL control concept produces aircraft transient and steady-state control responses that are familiar to pilots of conventional jet transports, and has potential for good handling qualities ratings in all approach and landing phases. The effects of trailing-edge rate limits, real-engine dynamics, and atmospheric turbulence are considered in the study. A general discussion of STOL handling qualities problems and piloting techniques is included.

Improving supervision: a team approach.

PubMed

1993-01-01

This issue of "The Family Planning Manager" outlines an interactive team supervision strategy as a means of improving family planning service quality and enabling staff to perform to their maximum potential. Such an approach to supervision requires a shift from a monitoring to a facilitative role. Because supervisory visits to the field are infrequent, the regional supervisor, clinic manager, and staff should form a team to share ongoing supervisory responsibilities. The team approach removes individual blame and builds consensus. An effective team is characterized by shared leadership roles, concrete work problems, mutual accountability, an emphasis on achieving team objectives, and problem resolution within the group. The team supervision process includes the following steps: prepare a visit plan and schedule; meet with the clinic manager and staff to explain how the visit will be conducted; supervise key activity areas (clinical, management, and personnel); conduct a problem-solving team meeting; conduct a debriefing meeting with the clinic manager; and prepare a report on the visit, including recommendations and follow-up plans. In Guatemala's Family Planning Unit, teams identify problem areas on the basis of agreement that a problem exists, belief that the problem can be solved with available resources, and individual willingness to accept responsibility for the specific actions identified to correct the problem.

Stroke survivors' views and experiences on impact of visual impairment.

PubMed

Rowe, Fiona J

2017-09-01

We sought to determine stroke survivors' views on impact of stroke-related visual impairment to quality of life. Stroke survivors with visual impairment, more than 1 year post stroke onset, were recruited. Semistructured biographical narrative interviews were audio-recorded and transcribed verbatim. A thematic approach to analysis of the qualitative data was adopted. Transcripts were systematically coded using NVivo10 software. Thirty-five stroke survivors were interviewed across the UK: 16 females, 19 males; aged 20-75 years at stroke onset. Five qualitative themes emerged: "Formal care," "Symptoms and self," "Adaptations," "Daily life," and "Information." Where visual problems existed, they were often not immediately recognized as part of the stroke syndrome and attributed to other causes such as migraine. Many participants did not receive early vision assessment or treatment for their visual problems. Visual problems included visual field loss, double vision, and perceptual problems. Impact of visual problems included loss in confidence, being a burden to others, increased collisions/accidents, and fear of falling. They made many self-identified adaptations to compensate for visual problems: magnifiers, large print, increased lighting, use of white sticks. There was a consistent lack of support and provision of information about visual problems. Poststroke visual impairment causes considerable impact to daily life which could be substantially improved by simple measures including early formal visual assessment, management and advice on adaptive strategies and self-management options. Improved education about poststroke visual impairment for the public and clinicians could aid earlier diagnosis of visual impairments.

Joint Occurrence of Pain and Sleep Disturbances in People with Dementia. A Systematic Review.

PubMed

Flo, Elisabeth; Bjorvatn, Bjorn; Corbett, Anne; Pallesen, Stale; Husebo, Bettina S

2017-01-01

Advancing age is associated with high prevalence of pain, sleep problems and dementia. Dementia is frequently accompanied by distressing behavioral and psychological symptoms, including sleep problems. The etiology of sleep problems in dementia is multifactorial. It has been suggested that untreated pain may contribute to sleep problems, and pain treatment has been shown to reduce sleep problems in people with dementia. This systematic review aims to provide an overview of the studies that have investigated the association and/or possible interaction between pain and sleep in dementia. A systematic search was performed in MEDLINE, EMBASE, Cochrane and PsychINFO, including text words and MESH terms covering dementia, pain and sleep. Also, reference lists in the included publications were examined to retrieve publications. Publications had to investigate sleep and pain in relation to dementia to be included in this review. The search produced 1750 independent hits. Out of the 49 publications studied in full text, 11 publications were included. Only one controlled trial was identified and represented the only insights to the possible interactional relationship between pain, sleep and dementia. Pain or pain intensity were related to sleep in 6 of the included studies, while the remaining studies could neither support nor contradict a relationship between sleep and pain in people with dementia. None of the studies employed objective sleep assessment. There is a need for high quality studies investigating the interaction between sleep and pain in people with dementia, using objective sleep measurements and pain assessment suitable for people with dementia. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Sexual satisfaction, anxiety, depression and quality of life among Turkish colorectal cancer patients [Izmir Oncology Group (IZOG) study].

PubMed

Akyol, Murat; Ulger, Eda; Alacacioglu, Ahmet; Kucukzeybek, Yuksel; Yildiz, Yasar; Bayoglu, Vedat; Gumus, Zehra; Yildiz, Ibrahim; Salman, Tarık; Varol, Umut; Ayakdas, Semra; Tarhan, Mustafa Oktay

2015-07-01

Determination of psychological problems will shed light on the terms of solution and provide support to patients about these problems will ensure the patients' coherence to the treatment and will enhance the benefits they receive from treatment. In this study, we aimed to determine these psychosocial problems and the interactions with each other in colon cancer patients. In this study, 105 patients with colorectal cancer were included. The forms consist of sociodemographic features, Hospital Anxiety and Depression Scale, European Organization for Research on Treatment of Cancer Questionnaires Quality of Life-C30 and Golombok-Rust Inventory of Sexual Satisfaction questionnaires. Male patients had significantly higher European Organization for Research on Treatment of Cancer Questionnaires Quality of Life-C30 function scales and global quality-of-life scores than female patients. Golombok-Rust Inventory of Sexual Satisfaction scores of female patients were significantly higher than that of male patients. European Organization for Research on Treatment of Cancer Questionnaires Quality of Life-C30 function scales and global quality-of-life scores of the patients with high depression scores were significantly lower, conversely symptom scale scores of the patients with high depression scores were significantly higher than that of the patients with low depression scores. Patients with low anxiety scores had significantly higher European Organization for Research on Treatment of Cancer Questionnaires Quality of Life-C30 function scales and global quality-of-life scores than the patients with high anxiety scores. Symptom scale scores of the patients with high anxiety scores were significantly higher than that of the patients with low anxiety scores. The scores of Golombok-Rust Inventory of Sexual Satisfaction except premature ejaculation and vaginismus were significantly higher in patients with high anxiety scores and a significant difference was determined in touch, avoidance and anorgasm. This study demonstrates that there is a significant association with anxiety/depression symptoms and quality-of-life scores, sexual dysfunction. Sexual dysfunction is significantly more common in patients with high anxiety and depression scores. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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…

Alternative Medications for Medications Included in the Use of High-Risk Medications in the Elderly and Potentially Harmful Drug–Disease Interactions in the Elderly Quality Measures

PubMed Central

Hanlon, Joseph T.; Semla, Todd P.; Schmader, Kenneth E.

2016-01-01

The National Committee for Quality Assurance (NCQA) and the Pharmacy Quality Alliance (PQA) use the American Geriatrics Society (AGS) Beers Criteria to designate the quality measure Use of High-Risk Medications in the Elderly (HRM). The Centers for Medicare and Medicaid Services (CMS) use the HRM measure to monitor and evaluate the quality of care provided to Medicare beneficiaries. NCQA additionally uses the AGS Beers Criteria to designate the quality measure Potentially Harmful Drug–Disease Interactions in the Elderly. Medications included in these measures may be harmful to elderly adults, negatively affect a health care plan’s quality ratings, and be denied as a health care plan drug benefit. Prescribers, pharmacists, patients, and health care plans may benefit from evidence-based alternative medication treatments to avoid these problems. Therefore the goal of this work was to develop a list of alternative medications to those included in the two measures. The authors conducted a comprehensive literature review for 2000 to 2014 and a search of their personal files. From the evidence, they prepared a list of drug-therapy alternatives with supporting references. A reference list of non-pharmacological approaches was also provided when appropriate. NCQA, PQA, the 2015 AGS Beers Criteria panel, and the Executive Committee of the AGS reviewed the drug therapy alternatives and nonpharmacological approaches. Recommendations by these groups were incorporated into the final list of alternatives. The final product of drug-therapy alternatives to medications included in the two quality measures and some nonpharmacological resources will be useful to health professionals, consumers, payers, and health systems that care for older adults. PMID:26447889

PRISMA and AMSTAR Show Systematic Reviews of Health Literacy and Cancer Screening are Good Quality.

PubMed

Sharma, Sakshi; Oremus, Mark

2018-04-11

To evaluate the reporting and methodological quality of systematic reviews (SRs) in health literacy and cancer screening; to investigate factors that may influence overall quality. A review of SRs published between 2009 and 2017. We calculated indices to represent the included SRs' adherence to PRISMA and AMSTAR. To assess possible determinants of SR quality, we regressed the index scores on year and region of publication, journal impact factor, authors' reported use of PRISMA, and presence of funding statements. We included 19 SRs and median index scores were 0.86 for PRISMA (interquartile range [IQR] = 0.11; range = 0.32 to 1.00) and 0.67 for AMSTAR (IQR = 0.30; range = 0.22 to 1.00). Methodological and reporting problems pertained to protocol registration or publication, number of raters used, gray literature searches, excluded article lists, and unintegrated discussions of risk of bias and efficacy. Only journal impact factor was statistically significantly associated (positively) with PRISMA and AMSTAR index scores. The quality of SRs in health literacy and cancer screening was generally good. Systematic reviewers should register or publish their protocols, include PRISMA and AMSTAR checklists when submitting SRs to journals, and self-evaluate their SRs before submission. Copyright © 2018. Published by Elsevier Inc.

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.

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.

Health care reform: will quality remodeling affect obstetrician-gynecologists in addition to patients?

