quality rating aqr: Topics by Science.gov

Sample records for quality rating aqr

The Airline Quality Rating 2004

NASA Technical Reports Server (NTRS)

Fink, Mary M. (Editor); Bowen, Brent D.; Headley, Dean E.

2004-01-01

The Airline Quality Rating (AQR) was developed and first announced in early 1991 as an objective method of comparing airline quality on combined multiple performance criteria. This current report, the Airline Quality Rating 2004, reflects monthly Airline Quality Rating scores for 2003. AQR scores for the calendar year 2003 are based on 15 elements in four major areas that focus on airline performance aspects important to air travel consumers. The Airline Quality Rating 2004 is a summary of month-by-month quality ratings for U.S. airlines that have at least 1 % of domestic passenger volume during 2003. Using the Airline Quality Rating system of weighted averages and monthly performance data in the areas of on-time arrivals, involuntary denied boardings, mishandled baggage, and a combination of 12 customer complaint categories, airlines comparative performance for the calendar year of 2003 is reported. This research monograph contains a brief summary of the AQR methodology, detailed data and charts that track comparative quality for domestic airline operations for the 12-month period of 2003, and industry results. Also, comparative Airline Quality Rating data for 2002 are included, where available, to provide historical perspective regarding performance quality in the industry.
The Airline Quality Rating 2003

NASA Technical Reports Server (NTRS)

Bowen, Brent D.; Headley, Dean E.

2003-01-01

The Airline Quality Rating (AQR) was developed and first announced in early 1991 as an objective method of comparing airline quality on combined multiple performance criteria. This current report, the Airline Quality Rating 2003, reflects monthly Airline Quality Rating scores for 2002. AQR scores for the calendar year 2002 are based on 15 elements that focus on airline performance areas important to air travel consumers. The Airline Quality Rating 2003 is a summary of month-by-month quality ratings for the 10 largest U.S. airlines operating during 2002. Using the Airline Quality Rating system of weighted averages and monthly performance data in the areas of ontime arrivals, involuntary denied boardings, mishandled baggage, and a combination of 12 customer complaint categories, airlines comparative performance for the calendar year of 2002 is reported. This research monograph contains a brief summary of the AQR methodology, detailed data and charts that track comparative quality for domestic airline operations for the 12-month period of 2002, and industry average results. Also, comparative Airline Quality Rating data for 2001 are included for each airline to provide historical perspective regarding performance quality in the industry.
The Airline Quality Rating 2002

NASA Technical Reports Server (NTRS)

Bowen, Brent D.; Headley, Dean E.

2002-01-01

The Airline Quality Rating (AQR) was developed and first announced in early 1991 as an objective method of comparing airline quality on combined multiple performance criteria. This current report, Airline Quality Rating 2002, reflects monthly Airline Quality Rating scores for 2001. AQR scores for the calendar year 2001 are based on 15 elements that focus on airline performance areas important to air travel consumers. The Airline Quality Rating 2002 is a summary of month-by-month quality ratings for the 11 largest U.S. airlines operating during 2001. Using the Airline Quality Rating system of weighted averages and monthly performance data in the areas of on-time arrivals, involuntary denied boardings, mishandled baggage, and a combination of 12 customer complaint categories, airlines comparative performance for the calendar year of 2001 is reported. This research monograph contains a brief summary of the AQR methodology, detailed data and charts that track comparative quality for domestic airline operations for the 12-month period of 2001, and industry average results. Also, comparative Airline Quality Rating data for 2000 are included for each airline to provide historical perspective regarding performance quality in the industry.
The Airline Quality Rating 2001

NASA Technical Reports Server (NTRS)

Bowen, Brent D.; Headley, Dean E.

2001-01-01

The Airline Quality Rating (AQR) was developed and first announced in early 1991 as an objective method of comparing airline quality on combined multiple performance criteria. This current report, Airline Quality Rating 2001, reflects monthly Airline Quality Rating scores for 2000. AQR scores for the calendar year 2000 are based on 15 elements that focus on airline performance areas important to air travel consumers. The Airline Quality Rating 2001 is a summary of month-by-month quality ratings for the ten major U.S. airlines operating during 2000. Using the Airline Quality Rating system of weighted averages and monthly performance data in the areas of on-time arrivals, involuntary denied boardings, mishandled baggage, and a combination of 12 customer complaint categories, major airlines comparative performance for the calendar year of 2000 is reported. This research monograph contains a brief summary of the AQR methodology, detailed data and charts that track comparative quality for major airlines domestic operations for the 12 month period of 2000, and industry average results. Also, comparative Airline Quality Rating data for 1999 are included for each airline to provide historical perspective regarding performance quality in the industry.
The Airline Quality Rating 1999

NASA Technical Reports Server (NTRS)

Bowen, Brent D.; Headley, Dean E.

1999-01-01

The Airline Quality Rating (AQR) was developed and first announced in early 1991 as an objective method of comparing airline performance on combined multiple criteria. This current report, Airline Quality Rating 1999, reflects an updated approach to calculating monthly Airline Quality Rating scores for 1998. AQR scores for the calendar year 1998 are based on 15 elements that focus on airline performance areas important to air travel consumers. The Airline Quality Rating is a summary of month-by-month quality ratings for the ten major U.S. airlines operating during 1998. Using the Airline Quality Rating system of weighted averages and monthly performance data in the areas of on-time arrivals, involuntary denied boardings, mishandled baggage, and a combination of 12 customer complaint categories, major airlines comparative performance for the calendar year 1998 is reported. This research monograph contains a brief summary of the AQR methodology, detailed data and charts that track comparative quality for major airlines domestic operations for the 12 month period of 1998, and industry average results. Also, comparative Airline Quality Rating data for 1997, using the updated criteria, are included to provide a reference point regarding quality in the industry.
The Airline Quality Rating 2004

NASA Technical Reports Server (NTRS)

Bowen, Brent D.; Headley, Dean E.

2004-01-01

The Airline Quality Rating (AQR) was developed and first announced in early 1991 as an objective method of comparing airline quality on combined multiple performance criteria. This current report, the Airline Quality Rating 2004, reflects monthly Airline Quality Rating scores for 2003. AQR scores far the calendar year 2003 are based on 15 elemnts in four major areas that focus on airline performance aspects important to air travel consumers. The Airline Quality Rating 2004 is a summary of month-by-month quality ratings for U.S. airlines that have at least 1% of domestic passenger volume during 2003. Using the Airline Quality Rating system of weighted averages and monthly performance data in the areas of on-time arrivals, involuntary denied boardings, mishandled baggage, and a combination of 12 customer complaint categories, airlines comparative performance for the calendar year of 2003 is reported. This research monograph contains a brief summary of the AQR methodology, detailed data and charts that track comparative quality for domestic airline operations for the 12-month period of 2003, and industry results. Also, comparative Airline Quality Rating data for 2002 are included, where available, to provide historical perspective
The UNO Aviation Monograph Series: The Airline Quality Rating 1997

NASA Technical Reports Server (NTRS)

Bowen, Brent D.; Headley, Dean E.

1997-01-01

The Airline Quality Rating (AQR) was developed and first announced in early 1991 as an objective method of comparing airline performance on combined multiple factors important to consumers. Development history and calculation details for the AQR rating system are detailed in The Airline Quality Rating 1991 issued in April, 1991, by the National Institute for Aviation Research at Wichita State University. This current report, Airline Rating 1997, contains monthly Airline Quality Rating scores for 1996. Additional copies are available by contacting Wichita State University or the University of Nebraska at Omaha. The Airline Quality Rating (AQR) 1997 is a summary of a month-by-month quality ratings for the nine major domestic U.S. airlines operating during 1996. Using the Airline Quality Rating system and monthly performance data for each airline for the calendar year of 1996, individual and comparative ratings are reported. This research monograph contains a brief summary of the AQR methodology, detailed data and charts that track comparative quality for major domestic airlines across the 12 month period of 1996, and industry average results. Also comparative Airline Quality Rating data for 1991 through 1995 are included to provide a longer term view of quality in the industry.
The UNO Aviation Monograph Series: The Airline Quality Rating 1998

NASA Technical Reports Server (NTRS)

Bowen, Brent D.; Headley, Dean E.

1998-01-01

The Airline Quality Rating (AQR) was developed and first announced in early 1991 as an objective method of comparing airline performance on combined multiple factors important to consumers. Development history and calculation details for the AQR rating system are detailed in The Airline Quality Rating 1991 issued in April, 1991, by the National Institute for Aviation Research at Wichita State University. This current report, Airline Quality Rating 1998, contains monthly Airline Quality Rating scores for 1997. Additional copies are available by contacting Wichita State University or University of Nebraska at Omaha. The Airline Quality Rating 1998 is a summary of month-by-month quality ratings for the ten major U.S. airlines operating during 1997. Using the Airline Quality Rating system and monthly performance data for each airline for the calendar year of 1997, individual and comparative ratings are reported. This research monograph contains a brief summary of the AQR methodology, detailed data and charts that track comparative quality for major airlines domestic operations for the 12 month period of 1997, and industry average results. Also, comparative Airline Quality Rating data for 1991 through 1996 are included to provide a longer term view of quality in the industry.
The Airline Quality Rating 2001 (PDF file)

DOT National Transportation Integrated Search

2001-04-01

The Airline Quality Rating (AQR) was developed and first announced in early : 1991 as an objective method of comparing airline quality on combined multiple : performance criteria. This current report, Airline Quality Rating 2001, reflects monthly Air...
R Aqr observing campaign

NASA Astrophysics Data System (ADS)

Waagen, Elizabeth O.

2016-01-01

Dr. George Wallerstein (University of Washington) has requested AAVSO coverage of the long period/symbiotic variable R Aquarii beginning immediately in support of high resolution spectroscopic observations planned for 2016 January 19 and 21. Several other astronomers, including Drs. Lee Anne Willson (Iowa State University), Ulisse Munari (INAF, Astronomical Observatory of Padua, Italy), and Fred Walter (Stony Brook University) are studying R Aqr closely and additional spectroscopic and other observations are planned for the near future. R Aqr is both a Mira (M) and a symbiotic (ZAND) - it is a close binary system consisting of a hot star and a late-type star (the Mira), both enveloped in nebulosity. As a result, the very interesting light curve shows not only the Mira pulsation but also complex eclipse behavior as the two stars interact. The period of Mira variation is 387.0 days; the eclipse period is 43.6-44 years. The cause of the eclipse is unknown; several theories h! ave been proposed, including a focused accretion stream, a disk or cloud around the secondary, and a triggered mass loss that produces an opaque cloud. Careful investigation of this upcoming event should help to resolve this question. The last eclipse of R Aqr was in 1978. The next eclipse is predicted for 2022, but may be early. The current behavior of R Aqr suggests that the eclipse, which lasts for several years, may either be beginning or its beginning may be imminent. R Aqr was at minimum in early December 2015 at magnitude V=11.4, and is currently at visual magnitude 11.0. During this phase of the approximately 44-year eclipse cycle, at maximum it may be as bright as V 6.0-6.5 but is not expected to become brighter. Beginning immediately, nightly BVRI CCD and DSLR photometry and visual observations are requested. As R Aqr brightens towards maximum and is in range, PEP observations are also requested. Ongoing spectroscopy over the next several years will be interesting to see as the system
Analysis of the FF Aqr spectra

NASA Astrophysics Data System (ADS)

Shimanskaya, N. N.; Bikmaev, I. F.; Shimansky, V. V.

2011-07-01

We determine the atmospheric parameters of the secondary in the close binary system FF Aqr and analyze its chemical composition. A series of high-resolution spectra are taken at different orbital phases using the coude echelle spectrometer of the 1.5-m Russian-Turkish Telescope (RTT150). We show that the absorption line intensity of heavy elements varies with phase due to the spotty nature of the cool component. We determine the abundances of heavy elements in the star's atmosphere by modelling the synthetic spectra and performing a differential analysis of the chemical composition of FF Aqr relative to the solar composition. Our analysis of the averaged spectrum of FF Aqr yielded 539 abundance estimates for 21 chemical elements. We found the metallicity of the star ([ Fe/H] = -0.11 ± 0.08) to be close solar, in agreement with the hypothesis that FF Aqr should belong to the Galactic disk. The inferred chemical composition of the objects exhibits no anomalous abundances of the α-, r-, and s-process elements like those earlier found in other systems (IN Com, LW Hya, V471 Tau). The lack of such anomalies in FF Aqr must be due to the fact that the elements heavier than 16 O cannot be synthesized in the core of the primary during the last stages of its evolution.
Multiple color light curves and period changes investigation of the contact binary HV Aqr

NASA Astrophysics Data System (ADS)

Li, K.; Qian, S.-B.

2013-07-01

New V, R and I light curves of the short period binary system, HV Aqr, are presented. Photometric solutions were derived using the Wilson-Devinney code. Our new determined light curves do not show O'Connell effect. The nearly symmetry and complete eclipses of the light curves of HV Aqr enable us to determine high-precision photometric parameters of the binary system. The new solutions suggest that HV Aqr is a low mass ratio (q=0.1455) deep contact binary with a contact degree of f=55.9%. Based on all available times of light minimum, we analyzed the long-term period changes of HV Aqr. A secular decrease rate of dP/dt=8.84(±0.18)×10-8 days yr-1 was determined. The continuous period decrease can be explained by the mass transfer from the primary component to the secondary and angular momentum loss via magnetic stellar wind. A conservative mass transfer rate of dM1/dt=1.81×10-8M⊙ yr-1 and angular momentum loss rate at dJ/dt=5.96×1045 g cm2 s-1 yr-1 were derived. As the orbital period decreases, the contact degree of HV Aqr will become deeper and finally it will evolve into a single rapid-rotation star.
FO Aqr time-series observations requested

NASA Astrophysics Data System (ADS)

Waagen, Elizabeth O.

2016-07-01

Dr. Colin Littlefield (University of Notre Dame) and colleagues Drs. Peter Garnavich (Notre Dame), Erin Aadland (Minnesota State), and Mark Kennedy (University College Cork) have requested AAVSO assistance in monitoring the intermediate polar cataclysmic variable FO Aqr beginning immediately. Littlefield, who with his colleagues recently published ATel #9216 and #9225, writes: "This system is in a faint state for the first time in its observational record, implying a dropoff in the mass-transfer rate. AAVSO observations contributed by Shawn Dvorak [the only observer following FO Aqr at the time] were particularly helpful in detecting this low state. Since early May, the system has recovered to V 15, but it is still well below its normal brightness. In addition, our time-series photometry shows a very strong 11.26-minute photometric period. By contrast, during its bright state, FO Aqr's light curve is dominated by a 20.9-minute period, corresponding with the spin period of the white dwarf. We interpret our observations as evidence that the system's accretion processes have changed dramatically as a result of the reduced mass-transfer rate. We have...determined that...[the 11.26-min] periodicity is dependent on the orbital phase of the binary. The 11.26-min period is dominant for about half of the orbit, but for the other half, a 22.5-min period is stronger. AAVSO observers can help us study both of these periods as well as their dependence on the orbital phase. We are particularly interested in any changes in this behavior as the system continues to brighten...Time-series photometry of FO Aqr [is requested] in order to better study the evolution of the 11.26-minute period as the system rebrightens. Unfiltered photometry reduced with a V zeropoint would be the most useful to us...A cadence of less than 60 seconds per image is important, given the brevity of these periods (especially the 11.26-min period). Finder charts with sequence may be created using the AAVSO
A flickering study of nova-like systems KR Aur and UU Aqr

NASA Astrophysics Data System (ADS)

Dobrotka, A.; Mineshige, S.; Casares, J.

2012-03-01

We present a study of the flickering activity in two nova-like systems, KR Aur and UU Aqr. We applied a statistical model of flickering simulations in accretion discs based on turbulent angular momentum transport between two adjacent rings with an exponential distribution of the turbulence dimension scale. The model is based on a steady-state disc model, which is satisfied in the case of hot ionized discs of nova-like cataclysmic variables. Our model successfully fits the observed power-density spectrum of KR Aur with the disc parameter α= 0.10-0.40 and an inner-disc truncation radius in the range Rin= 0.88-1.67 × 109 cm. The exact values depend on the mass-transfer rate in the sense that α decreases and Rin increases with mass-transfer rate. In any case, the inner-disc radius found for KR Aur is considerably smaller than those for quiescent dwarf novae, as predicted by the disc instability model. On the other hand, our simulations fail to reproduce the power-density spectrum of UU Aqr. A tantalizing explanation involves the possible presence of spiral waves, which are expected in UU Aqr because of its low mass ratio but not in KR Aur. In general our model predicts the observed concentration of flickering in the central disc. We explain this by the radial dependence of the angular-momentum gradient.
EUVE and IR observations of the Polars HU Aqr and AR UMa

NASA Astrophysics Data System (ADS)

Howell, S.; Ciardi, D.

1999-12-01

Simultaneous EUVE and ground-based near-infrared J and K observations of the magnetic CV HU Aqr were performed. The observations occurred during a super-high state never before observed in HU Aqr. The average EUVE count-rate was 30-60 times higher than had been measured previously, allowing us to present the first ever EUV spectra of HU Aqr. The near-infrared observations show a corresponding flux increase of 2-3 times over previous J and K observations. However, the near-infrared eclipse minimum during this super-high state are the same as seen in previous observations, indicating that the eclipse in the near-infrared is total. We present a detailed comparison of the EUV and near-infrared emission of HU Aqr as a function of orbital phase and discuss the geometry and physical properties of the high energy and infrared emitting regions. AR UMa is the brightest EUV source yet observed with the EUVE satellite and is also the polar with the largest magnetic field, 250 MG. EUVE observations of the polar AR UMa have allowed, for the first time, EUV time-resolved spectral analysis and radial velocity measurements. We present EUV phase-resolved photometry and spectroscopy and show that the He 304 emission line is not produced on the heated face of the secondary star, but emanates from the inner illuminated regions of the coupling region and accretion stream. We comment on the overall structure of the accretion geometry as well. The authors acknowledge partial support of the research by NASA cooperative agreement NCC5-138 via an EUVE guest Observer mini-grant.
PHOTOMETRIC ANALYSIS OF HS Aqr, EG Cep, VW LMi, AND DU Boo

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

Djurasevic, G.; Latkovic, O.; Bastuerk, Oe.

2013-03-15

We analyze new multicolor light curves for four close late-type binaries: HS Aqr, EG Cep, VW LMi, and DU Boo, in order to determine the orbital and physical parameters of the systems and estimate the distances. The analysis is done using the modeling code of G. Djurasevic, and is based on up-to-date measurements of spectroscopic elements. All four systems have complex, asymmetric light curves that we model by including bright or dark spots on one or both components. Our findings indicate that HS Aqr and EG Cep are in semi-detached, while VW LMi and DU Boo are in overcontact configurations.
77 FR 40659 - AQR Capital Management, LLC, et al.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-10

... SECURITIES AND EXCHANGE COMMISSION [Investment Company Act Release No. 30128; 812-13833] AQR... Investment Company Act of 1940 (the ``Act'') for an exemption from sections 12(d)(1)(A) and (B) of the Act... Application: The requested order would (a) permit certain registered management investment companies to...
Indications of stellar prominence oscillations on fast rotating stars: the cases of HK Aqr and PZ Tel

NASA Astrophysics Data System (ADS)

Leitzinger, M.; Odert, P.; Zaqarashvili, T. V.; Greimel, R.; Hanslmeier, A.; Lammer, H.

2016-11-01

We present the analysis of six nights of spectroscopic monitoring of two young and fast rotating late-type stars, namely the dMe star HK Aqr and the dG/dK star PZ Tel. On both stars, we detect absorption features reminiscent of signatures of corotating cool clouds or prominences visible in Hα. Several prominences on HK Aqr show periodic variability in the prominence tracks which follow a sinusoidal motion (indication of prominence oscillations). On PZ Tel, we could not find any periodic variability in the prominence tracks. By fitting sinusoidal functions to the prominence tracks, we derive amplitudes and periods which are similar to those of large-amplitude oscillations seen in solar prominences. In one specific event, we also derive a periodic variation of the prominence track in the Hβ spectral line which shows an anti-phase variation with the one derived for the Hα spectral line. Using these parameters and estimated mass density of a prominence on HK Aqr, we derive a minimum magnetic field strength of ˜2 G. The relatively low strength of the magnetic field is explained by the large height of this stellar prominence (≥ 0.67 stellar radii above the surface).
Kinematics of the symbiotic system R Aqr

NASA Astrophysics Data System (ADS)

Navarro, S.; Corral, L. J.; Steffen, W.

2014-04-01

We present the results of the kinematical analysis of the symbiotic system R Aqr. We obtained high dispersion spectra with the MES spectrograph at the 2.1 m telescope of San Pedro Mártir (MEZCAL). The used filter were Ha + [NII], (λc = 6575Å, Δλ = 90Å). We analyse the [NII] λλ6583 line. When the observations are compared with previous ones by Solf (1992) we detected an important change in the projected velocities of the observed knots, supporting the idea of a precessing jet. We are working also in a 3-D kinematic model for the object using the measured velocities and the state of the model is presented.
Optical Variability Analysis of UU Aqr - an Eclipsing Nova-like System

NASA Astrophysics Data System (ADS)

Khruzina, T.; Katysheva, N.; Golysheva, P.; Shugarov, S.

2015-12-01

By using our photometric observations of nova-like system UU Aqr with unstable light curve during a few nights, we plotted phase-folded light curves and calculated a model of the system. We show that the complicated character of light curves can be explained by the spiral arms in the disk. We decomposed the syntesis photometric curve into separated components as accretion disk, white and red dwarf, hot line.

Newly Uncovered Large-Scale Component of the Northern Jet in R Aqr

NASA Astrophysics Data System (ADS)

Montez, Rodolfo; Karovska, Margarita; Nichols, Joy S.; Kashyap, Vinay

2017-06-01

R Aqr is a symbiotic system comprised a compact white dwarf and Mira giant star. The interaction of these stars is responsible for the presence of a two-sided jet structure that is seen across the electromagnetic spectrum. X-ray emission from the jet was first discovered in 2000 with an observation by the Chandra X-ray Observatory. Since then follow-up observations have traced the evolution of the X-ray emission from the jet and a central compact source. In X-rays, the NE jet is brighter than the SW jet, but the full extent of the SW jet was larger - before it began fading below the detection threshold. However, we have uncovered evidence for large-scale emission associated with the NE jet that matches the extent of the SW jet. The emission has escaped previous identification because it is near the detection threshold, but it has been present since the first 2000 observation and clearly evolves in subsequent observations. We present our study of the emission from this component of the NE jet, its relationship to multiwavelength observations, and how it impacts our interpretation of the jet-phenomenon in R Aqr.
IUE observations of circumstellar emission from the late-type variable R AQR (M6 + pec)

NASA Technical Reports Server (NTRS)

Hobbs, R. W.; Michalitsianos, A. G.; Kafatos, M.

1981-01-01

The IUE observations of R Aqr (M7 + pec) obtained in low dispersion are discussed with particular reference to circumstellar emission. Strong permitted, semiforbidden, and forbidden emission lines are seen, superimposed on a bright ultraviolet continuum. It is deduced that the strong emission line spectrum that involves C III, C IV, Si III, (0 II) and (0 III) probably arises from a dense compact nebula the size of which is comparable to the orbital radius of the binary system of which R Aqr is the primary star. The low excitation emission lines of Fe II, Mg II, 0 I, and Si II probably a white dwarf, comparable to or somewhat brighter than the Sun, since such a star can produce enough ionizing photons to excite the continuum and emission line spectrum and yet be sufficiently faint as to escape detection by direct observation. The UV continuum is attributed to Balmer recombination from the dense nebula and not to blackbody emission from the hot companion.
Five X-ray observations of the intermediate polar FO Aqr spanning ten years

NASA Technical Reports Server (NTRS)

Beardmore, A. P.; Mukai, K.; Norton, A. J.; Osborne, J. P.; Taylor, P.

1996-01-01

The comparison of five X-ray observations of FO Aqr reveals that the morphology of the X-ray light curve changes considerably with time. Power spectra from 1988 and 1993 reveal a sideband component, while power spectra from 1990 do not. This suggests that the amount of disk overflow accretion varies as a function of time. From structured spin folded light curves, the presence of complex, multicomponent emitting regions near the white dwarf's surface can be inferred.
Coronal Abundances In Xi Boo A, Abundances in the Corona of FK Aqr and the Origin of Cosmic Ray

NASA Technical Reports Server (NTRS)

Drake, Jeremy; Oliversen, Ronald J. (Technical Monitor)

2002-01-01

Both Xi Boo A and FK Agr observations have been acquired, reduced and analysed. The results of the Xi Boo A study were published in ApJ (Drake, J.J., Kashyap, V., 2001, Up, 547, 428). Work is ongoing to determine the coronet metallicity of FK Aqr based on EUVE spectra and DO photometer data, using the techniques developed in the Drake & Kashyap paper. Preliminary synthetic spectra for FK Aqr have been developed, and further work to heap define the hot plasma emission measure distribution is underway. Progress on spectral analysis has been hampered following the post-doctoral scientist, Vinay Kashyap, taking up new position. A suitable replacement has been difficult to find, but new hire is expected shortly. However, good progress has been made on analysis of DO photometric variations in FK Age, with a publication now ready (Kashyap, V., Drake, J.J., Guedel, M., Audard, M.) for submission to a mainstream astrophysical journal.
Multiwavelength Study of Powerful New Jet Activity in the Symbiotic Binary System R Aqr

NASA Astrophysics Data System (ADS)

Karovska, Margarita

2016-09-01

We propose to carry out coordinated high-spatial resolution Chandra ACIS-S and HST/WFC3 observations of R Aqr, a very active symbiotic interacting binary system. Our main goal is to study the physical characteristics of multi-scale components of the powerful jet; from near the central binary (within a few AU) to the jet-circumbinary material interaction region (2500 AU) and beyond , and especially of the recently discovered inner jet, to gain insight on early jet formation and propagation, such as jet kinematics and precession.
Multiwavelength Study of Powerful New Jet Activity in the Symbiotic System R AQR

NASA Astrophysics Data System (ADS)

Karovska, Margarita

2016-10-01

We propose to carry out coordinated high-spatial resolution Chandra ACIS-S and multiwavelength (UV-Optical) HST/WFC3 observations of R Aqr, a very active symbiotic interacting binary system. Our main goal is to study the physical characteristics of the multi-scale components of the powerful jet; from the vicinity of the central binary (within a few AU) to the jet-circumbinary material interaction region (2500 AU) and beyond, and especially of the recently discovered new component of the inner jet (likely due to recent ejection of material). Our main goal is to gain new insight on early jet formation and propagation, including jet kinematics and precession.
Elemental abundance analyses with DAO spectrograms: XXXII. HR 6455 (A3 III), δ Aqr (A3 V), η Lep (F2 V), and 1 Boo (A1 V)

NASA Astrophysics Data System (ADS)

Yüce, K.; Adelman, S. J.; Gulliver, A. F.; Hill, G.

2011-08-01

We examine the sharp-lined stars HR 6455 (A3 III, v sin i = 8.7 km s-1) and η Lep (F2 V, v sin i = 13.5 km s-1) as well as δ Aqr (A3 V, v sin i = 81 km s-1) and 1 Boo (A1 V, v sin i = 59 km s-1) to increase the number consistently analyzed A and F stars using high dispersion and high S/N (≥200) spectrograms obtained with CCD detectors at the long Coudé camera of the 1.22-m telescope of the Dominion Astrophysical Observatory. Such studies contribute to understanding systematic abundance differences between normal and non-magnetic main-sequence band chemically peculiar A and early F stars. LTE fine analyses of HR 6455, δ Aqr, and 1 Boo using Kurucz's ATLAS suite programs show the same general elemental abundance trends with differences in the metal richness. Light and iron-peak element abundances are generally solar or overabundant while heavy element and rare earth element abundances are overabundant. HR 6455 is an evolved Am star while δ Aqr and 1 Boo show the phenomenon to different extents. Most derived abundances of η Lep are solar. Table 3 is available at the CDS via http://cdsarc.u-strasbg.fr/cgi-bin/qcat?J/AN/332/681
Missouri Quality Rating System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Missouri's Quality Rating System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…
New Hampshire Quality Rating System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of New Hampshire's Quality Rating System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…
RR Lyrae, Delta Scuti, SX Phoenicis stars and Baade-Wesselink method. I - Photometric and radial velocity measurements of four field stars - RR Cet, DX Del, BS AQR and DY Peg

NASA Astrophysics Data System (ADS)

Meylan, G.; Burki, G.; Rufener, F.; Mayor, M.; Burnet, M.; Ischi, E.

1986-04-01

Simultaneous measurements in the Geneva seven-color photometry and in radial velocities with the spectrophotometer CORAVEL for two RR Lyrae, one Delta Scuti and one SX Phoenicis field star were obtained in order to apply the Baade-Wesselink method to these kinds of variable stars. As a first step, the data regarding the RR Cet, DX Del, BS Aqr, and DY Peg are presented. The target of this study will consist in determining the physical parameters (temperature, gravity, metal content, mass, luminosity) and distances of these stars.
Iowa Child Care Quality Rating System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Iowa's Child Care Quality Rating System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile is divided into the following categories: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for Family Child Care Programs;…
Minorities and Women in Naval Aviation Training: A Look Back at a 1997 Study

DTIC Science & Technology

2011-02-28

Flight Aptitude Rating (FOFAR), the Pilot Biographical Inventory ( PBI ), the NFO Biographical Inventory (FOBI), and the Officer Aptitude Rating (OAR...Hiatt, et al., 1997). The AQR measures math and verbal skills, the FAR and PFAR assess mechanical and visual spatial abilities, and the PBI and FOBI...three composites: the AQR, the PFAR, and PBI for pilots; and a parallel composite for NFOs. Selection to the aviation program was made based on
Louisiana Quality Start Child Care Rating System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Louisiana's Quality Start Child Care Rating System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs;…
A Study of the Mass Loss Rates of Symbiotic Star Systems

NASA Technical Reports Server (NTRS)

Korreck, K. E.; Kellogg, E.; Sokoloski, J. L.

2007-01-01

The amount of mass loss in symbiotic systems is investigated, specifically mass loss via the formation of jets in R Aquarii (R Aqr). The jets in R Aqr have been observed in the X-ray by Chandra over a four year time period. The jet changes on times scales of a year and new outflows have been observed. Understanding the amount of mass and the frequency of ejection further constrain the ability of the white dwarf in the system to accrete enough mass to become a Type la supernova progenitor. The details of multi-wavelength studies, such as speed, density and spatial extent of the jets will be discussed in order to understand the mass balance in the binary system. We examine other symbiotic systems to determine trends in mass loss in this class of objects.
Quality Rating and Improvement Systems: A Strategic Movement for Defining Quality

ERIC Educational Resources Information Center

Neugebauer, Roger

2009-01-01

One of the most important trends in the early childhood field is the emergence of quality rating systems (QRS), or quality rating and improvement systems (QRIS), which are designed to assess, improve, and communicate the level of quality of early and school-age care programs. QRS came onto the scene in 1998 when Oklahoma enacted its "Reaching…
45 CFR 155.1400 - Quality rating system.

Code of Federal Regulations, 2014 CFR

2014-10-01

... the quality rating information assigned to each QHP on its Web site, in accordance with § 155.205(b)(1... 45 Public Welfare 1 2014-10-01 2014-10-01 false Quality rating system. 155.1400 Section 155.1400... EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT Quality...
Acquired resistance to combination treatment through loss of synergy with MEK and PI3K inhibitors in colorectal cancer

PubMed Central

Bhattacharya, Bhaskar; Low, Sarah Hong Hui; Chong, Mei Ling; Chia, Dilys; Koh, King Xin; Sapari, Nur Sabrina; Kaye, Stanley; Hung, Huynh; Benoukraf, Touati; Soong, Richie

2016-01-01

Historically, understanding of acquired resistance (AQR) to combination treatment has been based on knowledge of resistance to its component agents. To test whether an altered drug interaction could be an additional factor in AQR to combination treatment, models of AQR to combination and single agent MEK and PI3K inhibitor treatment were generated. Combination indices indicated combination treatment of PI3K and MEK inhibitors remained synergistic in cells with AQR to single agent but not combination AQR cells. Differences were also observed between the models in cellular phenotypes, pathway signaling and drug cross-resistance. Genomics implicated TGFB2-EDN1 overexpression as candidate determinants in models of AQR to combination treatment. Supplementation of endothelin in parental cells converted synergism to antagonism. Silencing of TGFB2 or EDN1 in cells with AQR conferred synergy between PI3K and MEK inhibitor. These results highlight that AQR to combination treatment may develop through alternative mechanisms to those of single agent treatment, including a change in drug interaction. PMID:27081080
Illinois Quality Counts: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Illinois' Quality Counts prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for Family…
Quality Rating and Improvement System State Evaluations and Research

ERIC Educational Resources Information Center

Ferguson, Daniel

2016-01-01

A quality rating and improvement system (QRIS) is a method used by states and local jurisdictions to assess the level of quality of child care and early education programs, improve quality, and convey quality ratings to parents and other consumers. A typical QRIS incorporates the following components: quality standards for participating providers;…
Clinical quality is independently associated with favorable bond ratings.

PubMed

Haydar, Ziad; Nicewander, David; Convery, Paul; Black, Michael; Ballard, David

2010-01-01

The relation between clinical quality and bond rating for nonprofit hospitals has been proposed but never fully studied. We analyzed the relation between bond rating, clinical quality measures (The Joint Commission/Centers for Medicare and Medicaid Services [CMS] core measures), and balance sheet and income statement financial measures of 236 hospitals across the United States that are rated by Moody's Investors Service and that reported clinical quality measures to CMS during the study period. We found a statistically significant relation between higher quality measures and more favorable bond ratings. This association remained significant after controlling for traditional financial parameters.

Subjective quality evaluation of low-bit-rate video

NASA Astrophysics Data System (ADS)

Masry, Mark; Hemami, Sheila S.; Osberger, Wilfried M.; Rohaly, Ann M.

2001-06-01

A subjective quality evaluation was performed to qualify vie4wre responses to visual defects that appear in low bit rate video at full and reduced frame rates. The stimuli were eight sequences compressed by three motion compensated encoders - Sorenson Video, H.263+ and a Wavelet based coder - operating at five bit/frame rate combinations. The stimulus sequences exhibited obvious coding artifacts whose nature differed across the three coders. The subjective evaluation was performed using the Single Stimulus Continuos Quality Evaluation method of UTI-R Rec. BT.500-8. Viewers watched concatenated coded test sequences and continuously registered the perceived quality using a slider device. Data form 19 viewers was colleted. An analysis of their responses to the presence of various artifacts across the range of possible coding conditions and content is presented. The effects of blockiness and blurriness on perceived quality are examined. The effects of changes in frame rate on perceived quality are found to be related to the nature of the motion in the sequence.
Virginia Star Quality Initiative: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Virginia's Star Quality Initiative prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators…
Mississippi Quality Step System: QRS Profile. The Child Care Quality Rating System (QRS)Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Mississippi's Quality Step System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Application…
Palm Beach Quality Counts: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Palm Beach's Quality Counts prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…
Maine Quality for ME: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Maine's Quality for ME prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for Family…
Miami-Dade Quality Counts: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Miami-Dade's Quality Counts prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…
Indiana Paths to Quality: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Indiana's Paths to Quality prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…
Quality Rating Systems--The Experiences of Center Directors

ERIC Educational Resources Information Center

Friedman, Dana E.

2007-01-01

Quality Rating System (QRS) initiatives define levels of quality based on research and then support providers with funding and technical assistance to increase their quality. Each program is assessed and given a number of "stars" to indicate to parents what level of quality the program has reached. In this article, the author describes…
Request to monitor 2035-01 AE Aqr for multiwavelength campaign AND Reminder to monitor HT Cas, Z Cha, and OY Car

NASA Astrophysics Data System (ADS)

Waagen, Elizabeth O.

2005-08-01

AAVSO Alert Notice 326 contains two topics. First: Dr. Christopher Mauche (Lawrence Livermore National Laboratory) has requested our assistance in monitoring the novalike intermediate polar AE Aqr in support of multiwavelength (gamma-ray, X-ray, UV, optical, and radio) observations scheduled for August-September 2005. AAVSO observations, particularly CCD ones, are requested to correlate with these multiwavelength observations; visual observations are also encouraged. Second: as announced in Alert Notice 317, Drs. Christopher Mauche, Peter Wheatley, and Koji Mukai have obtained time on XMM-Newton to observe HT Cas, Z Cha, or OY Car in outburst, and they have requested our assistance in monitoring these stars closely so we can inform them promptly when any of them go into outburst. Very prompt notification is essential because of the time required to trigger the satellite and the shortness of the outbursts of the target stars. Please monitor HT Cas, OY Car, and Z Cha closely from now through at least a month after the last observing window closes, and notify Headquarters immediately if any of the target stars goes into outburst. Both visual and CCD observations are encouraged. Finder charts with sequence may be created using the AAVSO Variable Star Plotter (https://www.aavso.org/vsp). Observations should be submitted to the AAVSO International Database. See full Alert Notice for more details.
Ohio Step Up to Quality: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Ohio's Step Up to Quality prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for Family…
45 CFR 156.1120 - Quality rating system.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Quality rating system. 156.1120 Section 156.1120 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Quality...
Quality Improvement Efforts among Early Childhood Education Programs Participating in Iowa's Quality Rating System. REL 2017-244

ERIC Educational Resources Information Center

Hawkinson, Laura E.; Faria, Ann-Marie; Bouacha, Nora; Lee, Dong Hoon; Metzger, Ivan

2017-01-01

This report describes the quality improvement efforts of early childhood education programs participating in Iowa's Quality Rating System (QRS). It identifies supports and barriers to quality improvement and examines how quality improvement supports and activities relate to changes in program quality ratings across time. The study team developed…
Rating the Quality of Open Textbooks: How Reviewer and Text Characteristics Predict Ratings

ERIC Educational Resources Information Center

Fischer, Lane; Ernst, David; Mason, Stacie

2017-01-01

Using data collected from peer reviews for Open Textbook Library titles, this paper explores questions about rating the quality of open textbooks. The five research questions addressed the relationship between textbook and reviewer characteristics and ratings. Although reviewers gave textbooks high ratings generally, reviewers identified…
North Carolina Star Rated License System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of North Carolina's Star Rated License System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…
Technical efficiency of nursing homes: do five-star quality ratings matter?

PubMed

Dulal, Rajendra

2017-02-28

This study investigates associations between five-star quality ratings and technical efficiency of nursing homes. The sample consists of a balanced panel of 338 nursing homes in California from 2009 through 2013 and uses two-stage data envelopment (DEA) analysis. The first-stage applies an input oriented variable returns to scale DEA analysis. The second-stage uses a left censored random-effect Tobit regression model. The five-star quality ratings i.e., health inspections, quality measures, staffing available on the Nursing Home Compare website are divided into two categories: outcome and structure form of quality. Results show that quality measures ratings and health inspection ratings, used as outcome form of quality, are not associated with mean technical efficiency. These quality ratings, however, do affect the technical efficiency of a particular nursing home and hence alter the ranking of nursing homes based on efficiency scores. Staffing rating, categorized as a structural form of quality, is negatively associated with mean technical efficiency. These findings show that quality dimensions are associated with technical efficiency in different ways, suggesting that multiple dimensions of quality should be included in the efficiency analysis of nursing homes. They also suggest that patient care can be enhanced through investing more in improving care delivery rather than simply raising the number of staff per resident.
Compendium of Quality Rating Systems and Evaluations: The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Tout, Kathryn; Starr, Rebecca; Soli, Margaret; Moodie, Shannon; Kirby, Gretchen; Boller, Kimberly

2010-01-01

Quality Rating Systems (QRS) are currently operating, under development, or being piloted in over 25 states or local areas. As the QRS model becomes integrated into the landscape of child care and education service delivery, policy, and the decisions parents make about child care across the United States, there is an increasing need for…
Rates of urbanisation and the resiliency of air and water quality.

PubMed

Duh, Jiunn-Der; Shandas, Vivek; Chang, Heejun; George, Linda A

2008-08-01

Global human population and urban development are increasing at unprecedented rates and creating tremendous stress on local, regional, and global air and water quality. However, little is known about how urban areas vary in their capacity to address effectively air and water quality impacts associated to urban development. There exists a need to better understanding the factors that mediate the interactions between urbanisation and variations of environmental quality. By synthesizing literatures on the relationship between urban development and air and water quality, we assess the amount of scholarship for each of these cities, characterize population growth rates in one hundred of the largest global cities, and link growth trends to changes in air and water quality. Our results suggest that, while there is a growing literature linking urbanisation and environmental quality, some regions of the globe are better represented than others, and that these trends are consistent with our characterization of population growth rates. In addition, the comparison between population growth rates and air and water quality suggest that multiple factors affect the environmental quality, and that approaching rates of urbanisation through the lens of 'resiliency' can be an effective integrative concept for studying the capacity of urban areas to respond to rapid rates of change. Based on these results we offer a framework for systematically assessing changes in air and water quality in megacities.
Comparing Cultural Differences in Two Quality Measures in Chinese Kindergartens: The Early Childhood Environment Rating Scale-Revised and the Kindergarten Quality Rating System

ERIC Educational Resources Information Center

Hu, Bi Ying

2015-01-01

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

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Tennessee's Star-Quality Child Care Program prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…
Oregon Child Care Quality Indicators Program: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Oregon's Child Care Quality Indicators Program prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

Examining Pre-School Classroom Quality in a Statewide Quality Rating and Improvement System

ERIC Educational Resources Information Center

Jeon, Lieny; Buettner, Cynthia K.; Hur, Eunhye

2014-01-01

Background: Research has documented the importance of high-quality early childhood experiences in preparing children for school. Quality rating and improvement systems (QRIS) have recently emerged in many states as a way to build quality of child care and to promote better child outcomes. Objective: The goal of this study was to determine if…
Search for gamma-ray emission from AE Aquarii with seven year of Fermi LAT observations

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

Li, Jian; Torres, Diego F.; Rea, Nanda

2016-11-14

AE Aquarii (AE Aqr) is a cataclysmic binary hosting one of the fastest rotating (more » $${P}_{\\mathrm{spin}}$$ = 33.08 s) white dwarfs (WDs) known. Based on seven years of Fermi Large Area Telescope (LAT) Pass 8 data, we report on a deep search for gamma-ray emission from AE Aqr. When using X-ray observations from ASCA, XMM-Newton, Chandra, Swift, Suzaku, and NuSTAR, spanning 20 years, we substantially extend and improve the spin ephemeris of AE Aqr. Using this ephemeris, we searched for gamma-ray pulsations at the spin period of the WD. We detected no gamma-ray pulsations above 3σ significance. Neither phase-averaged gamma-ray emission nor gamma-ray variability of AE Aqr is detected by Fermi LAT. We also impose the most restrictive upper limit to the gamma-ray flux from AE Aqr to date: $$1.3\\times {10}^{-12}$$ erg cm -2 s -1 in the 100 MeV–300 GeV energy range, providing constraints on models.« less
Rating methodological quality: toward improved assessment and investigation.

PubMed

Moyer, Anne; Finney, John W

2005-01-01

Assessing methodological quality is considered essential in deciding what investigations to include in research syntheses and in detecting potential sources of bias in meta-analytic results. Quality assessment is also useful in characterizing the strengths and limitations of the research in an area of study. Although numerous instruments to measure research quality have been developed, they have lacked empirically-supported components. In addition, different summary quality scales have yielded different findings when they were used to weight treatment effect estimates for the same body of research. Suggestions for developing improved quality instruments include: distinguishing distinct domains of quality, such as internal validity, external validity, the completeness of the study report, and adherence to ethical practices; focusing on individual aspects, rather than domains of quality; and focusing on empirically-verified criteria. Other ways to facilitate the constructive use of quality assessment are to improve and standardize the reporting of research investigations, so that the quality of studies can be more equitably and thoroughly compared, and to identify optimal methods for incorporating study quality ratings into meta-analyses.
Crystal Growth Rate Dispersion: A Predictor of Crystal Quality in Microgravity?

NASA Technical Reports Server (NTRS)

Kephart, Richard D.; Judge, Russell A.; Snell, Edward H.; vanderWoerd, Mark J.

2003-01-01

In theory macromolecular crystals grow through a process involving at least two transport phenomena of solute to the crystal surface: diffusion and convection. In absence of standard gravitational forces, the ratio of these two phenomena can change and explain why crystal growth in microgravity is different from that on Earth. Experimental evidence clearly shows, however, that crystal growth of various systems is not equally sensitive to reduction in gravitational forces, leading to quality improvement in microgravity for some crystals but not for others. We hypothesize that the differences in final crystal quality are related to crystal growth rate dispersion. If growth rate dispersion exists on Earth, decreases in microgravity, and coincides with crystal quality improvements then this dispersion is a predictor for crystal quality improvement. In order to test this hypothesis, we will measure growth rate dispersion both in microgravity and on Earth and will correlate the data with previously established data on crystal quality differences for the two environments. We present here the first crystal growth rate measurement data for three proteins (lysozyme, xylose isomerase and human recombinant insulin), collected on Earth, using hardware identical to the hardware to be used in microgravity and show how these data correlate with crystal quality improvements established in microgravity.
Relationships between Medicare Advantage contract characteristics and quality-of-care ratings: an observational analysis of Medicare Advantage star ratings.

PubMed

Xu, Peng; Burgess, James F; Cabral, Howard; Soria-Saucedo, Rene; Kazis, Lewis E

2015-03-03

The Centers for Medicare & Medicaid Services (CMS) publishes star ratings on Medicare Advantage (MA) contracts to measure plan quality of care with implications for reimbursement and bonuses. To investigate whether MA contract characteristics are associated with quality of care through the Medicare plan star ratings. Retrospective study of MA star ratings in 2010. Unadjusted and adjusted multivariable linear regression models assessed the relationship between 5-star rating summary scores and plan characteristics. CMS MA contracts nationally. 409 (71%) of a total of 575 MA contracts, covering 10.56 million Medicare beneficiaries (90% of the MA population) in the United States in 2010. The MA quality ratings summary score (stars range from 1 to 5) is a quality measure based on 36 indicators related to processes of care, health outcomes, access to care, and beneficiary satisfaction. Nonprofit, larger, and older MA contracts were more likely to receive higher star ratings. Star ratings ranged from 2 to 5. Nonprofit contracts received an average 0.55 (95% CI, 0.42 to 0.67) higher star ratings than for-profit contracts (P < 0.001) after controls were set for contract characteristics. The study focused on persons aged 65 years or older covered by MA. In 2010, nonprofit MA contracts received significantly higher star ratings than for-profit contracts. When comparing health plans in the future, the CMS should give increasing attention to for-profit plans with lower quality ratings and consider developing programs to assist newer and smaller plans in improving their care for Medicare beneficiaries. None.
Comparing Public Quality Ratings for Accredited and Nonaccredited Nursing Homes.

PubMed

Williams, Scott C; Morton, David J; Braun, Barbara I; Longo, Beth Ann; Baker, David W

2017-01-01

Compare quality ratings of accredited and nonaccredited nursing homes using the publicly available Centers for Medicare and Medicaid Services (CMS) Nursing Home Compare data set. This cross-sectional study compared the performance of 711 Joint Commission-accredited (TJC-accredited) nursing homes (81 of which also had Post-Acute Care Certification) to 14,926 non-Joint Commission-accredited (non-TJC-accredited) facilities using the Nursing Home Compare data set (as downloaded on April 2015). Measures included the overall Five-Star Quality Rating and its 4 components (health inspection, quality measures, staffing, and RN staffing), the 18 Nursing Home Compare quality measures (5 short-stay measures, 13 long-stay measures), as well as inspection deficiencies, fines, and payment denials. t tests were used to assess differences in rates for TJC-accredited nursing homes versus non-TJC-accredited nursing homes for quality measures, ratings, and fine amounts. Analysis of variance models were used to determine differences in rates using Joint Commission accreditation status, nursing home size based on number of beds, and ownership type. An additional model with an interaction term using Joint Commission accreditation status and Joint Commission Post-Acute Care Certification status was used to determine differences in rates for Post-Acute Care Certified nursing homes. Binary variables (eg, deficiency type, fines, and payment denials) were evaluated using a logistic regression model with the same covariates. After controlling for the influences of facility size and ownership type, TJC-accredited nursing homes had significantly higher star ratings than non-TJC-accredited nursing homes on each of the star rating component subscales (P < .05) (but not on the overall star rating), and TJC-accredited nursing homes with Post-Acute Care Certification performed statistically better on the overall star rating, as well as 3 of the 4 subscales (P < .05). TJC-accredited nursing homes
Quality Rating and Improvement Systems and Children's Cognitive Development

ERIC Educational Resources Information Center

Jeon, Lieny; Buettner, Cynthia K.

2015-01-01

Background: Providing enriched learning environments is important to stimulating children's development in early childhood. Early child-care policymakers in many states in the US have adopted Quality Rating and Improvement Systems (QRIS) as a way to verify quality of child care and to support children's school readiness. Objective: The purpose of…
Validity of portfolio assessment: which qualities determine ratings?

PubMed

Driessen, Erik W; Overeem, Karlijn; van Tartwijk, Jan; van der Vleuten, Cees P M; Muijtjens, Arno M M

2006-09-01

The portfolio is becoming increasingly accepted as a valuable tool for learning and assessment. The validity of portfolio assessment, however, may suffer from bias due to irrelevant qualities, such as lay-out and writing style. We examined the possible effects of such qualities in a portfolio programme aimed at stimulating Year 1 medical students to reflect on their professional and personal development. In later curricular years, this portfolio is also used to judge clinical competence. We developed an instrument, the Portfolio Analysis Scoring Inventory, to examine the impact of form and content aspects on portfolio assessment. The Inventory consists of 15 items derived from interviews with experienced mentors, the literature, and the criteria for reflective competence used in the regular portfolio assessment procedure. Forty portfolios, selected from 231 portfolios for which ratings from the regular assessment procedure were available, were rated by 2 researchers, independently, using the Inventory. Regression analysis was used to estimate the correlation between the ratings from the regular assessment and those resulting from the Inventory items. Inter-rater agreement ranged from 0.46 to 0.87. The strongest predictor of the variance in the regular ratings was 'quality of reflection' (R 0.80; R2 66%). No further items accounted for a significant proportion of variance. Irrelevant items, such as writing style and lay-out, had negligible effects. The absence of an impact of irrelevant criteria appears to support the validity of the portfolio assessment procedure. Further studies should examine the portfolio's validity for the assessment of clinical competence.
Uncovering Predictors of Disagreement: Ensuring the Quality of Expert Ratings

ERIC Educational Resources Information Center

Hoth, Jessica; Schwarz, Björn; Kaiser, Gabriele; Busse, Andreas; König, Johannes; Blömeke, Sigrid

2016-01-01

Rating scales are a popular item format used in many types of assessments. Yet, defining which rating is correct often represents a challenge. Using expert ratings as benchmarks is one approach to ensuring the quality of a rating instrument. In this paper, such expert ratings are analyzed in detail taking a video-based test instrument of teachers'…
Nursing home 5-star rating system exacerbates disparities in quality, by payer source.

PubMed

Konetzka, R Tamara; Grabowski, David C; Perraillon, Marcelo Coca; Werner, Rachel M

2015-05-01

Market-based reforms in health care, such as public reporting of quality, may inadvertently exacerbate disparities. We examined how the Centers for Medicare and Medicare Services' five-star rating system for nursing homes has affected residents who are dually enrolled in Medicare and Medicaid ("dual eligibles"), a particularly vulnerable and disadvantaged population. Specifically, we assessed the extent to which dual eligibles and non-dual eligibles avoided the lowest-rated nursing homes and chose the highest-rated homes once the five-star rating system began, in late 2008. We found that both populations resided in better-quality homes over time but that by 2010 the increased likelihood of choosing the highest-rated homes was substantially smaller for dual eligibles than for non-dual eligibles. Thus, the gap in quality, as measured by a nursing home's star rating, grew over time. Furthermore, we found that the benefit of the five-star system to dual eligibles was largely due to providers' improving their ratings, not to consumers' choosing different providers. We present evidence suggesting that supply constraints play a role in limiting dual eligibles' responses to quality ratings, since high-quality providers tend to be located close to relatively affluent areas. Increases in Medicaid payment rates for nursing home services may be the only long-term solution. Project HOPE—The People-to-People Health Foundation, Inc.
Effects of Tone-Quality Changes on Intonation and Tone-Quality Ratings of High School and College Instrumentalists.

ERIC Educational Resources Information Center

Geringer, John M.; Worthy, Michael D.

1999-01-01

Investigates effects of variations in tone quality on listeners' perception of both tone quality and intonation. Indicates that more inexperienced instrumentalists rated stimuli that were "brighter" in quality as sharper in intonation, and those that were "darker" as flatter. Also, finds differences for brass versus woodwind instruments. (DSK)
Colorado Qualistar. QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Colorado's Qualistar prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for Family…
District of Columbia Going for the Gold Tiered Rate Reimbursement System. QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of District of Columbia's Going for the Gold Tiered Rate Reimbursement Systemp repared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for…
Application of psychometric theory to the measurement of voice quality using rating scales.

PubMed

Shrivastav, Rahul; Sapienza, Christine M; Nandur, Vuday

2005-04-01

Rating scales are commonly used to study voice quality. However, recent research has demonstrated that perceptual measures of voice quality obtained using rating scales suffer from poor interjudge agreement and reliability, especially in the mid-range of the scale. These findings, along with those obtained using multidimensional scaling (MDS), have been interpreted to show that listeners perceive voice quality in an idiosyncratic manner. Based on psychometric theory, the present research explored an alternative explanation for the poor interlistener agreement observed in previous research. This approach suggests that poor agreement between listeners may result, in part, from measurement errors related to a variety of factors rather than true differences in the perception of voice quality. In this study, 10 listeners rated breathiness for 27 vowel stimuli using a 5-point rating scale. Each stimulus was presented to the listeners 10 times in random order. Interlistener agreement and reliability were calculated from these ratings. Agreement and reliability were observed to improve when multiple ratings of each stimulus from each listener were averaged and when standardized scores were used instead of absolute ratings. The probability of exact agreement was found to be approximately .9 when using averaged ratings and standardized scores. In contrast, the probability of exact agreement was only .4 when a single rating from each listener was used to measure agreement. These findings support the hypothesis that poor agreement reported in past research partly arises from errors in measurement rather than individual differences in the perception of voice quality.
High angle of attack flying qualities criteria for longitudinal rate command systems

NASA Technical Reports Server (NTRS)

Wilson, David J.; Citurs, Kevin D.; Davidson, John B.

1994-01-01

This study was designed to investigate flying qualities requirements of alternate pitch command systems for fighter aircraft at high angle of attack. Flying qualities design guidelines have already been developed for angle of attack command systems at 30, 45, and 60 degrees angle of attack, so this research fills a similar need for rate command systems. Flying qualities tasks that require post-stall maneuvering were tested during piloted simulations in the McDonnell Douglas Aerospace Manned Air Combat Simulation facility. A generic fighter aircraft model was used to test angle of attack rate and pitch rate command systems for longitudinal gross acquisition and tracking tasks at high angle of attack. A wide range of longitudinal dynamic variations were tested at 30, 45, and 60 degrees angle of attack. Pilot comments, Cooper-Harper ratings, and pilot induced oscillation ratings were taken from five pilots from NASA, USN, CAF, and McDonnell Douglas Aerospace. This data was used to form longitudinal design guidelines for rate command systems at high angle of attack. These criteria provide control law design guidance for fighter aircraft at high angle of attack, low speed flight conditions. Additional time history analyses were conducted using the longitudinal gross acquisition data to look at potential agility measures of merit and correlate agility usage to flying qualities boundaries. This paper presents an overview of this research.
Moving up the Ladder: How Do States Deliver Quality Improvement Supports within Their Quality Rating and Improvement Systems? Brief

ERIC Educational Resources Information Center

Holod, Aleksandra; Faria, Ann-Marie; Weinberg, Emily; Howard, Eboni

2015-01-01

As national attention has increasingly focused on the potential for high-quality early childhood education (ECE) to improve children's school readiness, states have developed quality rating and improvement systems (QRISs) to document the quality of ECE programs, support systematic quality improvement, and provide clear information to families…
Quality rating and private-prices: Evidence from the nursing home industry.

PubMed

Huang, Sean Shenghsiu; Hirth, Richard A

2016-12-01

We use the rollout of the five-star rating of nursing homes to study how private-pay prices respond to quality rating. We find that star rating increases the price differential between top- and bottom-ranked facilities. On average, prices of top-ranked facilities increased by 4.8 to 6.0 percent more than the prices of bottom-ranked facilities. We find stronger price effects in markets that are less concentrated where consumers may have more choices of alternative nursing homes. Our results suggest that with simplified design and when markets are less concentrated, consumers are more responsive to quality reporting. Copyright Â© 2016 Elsevier B.V. All rights reserved.
Rating educational quality: factors in the erosion of professional standards.

PubMed

Albanese, M

1999-06-01

Changes in the health care environment are putting increasing pressure on medical schools to make faculty accountable and to document the quality of the medical education they provide. Faculty's ratings of students' performances and students' ratings of faculty's teaching are important elements in these efforts to document educational quality. This article discusses selected research related to factors affecting raters' judgments, analyzes how changes in the health care environment are influencing such judgments, and links these influences to the system that upholds professional standards. Ratings are known to have a positive bias (generosity error), provide limited discrimination, and often fail to document serious deficits. The potential sources of these problems relate to the mechanics of the rating task, the system used to obtain ratings, and factors affecting rater judgment. As managed care demands reduce the time faculty have for teaching, as system-wide disincentives to provide negative ratings proliferate, and as social engineering challenges, such as the Americans with Disabilities Act, impose differential standards for students, the natural tendency to avoid giving negative ratings becomes even harder to resist. Ultimately, these forces compromise the capability of faculty to uphold the standards of the profession. The author calls for a national effort to stem the erosion of those standards.
Can better infrastructure and quality reduce hospital infant mortality rates in Mexico?

PubMed

Aguilera, Nelly; Marrufo, Grecia M

2007-02-01

Preliminary evidence from hospital discharges hints enormous disparities in infant hospital mortality rates. At the same time, public health agencies acknowledge severe deficiencies and variations in the quality of medical services across public hospitals. Despite these concerns, there is limited evidence of the contribution of hospital infrastructure and quality in explaining variations in outcomes among those who have access to medical services provided at public hospitals. This paper provides evidence to address this question. We use probabilistic econometric methods to estimate the impact of material and human resources and hospital quality on the probability that an infant dies controlling for socioeconomic, maternal and reproductive risk factors. As a measure of quality, we calculate for the first time for Mexico patient safety indicators developed by the AHRQ. We find that the probability to die is affected by hospital infrastructure and by quality. In this last regard, having been treated in a hospital with the worse quality incidence doubles the probability to die. This paper also presents evidence on the contribution of other risk factors on perinatal mortality rates. The conclusions of this paper suggest that lower infant mortality rates can be reached by implementing a set of coherent public policy actions including an increase and reorganization of hospital infrastructure, quality improvement, and increasing demand for health by poor families.
Application of Psychometric Theory to the Measurement of Voice Quality Using Rating Scales

ERIC Educational Resources Information Center

Shrivastav, Rahul; Sapienza, Christine M.; Nandur, Vuday

2005-01-01

Rating scales are commonly used to study voice quality. However, recent research has demonstrated that perceptual measures of voice quality obtained using rating scales suffer from poor interjudge agreement and reliability, especially in the midrange of the scale. These findings, along with those obtained using multidimensional scaling (MDS), have…

Pennsylvania Keystone STARS: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Pennsylvania's Keystone STARS prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…
Minnesota Parent Aware: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Minnesota's Parent Aware prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for Family…
Nonlinear frequency compression: effects on sound quality ratings of speech and music.

PubMed

Parsa, Vijay; Scollie, Susan; Glista, Danielle; Seelisch, Andreas

2013-03-01

Frequency lowering technologies offer an alternative amplification solution for severe to profound high frequency hearing losses. While frequency lowering technologies may improve audibility of high frequency sounds, the very nature of this processing can affect the perceived sound quality. This article reports the results from two studies that investigated the impact of a nonlinear frequency compression (NFC) algorithm on perceived sound quality. In the first study, the cutoff frequency and compression ratio parameters of the NFC algorithm were varied, and their effect on the speech quality was measured subjectively with 12 normal hearing adults, 12 normal hearing children, 13 hearing impaired adults, and 9 hearing impaired children. In the second study, 12 normal hearing and 8 hearing impaired adult listeners rated the quality of speech in quiet, speech in noise, and music after processing with a different set of NFC parameters. Results showed that the cutoff frequency parameter had more impact on sound quality ratings than the compression ratio, and that the hearing impaired adults were more tolerant to increased frequency compression than normal hearing adults. No statistically significant differences were found in the sound quality ratings of speech-in-noise and music stimuli processed through various NFC settings by hearing impaired listeners. These findings suggest that there may be an acceptable range of NFC settings for hearing impaired individuals where sound quality is not adversely affected. These results may assist an Audiologist in clinical NFC hearing aid fittings for achieving a balance between high frequency audibility and sound quality.
Mammography Clinical Image Quality and the False Positive Rate in a Canadian Breast Cancer Screening Program.

PubMed

Guertin, Marie-Hélène; Théberge, Isabelle; Zomahoun, Hervé Tchala Vignon; Dufresne, Michel-Pierre; Pelletier, Éric; Brisson, Jacques

2018-05-01

The study sought to determine if mammography quality is associated with the false positive (FP) rate in the Quebec breast cancer screening program in 2004 and 2005. Mammography quality of a random sample of screen-film mammograms was evaluated by an expert radiologist following the criteria of the Canadian Association of Radiologists. For each screening examination, scores ranging from 1 (poor quality) to 5 (excellent quality) were attributed for positioning, compression, contrast, exposure level, sharpness, and artifacts. A final overall quality score (lower or higher) was also given. Poisson regression models with robust estimation of variance and adjusted for potential confounding factors were used to assess associations of mammography quality with the FP rate. Among 1,209 women without cancer, there were 104 (8.6%) FPs. Lower overall mammography quality is associated with an increase in the FP rate (risk ratio [RR], 1.4; 95% confidence interval [CI], 1.0-2.1; P = .07) but this increase was not statistically significant. Artifacts were associated with an increase in the FP rate (RR, 2.1; 95% CI, 1.3-3.3; P = .01) whereas lower quality of exposure level was related to a reduction of the FP rate (RR, 0.4; 95% CI, 0.1-1.0; P = .01). Lower quality scores for all other quality attributes were related to a nonstatistically significant increase in the FP rate of 10%-30%. Artifacts can have a substantial effect on the FP rate. The effect of overall mammography quality on the FP rate may also be substantial and needs to be clarified. Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.
Development and validation of a Chinese music quality rating test.

PubMed

Cai, Yuexin; Zhao, Fei; Zheng, Yiqing

2013-09-01

The present study aims to develop and validate a Chinese music quality rating test (MQRT). In Experiment 1, 22 music pieces were initially selected and paired as a 'familiar music piece' and 'unfamiliar music piece' based on familiarities amongst the general public in the categories of classical music (6), Chinese folk music (8), and pop music (8). Following the selection criteria, one pair of music pieces from each music category was selected and used for the MQRT in Experiment 2. In Experiment 2, the MQRT was validated using these music pieces in the categories 'Pleasantness', 'Naturalness', 'Fullness', 'Roughness', and 'Sharpness'. Seventy-two adult participants and 30 normal-hearing listeners were recruited in Experiments 1 and 2, respectively. Significant differences between the familiar and unfamiliar music pieces were found in respect of pleasantness rating for folk and pop music pieces as well as in sharpness rating for pop music pieces. The comparison of music category effect on MQRT found significant differences in pleasantness, fullness, and sharpness ratings. The Chinese MQRT developed in the present study is an effective tool for assessing music quality.
Content, Quality, and Assessment Tools of Physician-Rating Websites in 12 Countries: Quantitative Analysis.

PubMed

Rothenfluh, Fabia; Schulz, Peter J

2018-06-14

Websites on which users can rate their physician are becoming increasingly popular, but little is known about the website quality, the information content, and the tools they offer users to assess physicians. This study assesses these aspects on physician-rating websites in German- and English-speaking countries. The objective of this study was to collect information on websites with a physician rating or review tool in 12 countries in terms of metadata, website quality (transparency, privacy and freedom of speech of physicians and patients, check mechanisms for appropriateness and accuracy of reviews, and ease of page navigation), professional information about the physician, rating scales and tools, as well as traffic rank. A systematic Web search based on a set of predefined keywords was conducted on Google, Bing, and Yahoo in August 2016. A final sample of 143 physician-rating websites was analyzed and coded for metadata, quality, information content, and the physician-rating tools. The majority of websites were registered in the United States (40/143) or Germany (25/143). The vast majority were commercially owned (120/143, 83.9%), and 69.9% (100/143) displayed some form of physician advertisement. Overall, information content (mean 9.95/25) as well as quality were low (mean 18.67/47). Websites registered in the United Kingdom obtained the highest quality scores (mean 26.50/47), followed by Australian websites (mean 21.50/47). In terms of rating tools, physician-rating websites were most frequently asking users to score overall performance, punctuality, or wait time in practice. This study evidences that websites that provide physician rating should improve and communicate their quality standards, especially in terms of physician and user protection, as well as transparency. In addition, given that quality standards on physician-rating websites are low overall, the development of transparent guidelines is required. Furthermore, attention should be paid to the
Estimating respiratory rate from FBG optical sensors by using signal quality measurement.

PubMed

Yongwei Zhu; Maniyeri, Jayachandran; Fook, Victor Foo Siang; Haihong Zhang

2015-08-01

Non-intrusiveness is one of the advantages of in-bed optical sensor device for monitoring vital signs, including heart rate and respiratory rate. Estimating respiratory rate reliably using such sensors, however, is challenging, due to body movement, signal variation according to different subjects or body positions, etc. This paper presents a method for reliable respiratory rate estimation for FBG optical sensors by introducing signal quality estimation. The method estimates the quality of the signal waveform by detecting regularly repetitive patterns using proposed spectrum and cepstrum analysis. Multiple window sizes are used to cater for a wide range of target respiratory rates. Furthermore, the readings of multiple sensors are fused to derive a final respiratory rate. Experiments with 12 subjects and 2 body positions were conducted using polysomnography belt signal as groundtruth. The results demonstrated the effectiveness of the method.
Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

ERIC Educational Resources Information Center

Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

2015-01-01

The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…
Primary care practice and facility quality orientation: influence on breast and cervical cancer screening rates.

PubMed

Goldzweig, Caroline Lubick; Parkerton, Patricia H; Washington, Donna L; Lanto, Andrew B; Yano, Elizabeth M

2004-04-01

Despite the importance of early cancer detection, variation in screening rates among physicians is high. Insights into factors influencing variation can guide efforts to decrease variation and increase screening rates. To explore the association of primary care practice features and a facility's quality orientation with breast and cervical cancer screening rates. Cross-sectional study of screening rates among 144 Department of Veterans Affairs (VA) medical centers and for a national sample of women. We linked practice structure and quality improvement characteristics of individual VA medical centers from 2 national surveys (1 to primary care directors and 1 to a stratified random sample of employees) to breast and cervical cancer screening rates determined from a review of random medical records. We conducted bivariate analyses and multivariate logistic regression of primary care practice and facility features on cancer screening rates, above and below the median. While the national screening rates were high for breast (87%) and cervical cancer (90%), higher screening rates were more likely when primary care providers were consistently notified of specialty visits and when staff perceived a greater organizational commitment to quality and anticipated rewards and recognition for better performance. Organization and quality orientation of the primary care practice and its facility can enhance breast and cervical cancer screening rates. Internal recognition of quality performance and an overall commitment to quality improvement may foster improved prevention performance, with impact varying by clinical service.
Effects of a preceptorship programme on turnover rate, cost, quality and professional development.

PubMed

Lee, Tso-Ying; Tzeng, Wen-Chii; Lin, Chia-Huei; Yeh, Mei-Ling

2009-04-01

The purpose of the present study was to design a preceptorship programme and to evaluate its effects on turnover rate, turnover cost, quality of care and professional development. A high turnover rate of nurses is a common global problem. How to improve nurses' willingness to stay in their jobs and reduce the high turnover rate has become a focus. Well-designed preceptorship programmes could possibly decrease turnover rates and improve professional development. A quasi-experimental research design was used. First, a preceptorship programme was designed to establish the role and responsibilities of preceptors in instructing new nurses. Second, a quasi-experimental design was used to evaluate the preceptorship programme. Data on new nurses' turnover rate, turnover cost, quality of nursing care, satisfaction of preceptor's teaching and preceptor's perception were measured. After conducting the preceptorship programme, the turnover rate was 46.5% less than the previous year. The turnover cost was decreased by US$186,102. Additionally, medication error rates made by new nurses dropped from 50-0% and incident rates of adverse events and falls decreased. All new nurses were satisfied with preceptor guidance. The preceptorship programme effectively lowered the turnover rate of new nurses, reduced turnover costs and enhanced the quality of nursing care, especially by reducing medication error incidents. Positive feedback about the programme was received from new nurses. Study findings may offer healthcare administrators another option for retaining new nurses, controlling costs, improving quality and fostering professional development. In addition, incentives and effective support from the organisation must be considered when preceptors perform preceptorship responsibilities.
Promoting Access to Quality Child Care: Critical Steps in Conducting Market Rate Surveys and Establishing Rate Policies.

ERIC Educational Resources Information Center

Stoney, Louise

This report is designed to help policymakers, child care providers, and advocates establish child care rate support policies that support high quality in the context of government-subsidized, privately-provided child care. It also provides advice on the development and interpretation of market rate surveys of local child care fees. Part 1…
The association of Nursing Home Compare quality measures with market competition and occupancy rates.

PubMed

Castle, Nicholas G; Liu, Darren; Engberg, John

2008-01-01

Since 2002, the Centers for Medicare and Medicaid Services have reported quality measures on the Nursing Home Compare Web site. It has been assumed that nursing homes are able to make improvements on these measures. In this study researchers examined nursing homes to see whether they have improved their quality scores, after accounting for regression to the mean. Researchers also examined whether gains varied according to market competition or market occupancy rates. They identified some regression to the mean for the quality measure scores over time; nevertheless, they also determined that some nursing homes had indeed made small improvements in their quality measure scores. As would be predicted based on the market-driven mechanism underlying quality improvements using report cards, the greatest improvements occurred in the most competitive markets and in those with the Lowest average occupancy rates. As policies to promote more competition in Long-term care proceed, further reducing occupancy rates, further, albeit small, quality gains will likely be made in the future.
Alternative Pathways in Family Child Care Quality Rating and Improvement Systems

ERIC Educational Resources Information Center

Kelton, Robyn E.; Talan, Teri N.; Bloom, Paula J.

2013-01-01

As research continues to underscore the positive impact high-quality early childhood programs have on young children, numerous states have implemented quality rating and improvement systems (QRIS) to measure and improve the services young children receive across a wide range of early learning settings. These state systems range from two to five…
Transfusion rate as a quality metric: is blood conservation a learnable skill?

PubMed

Paone, Gaetano; Brewer, Robert; Likosky, Donald S; Theurer, Patricia F; Bell, Gail F; Cogan, Chad M; Prager, Richard L

2013-10-01

Between January 2008 and December 2012, a multicenter quality collaborative initiated a focus on blood conservation as a quality metric, with educational presentations and quarterly reporting of institutional-level perioperative transfusion rates and outcomes. This prospective cohort study was undertaken to determine the effect of that initiative on transfusion rates after isolated coronary artery bypass grafting (CABG). Between January 1, 2008, and December 31, 2012, 30,271 patients underwent isolated CABG in Michigan. Evaluated were annual crude and adjusted trends in overall transfusion rates for red blood cells (RBCs), fresh frozen plasma (FFP), and platelets, and in operative death. Transfusion rates continuously decreased for all blood products. RBC use decreased from 56.4% in 2008 (baseline) to 38.3% in 2012, FFP use decreased from 14.8% to 9.1%, and platelet use decreased from 20.5% to 13.4% (ptrend < 0.001 for all). A significant reduction occurred in deep sternal wound infection, reoperation for bleeding, renal failure, prolonged ventilation, initial ventilator time, and intensive care unit duration. The percentage of patients discharged home significantly increased (ptrend < 0.001). Mortality rates did not differ significantly (ptrend = 0.11). In a multicenter quality collaborative, increased attention to transfusion-related outcomes and blood conservation techniques, coincident with regular reporting and review of perioperative transfusion rates as a quality metric, was associated with a significant decrease in blood product utilization. These reductions were concurrent with significant improvement in most perioperative outcomes. This intervention was also safe, as it was not associated with any increases in mortality. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Implications of QRIS Design for the Distribution of Program Ratings and Linkages between Ratings and Observed Quality. OPRE Research Brief 2014-33

ERIC Educational Resources Information Center

Tout, Kathryn; Chien, Nina; Rothenberg, Laura; Li, Weilin

2014-01-01

This Brief compares three hypothetical Quality Rating and Improvement Systems (QRIS) that use different rating structures: block, points, and hybrid. Because the quality standards in the hypothetical QRIS are held relatively constant across structures, analyses can be conducted to determine how structure relates to key QRIS outcomes. Three…
How Would Programs Rate under California's Proposed Quality Rating and Improvement System? Evidence from Statewide and County Data on Early Care and Education Program Quality. Documented Briefing

ERIC Educational Resources Information Center

Karoly, Lynn A.; Zellman, Gail L.