PubMed

von Gruenigen, Vivian E; Deveny, T Clifford

2011-05-01

The Patient Protection and Affordable Care Act is a federal statute that attempts to address many fundamental problems with the current health care system including the uninsured, rising health care costs, and quality care. Quality metrics have been in development for years (by private and governmental sectors), and momentum is growing. The purpose of this commentary is to explore quality changes in the way practicing obstetricians and gynecologists will be held accountable for quality service. Two new options being explored for health care, both focusing on improving quality and physician metrics, include value-based purchasing and accountable-care organizations. Both will likely consist of universal clinical algorithms and cost monitoring as measures. For obstetrics this will probably include physician's rates of cesarean deliveries and elective inductions. For gynecology this may comprise of indications for hysterectomy with documented failed medical management, minor surgical management, or both medical and minor surgical management. It is anticipated patients will no longer be able to request obstetric testing, pregnancy induction, or hysterectomy. It is imperative we, as obstetrician-gynecologists, are involved in health care reform that inevitably involves the care of women. The expectation is that the American Congress of Obstetricians and Gynecologists (ACOG) will further develop evidenced-based opinions and guidelines, as medical communities embrace ACOG documents and reference these in hospital policies and peer review.

Development and testing of emergency department patient transfer communication measures.

PubMed

Klingner, Jill; Moscovice, Ira

2012-01-01

Communication problems are a major contributing factor to adverse events in hospitals.(1) The contextual environment in small rural hospitals increases the importance of emergency department (ED) patient transfer communication quality. This study addresses the communication problems through the development and testing of ED quality measurement of interfacility patient transfer communication. Input from existing measures, measurement and health care delivery experts, as well as hospital frontline staff was used to design and modify ED quality measures. Three field tests were conducted to determine the feasibility of data collection and the effectiveness of different training methods and types of partnerships. Measures were evaluated based on their prevalence, ease of data collection, and usefulness for internal and external improvement. It is feasible to collect ED quality measure data. Different data sources, data collection, and data entry methods, training and partners can be used to examine hospital ED quality. There is significant room for improvement in the communication of patient information between health care facilities. Current health care reform efforts highlight the importance of clear communication between organizations held accountable for patient safety and outcomes. The patient transfer communication measures have been tested in a wide range of rural settings and have been vetted nationally. They have been endorsed by the National Quality Forum, are included in the National Quality Measurement Clearinghouse supported by the Agency for Health Care Research and Quality (AHRQ), and are under consideration by the Centers for Medicare and Medicaid Services for future payment determinations beginning in calendar year 2013. © 2011 National Rural Health Association.

Sociotropic or autonomous personality and problem solving in peritoneal dialysis patients.

PubMed

Demir, S; Tufan, G; Erem, O

2010-01-01

This study investigated the sociotropic and autonomous personality characteristics and perceived problem solving ability of continuous ambulatory peritoneal dialysis (CAPD) patients, and their relationship with quality of life. The study included 14 CAPD patients and 54 healthy volunteers. Sociotropy and autonomy scores were significantly higher in CAPD patients than in the healthy control group. Among CAPD patients, there was a significant correlation between problem solving and serum phosphate, parathormone levels and erythrocyte sedimentation rate. There was a negative correlation between total dialysis time and sociotropy in CAPD patients, and a positive correlation between general health/pain perception and autonomy. Appropriate medical management, time on dialysis and positive self-perception of health were correlated with better problem solving ability and higher autonomous but lower sociotropic personality styles.

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…

Evaluation of the influence of dominance rules for the assembly line design problem under consideration of product design alternatives

NASA Astrophysics Data System (ADS)

Oesterle, Jonathan; Lionel, Amodeo

2018-06-01

The current competitive situation increases the importance of realistically estimating product costs during the early phases of product and assembly line planning projects. In this article, several multi-objective algorithms using difference dominance rules are proposed to solve the problem associated with the selection of the most effective combination of product and assembly lines. The list of developed algorithms includes variants of ant colony algorithms, evolutionary algorithms and imperialist competitive algorithms. The performance of each algorithm and dominance rule is analysed by five multi-objective quality indicators and fifty problem instances. The algorithms and dominance rules are ranked using a non-parametric statistical test.

An investigation of Taiwanese early adolescents' self-evaluations concerning the Big 6 information problem-solving approach.

PubMed

Chang, Chiung-Sui

2007-01-01

The study developed a Big 6 Information Problem-Solving Scale (B61PS), including the subscales of task definition and information-seeking strategies, information access and synthesis, and evaluation. More than 1,500 fifth and sixth graders in Taiwan responded. The study revealed that the scale showed adequate reliability in assessing the adolescents' perceptions about the Big 6 information problem-solving approach. In addition, the adolescents had quite different responses toward different subscales of the approach. Moreover, females tended to have higher quality information-searching skills than their male counterparts. The adolescents of different grades also displayed varying views toward the approach. Other results are also provided.

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,…

Poor sleep quality and nightmares are associated with non-suicidal self-injury in adolescents.

PubMed

Liu, Xianchen; Chen, Hua; Bo, Qi-Gui; Fan, Fang; Jia, Cun-Xian

2017-03-01

Non-suicidal self-injury (NSSI) is prevalent and is associated with increased risk of suicidal behavior in adolescents. This study examined which sleep variables are associated with NSSI, independently from demographics and mental health problems in Chinese adolescents. Participants consisted of 2090 students sampled from three high schools in Shandong, China and had a mean age of 15.49 years. Participants completed a sleep and health questionnaire to report their demographic and family information, sleep duration and sleep problems, impulsiveness, hopelessness, internalizing and externalizing problems, and NSSI. A series of regression analyses were conducted to examine the associations between sleep variables and NSSI. Of the sample, 12.6 % reported having ever engaged in NSSI and 8.8 % engaged during the last year. Univariate logistic analyses demonstrated that multiple sleep variables including short sleep duration, insomnia symptoms, poor sleep quality, sleep insufficiency, unrefreshed sleep, sleep dissatisfaction, daytime sleepiness, fatigue, snoring, and nightmares were associated with increased risk of NSSI. After adjusting for demographic and mental health variables, NSSI was significantly associated with sleeping <6 h per night, poor sleep quality, sleep dissatisfaction, daytime sleepiness, and frequent nightmares. Stepwise logistic regression model demonstrated that poor sleep quality (OR = 2.18, 95 % CI = 1.37-3.47) and frequent nightmares (OR = 2.88, 95 % CI = 1.45-5.70) were significantly independently associated with NSSI. In conclusion, while multiple sleep variables are associated with NSSI, poor sleep quality and frequent nightmares are independent risk factors of NSSI. These findings may have important implications for further research of sleep self-harm mechanisms and early detection and prevention of NSSI in adolescents.

Conclusions for mammography screening after 25-year follow-up of the Canadian National Breast Cancer Screening Study (CNBSS).

PubMed

Heywang-Köbrunner, S H; Schreer, I; Hacker, A; Noftz, M R; Katalinic, A

2016-02-01

Twenty-five-year follow-up data of the Canadian National Breast Cancer Screening Study (CNBSS) indicated no mortality reduction. What conclusions should be drawn? After conducting a systematic literature search and narrative analysis, we wish to recapitulate important details of this study, which may have been neglected: Sixty-eight percent of all included cancers were palpable, a situation that does not allow testing the value of early detection. Randomisation was performed at the sites after palpation, while blinding was not guaranteed. In the first round, this "randomisation" assigned 19/24 late stage cancers to the mammography group and only five to the control group, supporting the suspicion of severe errors in the randomisation process. The responsible physicist rated mammography quality as "far below state of the art of that time". Radiological advisors resigned during the study due to unacceptable image quality, training, and medical quality assurance. Each described problem may strongly influence the results between study and control groups. Twenty-five years of follow-up cannot heal these fundamental problems. This study is inappropriate for evidence-based conclusions. The technology and quality assurance of the diagnostic chain is shown to be contrary to today's screening programmes, and the results of the CNBSS are not applicable to them. • The evidence base of the Canadian study (CNBSS) has to be questioned.• Severe flaws in the randomization process and test methods occurred. • Problems were criticized during and after conclusion of the trial by experts.• The results are not applicable to quality-assured screening programs. • The evidence base of this study must be re-analyzed.

Self-reported distress in patients with ovarian cancer: is it related to disease status?

PubMed

Ploos van Amstel, Floortje K; van Ham, Maaike A P C; Peters, Esmee J; Prins, Judith B; Ottevanger, Petronella B

2015-02-01

Patients with epithelial ovarian cancer have a poor prognosis and often undergo intensive treatment. These patients are therefore at risk for experiencing distress and reduced quality of life. The aim of this study was to explore the self-reported distress severity, experienced problems, and quality of life in relation to their disease status. This cross-sectional study was conducted in 2011 at a University Medical Center. Women with ovarian cancer (n = 273), both during and after treatment, were asked by mail to fill in self-report questionnaires. Distress was measured using with the Distress Thermometer (DT), Hospital Anxiety and Depression Scale, and Impact of Event Scale. Problems and quality of life were assessed with the problem list of the DT, and European Organization for Research and Treatment of Cancer Quality of Life C-30 and OV28. The questionnaire data of 104 patients were analyzed. Screening with the DT revealed distress in 32% [mean (SD), 3.1 (2.6)]. Distress was found with the Hospital Anxiety and Depression Scale in 14% [8.6 (5.9)] and with the Impact of Event Scale in 18% of the patients [17.5 (15.5)]. No significant differences were found in distress severity and self-reported problems between patients with and without recurrence. In both groups, the problems fatigue, condition, and neuropathy were most reported. Patients with distress (DT ≥ 5) experienced significantly worse functioning, more problems, and lower quality of life than patients without distress (P < 0.01). This study showed that disease status in patients with ovarian cancer seems to have no influence on distress, quality of life, and the problems encountered. However, distressed patients experienced more problems, with physical and emotional functioning, and had lower quality of life. The problems fatigue, physical condition, and neuropathy are the most prevailing.