2012-01-01

In 2010, the California Early Learning Quality Improvement System (CAEL QIS) Advisory Committee recommended a structure for a voluntary quality rating and improvement system (QRIS) that could apply to the state's 11,000 licensed centers and 36,600 licensed family child care homes (FCCHs). The proposed design consisted of an unweighted block system…
Poor semen quality may contribute to recent decline in fertility rates.

PubMed

Jensen, Tina Kold; Carlsen, Elisabeth; Jørgensen, Niels; Berthelsen, Jørgen G; Keiding, Niels; Christensen, Kaare; Petersen, Jørgen Holm; Knudsen, Lisbeth B; Skakkebaek, Niels E

2002-06-01

During past decades, we have witnessed a remarkable decline in fertility rates (number of births per 1000 women of reproductive age) in the industrialized world. It seems beyond doubt that the enormous social changes of our societies play the major role in this decline, but can it be attributed to changing social structures alone or is a reduced fecundity in the population also a factor? To address this we have focused on trends in teenage pregnancies (which to a large extent are unplanned). During the period in question fertility rates among 15-19 year old Danish women have been falling and the decline in fertility rate is not counterbalanced by an increase in the rate of induced abortion. When seen together with recent results from Denmark, which have shown that more than 30% of 19 year old men from the general population now have sperm counts in the subfertile range, we argue that this fall may not be attributable to social factors, changes in conception practices or diminished sexual activity alone. It seems reasonable also to consider widespread poor semen quality among men as a potential contributing factor to low fertility rates among teenagers. Due to the concern caused by the low sperm count among younger Danish men, the Danish Ministries of Health and Environment have launched a surveillance programme which includes an annual examination of the semen quality in 600 young Danes from the general population. We propose that researchers in other countries with low and falling fertility rates among young women should consider the possibility that semen quality of their younger male cohorts may also have deteriorated.
Modeling the time--varying subjective quality of HTTP video streams with rate adaptations.

PubMed

Chen, Chao; Choi, Lark Kwon; de Veciana, Gustavo; Caramanis, Constantine; Heath, Robert W; Bovik, Alan C

2014-05-01

Newly developed hypertext transfer protocol (HTTP)-based video streaming technologies enable flexible rate-adaptation under varying channel conditions. Accurately predicting the users' quality of experience (QoE) for rate-adaptive HTTP video streams is thus critical to achieve efficiency. An important aspect of understanding and modeling QoE is predicting the up-to-the-moment subjective quality of a video as it is played, which is difficult due to hysteresis effects and nonlinearities in human behavioral responses. This paper presents a Hammerstein-Wiener model for predicting the time-varying subjective quality (TVSQ) of rate-adaptive videos. To collect data for model parameterization and validation, a database of longer duration videos with time-varying distortions was built and the TVSQs of the videos were measured in a large-scale subjective study. The proposed method is able to reliably predict the TVSQ of rate adaptive videos. Since the Hammerstein-Wiener model has a very simple structure, the proposed method is suitable for online TVSQ prediction in HTTP-based streaming.
A pressure ulcer and fall rate quality composite index for acute care units: A measure development study.

PubMed

Boyle, Diane K; Jayawardhana, Ananda; Burman, Mary E; Dunton, Nancy E; Staggs, Vincent S; Bergquist-Beringer, Sandra; Gajewski, Byron J

2016-11-01

Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement. The study objective was to develop a unit-level inpatient composite nursing care quality performance index-the Pressure Ulcer and Fall Rate Quality Composite Index. Two-phase measure development study. 5144 patient care units in 857 United States hospitals participating in the National Database of Nursing Quality Indictors ® during the year 2013. The Pressure Ulcer and Fall Rate Quality Composite Index was developed in two phases. In Phase 1 the formula was generated using a utility function and generalized penalty analysis. Experts with experience in healthcare quality measurement provided the point of indicator equivalence. In Phase 2 initial validity evidence was gathered based on hypothesized relationships between the Pressure Ulcer and Fall Rate Quality Composite Index and other variables using two-level (unit, hospital) hierarchical linear mixed modeling. The Pressure Ulcer and Fall Rate Quality Composite Index=100-PUR-FR, where PUR is pressure ulcer rate and FR is total fall rate. Higher scores indicate better quality. Bland-Altman plots demonstrated agreement between pairs of experts and provided evidence for inter-rater reliability of the formula. The validation process demonstrated that higher registered nurse skill mix, higher percent of registered nurses with a baccalaureate in nursing or higher degree, higher percent of registered nurses with national specialty certification, and lower percent of hours supplied by agency staff were significantly associated with higher Pressure Ulcer and Fall Rate Quality Composite Index scores. Higher percentages of unit patients at risk for a hospital-acquired pressure ulcer and higher unit rates of physical restraint use were not associated with higher Pressure
A PRESSURE ULCER AND FALL RATE QUALITY COMPOSITE INDEX FOR ACUTE CARE UNITS: A MEASURE DEVELOPMENT STUDY

PubMed Central

Jayawardhana, Ananda; Burman, Mary E.; Dunton, Nancy E.; Staggs, Vincent S.; Bergquist-Beringer, Sandra; Gajewski, Byron J.

2016-01-01

Background Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement. Objective The study objective was to develop a unit-level inpatient composite nursing care quality performance index – the Pressure Ulcer and Fall Rate Quality Composite Index. Design Two-phase measure development study. Settings 5,144 patient care units in 857 United States hospitals participating in the National Database of Nursing Quality Indictors® during the year 2013. Methods The Pressure Ulcer and Fall Rate Quality Composite Index was developed in two phases. In Phase 1 the formula was generated using a utility function and generalized penalty analysis. Experts with experience in healthcare quality measurement provided the point of indicator equivalence. In Phase 2 initial validity evidence was gathered based on hypothesized relationships between the Pressure Ulcer and Fall Rate Quality Composite Index and other variables using two-level (unit, hospital) hierarchical linear mixed modeling. Results The Pressure Ulcer and Fall Rate Quality Composite Index = 100 − PUR − FR, where PUR is pressure ulcer rate and FR is total fall rate. Higher scores indicate better quality. Bland-Altman plots demonstrated agreement between pairs of experts and provided evidence for inter-rater reliability of the formula. The validation process demonstrated that higher registered nurse skill mix, higher percent of registered nurses with a baccalaureate in nursing or higher degree, higher percent of registered nurses with national specialty certification, and lower percent of hours supplied by agency staff were significantly associated with higher Pressure Ulcer and Fall Rate Quality Composite Index scores. Higher percentages of unit patients at risk for a hospital-acquired pressure ulcer and higher unit rates of

Impact of increased collection rates and the use of commingled collection systems on the quality of recovered paper. Part 1: increased collection rates.

PubMed

Miranda, Ruben; Monte, M; Blanco, Angeles

2011-11-01

The recovery and utilization of recovered paper have increased over past decades all over the world due to economic, environmental, and social issues. However, it is well known that an extended recovered paper collection is detrimental to its quality, either by the exploitation of lower quality sources such as households, or the spreading of commingled systems instead of selective collection systems. The influence of these two factors was assessed by analyzing the quality of different recovered paper grades used as raw material in a mill located in Madrid (Spain) producing newsprint and light weight coated paper from recovered paper. Part 1 of the paper deals with the impact of increased collection rates on the quality of recovered paper and Part 2 with the use of commingled collection systems. Results of Part 1 show that increased collection rates have a large impact on the quality of the recovered paper. The quality, measured as total unusable material and moisture contents, had deteriorated very rapidly in only 4 years (2005-2008) as a consequence of increased collection rates. Collection rates increased in Spain from 58.5% to 68.6% during this period, resulting in more than 50% increase of total unusable material and 25% of moisture content. The downgrading of the quality of recovered paper is one of the major threats for extending the current limits of paper recycling. Therefore, future challenge is to increase its availability but maintaining its quality. Copyright © 2011 Elsevier Ltd. All rights reserved.
Coaching and Quality Assistance in Quality Rating Improvement Systems: Approaches Used by TA Providers to Improve Quality in Early Care and Education Programs and Home-Based Settings

ERIC Educational Resources Information Center

Smith, Sheila; Robbins, Taylor; Schneider, Will; Kreader, J. Lee; Ong, Christine

2012-01-01

Quality Rating Improvement Systems (QRISs) commonly offer on-site technical assistance (TA) and coaching to help early care and education settings achieve quality improvements and a higher QRIS rating. In surveys of administrators overseeing statewide QRISs, almost all states reported the use of on-site TA and coaching in both center-based and…
Contributors to Patients' Ratings of Quality of Care Among Ethnically Diverse Patients with Type 2 Diabetes.

PubMed

Choi, Sarah E; Ngo-Metzger, Quyen; Billimek, John; Greenfield, Sheldon; Kaplan, Sherrie H; Sorkin, Dara H

2016-04-01

We examined racial/ethnic differences in patients' ratings of components of interpersonal quality [participatory decision making (PDM) style, being treated as an equal partner, and feelings of trust], and evaluated the association between each of these components and patients' ratings of overall healthcare quality among non-Hispanic white (NHW), Vietnamese American, and Mexican American patients with type 2 diabetes. The findings indicated that although all three components were significantly associated with ratings of overall healthcare quality, the significant interactions between race/ethnicity and both PDM style (β = -0.09, p < 0.01) and equal partner (β = -0.06, p < 0.05) for the Vietnamese American patients suggested that the relationship between these components and patients' ratings of healthcare quality were less strong among Vietnamese American patients than among the NHW patients. Understanding racial/ethnic differences in the components of interpersonal quality that are associated with patients' ratings of overall healthcare quality is an important step for improving patients' experiences of their own care.
Modern methods for the quality management of high-rate melt solidification

NASA Astrophysics Data System (ADS)

Vasiliev, V. A.; Odinokov, S. A.; Serov, M. M.

2016-12-01

The quality management of high-rate melt solidification needs combined solution obtained by methods and approaches adapted to a certain situation. Technological audit is recommended to estimate the possibilities of the process. Statistical methods are proposed with the choice of key parameters. Numerical methods, which can be used to perform simulation under multifactor technological conditions, and an increase in the quality of decisions are of particular importance.
Adjusted hospital death rates: a potential screen for quality of medical care.

PubMed

Dubois, R W; Brook, R H; Rogers, W H

1987-09-01

Increased economic pressure on hospitals has accelerated the need to develop a screening tool for identifying hospitals that potentially provide poor quality care. Based upon data from 93 hospitals and 205,000 admissions, we used a multiple regression model to adjust the hospitals crude death rate. The adjustment process used age, origin of patient from the emergency department or nursing home, and a hospital case mix index based on DRGs (diagnostic related groups). Before adjustment, hospital death rates ranged from 0.3 to 5.8 per 100 admissions. After adjustment, hospital death ratios ranged from 0.36 to 1.36 per 100 (actual death rate divided by predicted death rate). Eleven hospitals (12 per cent) were identified where the actual death rate exceeded the predicted death rate by more than two standard deviations. In nine hospitals (10 per cent), the predicted death rate exceeded the actual death rate by a similar statistical margin. The 11 hospitals with higher than predicted death rates may provide inadequate quality of care or have uniquely ill patient populations. The adjusted death rate model needs to be validated and generalized before it can be used routinely to screen hospitals. However, the remaining large differences in observed versus predicted death rates lead us to believe that important differences in hospital performance may exist.
Sleep Quality Estimation based on Chaos Analysis for Heart Rate Variability

NASA Astrophysics Data System (ADS)

Fukuda, Toshio; Wakuda, Yuki; Hasegawa, Yasuhisa; Arai, Fumihito; Kawaguchi, Mitsuo; Noda, Akiko

In this paper, we propose an algorithm to estimate sleep quality based on a heart rate variability using chaos analysis. Polysomnography(PSG) is a conventional and reliable system to diagnose sleep disorder and to evaluate its severity and therapeatic effect, by estimating sleep quality based on multiple channels. However, a recording process requires a lot of time and a controlled environment for measurement and then an analyzing process of PSG data is hard work because the huge sensed data should be manually evaluated. On the other hand, it is focused that some people make a mistake or cause an accident due to lost of regular sleep and of homeostasis these days. Therefore a simple home system for checking own sleep is required and then the estimation algorithm for the system should be developed. Therefore we propose an algorithm to estimate sleep quality based only on a heart rate variability which can be measured by a simple sensor such as a pressure sensor and an infrared sensor in an uncontrolled environment, by experimentally finding the relationship between chaos indices and sleep quality. The system including the estimation algorithm can inform patterns and quality of own daily sleep to a user, and then the user can previously arranges his life schedule, pays more attention based on sleep results and consult with a doctor.
Quality in Colonoscopy: Beyond the Adenoma Detection Rate Fever

PubMed Central

Taveira, Filipe; Areia, Miguel; Elvas, Luís; Alves, Susana; Brito, Daniel; Saraiva, Sandra; Cadime, Ana Teresa

2017-01-01

Background Colonoscopy quality is a hot topic in gastroenterological communities, with several actual guidelines focusing on this aspect. Although the adenoma detection rate (ADR) is the single most important indicator, several other metrics are described and need reporting. Electronic medical reports are essential for the audit of quality indicators; nevertheless, they have proved not to be faultless. Aim The aim of this study was to analyse and audit quality indicators (apart from ADR) using only our internal electronic endoscopy records as a starting point for improvement. Methods An analysis of electronically recorded information of 8,851 total colonoscopies from a single tertiary centre from 2010 to 2015 was performed. Results The mean patient age was 63.4 ± 8.5 years; 45.5% of them were female, and in 14.6% sedation was used. Photographic documentation was done in 98.4% with 10.7 photographs on average, and 37.4% reports had <8 pictures per exam. Bowel preparation was rated as adequate in 67%, fair in 27% and inadequate in 4.9% of cases. The adjusted caecal intubation rate (CIR) was 92%, while negative predictors were inadequate preparation (OR 119, 95% CI 84–170), no sedation (OR 2.39, 95% CI 1.81–3.15), female gender (OR 1.61, 95% CI 1.38–1.88) and age ≥65 years (OR 1.56, 95% CI 1.34–1.82). In 28% of patients, a snare polypectomy was performed, correlating with adequate preparation (OR 5.75, 95% CI 3.90–8.48), male gender (OR 1.82, 95% CI 1.64–2.01) and age ≥65 years (OR 1.25, 95% CI 1.13–1.37; p < 0.01) as positive predictors. An annual evolution was observed with improvements in photographic documentation (10.7 vs. 12.9; p < 0.001), CIR (91 vs. 94%; p = 0.002) and “adequate” bowel preparation (p = 0.004). Conclusions: There is much more to report than the ADR to ensure quality in colonoscopy practice. Better registry systematization and integrated software should be goals to achieve in the short term. PMID:29255755
Correlations between quality ratings of skilled nursing facilities and multidrug-resistant urinary tract infections.

PubMed

Gucwa, Azad L; Dolar, Veronika; Ye, Chao; Epstein, Stephanie

2016-11-01

The purpose of this study was to determine risk factors for the acquisition of urinary tract infections (UTIs) and multidrug-resistant organisms (MDROs) in residents of skilled nursing facilities (SNFs). Using the informational database provided by the Centers for Medicare and Medicaid Services (CMS), a retrospective logistic regression was performed on 1,523 urine cultures from 12 SNFs located in Long Island, New York. Of the 1,142 positive urine cultures, Escherichia coli was most prevalent. Additionally, 164 (14.4%) of the UTIs were attributed to an MDRO. In multivariate logistic regression, sex and overall quality rating predicted the occurrence of UTIs, whereas identification of MDROs was dependent on the level of nursing care received. The mean predicted probability of UTIs and receipt of contaminated samples was inversely dependent on the facility's rating, where the likelihood increased as overall quality ratings decreased. The CMS's quality rating system may provide some insight into the status of infection control practices in SNFs. The results of this study suggest that potential consumers should focus on the overall star ratings and the competency of the nursing staff in these facilities rather than on individual quality measures. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Effect of paper quality on the response rate to a postal survey: A randomised controlled trial. [ISRCTN32032031

PubMed Central

Clark, T Justin; Khan, Khalid S; Gupta, Janesh K

2001-01-01

Background Response rates to surveys are declining and this threatens the validity and generalisability of their findings. We wanted to determine whether paper quality influences the response rate to postal surveys Methods A postal questionnaire was sent to all members of the British Society of Gynaecological Endoscopy (BSGE). Recipients were randomised to receiving the questionnaire printed on standard quality paper or high quality paper. Results The response rate for the recipients of high quality paper was 43/195 (22%) and 57/194 (29%) for standard quality paper (relative rate of response 0.75, 95% CI 0.33–1.05, p = 0.1 Conclusion The use of high quality paper did not increase response rates to a questionnaire survey of gynaecologists affiliated to an endoscopic society. PMID:11782286
Social Media and Rating Sites as Tools to Understanding Quality of Care: A Scoping Review

PubMed Central

Van de Belt, Tom H; Engelen, Lucien JLPG; Schoonhoven, Lisette; Kool, Rudolf B

2014-01-01

Background Insight into the quality of health care is important for any stakeholder including patients, professionals, and governments. In light of a patient-centered approach, it is essential to assess the quality of health care from a patient’s perspective, which is commonly done with surveys or focus groups. Unfortunately, these “traditional” methods have significant limitations that include social desirability bias, a time lag between experience and measurement, and difficulty reaching large groups of people. Information on social media could be of value to overcoming these limitations, since these new media are easy to use and are used by the majority of the population. Furthermore, an increasing number of people share health care experiences online or rate the quality of their health care provider on physician rating sites. The question is whether this information is relevant to determining or predicting the quality of health care. Objective The goal of our research was to systematically analyze the relation between information shared on social media and quality of care. Methods We performed a scoping review with the following goals: (1) to map the literature on the association between social media and quality of care, (2) to identify different mechanisms of this relationship, and (3) to determine a more detailed agenda for this relatively new research area. A recognized scoping review methodology was used. We developed a search strategy based on four themes: social media, patient experience, quality, and health care. Four online scientific databases were searched, articles were screened, and data extracted. Results related to the research question were described and categorized according to type of social media. Furthermore, national and international stakeholders were consulted throughout the study, to discuss and interpret results. Results Twenty-nine articles were included, of which 21 were concerned with health care rating sites. Several studies
Social media and rating sites as tools to understanding quality of care: a scoping review.

PubMed

Verhoef, Lise M; Van de Belt, Tom H; Engelen, Lucien J L P G; Schoonhoven, Lisette; Kool, Rudolf B

2014-02-20

Insight into the quality of health care is important for any stakeholder including patients, professionals, and governments. In light of a patient-centered approach, it is essential to assess the quality of health care from a patient's perspective, which is commonly done with surveys or focus groups. Unfortunately, these "traditional" methods have significant limitations that include social desirability bias, a time lag between experience and measurement, and difficulty reaching large groups of people. Information on social media could be of value to overcoming these limitations, since these new media are easy to use and are used by the majority of the population. Furthermore, an increasing number of people share health care experiences online or rate the quality of their health care provider on physician rating sites. The question is whether this information is relevant to determining or predicting the quality of health care. The goal of our research was to systematically analyze the relation between information shared on social media and quality of care. We performed a scoping review with the following goals: (1) to map the literature on the association between social media and quality of care, (2) to identify different mechanisms of this relationship, and (3) to determine a more detailed agenda for this relatively new research area. A recognized scoping review methodology was used. We developed a search strategy based on four themes: social media, patient experience, quality, and health care. Four online scientific databases were searched, articles were screened, and data extracted. Results related to the research question were described and categorized according to type of social media. Furthermore, national and international stakeholders were consulted throughout the study, to discuss and interpret results. Twenty-nine articles were included, of which 21 were concerned with health care rating sites. Several studies indicate a relationship between information
Determining the predictors of change in quality of life self-ratings and carer-ratings for community-dwelling people with Alzheimer disease.

PubMed

Bosboom, Pascalle R; Alfonso, Helman; Almeida, Osvaldo P

2013-01-01

The aim of this study was to determine the factors that mediate changes in Health Related Quality of Life (HRQoL) ratings by community-dwelling people with Alzheimer disease (AD) and carers over a period of 18 months. We completed an 18-month longitudinal study of 80 community-dwelling older adults diagnosed with probable AD of mild or moderate severity (NINCDS-ADRD criteria) and their family carers. The primary outcome of interest was the 18-month change in HRQoL ratings as measured with the Quality of Life-AD (QoL-AD) (by carer and by self). Explanatory variables included demographics, lifestyle, cognition, awareness, psychopathology, burden-of-care, use of medication, and functionality in daily life. We found a significant decline (8.7%, P=0.003) in QoL-AD carer-ratings, but not in self-ratings. The final parsimonious model of predictors of changes in QoL-AD self-ratings explained 22.6% of the variance; only changes on Hospital Anxiety and Depression Scale Anxiety retained significance. The final model of predictors of changes in carer-ratings explained 55.0% of the variance: that is, changes on Informant Questionnaire on Cognitive Decline in the Elderly, changes on Hospital Anxiety and Depression Scale Depression, practicing hobbies at 18 months, and number of visit(s) or admission(s) to hospital. HRQoL self-ratings and carer-ratings of community-dwelling people with AD do not decline at same rate over 18 months and changes are associated with different factors. Interventions designed to optimize quality of life of people with AD should consider carefully whose HRQoL ratings they wish to change.
Reducing the Primary Cesarean Birth Rate: A Quality Improvement Project.

PubMed

Javernick, Julie A; Dempsey, Amy

2017-07-01

Research continues to support vaginal birth as the safest mode of childbirth, but despite this, cesarean birth has become the most common surgical procedure performed on women. The rate has increased 500% since the 1970s without a corresponding improvement in maternal or neonatal outcomes. A Colorado community hospital recognized that its primary cesarean birth rate was higher than national and state benchmark levels. To reduce this rate, the hospital collaborated with its largest maternity care provider group to implement a select number of physiologic birth practices and measure improvement in outcomes. Using a pre- and postprocess measure study design, the quality improvement project team identified and implemented 3 physiologic birth parameters over a 12-month period that have been shown to promote vaginal birth. These included reducing elective induction of labor in women less than 41 weeks' gestation; standardizing triage to admit women at greater than or equal to 4 cm dilation; and increasing the use of intermittent auscultation as opposed to continuous fetal monitoring for fetal surveillance. The team also calculated each obstetrician-gynecologist's primary cesarean birth rate monthly and delivered these rates to the providers. Outcomes showed that the provider group decreased its primary cesarean birth rate from 28.9% to 12.2% in the 12-month postprocess measure period. The 57.8% decrease is statistically significant (odds ratio [OR], 0.345; z = 6.52, P < .001; 95% confidence interval [CI], 0.249-0.479). While this quality improvement project cannot be translated to other settings, promotion of physiologic birth practices, along with audit and feedback, had a statistically significant impact on the primary cesarean birth rate for this provider group and, consequently, on the community hospital where they attend births. © 2017 by the American College of Nurse-Midwives.
Enhancing Global Competitiveness: Benchmarking Airline Operational Performance in Highly Regulated Environments

NASA Technical Reports Server (NTRS)

Bowen, Brent D.; Headley, Dean E.; Kane, Karisa D.

1998-01-01

Enhancing competitiveness in the global airline industry is at the forefront of attention with airlines, government, and the flying public. The seemingly unchecked growth of major airline alliances is heralded as an enhancement to global competition. However, like many mega-conglomerates, mega-airlines will face complications driven by size regardless of the many recitations of enhanced efficiency. Outlined herein is a conceptual model to serve as a decision tool for policy-makers, managers, and consumers of airline services. This model is developed using public data for the United States (U.S.) major airline industry available from the U/S. Department of Transportation, Federal Aviation Administration, the National Aeronautics and Space Administration, the National Transportation Safety Board, and other public and private sector sources. Data points include number of accidents, pilot deviations, operational performance indicators, flight problems, and other factors. Data from these sources provide opportunity to develop a model based on a complex dot product equation of two vectors. A row vector is weighted for importance by a key informant panel of government, industry, and consumer experts, while a column vector is established with the factor value. The resulting equation, known as the national Airline Quality Rating (AQR), where Q is quality, C is weight, and V is the value of the variables, is stated Q=C[i1-19] x V[i1-19]. Looking at historical patterns of AQR results provides the basis for establishment of an industry benchmark for the purpose of enhancing airline operational performance. A 7 year average of overall operational performance provides the resulting benchmark indicator. Applications from this example can be applied to the many competitive environments of the global industry and assist policy-makers faced with rapidly changing regulatory challenges.
[Can quality of life in psychotherapy be measured with clinician-ratings? A comparison of patient- and clinician-ratings using the SF-8].

PubMed

Schulz, H; Harfst, T; Andreas, S; Kawski, S; Koch, U; Rabung, S

2009-10-01

Quality of life is a major criterion of the outcome of psychotherapeutic interventions. The concept of quality of life emphasizes patient self-ratings. However, they can be burdensome or inappropriate in some cases. Therefore we have compared self-ratings and clinician-ratings of quality of life. Self- and clinician-ratings of the SF-8 (1-week recall version) were measured from consecutive samples of 1 812 inpatients from eleven psychotherapeutic clinics at admission and at discharge six weeks later. A physical summary score (PSS) and a mental summary score (MSS) were calculated. Pearson product-moment correlations were used. Self- and clinician-ratings of the PSS correlate r=0.48 at admission and r=0.58 at discharge, of the MSS r=0.46 and r=0.51, respectively. Concerning single items we find the highest correlation for item 4 (bodily pain: r=0.53 and r=0.55), the lowest for item 6 (social functioning: r=0.26 and r=0.30). Change scores of the PSS correlate r=0.20, of the MSS r=0.32. Correlations differ between diagnostic groups: Correlations are low for patients with either schizophrenia (F2), depressive episode (F32) or personality disorder (F60-62), comparatively higher for patients with dysthymia. Comparing correlations across the 11 clinics reveals substantial differences, for the MSS ranging from r=0.38 to r=0.58 at admission and r=0.27 to r=0.68 at discharge. Patient self-ratings of quality of life as a psychotherapeutic outcome measure using the SF-8 Health Survey could not be substituted by clinician-ratings, they should be used as complements. Georg Thieme Verlag KG Stuttgart . New York.
Delaware Stars for Early Success. QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Delaware's Stars for Early Success prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators…
Vermont STep Ahead Recognition System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Vermont's STep Ahead Recognition System (STARS) prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for All Child Care Programs;…
Kentucky STARS for KIDS NOW: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Kentucky's STARS for KIDS NOW prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…
Assessing the Validity of the Qualistar Early Learning Quality Rating and Improvement System as a Tool for Improving Child-Care Quality

ERIC Educational Resources Information Center

Zellman, Gail L.; Perlman, Michal; Le, Vi-Nhuan; Setodji, Claude Messan

2008-01-01

As a result of the generally low quality of child care in the United States and the increased emphasis on accountability in education policy, quality rating systems (QRSs) are proliferating in the child-care arena. QRSs assess child-care providers on multiple dimensions of quality and integrate these assessments into an easily understood summary…
The [N II] Kinematics of R Aquarii

NASA Technical Reports Server (NTRS)

Hollis, J. M.; Vogel, S. N.; VanBuren, D.; Strong, J. P.; Lyon, R. G.; Dorband, J. E.

1998-01-01

We report a kinematic study of the symbiotic star system R Aqr derived from [N H]lambda 6584 emission observations with a Fabry-Perot imaging spectrometer. The [N II] spatial structure of the R Aqr jet, first observed circa 1977, and surrounding hourglass-shaped nebulosity, due to an explosion approximately 660 years ago, are derived from 41 velocity planes spaced at approximately 12 km/s intervals. Fabry-Perot imagery shows the elliptical nebulosity comprising the waist of the hourglass shell is consistent with a circular ring expanding radially at 55 km/s as seen at an inclination angle, i approximately 70 deg. Fabry-Perot imagery shows the two-sided R Aqr jet is collimated flow in opposite directions. The intensity-velocity structure of the strong NE jet component is shown in contrast to the amorphous SW jet component. We offer a idealized schematic model for the R Aqr jet motion which results in a small-scale helical structure forming around a larger-scale helical path. The implications of such a jet model are discussed. We present a movie showing a side-by-side comparison of the spatial structure of the model and the data as a function of the 41 velocity planes.

Acute and Subchronic Oral Toxicity Evaluation of Aqueous Root Extract of Dicoma anomala Sond. in Wistar Rats

PubMed Central

Balogun, Fatai Oladunni; Tom Ashafa, Anofi Omotayo

2016-01-01

The present study evaluated the safety of aqueous root extract of Dicoma anomala (AQRED) through acute and subchronic toxicity studies. Single oral dose of AQRED at the concentration of 0, 5, 300, and 2000 mg/kg as well as 125, 250, and 500 mg/kg/day was administered to rats for 14-day acute and 90-day subchronic oral toxicity studies. The results revealed no mortalities or observed clinical signs of toxicity in all the rats during both investigation periods. In subchronic toxicity testing, administration of AQRED also did not cause any changes in body weight as well as food and water consumption patterns. The haematological parameters and blood chemistry revealed no significant difference (p > 0.05) between the treatment and the control except in platelet count, alkaline phosphatase, and sodium levels where there was a significant increase (p < 0.05), although there was also a significant reduction (p < 0.05) in alanine transaminase, aspartate transaminase, and creatinine when compared to control. However, these changes were not reflecting the results from histology. Conclusively, the obtained results suggested that the LD50 of AQRED is in excess of 2000 mg/kg and its oral administration for 90 days revealed that it is unlikely to be toxic, hence, safe. PMID:27200099
A cross-sectional study assessing the association between online ratings and structural and quality of care measures: results from two German physician rating websites.

PubMed

Emmert, Martin; Adelhardt, Thomas; Sander, Uwe; Wambach, Veit; Lindenthal, Jörg

2015-09-24

Even though physician rating websites (PRWs) have been gaining in importance in both practice and research, little evidence is available on the association of patients' online ratings with the quality of care of physicians. It thus remains unclear whether patients should rely on these ratings when selecting a physician. The objective of this study was to measure the association between online ratings and structural and quality of care measures for 65 physician practices from the German Integrated Health Care Network "Quality and Efficiency" (QuE). Online reviews from two German PRWs were included which covered a three-year period (2011 to 2013) and included 1179 and 991 ratings, respectively. Information for 65 QuE practices was obtained for the year 2012 and included 21 measures related to structural information (N = 6), process quality (N = 10), intermediate outcomes (N = 2), patient satisfaction (N = 1), and costs (N = 2). The Spearman rank coefficient of correlation was applied to measure the association between ratings and practice-related information. Patient satisfaction results from offline surveys and the patients per doctor ratio in a practice were shown to be significantly associated with online ratings on both PRWs. For one PRW, additional significant associations could be shown between online ratings and cost-related measures for medication, preventative examinations, and one diabetes type 2-related intermediate outcome measure. There again, results from the second PRW showed significant associations with the age of the physicians and the number of patients per practice, four process-related quality measures for diabetes type 2 and asthma, and one cost-related measure for medication. Several significant associations were found which varied between the PRWs. Patients interested in the satisfaction of other patients with a physician might select a physician on the basis of online ratings. Even though our results indicate associations
Exploring individual quality: Basal metabolic rate and reproductive performance in storm-petrels

USGS Publications Warehouse

Blackmer, A.L.; Mauck, R.A.; Ackerman, Joshua T.; Huntington, C.E.; Nevitt, G.A.; Williams, J.B.

2005-01-01

Despite evidence that some individuals achieve both superior reproductive performance and high survivorship, the factors underlying variation in individual quality are not well understood. The compensation and increased-intake hypotheses predict that basal metabolic rate (BMR) influences reproductive performance; if so, variation in BMR may be related to differences in individual quality. We evaluated whether BMR measured during the incubation period provides a proximate explanation for variation in individual quality by measuring the BMRs and reproductive performance of Leach's storm-petrels (Oceanodroma leucorhoa) breeding on Kent Island, New Brunswick, Canada, during 2000 and 2001. We statistically controlled for internal (body mass, breeding age, sex) and external (year, date, time of day) effects on BMR. We found that males with relatively low BMRs hatched their eggs earlier in the season and that their chicks' wing growth rates were faster compared to males with relatively high BMRs. Conversely, BMR was not related to egg volume, hatching date, or chick growth rate for females or to lifetime (???23 years) hatching success for either sex. Thus, for males but not for females, our results support the compensation hypothesis. This hypothesis predicts that animals with low BMRs will achieve better reproductive performance than animals with high BMRs because they have lower self-maintenance costs and therefore can apportion more energy to reproduction. These results provide evidence that intraspecific variation in reproductive performance is related to BMR and suggest that BMR may influence individual quality in males. ?? The Author 2005. Published by Oxford University Press on behalf of the International Society for Behavioral Ecology. All rights reserved.
The Influence of Race/Ethnicity and Education on Family Ratings of the Quality of Dying in the ICU.

PubMed

Lee, Janet J; Long, Ann C; Curtis, J Randall; Engelberg, Ruth A

2016-01-01

Racial and ethnic differences in end-of-life care may be attributable to both patient preferences and health-care disparities. Identifying factors that differentiate preferences from disparities may enhance end-of-life care for critically ill patients and their families. To understand the association of minority race/ethnicity and education with family ratings of the quality of dying and death, taking into consideration possible markers of patient and family preferences for end-of-life care as mediators of this association. Data were obtained from 15 intensive care units participating in a cluster-randomized trial of a palliative care intervention. Family members of decedents completed self-report surveys evaluating quality of dying. We used regression analyses to identify associations between race/ethnicity, education, and quality of dying ratings. We then used path analyses to investigate whether advance directives and life-sustaining treatment acted as mediators between patient characteristics and ratings of quality of dying. Family members returned 1290 surveys for 2850 decedents. Patient and family minority race/ethnicity were both associated with lower ratings of quality of dying. Presence of a living will and dying in the setting of full support mediated the relationship between patient race and family ratings; patient race exerted an indirect, rather than direct, effect on quality of dying. Family minority race had a direct effect on lower ratings of quality of dying. Neither patient nor family education was associated with quality of dying. Minority race/ethnicity was associated with lower family ratings of quality of dying. This association was mediated by factors that may be markers of patient and family preferences (living will, death in the setting of full support); family member minority race/ethnicity was directly associated with lower ratings of quality of dying. Our findings generate hypothesized pathways that require future evaluation. Copyright �
Effects of dynamic aeroelasticity on handling qualities and pilot rating

NASA Technical Reports Server (NTRS)

Swaim, R. L.; Yen, W.-Y.

1978-01-01

Pilot performance parameters, such as pilot ratings, tracking errors, and pilot comments, were recorded and analyzed for a longitudinal pitch tracking task on a large, flexible aircraft. The tracking task was programmed on a fixed-base simulator with a CRT attitude director display of pitch angle command, pitch angle, and pitch angle error. Parametric variations in the undamped natural frequencies of the two lowest frequency symmetric elastic modes were made to induce varying degrees of rigid body and elastic mode interaction. The results indicate that such mode interaction can drastically affect the handling qualities and pilot ratings of the task.
Examining the Relationship Between Perceived Quality of Care and Actual Quality of Care as Measured by 30-Day Readmission Rates.

PubMed

Salinas, Stanley R

To test the relationship between patient experience, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and actual quality of care, as measured by 30-day readmission rates. Both HCAHPS data and outcome data reported to the Centers of Medicare & Medicaid Services (CMS). This secondary, nationwide (N = 4060), hospital-level study focused only on acute care hospitals. HCAHPS question 22 "Would you recommend this hospital to your friends and family?" was used to determine level of overall satisfaction, and 30-day readmission rates, as reported to the CMS, was used as a proxy for actual quality of care. A statistically significant relationship was found between patient experience and actual quality outcomes. The results of this study reinforce the inclusion of patient experience in Medicare's Value Based Purchasing program as a matter of good public policy.
Physiotherapist agreement when visually rating movement quality during lower extremity functional screening tests.

PubMed

Whatman, Chris; Hing, Wayne; Hume, Patria

2012-05-01

To investigate physiotherapist agreement in rating movement quality during lower extremity functional tests using two visual rating methods and physiotherapists with differing clinical experience. Clinical measurement. Six healthy individuals were rated by 44 physiotherapists. These raters were in three groups (inexperienced, novice, experienced). Video recordings of all six individuals performing four lower extremity functional tests were visually rated (dichotomous or ordinal scale) using two rating methods (overall or segment) on two occasions separated by 3-4 weeks. Intra and inter-rater agreement for physiotherapists was determined using overall percentage agreement (OPA) and the first order agreement coefficient (AC1). Intra-rater agreement for overall and segment methods ranged from slight to almost perfect (OPA: 29-96%, AC1: 0.01 to 0.96). AC1 agreement was better in the experienced group (84-99% likelihood) and for dichotomous rating (97-100% likelihood). Inter-rater agreement ranged from fair to good (OPA: 45-79%; AC1: 0.22-0.71). AC1 agreement was not influenced by clinical experience but was again better using dichotomous rating. Physiotherapists' visual rating of movement quality during lower extremity functional tests resulted in slight to almost perfect intra-rater agreement and fair to good inter-rater agreement. Agreement improved with increased level of clinical experience and use of dichotomous rating. Copyright © 2011 Elsevier Ltd. All rights reserved.
Flame quality monitor system for fixed firing rate oil burners

DOEpatents

Butcher, Thomas A.; Cerniglia, Philip

1992-01-01

A method and apparatus for determining and indicating the flame quality, or efficiency of the air-fuel ratio, in a fixed firing rate heating unit, such as an oil burning furnace, is provided. When the flame brightness falls outside a preset range, the flame quality, or excess air, has changed to the point that the unit should be serviced. The flame quality indicator output is in the form of lights mounted on the front of the unit. A green light indicates that the flame is about in the same condition as when the burner was last serviced. A red light indicates a flame which is either too rich or too lean, and that servicing of the burner is required. At the end of each firing cycle, the flame quality indicator goes into a hold mode which is in effect during the period that the burner remains off. A yellow or amber light indicates that the burner is in the hold mode. In this mode, the flame quality lights indicate the flame condition immediately before the burner turned off. Thus the unit can be viewed when it is off, and the flame condition at the end of the previous firing cycle can be observed.
Do the stars align? Distribution of high-quality ratings of healthcare sectors across US markets.

PubMed

Figueroa, Jose; Feyman, Yevgeniy; Blumenthal, Daniel; Jha, Ashish

2018-04-01

The US government created five-star rating systems to evaluate hospital, nursing homes, home health agency and dialysis centre quality. The degree to which quality is a property of organisations versus geographical markets is unclear. To determine whether high-quality healthcare service sectors are clustered within US healthcare markets. Using data from the Centers for Medicare and Medicaid Services' Hospital, Dialysis, Nursing Home and Home Health Compare databases, we calculated the mean star ratings of four healthcare sectors in 304 US hospital referral regions (HRRs). For each sector, we ranked HRRs into terciles by mean star rating. Within each HRR, we assessed concordance of tercile rank across sectors using a multirater kappa. Using t-tests, we compared characteristics of HRRs with three to four top-ranked sectors, one to two top-ranked sectors and zero top-ranked sectors. Six HRRs (2.0% of HRRs) had four top-ranked healthcare sectors, 38 (12.5%) had three top-ranked health sectors, 71 (23.4%) had two top-ranked sectors, 111 (36.5%) had one top-ranked sector and 78 (25.7%) HRRs had no top-ranked sectors. A multirater kappa across all sectors showed poor to slight agreement (K=0.055). Compared with HRRs with zero top-ranked sectors, those with three to four top-ranked sectors had higher median incomes, fewer black residents, lower mortality rates and were less impoverished. Results were similar for HRRs with one to two top-ranked sectors. Few US healthcare markets exhibit high-quality performance across four distinct healthcare service sectors, suggesting that high-quality care in one sector may not be dependent on or improve care quality in other sectors. Policies that promote accountability for quality across sectors (eg, bundled payments and shared quality metrics) may be needed to systematically improve quality across sectors. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No
Manipulation of follicle development to ensure optimal oocyte quality and conception rates in cattle.

PubMed

Baruselli, P S; Sá Filho, M F; Ferreira, R M; Sales, J N S; Gimenes, L U; Vieira, L M; Mendanha, M F; Bó, G A

2012-08-01

Over the last several decades, a number of therapies have been developed that manipulate ovarian follicle growth to improve oocyte quality and conception rates in cattle. Various strategies have been proposed to improve the responses to reproductive biotechnologies following timed artificial insemination (TAI), superovulation (SOV) or ovum pickup (OPU) programmes. During TAI protocols, final follicular growth and size of the ovulatory follicle are key factors that may significantly influence oocyte quality, ovulation, the uterine environment and consequently pregnancy outcomes. Progesterone concentrations during SOV protocols influence follicular growth, oocyte quality and embryo quality; therefore, several adjustments to SOV protocols have been proposed depending on the animal category and breed. In addition, the success of in vitro embryo production is directly related to the number and quality of cumulus oocyte complexes harvested by OPU. Control of follicle development has a significant impact on the OPU outcome. This article discusses a number of key points related to the manipulation of ovarian follicular growth to maximize oocyte quality and improve conception rates following TAI and embryo transfer of in vivo- and in vitro-derived embryos in cattle. © 2012 Blackwell Verlag GmbH.
Effect of centrifugal fractionation protocols on quality and recovery rate of equine sperm.

PubMed

Edmond, A J; Brinsko, S P; Love, C C; Blanchard, T L; Teague, S R; Varner, D D

2012-03-15

Centrifugal fractionation of semen is commonly done to improve quality of human semen in assisted-reproduction laboratories, allowing sperm separation based on their isopycnic points. Sperm with morphologic abnormalities are often more buoyant, promoting their retention above defined density media, with structurally normal sperm passing through the media following centrifugation. Three experiments were conducted to evaluate the effects of density-medium type, centrifuge-tube size, sperm number, and density-medium volume (column height) on stallion sperm quality and recovery rate in sperm pellets following centrifugation. In all three experiments, equine semen was initially centrifuged to increase sperm concentration. In Experiment 1, semen was layered over continuous or discontinuous gradients. For Experiment 2, semen was layered over three column heights of continuous gradients in 15- or 50-ml conical-bottom tubes. For Experiment 3, increasing sperm numbers were layered over continuous gradient in 15- or 50-ml conical-bottom tubes. Following centrifugation, sperm pellets were evaluated for sperm morphologic quality, motility, DNA integrity, and recovery rate. Centrifugal fractionation improved (P < 0.05) sperm morphology, motility, and DNA integrity, as compared to controls. The continuous gradient increased (P < 0.05) sperm recovery rate relative to the discontinuous gradient, whereas sperm processed in 15-ml tubes yielded higher velocity and higher recovery rates (P < 0.05 for each) than that processed in 50-ml tubes. Sperm recovery rate was not affected (P > 0.05) by column height of gradient. Increasing sperm number subjected to gradient centrifugation decreased (P < 0.05) sperm recovery rate when 15-ml tubes were used. Copyright © 2012 Elsevier Inc. All rights reserved.
Impact of fair bowel preparation quality on adenoma and serrated polyp detection: data from the New Hampshire colonoscopy registry by using a standardized preparation-quality rating.

PubMed

Anderson, Joseph C; Butterly, Lynn F; Robinson, Christina M; Goodrich, Martha; Weiss, Julia E

2014-09-01

The effect of colon preparation quality on adenoma detection rates (ADRs) is unclear, partly because of lack of uniform colon preparation ratings in prior studies. The New Hampshire Colonoscopy Registry collects detailed data from colonoscopies statewide, by using a uniform preparation quality scale after the endoscopist has cleaned the mucosa. To compare the overall and proximal ADR and serrated polyp detection rates (SDR) in colonoscopies with differing levels of colon preparation quality. Cross-sectional. New Hampshire statewide registry. Patients undergoing colonoscopy. We examined colon preparation quality for 13,022 colonoscopies, graded by using specific descriptions provided to endoscopists. ADR and SDR are the number of colonoscopies with at least 1 adenoma or serrated polyp (excluding those in the rectum and/or sigmoid colon) detected divided by the total number of colonoscopies, for the preparation categories: optimal (excellent and/or good), fair, and poor. Overall/proximal ADR/SDR. The overall detection rates in examinations with fair colon preparation quality (SDR 8.9%; 95% confidence interval [CI], 7.4-10.7, ADR 27.1%; 95% CI, 24.6-30.0) were similar to rates observed in colonoscopies with optimal preparation quality (SDR 8.8%; 95% CI, 8.3-9.4, ADR 26.3%; 95% CI, 25.6-27.2). This finding also was observed for rates in the proximal colon. A logistic regression model (including withdrawal time) found that proximal ADR was statistically lower in the poor preparation category (odds ratio 0.45; 95% CI, 0.24-0.84; P < .01) than in adequately prepared colons. Homogeneous population. In our sample, there was no significant difference in overall or proximal ADR or SDR between colonoscopies with fair versus optimal colon preparation quality. Poor colon preparation quality may reduce the proximal ADR. Published by Mosby, Inc.
Orbital Light Curves of UU Aquarii in Stunted Outburst

NASA Astrophysics Data System (ADS)

Robertson, J. W.; Honeycutt, R. K.; Henden, A. A.; Campbell, R. T.

2018-02-01

Stunted outbursts are ∼0.ͫ6 eruptions, typically lasting 5–10 days, which are found in some novalike cataclysmic variables, including UU Aqr. The mechanism responsible for stunted outbursts is uncertain but is likely related to an accretion disk instability or to variations in the mass transfer rate. A campaign to monitor the eclipse light curves in UU Aqr has been conducted in order to detect any light curve distortions due to the appearance of a hot spot on the disk at the location of the impact point of the accretion stream. If stunted outbursts are due to a temporary mass transfer enhancement, then predictable deformations of the orbital light curve are expected to occur during such outbursts. This study used 156 eclipses on 135 nights during the years 2000–2012. During this interval, random samples found the system to be in stunted outbursts 4%–5% of the time, yielding ∼7 eclipses obtained during some stage of stunted outburst. About half of the eclipses obtained during stunted outbursts showed clear evidence for hot spot enhancement, providing strong evidence that the stunted outbursts in UU Aqr are associated with mass transfer variations. The other half of the eclipses during stunted outburst showed little or no evidence for hot spot enhancement. Furthermore, there were no systematic changes in the hot spot signature as stunted outbursts progressed. Therefore, we have tentatively attributed the changes in hot spot visibility during stunted outburst to random blobby accretion, which likely further modulates the strength of the accretion stream on orbital timescales.
Examining Changes to Michigan's Early Childhood Quality Rating and Improvement System (QRIS). REL 2015-029

ERIC Educational Resources Information Center

Faria, Ann-Marie; Hawkinson, Laura E.; Greenberg, Ariela C.; Howard, Eboni C.; Brown, Leah

2015-01-01

Documenting and improving early childhood program quality is a national priority, leading to a rapid expansion of Quality Rating and Improvement Systems (QRISs). QRISs document and improve the quality of early childhood education programs and provide clear information to families about their child care choices. The current study described how…
Quality of Child Care Using the Environment Rating Scales: A Meta-Analysis of International Studies

ERIC Educational Resources Information Center

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

2016-01-01

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

PubMed Central

Landsberger, David M.; Vermeire, Katrien; Claes, Annes; Van Rompaey, Vincent; Van de Heyning, Paul

2015-01-01

Objectives Although it has been previously shown that changes in temporal coding produce changes in pitch in all cochlear regions, research has suggested that temporal coding might be best encoded in relatively apical locations. We hypothesized that although temporal coding may provide useable information at any cochlear location, low rates of stimulation might provide better sound quality in apical regions that are more likely to encode temporal information in the normal ear. In the present study, sound qualities of single electrode pulse trains were scaled to provide insight into the combined effects of cochlear location and stimulation rate on sound quality. Design Ten long term users of MED-EL cochlear implants with 31 mm electrode arrays (Standard or FLEXSOFT) were asked to scale the sound quality of single electrode pulse trains in terms of how “Clean”, “Noisy”, “High”, and “Annoying” they sounded. Pulse trains were presented on most electrodes between 1 and 12 representing the entire range of the long electrode array at stimulation rates of 100, 150, 200, 400, or 1500 pulses per second. Results While high rates of stimulation are scaled as having a “Clean” sound quality across the entire array, only the most apical electrodes (typically 1 through 3) were considered “Clean” at low rates. Low rates on electrodes 6 through 12 were not rated as “Clean” while the low rate quality of electrodes 4 and 5 were typically in between. Scaling of “Noisy” responses provided an approximately inverse pattern as “Clean” responses. “High” responses show the trade-off between rate and place of stimulation on pitch. Because “High” responses did not correlate with “Clean” responses, subjects were not rating sound quality based on pitch. Conclusions If explicit temporal coding is to be provided in a cochlear implant, it is likely to sound better when provided apically. Additionally, the finding that low rates sound clean only at
Rating the raters: assessing the quality of Hamilton rating scale for depression clinical interviews in two industry-sponsored clinical drug trials.

PubMed

Engelhardt, Nina; Feiger, Alan D; Cogger, Kenneth O; Sikich, Dawn; DeBrota, David J; Lipsitz, Joshua D; Kobak, Kenneth A; Evans, Kenneth R; Potter, William Z

2006-02-01

The quality of clinical interviews conducted in industry-sponsored clinical drug trials is an important but frequently overlooked variable that may influence the outcome of a study. We evaluated the quality of Hamilton Rating Scale for Depression (HAM-D) clinical interviews performed at baseline in 2 similar multicenter, randomized, placebo-controlled depression trials sponsored by 2 pharmaceutical companies. A total of 104 audiotaped HAM-D clinical interviews were evaluated by a blinded expert reviewer for interview quality using the Rater Applied Performance Scale (RAPS). The RAPS assesses adherence to a structured interview guide, clarification of and follow-up to patient responses, neutrality, rapport, and adequacy of information obtained. HAM-D interviews were brief and cursory and the quality of interviews was below what would be expected in a clinical drug trial. Thirty-nine percent of the interviews were conducted in 10 minutes or less, and most interviews were rated fair or unsatisfactory on most RAPS dimensions. Results from our small sample illustrate that the clinical interview skills of raters who administered the HAM-D were below what many would consider acceptable. Evaluation and training of clinical interview skills should be considered as part of a rater training program.
Absolute Parameters for the F-type Eclipsing Binary BW Aquarii

NASA Astrophysics Data System (ADS)

Maxted, P. F. L.

2018-05-01

BW Aqr is a bright eclipsing binary star containing a pair of F7V stars. The absolute parameters of this binary (masses, radii, etc.) are known to good precision so they are often used to test stellar models, particularly in studies of convective overshooting. ... Maxted & Hutcheon (2018) analysed the Kepler K2 data for BW Aqr and noted that it shows variability between the eclipses that may be caused by tidally induced pulsations. ... Table 1 shows the absolute parameters for BW Aqr derived from an improved analysis of the Kepler K2 light curve plus the RV measurements from both Imbert (1979) and Lester & Gies (2018). ... The values in Table 1 with their robust error estimates from the standard deviation of the mean are consistent with the values and errors from Maxted & Hutcheon (2018) based on the PPD calculated using emcee for a fit to the entire K2 light curve.
Spectral analysis of epicardial 60-lead electrograms in dogs with 4-week-old myocardial infarction.

PubMed

Hosoya, Y; Ikeda, K; Komatsu, T; Yamaki, M; Kubota, I

2001-01-01

There were few studies on the spectral analysis of multiple-lead epicardial electrograms in chronic myocardial infarction. Spectral analysis of multi-lead epicardial electrograms was performed in 6 sham-operated dogs (N group) and 8 dogs with 4-week-old myocardial infarction (MI group). Four weeks after the ligation of left anterior descending coronary artery, fast Fourier transform was performed on 60-lead epicardial electrograms, and then inverse transform was performed on 5 frequency ranges from 0 to 250 Hz. From the QRS onset to QRS offset, the time integration of unsigned value of reconstructed waveform was calculated and displayed as AQRS maps. On 0-25 Hz AQRS map, there was no significant difference between the 2 groups. In the frequency ranges of 25-250 Hz, MI group had significantly smaller AQRS values than N group solely in the infarct zone. It was shown that high frequency potentials (25-250 Hz) within QRS complex were reduced in the infarct zone.
Effects of dietary quality on basal metabolic rate and internal morphology of European starlings (Sturnus vulgaris)

USGS Publications Warehouse

Geluso, Keith; Hayes, J.P.

1999-01-01

European starlings (Sturnus vulgaris) were fed either a low- or high-quality diet to test the effects of dietary quality on basal metabolic rate (BMR) and internal morphology. Basal metabolic rate did not differ significantly between the two dietary groups, but internal morphology differed greatly. Starlings fed the low-quality diet had heavier gastrointestinal tracts, gizzards, and livers. Starlings fed the high-quality diet had heavier breast muscles. Starlings on the low-quality diet maintained mass, while starlings on the high-quality diet gained mass. Dry matter digestibility and energy digestibility were lower for starlings fed the low-quality diet, and their food and water intake were greater than starlings on the high-quality diet. The lack of dietary effect on BMR may be the result of increased energy expenditure of digestive organs paralleling a reduction of energy expenditure of organs and tissues not related to digestion (i.e., skeletal muscle). This trade-off in energy allocation among organs suggests a mechanism by which organisms may alter BMR in response to a change in seasonal variation in food availability.

Los Angeles County Steps to Excellence Project: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of Los Angeles County's Steps to Excellence Project prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs;…
Comparison of broiler litter and commercial fertilizer at equivalent N rates on soil quality

USDA-ARS?s Scientific Manuscript database

A 3-year study was conducted to determine the effects of variable rates of broiler litter relative to inorganic fertilizer at equivalent N rates on soil nutrient content and quality in an upland Granada silt loam (fine-silty, mixed, active, Thermic, Fraglossudalfs) soil. Treatments included annual b...
QualComp: a new lossy compressor for quality scores based on rate distortion theory

PubMed Central

2013-01-01

Background Next Generation Sequencing technologies have revolutionized many fields in biology by reducing the time and cost required for sequencing. As a result, large amounts of sequencing data are being generated. A typical sequencing data file may occupy tens or even hundreds of gigabytes of disk space, prohibitively large for many users. This data consists of both the nucleotide sequences and per-base quality scores that indicate the level of confidence in the readout of these sequences. Quality scores account for about half of the required disk space in the commonly used FASTQ format (before compression), and therefore the compression of the quality scores can significantly reduce storage requirements and speed up analysis and transmission of sequencing data. Results In this paper, we present a new scheme for the lossy compression of the quality scores, to address the problem of storage. Our framework allows the user to specify the rate (bits per quality score) prior to compression, independent of the data to be compressed. Our algorithm can work at any rate, unlike other lossy compression algorithms. We envisage our algorithm as being part of a more general compression scheme that works with the entire FASTQ file. Numerical experiments show that we can achieve a better mean squared error (MSE) for small rates (bits per quality score) than other lossy compression schemes. For the organism PhiX, whose assembled genome is known and assumed to be correct, we show that it is possible to achieve a significant reduction in size with little compromise in performance on downstream applications (e.g., alignment). Conclusions QualComp is an open source software package, written in C and freely available for download at https://sourceforge.net/projects/qualcomp. PMID:23758828
Audit and Feedback: A Quality Improvement Study to Increase Pneumococcal Vaccination Rates.

PubMed

Clark, Rebecca Culver; Carter, Kimberly Ferren; Jackson, Julie; Hodges, Deborah

The purpose of this quality improvement study was to explore the impact of audit and feedback on the pneumococcal immunization rate for at-risk adults in ambulatory settings. Study findings support the hypothesis that timely, individualized audit and feedback can have a positive impact on immunization rate; generalized feedback that did not provide actionable information did not have the same impact. The difference between the interventions was significant, χ (1, N = 1993) = 124.7, P <.001.
USING WINTER FLOUNDER GROWTH RATES AND STABLE ISOTOPES TO ASSESS HABITAT QUALITY

EPA Science Inventory

We used winter flounder growth rates and stable isotopes to assess habitat quality across an anthropogenic gradient in Narragansett Bay, Rhode Island. Cages (1 m2) were placed in the Providence River which had the highest nutrient concentrations and greatest development, Prudence...
Publication Ratings versus Peer Ratings of Universities

ERIC Educational Resources Information Center

Anderson, Richard C.; And Others

1978-01-01

A quantitative comparison of peer versus bibliometric procedures for rating the quality of U.S. universities is presented. The quality of graduate faculty is measured by the Roose-Andersen peer rating, while bibliometric ratings are based on the number, average "quality," and total influence of university papers in each field.…
How do women with chronic fatigue syndrome/myalgic encephalomyelitis rate quality and coordination of healthcare services? A cross-sectional study.

PubMed

Hansen, Anne Helen; Lian, Olaug S

2016-04-04

To test the association between self-rated health and self-rated degree of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and CFS/ME patients' assessment of quality of primary care, specialist care and coordination of care. Cross-sectional study. Self-reported questionnaire data from women members of The Norwegian ME Association obtained in 2013. 431 women with CFS/ME aged 16-73 years. The participants' assessment of quality in primary care, specialist care and in coordination of care (good/very good or poor/very poor). Main explanatory variables: self-rated health and self-rated degree of CFS/ME. Quality of care was rated poor by 60.6% in primary care, by 47.7% in specialist care, and by 71.2% regarding coordination of care. Poorer self-rated health increased the probability of rating quality in primary care poor, particularly among women 40 years and over (OR 2.38, 95% CI 1.63 to 3.49), women with university education (OR 2.57, CI 1.68 to 3.94), and owing to less frequent general practitioner (GP) visits (OR 2.46, CI 1.60 to 3.78). Poorer self-rated health increased the probability of rating quality poor in specialist care (OR 1.38, CI 1.05 to 1.82), but not in coordination of care. A more severe CFS/ME was associated with a higher probability of rating quality in primary care poor (OR 0.61, CI 0.38 to 0.93). Frequent visitors and those with a long GP relationship were less likely to report primary care quality as poor. A large proportion of women with CFS/ME rated quality of care poor/very poor in primary care, specialist care and in coordination of care. The dissatisfaction was higher for primary care than for specialist care. Overall, poorer self-rated health and a more severe CFS/ME were associated with lower quality scores in primary and specialist care, but not in coordination of care. Healthcare services, as assessed by women with CFS/ME, do have a large potential for improvement. Published by the BMJ Publishing Group Limited. For
Swithchgrass biomass quality as affected by nitrogen rate, harvest time and storage

USDA-ARS?s Scientific Manuscript database

The main purpose of this study was to assess the sustainability of switchgrass biomass quality as affected by storage after harvesting, delaying the harvest time, and applying different rates of nitrogen (N). The present study was conducted at Bristol, South Dakota under switchgrass land previously ...
Predictors of family caregiver ratings of patient quality of life in Alzheimer disease: cross-sectional results from the Canadian Alzheimer's Disease Quality of Life Study.

PubMed

Naglie, Gary; Hogan, David B; Krahn, Murray; Black, Sandra E; Beattie, B Lynn; Patterson, Christopher; Macknight, Chris; Freedman, Morris; Borrie, Michael; Byszewski, Anna; Bergman, Howard; Streiner, David; Irvine, Jane; Ritvo, Paul; Comrie, Janna; Kowgier, Matthew; Tomlinson, George

2011-10-01

To assess whether the core symptoms of Alzheimer disease (AD) and caregiver factors consistently predict family caregiver ratings of patient quality of life (QOL) as assessed by a variety of QOL measures in a large national sample. : Cross-sectional. Fifteen dementia and geriatric clinics across Canada. : Family caregivers (n = 412) of community-living patients with AD of all severities. Caregiver ratings of patient QOL using three utility indexes, the European Quality of Life-5 Dimensions, Quality of Well-Being Scale and Health Utilities Index; a global QOL visual analogue scale; a disease-specific measure, the Quality of Life-Alzheimer's Disease; and a generic health status measure, the Short Form-36. Patient cognition was assessed with the cognitive subscale of the Alzheimer's Disease Assessment Scale and Mini-Mental State Examination, function with the Disability Assessment for Dementia, and behavioral and psychological symptoms with the Neuropsychiatric Inventory and the Geriatric Depression Scale. Caregiver burden was assessed with the Zarit Burden Interview and caregiver depression with the Center for Epidemiologic Studies Depression scale. One-way analysis of variance and fully adjusted multiple linear regression were used to assess the relationship between patient dementia symptom and caregiver variables with QOL ratings. In multivariable analyses, caregiver ratings of patient function and depressive symptoms were the only consistent independent predictors of caregiver-rated QOL across the QOL measures. Caregiver ratings of patient function and depression were consistent independent predictors of caregiver-rated QOL, using a spectrum of QOL measures, while measures of patient cognition and caregiver burden and depression were not. These findings support the continued use of caregiver ratings as an important source of information about patient QOL and endorse the inclusion in AD clinical trials of caregiver-rated measures of patient function, depression
Perception gap in quality-of-life ratings: an empirical investigation of nursing home residents and caregivers.

PubMed

Mittal, Vikas; Rosen, Jules; Govind, Rahul; Degenholtz, Howard; Shingala, Sunil; Hulland, Shelley; Rhee, Yongjoo; Kastango, Kari B; Mulsant, Benoit H; Castle, Nick; Rubin, Fred H; Nace, David

2007-04-01

Several studies have previously documented the existence of a perception gap-the extent to which quality-of-life ratings provided by nursing home residents and caregivers diverge. In this study we use Helson's adaptation-level theory to investigate three types of antecedents: (a) focal factors, (b) background factors, and (c) residual factors. We calculated the perception gap for 11 quality-of-life domains. Caregivers rated both job satisfaction and their perception of quality of life of residents in the unit where they provided service. Concurrently, residents from these units completed quality-of-life interviews. We computed the perception gap by subtracting the residents' ratings from the caregivers' ratings for each quality-of-life domain. We conducted a hierarchical linear model using 3,850 observations to predict the perception gap. Caregivers perceive quality of life to be lower than residents do across all domains fairly consistently. Caregiver demographics do not directly predict the perception gap. However, satisfaction with work, pay, and promotion were significant predictors (p <.05), and satisfaction with supervisor was a marginally significant predictor (p <.10), of the perception gap. As satisfaction with these job dimensions increased, the perception gap decreased. Additional models show that several caregiver demographics directly influence job-satisfaction dimensions, though they did not influence the perception gap. Job-satisfaction dimensions, rather than caregiver characteristics, are the appropriate predictors of the perception gap. However, caregiver demographics exert their influence indirectly by means of job satisfaction. A key finding is that higher job satisfaction leads to a smaller perception gap. Helson's adaptation-level theory appears to be a useful approach for understanding the antecedents of the perception gap.
Quality ratings of frequency-compressed speech by participants with extensive high-frequency dead regions in the cochlea

PubMed Central

Salorio-Corbetto, Marina; Baer, Thomas; Moore, Brian C. J.

2017-01-01

Abstract Objective: The objective was to assess the degradation of speech sound quality produced by frequency compression for listeners with extensive high-frequency dead regions (DRs). Design: Quality ratings were obtained using values of the starting frequency (Sf) of the frequency compression both below and above the estimated edge frequency, fe, of each DR. Thus, the value of Sf often fell below the lowest value currently used in clinical practice. Several compression ratios were used for each value of Sf. Stimuli were sentences processed via a prototype hearing aid based on Phonak Exélia Art P. Study sample: Five participants (eight ears) with extensive high-frequency DRs were tested. Results: Reductions of sound-quality produced by frequency compression were small to moderate. Ratings decreased significantly with decreasing Sf and increasing CR. The mean ratings were lowest for the lowest Sf and highest CR. Ratings varied across participants, with one participant rating frequency compression lower than no frequency compression even when Sf was above fe. Conclusions: Frequency compression degraded sound quality somewhat for this small group of participants with extensive high-frequency DRs. The degradation was greater for lower values of Sf relative to fe, and for greater values of CR. Results varied across participants. PMID:27724057
Children's Sleep and Autonomic Function: Low Sleep Quality Has an Impact on Heart Rate Variability

PubMed Central

Michels, Nathalie; Clays, Els; De Buyzere, Marc; Vanaelst, Barbara; De Henauw, Stefaan; Sioen, Isabelle

2013-01-01

Objectives: Short sleep duration and poor sleep quality in children have been associated with concentration, problem behavior, and emotional instability, but recently also with disrupted autonomic nervous function, which predicts cardiovascular health. Heart rate variability (HRV) was used as noninvasive indicator of autonomic function to examine the influence of sleep. Design: Cross-sectional and longitudinal observational study on the effect of sleep on HRV Participants: Belgian children (5-11 years) of the ChiBS study in 2010 (N = 334) and 2011 (N = 293). Interventions: N/A. Methods: Sleep duration was reported and in a subgroup sleep quality (efficiency, latency, awakenings) was measured with accelerometry. High-frequency (HF) power and autonomic balance (LF/HF) were calculated on supine 5-minute HRV measurements. Stress was measured by emotion and problem behavior questionnaires. Sleep duration and quality were used as HRV predictors in corrected cross-sectional and longitudinal regressions. Stress was tested as mediator (intermediate pathway) or moderator (interaction) in sleep-HRV associations. Results: In both cross-sectional and longitudinal analyses, long sleep latency could predict lower HF (parasympathetic activity), while nocturnal awakenings, sleep latency, low sleep efficiency, and low corrected sleep duration were related to higher LF/HF (sympathetic/parasympathetic balance). Parental reported sleep duration was not associated with HRV. The significances remained after correction for stress. Stress was not a mediator, but a moderator (enhancer) in the relationship between sleep quality and HRV. Conclusions: Low sleep quality but not parent-reported low sleep duration leads to an unhealthier heart rate variability pattern (sympathetic over parasympathetic dominance). This stresses the importance of good sleep quality for cardiovascular health in children. Citation: Michels N; Clays E; De Buyzere M; Vanaelst B; De Henauw S; Sioen I. Children's sleep
Changes in dialysis treatment modalities during institution of flat rate reimbursement and quality assurance programs.

PubMed

Kleophas, Werner; Karaboyas, Angelo; Li, Yun; Bommer, Juergen; Reichel, Helmut; Walter, Andreas; Icks, Andrea; Rump, Lars C; Pisoni, Ronald L; Robinson, Bruce M; Port, Friedrich K

2013-09-01

Dialysis procedure rates in Germany were changed in 2002 from per-session to weekly flat rate payments, and quality assurance was introduced in 2009 with defined treatment targets for spKt/V, dialysis frequency, treatment time, and hemoglobin. In order to understand trends in treatment parameters before and after the introduction of these changes, we analyzed data from 407 to 618 prevalent patients each year (hemodialysis over 90 days) in 14-21 centers in cross-sections of the Dialysis Outcomes and Practice Patterns Study (phases 1-4, 1998-2011). Descriptive statistics were used to report differences over time in the four quality assurance parameters along with erythropoietin-stimulating agent (ESA) and intravenous iron doses. Time trends were analyzed using linear mixed models adjusted for patient demographics and comorbidities. The proportion of patients with short treatment times (less than 4 h) and low spKt/V (below 1.2) improved throughout the study and was lowest after implementation of quality assurance. Hemoglobin levels have increased since 1998 and remained consistent since 2005, with only 8-10% of patients below 10 g/dl. About 90% of patients were prescribed ESAs, with the dose declining since peaking in 2006. Intravenous iron use was highest in 2011. Hence, trends to improve quality metrics for hemodialysis have been established in Germany even after introduction of flat rate reimbursement. Thus, analysis of facility practice patterns is needed to maintain quality of care in a cost-containment environment.
Online physician ratings fail to predict actual performance on measures of quality, value, and peer review.

PubMed

Daskivich, Timothy J; Houman, Justin; Fuller, Garth; Black, Jeanne T; Kim, Hyung L; Spiegel, Brennan

2018-04-01

Patients use online consumer ratings to identify high-performing physicians, but it is unclear if ratings are valid measures of clinical performance. We sought to determine whether online ratings of specialist physicians from 5 platforms predict quality of care, value of care, and peer-assessed physician performance. We conducted an observational study of 78 physicians representing 8 medical and surgical specialties. We assessed the association of consumer ratings with specialty-specific performance scores (metrics including adherence to Choosing Wisely measures, 30-day readmissions, length of stay, and adjusted cost of care), primary care physician peer-review scores, and administrator peer-review scores. Across ratings platforms, multivariable models showed no significant association between mean consumer ratings and specialty-specific performance scores (β-coefficient range, -0.04, 0.04), primary care physician scores (β-coefficient range, -0.01, 0.3), and administrator scores (β-coefficient range, -0.2, 0.1). There was no association between ratings and score subdomains addressing quality or value-based care. Among physicians in the lowest quartile of specialty-specific performance scores, only 5%-32% had consumer ratings in the lowest quartile across platforms. Ratings were consistent across platforms; a physician's score on one platform significantly predicted his/her score on another in 5 of 10 comparisons. Online ratings of specialist physicians do not predict objective measures of quality of care or peer assessment of clinical performance. Scores are consistent across platforms, suggesting that they jointly measure a latent construct that is unrelated to performance. Online consumer ratings should not be used in isolation to select physicians, given their poor association with clinical performance.
Quality Improvement Initiatives Lead to Reduction in Nulliparous Term Singleton Vertex Cesarean Delivery Rate

PubMed Central

Vadnais, Mary A.; Hacker, Michele R.; Shah, Neel T.; Jordan, JoAnn; Modest, Anna M.; Siegel, Molly; Golen, Toni H.

2018-01-01

Background The nulliparous term singleton vertex (NTSV) cesarean delivery rate has been recognized as a meaningful benchmark. Variation in the NTSV cesarean delivery rate among hospitals and providers suggests many hospitals may be able to safely improve their rates. The NTSV cesarean delivery rate at the authors’ institution was higher than state and national averages. This study was conducted to determine the influence of a set of quality improvement interventions on the NTSV cesarean delivery rate. Methods From 2008 through 2015, at a single tertiary care academic medical center, a multi-strategy approach that included provider education, provider feedback, and implementation of new policies was used to target evidence-based and inferred factors that influence the NTSV cesarean delivery rate. Data on mode of delivery, maternal outcomes, and neonatal outcomes were collected from birth certificates and administrative claims data. The Cochran-Armitage test and linear regression were used to calculate the p-trend for categorical and continuous variables, respectively. Results More than 20,000 NTSV deliveries were analyzed, including more than 15,000 during the intervention period. The NTSV cesarean delivery rate declined from 35% to 21% over eight years. The total cesarean delivery rate declined as well. Increase in meconium aspiration syndrome and maternal transfusion were observed. Conclusion Quality improvement initiatives can decrease the NTSV cesarean delivery rate. Any increased incidence of fetal or maternal complications associated with decreased NTSV cesarean delivery rate should be considered in the context of the risks and benefits of vaginal delivery compared to cesarean delivery. PMID:28334563
Detecting When “Quality of Life” Has Been “Enhanced”: Estimating Change in Quality of Life Ratings

PubMed Central

Tractenberg, Rochelle E.; Yumoto, Futoshi; Aisen, Paul S.

2015-01-01

Objective To demonstrate challenges in the estimation of change in quality of life (QOL). Methods Data were taken from a completed clinical trial with negative results. Responses to 13 QOL items were obtained 12 months apart from 258 persons with Alzheimer’s disease (AD) participating in a randomized, placebo-controlled clinical trial with two treatment arms. Two analyses to estimate whether “change” in QOL occurred over 12 months are described. A simple difference (later - earlier) was calculated from total scores (standard approach). A Qualified Change algorithm (novel approach) was applied to each item: differences in ratings were classified as either: improved, worsened, stayed poor, or stayed “positive” (fair, good, excellent). The strengths of evidence supporting a claim that “QOL changed”, derived from the two analyses, were compared by considering plausible alternative explanations for, and interpretations of, results obtained under each approach. Results Total score approach: QOL total scores decreased, on average, in the two treatment (both −1.0, p < 0.05), but not the placebo (=−0.59, p > 0.3) groups. Qualified change approach: Roughly 60% of all change in QOL items was worsening in every arm; 17% - 42% of all subjects experienced change in each item. Conclusions Totalling the subjective QOL item ratings collapses over items, and suggests a potentially misleading “overall” level of change (or no change, as in the placebo arm). Leaving the items as individual components of “quality” of life they were intended to capture, and qualifying the direction and amount of change in each, suggests that at least 17% of any group experienced change on every item, with 60% of all observed change being worsening. Discussion Summarizing QOL item ratings as a total “score” collapses over the face-valid, multi-dimensional components of the construct “quality of life”. Qualified Change provides robust evidence of changes to QOL or �
New Mexico Look for the STARS--AIM HIGH: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

This paper presents a profile of New Mexico's Look for the STARS--AIM HIGH prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…
A Systematic Review of Methods for Evaluating Rating Quality in Language Assessment

ERIC Educational Resources Information Center

Wind, Stefanie A.; Peterson, Meghan E.

2018-01-01

The use of assessments that require rater judgment (i.e., rater-mediated assessments) has become increasingly popular in high-stakes language assessments worldwide. Using a systematic literature review, the purpose of this study is to identify and explore the dominant methods for evaluating rating quality within the context of research on…
Using Student Ratings to Measure Quality of Teaching in Six European Countries

ERIC Educational Resources Information Center

Kyriakides, Leonidas; Creemers, Bert P. M.; Panayiotou, Anastasia; Vanlaar, Gudrun; Pfeifer, Michael; Cankar, Gašper; McMahon, Léan

2014-01-01

This paper argues for the value of using student ratings to measure quality of teaching. An international study to test the validity of the dynamic model of educational effectiveness was conducted. At classroom level, the model consists of eight factors relating to teacher behaviour: orientation, structuring, questioning, teaching modelling,…
Do We Need to Weight Satisfaction Scores with Importance Ratings in Measuring Quality of Life?

ERIC Educational Resources Information Center

Wu, Chia-Huei; Yao, Grace

2006-01-01

Trauer and Mackinnon (2001; Quality of life research 10, pp. 579-585) recently proposed that weighting satisfaction scores by importance ratings in measuring quality of life is undesirable and unnecessary. However, they didn't use empirical data to support their claim. In this study, different weighting algorithms developed by Cummins (1997;…

GRADE guidelines: 5. Rating the quality of evidence--publication bias.

PubMed

Guyatt, Gordon H; Oxman, Andrew D; Montori, Victor; Vist, Gunn; Kunz, Regina; Brozek, Jan; Alonso-Coello, Pablo; Djulbegovic, Ben; Atkins, David; Falck-Ytter, Yngve; Williams, John W; Meerpohl, Joerg; Norris, Susan L; Akl, Elie A; Schünemann, Holger J

2011-12-01

In the GRADE approach, randomized trials start as high-quality evidence and observational studies as low-quality evidence, but both can be rated down if a body of evidence is associated with a high risk of publication bias. Even when individual studies included in best-evidence summaries have a low risk of bias, publication bias can result in substantial overestimates of effect. Authors should suspect publication bias when available evidence comes from a number of small studies, most of which have been commercially funded. A number of approaches based on examination of the pattern of data are available to help assess publication bias. The most popular of these is the funnel plot; all, however, have substantial limitations. Publication bias is likely frequent, and caution in the face of early results, particularly with small sample size and number of events, is warranted. Copyright © 2011 Elsevier Inc. All rights reserved.
Increasing recruitment rates in an inpatient clinical research study using quality improvement methods.

PubMed

Sauers, Hadley S; Beck, Andrew F; Kahn, Robert S; Simmons, Jeffrey M

2014-11-01

One important benefit of successful patient recruitment is increased generalizability of findings. We sought to optimize enrollment of children admitted with asthma as part of a population-based, prospective, observational cohort study with the goal of enrolling at least 60% of all eligible and staffed patients. Quality improvement methods were used to improve cohort recruitment. Weekly meetings with study staff and study leadership were held to plan and discuss how to maximize recruitment rates. Significant initial variability in recruitment success prompted the team to use small-scale tests of change to increase recruitment numbers. A number of tests were trialed, focusing primarily on reducing patient refusals and improving recruitment process efficiency. Recruitment rates were calculated by dividing eligible by enrolled patients and displayed using annotated Shewhart control charts. Control charts were used to illustrate week-to-week variability while also enabling differentiation of common-cause and special-cause variation. The study enrolled 774 patients, representing 54% of all eligible and 59% of those eligible for whom staff were available to enroll. Our mean weekly recruitment rate increased from 55% during the first 3 months of the study to a statistically significant sustained rate of 61%. This was sustained given numerous obstacles, such as departing and hiring of staff and adding a second recruitment location. Implementing quality improvement methods within a larger research study led to an increase in the rate of recruitment as well as the stability in recruitment rates from week-to-week. Copyright © 2014 by the American Academy of Pediatrics.
Fieldwork measurement of indoor environmental quality (IEQ) in Malaysian platinum-rated green office buildings

NASA Astrophysics Data System (ADS)

Tharim, Asniza Hamimi Abdul; Samad, Muna Hanim Abdul; Ismail, Mazran

2017-10-01

An Indoor Environmental Quality (IEQ) fieldwork assessment was conducted in the Platinum-rated GBI office building located in Putrajaya Malaysia. The aim of the study is to determine the current indoor performance of the selected green office building. The field measurement consists of several IEQ parameters counted under the GBI Malaysia namely the Thermal Comfort of temperature, relative humidity, air movement and heat transfer as well as solar radiation. This field measurement also comprises of the measurement for the background noise, visual lighting and Indoor Air Quality (IAQ) focusing on the aspect of carbon dioxide concentration. All the selected indoor parameters were measured for the period of five working days and the results were compared to the Malaysian Standard. Findings of the field measurement show good indoor performance of the Platinum rated office building that complies with the GBI standard. It is hoped that the research findings will be beneficial for future design and construction of office building intended to be rated under the GBI Malaysia.
Quality Control of Structural MRI Images Applied Using FreeSurfer—A Hands-On Workflow to Rate Motion Artifacts

PubMed Central

Backhausen, Lea L.; Herting, Megan M.; Buse, Judith; Roessner, Veit; Smolka, Michael N.; Vetter, Nora C.

2016-01-01

In structural magnetic resonance imaging motion artifacts are common, especially when not scanning healthy young adults. It has been shown that motion affects the analysis with automated image-processing techniques (e.g., FreeSurfer). This can bias results. Several developmental and adult studies have found reduced volume and thickness of gray matter due to motion artifacts. Thus, quality control is necessary in order to ensure an acceptable level of quality and to define exclusion criteria of images (i.e., determine participants with most severe artifacts). However, information about the quality control workflow and image exclusion procedure is largely lacking in the current literature and the existing rating systems differ. Here, we propose a stringent workflow of quality control steps during and after acquisition of T1-weighted images, which enables researchers dealing with populations that are typically affected by motion artifacts to enhance data quality and maximize sample sizes. As an underlying aim we established a thorough quality control rating system for T1-weighted images and applied it to the analysis of developmental clinical data using the automated processing pipeline FreeSurfer. This hands-on workflow and quality control rating system will aid researchers in minimizing motion artifacts in the final data set, and therefore enhance the quality of structural magnetic resonance imaging studies. PMID:27999528
Measurement Quality of the Chinese Early Childhood Program Rating Scale: An Investigation Using Multivariate Generalizability Theory

ERIC Educational Resources Information Center

Chen, Dezhi; Hu, Bi Ying; Fan, Xitao; Li, Kejian

2014-01-01

Adapted from the Early Childhood Environment Rating Scale-Revised, the Chinese Early Childhood Program Rating Scale (CECPRS) is a culturally comparable measure for assessing the quality of early childhood education and care programs in the Chinese cultural/social contexts. In this study, 176 kindergarten classrooms were rated with CECPRS on eight…
Measuring Infiltration Rates in Homes as a Basis for Understanding Indoor Air Quality

NASA Astrophysics Data System (ADS)

Jerz, G. G.; Lamb, B. K.; Pressley, S. N.; O'Keeffe, P.; Fuchs, M.; Kirk, M.

2015-12-01

Infiltration rates, or the rate of air exchange, of houses are important to understand because ventilation can be a dominate factor in determining indoor air quality. There are chemicals that are emitted from surfaces or point sources inside the home which are harmful to humans; these chemicals come from various objects including furniture, cleaning supplies, building materials, gas stoves, and the surrounding environment. The use of proper ventilation to cycle cleaner outdoor air into the house can be crucial for maintaining healthy living conditions in the home. At the same time, there can also be outdoor pollutants which infiltrate the house and contribute to poor indoor air quality. In either case, it is important to determine infiltration rates as a function of outdoor weather conditions, the house structure properties and indoor heating and cooling systems. In this work, the objective is to measure ventilation rates using periodic releases of a tracer gas and measuring how quickly the tracer concentration decays. CO2 will be used as the tracer gas because it is inert and harmless at low levels. An Arduino timer is connected to a release valve which controls the release of 9.00 SLPM of CO2 into the uptake vent within the test home. CO2 will be released until there is at least a 200 to 300 ppm increase above ambient indoor levels. Computers with CO2 sensors and temperature/pressure sensors attached will be used to record data from different locations within the home which will continuously record data up to a week. The results from these periodic ventilation measurements will be analyzed with respect to outdoor wind and temperature conditions and house structure properties. The data will be used to evaluate an established indoor air quality model.
Influence of chest compression rate guidance on the quality of cardiopulmonary resuscitation performed on manikins.

PubMed

Jäntti, H; Silfvast, T; Turpeinen, A; Kiviniemi, V; Uusaro, A

2009-04-01

The adequate chest compression rate during CPR is associated with improved haemodynamics and primary survival. To explore whether the use of a metronome would affect also chest compression depth beside the rate, we evaluated CPR quality using a metronome in a simulated CPR scenario. Forty-four experienced intensive care unit nurses participated in two-rescuer basic life support given to manikins in 10min scenarios. The target chest compression to ventilation ratio was 30:2 performed with bag and mask ventilation. The rescuer performing the compressions was changed every 2min. CPR was performed first without and then with a metronome that beeped 100 times per minute. The quality of CPR was analysed with manikin software. The effect of rescuer fatigue on CPR quality was analysed separately. The mean compression rate between ventilation pauses was 137+/-18compressions per minute (cpm) without and 98+/-2cpm with metronome guidance (p<0.001). The mean number of chest compressions actually performed was 104+/-12cpm without and 79+/-3cpm with the metronome (p<0.001). The mean compression depth during the scenario was 46.9+/-7.7mm without and 43.2+/-6.3mm with metronome guidance (p=0.09). The total number of chest compressions performed was 1022 without metronome guidance, 42% at the correct depth; and 780 with metronome guidance, 61% at the correct depth (p=0.09 for difference for percentage of compression with correct depth). Metronome guidance corrected chest compression rates for each compression cycle to within guideline recommendations, but did not affect chest compression quality or rescuer fatigue.
Improving rates of cotrimoxazole prophylaxis in resource-limited settings: implementation of a quality improvement approach.

PubMed

Bardfield, J; Agins, B; Palumbo, M; Wei, A L; Morris, J; Marston, B

2014-12-01

To demonstrate the effectiveness of quality improvement methods to monitor and improve administration of cotrimoxazole (CTX) prophylaxis to improve health outcomes among adults living with HIV/AIDS in low resource countries. Program evaluation. HIV/AIDS health care facilities in Uganda, Mozambique, Namibia and Haiti. Performance measures based on national guidelines are developed in each country. These may include CD4 monitoring, ART adherence and uptake of CTX prophylaxis. CTX prophylaxis is routinely selected, because it has been shown to reduce HIV-related morbidity and mortality. Patient records are sampled using a standard statistical table to achieve a minimum confidence interval of 90% with a spread of ±8% in participating clinics. If an electronic medical record is available, all patients are reviewed. Routine review of performance measures, usually every 6 months, is conducted to identify gaps in care. Improvement interventions are developed and implemented at health facilities, informed by performance results, and local/national public health priorities. Median clinic rates of CTX prophylaxis. Median performance rates of CTX prophylaxis generally improved for adult HIV+ patients between 2006 and 2013 across countries, with median clinic rates higher than baseline at follow-up in 16 of 18 groups of clinics implementing CTX -focused improvement projects. Quality management offers a data-driven method to improve the quality of HIV care in low resource countries. Application of improvement principles has been shown to be effective to increase the rates of CTX prophylaxis in national HIV programs in multiple countries. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
Quality Rating and Improvement System (QRIS) Validation Study Designs. CEELO FastFacts

ERIC Educational Resources Information Center

Schilder, D.

2013-01-01

In this "Fast Facts," a state has received Race to the Top Early Learning Challenge funds and is seeking information to inform the design of the Quality Rating and Improvement System (QRIS) validation study. The Center on Enhancing Early Learning Outcomes (CEELO) responds that according to Resnick (2012), validation of a QRIS is an…
A comprehensive database of quality-rated fossil ages for Sahul's Quaternary vertebrates.

PubMed

Rodríguez-Rey, Marta; Herrando-Pérez, Salvador; Brook, Barry W; Saltré, Frédérik; Alroy, John; Beeton, Nicholas; Bird, Michael I; Cooper, Alan; Gillespie, Richard; Jacobs, Zenobia; Johnson, Christopher N; Miller, Gifford H; Prideaux, Gavin J; Roberts, Richard G; Turney, Chris S M; Bradshaw, Corey J A

2016-07-19

The study of palaeo-chronologies using fossil data provides evidence for past ecological and evolutionary processes, and is therefore useful for predicting patterns and impacts of future environmental change. However, the robustness of inferences made from fossil ages relies heavily on both the quantity and quality of available data. We compiled Quaternary non-human vertebrate fossil ages from Sahul published up to 2013. This, the FosSahul database, includes 9,302 fossil records from 363 deposits, for a total of 478 species within 215 genera, of which 27 are from extinct and extant megafaunal species (2,559 records). We also provide a rating of reliability of individual absolute age based on the dating protocols and association between the dated materials and the fossil remains. Our proposed rating system identified 2,422 records with high-quality ages (i.e., a reduction of 74%). There are many applications of the database, including disentangling the confounding influences of hypothetical extinction drivers, better spatial distribution estimates of species relative to palaeo-climates, and potentially identifying new areas for fossil discovery.
Switchgrass Biomass Quality as Affected by Nitrogen Rate, Harvest Time, and Storage

DOE PAGES

Ibrahim, Mostafa; Hong, Chang Oh.; Singh, Shikha; ...

2017-01-25

The purpose of this study was to assess the changes in switchgrass (Panicum virgatum L.) biomass quality as affected by N rate, harvest time, and storage. This research was conducted near Bristol, SD, in 2010 and 2011. Treatments included three N rates (0, 56, and 112 kg N ha –1) applied annually and each N rate replicated four times. After a killing frost, all of the plots were harvested and baled in large round bales in October 2010 and November 2011. An area of about 30 m 2 from each plot was left unharvested to represent storage of standing switchgrassmore » over the winter and to determine dry matter yields. Switchgrass was analyzed for hemicellulose, cellulose, lignin, mineral elements, N, and C. In the first season, storage of the fall harvested switchgrass bales numerically increased the concentrations of hemicellulose, lignin, and N. In the second season, they increased significantly. Mineral elements significantly increased in both sampling seasons. Delaying harvest until spring decreased lignin, N, and mineral elements concentration, and increased cellulose and hemicellulose concentrations, but also reduced biomass yield. Results from this study suggest that delaying the switchgrass harvest until spring increased the overall feedstock quality for ethanol production, but yield reductions must be considered to determine the overall economic impact of a delayed harvest.« less
Switchgrass Biomass Quality as Affected by Nitrogen Rate, Harvest Time, and Storage

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

Ibrahim, Mostafa; Hong, Chang Oh.; Singh, Shikha

The purpose of this study was to assess the changes in switchgrass (Panicum virgatum L.) biomass quality as affected by N rate, harvest time, and storage. This research was conducted near Bristol, SD, in 2010 and 2011. Treatments included three N rates (0, 56, and 112 kg N ha –1) applied annually and each N rate replicated four times. After a killing frost, all of the plots were harvested and baled in large round bales in October 2010 and November 2011. An area of about 30 m 2 from each plot was left unharvested to represent storage of standing switchgrassmore » over the winter and to determine dry matter yields. Switchgrass was analyzed for hemicellulose, cellulose, lignin, mineral elements, N, and C. In the first season, storage of the fall harvested switchgrass bales numerically increased the concentrations of hemicellulose, lignin, and N. In the second season, they increased significantly. Mineral elements significantly increased in both sampling seasons. Delaying harvest until spring decreased lignin, N, and mineral elements concentration, and increased cellulose and hemicellulose concentrations, but also reduced biomass yield. Results from this study suggest that delaying the switchgrass harvest until spring increased the overall feedstock quality for ethanol production, but yield reductions must be considered to determine the overall economic impact of a delayed harvest.« less
Quality Rating and Improvement Systems for Early Care and Education. Early Childhood Highlights. Volume 1, Issue 1

ERIC Educational Resources Information Center

Child Trends, 2010

2010-01-01

Research suggests that high quality early care and education programs can have a significant impact on improving the cognitive, academic and social skills of all children, especially those most at risk for later school failure. A number of states are developing Quality Rating and Improvement Systems (QRIS) to assess and improve the quality of…
On Martell and Kaitchuck's model for the intermediate polar FO Aquarii

NASA Technical Reports Server (NTRS)

Mukai, Koji; Hellier, Coel

1992-01-01

Attention is given to the proposals of Martell and Kaitchuck (1991) that FO Aqr is a low-inclination system, rather than an eclipsing system, as recently claimed, and that the dominant periodicity (21 min) is the beat period rather than the white dwarf spin period, as is commonly supposed. It is shown that both proposals make it harder to understand the observations of this star, while there is no substantive evidence in their favor. It is concluded that FO Aqr is most likely a high-inclination system in which the secondary eclipses part of the accretion flow.
Non-invasive Fetal ECG Signal Quality Assessment for Multichannel Heart Rate Estimation.

PubMed

Andreotti, Fernando; Graser, Felix; Malberg, Hagen; Zaunseder, Sebastian

2017-12-01

The noninvasive fetal ECG (NI-FECG) from abdominal recordings offers novel prospects for prenatal monitoring. However, NI-FECG signals are corrupted by various nonstationary noise sources, making the processing of abdominal recordings a challenging task. In this paper, we present an online approach that dynamically assess the quality of NI-FECG to improve fetal heart rate (FHR) estimation. Using a naive Bayes classifier, state-of-the-art and novel signal quality indices (SQIs), and an existing adaptive Kalman filter, FHR estimation was improved. For the purpose of training and validating the proposed methods, a large annotated private clinical dataset was used. The suggested classification scheme demonstrated an accuracy of Krippendorff's alpha in determining the overall quality of NI-FECG signals. The proposed Kalman filter outperformed alternative methods for FHR estimation achieving accuracy. The proposed algorithm was able to reliably reflect changes of signal quality and can be used in improving FHR estimation. NI-ECG signal quality estimation and multichannel information fusion are largely unexplored topics. Based on previous works, multichannel FHR estimation is a field that could strongly benefit from such methods. The developed SQI algorithms as well as resulting classifier were made available under a GNU GPL open-source license and contributed to the FECGSYN toolbox.
Rating a Sports Medicine Surgeon's "Quality" in the Modern Era: an Analysis of Popular Physician Online Rating Websites.

PubMed

Nwachukwu, Benedict U; Adjei, Joshua; Trehan, Samir K; Chang, Brenda; Amoo-Achampong, Kelms; Nguyen, Joseph T; Taylor, Samuel A; McCormick, Frank; Ranawat, Anil S

2016-10-01

Consumer-driven healthcare and an increasing emphasis on quality metrics have encouraged patient engagement in the rating of healthcare. As such, online physician rating websites have become mainstream and may play a potential role in future healthcare policy. The purpose of this study was to evaluate online patient ratings for US sports medicine surgeons, determine predictors of positive ratings and analyze for inter-website scoring correlation. The American Orthopedic Society for Sports Medicine (AOSSM) member directory was sampled. Surgeon demographic and rating data were searched on three online physicians rating websites: HealthGrades.com (HG), RateMDs.com (RM) and Vitals.com (V). Written rating comments were categorized as relating to the following: surgeon competence, surgeon affability and process of care. Bivariate linear regression, Pearson correlation and multivariable analyses were used to determine factors associated with positive ratings. Two hundred seventy-five sports medicine surgeons were included. Two hundred seventy-one (99%) had ratings on at least one of the three websites. Sports surgeons were rated highly across all three websites (mean >4.0/5); however, there was only a low to moderate degree of correlation among websites. On HG, female surgeons and surgeons in academia were more likely to receive higher overall ratings. Across all three websites, increased number of years in practice inversely correlated with ratings; this relationship neared significance for HG and was significant for RM. A surgeon's online presence or geographic location was not associated with higher ratings. In multivariable regression analysis for ratings on HG, female sex was the only significant predictor of higher ratings. Two thousand three hundred forty-one written comments were analyzed: perceived surgeon competence and communication influenced the direction of ratings for the top and bottom tier surgeons. There was a low degree of correlation among online
Far Ultraviolet Spectroscopy of Seven Nova-Like Variables

NASA Astrophysics Data System (ADS)

Mizusawa, Trisha; Merritt, Jason; Ballouz, Ronald-Louis; Bonaro, Michael; Foran, Sean; Plumberg, Christopher; Stewart, Heather; Wiley, Trayer; Sion, Edward M.

2010-03-01

We present the results of a multicomponent synthetic spectral analysis of the archival far ultraviolet spectra of several key nova-like variables including members of the SW Sex, RW Tri, UX UMa, and VY Scl subclasses: KR Aur, RW Tri, V825 Her, V795 Her, BP Lyn, V425 Cas, and HL Aqr. Accretion rates as well as the possible flux contribution of the accreting white dwarf are included in our analysis. Except for RW Tri, which has a reliable trigonometric parallax, we computed the distances to the nova-like systems using the method of Knigge. Our analysis of seven archival IUE spectra of RW Tri at its parallax distance of 341 pc consistently indicates a low mass (˜0.4 M⊙) white dwarf and an average accretion rate, . For KR Aur, we estimate that the white dwarf has Teff = 29,000 ± 2000 K, log g = 8.4, and contributes 18% of the far-UV flux, while an accretion disk with accretion rate at an inclination of 41° contributes the remainder. We find that an accretion disk dominates the far-UV spectrum of V425 Cas but a white dwarf contributes nonnegligibly with approximately 18% of the far-UV flux. For the two high state nova-likes, HL Aqr and V825 Her, their accretion disks totally dominate with and 3 × 10-9 M⊙ yr-1, respectively. For BP Lyn we find while for V795 Her, we find an accretion rate of . We discuss the implications of our results for the evolutionary status of nova-like variables.
Effectiveness of a multi-component quality improvement intervention on rates of hyperglycaemia

PubMed Central

Franco, Thérèse; Aaronson, Barry; Brown, Laurel; Blackmore, Craig; Rupp, Stephen; Lee, Grace

2017-01-01

Purpose To evaluate the effectiveness of a multifaceted, hospital-wide glycaemic control quality improvement programme. Methods The quality improvement intervention comprised three components, derived through root cause analysis: standardising and simplifying care (including evidence-based order sets), increasing visibility (through provider access to clinical data and direct feedback) and educational outreach (directed at the entire institution). Effectiveness was determined at a single urban acute care hospital through time-series analysis with statistical process control charts. Primary outcomes included rate of hyperglycaemia and rate of hypoglycaemia. Results The study included 70 992 hospital admissions for 50 404 patients, with 3 35 645 patient days. The hyperglycaemia ratio decreased 25.2% from 14.1% to 10.5% (95% CI 3.3 to 3.9 percentage points, p<0.001). The ratio of patient days with highly elevated blood glucose (>299 mg/dL) decreased 31.8% from 4.8% to 3.3% (95% CI 1.4 to 1.7 percentage points, p<0.001). Hypoglycaemia ratio decreased from 5.2% to 4.6% (95% CI 0.27 to 0.89 percentage points, p<0.001) in patients with diabetes, but increased in patients without diabetes from 1.2% to 1.7% (95% CI 0.46 to 0.70 percentage points, p<0.001). Conclusions We demonstrate improved hospital-wide glycaemic control after a multifaceted quality improvement intervention in the context of strong institutional commitment, national mentorship and Lean management PMID:29450273
Characterization of Adipose Tissue Product Quality Using Measurements of Oxygen Consumption Rate.

PubMed

Suszynski, Thomas M; Sieber, David A; Mueller, Kathryn; Van Beek, Allen L; Cunningham, Bruce L; Kenkel, Jeffrey M

2018-03-14

Fat grafting is a common procedure in plastic surgery but associated with unpredictable graft retention. Adipose tissue (AT) "product" quality is affected by the methods used for harvest, processing and transfer, which vary widely amongst surgeons. Currently, there is no method available to accurately assess the quality of AT. In this study, we present a novel method for the assessment of AT product quality through direct measurements of oxygen consumption rate (OCR). OCR has exhibited potential in predicting outcomes following pancreatic islet transplant. Our study aim was to reapportion existing technology for its use with AT preparations and to confirm that these measurements are feasible. OCR was successfully measured for en bloc and postprocessed AT using a stirred microchamber system. OCR was then normalized to DNA content (OCR/DNA), which represents the AT product quality. Mean (±SE) OCR/DNA values for fresh en bloc and post-processed AT were 149.8 (± 9.1) and 61.1 (± 6.1) nmol/min/mg DNA, respectively. These preliminary data suggest that: (1) OCR and OCR/DNA measurements of AT harvested using conventional protocol are feasible; and (2) standard AT processing results in a decrease in overall AT product quality. OCR measurements of AT using existing technology can be done and enables accurate, real-time, quantitative assessment of the quality of AT product prior to transfer. The availability and further validation of this type of assay could enable optimization of fat grafting protocol by providing a tool for the more detailed study of procedural variables that affect AT product quality.
Ranking Reputation and Quality in Online Rating Systems

PubMed Central

Liao, Hao; Zeng, An; Xiao, Rui; Ren, Zhuo-Ming; Chen, Duan-Bing; Zhang, Yi-Cheng

2014-01-01

How to design an accurate and robust ranking algorithm is a fundamental problem with wide applications in many real systems. It is especially significant in online rating systems due to the existence of some spammers. In the literature, many well-performed iterative ranking methods have been proposed. These methods can effectively recognize the unreliable users and reduce their weight in judging the quality of objects, and finally lead to a more accurate evaluation of the online products. In this paper, we design an iterative ranking method with high performance in both accuracy and robustness. More specifically, a reputation redistribution process is introduced to enhance the influence of highly reputed users and two penalty factors enable the algorithm resistance to malicious behaviors. Validation of our method is performed in both artificial and real user-object bipartite networks. PMID:24819119

Implementation of a Surgeon-Level Comparative Quality Performance Review to Improve Positive Surgical Margin Rates during Radical Prostatectomy.

PubMed

Matulewicz, Richard S; Tosoian, Jeffrey J; Stimson, C J; Ross, Ashley E; Chappidi, Meera; Lotan, Tamara L; Humphreys, Elizabeth; Partin, Alan W; Schaeffer, Edward M

2017-05-01

Success in the era of value-based payment will depend on the capacity of health systems to improve quality while controlling costs. Comparative quality performance review can be used to drive improvements in surgical outcomes and thereby reduce costs. We sought to determine the efficacy of a comparative quality performance review to improve a surgeon-level measure of surgical oncologic quality, that is the positive surgical margin rate at the time of radical prostatectomy. Eight surgeons who performed consecutive radical prostatectomies at a single high volume institution between January 1, 2015 and December 31, 2015 were included in analysis. Individual surgeons were provided with confidential report cards every 6 months detailing their case mix, case volume and pT2 radical prostatectomy positive surgical margin rate relative to 1) their own self-matched data, 2) the de-identified data of their colleagues and 3) institutional aggregate data during the study period. Positive surgical margin rates were compared before and after intervention. Hierarchal logistic regression analysis was used to examine the association of study period on the odds of positive surgical margins, adjusted for prostate specific antigen level and National Comprehensive Cancer Network® risk group. Overall, 1,822 (1,392 before and 430 after intervention) radical prostatectomies were performed that met study inclusion criteria. The aggregate departmental unadjusted positive surgical margin rates were 10.6% and 7.4% in the pre-intervention and post-intervention groups, respectively. After adjusting for higher risk cancer in the post-intervention group, there was a significant protective association of post-intervention status on positive margins (OR 0.64, 95% CI 0.43-0.97, p = 0.03). All 5 surgeons with positive surgical margin rates higher than the aggregate department rate in the pre-intervention period showed improvement after intervention. Comparative quality performance review can be
Psychiatric symptoms and response quality to self-rated personality tests: Evidence from the PsyCoLaus study.

PubMed

Dupuis, Marc; Meier, Emanuele; Rudaz, Dominique; Strippoli, Marie-Pierre F; Castelao, Enrique; Preisig, Martin; Capel, Roland; Vandeleur, Caroline L

2017-06-01

Despite the fact that research has demonstrated consistent associations between self-rated measures of personality dimensions and mental disorders, little has been undertaken to investigate the relation between psychiatric symptoms and response patterns to self-rated tests. The aim of this study was to investigate the association between psychiatric symptoms and response quality using indices from our functional method. A sample of 1,784 participants from a Swiss population-based cohort completed a personality inventory (NEO-FFI) and a symptom checklist of 90 items (SCL-90-R). Different indices of response quality were calculated based on the responses given to the NEO-FFI. Associations among the responses to indices of response quality, sociodemographic characteristics and the SCL-90-R dimensions were then established. Psychiatric symptoms were associated with several important differences in response quality, questioning subjects' ability to provide valid information using self-rated instruments. As suggested by authors, psychiatric symptoms seem associated with differences in personality scores. Nonetheless, our study shows that symptoms are also related to differences in terms of response patterns as sources of differences in personality scores. This could constitute a bias for clinical assessment. Future studies could still determine whether certain subpopulations of subjects are more unable to provide valid information to self-rated questionnaires than others. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
Genotype, environment, seeding rate, and top-dressed nitrogen effects on end-use quality of modern Nebraska winter wheat.

PubMed

Bhatta, Madhav; Regassa, Teshome; Rose, Devin J; Baenziger, P Stephen; Eskridge, Kent M; Santra, Dipak K; Poudel, Rachana

2017-12-01

Fine-tuning production inputs such as seeding rate, nitrogen (N), and genotype may improve end-use quality of hard red winter wheat (Triticum aestivium L.) when growing conditions are unpredictable. Studies were conducted at the Agronomy Research Farm (ARF; Lincoln, NE, USA) and the High Plains Agricultural Laboratory (HPAL; Sidney, NE, USA) in 2014 and 2015 in Nebraska, USA, to determine the effects of genotype (6), environment (4), seeding rate (3), and flag leaf top-dressed N (0 and 34 kg N ha -1 ) on the end-use quality of winter wheat. End-use quality traits were influenced by environment, genotype, seeding rate, top-dressed N, and their interactions. Mixograph parameters had a strong correlation with grain volume weight and flour yield. Doubling the recommended seeding rate and N at the flag leaf stage increased grain protein content by 8.1% in 2014 and 1.5% in 2015 at ARF and 4.2% in 2014 and 8.4% in 2015 at HPAL. The key finding of this research is that increasing seeding rates up to double the current recommendations with N at the flag leaf stage improved most of the end-use quality traits. This will have a significant effect on the premium for protein a farmer could receive when marketing wheat. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.
Exploring Rating Quality in Rater-Mediated Assessments Using Mokken Scale Analysis

PubMed Central

Wind, Stefanie A.; Engelhard, George

2015-01-01

Mokken scale analysis is a probabilistic nonparametric approach that offers statistical and graphical tools for evaluating the quality of social science measurement without placing potentially inappropriate restrictions on the structure of a data set. In particular, Mokken scaling provides a useful method for evaluating important measurement properties, such as invariance, in contexts where response processes are not well understood. Because rater-mediated assessments involve complex interactions among many variables, including assessment contexts, student artifacts, rubrics, individual rater characteristics, and others, rater-assigned scores are suitable candidates for Mokken scale analysis. The purposes of this study are to describe a suite of indices that can be used to explore the psychometric quality of data from rater-mediated assessments and to illustrate the substantive interpretation of Mokken-based statistics and displays in this context. Techniques that are commonly used in polytomous applications of Mokken scaling are adapted for use with rater-mediated assessments, with a focus on the substantive interpretation related to individual raters. Overall, the findings suggest that indices of rater monotonicity, rater scalability, and invariant rater ordering based on Mokken scaling provide diagnostic information at the level of individual raters related to the requirements for invariant measurement. These Mokken-based indices serve as an additional suite of diagnostic tools for exploring the quality of data from rater-mediated assessments that can supplement rating quality indices based on parametric models. PMID:29795883
A succinct rating scale for radiology report quality

PubMed Central

Yang, Chengwu; Ouyang, Tao; Peterson, Christine M; Sarwani, Nabeel I; Tappouni, Rafel; Bruno, Michael

2014-01-01

Context: Poorly written radiology reports are common among residents and are a significant challenge for radiology education. While training may improve report quality, a professionally developed reliable and valid scale to measure report quality does not exist. Objectives: To develop a measurement tool for report quality, the quality of report scale, with rigorous validation through empirical data. Methods: A research team of an experienced psychometrician and six senior radiologists conducted qualitative and quantitative studies. Five items were identified for the quality of report scale, each measuring a distinct aspect of report quality. Two dedicated training sessions were designed and implemented to help residents generate high-quality reports. In a blinded fashion, the quality of report scale was applied to 804 randomly selected reports issued before (n = 403) and after (n = 401) training. Full-scale psychometrical assessments were implemented onto the quality of report scale’s item- and scale-scores from the reports. The quality of report scale scores were correlated with report professionalism and attendings’ preference and were compared pre-/post-training. Results: The quality of report scale showed sound psychometrical properties, with high validity and reliability. Reports with higher quality of report scale score were more professional and preferable by attendings. Training improved the quality of report scale score, empirically validating the quality of report scale further. Conclusion: While succinct and practitioner friendly, the quality of report scale is a reliable and valid measure of radiology report quality and has the potential to be easily adapted to other fields such as pathology, where similar training would be beneficial. PMID:26770756
Effect of dissolved organic carbon quality on microbial decomposition and nitrification rates in stream sediments

USGS Publications Warehouse

Strauss, E.A.; Lamberti, G.A.

2002-01-01

1. Microbial decomposition of dissolved organic carbon (DOC) contributes to overall stream metabolism and can influence many processes in the nitrogen cycle, including nitrification. Little is known, however, about the relative decomposition rates of different DOC sources and their subsequent effect on nitrification. 2. In this study, labile fraction and overall microbial decomposition of DOC were measured for leaf leachates from 18 temperate forest tree species. Between 61 and 82% (mean, 75%) of the DOC was metabolized in 24 days. Significant differences among leachates were found for labile fraction rates (P < 0.0001) but not for overall rates (P = 0.088). 3. Nitrification rates in stream sediments were determined after addition of 10 mg C L-1 of each leachate. Nitrification rates ranged from below detection to 0.49 ??g N mL sediment-1 day-1 and were significantly correlated with two independent measures of leachate DOC quality, overall microbial decomposition rate (r = -0.594, P = 0.0093) and specific ultraviolet absorbance (r = 0.469, P = 0.0497). Both correlations suggest that nitrification rates were lower in the presence of higher quality carbon. 4. Nitrification rates in sediments also were measured after additions of four leachates and glucose at three carbon concentrations (10, 30, and 50 mg C L-1). For all carbon sources, nitrification rates decreased as carbon concentration increased. Glucose and white pine leachate most strongly depressed nitrification. Glucose likely increased the metabolism of heterotrophic bacteria, which then out-competed nitrifying bacteria for NH4+. White pine leachate probably increased heterotrophic metabolism and directly inhibited nitrification by allelopathy.
Classroom Quality Rating Systems: How Do Teachers Prepare and What Do They Think about the Process?

ERIC Educational Resources Information Center

Scott-Little, Catherine; Brown, E. Glyn; Hooks, Laura McDonald; Marshall, Betty Jo

2008-01-01

Working with the South Carolina Department of Education, the authors surveyed prekindergarten and kindergarten teachers whose schools participated in a quality rating system to see what they did to get ready for the observation and what they thought of the evaluation process. The authors also asked them what they thought about the quality of their…
Analysis of Aircraft Control Performance using a Fuzzy Rule Base Representation of the Cooper-Harper Aircraft Handling Quality Rating

NASA Technical Reports Server (NTRS)

Tseng, Chris; Gupta, Pramod; Schumann, Johann

2006-01-01

The Cooper-Harper rating of Aircraft Handling Qualities has been adopted as a standard for measuring the performance of aircraft since it was introduced in 1966. Aircraft performance, ability to control the aircraft, and the degree of pilot compensation needed are three major key factors used in deciding the aircraft handling qualities in the Cooper- Harper rating. We formulate the Cooper-Harper rating scheme as a fuzzy rule-based system and use it to analyze the effectiveness of the aircraft controller. The automatic estimate of the system-level handling quality provides valuable up-to-date information for diagnostics and vehicle health management. Analyzing the performance of a controller requires a set of concise design requirements and performance criteria. Ir, the case of control systems fm a piloted aircraft, generally applicable quantitative design criteria are difficult to obtain. The reason for this is that the ultimate evaluation of a human-operated control system is necessarily subjective and, with aircraft, the pilot evaluates the aircraft in different ways depending on the type of the aircraft and the phase of flight. In most aerospace applications (e.g., for flight control systems), performance assessment is carried out in terms of handling qualities. Handling qualities may be defined as those dynamic and static properties of a vehicle that permit the pilot to fully exploit its performance in a variety of missions and roles. Traditionally, handling quality is measured using the Cooper-Harper rating and done subjectively by the human pilot. In this work, we have formulated the rules of the Cooper-Harper rating scheme as fuzzy rules with performance, control, and compensation as the antecedents, and pilot rating as the consequent. Appropriate direct measurements on the controller are related to the fuzzy Cooper-Harper rating system: a stability measurement like the rate of change of the cost function can be used as an indicator if the aircraft is under
Children's sleep and autonomic function: low sleep quality has an impact on heart rate variability.

PubMed

Michels, Nathalie; Clays, Els; De Buyzere, Marc; Vanaelst, Barbara; De Henauw, Stefaan; Sioen, Isabelle

2013-12-01

Short sleep duration and poor sleep quality in children have been associated with concentration, problem behavior, and emotional instability, but recently also with disrupted autonomic nervous function, which predicts cardiovascular health. Heart rate variability (HRV) was used as noninvasive indicator of autonomic function to examine the influence of sleep. Cross-sectional and longitudinal observational study on the effect of sleep on HRV. Belgian children (5-11 years) of the ChiBS study in 2010 (N = 334) and 2011 (N = 293). N/A. Sleep duration was reported and in a subgroup sleep quality (efficiency, latency, awakenings) was measured with accelerometry. High-frequency (HF) power and autonomic balance (LF/HF) were calculated on supine 5-minute HRV measurements. Stress was measured by emotion and problem behavior questionnaires. Sleep duration and quality were used as HRV predictors in corrected cross-sectional and longitudinal regressions. Stress was tested as mediator (intermediate pathway) or moderator (interaction) in sleep-HRV associations. In both cross-sectional and longitudinal analyses, long sleep latency could predict lower HF (parasympathetic activity), while nocturnal awakenings, sleep latency, low sleep efficiency, and low corrected sleep duration were related to higher LF/HF (sympathetic/parasympathetic balance). Parental reported sleep duration was not associated with HRV. The significances remained after correction for stress. Stress was not a mediator, but a moderator (enhancer) in the relationship between sleep quality and HRV. Low sleep quality but not parent-reported low sleep duration leads to an unhealthier heart rate variability pattern (sympathetic over parasympathetic dominance). This stresses the importance of good sleep quality for cardiovascular health in children.
The Role of Gender in Students' Ratings of Teaching Quality in Computer Science and Environmental Engineering

ERIC Educational Resources Information Center

Price, Linda; Svensson, Ingrid; Borell, Jonas; Richardson, John T. E.

2017-01-01

Students' ratings of teaching quality on course units in a computer science program and an environmental engineering program at a large Swedish university were obtained using the Course Experience Questionnaire; 8888 sets of ratings were obtained from men and 4280 sets were obtained from women over ten academic years. These student ratings from…
Marital Status, Marital Quality, and Heart Rate Variability in the MIDUS Cohort

PubMed Central

Donoho, Carrie J.; Seeman, Teresa E.; Sloan, Richard P.; Crimmins, Eileen M.

2015-01-01

Previous research has shown marital status and marital quality are consistent predictors of health outcomes, including cardiovascular disease and mortality. To better understand the relationship between marital status, marital quality, and cardiovascular health, we examined how marital status and marital quality were associated with an early indicator of deteriorating cardiovascular health, high-frequency heart rate variability (HF-HRV). This study uses data from the National Survey of Midlife in the United States (MIDUS) Biomarker Sub-study (n = 907) to examine differences in HF-HRV by traditional marital status categories (married, divorced, widowed, and never married), as well as further differentiating between the continuously married and remarried. In addition, links were also examined between HF-HRV and changes in marital quality (marital satisfaction, support, strain), among individuals in long-term marriages. No significant differences in HF-HRV were observed between married persons and those widowed, divorced, and never married. However, continuously married individuals had higher HF-HRV than remarried adults. Increases in marital satisfaction and support over 10 years were associated with higher HF-HRV, while increased marital strain over 10 years was associated with lower HFHRV. Higher HF-HRV among the continuously married compared to the remarried suggests previous marital disruptions may have lasting effects on cardiovascular health, or that there may be other differences between the remarried versus those who remain married to the same person. Associations between marital quality and HF-HRV suggest variations in the quality of one’s marriage may affect cardiovascular health. PMID:25844496
Inter-rater agreement of the Quality of Life-Alzheimer's Disease (QoL-AD) self-rating and proxy rating scale: secondary analysis of RightTimePlaceCare data.

PubMed

Römhild, Josephine; Fleischer, Steffen; Meyer, Gabriele; Stephan, Astrid; Zwakhalen, Sandra; Leino-Kilpi, Helena; Zabalegui, Adelaida; Saks, Kai; Soto-Martin, Maria; Sutcliffe, Caroline; Rahm Hallberg, Ingalill; Berg, Almuth

2018-06-28

To assess the quality of life of people with dementia, measures are required for self-rating by the person with dementia, and for proxy rating by others. The Quality of Life in Alzheimer's Disease scale (QoL-AD) is available in two versions, QoL-AD-SR (self-rating) and QoL-AD-PR (proxy rating). The aim of our study was to analyse the inter-rater agreement between self- and proxy ratings, in terms of both the total score and the items, including an analysis specific to care setting, and to identify factors associated with this agreement. Cross-sectional QoL-AD data from the 7th Framework European RightTimePlaceCare study were analysed. A total of 1330 cases were included: n = 854 receiving home care and n = 476 receiving institutional long-term nursing care. The proxy raters were informal carers (home care) and best-informed professional carers (institutional long-term nursing care). Inter-rater agreement was investigated using Bland-Altman plots for the QoL-AD total score and by weighted kappa statistics for single items. Associations were investigated by regression analysis. The overall QoL-AD assessment of those with dementia revealed a mean value of 33.2 points, and the proxy ratings revealed a mean value of 29.8 points. The Bland-Altman plots revealed a poor agreement between self- and proxy ratings for the overall sample and for both care settings. With one exception (item 'Marriage' weighted kappa 0.26), the weighted kappa values for the single QoL-AD items were below 0.20, indicating poor agreement. Home care setting, dementia-related behavioural and psychological symptoms, and the functional status of the person with dementia, along with the caregiver burden, were associated with the level of agreement. Only the home care setting was associated with an increase larger than the predefined acceptable difference between self- and proxy ratings. Proxy quality of life ratings from professional and informal carers appear to be lower than the self-ratings
Medicare Program; FY 2018 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements. Final rule.

PubMed

2017-08-04

This final rule will update the hospice wage index, payment rates, and cap amount for fiscal year (FY) 2018. Additionally, this rule includes new quality measures and provides an update on the hospice quality reporting program.
A comprehensive database of quality-rated fossil ages for Sahul’s Quaternary vertebrates

PubMed Central

Rodríguez-Rey, Marta; Herrando-Pérez, Salvador; Brook, Barry W.; Saltré, Frédérik; Alroy, John; Beeton, Nicholas; Bird, Michael I.; Cooper, Alan; Gillespie, Richard; Jacobs, Zenobia; Johnson, Christopher N.; Miller, Gifford H.; Prideaux, Gavin J.; Roberts, Richard G.; Turney, Chris S.M.; Bradshaw, Corey J.A.

2016-01-01

The study of palaeo-chronologies using fossil data provides evidence for past ecological and evolutionary processes, and is therefore useful for predicting patterns and impacts of future environmental change. However, the robustness of inferences made from fossil ages relies heavily on both the quantity and quality of available data. We compiled Quaternary non-human vertebrate fossil ages from Sahul published up to 2013. This, the FosSahul database, includes 9,302 fossil records from 363 deposits, for a total of 478 species within 215 genera, of which 27 are from extinct and extant megafaunal species (2,559 records). We also provide a rating of reliability of individual absolute age based on the dating protocols and association between the dated materials and the fossil remains. Our proposed rating system identified 2,422 records with high-quality ages (i.e., a reduction of 74%). There are many applications of the database, including disentangling the confounding influences of hypothetical extinction drivers, better spatial distribution estimates of species relative to palaeo-climates, and potentially identifying new areas for fossil discovery. PMID:27434208
Dynamic Evolution in the Symbiotic R Aquarii

NASA Technical Reports Server (NTRS)

DePasquale, J. M.; Nichols, J. S.; Kellogg, E. M.

2007-01-01

We report on multiple Chandra observations spanning a period of 5 years as well as a more recent XMM observation of the nearby symbiotic binary R Aqr. Spectral analysis of these four observations reveals considerable variability in hardness ratios and in the strength and ionization levels of emission lines which provides insight into white dwarf accretion processes as well as continuum and line formation mechanisms. Chandra imaging of the central source also shows the formation and evolution of a new south west jet. This growing body of high-resolution X-ray data of R Aqr provides a unique glimpse into white dwarf wind-accretion processes and jet formation.
Staff Preparation, Reward, and Support: Are Quality Rating and Improvement Systems Addressing All of the Key Ingredients Necessary for Change? Policy Report

ERIC Educational Resources Information Center

Austin, Lea J. E.; Whitebook, Marcy; Connors, Maia; Darrah, Rory

2011-01-01

Reflecting the growing momentum in support of quality rating and improvement systems (QRISs) as a key strategy to improve early care and education quality, significant amounts of public dollars have been devoted to their development and implementation. In this brief, the authors report on their investigation of both quality rating and improvement…
How Online Quality Ratings Influence Patients' Choice of Medical Providers: Controlled Experimental Survey Study.

PubMed

Yaraghi, Niam; Wang, Weiguang; Gao, Guodong Gordon; Agarwal, Ritu

2018-03-26

In recent years, the information environment for patients to learn about physician quality is being rapidly changed by Web-based ratings from both commercial and government efforts. However, little is known about how various types of Web-based ratings affect individuals' choice of physicians. The objective of this research was to measure the relative importance of Web-based quality ratings from governmental and commercial agencies on individuals' choice of primary care physicians. In a choice-based conjoint experiment conducted on a sample of 1000 Amazon Mechanical Turk users in October 2016, individuals were asked to choose their preferred primary care physician from pairs of physicians with different ratings in clinical and nonclinical aspects of care provided by governmental and commercial agencies. The relative log odds of choosing a physician increases by 1.31 (95% CI 1.26-1.37; P<.001) and 1.32 (95% CI 1.27-1.39; P<.001) units when the government clinical ratings and commercial nonclinical ratings move from 2 to 4 stars, respectively. The relative log odds of choosing a physician increases by 1.12 (95% CI 1.07-1.18; P<.001) units when the commercial clinical ratings move from 2 to 4 stars. The relative log odds of selecting a physician with 4 stars in nonclinical ratings provided by the government is 1.03 (95% CI 0.98-1.09; P<.001) units higher than a physician with 2 stars in this rating. The log odds of selecting a physician with 4 stars in nonclinical government ratings relative to a physician with 2 stars is 0.23 (95% CI 0.13-0.33; P<.001) units higher for females compared with males. Similar star increase in nonclinical commercial ratings increases the relative log odds of selecting the physician by female respondents by 0.15 (95% CI 0.04-0.26; P=.006) units. Individuals perceive nonclinical ratings provided by commercial websites as important as clinical ratings provided by government websites when choosing a primary care physician. There are
How Online Quality Ratings Influence Patients’ Choice of Medical Providers: Controlled Experimental Survey Study

PubMed Central

Wang, Weiguang; Gao, Guodong (Gordon); Agarwal, Ritu

2018-01-01

Background In recent years, the information environment for patients to learn about physician quality is being rapidly changed by Web-based ratings from both commercial and government efforts. However, little is known about how various types of Web-based ratings affect individuals’ choice of physicians. Objective The objective of this research was to measure the relative importance of Web-based quality ratings from governmental and commercial agencies on individuals’ choice of primary care physicians. Methods In a choice-based conjoint experiment conducted on a sample of 1000 Amazon Mechanical Turk users in October 2016, individuals were asked to choose their preferred primary care physician from pairs of physicians with different ratings in clinical and nonclinical aspects of care provided by governmental and commercial agencies. Results The relative log odds of choosing a physician increases by 1.31 (95% CI 1.26-1.37; P<.001) and 1.32 (95% CI 1.27-1.39; P<.001) units when the government clinical ratings and commercial nonclinical ratings move from 2 to 4 stars, respectively. The relative log odds of choosing a physician increases by 1.12 (95% CI 1.07-1.18; P<.001) units when the commercial clinical ratings move from 2 to 4 stars. The relative log odds of selecting a physician with 4 stars in nonclinical ratings provided by the government is 1.03 (95% CI 0.98-1.09; P<.001) units higher than a physician with 2 stars in this rating. The log odds of selecting a physician with 4 stars in nonclinical government ratings relative to a physician with 2 stars is 0.23 (95% CI 0.13-0.33; P<.001) units higher for females compared with males. Similar star increase in nonclinical commercial ratings increases the relative log odds of selecting the physician by female respondents by 0.15 (95% CI 0.04-0.26; P=.006) units. Conclusions Individuals perceive nonclinical ratings provided by commercial websites as important as clinical ratings provided by government websites when
Unit-level voluntary turnover rates and customer service quality: implications of group cohesiveness, newcomer concentration, and size.

PubMed

Hausknecht, John P; Trevor, Charlie O; Howard, Michael J

2009-07-01

Despite substantial growth in the service industry and emerging work on turnover consequences, little research examines how unit-level turnover rates affect essential customer-related outcomes. The authors propose an operational disruption framework to explain why voluntary turnover impairs customers' service quality perceptions. On the basis of a sample of 75 work units and data from 5,631 employee surveys, 59,602 customer surveys, and organizational records, results indicate that unit-level voluntary turnover rates are negatively related to service quality perceptions. The authors also examine potential boundary conditions related to the disruption framework. Of 3 moderators studied (group cohesiveness, group size, and newcomer concentration), results show that turnover's negative effects on service quality are more pronounced in larger units and in those with a greater concentration of newcomers.
Stocking rate and fuels reduction effects on beef cattle diet composition and quality

Treesearch

Abe Clark; Tim DelCurto; Martin Vavra; Brian L. Dick

2013-01-01

An experiment was conducted to evaluate the influence of forest fuels reduction on diet quality, botanical composition, relative preference, and foraging efficiency of beef cattle grazing at different stocking rates. A split plot factorial design was used, with whole plots (3 ha) being fuel reduced or no treatment (control), and split plots (1 ha) within whole plots...

Sensor Data Quality and Angular Rate Down-Selection Algorithms on SLS EM-1

NASA Technical Reports Server (NTRS)

Park, Thomas; Oliver, Emerson; Smith, Austin

2018-01-01

The NASA Space Launch System Block 1 launch vehicle is equipped with an Inertial Navigation System (INS) and multiple Rate Gyro Assemblies (RGA) that are used in the Guidance, Navigation, and Control (GN&C) algorithms. The INS provides the inertial position, velocity, and attitude of the vehicle along with both angular rate and specific force measurements. Additionally, multiple sets of co-located rate gyros supply angular rate data. The collection of angular rate data, taken along the launch vehicle, is used to separate out vehicle motion from flexible body dynamics. Since the system architecture uses redundant sensors, the capability was developed to evaluate the health (or validity) of the independent measurements. A suite of Sensor Data Quality (SDQ) algorithms is responsible for assessing the angular rate data from the redundant sensors. When failures are detected, SDQ will take the appropriate action and disqualify or remove faulted sensors from forward processing. Additionally, the SDQ algorithms contain logic for down-selecting the angular rate data used by the GN&C software from the set of healthy measurements. This paper provides an overview of the algorithms used for both fault-detection and measurement down selection.
The Study of an Integrated Rating System for Supplier Quality Performance in the Semiconductor Industry

NASA Astrophysics Data System (ADS)

Lee, Yu-Cheng; Yen, Tieh-Min; Tsai, Chih-Hung

This study provides an integrated model of Supplier Quality Performance Assesment (SQPA) activity for the semiconductor industry through introducing the ISO 9001 management framework, Importance-Performance Analysis (IPA) Supplier Quality Performance Assesment and Taguchi`s Signal-to-Noise Ratio (S/N) techniques. This integrated model provides a SQPA methodology to create value for all members under mutual cooperation and trust in the supply chain. This method helps organizations build a complete SQPA framework, linking organizational objectives and SQPA activities to optimize rating techniques to promote supplier quality improvement. The techniques used in SQPA activities are easily understood. A case involving a design house is illustrated to show our model.
Rate control and quality assurance during rhythmic force tracking.

PubMed

Huang, Cheng-Ya; Su, Jyong-Huei; Hwang, Ing-Shiou

2014-02-01

Movement characteristics can be coded in the single neurons or in the summed activity of neural populations. However, whether neural oscillations are conditional to the frequency demand and task quality of rhythmic force regulation is still unclear. This study was undertaken to investigate EEG dynamics and behavior correlates during force-tracking at different target rates. Fourteen healthy volunteers conducted load-varying isometric abduction of the index finger by coupling the force output to sinusoidal targets at 0.5 Hz, 1.0 Hz, and 2.0 Hz. Our results showed that frequency demand significantly affected EEG delta oscillation (1-4 Hz) in the C3, CP3, CPz, and CP4 electrodes, with the greatest delta power and lowest delta peak around 1.5 Hz for slower tracking at 0.5 Hz. Those who had superior tracking congruency also manifested enhanced alpha oscillation (8-12 Hz). Alpha rhythms of the skilled performers during slow tracking spread through the whole target cycle, except for the phase of direction changes. However, the alpha rhythms centered at the mid phase of a target cycle with increasing target rate. In conclusion, our findings clearly suggest two advanced roles of cortical oscillation in rhythmic force regulation. Rate-dependent delta oscillation involves a paradigm shift in force control under different time scales. Phasic organization of alpha rhythms during rhythmic force tracking is related to behavioral success underlying the selective use of bimodal controls (feedback and feedforward processes) and the timing of attentional focus on the target's peak velocity. Copyright © 2013 Elsevier B.V. All rights reserved.
Prediction of pilot opinion ratings using an optimal pilot model. [of aircraft handling qualities in multiaxis tasks

NASA Technical Reports Server (NTRS)

Hess, R. A.

1977-01-01

A brief review of some of the more pertinent applications of analytical pilot models to the prediction of aircraft handling qualities is undertaken. The relative ease with which multiloop piloting tasks can be modeled via the optimal control formulation makes the use of optimal pilot models particularly attractive for handling qualities research. To this end, a rating hypothesis is introduced which relates the numerical pilot opinion rating assigned to a particular vehicle and task to the numerical value of the index of performance resulting from an optimal pilot modeling procedure as applied to that vehicle and task. This hypothesis is tested using data from piloted simulations and is shown to be reasonable. An example concerning a helicopter landing approach is introduced to outline the predictive capability of the rating hypothesis in multiaxis piloting tasks.
COMP report: CPQR technical quality control guidelines for low-dose-rate permanent seed brachytherapy.

PubMed

Beaulieu, Luc; Radford, Dee-Ann; Eduardo Villarreal-Barajas, J

2018-03-14

The Canadian Organization of Medical Physicists (COMP), in close partnership with the Canadian Partnership for Quality Radiotherapy (CPQR) has developed a series of Technical Quality Control (TQC) guidelines for radiation treatment equipment. These guidelines outline the performance objectives that equipment should meet in order to ensure an acceptable level of radiation treatment quality. The TQC guidelines have been rigorously reviewed and field tested in a variety of Canadian radiation treatment facilities. The development process enables rapid review and update to keep the guidelines current with changes in technology. This article contains detailed performance objectives and safety criteria for low-dose-rate (LDR) permanent seed brachytherapy. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.
Packet Scheduling Mechanism to Improve Quality of Short Flows and Low-Rate Flows

NASA Astrophysics Data System (ADS)

Yokota, Kenji; Asaka, Takuya; Takahashi, Tatsuro

In recent years elephant flows are increasing by expansion of peer-to-peer (P2P) applications on the Internet. As a result, bandwidth is occupied by specific users triggering unfair resource allocation. The main packet-scheduling mechanism currently employed is first-in first-out (FIFO) where the available bandwidth of short flows is limited by elephant flows. Least attained service (LAS), which decides transfer priority of packets by the total amount of transferred data in all flows, was proposed to solve this problem. However, routers with LAS limit flows with large amount of transferred data even if they are low-rate. Therefore, it is necessary to improve the quality of low-rate flows with long holding times such as voice over Internet protocol (VoIP) applications. This paper proposes rate-based priority control (RBPC), which calculates the flow rate and control the priority by using it. Our proposed method can transfer short flows and low-rate flows in advance. Moreover, its fair performance is shown through simulations.
Individual differences in individualism and collectivism predict ratings of virtual cities' liveability and environmental quality.

PubMed

Rubin, Mark; Morrison, Tessa

2014-01-01

The present research investigated individual differences in individualism and collectivism as predictors of people's reactions to cities. Psychology undergraduate students (N = 148) took virtual guided tours around historical cities. They then evaluated the cities' liveability and environmental quality and completed measures of individualism and collectivism. Mediation analyses showed that people who scored high in self-responsibility (individualism) rated the cities as more liveable because they perceived them to be richer and better resourced. In contrast, people who scored high in collectivism rated the cities as having a better environmental quality because they perceived them to (1) provide a greater potential for community and social life and (2) allow people to express themselves. These results indicate that people's evaluations of virtual cities are based on the degree to which certain aspects of the cities are perceived to be consistent with individualist and collectivist values.
The use of noise equivalent count rate and the NEMA phantom for PET image quality evaluation.

PubMed

Yang, Xin; Peng, Hao

2015-03-01

PET image quality is directly associated with two important parameters among others: count-rate performance and image signal-to-noise ratio (SNR). The framework of noise equivalent count rate (NECR) was developed back in the 1990s and has been widely used since then to evaluate count-rate performance for PET systems. The concept of NECR is not entirely straightforward, however, and among the issues requiring clarification are its original definition, its relationship to image quality, and its consistency among different derivation methods. In particular, we try to answer whether a higher NECR measurement using a standard NEMA phantom actually corresponds to better imaging performance. The paper includes the following topics: 1) revisiting the original analytical model for NECR derivation; 2) validating three methods for NECR calculation based on the NEMA phantom/standard; and 3) studying the spatial dependence of NECR and quantitative relationship between NECR and image SNR. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
GRADE guidelines: 10. Considering resource use and rating the quality of economic evidence.

PubMed

Brunetti, Massimo; Shemilt, Ian; Pregno, Silvia; Vale, Luke; Oxman, Andrew D; Lord, Joanne; Sisk, Jane; Ruiz, Francis; Hill, Suzanne; Guyatt, Gordon H; Jaeschke, Roman; Helfand, Mark; Harbour, Robin; Davoli, Marina; Amato, Laura; Liberati, Alessandro; Schünemann, Holger J

2013-02-01

In this article, we describe how to include considerations about resource utilization when making recommendations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. We focus on challenges with rating the confidence in effect estimates (quality of evidence) and incorporating resource use into evidence profiles and Summary of Findings (SoF) tables. GRADE recommends that important differences in resource use between alternative management strategies should be included along with other important outcomes in the evidence profile and SoF table. Key steps in considering resources in making recommendations with GRADE are the identification of items of resource use that may differ between alternative management strategies and that are potentially important to decision makers, finding evidence for the differences in resource use, making judgments regarding confidence in effect estimates using the same criteria used for health outcomes, and valuing the resource use in terms of costs for the specific setting for which recommendations are being made. With our framework, decision makers will have access to concise summaries of recommendations, including ratings of the quality of economic evidence, and better understand the implications for clinical decision making. Copyright © 2013 Elsevier Inc. All rights reserved.
Clinical Rating of Movement-Pattern Quality in Patients With Femoroacetabular Impingement Syndrome: A Methodological Study.

PubMed

Casartelli, Nicola C; Maffiuletti, Nicola A; Brunner, Romana; Büchi, Marcel; Sutter, Reto; Pfirrmann, Christian W; Naal, Florian D; Leunig, Michael; Bizzini, Mario

2018-04-01

Study Design Cross-sectional study. Objectives To evaluate intrarater and interrater agreement among physical therapists with different clinical experience in performing a visual rating of movement-pattern quality of patients with femoroacetabular impingement (FAI) syndrome using a semi-quantitative scale. Background Visual rating of movement patterns in patients with FAI syndrome is of interest, because poor control of dynamic hip motion is frequently noted. Methods A video camera was used to record the performance of 34 patients with FAI syndrome performing single-limb standing, squat, frontal lunge, hop lunge, bridge, and plank. Visual rating of movement, as recorded on video, was performed by a highly experienced, a moderately experienced, and a novice physical therapist on 2 occasions using a semi-quantitative scale. Hip abductor strength was assessed using dynamometry, and hip pain and function were assessed with a patient-reported questionnaire. Intrarater and interrater agreement among physical therapists was evaluated using Gwet's agreement coefficient 1. Construct validity was evaluated as the association between physical therapists' rating and patients' hip abductor strength, pain, and function. Results Good intrarater and interrater agreement was observed in the highly experienced and moderately experienced physical therapists when rating single-limb standing, bridge, and plank. Poor to moderate intrarater and interrater agreement was found when they rated squat, frontal lunge, and hop lunge. Poor performers, as rated by the highly experienced physical therapist only, demonstrated lower hip abductor strength (P<.05), and similar hip pain and hip function compared to those of good performers. Conclusion Movement-pattern quality of patients with FAI syndrome should be rated by a highly experienced physical therapist. J Orthop Sports Phys Ther 2018;48(4):260-269. doi:10.2519/jospt.2018.7840.
SDN-1/Syndecan Acts in Parallel to the Transmembrane Molecule MIG-13 to Promote Anterior Neuroblast Migration.

PubMed

Sundararajan, Lakshmi; Norris, Megan L; Lundquist, Erik A

2015-05-28

The Q neuroblasts in Caenorhabditis elegans display left-right asymmetry in their migration, with QR and descendants on the right migrating anteriorly, and QL and descendants on the left migrating posteriorly. Initial QR and QL migration is controlled by the transmembrane receptors UNC-40/DCC, PTP-3/LAR, and the Fat-like cadherin CDH-4. After initial migration, QL responds to an EGL-20/Wnt signal that drives continued posterior migration by activating MAB-5/Hox activity in QL but not QR. QR expresses the transmembrane protein MIG-13, which is repressed by MAB-5 in QL and which drives anterior migration of QR descendants. A screen for new Q descendant AQR and PQR migration mutations identified mig-13 as well as hse-5, the gene encoding the glucuronyl C5-epimerase enzyme, which catalyzes epimerization of glucuronic acid to iduronic acid in the heparan sulfate side chains of heparan sulfate proteoglycans (HSPGs). Of five C. elegans HSPGs, we found that only SDN-1/Syndecan affected Q migrations. sdn-1 mutants showed QR descendant AQR anterior migration defects, and weaker QL descendant PQR migration defects. hse-5 affected initial Q migration, whereas sdn-1 did not. sdn-1 and hse-5 acted redundantly in AQR and PQR migration, but not initial Q migration, suggesting the involvement of other HSPGs in Q migration. Cell-specific expression studies indicated that SDN-1 can act in QR to promote anterior migration. Genetic interactions between sdn-1, mig-13, and mab-5 suggest that MIG-13 and SDN-1 act in parallel to promote anterior AQR migration and that SDN-1 also controls posterior migration. Together, our results indicate previously unappreciated complexity in the role of multiple signaling pathways and inherent left-right asymmetry in the control of Q neuroblast descendant migration. Copyright © 2015 Sundararajan et al.
SDN-1/Syndecan Acts in Parallel to the Transmembrane Molecule MIG-13 to Promote Anterior Neuroblast Migration

PubMed Central

Sundararajan, Lakshmi; Norris, Megan L.; Lundquist, Erik A.

2015-01-01

The Q neuroblasts in Caenorhabditis elegans display left-right asymmetry in their migration, with QR and descendants on the right migrating anteriorly, and QL and descendants on the left migrating posteriorly. Initial QR and QL migration is controlled by the transmembrane receptors UNC-40/DCC, PTP-3/LAR, and the Fat-like cadherin CDH-4. After initial migration, QL responds to an EGL-20/Wnt signal that drives continued posterior migration by activating MAB-5/Hox activity in QL but not QR. QR expresses the transmembrane protein MIG-13, which is repressed by MAB-5 in QL and which drives anterior migration of QR descendants. A screen for new Q descendant AQR and PQR migration mutations identified mig-13 as well as hse-5, the gene encoding the glucuronyl C5-epimerase enzyme, which catalyzes epimerization of glucuronic acid to iduronic acid in the heparan sulfate side chains of heparan sulfate proteoglycans (HSPGs). Of five C. elegans HSPGs, we found that only SDN-1/Syndecan affected Q migrations. sdn-1 mutants showed QR descendant AQR anterior migration defects, and weaker QL descendant PQR migration defects. hse-5 affected initial Q migration, whereas sdn-1 did not. sdn-1 and hse-5 acted redundantly in AQR and PQR migration, but not initial Q migration, suggesting the involvement of other HSPGs in Q migration. Cell-specific expression studies indicated that SDN-1 can act in QR to promote anterior migration. Genetic interactions between sdn-1, mig-13, and mab-5 suggest that MIG-13 and SDN-1 act in parallel to promote anterior AQR migration and that SDN-1 also controls posterior migration. Together, our results indicate previously unappreciated complexity in the role of multiple signaling pathways and inherent left-right asymmetry in the control of Q neuroblast descendant migration. PMID:26022293
New insights into the outflows from R Aquarii

NASA Astrophysics Data System (ADS)

Liimets, T.; Corradi, R. L. M.; Jones, D.; Verro, K.; Santander-García, M.; Kolka, I.; Sidonio, M.; Kankare, E.; Kankare, J.; Pursimo, T.; Wilson, P. A.

2018-05-01

Context. The source R Aquarii is a symbiotic binary surrounded by a large and complex nebula with a prominent curved jet. It is one of the closest known symbiotic systems, and therefore offers a unique opportunity to study the central regions of these systems and the formation and evolution of astrophysical jets. Aims: We aim to study the evolution of the central jet and outer nebula of R Aqr, taking advantage of a long term monitoring campaign of optical imaging, as well as of high-resolution integral field spectroscopy. Methods: Narrow-band images acquired over a period of more than 21 yr were compared in order to study the expansion and evolution of all components of the R Aqr nebula. The magnification method was used to derive the kinematic ages of the features that appear to expand radially. Integral field spectroscopy of the [O III] 5007 Å emission is used to study the velocity structure of the central regions of the jet. Results: New extended features, further out than the previously known hourglass nebula, are detected. The kinematic distance to R Aqr is calculated to be 178 pc using the expansion of the large hourglass nebula. This nebula of R Aqr is found to be roughly 650 yr old, while the inner regions have ages ranging from 125 to 290 yr. The outer nebula is found to be well described by a ballistic expansion, while for most components of the jet strong deviations from such behaviour are found. We find that the northern jet is mostly red-shifted while its southern part is blue-shifted, apparently at odds with findings from previous studies but almost certainly a consequence of the complex nature of the jet and variations in ionisation and illumination between observations.
Medicare Program; FY 2017 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements. Final rule.

PubMed

2016-08-05

This final rule will update the hospice wage index, payment rates, and cap amount for fiscal year (FY) 2017. In addition, this rule changes the hospice quality reporting program, including adopting new quality measures. Finally, this final rule includes information regarding the Medicare Care Choices Model (MCCM).
Fatigue, not self-rated motor symptom severity, affects quality of life in functional motor disorders.

PubMed

Gelauff, J M; Kingma, E M; Kalkman, J S; Bezemer, R; van Engelen, B G M; Stone, J; Tijssen, M A J; Rosmalen, J G M

2018-06-02

While fatigue is found to be an impairing symptom in functional motor disorders (FMD) in clinical practice, scientific evidence is lacking. We investigated fatigue severity and subtypes in FMD compared to organic neurological disease. Furthermore, the role of fatigue within FMD and its impact on quality of life and self-rated health were investigated. Data from 181 patients participating in the self-help on the internet for functional motor disorders, randomised Trial were included. Data from 217 neurological controls with neuromuscular disorders (NMD) originated from a historical cohort. Fatigue was measured using the checklist individual strength (CIS). Motor symptom severity, depression and anxiety were correlated to fatigue. For multivariable regression analyses, physical functioning and pain were additionally taken into account. Severe fatigue was, respectively, present in 78 and 53% of FMD and NMD patients (p < 0.001). FMD patients scored higher than NMD patients on all fatigue subdomains (p < 0.001). In the FMD group, fatigue subdomains were correlated to depression, anxiety and partly to motor symptom severity. Quality of life was negatively associated with fatigue [OR 0.93 (0.90-0.96), p < 0.001] and depression [OR 0.87 (0.81-0.93), p < 0.001], but not self-rated motor symptom severity. Self-rated health was negatively associated with fatigue [OR 0.92 (0.88-0.96), p < 0.001] and pain [OR 0.98 (0.97-0.99), p < 0.001]. Fatigue was found to be a prevalent problem in FMD, more so than in organic neurological disease. It significantly affected quality of life and self-rated health, while other factors such as motor symptom severity did not. Fatigue should be taken into account in clinical practice and treatment trials.
SPHERE/ZIMPOL observations of the symbiotic system R Aquarii. I. Imaging of the stellar binary and the innermost jet clouds

NASA Astrophysics Data System (ADS)

Schmid, H. M.; Bazzon, A.; Milli, J.; Roelfsema, R.; Engler, N.; Mouillet, D.; Lagadec, E.; Sissa, E.; Sauvage, J.-F.; Ginski, C.; Baruffolo, A.; Beuzit, J. L.; Boccaletti, A.; Bohn, A. J.; Claudi, R.; Costille, A.; Desidera, S.; Dohlen, K.; Dominik, C.; Feldt, M.; Fusco, T.; Gisler, D.; Girard, J. H.; Gratton, R.; Henning, T.; Hubin, N.; Joos, F.; Kasper, M.; Langlois, M.; Pavlov, A.; Pragt, J.; Puget, P.; Quanz, S. P.; Salasnich, B.; Siebenmorgen, R.; Stute, M.; Suarez, M.; Szulágyi, J.; Thalmann, C.; Turatto, M.; Udry, S.; Vigan, A.; Wildi, F.

2017-06-01

Context. R Aqr is a symbiotic binary system consisting of a mira variable, a hot companion with a spectacular jet outflow, and an extended emission line nebula. Because of its proximity to the Sun, this object has been studied in much detail with many types of high resolution imaging and interferometric techniques. We have used R Aqr as test target for the visual camera subsystem ZIMPOL, which is part of the new extreme adaptive optics (AO) instrument SPHERE at the Very Large Telescope (VLT). Aims: We describe SPHERE/ZIMPOL test observations of the R Aqr system taken in Hα and other filters in order to demonstrate the exceptional performance of this high resolution instrument. We compare our observations with data from the Hubble Space Telescope (HST) and illustrate the complementarity of the two instruments. We use our data for a detailed characterization of the inner jet region of R Aqr. Methods: We analyze the high resolution ≈ 25 mas images from SPHERE/ZIMPOL and determine from the Hα emission the position, size, geometric structure, and line fluxes of the jet source and the clouds in the innermost region <2'' (<400 AU) of R Aqr. The data are compared to simultaneous HST line filter observations. The Hα fluxes and the measured sizes of the clouds yield Hα emissivities for many clouds from which one can derive the mean density, mass, recombination time scale, and other cloud parameters. Results: Our Hα data resolve for the first time the R Aqr binary and we measure for the jet source a relative position 45 mas West (position angle -89.5°) of the mira. The central jet source is the strongest Hα component with a flux of about 2.5 × 10-12 erg cm-2 s-1. North east and south west from the central source there are many clouds with very diverse structures. Within 0.5'' (100 AU) we see in the SW a string of bright clouds arranged in a zig-zag pattern and, further out, at 1''-2'', fainter and more extended bubbles. In the N and NE we see a bright, very
The influence of re-employment on quality of life and self-rated health, a longitudinal study among unemployed persons in the Netherlands

PubMed Central

2013-01-01

Background Unemployed persons have a poorer health compared with employed persons and unemployment may cause ill health. The aim of this study was to investigate the effect of re-employment on quality of life and health among unemployed persons on social benefits. Methods A prospective study with 18 months follow-up was conducted among unemployed persons (n=4,308) in the Netherlands, receiving either unemployment benefits or social security benefits. Quality of life, self-rated health, and employment status were measured at baseline and every 6 months of follow up with questionnaires. Generalized estimating equations (GEE) modeling was performed to study the influence of re-employment on change in self-rated health and quality of life over time. Results In the study population 29% had a less than good quality of life and 17% had a poor self-rated health. Persons who started with paid employment during the follow-up period were more likely to improve towards a good quality of life (OR 1.76) and a good self-rated health (OR 2.88) compared with those persons who remained unemployed. Up to 6 months after re-employment, every month with paid employment, the likelihood of a good quality of life increased (OR 1.12). Conclusions Starting with paid employment improves quality of life and self-rated health. This suggests that labour force participation should be considered as an important measure to improve health of unemployed persons. Improving possibilities for unemployed persons to find paid employment will reduce socioeconomic inequalities in health. PMID:23706106
Embryo quality and implantation rate in two different culture media: ISM1 versus Universal IVF Medium.