Group-based parent training programmes for improving emotional and behavioural adjustment in young children.

PubMed

Barlow, Jane; Bergman, Hanna; Kornør, Hege; Wei, Yinghui; Bennett, Cathy

2016-08-01

Emotional and behavioural problems in children are common. Research suggests that parenting has an important role to play in helping children to become well-adjusted, and that the first few months and years are especially important. Parenting programmes may have a role to play in improving the emotional and behavioural adjustment of infants and toddlers, and this review examined their effectiveness with parents and carers of young children. 1. To establish whether group-based parenting programmes are effective in improving the emotional and behavioural adjustment of young children (maximum mean age of three years and 11 months); and2. To assess whether parenting programmes are effective in the primary prevention of emotional and behavioural problems. In July 2015 we searched CENTRAL (the Cochrane Library), Ovid MEDLINE, Embase (Ovid), and 10 other databases. We also searched two trial registers and handsearched reference lists of included studies and relevant systematic reviews. Two reviewers independently assessed the records retrieved by the search. We included randomised controlled trials (RCTs) and quasi-RCTs of group-based parenting programmes that had used at least one standardised instrument to measure emotional and behavioural adjustment in children. One reviewer extracted data and a second reviewer checked the extracted data. We presented the results for each outcome in each study as standardised mean differences (SMDs) with 95% confidence intervals (CIs). Where appropriate, we combined the results in a meta-analysis using a random-effects model. We used the GRADE (Grades of Recommendations, Assessment, Development, and Evaluation) approach to assess the overall quality of the body of evidence for each outcome. We identified 22 RCTs and two quasi-RCTs evaluating the effectiveness of group-based parenting programmes in improving the emotional and behavioural adjustment of children aged up to three years and 11 months (maximum mean age three years 11 months).The total number of participants in the studies were 3161 parents and their young children. Eight studies were conducted in the USA, five in the UK, four in Canada, five in Australia, one in Mexico, and one in Peru. All of the included studies were of behavioural, cognitive-behavioural or videotape modelling parenting programmes.We judged 50% (or more) of the included studies to be at low risk for selection bias, detection bias (observer-reported outcomes), attrition bias, selective reporting bias, and other bias. As it is not possible to blind participants and personnel to the type of intervention in these trials, we judged all studies to have high risk of performance bias. Also, there was a high risk of detection bias in the 20 studies that included parent-reported outcomes.The results provide evidence that group-based parenting programmes reduce overall emotional and behavioural problems (SMD -0.81, 95% CI -1.37 to -0.25; 5 studies, 280 participants, low quality evidence) based on total parent-reported data assessed at postintervention. This result was not, however, maintained when two quasi-RCTs were removed as part of a sensitivity analysis (SMD -0.67, 95% CI -1.43 to 0.09; 3 studies, 221 participants). The results of data from subscales show evidence of reduced total externalising problems (SMD -0.23, 95% CI -0.46 to -0.01; 8 studies, 989 participants, moderate quality evidence). Single study results show very low quality evidence of reductions in externalising problems hyperactivity-inattention subscale (SMD -1.34; 95% CI -2.37 to -0.31; 19 participants), low quality evidence of no effect on total internalising problems (SMD 0.34; 95% CI -0.12 to 0.81; 73 participants), and very low quality evidence of an increase in social skills (SMD 3.59; 95% CI 2.42 to 4.76; 32 participants), based on parent-reported data assessed at postintervention. Results for secondary outcomes, which were also measured using subscales, show an impact on parent-child interaction in terms of reduced negative behaviour (SMD -0.22, 95% CI -0.39 to -0.06; 7 studies, 941 participants, moderate quality evidence), and improved positive behaviour (SMD 0.48, 95% CI 0.17 to 0.79; 4 studies, 173 participants, moderate quality evidence) as rated by independent observers postintervention. No further meta-analyses were possible. Results of subgroup analyses show no evidence for treatment duration (seven weeks or less versus more than eight weeks) and inconclusive evidence for prevention versus treatment interventions. The findings of this review, which relate to the broad group of universal and at-risk (targeted) children and parents, provide tentative support for the use of group-based parenting programmes to improve the overall emotional and behavioural adjustment of children with a maximum mean age of three years and 11 months, in the short-term. There is, however, a need for more research regarding the role that these programmes might play in the primary prevention of both emotional and behavioural problems, and their long-term effectiveness.

Improving care transitions through meaningful use stage 2: continuity of care document.

PubMed

Murphy, Lyn Stankiewicz; Wilson, Marisa L; Newhouse, Robin P

2013-02-01

In this department, Drs Murphy, Wilson, and Newhouse highlight hot topics in nursing outcomes, research, and evidence-based practice relevant to the nurse administrator. The goal is to discuss the practical implications for nurse leaders in diverse healthcare settings. Content includes evidence-based projects and decision making, locating measurement tools for quality improvement and safety projects, using outcome measures to evaluate quality, practice implications of administrative research, and exemplars of projects that demon strate innovative approaches to organizational problems. In this article, the authors describe the elements of continuity of care documentation, how sharing information can improve the quality and safety of care transitions and the implications for nurse executives.

Anal Health Care Basics

PubMed Central

Chang, Jason; McLemore, Elisabeth; Tejirian, Talar

2016-01-01

Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy. The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate. Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area. Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases. In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists. PMID:27723447

Association between serum bicarbonate and pH with depression, cognition and sleep quality in hemodialysis patients.

PubMed

Afsar, Baris; Elsurer, Rengin

2015-07-01

Metabolic acidosis is a common feature in chronic renal failure patients, worsening progressively as renal function declines. There are conflicting data in hemodialysis (HD) patients with regard to acidosis, alkalosis and mortality. In HD patients, cognitive impairment, depression, sleep disorders and impaired quality of life are very common. Besides, these conditions are related with increased morbidity and mortality. However, no previous study investigated the relationship between pH, venous bicarbonate and anion gap with depression, sleep problems and cognitive function in HD patients. In this study we investigated these relationships. In total, 65 HD patients were included. The demographic parameters and laboratory parameters including bicarbonate, pH and anion gap was measured for all patients. Depressive symptoms, sleep quality and cognitive function, were measured by Beck depression inventory, The Pittsburgh Sleep Quality Index and by Mini Mental State Examination, respectively. We found that, sleep quality but not cognitive function or depression was independently related with venous pH and bicarbonate. Anion gap has no independent relationship with sleep quality, cognitive function and depression. In conclusion, metabolic acidosis and bicarbonate levels were independently related with sleep quality in HD patients. However, there was no association between metabolic acidosis and bicarbonate levels with cognitive function and depression.

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.

Developing Quality Indicators and Auditing Protocols from Formal Guideline Models: Knowledge Representation and Transformations

PubMed Central

Advani, Aneel; Goldstein, Mary; Shahar, Yuval; Musen, Mark A.

2003-01-01

Automated quality assessment of clinician actions and patient outcomes is a central problem in guideline- or standards-based medical care. In this paper we describe a model representation and algorithm for deriving structured quality indicators and auditing protocols from formalized specifications of guidelines used in decision support systems. We apply the model and algorithm to the assessment of physician concordance with a guideline knowledge model for hypertension used in a decision-support system. The properties of our solution include the ability to derive automatically (1) context-specific and (2) case-mix-adjusted quality indicators that (3) can model global or local levels of detail about the guideline (4) parameterized by defining the reliability of each indicator or element of the guideline. PMID:14728124

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.

A Systematic Review of Land-Based Self-Exclusion Programs: Demographics, Gambling Behavior, Gambling Problems, Mental Symptoms, and Mental Health.

PubMed

Kotter, Roxana; Kräplin, Anja; Pittig, Andre; Bühringer, Gerhard

2018-05-02

Systematic and quantitative reviews on the effects of land-based self-exclusion are scarce. Therefore, the current review aimed to provide a comprehensive summary of (1) the demographic characteristics of land-based self-excluders and changes after exclusion, including (2) gambling behavior, (3) gambling problems, (4) mental symptoms, and (5) mental health. A systematic database and literature search was performed following PRISMA guidelines. Nineteen naturalistic studies met the eligibility criteria. The quality of all included records was rated via adaption of the Newcastle-Ottawa Scale. Results from higher-quality records were more heavily weighted. Self-excluders were predominantly men in their early or middle forties. Changes after exclusion revealed wide ranges in the rates of abstinence (13-81%), rates of gambling reduction (29-92%), and rates of exclusion breaches (8-59%). The records consistently demonstrated significant changes in pathological gambling from before exclusion (61-95%) to after exclusion (13-26%). Up to 73% of self-excluders exhibited symptoms of anxiety, depression, and substance use disorders at program enrollment. Several aspects of mental health improved after exclusion, e.g., quality of life. Problem and pathological gambling are most prevalent in young men, but self-exclusion was most prominent in middle-aged men. The magnitude of effects widely differed between studies despite overall benefits of self-exclusion, and many individuals continued gambling after exclusion. This shortcoming could be minimized using improved access controls and the extension of exclusion to other gambling segments. High rates of pathological gambling and other mental disorders in self-excluders highlight the need for improved early detection and treatment accessibility.

PFLOTRAN Verification: Development of a Testing Suite to Ensure Software Quality

NASA Astrophysics Data System (ADS)

Hammond, G. E.; Frederick, J. M.

2016-12-01

In scientific computing, code verification ensures the reliability and numerical accuracy of a model simulation by comparing the simulation results to experimental data or known analytical solutions. The model is typically defined by a set of partial differential equations with initial and boundary conditions, and verification ensures whether the mathematical model is solved correctly by the software. Code verification is especially important if the software is used to model high-consequence systems which cannot be physically tested in a fully representative environment [Oberkampf and Trucano (2007)]. Justified confidence in a particular computational tool requires clarity in the exercised physics and transparency in its verification process with proper documentation. We present a quality assurance (QA) testing suite developed by Sandia National Laboratories that performs code verification for PFLOTRAN, an open source, massively-parallel subsurface simulator. PFLOTRAN solves systems of generally nonlinear partial differential equations describing multiphase, multicomponent and multiscale reactive flow and transport processes in porous media. PFLOTRAN's QA test suite compares the numerical solutions of benchmark problems in heat and mass transport against known, closed-form, analytical solutions, including documentation of the exercised physical process models implemented in each PFLOTRAN benchmark simulation. The QA test suite development strives to follow the recommendations given by Oberkampf and Trucano (2007), which describes four essential elements in high-quality verification benchmark construction: (1) conceptual description, (2) mathematical description, (3) accuracy assessment, and (4) additional documentation and user information. Several QA tests within the suite will be presented, including details of the benchmark problems and their closed-form analytical solutions, implementation of benchmark problems in PFLOTRAN simulations, and the criteria used to assess PFLOTRAN's performance in the code verification procedure. References Oberkampf, W. L., and T. G. Trucano (2007), Verification and Validation Benchmarks, SAND2007-0853, 67 pgs., Sandia National Laboratories, Albuquerque, NM.

Ensuring and Maintaining Quality in Schools through Central Regulation: Some Lessons from England and Wales (An Ecology of Quality in School Education)

ERIC Educational Resources Information Center

Lee, John

2002-01-01

The problem of ensuring quality in mass education systems is as old as the systems themselves. Responses to this problem reflect the political and cultural organisation of different nation states. In the USA the problem has to be dealt with at a local level. The federal government is very restricted in powers in the field of education and social…

7 CFR 634.12 - Eligible project areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... agricultural portion of a 208 water quality management plan, or revised portions thereof, and have identified agricultural nonpoint source water quality problems are eligible for authorization under RCWP. Those critical areas or sources of pollutants significantly contributing to the water quality problems are eligible for...

Access to essential drugs in poor countries: a lost battle?

PubMed

Pécoul, B; Chirac, P; Trouiller, P; Pinel, J

1999-01-27

Drugs offer a simple, cost-effective solution to many health problems, provided they are available, affordable, and properly used. However, effective treatment is lacking in poor countries for many diseases, including African trypanosomiasis, Shigella dysentery, leishmaniasis, tuberculosis, and bacterial meningitis. Treatment may be precluded because no effective drug exists, it is too expensive, or it has been withdrawn from the market. Moreover, research and development in tropical diseases have come to a near standstill. This article focuses on the problems of access to quality drugs for the treatment of diseases that predominantly affect the developing world: (1) poor-quality and counterfeit drugs; (2) lack of availability of essential drugs due to fluctuating production or prohibitive cost; (3) need to develop field-based drug research to determine optimum utilization and remotivate research and development for new drugs for the developing world; and (4) potential consequences of recent World Trade Organization agreements on the availability of old and new drugs. These problems are not independent and unrelated but are a result of the fundamental nature of the pharmaceutical market and the way it is regulated.

Exploring the relationship between work-related rumination, sleep quality, and work-related fatigue.

PubMed

Querstret, Dawn; Cropley, Mark

2012-07-01

This study examined the association among three conceptualizations of work-related rumination (affective rumination, problem-solving pondering, and detachment) with sleep quality and work-related fatigue. It was hypothesized that affective rumination and poor sleep quality would be associated with increased fatigue and that problem-solving pondering and detachment would be associated with decreased fatigue. The mediating effect of sleep quality on the relationship between work-related rumination and fatigue was also tested. An online questionnaire was completed by a heterogeneous sample of 719 adult workers in diverse occupations. The following variables were entered as predictors in a regression model: affective rumination, problem-solving pondering, detachment, and sleep quality. The dependent variables were chronic work-related fatigue (CF) and acute work-related fatigue (AF). Affective rumination was the strongest predictor of increased CF and AF. Problem-solving pondering was a significant predictor of decreased CF and AF. Poor sleep quality was predictive of increased CF and AF. Detachment was significantly negatively predictive for AF. Sleep quality partially mediated the relationship between affective rumination and fatigue and between problem-solving pondering and fatigue. Work-related affective rumination appears more detrimental to an individual's ability to recover from work than problem-solving pondering. In the context of identifying mechanisms by which demands at work are translated into ill-health, this appears to be a key finding and suggests that it is the type of work-related rumination, not rumination per se, that is important.

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

Photoacoustic image reconstruction via deep learning

NASA Astrophysics Data System (ADS)

Antholzer, Stephan; Haltmeier, Markus; Nuster, Robert; Schwab, Johannes

2018-02-01

Applying standard algorithms to sparse data problems in photoacoustic tomography (PAT) yields low-quality images containing severe under-sampling artifacts. To some extent, these artifacts can be reduced by iterative image reconstruction algorithms which allow to include prior knowledge such as smoothness, total variation (TV) or sparsity constraints. These algorithms tend to be time consuming as the forward and adjoint problems have to be solved repeatedly. Further, iterative algorithms have additional drawbacks. For example, the reconstruction quality strongly depends on a-priori model assumptions about the objects to be recovered, which are often not strictly satisfied in practical applications. To overcome these issues, in this paper, we develop direct and efficient reconstruction algorithms based on deep learning. As opposed to iterative algorithms, we apply a convolutional neural network, whose parameters are trained before the reconstruction process based on a set of training data. For actual image reconstruction, a single evaluation of the trained network yields the desired result. Our presented numerical results (using two different network architectures) demonstrate that the proposed deep learning approach reconstructs images with a quality comparable to state of the art iterative reconstruction methods.

The microbiology of apples and apple products.

PubMed

Doores, S

1983-01-01

The apple industry has reached an annual production level of 8.5 billion pounds. CA storage of 25% of this crop has enabled a fresh market on a year-round basis. To achieve high quality in raw fruit and processed apple products, careful attention must be paid to maintaining a microbiologically stable environment. The ecology of the microflora associated with the apple is a reflection of the orchard, handling, harvesting, and storage practices. Yeasts predominate on orchard fruit, molds may become a storage problem, and bacteria cause spoilage, off flavors, and loss of quality in juice products. Despite the microbial problems inherent in producing of quality product, the apple industry is faced with the occurrence of patulin. Patulin, a mycotoxin produced by Penicillium and Aspergillus species, has been associated with damaged fruit. Decreased temperatures, coupled with CA storage; can deter mold growth and patulin production. Laboratory detection methods for derivations of patulin are able to detect microgram quantities. Means to eliminate patulin formed in apple products include addition of ascorbate and SO2, extending fermentation, or charcoal filtering. However, degradation products of patulin have not been evaluated toxicologically.

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.

Economic evaluation of interventions for problem drinking and alcohol dependence: cost per QALY estimates.

PubMed

Mortimer, Duncan; Segal, Leonie

2005-01-01

To compare the performance of competing and complementary interventions for prevention or treatment of problem drinking and alcohol dependence. To provide an example of how health maximising decision-makers might use performance measures such as cost per quality adjusted life year (QALY) league tables to formulate an optimal package of interventions for problem drinking and alcohol dependence. A time-dependent state-transition model was used to estimate QALYs gained per person for each intervention as compared to usual care in the relevant target population. Cost per QALY estimates for each of the interventions fall below any putative funding threshold for developed economies. Interventions for problem drinkers appear to offer better value than interventions targeted at those with a history of severe physical dependence. Formularies such as Australia's Medicare should include a comprehensive package of interventions for problem drinking and alcohol dependence.

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

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…

EPA RESEARCH HIGHLIGHTS -- MODELS-3/CMAQ OFFERS COMPREHENSIVE APPROACH TO AIR QUALITY MODELING

EPA Science Inventory

Regional and global coordinated efforts are needed to address air quality problems that are growing in complexity and scope. Models-3 CMAQ contains a community multi-scale air quality modeling system for simulating urban to regional scale pollution problems relating to troposphe...

Valuing U.S. Water Quality at Regional and National Scales

EPA Science Inventory

Assessing and monetizing the benefits of water quality at a regional and/or national scale is a challenging problem. One of the biggest problems is a lack of consistency in the monitoring and assessment methods used by states to assess water quality. Despite this inconsistency,...