PubMed

Xella, Susanna; Marsella, Tiziana; Tagliasacchi, Daniela; Giulini, Simone; La Marca, Antonio; Tirelli, Alessandra; Volpe, Annibale

2010-04-01

To compare the outcome of two different culture media marketed by the MediCult AS Company (Jyllinge, Denmark)-Universal IVF Medium and ISM1 Medium culture-which, in addition to glucose, pyruvate, and energy-providing components, also contain amino acids, nucleotides, vitamins, and cholesterol. Laboratory and retrospective clinical study. University teaching hospital. A total of 726 patients, undergoing IVF-intracytoplasmic sperm injection procedure, comparable in mean age range, oocyte retrieval, and infertility indication, were included in the study. Laboratory quality and standard procedures were maintained unaffected. Oocyte retrieval, different embryo culture media. Embryo quality, ongoing pregnancy, and implantation rate. The frequency of good-quality embryos (79% vs. 74%) and the percentages of ongoing pregnancy (27.5% vs. 18%) and implantation rate (15% vs. 10%) were significantly higher in the group treated with ISM1 Medium rather than Universal IVF Medium. ISM1 Medium culture seems to improve the performance of embryonic growth and development, as well as increasing the percentage of pregnancy. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Association Between Study Quality and Publication Rates of Medical Education Abstracts Presented at the Society of General Internal Medicine Annual Meeting.

PubMed

Sawatsky, Adam P; Beckman, Thomas J; Edakkanambeth Varayil, Jithinraj; Mandrekar, Jayawant N; Reed, Darcy A; Wang, Amy T

2015-08-01

Studies reveal that 44.5% of abstracts presented at national meetings are subsequently published in indexed journals, with lower rates for abstracts of medical education scholarship. We sought to determine whether the quality of medical education abstracts is associated with subsequent publication in indexed journals, and to compare the quality of medical education abstracts presented as scientific abstracts versus innovations in medical education (IME). Retrospective cohort study. Medical education abstracts presented at the Society of General Internal Medicine (SGIM) 2009 annual meeting. Publication rates were measured using database searches for full-text publications through December 2013. Quality was assessed using the validated Medical Education Research Study Quality Instrument (MERSQI). Overall, 64 (44%) medical education abstracts presented at the 2009 SGIM annual meeting were subsequently published in indexed medical journals. The MERSQI demonstrated good inter-rater reliability (intraclass correlation range, 0.77-1.00) for grading the quality of medical education abstracts. MERSQI scores were higher for published versus unpublished abstracts (9.59 vs. 8.81, p = 0.03). Abstracts with a MERSQI score of 10 or greater were more likely to be published (OR 3.18, 95% CI 1.47-6.89, p = 0.003). ). MERSQI scores were higher for scientific versus IME abstracts (9.88 vs. 8.31, p < 0.001). Publication rates were higher for scientific abstracts (42 [66%] vs. 37 [46%], p = 0.02) and oral presentations (15 [23%] vs. 6 [8%], p = 0.01). The publication rate of medical education abstracts presented at the 2009 SGIM annual meeting was similar to reported publication rates for biomedical research abstracts, but higher than publication rates reported for medical education abstracts. MERSQI scores were associated with higher abstract publication rates, suggesting that attention to measures of quality--such as sampling, instrument validity, and data analysis
Effects of a constant rate infusion of detomidine on cardiovascular function, isoflurane requirements and recovery quality in horses.

PubMed

Schauvliege, Stijn; Marcilla, Miguel Gozalo; Verryken, Kirsten; Duchateau, Luc; Devisscher, Lindsey; Gasthuys, Frank

2011-11-01

To examine the influence of a detomidine constant rate infusion (CRI) on cardiovascular function, isoflurane requirements and recovery quality in horses undergoing elective surgery. Prospective, randomized, blinded, clinical trial. Twenty adult healthy horses. After sedation (detomidine, 10 μg kg(-1) intravenously [IV]) and induction of anaesthesia (midazolam 0.06 mg kg(-1) , ketamine 2.2 mg kg(-1) IV), anaesthesia was maintained with isoflurane in oxygen/air (inspiratory oxygen fraction 55%). When indicated, the lungs were mechanically ventilated. Dobutamine was administered when MAP<70 mmHg. The horses were randomly allocated to one of two groups and throughout anaesthesia, received either a detomidine (5 μg kg(-1) hour(-1) ) (D) or saline (S) CRI, with the anaesthetist unaware of the treatment. Monitoring included end-tidal isoflurane concentration, arterial pH, PaCO(2) , PaO(2) , dobutamine administration rate, heart rate (HR), arterial pressure, cardiac index (CI), systemic vascular resistance (SVR), stroke index and oxygen delivery index (ḊO(2) I). For recovery from anaesthesia, all horses received 2.5 μg kg(-1) detomidine IV. Recovery quality and duration were recorded in each horse. For statistical analysis, anova, Pearson chi-square and Wilcoxon rank sum tests were used as relevant. Heart rate (p=0.0176) and ḊO(2) I (p= 0.0084) were lower and SVR higher (p=0.0126) in group D, compared to group S. Heart rate (p=0.0011) and pH (p=0.0187) increased over time. Significant differences in isoflurane requirements were not detected. Recovery quality and duration were comparable between treatments. A detomidine CRI produced cardiovascular effects typical for α(2) -agonists, without affecting isoflurane requirements, recovery duration or recovery quality. © 2011 The Authors. Veterinary Anaesthesia and Analgesia. © 2011 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

Studies on deflection area vectors of QRS and T and ventricular gradient in right ventricular hypertrophy.

PubMed

Kawaguchi, Y

1985-04-01

QRS deflection area vector (Aqrs), T deflection area vector (At) and ventricular gradient (G) in right ventricular hypertrophy were studied in 53 subjects divided on the basis of cardiac catheterization data into four subgroups; normal controls, mild MS group, right ventricular pressure overload group and right ventricular volume overload group. Aqrs, At and G of the four subgroups were calculated using a microcomputer and compared. Aqrs in right ventricular pressure overload group and volume overload group was shifted to the right and slightly anteriorly from that in normal control group. At in right ventricular pressure overload group and volume overload group was shifted slightly upwards and significantly posteriorly from that in the normal control and mild MS groups. G in right ventricular pressure overload group and volume overload group was shifted to the right and significantly posteriorly from that in normal control and mild MS groups. Using multivariative analysis, we developed criteria for diagnosing right ventricular hypertrophy with At: 0.059At(Z) - 0.0145 [At] - 0.2608 less than or equal to 0. Application of this criteria achieved 82.4% (28 of 34) sensitivity in the patients with right ventricular hypertrophy and 90.9% (10 of 11) specificity in the normal control subjects.
Quality Rating Improvement System "for" Early Care "and" Education: Development, Implementation, Evaluation and Learning

ERIC Educational Resources Information Center

Shen, Jianping; Ma, Xin

2013-01-01

Quality Rating Improvement System (QRIS) has gained national momentum. The authors first present a national scene of QRIS and then use Children's Services Council of Palm Beach County as a case study to illustrate a number of things. First, they look at the logic model behind the QRIS. Next, they review the design and implementation of the QRIS in…
Determination of the water quality index ratings of water in the Mpumalanga and North West provinces, South Africa

NASA Astrophysics Data System (ADS)

Wanda, Elijah M. M.; Mamba, Bhekie B.; Msagati, Titus A. M.

2016-04-01

This study reports on the water quality index (WQI) of wastewater and drinking water in the Mpumalanga and North West provinces of South Africa. The WQI is one of the most effective tools available to water sustainability researchers, because it provides an easily intelligible ranking of water quality on a rating scale from 0 to 100, based on the ascription of different weightings to several different parameters. In this study the WQI index ratings of wastewater and drinking water samples were computed according to the levels of pH, electrical conductivity (EC), biochemical oxygen demand (BOD), E. coli, temperature, turbidity and nutrients (nitrogen and phosphates) found in water samples collected from the two provinces between June and December, 2014. This study isolated three groups of WQ-rated waters, namely: fair (with a WQI range = 32.87-38.54%), medium (with a WQI range = 56.54-69.77%) and good (with a WQI range = 71.69-81.63%). More specifically, 23%, 23% and 54% of the sampled sites registered waters with fair, medium and good WQ ratings respectively. None of the sites sampled during the entire period of the project registered excellent or very good water quality ratings, which would ordinarily indicate that no treatment is required to make it fit for human consumption. Nevertheless, the results obtained by the Eerstehoek and Schoemansville water treatment plants in Mpumalanga and North West provinces, respectively, suggest that substantial improvement in the quality of water samples is possible, since the WQI values for all of the treated samples were higher than those for raw water. Presence of high levels of BOD, low levels of dissolved oxygen (DO), E. coli, nitrates and phosphates especially in raw water samples greatly affected their overall WQ ratings. It is recommended that a point-of-use system should be introduced to treat water intended for domestic purposes in the clean-water-deprived areas.
Handling Qualities of a Large Civil Tiltrotor in Hover using Translational Rate Command

NASA Technical Reports Server (NTRS)

Malpica, Carlos A.; Theodore, Colin R.; Lawrence, Ben; Lindsey, James; Blanken, Chris

2012-01-01

A Translational Rate Command (TRC) control law has been developed to enable low speed maneuvering of a large civil tiltrotor with minimal pitch changes by means of automatic nacelle angle deflections for longitudinal velocity control. The nacelle actuator bandwidth required to achieve Level 1 handling qualities in hover and the feasibility of additional longitudinal cyclic control to augment low bandwidth nacelle actuation were investigated. A frequency-domain handling qualities criterion characterizing TRC response in terms of bandwidth and phase delay was proposed and validated against a piloted simulation conducted on the NASA-Ames Vertical Motion Simulator. Seven experimental test pilots completed evaluations in the ADS-33E-PRF Hover Mission Task Element (MTE) for a matrix of nacelle actuator bandwidths, equivalent rise times and control response sensitivities, and longitudinal cyclic control allocations. Evaluated against this task, longitudinal phase delay shows the Level 1 boundary is around 0.4 0.5 s. Accordingly, Level 1 handling qualities were achieved either with a nacelle actuator bandwidth greater than 4 rad/s, or by employing longitudinal cyclic control to augment low bandwidth nacelle actuation.
Direct Measurements of the Ozone Production Rate: Methods, Measurements, and Implications for Air Quality Monitoring

NASA Astrophysics Data System (ADS)

Brune, W. H.; Baier, B.; Miller, D. O.; Apel, E. C.; Wisthaler, A.; Fried, A.; Cantrell, C. A.; Blake, D. R.; Brown, S. S.; McDuffie, E. E.; Kaser, L.; Long, R.; Weinheimer, A. J.

2017-12-01

Ground level ozone pollution remains a health hazard in the United States despite dramatic reductions due to regulatory actions over the past three decades. The key to understanding the link between the ozone precursor gases, nitrogen oxides (NOx) and volatile organic compounds (VOCs), and ozone pollution is the ozone production rate. However, in air quality models, uncertainties in emissions and meteorology hide the true sensitivity of modeled ozone to the chemistry of the ozone production rate. A better way to understand the ozone production rate is to measure it directly. We devised a method for measuring the ozone production rate directly and have deployed it in a few field studies. In this presentation, we will discuss some fairly recent observations, the strengths and weaknesses of the current method, and a path toward routine monitoring of the ozone production rate.
Junior doctors in their first year: mental health, quality of life, burnout and heart rate variability.

PubMed

Henning, Marcus A; Sollers, John; Strom, Joanna M; Hill, Andrew G; Lyndon, Mataroria P; Cumin, David; Hawken, Susan J

2014-04-01

There is a burgeoning interest in, and evidence of, quality of life and burnout issues among doctors. It was hypothesized that the junior doctors in this study would experience psychosocial and physiological changes over time, and that the obtained measures would indicate psychosocial and physiological anomalies. In addition, it was hypothesized that their psychosocial perceptions would be significantly associated with their physiological measures. A total sample of 17 junior doctors in their first year of training volunteered for this study. Over four time periods separated by 6 week phases, the doctors completed a set of quality of life and psychosocial inventories and wore a Polar RS800 Heart Rate Monitor over a day and night time interval. The findings showed that this sample of doctors did not report any problems associated with depression, anxiety, stress, burnout or quality of life (psychosocial measures). In addition, their heart rate variability scores (physiological measures) did not show any significant fluctuations. Furthermore, the responses from the self-report instruments measuring stress, anxiety, depression, quality of life and burnout did not consistently correlate with the HRV information suggesting a mind-body disconnection. More work needs to be done on larger samples to investigate these findings further given that the literature shows that junior doctors are likely to be stressed and working in stress-provoking environments.
Validation of Quality Rating and Improvement Systems for Early Care and Education and School-Age Care. Research-to-Policy, Research-to-Practice Brief. OPRE 2012-29

ERIC Educational Resources Information Center

Zellman, Gail L.; Fiene, Richard

2012-01-01

Quality Rating and Improvement Systems (QRIS) for early care and education and school age care programs are designed to collect information about quality and to use that information to produce program-level ratings, which are the foundation of a QRIS. The ratings are intended to make program quality transparent for parents and other stakeholders…
Nurse occupational burnout and patient-rated quality of care: The boundary conditions of emotional intelligence and demographic profiles.

PubMed

Chao, Minston; Shih, Chih-Ting; Hsu, Shu-Fen

2016-01-01

Most previous studies on the relationship between occupational burnout and the quality of care among nurses have used self-reported data on the quality of care from nurses, thus rendering evaluating the relationship between burnout and the quality of care difficult. Hospitals increasingly hire contract nurses and high turnover rates remain a concern. Little is known about whether nurses' emotional intelligence and demographic factors such as contract status, tenure, and marital status affect the quality of care when burnout occurs. This study investigated the relationship between burnout and patient-rated quality of care and investigated the moderating role of emotional intelligence and demographic variables. Hierarchical moderated regression was used to analyze 98 sets of paired data obtained from nurses and their patients at a teaching hospital in northern Taiwan. The results suggest that occupational burnout has a less unfavorable effect on the quality of care from permanent, married, and senior nurses. Nursing management should pay particular attention to retaining permanent, married, and senior nurses. To ensure a sustainable nursing workforce in the future, newly graduated registered nurses should have access to permanent positions and opportunities for long-term professional development. In addition, married nurses should be provided with flexible work-family arrangements to ensure their satisfaction in the nursing profession. © 2015 Japan Academy of Nursing Science.
Smartphone Apps for Measuring Human Health and Climate Change Co-Benefits: A Comparison and Quality Rating of Available Apps

PubMed Central

Sullivan, Rachel K; Marsh, Samantha; Halvarsson, Jakob; Holdsworth, Michelle; Waterlander, Wilma; Poelman, Maartje P; Salmond, Jennifer Ann; Christian, Hayley; Koh, Lenny SC; Cade, Janet E; Spence, John C; Woodward, Alistair

2016-01-01

Background Climate change and the burden of noncommunicable diseases are major global challenges. Opportunities exist to investigate health and climate change co-benefits through a shift from motorized to active transport (walking and cycling) and a shift in dietary patterns away from a globalized diet to reduced consumption of meat and energy dense foods. Given the ubiquitous use and proliferation of smartphone apps, an opportunity exists to use this technology to capture individual travel and dietary behavior and the associated impact on the environment and health. Objective The objective of the study is to identify, describe the features, and rate the quality of existing smartphone apps which capture personal travel and dietary behavior and simultaneously estimate the carbon cost and potential health consequences of these actions. Methods The Google Play and Apple App Stores were searched between October 19 and November 6, 2015, and a secondary Google search using the apps filter was conducted between August 8 and September 18, 2016. Eligible apps were required to estimate the carbon cost of personal behaviors with the potential to include features to maximize health outcomes. The quality of included apps was assessed by 2 researchers using the Mobile Application Rating Scale (MARS). Results Out of 7213 results, 40 apps were identified and rated. Multiple travel-related apps were identified, however no apps solely focused on the carbon impact or health consequences of dietary behavior. None of the rated apps provided sufficient information on the health consequences of travel and dietary behavior. Some apps included features to maximize participant engagement and encourage behavior change towards reduced greenhouse gas emissions. Most apps were rated as acceptable quality as determined by the MARS; 1 was of poor quality and 10 apps were of good quality. Interrater reliability of the 2 evaluators was excellent (ICC=0.94, 95% CI 0.87-0.97). Conclusions Existing
Boar sperm quality in lines of pigs selected for either ovulation rate or uterine capacity

USDA-ARS?s Scientific Manuscript database

Selection for 11 generations in swine for ovulation rate (OR) or uterine capacity (UC) resulted in significant changes in component traits of litter size. Our objective was to conserve the unique germplasm for the future and to characterize sperm quality as a correlated response to the selection cr...
Decreased Sperm Motility Retarded ICSI Fertilization Rate in Severe Oligozoospermia but Good-Quality Embryo Transfer Had Achieved the Prospective Clinical Outcomes.

PubMed

Zheng, Jufeng; Lu, Yongning; Qu, Xianqin; Wang, Peng; Zhao, Luiwen; Gao, Minzhi; Shi, Huijuan; Jin, Xingliang

Spermatozoa motility is the critical parameter to affect the treatment outcomes during assisted reproductive technologies (ART), but its reproductive capability remains a little informed in condition of severe male factor infertility. This retrospective cohort study aimed to evaluate the effects of reduced sperm motility on the embryological and clinical outcomes in intra-cytoplasmic sperm injection (ICSI) treatment of severe oligozoospermia. 966 cycles (812 couples) of severe oligozoospermia diagnosed by spermatozoa count ≤ 5 × 106/mL and motile spermatozoa ≤ 2 × 106/mL were divided into four groups in according to the number of motile spermatozoa in one ejaculate on the day of oocyte retrieval (Group B-E). The control (Group A) was 188 cycles of moderate oligozoospermia with spermatozoa count > 5 × 106/mL and motile spermatozoa > 2 × 106/mL. All female partners were younger than 35 years of age. Logistic regression analyzed embryological outcomes (the rates of fertilization, cleavage and good-quality embryo) and clinical outcomes (the rates of pregnancy, implantation, early miscarriage and live birth). Quality of embryo transfer (ET) was divided into three classes as continuous factor to test the effects of embryo quality on clinical outcomes. The reduction in the number of motile sperm in four groups of severe oligozoospermia gave rise to comparable inability of the fertilization (p < 0.001) and a decreased rate of good-quality embryo at Day 3 (p < 0.001) by compared to the control. The cleavage rate of the derived zygotes was similar to the control. ET classes significantly affected the clinical outcomes (p < 0.001). Class I ET gave rise to similar rates of clinical outcomes between five groups, but Class II and Class III ET retarded the rates of pregnancy, implantation and live birth and this particularly occurred in Group C, D and E. The rate of early miscarriage was not comparably different between groups. Overall rates in all groups were 41
Beyond the false negative rate: development of quality indicators for sentinel lymph node biopsy in breast cancer.

PubMed

Quan, May Lynn; Wells, Bryan J; McCready, David; Wright, Frances C; Fraser, Novlette; Gagliardi, Anna R

2010-02-01

Sentinel lymph node biopsy (SNLB) has been adopted as the standard method of axillary staging for women with clinically node-negative early-stage breast cancer. The false negative rate as a quality indicator is impractical given the need for a completion axillary dissection to calculate. The objective of this study was to develop practical quality indicators for SLNB using an expert consensus method and to determine if they were feasible to measure. We used a modified Delphi consensus process to develop quality indicators for SLNB. A multidisciplinary expert panel reviewed potential indicators extracted from the medical literature to select quality indicators that were relevant and measurable. Feasibility was determined by abstracting the quality indicator variables from a retrospective chart review. The expert panel prioritized 11 quality indicators as benchmarks for assessing the quality of surgical care in SNLB. Nine of the indicators were measurable at the chart or institutional level. A systematic evidence- and consensus-based approach was used to develop measurable quality indicators that could be used by practicing surgeons and administrators to evaluate performance of SLNB in breast cancer.
Adaptive prospective ECG-triggered sequence coronary angiography in dual-source CT without heart rate control: Image quality and diagnostic performance.

PubMed

Pan, Chang-Jie; Qian, Nong; Wang, Tao; Tang, Xiao-Qiang; Xue, Yue-Jun

2013-02-01

The aim of this study was to evaluate the accuracy of using second generation dual-source CT (DSCT) to obtain high quality images and diagnostic performance and to reduce the radiation dose in adaptive prospective electrocardiography (ECG)-triggered sequence (CorAdSeq) CT coronary angiography (CTCA) without heart rate control. No prescan β-blockers were administered. Un-enhanced CT and CTCA with adaptive prospective CorAdSeq scanning without heart rate control were performed in 683 consecutive patients divided into two body mass index (BMI) groups: BMI <25 kg/m(2) (group A, n=412) and BMI ≥25 kg/m(2) (group B, n=271). The image quality and quantitative stenosis of all coronary segments with a diameter ≥1 mm were assessed. The mean heart rate (MHR), heart rate variability (HRV) and radiation dose values were recorded. In 426 cases, the diagnostic performance was evaluated using quantitative conventional coronary angiography as the reference standard. Diagnostic image quality was obtained in 98.5% of segments in group A and in 98.8% of segments in group B, with no significant differences between the groups. No correlations were observed between the image quality score and MHR or HRV (P=0.492, P=0.564, respectively). The effective radiation doses in groups A and B were 2.57±1.01 mSv and 6.36±1.88 mSv, respectively. The sensitivities and specificities of diagnosing coronary heart disease per patient were 99.6% and 97.8% in group A and 99.5% and 97.5% in group B, respectively (P>0.05). Adaptive prospective CorAdSeq scanning, without heart rate control, by second generation DSCT had a high image quality and diagnostic performance for coronary artery stenosis with lower radiation doses.
Sleep quality, but not quantity, is associated with self-perceived minor error rates among emergency department nurses.

PubMed

Weaver, Amy L; Stutzman, Sonja E; Supnet, Charlene; Olson, DaiWai M

2016-03-01

The emergency department (ED) is demanding and high risk. The impact of sleep quantity has been hypothesized to impact patient care. This study investigated the hypothesis that fatigue and impaired mentation, due to sleep disturbance and shortened overall sleeping hours, would lead to increased nursing errors. This is a prospective observational study of 30 ED nurses using self-administered survey and sleep architecture measured by wrist actigraphy as predictors of self-reported error rates. An actigraphy device was worn prior to working a 12-hour shift and nurses completed the Pittsburgh Sleep Quality Index (PSQI). Error rates were reported on a visual analog scale at the end of a 12-hour shift. The PSQI responses indicated that 73.3% of subjects had poor sleep quality. Lower sleep quality measured by actigraphy (hours asleep/hours in bed) was associated with higher self-perceived minor errors. Sleep quantity (total hours slept) was not associated with minor, moderate, nor severe errors. Our study found that ED nurses' sleep quality, immediately prior to a working 12-hour shift, is more predictive of error than sleep quantity. These results present evidence that a "good night's sleep" prior to working a nursing shift in the ED is beneficial for reducing minor errors. Copyright © 2016 Elsevier Ltd. All rights reserved.
Impact of the use of an endorectal coil for 3 T prostate MRI on image quality and cancer detection rate

NASA Astrophysics Data System (ADS)

Gawlitza, Josephin; Reiss-Zimmermann, Martin; Thörmer, Gregor; Schaudinn, Alexander; Linder, Nicolas; Garnov, Nikita; Horn, Lars-Christian; Minh, Do Hoang; Ganzer, Roman; Stolzenburg, Jens-Uwe; Kahn, Thomas; Moche, Michael; Busse, Harald

2017-02-01

This work aims to assess the impact of an additional endorectal coil on image quality and cancer detection rate within the same patients. At a single academic medical center, this transversal study included 41 men who underwent T2- and diffusion-weighted imaging at 3 T using surface coils only or in combination with an endorectal coil in the same session. Two blinded readers (A and B) randomly evaluated all image data in separate sessions. Image quality with respect to localization and staging was rated on a five-point scale. Lesions were classified according to their prostate imaging reporting and data system (PIRADS) score version 1. Standard of reference was provided by whole-mount step-section analysis. Mean image quality scores averaged over all localization-related items were significantly higher with additional endorectal coil for both readers (p < 0.001), corresponding staging-related items were only higher for reader B (p < 0.001). With an endorectal coil, the rate of correctly detecting cancer per patient was significantly higher for reader B (p < 0.001) but not for reader A (p = 0.219). The numbers of histologically confirmed tumor lesions were rather similar for both settings. The subjectively rated 3-T image quality was improved with an endorectal coil. In terms of diagnostic performance, the use of an additional endorectal coil was not superior.
Impact of the use of an endorectal coil for 3 T prostate MRI on image quality and cancer detection rate

PubMed Central

Gawlitza, Josephin; Reiss-Zimmermann, Martin; Thörmer, Gregor; Schaudinn, Alexander; Linder, Nicolas; Garnov, Nikita; Horn, Lars-Christian; Minh, Do Hoang; Ganzer, Roman; Stolzenburg, Jens-Uwe; Kahn, Thomas; Moche, Michael; Busse, Harald

2017-01-01

This work aims to assess the impact of an additional endorectal coil on image quality and cancer detection rate within the same patients. At a single academic medical center, this transversal study included 41 men who underwent T2- and diffusion-weighted imaging at 3 T using surface coils only or in combination with an endorectal coil in the same session. Two blinded readers (A and B) randomly evaluated all image data in separate sessions. Image quality with respect to localization and staging was rated on a five-point scale. Lesions were classified according to their prostate imaging reporting and data system (PIRADS) score version 1. Standard of reference was provided by whole-mount step-section analysis. Mean image quality scores averaged over all localization-related items were significantly higher with additional endorectal coil for both readers (p < 0.001), corresponding staging-related items were only higher for reader B (p < 0.001). With an endorectal coil, the rate of correctly detecting cancer per patient was significantly higher for reader B (p < 0.001) but not for reader A (p = 0.219). The numbers of histologically confirmed tumor lesions were rather similar for both settings. The subjectively rated 3-T image quality was improved with an endorectal coil. In terms of diagnostic performance, the use of an additional endorectal coil was not superior. PMID:28145525
Impact of the use of an endorectal coil for 3 T prostate MRI on image quality and cancer detection rate.

PubMed

Gawlitza, Josephin; Reiss-Zimmermann, Martin; Thörmer, Gregor; Schaudinn, Alexander; Linder, Nicolas; Garnov, Nikita; Horn, Lars-Christian; Minh, Do Hoang; Ganzer, Roman; Stolzenburg, Jens-Uwe; Kahn, Thomas; Moche, Michael; Busse, Harald

2017-02-01

This work aims to assess the impact of an additional endorectal coil on image quality and cancer detection rate within the same patients. At a single academic medical center, this transversal study included 41 men who underwent T2- and diffusion-weighted imaging at 3 T using surface coils only or in combination with an endorectal coil in the same session. Two blinded readers (A and B) randomly evaluated all image data in separate sessions. Image quality with respect to localization and staging was rated on a five-point scale. Lesions were classified according to their prostate imaging reporting and data system (PIRADS) score version 1. Standard of reference was provided by whole-mount step-section analysis. Mean image quality scores averaged over all localization-related items were significantly higher with additional endorectal coil for both readers (p < 0.001), corresponding staging-related items were only higher for reader B (p < 0.001). With an endorectal coil, the rate of correctly detecting cancer per patient was significantly higher for reader B (p < 0.001) but not for reader A (p = 0.219). The numbers of histologically confirmed tumor lesions were rather similar for both settings. The subjectively rated 3-T image quality was improved with an endorectal coil. In terms of diagnostic performance, the use of an additional endorectal coil was not superior.
Self-Rated Communication-Related Quality of Life of Individuals With Oromandibular Dystonia Receiving Botulinum Toxin Injections.

PubMed

Page, Allyson D; Siegel, Lauren; Jog, Mandar

2017-06-22

In this preliminary study, we examined self-rated communication-related quality of life (CR-QoL) of 10 control participants and 10 individuals with oromandibular dystonia (OMD) and dysarthria receiving therapeutic botulinum toxin (BoNT-A) injections. Participants with OMD and associated dysarthria self-rated CR-QoL pre- and post- BoNT-A injection using the American Speech-Language-Hearing Association's Quality of Communication Life Scale (ASHA QCL; Paul et al., 2004). Control participants self-rated CR-QoL during a single experimental visit. Significant differences were found between control participants and participants with OMD on ratings of CR-QoL across all 5 domains and subdomains of the ASHA QCL. No significant differences in CR-QoL were found over the course of the BoNT-A treatment cycle. CR-QoL was rated lower by participants with OMD as compared with control participants across all ASHA QCL domains/subdomains with "socialization/activities" and "confidence/self-concept" having the largest effect sizes. No differences in CR-QoL were found over the course of the treatment cycle. We advocate for outcome measures that include patient report. The use of patient-reported outcome measures in conjunction with objective or impairment-based outcome measures can help inform meaningful clinical indicators of treatment success. This study adds novel information that may aid our understanding of the experience of living with OMD in this underserviced clinical population.
X-rays from accretion of red giant winds

NASA Technical Reports Server (NTRS)

Jura, M.; Helfand, D. J.

1984-01-01

X-ray observations of the late-type red giants Mira and R Aqr obtained with the Einstein Observatory are presented, and the general problems of white dwarf accretion from late-type giant winds is considered. The extremely low measured luminosities obtained for the two systems leads to the conclusion that the companions of Mira and R Aqr are most likely low-mass main sequence objects rather than white dwarfs as is usually assumed. The expected X-ray luminosities of true red giant/white dwarf systems are considered, and it is concluded that far too few have been detected if the canonical accretion scenario is adopted. A possible explanation of this situation in terms of grain-dominated Eddington-limited accretion is proposed.
Proxy rated quality of life of care home residents with dementia: a systematic review.

PubMed

Robertson, Sarah; Cooper, Claudia; Hoe, Juanita; Hamilton, Olivia; Stringer, Aisling; Livingston, Gill

2017-04-01

Quality of life (QoL) is an important outcome for people with dementia living in care homes but usually needs to be rated by a proxy. We do not know if relative or paid carer proxy reports differ. We conducted the first systematic review and meta-analysis of data investigating whether and how these proxy reports of QoL differ. We searched four databases: Medline, Embase, PsychInfo, and CINAHL in October 2015 with the terms: dementia, QoL, proxy, and care home. Included studies either compared proxy QoL ratings or investigated the factors associated with them. We meta-analyzed data comparing staff and family proxy rated QoL. We included 17/105 papers identified. We found no difference between global proxy ratings of QoL (n = 1,290; pooled effect size 0.06 (95% CI = -0.08 to 0.19)). Studies investigating factors associated with ratings (n = 3,537) found family and staff ratings correlated with the resident's physical and mental health. Staff who were more distressed rated resident QoL lower. Relatives rated it lower when the resident had lived in the care home for longer, when they observed more restraint, or contributed more to fees. Relatives and staff proxy QoL ratings share a clear relationship to resident health and overall ratings were similar. Rater-specific factors were, however, also associated with scores. Understanding why different raters consider the QoL of the same person differently is an important consideration when evaluating the meaning of proxy rated QoL. Proxy raters' backgrounds may affect their rating of QoL.

The endoscopy Global Rating Scale – Canada: Development and implementation of a quality improvement tool

PubMed Central

MacIntosh, Donald; Dubé, Catherine; Hollingworth, Roger; van Zanten, Sander Veldhuyzen; Daniels, Sandra; Ghattas, George

2013-01-01

BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer. OBJECTIVE: To adapt the United Kingdom Global Rating Scale (UK-GRS) to develop a web-based and patient-centred tool to assess and improve the quality of endoscopy services provided. METHODS: Based on feedback from 22 sites across Canada that completed the UK endoscopy GRS, and integrating results of the Canadian consensus on safety and quality indicators in endoscopy and other Canadian consensus reports, a working group of endoscopists experienced with the GRS developed the GRS-Canada (GRS-C). RESULTS: The GRS-C mirrors the two dimensions (clinical quality and quality of the patient experience) and 12 patient-centred items of the UK-GRS, but was modified to apply to Canadian health care infrastructure, language and current practice. Each item is assessed by a yes/no response to eight to 12 statements that are divided into levels graded D (basic) through A (advanced). A core team consisting of a booking clerk, charge nurse and the physician responsible for the unit is recommended to complete the GRS-C twice yearly. CONCLUSION: The GRS-C is intended to improve endoscopic services in Canada by providing endoscopy units with a straightforward process to review the quality of the service they provide. PMID:23472242
Smartphone Apps for Measuring Human Health and Climate Change Co-Benefits: A Comparison and Quality Rating of Available Apps.

PubMed

Sullivan, Rachel K; Marsh, Samantha; Halvarsson, Jakob; Holdsworth, Michelle; Waterlander, Wilma; Poelman, Maartje P; Salmond, Jennifer Ann; Christian, Hayley; Koh, Lenny Sc; Cade, Janet E; Spence, John C; Woodward, Alistair; Maddison, Ralph

2016-12-19

Climate change and the burden of noncommunicable diseases are major global challenges. Opportunities exist to investigate health and climate change co-benefits through a shift from motorized to active transport (walking and cycling) and a shift in dietary patterns away from a globalized diet to reduced consumption of meat and energy dense foods. Given the ubiquitous use and proliferation of smartphone apps, an opportunity exists to use this technology to capture individual travel and dietary behavior and the associated impact on the environment and health. The objective of the study is to identify, describe the features, and rate the quality of existing smartphone apps which capture personal travel and dietary behavior and simultaneously estimate the carbon cost and potential health consequences of these actions. The Google Play and Apple App Stores were searched between October 19 and November 6, 2015, and a secondary Google search using the apps filter was conducted between August 8 and September 18, 2016. Eligible apps were required to estimate the carbon cost of personal behaviors with the potential to include features to maximize health outcomes. The quality of included apps was assessed by 2 researchers using the Mobile Application Rating Scale (MARS). Out of 7213 results, 40 apps were identified and rated. Multiple travel-related apps were identified, however no apps solely focused on the carbon impact or health consequences of dietary behavior. None of the rated apps provided sufficient information on the health consequences of travel and dietary behavior. Some apps included features to maximize participant engagement and encourage behavior change towards reduced greenhouse gas emissions. Most apps were rated as acceptable quality as determined by the MARS; 1 was of poor quality and 10 apps were of good quality. Interrater reliability of the 2 evaluators was excellent (ICC=0.94, 95% CI 0.87-0.97). Existing apps capturing travel and dietary behavior and the
Sampling frequency for water quality variables in streams: Systems analysis to quantify minimum monitoring rates.

PubMed

Chappell, Nick A; Jones, Timothy D; Tych, Wlodek

2017-10-15

Insufficient temporal monitoring of water quality in streams or engineered drains alters the apparent shape of storm chemographs, resulting in shifted model parameterisations and changed interpretations of solute sources that have produced episodes of poor water quality. This so-called 'aliasing' phenomenon is poorly recognised in water research. Using advances in in-situ sensor technology it is now possible to monitor sufficiently frequently to avoid the onset of aliasing. A systems modelling procedure is presented allowing objective identification of sampling rates needed to avoid aliasing within strongly rainfall-driven chemical dynamics. In this study aliasing of storm chemograph shapes was quantified by changes in the time constant parameter (TC) of transfer functions. As a proportion of the original TC, the onset of aliasing varied between watersheds, ranging from 3.9-7.7 to 54-79 %TC (or 110-160 to 300-600 min). However, a minimum monitoring rate could be identified for all datasets if the modelling results were presented in the form of a new statistic, ΔTC. For the eight H + , DOC and NO 3 -N datasets examined from a range of watershed settings, an empirically-derived threshold of 1.3(ΔTC) could be used to quantify minimum monitoring rates within sampling protocols to avoid artefacts in subsequent data analysis. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Improving response rate and quality of survey data with a scratch lottery ticket incentive

PubMed Central

2012-01-01

Background The quality of data collected in survey research is usually indicated by the response rate; the representativeness of the sample, and; the rate of completed questions (item-response). In attempting to improve a generally declining response rate in surveys considerable efforts are being made through follow-up mailings and various types of incentives. This study examines effects of including a scratch lottery ticket in the invitation letter to a survey. Method Questionnaires concerning oral health were mailed to a random sample of 2,400 adults. A systematically selected half of the sample (1,200 adults) received a questionnaire including a scratch lottery ticket. One reminder without the incentive was sent. Results The incentive increased the response rate and improved representativeness by reaching more respondents with lower education. Furthermore, it reduced item nonresponse. The initial incentive had no effect on the propensity to respond after the reminder. Conclusion When attempting to improve survey data, three issues become important: response rate, representativeness, and item-response. This study shows that including a scratch lottery ticket in the invitation letter performs well on all the three. PMID:22515335
Effect of metronome rates on the quality of bag-mask ventilation during metronome-guided 30:2 cardiopulmonary resuscitation: A randomized simulation study.

PubMed

Na, Ji Ung; Han, Sang Kuk; Choi, Pil Cho; Shin, Dong Hyuk

2017-01-01

Metronome guidance is a feasible and effective feedback technique to improve the quality of cardiopulmonary resuscitation (CPR). The rate of the metronome should be set between 100 to 120 ticks/minute and the speed of ventilation may have crucial effect on the quality of ventilation. We compared three different metronome rates (100, 110, 120 ticks/minute) to investigate its effect on the quality of ventilation during metronome-guided 30:2 CPR. This is a prospective, randomized, crossover observational study using a RespiTrainer○ r . To simulate 30 chest compressions, one investigator counted from 1 to 30 in cadence with the metronome rate (1 count for every 1 tick), and the participant performed 2 consecutive ventilations immediately following the counting of 30. Thirty physicians performed 5 sets of 2 consecutive (total 10) bag-mask ventilations for each metronome rate. Participants were instructed to squeeze the bag over 2 ticks (1.0 to 1.2 seconds depending on the rate of metronome) and deflate the bag over 2 ticks. The sequence of three different metronome rates was randomized. Mean tidal volume significantly decreased as the metronome rate was increased from 110 ticks/minute to 120 ticks/minute (343±84 mL vs. 294±90 mL, P =0.004). Peak airway pressure significantly increased as metronome rate increased from 100 ticks/minute to 110 ticks/minute (18.7 vs. 21.6 mmHg, P =0.006). In metronome-guided 30:2 CPR, a higher metronome rate may adversely affect the quality of bag-mask ventilations. In cases of cardiac arrest where adequate ventilation support is necessary, 100 ticks/minute may be better than 110 or 120 ticks/minute to deliver adequate tidal volume during audio tone guided 30:2 CPR.
Effect of metronome rates on the quality of bag-mask ventilation during metronome-guided 30:2 cardiopulmonary resuscitation: A randomized simulation study

PubMed Central

Na, Ji Ung; Han, Sang Kuk; Choi, Pil Cho; Shin, Dong Hyuk

2017-01-01

BACKGROUND: Metronome guidance is a feasible and effective feedback technique to improve the quality of cardiopulmonary resuscitation (CPR). The rate of the metronome should be set between 100 to 120 ticks/minute and the speed of ventilation may have crucial effect on the quality of ventilation. We compared three different metronome rates (100, 110, 120 ticks/minute) to investigate its effect on the quality of ventilation during metronome-guided 30:2 CPR. METHODS: This is a prospective, randomized, crossover observational study using a RespiTrainer○r. To simulate 30 chest compressions, one investigator counted from 1 to 30 in cadence with the metronome rate (1 count for every 1 tick), and the participant performed 2 consecutive ventilations immediately following the counting of 30. Thirty physicians performed 5 sets of 2 consecutive (total 10) bag-mask ventilations for each metronome rate. Participants were instructed to squeeze the bag over 2 ticks (1.0 to 1.2 seconds depending on the rate of metronome) and deflate the bag over 2 ticks. The sequence of three different metronome rates was randomized. RESULTS: Mean tidal volume significantly decreased as the metronome rate was increased from 110 ticks/minute to 120 ticks/minute (343±84 mL vs. 294±90 mL, P=0.004). Peak airway pressure significantly increased as metronome rate increased from 100 ticks/minute to 110 ticks/minute (18.7 vs. 21.6 mmHg, P=0.006). CONCLUSION: In metronome-guided 30:2 CPR, a higher metronome rate may adversely affect the quality of bag-mask ventilations. In cases of cardiac arrest where adequate ventilation support is necessary, 100 ticks/minute may be better than 110 or 120 ticks/minute to deliver adequate tidal volume during audio tone guided 30:2 CPR. PMID:28458759
Disk-Anchored Magnetic Propellers - A Cure for the SW Sex Syndrome

NASA Astrophysics Data System (ADS)

Horne, Keith

In AE Aqr, magnetic fields transfer energy and angular momentum from a rapidly-spinning white dwarf to material in the gas stream from the companion star, with the effect of spinning down the white dwarf while flinging the gas stream material out of the binary system. This magnetic propeller produces a host of observable signatures, chief among which are broad, single-peaked, flaring emission lines with phase-shifted orbital kinematics. SW Sex stars have accretion disks, but also broad, single-peaked, phase-shifted emission lines similar to those seen in AE Aqr. We propose that a magnetic propeller similar to that which operates in AE Aqr is also at work in SW Sex stars - and to some extent in all nova-like systems. The propeller is anchored in the inner accretion disk, rather than, or in addition to, the white dwarf. Energy and angular momentum are thereby extracted from the inner disk and transferred to gas-stream material flowing above the disk, which is consequently pitched out of the system. This provides a non-local, dissipationless angular-momentum-extraction mechanism, which should result in cool inner disks with temperature profiles flatter than T propto R^{-3/4}, as observed in eclipse mapping studies of nova-like variables. The disk-anchored magnetic propeller model appears to explain qualitatively most if not all of the peculiar features of the SW Sex syndrome.
Quality of information about success rates provided on assisted reproductive technology clinic websites in Australia and New Zealand.

PubMed

Hammarberg, Karin; Prentice, Tess; Purcell, Isabelle; Johnson, Louise

2018-06-01

Many factors influence the chance of having a baby with assisted reproductive technologies (ART). A 2016 Australian Competition and Consumer Commission (ACCC) investigation concluded that ART clinics needed to improve the quality of information they provide about chance of ART success. To evaluate changes in the quality of information about success rates provided on the websites of ART clinics in Australia and New Zealand before and after the ACCC investigation. Desktop audits of websites of ART clinics in Australia and New Zealand were conducted in 2016 and 2017 and available information about success rates was scored using a matrix with eight variables and a possible range of scores of 0-9. Of the 54 clinic websites identified in 2016, 32 had unique information and were eligible to be audited. Of these, 29 were also eligible to be audited in 2017. While there was a slight improvement in the mean score from 2016 to 2017 (4.93-5.28), this was not statistically significantly different. Of the 29 clinics, 14 had the same score on both occasions, 10 had a higher and five a lower information quality score in 2017. To allow people who consider ART to make informed decisions about treatment they need comprehensive and accurate information about what treatment entails and what the likely outcomes are. As measured by a scoring matrix, most ART clinics had not improved the quality of the information about success rates following the ACCC investigation. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Immunization dropout rate and data quality among children 12-23 months of age in Ghana.

PubMed

Baguune, Benjamin; Ndago, Joyce Aputere; Adokiya, Martin Nyaaba

2017-01-01

Immunization against diseases is one of the most important public health interventions with cost effective means to preventing childhood morbidity, mortality and disability. However, a proportion of children particularly in Africa are not fully immunized with the recommended vaccines. Thus, many children are still susceptible to the Expanded Program on Immunization (EPI) targeted diseases. The objective of this study was to determine the immunization dropout rate and data quality among children aged 12-23 months in Techiman Municipality, Ghana. A cross-sectional cluster survey was conducted among 600 children. Data was collected using semi-structured questionnaire through face-to-face interviews. Before the main data collection, the tools were pre-tested in three different communities in the Municipality. The mothers/caregivers were interviewed, extracted information from the child immunization cards and observation employed to confirm the presence of Bacillus Calmette-Guerin (BCG) scar on each child. Routine immunization data was also extracted from immunization registers and annual reports in the Municipality. I mmunization coverage for each of the fifteen vaccines doses is above 90.0% while full childhood immunized status is 89.5%. Immunization dropout rate was 5.6% (using BCG and Measles as proxy vaccines). This is lower than the 10.0% cutoff point by World Health Organization. However, routine administrative data was characterized by some discrepancies (e.g. > 100.0% immunization coverage for each of the vaccines) and high dropout rate (BCG - Measles = 31.5%). Binary regression was performed to determine predictors of dropout rate. The following were statistically significant: married (OR = 0.31; 95% = CI 0.15-0.62; and p = 0.001), Christianity (OR = 0.27; 95% CI = 0.13-0.91; and p < 0.001), female child (OR = 0.50; 95% CI = 0.26-0.91; and p = 0.024) and possession of immunization card (OR = 50.3; 95% CI = 14.40-175.92; and p
An assessment of bird habitat quality using population growth rates

USGS Publications Warehouse

Knutson, M.G.; Powell, L.A.; Hines, R.K.; Friberg, M.A.; Niemi, G.J.

2006-01-01

Survival and reproduction directly affect population growth rate (lambda) making lambda a fundamental parameter for assessing habitat quality. We used field data, literature review, and a computer simulation to predict annual productivity and lambda for several species of landbirds breeding in floodplain and upland forests in the Midwestern United States. We monitored 1735 nests of 27 species; 760 nests were in the uplands and 975 were in the floodplain. Each type of forest habitat (upland and floodplain) was a source habitat for some species. Despite a relatively low proportion of regional forest cover, the majority of species had stable or increasing populations in all or some habitats, including six species of conservation concern. In our search for a simple analog for lambda, we found that only adult apparent survival, juvenile survival, and annual productivity were correlated with lambda; daily nest survival and relative abundance estimated from point counts were not. Survival and annual productivity are among the most costly demographic parameters to measure and there does not seem to be a low-cost alternative. In addition, our literature search revealed that the demographic parameters needed to model annual productivity and lambda were unavailable for several species. More collective effort across North America is needed to fill the gaps in our knowledge of demographic parameters necessary to model both annual productivity and lambda. Managers can use habitat-specific predictions of annual productivity to compare habitat quality among species and habitats for purposes of evaluating management plans.
Development of forensic-quality full mtGenome haplotypes: success rates with low template specimens.

PubMed

Just, Rebecca S; Scheible, Melissa K; Fast, Spence A; Sturk-Andreaggi, Kimberly; Higginbotham, Jennifer L; Lyons, Elizabeth A; Bush, Jocelyn M; Peck, Michelle A; Ring, Joseph D; Diegoli, Toni M; Röck, Alexander W; Huber, Gabriela E; Nagl, Simone; Strobl, Christina; Zimmermann, Bettina; Parson, Walther; Irwin, Jodi A

2014-05-01

Forensic mitochondrial DNA (mtDNA) testing requires appropriate, high quality reference population data for estimating the rarity of questioned haplotypes and, in turn, the strength of the mtDNA evidence. Available reference databases (SWGDAM, EMPOP) currently include information from the mtDNA control region; however, novel methods that quickly and easily recover mtDNA coding region data are becoming increasingly available. Though these assays promise to both facilitate the acquisition of mitochondrial genome (mtGenome) data and maximize the general utility of mtDNA testing in forensics, the appropriate reference data and database tools required for their routine application in forensic casework are lacking. To address this deficiency, we have undertaken an effort to: (1) increase the large-scale availability of high-quality entire mtGenome reference population data, and (2) improve the information technology infrastructure required to access/search mtGenome data and employ them in forensic casework. Here, we describe the application of a data generation and analysis workflow to the development of more than 400 complete, forensic-quality mtGenomes from low DNA quantity blood serum specimens as part of a U.S. National Institute of Justice funded reference population databasing initiative. We discuss the minor modifications made to a published mtGenome Sanger sequencing protocol to maintain a high rate of throughput while minimizing manual reprocessing with these low template samples. The successful use of this semi-automated strategy on forensic-like samples provides practical insight into the feasibility of producing complete mtGenome data in a routine casework environment, and demonstrates that large (>2kb) mtDNA fragments can regularly be recovered from high quality but very low DNA quantity specimens. Further, the detailed empirical data we provide on the amplification success rates across a range of DNA input quantities will be useful moving forward as PCR
Effects of Nitrogen Application Rate on the Yields, Nutritive Value and Silage Fermentation Quality of Whole-crop Wheat.

PubMed

Li, C J; Xu, Z H; Dong, Z X; Shi, S L; Zhang, J G

2016-08-01

Whole-crop wheat (Triticum aestivum L.) as forage has been extensively used in the world. In this study, the effects of N application rates on the yields, nutritive value and silage quality were investigated. The N application rates were 0, 75, 150, 225, and 300 kg/ha. The research results indicated that the dry matter yield of whole-crop wheat increased significantly with increasing N rate up to 150 kg/ha, and then leveled off. The crude protein content and in vitro dry matter digestibility of whole-crop wheat increased significantly with increasing N up to 225 kg/ha, while they no longer increased at N 300 kg/ha. On the contrary, the content of various fibers tended to decrease with the increase of N application. The content of lactic acid, acetic acid and propionic acid in silages increased with the increase of N rate (p<0.05). The ammonia-N content of silages with higher N application rates (≥225 kg/ha) was significantly higher than that with lower N application rates (≤150 kg/ha). Whole-crop wheat applied with high levels of N accumulated more nitrate-N. In conclusion, taking account of yields, nutritive value, silage quality and safety, the optimum N application to whole-crop wheat should be about 150 kg/ha at the present experiment conditions.
Stronger influence of litter quality on decomposition rates than microbial home field advantage in novel subtropical dry forests

NASA Astrophysics Data System (ADS)

Marin-Spiotta, E.; Atkinson, E. E.

2015-12-01

Litter decomposition is one of the most studied ecosystem processes, given its role in carbon cycling and nutrient availability, yet our knowledge of how decomposition is influenced by novel species assemblages in tropical forests emerging on post-agricultural landscapes is limited. This is especially true in tropical dry forests, which are some of the most fragmented forests worldwide due to human pressures and sensitive to changes in rainfall and fire regimes. Here we tested for the effects of litter quality, site conditions, and microbial "home-field advantage" on decomposition rates in subtropical dry forests in St. Croix, U.S. Virgin Islands. We conducted a 22-month in situ and reciprocal transplant field decomposition experiment of aboveground litter and fine roots in 10-year old sites dominated by an early successional N-fixing tree and 40-year old mixed-species secondary forests. Total annual litterfall mass did not differ between the two forest types, but monthly amounts did, with more litter accumulating in the 40-year old secondary forests during the dry season and in the 10-year old secondary forests during the wet season. Litter chemistry differed between the two forest types and showed divergent patterns over the two-year field incubation. To test for the effects of litter quality on decomposition rates, we compared mass loss rates for aboveground and root litter from each forest decomposed in situ and transplanted to the other forest type. Litter in the 10-year old forests decomposed faster in situ (k= 1.07 ± 0.04) than when it was transplanted (k=0.86 ± 0.04). Litter from the 40-year old forests showed the opposite pattern. In situ root decomposition in both forests occurred at the same rate compared to roots that were transplanted there from the other forest type, suggesting that site conditions were equally important as litter quality. Our results were not consistent with a microbial home-field advantage for litter and root decomposition, that
Quality Profiles in Early Childhood: An Example from Virginia's Quality Rating Improvement System

ERIC Educational Resources Information Center

Squibb, Kathryn M.

2013-01-01

Quality in early childhood settings has emerged as an important factor in determining whether the potential benefits of educational experiences before kindergarten will be realized. Research demonstrates that in order for such interventions to be beneficial to young children's development, the quality of their educational environments and…
A multicenter prospective study to assess the effect of early cleavage on embryo quality, implantation, and live-birth rate.

PubMed

de los Santos, Maria José; Arroyo, Gemma; Busquet, Ana; Calderón, Gloria; Cuadros, Jorge; Hurtado de Mendoza, Maria Victoria; Moragas, Marta; Herrer, Raquel; Ortiz, Agueda; Pons, Carme; Ten, Jorge; Vilches, Miguel Angel; Figueroa, Maria José

2014-04-01

To investigate the impact of early cleavage (EC) on embryo quality, implantation, and live-birth rates. Prospective cross-sectional study. Multicenter study. Seven hundred embryo transfers and 1,028 early-stage human embryos. None. Implantation according to the presence of EC and embryo quality. The presence of EC is associated with embryo quality, especially in cycles with autologous oocytes. However, the use of EC as an additional criterion for selecting an embryo for transfer does not appear to significantly improve likelihood of implantation. Furthermore, embryos that presented EC had live-birth rates per implanted embryo similar to those that did not show any sign of cleavage. At least for conventional embryo culture and morphologic evaluations, the additional evaluation of EC in embryos may not be valuable to improve embryo implantation. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
The effect of an educational intervention in family phisicians on self-rated quality of life in patients with medically unexplained symptoms.

PubMed

Ivetić, Vojislav; Pašić, Klemen; Selič, Polona

2017-06-01

Medically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to evaluate the effect of an educational intervention (EI) on self-rated quality of life, treatment satisfaction, and the family physician-patient relationship in patients with MUS. In a multi-centre longitudinal intervention study, which was performed between 2012 and 2014, patients were asked to rate their quality of life, assess their depression, anxiety, stress and somatisation, complete the Hypochondriasis Index, the Medical Interview Satisfaction Scale and the Patient Enablement Instrument for assessing the physician-patient relationship, before and after the EI. The mean values before and after the intervention showed that after the EI, patients with MUS gave a lower (total) mean rating of their health issues and a higher rating of their quality of life, and they also had a more positive opinion of their relationship with the physician (p<0.05). However, there were no differences in the (total) rating of treatment satisfaction before and after the EI (p=0.423). Significant differences in the symptoms in patients with MUS before and after the intervention were confirmed for stress, somatisation and hypochondriasis (p<0.05). It could be beneficial to equip family physicians with the knowledge, skills and tools to reduce hypochondriasis and somatisation in MUS patients, which would improve patients' self-rated health status.
[Do laymen understand information about hospital quality? An empirical verification using risk-adjusted mortality rates as an example].

PubMed

Sander, Uwe; Kolb, Benjamin; Taheri, Fatemeh; Patzelt, Christiane; Emmert, Martin

2017-11-01

The effect of public reporting to improve quality in healthcare is reduced by the limited intelligibility of information about the quality of healthcare providers. This may result in worse health-related choices especially for older people and those with lower levels of education. There is, as yet, little information as to whether laymen understand the concepts behind quality comparisons and if this comprehension is correlated with hospital choices. An instrument with 20 items was developed to analyze the intelligibility of five technical terms which were used in German hospital report cards to explain risk-adjusted death rates. Two online presentations of risk-adjusted death rates for five hospitals in the style of hospital report cards were developed. An online survey of 353 volunteers tested the comprehension of the risk-adjusted mortality rates and included an experimental hospital choice. The intelligibility of five technical terms was tested: risk-adjusted, actual and expected death rate, reference range and national average. The percentages of correct answers for the five technical terms were in the range of 75.0-60.2%. Between 23.8% and 5.1% of the respondents were not able to answer the question about the technical term itself. The least comprehensible technical terms were "risk-adjusted death rate" and "reference range". The intelligibility of the 20 items that were used to test the comprehension of the risk-adjusted mortality was between 89.5% and 14.2%. The two items that proved to be least comprehensible were related to the technical terms "risk-adjusted death rate" and "reference range". For all five technical terms it was found that a better comprehension correlated significantly with better hospital choices. We found a better than average intelligibility for the technical terms "actual and expected death rate" and for "national average". The least understandable were "risk-adjusted death rate" and "reference range". Since the self
USING WINTER FLOUNDER GROWTH RATES TO ASSESS HABITAT QUALITY ACROSS AN ANTHROPOGENIC GRADIENT IN NARRAGANSETT BAY, RI

EPA Science Inventory

We used growth rates of juvenile winter flounder Pseudopleuronectes americanus to assess anthropogenic influence on habitat quality at three sites in Narragansett Bay, Rhode Island. The upper bay site, Gaspee Point, had the highest population density and concentration of total ni...
IUE observations of circumstellar emission from the late type variable R Aquarii /M7 + pec/

NASA Technical Reports Server (NTRS)

Michalitsianos, A. G.; Hobbs, R. W.; Kafatos, M.

1980-01-01

IUE observations of R Aquarii (M7 + pec) have been obtained in low dispersion in order to study its circumstellar emission. Strong permitted, semiforbidden, and forbidden emission lines are identified that are superposed on a bright ultraviolet continuum. From the analysis it is deduced that the strong emission-line spectrum that involves semiforbidden C III, C IV, semiforbidden Si III, forbidden O II, and forbidden O III probably arises from a dense compact nebula the size of which is comparable to the binary system of which R Aqr is the primary star. Low-excitation emission lines of Fe II, Mg II, O I, and Si II suggest the presence of a warm chromosphere (T less than about 10,000 K) in the primary M7 late type giant. The secondary is identified as a white dwarf, comparable to or somewhat brighter than the sun, since such a star can produce enough ionizing photons to excite the continuum and emission-line spectrum and yet be sufficiently faint to escape detection by direct observation. The UV continuum observed is attributed to Balmer recombination and not to blackbody emission from the hot companion. The general spectral properties of R Aqr between 1200 A and 3200 A are discussed in the context of the model for the circumstellar nebula, the companion, and the mass-loss rate of the primary star.
Tank cultivation of the red algae Palmaria mollis: Effects of nutrients on growth rate, biochemical quality, and epiphytic growth

NASA Astrophysics Data System (ADS)

Ben, D.; Langdon, C. J.

2016-02-01

Pacific dulse (Palmaria mollis) is a candidate for aquaculture production in Oregon due to its high protein content, fast growth rate, and ability to fare in cold water conditions. Current cultivation methods use the F/2 medium to supply nutrients to macroalgae cultures. The F/2 medium is a costly mixture of nitrate, phosphate, trace metals and vitamins. The F/2 medium has been the standard for microalgae cultivation, but research has lacked on the necessity of all or part of this mixture for macroalgae cultivation. This study is designed to contribute to the development of Pacific dulse cultivation by measuring how different fertilizer regimens affect the growth, biochemical composition, and quality of Palmaria mollis (C-3 variety) in hopes to reduce the production cost. I hypothesis that dulse will not require additional nutrients during summer cultivation, due to summer upwelling conditions. Experiments were conducted in a flow-through water system, controlling for flow rate, stocking density, and nutrient supplementation. To test this, two replicates of four nutrient regimes were organized: no supplemental nutrients, all nutrients (standard F/2 medium), nitrate/phosphate only, and nitrate/phosphate with trace metals. Each tank was monitored weekly for color quality, epiphytic growth, specific growth rate, production and a final biochemical analysis. This study has preliminarily concluded that supplemental nutrients have no significant effect on production or biochemical quality, but does have an effect quality of epiphytic growth.

Effects of nitrogen rate and application method on early production and fruit quality in highbush blueberry

USDA-ARS?s Scientific Manuscript database

A field study was conducted to examine the effects of nitrogen (N) rate and method of N fertilizer application on growth, yield, and fruit quality in highbush blueberry (Vaccinium corymbosum L.) during the first 4 years after planting in south-coastal BC. Nitrogen was applied at 0-150% of current pr...
Effect of cooling rate on sperm quality of cryopreserved Andalusian donkey spermatozoa.

PubMed

Demyda-Peyrás, S; Bottrel, M; Acha, D; Ortiz, I; Hidalgo, M; Carrasco, J J; Gómez-Arrones, V; Gósalvez, J; Dorado, J

2018-06-01

The aim of this study was to evaluate the effect of different cooling rates on post-thaw quality of cryopreserved donkey spermatozoa. Eighteen ejaculates from six adult Andalusian donkeys (three ejaculates per donkey) were collected using an artificial vagina. Pooled semen samples (two ejaculates per pool) were divided into three aliquots, and frozen in Gent freezing extender using three different cryopreservation protocols (P): P1 (conventional slow freezing, as control): semen pre-cooled in an Equitainer for 2 h and frozen in liquid nitrogen (LN 2 ) vapour; P2 (controlled pre-freeze cooling rate): semen pre-cooled at a controlled rate for 73 min and frozen in LN 2 vapour; and P3 (rapid freezing) semen frozen immediately in LN 2 vapour. After thawing at 37 °C for 30 s, semen samples were assessed for motility, morphology, acrosome and plasma membrane integrity; spermatozoa were also tested for DNA integrity. Significant (P < 0.01) differences were found between the cryopreservation protocols for all sperm parameters evaluated, except for DNA integrity. Semen samples frozen using P2 showed significantly (P < 0.01) higher values for sperm motility, morphology, sperm membrane integrity, and acrosome integrity. On the contrary, P3 reduced sperm motility (P < 0.01) and increased the percentage of spermatozoa with damaged plasma membrane (P < 0.001). In our study, we demonstrated that the sperm of Andalusian donkey is particularly sensitive to the cooling rate used before freezing. Furthermore, Andalusian donkey semen can be successfully cryopreserved using controlled cooling rates combined with freezing in LN 2 vapour. Copyright © 2018 Elsevier B.V. All rights reserved.
Comparing Self-Rated Health, Satisfaction and Quality of Life Scores between Diabetics and Others Living in the Bella Coola Valley

ERIC Educational Resources Information Center

Grigg, Angela; Thommasen, Harvey V.; Tildesley, Hugh; Michalos, Alex C.

2006-01-01

Objective: To investigate the relative effect that diabetes has on self-rated health, satisfaction with various specific domains of life, and satisfaction with quality of life operationalized as happiness, satisfaction with life as a whole, and satisfaction with overall quality of life. Design: Mixed methods--mailed survey and chart review. Study…
Incremental Validity of Spouse Ratings versus Self-Reports of Personality as Predictors of Marital Quality and Behavior during Marital Conflict

ERIC Educational Resources Information Center

Cundiff, Jenny M.; Smith, Timothy W.; Frandsen, Clay A.

2012-01-01

The personality traits of neuroticism and agreeableness are consistently related to marital quality, influencing the individual's own (i.e., actor effect) and the spouse's marital quality (i.e., partner effect). However, this research has almost exclusively relied on self-reports of personality, despite the fact that spouse ratings have been found…
Rating, ranking, and understanding acoustical quality in university classrooms

NASA Astrophysics Data System (ADS)

Hodgson, Murray

2002-08-01

Nonoptimal classroom acoustical conditions directly affect speech perception and, thus, learning by students. Moreover, they may lead to voice problems for the instructor, who is forced to raise his/her voice when lecturing to compensate for poor acoustical conditions. The project applied previously developed simplified methods to predict speech intelligibility in occupied classrooms from measurements in unoccupied and occupied university classrooms. The methods were used to predict the speech intelligibility at various positions in 279 University of British Columbia (UBC) classrooms, when 70% occupied, and for four instructor voice levels. Classrooms were classified and rank ordered by acoustical quality, as determined by the room-average speech intelligibility. This information was used by UBC to prioritize classrooms for renovation. Here, the statistical results are reported to illustrate the range of acoustical qualities found at a typical university. Moreover, the variations of quality with relevant classroom acoustical parameters were studied to better understand the results. In particular, the factors leading to the best and worst conditions were studied. It was found that 81% of the 279 classrooms have "good," "very good," or "excellent" acoustical quality with a "typical" (average-male) instructor. However, 50 (18%) of the classrooms had "fair" or "poor" quality, and two had "bad" quality, due to high ventilation-noise levels. Most rooms were "very good" or "excellent" at the front, and "good" or "very good" at the back. Speech quality varied strongly with the instructor voice level. In the worst case considered, with a quiet female instructor, most of the classrooms were "bad" or "poor." Quality also varies with occupancy, with decreased occupancy resulting in decreased quality. The research showed that a new classroom acoustical design and renovation should focus on limiting background noise. They should promote high instructor speech levels at the back
[Relationships between decomposition rate of leaf litter and initial quality across the alpine timberline ecotone in Western Sichuan, China].

PubMed

Yang, Lin; Deng, Chang-chun; Chen Ya-mei; He, Run-lian; Zhang, Jian; Liu, Yang

2015-12-01

The relationships between litter decomposition rate and their initial quality of 14 representative plants in the alpine forest ecotone of western Sichuan were investigated in this paper. The decomposition rate k of the litter ranged from 0.16 to 1.70. Woody leaf litter and moss litter decomposed much slower, and shrubby litter decomposed a little faster. Then, herbaceous litters decomposed fastest among all plant forms. There were significant linear regression relationships between the litter decomposition rate and the N content, lignin content, phenolics content, C/N, C/P and lignin/N. Lignin/N and hemicellulose content could explain 78.4% variation of the litter decomposition rate (k) by path analysis. The lignin/N could explain 69.5% variation of k alone, and the direct path coefficient of lignin/N on k was -0.913. Principal component analysis (PCA) showed that the contribution rate of the first sort axis to k and the decomposition time (t) reached 99.2%. Significant positive correlations existed between lignin/N, lignin content, C/N, C/P and the first sort axis, and the closest relationship existed between lignin/N and the first sort axis (r = 0.923). Lignin/N was the key quality factor affecting plant litter decomposition rate across the alpine timberline ecotone, with the higher the initial lignin/N, the lower the decomposition rate of leaf litter.
Perception Gap in Quality-of-Life Ratings: An Empirical Investigation of Nursing Home Residents and Caregivers

ERIC Educational Resources Information Center

Mittal, Vikas; Rosen, Jules; Govind, Rahul; Degenholtz, Howard; Shingala, Sunil; Hulland, Shelley; Rhee, YongJoo; Kastango, Kari B.; Mulsant, Benoit H.; Castle, Nick; Rubin, Fred H.; Nace, David

2007-01-01

Purpose: Several studies have previously documented the existence of a perception gap--the extent to which quality-of-life ratings provided by nursing home residents and caregivers diverge. In this study we use Helson's adaptation-level theory to investigate three types of antecedents: (a) focal factors, (b) background factors, and (c) residual…
Effect of meal environment on diet quality rating.

PubMed

Woodruff, Sarah J; Hanning, Rhona M

2009-01-01

Family meals have been associated with improved dietary quality in children and adolescents, and yet very little is known about family meals beyond their frequency. Specific aspects of the breakfast, lunch, and dinner meal environments were described and compared, and the associations with overall diet quality were investigated. Data on food intake and meal environments were obtained in northern Ontario, southern Ontario, and Nova Scotia grades six, seven, and eight classrooms over the 2005 to 2006 school year. Specific aspects of the meal environments described were where the meal was consumed, with whom participants consumed each meal, who prepared the meal, and where the food was originally purchased. Diet quality was assessed using the Canadian version of the Healthy Eating Index. Cluster K-means procedures were used to classify into groups observations about the four meal environment variables. Three, eight, and six clusters of meal environments were identified for breakfast, lunch, and dinner, respectively. Diet quality was negatively associated with consuming/ purchasing meals outside the home, and with skipping breakfast, lunch, and/or dinner. Results have immediate relevance for family-based and/or school programs and policies aimed at educating and feeding children and adolescents.
Real-time transmission of full-motion echocardiography over a high-speed data network: impact of data rate and network quality of service.

PubMed

Main, M L; Foltz, D; Firstenberg, M S; Bobinsky, E; Bailey, D; Frantz, B; Pleva, D; Baldizzi, M; Meyers, D P; Jones, K; Spence, M C; Freeman, K; Morehead, A; Thomas, J D

2000-08-01

With high-resolution network transmission required for telemedicine, education, and guided-image acquisition, the impact of errors and transmission rates on image quality needs evaluation. We transmitted clinical echocardiograms from 2 National Aeronautics and Space Administration (NASA) research centers with the use of Motion Picture Expert Group-2 (MPEG-2) encoding and asynchronous transmission mode (ATM) network protocol over the NASA Research and Education Network. Data rates and network quality (cell losses [CLR], errors [CER], and delay variability [CVD]) were altered and image quality was judged. At speeds of 3 to 5 megabits per second (Mbps), digital images were superior to those on videotape; at 2 Mbps, images were equivalent. Increasing CLR caused occasional, brief pauses. Extreme CER and CDV increases still yielded high-quality images. Real-time echocardiographic acquisition, guidance, and transmission is feasible with the use of MPEG-2 and ATM with broadcast quality seen above 3 Mbps, even with severe network quality degradation. These techniques can be applied to telemedicine and used for planned echocardiography aboard the International Space Station.
Real-time transmission of full-motion echocardiography over a high-speed data network: impact of data rate and network quality of service

NASA Technical Reports Server (NTRS)

Main, M. L.; Foltz, D.; Firstenberg, M. S.; Bobinsky, E.; Bailey, D.; Frantz, B.; Pleva, D.; Baldizzi, M.; Meyers, D. P.; Jones, K.;

2000-01-01

With high-resolution network transmission required for telemedicine, education, and guided-image acquisition, the impact of errors and transmission rates on image quality needs evaluation. METHODS: We transmitted clinical echocardiograms from 2 National Aeronautics and Space Administration (NASA) research centers with the use of Motion Picture Expert Group-2 (MPEG-2) encoding and asynchronous transmission mode (ATM) network protocol over the NASA Research and Education Network. Data rates and network quality (cell losses [CLR], errors [CER], and delay variability [CVD]) were altered and image quality was judged. RESULTS: At speeds of 3 to 5 megabits per second (Mbps), digital images were superior to those on videotape; at 2 Mbps, images were equivalent. Increasing CLR caused occasional, brief pauses. Extreme CER and CDV increases still yielded high-quality images. CONCLUSIONS: Real-time echocardiographic acquisition, guidance, and transmission is feasible with the use of MPEG-2 and ATM with broadcast quality seen above 3 Mbps, even with severe network quality degradation. These techniques can be applied to telemedicine and used for planned echocardiography aboard the International Space Station.

Sperm chromatin structure assay results after swim-up are related only to embryo quality but not to fertilization and pregnancy rates following IVF.

PubMed

Niu, Zhi-Hong; Shi, Hui-Juan; Zhang, Hui-Qin; Zhang, Ai-Jun; Sun, Yi-Juan; Feng, Yun

2011-11-01

The aim of this study was to investigate whether the sperm chromatin structure assay (SCSA) results after swim-up are related to fertilization rates, embryo quality and pregnancy rates following in vitro fertilization (IVF). A total of 223 couples undergoing IVF in our hospital from October 2008 to September 2009 were included in this study. Data on the IVF process and sperm chromatin structure assay results were collected. Fertilization rate, embryo quality and IVF success rates of different DNA fragmentation index (DFI) subgroups and high DNA stainability (HDS) subgroups were compared. There were no significant differences in fertilization rate, clinical pregnancy or delivery rates between the DFI and HDS subgroups. However, the group with abnormal DFI had a lower good embryo rate. So, we concluded that the SCSA variables, either DFI or HDS after swim-up preparation, were not valuable in predicting fertilization failure or pregnancy rate, but an abnormal DFI meant a lower good embryo rate following IVF.
Rating the methodological quality of single-subject designs and n-of-1 trials: introducing the Single-Case Experimental Design (SCED) Scale.

PubMed

Tate, Robyn L; McDonald, Skye; Perdices, Michael; Togher, Leanne; Schultz, Regina; Savage, Sharon

2008-08-01

Rating scales that assess methodological quality of clinical trials provide a means to critically appraise the literature. Scales are currently available to rate randomised and non-randomised controlled trials, but there are none that assess single-subject designs. The Single-Case Experimental Design (SCED) Scale was developed for this purpose and evaluated for reliability. Six clinical researchers who were trained and experienced in rating methodological quality of clinical trials developed the scale and participated in reliability studies. The SCED Scale is an 11-item rating scale for single-subject designs, of which 10 items are used to assess methodological quality and use of statistical analysis. The scale was developed and refined over a 3-year period. Content validity was addressed by identifying items to reduce the main sources of bias in single-case methodology as stipulated by authorities in the field, which were empirically tested against 85 published reports. Inter-rater reliability was assessed using a random sample of 20/312 single-subject reports archived in the Psychological Database of Brain Impairment Treatment Efficacy (PsycBITE). Inter-rater reliability for the total score was excellent, both for individual raters (overall ICC = 0.84; 95% confidence interval 0.73-0.92) and for consensus ratings between pairs of raters (overall ICC = 0.88; 95% confidence interval 0.78-0.95). Item reliability was fair to excellent for consensus ratings between pairs of raters (range k = 0.48 to 1.00). The results were replicated with two independent novice raters who were trained in the use of the scale (ICC = 0.88, 95% confidence interval 0.73-0.95). The SCED Scale thus provides a brief and valid evaluation of methodological quality of single-subject designs, with the total score demonstrating excellent inter-rater reliability using both individual and consensus ratings. Items from the scale can also be used as a checklist in the design, reporting and critical
Dynamic rating curve assessment in hydrometric stations and calculation of the associated uncertainties : Quality and monitoring indicators

NASA Astrophysics Data System (ADS)

Morlot, Thomas; Perret, Christian; Favre, Anne-Catherine

2013-04-01

Whether we talk about safety reasons, energy production or regulation, water resources management is one of EDF's (French hydropower company) main concerns. To meet these needs, since the fifties EDF-DTG operates a hydrometric network that includes more than 350 hydrometric stations. The data collected allow real time monitoring of rivers (hydro meteorological forecasts at points of interests), as well as hydrological studies and the sizing of structures. Ensuring the quality of stream flow data is a priority. A rating curve is an indirect method of estimating the discharge in rivers based on water level measurements. The value of discharge obtained thanks to the rating curve is not entirely accurate due to the constant changes of the river bed morphology, to the precision of the gaugings (direct and punctual discharge measurements) and to the quality of the tracing. As time goes on, the uncertainty of the estimated discharge from a rating curve « gets older » and increases: therefore the final level of uncertainty remains particularly difficult to assess. Moreover, the current EDF capacity to produce a rating curve is not suited to the frequency of change of the stage-discharge relationship. The actual method does not take into consideration the variation of the flow conditions and the modifications of the river bed which occur due to natural processes such as erosion, sedimentation and seasonal vegetation growth. In order to get the most accurate stream flow data and to improve their reliability, this study undertakes an original « dynamic» method to compute rating curves based on historical gaugings from a hydrometric station. A curve is computed for each new gauging and a model of uncertainty is adjusted for each of them. The model of uncertainty takes into account the inaccuracies in the measurement of the water height, the quality of the tracing, the uncertainty of the gaugings and the aging of the confidence intervals calculated with a variographic
Mothers' and Fathers' Ratings of Family Relationship Quality: Associations with Preadolescent and Adolescent Anxiety and Depressive Symptoms in a Clinical Sample

ERIC Educational Resources Information Center

Queen, Alexander H.; Stewart, Lindsay M.; Ehrenreich-May, Jill; Pincus, Donna B.

2013-01-01

This study examined the independent associations among three family relationship quality factors--cohesion, expressiveness, and conflict--with youth self-reported depressive and anxiety symptoms in a clinical sample of anxious and depressed youth. Ratings of family relationship quality were obtained through both mother and father report. The…
Sensor Data Quality and Angular Rate Down-Selection Algorithms on SLS EM-1

NASA Technical Reports Server (NTRS)

Park, Thomas; Smith, Austin; Oliver, T. Emerson

2018-01-01

The NASA Space Launch System Block 1 launch vehicle is equipped with an Inertial Navigation System (INS) and multiple Rate Gyro Assemblies (RGA) that are used in the Guidance, Navigation, and Control (GN&C) algorithms. The INS provides the inertial position, velocity, and attitude of the vehicle along with both angular rate and specific force measurements. Additionally, multiple sets of co-located rate gyros supply angular rate data. The collection of angular rate data, taken along the launch vehicle, is used to separate out vehicle motion from flexible body dynamics. Since the system architecture uses redundant sensors, the capability was developed to evaluate the health (or validity) of the independent measurements. A suite of Sensor Data Quality (SDQ) algorithms is responsible for assessing the angular rate data from the redundant sensors. When failures are detected, SDQ will take the appropriate action and disqualify or remove faulted sensors from forward processing. Additionally, the SDQ algorithms contain logic for down-selecting the angular rate data used by the GNC software from the set of healthy measurements. This paper explores the trades and analyses that were performed in selecting a set of robust fault-detection algorithms included in the GN&C flight software. These trades included both an assessment of hardware-provided health and status data as well as an evaluation of different algorithms based on time-to-detection, type of failures detected, and probability of detecting false positives. We then provide an overview of the algorithms used for both fault-detection and measurement down selection. We next discuss the role of trajectory design, flexible-body models, and vehicle response to off-nominal conditions in setting the detection thresholds. Lastly, we present lessons learned from software integration and hardware-in-the-loop testing.
Emergency Department Waiting Times (EDWaT): A Patient Flow Management and Quality of Care Rating mHealth Application.

PubMed

Househ, Mowafa; Yunus, Faisel

2014-01-01

Saudi hospital emergency departments (ED) have suffered from long waiting times, which have led to a delay in emergency patient care. The increase in the population of Saudi Arabia is likely to further stretch the healthcare services due to overcrowding leading to decreased healthcare quality, long patient waits, patient dissatisfaction, ambulance diversions, decreased physician productivity, and increased frustration among medical staff. This will ultimately put patients at risk for poor health outcomes. Time is of the essence in emergencies and to get to an ED that has the shortest waiting time can mean life or death for a patient, especially in cases of stroke and myocardial infarction. In this paper, we present our work on the development of a mHealth Application - EDWaT - that will: provide patient flow information to the emergency medical services staff, help in quick routing of patients to the nearest hospital, and provide an opportunity for patients to review and rate the quality of care received at an ED, which will then be forwarded to ED services administrators. The quality ratings will help patients to choose between two EDs with the same waiting time and distance from their location. We anticipate that the use of EDWaT will help improve ED wait times and the quality of care provision in Saudi hospitals EDs.
Speech Clarity Index (Ψ): A Distance-Based Speech Quality Indicator and Recognition Rate Prediction for Dysarthric Speakers with Cerebral Palsy

NASA Astrophysics Data System (ADS)

Kayasith, Prakasith; Theeramunkong, Thanaruk

It is a tedious and subjective task to measure severity of a dysarthria by manually evaluating his/her speech using available standard assessment methods based on human perception. This paper presents an automated approach to assess speech quality of a dysarthric speaker with cerebral palsy. With the consideration of two complementary factors, speech consistency and speech distinction, a speech quality indicator called speech clarity index (Ψ) is proposed as a measure of the speaker's ability to produce consistent speech signal for a certain word and distinguished speech signal for different words. As an application, it can be used to assess speech quality and forecast speech recognition rate of speech made by an individual dysarthric speaker before actual exhaustive implementation of an automatic speech recognition system for the speaker. The effectiveness of Ψ as a speech recognition rate predictor is evaluated by rank-order inconsistency, correlation coefficient, and root-mean-square of difference. The evaluations had been done by comparing its predicted recognition rates with ones predicted by the standard methods called the articulatory and intelligibility tests based on the two recognition systems (HMM and ANN). The results show that Ψ is a promising indicator for predicting recognition rate of dysarthric speech. All experiments had been done on speech corpus composed of speech data from eight normal speakers and eight dysarthric speakers.
Issues for the Next Decade of Quality Rating and Improvement Systems. Issue Brief. Publication #2009-14

ERIC Educational Resources Information Center

Tout, Kathryn; Zaslow, Martha; Halle, Tamara; Forry, Nicole

2009-01-01

Since the first child care Quality Rating System (QRS) was implemented in Oklahoma 11 years ago (in 1998), 16 additional statewide systems have been launched and numerous states are piloting or developing a QRS (Zaslow, Tout, & Martinez-Beck, forthcoming). As QRS stakeholders across the nation look ahead to the next decade, it is important to take…
[Effects of nitrogen fertilizer application rate on nitrogen use efficiency and grain yield and quality of different rice varieties].

PubMed

Cong, Xi Han; Shi, Fu Zhi; Ruan, Xin Min; Luo, Yu Xiang; Ma, Ting Chen; Luo, Zhi Xiang

2017-04-18

To provide scientific basis for reasonable application of nitrogen and create varieties with high N use-efficiency, an experiment was carried out to study the effects of nitrogen fertilizer application rate on grain yield, N use rate and quality of different rice varieties. Four different genotypic rice varieties, Nipponbare, N70, N178 and OM052 were used as tested material and three levels of nitrogen application rate (0, 120, 270 kg·hm -2 ) were conducted. Urea as nitrogen source was applied as basal (70%) and panicle (30%) fertilizer. The results showed that nitrogen fertilizer could raise yield mainly because of the increased effective panicles and filled grains per panicle. When the N application rate was 120 and 270 kg·hm -2 , OM052 had the largest grain yield among four varieties, being 41.1% and 76.8% higher, respectively compared with control. Difference in grain yield among four varieties was due to the difference of nitrogen use efficiency. Under 120 and 270 kg·hm -2 nitrogen levels, Nipponbare had the lowest grain yield and N agronomic efficiency (NAE, 40.90 g·g -1 and 18.56 g·g -1 ), which was a variety with low N use-efficiency. On the contrary, OM052 had the highest grain yield and NAE (145.9 g·g -1 and 81.24 g·g -1 ), was a variety with high N use-efficiency. N fertilizer application increased the amylose content and protein content, lengthened gel consistency, reduced chalky kernel, chalkiness, and alkali digestion value. With the increase of N fertilizer application, hot paste viscosity, peak viscosity, consistence viscosity and breakdown viscosity were decreased gradually, and setback viscosity was increased. Correlation analysis showed that the yield and yield components had more significant correlations with appearance quality, cooking and eating quality under low N level. This study confirmed that OM052 was a double high variety with extremely high N agronomic efficiency and yield. Reasonable application of nitrogen fertilizer could
A cross-sectional study assessing the association between online ratings and clinical quality of care measures for US hospitals: results from an observational study.

PubMed

Emmert, Martin; Meszmer, Nina; Schlesinger, Mark

2018-02-05

Little is known about the usefulness of online ratings when searching for a hospital. We therefore assess the association between quantitative and qualitative online ratings for US hospitals and clinical quality of care measures. First, we collected a stratified random sample of 1000 quantitative and qualitative online ratings for hospitals from the website RateMDs. We used an integrated iterative approach to develop a categorization scheme to capture both the topics and sentiment in the narrative comments. Next, we matched the online ratings with hospital-level quality measures published by the Centers for Medicare and Medicaid Services. Regarding nominally scaled measures, we checked for differences in the distribution among the online rating categories. For metrically scaled measures, we applied the Spearman rank coefficient of correlation. Thirteen of the twenty-nine quality of care measures were significantly associated with the quantitative online ratings (Spearman p = ±0.143, p < 0.05 for all). Thereof, eight associations indicated better clinical outcomes for better online ratings. Seven of the twenty-nine clinical measures were significantly associated with the sentiment of patient narratives (p = ±0.114, p < 0.05 for all), whereof four associations indicated worse clinical outcomes in more favorable narrative comments. There seems to be some association between quantitative online ratings and clinical performance measures. However, the relatively weak strength and inconsistency of the direction of the association as well as the lack of association with several other clinical measures may not enable the drawing of strong conclusions. Narrative comments also seem to have limited potential to reflect the clinical quality of care in its current form. Thus, online ratings are of limited usefulness in guiding patients towards high-performing hospitals from a clinical point of view. Nevertheless, patients might prefer different aspects of care

[Quality Improvement Project: Increasing the Rate of Proper Use of Infant Transferring Warmers].

PubMed

Huang, Hsiu-Yu; Fann, Guei-Ling

2015-10-01

Infant-transferring warmers provide a warm environment and emergency care facilities such ventilators for high-risk infants during transport. Accurate use of this warmer has been demonstrated to reduce rates of neonatal complications and increase rates of survival. This project found that, despite the complaints of nurses that warmers occasionally malfunctioned during the transfer process, warmer functions nearly always tested normal after use. Therefore, the researchers surveyed ward nurses to better understand the underlying reasons for these complaints. Results found that only 68.4% of those surveyed operated the warmer correctly. The reasons for improper use were analyzed and categorized as: Nurse-related factors - lack of warmer operating knowledge and experience in the clinic; System-related factors - lack of a standard operating procedure (SOP) and monitor/audit practices and an incomplete training protocol; Equipment-related factors - lack of an equipment preparation SOP and difficulties in setting the ventilator properly. The purpose of this project was to achieve a 100% rate of proper warmer use among nurses. Through continuous clinical education, we created a standard operating procedure for warmer operation, created a video and poster for warmer users, simplified the equipment preparation SOP, and periodically monitored and checked results. After the intervention, 100% of the nurses were able to use the warmers correctly. Additionally, the rate of satisfaction for nursing-warmer use among the participating nurses increased from 51.4% to 80.6%. This project effectively increased the rate for correctly using transferring warmers among participating nurses and improved the quality of medical care.
Effects of rhythmical and extra-rhythmical qualities of music on heart rate during stationary bike activities.

PubMed

DI Cagno, Alessandra; Iuliano, Enzo; Fiorilli, Giovanni; Aquino, Giovanna; Giombini, Arrigo; Menotti, Federica; Tsopani, Despina; Calcagno, Giuseppe

2016-10-01

The aim of this study was to evaluate the effects of rhythmical and extra-rhythmical qualities of music on the heart rate (HR) and rates of perceived exertion (RPE), during sub-maximal stationary bike activity. HR of 28 female adult participants was monitored during 3 session of physical activity, performed under 3 different conditions: Hi-BPM (music with 150-170 BPM), RHYTHM (rhythmical qualities only of Hi-BPM condition) and control condition without music (CONTROL). Four parameters were analyzed: the highest HR value (High-HR), High-HR minus starting HR (∆HR), time to reach the 75% of Maximal HR (MHR) (TimeTo75%) and time over 75% MHR (TimeOver75%). HR trend analysis was performed to evaluate differences among the three conditions. OMNI-Cycle Scale was administered to evaluate RPE. MANOVA showed significant differences between the three conditions in TimeTo75%, ∆HR (P<0.01) and TimeOver75% (P<0.05). In RHYTHM and CONTROL conditions after reaching 75% MHR, the HR increase were significantly lower than Hi-BPM (P<0.01). No significant differences were found in OMNI-Cycle Scale scores of Hi-BPM and RHYTHM whereas RPE was significantly higher in CONTROL condition (P<0.05). Hi-BPM and RHYTHM music allowed a faster reaching of the aerobic training zone compared to CONTROL conditions. Nevertheless, after 75% MHR, extra-rhythmical qualities are necessary to maintain or to increase the working HR levels.
Bloodstream infection rates in outpatient hemodialysis facilities participating in a collaborative prevention effort: a quality improvement report.

PubMed

Patel, Priti R; Yi, Sarah H; Booth, Stephanie; Bren, Virginia; Downham, Gemma; Hess, Sally; Kelley, Karen; Lincoln, Mary; Morrissette, Kathy; Lindberg, Curt; Jernigan, John A; Kallen, Alexander J

2013-08-01

Bloodstream infections (BSIs) cause substantial morbidity in hemodialysis patients. In 2009, the US Centers for Disease Control and Prevention (CDC) sponsored a collaborative project to prevent BSIs in outpatient hemodialysis facilities. We sought to assess the impact of a set of interventions on BSI and access-related BSI rates in participating facilities using data reported to the CDC's National Healthcare Safety Network (NHSN). Quality improvement project. Patients in 17 outpatient hemodialysis facilities that volunteered to participate. Facilities reported monthly event and denominator data to NHSN, received guidance from the CDC, and implemented an evidence-based intervention package that included chlorhexidine use for catheter exit-site care, staff training and competency assessments focused on catheter care and aseptic technique, hand hygiene and vascular access care audits, and feedback of infection and adherence rates to staff. Crude and modeled BSI and access-related BSI rates. Up to 12 months of preintervention (January 2009 through December 2009) and 15 months of intervention period (January 2010 through March 2011) data from participating centers were analyzed. Segmented regression analysis was used to assess changes in BSI and access-related BSI rates during the preintervention and intervention periods. Most (65%) participating facilities were hospital based. Pooled mean BSI and access-related BSI rates were 1.09 and 0.73 events per 100 patient-months during the preintervention period and 0.89 and 0.42 events per 100 patient-months during the intervention period, respectively. Modeled rates decreased 32% (P = 0.01) for BSIs and 54% (P < 0.001) for access-related BSIs at the start of the intervention period. Participating facilities were not representative of all outpatient hemodialysis centers nationally. There was no control arm to this quality improvement project. Facilities participating in a collaborative successfully decreased their BSI and
Assessing Quality of Program Environments for Children and Youth with Autism: Autism Program Environment Rating Scale (APERS)

ERIC Educational Resources Information Center

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

2018-01-01

The purpose of this study was to examine the psychometric properties of the "Autism Program Environment Rating Scale" ("APERS"), an instrument designed to assess quality of program environments for students with autism spectrum disorder. Data sets from two samples of public school programs that provided services to children and…
Are Facebook user ratings associated with hospital cost, quality and patient satisfaction? A cross-sectional analysis of hospitals in New York State.

PubMed

Campbell, Lauren; Li, Yue

2018-02-01

Hospital care costs are high while quality varies across hospitals. Patient satisfaction may be associated with better clinical quality, and social media ratings may offer another opportunity to measure patient satisfaction with care. To test if Facebook user ratings of hospitals are associated with existing measures of patient satisfaction, cost and quality. Data were obtained from Centers for Medicare and Medicaid Services Hospital Compare, the Hospital Inpatient Prospective Payment System impact files and the Area Health Resource File for 2015. Information from hospitals' Facebook pages was collected in July 2016. Multivariate linear regression was used to test if there is an association between Facebook user ratings (star rating and adjusted number of 'likes') and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction measures, the 30-day all-cause readmission rate, and the Medicare spending per beneficiary (MSPB) ratio. One hundred and thirty-six acute care hospitals in New York State in 2015. An increase in the Facebook star rating is associated with significant increases in 21/23 HCAHPS measures (p≤0.003). An increase in the adjusted number of 'likes' is associated with very small increases in 3/23 HCAHPS measures (p<0.05). Facebook user ratings are not associated with the 30-day all-cause readmission rate or the Medicare spending per beneficiary ratio. Results demonstrate an association between HCAHPS patient satisfaction measures and Facebook star ratings. Adjusted number of 'likes' may not be a useful measure of patient satisfaction. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Neglected X-ray discovered polars. I. Giant flares in V358 Aquarii

NASA Astrophysics Data System (ADS)

Beuermann, K.; Burwitz, V.; Reinsch, K.; Schwope, A.; Thomas, H.-C.

2017-07-01

We report photometric and spectroscopic observations of the polar V358 Aqr (=RX J2316-0527) collected over 25 yr. It was discovered as a bright very soft X-ray source in the ROSAT All Sky Survey, but had lapsed into a low state when reobserved in 1993. We have obtained an optical photometric ephemeris, which is free of cycle count errors and allows to correctly phase events around the orbit even for observations that lie decades apart. V358 Aqr possesses an accreting pole in the upper hemisphere of the white dwarf that is visible over the entire orbital period of 209.45 min. The magnetic field strength derived from cyclotron line emission is 31.8 MG. The orbital motion of the cyclotron lines yields an inclination of 60° and an offset of the magnetic pole from the rotational axis of about 10°. The secondary star is of spectral type dM4.0 ± 0.5 and the distance is 540 ± 100 pc. V358 Aqr is peculiar in showing giant optical outbursts that bear all of the characteristics of stellar flares. With two flares observed in 72 h on source, the flare frequency may be high. The total energy radiated in the flare of 28 November 2010 exceeded 1036 erg. While the flares clearly occur on the secondary star, it seems that they may or may not be connected with coronal mass ejection and subsequent accretion onto the white dwarf.
Dynamic rating curve assessment for hydrometric stations and computation of the associated uncertainties: Quality and station management indicators

NASA Astrophysics Data System (ADS)

Morlot, Thomas; Perret, Christian; Favre, Anne-Catherine; Jalbert, Jonathan

2014-09-01

A rating curve is used to indirectly estimate the discharge in rivers based on water level measurements. The discharge values obtained from a rating curve include uncertainties related to the direct stage-discharge measurements (gaugings) used to build the curves, the quality of fit of the curve to these measurements and the constant changes in the river bed morphology. Moreover, the uncertainty of discharges estimated from a rating curve increases with the “age” of the rating curve. The level of uncertainty at a given point in time is therefore particularly difficult to assess. A “dynamic” method has been developed to compute rating curves while calculating associated uncertainties, thus making it possible to regenerate streamflow data with uncertainty estimates. The method is based on historical gaugings at hydrometric stations. A rating curve is computed for each gauging and a model of the uncertainty is fitted for each of them. The model of uncertainty takes into account the uncertainties in the measurement of the water level, the quality of fit of the curve, the uncertainty of gaugings and the increase of the uncertainty of discharge estimates with the age of the rating curve computed with a variographic analysis (Jalbert et al., 2011). The presented dynamic method can answer important questions in the field of hydrometry such as “How many gaugings a year are required to produce streamflow data with an average uncertainty of X%?” and “When and in what range of water flow rates should these gaugings be carried out?”. The Rocherousse hydrometric station (France, Haute-Durance watershed, 946 [km2]) is used as an example throughout the paper. Others stations are used to illustrate certain points.
An investigation of quality improvement initiatives in decreasing the rate of avoidable 30-day, skilled nursing facility-to-hospital readmissions: a systematic review.

PubMed

Mileski, Michael; Topinka, Joseph Baar; Lee, Kimberly; Brooks, Matthew; McNeil, Christopher; Jackson, Jenna

2017-01-01

The main objective was to investigate the applicability and effectiveness of quality improvement initiatives in decreasing the rate of avoidable 30-day, skilled nursing facility (SNF)-to-hospital readmissions. The rate of rehospitalizations from SNF within 30 days of original discharge has increased within the last decade. The research team participants conducted a literature review via Cumulative Index of Nursing and Allied Health Literature and PubMed to collect data about quality improvement implemented in SNFs. The most common facilitator was the incorporation of specialized staff. The most cited barriers were quality improvement tracking and implementation. These strategy examples can be useful to acute care hospitals attempting to lower bounce back from subacute care providers and long-term care facilities seeking quality improvement initiatives to reduce hospital readmissions.
Importance of rate control or rate regulation for improving exercise capacity and quality of life in patients with permanent atrial fibrillation and normal left ventricular function: a randomised controlled study

PubMed Central

Levy, T; Walker, S; Mason, M; Spurrell, P; Rex, S; Brant, S; Paul, V

2001-01-01

OBJECTIVE—To determine the importance of rhythm regulation or rate control in patients with permanent atrial fibrillation (AF) and normal left ventricular function. PATIENTS AND INTERVENTIONS—Thirty six patients with a mixed fast and slow ventricular response rate to their AF were randomised to either His bundle ablation (HBA) and VVIR pacemaker (HBA group) or VVI pacemaker and atrioventricular modifying drugs (Med group). Outcomes assessed at one, three, six, and 12 months included exercise duration and quality of life. RESULTS—Exercise duration significantly improved from baseline in both groups. There was no difference in outcome between the groups (Med +40% v HBA +20%, p = NS). The heart rate profile on exercise was similarly slowed in both groups compared to baseline. Quality of life significantly improved in both treatment arms for the modified Karolinska questionnaire (KQ) (Med +50% v HBA +50%, p = NS) and the Nottingham health profile (NHP) (Med +40% v HBA +20%, p = NS). However, for the individual symptom scores of each questionnaire more were improved in the Med group (KQ-Med 6 improved v HBA 4, NHP-Med 3 v HBA 1). Left ventricular function was equally preserved by both treatments during follow up. CONCLUSION—In these patients control of ventricular response rate with either HBA + VVIR pacemaker or atrioventricular modifying drugs + VVI pacemaker will lead to a significant improvement in exercise duration and quality of life. Rhythm regulation by HBA did not confer additional benefit, suggesting rate control alone is necessary for the successful symptomatic treatment of these patients in permanent AF.   Keywords: ablation; atrial fibrillation; pacemaker; atrioventricular modifying drugs PMID:11156667
The C IV doublet ratio intensity effect in symbiotic stars

NASA Technical Reports Server (NTRS)

Michalitsianos, A. G.; Fahey, M.; Kafatos, M.; Viotti, R.; Cassatella, A.

1988-01-01

High-resolution UV spectra in the 1200-2000 wavelength range of the symbiotic variable R Aqr and its nebular jet were obtained in July 1987 with the IUE. The line profile structure of the C IV 1548, 1550 doublet in the jet indicates multicomponent velocity structure from an optically thin emitting gas. The C IV doublet profiles in the compact H II region engulfing the Mira and hot companion binary also suggest multicomponent structure with radial velocities up to about -100 km/s. The value of the doublet intensity ratio in the R Aqr H II region has been observed in other similar symbiotic stars, such as RX Pup. It is suggested that the anomalous behavior of the C IV doublet intensities may be useful for studying the spatial structure and temporal nature of winds in symbiotic stars.
Evaluation of third-degree and fourth-degree laceration rates as quality indicators.

PubMed

Friedman, Alexander M; Ananth, Cande V; Prendergast, Eri; D'Alton, Mary E; Wright, Jason D

2015-04-01

To examine the patterns and predictors of third-degree and fourth-degree laceration in women undergoing vaginal delivery. We identified a population-based cohort of women in the United States who underwent a vaginal delivery between 1998 and 2010 using the Nationwide Inpatient Sample. Multivariable log-linear regression models were developed to account for patient, obstetric, and hospital factors related to lacerations. Between-hospital variability of laceration rates was calculated using generalized log-linear mixed models. Among 7,096,056 women who underwent vaginal delivery in 3,070 hospitals, 3.3% (n=232,762) had a third-degree laceration and 1.1% (n=76,347) had a fourth-degree laceration. In an adjusted model for fourth-degree lacerations, important risk factors included shoulder dystocia and forceps and vacuum deliveries with and without episiotomy. Other demographic, obstetric, medical, and hospital variables, although statistically significant, were not major determinants of lacerations. Risk factors in a multivariable model for third-degree lacerations were similar to those in the fourth-degree model. Regression analysis of hospital rates (n=3,070) of lacerations demonstrated limited between-hospital variation. Risk of third-degree and fourth-degree laceration was most strongly related to operative delivery and shoulder dystocia. Between-hospital variation was limited. Given these findings and that the most modifiable practice related to lacerations would be reduction in operative vaginal deliveries (and a possible increase in cesarean delivery), third-degree and fourth-degree laceration rates may be a quality metric of limited utility.
Quality indicators for eye bank.

PubMed

Acharya, Manisha; Biswas, Saurabh; Das, Animesh; Mathur, Umang; Dave, Abhishek; Singh, Ashok; Dubey, Suneeta

2018-03-01

The aim of this study is to identify quality indicators of the eye bank and validate their effectivity. Adverse reaction rate, discard rate, protocol deviation rate, and compliance rate were defined as Quality Indicators of the eye bank. These were identified based on definition of quality that captures two dimensions - "result quality" and "process quality." The indicators were measured and tracked as part of quality assurance (QA) program of the eye bank. Regular audits were performed to validate alignment of standard operating procedures (SOP) with regulatory and surgeon acceptance standards and alignment of activities performed in the eye bank with the SOP. Prospective study of the indicators was performed by comparing their observed values over the period 2011-2016. Adverse reaction rate decreased more than 8-fold (from 0.61% to 0.07%), discard rate decreased and stabilized at 30%, protocol deviation rate decreased from 1.05% to 0.08%, and compliance rate reported by annual quality audits improved from 59% to 96% at the same time. In effect, adverse reaction rate, discard rate, and protocol deviation rate were leading indicators, and compliance rate was the trailing indicator. These indicators fulfill an important gap in available literature on QA in eye banking. There are two ways in which these findings can be meaningful. First, eye banks which are new to quality measurement can adopt these indicators. Second, eye banks which are already deeply engaged in quality improvement can test these indicators in their eye bank, thereby incorporating them widely and improving them over time.
On measurements and their quality. Paper 4: verbal anchors and the number of response options in rating scales.

PubMed

Beckstead, Jason W

2014-05-01

This is the last in a short series of papers on measurement theory and practice with particular relevance to intervention research in nursing, midwifery, and healthcare. Understanding how it is that people respond to the questions posed by researchers is fundamental to progress in the social and health sciences. For decades methodologists in psychology, marketing, education, and survey research have studied this issue. In this paper I review this diverse empirical literature to synthesize basic principles for creating rating scales which can reduce measurement error and increase the quality of resulting data. After introducing a theoretical framework known as the cognitive aspects of survey methods (CASM), I review the fundamentals of psychological scaling theory and discuss how it has been used to study the meanings of verbal response options and provide an illustration of how the quality of measurements may be influenced by our choice of the verbal phrases we present as response options. Next, I review the research on the optimal number of response options to use in various measurement situations and how verbal and numeric anchors can combine to influence data quality. Finally, I summarize the issues covered and present recommendations for best practice when creating and using rating scales in research. Copyright © 2013 Elsevier Ltd. All rights reserved.
The Role of Access to Head Start and Quality Ratings for Spanish-Speaking Dual Language Learners’ (DLLs) Participation in Early Childhood Education

PubMed Central

2014-01-01

Data from the Head Start Impact Study (N = 4,442) were used to test for differences between Spanish-speaking Dual Language Learners (DLLs) and monolingual English-speaking children in: (1) Head Start attendance rates when randomly assigned admission; and (2) quality ratings of other early childhood education (ECE) programs attended when not randomly assigned admission to Head Start. Logistic regressions showed that Spanish-speaking DLL children randomly assigned a spot in Head Start were more likely than monolingual-English learners to attend. Further, Spanish-speaking DLLs not randomly assigned a spot in Head Start were more likely to attend higher-quality ECE centers than non-DLL children. Policy implications are discussed, suggesting that, if given access, Spanish-speaking DLL families will take advantage of quality ECE programs. PMID:25018585
A music quality rating test battery for cochlear implant users to compare the FSP and HDCIS strategies for music appreciation.

PubMed

Looi, Valerie; Winter, Philip; Anderson, Ilona; Sucher, Catherine

2011-08-01

The purpose of this study was to develop a music quality rating test battery (MQRTB) and pilot test it by comparing appraisal ratings from cochlear implant (CI) recipients using the fine-structure processing (FSP) and high-definition continuous interleaved sampling (HDCIS) speech processing strategies. The development of the MQRTB involved three stages: (1) Selection of test items for the MQRTB; (2) Verification of its length and complexity with normally-hearing individuals; and (3) Pilot testing with CI recipients. Part 1 involved 65 adult listeners, Part 2 involved 10 normally-hearing adults, and Part 3 involved five adult MED-EL CI recipients. The MQRTB consisted of ten songs, with ratings made on scales assessing pleasantness, naturalness, richness, fullness, sharpness, and roughness. Results of the pilot study, which compared FSP and HDCIS for music, indicated that acclimatization to a strategy had a significant effect on ratings (p < 0.05). When acclimatized to FSP, the group rated FSP as closer to 'exactly as I want it to sound' than HDCIS (p < 0.05), and that HDCIS sounded significantly sharper and rougher than FSP. However when acclimatized to HDCIS, there were no significant differences between ratings. There was no effect of song familiarity or genre on ratings. Overall the results suggest that the use of FSP as the default strategy for MED-EL recipients would have a positive effect on music appreciation, and that the MQRTB is an effective tool for assessing music sound quality.
Changes in the Silicate Dust Features of the Symbiotic Star R Aquarii Prior to the Upcoming 2022 Eclipse and Periastron Events

NASA Astrophysics Data System (ADS)

Omelian, Eric; Sankrit, Ravi; Helton, Andrew; Gorti, Uma; Wagner, R. Mark

2018-01-01

The symbiotic star, R Aquarii (R Aqr) consists of a dusty, pulsating Mira (period 387 days) and a hot white dwarf (WD) that orbit each other with a period of about 44 years. Based on the light curve from ca. 1890 CE onwards, and associated nebular and jet activity, it has been established (with a high degree of confidence) that the WD eclipses the Mira around the time of the periastron passage. One of the phenomena associated with this phase in the orbit is enhanced accretion onto the WD, which in turn energizes the jet outflow. The next eclipse is imminent, and it is estimated that periastron will occur in 2022. Infrared observations of R Aqr have established that the emission consists of a thermal spectrum with an effective temperature of about 2500 K with superposed silicate dust features. These silicate features are known to vary with time, and UKIRT spectra taken within a single Mira phase have shown that some of the variation is correlated with the pulsation of the dust envelope of the AGB star.We have used the FORCAST instrument on SOFIA to observe R Aqr during Cycles 4 and 5 as part of an ongoing monitoring of the system as it goes through eclipse and periastron. Photometry between 6 and 37 μm, and spectra covering the 10 and 18 μm silicate features have shown significant changes in the spectrum compared with earlier data in the same wavelength range obtained by ISO at an epoch closer to apastron. We present our data along with archival data from other IR observatories and use them to characterize the changes in the silicate emission. These data are presented along with model calculations using DUSTY and RADMC-3D that we have used to explore the changes in dust properties that are necessary to explain the differences in the emission profiles. We also present our plans for continued monitoring of R Aqr through the upcoming eclipse, which is required in order to separate the effects of pulsation from the longer-term orbital effects on the dust profiles.
Mothers' and fathers' ratings of family relationship quality: associations with preadolescent and adolescent anxiety and depressive symptoms in a clinical sample.

PubMed

Queen, Alexander H; Stewart, Lindsay M; Ehrenreich-May, Jill; Pincus, Donna B

2013-06-01

This study examined the independent associations among three family relationship quality factors--cohesion, expressiveness, and conflict--with youth self-reported depressive and anxiety symptoms in a clinical sample of anxious and depressed youth. Ratings of family relationship quality were obtained through both mother and father report. The sample included families of 147 preadolescents and adolescents (56.6 % female; 89.8 % Caucasian), 11-18 years old (M = 13.64, SD = 1.98) assigned a principal diagnosis of an anxiety or depressive disorder. When controlling for age and concurrent anxiety symptoms, regression analyses revealed that for boys, both father- and mother-rated family cohesion predicted depressive symptoms. For girls, mother-rated family expressiveness and conflict predicted depressive symptoms. Youth anxiety symptoms were not significantly associated with any family relationship variables, controlling for concurrent depressive symptoms. Findings suggest that parent-rated family relationship factors may be more related to youth depressive than anxiety symptoms in this clinical sample. In addition, family cohesion, as perceived by parents, may be more related to boys' depression, whereas expressiveness and conflict (as rated by mothers) may be more related to girls' depression. Clinical implications and recommendations for future research are discussed.
A quality improvement project to improve the Medicare and Medicaid Services (CMS) sepsis bundle compliance rate in a large healthcare system.

PubMed

Raschke, Robert A; Groves, Robert H; Khurana, Hargobind S; Nikhanj, Nidhi; Utter, Ethel; Hartling, Didi; Stoffer, Brenda; Nunn, Kristina; Tryon, Shona; Bruner, Michelle; Calleja, Maria; Curry, Steven C

2017-01-01

Sepsis is a leading cause of mortality and morbidity in hospitalised patients. The Centers for Medicare and Medicaid Services (CMS) mandated that US hospitals report sepsis bundle compliance rate as a quality process measure in October 2015. The specific aim of our study was to improve the CMS sepsis bundle compliance rate from 30% to 40% across 20 acute care hospitals in our healthcare system within 1 year. The study included all adult inpatients with sepsis sampled according to CMS specifications from October 2015 to September 2016. The CMS sepsis bundle compliance rate was tracked monthly using statistical process control charting. A baseline rate of 28.5% with 99% control limits was established. We implemented multiple interventions including computerised decision support systems (CDSSs) to increase compliance with the most commonly missing bundle elements. Compliance reached 42% (99% statistical process control limits 18.4%-38.6%) as CDSS was implemented system-wide, but this improvement was not sustained after CMS changed specifications of the outcome measure. Difficulties encountered elucidate shortcomings of our study methodology and of the CMS sepsis bundle compliance rate as a quality process measure.
Psychological morbidity, quality of life, and self-rated health in the military personnel

PubMed Central

Chou, Han-Wei; Tzeng, Wen-Chii; Chou, Yu-Ching; Yeh, Hui-Wen; Chang, Hsin-An; Kao, Yu-Cheng; Tzeng, Nian-Sheng

2014-01-01

Objective The mental health of military personnel varies as a result of different cultural, political, and administrative factors. The purpose of this study was to evaluate the psychological morbidity and quality of life of military personnel in Taiwan. Materials and methods This cross-sectional study utilized the World Health Organization Quality of Life Instrument, brief version, Taiwan version, the General Health Questionnaire-12, Chinese version, and the Visual Analog Scale (VAS) in several military units. Results More than half of the subjects (55.3%) identified themselves as mentally unhealthy on the General Health Questionnaire-12, Chinese version; however, a higher percentage of officers perceived themselves as healthy (57.4%) than did noncommissioned officers (38.5%) or enlisted men (42.2%). Officers also had higher total quality of life (QOL) scores (83.98) than did enlisted men (79.67). Scores on the VAS also varied: officers: 72.5; noncommissioned officers: 67.7; and enlisted men: 66.3. The VAS and QOL were positively correlated with perceived mental health among these military personnel. Conclusion Our subjects had higher rates of perceiving themselves as mentally unhealthy compared to the general population. Those of higher rank perceived themselves as having better mental health and QOL. Improving mental health could result in a better QOL in the military. The VAS may be a useful tool for the rapid screening of self-reported mental health, which may be suitable in cases of stressful missions, such as in disaster rescue; however, more studies are needed to determine the optimal cut-off point of this measurement tool. PMID:24570587
Level of structural quality and process quality in rural preschool classrooms

PubMed Central

Hartman, Suzanne C.; Warash, Barbara G.; Curtis, Reagan; Hirst, Jessica Day

2017-01-01

Preschool classrooms with varying levels of structural quality requirements across the state of West Virginia were investigated for differences in measured structural and process quality. Quality was measured using group size, child-to-teacher/staff ratio, teacher education, and the Early Childhood Environmental Rating Scale-Revised (ECERS-R; Harms, T., Clifford, R. M., & Cryer, D. (2005). The early childhood environment rating scale-revised. New York, NY: Teachers College Press). Thirty-six classrooms with less structural quality requirements and 136 with more structural quality requirements were measured. There were significant differences between classroom type, with classrooms with more structural quality requirements having significantly higher teacher education levels and higher environmental rating scores on the ECERS-R subscales of Space and Furnishings, Activities, and Program Structure. Results support previous research that stricter structural state regulations are correlated with higher measured structural and process quality in preschool classrooms. Implications for preschool state quality standards are discussed. PMID:29056814

Perceived neighborhood quality, sleep quality, and health status: Evidence from the Survey of the Health of Wisconsin

PubMed Central

Hale, Lauren; Hill, Terrence D.; Friedman, Elliot; Nieto, F. Javier; Galvao, Loren W.; Engelman, Corinne D.; Malecki, Kristen M.C.; Peppard, Paul E.

2013-01-01

Why does living in a disadvantaged neighborhood predict poorer mental and physical health? Recent research focusing on the Southwestern United States suggests that disadvantaged neighborhoods favor poor health, in part, because they undermine sleep quality. Building on previous research, we test whether this process extends to the Midwestern United States. Specifically, we use cross-sectional data from the Survey of the Health of Wisconsin (SHOW), a statewide probability sample of Wisconsin adults, to examine whether associations among perceived neighborhood quality (e.g., perceptions of crime, litter, and pleasantness in the neighborhood) and health status (overall self-rated health and depression) are mediated by overall sleep quality (measured as self-rated sleep quality and physician diagnosis of sleep apnea). We find that perceptions of low neighborhood quality are associated with poorer self-rated sleep quality, poorer self-rated health, and more depressive symptoms. We also observe that poorer self-rated sleep quality is associated with poorer self-rated health and more depressive symptoms. Our mediation analyses indicate that self-rated sleep quality partially mediates the link between perceived neighborhood quality and health status. Specifically, self-rated sleep quality explains approximately 20% of the association between neighborhood quality and self-rated health and nearly 19% of the association between neighborhood quality and depression. Taken together, these results confirm previous research and extend the generalizability of the indirect effect of perceived neighborhood context on health status through sleep quality. PMID:22901794
Perceived neighborhood quality, sleep quality, and health status: evidence from the Survey of the Health of Wisconsin.

PubMed

Hale, Lauren; Hill, Terrence D; Friedman, Elliot; Nieto, F Javier; Galvao, Loren W; Engelman, Corinne D; Malecki, Kristen M C; Peppard, Paul E

2013-02-01

Why does living in a disadvantaged neighborhood predict poorer mental and physical health? Recent research focusing on the Southwestern United States suggests that disadvantaged neighborhoods favor poor health, in part, because they undermine sleep quality. Building on previous research, we test whether this process extends to the Midwestern United States. Specifically, we use cross-sectional data from the Survey of the Health of Wisconsin (SHOW), a statewide probability sample of Wisconsin adults, to examine whether associations among perceived neighborhood quality (e.g., perceptions of crime, litter, and pleasantness in the neighborhood) and health status (overall self-rated health and depression) are mediated by overall sleep quality (measured as self-rated sleep quality and physician diagnosis of sleep apnea). We find that perceptions of low neighborhood quality are associated with poorer self-rated sleep quality, poorer self-rated health, and more depressive symptoms. We also observe that poorer self-rated sleep quality is associated with poorer self-rated health and more depressive symptoms. Our mediation analyses indicate that self-rated sleep quality partially mediates the link between perceived neighborhood quality and health status. Specifically, self-rated sleep quality explains approximately 20% of the association between neighborhood quality and self-rated health and nearly 19% of the association between neighborhood quality and depression. Taken together, these results confirm previous research and extend the generalizability of the indirect effect of perceived neighborhood context on health status through sleep quality. Copyright © 2012 Elsevier Ltd. All rights reserved.
Cesarean Delivery Rates Vary 10-Fold Among US Hospitals; Reducing Variation May Address Quality, Cost Issues

PubMed Central

Kozhimannil, Katy Backes; Law, Michael R.; Virnig, Beth A.

2013-01-01

Cesarean delivery is the most commonly performed surgical procedure in the United States, and cesarean rates are increasing. Working with 2009 data from 593 US hospitals nationwide, we found that cesarean rates varied tenfold across hospitals, from 7.1 percent to 69.9 percent. Even for women with lower-risk pregnancies, in which more limited variation might be expected, cesarean rates varied fifteen-fold, from 2.4 percent to 36.5 percent. Thus, vast differences in practice patterns are likely to be driving the costly overuse of cesarean delivery in many US hospitals. Because Medicaid pays for nearly half of US births, government efforts to decrease variation are warranted. We focus on four promising directions for reducing these variations, including better coordination of maternity care, more data collection and measurement, tying Medicaid payment to quality improvement, and enhancing patient-centered decision making through public reporting. PMID:23459732
Living on a trophic subsidy: Algal quality drives an upper-shore herbivore's consumption, preference and absorption but not growth rates.

PubMed

Quintanilla-Ahumada, Diego; Quijón, Pedro A; Navarro, Jorge M; Pulgar, José; Duarte, Cristian

2018-01-01

The transfer of seaweeds from subtidal bottoms to nearby intertidal rocky shores is a common but often overlooked phenomenon. Freshly detached seaweeds often represent critical trophic subsidies for herbivores living in upper-shore rocky intertidal areas, such as the marine snail Diloma nigerrima. This species relies on three species of seaweeds for food and displays feeding strategies to deal with a resource that is scarce and at times unpredictable. This study focused on the nutritional quality of freshly detached algae (Durvillaea antarctica, Lessonia spicata and Lessonia trabeculata) and measured Diloma nigerrima's algal consumption rates in trials with and without choice. Absorption efficiency and growth of individual snails fed on each alga were also measured. Durvillaea antarctica had the highest nutritional quality and was the most consumed algae in both single and multiple-choice trials. Absorption efficiency was also highest for D. antarctica but growth rates of snails fed with this species were similar to those fed with the other algae. Combined, these results suggest that D. nigerrima has the ability to discriminate among seaweeds based on their nutritional quality. A potential increase in oxygen uptake when D. nigerrima is consuming the preferred food item is also proposed as a plausible hypothesis to explain the mismatch between snails' preference and growth rate. These results aim to guide further studies on trophic subsidies and their role in coastal systems.
The effect of low ventilation rate with elevated bioeffluent concentration on work performance, perceived indoor air quality, and health symptoms.

PubMed

Maula, H; Hongisto, V; Naatula, V; Haapakangas, A; Koskela, H

2017-11-01

The aim of this laboratory experiment was to study the effects of ventilation rate, and related changes in air quality, predominantly bioeffluents, on work performance, perceived indoor air quality, and health symptoms in a typical conditions of modern open-plan office with low material and equipment emissions. In Condition A, outdoor air flow rate of 28.2 l/s person (CO 2 level 540 ppm) was applied and in Condition B, outdoor air flow rate was 2.3 l/s person (CO 2 level 2260 ppm). CO 2 concentration level was used as an indicator of bioeffluents. Performance was measured with seven different tasks which measure different cognitive processes. Thirty-six subjects participated in the experiment. The exposure time was 4 hours. Condition B had a weak negative effect on performance only in the information retrieval tasks. Condition B increased slightly subjective workload and perceived fatigue. No effects on health symptoms were found. The intensity of symptoms was low in both conditions. The experimental condition had an effect on perceived air quality and observed odor intensity only in the beginning of the session. Although the room temperature was controlled in both conditions, the heat was perceived to impair the performance more in Condition B. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Effect of injection rate on contrast-enhanced MR angiography image quality: Modulation transfer function analysis.

PubMed

Clark, Toshimasa J; Wilson, Gregory J; Maki, Jeffrey H

2017-07-01

Contrast-enhanced (CE)-MRA optimization involves interactions of sequence duration, bolus timing, contrast recirculation, and both R 1 relaxivity and R2*-related reduction of signal. Prior data suggest superior image quality with slower gadolinium injection rates than typically used. A computer-based model of CE-MRA was developed, with contrast injection, physiologic, and image acquisition parameters varied over a wide gamut. Gadolinium concentration was derived using Verhoeven's model with recirculation, R 1 and R2* calculated at each time point, and modulation transfer curves used to determine injection rates, resulting in optimal resolution and image contrast for renal and carotid artery CE-MRA. Validation was via a vessel stenosis phantom and example patients who underwent carotid CE-MRA with low effective injection rates. Optimal resolution for renal and carotid CE-MRA is achieved with injection rates between 0.5 to 0.9 mL/s and 0.2 to 0.3 mL/s, respectively, dependent on contrast volume. Optimal image contrast requires slightly faster injection rates. Expected signal-to-noise ratio varies with both contrast volume and cardiac output. Simulated vessel phantom and clinical carotid CE-MRA exams at an effective contrast injection rate of 0.4 to 0.5 mL/s demonstrate increased resolution. Optimal image resolution is achieved at intuitively low, effective injection rates (0.2-0.9 mL/s, dependent on imaging parameters and contrast injection volume). Magn Reson Med 78:357-369, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.
Long-term dynamics of death rates of emphysema, asthma, and pneumonia and improving air quality

PubMed Central

Kravchenko, Julia; Akushevich, Igor; Abernethy, Amy P; Holman, Sheila; Ross, William G; Lyerly, H Kim

2014-01-01

Background The respiratory tract is a major target of exposure to air pollutants, and respiratory diseases are associated with both short- and long-term exposures. We hypothesized that improved air quality in North Carolina was associated with reduced rates of death from respiratory diseases in local populations. Materials and methods We analyzed the trends of emphysema, asthma, and pneumonia mortality and changes of the levels of ozone, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and particulate matters (PM2.5 and PM10) using monthly data measurements from air-monitoring stations in North Carolina in 1993–2010. The log-linear model was used to evaluate associations between air-pollutant levels and age-adjusted death rates (per 100,000 of population) calculated for 5-year age-groups and for standard 2000 North Carolina population. The studied associations were adjusted by age group-specific smoking prevalence and seasonal fluctuations of disease-specific respiratory deaths. Results Decline in emphysema deaths was associated with decreasing levels of SO2 and CO in the air, decline in asthma deaths–with lower SO2, CO, and PM10 levels, and decline in pneumonia deaths–with lower levels of SO2. Sensitivity analyses were performed to study potential effects of the change from International Classification of Diseases (ICD)-9 to ICD-10 codes, the effects of air pollutants on mortality during summer and winter, the impact of approach when only the underlying causes of deaths were used, and when mortality and air-quality data were analyzed on the county level. In each case, the results of sensitivity analyses demonstrated stability. The importance of analysis of pneumonia as an underlying cause of death was also highlighted. Conclusion Significant associations were observed between decreasing death rates of emphysema, asthma, and pneumonia and decreases in levels of ambient air pollutants in North Carolina. PMID:25018627
Long-term dynamics of death rates of emphysema, asthma, and pneumonia and improving air quality.

PubMed

Kravchenko, Julia; Akushevich, Igor; Abernethy, Amy P; Holman, Sheila; Ross, William G; Lyerly, H Kim

2014-01-01

The respiratory tract is a major target of exposure to air pollutants, and respiratory diseases are associated with both short- and long-term exposures. We hypothesized that improved air quality in North Carolina was associated with reduced rates of death from respiratory diseases in local populations. We analyzed the trends of emphysema, asthma, and pneumonia mortality and changes of the levels of ozone, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and particulate matters (PM2.5 and PM10) using monthly data measurements from air-monitoring stations in North Carolina in 1993-2010. The log-linear model was used to evaluate associations between air-pollutant levels and age-adjusted death rates (per 100,000 of population) calculated for 5-year age-groups and for standard 2000 North Carolina population. The studied associations were adjusted by age group-specific smoking prevalence and seasonal fluctuations of disease-specific respiratory deaths. Decline in emphysema deaths was associated with decreasing levels of SO2 and CO in the air, decline in asthma deaths-with lower SO2, CO, and PM10 levels, and decline in pneumonia deaths-with lower levels of SO2. Sensitivity analyses were performed to study potential effects of the change from International Classification of Diseases (ICD)-9 to ICD-10 codes, the effects of air pollutants on mortality during summer and winter, the impact of approach when only the underlying causes of deaths were used, and when mortality and air-quality data were analyzed on the county level. In each case, the results of sensitivity analyses demonstrated stability. The importance of analysis of pneumonia as an underlying cause of death was also highlighted. Significant associations were observed between decreasing death rates of emphysema, asthma, and pneumonia and decreases in levels of ambient air pollutants in North Carolina.
Another Look at College Student's Ratings of Course Quality: Data from Penn State Student Surveys in Three Settings

ERIC Educational Resources Information Center

Willits, Fern; Brennan, Mark

2017-01-01

This study assessed the relationships of student attributes, course characteristics and course outcomes to college students' ratings of course quality in three types of settings. The analysis utilised data from online surveys of samples of college students conducted in 2011 and 2012 at the Pennsylvania State University. Included in the analysis…
Patients with OCD report lower quality of life after controlling for expert-rated symptoms of depression and anxiety.

PubMed

Jahangard, Leila; Fadaei, Vahid; Sajadi, Arezoo; Haghighi, Mohammad; Ahmadpanah, Mohammad; Matinnia, Nasrin; Bajoghli, Hafez; Sadeghi Bahmani, Dena; Lang, Undine; Holsboer-Trachsler, Edith; Brand, Serge

2017-12-02

One to three percent of the adult population suffers from obsessive-compulsive disorders (OCD). Previous studies have also shown that, compared to controls, patients with OCD report a lower QoL. The latter is associated with self-rated symptoms of depression and anxiety. The aim of the present study was to compare the quality of life of OCD patients with that of healthy controls, while introducing expert-rated symptoms of depression and anxiety as covariates. Gender was also taken into account as an additional associated factor. A total of 100 patients diagnosed with OCD (mean age: 32 years; 64% females) and healthy 100 controls (mean age: 31 years; 59% females; no discernible psychiatric disorder) took part in the present cross-sectional study. All participants completed questionnaires covering socio-demographic characteristics and dimensions of QoL. Experts rated participants' symptoms of OCD (Yale-Brown Obsessive-Compulsive Scale), anxiety (Hamilton Anxiety Rating Scale) and depression (Hamilton Depression Rating Scale). Compared to healthy controls, patients with OCD reported a lower QoL, and had higher symptoms of depression and anxiety. This pattern was particularly pronounced among female patients with OCD. QoL was lower in patients with OCD, even when controlling for depression and anxiety. Results from binary logistic regressions showed that female gender, low QoL and higher symptoms of OCD, depression and anxiety together predicted status as patient with OCD. Compared to healthy controls, patients with OCD have a poorer quality of life and this is independent of depression or anxiety, and is particularly pronounced among female patients. Thus, treatment of OCD might take into account patients' comorbidities and gender. Copyright © 2017 Elsevier B.V. All rights reserved.
Association of journal quality indicators with methodological quality of clinical research articles.

PubMed

Lee, Kirby P; Schotland, Marieka; Bacchetti, Peter; Bero, Lisa A

2002-06-05

The ability to identify scientific journals that publish high-quality research would help clinicians, scientists, and health-policy analysts to select the most up-to-date medical literature to review. To assess whether journal characteristics of (1) peer-review status, (2) citation rate, (3) impact factor, (4) circulation, (5) manuscript acceptance rate, (6) MEDLINE indexing, and (7) Brandon/Hill Library List indexing are predictors of methodological quality of research articles, we conducted a cross-sectional study of 243 original research articles involving human subjects published in general internal medical journals. The mean (SD) quality score of the 243 articles was 1.37 (0.22). All journals reported a peer-review process and were indexed on MEDLINE. In models that controlled for article type (randomized controlled trial [RCT] or non-RCT), journal citation rate was the most statistically significant predictor (0.051 increase per doubling; 95% confidence interval [CI], 0.037-0.065; P<.001). In separate analyses by article type, acceptance rate was the strongest predictor for RCT quality (-0.113 per doubling; 95% CI, -0.148 to -0.078; P<.001), while journal citation rate was the most predictive factor for non-RCT quality (0.051 per doubling; 95% CI, 0.044-0.059; P<.001). High citation rates, impact factors, and circulation rates, and low manuscript acceptance rates and indexing on Brandon/Hill Library List appear to be predictive of higher methodological quality scores for journal articles.
A quality improvement initiative to increase HPV vaccine rates using an educational and reminder strategy with parents of preteen girls.

PubMed

Cassidy, Brenda; Braxter, Betty; Charron-Prochownik, Denise; Schlenk, Elizabeth A

2014-01-01

A quality improvement project was undertaken to determine if an evidence-based educational brochure and reminder system can increase human papillomavirus (HPV) vaccine uptake and dose completion rates. Development of a brochure to promote HPV vaccine uptake was based on predictors of parental acceptance and Health Belief Model concepts. Electronic alerts prompted telephone reminders for dose completion. This quality improvement project utilized a quasi-experimental design with 24 parents of preteen girls from a private pediatric practice and a historical control group of 29 parents. HPV vaccine rates were compared between the groups. A significant difference in HPV vaccine uptake (χ(2) = 11.668, P = .001; odds ratio [OR] = 9.429, 95% confidence interval [CI] = 2.686-33.101) and dose completion (χ(2) = 16.171, P < .001; OR = 22.500, 95% CI = 4.291-117.990) rates were found between the historical control and intervention groups. Parents who received the clinical protocol were 9.4 times and 22.5 times more likely to have HPV vaccine uptake and dose completion, respectively. Low national HPV vaccine rates demonstrate the need for theory-based vaccine delivery programs. These results show that an evidence-based educational brochure and reminder system appeared to improve HPV vaccine uptake and dose completion rates at this private pediatric practice. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.
78 FR 38755 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-27

... Proposed Rule Change To Eliminate an Erroneous Reference to the Retired Automatic Quotation Refresh...'s Statement of the Terms of Substance of the Proposed Rule Change The Exchange proposes to eliminate...,'' which references the AQR functionality that was retired. Accordingly, NASDAQ is proposing to eliminate...
Public reporting of colonoscopy quality is associated with an increase in endoscopist adenoma detection rate.

PubMed

Abdul-Baki, Heitham; Schoen, Robert E; Dean, Katie; Rose, Sherri; Leffler, Daniel A; Kuganeswaran, Eliathamby; Morris, Michele; Carrell, David; Mehrotra, Ateev

2015-10-01

Colonoscopy is the predominant method for colorectal cancer screening in the United States. Previous studies have documented variation across physicians in colonoscopy quality as measured by the adenoma detection rate (ADR). ADR is the primary quality measure of colonoscopy examinations and an indicator of the likelihood of subsequent colorectal cancer. There is interest in mechanisms to improve the ADR. In Central Illinois, a local employer and a quality improvement organization partnered to publically report physician colonoscopy quality. We assessed whether this initiative was associated with an improvement in the ADR. We compared ADRs before and after public reporting at a private practice endoscopy center with 11 gastroenterologists in Peoria, Illinois, who participated in the initiative. To generate the ADR, colonoscopy and pathology reports from examinations performed over 4 years at the endoscopy center were analyzed by using previously validated natural language processing software. A central Illinois endoscopy center. The ADR in the pre-public reporting period was 34.3% and 39.2% in the post-public reporting period (an increase of 4.9%, P < .001). The increase in the right-sided ADR was 5.1% (P < .01), whereas the increase in the left-sided ADR was 2.1% (P < .05). The increase in the ADR was 7.8% for screening colonoscopies (P < 0.05) and 3.5% for nonscreening colonoscopies (P < .05). All but 1 physician's ADR increased (range -2.7% to 10.5%). There was no statistically significant change in the advanced ADR (increase of 0.8%, P = .22). There was no concurrent control group to assess whether the increased ADR was due to a secular trend. A public reporting initiative on colonoscopy quality was associated with an increase in ADR. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
Influence of Movement Quality on Heart Rate While Performing the Dance-Specific Aerobic Fitness Test (DAFT) in Preprofessional Contemporary Dancers.

PubMed

Tiemens, Annemiek; van Rijn, Rogier M; Wyon, Matthew A; Redding, Emma; Stubbe, Janine H

2018-06-01

To explore whether movement quality has influence on heart rate (HR) frequency during the dance-specific aerobic fitness test (DAFT). Thirteen contemporary university dance students (age 19 ± 1.46 yrs) underwent two trials performing the DAFT while wearing a Polar HR monitor (Kempele, Finland). During the first trial, dancers were asked to perform the movements as if they were performing on stage, whereas during the second trial, standardized verbal instructions were given to reduce the quality of movement (e.g., no need to perform technically correct pliés). The variables measured at each trial were HR for all five stages of the DAFT and HR recovery (1 and 2 min after finishing the DAFT), movement quality (MQ) score, and rate of perceived exertion score (RPE). There were significant differences in HR between Trial 1 and Trial 2. For all stages and the resting period, HR was lower during Trial 2 (p<0.001). Also, the RPE score was significantly lower and the MQ score was significantly higher, indicating a poorer performance, during Trial 2 (both p<0.001). The results suggest that DAFT performance with lower movement quality elicits lower HR frequency and RPE during the DAFT. We recommend that specific instructions be given to participants about executing the movement sequence during the DAFT before testing commences. Also, movement quality must be taken into account when interpreting HR results from the DAFT in order to distinguish if a dancer's low HR results from good aerobic fitness or from poor performance of the movement sequence.
Conducting Field Research in a Primary School Setting: Methodological Considerations for Maximizing Response Rates, Data Quality and Quantity

ERIC Educational Resources Information Center

Trapp, Georgina; Giles-Corti, Billie; Martin, Karen; Timperio, Anna; Villanueva, Karen

2012-01-01

Background: Schools are an ideal setting in which to involve children in research. Yet for investigators wishing to work in these settings, there are few method papers providing insights into working efficiently in this setting. Objective: The aim of this paper is to describe the five strategies used to increase response rates, data quality and…
Effect of Tai Chi on physical function, fall rates and quality of life among older stroke survivors.

PubMed

Taylor-Piliae, Ruth E; Hoke, Tiffany M; Hepworth, Joseph T; Latt, L Daniel; Najafi, Bijan; Coull, Bruce M

2014-05-01

To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life. Single-blind, randomized controlled trial. General community. Community-dwelling survivors of stroke (N=145; 47% women; mean age, 70y; time poststroke: 3y; ischemic stroke: 66%; hemiparesis: 73%) who were aged ≥50 years and were ≥3 months poststroke. Yang style 24-posture short-form TC (n=53), strength and range of movement exercises (SS) (n=44), or usual care (UC) (n=48) for 12 weeks. The TC and SS groups attended a 1-hour class 3 times per week, whereas the UC group had weekly phone calls. Physical function: Short Physical Performance Battery, fall rates, and 2-minute step test; quality of life: Medical Outcomes Study 36-Item Short-Form Health Survey, Center for Epidemiologic Studies Depression Scale, and Pittsburgh Sleep Quality Index. During the intervention, TC participants had two thirds fewer falls (5 falls) than the SS (14 falls) and UC (15 falls) groups (χ(2)=5.6, P=.06). There was a significant group by time interaction for the 2-minute step test (F2,142=4.69, P<.01). Post hoc tests indicated that the TC (t53=2.45, P=.02) and SS (t44=4.63, P<.01) groups had significantly better aerobic endurance over time, though not in the UC group (t48=1.58, P=.12). Intervention adherence rates were 85%. TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention was more effective in reducing fall rates than SS or UC interventions. Future studies examining the effectiveness of TC as a fall prevention strategy for community-dwelling survivors of stroke are recommended. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Survey of breast implant patients: characteristics, depression rate, and quality of life.

PubMed

Kalaaji, Amin; Bjertness, Cecilie Bergsmark; Nordahl, Cathrine; Olafsen, Kjell

2013-02-01

Quality of life (QOL) among breast augmentation patients is a growing research area, with newly worrisome data on psychological health in this group. The authors investigate characteristics of breast implant patients, including motivations for surgery, depression rate, effect of surgery on daily activity and work activity, and overall psychosocial and cosmetic changes through a self-reported survey. Of 121 consecutive breast augmentation patients treated by the senior author (AK) between 2005 and 2008, a total of 93 patients were reachable via e-mail and were sent a 47-question survey, which they could return anonymously. Answers were processed by QuestBack mail system (QuestBack AS, Oslo, Norway) and sent to the authors as diagrams and figures, rather than as raw data. The response rate for this survey was 67%. Average follow-up was 2.8 years. For 65%, the motivation for surgery was cosmetic; 48% replied it was for emotional reasons (reduced self-esteem), 22% for intimate reasons, and 10% for physical reasons. Before the operation, 6% of respondents reported diagnosed depression. The postoperative changes were equal between improved and worsened depression. In 27%, the operation increased motivation for daily activities; 73% felt like a "whole" person, and 26% experienced improvement in social skills. In terms of the cosmetic result, 93% were satisfied or very satisfied. However, 27% indicated they were unsatisfied or very unsatisfied with skin sensation. Although in some cases depression increased postoperatively, the depression rate in our study was still lower than the published range in the general population in Norway. Breast enlargement increased motivation to perform daily activities in our patients. The procedure improved QOL in both psychosocial and cosmetic aspects. However, the relatively high percentage of patients who experienced reduced breast skin sensitivity postoperatively can represent a challenge for the surgeon. Multicenter/clinic studies are
My eyes, your eyes--the relationship between CMS five-star rating of nursing homes and family rating of experience of care in Maryland.

PubMed

Çalıkoğlu, Şule; Christmyer, Carol S; Kozlowski, Bruce U

2012-01-01

In 2008, the Centers for Medicaid and Medicare Services (CMS) launched the Five-Star Quality Rating System to help consumers compare nursing homes. The quality rating system consists of three domains: nursing home inspection results, staffing, and quality measures (QMs) and an overall rating calculated from the three domains. The Five-Star System has both advocates and detractors. One source of criticism about the rating system is its lack of input from consumer surveys. Although different dimensions of quality have been recognized as important by the experts and studied in the literature, how these dimensions are linked with each other is largely unknown. This article describes an analysis of the relationship between overall experience of care ratings from a family survey and ratings obtained on the CMS Five-Star Quality Rating for Maryland nursing homes. The results indicated a strong positive correlation between family experience of care score and two five-star domains, namely health inspections and nurse staffing, and no relationship with the quality domain. The lack of relationship between the quality domain and the family score may be due to inadequate risk adjustment or that each rating system measures different aspects of quality. © 2011 National Association for Healthcare Quality.
Living on a trophic subsidy: Algal quality drives an upper-shore herbivore’s consumption, preference and absorption but not growth rates

PubMed Central

Quintanilla-Ahumada, Diego; Quijón, Pedro A.; Navarro, Jorge M.; Pulgar, José

2018-01-01

The transfer of seaweeds from subtidal bottoms to nearby intertidal rocky shores is a common but often overlooked phenomenon. Freshly detached seaweeds often represent critical trophic subsidies for herbivores living in upper-shore rocky intertidal areas, such as the marine snail Diloma nigerrima. This species relies on three species of seaweeds for food and displays feeding strategies to deal with a resource that is scarce and at times unpredictable. This study focused on the nutritional quality of freshly detached algae (Durvillaea antarctica, Lessonia spicata and Lessonia trabeculata) and measured Diloma nigerrima’s algal consumption rates in trials with and without choice. Absorption efficiency and growth of individual snails fed on each alga were also measured. Durvillaea antarctica had the highest nutritional quality and was the most consumed algae in both single and multiple-choice trials. Absorption efficiency was also highest for D. antarctica but growth rates of snails fed with this species were similar to those fed with the other algae. Combined, these results suggest that D. nigerrima has the ability to discriminate among seaweeds based on their nutritional quality. A potential increase in oxygen uptake when D. nigerrima is consuming the preferred food item is also proposed as a plausible hypothesis to explain the mismatch between snails’ preference and growth rate. These results aim to guide further studies on trophic subsidies and their role in coastal systems. PMID:29672599

32 CFR Appendix A to Part 989 - Glossary of References, Abbreviations, Acronyms, and Terms

Code of Federal Regulations, 2010 CFR

2010-07-01

... Engineering and the Environment AFCEE/TDB AFCEE Technical Directorate, Built Infrastructure Division (AFCEE... Materiel Command HQ USAF Headquarters, United States Air Force HQ USAF/A7C The Air Force Civil Engineer.../AQR Deputy Assistant Secretary of the Air Force (Science, Technology, and Engineering) SAF/GC Air...
Taichi exercise for self-rated sleep quality in older people: a systematic review and meta-analysis.

PubMed

Du, Shizheng; Dong, Jianshu; Zhang, Heng; Jin, Shengji; Xu, Guihua; Liu, Zengxia; Chen, Lixia; Yin, Haiyan; Sun, Zhiling

2015-01-01

.69, -0.19)], and daytime dysfunction [standardized mean difference=-0.34, 95% confidence interval (-0.59, -0.09)]. Daytime sleepiness improvement was also observed. Weak evidence shows that Taichi exercise has a beneficial effect in improving self-rated sleep quality for older adults, suggesting that Taichi could be an effective alternative and complementary approach to existing therapies for older people with sleep problems. More rigorous experimental studies are required. Copyright © 2014 Elsevier Ltd. All rights reserved.
Comparison of methodological quality rating of systematic reviews on neuropathic pain using AMSTAR and R-AMSTAR.

PubMed

Dosenovic, Svjetlana; Jelicic Kadic, Antonia; Vucic, Katarina; Markovina, Nikolina; Pieper, Dawid; Puljak, Livia

2018-05-08

quality ratings. Our results point out to weaknesses in the methodology of existing SRs on interventions for the management NeuP and call for future improvement by better adherence to analyzed quality checklists, either AMSTAR or R-AMSTAR.
Coaching as Part of a Pilot Quality Rating Scale Initiative: Challenges to--and Supports for--the Change-Making Process

ERIC Educational Resources Information Center

Ackerman, Debra J.

2008-01-01

Several nonprofit agencies in a large Midwestern city provide assistance to early care and education programs participating in a pilot Quality Rating Scale (QRS) initiative by pairing them with itinerant consultants, who are known as coaches. Despite this assistance, not all programs improve their QRS score. Furthermore, while pilot stakeholders…
Assessment of Metabolome Annotation Quality: A Method for Evaluating the False Discovery Rate of Elemental Composition Searches

PubMed Central

Matsuda, Fumio; Shinbo, Yoko; Oikawa, Akira; Hirai, Masami Yokota; Fiehn, Oliver; Kanaya, Shigehiko; Saito, Kazuki

2009-01-01

Background In metabolomics researches using mass spectrometry (MS), systematic searching of high-resolution mass data against compound databases is often the first step of metabolite annotation to determine elemental compositions possessing similar theoretical mass numbers. However, incorrect hits derived from errors in mass analyses will be included in the results of elemental composition searches. To assess the quality of peak annotation information, a novel methodology for false discovery rates (FDR) evaluation is presented in this study. Based on the FDR analyses, several aspects of an elemental composition search, including setting a threshold, estimating FDR, and the types of elemental composition databases most reliable for searching are discussed. Methodology/Principal Findings The FDR can be determined from one measured value (i.e., the hit rate for search queries) and four parameters determined by Monte Carlo simulation. The results indicate that relatively high FDR values (30–50%) were obtained when searching time-of-flight (TOF)/MS data using the KNApSAcK and KEGG databases. In addition, searches against large all-in-one databases (e.g., PubChem) always produced unacceptable results (FDR >70%). The estimated FDRs suggest that the quality of search results can be improved not only by performing more accurate mass analysis but also by modifying the properties of the compound database. A theoretical analysis indicates that FDR could be improved by using compound database with smaller but higher completeness entries. Conclusions/Significance High accuracy mass analysis, such as Fourier transform (FT)-MS, is needed for reliable annotation (FDR <10%). In addition, a small, customized compound database is preferable for high-quality annotation of metabolome data. PMID:19847304
The influence of rifaximin on diverticulitis rate and quality of life in patients with diverticulosis.

PubMed

Banasiewicz, Tomasz; Francuzik, Wojciech; Bobkiewicz, Adam; Krokowicz, Łukasz; Borejsza-Wysocki, Maciej; Paszkowski, Jacek; Studniarek, Adam; Krokowicz, Piotr; Grochowalski, Marcin; Szczepkowski, Marek; Lorenc, Zbigniew

2017-02-28

Diverticulosis, its associated symptoms and complications are one of the most common pathologies of the gastrointestinal tract in more economically developed countries. Presence of diverticuli and their clinical consequences can be divided into four categories: 1) diverticulosis, i.e. an asymptomatic presence of diverticuli that are usually found by accident 2) symptomatic uncomplicated diverticulosis 3) diverticulitis (acute uncomplicated diverticulitis) 4) complications of diverticulitis (conditions requiring hospital stay). The aim of this study was to retrospectively analyze the efficacy of rifaximin in preventing diverticulitis in patients visiting proctology clinics. The diagnostic criterium for diverticulosis was confirmation by colonoscopy, barium enema or CT colography (virtual colonoscopy) as well as history of at least one documented episode of diverticulosis. History of diverticulosis was evaluated based on medical records, clinical symptoms, elevated level of CRP (>5.0) and/or diagnostic imaging (ultrasound, CT). After setting strict exclusion criteria, 248 patients were qualified for the study out of 686, and they were later divided into two groups: control group (group I - 145 patients) and studied group (group II - 103 patients receiving rifaximin prophylaxis). Diverticulitis rate was comparable in both groups over a period of 6 months before study (p = 0.1306) and 6 months of treatment (p=0.3044). Between the 6th and 12th month of treatment, a significantly lower rate of diverticulitis was noted in the group receiving rifaximin compared to control group (p<0.0001). Patients receiving rifaximin reported higher quality of life (which was assessed using the VAS scale) compared to control group after 12 months. The results confirmed the efficacy of riaximin in prevention of diverticulitis, even in the scheme of repeated courses every 3 months. Not only did application of rifaximin lower the rate of diverticulitis and its complications in patients
[Caesarean section in german hospitals: validity of hospital quality report data for monitoring C-section rates].

PubMed

Junghänel, K; Renz-Polster, H; Jarczok, M N; Hornemann, A; Böhler, T; De Bock, F

2015-04-01

It is not known if "hospital quality reports" (HQR) document Caesarean (C-) section rates at the hospital level accurately enough for use as a reliable data source when it comes to explaining regional variations of C-sections in Germany by factors at the hospital level. We aimed to answer this question using HQR from hospitals in Baden-Württemberg as data source. Diagnostic and procedure codes from HQR for the year 2008 (HQRdata), were used to calculate numbers of births, numbers of C-sections, and rates of births by C-section (CSR) for 94 of 97 hospitals in Baden-Württemberg. These numbers were compared to internal hospital (IH) data delivered upon request by 80 of 97 hospitals and stemming from vital statistics, birth registry forms, or external quality assurance datasets. There was no difference in the number of births between HQR data and IH data, but the number of C-sections and the CSR differed significantly (p<0.05; Wilcoxon rank sum test). CSR calculated using HQR data was 4.9 ± 17.9% higher than CSR from IH data (absolute difference 1.5 ± 5.8%). The correlation between the 2 data sources was moderate (r=0.73). Only 55% of the variance in IH data-based CSR was explained by HQR data. The proportion between highest and lowest CSR in hospitals in Baden-Württemberg was 4.9 for HQR data and 3.6 for IH data. There are significant and relevant differences between C-section rates based on ei-ther HQR or IH data. This questions routine data from HQR for 2008 as a reliable data source for research work. © Georg Thieme Verlag KG Stuttgart · New York.
Drying Rate and Product Quality Evaluation of Roselle (Hibiscus sabdariffa L.) Calyces Extract Dried with Foaming Agent under Different Temperatures.

PubMed

Djaeni, Mohamad; Kumoro, Andri Cahyo; Sasongko, Setia Budi; Utari, Febiani Dwi

2018-01-01

The utilisation of roselle ( Hibiscus sabdariffa L.) calyx as a source of anthocyanins has been explored through intensive investigations. Due to its perishable property, the transformation of roselle calyces into dried extract without reducing their quality is highly challenging. The aim of this work was to study the effect of air temperatures and relative humidity on the kinetics and product quality during drying of roselle extract foamed with ovalbumin and glycerol monostearate (GMS). The results showed that foam mat drying increased the drying rate significantly and retained the antioxidant activity and colour of roselle calyces extract. Shorter drying time was achieved when higher air temperature and/or lower relative humidity was used. Foam mat drying produced dried brilliant red roselle calyces extract with better antioxidant activity and colour qualities when compared with nonfoam mat drying. The results showed the potential for retaining the roselle calyces extract quality under suggested drying conditions.
Oral Health–Related Quality of Life and Self-Rated Speech in Children With Existing Fistulas in Mid-Childhood and Adolescence

PubMed Central

Long, Ross E.; Wilson-Genderson, Maureen; Grayson, Barry H.; Flores, Roberto; Broder, Hillary L.

2016-01-01

Objective To report the associations of oro-nasal fistulae on the patient-centered outcomes oral health–related quality of life and self-reported speech outcomes in school aged-children. Design Prospective, nonrandomized multicenter design. Setting Six ACPA-accredited cleft centers. Participants Patients with cleft palate at the age of mixed dentition. Interventions None. Main Outcome Measures Prevalence of fistula and location of fistula (Pittsburgh Classification System). Patients were placed into one of three groups based on the following criteria: alveolar cleft present, no previous repair (Group 1); alveolar cleft present, previously repaired (Group 2); no congenital alveolar cleft (Group 3). Presence of fistula and subgroup classification were correlated to oral health–related quality of life (Child Oral Health Impact Profile [COHIP]) and perceived speech outcomes. Results The fistula rate was 5.52% (62 of 1198 patients). There was a significant difference in fistula rate between the three groups: Group 1 (11.15%), Group 2 (4.44%), Group 3 (1.90%). Patients with fistula had significantly lower COHIP scores (F1,1188 = 4.79; P = .03) and worse self-reported speech scores (F1,1197 = 4.27; P = .04). Group 1 patients with fistula had the lowest COHIP scores (F5,1188 = 4.78, P =.02) and the lowest speech scores (F5,1188 = 3.41, P = .003). Conclusions Presence of palatal fistulas was associated with lower oral health–related quality of life and perceived speech among youth with cleft. The poorest outcomes were reported among those with the highest fistula rates, including an unrepaired alveolar cleft. PMID:26437081
Capturing Functional Independence Measure (FIM®) Ratings.

PubMed

Torres, Audrey

The aim of the study was to identify interventions to capture admission functional independence measure (FIM®) ratings on the day of admission to an inpatient rehabilitation facility. A quantitative evidence-based practice quality improvement study utilizing descriptive statistics. Admission FIM® ratings from patients discharged in June 2012 (retrospective review) were compared to admission FIM® ratings from patients discharged in June 2014 (prospective review). The logic model was utilized to determine the project inputs, outputs, and outcomes. Interventions to capture admission FIM® ratings on the day of admission are essential to accurately predict the patient's burden of care, length of stay, and reimbursement. Waiting until Day 2 or Day 3 after admission to capture the admission FIM® assessment resulted in inflated admission FIM® ratings and suboptimal quality outcomes. Interventions to capture admission FIM® ratings on the day of admission were successful at improving the quality of care, length of stay efficiency, and accurately recording admission FIM® ratings to determine the patient's burden of care.
A Two-State Study of Family Child Care Engagement in Quality Rating and Improvement Systems: A Mixed-Methods Analysis

ERIC Educational Resources Information Center

Hallam, Rena; Hooper, Alison; Bargreen, Kaitlin; Buell, Martha; Han, Myae

2017-01-01

Research Findings: The current study is a mixed-methods investigation of family child care provider participation in voluntary Quality Rating and Improvement Systems (QRIS) in 2 states. Study 1 is an analysis of matched QRIS and child care licensing administrative data extracted from both states in May, 2014. Poverty and population density…
Differences between Higher and Lower Achievement Rate and Leadership Qualities, Instructional Practices, Parental Involvement, Opportunity to Learn, and Professional Development

ERIC Educational Resources Information Center

Ficarra, Laura

2017-01-01

The purpose of this mixed study was to investigate the differences between higher and lower achievement middle school rates pertaining to leadership qualities, opportunity to learn, instructional practices, parental involvement, and professional development. Qualitatively, principals were interviewed using a semi-structured interview protocol.…
The GRACE checklist for rating the quality of observational studies of comparative effectiveness: a tale of hope and caution.

PubMed

Dreyer, Nancy A; Velentgas, Priscilla; Westrich, Kimberly; Dubois, Robert

2014-03-01

While there is growing demand for information about comparative effectiveness (CE), there is substantial debate about whether and when observational studies have sufficient quality to support decision making. To develop and test an item checklist that can be used to qualify those observational CE studies sufficiently rigorous in design and execution to contribute meaningfully to the evidence base for decision support. An 11-item checklist about data and methods (the GRACE checklist) was developed through literature review and consultation with experts from professional societies, payer groups, the private sector, and academia. Since no single gold standard exists for validation, checklist item responses were compared with 3 different types of external quality ratings (N=88 articles). The articles compared treatment effectiveness and/or safety of drugs, medical devices, and medical procedures. We validated checklist item responses 3 ways against external quality ratings, using published articles of observational CE or safety studies: (a) Systematic Review-quality assessment from a published systematic review; (b) Single Expert Review-quality assessment made according to the solicited "expert opinion" of a senior researcher; and (c) Concordant Expert Review-quality assessments from 2 experts for which there was concordance. Volunteers (N=113) from 5 continents completed 280 article assessments using the checklist. Positive and negative predictive values (PPV, NPV, respectively) of individual items were estimated to compare testers' assessments with those of experts. Taken as a whole, the scale had better NPV than PPV, for both data and methods. The most consistent predictor of quality relates to the validity of the primary outcomes measurement for the study purpose. Other consistent markers of quality relate to using concurrent comparators, minimizing the effects of bias by prudent choice of covariates, and using sensitivity analysis to test robustness of results
Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist.

PubMed

Terwee, Caroline B; Mokkink, Lidwine B; Knol, Dirk L; Ostelo, Raymond W J G; Bouter, Lex M; de Vet, Henrica C W

2012-05-01

The COSMIN checklist is a standardized tool for assessing the methodological quality of studies on measurement properties. It contains 9 boxes, each dealing with one measurement property, with 5-18 items per box about design aspects and statistical methods. Our aim was to develop a scoring system for the COSMIN checklist to calculate quality scores per measurement property when using the checklist in systematic reviews of measurement properties. The scoring system was developed based on discussions among experts and testing of the scoring system on 46 articles from a systematic review. Four response options were defined for each COSMIN item (excellent, good, fair, and poor). A quality score per measurement property is obtained by taking the lowest rating of any item in a box ("worst score counts"). Specific criteria for excellent, good, fair, and poor quality for each COSMIN item are described. In defining the criteria, the "worst score counts" algorithm was taken into consideration. This means that only fatal flaws were defined as poor quality. The scores of the 46 articles show how the scoring system can be used to provide an overview of the methodological quality of studies included in a systematic review of measurement properties. Based on experience in testing this scoring system on 46 articles, the COSMIN checklist with the proposed scoring system seems to be a useful tool for assessing the methodological quality of studies included in systematic reviews of measurement properties.
Application of the Rasch Rating Scale Model to the Assessment of Quality of Life of Persons with Intellectual Disability

ERIC Educational Resources Information Center

Gomez, Laura E.; Arias, Benito; Verdugo, Miguel Angel; Navas, Patricia

2012-01-01

Background: Most instruments that assess quality of life have been validated by means of the classical test theory (CTT). However, CTT limitations have resulted in the development of alternative models, such as the Rasch rating scale model (RSM). The main goal of this paper is testing and improving the psychometric properties of the INTEGRAL…
Evaluation of the indoor air quality minimum ventilation rate procedure for use in California retail buildings.

PubMed

Dutton, S M; Mendell, M J; Chan, W R; Barrios, M; Sidheswaran, M A; Sullivan, D P; Eliseeva, E A; Fisk, W J

2015-02-01

This research assesses benefits of adding to California Title-24 ventilation rate (VR) standards a performance-based option, similar to the American Society of Heating, Refrigerating, and Air Conditioning Engineers 'Indoor Air Quality Procedure' (IAQP) for retail spaces. Ventilation rates and concentrations of contaminants of concern (CoC) were measured in 13 stores. Mass balance models were used to estimate 'IAQP-based' VRs that would maintain concentrations of all CoCs below health- or odor-based reference concentration limits. An intervention study in a 'big box' store assessed how the current VR, the Title 24-prescribed VR, and the IAQP-based VR (0.24, 0.69, and 1.51 air changes per hour) influenced measured IAQ and perceived of IAQ. Neither current VRs nor Title 24-prescribed VRs would maintain all CoCs below reference limits in 12 of 13 stores. In the big box store, the IAQP-based VR kept all CoCs below limits. More than 80% of subjects reported acceptable air quality at all three VRs. In 11 of 13 buildings, saving energy through lower VRs while maintaining acceptable IAQ would require source reduction or gas-phase air cleaning for CoCs. In only one of the 13 retail stores surveyed, application of the IAQP would have allowed reduced VRs without additional contaminant-reduction strategies. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
Drying Rate and Product Quality Evaluation of Roselle (Hibiscus sabdariffa L.) Calyces Extract Dried with Foaming Agent under Different Temperatures

PubMed Central

Kumoro, Andri Cahyo; Sasongko, Setia Budi; Utari, Febiani Dwi

2018-01-01

The utilisation of roselle (Hibiscus sabdariffa L.) calyx as a source of anthocyanins has been explored through intensive investigations. Due to its perishable property, the transformation of roselle calyces into dried extract without reducing their quality is highly challenging. The aim of this work was to study the effect of air temperatures and relative humidity on the kinetics and product quality during drying of roselle extract foamed with ovalbumin and glycerol monostearate (GMS). The results showed that foam mat drying increased the drying rate significantly and retained the antioxidant activity and colour of roselle calyces extract. Shorter drying time was achieved when higher air temperature and/or lower relative humidity was used. Foam mat drying produced dried brilliant red roselle calyces extract with better antioxidant activity and colour qualities when compared with nonfoam mat drying. The results showed the potential for retaining the roselle calyces extract quality under suggested drying conditions. PMID:29755991
Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care

PubMed Central

Aiken, Linda H; Rafferty, Anne Marie; Bruyneel, Luk; McHugh, Matthew; Maier, Claudia B; Moreno-Casbas, Teresa; Ball, Jane E; Ausserhofer, Dietmar; Sermeus, Walter

2017-01-01

Objectives To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. Design Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. Setting Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. Participants Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals. Main outcome measures Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction. Results Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80
Relationship Between Rates of Binocular Visual Field Loss and Vision-Related Quality of Life in Glaucoma

PubMed Central

Lisboa, Renato; Chun, Yeoun Sook; Zangwill, Linda M.; Weinreb, Robert N.; Rosen, Peter N.; Liebmann, Jeffrey M.; Girkin, Christopher A.; Medeiros, Felipe A.

2013-01-01

Objective To evaluate the relationship between binocular rates of visual field change and vision-related quality of life (VRQOL) in glaucoma. Methods The study included 796 eyes of 398 participants that had diagnosed or suspected glaucoma followed for an average of 7.3 ± 2.0 years. Subjects were recruited from the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Evaluation Study (ADAGES). VRQOL was evaluated using the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) at the last follow-up visit. Integrated binocular visual fields (BVF) were calculated from the monocular fields of each patient. Linear regression of mean deviation (MD) values was used to evaluate rates of visual field change during the follow-up period. Logistic regression models were used to investigate the relationship between abnormal VRQOL and rates of visual field change, while adjusting for potentially confounding socio-economic and demographic variables. Results Thirty-two patients (8.0%) had abnormal VRQOL as determined by the results of the NEI VFQ-25 questionnaire. Subjects with abnormal VRQOL had significantly faster rates of BVF change than those with normal VRQOL (−0.18 db/year vs. −0.06 dB/year, respectively; P < 0.001). Rates of BVF change were significantly associated with abnormality in VRQOL (OR = 1.31 per 0.1dB/year faster; P = 0.038), after adjustment for confounding variables. Conclusions Patients with faster rates of BVF change were at higher risk of reporting abnormal VRQOL. Assessment of rates of BVF change may provide useful information in determining risk of functional impairment in glaucoma. PMID:23450425
Challenges in assessing hospital-level stroke mortality as a quality measure: comparison of ischemic, intracerebral hemorrhage, and total stroke mortality rates.

PubMed

Xian, Ying; Holloway, Robert G; Pan, Wenqin; Peterson, Eric D

2012-06-01

Public reporting efforts currently profile hospitals based on overall stroke mortality rates, yet the "mix" of hemorrhagic and ischemic stroke cases may impact this rate. Using the 2005 to 2006 New York state data, we examined the degree to which hospital stroke mortality rankings varied regarding ischemic versus hemorrhagic versus total stroke. Observed/expected ratio was calculated using the Agency for Healthcare Research and Quality Inpatient Quality Indicator software. The observed/expected ratio and outlier status based on stroke types across hospitals were examined using Pearson correlation coefficients (r) and weighted κ. Overall 30-day stroke mortality rates were 15.2% and varied from 11.3% for ischemic stroke and 37.3% for intracerebral hemorrhage. Hospital risk-adjusted ischemic stroke observed/expected ratio was weakly correlated with its own intracerebral hemorrhage observed/expected ratio (r=0.38). When examining hospital performance group (mortality better, worse, or no different than average), disagreement was observed in 35 of 81 hospitals (κ=0.23). Total stroke mortality observed/expected ratio and rankings were correlated with intracerebral hemorrhage (r=0.61 and κ=0.36) and ischemic stroke (r=0.94 and κ=0.71), but many hospitals still switched classification depending on mortality metrics. However, hospitals treating a higher percent of hemorrhagic stroke did not have a statistically significant higher total stroke mortality rate relative to those treating fewer hemorrhagic strokes. Hospital stroke mortality ratings varied considerably depending on whether ischemic, hemorrhagic, or total stroke mortality rates were used. Public reporting of stroke mortality measures should consider providing risk-adjusted outcome on separate stroke types.

Effects of exercise intensity and duration on nocturnal heart rate variability and sleep quality.

PubMed

Myllymäki, Tero; Rusko, Heikki; Syväoja, Heidi; Juuti, Tanja; Kinnunen, Marja-Liisa; Kyröläinen, Heikki

2012-03-01

Acute physical exercise may affect cardiac autonomic modulation hours or even days during the recovery phase. Although sleep is an essential recovery period, the information on nocturnal autonomic modulation indicated by heart rate variability (HRV) after different exercises is mostly lacking. Therefore, this study investigated the effects of exercise intensity and duration on nocturnal HR, HRV, HR, and HRV-based relaxation, as well as on actigraphic and subjective sleep quality. Fourteen healthy male subjects (age 36 ± 4 years, maximal oxygen uptake 49 ± 4 ml/kg/min) performed five different running exercises on separate occasions starting at 6 p.m. with HR guidance at home. The effect of intensity was studied with 30 min of exercises at intensities corresponding to HR level at 45% (easy), 60% (moderate) and 75% (vigorous) of their maximal oxygen uptake. The effect of duration was studied with 30, 60, and 90 min of moderate exercises. Increased exercise intensity elevated nocturnal HR compared to control day (p < 0.001), but it did not affect nocturnal HRV. Nocturnal HR was greater after the day with 90- than 30- or 60-min exercises (p < 0.01) or control day (p < 0.001). Nocturnal HRV was lower after the 90-min exercise day compared to control day (p < 0.01). Neither exercise intensity nor duration had any impact on actigraphic or subjective sleep quality. The results suggest that increased exercise intensity and/or duration cause delayed recovery of nocturnal cardiac autonomic modulation, although long exercise duration was needed to induce changes in nocturnal HRV. Increased exercise intensity or duration does not seem to disrupt sleep quality.
Do Health Care Providers Use Online Patient Ratings to Improve the Quality of Care? Results From an Online-Based Cross-Sectional Study.

PubMed

Emmert, Martin; Meszmer, Nina; Sander, Uwe

2016-09-19

Physician-rating websites have become a popular tool to create more transparency about the quality of health care providers. So far, it remains unknown whether online-based rating websites have the potential to contribute to a better standard of care. Our goal was to examine which health care providers use online rating websites and for what purposes, and whether health care providers use online patient ratings to improve patient care. We conducted an online-based cross-sectional study by surveying 2360 physicians and other health care providers (September 2015). In addition to descriptive statistics, we performed multilevel logistic regression models to ascertain the effects of providers' demographics as well as report card-related variables on the likelihood that providers implement measures to improve patient care. Overall, more than half of the responding providers surveyed (54.66%, 1290/2360) used online ratings to derive measures to improve patient care (implemented measures: mean 3.06, SD 2.29). Ophthalmologists (68%, 40/59) and gynecologists (65.4%, 123/188) were most likely to implement any measures. The most widely implemented quality measures were related to communication with patients (28.77%, 679/2360), the appointment scheduling process (23.60%, 557/2360), and office workflow (21.23%, 501/2360). Scaled-survey results had a greater impact on deriving measures than narrative comments. Multilevel logistic regression models revealed medical specialty, the frequency of report card use, and the appraisal of the trustworthiness of scaled-survey ratings to be significantly associated predictors for implementing measures to improve patient care because of online ratings. Our results suggest that online ratings displayed on physician-rating websites have an impact on patient care. Despite the limitations of our study and unintended consequences of physician-rating websites, they still may have the potential to improve patient care.
Cryopreserving turkey semen in straws and nitrogen vapour using DMSO or DMA: effects of cryoprotectant concentration, freezing rate and thawing rate on post-thaw semen quality.

PubMed

Iaffaldano, N; Di Iorio, M; Miranda, M; Zaniboni, L; Manchisi, A; Cerolini, S

2016-04-01

1. This study was designed to identify a suitable protocol for freezing turkey semen in straws exposed to nitrogen vapour by examining the effects of dimethylacetamide (DMA) or dimethylsulfoxide (DMSO) as cryoprotectant (CPA), CPA concentration, freezing rate and thawing rate on in vitro post-thaw semen quality. 2. Pooled semen samples were diluted 1:1 (v:v) with a freezing extender composed of Tselutin diluent containing DMA or DMSO to give final concentrations of 8% or 18% DMA and 4% or 10% DMSO. The semen was packaged in 0.25 ml plastic straws and frozen at different heights above the liquid nitrogen (LN2) surface (1, 5 and 10 cm) for 10 min. Semen samples were thawed at 4°C for 5 min or at 50°C for 10 s. After thawing, sperm motility, viability and osmotic tolerance were determined. 3. Cryosurvival of turkey sperm was affected by DMSO concentration. Freezing rate affected the motility of sperm cryopreserved using both CPAs, while thawing rates showed an effect on the motility of sperm cryopreserved using DMA and on the viability of sperm cryopreserved using DMSO. Significant interactions between freezing rate × thawing rate on sperm viability in the DMA protocol were found. 4. The most effective freezing protocol was the use of 18% DMA or 10% DMSO with freezing 10 cm above the LN2 surface and a thawing temperature of 50°C. An efficient protocol for turkey semen would improve prospects for sperm cryobanks and the commercial use of frozen turkey semen.
78 FR 4536 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-22

... and test these significant changes to their systems by January 15, 2013. The Exchange has received... member firms adequate time to program and test their systems to use the Market Maker Peg Order \\6\\ or... Market Maker Peg Order, which is designed to replace AQR. See Securities Exchange Act Release No. 67584...
On-demand Reporting of Risk-adjusted and Smoothed Rates for Quality Profiling in ACS NSQIP.

PubMed

Cohen, Mark E; Liu, Yaoming; Huffman, Kristopher M; Ko, Clifford Y; Hall, Bruce L

2016-12-01

Surgical quality improvement depends on hospitals having accurate and timely information about comparative performance. Profiling accuracy is improved by risk adjustment and shrinkage adjustment to stabilize estimates. These adjustments are included in ACS NSQIP reports, where hospital odds ratios (OR) are estimated using hierarchical models built on contemporaneous data. However, the timeliness of feedback remains an issue. We describe an alternative, nonhierarchical approach, which yields risk- and shrinkage-adjusted rates. In contrast to our "Traditional" NSQIP method, this approach uses preexisting equations, built on historical data, which permits hospitals to have near immediate access to profiling results. We compared our traditional method to this new "on-demand" approach with respect to outlier determinations, kappa statistics, and correlations between logged OR and standardized rates, for 12 models (4 surgical groups by 3 outcomes). When both methods used the same contemporaneous data, there were similar numbers of hospital outliers and correlations between logged OR and standardized rates were high. However, larger differences were observed when the effect of contemporaneous versus historical data was added to differences in statistical methodology. The on-demand, nonhierarchical approach provides results similar to the traditional hierarchical method and offers immediacy, an "over-time" perspective, application to a broader range of models and data subsets, and reporting of more easily understood rates. Although the nonhierarchical method results are now available "on-demand" in a web-based application, the hierarchical approach has advantages, which support its continued periodic publication as the gold standard for hospital profiling in the program.
Shop for quality or volume? Volume, quality, and outcomes of coronary artery bypass surgery.

PubMed

Auerbach, Andrew D; Hilton, Joan F; Maselli, Judith; Pekow, Penelope S; Rothberg, Michael B; Lindenauer, Peter K

2009-05-19

Care from high-volume centers or surgeons has been associated with lower mortality rates in coronary artery bypass surgery, but how volume and quality of care relate to each other is not well understood. To determine how volume and differences in quality of care influence outcomes after coronary artery bypass surgery. Observational cohort. 164 hospitals in the United States. 81,289 patients 18 years or older who had coronary artery bypass grafting from 1 October 2003 to 1 September 2005. Hospital and surgeon case volumes were estimated by using a data set. Quality measures were defined by whether patients received specific medications and by counting the number of measures missed. Hierarchical models were used to estimate effects of volume and quality on death and readmission up to 30 days. After adjustment for clinical factors, lowest surgeon volume and highest hospital volume were associated with higher mortality rates and lower readmission risk, respectively. Patients who did not receive aspirin (odds ratio, 1.89 [95% CI, 1.65 to 2.16) or beta-blockers (odds ratio, 1.29 [CI, 1.12 to 1.49]) had higher odds for death, after adjustment for clinical risk factors and case volume. Adjustment for individual quality measures did not alter associations between volume and readmission or death. However, if no quality measures were missed, mortality rates at the lowest-volume centers (adjusted mortality rate, 1.05% [CI, 0.81% to 1.29%]) and highest-volume centers (adjusted mortality rate, 0.98% [CI, 0.72% to 1.25%]) were similar. Because administrative data were used, the quality measures may not replicate measures collected through chart abstraction. Maximizing adherence to quality measures is associated with improved mortality rates, independent of hospital or surgeon volume. California HealthCare Foundation.
Interaction of initial litter quality and thinning intensity on litter decomposition rate, nitrogen accumulation and release in a pine plantation

Treesearch

Xiao Chen; Deborah Page-Dumroese; Ruiheng Lv; Weiwei Wang; Guolei Li; Yong Liu

2014-01-01

Thinning alters litter quality and microclimate under forests. Both of these two changes after thinning induce alterations of litter decomposition rates and nutrient cycling. However, a possible interaction between these two changes remains unclear. We placed two types of litter (LN, low N concentration litter; HN, high N concentration litter) in a Chinese pine (Pinus...
High-quality cardiopulmonary resuscitation.

PubMed

Nolan, Jerry P

2014-06-01

The quality of cardiopulmonary resuscitation (CPR) impacts on outcome after cardiac arrest. This review will explore the factors that contribute to high-quality CPR and the metrics that can be used to monitor performance. A recent consensus statement from North America defined five key components of high-quality CPR: minimizing interruptions in chest compressions, providing compressions of adequate rate and depth, avoiding leaning on the chest between compressions, and avoiding excessive ventilation. Studies have shown that real-time feedback devices improve the quality of CPR and, in one before-and-after study, outcome from out-of-hospital cardiac arrest. There is evidence for increasing survival rates following out-of-hospital cardiac arrest and this is associated with increasing rates of bystander CPR. The quality of CPR provided by healthcare professionals can be improved with real-time feedback devices. The components of high-quality CPR and the metrics that can be measured and fed back to healthcare professionals have been defined by expert consensus. In the future, real-time feedback based on the physiological responses to CPR may prove more effective.
The Effect of Anchors and Training on the Reliability of Voice Quality Ratings for Different Types of Speech Stimuli.

PubMed

Brinca, Lilia; Batista, Ana Paula; Tavares, Ana Inês; Pinto, Patrícia N; Araújo, Lara

2015-11-01

The main objective of the present study was to investigate if the type of voice stimuli-sustained vowel, oral reading, and connected speech-results in good intrarater and interrater agreement/reliability. A short-term panel study was performed. Voice samples from 30 native European Portuguese speakers were used in the present study. The speech materials used were (1) the sustained vowel /a/, (2) oral reading of the European Portuguese version of "The Story of Arthur the Rat," and (3) connected speech. After an extensive training with textual and auditory anchors, the judges were asked to rate the severity of dysphonic voice stimuli using the phonation dimensions G, R, and B from the GRBAS scale. The voice samples were judged 6 months and 1 year after the training. Intrarater agreement and reliability were generally very good for all the phonation dimensions and voice stimuli. The highest interrater reliability was obtained using the oral reading stimulus, particularly for phonation dimensions grade (G) and breathiness (B). Roughness (R) was the voice quality that was the most difficult to evaluate, leading to interrater unreliability in all voice quality ratings. Extensive training using textual and auditory anchors and the use of anchors during the voice evaluations appear to be good methods for auditory-perceptual evaluation of dysphonic voices. The best results of interrater reliability were obtained when the oral reading stimulus was used. Breathiness appears to be a voice quality that is easier to evaluate than roughness. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Does coastal lagoon habitat quality affect fish growth rate and their recruitment? Insights from fishing and acoustic surveys

NASA Astrophysics Data System (ADS)

Brehmer, P.; Laugier, T.; Kantoussan, J.; Galgani, F.; Mouillot, D.

2013-07-01

Ensuring the sustainability of fish resources necessitates understanding their interaction with coastal habitats, which is becoming ever more challenging in the context of ever increasing anthropogenic pressures. The ability of coastal lagoons, exposed to major sources of disturbance, to provide resources and suitable habitats for growth and survival of juvenile fish is especially important. We analysed three lagoons with different ecological statuses and habitat quality on the basis of their eutrophication and ecotoxicity (Trix test) levels. Fish abundances were sampled using fishing and horizontal beaming acoustic surveys with the same protocols in the same year. The relative abundance of Anguilla anguilla, Dicentrarchus labrax or the Mugilidae group was not an indicator of habitat quality, whereas Atherina boyeri and Sparus aurata appeared to be more sensitive to habitat quality. Fish abundance was higher in the two lagoons with high eutrophication and ecotoxicity levels than in the less impacted lagoon, while fish sizes were significantly higher in the two most severely impacted lagoons. This leads us to suggest low habitat quality may increase fish growth rate (by the mean of a cascading effect), but may reduce lagoon juvenile abundance by increasing larval mortality. Such a hypothesis needs to be further validated using greater investigations which take into account more influences on fish growth and recruitment in such variable environments under complex multi-stressor conditions.
Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care.

PubMed

Aiken, Linda H; Sloane, Douglas; Griffiths, Peter; Rafferty, Anne Marie; Bruyneel, Luk; McHugh, Matthew; Maier, Claudia B; Moreno-Casbas, Teresa; Ball, Jane E; Ausserhofer, Dietmar; Sermeus, Walter

2017-07-01

To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals. Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction. Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80quality and safety of hospital care and contribute to hospital nurse
Association of Centers for Medicare & Medicaid Services Overall Hospital Quality Star Rating With Outcomes in Advanced Laparoscopic Abdominal Surgery.

PubMed

Koh, Christina Y; Inaba, Colette S; Sujatha-Bhaskar, Sarath; Nguyen, Ninh T

2017-12-01

The Centers for Medicare & Medicaid Services (CMS) recently released the Overall Hospital Quality Star Rating to help patients compare hospitals based on a 5-star scale. The star rating was designed to assess overall quality of the institution; thus, its validity toward specifically assessing surgical quality is unknown. To examine whether CMS high-star hospitals (HSHs) have improved patient outcomes and resource use in advanced laparoscopic abdominal surgery compared with low-star hospitals (LSHs). Using the University HealthSystem Consortium database (which includes academic centers and their affiliate hospitals) from January 1, 2013, through December 31, 2015, this administrative database observational study compared outcomes of 72 662 advanced laparoscopic abdominal operations between HSHs (4-5 stars) and LSHs (1-2 stars). The star rating includes 57 measures across 7 areas of quality. Patients who underwent advanced laparoscopic abdominal surgery, including bariatric surgery (sleeve gastrectomy, Roux-en-Y gastric bypass), colorectal surgery (colectomy, proctectomy), or hiatal hernia surgery (paraesophageal hernia repair, Nissen fundoplication), were included. Risk adjustment included exclusion of patients with major and extreme severity of illness. Main outcome measures included serious morbidity, in-hospital mortality, intensive care unit admissions, and cost. A total of 72 662 advanced laparoscopic abdominal operations were performed in patients at 66 HSHs (n = 38 299; mean [SD] age, 51.26 [15.25] years; 12 096 [31.5%] male and 26 203 [68.4%] female; 28 971 [75.6%] white and 9328 [24.4%] nonwhite) and 78 LSHs (n = 34 363; mean [SD] age, 49.77 [14.77] years; 9902 [28.8%] male and 24 461 [71.2%] female; 21 876 [67.6%] white and 12 487 [32.4%] nonwhite). The HSHs were observed to have fewer intensive care unit admissions (1007 [2.6%] vs 1711 [5.0%], P < .001) and lower mean cost ($7866 vs $8708, P < .001). No significant difference was
Participation Rates, Process Monitoring, and Quality Improvement Among Cardiac Rehabilitation Programs in the United States: A NATIONAL SURVEY.

PubMed

Pack, Quinn R; Squires, Ray W; Lopez-Jimenez, Francisco; Lichtman, Steven W; Rodriguez-Escudero, Juan P; Lindenauer, Peter K; Thomas, Randal J

2015-01-01

Although strategies exist for improving cardiac rehabilitation (CR) participation rates, it is unclear how frequently these strategies are used and what efforts are being made by CR programs to improve participation rates. We surveyed all CR program directors in the American Association of Cardiovascular and Pulmonary Rehabilitation's database. Data collection included program characteristics, the use of specific referral and recruitment strategies, and self-reported program participation rates. Between 2007 and 2012, 49% of programs measured referral of inpatients from the hospital, 21% measured outpatient referral from office/clinic, 71% measured program enrollment, and 74% measured program completion rates. Program-reported participation rates (interquartile range) were 68% (32-90) for hospital referral, 35% (15-60) for office/clinic referral, 70% (46-80) for enrollment, and 75% (62-82) for program completion. The majority of programs utilized a hospital-based systematic referral, liaison-facilitated referral, or inpatient CR program referral (64%, 68%, and 60% of the time, respectively). Early appointments (<2 weeks) were utilized by 35%, and consistent phone call appointment reminders were utilized by 50% of programs. Quality improvement (QI) projects were performed by about half of CR programs. Measurement of participation rates was highly correlated with performing QI projects (P < .0001.) : Although programs are aware of participation rate gaps, the monitoring of participation rates is suboptimal, QI initiatives are infrequent, and proven strategies for increasing patient participation are inconsistently utilized. These issues likely contribute to the national CR participation gap and may prove to be useful targets for national QI initiatives.
Improving organizational climate for quality and quality of care: does membership in a collaborative help?

PubMed

Nembhard, Ingrid M; Northrup, Veronika; Shaller, Dale; Cleary, Paul D

2012-11-01

The lack of quality-oriented organizational climates is partly responsible for deficiencies in patient-centered care and poor quality more broadly. To improve their quality-oriented climates, several organizations have joined quality improvement collaboratives. The effectiveness of this approach is unknown. To evaluate the impact of collaborative membership on organizational climate for quality and service quality. Twenty-one clinics, 4 of which participated in a collaborative sponsored by the Institute for Clinical Systems Improvement. Pre-post design. Preassessments occurred 2 months before the collaborative began in January 2009. Postassessments of service quality and climate occurred about 6 months and 1 year, respectively, after the collaborative ended in January 2010. We surveyed clinic employees (eg, physicians, nurses, receptionists, etc.) about the organizational climate and patients about service quality. Prioritization of quality care, high-quality staff relationships, and open communication as indicators of quality-oriented climate and timeliness of care, staff helpfulness, doctor-patient communication, rating of doctor, and willingness to recommend doctor's office as indicators of service quality. There was no significant effect of collaborative membership on quality-oriented climate and mixed effects on service quality. Doctors' ratings improved significantly more in intervention clinics than in control clinics, staff helpfulness improved less, and timeliness of care declined more. Ratings of doctor-patient communication and willingness to recommend doctor were not significantly different between intervention and comparison clinics. Membership in the collaborative provided no significant advantage for improving quality-oriented climate and had equivocal effects on service quality.
Independent Evaluation of California's Race to the Top: Early Learning Challenge Quality Rating and Improvement System. Half-Term Report

ERIC Educational Resources Information Center

Hawkinson, Laura E.; Quick, Heather E.; Muenchow, Susan; Anthony, Jennifer; Weinberg, Emily; Holod, Aleksandra; Parrish, Deborah; Meakin, John; Lee, Dong Hoon; Tarrant, Kate; Cannon, Jill S.; Zellman, Gail L.; Karoly, Lynn A.

2015-01-01

The first step in the Validity and Reliability Study summarizes the history and purpose of California's quality rating and improvement system (QRIS), reviews findings from other QRIS evaluation studies, and describes the approach to validating the system in California. The majority of this report focuses on providing context for the California…
Next day discharge rate has little use as a quality measure for individual physician performance.

PubMed

Inabnit, Christopher; Markwell, Stephen; Gruwell, Jack; Jaeger, Cassie; Millburg, Lance; Griffen, David

2018-06-18

Emergency Department (ED) physicians' next day discharge rate (NDDR), the percentage of patients who were admitted from the ED and subsequently discharged within the next calendar day was hypothesized as a potential measure for unnecessary admissions. The objective was to determine if NDDR has validity as a measure for quality of individual ED physician performance. Hospital admission data was obtained for thirty-six ED physicians for calendar year 2015. Funnel plots were used to identify NDDR outliers beyond 95% control limits. A mixed model logistic regression was built to investigate factors contributing to NDDR. To determine yearly variation, data from calendar years 2014 and 2016 were analyzed, again by funnel plots and logistic regression. Intraclass correlation coefficient was used to estimate the percent of total variation in NDDR attributable to individual ED physicians. NDDR varied significantly among ED physicians. Individual ED physician outliers in NDDR varied year to year. Individual ED physician contribution to NDDR variation was minimal, accounting for 1%. Years of experience in Emergency Medicine practice was not correlated with NDDR. NDDR does not appear to be a reliable independent quality measure for individual ED physician performance. The percent of variance attributable to the ED physician was 1%. Copyright © 2018. Published by Elsevier Inc.
Differences in Colonoscopy Quality Among Facilities: Development of a Post-Colonoscopy Risk-Standardized Rate of Unplanned Hospital Visits.

PubMed

Ranasinghe, Isuru; Parzynski, Craig S; Searfoss, Rana; Montague, Julia; Lin, Zhenqiu; Allen, John; Vender, Ronald; Bhat, Kanchana; Ross, Joseph S; Bernheim, Susannah; Krumholz, Harlan M; Drye, Elizabeth E

2016-01-01

Colonoscopy is a common procedure, yet little is known about variations in colonoscopy quality among outpatient facilities. We developed an outcome measure to profile outpatient facilities by estimating risk-standardized rates of unplanned hospital visits within 7 days of colonoscopy. We used a 20% sample of 2010 Medicare outpatient colonoscopy claims (331,880 colonoscopies performed at 8140 facilities) from patients ≥65 years or older, and developed a patient-level logistic regression model to estimate the risk of unplanned hospital visits (ie, emergency department visits, observation stays, and inpatient admissions) within 7 days of colonoscopy. We then used the patient-level risk model variables and hierarchical logistic regression to estimate facility rates of risk-standardized unplanned hospital visits using data from the Healthcare Cost and Utilization Project (325,811 colonoscopies at 992 facilities), from 4 states containing 100% of colonoscopies per facility. Outpatient colonoscopies were followed by 5412 unplanned hospital visits within 7 days (16.3/1000 colonoscopies). Hemorrhage, abdominal pain, and perforation were the most common causes of unplanned hospital visits. Fifteen variables were independently associated with unplanned hospital visits (c = 0.67). A history of fluid and electrolyte imbalance (odds ratio [OR] = 1.43; 95% confidence interval [CI]: 1.29-1.58), psychiatric disorders (OR = 1.34; 95% CI: 1.22-1.46), and, in the absence of prior arrhythmia, increasing age past 65 years (aged >85 years vs 65-69 years: OR = 1.87; 95% CI: 1.54-2.28) were most strongly associated. The facility risk-standardized unplanned hospital visits calculated using Healthcare Cost and Utilization Project data showed significant variation (median 12.3/1000; 5th-95th percentile, 10.5-14.6/1000). Median risk-standardized unplanned hospital visits were comparable between ambulatory surgery centers and hospital outpatient departments (each was 10.2/1000), and
Effect of an oral anxiolytic medication and heart rate variability on image quality of 64-slice MDCT coronary angiography.

PubMed

Cubuk, R; Tasali, N; Yilmazer, S; Gokalp, P; Celik, L; Dagdeviren, B; Guney, S

2011-02-01

The aim of the study was to investigate the relationship between image quality in 64-slice multidetector computed tomography (MDCT) and patients' preimaging anxiety status and heart rate variability (HRV), and to evaluate the efficacy of an orally administered anxiolytic medication on HRV and image quality. Sixty patients [14 women, 46 men; mean age 52.53 ± 10.55 (SD), range 33-78 years] were studied. Anxiety levels were assessed with the State-Trait Anxiety Inventory 60 min before the procedure. The participating patients were randomly assigned to one of the two study groups: a control group (no medication administered for anxiety reduction) and an anxiolytic medication group, with 30 patients in each group. The presence of motion artefacts and image quality for each coronary artery segment were evaluated using a four-point grading system. To estimate HRV, the duration of each heartbeat during MDCT data acquisition was measured in each patient. A moderate correlation was found between HRV during MDCT scanning and the mean image quality for all coronary segments (r=0.47, p<0.01). There was an association between HRV and state anxiety scores in all cases (r=0.370, p<0.01). HRV in the patients who received alprazolam was statistically significantly lower than in controls (p<0.05). The average image quality in patients who used alprazolam was also statistically significantly higher than in controls (p<0.05). The most important finding in our study is that oral premedication to reduce anxiety is also effective in decreasing HRV and improves image quality. Therefore, we suggest that using alprazolam in addition to a β-blocker may improve image quality in patients undergoing MDCT coronary angiography (MDCT-CA). Anxiolytic usage may improve image quality by lowering the HRV in selected cases where administration of a β-blocker is contraindicated. We also suggest that further studies in larger series are required to validate this finding.
Joint DoD versus Navy Specific Lead Generation Advertising: Comparison of Conversion Rates to Quality Enlistments and Marginal Costs.

DTIC Science & Technology

1984-09-01

7D-Rt46 982 JOINT DOD VERSUS NAVY SPECIFIC LEAD GENERATION j/j ADVERTISING : COMPARISON OF..(U) J B FUGUR SCHOOL OF N BUSINESS DURHAM NC R C MOREY...REPORT I PEPIO0 COV9cO JOINT DOD VERSUS NAVY SPECIFIC LEAD GENERATION Technical Report ADVERTISING : Comparison of Conversion Rates to (0 Quality...block number) . Upper-Mental, High School Degree, enlistment contracts, national leads, Z Joint DOD advertising , Service Specific Advertising , conversion
Influence of liquid-volume and airflow rates on spray application quality and homogeneity in super-intensive olive tree canopies.

PubMed

Miranda-Fuentes, Antonio; Rodríguez-Lizana, Antonio; Gil, Emilio; Agüera-Vega, J; Gil-Ribes, Jesús A

2015-12-15

Olive is a key crop in Europe, especially in countries around the Mediterranean Basin. Optimising the parameters of a spray is essential for sustainable pesticide use, especially in high-input systems, such as the super-intensive hedgerow system. Parameters may be optimised by adjusting the applied volume and airflow rate of sprays, in addition to the liquid to air proportion and the relationship between air velocity and airflow rate. Two spray experiments using a commercial airblast sprayer were conducted in a super-intensive orchard to study how varying the liquid volume rate (testing volumes of 182, 619, and 1603 l ha(-1)) and volumetric airflow rate (with flow rates of 11.93, 8.90, and 6.15 m(3) s(-1)) influences the coverage parameters and the amount and distribution of deposits in different zones of the canopy.. Our results showed that an increase in the application volume raised the mean deposit and percentage coverage, but decreased the application efficiency, spray penetration, and deposit homogeneity. Furthermore, we found that the volumetric airflow rate had a lower influence on the studied parameters than the liquid volume; however, an increase in the airflow rate improved the application efficiency and homogeneity to a certain threshold, after which the spray quality decreased. This decrease was observed in the high-flow treatment. Our results demonstrate that intermediate liquid volume rates and volumetric airflow rates are required for the optimal spraying of pesticides on super-intensive olive crops, and would reduce current pollution levels. Copyright © 2015 Elsevier B.V. All rights reserved.

Does a hospital's quality depend on the quality of other hospitals? A spatial econometrics approach

PubMed Central

Gravelle, Hugh; Santos, Rita; Siciliani, Luigi

2014-01-01

We examine whether a hospital's quality is affected by the quality provided by other hospitals in the same market. We first sketch a theoretical model with regulated prices and derive conditions on demand and cost functions which determine whether a hospital will increase its quality if its rivals increase their quality. We then apply spatial econometric methods to a sample of English hospitals in 2009–10 and a set of 16 quality measures including mortality rates, readmission, revision and redo rates, and three patient reported indicators, to examine the relationship between the quality of hospitals. We find that a hospital's quality is positively associated with the quality of its rivals for seven out of the sixteen quality measures. There are no statistically significant negative associations. In those cases where there is a significant positive association, an increase in rivals' quality by 10% increases a hospital's quality by 1.7% to 2.9%. The finding suggests that for some quality measures a policy which improves the quality in one hospital will have positive spillover effects on the quality in other hospitals. PMID:25843994
Does a hospital's quality depend on the quality of other hospitals? A spatial econometrics approach.

PubMed

Gravelle, Hugh; Santos, Rita; Siciliani, Luigi

2014-11-01

We examine whether a hospital's quality is affected by the quality provided by other hospitals in the same market. We first sketch a theoretical model with regulated prices and derive conditions on demand and cost functions which determine whether a hospital will increase its quality if its rivals increase their quality. We then apply spatial econometric methods to a sample of English hospitals in 2009-10 and a set of 16 quality measures including mortality rates, readmission, revision and redo rates, and three patient reported indicators, to examine the relationship between the quality of hospitals. We find that a hospital's quality is positively associated with the quality of its rivals for seven out of the sixteen quality measures. There are no statistically significant negative associations. In those cases where there is a significant positive association, an increase in rivals' quality by 10% increases a hospital's quality by 1.7% to 2.9%. The finding suggests that for some quality measures a policy which improves the quality in one hospital will have positive spillover effects on the quality in other hospitals.
Spillover between Marital Quality and Parent-child Relationship Quality: Parental Depressive Symptoms as Moderators

PubMed Central

Kouros, Chrystyna D.; Papp, Lauren M.; Goeke-Morey, Marcie C.; Cummings, E. Mark

2015-01-01

Using a daily diary method, this study examined concurrent and time-lagged relations between marital and parent-child relationship qualities, providing a test of the spillover and compensatory hypotheses. Additionally, this study tested both mothers’ and fathers’ depressive symptoms as moderators of these daily linkages. Participants were 203 families, in which mothers and fathers completed daily diaries for 15 days. At the end of each reporting day, parents independently rated the emotional quality of their relationship with their spouse and with their child that day. Controlling for global levels of marital satisfaction, marital conflict, and parenting, a positive association was found between mothers’ and fathers’ daily ratings of marital quality and their ratings of parent-child relationship quality, supporting the spillover hypothesis. When considering time-lagged relations, support was found for the compensatory hypothesis for mothers: lower levels of marital quality were related to increases in mother-child relationship quality from one day to the next. Further, both maternal and paternal depressive symptoms moderated the link between marital quality and the other parent’s relationship quality with their child. Whereas maternal depressive symptoms strengthened spillover relations for fathers on the next day, paternal depression was related to less spillover for mothers on the same day. Alternative models did not find evidence for parent-child relationship quality as a predictor of changes in marital quality on the next day. The findings underscore the importance of the quality of the marital relationship for predicting the quality of other family relationships. PMID:24821519
Is there a difference between child self-ratings and parent proxy-ratings of the quality of life of children with a diagnosis of attention-deficit hyperactivity disorder (ADHD)? A systematic review of the literature.

PubMed

Galloway, Helen; Newman, Emily

2017-03-01

There are contemporary indicators that parent proxy-ratings and child self-ratings of a child's quality of life (QoL) are not interchangeable. This review examines dual informant studies to assess parent-child agreement on the QoL of children with attention-deficit/hyperactivity disorder. A systematic search of four major databases (PsycINFO, MEDLINE, EMBASE and Cochrane databases) was completed, and related peer-reviewed journals were hand-searched. Studies which reported quantitative QoL ratings for matched parent and child dyads were screened in accordance with relevant inclusion and exclusion criteria. Key findings were extracted from thirteen relevant studies, which were rated for conformity to the recommendations of an adapted version of the STROBE statement guidelines for observational studies. In the majority of studies reviewed, children rated their QoL more highly than their parents. There was some evidence for greater agreement on the physical health domain than psychosocial domains.
Novel Integration of Frame Rate Up Conversion and HEVC Coding Based on Rate-Distortion Optimization.

PubMed

Guo Lu; Xiaoyun Zhang; Li Chen; Zhiyong Gao

2018-02-01

Frame rate up conversion (FRUC) can improve the visual quality by interpolating new intermediate frames. However, high frame rate videos by FRUC are confronted with more bitrate consumption or annoying artifacts of interpolated frames. In this paper, a novel integration framework of FRUC and high efficiency video coding (HEVC) is proposed based on rate-distortion optimization, and the interpolated frames can be reconstructed at encoder side with low bitrate cost and high visual quality. First, joint motion estimation (JME) algorithm is proposed to obtain robust motion vectors, which are shared between FRUC and video coding. What's more, JME is embedded into the coding loop and employs the original motion search strategy in HEVC coding. Then, the frame interpolation is formulated as a rate-distortion optimization problem, where both the coding bitrate consumption and visual quality are taken into account. Due to the absence of original frames, the distortion model for interpolated frames is established according to the motion vector reliability and coding quantization error. Experimental results demonstrate that the proposed framework can achieve 21% ~ 42% reduction in BDBR, when compared with the traditional methods of FRUC cascaded with coding.
Key interventions and quality indicators for quality improvement of STEMI care: a RAND Delphi survey.

PubMed

Aeyels, Daan; Sinnaeve, Peter R; Claeys, Marc J; Gevaert, Sofie; Schoors, Danny; Sermeus, Walter; Panella, Massimiliano; Coeckelberghs, Ellen; Bruyneel, Luk; Vanhaecht, Kris

2017-12-13

Identification, selection and validation of key interventions and quality indicators for improvement of in hospital quality of care for ST-elevated myocardial infarction (STEMI) patients. A structured literature review was followed by a RAND Delphi Survey. A purposively selected multidisciplinary expert panel of cardiologists, nurse managers and quality managers selected and validated key interventions and quality indicators prior for quality improvement for STEMI. First, 34 experts (76% response rate) individually assessed the appropriateness of items to quality improvement on a nine point Likert scale. Twenty-seven key interventions, 16 quality indicators at patient level and 27 quality indicators at STEMI care programme level were selected. Eighteen additional items were suggested. Experts received personal feedback, benchmarking their score with group results (response rate, mean, median and content validity index). Consequently, 32 experts (71% response rate) openly discussed items with an item-content validity index above 75%. By consensus, the expert panel validated a final set of 25 key interventions, 13 quality indicators at patient level and 20 quality indicators at care programme level prior for improvement of in hospital care for STEMI. A structured literature review and multidisciplinary expertise was combined to validate a set of key interventions and quality indicators prior for improvement of care for STEMI. The results allow researchers and hospital staff to evaluate and support quality improvement interventions in a large cohort within the context of a health care system.
Parasympathetic reinnervation accompanied by improved post-exercise heart rate recovery and quality of life in heart transplant recipients.

PubMed

Imamura, Teruhiko; Kinugawa, Koichiro; Okada, Ikuko; Kato, Naoko; Fujino, Takeo; Inaba, Toshiro; Maki, Hisataka; Hatano, Masaru; Kinoshita, Osamu; Nawata, Kan; Kyo, Shunei; Ono, Minoru

2015-01-01

Although sympathetic reinnervation is accompanied by the improvement of exercise tolerability during the first years after heart transplantation (HTx), little is known about parasympathetic reinnervation and its clinical impact. We enrolled 21 recipients (40 ± 16 years, 71% male) who had received successive cardiopulmonary exercise testing at 6 months, and 1 and 2 years after HTx. Exercise parameters such as peak oxygen consumption or achieved maximum load remained unchanged, whereas recovery parameters including heart rate (HR) recovery during 2 minutes and the delay of peak HR, which are influenced by parasympathetic activity, improved significantly during post-HTx 2 years (P < 0.05 for both). HR variability was analysed at post-HTx 6 months in 18 recipients, and high frequency power, representing parasympathetic activity, was significantly associated with the 2 recovery parameters (P < 0.05 for all). We also assessed quality of life using the Minnesota Living with Heart Failure (HF) Questionnaire at post-HTx 6 months and 2 years in the same 18 recipients, and those with improved recovery parameters enjoyed a better HF-specific quality of life (P < 0.05 for both). In conclusion, parasympathetic reinnervation emerges along with improved post-exercise recovery ability of HR and quality of life during post-HTx 2 years.
Health-Related Quality of Life After Single-Fraction High-Dose-Rate Brachytherapy and Hypofractionated External Beam Radiotherapy for Prostate Cancer

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

Morton, Gerard C., E-mail: gerard.morton@sunnybrook.ca; Loblaw, D. Andrew; Chung, Hans

Purpose: To investigate the change in health-related quality of life for men after high-dose-rate brachytherapy and external beam radiotherapy for prostate cancer and the factors associated with this change. Methods and Materials: Eligible patients had clinically localized intermediate-risk prostate cancer. The patients received high-dose-rate brachytherapy as a single 15-Gy implant, followed by external beam radiotherapy to 37.5 Gy in 15 fractions. The patients were monitored prospectively for toxicity (Common Terminology Criteria for Adverse Events, version 3.0) and health-related quality of life (Expanded Prostate Cancer Index Composite [EPIC]). The proportion of patients developing a clinically significant difference in the EPIC domainmore » score (minimally important difference of >0.5 standard deviation) was determined and correlated with the baseline clinical and dosimetric factors. The study accrued 125 patients, with a median follow-up of 24 months. Results: By 24 months, 23% had Grade 2 urinary toxicity and only 5% had Grade 2 bowel toxicity, with no Grade 3 toxicity. The proportion of patients reporting a significant decrease in EPIC urinary, bowel, sexual, and hormonal domain scores was 53%, 51%, 45%, and 40% at 12 months and 57%, 65%, 51%, and 30% at 24 months, respectively. The proportion with a >1 standard deviation decrease in the EPIC urinary, bowel, sexual, and hormonal domain scores was 38%, 36%, 24%, and 20% at 12 months and 46%, 48%, 19%, and 8% at 24 months, respectively. On multivariate analysis, the dose to 10% of the urethra was associated with a decreasing EPIC urinary domain score (p = .0089) and, less strongly (p = .0312) with a decreasing hormonal domain score. No association was found between the prostate volume, bladder dose, or high-dose volume and urinary health-related quality of life. A high baseline International Index of Erectile Function score was associated (p = .0019) with a decreasing sexual domain score. The optimal
Visual Perception Based Rate Control Algorithm for HEVC

NASA Astrophysics Data System (ADS)

Feng, Zeqi; Liu, PengYu; Jia, Kebin

2018-01-01

For HEVC, rate control is an indispensably important video coding technology to alleviate the contradiction between video quality and the limited encoding resources during video communication. However, the rate control benchmark algorithm of HEVC ignores subjective visual perception. For key focus regions, bit allocation of LCU is not ideal and subjective quality is unsatisfied. In this paper, a visual perception based rate control algorithm for HEVC is proposed. First bit allocation weight of LCU level is optimized based on the visual perception of luminance and motion to ameliorate video subjective quality. Then λ and QP are adjusted in combination with the bit allocation weight to improve rate distortion performance. Experimental results show that the proposed algorithm reduces average 0.5% BD-BR and maximum 1.09% BD-BR at no cost in bitrate accuracy compared with HEVC (HM15.0). The proposed algorithm devotes to improving video subjective quality under various video applications.
Total Quality Management of Information System for Quality Assessment of Pesantren Using Fuzzy-SERVQUAL

NASA Astrophysics Data System (ADS)

Faizah, Arbiati; Syafei, Wahyul Amien; Isnanto, R. Rizal

2018-02-01

This research proposed a model combining an approach of Total Quality Management (TQM) and Fuzzy method of Service Quality (SERVQUAL) to asses service quality. TQM implementation was as quality management orienting on customer's satisfaction by involving all stakeholders. SERVQUAL model was used to measure quality service based on five dimensions such as tangible, reliability, responsiveness, assurance, and empathy. Fuzzy set theory was to accommodate subjectivity and ambiguity of quality assessment. Input data consisted of indicator data and quality assessment aspect. Input data was, then, processed to be service quality assessment questionnaires of Pesantren by using Fuzzy method to get service quality score. This process consisted of some steps as follows : inputting dimension and questionnaire data to data base system, filling questionnaire through system, then, system calculated fuzzification, defuzzification, gap of quality expected and received by service receivers, and calculating each dimension rating showing quality refinement priority. Rating of each quality dimension was, then, displayed at dashboard system to enable users to see information. From system having been built, it could be known that tangible dimension had the highest gap, -0.399, thus it needs to be prioritized and gets evaluation and refinement action soon.
Family Income, Parent Education, and Perceived Constraints as Predictors of Observed Program Quality and Parent Rated Program Quality

ERIC Educational Resources Information Center

Torquati, Julia C.; Raikes, Helen H.; Huddleston-Casas, Catherine A.; Bovaird, James A.; Harris, Beatrice A.

2011-01-01

Observed child care quality and parent perceptions of child care quality received by children in poor (below Federal Poverty Line, FPL), low-income (between FPL and 200% of FPL), and non-low-income families were examined. Observations were completed in 359 center- and home-based child care programs in four Midwestern states and surveys were…
[Study on seed quality test and quality standard of Pesudostellaria heterophylla].

PubMed

Xiao, Cheng-Hong; Zhou, Tao; Jiang, Wei-Ke; Chen, Min; Xiong, Hou-Xi; Liao, Ming-Wu

2014-08-01

Referring to the rules for agricultural seed testing (GB /T 3543-1995) issued by China, the test of sampling, seed purity, weight per 1 000 seeds, seed moisture, seed viability and germination rate had been studied for screening seed quality test methods of Pesudostellaria heterophylla. The seed quality from different collection areas was measured. The results showed that at least 6.5 g seeds should be sampled and passed through 10-mesh sieve for purity analysis. The weight of 1 000 seeds was determined by using the 500-seed method. The phenotypic observation and size measurement were used for authenticity testing. The seed moisture was determined under the higher temperature (130 ± 2) degrees C for 5 hours. The seeds were dipped into 0.2% TTC sustaining 1 hour at 40 degrees C, then the viability could be determined. The break dormancy seeds were cultured on sand at 10 degrees C. K cluster analysis was applied for the data analysis, the seed quality from different collection areas grading of P. Heterophylla was described as three grades. The seed quality of each grade should reach following requirements: for first grade seeds, germination rate ≥ 86%, 1 000-grain weight ≥ 2.59 g, purity ≥ 87%, moisture ≤ 13.1%; for second grade seeds, germination rate ≥ 70%, 1 000-grain weight ≥ 2.40 g, purity ≥ 77%, moisture ≤ 14.3%; for third grade seeds, germination rate ≥ 41%, 1 000-grain weight ≥ 2.29 g, purity ≥ 76%, moisture ≤ 15.8%. The seed testing methods for quality items of P. heterophylla had been initially established, as well as the primary P. heterophylla seed quality classification standard.
Apparatus and method for combusting low quality fuel

DOEpatents

Brushwood, John Samuel; Pillsbury, Paul; Foote, John; Heilos, Andreas

2003-11-04

A gas turbine (12) capable of combusting a low quality gaseous fuel having a ratio of flammability limits less than 2, or a heat value below 100 BTU/SCF. A high quality fuel is burned simultaneously with the low quality fuel to eliminate instability in the combustion flame. A sensor (46) is used to monitor at least one parameter of the flame indicative of instability. A controller (50) having the sensor signal (48) as input is programmed to control the relative flow rates of the low quality and high quality fuels. When instability is detected, the flow rate of high quality fuel is automatically increased in relation to the flow rate of low quality fuel to restore stability.
Socio-demographic differentials of adult health indicators in Matlab, Bangladesh: self-rated health, health state, quality of life and disability level

PubMed Central

Razzaque, Abdur; Nahar, Lutfun; Akter Khanam, Masuma; Kim Streatfield, Peter

2010-01-01

Background Mortality has been declining in Bangladesh since the mid- twentieth century, while fertility has been declining since the late 1970s, and the country is now passing through the third stage of demographic transition. This type of demographic transition has produced a huge youthful population with a growing number of older people. For assessing health among older people, this study examines self-rated health, health state, quality of life and disability level in persons aged 50 and over. Data and methods This is a collaborative study between the World Health Organization Study on global AGEing and adult health and the International Network for the Demographic Evaluation of Populations and Their Health in developing countries which collected data from eight countries. Two sources of data from the Matlab study area were used: health indicator data collected as a part of the study, together with the ongoing Health and Demographic Surveillance System (HDSS) data. For the survey, a total of 4,000 randomly selected people aged 50 and over (HDSS database) were interviewed. The four health indicators derived from these data are self-rated health (five categories), health state (eight domains), quality of life (eight items) and disability level (12 items). Self-rated health was coded as dummy while scores were calculated for the rest of the three health indicators using WHO-tested instruments. Results After controlling for all the variables in the regression model, all four indicators of health (self-rated health, health state, quality of life and disability level) documented that health was better for males than females, and health deteriorates with increasing age. Those people who were in current partnerships had generally better health than those who were single, and better health was associated with higher levels of education and asset score. Conclusions To improve the health of the population it is important to know health conditions in advance rather than
Rating Communication in GP Consultations: The Association Between Ratings Made by Patients and Trained Clinical Raters

PubMed Central

Burt, Jenni; Abel, Gary; Elmore, Natasha; Newbould, Jenny; Davey, Antoinette; Llanwarne, Nadia; Maramba, Inocencio; Paddison, Charlotte; Benson, John; Silverman, Jonathan; Elliott, Marc N.; Campbell, John; Roland, Martin

2016-01-01

Patient evaluations of physician communication are widely used, but we know little about how these relate to professionally agreed norms of communication quality. We report an investigation into the association between patient assessments of communication quality and an observer-rated measure of communication competence. Consent was obtained to video record consultations with Family Practitioners in England, following which patients rated the physician’s communication skills. A sample of consultation videos was subsequently evaluated by trained clinical raters using an instrument derived from the Calgary-Cambridge guide to the medical interview. Consultations scored highly for communication by clinical raters were also scored highly by patients. However, when clinical raters judged communication to be of lower quality, patient scores ranged from “poor” to “very good.” Some patients may be inhibited from rating poor communication negatively. Patient evaluations can be useful for measuring relative performance of physicians’ communication skills, but absolute scores should be interpreted with caution. PMID:27698072
Participant-Informant Relationships Affect Quality of Life Ratings in Incipient and Clinical Alzheimer Disease.

PubMed

Lin, Amy; Brook, Jenny; Grill, Joshua D; Teng, Edmond

2017-03-01

Clinical trials in incipient and clinical Alzheimer disease (AD) often include informant-reported outcomes. Whereas informant reports in AD dementia may be modulated by the nature of participant-informant relationships, whether informant type affects reporting at earlier disease stages is less certain. We sought to determine the effects of participant-informant relationships on informant assessments of quality of life (QOL), functional abilities, and behavioral symptoms in individuals with normal cognition (NC), mild cognitive impairment (MCI), and mild-to-moderate AD dementia. Cross-sectional. Easton Center for Alzheimer Disease Research at the University of California, Los Angeles. A total of 399 individuals who met criteria for NC (N = 100), MCI [amnestic (N = 125) and nonamnestic (N = 61)], and AD (N = 113). Participants were subdivided into groups based on informant-participant relationships (spouse versus other). We examined informant effects on the Quality of Life-Alzheimer's Disease (QOL-AD) scale, the Functional Activities Questionnaire (FAQ), and the Neuropsychiatric Inventory (NPI). After adjustments for demographic and cognitive factors, spouse informants reported higher participant QOL in the amnestic MCI and AD groups than did other informants. No informant effects were seen on QOL-AD ratings in the nonamnestic MCI or NC groups or on the FAQ or NPI in the MCI and AD groups. Participant-informant relationships may modulate informant responses on subjective measures such as the QOL-AD in both incipient and clinical AD. Clinical trials that use informant measures may need to address these effects. Published by Elsevier Inc.
The effect of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills rate of nurses in hospitals of tabriz, iran.

PubMed

Khodadadi, Esmail; Ebrahimi, Hossein; Moghaddasian, Sima; Babapour, Jalil

2013-03-01

Having an effective relationship with the patient in the process of treatment is essential. Nurses must have communication skills in order to establish effective relationships with the patients. This study evaluated the impact of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills of nurses. This is an experimental study with a control group that has been done in 2012. The study sample consisted of 73 nurses who work in hospitals of Tabriz; they were selected by proportional randomizing method. The intervention was only conducted on the experimental group. In order to measure the quality of care 160 patients, who had received care by nurses, participated in this study. The Data were analyzed by SPSS (ver.13). Comparing the mean scores of communication skills showed a statistically significant difference between control and experimental groups after intervention. The paired t-test showed a statistically significant difference in the experimental group before and after the intervention. Independent t-test showed a statistically significant difference between the rate of quality of care in patients of control and experimental groups after the intervention. The results showed that the training of communication skills can increase the nurse's rate of communication skills and cause elevation in quality of nursing care. Therefore, in order to improve the quality of nursing care it is recommended that communication skills be established and taught as a separate course in nursing education.
The Effect of Communication Skills Training on Quality of Care, Self-Efficacy, Job Satisfaction and Communication Skills Rate of Nurses in Hospitals of Tabriz, Iran

PubMed Central

Khodadadi, Esmail; Ebrahimi, Hossein; Moghaddasian, Sima; Babapour, Jalil

2013-01-01

Introduction: Having an effective relationship with the patient in the process of treatment is essential. Nurses must have communication skills in order to establish effective relationships with the patients. This study evaluated the impact of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills of nurses. Methods: This is an experimental study with a control group that has been done in 2012. The study sample consisted of 73 nurses who work in hospitals of Tabriz; they were selected by proportional randomizing method. The intervention was only conducted on the experimental group. In order to measure the quality of care 160 patients, who had received care by nurses, participated in this study. The Data were analyzed by SPSS (ver.13). Results: Comparing the mean scores of communication skills showed a statistically significant difference between control and experimental groups after intervention. The paired t-test showed a statistically significant difference in the experimental group before and after the intervention. Independent t-test showed a statistically significant difference between the rate of quality of care in patients of control and experimental groups after the intervention. Conclusion: The results showed that the training of communication skills can increase the nurse's rate of communication skills and cause elevation in quality of nursing care. Therefore, in order to improve the quality of nursing care it is recommended that communication skills be established and taught as a separate course in nursing education. PMID:25276707
The effects of anonymity on student ratings of teaching and course quality in a bachelor degree programme.

PubMed

Scherer, Theresa; Straub, Jan; Schnyder, Daniel; Schaffner, Noemi

2013-01-01

Are there any clear differences between the outcomes of anonymous and personalised student evaluations of teaching quality? During a two-year period students were randomly divided into two separate groups, "anonymous" and "personalised", for end-of-module evaluations. The quality of the module was assessed using a standardised questionnaire. Additionally, students were given the option to add "further comments" if they wanted to highlight specifics. These optional comments were independently assessed by three people, using a five-dimensional rating instrument: positive/negative; differentiated/absolute; naming a person/general; containing an order/neutral; visually accentuated/blank. The database consisted of 615 evaluation forms, of which 306 were completed anonymously. In order to identify whether there were any differences between the anonymous and personalised data, a multivariate variance analysis was performed. Based on the scale, the answers to the questions and the quality of the comments were evaluated. Furthermore, an assessment was made to determine if there were any differences in the number of optional comments between the two groups. No significant differences were identified in the informative quality of data between the anonymous and personalised student evaluations. However, students in the personalised group had a tendency to include more details in their written answers. Personalised evaluations do not generate more biased results in terms of social desirability, as long as the evaluation concept is characterised by a closed-circle process and is transparent. In other words, it is imperative that the outcomes of the evaluation are reported back to the students. Moreover, there has to be an opportunity for students to discuss any further suggestions and/or future desires in an open environment. In this way the students respect and understand that their feedback is being taken seriously; consequently, they feel able to provide a constructive and
Candidate Quality Measures for Hand Surgery.

PubMed

2017-11-01

Quality measures are tools used by physicians, health care systems, and payers to evaluate performance, monitor the outcomes of interventions, and inform quality improvement efforts. A paucity of quality measures exist that address hand surgery care. We completed a RAND/UCLA (University of California Los Angeles) Delphi Appropriateness process with the goal of developing and evaluating candidate hand surgery quality measures to be used for national quality measure development efforts. A consortium of 9 academic upper limb surgeons completed a RAND/UCLA Delphi Appropriateness process to evaluate the importance, scientific acceptability, usability, and feasibility of 44 candidate quality measures. These addressed hand problems the panelists felt were most appropriate for quality measure development. Panelists rated the measures on an ordinal scale between 1 (definitely not valid) and 9 (definitely valid) in 2 rounds (preliminary round and final round) with an intervening face-to-face discussion. Ratings from 1 to 3 were considered not valid, 4 to 6 as equivocal or uncertain, and 7 to 9 as valid. If no more than 2 of the 9 ratings were outside the 3-point range that included the median (1-3, 4-6, or 7-9), the panelists were considered to be in agreement. If 3 or more of the panelists' ratings of a measure were within the 1 to 3 range and 3 or more ratings were in the 7 to 9 range, the panelists were considered to be in disagreement. There was agreement on 43% (19) of the measures as important, 27% (12) as scientifically sound, 48% (21) as usable, and 59% (26) as feasible to complete. Ten measures met all 4 of these criteria and were, therefore, considered valid measurements of quality. Quality measures that were developed address outcomes (patient-reported outcomes for assessment and improvement of function) and processes of care (utilization rates of imaging, antibiotics, occupational therapy, ultrasound, and operative treatment). The consortium developed 10

Fruit flies may face a nutrient-dependent life-history trade-off between secondary sexual trait quality, survival and developmental rate.

PubMed

Gray, Lindsey J; Simpson, Stephen J; Polak, Michal

2018-01-01

Optimal life-history strategies are those that best allocate finite environmental resources to competing traits. We used the geometric framework for nutrition to evaluate life-history strategies followed by Drosophila melanogaster by measuring the condition-dependent performance of life-history traits, including the morphology of male secondary sexual characters, sex combs. We found that depending on their rearing environment flies faced different forms of trait trade-offs and accordingly followed different life-history strategies. High-energy, high-carbohydrate, low-protein diets supported development of the largest and most symmetrical sex combs, however, consistent with handicap models of sexual selection these foods were associated with reduced fly survival and developmental rate. Expressing the highest quality sex combs may have required secondary sexual trait quality to be traded-off with developmental rate, and our results indicated that flies unable to slow development died. As larval nutritional environments are predominantly determined by female oviposition substrate choice, we tested where mated female flies laid the most eggs. Mothers chose high-energy, high-protein foods associated with rapid larval development. Mothers avoided high-carbohydrate foods associated with maximal sex comb expression, showing they may avoid producing fewer 'sexy' sons in favour of producing offspring that develop rapidly. Copyright © 2017 Elsevier Ltd. All rights reserved.
Effects of consensus training on the reliability of auditory perceptual ratings of voice quality.

PubMed

Iwarsson, Jenny; Reinholt Petersen, Niels

2012-05-01

This study investigates the effect of consensus training of listeners on intrarater and interrater reliability and agreement of perceptual voice analysis. The use of such training, including a reference voice sample, could be assumed to make the internal standards held in memory common and more robust, which is of great importance to reduce the variability of auditory perceptual ratings. A prospective design with testing before and after training. Thirteen students of audiologopedics served as listening subjects. The ratings were made using a multidimensional protocol with four-point equal-appearing interval scales. The stimuli consisted of text reading by authentic dysphonic patients. The consensus training for each perceptual voice parameter included (1) definition, (2) underlying physiology, (3) presentation of carefully selected sound examples representing the parameter in three different grades followed by group discussions of perceived characteristics, and (4) practical exercises including imitation to make use of the listeners' proprioception. Intrarater reliability and agreement showed a marked improvement for intermittent aphonia but not for vocal fry. Interrater reliability was high for most parameters before training with a slight increase after training. Interrater agreement showed marked increases for most voice quality parameters as a result of the training. The results support the recommendation of specific consensus training, including use of a reference voice sample material, to calibrate, equalize, and stabilize the internal standards held in memory by the listeners. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.
Male adiposity impairs clinical pregnancy rate by in vitro fertilization without affecting day 3 embryo quality.

PubMed

Merhi, Zaher O; Keltz, Julia; Zapantis, Athena; Younger, Joshua; Berger, Dara; Lieman, Harry J; Jindal, Sangita K; Polotsky, Alex J

2013-08-01

Male adiposity is detrimental for achieving clinical pregnancy rate (CPR) following assisted reproductive technologies (ART). The hypothesis that the association of male adiposity with decreased success following ART is mediated by worse embryo quality was tested. Retrospective study including 344 infertile couples undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles was performed. Cycle determinants included number of oocytes retrieved, zygote PN-score, total number of embryos available on day 3, number of embryos transferred, composite day 3 grade for transferred embryos, composite day 3 grade per cycle, and CPR. Couples with male body mass index (BMI) over 25 kg m(-2) (overweight and obese) exhibited significantly lower CPR compared to their normal weight counterparts (46.7% vs. 32.0% respectively, P = 0.02). No significant difference was observed for any embryo quality metrics when analyzed by male BMI: mean zygote PN-scores, mean composite day 3 grades for transferred embryos or composite day 3 grades per cycle. In a multivariable logistic regression analysis adjusting for female age, female BMI, number of embryos transferred and sperm concentration, male BMI over 25 kg m(-2) was associated with a lower chance for CPR after IVF (OR = 0.17 [95% CI: 0.04-0.65]; P = 0.01) but not after ICSI cycles (OR = 0.88 [95% CI: 0.41-1.88]; P = 0.75). In this cohort, male adiposity was associated with decreased CPR following IVF but embryo quality was not affected. Embryo grading based on conventional morphologic criteria does not explain the poorer clinical pregnancy outcomes seen in couples with overweight or obese male partner. Copyright © 2013 The Obesity Society.
When Rating Systems Do Not Rate: Evaluating ERA's Performance

ERIC Educational Resources Information Center

Henman, Paul; Brown, Scott D.; Dennis, Simon

2017-01-01

In 2015, the Australian Government's Excellence in Research for Australia (ERA) assessment of research quality declined to rate 1.5 per cent of submissions from universities. The public debate focused on practices of gaming or "coding errors" within university submissions as the reason for this outcome. The issue was about the…
Oral health-related quality of life in youth receiving cleft-related surgery: self-report and proxy ratings.

PubMed

Broder, Hillary L; Wilson-Genderson, Maureen; Sischo, Lacey

2017-04-01

This paper evaluated the impact of cleft-related surgery on the oral health-related quality of life (OHRQoL) of youth with cleft over time. Data were derived from a 5-year, multi-center, prospective, longitudinal study of 1196 youth with cleft lip and/or palate and their caregivers. Eligible youth were between 7.5 and 18.5 years old, spoke English or Spanish, and were non-syndromic. During each observational period, which included baseline, and 1- and 2-year post-baseline follow-up visits, youths and their caregivers completed the Child Oral Health Impact Profile, a validated measure of OHRQoL. Multilevel mixed-effects models were used to analyze the effects of receipt of craniofacial surgery on OHRQoL over time. During the course of this study a total of 516 patients (43 %) received at least one surgery. Youth in the surgery recommendation group had lower self- (β = -2.18, p < 0.05) and proxy-rated (β = -2.92, p < 0.02) OHRQoL when compared to non-surgical self- and proxy-rated OHRQoL at baseline. Both surgical and non-surgical youth (β = 3.73, p < 0.001) and caregiver (β = 1.91, p < 0.05) ratings of OHRQoL improved over time. There was significant incremental improvement (time × surgery interaction) in self-reported OHRQoL for youth postsurgery (β = 1.04, p < 0.05), but this postsurgery increment was not seen in the caregiver proxy ratings. Surgical intervention impacts OHRQoL among youth with cleft. Youth who were surgical candidates had lower baseline self- and caregiver-rated OHRQoL when compared to non-surgical youth. Youth who underwent cleft-related surgery had significant incremental improvements in self-rated but not caregiver (proxy)-rated OHRQoL after surgery.
Estimation of an optimal chemotherapy utilisation rate for cancer: setting an evidence-based benchmark for quality cancer care.

PubMed

Jacob, S A; Ng, W L; Do, V

2015-02-01

There is wide variation in the proportion of newly diagnosed cancer patients who receive chemotherapy, indicating the need for a benchmark rate of chemotherapy utilisation. This study describes an evidence-based model that estimates the proportion of new cancer patients in whom chemotherapy is indicated at least once (defined as the optimal chemotherapy utilisation rate). The optimal chemotherapy utilisation rate can act as a benchmark for measuring and improving the quality of care. Models of optimal chemotherapy utilisation were constructed for each cancer site based on indications for chemotherapy identified from evidence-based treatment guidelines. Data on the proportion of patient- and tumour-related attributes for which chemotherapy was indicated were obtained, using population-based data where possible. Treatment indications and epidemiological data were merged to calculate the optimal chemotherapy utilisation rate. Monte Carlo simulations and sensitivity analyses were used to assess the effect of controversial chemotherapy indications and variations in epidemiological data on our model. Chemotherapy is indicated at least once in 49.1% (95% confidence interval 48.8-49.6%) of all new cancer patients in Australia. The optimal chemotherapy utilisation rates for individual tumour sites ranged from a low of 13% in thyroid cancers to a high of 94% in myeloma. The optimal chemotherapy utilisation rate can serve as a benchmark for planning chemotherapy services on a population basis. The model can be used to evaluate service delivery by comparing the benchmark rate with patterns of care data. The overall estimate for other countries can be obtained by substituting the relevant distribution of cancer types. It can also be used to predict future chemotherapy workload and can be easily modified to take into account future changes in cancer incidence, presentation stage or chemotherapy indications. Copyright © 2014 The Royal College of Radiologists. Published by
Correlative responses for carcass and meat quality traits to selection for ovulation rate or prenatal survival in French Large White pigs.

PubMed

Rosendo, A; Druet, T; Péry, C; Bidanel, J P

2010-03-01

Correlated effects of selection for components of litter size on carcass and meat quality traits were estimated using data from 3 lines of pigs derived from the same Large White base population. Two lines were selected for 6 generations on high ovulation rate at puberty (OR) or high prenatal survival corrected for ovulation rate in the first 2 parities (PS). The third line was an unselected control (CON). The 3 lines were kept for a 7th generation, but without any selection. Carcass and meat quality traits were recorded on the 5th to 7th generation of the experiment. Carcass traits included dressing percentage, carcass length (LGTH), average backfat thickness (ABT), estimated lean meat content, and 8 carcass joint weight traits. Meat quality traits included pH recorded 24 h after slaughter (pH24) of LM, gluteus superficialis (GS), biceps femoris (BF), and adductor femoris (AD) muscles, as well as reflectance and water-holding capacity (WHC) of GS and BF muscles. Heritabilities of carcass and meat quality traits and their genetic correlations with OR and PS were estimated using REML methodology applied to a multiple trait animal model. Correlated responses to selection were then estimated by computing differences between OR or PS and CON lines at generations 5 to 7 using least squares and mixed model methodology. Heritability (h(2)) estimates were 0.08 +/- 0.04, 0.58 +/- 0.10, 0.70 +/- 0.10, and 0.74 +/- 0.10 for dressing percentage, LGTH, ABT, and lean meat content, respectively, ranged from 0.28 to 0.72 for carcass joint traits, from 0.28 to 0.45 for pH24 and reflectance measurements, and from 0.03 to 0.11 for WHC measurements. Both OR and PS had weak genetic correlations with carcass (r(G) = -0.09 to 0.17) and most meat quality traits. Selection for OR did not affect any carcass composition or meat quality trait. Correlated responses to selection for PS were also limited, with the exception of a decrease in pH24 of GS and BF muscles (-0.12 to -0.14 after 6
Comparing blastocyst quality and live birth rates of intravaginal culture using INVOcell™ to traditional in vitro incubation in a randomized open-label prospective controlled trial.

PubMed

Doody, Kevin J; Broome, E Jason; Doody, Kathleen M

2016-04-01

The purpose of this study is to to compare the efficacy of intravaginal culture (IVC) of embryos in INVOcell™ (INVO Bioscience, MA, USA) to traditional in vitro fertilization (IVF) incubators in a laboratory setting using a mild pre-determined stimulation regimen based solely on anti-mullerian hormone (AMH) and body weight with minimal ultrasound monitoring. The primary endpoint examined was total quality blastocysts expressed as a percentage of total oocytes placed in incubation. Secondary endpoints included percentage of quality blastocysts transferred, pregnancy, and live birth rates. In this prospective randomized open-label controlled single-center study, 40 women aged <38 years of age with a body mass index (BMI) of <36 and an AMH of 1-3 ng/mL were randomized prior to trigger to receive either IVC or IVF. Controlled ovarian stimulation was administered with human menopausal gonadotropin (hMG) in a fixed gonadotropin-releasing hormone (GnRH) agonist cycle based solely on AMH and body weight. A single ultrasound-monitoring visit was performed on the 10th day of stimulation. One or two embryos were transferred following 5 days of culture. IVF produced a greater percentage of total quality embryos as compared to IVC (50.6 vs. 30.7 %, p = 0.0007, respectively). There was no significant difference between in IVF and IVC in the percentage of quality blastocysts transferred (97.5 vs. 84.9 %, p = 0.09) or live birth rate (60 % IVF, 55 % IVC). IVF was shown to be superior to IVC in creating quality blastocysts. However, both IVF and IVC produced identical blastocysts for transfer resulting in similar live birth rates. IVC using INVOcell™ is effective and may broaden access to fertility care in selected patient populations by ameliorating the need for a traditional IVF laboratory setting. Further studies will help elucidate the potential physiological, psychological, geographic, and financial impact of IVC on the delivery of fertility care.
Validation Studies for Early Learning and Care Quality Rating and Improvement Systems: A Review of the Literature. Working Paper WR-1051-DOEL

ERIC Educational Resources Information Center

Karoly, Lynn A.

2014-01-01

Care Quality Rating and Improvement Systems (QRISs) have advanced and matured, a number of states and localities have undertaken evaluations to validate the systems. Such efforts stem from the desire to ensure that the system is designed and operating in the ways envisioned when the system was established. Given that a central component in a QRIS…
Measurements of Protein Crystal Face Growth Rates

NASA Technical Reports Server (NTRS)

Gorti, S.

2014-01-01

Protein crystal growth rates will be determined for several hyperthermophile proteins.; The growth rates will be assessed using available theoretical models, including kinetic roughening.; If/when kinetic roughening supersaturations are established, determinations of protein crystal quality over a range of supersaturations will also be assessed.; The results of our ground based effort may well address the existence of a correlation between fundamental growth mechanisms and protein crystal quality.
A Hyporheic Mesocosm Experiment: Influence of Quantity and Quality of stream-source DOC on Rates of Hyporheic Metabolism

NASA Astrophysics Data System (ADS)

Serchan, S. P.; Wondzell, S. M.; Haggerty, R.; Pennington, R.; Feris, K. P.; Sanfilippo, A. R.; Reeder, W. J.; Tonina, D.

2016-12-01

Hyporheic zone biogeochemical processes can influence stream water chemistry. Some estimates show that 50-90% stream water CO2 is produced in the hyporheic zone through heterotrophic metabolism of organic matter, usually supplied from the stream as dissolved organic carbon (DOC). Preliminary results from our well network at the HJ Andrews WS1, indicate that dissolved inorganic carbon (DIC) is 1.5-2 times higher in the hyporheic zone than in stream water. Conversely, DOC (mg/L) is 1.5 times higher in stream water than in the hyporheic zone throughout the year. Overall, the hyporheic zone appears to be a net source of DIC. However, the increase in DIC along hyporheic flow paths is approximately 10-times greater than the loss of DOC, suggesting that metabolism of buried particulate organic carbon (POC) is a major source of organic carbon for microbial metabolism. However, we cannot completely rule out alternative sources of DIC, especially those originating in the overlying riparian soil, because hyporheic processes are difficult to isolate in well networks. To study hyporheic zone biogeochemical processes, particularly the transformation of organic carbon to inorganic carbon species, we designed and built six replicate 2-m long hyporheic mesocosms in which we are conducting DOC amendment experiments. We examine the role of DOC quality and quantity on hyporheic respiration by injecting labile (acetate) and refractory (fulvic acid) organic carbon and comparing rates of O2 consumption, DOC loss, and DIC gains against a control. We expect that stream source DOC is limiting in this small headwater stream, forcing hyporheic metabolism to rely on buried POC. However, the long burial time of POC suggests it is likely of low quality so that supplying labile DOC in stream water should shift hyporheic metabolism away from POC rather than increase the overall rate of metabolism. Future experiments will examine natural sources of DOC (stream periphyton, leaf, and soil humic
Do inter-hospital comparisons of in-hospital, acute myocardial infarction case-fatality rates serve the purpose of fostering quality improvement? An evaluative study.

PubMed

Aelvoet, Willem; Terryn, Nathalie; Molenberghs, Geert; De Backer, Guy; Vrints, Christiaan; van Sprundel, Marc

2010-12-08

In-hospital case-fatality rates in patients, admitted for acute myocardial infarction (AMI-CFRs), are internationally used as a quality indicator. Attempting to encourage the hospitals to assume responsibility, the Belgian Ministry of Health decided to stimulate initiatives of quality improvement by means of a limited set of indicators, among which AMI-CFR, to be routinely analyzed. In this study we aimed, by determining the existence of inter-hospital differences in AMI-CFR, (1) to evaluate to which extent Belgian discharge records allow the assessment of quality of care in the field of AMI, and (2) to identify starting points for quality improvement. Hospital discharge records from all the Belgian short-term general hospitals in the period 2002-2005. The study population (N = 46,287) included patients aged 18 years and older, hospitalized for AMI. No unique patient identifier being present, we tried to track transferred patients. We assessed data quality through a comparison of MCD with data from two registers for acute coronary events and through transfer and sensitivity analyses. We compared AMI-CFRs across hospitals, using multivariable logistic regression models. In the main model hospitals, Charlson's co-morbidity index, age, gender and shock constituted the covariates. We carried out two types of analyses: a first one wherein transferred-out cases were excluded, to avoid double counting of patients when computing rates, and a second one with exclusion of all transferred cases, to allow the study of patients admitted into, treated in and discharged from the same hospital. We identified problems regarding both the CFR's numerator and denominator.Sensitivity analyses revealed differential coding and/or case management practices. In the model with exclusion of transfer-out cases, the main determinants of AMI-CFR were cardiogenic shock (OR(adj) 23.0; 95% CI [20.9;25.2]), and five-year age groups OR(adj) 1.23; 95% CI [1.11;1.36]). Sizable inter-hospital and inter
Do inter-hospital comparisons of in-hospital, acute myocardial infarction case-fatality rates serve the purpose of fostering quality improvement? An evaluative study

PubMed Central

2010-01-01

Background In-hospital case-fatality rates in patients, admitted for acute myocardial infarction (AMI-CFRs), are internationally used as a quality indicator. Attempting to encourage the hospitals to assume responsibility, the Belgian Ministry of Health decided to stimulate initiatives of quality improvement by means of a limited set of indicators, among which AMI-CFR, to be routinely analyzed. In this study we aimed, by determining the existence of inter-hospital differences in AMI-CFR, (1) to evaluate to which extent Belgian discharge records allow the assessment of quality of care in the field of AMI, and (2) to identify starting points for quality improvement. Methods Hospital discharge records from all the Belgian short-term general hospitals in the period 2002-2005. The study population (N = 46,287) included patients aged 18 years and older, hospitalized for AMI. No unique patient identifier being present, we tried to track transferred patients. We assessed data quality through a comparison of MCD with data from two registers for acute coronary events and through transfer and sensitivity analyses. We compared AMI-CFRs across hospitals, using multivariable logistic regression models. In the main model hospitals, Charlson's co-morbidity index, age, gender and shock constituted the covariates. We carried out two types of analyses: a first one wherein transferred-out cases were excluded, to avoid double counting of patients when computing rates, and a second one with exclusion of all transferred cases, to allow the study of patients admitted into, treated in and discharged from the same hospital. Results We identified problems regarding both the CFR's numerator and denominator. Sensitivity analyses revealed differential coding and/or case management practices. In the model with exclusion of transfer-out cases, the main determinants of AMI-CFR were cardiogenic shock (ORadj 23.0; 95% CI [20.9;25.2]), and five-year age groups ORadj 1.23; 95% CI [1.11;1.36]). Sizable
Race to the Top--Early Learning Challenge (RTT-ELC): Descriptive Study of Tiered Quality Rating and Improvement Systems (TQRIS). Master Data Collection Protocol

ERIC Educational Resources Information Center

Mathematica Policy Research, Inc., 2015

2015-01-01

This master data collection protocol describes the data that Mathematica collected for the Race to the Top-Early Learning Challenge Study of Tiered Quality Rating and Improvement Systems. This study was conducted for the Department of Education's Institute of Education Sciences. The data were collected from reviews of applications, documents, and…
Boar taint, meat quality and fail rate in entire male pigs and male pigs immunized against gonadotrophin releasing factor as related to body weight and feeding regime.

PubMed

Moore, K L; Mullan, B P; Dunshea, F R

2017-03-01

The objective of this experiment was to compare the pork quality of entire male pigs and pigs immunized against GnRF (IC males) at both light (64.8kg) and heavy (106kg) liveweights and two feeding regimes (restricted at 2.5 times maintenance and ad libitum). There was no difference in objective measurements (P>0.05) or eating pork quality (P>0.1) between entire male and IC males. Fail rates were reduced by 9.1% and 12% for pork from IC males for quality grade (P=0.007) and re-purchase intention (P=0.001), respectively, compared to pork from entire males. Skatole (P=0.001) and androstenone (P<0.001) levels in belly fat were higher in entire male than IC male pigs. In addition, 37.5% of the light entire male pigs fed ad libitum showed skatole levels that exceeded the sensory threshold of 0.2μg/g. This work confirms that immunization against GnRF is effective in eliminating boar taint and reducing pork quality fail rates by approximately 10% compared to pork from entire males. Copyright © 2016 Elsevier Ltd. All rights reserved.
Survey for δ Sct components in eclipsing binaries and new correlations between pulsation frequency and fundamental stellar characteristics

NASA Astrophysics Data System (ADS)

Liakos, A.; Niarchos, P.; Soydugan, E.; Zasche, P.

2012-05-01

CCD observations of 68 eclipsing binary systems, candidates for containing δ Scuti components, were obtained. Their light curves are analysed using the PERIOD04 software for possible pulsational behaviour. For the systems QY Aql, CZ Aqr, TY Cap, WY Cet, UW Cyg, HL Dra, HZ Dra, AU Lac, CL Lyn and IO UMa, complete light curves were observed due to the detection of a pulsating component. All of them, except QY Aql and IO UMa, are analysed with modern astronomical softwares in order to determine their geometrical and pulsational characteristics. Spectroscopic observations of WY Cet and UW Cyg were used to estimate the spectral class of their primary components, while for HZ Dra radial velocities of its primary were measured. O - C diagram analysis was performed for the cases showing peculiar orbital period variations, namely CZ Aqr, TY Cap, WY Cet and UW Cyg, with the aim of obtaining a comprehensive picture of these systems. An updated catalogue of 74 close binaries including a δ Scuti companion is presented. Moreover, a connection between orbital and pulsation periods, as well as a correlation between evolutionary status and dominant pulsation frequency for these systems, is discussed.
Use of insecticide quantification kits to investigate the quality of spraying and decay rate of bendiocarb on different wall surfaces in Kagera region, Tanzania.

PubMed

Thawer, Narjis G; Ngondi, Jeremiah M; Mugalura, Frances E; Emmanuel, Isaac; Mwalimu, Charles D; Morou, Evangelia; Vontas, John; Protopopoff, Natacha; Rowland, Mark; Mutagahywa, Joshua; Lalji, Shabbir; Molteni, Fabrizio; Ramsan, Mahdi M; Willilo, Ritha; Wright, Alexandra; Kafuko, Jessica M; Ndong, Isaiah; Reithinger, Richard; Magesa, Stephen Masingili

2015-04-22

Bendiocarb was introduced for the first time for Indoor Residual Spraying (IRS) in Tanzania in 2012 as part of the interim national insecticide resistance management plan. This move followed reports of increasingly alarming levels of pyrethroid resistance across the country. This study used the insecticide quantification kit (IQK) to investigate the intra-operational IRS coverage and quality of spraying, and decay rate of bendiocarb on different wall surfaces in Kagera region. To assess intra-operational IRS coverage and quality of spraying, 104 houses were randomly selected out of 161,414 sprayed houses. A total of 509 samples (218 in Muleba and 291 in Karagwe) were obtained by scraping the insecticide samples from wall surfaces. To investigate decay rate, 66 houses (36 in Muleba and 30 in Karagwe) were selected and samples were collected monthly for a period of five months. Laboratory testing of insecticide concentration was done using IQK(TM) [Innovative Vector Control Consortium]. Of the 509 samples, 89.5% met the World Health Organization (WHO) recommended concentration (between 100-400 mg/m(2)) for IRS target dosage. The proportion of samples meeting WHO standards varied between Karagwe (84.3%) and Muleba (96.3%) (p < 0.001). Assessment of quality of spraying at house level revealed that Muleba (84.8%) had a significantly higher proportion of households that met the expected target dosage (100-400 mg/m(2)) compared to Karagwe (68.9%) (p < 0.001). The quality of spraying varied across different wall substrates in both districts. Evaluation of bendiocarb decay showed that the proportion of houses with recommended concentration declined from 96.9%, 93.5% and 76.2% at months one, two, and three post IRS, respectively (p-trend = 0.03). The rate of decay increased in the fourth and fifth month post spraying with only 55.9% and 26.3% houses meeting the WHO recommendations, respectively. IQK is an important tool for assessing IRS coverage and quality of
Development of a nonlocal convective mixing scheme with varying upward mixing rates for use in air quality and chemical transport models.

PubMed

Mihailović, Dragutin T; Alapaty, Kiran; Sakradzija, Mirjana

2008-06-01

Asymmetrical convective non-local scheme (CON) with varying upward mixing rates is developed for simulation of vertical turbulent mixing in the convective boundary layer in air quality and chemical transport models. The upward mixing rate form the surface layer is parameterized using the sensible heat flux and the friction and convective velocities. Upward mixing rates varying with height are scaled with an amount of turbulent kinetic energy in layer, while the downward mixing rates are derived from mass conservation. This scheme provides a less rapid mass transport out of surface layer into other layers than other asymmetrical convective mixing schemes. In this paper, we studied the performance of a nonlocal convective mixing scheme with varying upward mixing in the atmospheric boundary layer and its impact on the concentration of pollutants calculated with chemical and air-quality models. This scheme was additionally compared versus a local eddy-diffusivity scheme (KSC). Simulated concentrations of NO(2) and the nitrate wet deposition by the CON scheme are closer to the observations when compared to those obtained from using the KSC scheme. Concentrations calculated with the CON scheme are in general higher and closer to the observations than those obtained by the KSC scheme (of the order of 15-20%). Nitrate wet deposition calculated with the CON scheme are in general higher and closer to the observations than those obtained by the KSC scheme. To examine the performance of the scheme, simulated and measured concentrations of a pollutant (NO(2)) and nitrate wet deposition was compared for the year 2002. The comparison was made for the whole domain used in simulations performed by the chemical European Monitoring and Evaluation Programme Unified model (version UNI-ACID, rv2.0) where schemes were incorporated.
Quality in Family Child Care Settings: The Relationship between Provider Educational Experiences and Global Quality Scores in a Statewide Quality Rating and Improvement System

ERIC Educational Resources Information Center

Hallam, Rena A.; Bargreen, Kaitlin N.; Ridgley, Robyn

2013-01-01

This study is a secondary analysis of a statewide sample of licensed family child care providers in the Tennessee Child Care Evaluation and Report Card Program ("N"?=?1,145) that describes the general quality of family child care programs in the state and examines the relationships between provider education and global quality. Study…
Toxicities Affecting Quality of Life After Chemo-IMRT of Oropharyngeal Cancer: Prospective Study of Patient-Reported, Observer-Rated, and Objective Outcomes

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

Hunter, Klaudia U.; Schipper, Matthew; Feng, Felix Y.

2013-03-15

Purpose: To test the hypothesis that intensity modulated radiation therapy (IMRT) aiming to spare the salivary glands and swallowing structures would reduce or eliminate the effects of xerostomia and dysphagia on quality of life (QOL). Methods and Materials: In this prospective, longitudinal study, 72 patients with stage III-IV oropharyngeal cancer were treated uniformly with definitive chemo-IMRT sparing the salivary glands and swallowing structures. Overall QOL was assessed by summary scores of the Head Neck QOL (HNQOL) and University of Washington QOL (UWQOL) questionnaires, as well as the HNQOL “Overall Bother” question. Quality of life, observer-rated toxicities (Common Toxicity Criteria Adversemore » Effects scale, version 2), and objective evaluations (videofluoroscopy assessing dysphagia and saliva flow rates assessing xerostomia) were recorded from before therapy through 2 years after therapy. Correlations between toxicities/objective evaluations and overall QOL were assessed using longitudinal repeated measures of analysis and Pearson correlations. Results: All observer-rated toxicities and QOL scores worsened 1-3 months after therapy and improved through 12 months, with minor further improvements through 24 months. At 12 months, dysphagia grades 0-1, 2, and 3, were observed in 95%, 4%, and 1% of patients, respectively. Using all posttherapy observations, observer-rated dysphagia was highly correlated with all overall QOL measures (P<.0001), whereas xerostomia and mucosal and voice toxicities were significantly correlated with some, but not all, overall QOL measures, with lower correlation coefficients than dysphagia. Late overall QOL (≥6 or ≥12 months after therapy) was primarily associated with observer-rated dysphagia, and to a lesser extent with xerostomia. Videofluoroscopy scores, but not salivary flows, were significantly correlated with some of the overall QOL measures. Conclusion: After chemo-IMRT, although late dysphagia was on average

Quality Management, Certification and Rating of Health Information on the Net with MedCERTAIN: Using a medPICS/RDF/XML metadata structure for implementing eHealth ethics and creating trust globally

PubMed Central

Eysenbach, Gunther; Yihune, Gabriel; Lampe, Kristian; Cross, Phil; Brickley, Dan

2000-01-01

MedCERTAIN (MedPICS Certification and Rating of Trustworthy Health Information on the Net, http://www.medcertain.org/) is a recently launched international project funded under the European Union's (EU) "Action Plan for safer use of the Internet". It provides a technical infrastructure and a conceptual basis for an international system of "quality seals", ratings and self-labelling of Internet health information, with the final aim to establish a global "trustmark" for networked health information. Digital "quality seals" are evaluative metadata (using standards such as PICS=Platform for Internet Content Selection, now being replaced by RDF/XML) assigned by trusted third-party raters. The project also enables and encourages self-labelling with descriptive metainformation by web authors. Together these measures will help consumers as well as professionals to identify high-quality information on the Internet. MedCERTAIN establishes a fully functional demonstrator for a self- and third-party rating system enabling consumers and professionals to filter harmful health information and to positively identify and select high quality information. We aim to provide a trustmark system which allows citizens to place greater confidence in networked information, to encourage health information providers to follow best practices guidelines such as the Washington eHealth Code of Ethics, to provide effective feedback and law enforcement channels to handle user complaints, and to stimulate medical societies to develop standard for patient information. The project further proposes and identifies standards for interoperability of rating and description services (such as libraries or national health portals) and fosters a worldwide collaboration to guide consumers to high-quality information on the web.
Real-time video quality monitoring

NASA Astrophysics Data System (ADS)

Liu, Tao; Narvekar, Niranjan; Wang, Beibei; Ding, Ran; Zou, Dekun; Cash, Glenn; Bhagavathy, Sitaram; Bloom, Jeffrey

2011-12-01

The ITU-T Recommendation G.1070 is a standardized opinion model for video telephony applications that uses video bitrate, frame rate, and packet-loss rate to measure the video quality. However, this model was original designed as an offline quality planning tool. It cannot be directly used for quality monitoring since the above three input parameters are not readily available within a network or at the decoder. And there is a great room for the performance improvement of this quality metric. In this article, we present a real-time video quality monitoring solution based on this Recommendation. We first propose a scheme to efficiently estimate the three parameters from video bitstreams, so that it can be used as a real-time video quality monitoring tool. Furthermore, an enhanced algorithm based on the G.1070 model that provides more accurate quality prediction is proposed. Finally, to use this metric in real-world applications, we present an example emerging application of real-time quality measurement to the management of transmitted videos, especially those delivered to mobile devices.
Improvement of bio-oil yield and quality in co-pyrolysis of corncobs and high density polyethylene in a fixed bed reactor at low heating rate

NASA Astrophysics Data System (ADS)

Supramono, D.; Lusiani, S.

2016-11-01

Over the past few decades, interest in developing biomass-derived fuel has been increasing rapidly due to the decrease in fossil fuel reserves. Bio-oil produced by biomass pyrolysis however contains high oxygen compounds resulting in low calorific-value fuel and therefore requiring upgrading. In co-pyrolysis of the feed blend of plastics of High Density Polyethylene (HDPE) and biomass of com cob particles, at some compositions free radicals from plastic decomposition containing more hydrogen radicals are able to bond oxygen radicals originating from biomass to reduce oxygenate compounds in the bio-oil thus increasing bio-oil quality. This phenomenon is usually called synergetic effect. In addition to that, the pattern of heating of the feed blend in the pyrolysis reactor is predicted to affect biooil quality and yield. In a batch reactor, co-pyrolysis of corncobs and HDPE requires low heating rate to reach a peak temperature at temperature rise period followed by heating for some time at peak temperature called holding time at constant temperature period. No research has been carried out to investigate how long holding time is set in co-pyrolysis of plastic and biomass to obtain high yield of bio-oil. Holding time may affect either crosslinking of free radicals in gas phase, which increases char product, or secondary pyrolysis in the gas phase, which increases non-condensable gas in the gas phase of pyrolysis reactor, both of which reduce bio-oil yield. Therefore, holding time of co-pyrolysis affects the mass rate of bio-oil formation as the pyrolysis proceeds and quality of the bio-oil. In the present work, effects of holding time on the yield and quality of bio-oil have been investigated using horizontal fixed bed of the feed blends at heating rate of 5°C, peak temperature of 500°C and N2 flow rate of 700 ml/minute. Holding time was varied from 0 to 70 minutes with 10 minutes interval. To investigate the effects of holding time, the composition of HDPE in the
Colometer: a real-time quality feedback system for screening colonoscopy.

PubMed

Filip, Dobromir; Gao, Xuexin; Angulo-Rodríguez, Leticia; Mintchev, Martin P; Devlin, Shane M; Rostom, Alaa; Rosen, Wayne; Andrews, Christopher N

2012-08-28

To investigate the performance of a new software-based colonoscopy quality assessment system. The software-based system employs a novel image processing algorithm which detects the levels of image clarity, withdrawal velocity, and level of the bowel preparation in a real-time fashion from live video signal. Threshold levels of image blurriness and the withdrawal velocity below which the visualization could be considered adequate have initially been determined arbitrarily by review of sample colonoscopy videos by two experienced endoscopists. Subsequently, an overall colonoscopy quality rating was computed based on the percentage of the withdrawal time with adequate visualization (scored 1-5; 1, when the percentage was 1%-20%; 2, when the percentage was 21%-40%, etc.). In order to test the proposed velocity and blurriness thresholds, screening colonoscopy withdrawal videos from a specialized ambulatory colon cancer screening center were collected, automatically processed and rated. Quality ratings on the withdrawal were compared to the insertion in the same patients. Then, 3 experienced endoscopists reviewed the collected videos in a blinded fashion and rated the overall quality of each withdrawal (scored 1-5; 1, poor; 3, average; 5, excellent) based on 3 major aspects: image quality, colon preparation, and withdrawal velocity. The automated quality ratings were compared to the averaged endoscopist quality ratings using Spearman correlation coefficient. Fourteen screening colonoscopies were assessed. Adenomatous polyps were detected in 4/14 (29%) of the collected colonoscopy video samples. As a proof of concept, the Colometer software rated colonoscope withdrawal as having better visualization than the insertion in the 10 videos which did not have any polyps (average percent time with adequate visualization: 79% ± 5% for withdrawal and 50% ± 14% for insertion, P < 0.01). Withdrawal times during which no polyps were removed ranged from 4-12 min. The median quality
Effect of a high fat diet on ovary morphology, in vitro development, in vitro fertilisation rate and oocyte quality in mice.

PubMed

Sohrabi, Maryam; Roushandeh, Amaneh Mohammadi; Alizadeh, Zohreh; Vahidinia, Aliasghar; Vahabian, Mehrangiz; Hosseini, Mahnaz

2015-10-01

The aim of this study was to determine the effect of a high-fat diet (HFD) on oocyte maturation and quality in a mouse model. Female BALB/c mice were allocated to one of the following groups: (a) control group (n = 40), which received a controlled diet; or (b) HFD group (n = 40), which received an HFD for 12 weeks. Sections of the ovary were examined histologically. The number of follicles and corpora lutea were counted. In vitro maturation and in vitro fertilisation (IVF) were assessed in germinal vesicle (GV) and metaphase II (MII) oocytes, respectively. The expression of bone morphogenetic protein 15 (BMP15) and leptin receptor genes in GV and MII oocytes was evaluated using reverse transcription real-time polymerase chain reactions. In the HFD group, there was a decreased number of primordial and Graafian follicles, as well as corpora lutea (p < 0.05). The rate of oocyte development to the MII stage was also reduced (p < 0.001). Cumulus expansion was observed more frequently in the control group than the HFD group (p < 0.05). The IVF rate in the HFD group was lower than that in the control group (p < 0.05). In the HFD group, BMP15 and leptin receptor genes were upregulated in the GV stage (p > 0.05) and MII stage (p < 0.05), compared to the control group. An HFD reduces folliculogenesis in the primordial and Graafian stages, in vitro maturation and in vitro fertilisation rates, as well as oocyte quality in mice.
PROBABILISTIC PROGRAMMING FOR ADVANCED MACHINE LEARNING (PPAML) DISCRIMINATIVE LEARNING FOR GENERATIVE TASKS (DILIGENT)

DTIC Science & Technology

2017-11-29

Structural connections of the frames (fragments) in the knowledge. We call the fundamental elements of the knowledge a limited number of elements...the result of contracted fundamental research deemed exempt from public affairs security and policy review in accordance with SAF/AQR memorandum dated...AVAILABILITY STATEMENT Approved for Public Release; Distribution Unlimited. This report is the result of contracted fundamental research deemed exempt from
Aquarius

NASA Astrophysics Data System (ADS)

Murdin, P.

2000-11-01

(the Water-bearer; abbrev. Aqr, gen. Aquarii; area 980 sq. deg.) A southern zodiacal constellation that lies between Pegasus and Piscis Austrinus, and culminates at midnight in late August. Its origin dates back to Babylonian times and it is said to represent Ganymede in Greek mythology, who was snatched up by Aquila (the eagle) on Zeus's behest, to become cup-bearer to the gods. Its brightest st...
A Sleep Questionnaire for Children with Severe Psychomotor Impairment (SNAKE)-Concordance with a Global Rating of Sleep Quality.

PubMed

Dreier, Larissa Alice; Zernikow, Boris; Blankenburg, Markus; Wager, Julia

2018-02-01

Sleep problems are a common and serious issue in children with life-limiting conditions (LLCs) and severe psychomotor impairment (SPMI). The "Sleep Questionnaire for Children with Severe Psychomotor Impairment" (Schlaffragebogen für Kinder mit Neurologischen und Anderen Komplexen Erkrankungen, SNAKE) was developed for this unique patient group. In a proxy rating, the SNAKE assesses five different dimensions of sleep(-associated) problems (disturbances going to sleep, disturbances remaining asleep, arousal and breathing disorders, daytime sleepiness, and daytime behavior disorders). It has been tested with respect to construct validity and some aspects of criterion validity. The present study examined whether the five SNAKE scales are consistent with parents' or other caregivers' global ratings of a child's sleep quality. Data from a comprehensive dataset of children and adolescents with LLCs and SPMI were analyzed through correlation coefficients and Mann-Whitney U testing. The results confirmed the consistency of both sources of information. The highest levels of agreements with the global rating were achieved for disturbances in terms of going to sleep and disturbances with respect to remaining asleep. The results demonstrate that the scales and therefore the SNAKE itself is well-suited for gathering information on different sleep(-associated) problems in this vulnerable population.
Identifying a Comparison for Matching Rough Voice Quality

ERIC Educational Resources Information Center

Patel, Sona; Shrivastav, Rahul; Eddins, David A.

2012-01-01

Purpose: Perceptual estimates of voice quality obtained using rating scales are subject to contextual biases that influence how individuals assign numbers to estimate the magnitude of vocal quality. Because rating scales are commonly used in clinical settings, assessments of voice quality are also subject to the limitations of these scales.…
Multicolor eclipse studies of UU Aquarii. 1: Observations and system parameters

NASA Technical Reports Server (NTRS)

Baptista, R.; Steiner, J. E.; Cieslinski, D.

1994-01-01

A study of the eclipses in UU Aqr from multicolor high-speed photometry is presented. A revised ephemeris for the times of minimum and an upper limit for orbital period variations are obtained. We use measurements of contact phases in the eclipse light curve to derive the binary geometry and to estimate masses and relevant dimensions. We find a mass ratio of q = 0.30 +/- 0.07 and an inclination of i = 78 deg +/- 2 deg. The masses of the component stars are M(sub 1) = 0.67 +/- 0.14 solar mass and M(sub 2) = 0.20 +/- 0.07 solar mass. Our photometric model predicts K(sub 1) = 84 +/- 26 km/s, which is approximately 30% smaller than the velocity amplitude obtained from the emission lines. From the white dwarf fluxes we estimate T(sub wd) approximately = 34,000 K and a distance of d = 270 +/- 50 pc if the inner disk is opaque. UU Aqr has long term brightness variations of approximately = 0.3 m on timescales of approximately 4 yr. The system was in a 'high' state in 1989 and 1990 and in a 'low' state in 1988 and 1992. The high state results from an increase in the brightness of the outer and cooler parts of the disk, mainly due to the appearance of a bright spot at disk rim. Based on the smooth and gradual eclipse shape and on the absence of a prominent hump in the light curve we suggest that UU Aqr is a high mass-transfer nova-like system with a relatively bright and optically thick accretion disk. We find no perceptible eclipse in the H-alpha emission line. The fluxes at mid-eclipse can be fitted by a compostion of a late-type spectrum plus an optically thin hydrogen emission-line spectrum. These evidences suggest that the emission lines are formed in an extended region only partially occulted during eclipse.
THE CIRCUMSTELLAR DISK OF THE Be STAR o AQUARII AS CONSTRAINED BY SIMULTANEOUS SPECTROSCOPY AND OPTICAL INTERFEROMETRY

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

Sigut, T. A. A.; Tycner, C.; Jansen, B.

Omicron Aquarii is a late-type, Be shell star with a stable and nearly symmetric Hα emission line. We combine Hα interferometric observations obtained with the Navy Precision Optical Interferometer covering 2007 through 2014 with Hα spectroscopic observations over the same period and a 2008 observation of the system's near-infrared spectral energy distribution to constrain the properties of o Aqr's circumstellar disk. All observations are consistent with a circumstellar disk seen at an inclination of 75° ± 3° with a position angle on the sky of 110° ± 8° measured East from North. From the best-fit disk density model, we find that 90% ofmore » the Hα emission arises from within 9.5 stellar radii, and the mass associated with this Hα disk is ∼1.8 × 10{sup −10} of the stellar mass, and that the associated angular momentum, assuming Keplerian rotation for the disk, is ∼1.6 × 10{sup −8} of the total stellar angular momentum. The occurrence of a central quasi-emission feature in Mg ii λ4481 is also predicted by this best-fit disk model and the computed profile compares successfully with observations from 1999. To obtain consistency between the Hα line profile modeling and the other constraints, it was necessary in the profile fitting to weight the line core (emission peaks and central depression) more heavily than the line wings, which were not well reproduced by our models. This may reflect the limitation of assuming a single power law for the disk's variation in equatorial density. The best-fit disk density model for o Aqr predicts that Hα is near its maximum strength as a function of disk density, and hence the Hα equivalent width and line profile change only weakly in response to large (factor of ∼5) changes in the disk density. This may in part explain the remarkable observed stability of o Aqr's Hα emission line profile.« less
Heart Rate Variability Reflects the Natural History of Physiological Development in Healthy Children and Is Not Associated with Quality of Life

PubMed Central

Seifert, Georg; Calaminus, Gabriele; Wiener, Andreas; Cysarz, Dirk

2014-01-01

Background Quality of life (QoL), being the sum expression of diverse influencing factors, is not easy to determine. A clinically relevant option would be to identify and measure quality of life on the basis of physiological parameters which correlate plausibly and statistically with psychometrically measured QoL. Analysis of heart rate variability (HRV) offers readily measurable physiological parameters which could be of use here. A correlation of HRV with both course of disease and QoL has been reported in patients with chronic illness. Various psychometric instruments have been developed for use in paediatric oncology. The aim of this study was to obtain data on HRV and QoL and their correlations, initially in healthy children. Methods Holter ECG and quality of life were examined in 160 children and adolescents (72 male) aged between 8 and 18 years. QoL was determined with the established questionnaire PEDQoL. Standard parameters of HRV from the frequency domain were calculated and correlated with QoL domains using Spearman (nonparametric) correlation analysis. Results Minor but significant associations were revealed only with regard to the PEDQoL domain “autonomy” on the one hand and heart rate and HRV (e.g. MRR, MRRn, MRRd, HRV_ULF, SDNN) parameters which evidently reflect distinct physiological functions on the other. Conclusions In healthy children and adolescents we have a first indication that there is a correlation between parameters of HRV and QoL. However, to a greater extent, HRV reflects associated physiological processes of the autonomic nervous system. A higher correlation is more likely to be found in chronically ill children. PMID:24625571
Dosimetric quality endpoints for low-dose-rate prostate brachytherapy using biological effective dose (bed) vs. conventional dose

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

Singh, Rachana; Al-Hallaq, Hania; Pelizzari, Charles A.

2003-12-31

The purpose of this study was to compare conventional low-dose-rate prostate brachytherapy dosimetric quality parameters with their biological effective dose (BED) counterparts. To validate a model for transformation from conventional dose to BED, the postimplant plans of 31 prostate brachytherapy patients were evaluated using conventional dose-volume histogram (DVH) quality endpoints and analogous BED-DVH endpoints. Based on CT scans obtained 4 weeks after implantation, DVHs were computed and standard dosimetric endpoints V100 (volume receiving 100% of the prescribed dose), V150, V200, HI (1-[V150/V100]), and D90 (dose that 90% of the target volume received) were obtained for quality analysis. Using known andmore » reported transformations, dose grids were transformed to BED-early ({alpha}/{beta} = 10 Gy) and BED-late ({alpha}/{beta} = 3 Gy) grids, and the same dosimetric endpoints were analyzed. For conventional, BED-early and BED-late DVHs, no differences in V100 were seen (0.896, 0.893, and 0.894, respectively). However, V150 and V200 were significantly higher for both BED-early (0.582 and 0.316) and BED-late (0.595 and 0.337), compared with the conventional (0.539 and 0.255) DVHs. D90 was significantly lower for the BED-early (103.1 Gy) and BED-late transformations (106.9 Gy) as compared with the conventional (119.5 Gy) DVHs. The conventional prescription parameter V100 is the same for the corresponding BED-early and BED-late transformed DVHs. The toxicity parameters V150 and V200 are slightly higher using the BED transformations, suggesting that the BED doses are somewhat higher than predicted using conventional DVHs. The prescription/quality parameter D90 is slightly lower, implying that target coverage is lower than predicted using conventional DVHs. This methodology can be applied to analyze BED dosimetric endpoints to improve clinical outcome and reduce complications of prostate brachytherapy.« less
Eye of the Beholder: Stage Entrance Behavior and Facial Expression Affect Continuous Quality Ratings in Music Performance

PubMed Central

Waddell, George; Williamon, Aaron

2017-01-01

Judgments of music performance quality are commonly employed in music practice, education, and research. However, previous studies have demonstrated the limited reliability of such judgments, and there is now evidence that extraneous visual, social, and other “non-musical” features can unduly influence them. The present study employed continuous measurement techniques to examine how the process of forming a music quality judgment is affected by the manipulation of temporally specific visual cues. Video footage comprising an appropriate stage entrance and error-free performance served as the standard condition (Video 1). This footage was manipulated to provide four additional conditions, each identical save for a single variation: an inappropriate stage entrance (Video 2); the presence of an aural performance error midway through the piece (Video 3); the same error accompanied by a negative facial reaction by the performer (Video 4); the facial reaction with no corresponding aural error (Video 5). The participants were 53 musicians and 52 non-musicians (N = 105) who individually assessed the performance quality of one of the five randomly assigned videos via a digital continuous measurement interface and headphones. The results showed that participants viewing the “inappropriate” stage entrance made judgments significantly more quickly than those viewing the “appropriate” entrance, and while the poor entrance caused significantly lower initial scores among those with musical training, the effect did not persist long into the performance. The aural error caused an immediate drop in quality judgments that persisted to a lower final score only when accompanied by the frustrated facial expression from the pianist; the performance error alone caused a temporary drop only in the musicians' ratings, and the negative facial reaction alone caused no reaction regardless of participants' musical experience. These findings demonstrate the importance of visual
Patient Decision Aids Improve Decision Quality and Patient Experience and Reduce Surgical Rates in Routine Orthopaedic Care: A Prospective Cohort Study.

PubMed

Sepucha, Karen; Atlas, Steven J; Chang, Yuchiao; Dorrwachter, Janet; Freiberg, Andrew; Mangla, Mahima; Rubash, Harry E; Simmons, Leigh H; Cha, Thomas

2017-08-02

Patient decision aids are effective in randomized controlled trials, yet little is known about their impact in routine care. The purpose of this study was to examine whether decision aids increase shared decision-making when used in routine care. A prospective study was designed to evaluate the impact of a quality improvement project to increase the use of decision aids for patients with hip or knee osteoarthritis, lumbar disc herniation, or lumbar spinal stenosis. A usual care cohort was enrolled before the quality improvement project and an intervention cohort was enrolled after the project. Participants were surveyed 1 week after a specialist visit, and surgical status was collected at 6 months. Regression analyses adjusted for clustering of patients within clinicians and examined the impact on knowledge, patient reports of shared decision-making in the visit, and surgical rates. With 550 surveys, the study had 80% to 90% power to detect a difference in these key outcomes. The response rates to the 1-week survey were 70.6% (324 of 459) for the usual care cohort and 70.2% (328 of 467) for the intervention cohort. There was no significant difference (p > 0.05) in any patient characteristic between the 2 cohorts. More patients received decision aids in the intervention cohort at 63.6% compared with the usual care cohort at 27.3% (p = 0.007). Decision aid use was associated with higher knowledge scores, with a mean difference of 18.7 points (95% confidence interval [CI], 11.4 to 26.1 points; p < 0.001) for the usual care cohort and 15.3 points (95% CI, 7.5 to 23.0 points; p = 0.002) for the intervention cohort. Patients reported more shared decision-making (p = 0.009) in the visit with their surgeon in the intervention cohort, with a mean Shared Decision-Making Process score (and standard deviation) of 66.9 ± 27.5 points, compared with the usual care cohort at 62.5 ± 28.6 points. The majority of patients received their preferred treatment, and this did not differ
Quality of Death Rates by Race and Hispanic Origin: A Summary of Current Research, 1999. Vital and Health Statistics. Series 2: Data Evaluation and Methods Research. No. 128.

ERIC Educational Resources Information Center

National Center for Health Statistics (DHHS/PHS), Hyattsville, MD.

This report summarizes current knowledge and research on the quality and reliability of death rates by race and Hispanic origin in official mortality statistics of the United States produced by the National Center for Health Statistics (NCHS). It provides a quantitative assessment of bias in death rates by race and Hispanic origin and identifies…
Quality of drinking water and high incidence rate of esophageal cancer in Golestan province of Iran: a probable link.

PubMed

Keshavarzi, Behnam; Moore, Farid; Najmeddin, Ali; Rahmani, Farah; Malekzadeh, Ahad

2012-02-01

Golestan province in north Iran is known to be a high-risk area for esophageal cancer (EC). Of a long list of multiple risk factors, this study focuses on a possible link between the epidemiologic patterns of EC and the anomalous concentration of some ions and elements in the drinking water sources. A total of 183 samples from 45 villages covering a wide range of EC mortality rates are collected and analyzed. The results demonstrate that NO(3)(-), SO(4)(2-), Sb, and Sr exceed the recommended maximum concentration level (MCL) in drinking water. This is more prominent in the villages with high esophageal cancer mortality rate, suggesting a possible link between EC incidence and water quality. Se concentration in drinking water increases from low to the high EC areas, a finding contrary to the expected trend. It is concluded that Se deficiency does not play a major role in the etiology of EC in the Golestan province. The statistical results obtained from Mann-Whitney and Kruskal-Wallis tests along with cluster analysis are consistent with the observed trend of EC mortality rate in Golestan province. © Springer Science+Business Media B.V. 2011
Quality Control of High-Dose-Rate Brachytherapy: Treatment Delivery Analysis Using Statistical Process Control

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

Able, Charles M., E-mail: cable@wfubmc.edu; Bright, Megan; Frizzell, Bart

Purpose: Statistical process control (SPC) is a quality control method used to ensure that a process is well controlled and operates with little variation. This study determined whether SPC was a viable technique for evaluating the proper operation of a high-dose-rate (HDR) brachytherapy treatment delivery system. Methods and Materials: A surrogate prostate patient was developed using Vyse ordnance gelatin. A total of 10 metal oxide semiconductor field-effect transistors (MOSFETs) were placed from prostate base to apex. Computed tomography guidance was used to accurately position the first detector in each train at the base. The plan consisted of 12 needles withmore » 129 dwell positions delivering a prescribed peripheral dose of 200 cGy. Sixteen accurate treatment trials were delivered as planned. Subsequently, a number of treatments were delivered with errors introduced, including wrong patient, wrong source calibration, wrong connection sequence, single needle displaced inferiorly 5 mm, and entire implant displaced 2 mm and 4 mm inferiorly. Two process behavior charts (PBC), an individual and a moving range chart, were developed for each dosimeter location. Results: There were 4 false positives resulting from 160 measurements from 16 accurately delivered treatments. For the inaccurately delivered treatments, the PBC indicated that measurements made at the periphery and apex (regions of high-dose gradient) were much more sensitive to treatment delivery errors. All errors introduced were correctly identified by either the individual or the moving range PBC in the apex region. Measurements at the urethra and base were less sensitive to errors. Conclusions: SPC is a viable method for assessing the quality of HDR treatment delivery. Further development is necessary to determine the most effective dose sampling, to ensure reproducible evaluation of treatment delivery accuracy.« less
Association between rates of binocular visual field loss and vision-related quality of life in patients with glaucoma.

PubMed

Lisboa, Renato; Chun, Yeoun Sook; Zangwill, Linda M; Weinreb, Robert N; Rosen, Peter N; Liebmann, Jeffrey M; Girkin, Christopher A; Medeiros, Felipe A

2013-04-01

It is reasonable to hypothesize that for 2 patients with similar degrees of integrated binocular visual field (BVF) loss, the patient with a history of faster disease progression will report worse vision-related quality of life (VRQOL) than the patient with slowly progressing damage. However, to our knowledge, this hypothesis has not been investigated in the literature. To evaluate the association between binocular rates of visual field change and VRQOL in patients with glaucoma. DESIGN Observational cohort study. Patients were recruited from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study. The study included 796 eyes of 398 patients with diagnosed or suspected glaucoma followed up from October 1, 1998, until January 31, 2012, for a mean (SD) of 7.3 (2.0) years. The VRQOL was evaluated using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) at the last follow-up visit. The NEI VFQ-25 was completed for all patients during the period extending from December 1, 2009, through January 31, 2012. Integrated BVFs were calculated from the monocular fields of each patient. Linear regression of mean deviation values was used to evaluate rates of BVF change during the follow-up period. Logistic regression models were used to investigate the association between abnormal VRQOL and rates of BVF change, while adjusting for potentially confounding socioeconomic and demographic variables. Thirty-two patients (8.0%) had abnormal VRQOL as determined by the results of the NEI VFQ-25. Patients with abnormal VRQOL had significantly faster rates of BVF change than those with normal VRQOL (-0.18 vs -0.06 dB/y; P < .001). Rates of BVF change were significantly associated with abnormality in VRQOL (odds ratio = 1.31 per 0.1 dB/y faster; P = .04), after adjustment for confounding variables. Patients with faster rates of BVF change were at higher risk of reporting abnormal VRQOL. Assessment of rates of BVF change
The bipolar jet of the symbiotic star R Aquarii: A study of its morphology using the high-resolution HST WFC3/UVIS camera

NASA Astrophysics Data System (ADS)

Melnikov, Stanislav; Stute, Matthias; Eislöffel, Jochen

2018-04-01

Context. R Aqr is a symbiotic binary system consisting of a Mira variable with a pulsation period of 387 days and a hot companion which is presumably a white dwarf with an accretion disk. This binary system is the source of a prominent bipolar gaseous outflow. Aims: We use high spatial resolution and sensitive images from the Hubble Space Telescope (HST) to identify and investigate the different structural components that form the complex morphology of the R Aqr jet. Methods: We present new high-resolution HST WFC3/UVIS narrow-band images of the R Aqr jet obtained in 2013/14 using the [OIII]λ5007, [OI]λ6300, [NII]λ6583, and Hα emission lines. These images also allow us to produce detailed maps of the jet flow in several line ratios such as [OIII]λ5007/[OI]λ6300 and [NII]λ6583/[OI]λ6300 which are sensitive to the outflow temperature and its hydrogen ionisation fraction. The new emission maps together with archival HST data are used to derive and analyse the proper motion of prominent emitting features which can be traced over 20 years with the HST observations. Results: The images reveal the fine gas structure of the jet out to distances of a few tens of arcseconds from the central region, as well as in the innermost region, within a few arcseconds around the stellar source. They reveal for the first time the straight, highly collimated jet component which can be traced to up to 900 AU in the NE direction. Images in [OIII]λ5007, [OI]λ6300, and [NII]λ6583 clearly show a helical pattern in the jet beams which may derive from the small-scale precession of the jet. The highly collimated jet is accompanied by a wide opening angle outflow which is filled by low excitation gas. The position angles of the jet structures as well as their opening angles are calculated. Our measurements of the proper motions of some prominent emission knots confirm the scenario of gas acceleration during the propagation of the outflow. Finally, we produce several detailed line ratio

National Utility Rate Database: Preprint

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

Ong, S.; McKeel, R.

2012-08-01

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

PubMed

Hassett, Leanne; Simpson, Grahame; Cotter, Rachel; Whiting, Diane; Hodgkinson, Adeline; Martin, Diane

2015-04-01

To investigate whether the introduction of an electronic goals system followed by staff training improved the quality, rating, framing and structure of goals written by a community-based brain injury rehabilitation team. Interrupted time series design. Two interventions were introduced six months apart. The first intervention comprised the introduction of an electronic goals system. The second intervention comprised a staff goal training workshop. An audit protocol was devised to evaluate the goals. A random selection of goal statements from the 12 months prior to the interventions (Time 1 baseline) were compared with all goal statements written after the introduction of the electronic goals system (Time 2) and staff training (Time 3). All goals were de-identified for client and time-period, and randomly ordered. A total of 745 goals (Time 1 n = 242; Time 2 n = 283; Time 3 n = 220) were evaluated. Compared with baseline, the introduction of the electronic goals system alone significantly increased goal rating, framing and structure (χ(2) tests 144.7, 18.9, 48.1, respectively, p < 0.001). The addition of staff training meant that the improvement in goal quality, which was only a trend at Time 2, was statistically significant at Time 3 (χ(2) 15.0, p ≤ 001). The training also led to a further significant increase in the framing and structuring of goals over the electronic goals system (χ(2) 11.5, 12.5, respectively, p ≤ 0.001). An electronic goals system combined with staff training improved the quality, rating, framing and structure of goal statements. © The Author(s) 2014.
The Impact of Dose Rate on the Accuracy of Step-and-Shoot Intensity-modulated Radiation Therapy Quality Assurance Using Varian 2300CD.

PubMed

Njeh, Christopher F; Salmon, Howard W; Schiller, Claire

2017-01-01

Intensity-modulated radiation therapy (IMRT) delivery using "step-and-shoot" technique on Varian C-Series linear accelerator (linac) is influenced by the communication frequency between the multileaf collimator and linac controllers. Hence, the dose delivery accuracy is affected by the dose rate. Our aim was to quantify the impact of using two dose rates on plan quality assurance (QA). Twenty IMRT patients were selected for this study. The plan QA was measured at two different dose rates. A gamma analysis was performed, and the degree of plan modulation on the QA pass rate was also evaluated in terms of average monitor unit per segment (MU/segment) and the total number of segments. The mean percentage gamma pass rate of 94.9% and 93.5% for 300 MU/min and 600 MU/min dose rate, respectively, was observed. There was a significant ( P = 0.001) decrease in percentage gamma pass rate when the dose rate was increased from 300 MU/min to 600 MU/min. There was a weak, but significant association between the percentage pass rate at both dose rate and total number of segments. The total number of MU was significantly correlated to the total number of segments ( r = 0.59). We found a positive correlation between the percentage pass rate and mean MU/segment, r = 0.52 and r = 0.57 for 300 MU/min and 600 MU/min, respectively. IMRT delivery using step-and-shoot technique on Varian 2300CD is impacted by the dose rate and the total amount of segments.
Adding Postal Follow-Up to a Web-Based Survey of Primary Care and Gastroenterology Clinic Physician Chiefs Improved Response Rates but not Response Quality or Representativeness.

PubMed

Partin, Melissa R; Powell, Adam A; Burgess, Diana J; Haggstrom, David A; Gravely, Amy A; Halek, Krysten; Bangerter, Ann; Shaukat, Aasma; Nelson, David B

2015-09-01

This study assessed whether postal follow-up to a web-based physician survey improves response rates, response quality, and representativeness. We recruited primary care and gastroenterology chiefs at 125 Veterans Affairs medical facilities to complete a 10-min web-based survey on colorectal cancer screening and diagnostic practices in 2010. We compared response rates, response errors, and representativeness in the primary care and gastroenterology samples before and after adding postal follow-up. Adding postal follow-up increased response rates by 20-25 percentage points; markedly greater increases than predicted from a third e-mail reminder. In the gastroenterology sample, the mean number of response errors made by web responders (0.25) was significantly smaller than the mean number made by postal responders (2.18), and web responders provided significantly longer responses to open-ended questions. There were no significant differences in these outcomes in the primary care sample. Adequate representativeness was achieved before postal follow-up in both samples, as indicated by the lack of significant differences between web responders and the recruitment population on facility characteristics. We conclude adding postal follow-up to this web-based physician leader survey improved response rates but not response quality or representativeness. © The Author(s) 2013.
The association between quality of care and quality of life in long-stay nursing home residents with preserved cognition.

PubMed

Kim, Sun Jung; Park, Eun-Cheol; Kim, Sulgi; Nakagawa, Shunichi; Lung, John; Choi, Jong Bum; Ryu, Woo Sang; Min, Too Jae; Shin, Hyun Phil; Kim, Kyudam; Yoo, Ji Won

2014-03-01

To assess the overall quality of life of long-stay nursing home residents with preserved cognition, to examine whether the Centers for Medicare and Medicaid Service's Nursing Home Compare 5-star quality rating system reflects the overall quality of life of such residents, and to examine whether residents' demographics and clinical characteristics affect their quality of life. Quality of life was measured using the Participant Outcomes and Status Measures-Nursing Facility survey, which has 10 sections and 63 items. Total scores range from 20 (lowest possible quality of life) to 100 (highest). Long-stay nursing home residents with preserved cognition (n = 316) were interviewed. The average quality- of-life score was 71.4 (SD: 7.6; range: 45.1-93.0). Multilevel regression models revealed that quality of life was associated with physical impairment (parameter estimate = -0.728; P = .04) and depression (parameter estimate = -3.015; P = .01) but not Nursing Home Compare's overall star rating (parameter estimate = 0.683; P = .12) and not pain (parameter estimate = -0.705; P = .47). The 5-star quality rating system did not reflect the quality of life of long-stay nursing home residents with preserved cognition. Notably, pain was not associated with quality of life, but physical impairment and depression were. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.
Back Massage to Decrease State Anxiety, Cortisol Level, Blood Prsessure, Heart Rate and Increase Sleep Quality in Family Caregivers of Patients with Cancer: A Randomised Controlled Trial.

PubMed

Pinar, Rukiye; Afsar, Fisun

2015-01-01

The objective of this study was to evaluate the effect of back massage on the anxiety state, cortisol level, systolic/diastolic blood pressure, pulse rate, and sleep quality in family caregivers of patients with cancer. Forty-four family caregivers were randomly assigned to either the experimental or control group (22 interventions, 22 controls) after they were matched on age and gender. The intervention consisted of back massage for 15 minutes per day for a week. Main research outcomes were measured at baseline (day I) and follow-up (day 7). Unpaired t-test, paired t test and chi-square test were used to analyse data. The majority of the caregivers were women, married, secondary school educated and housewife. State anxiety (p<0.001), cortisol level (p<0.05), systolic/diastolic blood pressure (p<0.001, p<0.01 respectively), and pulse rate (p<0.01) were significantly decreased, and sleep quality (p<0.001) increased after back massage intervention. The study results show that family caregivers for patients with cancer can benefit from back massage to improve state anxiety, cortisol level, blood pressure and heart rate, and sleep quality. Oncology nurses can take advantage of back massage, which is non-pharmacologic and easily implemented method, as an independent nursing action to support caregivers for patients with cancer.
On the origin of the peculiar cataclysmic variable AE Aquarii

NASA Astrophysics Data System (ADS)

Beskrovnaya, N. G.; Ikhsanov, N. R.

2015-02-01

The nova-like variable AE Aquarii is a close binary system containing a red dwarf and a magnetized white dwarf rotating with the period of 33 s. A short spin period of the white dwarf is caused by an intensive mass exchange between the system components during a previous epoch. We show that a high rate of disk accretion onto the white dwarf surface resulted in temporary screening of its magnetic field and spin-up of the white dwarf to its present spin period. Transition of the white dwarf to the ejector state occurred at a final stage of the spin-up epoch after its magnetic field had emerged from the accreted plasma due to diffusion. In the frame of this scenario AE Aqr represents a missing link in the chain of Polars evolution and the white dwarf resembles a recycled pulsar.
Effects of night-time on-call work on heart rate variability before bed and sleep quality in visiting nurses.

PubMed

Kikuchi, Yukiko; Ishii, Noriko; Kodama, Hideya

2018-05-28

In Japan, many visiting nurses work carrying cell phones to respond to calls from users even at night (on-call work). The purpose of this study was to investigate whether on-call work affected heart rate variability (HRV) before bed and decreased sleep quality in visiting nurses even if their sleep was not interrupted due to actual calls. Thirty-one visiting nurses (mean age, 49.8 years; standard deviation, 6.3 years) were asked to record their 2.5-min resting HRV before bed, and to undergo one-channel sleep electroencephalography (EEG) and subjective sleep evaluations upon waking (Oguri, Shirakawa, and Azumi Sleep Inventory) at home for 4-5 consecutive days, including both on-call and non-on-call days. Paired data sets of outcome measures, including HRV parameters, sleep macrostructure variables, and subjective sleep quality scores between on-call and non-on-call days were compared; the most recent measurements for each category were used for each subject. There were no differences in HRV measures and objective sleep EEG variables. A significant increase in "sleepiness on rising" and a decrease in "feeling refreshed" were observed on on-call days (P = 0.019 and 0.021, respectively), and younger subjects (≤ 51 years old) demonstrated a significant reduction in "sleepiness on rising" (significant interaction effect, P = 0.029). Adverse effects of on-call work on sleep quality in most visiting nurses are thought to be subjective, and relatively young nurses tend to notice a decrease in sleep quality. On-call work itself does not appear to be a substantial stressor that could affect HRV and sleep structure.
Comparison of self and proxy ratings for voice handicap index and motor-related quality-of-life of individuals with Parkinson's disease.

PubMed

Parveen, Sabiha; Goberman, Alexander M

2017-04-01

Quality-of-life (QoL) consists of health, psychological well-being and communication-related domains. Due to the heterogeneous nature of Parkinson disease (PD), it is important to examine effects of different domains including motor and cognitive performance or motor and speech performance among the same set of individuals. Existing studies indicate mixed findings due to use of different QoL measures and lack of general consensus regarding QoL components. The present study examined self and proxy ratings for 20 individuals with PD on Voice Handicap Index (VHI) and PDQ-39 mobility to determine effects on speech and motor-related QoL, respectively. There was good level of agreement between self and proxy ratings for PDQ-39 mobility ratings alone. In addition, no overall group differences were found for self and proxy ratings of VHI and PDQ-39 mobility ratings, thus indicating similar perceptions by individuals with PD and their communication partners for speech and motor-related changes associated with PD. Further, no significant correlations between speech and motor-related QoL were found, thereby suggesting these domains to be independent of each other. The present study indicates the need to consider both self and proxy reports to understand the impact of PD on a person's overall functioning.
Outcome Rating Scale and Session Rating Scale in Psychological Practice: Clinical Utility of Ultra-Brief Measures

ERIC Educational Resources Information Center

Campbell, Alistair; Hemsley, Samantha

2009-01-01

The validity and reliability of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) were evaluated against existing longer measures, including the Outcome Questionnaire-45, Working Alliance Inventory, Depression Anxiety Stress Scale-21, Quality of Life Scale, Rosenberg Self-Esteem Scale and General Self-efficacy Scale. The measures…
Assessing U.S. Public School Quality: The Advantages of Combining Internal "Consumer Ratings" with External NCLB Ratings

ERIC Educational Resources Information Center

Price, Heather E.

2016-01-01

The school quality assessment process under No Child Left Behind (NCLB) is criticized for oversimplifying and overemphasizing standardized test results and unfairly targeting diverse, urban schools. There has been much development in alternative test score evaluations, especially value-added models. These developments have tilted the public…
Effect of equilibration times, freezing, and thawing rates on post-thaw quality of buffalo (Bubalus bubalis) bull spermatozoa.

PubMed

Shah, S A H; Andrabi, S M H; Qureshi, I Z

2016-09-01

The effects of equilibration times (E1, 2 h; E2, 4 h; E3, 6 h), freezing rates (FR1, manual, 5 cm above liquid nitrogen (LN2 ) for 10 min, plunging in LN2 ; FR2, programmable ultra-fast, holding at +4 °C for 2 min, from 4 to -10 °C at -10 °C/min, from -10 to -20 °C at -15 °C/min, from -20 to -120 °C at -60 °C/min, holding at -120 °C for 30 sec, plunging in LN2 ), and thawing rates (T1, 37 °C for 30 sec; T2, 50 °C for 15 sec; T3, 70 °C for 7 sec) were evaluated on quality of buffalo bull spermatozoa. Progressive motility (%), rapid velocity (%), average path velocity (VAP, μm/s), straight line velocity (VSL, μm/s), and mitochondrial transmembrane potential (%) were higher (p < 0.05) with E2, FR2, and T3 compared to other groups. Sperm curved line velocity (VCL, μm/s) was higher (p < 0.05) with E2 and FR2 compared to other groups. Sperm straightness (%) and linearity (LIN, %) were higher (p < 0.05) with E2 compared to other groups. Sperm LIN was affected (p < 0.05) with T3 compared to other groups. Supravital-plasma membrane integrity (%), viability and acrosome integrity (%) of spermatozoa were higher (p < 0.05) with E2 and FR2 compared to other groups. Sperm DNA integrity (%) was higher (p < 0.05) with FR2 and T1 compared to other groups. We concluded that inclusion of 4 h-equilibration time, programmable ultra-fast freezing rate, and rapid thawing at 70 °C for 7 sec in cryopreservation protocol improves the post-thaw quality of buffalo bull spermatozoa. © 2016 American Society of Andrology and European Academy of Andrology.
Normative data on the diurnal pattern of the Karolinska Sleepiness Scale ratings and its relation to age, sex, work, stress, sleep quality and sickness absence/illness in a large sample of daytime workers.

PubMed

Åkerstedt, Torbjorn; Hallvig, David; Kecklund, Göran

2017-10-01

Self-rated sleepiness responds to sleep loss, time of day and work schedules. There is, however, a lack of a normative reference showing the diurnal pattern during a normal working day, compared with a day off, as well as differences depending on stress, sleep quality, sex, age and being sick listed. The present study sought to provide such data for the Karolinska Sleepiness Scale. Participants were 431 individuals working in medium-sized public service units. Sleepiness (Karolinska Sleepiness Scale, scale 1-9) was rated at six times a day for a working week and 2 days off (>90.000 ratings). The results show a clear circadian pattern, with high values during the morning (4.5 at 07:00 hours) and evening (6.0 at 22:00 hours), and with low values (3-4) during the 10:00-16:00 hours span. Women had significantly higher (0.5 units) Karolinska Sleepiness Scale values than men, as did younger individuals (0.3 units), those with stress (1.3 units above the low-stress group) and those with poor sleep quality (1.0 units above those with qood sleep quality). Days off showed reduced sleepiness (0.7 units), while being sick listed was associated with an increased sleepiness (0.8 units). Multiple regression analysis of mean sleepiness during the working week yielded mean daytime stress, mean sleep quality, age, and sex as predictors (not sleep duration). Improved sleep quality accounted for the reduced sleepiness during days off, but reduced stress was a second factor. Similar results were obtained in a longitudinal mixed-model regression analysis across the 7 days of the week. The percentage of ratings at Karolinska Sleepiness Scale risk levels (8 + 9) was 6.6%, but most of these were obtained at 22:00 hours. It was concluded that sleepiness ratings are strongly associated with time of day, sleep quality, stress, work day/day off, being ill, age, and sex. © 2017 European Sleep Research Society.
Initial Steps toward Validating and Measuring the Quality of Computerized Provider Documentation

PubMed Central

Hammond, Kenric W.; Efthimiadis, Efthimis N.; Weir, Charlene R.; Embi, Peter J.; Thielke, Stephen M.; Laundry, Ryan M.; Hedeen, Ashley

2010-01-01

Background: Concerns exist about the quality of electronic health care documentation. Prior studies have focused on physicians. This investigation studied document quality perceptions of practitioners (including physicians), nurses and administrative staff. Methods: An instrument developed from staff interviews and literature sources was administered to 110 practitioners, nurses and administrative staff. Short, long and original versions of records were rated. Results: Length transformation did not affect quality ratings. On several scales practitioners rated notes less favorably than administrators or nurses. The original source document was associated with the quality rating, as was tf·idf, a relevance statistic computed from document text. Tf·idf was strongly associated with practitioner quality ratings. Conclusion: Document quality estimates were not sensitive to modifying redundancy in documents. Some perceptions of quality differ by role. Intrinsic document properties are associated with staff judgments of document quality. For practitioners, the tf·idf statistic was strongly associated with the quality dimensions evaluated. PMID:21346983
Addressing the bias problem in the assessment of the quality of life of patients with dementia: determinants of the accuracy and precision of the proxy ratings.

PubMed

Gomez-Gallego, M; Gomez-Garcia, J; Ato-Lozano, E

2015-03-01

We aimed to examine the discrepancy between patients and caregivers' ratings of quality of life in terms of accuracy and precision, and identify factors associated with it, in order to facilitate the use of this scale as dementia progresses. Cross-sectional analytic study. Day care centres. Community-living patients with Alzheimer's disease in early or moderate stage and their principal caregivers. PARTICIPANTS rated patients' quality of life using DEMQOL. The discrepancy was assessed using the individual difference score and the residuals for each domain of DEMQOL. The scores on Mini-Mental State Examination, Geriatric Depression Scale, Neuropsychiatric Inventory, Clinical Insight Rating Scale, Cumulative Illness Rating Scale, Health Utilities Index Mark 3 and Zarit Burden Interview were considered as possible predictors of the discrepancy. A total of 276 subjects participated in the study (138 patients with Alzheimer's disease and their caregivers). Discrepancy measured by individual difference score was lower than that measured by the residuals. Burden and mood-related symptoms explained the positive differences and residuals, while pain, self-perceived depression and cognition determined the negative ones. Differences exist between patients and caregivers' perceptions about subjective states. The evaluations of each informant seem to be influenced by their own emotional state and the inner experience of the effects of the disease. Caregivers' ratings on DEMQOL could be useful to monitor the efficacy of any treatment whenever burden is low and patients have no great physical or emotional suffering.
Period changes of 7 bright RR Lyrae variables included in the BAV standard program.

NASA Astrophysics Data System (ADS)

Wunder, E.

1995-11-01

On the basis of 1578 times of maxima historical and present period changes of the RR Lyrae stars SW And, SW Aqr, AA Aql, X Ari, RS Boo, RR Cet and XZ Cyg are analysed. In tables the period jumps and the quadratic terms of the elements are quantified and timed; elements are given to describe the historical O-C-curves; instant elements are listed to support nowadays observations.
Query Storage and Relay in Research Root (LACREND RR)

DTIC Science & Technology

2017-05-30

QUERY STORAGE AND RELAY IN RESEARCH ROOT (LACREND-RR) UNIVERSITY OF SOUTHERN CALIFORNIA MAY 2017 FINAL TECHNICAL REPORT APPROVED FOR PUBLIC ...exempt from public affairs security and policy review in accordance with SAF/AQR memorandum dated 10 Dec 08 and AFRL/CA policy clarification...memorandum dated 16 Jan 09. This report is available to the general public , including foreign nationals. Copies may be obtained from the Defense Technical
Physics of Cool Stars: Densities, Sizes, and Energetics

NASA Technical Reports Server (NTRS)

Dupree, Andrea K.

2001-01-01

The ORFEUS 1 (Orbiting and Retrievable Far and Extreme Ultraviolet Spectrometer) telescope obtained far ultraviolet spectra (lambda-lambda 912-1218) of luminous cool stars as a part of our observing program. Two classes of objects were measured: luminous single stars beta Dra (HD 159181) and two hybrid stars alpha Aqr (HD 209750) and alpha TrA (HD 150798) and two active binary systems: 44i Boo and UX Ari.
Principles of Rapid Acquisition and Systems Engineering

DTIC Science & Technology

2012-06-14

Systems Engineering Research Council ( SERC ) research team interviewed over 30 organizations from across the DoD which focus on less traditional...enthusiasm • Lt Col John Elshaw, for his guidance on our statistical analysis • Our sponsors, the SERC , SAF/AQR, and the AF Center for Systems...experienced staff of 20 – 50 people” (Defense Science Board, 2011) Research Focus The Systems Engineering Research Center ( SERC ) has been charged with
Funding source and research report quality in nutrition practice-related research.

PubMed

Myers, Esther F; Parrott, J Scott; Cummins, Deborah S; Splett, Patricia

2011-01-01

The source of funding is one of many possible causes of bias in scientific research. One method of detecting potential for bias is to evaluate the quality of research reports. Research exploring the relationship between funding source and nutrition-related research report quality is limited and in other disciplines the findings are mixed. The purpose of this study is to determine whether types of funding sources of nutrition research are associated with differences in research report quality. A retrospective study of research reporting quality, research design and funding source was conducted on 2539 peer reviewed research articles from the American Dietetic Association's Evidence Analysis Library® database. Quality rating frequency distributions indicate 43.3% of research reports were rated as positive, 50.1% neutral, and 6.6% as negative. Multinomial logistic regression results showed that while both funding source and type of research design are significant predictors of quality ratings (χ2 = 118.99, p≤0.001), the model's usefulness in predicting overall research report quality is little better than chance. Compared to research reports with government funding, those not acknowledging any funding sources, followed by studies with University/hospital funding were more likely to receive neutral vs positive quality ratings, OR = 1.85, P <0.001 and OR = 1.54, P<0.001, respectively and those that did not report funding were more likely to receive negative quality ratings (OR = 4.97, P<0.001). After controlling for research design, industry funded research reports were no more likely to receive a neutral or negative quality rating than those funded by government sources. Research report quality cannot be accurately predicted from the funding source after controlling for research design. Continued vigilance to evaluate the quality of all research regardless of the funding source and to further understand other factors that affect quality ratings are

Self-rated health supersedes patient satisfaction with service quality as a predictor of survival in prostate cancer.

PubMed

Gupta, Digant; Patel, Kamal; Lis, Christopher G

2015-09-04

We have previously reported that higher patient satisfaction (PS) with service quality is associated with favorable survival outcomes in a variety of cancers. However, we argued that patients with greater satisfaction might be the ones with better self-rated health (SRH), a recognized predictor of cancer survival. We therefore investigated whether SRH can supersede patient satisfaction as a predictor of survival in prostate cancer. Nine hundred seventeen prostate cancer treated at four Cancer Treatment Centers of America(®) hospitals between July 2011 and March 2013. PS was measured on a 7-point scale ranging from "completely dissatisfied" to "completely satisfied". SRH was measured on a 7-point scale ranging from "very poor" to "excellent". Both were dichotomized into two categories: top box response (7) versus all others (1-6). Patient survival was the primary end point. Cox regression was used to evaluate the association between PS and survival controlling for covariates. The response rate for this study was 72%. Majority of patients (n = 517) had stage II disease. Seven hundred eighty-seven (85.8%) patients were "completely satisfied". Three hundred nineteen (34.8%) patients had "excellent" SRH. There was a weak but significant correlation between satisfaction and SRH (Kendall's tau b = 0.18; p < 0.001). On univariate analysis, "completely satisfied" patients had a significantly lower risk of mortality (HR = 0.46; 95% CI: 0.25-0.85; p = 0.01). Similarly, patients with "excellent" SRH had a significantly lower risk of mortality (HR = 0.25; 95% CI: 0.11-0.58; p = 0.001). On multivariate analysis, SRH was found to be a significant predictor of survival (HR = 0.31; 95% CI: 0.12-0.79; p = 0.01) while patient satisfaction was not (HR = 0.76; 95% CI: 0.40-1.5; p = 0.40). SRH supersedes patient satisfaction with service quality as a predictor of survival in prostate cancer. SRH should be used as a control variable in analyses involving patient satisfaction as a
Comparing the information conveyed by envelope modulation for speech intelligibility, speech quality, and music quality.

PubMed

Kates, James M; Arehart, Kathryn H

2015-10-01

This paper uses mutual information to quantify the relationship between envelope modulation fidelity and perceptual responses. Data from several previous experiments that measured speech intelligibility, speech quality, and music quality are evaluated for normal-hearing and hearing-impaired listeners. A model of the auditory periphery is used to generate envelope signals, and envelope modulation fidelity is calculated using the normalized cross-covariance of the degraded signal envelope with that of a reference signal. Two procedures are used to describe the envelope modulation: (1) modulation within each auditory frequency band and (2) spectro-temporal processing that analyzes the modulation of spectral ripple components fit to successive short-time spectra. The results indicate that low modulation rates provide the highest information for intelligibility, while high modulation rates provide the highest information for speech and music quality. The low-to-mid auditory frequencies are most important for intelligibility, while mid frequencies are most important for speech quality and high frequencies are most important for music quality. Differences between the spectral ripple components used for the spectro-temporal analysis were not significant in five of the six experimental conditions evaluated. The results indicate that different modulation-rate and auditory-frequency weights may be appropriate for indices designed to predict different types of perceptual relationships.
Comparing the information conveyed by envelope modulation for speech intelligibility, speech quality, and music quality

PubMed Central

Kates, James M.; Arehart, Kathryn H.

2015-01-01

This paper uses mutual information to quantify the relationship between envelope modulation fidelity and perceptual responses. Data from several previous experiments that measured speech intelligibility, speech quality, and music quality are evaluated for normal-hearing and hearing-impaired listeners. A model of the auditory periphery is used to generate envelope signals, and envelope modulation fidelity is calculated using the normalized cross-covariance of the degraded signal envelope with that of a reference signal. Two procedures are used to describe the envelope modulation: (1) modulation within each auditory frequency band and (2) spectro-temporal processing that analyzes the modulation of spectral ripple components fit to successive short-time spectra. The results indicate that low modulation rates provide the highest information for intelligibility, while high modulation rates provide the highest information for speech and music quality. The low-to-mid auditory frequencies are most important for intelligibility, while mid frequencies are most important for speech quality and high frequencies are most important for music quality. Differences between the spectral ripple components used for the spectro-temporal analysis were not significant in five of the six experimental conditions evaluated. The results indicate that different modulation-rate and auditory-frequency weights may be appropriate for indices designed to predict different types of perceptual relationships. PMID:26520329
Spectral Rate Theory for Two-State Kinetics

NASA Astrophysics Data System (ADS)

Prinz, Jan-Hendrik; Chodera, John D.; Noé, Frank

2014-02-01

Classical rate theories often fail in cases where the observable(s) or order parameter(s) used is a poor reaction coordinate or the observed signal is deteriorated by noise, such that no clear separation between reactants and products is possible. Here, we present a general spectral two-state rate theory for ergodic dynamical systems in thermal equilibrium that explicitly takes into account how the system is observed. The theory allows the systematic estimation errors made by standard rate theories to be understood and quantified. We also elucidate the connection of spectral rate theory with the popular Markov state modeling approach for molecular simulation studies. An optimal rate estimator is formulated that gives robust and unbiased results even for poor reaction coordinates and can be applied to both computer simulations and single-molecule experiments. No definition of a dividing surface is required. Another result of the theory is a model-free definition of the reaction coordinate quality. The reaction coordinate quality can be bounded from below by the directly computable observation quality, thus providing a measure allowing the reaction coordinate quality to be optimized by tuning the experimental setup. Additionally, the respective partial probability distributions can be obtained for the reactant and product states along the observed order parameter, even when these strongly overlap. The effects of both filtering (averaging) and uncorrelated noise are also examined. The approach is demonstrated on numerical examples and experimental single-molecule force-probe data of the p5ab RNA hairpin and the apo-myoglobin protein at low pH, focusing here on the case of two-state kinetics.
Learning and Personal Qualities.

ERIC Educational Resources Information Center

Nelville, Bernie

1979-01-01

Carl Rogers and Robert Carkhuff maintain that learning is dependent upon particular human qualities in the teacher. In this study, students in adult learning groups rated group members on the qualities of empathy, respect, concreteness, genuineness, honesty, and helpfulness. Results indicated that students, especially adults, can realize their…
Older Adults With a Combination of Vision and Hearing Impairment Experience Higher Rates of Cognitive Impairment, Functional Dependence, and Worse Outcomes Across a Set of Quality Indicators.

PubMed

Davidson, Jacob G S; Guthrie, Dawn M

2017-08-01

Hearing and vision impairment were examined across several health-related outcomes and across a set of quality indicators (QIs) in home care clients with both vision and hearing loss (or dual sensory impairment [DSI]). Data collected using the Resident Assessment Instrument for Home Care (RAI-HC) were analyzed in a sample of older home care clients. The QIs represent the proportion of clients experiencing negative outcomes (e.g., falls, social isolation). The average age of clients was 82.8 years ( SD = 7.9), 20.5% had DSI and 8.5% had a diagnosis of Alzheimer's disease (AD). Clients with DSI were more likely to have a diagnosis of dementia (not AD), have functional impairments, report loneliness, and have higher rates across 20 of the 22 QIs, including communication difficulty and cognitive decline. Clients with highly impaired hearing, and any visual impairment, had the highest QI rates. Individuals with DSI experience higher rates of adverse events across many health-related outcomes and QIs. Understanding the unique contribution of hearing and vision in this group can promote optimal quality of care.
The swiss neonatal quality cycle, a monitor for clinical performance and tool for quality improvement

PubMed Central

2013-01-01

Background We describe the setup of a neonatal quality improvement tool and list which peer-reviewed requirements it fulfils and which it does not. We report on the so-far observed effects, how the units can identify quality improvement potential, and how they can measure the effect of changes made to improve quality. Methods Application of a prospective longitudinal national cohort data collection that uses algorithms to ensure high data quality (i.e. checks for completeness, plausibility and reliability), and to perform data imaging (Plsek’s p-charts and standardized mortality or morbidity ratio SMR charts). The collected data allows monitoring a study collective of very low birth-weight infants born from 2009 to 2011 by applying a quality cycle following the steps ′guideline – perform - falsify – reform′. Results 2025 VLBW live-births from 2009 to 2011 representing 96.1% of all VLBW live-births in Switzerland display a similar mortality rate but better morbidity rates when compared to other networks. Data quality in general is high but subject to improvement in some units. Seven measurements display quality improvement potential in individual units. The methods used fulfil several international recommendations. Conclusions The Quality Cycle of the Swiss Neonatal Network is a helpful instrument to monitor and gradually help improve the quality of care in a region with high quality standards and low statistical discrimination capacity. PMID:24074151
12 CFR 614.4160 - Differential interest rate programs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... loans based on a variety of factors that may include type, purpose, amount, quality, funding or... rate programs, institutions may consider, among other things, the effect that such interest rate...
12 CFR 614.4160 - Differential interest rate programs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... loans based on a variety of factors that may include type, purpose, amount, quality, funding or... rate programs, institutions may consider, among other things, the effect that such interest rate...
12 CFR 614.4160 - Differential interest rate programs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... loans based on a variety of factors that may include type, purpose, amount, quality, funding or... rate programs, institutions may consider, among other things, the effect that such interest rate...
12 CFR 614.4160 - Differential interest rate programs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... loans based on a variety of factors that may include type, purpose, amount, quality, funding or... rate programs, institutions may consider, among other things, the effect that such interest rate...
Impact of Quality Improvement Educational Interventions on Documented Adherence to Quality Measures for Adults with Crohn's Disease.

PubMed

Greene, Laurence; Sapir, Tamar; Moreo, Kathleen; Carter, Jeffrey D; Patel, Barry; Higgins, Peter D R

2015-09-01

In recent years, leading organizations in inflammatory bowel disease (IBD) have developed quality measures for the care of adults with Crohn's disease or ulcerative colitis. We used chart audits to assess the impact of quality improvement educational activities on documented adherence to Physician Quality Reporting System measures for IBD. Twenty community-based gastroenterologists were recruited to participate in baseline chart audits (n = 200), a series of 4 accredited educational activities with feedback, and follow-up chart audits (n = 200). Trained abstractors reviewed randomly selected charts of adults with moderate or severe Crohn's disease. The charts were retrospectively abstracted for physicians' documented performance of the 2013 Physician Quality Reporting System IBD quality measures. We compared the physicians' baseline and posteducation rates of documented adherence with 10 of these measures. In a secondary analysis, we compared preeducation with posteducation difference scores of low-performing physicians, those whose baseline documentation rates were in the lowest quartile, and the rest of the cohort. At baseline, documentation of mean provider-level adherence to the 10 quality measures ranged from 3% to 98% (grand mean = 35.8%). In the overall analysis, baseline and posteducation rates of documented adherence did not differ significantly for any of the measures. However, for 4 measures, preeducation to posteducation difference scores were significantly greater among low performers than physicians in the highest 3 quartiles. The results of this preliminary pragmatic study indicate that quality improvement education affords the potential to improve adherence to Physician Quality Reporting System quality measures for IBD among low-performing gastroenterologists.
Comparisons of the effects of long-acting and short-acting GnRH agonists on embryo quality, endometrial thickness and pregnancy rate in human in vitro fertilization.

PubMed

Mao, Gen-Hong; Feng, Zonggang; He, Yan; Huang, Yu-Rong

2014-02-24

The aim was to compare the efficacy of long-acting and short-acting gonadotropin-releasing hormone (GnRH) agonists by long protocol on embryo quality, endometrial thickness and pregnancy rate in in vitro fertilization. In this retrospective study, long-term pituitary downregulation, achieved with long- and short-acting GnRH agonists (GnRHa), was performed for patients undergoing in vitro fertilization (n = 175). There were no significant differences between the long and short-acting GnRH group (63.16% vs. 66.26%, p > 0.05), and the secondary and primary infertility group (63.47% vs. 66.86%, p > 0.05) in embryo quality. Logistic regression analysis showed that type of infertility and endometrial thickness were significantly associated with pregnancy outcome. Patients in the long-acting GnRHa group had a thicker endometrium on the day of human chorionic gonadotrophin (hCG) administration (10.79 ±2.62 mm vs. 9.64 ±1.97 mm, p < 0.01), lower serum luteinizing hormone (LH) concentration (1.21 ±1.13 vs. 2.53 ±3.39) and a higher pregnancy rate (59.60% vs. 43.42%, p < 0.05) than those of patients in the short-acting GnRHa group. This work suggests that types of agonist protocol and infertility may not affect embryo quality. Type of infertility and endometrial thickness may be positive predictors for clinical pregnancy, but the key finding is that the long-acting GnRHa protocol may be an effective method of improving endometrial thickness, endometrial receptivity and pregnancy rate in in vitro fertilization.
Measuring Institutional Quality in Head and Neck Surgery Using Hospital-Level Data: Negative Margin Rates and Neck Dissection Yield.

PubMed

Schoppy, David W; Rhoads, Kim F; Ma, Yifei; Chen, Michelle M; Nussenbaum, Brian; Orosco, Ryan K; Rosenthal, Eben L; Divi, Vasu

2017-11-01

Negative margins and lymph node yields (LNY) of 18 or more from neck dissections in patients with head and neck squamous cell carcinomas (HNSCC) have been associated with improved patient survival. It is unclear whether these metrics can be used to identify hospitals with improved outcomes. To determine whether 2 patient-level metrics would predict outcomes at the hospital level. A retrospective review of records from the National Cancer Database (NCDB) was used to identify patients who underwent primary surgery and concurrent neck dissection for HNSCC between 2004 and 2013. The percentage of patients at each hospital with negative margins on primary resection and an LNY 18 or more from a neck dissection was quantified. Cox proportional hazard models were used to define the association between hospital performance on these metrics and overall survival. Margin status and lymph node yield at hospital level. Overall survival (OS). We identified 1008 hospitals in the NCDB where 64 738 patients met inclusion criteria. Of the 64 738 participants, 45 170 (69.8%) were men and 19 568 (30.2%) were women. The mean SD age of included patients was 60.5 (12.0) years. Patients treated at hospitals attaining the combined metric of a 90% or higher negative margin rate and 80% or more of cases with LNYs of 18 or more experienced a significant reduction in mortality (hazard ratio [HR] 0.93; 95% CI, 0.89-0.98). This benefit in survival was independent of the patient-level improvement associated with negative margins (HR, 0.73; 95% CI, 0.71-0.76) and LNY of 18 or more (HR, 0.85; 95% CI, 0.83-0.88). Including these metrics in the model neutralized the association of traditional measures of hospital quality (volume and teaching status). Treatment at hospitals that attain a high rate of negative margins and LNY of 18 or more is associated with improved survival in patients undergoing surgery for HNSCC. These surgical outcome measures predicted outcomes independent of traditional
Sleep Quality Among Pharmacy Students

PubMed Central

Clark, Andraya; Woolley, Thomas W.; Saunders, Amy

2015-01-01

Objective. To determine the quality of sleep among pharmacy students in the didactic portion of the curriculum at one school of pharmacy. Methods. The study consisted of an anonymous, voluntary survey that included the Pittsburgh Sleep Quality Index (PSQI), a self-rated instrument that measures sleep habits for a month. Results. The survey was completed by 253 students. Students in the lower grade point average (GPA) category had higher scores on 2 of 7 components of the PSQI and on the global score. Poor sleep quality, indicated by a global PSQI score of greater than 5, was reported by 140 students. The rate of poor sleeping was higher among students in the lower GPA category. Conclusion. Poor sleep quality was pervasive among surveyed pharmacy students in the didactic portion of the pharmacy school curriculum, especially among those with lower GPAs. PMID:25741025
The study of surgical image quality evaluation system by subjective quality factor method

NASA Astrophysics Data System (ADS)

Zhang, Jian J.; Xuan, Jason R.; Yang, Xirong; Yu, Honggang; Koullick, Edouard

2016-03-01

GreenLightTM procedure is an effective and economical way of treatment of benign prostate hyperplasia (BPH); there are almost a million of patients treated with GreenLightTM worldwide. During the surgical procedure, the surgeon or physician will rely on the monitoring video system to survey and confirm the surgical progress. There are a few obstructions that could greatly affect the image quality of the monitoring video, like laser glare by the tissue and body fluid, air bubbles and debris generated by tissue evaporation, and bleeding, just to name a few. In order to improve the physician's visual experience of a laser surgical procedure, the system performance parameter related to image quality needs to be well defined. However, since image quality is the integrated set of perceptions of the overall degree of excellence of an image, or in other words, image quality is the perceptually weighted combination of significant attributes (contrast, graininess …) of an image when considered in its marketplace or application, there is no standard definition on overall image or video quality especially for the no-reference case (without a standard chart as reference). In this study, Subjective Quality Factor (SQF) and acutance are used for no-reference image quality evaluation. Basic image quality parameters, like sharpness, color accuracy, size of obstruction and transmission of obstruction, are used as subparameter to define the rating scale for image quality evaluation or comparison. Sample image groups were evaluated by human observers according to the rating scale. Surveys of physician groups were also conducted with lab generated sample videos. The study shows that human subjective perception is a trustworthy way of image quality evaluation. More systematic investigation on the relationship between video quality and image quality of each frame will be conducted as a future study.
Vision-related quality of life and self-rated satisfaction outcomes of rhegmatogenous retinal detachment surgery: three-year prospective study.

PubMed

Zou, Haidong; Zhang, Xi; Xu, Xun; Liu, Haiyun; Bai, Lin; Xu, Xian

2011-01-01

Subjective functional outcomes measurements, such as vision health-related quality of life (VRQoL) and self-rated satisfaction measures can provide helpful multidimensional vision health information that is more comprehensive than traditional objective measures, such as best corrected visual acuity (BCVA). The purpose of this study is to demonstrate 3-year longitudinal postoperative VRQoL and self-rated satisfaction changes after rhegmatogenous retinal detachment (RRD) surgery. A prospective case series report was conducted in 92 RRD patients who underwent surgery during January 2004 through December 2006. Preoperative, 3-month, 1-year and 3-year postoperative patient VRQoL and self-rated satisfaction were assessed by face-to-face interviews. The importance of objective variables for predicting three dependent variables: CLVQOL composite scores change, 3-year postoperative CVLQOL composite score and self-rated satisfaction degree scores were calculated by stepwise multivariate linear or logistic regression analysis methods. The total CLVQOL composite scores change ranged between -48 and 90 (mean±standard deviation: 19.48±31.34), including positive changes in 62 patients. The self-rated satisfaction degree scores ultimately improved in 86 patients as compared with preoperative degrees. Statistically significant increases occurred only in the composite scores of subscale mobility and self-rated satisfaction degrees in the first 3 months, while the composite scores of the remaining subscales, and the total CLVQOL, BCVA in the RRD eye and weighted average BCVA, increased steadily throughout the first postoperative year. A better 3-year postoperative weighted average BCVA was associated with all of the 3 dependent outcome variables. VRQoL of RRD patients improved substantially after surgery and they were satisfied with their postoperative vision. The BCVA, VRQoL and self-rated satisfactory degree scores recovered in different patterns, and supplemented each other in
Landscape scale measures of steelhead (Oncorhynchus mykiss) bioenergetic growth rate potential in Lake Michigan and comparison with angler catch rates

USGS Publications Warehouse

Hook, T.O.; Rutherford, E.S.; Brines, Shannon J.; Geddes, C.A.; Mason, D.M.; Schwab, D.J.; Fleischer, G.W.

2004-01-01

The relative quality of a habitat can influence fish consumption, growth, mortality, and production. In order to quantify habitat quality, several authors have combined bioenergetic and foraging models to generate spatially explicit estimates of fish growth rate potential (GRP). However, the capacity of GRP to reflect the spatial distributions of fishes over large areas has not been fully evaluated. We generated landscape scale estimates of steelhead (Oncorhynchus mykiss) GRP throughout Lake Michigan for 1994-1996, and used these estimates to test the hypotheses that GRP is a good predictor of spatial patterns of steelhead catch rates. We used surface temperatures (measured with AVHRR satellite imagery) and acoustically measured steelhead prey densities (alewife, Alosa pseudoharengus) as inputs for the GRP model. Our analyses demonstrate that potential steelhead growth rates in Lake Michigan are highly variable in both space and time. Steelhead GRP tended to increase with latitude, and mean GRP was much higher during September 1995, compared to 1994 and 1996. In addition, our study suggests that landscape scale measures of GRP are not good predictors of steelhead catch rates throughout Lake Michigan, but may provide an index of interannual variation in system-wide habitat quality.
The effects of aircraft design on STOL ride quality

NASA Technical Reports Server (NTRS)

Jones, C. R.; Jacobson, I. D.

1975-01-01

Effects of aircraft dynamic characteristics on passenger ride quality are investigated to determine ride-quality isocontours similar to aircraft handling-qualities contours. Measurements are made on a moving-base simulator while varying the aircraft short-period and Dutch Roll frequencies and dampings. Both pilot ratings and subjective ride-quality ratings are obtained during flight. Ride and handling qualities were found to be complementary for the Dutch Roll mode, but not for the short-period mode. Regions of optimal ride and handling qualities are defined for the short-period mode, and the effects of turbulence levels studied.
Exploring consumer understanding and preferences for pharmacy quality information

PubMed Central

Shiyanbola, Olayinka O.; Mort, Jane R.

2014-01-01

Objective: To describe consumer understanding of pharmacy quality measures and consumer preferences for pharmacy quality information. Methods: Semi-structured focus group design was combined with survey methods. Adults who filled prescription medications for self-reported chronic illnesses at community pharmacies discussed their understanding of Pharmacy Quality Alliance approved quality measures. Questions examined preference of pharmacy quality information rating systems (e.g. stars versus percentages) and desired data display/formats. During the focus group, participants completed a survey examining their understanding of each pharmacy quality measure. All focus group discussions were transcribed verbatim. Data were analyzed using thematic analysis and descriptive statistics. Results: Thirty-four individuals participated (mean age= 62.85; SD=16.05). Participants were unfamiliar with quality measures information and their level of understanding differed for each quality measure. Surveys indicated 94.1% understood “Drug-Drug Interactions” and “Helping Patients Get Needed Medications” better than other measures (e.g., 76.5% understood “Suboptimal Treatment of Hypertension in Patients with Diabetes”). Qualitative analysis indicated participants preferred an overall pharmacy rating for quick access and use. However, participants also wanted quality measures information displayed by health conditions. Participants favored comparison of their pharmacy to city data instead of state data. Most participants liked star ratings better than percentages, letter grades, or numerical ratings. Conclusions: Individuals who have a chronic illness and regularly use community pharmacies are interested in pharmacy quality measures. However, specific quality measures were not understood by some participants. Participants had specific preferences for the display of pharmacy quality information which will be helpful in the design of appropriate quality report systems. PMID

Early definitive treatment rate as a quality indicator of care in acute gallstone pancreatitis.

PubMed

Green, R; Charman, S C; Palser, T

2017-11-01

Early definitive treatment (cholecystectomy or endoscopic sphincterotomy in the same admission or within 2 weeks after discharge) of gallstone disease after a biliary attack of acute pancreatitis is standard of care. This study investigated whether compliance with early definitive treatment for acute gallstone pancreatitis can be used as a care quality indicator for the condition. A retrospective cohort study was conducted using the Hospital Episode Statistics database. All emergency admissions to National Health Service hospitals in England with a first time diagnosis of acute gallstone pancreatitis in the financial years 2008, 2009 and 2010 were examined. Trends in early definitive treatment between hospital trusts were examined and patient morbidity outcomes were determined. During the study interval there were 19 510 patients with an overall rate of early definitive treatment at 34·7 (range 9·4-84·7) per cent. In the 1-year follow-up period, 4661 patients (23·9 per cent) had one or more emergency readmissions for complications related to gallstone pancreatitis. Of these, 2692 (57·8 per cent) were readmissions for acute pancreatitis; 911 (33·8 per cent) were within the first 2 weeks of discharge, with the remaining 1781 (66·2 per cent) occurring after the point at which definitive treatment should have been received. Early definitive treatment resulted in a 39 per cent reduction in readmission risk (adjusted risk ratio (RR) 0·61, 95 per cent c.i. 0·58 to 0·65). The risk was further reduced for acute pancreatitis readmissions to 54 per cent in the early definitive treatment group (adjusted RR 0·46, 0·42 to 0·51). In acute gallstone pancreatitis, compliance with recommended early definitive treatment varied considerably, with associated variation in outcomes. Compliance should be used as a quality indicator to improve care. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.
Optimal firing rate estimation

NASA Technical Reports Server (NTRS)

Paulin, M. G.; Hoffman, L. F.

2001-01-01

We define a measure for evaluating the quality of a predictive model of the behavior of a spiking neuron. This measure, information gain per spike (Is), indicates how much more information is provided by the model than if the prediction were made by specifying the neuron's average firing rate over the same time period. We apply a maximum Is criterion to optimize the performance of Gaussian smoothing filters for estimating neural firing rates. With data from bullfrog vestibular semicircular canal neurons and data from simulated integrate-and-fire neurons, the optimal bandwidth for firing rate estimation is typically similar to the average firing rate. Precise timing and average rate models are limiting cases that perform poorly. We estimate that bullfrog semicircular canal sensory neurons transmit in the order of 1 bit of stimulus-related information per spike.
Executing Quality: A Grounded Theory of Child Care Quality Improvement Engagement Process in Pennsylvania

ERIC Educational Resources Information Center

Critchosin, Heather

2014-01-01

Executing Quality describes the perceived process experienced by participants while engaging in Keystone Standards, Training, Assistance, Resources, and Support (Keystone STARS) quality rating improvement system (QRIS). The purpose of this qualitative inquiry was to understand the process of Keystone STARS engagement in order to generate a…
Funding Source and Research Report Quality in Nutrition Practice-Related Research

PubMed Central

Myers, Esther F.; Parrott, J. Scott; Cummins, Deborah S.; Splett, Patricia

2011-01-01

Background The source of funding is one of many possible causes of bias in scientific research. One method of detecting potential for bias is to evaluate the quality of research reports. Research exploring the relationship between funding source and nutrition-related research report quality is limited and in other disciplines the findings are mixed. Objective The purpose of this study is to determine whether types of funding sources of nutrition research are associated with differences in research report quality. Design A retrospective study of research reporting quality, research design and funding source was conducted on 2539 peer reviewed research articles from the American Dietetic Association's Evidence Analysis Library® database. Results Quality rating frequency distributions indicate 43.3% of research reports were rated as positive, 50.1% neutral, and 6.6% as negative. Multinomial logistic regression results showed that while both funding source and type of research design are significant predictors of quality ratings (χ2 = 118.99, p<0.001), the model's usefulness in predicting overall research report quality is little better than chance. Compared to research reports with government funding, those not acknowledging any funding sources, followed by studies with University/hospital funding were more likely to receive neutral vs positive quality ratings, OR = 1.85, P <0.001 and OR = 1.54, P<0.001, respectively and those that did not report funding were more likely to receive negative quality ratings (OR = 4.97, P<0.001). After controlling for research design, industry funded research reports were no more likely to receive a neutral or negative quality rating than those funded by government sources. Conclusion Research report quality cannot be accurately predicted from the funding source after controlling for research design. Continued vigilance to evaluate the quality of all research regardless of the funding source and to further understand
Assessing Quality in Home Visiting Programs

ERIC Educational Resources Information Center

Korfmacher, Jon; Laszewski, Audrey; Sparr, Mariel; Hammel, Jennifer

2013-01-01

Defining quality and designing a quality assessment measure for home visitation programs is a complex and multifaceted undertaking. This article summarizes the process used to create the Home Visitation Program Quality Rating Tool (HVPQRT) and identifies next steps for its development. The HVPQRT measures both structural and dynamic features of…
[Influence on AM fungi infection rate and medicine quality of Pinellia ternata in condition of three soil impact factors].

PubMed

Shen, Xue-Lian; Liu, Zuo-Yi; Guo, Qiao-Sheng; Zhu, Guo-Sheng; Cheng, Li-Tao

2013-04-01

To explore the influence on AM fungi infection rate and medicine quality of Pinellia ternate in the condition of three soil impact factors. Set the orthogonal test of three factors and levels. Determinate the AM fungi infection rate in early stage of mature & stage of mature of P. ternata, and the water content, water soluble extract, butanedioic acid content and alkaloid content of P. ternata tuber that be harvested also had be determinated. With the P levels to 30 mg x kg(-1) and 90 mg x kg(-1), AM fungi infection was the best when mixed inoculated of EM. Microbial agent inoculated played a decisive role in P. ternata growth and physiological activity, secondary influenced factor was P concentration, and the water stress was the minimal impact. Mixed inoculated of AM fungi and EM treatment with the low P levels (30, 90 mg x kg(-1)) proved better effect on enhancing the water extract content, anedioic acid and alkaloid content, while decreasing the water contents of P. ternata tuber.
Exploring Rating Quality in Rater-Mediated Assessments Using Mokken Scale Analysis

ERIC Educational Resources Information Center

Wind, Stefanie A.; Engelhard, George, Jr.

2016-01-01

Mokken scale analysis is a probabilistic nonparametric approach that offers statistical and graphical tools for evaluating the quality of social science measurement without placing potentially inappropriate restrictions on the structure of a data set. In particular, Mokken scaling provides a useful method for evaluating important measurement…
Antibiotic prescribing in relation to diagnoses and consultation rates in Belgium, the Netherlands and Sweden: use of European quality indicators.

PubMed

Tyrstrup, Mia; van der Velden, Alike; Engstrom, Sven; Goderis, Geert; Molstad, Sigvard; Verheij, Theo; Coenen, Samuel; Adriaenssens, Niels

2017-03-01

To assess the quality of antibiotic prescribing in primary care in Belgium, the Netherlands and Sweden using European disease-specific antibiotic prescribing quality indicators (APQI) and taking into account the threshold to consult and national guidelines. A retrospective observational database study. Routine primary health care registration networks in Belgium, the Netherlands and Sweden. All consultations for one of seven acute infections [upper respiratory tract infection (URTI), sinusitis, tonsillitis, otitis media, bronchitis, pneumonia and cystitis] and the antibiotic prescriptions in 2012 corresponding to these diagnoses. Consultation incidences for these diagnoses and APQI values (a) the percentages of patients receiving an antibiotic per diagnosis, (b) the percentages prescribed first-choice antibiotics and (c) the percentages prescribed quinolones. The consultation incidence for respiratory tract infection was much higher in Belgium than in the Netherlands and Sweden. Most of the prescribing percentage indicators (a) were outside the recommended ranges, with Belgium deviating the most for URTI and bronchitis, Sweden for tonsillitis and the Netherlands for cystitis. The Netherlands and Sweden prescribed the recommended antibiotics (b) to a higher degree and the prescribing of quinolones exceeded the proposed range for most diagnoses (c) in Belgium. The interpretation of APQI was found to be dependent on the consultation incidences. High consultation incidences were associated with high antibiotic prescription rates. Taking into account the recommended treatments from national guidelines improved the results of the APQI values for sinusitis in the Netherlands and cystitis in Sweden. Quality assessment using European disease-specific APQI was feasible and their inter-country comparison can identify opportunities for quality improvement. Their interpretation, however, should take consultation incidences and national guidelines into account. Differences in
Seed-Specific Expression of OsDWF4, a Rate-Limiting Gene Involved in Brassinosteroids Biosynthesis, Improves Both Grain Yield and Quality in Rice.

PubMed

Li, Qian-Feng; Yu, Jia-Wen; Lu, Jun; Fei, Hong-Yuan; Luo, Ming; Cao, Bu-Wei; Huang, Li-Chun; Zhang, Chang-Quan; Liu, Qiao-Quan

2018-04-18

Brassinosteroids (BRs) are essential plant-specific steroidal hormones that regulate diverse growth and developmental processes in plants. We evaluated the effects of OsDWF4, a gene that encodes a rate-limiting enzyme in BR biosynthesis, on both rice yield and quality when driven by the Gt1 or Ubi promoter, which correspond to seed-specific or constitutive expression, respectively. Generally, transgenic plants expressing OsDWF4 showed increased grain yield with more tillers and longer and heavier seeds. Moreover, the starch physicochemical properties of the transgenic rice were also improved. Interestingly, OsDWF4 was found to exert different effects on either rice yield or quality when driven by the different promoters. The overall performance of the pGt1::OsDWF4 lines was better than that of the pUbi::OsDWF4 lines. Our data not only demonstrate the effects of OsDWF4 overexpression on both rice yield and quality but also suggest that a seed-specific promoter is a good choice in BR-mediated rice breeding programs.
Associations between adult attachment and: oral health-related quality of life, oral health behaviour, and self-rated oral health.

PubMed

Meredith, Pamela; Strong, Jenny; Ford, Pauline; Branjerdporn, Grace

2016-02-01

Although adult attachment theory has been revealed as a useful theoretical framework for understanding a range of health parameters, the associations between adult attachment patterns and a range of oral health parameters have not yet been examined. The aim of this study was to examine potential associations between attachment insecurity and: (1) oral health-related quality of life (OHRQoL), (2) oral health behaviours, and (3) self-rated oral health. In association with this aim, sample characteristics were compared with normative data. The sample in this cross-sectional study was comprised of 265 healthy adults, recruited via convenience sampling. Data were collected on attachment patterns (Experiences in Close Relationships Scale-Short Form, ECR-S), OHRQoL (Oral Health Impact Profile-14, OHIP-14), oral health behaviours (modified Dental Neglect Scale, m-DNS), and self-rated oral health (one-item global rating of oral health). Multivariate regression models were performed. Both dimensions of attachment insecurity were associated with lowered use of favourable dental visiting behaviours, as well as decreased OHRQoL for both overall well-being and specific aspects of OHRQoL. Attachment avoidance was linked with diminished self-rated oral health. This study supports the potential value of an adult attachment framework for understanding a range of oral health parameters. The assessment of a client's attachment pattern may assist in the identification of people who are at risk of diminished OHRQoL, less adaptive dental visiting behaviours, or poorer oral health. Further research in this field may inform ways in which attachment approaches can enhance oral health-related interventions.
Making Computing on Encrypted Data Secure and Practical

DTIC Science & Technology

2013-06-01

with SAF/AQR memorandum dated 10 Dec 08 and AFRL/ CA policy clarification memorandum dated 16 Jan 09. This report is available to the general public...control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) JUNE 2013 2 . REPORT TYPE FINAL TECHNICAL REPORT 3...150 Irvine, CA 92697 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) Air Force Research
Do patient experiences on priority aspects of health care predict their global rating of quality of care? A study in five patient groups

PubMed Central

De Boer, Dolf; Delnoij, Diana; Rademakers, Jany

2010-01-01

Abstract Background Patient‐given global ratings are frequently interpreted as summary measures of the patient perspective, with limited understanding of what these ratings summarize. Global ratings may be determined by patient experiences on priority aspects of care. Objectives (i) identify patient priorities regarding elements of care for breast cancer, hip‐ or knee surgery, cataract surgery, rheumatoid arthritis and diabetes, (ii) establish whether experiences regarding priorities are associated with patient‐given global ratings, and (iii) determine whether patient experiences regarding priorities are better predictors of global ratings than experiences concerning less important aspects of care. Setting and participants Data collected for the development of five consumer quality index surveys – disease‐specific questionnaires that capture patient experiences and priorities – were used. Results Priorities varied: breast cancer patients for example, prioritized rapid access to care and diagnostics, while diabetics favoured dignity and appropriate frequency of tests. Experiences regarding priorities were inconsistently related to global ratings of care. Regression analyses indicated that demographics explain 2.4–8.4% of the variance in global rating. Introducing patient experiences regarding priorities increased the variance explained to 21.1–35.1%; models with less important aspects of care explained 11.8–23.2%. Conclusions Some experiences regarding priorities are strongly related to the global rating while others are poorly related. Global ratings are marginally dependent on demographics, and experiences regarding priorities are somewhat better predictors of global rating than experiences regarding less important elements. As it remains to be fully determined what global ratings summarize, caution is warranted when using these ratings as summary measures. PMID:20550597
Evaluating supplier quality performance using analytical hierarchy process

NASA Astrophysics Data System (ADS)

Kalimuthu Rajoo, Shanmugam Sundram; Kasim, Maznah Mat; Ahmad, Nazihah

2013-09-01

This paper elaborates the importance of evaluating supplier quality performance to an organization. Supplier quality performance evaluation reflects the actual performance of the supplier exhibited at customer's end. It is critical in enabling the organization to determine the area of improvement and thereafter works with supplier to close the gaps. Success of the customer partly depends on supplier's quality performance. Key criteria as quality, cost, delivery, technology support and customer service are categorized as main factors in contributing to supplier's quality performance. 18 suppliers' who were manufacturing automotive application parts evaluated in year 2010 using weight point system. There were few suppliers with common rating which led to common ranking observed by few suppliers'. Analytical Hierarchy Process (AHP), a user friendly decision making tool for complex and multi criteria problems was used to evaluate the supplier's quality performance challenging the weight point system that was used for 18 suppliers'. The consistency ratio was checked for criteria and sub-criteria. Final results of AHP obtained with no overlap ratings, therefore yielded a better decision making methodology as compared to weight point rating system.
What's in a Rating?

ERIC Educational Resources Information Center

Jacob, Brian A.; Walsh, Elias

2011-01-01

We examine the relationship between the formal ratings that principals give teachers and a variety of observable teacher characteristics, including proxies for productivity. Prior work has shown that principals can differentiate between more and less effective teachers, especially at the tails of the quality distribution, and that subjective…
Bluetooth Heart Rate Monitors For Spaceflight

NASA Technical Reports Server (NTRS)

Buxton, R. E.; West, M. R.; Kalogera, K. L.; Hanson, A. M.

2016-01-01

Heart rate monitoring is required for crewmembers during exercise aboard the International Space Station (ISS) and will be for future exploration missions. The cardiovascular system must be sufficiently stressed throughout a mission to maintain the ability to perform nominal and contingency/emergency tasks. High quality heart rate data are required to accurately determine the intensity of exercise performed by the crewmembers and show maintenance of VO2max. The quality of the data collected on ISS is subject to multiple limitations and is insufficient to meet current requirements. PURPOSE: To evaluate the performance of commercially available Bluetooth heart rate monitors (BT_HRM) and their ability to provide high quality heart rate data to monitor crew health aboard the ISS and during future exploration missions. METHODS: Nineteen subjects completed 30 data collection sessions of various intensities on the treadmill and/or cycle. Subjects wore several BT_HRM technologies for each testing session. One electrode-based chest strap (CS) was worn, while one or more optical sensors (OS) were worn. Subjects were instrumented with a 12-lead ECG to compare the heart rate data from the Bluetooth sensors. Each BT_HRM data set was time matched to the ECG data and a +/-5bpm threshold was applied to the difference between the 2 data sets. Percent error was calculated based on the number of data points outside the threshold and the total number of data points. RESULTS: The electrode-based chest straps performed better than the optical sensors. The best performing CS was CS1 (1.6% error), followed by CS4 (3.3% error), CS3 (6.4% error), and CS2 (9.2% error). The OS resulted in 10.4% error for OS1 and 14.9% error for OS2. CONCLUSIONS: The highest quality data came from CS1, but unfortunately it has been discontinued by the manufacturer. The optical sensors have not been ruled out for use, but more investigation is needed to determine how to obtain the best quality data. CS2 will be
Using an Inpatient Quality Improvement Curriculum for Internal Medicine Residents to Improve Pneumococcal Conjugate Vaccine Administration Rates.

PubMed

Jolin, Jonathan; van Aalst, Robertus; Volpp, Bryan; Taylor, Thomas; Cohen, Emily

2018-06-01

Pneumococcal infections are an important source of morbidity and mortality in older adults and persons with compromised immune systems. New recommendations from the Advisory Committee on Immunization Practices (ACIP) became available September 2014, which included recommendations for the use of the 13-valent pneumococcal conjugate vaccine (PCV13). A study was conducted to increase the PCV13 vaccination rates of hospitalized patients at the White River Junction Veterans Affairs Medical Center (White River Junction, Vermont) through the use of a resident-driven quality improvement (QI) project. From December 2014 through April 2016, 16 internal medicine inpatient residents addressed inpatient PCV13 vaccination rates by participating in the facility's QI curriculum. Eight Plan-Do-Study-Act cycles were used, including discharge template editing, electronic reminders, and the discovery of a vaccination administration documentation error in the record through data validation. The measure was the monthly percentage of patients who received PCV13 vaccination (vaccination completion rate) of those discharged from the hospital medicine service who were due for PCV13 vaccination. The percentage of veterans discharged with an up-to-date PCV13 vaccination on discharge increased from approximately 30% to 87% and was sustained. Despite being driven by many different residents, this project demonstrates that continuous improvement can be achieved through a structured and iterative process while providing active learning of core QI concepts to residents. It also displays a method in which new guidelines can be incorporated into practice in an effective manner. Finally, this project is an example of how resident-driven data validation can lead to further improvement. Published by Elsevier Inc.
Audiovisual quality estimation of mobile phone video cameras with interpretation-based quality approach

NASA Astrophysics Data System (ADS)

Radun, Jenni E.; Virtanen, Toni; Olives, Jean-Luc; Vaahteranoksa, Mikko; Vuori, Tero; Nyman, Göte

2007-01-01

We present an effective method for comparing subjective audiovisual quality and the features related to the quality changes of different video cameras. Both quantitative estimation of overall quality and qualitative description of critical quality features are achieved by the method. The aim was to combine two image quality evaluation methods, the quantitative Absolute Category Rating (ACR) method with hidden reference removal and the qualitative Interpretation- Based Quality (IBQ) method in order to see how they complement each other in audiovisual quality estimation tasks. 26 observers estimated the audiovisual quality of six different cameras, mainly mobile phone video cameras. In order to achieve an efficient subjective estimation of audiovisual quality, only two contents with different quality requirements were recorded with each camera. The results show that the subjectively important quality features were more related to the overall estimations of cameras' visual video quality than to the features related to sound. The data demonstrated two significant quality dimensions related to visual quality: darkness and sharpness. We conclude that the qualitative methodology can complement quantitative quality estimations also with audiovisual material. The IBQ approach is valuable especially, when the induced quality changes are multidimensional.
Embryo quality is the main factor affecting cumulative live birth rate after elective single embryo transfer in fresh stimulation cycles.

PubMed

Niinimäki, Maarit; Veleva, Zdravka; Martikainen, Hannu

2015-11-01

The study was aimed to evaluate which factors affect the cumulative live birth rate after elective single embryo transfer in women younger than 36 years. Additionally, number of children in women with more than one delivery per ovum pick-up after fresh elective single embryo transfer and subsequent frozen embryo transfers was assessed. Retrospective cohort study analysing data of a university hospital's infertility clinic in 2001-2010. A total of 739 IVF/ICSI cycles with elective single embryo transfer were included. Analyses were made per ovum pick-up including fresh and subsequent frozen embryo transfers. Factors affecting cumulative live birth rates were examined in uni- and multivariate analyses. A secondary endpoint was the number of children born after all treatments. In the fresh cycles, the live birth rate was 29.2% and the cumulative live birth rate was 51.3%, with a twin rate of 3.4%. In the multivariate analysis, having two (odds ratio (OR) 1.73; 95% confidence interval (CI) 1.12-2.67) or ≥3 top embryos (OR 2.66; 95% CI 1.79-3.95) was associated with higher odds for live birth after fresh and frozen embryo cycles. Age, body mass index, duration of infertility, diagnosis or total gonadotropin dose were not associated with the cumulative live birth rate. In cycles with one top embryo, the cumulative live birth rate was 40.2%, whereas it was 64.1% in those with at least three top embryos. Of women who had a live birth in the fresh cycle, 20.4% had more than one child after all frozen embryo transfers. Among women with three or more top embryos after ovum pick-up, 16.1% gave birth to more than one child. The cumulative live birth rate in this age group varies from 40% to 64% and is dependent on the quality of embryos. Women with three or more top embryos have good chance of having more than one child per ovum pick-up without elevated risk of multiple pregnancies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
The agreement between 3D, standard 2D and triplane 2D speckle tracking: effects of image quality and 3D volume rate.

PubMed

Trache, Tudor; Stöbe, Stephan; Tarr, Adrienn; Pfeiffer, Dietrich; Hagendorff, Andreas

2014-12-01

Comparison of 3D and 2D speckle tracking performed on standard 2D and triplane 2D datasets of normal and pathological left ventricular (LV) wall-motion patterns with a focus on the effect that 3D volume rate (3DVR), image quality and tracking artifacts have on the agreement between 2D and 3D speckle tracking. 37 patients with normal LV function and 18 patients with ischaemic wall-motion abnormalities underwent 2D and 3D echocardiography, followed by offline speckle tracking measurements. The values of 3D global, regional and segmental strain were compared with the standard 2D and triplane 2D strain values. Correlation analysis with the LV ejection fraction (LVEF) was also performed. The 3D and 2D global strain values correlated good in both normally and abnormally contracting hearts, though systematic differences between the two methods were observed. Of the 3D strain parameters, the area strain showed the best correlation with the LVEF. The numerical agreement of 3D and 2D analyses varied significantly with the volume rate and image quality of the 3D datasets. The highest correlation between 2D and 3D peak systolic strain values was found between 3D area and standard 2D longitudinal strain. Regional wall-motion abnormalities were similarly detected by 2D and 3D speckle tracking. 2DST of triplane datasets showed similar results to those of conventional 2D datasets. 2D and 3D speckle tracking similarly detect normal and pathological wall-motion patterns. Limited image quality has a significant impact on the agreement between 3D and 2D numerical strain values.
Deposition of device quality, low hydrogen content, hydrogenated amorphous silicon at high deposition rates

DOEpatents

Mahan, Archie Harvin; Molenbroek, Edith C.; Gallagher, Alan C.; Nelson, Brent P.; Iwaniczko, Eugene; Xu, Yueqin

2002-01-01

A method of fabricating device quality, thin-film a-Si:H for use as semiconductor material in photovoltaic and other devices, comprising in any order; positioning a substrate in a vacuum chamber adjacent a plurality of heatable filaments with a spacing distance L between the substrate and the filaments; heating the filaments to a temperature that is high enough to obtain complete decomposition of silicohydride molecules that impinge said filaments into Si and H atomic species; providing a flow of silicohydride gas, or a mixture of silicohydride gas containing Si and H, in said vacuum chamber while maintaining a pressure P of said gas in said chamber, which, in combination with said spacing distance L, provides a P.times.L product in a range of 10-300 mT-cm to ensure that most of the Si atomic species react with silicohydride molecules in the gas before reaching the substrate, to thereby grow a a-Si:H film at a rate of at least 50 .ANG./sec.; and maintaining the substrate at a temperature that balances out-diffusion of H from the growing a-Si:H film with time needed for radical species containing Si and H to migrate to preferred bonding sites.

Orion Handling Qualities During ISS Proximity Operations and Docking

NASA Technical Reports Server (NTRS)

Stephens, John-Paul; Vos, Gordon A.; Bilimoria, Karl D.; Mueller, Eric R.; Brazzel, Jack; Spehar, Pete

2011-01-01

NASA's Orion spacecraft is designed to autonomously rendezvous and dock with many vehicles including the International Space Station. However, the crew is able to assume manual control of the vehicle s attitude and flight path. In these instances, Orion must meet handling qualities requirements established by NASA. Two handling qualities assessments were conducted at the Johnson Space Center to evaluate preliminary designs of the vehicle using a six degree of freedom, high-fidelity guidance, navigation, and control simulation. The first assessed Orion s handling qualities during the last 20 ft before docking, and included both steady and oscillatory motions of the docking target. The second focused on manual acquisition of the docking axis during the proximity operations phase and subsequent station-keeping. Cooper-Harper handling qualities ratings, workload ratings and comments were provided by 10 evaluation pilots for the docking study and 5 evaluation pilots for the proximity operations study. For the docking task, both cases received 90% Level 1 (satisfactory) handling qualities ratings, exceeding NASA s requirement. All ratings for the ProxOps task were Level 1. These evaluations indicate that Orion is on course to meet NASA's handling quality requirements for ProxOps and docking.
Influence of the motion correction algorithm on the quality and interpretability of images of single-source 64-detector coronary CT angiography among patients grouped by heart rate.

PubMed

Machida, Haruhiko; Lin, Xiao-Zhu; Fukui, Rika; Shen, Yun; Suzuki, Shigeru; Tanaka, Isao; Ishikawa, Takuya; Tate, Etsuko; Ueno, Eiko

2015-02-01

We retrospectively investigated the effect of the motion correction algorithm (MCA) on image quality and interpretability by heart rate (HR) in coronary CT angiography (CCTA). For 105 patients (6 HR groups) undergoing CCTA, 2 readers independently graded the image quality of the 4 major coronary arteries reconstructed with and without MCA at diastole with HR ≤64 bpm and at systole and diastole ≥65 bpm using a 5-point scale. For each HR group and cardiac phase, we compared per-vessel and per-segment image quality using Wilcoxon signed rank test and percentages of interpretable image quality (scores 3-5) among without MCA at diastole with HR ≤64 bpm, as a reference, with MCA at diastole ≤69 bpm and at systole 70-79 bpm using the chi-square test. The motion correction algorithm reconstruction provided similar or better image quality and interpretability in all groups, with 96-100 % per-vessel (P = 0.008 for the right coronary artery; otherwise, P > 0.05) and 99 % per-segment interpretable image quality (P = 0.0002) at diastole with HR ≤69 bpm and at systole 70-79 bpm compared to the reference (88-100 and 97 %, respectively). MCA reconstruction preserved image quality and interpretability of CCTA with HR ≤79 bpm.
Real-time motion-based H.263+ frame rate control

NASA Astrophysics Data System (ADS)

Song, Hwangjun; Kim, JongWon; Kuo, C.-C. Jay

1998-12-01

Most existing H.263+ rate control algorithms, e.g. the one adopted in the test model of the near-term (TMN8), focus on the macroblock layer rate control and low latency under the assumptions of with a constant frame rate and through a constant bit rate (CBR) channel. These algorithms do not accommodate the transmission bandwidth fluctuation efficiently, and the resulting video quality can be degraded. In this work, we propose a new H.263+ rate control scheme which supports the variable bit rate (VBR) channel through the adjustment of the encoding frame rate and quantization parameter. A fast algorithm for the encoding frame rate control based on the inherent motion information within a sliding window in the underlying video is developed to efficiently pursue a good tradeoff between spatial and temporal quality. The proposed rate control algorithm also takes the time-varying bandwidth characteristic of the Internet into account and is able to accommodate the change accordingly. Experimental results are provided to demonstrate the superior performance of the proposed scheme.
Chest compression rate feedback based on transthoracic impedance.

PubMed

González-Otero, Digna M; Ruiz de Gauna, Sofía; Ruiz, Jesus; Daya, Mohamud R; Wik, Lars; Russell, James K; Kramer-Johansen, Jo; Eftestøl, Trygve; Alonso, Erik; Ayala, Unai

2015-08-01

Quality of cardiopulmonary resuscitation (CPR) is an important determinant of survival from cardiac arrest. The use of feedback devices is encouraged by current resuscitation guidelines as it helps rescuers to improve quality of CPR performance. To determine the feasibility of a generic algorithm for feedback related to chest compression (CC) rate using the transthoracic impedance (TTI) signal recorded through the defibrillation pads. We analysed 180 episodes collected equally from three different emergency services, each one using a unique defibrillator model. The new algorithm computed the CC-rate every 2s by analysing the TTI signal in the frequency domain. The obtained CC-rate values were compared with the gold standard, computed using the compression force or the ECG and TTI signals when the force was not recorded. The accuracy of the CC-rate, the proportion of alarms of inadequate CC-rate, chest compression fraction (CCF) and the mean CC-rate per episode were calculated. Intervals with CCs were detected with a mean sensitivity and a mean positive predictive value per episode of 96.3% and 97.0%, respectively. Estimated CC-rate had an error below 10% in 95.8% of the time. Mean percentage of accurate alarms per episode was 98.2%. No statistical differences were found between the gold standard and the estimated values for any of the computed metrics. We developed an accurate algorithm to calculate and provide feedback on CC-rate using the TTI signal. This could be integrated into automated external defibrillators and help improve the quality of CPR in basic-life-support settings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
[Are There any Differences in Quality or Complication Rate in Total Knee Arthroplasty after Establishing a Centre for Endoprosthesis?

PubMed

Düzgünoglu, Muzaffer; Hönle, Wolfgang; Scheller, Alexander; Schuh, Alexander

2018-05-18

The aim of the study is to show whether there are any changes in quality or incidence of complications in total knee arthroplasty (TKA) after establishing a centre for endoprothesis (EPZ). We conducted a retrospective study comparing 100 TKAs one year before establishing an EPZ (Group I) with 100 TKAs one year after establishing an EPZ (group II). Data were collected by analysing our electronic documentation system, and the report of the rehabilitation hospital. The following parameters were documented which are necessary to establish an EPZ: existence of X-rays before and after operation. Existence of full length weight bearing X-ray before operation or using a navigation device. Existence of preoperative planning, duration of TKA below 100 minutes. The following complications were documented: Periprosthetic infections, occurrence of periprosthetic fissures/fractures, thrombembolism, neurologic complications, patients' satisfaction rate with the hospital stay and mortality rate. Additionally femorotibial angle, femoral angle, tibial angle and tibial slope were measured. Statistical analysis was performed with SPSS 22.0. using the Kolmogorov-Smirnov test, the Qui-Square test and the Mann-Whitney U test. There were no statistical differences in local or systemic complications. The mean duration of operation was 82.9 min in group I (min.: 55, max.: 141) und 81.5 min in group II (min.: 57, max.: 129; p > 0.05). In group I, there were 20/100 cases (20%) with operation time longer than 100 minutes, in group II 13/100 cases (13%; p < 0.001). Analysis of anatomical femorotibial angle, femur angle, tibial angle and tibial slope showed no significant differences. The rate of documented survey of patients' satisfaction rate improved from 62% in group I to 98% in group II (p < 0.001). By establishing an EPZ, we achieved a significant improvement in the parameters operation time > 100 minutes and documented survey of patients' satisfaction rate, but not
Medicare program; FY 2014 hospice wage index and payment rate update; hospice quality reporting requirements; and updates on payment reform. final rule.

PubMed

2013-08-07

This final rule updates the hospice payment rates and the wage index for fiscal year (FY) 2014, and continues the phase out of the wage index budget neutrality adjustment factor (BNAF). Including the FY 2014 15 percent BNAF reduction, the total 5 year cumulative BNAF reduction in FY 2014 will be 70 percent. The BNAF phase-out will continue with successive 15 percent reductions in FY 2015 and FY 2016. This final rule also clarifies how hospices are to report diagnoses on hospice claims, and provides updates to the public on hospice payment reform. Additionally, this final rule changes the requirements for the hospice quality reporting program by discontinuing currently reported measures and implementing a Hospice Item Set with seven National Quality Forum (NFQ) endorsed measures beginning July 1, 2014, as proposed. Finally, this final rule will implement the hospice Experience of Care Survey on January 1, 2015, as proposed.
Testing for HPV as an objective measure for quality assurance in gynecologic cytology: positive rates in equivocal and abnormal specimens and comparison with the ASCUS to SIL ratio.

PubMed

Ko, Vincent; Nanji, Shabin; Tambouret, Rosemary H; Wilbur, David C

2007-04-25

Inappropriate use of the category of atypical squamous cells of undetermined significance (ASCUS) can result in overtreatment or undertreatment of patients, which may decrease the cost effectiveness of screening. Quality assurance tools, such as the ASCUS to squamous intraepithelial lesion ratio (ASCUS:SIL) and case review, are imperfect. High-risk HPV (hrHPV) testing is an objective test for a known viral carcinogen, and hrHPV may be more useful in monitoring the quality of ASCUS interpretations. hrHPV rates for cytologic diagnoses and patient age groups were calculated for a 2-year period. All hrHPV results for ASCUS and SIL over a 17-month period were analyzed by patient age group, over time, and by individual cytopathologist to compare hrHPV rates with the corresponding ASCUS:SIL. The hrHPV positive rate for SIL was >90%, and it was 32.6% for ASCUS. Stratification by patient age showed that approximately 50% of patients younger than 30 years and older than 70 years of age were hrHPV positive, whereas other patients had a lower rate ranging from 14% to 34%. The overall ASCUS:SIL was 1.42, and the overall hrHPV positive rate was 39.9%. Over time and by individual cytopathologist, the hrHPV rate performed similarly to the ASCUS:SIL. The analysis by patient age showed a high statistical correlation (R(2) = 0.9772) between the 2 methods. Despite differences between these techniques, the hrHPV rate closely recapitulates the ASCUS:SIL. When used together, the 2 methods can complement each other. The desirable hrHPV-positive range appears to be 40% to 50%; however, this may vary based on the patient population. The hrHPV rate is as quick and cost effective as determining the ASCUS:SIL. (c) 2007 American Cancer Society.
Low-rate image coding using vector quantization

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

Makur, A.

1990-01-01

This thesis deals with the development and analysis of a computationally simple vector quantization image compression system for coding monochrome images at low bit rate. Vector quantization has been known to be an effective compression scheme when a low bit rate is desirable, but the intensive computation required in a vector quantization encoder has been a handicap in using it for low rate image coding. The present work shows that, without substantially increasing the coder complexity, it is indeed possible to achieve acceptable picture quality while attaining a high compression ratio. Several modifications to the conventional vector quantization coder aremore » proposed in the thesis. These modifications are shown to offer better subjective quality when compared to the basic coder. Distributed blocks are used instead of spatial blocks to construct the input vectors. A class of input-dependent weighted distortion functions is used to incorporate psychovisual characteristics in the distortion measure. Computationally simple filtering techniques are applied to further improve the decoded image quality. Finally, unique designs of the vector quantization coder using electronic neural networks are described, so that the coding delay is reduced considerably.« less
Long-term health implications of school quality.

PubMed

Dudovitz, Rebecca N; Nelson, Bergen B; Coker, Tumaini R; Biely, Christopher; Li, Ning; Wu, Lynne C; Chung, Paul J

2016-06-01

Individual academic achievement is a well-known predictor of adult health, and addressing education inequities may be critical to reducing health disparities. Disparities in school quality are well documented. However, we lack nationally representative studies evaluating the impact of school quality on adult health. We aim to determine whether high school quality predicts adult health outcomes after controlling for baseline health, socio-demographics and individual academic achievement. We analyzed data from 7037 adolescents who attended one of 77 high schools in the Unites States and were followed into adulthood from the National Longitudinal Study of Adolescent to Adult Health. Selected school-level quality measures-average daily attendance, school promotion rate, parental involvement, and teacher experience-were validated based on ability to predict high school graduation and college attendance. Individual adult health outcomes included self-rated health, diagnosis of depression, and having a measured BMI in the obese range. Logistic regressions controlling for socio-demographics, baseline health, health insurance, and individual academic performance demonstrated that school quality significantly predicted all health outcomes. As hypothesized, attending a school with lower average daily attendance predicted lower self-rated health (Adjusted Odds Ratio (AOR) 1.59, p = 0.003) and higher odds of depression diagnosis (AOR 1.35, p = 0.03); and attending a school with higher parent involvement predicted lower odds of obesity (AOR 0.69, p = 0.001). However, attending a school with higher promotion rate also predicted lower self-rated health (AOR1.20, p < 0.001). High school quality may be an important, but complex, social determinant of health. These findings highlight the potential inter-dependence of education and health policy. Copyright © 2016 Elsevier Ltd. All rights reserved.
Rates of Beginning Teachers: Examining One Indicator of School Quality in an Equity Context

ERIC Educational Resources Information Center

Gagnon, Douglas J.; Mattingly, Marybeth J.

2015-01-01

The authors use national data to examine variation in the proportion of beginning teachers in school districts across the United States by poverty, race, and urbanicity. In addition to being a proxy for teacher quality, the proportion of beginning teachers in a district also speaks to teacher turnover and therefore broader school quality issues.…
Sound quality evaluation of air conditioning sound rating metric

NASA Astrophysics Data System (ADS)

Hodgdon, Kathleen K.; Peters, Jonathan A.; Burkhardt, Russell C.; Atchley, Anthony A.; Blood, Ingrid M.

2003-10-01

A product's success can depend on its acoustic signature as much as on the product's performance. The consumer's perception can strongly influence their satisfaction with and confidence in the product. A metric that can rate the content of the spectrum, and predict its consumer preference, is a valuable tool for manufacturers. The current method of assessing acoustic signatures from residential air conditioning units is defined in the Air Conditioning and Refrigeration Institute (ARI 270) 1995 Standard for Sound Rating of Outdoor Unitary Equipment. The ARI 270 metric, and modified versions of that metric, were implemented in software with the flexibility to modify the features applied. Numerous product signatures were analyzed to generate a set of synthesized spectra that targeted spectral configurations that challenged the metric's abilities. A subjective jury evaluation was conducted to establish the consumer preference for those spectra. Statistical correlations were conducted to assess the degree of relationship between the subjective preferences and the various metric calculations. Recommendations were made for modifications to improve the current metric's ability to predict subjective preference. [Research supported by the Air Conditioning and Refrigeration Institute.
Quality of longer term mental health facilities in Europe: validation of the quality indicator for rehabilitative care against service users' views.

PubMed

Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L; Turton, Penny; Kallert, Thomas; Schuster, Mirjam; Cervilla, Jorge A; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitris; Gonidakis, Fragiskos; Caldas-de-Almeida, José Miguel; Cardoso, Graça; King, Michael

2012-01-01

The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. 1750/2495 (70%) users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning). A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care. Interventions that improve quality of care in these
Poor tap water quality experiences and poor sleep quality during the Flint, Michigan Municipal Water Crisis.

PubMed

Kruger, Daniel J; Kodjebacheva, Gergana D; Cupal, Suzanne

2017-08-01

After inadequate official response to community concerns over water quality following changes in Flint's municipal water supply, this study sought evidence for a relationship between water quality and community mental health. The Speak to Your Health Community Survey is a community-based participatory component of the health surveillance system in Genesee County, Michigan. This cross-sectional survey recruits participants from every residential Census Tract of the county and strives for demographic representativeness. Respondents (n=834) rated their tap water quality (taste, smell, appearance) as poor (36%), fair (18%), good (20%), very good (17%), and excellent (10%). They rated their sleep quality as poor (12%), fair (28%), good (39%), very good (18%), and excellent (4%), and had an average (SD) sleep length of 408(90) minutes. Controlling for age, sex, years of education, and whether respondents were African American and Hispanic/Latino/a, lower perceived tap water quality was associated with lower sleep quality and shorter sleep length. Results indicate that adverse health conditions related to the water crisis extend beyond lead poisoning in children and include deterioration of sleep conditions among adult residents. Copyright © 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
Teaching and Research Quality Indicators and the Shaping of Higher Education. AIR 1997 Annual Forum Paper.

ERIC Educational Resources Information Center

Stanley, Elizabeth C.; Patrick, William J.

Two important sets of performance indicators for institutions of higher education have become established in the United Kingdom: research quality ratings and teaching quality ratings. The research quality ratings and, to a lesser extent, the teaching quality ratings influence the level of government funding provided to higher education…
Developing ratings for food products: lessons learned from media rating systems.

PubMed

Kunkel, Dale; McKinley, Christopher

2007-01-01

Children regularly consume low-nutrient, high-calorie food that is not consistent with a healthful diet, contributing to an increasing epidemic of overweight and obesity. Among the multiple causes of this problem is the food industry's emphasis on marketing calorie-dense food products to children. The Institute of Medicine (IOM) has recommended that industry adopt a uniform system of simplified food ratings to convey the nutritional qualities of food in a manner that is understandable and appealing to children and youth. This report analyzes the need for such a system in a food marketing environment that increasingly identifies healthful products for the consumer in inconsistent fashion. It considers evidence regarding current usage of food labeling and draws parallels with media rating systems in discussing the prospects for a uniform food rating system that would accomplish the IOM's objective.
Quality assessment and comparison of grading between examiners and supervisors of Bachelor theses in nursing education.

PubMed

Lundgren, Solveig M; Halvarsson, Maud; Robertsson, Barbro

2008-01-01

This study compares supervisors' and examiners' grading of quality of theses at Bachelor level in nursing. An instrument developed to asses the quality of theses was used. Eight aspects of quality were rated. One hundred and fifteen theses were rated by both examiner and supervisor. Significant correlations were found between examiners' and supervisors' ratings of all aspects of quality. Good agreement was found in 89-96% of the ratings on individual aspects of quality. The means of differences between ratings were small but significantly differed from zero in four out of eight aspects. In theses rated low for quality of language and formality, differences between examiners' and supervisors' ratings on all aspects of quality were significantly larger than in theses rated high for quality of language and formality. The general conclusion is that the evaluations made by examiners and by supervisors corresponded well. Differences found indicates that examiners in general give lower scores than supervisors especially on quality aspects that are most closely related to research methods and experiences. This study is part of a larger project that is investigating quality of theses and the student's attitudes and learning experiences of writing theses.
Flight Dynamics Aspects of a Large Civil Tiltrotor Simulation Using Translational Rate Command

NASA Technical Reports Server (NTRS)

Lawrence, Ben; Malpica, Carlos A.; Theodore, Colin R.; Decker, William A.; Lindsey, James E.

2011-01-01

An in-depth analysis of a Large Civil Tiltrotor simulation with a Translational Rate Command control law that uses automatic nacelle deflections for longitudinal velocity control and lateral cyclic for lateral velocity control is presented. Results from piloted real-time simulation experiments and offline time and frequency domain analyses are used to investigate the fundamental flight dynamic and control mechanisms of the control law. The baseline Translational Rate Command conferred handling qualities improvements over an attitude command attitude hold control law but in some scenarios there was a tendency to enter PIO. Nacelle actuator rate limiting strongly influenced the PIO tendency and reducing the rate limits degraded the handling qualities further. Counterintuitively, increasing rate limits also led to a worsening of the handling qualities ratings. This led to the identification of a nacelle rate to rotor longitudinal flapping coupling effect that induced undesired pitching motions proportional to the allowable amount of nacelle rate. A modification that applied a counteracting amount of longitudinal cyclic proportional to the nacelle rate significantly improved the handling qualities. The lateral axis of the Translational Rate Command conferred Level 1 handling qualities in a Lateral Reposition maneuver. Analysis of the influence of the modeling fidelity on the lateral flapping angles is presented. It is showed that the linear modeling approximation is likely to have under-predicted the side-force and therefore under-predicted the lateral flapping at velocities above 15 ft/s. However, at lower velocities, and therefore more weakly influenced by the side force modeling, the accelerations that the control law commands also significantly influenced the peak levels of lateral flapping achieved.
Failed heart rate control with oral metoprolol prior to coronary CT angiography: effect of additional intravenous metoprolol on heart rate, image quality and radiation dose.

PubMed

Jiménez-Juan, Laura; Nguyen, Elsie T; Wintersperger, Bernd J; Moshonov, Hadas; Crean, Andrew M; Deva, Djeven P; Paul, Narinder S; Torres, Felipe S

2013-01-01

The purpose of this study was to evaluate the effect of intravenous (i.v.) metoprolol after a suboptimal heart rate (HR) response to oral metoprolol (75-150 mg) on HR control, image quality (IQ) and radiation dose during coronary CTA using 320-MDCT. Fifty-three consecutive patients who failed to achieve a target HR of < 60 bpm after an oral dose of metoprolol and required supplementary i.v. metoprolol (5-20 mg) prior to coronary CTA were evaluated. Patients with HR < 60 bpm during image acquisition were defined as responders (R) and those with HR ≥ 60 bpm as non-responders (NR). Two observers assessed IQ using a 3-point scale (1-2, diagnostic and 3, non-diagnostic). Effective dose (ED) was estimated using dose-length product and a 0.014 mSV/mGy.cm conversion factor. Baseline characteristics and HR on arrival were similar in the two groups. 58% of patients didn't achieve the target HR after receiving i.v. metoprolol (NR). R had a significantly higher HR reduction after oral (mean HR 63.9 ± 4.5 bpm vs. 69.6 ± 5.6 bpm) (p < 0.005) and i.v. (mean HR 55.4 ± 3.9 bpm vs. 67.4 ± 5.3 bpm) (p < 0.005) doses of metoprolol. Studies from NR showed a significantly higher ED in comparison to R (8.0 ± 2.9 vs. 6.1 ± 2.2 mSv) (p = 0.016) and a significantly higher proportion of non-diagnostic coronary segments (9.2 vs. 2.5%) (p < 0.001). 58% of patients who do not achieve a HR of <60 bpm prior to coronary CTA with oral fail to respond to additional i.v. metoprolol and have studies with higher radiation dose and worse image quality.
Rate based failure detection

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

Johnson, Brett Emery Trabun; Gamage, Thoshitha Thanushka; Bakken, David Edward

This disclosure describes, in part, a system management component and failure detection component for use in a power grid data network to identify anomalies within the network and systematically adjust the quality of service of data published by publishers and subscribed to by subscribers within the network. In one implementation, subscribers may identify a desired data rate, a minimum acceptable data rate, desired latency, minimum acceptable latency and a priority for each subscription. The failure detection component may identify an anomaly within the network and a source of the anomaly. Based on the identified anomaly, data rates and or datamore » paths may be adjusted in real-time to ensure that the power grid data network does not become overloaded and/or fail.« less
A review of rate control in atrial fibrillation, and the rationale and protocol for the RATE-AF trial

PubMed Central

Deeks, Jonathan J; Griffith, Michael; Lip, Gregory YH; Mehta, Samir; Slinn, Gemma; Stanbury, Mary; Steeds, Richard P; Townend, Jonathan N

2017-01-01

Background and objective Atrial fibrillation (AF) is common and causes impaired quality of life, an increased risk of stroke and death as well as frequent hospital admissions. The majority of patients with AF require control of heart rate. In this article, we summarise the limited evidence from clinical trials that guides prescription, and present the rationale and protocol for a new randomised trial. As rate control has not yet been shown to reduce mortality, there is a clear need to compare the impact of therapy on quality of life, cardiac function and exercise capacity. Such a trial should concentrate on the long-term effects of treatment in the largest proportion of patients with AF, those with symptomatic permanent AF, with the aim of improving patient well-being. Design and intervention The RAte control Therapy Evaluation in permanent Atrial Fibrillation (RATE-AF) trial will enrol 160 participants with a prospective, randomised, open-label, blinded end point design comparing initial rate control with digoxin or bisoprolol. This will be the first head-to-head randomised trial of digoxin and beta-blockers in AF. Participants Recruited patients will be aged ≥60 years with permanent AF and symptoms of breathlessness (equivalent to New York Heart Association class II or above), with few exclusion criteria to maximise generalisability to routine clinical practice. Outcome measures The primary outcome is patient-reported quality of life, with secondary outcomes including echocardiographic ventricular function, exercise capacity and biomarkers of cellular and clinical response. Follow-up will occur at 6 and 12 months, with feasibility components to inform the design of a future trial powered to detect a difference in hospital admission. The RATE-AF trial will underpin an integrated approach to management including biomarkers, functions and symptoms that will guide future research into optimal, personalised rate control in patients with AF. Ethics and dissemination

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