Preconditioned Alternating Projection Algorithms for Maximum a Posteriori ECT Reconstruction

PubMed Central

Krol, Andrzej; Li, Si; Shen, Lixin; Xu, Yuesheng

2012-01-01

We propose a preconditioned alternating projection algorithm (PAPA) for solving the maximum a posteriori (MAP) emission computed tomography (ECT) reconstruction problem. Specifically, we formulate the reconstruction problem as a constrained convex optimization problem with the total variation (TV) regularization. We then characterize the solution of the constrained convex optimization problem and show that it satisfies a system of fixed-point equations defined in terms of two proximity operators raised from the convex functions that define the TV-norm and the constrain involved in the problem. The characterization (of the solution) via the proximity operators that define two projection operators naturally leads to an alternating projection algorithm for finding the solution. For efficient numerical computation, we introduce to the alternating projection algorithm a preconditioning matrix (the EM-preconditioner) for the dense system matrix involved in the optimization problem. We prove theoretically convergence of the preconditioned alternating projection algorithm. In numerical experiments, performance of our algorithms, with an appropriately selected preconditioning matrix, is compared with performance of the conventional MAP expectation-maximization (MAP-EM) algorithm with TV regularizer (EM-TV) and that of the recently developed nested EM-TV algorithm for ECT reconstruction. Based on the numerical experiments performed in this work, we observe that the alternating projection algorithm with the EM-preconditioner outperforms significantly the EM-TV in all aspects including the convergence speed, the noise in the reconstructed images and the image quality. It also outperforms the nested EM-TV in the convergence speed while providing comparable image quality. PMID:23271835

Preconditioned alternating projection algorithms for maximum a posteriori ECT reconstruction

NASA Astrophysics Data System (ADS)

Krol, Andrzej; Li, Si; Shen, Lixin; Xu, Yuesheng

2012-11-01

We propose a preconditioned alternating projection algorithm (PAPA) for solving the maximum a posteriori (MAP) emission computed tomography (ECT) reconstruction problem. Specifically, we formulate the reconstruction problem as a constrained convex optimization problem with the total variation (TV) regularization. We then characterize the solution of the constrained convex optimization problem and show that it satisfies a system of fixed-point equations defined in terms of two proximity operators raised from the convex functions that define the TV-norm and the constraint involved in the problem. The characterization (of the solution) via the proximity operators that define two projection operators naturally leads to an alternating projection algorithm for finding the solution. For efficient numerical computation, we introduce to the alternating projection algorithm a preconditioning matrix (the EM-preconditioner) for the dense system matrix involved in the optimization problem. We prove theoretically convergence of the PAPA. In numerical experiments, performance of our algorithms, with an appropriately selected preconditioning matrix, is compared with performance of the conventional MAP expectation-maximization (MAP-EM) algorithm with TV regularizer (EM-TV) and that of the recently developed nested EM-TV algorithm for ECT reconstruction. Based on the numerical experiments performed in this work, we observe that the alternating projection algorithm with the EM-preconditioner outperforms significantly the EM-TV in all aspects including the convergence speed, the noise in the reconstructed images and the image quality. It also outperforms the nested EM-TV in the convergence speed while providing comparable image quality.

Music-based therapeutic interventions for people with dementia.

PubMed

van der Steen, Jenny T; van Soest-Poortvliet, Mirjam C; van der Wouden, Johannes C; Bruinsma, Manon S; Scholten, Rob Jpm; Vink, Annemiek C

2017-05-02

Dementia is a clinical syndrome with a number of different causes which is characterised by deterioration in cognitive, behavioural, social and emotional functions. Pharmacological interventions are available but have limited effect to treat many of the syndrome's features. Less research has been directed towards non-pharmacological treatments. In this review, we examined the evidence for effects of music-based interventions as a treatment. To assess the effects of music-based therapeutic interventions for people with dementia on emotional well-being including quality of life, mood disturbance or negative affect, behavioural problems, social behaviour, and cognition at the end of therapy and four or more weeks after the end of treatment. We searched ALOIS, the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG) on 14 April 2010 using the terms: music therapy, music, singing, sing, auditory stimulation. Additional searches were also carried out on 3 July 2015 in the major healthcare databases MEDLINE, Embase, psycINFO, CINAHL and LILACS; and in trial registers and grey literature sources. On 12 April 2016, we searched the major databases for new studies for future evaluation. We included randomized controlled trials of music-based therapeutic interventions (at least five sessions) for people with dementia that measured any of our outcomes of interest. Control groups either received usual care or other activities. Two reviewers worked independently to screen the retrieved studies against the inclusion criteria and then to extract data and assess methodological quality of the included studies. If necessary, we contacted trial authors to ask for additional data, including relevant subscales, or for other missing information. We pooled data using random-effects models. We included 17 studies. Sixteen studies with a total of 620 participants contributed data to meta-analyses. Participants in the studies had dementia of varying degrees of severity, but all were resident in institutions. Five studies delivered an individual music intervention; in the others, the intervention was delivered to groups of participants. Most interventions involved both active and receptive musical elements. The methodological quality of the studies varied. All were at high risk of performance bias and some were at high risk of detection or other bias. At the end of treatment, we found low-quality evidence that music-based therapeutic interventions may have little or no effect on emotional well-being and quality of life (standardized mean difference, SMD 0.32, 95% CI -0.08 to 0.71; 6 studies, 181 participants), overall behaviour problems (SMD -0.20, 95% CI -0.56 to 0.17; 6 studies, 209 participants) and cognition (SMD 0.21, 95% CI -0.04 to 0.45; 6 studies, 257 participants). We found moderate-quality evidence that they reduce depressive symptoms (SMD -0.28, 95% CI -0.48 to -0.07; 9 studies, 376 participants), but do not decrease agitation or aggression (SMD -0.08, 95% CI -0.29 to 0.14; 12 studies, 515 participants). The quality of the evidence on anxiety and social behaviour was very low, so effects were very uncertain. The evidence for all long-term outcomes was also of very low quality. Providing people with dementia with at least five sessions of a music-based therapeutic intervention probably reduces depressive symptoms but has little or no effect on agitation or aggression. There may also be little or no effect on emotional well-being or quality of life, overall behavioural problems and cognition. We are uncertain about effects on anxiety or social behaviour, and about any long-term effects. Future studies should employ larger sample sizes, and include all important outcomes, in particular 'positive' outcomes such as emotional well-being and social outcomes. Future studies should also examine the duration of effects in relation to the overall duration of treatment and the number of sessions.

Life after critical illness: an overview.

PubMed

Rattray, Janice

2014-03-01

To illustrate the potential physical and psychological problems faced by patients after an episode of critical illness, highlight some of the interventions that have been tested and identify areas for future research. Recovery from critical illness is an international problem and as an issue is likely to increase. For some, recovery from critical illness is prolonged, subject to physical and psychological problems that may negatively impact upon health-related quality of life. The literature accessed for this review includes the work of a number of key researchers in the field of critical care research. These were identified from a number of sources include (1) personal knowledge of the research field accumulated over the last decade and (2) using the search engine 'The Knowledge Network Scotland'. Fatigue and weakness are significant problems for critical care survivors and are common in patients who have been in ICU for more than one week. Psychological problems include anxiety, depression, post-traumatic stress, delirium and cognitive impairment. Prevalence of these problems is difficult to establish for a number of methodological reasons that include the use of self-report questionnaires, the number of different questionnaires used and the variation in administration and timing. Certain subgroups of ICU survivors especially those at the more severe end of the illness severity spectrum are more at risk and this has been demonstrated for both physical and psychological problems. Findings from international studies of a range of potential interventions are presented. However, establishing effectiveness for most of these still has to be empirically demonstrated. What seems clear is the need for a co-ordinated, multidisciplinary, designated recovery and rehabilitation pathway that begins as soon as the patient is admitted into an intensive care unit. © 2013 John Wiley & Sons Ltd.

Forensic DNA testing.

PubMed

Butler, John M

2011-12-01

Forensic DNA testing has a number of applications, including parentage testing, identifying human remains from natural or man-made disasters or terrorist attacks, and solving crimes. This article provides background information followed by an overview of the process of forensic DNA testing, including sample collection, DNA extraction, PCR amplification, short tandem repeat (STR) allele separation and sizing, typing and profile interpretation, statistical analysis, and quality assurance. The article concludes with discussions of possible problems with the data and other forensic DNA testing techniques.

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.

Associations between physical activity and sedentary behavior with sleep quality and quantity in young adults.

PubMed

Kakinami, Lisa; O'Loughlin, Erin K; Brunet, Jennifer; Dugas, Erika N; Constantin, Evelyn; Sabiston, Catherine M; O'Loughlin, Jennifer

2017-02-01

Intensity and duration of physical activity (PA) and sedentary behavior are individually associated with sleep, but their independent associations are poorly characterized. The objectives of this study were to determine if PA and/or sedentary behavior are/is associated with sleep quality and/or quantity in a young adult sample. Cross-sectional. Montreal, Canada. Participants (n=658) from the Nicotine Dependence in Teens Study. PA measures included total minutes of light, moderate, and vigorous PA in the past week; sedentary measures included number of hours per day watching television (TV) and using the computer for leisure activities in the past week. Sleep measures included (1) the Pittsburgh Sleep Quality Index, which assesses sleep quality in the past month, and (2) number of hours of sleep per night in the past month. Data were analyzed using multiple logistic regression adjusting for age, sex, and mother's education. In multivariable analyses, each additional hour of TV and computer use per day was associated with a 17% and 13% increase, respectively, in the odds of reporting poor sleep quality. After additionally adjusting for PA, the association between TV use and poor sleep quality remained significant (odds ratio: 1.15, 95% confidence interval: 1.01-1.28). Sedentary behavior was not associated with sleep quantity. PA intensity and duration were not associated with sleep quality or quantity. More time spent doing sedentary activities was associated with poorer sleep quality, but PA was not associated. Clinicians treating young adults with sleep problems should inquire about sedentary behavior. Copyright © 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Development of an X-ray imaging system to prevent scintillator degradation for white synchrotron radiation.

PubMed

Zhou, Tunhe; Wang, Hongchang; Connolley, Thomas; Scott, Steward; Baker, Nick; Sawhney, Kawal

2018-05-01

The high flux of the white X-ray beams from third-generation synchrotron light sources can significantly benefit the development of high-speed X-ray imaging, but can also bring technical challenges to existing X-ray imaging systems. One prevalent problem is that the image quality deteriorates because of dust particles accumulating on the scintillator screen during exposure to intense X-ray radiation. Here, this problem has been solved by embedding the scintillator in a flowing inert-gas environment. It is also shown that the detector maintains the quality of the captured images even after days of X-ray exposure. This modification is cost-efficient and easy to implement. Representative examples of applications using the X-ray imaging system are also provided, including fast tomography and multimodal phase-contrast imaging for biomedical and geological samples. open access.

Efficient greedy algorithms for economic manpower shift planning

NASA Astrophysics Data System (ADS)

Nearchou, A. C.; Giannikos, I. C.; Lagodimos, A. G.

2015-01-01

Consideration is given to the economic manpower shift planning (EMSP) problem, an NP-hard capacity planning problem appearing in various industrial settings including the packing stage of production in process industries and maintenance operations. EMSP aims to determine the manpower needed in each available workday shift of a given planning horizon so as to complete a set of independent jobs at minimum cost. Three greedy heuristics are presented for the EMSP solution. These practically constitute adaptations of an existing algorithm for a simplified version of EMSP which had shown excellent performance in terms of solution quality and speed. Experimentation shows that the new algorithms perform very well in comparison to the results obtained by both the CPLEX optimizer and an existing metaheuristic. Statistical analysis is deployed to rank the algorithms in terms of their solution quality and to identify the effects that critical planning factors may have on their relative efficiency.

Language development in the early school years: the importance of close relationships with teachers.

PubMed

Spilt, Jantine L; Koomen, Helma M Y; Harrison, Linda J

2015-02-01

This longitudinal study examined developmental links between closeness in teacher-child relationships and children's receptive language ability from the end of the preschool years into the early elementary years, while controlling for changes in peer interaction quality and child behavioral functioning. The sample included children and their parents and teachers (N = 4,983) participating in the Longitudinal Study of Australian Children (LSAC) at ages 4-5, 6-7, and 8-9 years (3 waves). Teachers reported on levels of closeness in relationships with individual children. Independent assessments of receptive language were employed. Parents and teachers reported on peer interaction problems and child conduct problems. Results indicated reciprocal associations between close teacher-child relationships and receptive language development above and beyond associations with peer interaction quality and child behavioral functioning. However, the effects were only modest. PsycINFO Database Record (c) 2015 APA, all rights reserved.

The 1979 Southeastern Virginia Urban Plume Study. Volume 1: Description of experiments and selected aircraft data

NASA Technical Reports Server (NTRS)

Gregory, G. L.; Lee, R. B., III; Mathis, J. J., Jr.

1981-01-01

The Southeastern Virginia Urban Plume Study (SEV-UPS) utilizes remote sensors and satellite platforms to monitor the Earth's environment and resources. SEV-UPS focuses on the application of specific remote sensors to the monitoring and study of specific air quality problems. The 1979 SEV-UPS field program was conducted with specific objectives: (1) to provide correlative data to evaluate the Laser Absorption spectrometer ozone remote sensors; (2) to demonstrate the utility of the sensor for the study of urban ozone problems; (3) to provide additional insights into air quality phenomena occuring in Southeastern Virginia; and (4) to compare measurement results of various in situ measurement platforms. The field program included monitoring from 12 surface stations, 4 aircraft, 2 tethered balloons, 2 radiosonde release sites, and numerous surface meteorological observation sites. The aircraft monitored 03, NO, NOX, Bscat, temperature, and dewpoint temperature.

Development of an X-ray imaging system to prevent scintillator degradation for white synchrotron radiation

PubMed Central

Zhou, Tunhe; Wang, Hongchang; Scott, Steward

2018-01-01

The high flux of the white X-ray beams from third-generation synchrotron light sources can significantly benefit the development of high-speed X-ray imaging, but can also bring technical challenges to existing X-ray imaging systems. One prevalent problem is that the image quality deteriorates because of dust particles accumulating on the scintillator screen during exposure to intense X-ray radiation. Here, this problem has been solved by embedding the scintillator in a flowing inert-gas environment. It is also shown that the detector maintains the quality of the captured images even after days of X-ray exposure. This modification is cost-efficient and easy to implement. Representative examples of applications using the X-ray imaging system are also provided, including fast tomography and multimodal phase-contrast imaging for biomedical and geological samples. PMID:29714191

Cognitive and affective empathy in children with conduct problems: additive and interactive effects of callous-unemotional traits and autism spectrum disorders symptoms.

PubMed

Pasalich, Dave S; Dadds, Mark R; Hawes, David J

2014-11-30

Callous-unemotional (CU) traits and autism spectrum disorders (ASD) symptoms are characterized by problems in empathy; however, these behavioral features are rarely examined together in children with conduct problems. This study investigated additive and interactive effects of CU traits and ASD symptoms in relation to cognitive and affective empathy in a non-ASD clinic-referred sample. Participants were 134 children aged 3 to 9 years (M=5.60; 79% boys) with oppositional defiant/conduct disorder, and their parents. Clinicians, teachers, and parents reported on dimensions of child behavior, and parental reports of family dysfunction and direct observations of parental warmth/responsiveness assessed quality of family relationships. Results from multiple regression analysis showed that, over and above the effects of child conduct problem severity and quality of family relationships, both ASD symptoms and CU traits were uniquely associated with deficits in cognitive empathy. Moreover, CU traits demonstrated an independent association with affective empathy, and this relationship was moderated by ASD symptoms. That is, there was a stronger negative association between CU traits and affective empathy at higher versus lower levels of ASD symptoms. These findings suggest including both CU traits and ASD-related social impairments in models delineating the atypical development of empathy in children with conduct problems. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

Review of the logging residue problem and its reduction through marketing practices.

Treesearch

Thomas C. Adams; Richard C. Smith

1976-01-01

This study notes the increasing concern over logging residue in forest land management and describes the various administrative and technological means for accomplishing reductions of logging residue. Alternative sales arrangements can include such things as reduction of stumpage charges for low quality logs or required yarding of unutilized material to the landing or...

Contemporary wood utilization research needs in the Western United States.

Treesearch

Robert A. Monserud; Eini C. Lowell; Dennis R. Becker; Susan Stevens Hummel; Ellen M. Donoghue; R. James Barbour; Kenneth A. Kilborn; David L. Nicholls; Joe Roos; Randall A. Cantrell

2004-01-01

Contemporary wood utilization research needs in the Western United States are examined in this problem analysis. Key focal areas include: A. Changes in forest management actions and policies affect forest conditions and people, which in turn affect wood quality and wood utilization opportunities. B. Effects of natural disturbances (e.g., wildfire, insect outbreaks) on...

Quality ILL Service in the Network of CSIC Libraries: Five Years of Progress.

ERIC Educational Resources Information Center

Malo de Molina y Martin-Montalvo, Teresa; Quintana Martinez, Isabel

1997-01-01

Although Spanish interlibrary loans (ILL) have increased from 100 to 525 per 100,000 inhabitants, there are still many problems to resolve. Examines a plan developed by the Consejo Superior de Investigaciones Cientificas (CSIC) Library Network to improve ILL services. Provides a comparative analysis of ILL services from 1992-1995. Includes charts…

Application of Difference-in-Difference Techniques to the Evaluation of Drought-Tainted Water Conservation Programs.

ERIC Educational Resources Information Center

Bamezai, Anil

1995-01-01

Some of the threats to internal validity that arise when evaluating the impact of water conservation programs during a drought are illustrated. These include differential response to the drought, self-selection bias, and measurement error. How to deal with these problems when high-quality disaggregate data are available is discussed. (SLD)

Grade Distribution and Drying Degrade of Sweetgum and Yellow-poplar Structural Lumber

Treesearch

Timothy D. Faust

1990-01-01

The fact that the supply of southern pine timber is changing to include more lower quality plantation stock may provide incentive for utilizing lower density hardwoods for structural lumber. Yellow-poplar and sweetgum are potential substitutes for southern pine. A major problem in utilizing soft hardwoods for structural lumber is the difficulties associated with drying...

Self Efficacy, Alcohol Expectancy and Problem-Solving Appraisal as Predictors of Alcohol Use in College Students

ERIC Educational Resources Information Center

Biscaro, Michael; Broer, Karen; Taylor, Nancy

2004-01-01

Alcohol use and abuse are cause for concern because the educational process and quality of campus student life are disrupted. Abusive drinking can have serious consequences on all areas of college life, including economic, health, social and educational. Heavy alcohol use may result in personal injury, drunk driving, alcohol overdose, unplanned…

Asymmetric single-strand polymorphism: an accurate and cost-effective method to amplify and sequence allelic variants

USDA-ARS?s Scientific Manuscript database

We needed to obtain an alternative to conventional cloning to generate high-quality DNA sequences from a variety of nuclear orthologs for phylogenetic studies in potato, to save time and money and to avoid problems typically encountered in cloning. We tested a variety of SSCP protocols to include pu...

School-Central Office Relationships in Evidence Use: Understanding Evidence Use as a Systems Problem

ERIC Educational Resources Information Center

Honig, Meredith I.; Venkateswaran, Nitya

2012-01-01

Research on evidence use in school districts overwhelmingly focuses within schools on how school staff work with evidence including student performance data, research, and information about teaching quality. While important, this focus on schools reflects a mismatch with federal and state policies that demand not only that school staff work with…

The Challenges of Attaining Millennium Development Goals in Education in Africa by 2015

ERIC Educational Resources Information Center

Ojogwu, C. N.

2009-01-01

Millennium Development Goals were established by the United Nations to help underdeveloped countries to overcome problems of illiteracy, poverty, low health status and quality of life. Much emphasis was placed on the attainment of MDG targets in education because of its pivotal role in national development. The targets include education for all…

Task Scheduling in Desktop Grids: Open Problems

NASA Astrophysics Data System (ADS)

Chernov, Ilya; Nikitina, Natalia; Ivashko, Evgeny

2017-12-01

We survey the areas of Desktop Grid task scheduling that seem to be insufficiently studied so far and are promising for efficiency, reliability, and quality of Desktop Grid computing. These topics include optimal task grouping, "needle in a haystack" paradigm, game-theoretical scheduling, domain-imposed approaches, special optimization of the final stage of the batch computation, and Enterprise Desktop Grids.

Investigations into the sources and removal of taste and odor compounds at two treatment facilities on Eastern Lake Erie and Niagara River

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

Wittmeyer, S.; Cap, R.; Lange, C.

1996-11-01

Taste and odor problems in drinking water supplies have been a topic of research since the early 1900`s. Studies have identified various taste and odor compounds, including methyl-iso-borneol (MIB), geosmin, trichloranisole, and their potential sources, to include the phytoplankton genera Aphanizomenon, Anabaena, Microcystis, and Dinobryon. Many methods of treatment have been investigated to mitigate taste and odors, including the addition of copper sulfate and various chemical oxidants, as well as the introduction of bacteria capable of metabolizing oil-like organic compounds. Taste and odor problems associated with drinking water supplies have become increasingly important, in part because public awareness of watermore » quality issues such as chlorine and associated disinfection byproducts, and the perception that malodorous water may be associated with pathogens such as the infectious Cryptosporidium parvum. Due to marked increases in customer complaints beginning in 1993, and elevated levels of the taste and odor compounds. MIB and geosmin, in eastern Lake Erie and the Niagara River, the Erie County Water Authority (ECWA) initiated an investigation into the impact of MIB and geosmin on water quality, assessment of various means of effective removal, and potential sources.« less

Multi-method assessments of sleep over the transition to college and the associations with depression and anxiety symptoms.

PubMed

Doane, Leah D; Gress-Smith, Jenna L; Breitenstein, Reagan S

2015-02-01

A growing body of research has demonstrated links between sleep problems and symptoms of depression and anxiety in community and clinical samples of adolescents and young adults. Scant longitudinal research, however, has examined reciprocal associations over socio-contextual shifts such as the transition to college. Using multiple methods of assessment (e.g., actigraphy, subjective report), the current study assessed whether sleep quantity, quality or variability changed over the transition to college and investigated the potential cross-lagged relationships between adolescents' sleep and symptoms of anxiety and depression. The participants (N = 82; 24% male) were studied at three time points over approximately 1 year: spring of their senior year of high school (T1), fall of their first year of college (T2), and spring of their first year of college (T3). Sleep minutes, sleep efficiency, wake time variability and anxiety increased over the transition to college. Subjective reports of sleep problems decreased. Cross-lagged panel models indicated significant relationships between subjective sleep quality and anxiety symptoms over time where subjective sleep problems at T1 were associated with anxiety at T2, and anxiety at T2 was associated with subjective sleep problems at T3. In contrast, greater depressive symptoms at T1 preceded increases in subjective sleep problems, sleep latency and sleep start time variability at T2. Importantly, there were concurrent associations between symptoms of anxiety or depression at T2 and sleep efficiency, sleep start time variability, and subjective sleep problems. These findings suggest that, overall, sleep quantity and quality improved over the transition to college, although the overall amounts of sleep were still below developmental recommendations. However, for some youth, the first semester of college may be a sensitive period for both sleep problems and symptoms of anxiety. In contrast, depressive symptoms were stable across time but were associated with worsening sleep problems in the first semester of college. Implications for future prevention and intervention programs should include strategies to help youth cope effectively with adjustment like increased sleep variability and symptoms of anxiety associated with the transition to college.

Electronic medical record features and seven quality of care measures in physician offices.

PubMed

Hsiao, Chun-Ju; Marsteller, Jill A; Simon, Alan E

2014-01-01

The effect of electronic medical records (EMRs) on quality of care in physicians' offices is uncertain. This study used the 2008-2009 National Ambulatory Medical Care Survey to examine the relationship between EMRs features and quality in physician offices. The relationship between selected EMRs features and 7 quality measures was evaluated by testing 25 associations in multivariate models. Significant relationships include reminders for guideline-based interventions or screening tests associated with lower odds of inappropriate urinalysis and prescription of antibiotics for upper respiratory infection (URI), prescription order entry associated with lower odds of prescription of antibiotics for URI, and patient problem list associated with higher odds of inappropriate prescribing for elderly patients. EMRs system level was associated with lower odds of blood pressure check, inappropriate urinalysis, and prescription of antibiotics for URI compared with no EMRs. The results show both positive and inverse relationships between EMRs features and quality of care.

User's Guide for ERB 7 Matrix. Volume 1: Experiment Description and Quality Control Report for Year 1

NASA Technical Reports Server (NTRS)

Tighe, R. J.; Shen, M. Y. H.

1984-01-01

The Nimbus 7 ERB MATRIX Tape is a computer program in which radiances and irradiances are converted into fluxes which are used to compute the basic scientific output parameters, emitted flux, albedo, and net radiation. They are spatially averaged and presented as time averages over one-day, six-day, and monthly periods. MATRIX data for the period November 16, 1978 through October 31, 1979 are presented. Described are the Earth Radiation Budget experiment, the Science Quality Control Report, Items checked by the MATRIX Science Quality Control Program, and Science Quality Control Data Analysis Report. Additional material from the detailed scientific quality control of the tapes which may be very useful to a user of the MATRIX tapes is included. Known errors and data problems and some suggestions on how to use the data for further climatologic and atmospheric physics studies are also discussed.

Statistical process control methods allow the analysis and improvement of anesthesia care.

PubMed

Fasting, Sigurd; Gisvold, Sven E

2003-10-01

Quality aspects of the anesthetic process are reflected in the rate of intraoperative adverse events. The purpose of this report is to illustrate how the quality of the anesthesia process can be analyzed using statistical process control methods, and exemplify how this analysis can be used for quality improvement. We prospectively recorded anesthesia-related data from all anesthetics for five years. The data included intraoperative adverse events, which were graded into four levels, according to severity. We selected four adverse events, representing important quality and safety aspects, for statistical process control analysis. These were: inadequate regional anesthesia, difficult emergence from general anesthesia, intubation difficulties and drug errors. We analyzed the underlying process using 'p-charts' for statistical process control. In 65,170 anesthetics we recorded adverse events in 18.3%; mostly of lesser severity. Control charts were used to define statistically the predictable normal variation in problem rate, and then used as a basis for analysis of the selected problems with the following results: Inadequate plexus anesthesia: stable process, but unacceptably high failure rate; Difficult emergence: unstable process, because of quality improvement efforts; Intubation difficulties: stable process, rate acceptable; Medication errors: methodology not suited because of low rate of errors. By applying statistical process control methods to the analysis of adverse events, we have exemplified how this allows us to determine if a process is stable, whether an intervention is required, and if quality improvement efforts have the desired effect.

Study of Water Quality Changes due to Offshore Dike Development Plan at Semarang Bay

NASA Astrophysics Data System (ADS)

Wibowo, M.; Hakim, B. A.

2018-03-01

Now, coast of Semarang Gulf is experiencing rapid growth because Semarang as a center economic growth in Central Java. On the other hand, coast of Gulf Semarang also experience a variety of very complex problems, such as tidal flood, land subsidence, as well as coastal damage due to erosion and sedimentation process. To overcome these problems BPPT and other institutions proposed construction of offshore dike. Construction of the offshore dike is a technology intervention to the marine environment that will certainly affect the hydrodynamic balance in coastal water including water quality in the Gulf of Semarang. Therefore, to determine changes in water quality that will happen is necessary to study the water quality modeling. The study was conducted by using a computational modeling software MIKE-21 Eco Lab Module from DHI. Based on this study result knowed that development offshore dike will change water quality in the west and east dam that formed. In west dam the average value of the DO decline 81.56% - 93.32 % and the average value of BOD rise from 22.01 to 31.19% and in the east dam, there is an increase average value DO of 83.19% - 75.80%, while the average value of BOD decrease by 95,04% - 96.01%. To prevent the downward trend in water quality due to the construction of the offshore dike, its necessary precautions at the upstream area before entering the Gulf of Semarang.

Air Pollution over the States

ERIC Educational Resources Information Center

Environmental Science and Technology, 1972

1972-01-01

State plans for implementing air quality standards are evaluated together with problems in modeling procedures and enforcement. Monitoring networks, standards, air quality regions, and industrial problems are also discussed. (BL)

Who is the Treatment-Seeking Young Adult with Severe Obesity: A Comprehensive Characterization with Emphasis on Mental Health.

PubMed

Dreber, Helena; Reynisdottir, Signy; Angelin, Bo; Hemmingsson, Erik

2015-01-01

To characterize treatment-seeking young adults (16-25 years) with severe obesity, particularly mental health problems. Cross-sectional study of 165 participants (132 women, 33 men) with BMI ≥35 kg/m2 or ≥30 kg/m2 with comorbidities, enrolling in a multidisciplinary obesity treatment program. Data collection at admission of present and life-time health issues including symptomatology of anxiety, depression (Hospital Anxiety and Depression Scale) and attention-deficit/hyperactivity disorder (Adult ADHD Self-Report scale); self-esteem (Rosenberg Self-Esteem Scale), suicide attempts, health-related quality of life (Short Form-36 Health Survey), psychosocial functioning related to obesity (Obesity-related Problems Scale), cardiorespiratory fitness (Astrand's bicycle ergometer test), somatic and psychiatric co-morbidities, cardiometabolic risk factors, and micronutritional status. We used multiple regression analysis to identify variables independently associated with present anxiety and depressive symptomatology. Mean body mass index was 39.2 kg/m2 (SD = 5.2). We found evidence of poor mental health, including present psychiatric diagnoses (29%), symptomatology of anxiety (47%), depression (27%) and attention-deficit/hyperactivity disorder (37%); low self-esteem (42%), attempted suicide (12%), and low quality of life (physical component score = 46, SD = 11.2; mental component score = 36, SD = 13.9, P<0.001 for difference). Variables independently associated with present anxiety symptomatology (R2 = 0.33, P<0.001) included low self-esteem (P<0.001) and pain (P = 0.003), whereas present depressive symptomatology (R2 = 0.38, P<0.001) was independently associated with low self-esteem (P<0.001), low cardiorespiratory fitness (P = 0.009) and obesity-related problems (P = 0.018). The prevalence of type 2 diabetes was 3%, and hypertension 2%. Insulin resistance was present in 82%, lipid abnormality in 62%, and poor cardiorespiratory fitness in 92%. Forty-eight percent had at least one micronutritional deficiency, vitamin D being the most common (35%). A wide range of health issues, including quite severe mental health problems, was prevalent in treatment-seeking young adults with severe obesity. These are likely to constitute a major treatment challenge, including options relating to bariatric surgery.

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)

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…

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…

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…

Management of defects on lower extremities with the use of matriderm and skin graft.

PubMed

Choi, Jun-Young; Kim, Seong-Hun; Oh, Gwang-Jin; Roh, Si-Gyun; Lee, Nae-Ho; Yang, Kyung-Moo

2014-07-01

The reconstruction of large skin and soft tissue defects on the lower extremities is challenging. The skin graft is a simple and frequently used method for covering a skin defect. However, poor skin quality and architecture are well-known problems that lead to scar contracture. The collagen-elastin matrix, Matriderm, has been used to improve the quality of skin grafts; however, no statistical and objective review of the results has been reported. Thirty-four patients (23 male and 11 female) who previously received a skin graft and simultaneous application of Matriderm between January 2010 and June 2012 were included in this study. The quality of the skin graft was evaluated using Cutometer, occasionally accompanied by pathologic findings. All 34 patients showed good skin quality compared to a traditional skin graft and were satisfied with their results. The statistical data for the measurement of the mechanical properties of the skin were similar to those for normal skin. In addition, there was no change in the engraftment rate. The biggest problem of a traditional skin graft is scar contracture. However, the dermal matrix presents an improvement in skin quality with elastin and collagen. Therefore, a skin graft along with a simultaneous application of Matriderm is safe and effective and leads to a significantly better outcome from the perspective of skin elasticity.

Introducing quality management into primary health care services in Uganda.

PubMed Central

Omaswa, F.; Burnham, G.; Baingana, G.; Mwebesa, H.; Morrow, R.

1997-01-01

In 1994, a national quality assurance programme was established in Uganda to strengthen district-level management of primary health care services. Within 18 months both objective and subjective improvements in the quality of services had been observed. In the examples documented here, there was a major reduction in maternal mortality among pregnant women referred to Jinja District Hospital, a reduction in waiting times and increased patient satisfaction at Masaka District Hospital, and a marked reduction in reported cases of measles in Arua District. Beyond these quantitative improvements, increased morale of district health team members, improved satisfaction among patients, and greater involvement of local government in the decisions of district health committees have been observed. At the central level, the increased coordination of activities has led to new guidelines for financial management and the procurement of supplies. District quality management workshops followed up by regular support visits from the Ministry of Health headquarters have led to a greater understanding by central staff of the issues faced at the district level. The quality assurance programme has also fostered improved coordination among national disease-control programmes. Difficulties encountered at the central level have included delays in carrying out district support visits and the failure to provide appropriate support. At the district level, some health teams tackled problems over which they had little control or which were overly complex; others lacked the management capacity for problem solving. PMID:9185368

Health, lifestyle, and quality of life for young adults born very preterm.

PubMed

Cooke, R W I

2004-03-01

Children born very preterm and able to attend mainstream schools have been shown to have a high prevalence of behavioural, minor motor, and learning difficulties. It is not clear whether these problems persist into adulthood, impacting on lifestyle and quality of life. A previously studied cohort of very low birth weight infants born between 1980 and 1983, together with term classmate controls, were assessed at age 19-22 years using a postal questionnaire. The questionnaire included the SF-36 to assess quality of life, a social activities scale, a lifestyle questionnaire, the Hospital Anxiety and Depression Scale, and questions on current height, weight, health, family structure, and education and occupation. Of the 138 preterm and 163 term controls in the cohort, 79 preterm and 71 term returned questionnaires. Quality of life was assessed as similar on six of eight domains of the SF-36. Social activities were also similar. Preterms drank less alcohol, used fewer illicit drugs, but smoked as often. Rates for sexual intercourse were similar, although preterms had more children. Preterms were shorter than controls and were less satisfied with their appearance. They were more likely to use a regular prescription medicine. Fewer were or had been in higher education, and some remained unemployed. The problems experienced by very preterm infants at school appear to influence lifestyle and health, but not perceived quality of life in early adulthood.

A rapid response air quality analysis system for use in projects having stringent quality assurance requirements

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

Bowman, A.W.

1990-04-01

This paper describes an approach to solve air quality problems which frequently occur during iterations of the baseline change process. From a schedule standpoint, it is desirable to perform this evaluation in as short a time as possible while budgetary pressures limit the size of the staff available to do the work. Without a method in place to deal with baseline change proposal requests the environment analysts may not be able to produce the analysis results in the time frame expected. Using a concept called the Rapid Response Air Quality Analysis System (RAAS), the problems of timing and cost becomemore » tractable. The system could be adapted to assess other atmospheric pathway impacts, e.g., acoustics or visibility. The air quality analysis system used to perform the EA analysis (EA) for the Salt Repository Project (part of the Civilian Radioactive Waste Management Program), and later to evaluate the consequences of proposed baseline changes, consists of three components: Emission source data files; Emission rates contained in spreadsheets; Impact assessment model codes. The spreadsheets contain user-written codes (macros) that calculate emission rates from (1) emission source data (e.g., numbers and locations of sources, detailed operating schedules, and source specifications including horsepower, load factor, and duty cycle); (2) emission factors such as those published by the U.S. Environmental Protection Agency, and (3) control efficiencies.« less

Midwives' perceptions and experiences of caring for women who experience perinatal mental health problems: An integrative review.

PubMed

Noonan, Maria; Doody, Owen; Jomeen, Julie; Galvin, Rose

2017-02-01

perinatal mental health is an important public health issue and consideration must be given to care provision for effective support and care of women in the perinatal period. to synthesise primary research on midwives' perceived role in Perinatal Mental Health (PMH). integrative review. Whittemore and Knafl's (2005) framework was employed. A systematic search of the literature was completed. Studies were included if they met the following criteria: primary qualitative, quantitative and mixed methods research studies published in peer reviewed journals between January 2006 to February 2016, where the population of interest were midwives and the outcomes of interest were their perceived role in the management of women with PMH problems. The methodological quality of studies was assessed using the relevant CASP (Critical Appraisal Skills Programmes, 2014) criteria for quantitative and qualitative research studies. Data extraction, quality assessment and thematic analysis were conducted. a total of 3323 articles were retrieved and 22 papers were included in the review (15 quantitative, 6 qualitative and one mixed method study). The quality of the studies included was good overall. Two overarching themes emerged relating to personal and professional engagement. Within personal engagement four sub themes are presented: knowledge, skills, decision making and attitude. Within professional engagement four themes are presented: continuous professional development, organisation of care, referral, and support. the findings indicate midwives require continuous professional development opportunities that address knowledge, attitudes to PMH, communication and assessment skills. However educational and training support in the absence of appropriate referral pathways and support systems will have little benefit. Copyright © 2016 Elsevier Ltd. All rights reserved.

A systematic review of nonrandomized controlled trials on the curative effects of aquatic exercise

PubMed Central

Kamioka, Hiroharu; Tsutani, Kiichiro; Mutoh, Yoshiteru; Okuizum, Hiroyasu; Ohta, Miho; Handa, Shuichi; Okada, Shinpei; Kitayuguchi, Jun; Kamada, Masamitsu; Shiozawa, Nobuyoshi; Park, Sang-Jun; Honda, Takuya; Moriyama, Shoko

2011-01-01

Background: The objectives of this review were to integrate the evidence of curative effects through aquatic exercise and assess the quality of studies based on a review of nonrandomized controlled trials (nRCTs). Methods: Study design was a systematic review of nonrandomized controlled trials. Trials were eligible if they were nonrandomized clinical trials. Studies included one treatment group in which aquatic exercise was applied. We searched the following databases from 2000 up to July 20, 2009: MEDLINE via PubMed, CINAHL, and Ichushi-Web. Results: Twenty-one trials met all inclusion criteria. Languages included were English (N = 9), Japanese (N = 11), and Korean (N = 1). Target diseases were knee and/or hip osteoarthritis, poliomyelitis, chronic kidney disease, discomforts of pregnancy, cardiovascular diseases, and rotator cuff tears. Many studies on nonspecific disease (healthy participants) were included. All studies reported significant effectiveness in at least one or more outcomes. However results of evaluations with the TREND and CLEAR-NPT checklists generally showed a remarkable lack of description in the studies. Furthermore, there was the problem of heterogeneity, and we were therefore not able to perform a meta-analysis. Conclusion: Because there was insufficient evidence on aquatic exercise due to poor methodological and reporting quality and heterogeneity of nRCTs, we were unable to offer any conclusions about the effects of this intervention. However, we were able to identify problems with current nRCTs of aquatic exercise, and propose a strategy of strengthening study quality, stressing the importance of study feasibility as a future research agenda objective. PMID:21556311

Effective interventions on service quality improvement in a physiotherapy clinic.

PubMed

Gharibi, Farid; Tabrizi, JafarSadegh; Eteraf Oskouei, MirAli; AsghariJafarabadi, Mohammad

2014-01-01

Service quality is considered as a main domain of quality associ-ated with non-clinical aspect of healthcare. This study aimed to survey and im-proves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reli-able researcher made questionnaire with participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (P<0.001). Service quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers.