Motion-base simulator results of advanced supersonic transport handling qualities with active controls

NASA Technical Reports Server (NTRS)

Feather, J. B.; Joshi, D. S.

1981-01-01

Handling qualities of the unaugmented advanced supersonic transport (AST) are deficient in the low-speed, landing approach regime. Consequently, improvement in handling with active control augmentation systems has been achieved using implicit model-following techniques. Extensive fixed-based simulator evaluations were used to validate these systems prior to tests with full motion and visual capabilities on a six-axis motion-base simulator (MBS). These tests compared the handling qualities of the unaugmented AST with several augmented configurations to ascertain the effectiveness of these systems. Cooper-Harper ratings, tracking errors, and control activity data from the MBS tests have been analyzed statistically. The results show the fully augmented AST handling qualities have been improved to an acceptable level.

13. DETAIL VIEW OF BUTTRESS 4 SHOWING THE RESULTS OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. DETAIL VIEW OF BUTTRESS 4 SHOWING THE RESULTS OF POOR CONSTRUCTION WORK. THOUGH NOT A SERIOUS STRUCTURAL DEFICIENCY, THE 'HONEYCOMB' TEXTURE OF THE CONCRETE SURFACE WAS THE RESULT OF INADEQUATE TAMPING AT THE TIME OF THE INITIAL 'POUR'. - Hume Lake Dam, Sequioa National Forest, Hume, Fresno County, CA

Patient Experience Shows Little Relationship with Hospital Quality Management Strategies.

PubMed

Groene, Oliver; Arah, Onyebuchi A; Klazinga, Niek S; Wagner, Cordula; Bartels, Paul D; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A; Pfaff, Holger; DerSarkissian, Maral; Sunol, Rosa

2015-01-01

Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute myocardial infarction n = 1,379, hip fracture

New Quality Metrics for Web Search Results

NASA Astrophysics Data System (ADS)

Metaxas, Panagiotis Takis; Ivanova, Lilia; Mustafaraj, Eni

Web search results enjoy an increasing importance in our daily lives. But what can be said about their quality, especially when querying a controversial issue? The traditional information retrieval metrics of precision and recall do not provide much insight in the case of web information retrieval. In this paper we examine new ways of evaluating quality in search results: coverage and independence. We give examples on how these new metrics can be calculated and what their values reveal regarding the two major search engines, Google and Yahoo. We have found evidence of low coverage for commercial and medical controversial queries, and high coverage for a political query that is highly contested. Given the fact that search engines are unwilling to tune their search results manually, except in a few cases that have become the source of bad publicity, low coverage and independence reveal the efforts of dedicated groups to manipulate the search results.

14. DETAIL VIEW OF BUTTRESS 4 SHOWING THE RESULTS OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. DETAIL VIEW OF BUTTRESS 4 SHOWING THE RESULTS OF INADEQUATE TAMPING. THE SIZE OF THE GRANITE AGGREGATE USED IN THE DAMS CONCRETE IS CLEARLY SHOWN. - Hume Lake Dam, Sequioa National Forest, Hume, Fresno County, CA

[Active ageing and quality of life--Results of a WHO demonstration project].

PubMed

von dem Knesebeck, O; David, K; Bill, P; Hikl, R

2006-04-01

Based on the Active Ageing Programme of the World Health Organization (WHO), a demonstration project was conducted in a city in North-Rhine Westphalia between October 2002 and December 2004. The aim of the study was to promote an active ageing process, to maintain autonomy and independence among older people, and thereby to promote health and quality of life. The target group included people aged 55 to 80 years. The aim was to include older persons in a critical period of life due to loss of partner within the last five years and people undergoing a status change due to retirement within the last two years. 344 participants were visited at home to assess their health and psychosocial situation and to identify opportunities for activities. Participants were supported in their efforts to realise the agreed-upon activities. In this article results of the external evaluation are presented. It is analysed whether quality of life according to the WHOQOL Bref improves among participants in the course of the project. Results of non-parametric tests show small differences in quality of life between the three waves of interviews (at the beginning of the project, after one year, at the end of the project). This holds true when only those participants are analysed who retired within the last two years. However, quality of life significantly improves among older persons who lost their partner within the last five years. In terms of implementation of the WHO Active Ageing Programme results suggest application of a risk group strategy.

Genome-wide transcriptome study in wheat identified candidate genes related to processing quality, majority of them showing interaction (quality x development) and having temporal and spatial distributions

PubMed Central

2014-01-01

Background The cultivated bread wheat (Triticum aestivum L.) possesses unique flour quality, which can be processed into many end-use food products such as bread, pasta, chapatti (unleavened flat bread), biscuit, etc. The present wheat varieties require improvement in processing quality to meet the increasing demand of better quality food products. However, processing quality is very complex and controlled by many genes, which have not been completely explored. To identify the candidate genes whose expressions changed due to variation in processing quality and interaction (quality x development), genome-wide transcriptome studies were performed in two sets of diverse Indian wheat varieties differing for chapatti quality. It is also important to understand the temporal and spatial distributions of their expressions for designing tissue and growth specific functional genomics experiments. Results Gene-specific two-way ANOVA analysis of expression of about 55 K transcripts in two diverse sets of Indian wheat varieties for chapatti quality at three seed developmental stages identified 236 differentially expressed probe sets (10-fold). Out of 236, 110 probe sets were identified for chapatti quality. Many processing quality related key genes such as glutenin and gliadins, puroindolines, grain softness protein, alpha and beta amylases, proteases, were identified, and many other candidate genes related to cellular and molecular functions were also identified. The ANOVA analysis revealed that the expression of 56 of 110 probe sets was involved in interaction (quality x development). Majority of the probe sets showed differential expression at early stage of seed development i.e. temporal expression. Meta-analysis revealed that the majority of the genes expressed in one or a few growth stages indicating spatial distribution of their expressions. The differential expressions of a few candidate genes such as pre-alpha/beta-gliadin and gamma gliadin were validated by RT

The Second Stroke Audit of Catalonia shows improvements in many, but not all quality indicators.

PubMed

Abilleira, Sònia; Ribera, Aida; Sánchez, Emília; Tresserras, Ricard; Gallofré, Miquel

2012-01-01

Periodic audits allow monitoring of healthcare quality by comparing performances at different time points. Aims To assess quality of in-hospital stroke care in Catalonia in 2007 and compare it with 2005 (post-/preguidelines delivery, respectively). Data on 13 evidence-based performance measures were collected by a retrospective review of medical records of consecutive stroke admissions (January-December 2007) to 47 acute hospitals in Catalonia. Adherence was calculated according to the ratio (patients with documented performance measures' compliance) (valid cases for that measure). Sampling weights were applied to produce estimates of compliance. The proportions of compliance with performance measures in both audits were compared using random-effects logistic regressions, with each performance measure as the dependent variable and audit edition as the explanatory variable to determine whether changes in stroke care quality occurred along time. We analyzed 1767 events distributed among 47 hospitals. In 2007, there was an increase in tissue plasminogen activator administrations (2·8% vs. 5·9%) and stroke unit admissions (16·6% vs. 22·6%) and a reduction in seven-day mortality (9·5% vs. 6·8%). Logistic regression models provided evidence of improved adherences to seven performance measures (screening of dysphagia, management of hyperthermia, baseline computed tomography scan, baseline glycemia, rehabilitation needs, early mobilization, and anticoagulants for atrial fibrillation), but worsening of management of hypertension, dyslipidemia, and antithrombotics at discharge. The remaining three performance measures showed no changes. The Second Stroke Audit showed improvements in most dimensions of care, although unexpectedly a few but relevant performance measures became worse. Therefore, periodic stroke audits are needed to check changes in quality of care over time. © 2011 The Authors. International Journal of Stroke © 2011 World Stroke Organization.

Proteomics Quality Control: Quality Control Software for MaxQuant Results.

PubMed

Bielow, Chris; Mastrobuoni, Guido; Kempa, Stefan

2016-03-04

Mass spectrometry-based proteomics coupled to liquid chromatography has matured into an automatized, high-throughput technology, producing data on the scale of multiple gigabytes per instrument per day. Consequently, an automated quality control (QC) and quality analysis (QA) capable of detecting measurement bias, verifying consistency, and avoiding propagation of error is paramount for instrument operators and scientists in charge of downstream analysis. We have developed an R-based QC pipeline called Proteomics Quality Control (PTXQC) for bottom-up LC-MS data generated by the MaxQuant software pipeline. PTXQC creates a QC report containing a comprehensive and powerful set of QC metrics, augmented with automated scoring functions. The automated scores are collated to create an overview heatmap at the beginning of the report, giving valuable guidance also to nonspecialists. Our software supports a wide range of experimental designs, including stable isotope labeling by amino acids in cell culture (SILAC), tandem mass tags (TMT), and label-free data. Furthermore, we introduce new metrics to score MaxQuant's Match-between-runs (MBR) functionality by which peptide identifications can be transferred across Raw files based on accurate retention time and m/z. Last but not least, PTXQC is easy to install and use and represents the first QC software capable of processing MaxQuant result tables. PTXQC is freely available at https://github.com/cbielow/PTXQC .

Explaining variation in perceived team effectiveness: results from eleven quality improvement collaboratives.

PubMed

Strating, Mathilde M H; Nieboer, Anna P

2013-06-01

Explore effectiveness of 11 collaboratives focusing on 11 different topics, as perceived by local improvement teams and to explore associations with collaborative-, organisational- and team-level factors. Evidence underlying the effectiveness of quality improvement collaboratives is inconclusive and few studies investigated determinants of implementation success. Moreover, most evaluation studies on quality improvement collaboratives are based on one specific topic or quality problem, making it hard to compare across collaboratives addressing different topics. A multiple-case cross-sectional study. Quality improvement teams in 11 quality improvement collaboratives focusing on 11 different topics. Team members received a postal questionnaire at the end of each collaborative. Of the 283 improvement teams, 151 project leaders and 362 team members returned the questionnaire. Analysis of variance revealed that teams varied widely on perceived effectiveness. Especially, members in the Prevention of Malnutrition and Prevention of Medication Errors collaboratives perceived a higher effectiveness than other groups. Multilevel regression analyses showed that educational level of professionals, innovation attributes, organisational support, innovative culture and commitment to change were all significant predictors of perceived effectiveness. In total, 27·9% of the individual-level variance, 57·6% of the team-level variance and 80% of the collaborative-level variance could be explained. The innovation's attributes, organisational support, an innovative team culture and professionals' commitment to change are instrumental to perceived effectiveness. The results support the notion that a layered approach is necessary to achieve improvements in quality of care and provides further insight in the determinants of success of quality improvement collaboratives. Understanding which factors enhance the impact of quality improvement initiatives can help professionals to achieve

Gun Shows and Gun Violence: Fatally Flawed Study Yields Misleading Results

PubMed Central

Hemenway, David; Webster, Daniel; Pierce, Glenn; Braga, Anthony A.

2010-01-01

A widely publicized but unpublished study of the relationship between gun shows and gun violence is being cited in debates about the regulation of gun shows and gun commerce. We believe the study is fatally flawed. A working paper entitled “The Effect of Gun Shows on Gun-Related Deaths: Evidence from California and Texas” outlined this study, which found no association between gun shows and gun-related deaths. We believe the study reflects a limited understanding of gun shows and gun markets and is not statistically powered to detect even an implausibly large effect of gun shows on gun violence. In addition, the research contains serious ascertainment and classification errors, produces results that are sensitive to minor specification changes in key variables and in some cases have no face validity, and is contradicted by 1 of its own authors’ prior research. The study should not be used as evidence in formulating gun policy. PMID:20724672

Gun shows and gun violence: fatally flawed study yields misleading results.

PubMed

Wintemute, Garen J; Hemenway, David; Webster, Daniel; Pierce, Glenn; Braga, Anthony A

2010-10-01

A widely publicized but unpublished study of the relationship between gun shows and gun violence is being cited in debates about the regulation of gun shows and gun commerce. We believe the study is fatally flawed. A working paper entitled "The Effect of Gun Shows on Gun-Related Deaths: Evidence from California and Texas" outlined this study, which found no association between gun shows and gun-related deaths. We believe the study reflects a limited understanding of gun shows and gun markets and is not statistically powered to detect even an implausibly large effect of gun shows on gun violence. In addition, the research contains serious ascertainment and classification errors, produces results that are sensitive to minor specification changes in key variables and in some cases have no face validity, and is contradicted by 1 of its own authors' prior research. The study should not be used as evidence in formulating gun policy.

Better Data Quality for Better Healthcare Research Results - A Case Study.

PubMed

Hart, Robert; Kuo, Mu-Hsing

2017-01-01

Electronic Health Records (EHRs) have been identified as a key tool to collect data for healthcare research. However, EHR data must be of sufficient quality to support quality research results. Island Health, BC, Canada has invested and continues to invest in the development of solutions to address the quality of its EHR data and support high quality healthcare studies. This paper examines Island Health's data quality engine, its development and its successful implementation.

An interrupted time series analysis showed suboptimal improvement in reporting quality of trial abstract.

PubMed

Chhapola, Viswas; Tiwari, Soumya; Brar, Rekha; Kanwal, Sandeep Kumar

2016-03-01

To assess and compare the immediate and long-term change in reporting quality of randomized controlled trial (RCT) abstracts published in Pediatrics, The Journal of Pediatrics, and JAMA Pediatrics before and after the publication of Consolidated Standards of Reporting Trial (CONSORT)-abstract statement. Study had "Interrupted time-series" design. Eligible RCT abstracts were retrieved by PubMed search in two study periods from January 2003 to December 2007 (pre-CONSORT) and January 2010 to December 2014 (post-CONSORT). These abstracts were matched with the CONSORT checklist for abstracts. The primary outcome measure was CONSORT-abstract score defined as number of CONSORT items correctly reported divided by 18 and expressed as percentage. The mean percentage scores were used to compare reporting quality between pre- and post-CONSORT using segmented linear regression. A total of 424 RCT abstracts in pre-CONSORT and 467 in post-CONSORT were analyzed. A significant change in slope of regression line between two time periods (0.151 [confidence interval CI, 0.004-0.298], P = 0.044) was observed. Intercepts did not show a significant difference (-2.39 [CI, 4.93-0.157], P = 0.065). The overall reporting quality of RCT abstracts in the high-impact pediatrics journals was suboptimal (<50%); however, it improved when assessed over a 5-year period, implying slow but gradual adoption of guideline. Copyright © 2016 Elsevier Inc. All rights reserved.

Ride qualities criteria validation/pilot performance study: Flight test results

NASA Technical Reports Server (NTRS)

Nardi, L. U.; Kawana, H. Y.; Greek, D. C.

1979-01-01

Pilot performance during a terrain following flight was studied for ride quality criteria validation. Data from manual and automatic terrain following operations conducted during low level penetrations were analyzed to determine the effect of ride qualities on crew performance. The conditions analyzed included varying levels of turbulence, terrain roughness, and mission duration with a ride smoothing system on and off. Limited validation of the B-1 ride quality criteria and some of the first order interactions between ride qualities and pilot/vehicle performance are highlighted. An earlier B-1 flight simulation program correlated well with the flight test results.

[Risk adjusted assessment of quality of perinatal centers - results of perinatal/neonatal quality surveillance in Saxonia].

PubMed

Koch, R; Gmyrek, D; Vogtmann, Ch

2005-12-01

The weak point of the country-wide perinatal/neonatal quality surveillance as a tool for evaluation of achievements of a distinct clinic, is the ignorance of interhospital differences in the case-mix of patients. Therefore, that approach can not result in a reliable bench marking. To adjust the results of quality assessment of different hospitals according to their risk profile of patients by multivariate analysis. The perinatal/neonatal data base of 12.783 newborns of the saxonian quality surveillance from 1998 to 2000 was analyzed. 4 relevant quality indicators of newborn outcome -- a) severe intraventricular hemorrhage in preterm infants < 1500 g, b) death in hospital of preterm infants < 1500 g, c) death in newborns with birth weight > 2500 g and d) hypoxic-ischemic encephalopathy -- were targeted to find out specific risk predictors by considering 26 risk factors. A logistic regression model was used to develop the risk predictors. Risk predictors for the 4 quality indicators could be described by 3 - 9 out of 26 analyzed risk factors. The AUC (ROC)-values for these quality indicators were 82, 89, 89 and 89 %, what signifies their reliability. Using the new specific predictors for calculation the risk adjusted incidence rates of quality indicator yielded in some remarkable changes. The apparent differences in the outcome criteria of analyzed hospitals were found to be much less pronounced. The application of the proposed method for risk adjustment of quality indicators makes it possible to perform a more objective comparison of neonatal outcome criteria between different hospitals or regions.

External quality assurance of HER2 fluorescence in situ hybridisation testing: results of a UK NEQAS pilot scheme.

PubMed

Bartlett, John M S; Ibrahim, Merdol; Jasani, Bharat; Morgan, John M; Ellis, Ian; Kay, Elaine; Magee, Hilary; Barnett, Sarah; Miller, Keith

2007-07-01

Trastuzumab provides clinical benefit for advanced and early breast cancer patients whose tumours over-express or have gene amplification of the HER2 oncogene. The UK National External Quality Assessment Scheme (NEQAS) for immunohistochemical testing was established to assess and improve the quality of HER2 immunohistochemical testing. However, until recently, no provision was available for HER2 fluorescence in situ hybridisation (FISH) testing. A pilot scheme was set up to review the performance of FISH testing in clinical diagnostic laboratories. FISH was performed in 6 reference and 31 participating laboratories using a cell line panel with known HER2 status. Using results from reference laboratories as a criterion for acceptable performance, 60% of all results returned by participants were appropriate and 78% either appropriate or acceptable. However, 22.4% of results returned were deemed inappropriate, including 13 cases (4.2%) where a misdiagnosis would have been made had these been clinical specimens. The results of three consecutive runs show that both reference laboratories and a proportion of routine clinical diagnostic (about 25%) centres can consistently achieve acceptable quality control of HER2 testing. Data from a significant proportion of participating laboratories show that further steps are required, including those taken via review of performance under schemes such as NEQAS, to improve quality of HER2 testing by FISH in the "real world".

Assessment of national dosimetry quality audits results for teletherapy machines from 1989 to 2015.

PubMed

Muhammad, Wazir; Ullah, Asad; Mahmood, Khalid; Matiullah

2016-01-01

The purpose of this study was to ensure accuracy in radiation dose delivery, external dosimetry quality audit has an equal importance with routine dosimetry performed at clinics. To do so, dosimetry quality audit was organized by the Secondary Standard Dosimetry Laboratory (SSDL) of Pakistan Institute of Nuclear Science and Technology (PINSTECH) at the national level to investigate and minimize uncertainties involved in the measurement of absorbed dose, and to improve the accuracy of dose measurement at different radiotherapy hospitals. A total of 181 dosimetry quality audits (i.e., 102 of Co-60 and 79 of linear accelerators) for teletherapy units installed at 22 different sites were performed from 1989 to 2015. The percent deviation between users’ calculated/stated dose and evaluated dose (in the result of on-site dosimetry visits) were calculated and the results were analyzed with respect to the limits of ± 2.5% (ICRU "optimal model") ± 3.0% (IAEA on-site dosimetry visits limit) and ± 5.0% (ICRU minimal or "lowest acceptable" model). The results showed that out of 181 total on-site dosimetry visits, 20.44%, 16.02%, and 4.42% were out of acceptable limits of ± 2.5% ± 3.0%, and ± 5.0%, respectively. The importance of a proper ongoing quality assurance program, recommendations of the followed protocols, and properly calibrated thermometers, pressure gauges, and humidity meters at radiotherapy hospitals are essential in maintaining consistency and uniformity of absorbed dose measurements for precision in dose delivery.

How does study quality affect the results of a diagnostic meta-analysis?

PubMed Central

Westwood, Marie E; Whiting, Penny F; Kleijnen, Jos

2005-01-01

Background The use of systematic literature review to inform evidence based practice in diagnostics is rapidly expanding. Although the primary diagnostic literature is extensive, studies are often of low methodological quality or poorly reported. There has been no rigorously evaluated, evidence based tool to assess the methodological quality of diagnostic studies. The primary objective of this study was to determine the extent to which variations in the quality of primary studies impact the results of a diagnostic meta-analysis and whether this differs with diagnostic test type. A secondary objective was to contribute to the evaluation of QUADAS, an evidence-based tool for the assessment of quality in diagnostic accuracy studies. Methods This study was conducted as part of large systematic review of tests used in the diagnosis and further investigation of urinary tract infection (UTI) in children. All studies included in this review were assessed using QUADAS, an evidence-based tool for the assessment of quality in systematic reviews of diagnostic accuracy studies. The impact of individual components of QUADAS on a summary measure of diagnostic accuracy was investigated using regression analysis. The review divided the diagnosis and further investigation of UTI into the following three clinical stages: diagnosis of UTI, localisation of infection, and further investigation of the UTI. Each stage used different types of diagnostic test, which were considered to involve different quality concerns. Results Many of the studies included in our review were poorly reported. The proportion of QUADAS items fulfilled was similar for studies in different sections of the review. However, as might be expected, the individual items fulfilled differed between the three clinical stages. Regression analysis found that different items showed a strong association with test performance for the different tests evaluated. These differences were observed both within and between the three

External quality assurance of HER2 fluorescence in situ hybridisation testing: results of a UK NEQAS pilot scheme

PubMed Central

Bartlett, John M S; Ibrahim, Merdol; Jasani, Bharat; Morgan, John M; Ellis, Ian; Kay, Elaine; Magee, Hilary; Barnett, Sarah; Miller, Keith

2007-01-01

Background and Aims Trastuzumab provides clinical benefit for advanced and early breast cancer patients whose tumours over‐express or have gene amplification of the HER2 oncogene. The UK National External Quality Assessment Scheme (NEQAS) for immunohistochemical testing was established to assess and improve the quality of HER2 immunohistochemical testing. However, until recently, no provision was available for HER2 fluorescence in situ hybridisation (FISH) testing. A pilot scheme was set up to review the performance of FISH testing in clinical diagnostic laboratories. Methods FISH was performed in 6 reference and 31 participating laboratories using a cell line panel with known HER2 status. Results Using results from reference laboratories as a criterion for acceptable performance, 60% of all results returned by participants were appropriate and 78% either appropriate or acceptable. However, 22.4% of results returned were deemed inappropriate, including 13 cases (4.2%) where a misdiagnosis would have been made had these been clinical specimens. Conclusions The results of three consecutive runs show that both reference laboratories and a proportion of routine clinical diagnostic (about 25%) centres can consistently achieve acceptable quality control of HER2 testing. Data from a significant proportion of participating laboratories show that further steps are required, including those taken via review of performance under schemes such as NEQAS, to improve quality of HER2 testing by FISH in the “real world”. PMID:16963466

Improving quality of reproductive health care in Senegal through formative supervision: results from four districts

PubMed Central

Suh, Siri; Moreira, Philippe; Ly, Moussa

2007-01-01

Background In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. Methods This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. Results The most notable improvement across regions was in infection prevention. Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Conclusion Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality. PMID:18047678

A quality score for coronary artery tree extraction results

NASA Astrophysics Data System (ADS)

Cao, Qing; Broersen, Alexander; Kitslaar, Pieter H.; Lelieveldt, Boudewijn P. F.; Dijkstra, Jouke

2018-02-01

Coronary artery trees (CATs) are often extracted to aid the fully automatic analysis of coronary artery disease on coronary computed tomography angiography (CCTA) images. Automatically extracted CATs often miss some arteries or include wrong extractions which require manual corrections before performing successive steps. For analyzing a large number of datasets, a manual quality check of the extraction results is time-consuming. This paper presents a method to automatically calculate quality scores for extracted CATs in terms of clinical significance of the extracted arteries and the completeness of the extracted CAT. Both right dominant (RD) and left dominant (LD) anatomical statistical models are generated and exploited in developing the quality score. To automatically determine which model should be used, a dominance type detection method is also designed. Experiments are performed on the automatically extracted and manually refined CATs from 42 datasets to evaluate the proposed quality score. In 39 (92.9%) cases, the proposed method is able to measure the quality of the manually refined CATs with higher scores than the automatically extracted CATs. In a 100-point scale system, the average scores for automatically and manually refined CATs are 82.0 (+/-15.8) and 88.9 (+/-5.4) respectively. The proposed quality score will assist the automatic processing of the CAT extractions for large cohorts which contain both RD and LD cases. To the best of our knowledge, this is the first time that a general quality score for an extracted CAT is presented.

Uncertainty result of biotic index in analysing the water quality of Cikapundung river catchment area, Bandung

NASA Astrophysics Data System (ADS)

Surtikanti, Hertien Koosbandiah

2017-05-01

The Biotic Index was developed in Western Countries in response to the need in water quality evaluation. This method analysis is based on the classification of aquatic macrobenthos as a bioindicator for clean and polluted water. The aim of this study is to compare the analysis of Cikapundung river using 6 different Biotic Indexes. BI Shannon-Weiner, Belgian Biological Index (BBI), Family Biotic Index (FBI), Biological Monitoring Working Party (BMWP), Biological Monitoring Working Party-Average Score Per Taxon (BMWP-ASPT), and A Scoring System for Macroinvertebrate in Australian River (A SIGNAL). Those analysis are compared with Physical Water Index (CPI) which is developed in Indonesia. The result shows that a decreasing water quality is detected upstream to downstream of Cikapundung River. However, based on the CPI analysis result, the BMWP-ASPT biotic index analysis is more comprehensive than other BI in explaining Cikapundung water quality.

Higher quality of molecular testing, an unfulfilled priority: Results from external quality assessment for KRAS mutation testing in colorectal cancer.

PubMed

Tembuyser, Lien; Ligtenberg, Marjolijn J L; Normanno, Nicola; Delen, Sofie; van Krieken, J Han; Dequeker, Elisabeth M C

2014-05-01

Precision medicine is now a key element in clinical oncology. RAS mutational status is a crucial predictor of responsiveness to anti-epidermal growth factor receptor agents in metastatic colorectal cancer. In an effort to guarantee high-quality testing services in molecular pathology, the European Society of Pathology has been organizing an annual KRAS external quality assessment program since 2009. In 2012, 10 formalin-fixed, paraffin-embedded samples, of which 8 from invasive metastatic colorectal cancer tissue and 2 artificial samples of cell line material, were sent to more than 100 laboratories from 26 countries with a request for routine KRAS testing. Both genotyping and clinical reports were assessed independently. Twenty-seven percent of the participants genotyped at least 1 of 10 samples incorrectly. In total, less than 5% of the distributed specimens were genotyped incorrectly. Genotyping errors consisted of false negatives, false positives, and incorrectly genotyped mutations. Twenty percent of the laboratories reported a technical error for one or more samples. A review of the written reports showed that several essential elements were missing, most notably a clinical interpretation of the test result, the method sensitivity, and the use of a reference sequence. External quality assessment serves as a valuable educational tool in assessing and improving molecular testing quality and is an important asset for monitoring quality assurance upon incorporation of new biomarkers in diagnostic services. Copyright © 2014 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

The MicroArray Quality Control (MAQC) project shows inter- and intraplatform reproducibility of gene expression measurements

PubMed Central

2012-01-01

Over the last decade, the introduction of microarray technology has had a profound impact on gene expression research. The publication of studies with dissimilar or altogether contradictory results, obtained using different microarray platforms to analyze identical RNA samples, has raised concerns about the reliability of this technology. The MicroArray Quality Control (MAQC) project was initiated to address these concerns, as well as other performance and data analysis issues. Expression data on four titration pools from two distinct reference RNA samples were generated at multiple test sites using a variety of microarray-based and alternative technology platforms. Here we describe the experimental design and probe mapping efforts behind the MAQC project. We show intraplatform consistency across test sites as well as a high level of interplatform concordance in terms of genes identified as differentially expressed. This study provides a resource that represents an important first step toward establishing a framework for the use of microarrays in clinical and regulatory settings. PMID:16964229

Colostomy irrigation: results of 25 cases with particular reference to quality of life.

PubMed

Karadağ, Ayişe; Menteş, B Bülent; Ayaz, Sultan

2005-04-01

The aim of this study was to document our results with colostomy irrigation with particular emphasis on the possible contribution of irrigation on quality of life. Colostomy irrigation is a useful method of achieving faecal continence in selected conditions, and may improve quality of life. When successful, irrigation offers a regular, predictable elimination pattern and only a small covering is needed for security between irrigations. The digestive disease quality of life questionnaire-15 (DDQ-15) and Short Form-36 were used to analyse quality of life before and 12 months after stomatherapy in a series of 25 irrigating patients with permanent end colostomies. During the same time period, 10 similar patients with left-end colostomies who also received counselling but did not consent to colostomy irrigation were also analysed for comparison. Colostomy irrigation was found to be effective for achieving faecal continence in selected patients with end colostomies with no complications or significant side-effects, The digestive disease quality of life questionnaire-15 score improved significantly in both groups after stomatherapy (P < 0.0001 and P = 0.009 in the irrigating and non-irrigating groups respectively). The poststomatherapy digestive disease quality of life questionnaire-15 score of the irrigating group was also significantly higher than that of the non-irrigating group (P = 0.039). Although none of the poststomatherapy item scales of Short Form-36 differed significantly between the two groups, stomatherapy with CI resulted in significant improvements in role limitation due to physical problems, social functioning, role limitation due to emotional problems, general mental health, vitality and bodily pain (P < 0.05 for all comparisons). On the contrary, the non-irrigating patient group showed significant improvements only in social functioning and general mental health. Our findings suggest that colostomy irrigation can be a useful method of achieving faecal

Evaluation of Aesthetic and Quality-of-Life Results after Immediate Breast Reconstruction with Definitive Form-Stable Anatomical Implants.

PubMed

Kuroda, Flavia; Urban, Cicero; Zucca-Matthes, Gustavo; de Oliveira, Vilmar Marques; Arana, Gabriel Hubner; Iera, Marco; Rietjens, Mario; Santos, Gabriela; Spagnol, Caroline; de Lima, Rubens Silveira

2016-02-01

Although there are many reports on different techniques in breast reconstruction, there are few data regarding immediate breast reconstruction with definitive form-stable anatomical implants in terms of aesthetics and quality-of-life outcomes. Ninety-four patients underwent mastectomy with immediate breast reconstruction using anatomical implants and contralateral symmetrization. Aesthetic results were evaluated by three different methods: the patient's self-report, the assessment of four independent specialists (two breast surgeons and two plastic surgeons from different institutions), and the BCCT.core software. Quality of life was evaluated by means of the BREAST-Q instrument. Average age ± SD was 52.1 ± 11.6 years. Most of patients had medium size breasts and T1 tumors. Patients had evaluated their aesthetic results better than did software and specialists. There was no significant difference in the comparison between software and specialist's evaluation. Multifactorial analysis showed that age older than 70 years and radiotherapy were significant risk factors for poor aesthetic outcomes after immediate breast reconstruction with implants. Considering quality of life, most of the patients were satisfied with their outcome and psychosocial and sexual well-being. Immediate breast reconstruction with implants and contralateral symmetrization had a positive impact on the quality of life and showed satisfactory outcomes when evaluated by subjective and objective methods.

European external quality control study on the competence of laboratories to recognize rare sequence variants resulting in unusual genotyping results.

PubMed

Márki-Zay, János; Klein, Christoph L; Gancberg, David; Schimmel, Heinz G; Dux, László

2009-04-01

Depending on the method used, rare sequence variants adjacent to the single nucleotide polymorphism (SNP) of interest may cause unusual or erroneous genotyping results. Because such rare variants are known for many genes commonly tested in diagnostic laboratories, we organized a proficiency study to assess their influence on the accuracy of reported laboratory results. Four external quality control materials were processed and sent to 283 laboratories through 3 EQA organizers for analysis of the prothrombin 20210G>A mutation. Two of these quality control materials contained sequence variants introduced by site-directed mutagenesis. One hundred eighty-nine laboratories participated in the study. When samples gave a usual result with the method applied, the error rate was 5.1%. Detailed analysis showed that more than 70% of the failures were reported from only 9 laboratories. Allele-specific amplification-based PCR had a much higher error rate than other methods (18.3% vs 2.9%). The variants 20209C>T and [20175T>G; 20179_20180delAC] resulted in unusual genotyping results in 67 and 85 laboratories, respectively. Eighty-three (54.6%) of these unusual results were not recognized, 32 (21.1%) were attributed to technical issues, and only 37 (24.3%) were recognized as another sequence variant. Our findings revealed that some of the participating laboratories were not able to recognize and correctly interpret unusual genotyping results caused by rare SNPs. Our study indicates that the majority of the failures could be avoided by improved training and careful selection and validation of the methods applied.

[Patient-doctor interaction in rehabilitation: is there a relationship between perceived interaction quality and long term treatment results?].

PubMed

Dibbelt, S; Schaidhammer, M; Fleischer, C; Greitemann, B

2010-10-01

showed low but significant correlations with patient-related aspects like coping with disease, health-related knowledge and former positive experiences with physicians. A stepwise regression analysis revealed that interaction quality seems to contribute to enhanced treatment results independently of patients' competences. Our results suggest a positive relationship between perceived interaction quality as defined by the P.A.INT-Questionnaire and treatment effects 6 months after discharge. Comparisons of patient and physician evaluations showed that physicians seem to be successful in building relationships on the affective level but less successful on the instrumental level (i. e., information, structuring and reinforcement). Our data underline the importance of interaction quality for the success of rehabilitation and thus the importance of specific skills such as providing and collecting information, recognizing patients' concerns and goals as well as reinforcement of health-related action. This is especially important when knowledge of disease and coping with disease on patients' side is poor. Interaction quality seems to contribute to better treatment results independently of patients' competences. © Georg Thieme Verlag KG Stuttgart · New York.

Fuel quality-processing study. Volume 1: Overview and results

NASA Technical Reports Server (NTRS)

Jones, G. E., Jr.

1982-01-01

The methods whereby the intermediate results were obtained are outlined, and the evaluation of the feasible paths from liquid fossil fuel sources to generated electricity is presented. The segments from which these paths were built are the results from the fuel upgrading schemes, on-site treatments, and exhaust gas treatments detailed in the subsequent volumes. The salient cost and quality parameters are included.

SF-36 Shows Increased Quality of Life Following Complete Reduction of Postmastectomy Lymphedema with Liposuction

PubMed Central

Bagheri, Shirin; Hansson, Emma; Manjer, Jonas; Troëng, Thomas; Brorson, Håkan

2017-01-01

Abstracts Background: Arm lymphedema after breast cancer surgery affects women both from physical and psychological points of view. Lymphedema leads to adipose tissue deposition. Liposuction and controlled compression therapy (CCT) reduces the lymphedema completely. Methods and Results: Sixty female patients with arm lymphedema were followed for a 1-year period after surgery. The 36-item short-form health survey (SF-36) was used to assess health-related quality of life (HRQoL). Patients completed the SF-36 questionnaire before liposuction, and after 1, 3, 6, and 12 months. Preoperative excess arm volume was 1365 ± 73 mL. Complete reduction was achieved after 3 months and was sustained during follow-up. The adipose tissue volume removed at surgery was 1373 ± 56 mL. One month after liposuction, better scores were found in mental health. After 3 months, an increase in physical functioning, bodily pain, and vitality was detected. After 1 year, an increase was also seen for social functioning. The physical component score was higher at 3 months and thereafter, while the mental component score was improved at 3 and 12 months. Compared with SF-36 norm data for the Swedish population, only physical functioning showed lower values than the norm at baseline. After liposuction, general health, bodily pain, vitality, mental health, and social functioning showed higher values at various time points. Conclusions: Liposuction of arm lymphedema in combination with CCT improves patients HRQoL as measured with SF-36. The treatment seems to target and improve both the physical and mental health domains. PMID:28135120

Genome-wide transcriptome study in wheat identified candidate genes related to processing quality, majority of them showing interaction (quality x development) and having temporal and spatial distributions.

PubMed

Singh, Anuradha; Mantri, Shrikant; Sharma, Monica; Chaudhury, Ashok; Tuli, Rakesh; Roy, Joy

2014-01-16

The cultivated bread wheat (Triticum aestivum L.) possesses unique flour quality, which can be processed into many end-use food products such as bread, pasta, chapatti (unleavened flat bread), biscuit, etc. The present wheat varieties require improvement in processing quality to meet the increasing demand of better quality food products. However, processing quality is very complex and controlled by many genes, which have not been completely explored. To identify the candidate genes whose expressions changed due to variation in processing quality and interaction (quality x development), genome-wide transcriptome studies were performed in two sets of diverse Indian wheat varieties differing for chapatti quality. It is also important to understand the temporal and spatial distributions of their expressions for designing tissue and growth specific functional genomics experiments. Gene-specific two-way ANOVA analysis of expression of about 55 K transcripts in two diverse sets of Indian wheat varieties for chapatti quality at three seed developmental stages identified 236 differentially expressed probe sets (10-fold). Out of 236, 110 probe sets were identified for chapatti quality. Many processing quality related key genes such as glutenin and gliadins, puroindolines, grain softness protein, alpha and beta amylases, proteases, were identified, and many other candidate genes related to cellular and molecular functions were also identified. The ANOVA analysis revealed that the expression of 56 of 110 probe sets was involved in interaction (quality x development). Majority of the probe sets showed differential expression at early stage of seed development i.e. temporal expression. Meta-analysis revealed that the majority of the genes expressed in one or a few growth stages indicating spatial distribution of their expressions. The differential expressions of a few candidate genes such as pre-alpha/beta-gliadin and gamma gliadin were validated by RT-PCR. Therefore, this study

Vestibular schwannomas: clinical results and quality of life after microsurgery or gamma knife radiosurgery.

PubMed

Myrseth, Erling; Møller, Per; Pedersen, Paal-Henning; Vassbotn, Flemming S; Wentzel-Larsen, Tore; Lund-Johansen, Morten

2005-05-01

The aim of the present study was to evaluate the overall treatment efficacy (tumor control, facial nerve function, complications) and quality of life for patients treated primarily for unilateral vestibular schwannomas of 30 mm or less, either by microsurgery or by gamma knife (GK) radiosurgery. The results for the two treatment groups are compared with each other, with main emphasis on the long-term quality of life. This is a retrospective study of 189 consecutive patients, 86 treated by microsurgery and 103 by gamma knife. The mean observation time was 5.9 years. All patients had a magnetic resonance imaging scan and clinical evaluation performed toward the end of the study. To evaluate the quality of life, we used two standardized questionnaires, the Glasgow Benefit Inventory and Short-Form 36. The questionnaires were sent to the 168 living patients. The reply rate was 83.3%. A total of 79.8% of the patients in the microsurgery group and 94.8% of the GK patients had a good facial nerve function (House-Brackmann Grade 1-2). Hearing was usually lost after microsurgery, whereas the GK patients had preserved hearing, which often became reduced over the years after the treatment. The treatment efficacy, defined as no need for additional treatment, was similar for the two treatment modalities. Quality of life was reduced compared with normative data, being most reduced in the microsurgery group. Some of the quality of life questions showed an association with facial nerve function and sex. Posttreatment facial nerve function, hearing, complication rates, and quality of life were all significantly in favor of GK radiosurgery.

Influence of raw milk quality on processed dairy products: How do raw milk quality test results relate to product quality and yield?

PubMed

Murphy, Steven C; Martin, Nicole H; Barbano, David M; Wiedmann, Martin

2016-12-01

This article provides an overview of the influence of raw milk quality on the quality of processed dairy products and offers a perspective on the merits of investing in quality. Dairy farmers are frequently offered monetary premium incentives to provide high-quality milk to processors. These incentives are most often based on raw milk somatic cell and bacteria count levels well below the regulatory public health-based limits. Justification for these incentive payments can be based on improved processed product quality and manufacturing efficiencies that provide the processor with a return on their investment for high-quality raw milk. In some cases, this return on investment is difficult to measure. Raw milks with high levels of somatic cells and bacteria are associated with increased enzyme activity that can result in product defects. Use of raw milk with somatic cell counts >100,000cells/mL has been shown to reduce cheese yields, and higher levels, generally >400,000 cells/mL, have been associated with textural and flavor defects in cheese and other products. Although most research indicates that fairly high total bacteria counts (>1,000,000 cfu/mL) in raw milk are needed to cause defects in most processed dairy products, receiving high-quality milk from the farm allows some flexibility for handling raw milk, which can increase efficiencies and reduce the risk of raw milk reaching bacterial levels of concern. Monitoring total bacterial numbers in regard to raw milk quality is imperative, but determining levels of specific types of bacteria present has gained increasing importance. For example, spores of certain spore-forming bacteria present in raw milk at very low levels (e.g., <1/mL) can survive pasteurization and grow in milk and cheese products to levels that result in defects. With the exception of meeting product specifications often required for milk powders, testing for specific spore-forming groups is currently not used in quality incentive programs in

Annual Report Card Shows Water Quality Improvements in Parts of the Mystic River Watershed

EPA Pesticide Factsheets

Each year, the US Environmental Protection Agency (EPA), in collaboration with the Mystic River Watershed Association (MyRWA), issues a Water Quality Report Card on water quality in the Mystic River watershed.

Quality initiatives: improving patient flow for a bone densitometry practice: results from a Mayo Clinic radiology quality initiative.

PubMed

Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K

2010-03-01

Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes.

Quality of the Exotic Parasitoid Cotesia flavipes (Hymenoptera: Braconidae) Does Not Show Deleterious Effects after Inbreeding for 10 Generations.

PubMed

Trevisan, Maíra; De Bortoli, Sergio A; Vacari, Alessandra M; Laurentis, Valéria L; Ramalho, Dagmara G

2016-01-01

Although the parasitoid Cotesia flavipes (Cameron) has proven effective in controlling sugarcane borer Diatraea saccharalis (Fabricius) for many years, concern has arisen over the quality of individuals produced at large scales. The parasitoid has been reared in laboratories in Brazil for more than 40 years, with no new introductions of new populations during that period. Since the quality of the parasitoids was not verified at the time of the species' introduction in Brazil, we do not know if there has been any reduction in quality so far. However, it is possible to determine whether the parasitoid could reduce in quality in future generations. Thus, the objective of this research was to assess the quality of these insects over 10 generations and look for evidence of any loss in quality. We used two populations: one from a biofactory that has been maintained in the laboratory for over 40 years, and an inbred laboratory population. Both were bred, and compared for 10 generations. We wanted to determine what happened to the quality of the parasitoid after 10 generations in an extreme inbreeding situation. To assure inbreeding, newly emerged females were forced to mate with a sibling. Individual females were then allowed to parasitize larvae of D. saccharalis. We performed evaluations for each generation until the tenth generation, and recorded the sex ratio, percentage emergence, number of offspring/females, and longevity of both males and females. Results of the measurements of biological characteristics demonstrated random significant differences between populations; best results were obtained intermittently for both the biofactory population and the inbred population. No significant differences across generations for the same population were observed. Thus, rearing of a C. flavipes population subjected to inbreeding for 10 generations was not sufficient to reveal any deleterious effects of inbreeding.

[Audit system on quality of breast cancer diagnosis and treatment: results of quality indicators on screen-detected lesions in Italy, 2010].

PubMed

Ponti, Antonio; Mano, Maria Piera; Tomatis, Mariano; Baiocchi, Diego; Barca, Alessandra; Berti, Rosa; Bisanti, Luigi; Casella, Denise; Deandrea, Silvia; Delrio, Daria; Donati, Giovanni; Falcini, Fabio; Frammartino, Brunella; Frigerio, Alfonso; Mantellini, Paola; Naldoni, Carlo; Orzalesi, Lorenzo; Pagano, Giovanni; Pietribiasi, Francesca; Ravaioli, Alessandra; Sedda, Maria Laura; Taffurelli, Mario; Cataliotti, Luigi; Segnan, Nereo

2012-01-01

This survey, conducted by the Italian breast screening network (GISMa), collects yearly individual data on diagnosis and treatment on about 50% of all screen-detected, operated lesions in Italy. The 2010 results show good overall quality and an improving trend over time. Critical issues were identified, including waiting times and compliance with the recommendations on not performing frozen section examination on small lesions. Preoperative diagnosis improved constantly over the years, but there is still a large variation between regions and programmes. For almost 90% of screen-detected invasive cancers the sentinel lymph node technique (SLN) was performed on the axilla, avoiding a large number of potentially harmful dissections. On the other hand, potential overuse of SLN for ductal carcinoma in situ deserves further investigation. The detailed results have been distributed, also by means of a web data warehouse, to regional and local screening programmes in order to allow multidisciplinary discussion and identification of the appropriate solutions to any issues documented by the data. It should be assigned priority to the problem of waiting times. Specialist Breast Units with adequate case volume and enough resources would provide the best setting for making monitoring effective in producing quality improvements with shorter waiting times.

[Analysis of the results of the SEIMC External Quality Control Program. Year 2013].

PubMed

de Gopegui Bordes, Enrique Ruiz; Orta Mira, Nieves; Del Remedio Guna Serrano, M; Medina González, Rafael; Rosario Ovies, María; Poveda, Marta; Gimeno Cardona, Concepción

2015-07-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology, molecular microbiology and HIV-1, HCV and HBV viral loads. This manuscript presents the analysis of results obtained of the participants from the 2013 SEIMC External Quality Control Programme, except viral loads controls, that they are summarized in a manuscript abroad. As a whole, the results obtained in 2013 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

[Quality of life and job performance resulting from operatively treated tibial plateau fractures].

PubMed

Roßbach, B P; Faymonville, C; Müller, L P; Stützer, H; Isenberg, J

2016-01-01

The aim of this article is to present the functional results and the effect on quality of life of surgically treated tibial plateau fractures in physically active and working patients with multiple and serious injuries. In addition, the relationships between functional and radiological outcome were evaluated and compared with activity in daily and professional life. In all, 41 injured patients were followed up a mean of 47 months after surgical treatment and examined with radiological, functional, as well as quality of life score. In the radiological scoring, a mean value of 72 points (max 100 points) was achieved. In the activity score, there was an average of 63.5 points (max 100 points). When evaluating the health-related quality of life, an average score of 69.6 points was achieved. There was a significant relationship between radiological and activity scores and the radiological and life quality scores. Furthermore, the relationship between activity and quality of life scores was considered significant. Surgeon's influence on the functional outcome could be confirmed. The functional and the radiological results were moderate. Quality of life was permanently affected by the consequences of tibial plateau fracture in 12 patients; 11 patients were not re-employed. However, the quality of life was assessed as good or very good and 28 patients had returned to work. The quality of life was firmly linked to the radiological and functional parameters, which tended to be influenced by the quality of the primary surgical treatment when looking at the overall population.

Phase quality map based on local multi-unwrapped results for two-dimensional phase unwrapping.

PubMed

Zhong, Heping; Tang, Jinsong; Zhang, Sen

2015-02-01

The efficiency of a phase unwrapping algorithm and the reliability of the corresponding unwrapped result are two key problems in reconstructing the digital elevation model of a scene from its interferometric synthetic aperture radar (InSAR) or interferometric synthetic aperture sonar (InSAS) data. In this paper, a new phase quality map is designed and implemented in a graphic processing unit (GPU) environment, which greatly accelerates the unwrapping process of the quality-guided algorithm and enhances the correctness of the unwrapped result. In a local wrapped phase window, the center point is selected as the reference point, and then two unwrapped results are computed by integrating in two different simple ways. After the two local unwrapped results are computed, the total difference of the two unwrapped results is regarded as the phase quality value of the center point. In order to accelerate the computing process of the new proposed quality map, we have implemented it in a GPU environment. The wrapped phase data are first uploaded to the memory of a device, and then the kernel function is called in the device to compute the phase quality in parallel by blocks of threads. Unwrapping tests performed on the simulated and real InSAS data confirm the accuracy and efficiency of the proposed method.

[Practice report: the process-based indicator dashboard. Visualising quality assurance results in standardised processes].

PubMed

Petzold, Thomas; Hertzschuch, Diana; Elchlep, Frank; Eberlein-Gonska, Maria

2014-01-01

Process management (PM) is a valuable method for the systematic analysis and structural optimisation of the quality and safety of clinical treatment. PM requires a high motivation and willingness to implement changes of both employees and management. Definition of quality indicators is required to systematically measure the quality of the specified processes. One way to represent comparable quality results is the use of quality indicators of the external quality assurance in accordance with Sect. 137 SGB V—a method which the Federal Joint Committee (GBA) and the institutions commissioned by the GBA have employed and consistently enhanced for more than ten years. Information on the quality of inpatient treatment is available for 30 defined subjects throughout Germany. The combination of specified processes with quality indicators is beneficial for the information of employees. A process-based indicator dashboard provides essential information about the treatment process. These can be used for process analysis. In a continuous consideration of these indicator results values can be determined and errors will be remedied quickly. If due consideration is given to these indicators, they can be used for benchmarking to identify potential process improvements. Copyright © 2014. Published by Elsevier GmbH.

Lean practices for quality results: a case illustration.

PubMed

Hwang, Pauline; Hwang, David; Hong, Paul

2014-01-01

Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations. The model is based on an extant literature review and a case illustration that explores actual lean implementation in a major USA hospital located in a Midwestern city (approximately 300,000 people). An exploratory/descriptive study using observation and follow-up interviews was conducted to identify lean practices in the hospital. Lean practice key drivers include growing elderly populations, rising medical expenses, decreasing insurance coverage and decreasing management support. Effectively implementing lean practices to increase bottom-line results and improve organisational integrity requires sharing goals and processes among healthcare managers and professionals. An illustration explains the model and the study provides a sound foundation for empirical work. Practical implications are included. Lean practices minimise waste and unnecessary hospital stays while simultaneously enhancing customer values and deploying resources in supply systems. Leadership requires clear project targets based on sound front-end planning because initial implementation steps involve uncertainty and ambiguity (i.e. fuzzy front-end planning). Since top management support is crucial for implementing lean practices successfully, a heavyweight manager, who communicates well both with top managers and project team members, is an important success factor when implementing lean practices. Increasingly, green orientation and sustainability initiatives are phrases that replaced lean practices. Effective results; e.g. waste reduction, employee satisfaction and customer values are applicable to bigger competitive challenges arising both in specific

Testing Delays Resulting in Increased Identification Accuracy in Line-Ups and Show-Ups.

ERIC Educational Resources Information Center

Dekle, Dawn J.

1997-01-01

Investigated time delays (immediate, two-three days, one week) between viewing a staged theft and attempting an eyewitness identification. Compared lineups to one-person showups in a laboratory analogue involving 412 subjects. Results show that across all time delays, participants maintained a higher identification accuracy with the showup…

Published methodological quality of randomized controlled trials does not reflect the actual quality assessed in protocols

PubMed Central

Mhaskar, Rahul; Djulbegovic, Benjamin; Magazin, Anja; Soares, Heloisa P.; Kumar, Ambuj

2011-01-01

Objectives To assess whether reported methodological quality of randomized controlled trials (RCTs) reflect the actual methodological quality, and to evaluate the association of effect size (ES) and sample size with methodological quality. Study design Systematic review Setting Retrospective analysis of all consecutive phase III RCTs published by 8 National Cancer Institute Cooperative Groups until year 2006. Data were extracted from protocols (actual quality) and publications (reported quality) for each study. Results 429 RCTs met the inclusion criteria. Overall reporting of methodological quality was poor and did not reflect the actual high methodological quality of RCTs. The results showed no association between sample size and actual methodological quality of a trial. Poor reporting of allocation concealment and blinding exaggerated the ES by 6% (ratio of hazard ratio [RHR]: 0.94, 95%CI: 0.88, 0.99) and 24% (RHR: 1.24, 95%CI: 1.05, 1.43), respectively. However, actual quality assessment showed no association between ES and methodological quality. Conclusion The largest study to-date shows poor quality of reporting does not reflect the actual high methodological quality. Assessment of the impact of quality on the ES based on reported quality can produce misleading results. PMID:22424985

Failure of Quality Control Measures To Prevent Reporting of False Resistance to Imipenem, Resulting in a Pseudo-Outbreak of Imipenem-Resistant Pseudomonas aeruginosa

PubMed Central

Carmeli, Yehuda; Eichelberger, Karen; Soja, Don; Dakos, Joanna; Venkataraman, Lata; DeGirolami, Paola; Samore, Matthew

1998-01-01

False results showing an outbreak of Pseudomonas aeruginosa with resistance to imipenem were traced to a defective lot of microdilution MIC testing panels. These panels contained two- to threefold lower concentrations of imipenem than expected and resulted in artifactual two- to fourfold increases in MICs of imipenem. The quality-control MIC results for Pseudomonas aeruginosa ATCC 27853 were 4 μg/ml, the highest value within the range recommended by the National Committee for Clinical Laboratory Standards. We recommend that this value be considered out of the quality-control range. PMID:9466787

In Urban And Rural India, A Standardized Patient Study Showed Low Levels Of Provider Training And Huge Quality Gaps

PubMed Central

Das, Jishnu; Holla, Alaka; Das, Veena; Mohanan, Manoj; Tabak, Diana; Chan, Brian

2013-01-01

This article reports on the quality of care delivered by private and public providers of primary health care services in rural and urban India. To measure quality, the study used standardized patients recruited from the local community and trained to present consistent cases of illness to providers. We found low overall levels of medical training among health care providers; in rural Madhya Pradesh, for example, 67 percent of health care providers who were sampled reported no medical qualifications at all. What’s more, we found only small differences between trained and untrained doctors in such areas as adherence to clinical checklists. Correct diagnoses were rare, incorrect treatments were widely prescribed, and adherence to clinical checklists was higher in private than in public clinics. Our results suggest an urgent need to measure the quality of health care services systematically and to improve the quality of medical education and continuing education programs, among other policy changes. PMID:23213162

POSNA Quality Safety Value Initiative: From Vision to Implementation to Early Results.

PubMed

Waters, Peter M; Flynn, John M

2015-01-01

The POSNA Quality, Safety and Value Initiative (QSVI) formally started with POSNA board approval in early 2011. The initial vision statement was: "To lead in defining our members' value based clinical care. To partner with hospital based and orthopedic organizational efforts to guarantee safe, high quality outcomes for our patients. To communicate our initiatives and results cooperatively with payer, credentialing, and compliance organizations to improve pediatric orthopedic care in North America."

Evaluating and improving the results of air quality models in Texas using TES, AIRS and other satellite data

NASA Astrophysics Data System (ADS)

Osterman, G.; Harper, C.; Estes, M.; Zhao, W.; Bowman, K.; Pierce, B.; Irion, B.; Kahn, B.; Al-Saadi, J.

2008-05-01

The Houston/Galveston/Brazoria (HGB) area of Texas has been classified as in moderate nonattainment of the Environmental Protection Agency (EPA) 8-hour standard for ground level ozone since April 30, 2004. The Texas Commission on Environmental Quality uses photochemical model results as one of its primary tools to develop strategies to bring the HGB area into attainment with the EPA standard. The state of Texas then includes the strategies into a revised version of its State Implementation Plan (SIP). We will discuss efforts that have been or soon will be underway to use satellite data to evaluate and improve the meteorological and photochemical modeling efforts at TCEQ. In particular we will show the use of GOES, AIRS and TES data to improve the ability to model, using the MM5 model, the meteorological conditions over Texas and the Gulf of Mexico. The meteorological fields are then used as one of the inputs to the CAMx air quality model used at TCEQ. We will discuss the use of chemical transport model results as initial and boundary conditions which are a key uncertainty in the modeling of the air above Houston. We will also discuss the use of TES data to assist in the evaluation of preliminary model results generated by TCEQ for time periods in 2005. The satellite data will provide key information on ozone and carbon monoxide concentrations away from surface monitors in the troposphere. We will show how satellite data is becoming a key tool in the effort to improve air quality in the HGB area and one that can easily applied for use in other regions of the country.

Do social relations buffer the effect of neighborhood deprivation on health-related quality of life? Results from the LifeLines Cohort Study.

PubMed

Klijs, Bart; Mendes de Leon, Carlos F; Kibele, Eva U B; Smidt, Nynke

2017-03-01

We investigated whether social relations buffer the effect of neighborhood deprivation on mental and physical health-related quality of life. Baseline data from the LifeLines Cohort Study (N=68,111) and a neighborhood deprivation index were used to perform mixed effect linear regression analyses. Results showed that fewer personal contacts (b, 95%CI: -0.88(-1.08;-0.67)) and lower social need fulfillment (-4.52(-4.67;-4.36)) are associated with lower mental health-related quality of life. Higher neighborhood deprivation was also associated with lower mental health related quality of life (-0.18(-0.24;-0.11)), but only for those with few personal contacts or low social need fulfillment. Our results suggest that social relations buffer the effect of neighborhood deprivation on mental health-related quality of life. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Process quality indicators in family medicine: results of an international comparison.

PubMed

Pavlič, Danica Rotar; Sever, Maja; Klemenc-Ketiš, Zalika; Švab, Igor

2015-12-02

The aim of our study was to describe variability in process quality in family medicine among 31 European countries plus Australia, New Zealand, and Canada. The quality of family medicine was measured in terms of continuity, coordination, community orientation, and comprehensiveness of care. The QUALICOPC study (Quality and Costs of Primary Care in Europe) was carried out among family physicians in 31 European countries (the EU 27 except for France, plus Macedonia, Iceland, Norway, Switzerland, and Turkey) and three non-European countries (Australia, Canada, and New Zealand). We used random sampling when national registers of practitioners were available. Regional registers or lists of facilities were used for some countries. A standardized questionnaire was distributed to the physicians, resulting in a sample of 6734 participants. Data collection took place between October 2011 and December 2013. Based on completed questionnaires, a three-dimensional framework was established to measure continuity, coordination, community orientation, and comprehensiveness of care. Multilevel linear regression analysis was performed to evaluate the variation of quality attributable to the family physician level and the country level. None of the 34 countries in this study consistently scored the best or worst in all categories. Continuity of care was perceived by family physicians as the most important dimension of quality. Some components of comprehensiveness of care, including medical technical procedures, preventive care and health care promotion, varied substantially between countries. Coordination of care was identified as the weakest part of quality. We found that physician-level characteristics contributed to the majority of variation. A comparison of process quality indicators in family medicine revealed similarities and differences within and between countries. The researchers found that the major proportion of variation can be explained by physicians' characteristics.

A Case Study Showing Parameters Affecting the Quality of Education: Faculty Perspective

ERIC Educational Resources Information Center

Kumari, Neeraj

2014-01-01

The study aims to examine the faculty members' perspective (age Wise, Gender Wise and Work Experience wise) of parameters affecting the quality of education in an affiliated Undergraduate Engineering Institution in Haryana. It is a descriptive type of research. The data has been collected with the help of 'Questionnaire Based Survey'. The sample…

Hidden consequences of success in pediatrics: parental health-related quality of life--results from the Care Project.

PubMed

Hatzmann, Janneke; Heymans, Hugo S A; Ferrer-i-Carbonell, Ada; van Praag, Bernard M S; Grootenhuis, Martha A

2008-11-01

The number of parents who care for a chronically ill child is increasing. Because of advances in medical care, parental caring tasks are changing. A detailed description of parental health-related quality of life will add to the understanding of the impact of caring for a chronically ill child. This will contribute to pediatric family care. Our goal was to determine the health-related quality of life of parents of chronically ill children compared with parents of healthy schoolchildren. A survey of 533 parents of children with chronic conditions (10 diagnosis groups, children aged 1-19 years, diagnosed >1 year ago, living at home) and 443 parents of schoolchildren was conducted between January 2006 and September 2007. Parents were approached through Emma Children's Hospital (which has a tertiary referral and a regional function) and through parent associations. The comparison group included parents of healthy schoolchildren. Health-related quality of life was assessed with the TNO-AZL Questionnaire for Adult's Health Related Quality of Life. Health-related quality of life measures gross and fine motor function, cognitive functioning, sleep, pain, social functioning, daily activities, sexuality, vitality, positive and depressive emotions, and aggressiveness. The health-related quality of life of the study group was compared with that of the comparison group, and effect sizes were estimated. The percentages of parents at risk for a low health-related quality of life were compared with the 25th percentile scores of the comparison group. RESULTS. Parents of chronically ill children had a significantly lower health-related quality of life. Subgroup analysis showed lower health-related quality of life on sleep, social functioning, daily activities, vitality, positive emotions, and depressive emotions in disease-specific groups. On average, 45% of the parents were at risk for health-related quality-of-life impairment. Parents of chronically ill children report a seriously

Adenoma Detection Rate: I Will Show You Mine if You Show Me Yours

PubMed Central

Oliveira Ferreira, Alexandre; Fidalgo, Catarina; Palmela, Carolina; Costa Santos, Maria Pia; Torres, Joana; Nunes, Joana; Loureiro, Rui; Ferreira, Rosa; Barjas, Elídio; Glória, Luísa; Santos, António Alberto; Cravo, Marília

2017-01-01

Background Colorectal cancer (CRC) is the first cause of cancer-related mortality in Portugal. CRC screening reduces disease-specific mortality. Colonoscopy is currently the preferred method for screening as it may contribute to the reduction of CRC incidence. This beneficial effect is strongly associated with the adenoma detection rate (ADR). Aim Our aim was to evaluate the quality of colonoscopy at our unit by measuring the currently accepted quality parameters and publish them as benchmarking indicators. Methods From 5,860 colonoscopies, 654 screening procedures (with and without previous fecal occult blood testing) were analyzed. Results The mean age of the patients was 66.4 ± 7.8 years, and the gender distribution was 1:1. The overall ADR was 36% (95% confidence interval [CI] 32–39), the mean number of adenomas per colonoscopy was 0.66 (95% CI 0.56–0.77), and the sessile serrate lesion detection rate was 1% (95% CI 0–2). The bowel preparation was rated as adequate in 496 (76%) patients. The adjusted cecal intubation rate (CIR) was 93.7% (95% CI 91.7–95.8). Most colonoscopies were performed under monitored anesthesia care (53%), and 35% were unsedated. The use of sedation (propofol or midazolam based) was associated with a higher CIR with an odds ratio of 3.60 (95% CI 2.02–6.40, p < 0.001). Conclusion Our data show an above-standard ADR. The frequency of poor bowel preparation and the low sessile serrated lesion detection rate were acknowledged, and actions were implemented to improve both indicators. Quality auditing in colonoscopy should be compulsory, and while many units may do so internally, this is the first national report from a high-throughput endoscopy unit. PMID:28848785

Does bacteriology laboratory automation reduce time to results and increase quality management?

PubMed

Dauwalder, O; Landrieve, L; Laurent, F; de Montclos, M; Vandenesch, F; Lina, G

2016-03-01

Due to reductions in financial and human resources, many microbiological laboratories have merged to build very large clinical microbiology laboratories, which allow the use of fully automated laboratory instruments. For clinical chemistry and haematology, automation has reduced the time to results and improved the management of laboratory quality. The aim of this review was to examine whether fully automated laboratory instruments for microbiology can reduce time to results and impact quality management. This study focused on solutions that are currently available, including the BD Kiestra™ Work Cell Automation and Total Lab Automation and the Copan WASPLab(®). Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Patient-doctor interaction in rehabilitation: the relationship between perceived interaction quality and long-term treatment results.

PubMed

Dibbelt, Susanne; Schaidhammer, Monika; Fleischer, Christian; Greitemann, Bernhard

2009-09-01

dialogue on admission more positively showed stronger treatment effects with respect to pain as well as to anxiety at discharge and six months after discharge. Analysis for single scales of the P.A.INT-Questionnaire revealed that this is due to affective and instrumental quality of the dialogues. Our results suggest a correlation between perceived interaction quality, as defined by our questionnaire and treatment effects six months after discharge. Comparisons of patient and physician evaluations showed that physicians seem to be successful in building relationships on the affective level, but less successful on the instrumental level (i.e. information, structuring and reinforcement). They also perceive disturbances on the relational and organisational level more strongly than patients. Our data underline the importance of interaction quality for the success of rehabilitation and thus the importance of specific skills such as providing and collecting information, recognizing patients' concerns and goals as well as reinforcement of health related action. Regular training and supervision should be provided to support physicians and to enhance their competence in dealing with patients concerns.

Evaluation of Observation-Fused Regional Air Quality Model Results for Population Air Pollution Exposure Estimation

PubMed Central

Chen, Gang; Li, Jingyi; Ying, Qi; Sherman, Seth; Perkins, Neil; Rajeshwari, Sundaram; Mendola, Pauline

2014-01-01

In this study, Community Multiscale Air Quality (CMAQ) model was applied to predict ambient gaseous and particulate concentrations during 2001 to 2010 in 15 hospital referral regions (HRRs) using a 36-km horizontal resolution domain. An inverse distance weighting based method was applied to produce exposure estimates based on observation-fused regional pollutant concentration fields using the differences between observations and predictions at grid cells where air quality monitors were located. Although the raw CMAQ model is capable of producing satisfying results for O3 and PM2.5 based on EPA guidelines, using the observation data fusing technique to correct CMAQ predictions leads to significant improvement of model performance for all gaseous and particulate pollutants. Regional average concentrations were calculated using five different methods: 1) inverse distance weighting of observation data alone, 2) raw CMAQ results, 3) observation-fused CMAQ results, 4) population-averaged raw CMAQ results and 5) population-averaged fused CMAQ results. It shows that while O3 (as well as NOx) monitoring networks in the HRR regions are dense enough to provide consistent regional average exposure estimation based on monitoring data alone, PM2.5 observation sites (as well as monitors for CO, SO2, PM10 and PM2.5 components) are usually sparse and the difference between the average concentrations estimated by the inverse distance interpolated observations, raw CMAQ and fused CMAQ results can be significantly different. Population-weighted average should be used to account spatial variation in pollutant concentration and population density. Using raw CMAQ results or observations alone might lead to significant biases in health outcome analyses. PMID:24747248

Marital quality and diabetes: results from the Health and Retirement Study.

PubMed

Whisman, Mark A; Li, Angela; Sbarra, David A; Raison, Charles L

2014-08-01

Poor marital quality is associated with many different indicators of poor health, including immunologic and metabolic responses that have relevance for distal disease outcomes such as diabetes. We conducted this study to evaluate whether poor marital quality was associated with the prevalence of diabetes in a population-based sample of Americans over the age of 50. Participants were married adults from the 2006 (N = 3,898) and 2008 (N = 3,452) waves of the Health and Retirement Study. Participants completed an interview and a self-report questionnaire, and current use of diabetes medication and glycosylated hemoglobin obtained from blood spot samples were used to index diabetes status. Marital quality was assessed with items regarding perceived frequency of positive and negative exchanges with partner. Decreasing frequency of positive exchanges and increasing frequency of negative exchanges with one's spouse were associated with higher prevalence of diabetes among men, but not women at both waves; gender significantly moderated the associations between partner exchanges and diabetes status for the 2006 data. The association between frequency of partner exchanges and diabetes status generally remained significant in men after accounting for demographic characteristics and other risk factors (obesity, hypertension, low physical activity). Poor marital quality as operationalized by rates of positive and negative partner exchanges was associated with increased prevalence of diabetes in men. These results are consistent with prior work on marriage and health, and suggest that poor marital quality may be a unique risk factor for diabetes.

Interim results of quality-control sampling of surface water for the Upper Colorado River National Water-Quality Assessment Study Unit, water years 1995-96

USGS Publications Warehouse

Spahr, N.E.; Boulger, R.W.

1997-01-01

Quality-control samples provide part of the information needed to estimate the bias and variability that result from sample collection, processing, and analysis. Quality-control samples of surface water collected for the Upper Colorado River National Water-Quality Assessment study unit for water years 1995?96 are presented and analyzed in this report. The types of quality-control samples collected include pre-processing split replicates, concurrent replicates, sequential replicates, post-processing split replicates, and field blanks. Analysis of the pre-processing split replicates, concurrent replicates, sequential replicates, and post-processing split replicates is based on differences between analytical results of the environmental samples and analytical results of the quality-control samples. Results of these comparisons indicate that variability introduced by sample collection, processing, and handling is low and will not affect interpretation of the environmental data. The differences for most water-quality constituents is on the order of plus or minus 1 or 2 lowest rounding units. A lowest rounding unit is equivalent to the magnitude of the least significant figure reported for analytical results. The use of lowest rounding units avoids some of the difficulty in comparing differences between pairs of samples when concentrations span orders of magnitude and provides a measure of the practical significance of the effect of variability. Analysis of field-blank quality-control samples indicates that with the exception of chloride and silica, no systematic contamination of samples is apparent. Chloride contamination probably was the result of incomplete rinsing of the dilute cleaning solution from the outlet ports of the decaport sample splitter. Silica contamination seems to have been introduced by the blank water. Sampling and processing procedures for water year 1997 have been modified as a result of these analyses.

Southern P indices, water quality data, and modeling results: a comparison

USDA-ARS?s Scientific Manuscript database

Phosphorus (P) indices in the south frequently produce different results for similar conditions. After collecting data from benchmark sites throughout the south (6 Arkansas, 1 Georgia, 2 Mississippi, 4 North Carolina, 4 Oklahoma, and 4 Texas site/treatment water quality and land treatment data sets...

76 FR 22868 - Certain Hot-Rolled Flat-Rolled Carbon-Quality Steel Products From Brazil: Final Results of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-25

...-Rolled Carbon-Quality Steel Products From Brazil: Final Results of Countervailing Duty Administrative... administrative review of the countervailing duty order on certain hot-rolled flat-rolled carbon- quality steel...-Quality Steel Products From Brazil: Preliminary Results of Countervailing Duty Administrative Review, 75...

[Feasibility and results of the short Diet Quality Screener in Primary Care: EMAP study].

PubMed

Ríos-Rodríguez, María de Los Ángeles; García-Cerdán, María Rosa; Calonge-Vallejo, Ana Rosa; Tobella-Andreu, Laia; Baena-Díez, José Miguel; Schröder, Helmut

To study the feasibility and results of the self-reported short diet quality screener (sDQS) in Primary Care. The variables associated with difficulty and inadequate diet are also determined. Cross-sectional descriptive study conducted with 196 participants aged >18 years with diabetes mellitus, hypertension, or hypercholesterolaemia, consecutively included from 4 Primary Health Care Centres in Barcelona. The main variables collected were, age, sex, educational level, cardiovascular risk factors, body mass index, time to complete the sDQS, degree of difficulty, and diet score: inadequate diet ≤18, adequate in some aspects 19-27, adequate >27. The mean age was 48.8 years (52% males). The analysis of the variables showed that the prevalence of having higher than a primary education level, hypertension, diabetes, hypercholesterolemia, and obesity was 50%, 54.6%, 23.5%, 56.6%, and 27.5%, respectively. The mean time to complete the questionnaire was 2.3min. More than 80% considered it easy or very easy. An inadequate diet was reported by 21.4%, adequate in some aspects by 76.5%, and an adequate diet only by 2%. To be older than 49 years and a low diet quality increased the risk of needing ≥2min to complete the sDQS (OR 2.0, 95% CI; 1.0-4.3, and OR 2.3, 95% CI; 1.1-5.1, respectively). Not following a low cholesterol diet and age less than 49 years increased the risk of a low diet quality (OR 2.2; 95% CI: 1.1-4.5, and OR 2.9; 95% CI: 1.2-6.8, respectively). The completion of the sDQS is easy and was not a significant time-burden in Primary Care. A significant proportion of participants with cardiovascular risk reported a low diet quality. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

[Analysis of the results of the SEIMC External Quality Control Program. Year 2012].

PubMed

de Gopegui Bordes, Enrique Ruiz; Guna Serrano, M del Remedio; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Gimeno Cardona, Concepción

2014-02-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2012 controls. As a whole, the results obtained in 2012 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests. Copyright © 2014 Elsevier España, S.L. All rights reserved.

[Analysis of the results of the SEIMC External Quality Control Program. Year 2014].

PubMed

Gopegui Bordes, Enrique Ruiz de; Guna Serrano, M Del Remedio; Orta Mira, Nieves; Medina González, Rafael; Rosario Ovies, María; Poveda, Marta; Gimeno Cardona, Concepción

2016-07-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2014 controls. As a whole, the results obtained in 2014 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of the SEIMC program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

The Dutch Review Process for Evaluating the Quality of Psychological Tests: History, Procedure, and Results

ERIC Educational Resources Information Center

Evers, Arne; Sijtsma, Klaas; Lucassen, Wouter; Meijer, Rob R.

2010-01-01

This article describes the 2009 revision of the Dutch Rating System for Test Quality and presents the results of test ratings from almost 30 years. The rating system evaluates the quality of a test on seven criteria: theoretical basis, quality of the testing materials, comprehensiveness of the manual, norms, reliability, construct validity, and…

Improving quality of reproductive health care in Senegal through formative supervision: results from four districts.

PubMed

Suh, Siri; Moreira, Philippe; Ly, Moussa

2007-11-29

In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. The most notable improvement across regions was in infection prevention.Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.

[Quality planning of Family Health Units using Quality Function Deployment (QFD)].

PubMed

Volpato, Luciana Fernandes; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi

2010-08-01

Quality is an indispensible requirement in the health field, and its pursuit is necessary in order to meet demands by a population that is aware of its rights, as part of the essence of good work relations, and to decrease technological costs. Quality thus involves all parties to the process (users and professionals), and is no longer merely an attribute of the health service. This study aimed to verify the possibility of quality planning in the Family Health Units, using Quality Function Deployment (QFD). QFD plans quality according to user satisfaction, involving staff professionals and identifying new approaches to improve work processes. Development of the array, called the House of Quality, is this method's most important characteristics. The results show a similarity between the quality demanded by users and the quality planned by professionals. The current study showed that QFD is an efficient tool for quality planning in public health services.

Published methodological quality of randomized controlled trials does not reflect the actual quality assessed in protocols.

PubMed

Mhaskar, Rahul; Djulbegovic, Benjamin; Magazin, Anja; Soares, Heloisa P; Kumar, Ambuj

2012-06-01

To assess whether the reported methodological quality of randomized controlled trials (RCTs) reflects the actual methodological quality and to evaluate the association of effect size (ES) and sample size with methodological quality. Systematic review. This is a retrospective analysis of all consecutive phase III RCTs published by eight National Cancer Institute Cooperative Groups up to 2006. Data were extracted from protocols (actual quality) and publications (reported quality) for each study. Four hundred twenty-nine RCTs met the inclusion criteria. Overall reporting of methodological quality was poor and did not reflect the actual high methodological quality of RCTs. The results showed no association between sample size and actual methodological quality of a trial. Poor reporting of allocation concealment and blinding exaggerated the ES by 6% (ratio of hazard ratio [RHR]: 0.94; 95% confidence interval [CI]: 0.88, 0.99) and 24% (RHR: 1.24; 95% CI: 1.05, 1.43), respectively. However, actual quality assessment showed no association between ES and methodological quality. The largest study to date shows that poor quality of reporting does not reflect the actual high methodological quality. Assessment of the impact of quality on the ES based on reported quality can produce misleading results. Copyright © 2012 Elsevier Inc. All rights reserved.

The project MOHAVE tracer study: study design, data quality, and overview of results

NASA Astrophysics Data System (ADS)

Green, Mark C.

In the winter and summer of 1992, atmospheric tracer studies were conducted in support of project MOHAVE, a visibility study in the southwestern United States. The primary goal of project MOHAVE is to determine the effects of the Mohave power plant and other sources upon visibility at Grand Canyon National Park. Perfluorocarbon tracers (PFTs) were released from the Mohave power plant and other locations and monitored at about 30 sites. The tracer data are being used for source attribution analysis and for evaluation of transport and dispersion models and receptor models. Collocated measurements showed the tracer data to be of high quality and suitable for source attribution analysis and model evaluation. The results showed strong influences of channeling by the Colorado River canyon during both winter and summer. Flow from the Mohave power plant was usually to the south, away from the Grand Canyon in winter and to the northeast, toward the Grand Canyon in summer. Tracer released at Lake Powell in winter was found to often travel downstream through the entire length of the Grand Canyon. Data from summer tracer releases in southern California demonstrated the existence of a convergence zone in the western Mohave Desert.

Langley Wind Tunnel Data Quality Assurance-Check Standard Results

NASA Technical Reports Server (NTRS)

Hemsch, Michael J.; Grubb, John P.; Krieger, William B.; Cler, Daniel L.

2000-01-01

A framework for statistical evaluation, control and improvement of wind funnel measurement processes is presented The methodology is adapted from elements of the Measurement Assurance Plans developed by the National Bureau of Standards (now the National Institute of Standards and Technology) for standards and calibration laboratories. The present methodology is based on the notions of statistical quality control (SQC) together with check standard testing and a small number of customer repeat-run sets. The results of check standard and customer repeat-run -sets are analyzed using the statistical control chart-methods of Walter A. Shewhart long familiar to the SQC community. Control chart results are presented for. various measurement processes in five facilities at Langley Research Center. The processes include test section calibration, force and moment measurements with a balance, and instrument calibration.

Audit system on Quality of breast cancer diagnosis and Treatment (QT): results of quality indicators on screen-detected lesions in Italy, 2011-2012.

PubMed

Ponti, Antonio; Mano, Maria Piera; Tomatis, Mariano; Baiocchi, Diego; Barca, Alessandra; Berti, Rosa; Casella, Denise; D'Ambrosio, Enrico; Delos, Erika; Donati, Giovanni; Falcini, Fabio; Frammartino, Brunella; Frigerio, Alfonso; Giudici, Fabiola; Mantellini, Paola; Naldoni, Carlo; Olla Atzeni, Carlo; Orzalesi, Lorenzo; Pagano, Giovanni; Pietribiasi, Francesca; Pitarella, Sabina; Ravaioli, Alessandra; Silvestri, Anna; Taffurelli, Mario; Tidone, Enrica; Zanconati, Fabrizio; Segnan, Nereo

2015-01-01

This annual survey, conducted by the Italian group for mammography screening (GISMa), collects individual data on diagnosis and treatment of about 50% of screen-detected, operated lesions in Italy. The 2011-2012 results show good overall quality and an improving trend over time. A number of critical issues have been identified, including waiting times (which have had a worsening trend over the years) and compliance with the recommendation of not performing frozen section examination on small lesions. Pre-operative diagnosis improved constantly over time, but there is still a large variation between Regions and programmes. For almost 90% of screen-detected invasive cancers a sentinel lymph node (SLN) biopsy was performed on the axilla, avoiding a large number of potentially harmful dissections. On the other hand, potential overuse of SLN dissection for ductal carcinoma in situ, although apparently starting to decline, deserves further investigation. The detailed results have been distributed, among other ways by means of a web-based data-warehouse, to regional and local screening programmes, in order to allow multidisciplinary discussion and identification of the appropriate solutions to any issues documented by the data. The problem of waiting times should be assigned priority. Specialist Breast Units with adequate case volume and enough resources would provide the best setting for making monitoring effective in producing quality improvements with shorter waiting times.

Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper.

PubMed

López-Sendón, José; González-Juanatey, José Ramón; Pinto, Fausto; Cuenca Castillo, José; Badimón, Lina; Dalmau, Regina; González Torrecilla, Esteban; López-Mínguez, José Ramón; Maceira, Alicia M; Pascual-Figal, Domingo; Pomar Moya-Prats, José Luis; Sionis, Alessandro; Zamorano, José Luis

2015-11-01

Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

[Analysis of the results of the SEIMC External Quality Control Program. Year 2011].

PubMed

Ruiz de Gopegui Bordes, Enrique; Guna Serrano, M del Remedio; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Gimeno Cardona, Concepción

2013-02-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica [SEIMC]) includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology, and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2011 controls. Overall, the results obtained in 2011 confirm the excellent skill and good technical standards found in previous years. Nevertheless, erroneous results can be obtained in any laboratory and in clinically relevant determinations. The results of this program highlight the need to implement both internal and external controls, such as those offered by the SEIMC program, in order to ensure maximal quality of microbiological tests. Copyright © 2013 Elsevier España, S.L. All rights reserved.

[Long-term treatment results and quality of life of the patients, operated on the reason of chronic pancreatitis, complicated by the obstructive jaundice].

PubMed

Gagua, A K; Zagaĭnov, V E; Evtikhova, E Iu

2013-01-01

Methods of surgical treatment of the patients, operated on the reason of chronic pancreatitis, complicated by the obstructive jaundice, were comparatively analyzed. 25 patients received pancreatoduodenal resection, 19 patients had the Bern variant of Beger operation. The quality of life was assessed with the use of MOS-SF-36. The duodenum preserving resection of the head of the pancreas showed better long-term results then pancreatoduodenal resection. Those patients, who received biliodigestive anastomosis as the basic operation, showed no good results at all.

[Outcome quality in rehabilitation of children and adolescents: results of project aiming at the development of a quality assurance programme].

PubMed

Farin, E; Gustke, M; Widera, T; Matthies, S

2012-06-01

This study reports on the results of a project that was initiated by the German pension fund and the statutory health insurers and conducted in 2009 to 2010 with the goal of developing, arranging and testing instruments for quality assurance for the outcome (including patient satisfaction) in inpatient medical rehabilitation centres for children and adolescents. After a 6-month concept phase in which instruments were developed using value benefit analyses, expert consensus procedures, surveys of centres, and qualitative (cognitive interviews) and quantitative (psychometric tests) pre-studies, data were collected in 23 child and adolescent rehabilitation centres using the instruments that had been developed. The project was limited to the following 4 main diagnoses: obesity, bronchial asthma, atopic eczema, and hyperkinetic disorders as well as related disorders (ICD: F90-F94). Children and adolescents over the age of 12 years were interviewed themselves, for younger children, the parents were interviewed. It was decided to include 7 constructs that can be considered as indicators of the quality of the outcome or of patient satisfaction: generic and disease-specific quality of life, perceived change in health, body function parameters (e. g., blood pressure), disease-related self-management, satisfaction of the children/adolescents with rehabilitation, and parent satisfaction. With respect to quality of life, blood pressure, Munich fitness test and lung function parameters, low to medium effects were achieved; with respect to body mass index, SCORAD score and disease-related self-management, the effects were strong. The results can be summarised to the effect that rehabilitation generally achieves noticeable effects in the areas where the impairment is pronounced. In both the parent and the rehabilitation patient survey, there was a high level of satisfaction. The parents of rehab patients under the age of 12 years gave the centres an average assessment of 1.6 to 1

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

PubMed

Sharma, Sakshi; Oremus, Mark

2018-04-11

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

Quality-assurance results for routine water analyses in U.S. Geological Survey laboratories, water year 1998

USGS Publications Warehouse

Ludtke, Amy S.; Woodworth, Mark T.; Marsh, Philip S.

2000-01-01

The U.S. Geological Survey operates a quality-assurance program based on the analyses of reference samples for two laboratories: the National Water Quality Laboratory and the Quality of Water Service Unit. Reference samples that contain selected inorganic, nutrient, and low-level constituents are prepared and submitted to the laboratory as disguised routine samples. The program goal is to estimate precision and bias for as many analytical methods offered by the participating laboratories as possible. Blind reference samples typically are submitted at a rate of 2 to 5 percent of the annual environmental-sample load for each constituent. The samples are distributed to the laboratories throughout the year. The reference samples are subject to the identical laboratory handling, processing, and analytical procedures as those applied to environmental samples and, therefore, have been used as an independent source to verify bias and precision of laboratory analytical methods and ambient water-quality measurements. The results are stored permanently in the National Water Information System and the Blind Sample Project's data base. During water year 1998, 95 analytical procedures were evaluated at the National Water Quality Laboratory and 63 analytical procedures were evaluated at the Quality of Water Service Unit. An overall evaluation of the inorganic and low-level constituent data for water year 1998 indicated 77 of 78 analytical procedures at the National Water Quality Laboratory met the criteria for precision. Silver (dissolved, inductively coupled plasma-mass spectrometry) was determined to be imprecise. Five of 78 analytical procedures showed bias throughout the range of reference samples: chromium (dissolved, inductively coupled plasma-atomic emission spectrometry), dissolved solids (dissolved, gravimetric), lithium (dissolved, inductively coupled plasma-atomic emission spectrometry), silver (dissolved, inductively coupled plasma-mass spectrometry), and zinc

Can we make reports of end-of-life care quality more consumer-focused? results of a nationwide quality measurement program.

PubMed

Smith, Dawn; Caragian, Nicole; Kazlo, Elena; Bernstein, Jennie; Richardson, Diane; Casarett, David

2011-03-01

The goal of this study was to define families' priorities for various aspects of end-of-life care, and to determine whether scores that reflect these priorities alter facilities' quality rankings. Nationwide telephone survey. 62 VA medical centers, including acute and long term care. For each patient who died in a participating facility, one family member was invited to participate. A survey included 14 items describing key aspects of the patient's care in his or her last month of life, and one global rating. A weighted score was calculated based on the association between each item and the global rating. Interviews were completed with family members for 3,897 of 7,110 patients (55%). Items showed an approximately 5-fold range of weights, indicating a wide variation in the importance that families placed on aspects of palliative care (low: pain management, weight = 0.54, 95% CI 0.38-0.70;/P/<0.001; high: providers were "kind, caring, and respectful: weight = 2.46, 95% CI 2.24-2.68;/P/<0.001). Weights were homogeneous across patient subgroups, and there were no significant changes in facilities' quality rankings when weights were used. Both weighted and unweighted scores showed similar evidence of the impact of process measures. There appears to be wide variation in the importance that families place on several aspects of end-of-life care. However, the impact of weighting was generally even across patient subgroups and facilities. Therefore, the use of weights to account for families' priorities is not likely to alter a facility's quality score.

Dynamic Analyses of Result Quality in Energy-Aware Approximate Programs

NASA Astrophysics Data System (ADS)

RIngenburg, Michael F.

Energy efficiency is a key concern in the design of modern computer systems. One promising approach to energy-efficient computation, approximate computing, trades off output precision for energy efficiency. However, this tradeoff can have unexpected effects on computation quality. This thesis presents dynamic analysis tools to study, debug, and monitor the quality and energy efficiency of approximate computations. We propose three styles of tools: prototyping tools that allow developers to experiment with approximation in their applications, online tools that instrument code to determine the key sources of error, and online tools that monitor the quality of deployed applications in real time. Our prototyping tool is based on an extension to the functional language OCaml. We add approximation constructs to the language, an approximation simulator to the runtime, and profiling and auto-tuning tools for studying and experimenting with energy-quality tradeoffs. We also present two online debugging tools and three online monitoring tools. The first online tool identifies correlations between output quality and the total number of executions of, and errors in, individual approximate operations. The second tracks the number of approximate operations that flow into a particular value. Our online tools comprise three low-cost approaches to dynamic quality monitoring. They are designed to monitor quality in deployed applications without spending more energy than is saved by approximation. Online monitors can be used to perform real time adjustments to energy usage in order to meet specific quality goals. We present prototype implementations of all of these tools and describe their usage with several applications. Our prototyping, profiling, and autotuning tools allow us to experiment with approximation strategies and identify new strategies, our online tools succeed in providing new insights into the effects of approximation on output quality, and our monitors succeed in

Quality of Diabetes Care Predicts the Development of Cardiovascular Events: Results of the AMD-QUASAR Study

PubMed Central

Rossi, Maria C.E.; Lucisano, Giuseppe; Comaschi, Marco; Coscelli, Carlo; Cucinotta, Domenico; Di Blasi, Patrizia; Bader, Giovanni; Pellegrini, Fabio; Valentini, Umberto; Vespasiani, Giacomo; Nicolucci, Antonio

2011-01-01

OBJECTIVE The QUASAR (Quality Assessment Score and Cardiovascular Outcomes in Italian Diabetes Patients) study aimed to assess whether a quality-of-care summary score predicted the development of cardiovascular (CV) events in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS In 67 diabetes clinics, data on randomly selected patients were extracted from electronic medical records. The score was calculated using process and outcome indicators based on monitoring, targets, and treatment of A1C, blood pressure, LDL cholesterol, and microalbuminuria. The score ranged from 0 to 40. RESULTS Overall, 5,181 patients were analyzed; 477 (9.2%) patients developed a CV event after a median follow-up of 28 months. The incidence rate (per 1,000 person-years) of CV events was 62.4 in patients with a score of <15, 41.0 in those with a score between 20 and 25 and 36.7 in those with a score of >25. Multilevel analysis, adjusted for clustering and case-mix, showed that the risk to develop a new CV event was 84% higher in patients with a score of <15 (incidence rate ratio [IRR] = 1.84; 95% confidence interval [CI] 1.29–2.62) and 17% higher in those with a score between 15 and 25 (IRR = 1.17; 95% CI 0.93–1.49) compared with those with a score of >25. Mean quality score varied across centers from 16.5 ± 7.5 to 29.1 ± 6.3. When the score was tested as the dependent variable, it emerged that 18% of the variance in the score could be attributed to setting characteristics. CONCLUSIONS Our study documented a close relationship between quality of diabetes care and long-term outcomes. A simple score can be used to monitor quality of care and compare the performance of different centers/physicians. PMID:21270192

Italian external quality assessment program for cystic fibrosis sweat chloride test: a 2015 and 2016 results comparison.

PubMed

Salvatore, Marco; Floridia, Giovanna; Amato, Annalisa; Censi, Federica; de Stefano, Maria Chiara; Ferrari, Gianluca; Tosto, Fabrizio; Taruscio, Domenica

2017-01-01

Diagnostic testing in cystic fibrosis (CF) is based on the sweat chloride test (SCT) in the context of appropriate signs and symptoms of disease and results of the gene mutation analysis. In 2014 the Istituto Superiore di Sanità (ISS) established a pilot Italian external quality assessment program for CF sweat chloride test (Italian EQA-SCT). In 2015 this activity was recognized as a third party service carried out by the ISS. The aim of the paper is to compare 2015 and 2016 results and experiences. The scheme is prospective; enrollment is voluntary and the payment of a fee is required. Participants are registered and identified by a specific Identification Number (ID) through a dedicated web-facility. Assessment covers analysis, interpretation and reporting of results. Thirteen and fifteen laboratories, participated in the 2015 and 2016 round respectively. Seven laboratories participated constantly from 2014, eleven participated both in 2015 and 2016 and four participated in 2016 for the first time. Variability in scores of chloride titration and heterogeneity in interpretation/reporting results were detected in both rounds. A total of 18 critical errors in chloride titration were made by eight different participants. Four laboratories made errors in chloride titration in 2015 but drastically improved their performance in 2016. In 2016 poor performance criteria were established and adopted. Even though results show variability in performance of laboratories, constant and mandatory participation may contribute to the improvement of performance and quality reached by laboratory.

A comparison of sediment quality results with acid volatile sulfide (AVS) and simultaneously extracted metals (SEM) ratio in Vojvodina (Serbia) sediments.

PubMed

Prica, M; Dalmacija, B; Roncević, S; Krcmar, D; Becelić, M

2008-01-25

The acid-volatile sulfide (AVS), simultaneously extracted metals (SEM), total metals, and pore-water metal concentrations were studied in Vojvodina (Serbia) sediments. In Serbia, there are no regulations concerning sediment quality standards and sediment management. Harmonization of legislation in the domain of environmental protection with EU requirements will increase the significance of the sediment issue. Sediment quality was assessed according to Dutch standards, but the results were also compared with Canadian and USEPA (United States Environmental Protection Agency) guidelines for sediment quality. A comparison of the results based on different criteria for sediment quality assessment shows that they are sometimes contradictory. Therefore, a single approach to quality assessment may be insufficient. The Sigma[SEM]/[AVS] ratio was found to be greater than one at several locations that were already recognized as places of high risk based on Dutch standards. Some other samples had Sigma[SEM]/[AVS]<1, despite of the high risk classification based on the Dutch evaluation. However, not all sediments with Sigma[SEM]/[AVS]>1 can cause increased toxicity because there are many other metal-binding phases in sediments. Metals that are associated with AVS may be released within sediments through storms, dredging activities, oxidation, etc., and may have adverse environmental impacts. This has to be taken into account during dredging, which is for some sediments necessary because the sediment is of class 4 (Dutch evaluation), because the dredging process will certainly increase the concentration of bioavailable heavy metals and disturb the sedimentation dynamics. The obtained results will be invaluable for future activities regarding dredging and sediment management in the country.

Single-Site, Results-Level Evaluation of Quality Awareness Training.

ERIC Educational Resources Information Center

Murray, Brian; Raffaele, Gary C.

1997-01-01

An interrupted time-series design pooling 6 12-year series evaluated the long-term effects of a quality training intervention in a factory. Training positively affected quality of goods and dollar utility. Production process was an important contextual factor in assessing the effect size of the intervention. (SK)

The economic impact of poor sample quality in clinical chemistry laboratories: results from a global survey.

PubMed

Erdal, Erik P; Mitra, Debanjali; Khangulov, Victor S; Church, Stephen; Plokhoy, Elizabeth

2017-03-01

Background Despite advances in clinical chemistry testing, poor blood sample quality continues to impact laboratory operations and the quality of results. While previous studies have identified the preanalytical causes of lower sample quality, few studies have examined the economic impact of poor sample quality on the laboratory. Specifically, the costs associated with workarounds related to fibrin and gel contaminants remain largely unexplored. Methods A quantitative survey of clinical chemistry laboratory stakeholders across 10 international regions, including countries in North America, Europe and Oceania, was conducted to examine current blood sample testing practices, sample quality issues and practices to remediate poor sample quality. Survey data were used to estimate costs incurred by laboratories to mitigate sample quality issues. Results Responses from 164 participants were included in the analysis, which was focused on three specific issues: fibrin strands, fibrin masses and gel globules. Fibrin strands were the most commonly reported issue, with an overall incidence rate of ∼3%. Further, 65% of respondents indicated that these issues contribute to analyzer probe clogging, and the majority of laboratories had visual inspection and manual remediation practices in place to address fibrin- and gel-related quality problems (55% and 70%, respectively). Probe maintenance/replacement, visual inspection and manual remediation were estimated to carry significant costs for the laboratories surveyed. Annual cost associated with lower sample quality and remediation related to fibrin and/or gel globules for an average US laboratory was estimated to be $100,247. Conclusions Measures to improve blood sample quality present an important step towards improved laboratory operations.

SF-36 Shows Increased Quality of Life Following Complete Reduction of Postmastectomy Lymphedema with Liposuction.

PubMed

Hoffner, Mattias; Bagheri, Shirin; Hansson, Emma; Manjer, Jonas; Troëng, Thomas; Brorson, Håkan

2017-03-01

Abstracts Background: Arm lymphedema after breast cancer surgery affects women both from physical and psychological points of view. Lymphedema leads to adipose tissue deposition. Liposuction and controlled compression therapy (CCT) reduces the lymphedema completely. Sixty female patients with arm lymphedema were followed for a 1-year period after surgery. The 36-item short-form health survey (SF-36) was used to assess health-related quality of life (HRQoL). Patients completed the SF-36 questionnaire before liposuction, and after 1, 3, 6, and 12 months. Preoperative excess arm volume was 1365 ± 73 mL. Complete reduction was achieved after 3 months and was sustained during follow-up. The adipose tissue volume removed at surgery was 1373 ± 56 mL. One month after liposuction, better scores were found in mental health. After 3 months, an increase in physical functioning, bodily pain, and vitality was detected. After 1 year, an increase was also seen for social functioning. The physical component score was higher at 3 months and thereafter, while the mental component score was improved at 3 and 12 months. Compared with SF-36 norm data for the Swedish population, only physical functioning showed lower values than the norm at baseline. After liposuction, general health, bodily pain, vitality, mental health, and social functioning showed higher values at various time points. Liposuction of arm lymphedema in combination with CCT improves patients HRQoL as measured with SF-36. The treatment seems to target and improve both the physical and mental health domains.

From Results to Action - Implementing an Indoor Air Quality Pilot Project

NASA Astrophysics Data System (ADS)

Collier, A. M.; Ware, G. E.; Iwasaki, P. G.; Billingsley, L. R.; Main, D.; Hannigan, M.; Pfotenhauer, D.

2016-12-01

One of the key differences between community-based participatory research (CBPR) and more conventional scientific research is the expectation that a project does not end with finalized results, but rather with taking action based on those results. Using an indoor air quality pilot project as an example, we will discuss how the consideration of potential actions and applications for the project findings should be integrated into planning throughout the life of a project. We will also share general reflections on effective CBPR from the perspective of both science and community partners on the project. In 2015, Taking Neighborhood Health to Heart (TNH2H), a community-based organization in Northeast Denver, researchers from the University of Colorado, Boulder, and AGU's Thriving Earth Exchange partnered to conduct a pilot project investigating indoor air quality in a Denver community. This partnership formed in response to community concerns about potential environmental contamination from dry cleaning operations, specifically through spills of the compound perchloroethylene. The exploration of the presence of radon, another indoor air quality concern common across the state of Colorado, was also added to the project. Using an iterative process, the team designed a sampling plan, selected a target location, and recruited homes and residents to participate in the pilot project. Radon and perchloroethylene data were then collected in 15 homes. Following data collection, results were first shared with project participants, after which de-identified data were shared with the members of TNH2H. Together TNH2H and researchers then developed strategies for public dissemination of the project findings. While we did not find levels of percholorethylene above the `action level' in any of the participating homes; however, we did find more frequent occurrences of radon levels above the `action level' than we had anticipated. For example, 80% of the homes in our study had radon

Quality in-training initiative--a solution to the need for education in quality improvement: results from a survey of program directors.

PubMed

Kelz, Rachel R; Sellers, Morgan M; Reinke, Caroline E; Medbery, Rachel L; Morris, Jon; Ko, Clifford

2013-12-01

The Next Accreditation System and the Clinical Learning Environment Review Program will emphasize practice-based learning and improvement and systems-based practice. We present the results of a survey of general surgery program directors to characterize the current state of quality improvement in graduate surgical education and introduce the Quality In-Training Initiative (QITI). In 2012, a 20-item survey was distributed to 118 surgical residency program directors from ACS NSQIP-affiliated hospitals. The survey content was developed in collaboration with the QITI to identify program director opinions regarding education in practice-based learning and improvement and systems-based practice, to investigate the status of quality improvement education in their respective programs, and to quantify the extent of resident participation in quality improvement. There was a 57% response rate. Eighty-five percent of program directors (n = 57) reported that education in quality improvement is essential to future professional work in the field of surgery. Only 28% (n = 18) of programs reported that at least 50% of their residents track and analyze their patient outcomes, compare them with norms/benchmarks/published standards, and identify opportunities to make practice improvements. Program directors recognize the importance of quality improvement efforts in surgical practice. Subpar participation in basic practice-based learning and improvement activities at the resident level reflects the need for support of these educational goals. The QITI will facilitate programmatic compliance with goals for quality improvement education. Copyright © 2013 American College of Surgeons. All rights reserved.

[Quality assurance in diagnostic radiology using an automated system. Experience and results].

PubMed

Princivalli, M; Stea, L; Ordóñez, P L; Bussoli, L; Marchetti, C

1995-05-01

The authors report their personal experience with the use of an integrated quality control system in the radiology department. The system we used was the RTI DIGI-X Plus, a Swedish-made product, allowing a wide range of parameters to be measured on diagnostic X-ray units for general radiography, mammography and fluoroscopy. Data can be retrieved with a minimum number of measurements. The "oRTIgo" software improves the quality assurance system and ensures document compliance with international recommendations. The equipment consists of a detector unit, a processor and a display unit. The detector consists of a rotating holder with 12 combinations of metal filters of various thickness mounted in front of two photo-diodes covered with identical X-ray intensifying gadoliniumoxysulfide screens. This unit is connected to a data acquisition system controlled by a microcomputer. Peak tube voltage and total tube filtration are derived from the ratio of detector signals. The relationship between this ratio and the measured quantity is determined by a calibration procedure. Furthermore, exposure time "mAs" value, "mAs" linearity and exposure (or kerma in air) can be measured. Digital storage can be performed and input signals displayed. A serial interface is used to communicate with a PC for QC management purposes. An error propagation model is used to determine the inaccuracy of peak tube voltage measurements. With the DIGI-X Plus system, measurements can be carried out in a shorter time and the stored data reprocessed later on. After QA testing on 20 X-ray units in the radiology department, in vivo doses were measured using a TLD Harshaw 100 on 46 randomly selected patients undergoing chest examinations. The results are reported and analyzed following the NRPB protocol and show high agreement with the recommended values.

Experienced quality factors: qualitative evaluation approach to audiovisual quality

NASA Astrophysics Data System (ADS)

Jumisko-Pyykkö, Satu; Häkkinen, Jukka; Nyman, Göte

2007-02-01

Subjective evaluation is used to identify impairment factors of multimedia quality. The final quality is often formulated via quantitative experiments, but this approach has its constraints, as subject's quality interpretations, experiences and quality evaluation criteria are disregarded. To identify these quality evaluation factors, this study examined qualitatively the criteria participants used to evaluate audiovisual video quality. A semi-structured interview was conducted with 60 participants after a subjective audiovisual quality evaluation experiment. The assessment compared several, relatively low audio-video bitrate ratios with five different television contents on mobile device. In the analysis, methodological triangulation (grounded theory, Bayesian networks and correspondence analysis) was applied to approach the qualitative quality. The results showed that the most important evaluation criteria were the factors of visual quality, contents, factors of audio quality, usefulness - followability and audiovisual interaction. Several relations between the quality factors and the similarities between the contents were identified. As a research methodological recommendation, the focus on content and usage related factors need to be further examined to improve the quality evaluation experiments.

Quality-assurance results for routine water analysis in US Geological Survey laboratories, water year 1991

USGS Publications Warehouse

Maloney, T.J.; Ludtke, A.S.; Krizman, T.L.

1994-01-01

The US. Geological Survey operates a quality- assurance program based on the analyses of reference samples for the National Water Quality Laboratory in Arvada, Colorado, and the Quality of Water Service Unit in Ocala, Florida. Reference samples containing selected inorganic, nutrient, and low ionic-strength constituents are prepared and disguised as routine samples. The program goal is to determine precision and bias for as many analytical methods offered by the participating laboratories as possible. The samples typically are submitted at a rate of approximately 5 percent of the annual environmental sample load for each constituent. The samples are distributed to the laboratories throughout the year. Analytical data for these reference samples reflect the quality of environmental sample data produced by the laboratories because the samples are processed in the same manner for all steps from sample login through data release. The results are stored permanently in the National Water Data Storage and Retrieval System. During water year 1991, 86 analytical procedures were evaluated at the National Water Quality Laboratory and 37 analytical procedures were evaluated at the Quality of Water Service Unit. An overall evaluation of the inorganic (major ion and trace metal) constituent data for water year 1991 indicated analytical imprecision in the National Water Quality Laboratory for 5 of 67 analytical procedures: aluminum (whole-water recoverable, atomic emission spectrometric, direct-current plasma); calcium (atomic emission spectrometric, direct); fluoride (ion-exchange chromatographic); iron (whole-water recoverable, atomic absorption spectrometric, direct); and sulfate (ion-exchange chromatographic). The results for 11 of 67 analytical procedures had positive or negative bias during water year 1991. Analytical imprecision was indicated in the determination of two of the five National Water Quality Laboratory nutrient constituents: orthophosphate as phosphorus and

Environmental quality of the operating theaters in Campania Region: long lasting monitoring results.

PubMed

Triassi, M; Novi, C; Nardone, A; Russo, I; Montuori, P

2015-01-01

The health risk level in the operating theaters is directly correlated to the safety level offered by the healthcare facilities. This is the reason why the national Authorities released several regulations in order to monitor better environmental conditions of the operating theaters, to prevent occupational injuries and disease and to optimize working conditions. For the monitoring of environmental quality of the operating theaters following parameters are considered: quantity of supplied gases, anesthetics concentration, operating theatres volume measurement, air change rate, air conditioning system and air filtration. The objective is to minimize the risks in the operating theaters and to provide the optimal environmental working conditions. This paper reports the environmental conditions of operating rooms performed for several years in the public hospitals of the Campania Region. Investigation of environmental conditions of 162 operating theaters in Campania Region from January 2012 till July 2014 was conducted. Monitoring and analysis of physical and chemical parameters was done. The analysis of the results has been made considering specific standards suggested by national and international regulations. The study showed that 75% of the operating theaters presented normal values for microclimatic monitoring, while the 25% of the operating theaters had at least one parameter outside the limits. The monitoring of the anesthetics gases showed that in 9% of measurements of nitrous oxides and 4% of measurements of halogenated was not within the normal values.

Validation of microbiological testing in cardiovascular tissue banks: results of a quality round trial.

PubMed

de By, Theo M M H; McDonald, Carl; Süßner, Susanne; Davies, Jill; Heng, Wee Ling; Jashari, Ramadan; Bogers, Ad J J C; Petit, Pieter

2017-11-01

Surgeons needing human cardiovascular tissue for implantation in their patients are confronted with cardiovascular tissue banks that use different methods to identify and decontaminate micro-organisms. To elucidate these differences, we compared the quality of processing methods in 20 tissue banks and 1 reference laboratory. We did this to validate the results for accepting or rejecting tissue. We included the decontamination methods used and the influence of antibiotic cocktails and residues with results and controls. The minor details of the processes were not included. To compare the outcomes of microbiological testing and decontamination methods of heart valve allografts in cardiovascular tissue banks, an international quality round was organized. Twenty cardiovascular tissue banks participated in this quality round. The quality round method was validated first and consisted of sending purposely contaminated human heart valve tissue samples with known micro-organisms to the participants. The participants identified the micro-organisms using their local decontamination methods. Seventeen of the 20 participants correctly identified the micro-organisms; if these samples were heart valves to be released for implantation, 3 of the 20 participants would have decided to accept their result for release. Decontamination was shown not to be effective in 13 tissue banks because of growth of the organisms after decontamination. Articles in the literature revealed that antibiotics are effective at 36°C and not, or less so, at 2-8°C. The decontamination procedure, if it is validated, will ensure that the tissue contains no known micro-organisms. This study demonstrates that the quality round method of sending contaminated tissues and assessing the results of the microbiological cultures is an effective way of validating the processes of tissue banks. Only when harmonization, based on validated methods, has been achieved, will surgeons be able to fully rely on the methods

Prediction of Groundwater Quality Trends Resulting from Anthropogenic Changes in Southeast Florida.

PubMed

Yi, Quanghee; Stewart, Mark

2018-01-01

The effects of surface water flow system changes caused by constructing water-conservation areas and canals in southeast Florida on groundwater quality under the Atlantic Coastal Ridge was investigated with numerical modeling. Water quality data were used to delineate a zone of groundwater with low total dissolved solids (TDS) within the Biscayne aquifer under the ridge. The delineated zone has the following characteristics. Its location generally coincides with an area where the Biscayne aquifer has high transmissivities, corresponds to a high recharge area of the ridge, and underlies a part of the groundwater mound formed under the ridge prior to completion of the canals. This low TDS groundwater appears to be the result of pre-development conditions rather than seepage from the canals constructed after the 1950s. Numerical simulation results indicate that the time for low TDS groundwater under the ridge to reach equilibrium with high TDS surface water in the water-conservation areas and Everglades National Park are approximately 70 and 60 years, respectively. The high TDS groundwater would be restricted to the water-conservation areas and the park due to its slow eastward movement caused by small hydraulic gradients in Rocky Glades and its mixing with the low TDS groundwater under the high-recharge area of the ridge. The flow or physical boundary conditions such as high recharge rates or low hydraulic conductivity layers may affect how the spatial distribution of groundwater quality in an aquifer will change when a groundwater flow system reaches equilibrium with an associated surface water flow system. © 2017, National Ground Water Association.

Engagement Insights: Survey Findings on the Quality of Undergraduate Education. Annual Results 2016

ERIC Educational Resources Information Center

National Survey of Student Engagement, 2016

2016-01-01

The National Survey of Student Engagement (NSSE) and its companion projects serve colleges and universities committed to monitoring and improving the quality of the undergraduate experience. While participating institutions receive detailed customized reports, the "Annual Results" series presents noteworthy aggregate findings from the…

Showing the Unsayable: Participatory Visual Approaches and the Constitution of 'Patient Experience' in Healthcare Quality Improvement.

PubMed

Papoulias, Constantina

2018-06-01

This article considers the strengths and potential contributions of participatory visual methods for healthcare quality improvement research. It argues that such approaches may enable us to expand our understanding of 'patient experience' and of its potential for generating new knowledge for health systems. In particular, they may open up dimensions of people's engagement with services and treatments which exceed both the declarative nature of responses to questionnaires and the narrative sequencing of self reports gathered through qualitative interviewing. I will suggest that working with such methods may necessitate a more reflexive approach to the constitution of evidence in quality improvement work. To this end, the article will first consider the emerging rationale for the use of visual participatory methods in improvement before outlining the implications of two related approaches-photo-elicitation and PhotoVoice-for the constitution of 'experience'. It will then move to a participatory model for healthcare improvement work, Experience Based Co-Design (EBCD). It will argue that EBCD exemplifies both the strengths and the limitations of adequating visual participatory approaches to quality improvement ends. The article will conclude with a critical reflection on a small photographic study, in which the author participated, and which sought to harness service user perspectives for the design of psychiatric facilities, as a way of considering the potential contribution of visual participatory methods for quality improvement.

Evaluation of long-term results and quality of life in patients who underwent rib fixation with titanium devices after trauma.

PubMed

Billè, Andrea; Okiror, Lawrence; Campbell, Aideen; Simons, Jason; Routledge, Tom

2013-06-01

To describe the long-term results, quality of life and chronic pain after chest wall fixation for traumatic rib fracture using a quality of life (QOL) score and a numeric pain score. Retrospective analysis of 10 consecutive patients who underwent surgery for rib fractures after trauma and reconstruction between October 2010 and March 2012. Chest rib fractures were fixed with titanium clips and bars or titanium plates and screws through a posterolateral thoracotomy. Pain was assessed with a numeric pain scale 0-10 and quality of life (QOL) with the EORTC questionnaire QLQ-C30. There were 5 males and 5 females. The median age was 58 years (range 21-80). There were no postoperative deaths. The only postoperative complication observed was a contralateral pleural effusion requiring drainage. Median length of stay of the drain and median length of hospital stay were 2 days (range 0-8) and 4 days (range 1-42 days), respectively. The average follow-up period of operatively managed patients was 14 months (range 8-23.5 months). Seven patients scored the pain as 0, one as 1 (mild), one as 4 (moderate) and one as 8 (severe). Only two patients are taking occasionally pain killers. Only one patient presents severe limitation in his life scoring his QOL as poor. Titanium devices (clips and bars; screws and plates) are effective and safe for repair of rib fractures and showed good long-term results in terms of pain and quality of life after the operation.

Assuring the Quality of Test Results in the Field of Nuclear Techniques and Ionizing Radiation. The Practical Implementation of Section 5.9 of the EN ISO/IEC 17025 Standard

NASA Astrophysics Data System (ADS)

Cucu, Daniela; Woods, Mike

2008-08-01

The paper aims to present a practical approach for testing laboratories to ensure the quality of their test results. It is based on the experience gained in assessing a large number of testing laboratories, discussing with management and staff, reviewing results obtained in national and international PTs and ILCs and exchanging information in the EA laboratory committee. According to EN ISO/IEC 17025, an accredited laboratory has to implement a programme to ensure the quality of its test results for each measurand. Pre-analytical, analytical and post-analytical measures shall be applied in a systematic manner. They shall include both quality control and quality assurance measures. When designing the quality assurance programme a laboratory should consider pre-analytical activities (like personnel training, selection and validation of test methods, qualifying equipment), analytical activities ranging from sampling, sample preparation, instrumental analysis and post-analytical activities (like decoding, calculation, use of statistical tests or packages, management of results). Designed on different levels (analyst, quality manager and technical manager), including a variety of measures, the programme shall ensure the validity and accuracy of test results, the adequacy of the management system, prove the laboratory's competence in performing tests under accreditation and last but not least show the comparability of test results. Laboratory management should establish performance targets and review periodically QC/QA results against them, implementing appropriate measures in case of non-compliance.

Ground-Water Quality Data in the Central Eastside San Joaquin Basin 2006: Results from the California GAMA Program

USGS Publications Warehouse

Landon, Matthew K.; Belitz, Kenneth

2008-01-01

for approximately one-sixth of the wells, and the results for these samples were used to evaluate the quality of the data for the ground-water samples. Assessment of the quality-control results showed that the environmental data were of good quality, with low bias and low variability, and resulted in censoring of less than 0.3 percent of the detections found in ground-water samples. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, water typically is treated, disinfected, and (or) blended with other waters to maintain acceptable water quality. Regulatory thresholds apply to treated water that is served to the consumer, not to raw ground water. However, to provide some context for the results, concentrations of constituents measured in the raw ground water were compared with health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and California Department of Public Health (CADPH) and thresholds established for aesthetic concerns (secondary maximum contaminant levels, SMCL-CA) by CADPH. VOCs and pesticides were detected in approximately half of the grid wells, and all detections in samples from CESJO wells were below health-based thresholds. All detections of nutrients and major elements in grid wells also were below health-based thresholds. Most detections of constituents of special interest, trace elements, and radioactive constituents in samples from grid wells were below health-based thresholds. Exceptions included two detections of arsenic that were above the USEPA maximum contaminant level (MCL-US), one detection of lead above the USEPA action level (AL-US), and one detection of vanadium and three detections of 1,2,3-TCP that were above the CADPH notification levels (NL-CA). All detections of radioactive constituents were below health-based thresholds, although fourteen samples had activities of radon-222 above the lower proposed MCL-US. Most of th

An Integrational Model of Quality of Life in Older Age. Results from the Esrc/mrc Hsrc Quality of Life Survey in Britain.(author Abstract)

ERIC Educational Resources Information Center

Bowling, Ann; Gabriel, Zahava

2004-01-01

This paper is based on the results of a national survey of the quality of life of 999 randomly sampled people aged 65 and over, living at home in Britain. The survey was semi-structured, and a sample of survey respondents was followed up and interviewed in-depth in order to explore their perceptions of quality of life in full. Comparisons are made…

43 CFR 3430.2-1 - Initial showing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT...-1 Initial showing. All preference right coal lease applications shall have contained or shall have been supplemented by the timely submission of: (a) Information on the quantity and quality of the coal...

Total Quality Management Elements and Results in Higher Education Institutions: The Greek Case

ERIC Educational Resources Information Center

Psomas, Evangelos; Antony, Jiju

2017-01-01

Purpose: The purpose of this paper is to determine the main total quality management (TQM) elements adopted and the respective results achieved by higher education institutions (HEIs) in Greece. Design/methodology/approach: A research study was designed and carried out in private sector Greek HEIs. Fifteen HEIs were approached through interviews…

Small cause - big effect: improvement in interface design results in improved data quality - a multicenter crossover study.

PubMed

Ahlbrandt, Janko; Henrich, Michael; Hartmann, Bernd A; Bundschuh, Bettina B; Schwarz, Julia; Klasen, Joachim; Röhrig, Rainer

2012-01-01

In Germany the core data set for anesthesia version 3.0 was recently introduced for external quality assurance, which includes five surgical tracer procedures. We found a low rate of correctly documented tracers when compared to procedure data (OPS-Codes) documented separately. Examination revealed that the graphical user interface (GUI) contravened the dialogue principles as defined in EN ISO 9241-110. We worked with the manufacturer to implement small improvements and roll out the software. A crossover study was conducted at a university hospital and a municipal hospital chain with five hospitals. All study sites and surgical tracer procedures combined, we found an improvement from 42% to 65% (p<0.001; N=34,610) correctly documented anesthesias. We also saw improvements for most of the observed surgical tracer procedures at all hospitals. Our results show the big effect small changes to the GUI can have on data quality. They also raise the question, if highly flexible and parameterized clinical documentation systems are suited to achieve high usability. Finding the right balance between GUIs designed by usability experts and the flexibility of parameterization by administrators will be a difficult task for the future and subject to further research.

Experimental results supporting the determination of service quality objectives for DBS systems

NASA Technical Reports Server (NTRS)

Chouinard, G.; Whyte, W. A., Jr.; Goldberg, A. A.; Jones, B. L.

1985-01-01

A summary of the results of a joint United States and Canadian program on subjective measurements of the picture degradation caused by noise and interference on an NTSC encoded color television signal is given in this paper. The effects of system noise, cochannel and adjacent channel interference, and both single entry and aggregate as well as a combination of these types of interference were subjectively evaluated by expert and nonexpert viewers under reference conditions. These results were used to develop the rationale used at RARC '83 to establish the service quality objective for planning the DBS service for the American continents.

Quality-control results for ground-water and surface-water data, Sacramento River Basin, California, National Water-Quality Assessment, 1996-1998

USGS Publications Warehouse

Munday, Cathy; Domagalski, Joseph L.

2003-01-01

Evaluating the extent that bias and variability affect the interpretation of ground- and surface-water data is necessary to meet the objectives of the National Water-Quality Assessment (NAWQA) Program. Quality-control samples used to evaluate the bias and variability include annual equipment blanks, field blanks, field matrix spikes, surrogates, and replicates. This report contains quality-control results for the constituents critical to the ground- and surface-water components of the Sacramento River Basin study unit of the NAWQA Program. A critical constituent is one that was detected frequently (more than 50 percent of the time in blank samples), was detected at amounts exceeding water-quality standards or goals, or was important for the interpretation of water-quality data. Quality-control samples were collected along with ground- and surface-water samples during the high intensity phase (cycle 1) of the Sacramento River Basin NAWQA beginning early in 1996 and ending in 1998. Ground-water field blanks indicated contamination of varying levels of significance when compared with concentrations detected in environmental ground-water samples for ammonia, dissolved organic carbon, aluminum, and copper. Concentrations of aluminum in surface-water field blanks were significant when compared with environmental samples. Field blank samples collected for pesticide and volatile organic compound analyses revealed no contamination in either ground- or surface-water samples that would effect the interpretation of environmental data, with the possible exception of the volatile organic compound trichloromethane (chloroform) in ground water. Replicate samples for ground water and surface water indicate that variability resulting from sample collection, processing, and analysis was generally low. Some of the larger maximum relative percentage differences calculated for replicate samples occurred between samples having lowest absolute concentration differences and(or) values near

75 FR 19369 - Certain Hot-Rolled Flat-Rolled Carbon Quality Steel Products from Brazil: Preliminary Results of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-14

...-Rolled Carbon Quality Steel Products from Brazil: Preliminary Results of Antidumping Duty Administrative... duty order on certain hot-rolled flat-rolled carbon quality steel products (hot-rolled steel) from... 1, 2008, through February 28, 2009. We preliminarily determine that the sale of hot-rolled steel...

Oil and gas impacts on air quality in federal lands in the Bakken region: an overview of the Bakken Air Quality Study and first results

NASA Astrophysics Data System (ADS)

Prenni, A. J.; Day, D. E.; Evanoski-Cole, A. R.; Sive, B. C.; Hecobian, A.; Zhou, Y.; Gebhart, K. A.; Hand, J. L.; Sullivan, A. P.; Li, Y.; Schurman, M. I.; Desyaterik, Y.; Malm, W. C.; Schichtel, B. A.; Collett, J. L., Jr.

2015-10-01

The Bakken formation contains billions of barrels of oil and gas trapped in rock and shale. Horizontal drilling and hydraulic fracturing methods have allowed for extraction of these resources, leading to exponential growth of oil production in the region over the past decade. Along with this development has come an increase in associated emissions to the atmosphere. Concern about potential impacts of these emissions on federal lands in the region prompted the National Park Service to sponsor the Bakken Air Quality Study over two winters in 2013-2014. Here we provide an overview of the study and present some initial results aimed at better understanding the impact of local oil and gas emissions on regional air quality. Data from the study, along with long term monitoring data, suggest that while power plants are still an important emissions source in the region, emissions from oil and gas activities are impacting ambient concentrations of nitrogen oxides and black carbon and may dominate recent observed trends in pollutant concentrations at some of the study sites. Measurements of volatile organic compounds also definitively show that oil and gas emissions were present in almost every air mass sampled over a period of more than four months.

Oil and gas impacts on air quality in federal lands in the Bakken region: an overview of the Bakken Air Quality Study and first results

NASA Astrophysics Data System (ADS)

Prenni, A. J.; Day, D. E.; Evanoski-Cole, A. R.; Sive, B. C.; Hecobian, A.; Zhou, Y.; Gebhart, K. A.; Hand, J. L.; Sullivan, A. P.; Li, Y.; Schurman, M. I.; Desyaterik, Y.; Malm, W. C.; Collett, J. L., Jr.; Schichtel, B. A.

2016-02-01

The Bakken formation contains billions of barrels of oil and gas trapped in rock and shale. Horizontal drilling and hydraulic fracturing methods have allowed for extraction of these resources, leading to exponential growth of oil production in the region over the past decade. Along with this development has come an increase in associated emissions to the atmosphere. Concern about potential impacts of these emissions on federal lands in the region prompted the National Park Service to sponsor the Bakken Air Quality Study over two winters in 2013-2014. Here we provide an overview of the study and present some initial results aimed at better understanding the impact of local oil and gas emissions on regional air quality. Data from the study, along with long-term monitoring data, suggest that while power plants are still an important emissions source in the region, emissions from oil and gas activities are impacting ambient concentrations of nitrogen oxides and black carbon and may dominate recent observed trends in pollutant concentrations at some of the study sites. Measurements of volatile organic compounds also definitively show that oil and gas emissions were present in almost every air mass sampled over a period of more than 4 months.

Quality of Diabetes Care: The Challenges of an Increasing Epidemic in Mexico. Results from Two National Health Surveys (2006 and 2012)

PubMed Central

Flores-Hernández, Sergio; Saturno-Hernández, Pedro J.; Reyes-Morales, Hortensia; Barrientos-Gutiérrez, Tonatiuh; Villalpando, Salvador; Hernández-Ávila, Mauricio

2015-01-01

Background The quality of diabetes care remains suboptimal according to numerous studies assessing the achievement of quality indicators for diabetes care in various healthcare settings. We report about global and specific quality indicators for diabetes care and their association to glycemic control at the population level in two national health surveys in Mexico. Methods We conducted a cross-sectional analysis of the 2006 and 2012 National Health Surveys in Mexico. We examined quality of care for 2,965 and 4,483 adults (≥ 20 years) with diagnosed type 2 diabetes using fourteen simple and two composite indicators derived from self-reported information. In a subsample for both surveys, glycated hemoglobin (HbA1c) was measured at the time of the interview. We obtained survey weight-adjusted estimators using multiple regression models (logistic and linear) with combined data files, including survey year as covariate to assess change. Results Global quality of care in 2012 was 40.8%, with a relative improvement of 11.7% between 2006 and 2012. Detections of cardiovascular disease risk factors (dyslipidemia and hypertension) were the indicators with the highest improvement, while non-pharmaceutical treatment and diabetic foot exams showed minor changes. We found a significant association between the quality of the process of diabetes care and glycemic control (OR 2.53, 95% CI 1.63-3.94). Age more than 65 years old, the type of health subsystem, gender (males), and high socio-economic status were also significantly associated to glycemic control. Conclusions Quality diabetes care and glycemic control improved and are significantly associated. However, according to international standards, the current situation remains suboptimal. A more holistic approach is needed, with an emphasis on improving quality in outpatient care. PMID:26230991

Geochemical evolution processes and water-quality observations based on results of the National Water-Quality Assessment Program in the San Antonio segment of the Edwards aquifer, 1996-2006

USGS Publications Warehouse

Musgrove, MaryLynn; Fahlquist, Lynne; Houston, Natalie A.; Lindgren, Richard J.; Ging, Patricia B.

2010-01-01

increase along flow paths; results for samples of Edwards aquifer groundwater show an increase from shallow/urban unconfined, to unconfined, to confined groundwater categories. These differences are consistent with longer residence times and greater extents of water-rock interaction controlling fluid compositions as groundwater evolves from shallow unconfined groundwater to deeper confined groundwater. Results for stable isotopes of hydrogen and oxygen indicate specific geochemical processes affect some groundwater samples, including mixing with downdip saline water, mixing with recent recharge associated with tropical cyclonic storms, or mixing with recharge water than has undergone evaporation. The composition of surface water recharging the aquifer, as well as mixing with downdip water from the Trinity aquifer or the saline zone, also might affect water quality. A time-series record (1938-2006) of discharge at Comal Springs, one of the major aquifer discharge points, indicates an upward trend for nitrate and chloride concentrations, which likely reflects anthropogenic activities. A small number of organic contaminants were routinely or frequently detected in Edwards aquifer groundwater samples. These were the pesticides atrazine, its degradate deethylatrazine, and simazine; the drinking-water disinfection byproduct chloroform; and the solvent tetrachloroethene. Detection of these contaminants was most frequent in samples of the shallow/urban unconfined groundwater category and least frequent in samples of the unconfined groundwater category. Results indicate that the shallow/urban unconfined part of the aquifer is most affected by anthropogenic contaminants and the unconfined part of the aquifer is the least affected. The high frequency of detection for these anthropogenic contaminants aquifer-wide and in samples of deep, confined groundwater indicates that the entire aquifer is susceptible to water-quality changes as a result of anthropogenic activities. L

Influence of air quality on the results of in vitro fertilization attempts: A retrospective study.

PubMed

Carré, Julie; Gatimel, Nicolas; Moreau, Jessika; Parinaud, Jean; Leandri, Roger

2017-03-01

To assess the influence of air quality on the results of IVF. We performed a retrospective study on 292 patients who have undergone an IVF attempt from April 2012 to December 2015 in our French university hospital. Patients were included in the study if data on the air quality at home and at work were available and if they haven't been gone for more than 4days in a month. Data were recorded during the 3 months before oocyte collection and 1 month after embryo transfer. Air quality measurements were obtained from the Observatoire Régional de l'Air en Midi-Pyrénées (ORAMIP) and concerned the levels of nitrogen dioxide (NO 2 ), ozone (O 3 ), particulate matter PM10 and SO 2 measured every day. Acute exposures to high levels NO 2 or PM10 were associated with lower results of IVF (ovarian response to stimulation, number of top embryos) while these parameters were enhanced when patients were exposed to high levels of O 3 during the first 2 months of folliculogenesis. These effects were found even for a short exposure (1day). Air quality has an impact on global health and also on the reproductive function and public and authorities must be aware of environmental protection. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Does adoption of electronic health records improve the quality of care management in France? Results from the French e-SI (PREPS-SIPS) study.

PubMed

Plantier, Morgane; Havet, Nathalie; Durand, Thierry; Caquot, Nicolas; Amaz, Camille; Biron, Pierre; Philip, Irène; Perrier, Lionel

2017-06-01

Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including the promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances. The aim of this study was to evaluate the impact of EHR use on the quality of care management in acute care hospitals throughout France. This retrospective study was based on data derived from three national databases for the year 2011: IPAQSS (indicators of improvement in the quality and the management of healthcare, "IPAQSS"), Hospi-Diag (French hospital performance indicators), and the national accreditation database. Several multivariate models were used to examine the association between the use of EHRs and specific EHR features with four quality indicators: the quality of patient record, the delay in sending information at hospital discharge, the pain status evaluation, and the nutritional status evaluation, while also adjusting for hospital characteristics. The models revealed a significant positive impact of EHR use on the four quality indicators. Additionally, they showed a differential impact according to the functionality of the element of the health record that was computerized. All four quality indicators were also impacted by the type of hospital, the geographical region, and the severity of the pathology. These results suggest that, to improve the quality of care management in hospitals, EHR adoption represents an important lever. They complete previous work dealing with EHR and the organizational performance of hospital surgical units. Copyright © 2017 Elsevier B.V. All rights reserved.

Water quality monitoring of Sweetwater and Loveland reservoirs--Phase one results 1998-1999

USGS Publications Warehouse

Majewski, Michael S.; Sidhu, Jagdeep S.; Mendez, Gregory O.

2002-01-01

In 1998, the U.S. Geological Survey began a study to assess the overall health of the watershed feeding the Sweetwater Reservoir in southern San Diego County, California. The study focussed on monitoring for organic chemical contamination and the effects of construction and operation of State Route 125 on water quality. Three environmental compartments (air, water, and bed sediments) are being sampled regularly for chemical contaminants, including volatile organic compounds, polynuclear aromatic hydrocarbons, polychlorinated biphenyls, pesticides, and major and trace elements. The study is divided into two phases. Phase I sampling is designed to establish baseline conditions for target compounds in terms of detection frequency and concentration in air, water, and bed sediments. Phase II sampling will continue at the established monitoring sites during and after construction of State Route 125 to assess chemical impact on water quality in the reservoir resulting from land-use changes and development in the watershed. This report describes the study design, the sampling and analytical methods, and presents the data results for the first year of the study, September 1998 to September 1999.

[Health insurance dentists' subjective perceptions of quality when implementing quality management in practice - results from a nationwide survey].

PubMed

Kettler, Nele; Chenot, Regine; Jordan, A Rainer

2015-01-01

Statutory health insurance dentists working in private practice have a duty to maintain and improve the quality of dental care. An individual practice's approach to quality management (QM) can be made to reflect the practice's philosophy on quality and standards and can be adapted to the specific requirements of the practice setting they are meant to serve. This study set out to collect data on the subjective perceptions of quality that exist among German dentists, and to canvass their views on the process and benefits of implementing QM systems. In doing so, this study aimed to identify the incentives and obstacles that currently exist in relation to the implementation and further development of practice-based QM systems. As part of a nationally representative cross-sectional study, a random sample of 2,084 dentists was asked to complete a questionnaire on perceptions of quality and QM. The response rate was 40.3 % (n=838). The study's primary end point was defined as the surveyed dentists' interpretative description of quality. The study's secondary end point was defined as the dentists' subjective evaluations of the benefits of QM in the day-to-day management of their own practices. Responses to open-ended questions were analysed using content analysis, while quantitative questions were analysed using descriptive univariate analysis. When analysing respondents' subjective perceptions of quality (primary end point), the following dimensions were revealed as highly significant: patient (mentioned by 31.4 % of the responders), quality of treatment (29.5 %) and staff (14.8 %). As far as the benefits of QM in the day-to-day management of the respondent's own practices (secondary end point) were concerned, these appeared to be linked to the ease of implementation of the organizational tools offered by QM systems: managing emergencies, team meetings and procedural check lists were ranked as "can be implemented to a reasonable degree" and "can be fully implemented

Preventing falls in assisted living: Results of a quality improvement pilot study.

PubMed

Zimmerman, Sheryl; Greene, Angela; Sloane, Philip D; Mitchell, Madeline; Giuliani, Carol; Nyrop, Kirsten; Walsh, Edith

Residents of assisted living (AL) communities are at high risk for falls, which result in negative outcomes and high health care costs. Adapting effective falls prevention programs for AL quality improvement (QI) has the potential to reduce falls, improve resident quality of life, and reduce costs. This project tested the feasibility and outcomes of an evidence-based multi-component QI program, the Assisted Living Falls Prevention and Monitoring Program (AL-FPMP). Resident posture and gait improved, likely due to exercise and/or physical therapy. Effective falls prevention QI programs can be implemented in AL, and are advised to (1) establish and maintain a falls team to create a culture focused on the reduction of falls risk; (2) teach staff to assess residents using the Morse Falls Scale to increase their awareness of residents' falls risk and improvement; and (3) modify existing exercise programs to address balance and lower body strength. Copyright © 2016 Elsevier Inc. All rights reserved.

Ground-Water Quality Data in the Santa Clara River Valley Study Unit, 2007: Results from the California GAMA Program

USGS Publications Warehouse

Montrella, Joseph; Belitz, Kenneth

2009-01-01

and age of the sampled ground water. Quality-control samples (blanks or replicates, or samples for matrix spikes) were collected from approximately 26 percent of the wells, and the analyses of these samples were used to evaluate the quality of the data for the ground-water samples. Assessment of the quality-control results showed that the quality of the environmental data was good, with low bias and low variability, and as a result, less than 0.1 percent of the analytes detected in ground-water samples were censored. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, water typically is treated, disinfected, and (or) blended with other waters to maintain acceptable water quality. Regulatory thresholds apply to treated water that is delivered (or, supplied) to the consumer, not to raw ground water. However, to provide some context for the results, concentrations of constituents measured in the raw ground water were compared with regulatory and non-regulatory thresholds established by the U.S. Environmental Protection Agency (USEPA) and the California Department of Public Health (CDPH) and thresholds established for aesthetic concerns (secondary maximum contaminant levels, SMCL-CA) by CDPH. Most constituents that were detected in ground-water samples were reported at concentrations below their established health-based thresholds. VOCs, pesticides and pesticide degradates, and potential wastewater-indicator compounds were detected in about 33 percent or less of the 42 SCRV grid wells. Concentrations of all detected organic constituents were below established health-based thresholds. Perchlorate was detected in approximately 12 percent of the SCRV grid wells; all concentrations reported were below the NL-CA threshold. Additional constituents, including major ions, trace elements, and nutrients were collected at 26 wells (16 grid wells and 10 understanding wells) of the 53 wells sampled f

Quality of Life, Disability, Well-Being, and Coping Strategies in Patients Undergoing Neurosurgical Procedures: Preoperative Results in an Italian Sample

PubMed Central

Quintas, Rui; Pagani, Marco; Brock, Stefano; Visintini, Sergio; Cusin, Alberto; Schiariti, Marco; Broggi, Morgan; Ferroli, Paolo; Leonardi, Matilde

2014-01-01

Background. The aim of this paper is to present the preliminary results of QoL, well-being, disability, and coping strategies of patients before neurosurgical procedure. Methods. We analysed data on preoperative quality of life (EUROHIS-QoL), disability (WHODAS-II), well-being (PGWB-S), coping strategies (Brief COPE), and functional status (KPS score) of a sample of patients with brain tumours and cerebrovascular and spinal degenerative disease admitted to Neurological Institute Carlo Besta. Statistical analysis was performed to illustrate the distribution of sociodemographic and clinical data, to compare mean test scores to the respective normative samples, and to investigate the differences between diagnoses, the correlation between tests, and the predictive power of sociodemographic and clinical variables of QoL. Results. 198 patients were included in the study. PGWB-S and EUROHIS-QoL scores were significantly lower than normative population. Patients with spinal diseases reported higher scores in WHODAS-II compared with oncological and cerebrovascular groups. Finally sociodemographic and clinical variables were significant predictors of EUROHIS-QoL, in particular PGWB-S and WHODAS-II. Conclusion. Our preliminary results show that preoperatory period is critical and the evaluation of coping strategies, quality of life, disability, and well-being is useful to plan tailored intervention and for a better management of each patient. PMID:25538963

Water-quality assessment of the Delmarva Peninsula, Delaware, Maryland, and Virginia; results of investigations, 1987-91

USGS Publications Warehouse

Shedlock, Robert J.; Denver, J.M.; Hayes, M.A.; Hamilton, P.A.; Koterba, M.T.; Bachman, L.J.; Phillips, P.J.; Banks, W.S.

1999-01-01

A regional ground-water-quality assessment of the Delmarva Peninsula was conducted as a pilot study for the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program. The study focused on the surficial aquifer and used both existing data and new data collected between 1988 and 1991. The new water samples were analyzed for major ions, nutrients, radon, volatile organic compounds, and a suite of herbicides and insecticides commonly used on corn, soybeans, and small grains. Samples also were collected from wells completed in deeper, confined aquifers and from selected streams, and analyzed for most of these constituents. The study employed a multi-scale network design. Regional networks were chosen to provide broad geographic coverage of the study area and to ensure that the major hydrogeologic settings of the surficial aquifer were adequately represented. Both the existing data and the data from samples collected during the study showed that agricultural activities had affected the quality of water in the surficial aquifer over most of the Peninsula.

Effect of sleep deficit, knowledge of results, and stimulus quality on reaction time and response force.

PubMed

Jaśkowski, P; Włodarczyk, D

1997-04-01

Some recent findings suggested that response force measured during reaction time experiments might reflect changes in activation. We performed an experiment in which the effect of sleep deprivation, knowledge of results, and stimulus quality on response force was studied in simple and choice reaction tasks. As expected, both simple and choice reaction times increased with sleep deficit. Further, simple and choice reactions were faster with knowledge of results and slowed down when stimulus quality was degraded. As sleep deprivation affects both arousal and activation, we expected a detrimental effect of sleep on force amplitude. On the other hand, knowledge of results was expected to increase force by its compensatory effect on arousal and activation. No effect of sleep deprivation on response force was found. Knowledge of results increased response force independently of sleep deprivation.

[Inter-and intra-operator variability in the analysis of semen parameters: results from a quality control program].

PubMed

Daoud, Salima; Chakroun-Feki, Nozha; Sellami, Afifa; Ammar-Keskes, Leila; Rebai, Tarek

2016-01-01

Semen analysis is a key part of male infertility investigation. The necessity of quality management implementation in the andrology laboratory has been recognized in order to ensure the reliability of its results. The aim of this study was to evaluate intra- and inter-individual variability in the assessment of semen parameters in our laboratory through a quality control programme. Four participants from the laboratory with different experience levels have participated in this study. Semen samples of varying quality were assessed for sperm motility, concentration and morphology and the results were used to evaluate inter-participant variability. In addition, replicates of each semen sample were analyzed to determine intra-individual variability for semen parameters analysis. The average values of inter-participant coefficients of variation for sperm motility, concentration and morphology were 12.8%, 19.8% and 48.9% respectively. The mean intra-participant coefficients of variation were, respectively, 6.9%, 12.3% and 42.7% for sperm motility, concentration and morphology. Despite some random errors of under- or overestimation, the overall results remained within the limits of acceptability for all participants. Sperm morphology assessment was particularly influenced by the participant's level of experience. The present data emphasize the need for appropriate training of the laboratory staff and for regular participation in internal quality control programmes in order to improve the reliability of laboratory results.

FQC Dashboard: integrates FastQC results into a web-based, interactive, and extensible FASTQ quality control tool

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

Brown, Joseph; Pirrung, Meg; McCue, Lee Ann

FQC is software that facilitates large-scale quality control of FASTQ files by carrying out a QC protocol, parsing results, and aggregating quality metrics within and across experiments into an interactive dashboard. The dashboard utilizes human-readable configuration files to manipulate the pages and tabs, and is extensible with CSV data.

Choosing GnRH Antagonist Protocol Shows Improved Oocyte and Embryo Quality, Coherent with the Perifollicular Vascularity (PFV) in Assisted Reproductive Techniques

PubMed Central

Ramachandran, Amar; Kumar, Pratap

2015-01-01

Introduction The parent oocyte from which the embryo is derived, determines its quality and the perifollicular vascularity (PFV) determines the micro-environment of the developing ovum. The PFV correlates well with the follicular oxygenation, oocyte maturation and embryo viability. PFV is imaged with Power Doppler Ultrasound. Aim To study and compare the association of the PFV of follicles with the quality of the oocytes and embryos in agonist and antagonist protocol, employed in Assisted Reproductive techniques (ART). Study Design A prospective observational study was conducted on 75 patients, who were recruited for ART cycles, out of which 25 were given the Agonist protocol and the remaining 50 received the Antagonist protocol. Materials and Methods The patients underwent the stimulation protocol. The PFV of preovulatory follicles were studied with Transvaginal Power Doppler and graded. Each oocyte retrieved carried the same label of its parent follicle. Embryos were cultured. The embryologist was blinded. The oocyte and embryo quality were assessed and compared with the PFV of parent follicle. Results Follicles with grade 1 and 2 PFV were predominantly observed. The yield of oocytes was independent of PFV. The mean yield of good quality embryos in conjunction with the PFV of the parent follicle was found to be highly significant in both the groups. The antagonist group had statistically significant yield of mature oocytes and embryos, compared to the agonist group. Conclusion Antagonist protocol had favourable outcomes compared with the agonist protocol. The retrieval of oocytes, even the mature ones and the yield of high grade embryos were found higher. As the PFV increased, the yield and overall pregnancy rates were higher. PFV as assessed by Power Doppler is a useful non-invasive biomarker of embryo quality and can be employed in conjunction with other biomarkers in ART to predict successful outcome. PMID:26674932

Institutional Consequences of Quality Assessment

ERIC Educational Resources Information Center

Joao Rosa, Maria; Tavares, Diana; Amaral, Alberto

2006-01-01

This paper analyses the opinions of Portuguese university rectors and academics on the quality assessment system and its consequences at the institutional level. The results obtained show that university staff (rectors and academics, with more of the former than the latter) held optimistic views of the positive consequences of quality assessment…

Quality of life in chemical warfare survivors with ophthalmologic injuries: the first results form Iran Chemical Warfare Victims Health Assessment Study

PubMed Central

Mousavi, Batool; Soroush, Mohammad Reza; Montazeri, Ali

2009-01-01

Background Iraq used chemical weapons extensively against the Iranians during the Iran-Iraq war (1980–1988). The aim of this study was to assess the health related quality of life (HRQOL) in people who had ophthalmologic complications due to the sulfur mustard gas exposure during the war. Methods The Veterans and Martyrs Affair Foundation (VMAF) database indicated that there were 196 patients with severe ophthalmologic complications due to chemical weapons exposure. Of these, those who gave consent (n = 147) entered into the study. Quality of life was measured using the 36-item Short Form Health Survey (SF-36) and scores were compared to those of the general public. In addition logistic regression analysis was performed to indicate variables that contribute to physical and mental health related quality of life. Results The mean age of the patients was 44.8 (SD = 8.7) ranging from 21 to 75 years. About one-third of the cases (n= 50) reported exposure to chemical weapons more than once. The mean exposure duration to sulfur mustard gas was 21.6 years (SD = 1.2). The lowest scores on the SF-36 subscales were found to be: the role physical and the general health. Quality of life in chemical warfare victims who had ophthalmologic problems was significantly lower than the general public (P < 0.001). The results obtained from logistic regression analysis indicated that those who did not participate in sport activities suffer from a poorer physical health (OR = 2.93, 95% CI = 1.36 to 6.30, P = 0.006). The analysis also showed that poor mental health was associated with longer time since exposure (OR = 1.58, 95% CI = 1.04 to 2.39, P = 0.03) and lower education (OR = 3.03, 95% CI = 1.21 to 7.56, P = 0.01). Conclusion The study findings suggest that chemical warfare victims with ophthalmologic complications suffer from poor health related quality of life. It seems that the need for provision of health and support for this population is urgent. In addition, further research

Ground-Water Quality Data in the San Fernando-San Gabriel Study Unit, 2005 - Results from the California GAMA Program

USGS Publications Warehouse

Land, Michael; Belitz, Kenneth

2008-01-01

samples were used to evaluate the quality of the data for the ground-water samples. Assessment of the quality-control results showed that the data had very little bias or variability and resulted in censoring of less than 0.7 percent (32 of 4,484 measurements) of the data collected for ground-water samples. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, water typically is treated, disinfected, or blended with other waters to maintain acceptable water quality. Regulatory thresholds apply to treated water that is served to the consumer, not to raw ground water. However, to provide some context for the results, concentrations of constituents measured in the raw ground water were compared with health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and California Department of Public Health (CDPH) and thresholds established for aesthetic concerns (secondary maximum contaminant levels, SMCL-CA) by CDPH. VOCs were detected in more than 90 percent (33 of 35) of grid wells. For all wells sampled for SFSG, nearly all VOC detections were below health-based thresholds, and most were less than one-tenth of the threshold values. Samples from seven wells had at least one detection of PCE, TCE, tetrachloromethane, NDMA, or 1,2,3-TCP at or above a health-based threshold. Pesticides were detected in about 90 percent (31 of 35) grid wells and all detections in samples from SFSG wells were below health-based thresholds. Major ions, trace elements, and nutrients in samples from 17 SFSG wells were all below health-based thresholds, with the exception of one detection of nitrate that was above the USEPA maximum contaminant level (MCL-US). With the exception of 14 samples having radon-222 above the proposed MCL-US, radioactive constituents were below health-based thresholds for 16 of the SFSG wells sampled. Total dissolved solids in 6 of the 24 SFSG wells that were sampled ha

Measuring the willingness to pay for drinking water quality improvements: results of a contingent valuation survey in Songzi, China.

PubMed

Jianjun, Jin; Wenyu, Wang; Ying, Fan; Xiaomin, Wang

2016-06-01

The aim of this study is to elicit local residents' willingness to pay (WTP), by applying the contingent valuation method as a surcharge on their water bill, for a given improvement in the drinking water quality and the supply reliability. The mean WTP for the drinking water quality improvement program was estimated to be 16.71 yuan (0.3% of total household income). The results note that more educated respondents and households with higher income and with fewer household members are, on average, willing to pay more. This study also demonstrates that respondents' concerns regarding drinking water quality and perceptions of the health risk of drinking water quality can have significant positive impacts on people's WTP. The research results can help decision-makers understand the local population's demand for improved drinking water quality and undertake an environmental cost-benefit analysis.

Results from the Big Spring basin water quality monitoring and demonstration projects, Iowa, USA

USGS Publications Warehouse

Rowden, R.D.; Liu, H.; Libra, R.D.

2001-01-01

Agricultural practices, hydrology, and water quality of the 267-km2 Big Spring groundwater drainage basin in Clayton County, Iowa, have been monitored since 1981. Land use is agricultural; nitrate-nitrogen (-N) and herbicides are the resulting contaminants in groundwater and surface water. Ordovician Galena Group carbonate rocks comprise the main aquifer in the basin. Recharge to this karstic aquifer is by infiltration, augmented by sinkhole-captured runoff. Groundwater is discharged at Big Spring, where quantity and quality of the discharge are monitored. Monitoring has shown a threefold increase in groundwater nitrate-N concentrations from the 1960s to the early 1980s. The nitrate-N discharged from the basin typically is equivalent to over one-third of the nitrogen fertilizer applied, with larger losses during wetter years. Atrazine is present in groundwater all year; however, contaminant concentrations in the groundwater respond directly to recharge events, and unique chemical signatures of infiltration versus runoff recharge are detectable in the discharge from Big Spring. Education and demonstration efforts have reduced nitrogen fertilizer application rates by one-third since 1981. Relating declines in nitrate and pesticide concentrations to inputs of nitrogen fertilizer and pesticides at Big Spring is problematic. Annual recharge has varied five-fold during monitoring, overshadowing any water-quality improvements resulting from incrementally decreased inputs. ?? Springer-Verlag 2001.

The quality of health care in prison: results of a year's programme of semistructured inspections.

PubMed Central

Reed, J.; Lyne, M.

1997-01-01

OBJECTIVES: To assess, as part of wider inspections by HM Inspectorate of Prisons, the extent and quality of health care in prisons in England and Wales. DESIGN: Inspections based on a set of "expectations" derived mainly from existing healthcare quality standards published by the prison service and existing ethical guidelines; questionnaire survey of prisoners. SUBJECTS: 19 prisons in England and Wales, 1996-7. MAIN OUTCOME MEASURES: Appraisals of needs assessment and the commissioning and delivery of health care against the inspectorate's expectations. RESULTS: The quality of health care varied greatly. A few prisons provided health care broadly equivalent to NHS care, but in many the health care was of low quality, some doctors were not adequately trained to do the work they faced, and some care failed to meet proper ethical standards. Little professional support was available to healthcare staff. CONCLUSIONS: The current policy for improving health care in prisons is not likely to achieve its objectives and is potentially wasteful. The prison service needs to recognise that expertise in the commissioning and delivery of health care is overwhelming based in the NHS. The current review of the provision of health care in prisons offers an opportunity to ensure that prisoners are not excluded from high quality health care. PMID:9418090

Annual Report Card Shows Water Quality Improvements in Parts of the Mystic River Watershed in 2017

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA), in collaboration with the Mystic River Watershed Association (MyRWA), announced its annual Water Quality Report Card on the Mystic River watershed for 2017.

Newly Built Undergraduate Schools Should Place Great Emphasis on Connotation Construction and Quality Promotion: An Analysis Based on the Qualification Evaluation Results for 41 Undergraduate Schools

ERIC Educational Resources Information Center

Binglin, Zhong

2016-01-01

The article presents a quantitative analysis of the evaluation results for 41 newly built undergraduate schools that submitted to the qualification evaluation of undergraduate work by Ministry of Education in 2013. It shows that newly built undergraduate schools should place great emphasis on connotation construction and quality promotion and on…

The quality of radiation care: the results of focus group interviews and concept mapping to explore the patient's perspective.

PubMed

Nijman, Jessica L; Sixma, Herman; van Triest, Baukelien; Keus, Ronald B; Hendriks, Michelle

2012-01-01

In this study, we explore the quality aspects of radiation care from the patient's perspective in order to develop a draft Consumer Quality Index (CQI) Radiation Care instrument. Four focus group discussions with (former) cancer patients were held to explore the aspects determining the quality of radiation care. The list of aspects generated was categorised based on similarity and importance in a concept mapping procedure. Four focus group discussions revealed seven main themes related to the quality of radiation care: information provision, a patient-centred approach, professional competence, planning and waiting times, accessibility, cooperation and communication, and follow-up care. Results of concept mapping procedures revealed which items the patients considered to be most important. A radiation oncologist who is up to date about the patient's file is of paramount importance for cancer patients receiving radiotherapy. The quality aspects found through focus group discussions provided useful insight into how patients experience radiation care. Furthermore, concept mapping made these results more solid. To evaluate the quality of radiation care from the patient's perspective, these quality aspects will be guiding in the development of a CQI Radiation Care. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

High-quality collection and disposal of WEEE: Environmental impacts and resultant issues.

PubMed

Baxter, John; Lyng, Kari-Anne; Askham, Cecilia; Hanssen, Ole Jørgen

2016-11-01

Life cycle assessment of the collection, transport and recycling of various types of waste electrical and electronic equipment (WEEE) in Norway shows that small amounts of critical materials (refrigerants, precious/trace metals) are vital for the overall environmental accounts of the value chains. High-quality recycling ensures that materials and energy are effectively recovered from WEEE. This recovery means that responsible waste handling confers net environmental benefits in terms of global warming potential (GWP), for all types of WEEE analysed. For refrigeration equipment, the potential reduction of GWP by high-quality recycling is so large as to be of national significance. For all waste types, the magnitude of the net benefit from recovering materials and energy exceeds the negative consequences of irresponsible disposal. One outcome of this may be widespread misunderstanding of the need for recycling. Furthermore, framing public communication on recycling in terms of avoiding negative consequences, as is essentially universal, may not convey an appropriate message. The issue is particularly important where the consumer regards products as relatively disposable and environmentally benign, and/or where the "null option" of retaining the product at end-of-life is especially prevalent. The paper highlights the implications of all these issues for policy-makers, waste collectors and recyclers, and consumers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Map showing general chemical quality of ground water in the Kaiparowits coal-basin area, Utah

USGS Publications Warehouse

Price, Don

1977-01-01

This is one of a series of maps that describe the geology and related natural resources in the Kaiparowits coal-basin area. Chemical analyses of water from about 40 widely scattered springs, 20 coal-exploration holes in the Kaiparowits Plateau, and 7 water wells in the vicinity of the communities of Escalante and Glen Canyon were used to compile this map. All the water samples were from depths of less than 1,000 feet (305 m). Water-quality data were also available from a number of petroleum wells and exploration holes more than 5,000 feet (1,524 m) deep; however, those data were used with considerable discretion because water produced by deep petroleum wells and exploration holes usually is more saline than water found at shallower depths at the drilling sites.Most of the chemical analyses used were collected by the U.S. Geological Survey in cooperation with State, local, and other Federal agencies. Published sources of data included Phoenix (1963), Iorns, Hembree, and Phoenix (1964), Cooley (1965), Feltis (1966), and Goode (1966, 1969), and the Environmental Impact Statement of the proposed Kaiparowits power project (U.S. Bureau of Land Management, 1976).Little or no ground-water-quality data were available for large areas in the Kaiparowits coal basin. In those areas, the indicated ranged of dissolved-solids concentrations in water from springs and wells are inferred largely from the geology as compiled by Stokes (1964) and Hackman and Wyant (1973). This is especially true for those areas where the designated ranges of dissolved-solids concentrations are 100-1,000 and 500-3,000 mg/l (milligrams per liter).El Paso Natural Gas Co., Resources Co., Kaiser Engineers, and Southern California Edison Co. provided ground-water samples and specific water-quality data collected from their exploratory drill holes on the Kaiparowits Plateau. The cooperation of those firms is gratefully acknowledged.

Workload and quality of life of surgeons. Results and implications of a large-scale survey by the German Society of Surgery.

PubMed

Bohrer, Thomas; Koller, Michael; Schlitt, Hans Juergen; Bauer, Hartwig

2011-06-01

the surgeons considered their quality of life even lower than that of their patients (non-surgeons, 17%; p < 0.001). Responses to the PLC quality of life questionnaire confirmed these results, showing score values lower than those of the German population reference data and of several patient groups. Multiple regression analyses showed that the strongest and most consistent influence variable for a low quality of life on all eight quality of life scores were restrictions in private life (range of standardized beta weights beta = 0.259 to 0.325), hierarchical and uncooperative working environment (beta = 0.057 to 0.235), lack of opportunities for continuing education (beta = 0.108 to 0.161), and inadequate salary (beta = 0.036 to 0.172). Improving the working conditions for surgeons requires a concerted action of all relevant parties, including hospital administrators, insurance companies, and the German Society of Surgery. The present study clearly identified measures that should be taken.

Application of Nemerow Index Method and Integrated Water Quality Index Method in Water Quality Assessment of Zhangze Reservoir

NASA Astrophysics Data System (ADS)

Zhang, Qian; Feng, Minquan; Hao, Xiaoyan

2018-03-01

[Objective] Based on the water quality historical data from the Zhangze Reservoir from the last five years, the water quality was assessed by the integrated water quality identification index method and the Nemerow pollution index method. The results of different evaluation methods were analyzed and compared and the characteristics of each method were identified.[Methods] The suitability of the water quality assessment methods were compared and analyzed, based on these results.[Results] the water quality tended to decrease over time with 2016 being the year with the worst water quality. The sections with the worst water quality were the southern and northern sections.[Conclusion] The results produced by the traditional Nemerow index method fluctuated greatly in each section of water quality monitoring and therefore could not effectively reveal the trend of water quality at each section. The combination of qualitative and quantitative measures of the comprehensive pollution index identification method meant it could evaluate the degree of water pollution as well as determine that the river water was black and odorous. However, the evaluation results showed that the water pollution was relatively low.The results from the improved Nemerow index evaluation were better as the single indicators and evaluation results are in strong agreement; therefore the method is able to objectively reflect the water quality of each water quality monitoring section and is more suitable for the water quality evaluation of the reservoir.

[Audit as a tool to assess and promote the quality of medical records and hospital appropriateness: metodology and preliminary results].

PubMed

Poscia, Andrea; Cambieri, Andrea; Tucceri, Chiara; Ricciardi, Walter; Volpe, Massimo

2015-01-01

In the actual economic context, with increasing health needs, efficiency and efficacy represents fundamental keyword to ensure a successful use of the resources and the best health outcomes. Together, the medical record, completely and correctly compiled, is an essential tool in the patient diagnostic and therapeutic path, but it's becoming more and more essential for the administrative reporting and legal claims. Nevertheless, even if the improvement of medical records quality and of hospital stay appropriateness represent priorities for every health organization, they could be difficult to realize. This study aims to present the methodology and the preliminary results of a training and improvement process: it was carried out from the Hospital Management of a third level Italian teaching hospital through audit cycles to actively involve their health professionals. A self assessment process of medical records quality and hospital stay appropriateness (inpatients admission and Day Hospital) was conducted through a retrospective evaluation of medical records. It started in 2012 and a random sample of 2295 medical records was examined: the quality assessment was performed using a 48-item evaluation grid modified from the Lombardy Region manual of the medical record, while the appropriateness of each days was assessed using the Italian version of Appropriateness Evaluation Protocol (AEP) - 2002ed. The overall assessment was presented through departmental audit: the audit were designed according to the indication given by the Italian and English Ministry of Health to share the methodology and the results with all the involved professionals (doctors and nurses) and to implement improvement strategies that are synthesized in this paper. Results from quality and appropriateness assessment show several deficiencies, due to 40% of minimum level of acceptability not completely satisfied and to 30% of inappropriateness between days of hospitalization. Furthermore, there are

Design, implementation, and initial results from a water-quality monitoring network for Atlanta, Georgia, USA

USGS Publications Warehouse

Horowitz, A.J.; Elrick, K.A.; Smith, J.J.

2005-01-01

In cooperation with the City of Atlanta, Georgia, the US Geological Survey has designed and implemented a water-quantity and quality monitoring network that measures a variety of biological and chemical constituents in water and suspended sediment. The network consists of 20 long-term monitoring sites and is intended to assess water-quality trends in response to planned infrastructural improvements. Initial results from the network indicate that nonpoint-source contributions may be more significant than point-source contributions for selected sediment associated trace elements and nutrients. There also are indications of short-term discontinuous point-source contributions of these same constituents during baseflow.

[Analysis on 2011 quality control results on aerobic plate count of microbiology laboratories in China].

PubMed

Han, Haihong; Li, Ning; Li, Yepeng; Fu, Ping; Yu, Dongmin; Li Zhigang; Du, Chunming; Guo, Yunchang

2015-01-01

To test the aerobic plate count examining capability of microbiology laboratories, to ensure the accuracy and comparability of quantitative bacteria examination results, and to improve the quality of monitoring. The 4 different concentration aerobic plate count piece samples were prepared and noted as I, II, III and IV. After homogeneity and stability tests, the samples were delivered to monitoring institutions. The results of I, II, III samples were logarithmic transformed, and evaluated with Z-score method using the robust average and standard deviation. The results of IV samples were evaluated as "satisfactory" when reported as < 10 CFU/piece or as "not satisfactory" otherwise. Pearson χ2 test was used to analyze the ratio results. 309 monitoring institutions, which was 99.04% of the total number, reported their results. 271 institutions reported a satisfactory result, and the satisfactory rate was 87.70%. There was no statistical difference in satisfactory rates of I, II and III samples which were 81.52%, 88.30% and 91.40% respectively. The satisfactory rate of IV samples was 93.33%. There was no statistical difference in satisfactory rates between provincial and municipal CDC. The quality control program has provided scientific data that the aerobic plate count capability of the laboratories meets the requirements of monitoring tasks.

Total quality management in American industry.

PubMed

Widtfeldt, A K; Widtfeldt, J R

1992-07-01

The definition of total quality management is conformance to customer requirements and specifications, fitness for use, buyer satisfaction, and value at an affordable price. The three individuals who have developed the total quality management concepts in the United States are W.E. Deming, J.M. Juran, and Philip Crosby. The universal principles of total quality management are (a) a customer focus, (b) management commitment, (c) training, (d) process capability and control, and (e) measurement through quality improvement tools. Results from the National Demonstration Project on Quality Improvement in Health Care showed the principles of total quality management could be applied to healthcare.

Sailing Can Improve Quality of Life of People with Severe Mental Disorders: Results of a Cross Over Randomized Controlled Trial

PubMed Central

Carta, Mauro Giovanni; Maggiani, Federica; Pilutzu, Laura; Moro, Maria Francesca; Mura, Gioia; Sancassiani, Federica; Vellante, Vellante; Migliaccio, Gian Mario; Machado, Sergio; Nardi, Antonio Egidio; Preti, Antonio

2014-01-01

The aim of this study was to evaluate the impact of a sailing rehabilitation program on the quality of life (QoL) in a sample of patients with severe mental disorders. The study adopted a randomized, crossover, waiting-list controlled design. The participants enrolled in the study were outpatients diagnosed with severe chronic mental disorders. The participants (N=40) exposed to rehabilitation with sailing took part in a series of supervised cruises near the gulf of Cagliari, South Sardinia, and showed a statistically significant improvement of their quality of life compared to the control group. This improvement was comparable to the improvement in psychopathologic status and social functioning as shown in a previous report of the same research project. The improvement was maintained at follow-up only during the trial and for a few months later: after 12 months, patients returned to their baseline values and their quality of life showed a worsening trend. This is the first study to show that rehabilitation with sailing may improve the quality of life of people with severe chronic mental disorders. In all likelihood, a program grounded on learning how to manage a sailing vessel - during which patients perform cruises that emphasize the exploration of the marine environment by sailing - might be interesting enough and capture the attention of the patients so as to favour greater effectiveness of standard rehabilitation protocols, but this should be specifically tested. PMID:25191521

Defining quality of care.

PubMed

Campbell, S M; Roland, M O; Buetow, S A

2000-12-01

This paper defines quality of health care. We suggest that there are two principal dimensions of quality of care for individual patients; access and effectiveness. In essence, do users get the care they need, and is the care effective when they get it? Within effectiveness, we define two key components--effectiveness of clinical care and effectiveness of inter-personal care. These elements are discussed in terms of the structure of the health care system, processes of care, and outcomes resulting from care. The framework relates quality of care to individual patients and we suggest that quality of care is a concept that is at its most meaningful when applied to the individual user of health care. However, care for individuals must placed in the context of providing health care for populations which introduces additional notions of equity and efficiency. We show how this framework can be of practical value by applying the concepts to a set of quality indicators contained within the UK National Performance Assessment Framework and to a set of widely used indicators in the US (HEDIS). In so doing we emphasise the differences between US and UK measures of quality. Using a conceptual framework to describe the totality of quality of care shows which aspects of care any set of quality indicators actually includes and measures and, and which are not included.

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.

Dissolution of Oxygen Precipitate Nuclei in n-Type CZ-Si Wafers to Improve Their Material Quality: Experimental Results

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

Sopori, Bhushan; Basnyat, Prakash; Devayajanam, Srinivas

2017-01-01

We present experimental results which show that oxygen-related precipitate nuclei (OPN) present in p-doped, n-type, Czochralski wafers can be dissolved using a flash-annealing process, yielding very high quality wafers for high-efficiency solar cells. Flash annealing consists of heating a wafer in an optical furnace to temperature between 1150 and 1250 degrees C for a short time. This process produces a large increase in the minority carrier lifetime (MCLT) and homogenizes each wafer. We have tested wafers from different axial locations of two ingots. All wafers reach nearly the same high value of MCLT. The OPN dissolution is confirmed by oxygenmore » analysis using Fourier transform infrared spectra and injection-level dependence of MCLT.« less

75 FR 75455 - Certain Hot-Rolled Flat-Rolled Carbon-Quality Steel Products From Brazil: Final Results of Full...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-03

...-Rolled Carbon-Quality Steel Products From Brazil: Final Results of Full Sunset Review of Countervailing... of the countervailing duty (CVD) order on certain hot-rolled flat-rolled carbon-quality steel products (hot-rolled steel) from Brazil, pursuant to section 751(c) of the Tariff Act of 1930, as amended...

Showing and telling: using tablet technology to engage students in mathematics

NASA Astrophysics Data System (ADS)

Ingram, Naomi; Williamson-Leadley, Sandra; Pratt, Keryn

2016-03-01

This paper reports on a qualitative investigation into the use of Show and Tell tablet technology in mathematics classrooms. A Show and Tell application (app) allows the user to capture voice and writing or text in real time. Described here are the perceptions of 11 teachers during and after their exploration into the use of Show and Tell in their primary and secondary classrooms. These perceptions were used to evaluate Show and Tell tablet technology against a framework of student engagement and effective pedagogy. The results of the study indicated that the teachers perceived both the level and the quality of the students' engagement were high. Using Show and Tell apps enabled the teachers to enact effective pedagogy within their classroom practices. Importantly, through the use of Show and Tell recordings, students' thinking became visible to themselves, their teachers and other students in the class. This thinking then formed the basis of robust discussions and negotiation about the mathematical concepts and the strategies the students used to solve problems.

Ten-year results of quality assurance in radiotherapy chart round.

PubMed

Taghavi Bayat, Bardia; Gill, Suki; Siva, Shankar; Tai, Keen Hun; Joon, Michael Lim; Foroudi, Farshad

2013-04-23

The Royal Australian and New Zealand College of Radiologists (RANZCR) initiated a unique instrument to audit the quality of patient notes and radiotherapy prescriptions. We present our experience collected over ten years from the use of the RANZCR audit instrument. In this study, the results of data collected prospectively from January 1999 to June 2009 through the audit instrument were assessed. Radiotherapy chart rounds were held weekly in the uro-oncology tumour stream and real time feedback was provided. Electronic medical records were retrospectively assessed in September 2009 to see if any omissions were subsequently corrected. In total 2597 patients were audited. One hundred and thirty seven (5%) patients had one hundred and ninety nine omissions in documentation or radiotherapy prescription. In 79% of chart rounds no omissions were found at all, in 12% of chart rounds one omission was found and in 9% of chart rounds two or more omissions were found. Out of 199 omissions, 95% were of record keeping and 2% were omissions in the treatment prescription. Of omissions, 152 (76%) were unfiled investigation results of which 77 (51%) were subsequently corrected. Real-time audit with feedback is an effective tool in assessing the standards of radiotherapy documentation in our department, and also probably contributed to the high level of attentiveness. A large proportion of omissions were investigation results, which highlights the need for an improved system of retrieval of investigation results in the radiation oncology department.

FQC Dashboard: integrates FastQC results into a web-based, interactive, and extensible FASTQ quality control tool

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

Brown, Joseph; Pirrung, Meg; McCue, Lee Ann

FQC is software that facilitates quality control of FASTQ files by carrying out a QC protocol using FastQC, parsing results, and aggregating quality metrics into an interactive dashboard designed to richly summarize individual sequencing runs. The dashboard groups samples in dropdowns for navigation among the data sets, utilizes human-readable configuration files to manipulate the pages and tabs, and is extensible with CSV data.

Groundwater-quality data in the northern Coast Ranges study unit, 2009: Results from the California GAMA Program

USGS Publications Warehouse

Mathany, Timothy M.; Dawson, Barbara J.; Shelton, Jennifer L.; Belitz, Kenneth

2011-01-01

This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, untreated groundwater typically is treated, disinfected, and (or) blended with other waters to maintain water quality. Regulatory benchmarks apply to water that is served to the consumer, not to untreated groundwater. However, to provide some context for the results, concentrations of constituents measured in the untreated groundwa

FQC Dashboard: integrates FastQC results into a web-based, interactive, and extensible FASTQ quality control tool

DOE PAGES

Brown, Joseph; Pirrung, Meg; McCue, Lee Ann

2017-06-09

FQC is software that facilitates quality control of FASTQ files by carrying out a QC protocol using FastQC, parsing results, and aggregating quality metrics into an interactive dashboard designed to richly summarize individual sequencing runs. The dashboard groups samples in dropdowns for navigation among the data sets, utilizes human-readable configuration files to manipulate the pages and tabs, and is extensible with CSV data.

Sentinel-2 radiometric image quality commissioning: first results

NASA Astrophysics Data System (ADS)

Lachérade, S.; Lonjou, V.; Farges, M.; Gamet, P.; Marcq, S.; Raynaud, J.-L.; Trémas, T.

2015-10-01

In partnership with the European Commission and in the frame of the Copernicus program, the European Space Agency (ESA) is developing the Sentinel-2 optical imaging mission devoted to the operational monitoring of land and coastal areas. The Sentinel-2 mission is based on a satellites constellation deployed in polar sun-synchronous orbit. Sentinel-2 offers a unique combination of global coverage with a wide field of view (290km), a high revisit (5 days with two satellites), a high spatial resolution (10m, 20m and 60m) and multi-spectral imagery (13 spectral bands in visible and shortwave infrared domains). The first satellite, Sentinel-2A, has been launched in June 2015. The Sentinel-2A Commissioning Phase starts immediately after the Launch and Early Orbit Phase and continues until the In-Orbit Commissioning Review which is planned three months after the launch. The Centre National d'Etudes Spatiales (CNES) supports ESA/ESTEC to insure the Calibration/Validation commissioning phase during the first three months in flight. This paper provides first an overview of the Sentinel-2 system and a description of the products delivered by the ground segment associated to the main radiometric specifications to achieve. Then the paper focuses on the preliminary radiometric results obtained during the in-flight commissioning phase. The radiometric methods and calibration sites used in the CNES image quality center to reach the specifications of the sensor are described. A status of the Sentinel-2A radiometric performances at the end of the first three months after the launch is presented. We will particularly address in this paper the results in term of absolute calibration, pixel to pixel relative sensitivity and MTF estimation.

[Service quality in health care: the application of the results of marketing research].

PubMed

Verheggen, F W; Harteloh, P P

1993-01-01

This paper deals with quality assurance in health care and its relation to quality assurance in trade and industry. We present the service quality model--a model of quality from marketing research--and discuss how it can be applied to health care. Traditional quality assurance appears to have serious flaws. It lacks a general theory of the sources of hazards in the complex process of patient care and tends to stagnate, for no real improvement takes place. Departing from this criticism, modern quality assurance in health care is marked by: defining quality in a preferential sense as "fitness for use"; the use of theories and models of trade and industry (process-control); an emphasis on analyzing the process, instead of merely inspecting it; use of the Deming problem solving technique (plan, do, check, act); improvement of the process of care by altering perceptions of parties involved. We present an experience of application and utilization of this method in the University Hospital Maastricht, The Netherlands. The successful application of this model requires a favorable corporate culture and motivation of the health care workers. This model provides a useful framework to uplift the traditional approach to quality assurance in health care.

Improving quality of care in general practices by self-audit, benchmarking and quality circles.

PubMed

Mahlknecht, Angelika; Abuzahra, Muna E; Piccoliori, Giuliano; Enthaler, Nina; Engl, Adolf; Sönnichsen, Andreas

2016-10-01

Guideline adherence of general practitioners (GP) regarding treatment of chronic conditions shows room for improvement. Thus, concepts have to be designed to promote quality of care. The aim of the interventional study "Improvement of Quality by Benchmarking" was to assess whether quality can be improved by self-auditing, benchmarking and quality circles in Salzburg (Austria) and South Tyrol (Italy). In this publication we present the Austrian results. Quality indicators were developed in a consensus process for eight chronic diseases based on pre-existing quality management systems. A quality score consisting of 35 indicators was calculated (0-5 points per indicator depending on fulfilment, maximum 175 points). Data were extracted from the electronic health records of participating practices in 2012, 2013 and 2014. A statistical pre-post analysis was performed using Wilcoxon signed-rank tests. A total of 20 GPs participated in the project. The mean quality score increased from 62.0 at baseline to 84.0 at the second follow-up (p = 0.003). Regarding the individual quality indicators, strong improvements were achieved between baseline and first follow-up, especially in process indicators concerning documentation. Between the first and second follow-up, quality remained in most cases at the same level. The validity of results is limited because of structural and technical problems. Due to the uncontrolled pre-post design we cannot exclude external influences on the results. Nevertheless, the intervention was able to improve measured quality of care. Barriers were detected that should be considered in a possible implementation of quality control programs.

Idaho's surface-water-quality monitoring program: results from five sites sampled during water years 1990-93

USGS Publications Warehouse

,

1994-01-01

In 1990, the U.S. Geological Survey (USGS), in cooperation with the Idaho Department of Health and Welfare, Division of Environmental Quality, implemented a statewide water-quality monitoring program in response to Idaho's antidegradation policy as required by the Clean Water Act. The program objective is to provide water-quality managers with a coordinated statewide network to detect trends in surface-water quality. The monitoring program includes the collection and analysis of samples from 56 sites on the Bear, Clearwater, Kootenai, Pend Oreille, Salmon, Snake, and Spokane Rivers and their tributaries (fig. 1). Samples are collected every year at 5 sites (annual sites) in drainage basins where long-term water-quality management is practiced, every other year at 19 sites (biennial sites) in basins where land and water uses change slowly, and every third year at 32 sites (triennial sites) where future development may affect water quality. Each year, 25 of the 56 sites are sampled. This report discusses results of sampling at five annual sites. During water years 1990-93 (October 1, 1989, through September 30, 1993), samples were collected six times per year at the five annual sites (fig. 1). Onsite analyses were made for discharge, specific conductance, pH, temperature, dissolved oxygen, bacteria (fecal coliform and fecal streptococci), and alkalinity. Laboratory analyses were made for major ions, nutrients, trace elements, and suspended sediment. Suspended sediment, nitrate, fecal coliform, trace elements, and specific conductance were used to characterize surface-water quality. Because concentrations of all trace elements except zinc were near detection limits, only zinc is discussed.

Functionality of hospital information systems: results from a survey of quality directors at Turkish hospitals.

PubMed

Saluvan, Mehmet; Ozonoff, Al

2018-01-12

We aimed to determine availability of core Hospital Information Systems (HIS) functions implemented in Turkish hospitals and the perceived importance of these functions on quality and patient safety. We surveyed quality directors (QDs) at civilian hospitals in the nation of Turkey. Data were collected via web survey using an instrument with 50 items describing core functionality of HIS. We calculated mean availability of each function, mean and median values of perceived impact on quality, and we investigated the relationship between availability and perceived importance. We received responses from 31% of eligible institutions, representing all major geographic regions of Turkey. Mean availability of 50 HIS functions was 65.6%, ranging from 19.6% to 97.4%. Mean importance score was 7.87 (on a 9-point scale) ranging from 7.13 to 8.41. Functions related to result management (89.3%) and decision support systems (52.2%) had the highest and lowest reported availability respectively. Availability and perceived importance were moderately correlated (r = 0.52). QDs report high importance of the HIS functions surveyed as they relate to quality and patient safety. Availability and perceived importance of HIS functions are generally correlated, with some interesting exceptions. These findings may inform future investments and guide policy changes within the Turkish healthcare system. Financial incentives, regulations around certified HIS, revisions to accreditation manuals, and training interventions are all policies which will help integrate HIS functions to support quality and patient safety in Turkish hospitals.

Quality planning in Construction Project

NASA Astrophysics Data System (ADS)

Othman, I.; Shafiq, Nasir; Nuruddin, M. F.

2017-12-01

The purpose of this paper is to investigate deeper on the factors that contribute to the effectiveness of quality planning, identifying the common problems encountered in quality planning, practices and ways for improvements in quality planning for construction projects. This paper involves data collected from construction company representatives across Malaysia that are obtained through semi-structured interviews as well as questionnaire distributions. Results shows that design of experiments (average index: 4.61), inspection (average index: 4.45) and quality audit as well as other methods (average index: 4.26) rank first, second and third most important factors respectively.

40 CFR 51.115 - Air quality data and projections.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Air quality data and projections. 51... quality data and projections. (a) Each plan must contain a summary of data showing existing air quality. (b) Each plan must: (1) Contain a summary of air quality concentrations expected to result from...

40 CFR 51.115 - Air quality data and projections.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 2 2012-07-01 2012-07-01 false Air quality data and projections. 51... quality data and projections. (a) Each plan must contain a summary of data showing existing air quality. (b) Each plan must: (1) Contain a summary of air quality concentrations expected to result from...

40 CFR 51.115 - Air quality data and projections.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 2 2011-07-01 2011-07-01 false Air quality data and projections. 51... quality data and projections. (a) Each plan must contain a summary of data showing existing air quality. (b) Each plan must: (1) Contain a summary of air quality concentrations expected to result from...

40 CFR 51.115 - Air quality data and projections.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 2 2013-07-01 2013-07-01 false Air quality data and projections. 51... quality data and projections. (a) Each plan must contain a summary of data showing existing air quality. (b) Each plan must: (1) Contain a summary of air quality concentrations expected to result from...

40 CFR 51.115 - Air quality data and projections.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 2 2014-07-01 2014-07-01 false Air quality data and projections. 51... quality data and projections. (a) Each plan must contain a summary of data showing existing air quality. (b) Each plan must: (1) Contain a summary of air quality concentrations expected to result from...

A Measure of Suffering in relation to Anxiety and Quality of Life in IBS Patients: Preliminary Results.

PubMed

Pletikosić Tončić, Sanda; Tkalčić, Mladenka

2017-01-01

Irritable bowel syndrome (IBS) is a chronic gastrointestinal (GI) disorder with a severe impact on quality of life (QoL). We explored the relationship of a visual measure of suffering, the PRISM-RII, with quality of life (QoL) and anxiety measures in IBS patients. Participants were 44 IBS patients who completed several questionnaires and kept a symptom diary for two weeks. The measures used were PRISM-RII (self-illness separation (SIS); illness perception measure (IPM)); IBS-36 (IBS health related QoL); SF-36 (physical and mental health related QoL); State-Trait Anxiety Inventory (STAI-T); Visceral Sensitivity Index (VSI; GI-specific anxiety); and a symptom diary. SIS was negatively correlated to VSI, while IPM was negatively correlated to SIS and the physical component of SF-36 and positively to VSI and symptom severity. We found significant differences between participants who perceive their illness as small and those who perceive it as medium in SIS, symptom severity, VSI, and the mental component of SF-36. Participants, who perceived their illness as small, represented their illness as more distant, showed lower average symptom severity, and had lower GI-specific anxiety and higher QoL. The results indicate that IPM and SIS can be useful in discriminating patients with more prominent psychological difficulties and QoL impairment.

Transgenic cotton over-producing spinach sucrose phosphate synthase showed enhanced leaf sucrose synthesis and improved fiber quality under controlled environmental conditions.

PubMed

Haigler, Candace H; Singh, Bir; Zhang, Deshui; Hwang, Sangjoon; Wu, Chunfa; Cai, Wendy X; Hozain, Mohamed; Kang, Wonhee; Kiedaisch, Brett; Strauss, Richard E; Hequet, Eric F; Wyatt, Bobby G; Jividen, Gay M; Holaday, A Scott

2007-04-01

Prior data indicated that enhanced availability of sucrose, a major product of photosynthesis in source leaves and the carbon source for secondary wall cellulose synthesis in fiber sinks, might improve fiber quality under abiotic stress conditions. To test this hypothesis, a family of transgenic cotton plants (Gossypium hirsutum cv. Coker 312 elite) was produced that over-expressed spinach sucrose-phosphate synthase (SPS) because of its role in regulation of sucrose synthesis in photosynthetic and heterotrophic tissues. A family of 12 independent transgenic lines was characterized in terms of foreign gene insertion, expression of spinach SPS, production of spinach SPS protein, and development of enhanced extractable V (max) SPS activity in leaf and fiber. Lines with the highest V (max) SPS activity were further characterized in terms of carbon partitioning and fiber quality compared to wild-type and transgenic null controls. Leaves of transgenic SPS over-expressing lines showed higher sucrose:starch ratio and partitioning of (14)C to sucrose in preference to starch. In two growth chamber experiments with cool nights, ambient CO(2) concentration, and limited light below the canopy, the transgenic line with the highest SPS activity in leaf and fiber had higher fiber micronaire and maturity ratio associated with greater thickness of the cellulosic secondary wall.

Impact of pre-imputation SNP-filtering on genotype imputation results

PubMed Central

2014-01-01

Background Imputation of partially missing or unobserved genotypes is an indispensable tool for SNP data analyses. However, research and understanding of the impact of initial SNP-data quality control on imputation results is still limited. In this paper, we aim to evaluate the effect of different strategies of pre-imputation quality filtering on the performance of the widely used imputation algorithms MaCH and IMPUTE. Results We considered three scenarios: imputation of partially missing genotypes with usage of an external reference panel, without usage of an external reference panel, as well as imputation of completely un-typed SNPs using an external reference panel. We first created various datasets applying different SNP quality filters and masking certain percentages of randomly selected high-quality SNPs. We imputed these SNPs and compared the results between the different filtering scenarios by using established and newly proposed measures of imputation quality. While the established measures assess certainty of imputation results, our newly proposed measures focus on the agreement with true genotypes. These measures showed that pre-imputation SNP-filtering might be detrimental regarding imputation quality. Moreover, the strongest drivers of imputation quality were in general the burden of missingness and the number of SNPs used for imputation. We also found that using a reference panel always improves imputation quality of partially missing genotypes. MaCH performed slightly better than IMPUTE2 in most of our scenarios. Again, these results were more pronounced when using our newly defined measures of imputation quality. Conclusion Even a moderate filtering has a detrimental effect on the imputation quality. Therefore little or no SNP filtering prior to imputation appears to be the best strategy for imputing small to moderately sized datasets. Our results also showed that for these datasets, MaCH performs slightly better than IMPUTE2 in most scenarios at

Trigram-based algorithms for OCR result correction

NASA Astrophysics Data System (ADS)

Bulatov, Konstantin; Manzhikov, Temudzhin; Slavin, Oleg; Faradjev, Igor; Janiszewski, Igor

2017-03-01

In this paper we consider a task of improving optical character recognition (OCR) results of document fields on low-quality and average-quality images using N-gram models. Cyrillic fields of Russian Federation internal passport are analyzed as an example. Two approaches are presented: the first one is based on hypothesis of dependence of a symbol from two adjacent symbols and the second is based on calculation of marginal distributions and Bayesian networks computation. A comparison of the algorithms and experimental results within a real document OCR system are presented, it's showed that the document field OCR accuracy can be improved by more than 6% for low-quality images.

Modelled air pollution levels versus EC air quality legislation - results from high resolution simulation.

PubMed

Chervenkov, Hristo

2013-12-01

An appropriate method for evaluating the air quality of a certain area is to contrast the actual air pollution levels to the critical ones, prescribed in the legislative standards. The application of numerical simulation models for assessing the real air quality status is allowed by the legislation of the European Community (EC). This approach is preferable, especially when the area of interest is relatively big and/or the network of measurement stations is sparse, and the available observational data are scarce, respectively. Such method is very efficient for similar assessment studies due to continuous spatio-temporal coverage of the obtained results. In the study the values of the concentration of the harmful substances sulphur dioxide, (SO2), nitrogen dioxide (NO2), particulate matter - coarse (PM10) and fine (PM2.5) fraction, ozone (O3), carbon monoxide (CO) and ammonia (NH3) in the surface layer obtained from modelling simulations with resolution 10 km on hourly bases are taken to calculate the necessary statistical quantities which are used for comparison with the corresponding critical levels, prescribed in the EC directives. For part of them (PM2.5, CO and NH3) this is done for first time with such resolution. The computational grid covers Bulgaria entirely and some surrounding territories and the calculations are made for every year in the period 1991-2000. The averaged over the whole time slice results can be treated as representative for the air quality situation of the last decade of the former century.

Children with autism show specific handwriting impairments

PubMed Central

Fuentes, Christina T.; Mostofsky, Stewart H.; Bastian, Amy J.

2009-01-01

Background: Handwriting skills, which are crucial for success in school, communication, and building children’s self-esteem, have been observed to be poor in individuals with autism. Little information exists on the handwriting of children with autism, without delineation of specific features that can contribute to impairments. As a result, the specific aspects of handwriting in which individuals with autism demonstrate difficulty remain unknown. Methods: A case-control study of handwriting samples from children with and without autism spectrum disorders (ASD) was performed using the Minnesota Handwriting Assessment. Samples were scored on an individual letter basis in 5 categories: legibility, form, alignment, size, and spacing. Subjects were also tested on the Wechsler Intelligence Scale for Children–IV and the Physical and Neurological Examination for Subtle (Motor) Signs. Results: We found that children with ASD do indeed show overall worse performance on a handwriting task than do age- and intelligence-matched controls. More specifically, children with ASD show worse quality of forming letters but do not show differences in their ability to correctly size, align, and space their letters. Within the ASD group, motor skills were significantly predictive of handwriting performance, whereas age, gender, IQ, and visuospatial abilities were not. Conclusions: We addressed how different elements of handwriting contribute to impairments observed in children with autism. Our results suggest that training targeting letter formation, in combination with general training of fine motor control, may be the best direction for improving handwriting performance in children with autism. GLOSSARY ADI-R = Autism Diagnostic Interview–Revised; ADOS-G = Autism Diagnostic Observation Schedule–Generic; ASD = autism spectrum disorders; DICA-IV = Diagnostic Interview for Children and Adolescents, 4th edition; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th

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

PubMed Central

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

2015-01-01

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

Groundwater Quality Data in the Mojave Study Unit, 2008: Results from the California GAMA Program

USGS Publications Warehouse

Mathany, Timothy M.; Belitz, Kenneth

2009-01-01

ground water. In total, over 230 constituents and water-quality indicators (field parameters) were investigated. Three types of quality-control samples (blanks, replicates, and matrix spikes) each were collected at approximately 5-8 percent of the wells, and the results for these samples were used to evaluate the quality of the data for the groundwater samples. Field blanks rarely contained detectable concentrations of any constituent, suggesting that contamination was not a significant source of bias in the data for the groundwater samples. Differences between replicate samples generally were within acceptable ranges, indicating acceptable analytical reproducibility. Matrix spike recoveries were within acceptable ranges for most compounds. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, untreated groundwater typically is treated, disinfected, or blended with other waters to maintain water quality. Regulatory thresholds apply to water that is served to the consumer, not to untreated ground water. However, to provide some context for the results, concentrations of constituents measured in the untreated ground water were compared with regulatory and non-regulatory health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and California Department of Public Health (CDPH) and thresholds established for aesthetic and technical concerns by CDPH. Comparisons between data collected for this study and thresholds for drinking-water are for illustrative purposes only, and are not indicative of compliance or non-compliance with those thresholds. Most constituents that were detected in groundwater samples in the 59 wells in MOJO were found at concentrations below drinking-water thresholds. In MOJO's 52 grid wells, volatile organic compounds (VOCs) were detected in 40 percent of the wells, and pesticides and pesticide degradates were detected in 23 percent of the grid wel

Groundwater Quality Data for the Northern Sacramento Valley, 2007: Results from the California GAMA Program

USGS Publications Warehouse

Bennett, Peter A.; Bennett, George L.; Belitz, Kenneth

2009-01-01

to 11 percent of the wells, and the results for these samples were used to evaluate the quality of the data obtained from the groundwater samples. Field blanks rarely contained detectable concentrations of any constituent, suggesting that contamination was not a noticeable source of bias in the data for the groundwater samples. Differences between replicate samples were within acceptable ranges for nearly all compounds, indicating acceptably low variability. Matrix-spike recoveries were within acceptable ranges for most compounds. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, raw groundwater typically is treated, disinfected, or blended with other waters to maintain water quality. Regulatory thresholds apply to water that is served to the consumer, not to raw ground water. However, to provide some context for the results, concentrations of constituents measured in the raw groundwater were compared with regulatory and nonregulatory health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and California Department of Public Health (CDPH) and with aesthetic and technical thresholds established by CDPH. Comparisons between data collected for this study and drinking-water thresholds are for illustrative purposes only and do not indicate compliance or noncompliance with those thresholds. The concentrations of most constituents detected in groundwater samples from REDSAC were below drinking-water thresholds. Volatile organic compounds (VOC) and pesticides were detected in less than one-quarter of the samples and were generally less than a hundredth of any health-based thresholds. NDMA was detected in one grid well above the NL-CA. Concentrations of all nutrients and trace elements in samples from REDSAC wells were below the health-based thresholds except those of arsenic in three samples, which were above the USEPA maximum contaminant level (MCL-US). However

Ground-Water Quality Data in the Central Sierra Study Unit, 2006 - Results from the California GAMA Program

USGS Publications Warehouse

Ferrari, Matthew J.; Fram, Miranda S.; Belitz, Kenneth

2008-01-01

the results for these samples were used to evaluate the quality of the data for the ground-water samples. Results from field blanks indicated contamination was not a noticeable source of bias in the data for ground-water samples. Differences between replicate samples were within acceptable ranges, indicating acceptably low variability. Matrix spike recoveries were within acceptable ranges for most constituents. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, water typically is treated, disinfected, or blended with other waters to maintain water quality. Regulatory thresholds apply to water that is served to the consumer, not to raw ground water. However, to provide some context for the results, concentrations of constituents measured in the raw ground water were compared with health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and California Department of Public Health (CDPH), and thresholds established for aesthetic concerns (Secondary Maximum Contaminant Levels, SMCL-CA) by CDPH. Therefore, any comparisons of the results of this study to drinking-water standards only is for illustrative purposes and is not indicative of compliance or non-compliance to those standards. Most constituents that were detected in ground-water samples were found at concentrations below drinking-water standards or thresholds. Six constituents? fluoride, arsenic, molybdenum, uranium, gross-alpha radioactivity, and radon-222?were detected at concentrations higher than thresholds set for health-based regulatory purposes. Three additional constituents?pH, iron and manganese?were detected at concentrations above thresholds set for aesthetic concerns. Volatile organic compounds (VOCs) and pesticides, were detected in less than one-third of the samples and generally at less than one one-hundredth of a health-based threshold.

Gender, marital power, and marital quality in later life.

PubMed

Bulanda, Jennifer Roebuck

2011-01-01

This study uses data from the 1992 Health and Retirement Study to examine gender differences in marital power and marital quality among older adults and to assess whether there are gender differences in the correlates of marital quality and marital power in later life. Results show that women report lower marital happiness, marital interaction, and marital power than do men, on average. These differences persist even after controlling for a number of life-course events and transitions. Further, results show that gender differences are also evident in the relationship of employment, childrearing, caregiving, and health factors with marital quality and power.

The Satellite based Monitoring Initiative for Regional Air quality (SAMIRA): Project summary and first results

NASA Astrophysics Data System (ADS)

Schneider, Philipp; Stebel, Kerstin; Ajtai, Nicolae; Diamandi, Andrei; Horalek, Jan; Nemuc, Anca; Stachlewska, Iwona; Zehner, Claus

2017-04-01

We present a summary and some first results of a new ESA-funded project entitled Satellite based Monitoring Initiative for Regional Air quality (SAMIRA), which aims at improving regional and local air quality monitoring through synergetic use of data from present and upcoming satellite instruments, traditionally used in situ air quality monitoring networks and output from chemical transport models. Through collaborative efforts in four countries, namely Romania, Poland, the Czech Republic and Norway, all with existing air quality problems, SAMIRA intends to support the involved institutions and associated users in their national monitoring and reporting mandates as well as to generate novel research in this area. The primary goal of SAMIRA is to demonstrate the usefulness of existing and future satellite products of air quality for improving monitoring and mapping of air pollution at the regional scale. A total of six core activities are being carried out in order to achieve this goal: Firstly, the project is developing and optimizing algorithms for the retrieval of hourly aerosol optical depth (AOD) maps from the Spinning Enhanced Visible and InfraRed Imager (SEVIRI) onboard of Meteosat Second Generation. As a second activity, SAMIRA aims to derive particulate matter (PM2.5) estimates from AOD data by developing robust algorithms for AOD-to-PM conversion with the support from model- and Lidar data. In a third activity, we evaluate the added value of satellite products of atmospheric composition for operational European-scale air quality mapping using geostatistics and auxiliary datasets. The additional benefit of satellite-based monitoring over existing monitoring techniques (in situ, models) is tested by combining these datasets using geostatistical methods and demonstrated for nitrogen dioxide (NO2), sulphur dioxide (SO2), and aerosol optical depth/particulate matter. As a fourth activity, the project is developing novel algorithms for downscaling coarse

How Are the Results of Quality Assurance Programs Used to Inform Practices at a Distance Higher Education?

ERIC Educational Resources Information Center

Darojat, Ojat

2018-01-01

This paper is to examine the implementation of quality assurance (QA) programs in distance higher education. Different challenges related to the development of QA programs at a distance higher institution and how to manage and implement the programs are discussed to show how the programs have been used to ensure the survival of the institution. A…

Quality assessment of urban environment

NASA Astrophysics Data System (ADS)

Ovsiannikova, T. Y.; Nikolaenko, M. N.

2015-01-01

This paper is dedicated to the research applicability of quality management problems of construction products. It is offered to expand quality management borders in construction, transferring its principles to urban systems as economic systems of higher level, which qualitative characteristics are substantially defined by quality of construction product. Buildings and structures form spatial-material basis of cities and the most important component of life sphere - urban environment. Authors justify the need for the assessment of urban environment quality as an important factor of social welfare and life quality in urban areas. The authors suggest definition of a term "urban environment". The methodology of quality assessment of urban environment is based on integrated approach which includes the system analysis of all factors and application of both quantitative methods of assessment (calculation of particular and integrated indicators) and qualitative methods (expert estimates and surveys). The authors propose the system of indicators, characterizing quality of the urban environment. This indicators fall into four classes. The authors show the methodology of their definition. The paper presents results of quality assessment of urban environment for several Siberian regions and comparative analysis of these results.

Results of a one-day, descriptive study of quality of life in patients with chronic wounds.

PubMed

Shukla, Vijay K; Shukla, Dinesh; Tripathi, Anuj K; Agrawal, Saurabh; Tiwary, Satyendra K; Prakash, Vivek

2008-05-01

Quality of life is a subjectively interpreted phenomenon that can be profoundly altered by the presence of a wound. Particularly when complete and expedient healing seems unrealistic, quality of life becomes the focus of care. To assess the influence of a variety of chronic wounds on patient quality of life, a 1-day, descriptive study was conducted among 50 consecutive outpatients (64% men, 36% women; age range 14 to 78 years) with chronic wounds who attended the Wound Clinic of the University Hospital, Varanasi, India. A quality-of-life questionnaire containing six parameters (physical activities, feelings, household duties, leisure time activities, social relations, and general activities) was developed and administered. Demographic information was available as a result of a previous study at this institution. Quality-of-life scores were grouped as satisfactory and unsatisfactory and participants were grouped by age (<30 years old, 30 to 60 years old, >60 years old). Wounds were classified by cause (diabetes, venous disease, pressure ulcer, and tuberculosis) and size (<10 cm2, 10 to 50 cm2, >50 cm2). The most common site was the lower limb or foot (39, 78%), followed by upper limb (six, 12%) and head, neck, and trunk (five, 10%). More than half (28, 56%) of all patients had an unsatisfactory overall quality-of-life score. The percentage of patients with satisfactory scores was higher in patients with smaller versus larger wounds and wounds located on upper rather than lower limbs, as well as in middle-aged versus younger or older patients. This patient-centered instrument helped document important quality-of-life concerns among chronic wound patients.

Relations of Water Quality to Agricultural Chemical Use and Environmental Setting at Various Scales - Results from Selected Studies of the National Water-Quality Assessment Program

USGS Publications Warehouse

,

2008-01-01

In 1991, the U.S. Geological Survey (USGS) began studies of 51 major river basins and aquifers across the United States as part of the National Water-Quality Assessment (NAWQA) Program to provide scientifically sound information for managing the Nation's water resources. The major goals of the NAWQA Program are to assess the status and long-term trends of the Nation's surface- and ground-water quality and to understand the natural and human factors that affect it (Gilliom and others, 1995). In 2001, the NAWQA Program began a second decade of intensive water-quality assessments. The 42 study units for this second decade were selected to represent a wide range of important hydrologic environments and potential contaminant sources. These NAWQA studies continue to address the goals of the first decade of the assessments to determine how water-quality conditions are changing over time. In addition to local- and regional-scale studies, NAWQA began to analyze and synthesize water-quality status and trends at the principal aquifer and major river-basin scales. This fact sheet summarizes results from four NAWQA studies that relate water quality to agricultural chemical use and environmental setting at these various scales: * Comparison of ground-water quality in northern and southern High Plains agricultural settings (principal aquifer scale); * Distribution patterns of pesticides and degradates in rain (local scale); * Occurrence of pesticides in shallow ground water underlying four agricultural areas (local and regional scales); and * Trends in nutrients and sediment over time in the Missouri River and its tributaries (major river-basin scale).

Groundwater-quality data in the Santa Barbara study unit, 2011: results from the California GAMA Program

USGS Publications Warehouse

Davis, Tracy A.; Kulongoski, Justin T.; Belitz, Kenneth

2013-01-01

elements, nutrients, major and minor ions, silica, total dissolved solids [TDS], alkalinity, and arsenic, chromium, and iron species); and radioactive constituents (radon-222 and gross alpha and gross beta radioactivity). Naturally occurring isotopes (stable isotopes of hydrogen and oxygen in water, stables isotopes of inorganic carbon and boron dissolved in water, isotope ratios of dissolved strontium, tritium activities, and carbon-14 abundances) and dissolved noble gases also were measured to help identify the sources and ages of the sampled groundwater. In total, 281 constituents and water-quality indicators were measured. Three types of quality-control samples (blanks, replicates, and matrix spikes) were collected at up to 12 percent of the wells in the Santa Barbara study unit, and the results for these samples were used to evaluate the quality of the data for the groundwater samples. Blanks rarely contained detectable concentrations of any constituent, suggesting that contamination from sample collection procedures was not a significant source of bias in the data for the groundwater samples. Replicate samples generally were within the limits of acceptable analytical reproducibility. Matrix-spike recoveries were within the acceptable range (70 to 130 percent) for approximately 82 percent of the compounds. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, untreated groundwater typically is treated, disinfected, and (or) blended with other waters to maintain water quality. Regulatory benchmarks apply to water that is served to the consumer, not to untreated groundwater. However, to provide some context for the results, concentrations of constituents measured in the untreated groundwater were compared with regulatory and non-regulatory health-based benchmarks established by the U.S. Environmental Protection Agency (USEPA) and CDPH and to non-regulatory benchmarks established for aesthetic concerns by

Quality Assessment of Urinary Stone Analysis: Results of a Multicenter Study of Laboratories in Europe

PubMed Central

Siener, Roswitha; Buchholz, Noor; Daudon, Michel; Hess, Bernhard; Knoll, Thomas; Osther, Palle J.; Reis-Santos, José; Sarica, Kemal; Traxer, Olivier; Trinchieri, Alberto

2016-01-01

After stone removal, accurate analysis of urinary stone composition is the most crucial laboratory diagnostic procedure for the treatment and recurrence prevention in the stone-forming patient. The most common techniques for routine analysis of stones are infrared spectroscopy, X-ray diffraction and chemical analysis. The aim of the present study was to assess the quality of urinary stone analysis of laboratories in Europe. Nine laboratories from eight European countries participated in six quality control surveys for urinary calculi analyses of the Reference Institute for Bioanalytics, Bonn, Germany, between 2010 and 2014. Each participant received the same blinded test samples for stone analysis. A total of 24 samples, comprising pure substances and mixtures of two or three components, were analysed. The evaluation of the quality of the laboratory in the present study was based on the attainment of 75% of the maximum total points, i.e. 99 points. The methods of stone analysis used were infrared spectroscopy (n = 7), chemical analysis (n = 1) and X-ray diffraction (n = 1). In the present study only 56% of the laboratories, four using infrared spectroscopy and one using X-ray diffraction, fulfilled the quality requirements. According to the current standard, chemical analysis is considered to be insufficient for stone analysis, whereas infrared spectroscopy or X-ray diffraction is mandatory. However, the poor results of infrared spectroscopy highlight the importance of equipment, reference spectra and qualification of the staff for an accurate analysis of stone composition. Regular quality control is essential in carrying out routine stone analysis. PMID:27248840

Quality Assessment of Urinary Stone Analysis: Results of a Multicenter Study of Laboratories in Europe.

PubMed

Siener, Roswitha; Buchholz, Noor; Daudon, Michel; Hess, Bernhard; Knoll, Thomas; Osther, Palle J; Reis-Santos, José; Sarica, Kemal; Traxer, Olivier; Trinchieri, Alberto

2016-01-01

After stone removal, accurate analysis of urinary stone composition is the most crucial laboratory diagnostic procedure for the treatment and recurrence prevention in the stone-forming patient. The most common techniques for routine analysis of stones are infrared spectroscopy, X-ray diffraction and chemical analysis. The aim of the present study was to assess the quality of urinary stone analysis of laboratories in Europe. Nine laboratories from eight European countries participated in six quality control surveys for urinary calculi analyses of the Reference Institute for Bioanalytics, Bonn, Germany, between 2010 and 2014. Each participant received the same blinded test samples for stone analysis. A total of 24 samples, comprising pure substances and mixtures of two or three components, were analysed. The evaluation of the quality of the laboratory in the present study was based on the attainment of 75% of the maximum total points, i.e. 99 points. The methods of stone analysis used were infrared spectroscopy (n = 7), chemical analysis (n = 1) and X-ray diffraction (n = 1). In the present study only 56% of the laboratories, four using infrared spectroscopy and one using X-ray diffraction, fulfilled the quality requirements. According to the current standard, chemical analysis is considered to be insufficient for stone analysis, whereas infrared spectroscopy or X-ray diffraction is mandatory. However, the poor results of infrared spectroscopy highlight the importance of equipment, reference spectra and qualification of the staff for an accurate analysis of stone composition. Regular quality control is essential in carrying out routine stone analysis.

[MusiQol: international questionnaire investigating quality of life in multiple sclerosis: validation results for the German subpopulation in an international comparison].

PubMed

Flachenecker, P; Vogel, U; Simeoni, M C; Auquier, P; Rieckmann, P

2011-10-01

The existing health-related quality of life questionnaires on multiple sclerosis (MS) only partially reflect the patient's point of view on the reduction of activities of daily living. Their development and validation was not performed in different languages. That is what prompted the development of the Multiple Sclerosis International Quality of Life (MusiQoL) Questionnaire as an international multidimensional measurement instrument. This paper presents this new development and the results of the German subgroup versus the total international sample. A total of 1,992 MS patients from 15 countries, including 209 German patients, took part in the study between January 2004 and February 2005. The patients took the MusiQoL survey at baseline and at 21±7 days as well as completing a symptom-related checklist and the SF-36 short form survey. Demographics, history and MS classification data were also generated. Reproducibility, sensitivity, convergent and discriminant validity were analysed. Convergent and discriminant validity and reproducibility were satisfactory for all dimensions of the MusiQoL. The dimensional scores correlated moderately but significantly with the SF-36 scores, but showed a discriminant validity in terms of gender, socioeconomic status and health status that was more pronounced in the overall population than in the German subpopulation. The highest correlations were observed between the MusiQoL dimension of activities of daily living and the Expanded Disability Status Scale (EDSS). The results of this study confirm the validity and reliability of MusiQoL as an instrument for measuring the quality of life of German and international MS patients.

Water-quality trends in the nation’s rivers and streams, 1972–2012—Data preparation, statistical methods, and trend results

USGS Publications Warehouse

Oelsner, Gretchen P.; Sprague, Lori A.; Murphy, Jennifer C.; Zuellig, Robert E.; Johnson, Henry M.; Ryberg, Karen R.; Falcone, James A.; Stets, Edward G.; Vecchia, Aldo V.; Riskin, Melissa L.; De Cicco, Laura A.; Mills, Taylor J.; Farmer, William H.

2017-04-04

Since passage of the Clean Water Act in 1972, Federal, State, and local governments have invested billions of dollars to reduce pollution entering rivers and streams. To understand the return on these investments and to effectively manage and protect the Nation’s water resources in the future, we need to know how and why water quality has been changing over time. As part of the National Water-Quality Assessment Project, of the U.S. Geological Survey’s National Water-Quality Program, data from the U.S. Geological Survey, along with multiple other Federal, State, Tribal, regional, and local agencies, have been used to support the most comprehensive assessment conducted to date of surface-water-quality trends in the United States. This report documents the methods used to determine trends in water quality and ecology because these methods are vital to ensuring the quality of the results. Specific objectives are to document (1) the data compilation and processing steps used to identify river and stream sites throughout the Nation suitable for water-quality, pesticide, and ecology trend analysis, (2) the statistical methods used to determine trends in target parameters, (3) considerations for water-quality, pesticide, and ecology data and streamflow data when modeling trends, (4) sensitivity analyses for selecting data and interpreting trend results with the Weighted Regressions on Time, Discharge, and Season method, and (5) the final trend results at each site. The scope of this study includes trends in water-quality concentrations and loads (nutrient, sediment, major ion, salinity, and carbon), pesticide concentrations and loads, and metrics for aquatic ecology (fish, invertebrates, and algae) for four time periods: (1) 1972–2012, (2) 1982–2012, (3) 1992–2012, and (4) 2002–12. In total, nearly 12,000 trends in concentration, load, and ecology metrics were evaluated in this study; there were 11,893 combinations of sites, parameters, and trend periods. The

Consumers' expected quality and intention to purchase high quality pork meat.

PubMed

Papanagiotou, P; Tzimitra-Kalogianni, I; Melfou, K

2013-03-01

Expected quality is believed to be one of the most important factors that influence consumers' intention to purchase food. The present study seeks to explore the concept of pork meat expected quality and compare it with self-stated consumer intention to purchase pork meat. The aim is attempted by means of a field research conducted in Greece, following a conjoint analytic procedure. Results show that quality expectations comply with intention to buy pork, in many aspects. However, several differences have been identified. More specifically, country of origin and marbling appear to be more important for respondents' purchase decisions than they are for their quality evaluations, while the opposite appears to be true for price. Finally, socio-demographic factors such as gender, level of education, place of purchase and consumption habits seem to influence perceptions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Changes to indoor air quality as a result of relocating families from slums to public housing

NASA Astrophysics Data System (ADS)

Burgos, Soledad; Ruiz, Pablo; Koifman, Rosalina

2013-05-01

One largely unstudied benefit of relocating families from slums to public housing is the potential improvement in indoor air quality (IAQ). We compared families that moved from slums to public housing with those that remained living in slums in Santiago, Chile in terms of fine particulate matter (PM2.5) as main indicator of change. A cross-sectional study of 98 relocated families and 71 still living in slums was carried out, obtaining indoor and outdoor samples by a Personal Environmental Monitor. Home characteristics, including indoor air pollution sources were collected through questionnaires. Multivariate regression models included the intervention (public housing or slum), indoor pollution sources, outdoor PM2.5 and family characteristics as predictors. Indoor PM2.5 concentrations were higher in slums (77.8 μg m-3 [SD = 35.7 μg m-3]) than in public housing (55.7 μg m-3 [SD = 34.6 μg m-3], p < 0.001). Differences between indoor and outdoor PM2.5 were significant only in the slum houses. The multivariate analysis showed that housing intervention significantly decreased indoor PM2.5 (10.4 μg m-3) after adjusting by the other predictors. Outdoor PM2.5 was the main predictor of indoor PM2.5. Other significant factors were water heating fuels and indoor smoking. Having infants 1-23 months was associated with a lowering of indoor PM2.5. Our results suggest that a public housing program that moves families from slums to public housing improves indoor air quality directly and also indirectly through air pollution sources.

Quality of diabetes care predicts the development of cardiovascular events: results of the AMD-QUASAR study.

PubMed

Rossi, Maria C E; Lucisano, Giuseppe; Comaschi, Marco; Coscelli, Carlo; Cucinotta, Domenico; Di Blasi, Patrizia; Bader, Giovanni; Pellegrini, Fabio; Valentini, Umberto; Vespasiani, Giacomo; Nicolucci, Antonio

2011-02-01

The QUASAR (Quality Assessment Score and Cardiovascular Outcomes in Italian Diabetes Patients) study aimed to assess whether a quality-of-care summary score predicted the development of cardiovascular (CV) events in patients with type 2 diabetes. In 67 diabetes clinics, data on randomly selected patients were extracted from electronic medical records. The score was calculated using process and outcome indicators based on monitoring, targets, and treatment of A1C, blood pressure, LDL cholesterol, and microalbuminuria. The score ranged from 0 to 40. Overall, 5,181 patients were analyzed; 477 (9.2%) patients developed a CV event after a median follow-up of 28 months. The incidence rate (per 1,000 person-years) of CV events was 62.4 in patients with a score of <15, 41.0 in those with a score between 20 and 25 and 36.7 in those with a score of >25. Multilevel analysis, adjusted for clustering and case-mix, showed that the risk to develop a new CV event was 84% higher in patients with a score of <15 (incidence rate ratio [IRR] = 1.84; 95% confidence interval [CI] 1.29-2.62) and 17% higher in those with a score between 15 and 25 (IRR = 1.17; 95% CI 0.93-1.49) compared with those with a score of >25. Mean quality score varied across centers from 16.5 ± 7.5 to 29.1 ± 6.3. When the score was tested as the dependent variable, it emerged that 18% of the variance in the score could be attributed to setting characteristics. Our study documented a close relationship between quality of diabetes care and long-term outcomes. A simple score can be used to monitor quality of care and compare the performance of different centers/physicians.

Quality of human-computer interaction - results of a national usability survey of hospital-IT in Germany

PubMed Central

2011-01-01

Background Due to the increasing functionality of medical information systems, it is hard to imagine day to day work in hospitals without IT support. Therefore, the design of dialogues between humans and information systems is one of the most important issues to be addressed in health care. This survey presents an analysis of the current quality level of human-computer interaction of healthcare-IT in German hospitals, focused on the users' point of view. Methods To evaluate the usability of clinical-IT according to the design principles of EN ISO 9241-10 the IsoMetrics Inventory, an assessment tool, was used. The focus of this paper has been put on suitability for task, training effort and conformity with user expectations, differentiated by information systems. Effectiveness has been evaluated with the focus on interoperability and functionality of different IT systems. Results 4521 persons from 371 hospitals visited the start page of the study, while 1003 persons from 158 hospitals completed the questionnaire. The results show relevant variations between different information systems. Conclusions Specialised information systems with defined functionality received better assessments than clinical information systems in general. This could be attributed to the improved customisation of these specialised systems for specific working environments. The results can be used as reference data for evaluation and benchmarking of human computer engineering in clinical health IT context for future studies. PMID:22070880

Ground-Water Quality Data in the Coachella Valley Study Unit, 2007: Results from the California GAMA Program

USGS Publications Warehouse

Goldrath, Dara A.; Wright, Michael T.; Belitz, Kenneth

2009-01-01

ground water. A quality-control sample (blank, replicate, or matrix spike) was collected at approximately one quarter of the wells, and the results for these samples were used to evaluate the quality of the data for the ground-water samples. Assessment of the quality-control information resulted in V-coding less than 0.1 percent of the data collected. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, water typically is treated, disinfected, and (or) blended with other waters to maintain acceptable water quality. Regulatory thresholds apply to treated water that is supplied to the consumer, not to raw ground water. However, to provide some context for the results, concentrations of constituents measured in the raw ground water were compared with health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and the California Department of Public Health (CDPH) and thresholds established for aesthetic purposes (secondary maximum contaminant levels, SMCL-CA) by CDPH. Most constituents detected in ground-water samples were at concentrations below drinking-water thresholds. Volatile organic compounds, pesticides, and pesticide degradates were detected in less than one-third of the grid well samples collected. All VOC and pesticide concentrations measured were below health-based thresholds. Potential waste-water indicators were detected in less than half of the wells sampled, and no detections were above health-based thresholds. Perchlorate was detected in seven grid wells; concentrations from two wells were above the CDPH maximum contaminant level (MCL-CA). Most detections of trace elements in samples collected from COA Study Unit wells were below water-quality thresholds. Exceptions include five samples of arsenic that were above the USEPA maximum contaminant level (MCL-US), two detections of boron above the CDPH notification level (NL-CA), and two detections of mol

Changing physician incentives for affordable, quality cancer care: results of an episode payment model.

PubMed

Newcomer, Lee N; Gould, Bruce; Page, Ray D; Donelan, Sheila A; Perkins, Monica

2014-09-01

This study tested the combination of an episode payment coupled with actionable use and quality data as an incentive to improve quality and reduce costs. Medical oncologists were paid a single fee, in lieu of any drug margin, to treat their patients. Chemotherapy medications were reimbursed at the average sales price, a proxy for actual cost. Five volunteer medical groups were compared with a large national payer registry of fee-for-service patients with cancer to examine the difference in cost before and after the initiation of the payment change. Between October 2009 and December 2012, the five groups treated 810 patients with breast, colon, and lung cancer using the episode payments. The registry-predicted fee-for-service cost of the episodes cohort was $98,121,388, but the actual cost was $64,760,116. The predicted cost of chemotherapy drugs was $7,519,504, but the actual cost was $20,979,417. There was no difference between the groups on multiple quality measures. Modifying the current fee-for-service payment system for cancer therapy with feedback data and financial incentives that reward outcomes and cost efficiency resulted in a significant total cost reduction. Eliminating existing financial chemotherapy drug incentives paradoxically increased the use of chemotherapy. Copyright © 2014 by American Society of Clinical Oncology.

Signal quality of endovascular electroencephalography

NASA Astrophysics Data System (ADS)

He, Bryan D.; Ebrahimi, Mosalam; Palafox, Leon; Srinivasan, Lakshminarayan

2016-02-01

Objective, Approach. A growing number of prototypes for diagnosing and treating neurological and psychiatric diseases are predicated on access to high-quality brain signals, which typically requires surgically opening the skull. Where endovascular navigation previously transformed the treatment of cerebral vascular malformations, we now show that it can provide access to brain signals with substantially higher signal quality than scalp recordings. Main results. While endovascular signals were known to be larger in amplitude than scalp signals, our analysis in rabbits borrows a standard technique from communication theory to show endovascular signals also have up to 100× better signal-to-noise ratio. Significance. With a viable minimally-invasive path to high-quality brain signals, patients with brain diseases could one day receive potent electroceuticals through the bloodstream, in the course of a brief outpatient procedure.

75 FR 10207 - Certain Cut-to-Length Carbon-Quality Steel Plate From the Republic of Korea: Final Results of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-05

... DEPARTMENT OF COMMERCE International Trade Administration [A-580-836] Certain Cut-to-Length Carbon... cut-to-length carbon-quality steel plate from the Republic of Korea and the intent to rescind the... results of the administrative review of the antidumping duty order on certain cut-to-length carbon-quality...

Results From the Audit of DOD’s American Recovery and Reinvestment Act of 2009 Initial Data Quality Review Implementation

DTIC Science & Technology

2009-11-03

Results From the Audit of DoD’s American Recovery and Reinvestment Act of 2009 Initial Data Quality Review Implementation Memorandum No. D-2010-RAM...number. 1. REPORT DATE 03 NOV 2009 2. REPORT TYPE 3. DATES COVERED 00-00-2009 to 00-00-2009 4. TITLE AND SUBTITLE Results From the Audit of...SUBJECT: Results From the Audit of DOD’ s American Recovery and Reinvestment Act of2009 Initial Data Quality Review Implementation (Report No. D

Ground-Water Quality Data in the San Francisco Bay Study Unit, 2007: Results from the California GAMA Program

USGS Publications Warehouse

Ray, Mary C.; Kulongoski, Justin T.; Belitz, Kenneth

2009-01-01

, replicate samples, matrix spike samples) were collected for approximately one-third of the wells, and the results for these samples were used to evaluate the quality of the data for the ground-water samples. Assessment of the quality-control information from the field blanks resulted in applying 'V' codes to approximately 0.1 percent of the data collected for ground-water samples (meaning a constituent was detected in blanks as well as the corresponding environmental data). See the Appendix section 'Quality-Control-Sample Results'. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, water typically is treated, disinfected, and (or) blended with other waters to maintain acceptable water quality. Regulatory thresholds apply to treated water that is delivered to the consumer, not to raw ground water. However, to provide some context for the results, concentrations of constituents measured in the raw ground water were compared with regulatory and non-regulatory health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and California Department of Public Health (CDPH) and thresholds established for aesthetic concerns (secondary maximum contaminant levels, SMCL-CA) by CDPH. VOCs were detected in about one-half of the grid wells, while pesticides were detected in about one-fifth of the grid wells. Concentrations of all VOCs and pesticides detected in samples from all SFBAY wells were below health-based thresholds. No pharmaceutical compounds were detected in any SFBAY well. One potential wastewater-indicator compound, caffeine, was detected in one grid well in SFBAY. Concentrations of most trace elements and nutrients detected in samples from all SFBAY wells were below health-based thresholds. Exceptions include nitrate, detected above the USEPA maximum contaminant level (MCL-US) in 3samples; arsenic, above the USEPA maximum contaminant level (MCL-US) in 3 samples; c

Evaluation of differences in quality of experience features for test stimuli of good-only and bad-only overall audiovisual quality

NASA Astrophysics Data System (ADS)

Strohmeier, Dominik; Kunze, Kristina; Göbel, Klemens; Liebetrau, Judith

2013-01-01

Assessing audiovisual Quality of Experience (QoE) is a key element to ensure quality acceptance of today's multimedia products. The use of descriptive evaluation methods allows evaluating QoE preferences and the underlying QoE features jointly. From our previous evaluations on QoE for mobile 3D video we found that mainly one dimension, video quality, dominates the descriptive models. Large variations of the visual video quality in the tests may be the reason for these findings. A new study was conducted to investigate whether test sets of low QoE are described differently than those of high audiovisual QoE. Reanalysis of previous data sets seems to confirm this hypothesis. Our new study consists of a pre-test and a main test, using the Descriptive Sorted Napping method. Data sets of good-only and bad-only video quality were evaluated separately. The results show that the perception of bad QoE is mainly determined one-dimensionally by visual artifacts, whereas the perception of good quality shows multiple dimensions. Here, mainly semantic-related features of the content and affective descriptors are used by the naïve test participants. The results show that, with increasing QoE of audiovisual systems, content semantics and users' a_ective involvement will become important for assessing QoE differences.

What contributes to long-term quality of life in breast cancer patients who are undergoing surgery? Results of a multidimensional study.

PubMed

Wittmann, Victoria; Látos, Melinda; Horváth, Zoltán; Simonka, Zsolt; Paszt, Attila; Lázár, György; Csabai, Márta

2017-08-01

This study aims to examine the key determinants of long-term quality of life in breast cancer patients who are undergoing surgery using a multidimensional approach and taking into account preoperative and post-operative psychological characteristics such as anxiety, depression, posttraumatic growth, body image, and physical activity as well as medical parameters. The study involved 63 breast cancer patients from the Department of Surgery at the University of Szeged. Assessments occurred 1 day before surgery as well as 3 days and 18 months after surgery using the Spielberger State and Trait Anxiety Inventory (STAI), Beck's Depression Inventory (BDI), Functional Assessment of Cancer Therapy-Breast Cancer Scale (FACT-B), Posttraumatic Growth Inventory (PTGI) and Breast Impact of Treatment Scale (BITS). Data relating to physical activity, medical parameters and sociodemographic characteristics were also collected. The level of depression did not change over time. State anxiety decreased 18 months after the surgery compared to before the surgery; however, there was a greater decrease immediately after the surgery and then anxiety increased again 18 months later. Trait anxiety was associated with quality of life, posttraumatic growth and body image. Posttraumatic growth and the level of depression were found to be possible contributing factors to the increase in long-term quality of life. The results show that the timely detection and proper management of psychological distress and the enhancement of posttraumatic growth are of great value, as they might be important contributing factors to long-term quality of life in breast cancer patients.

Groundwater-Quality Data in the Madera-Chowchilla Study Unit, 2008: Results from the California GAMA Program

USGS Publications Warehouse

Shelton, Jennifer L.; Fram, Miranda S.; Belitz, Kenneth

2009-01-01

, oxygen, and carbon, and activities of tritium and carbon-14), and dissolved noble gases also were measured to help identify the sources and ages of the sampled groundwater. In total, approximately 300 constituents and field water-quality indicators were investigated. Three types of quality-control samples (blanks, replicates, and samples for matrix spikes) each were collected at approximately 11 percent of the wells sampled for each analysis, and the results obtained from these samples were used to evaluate the quality of the data for the groundwater samples. Field blanks rarely contained detectable concentrations of any constituent, suggesting that data for the groundwater samples were not compromised by possible contamination during sample collection, handling or analysis. Differences between replicate samples were within acceptable ranges. Matrix spike recoveries were within acceptable ranges for most compounds. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, raw groundwater typically is treated, disinfected, or blended with other waters to maintain water quality. Regulatory thresholds apply to water that is served to the consumer, not to raw groundwater. However, to provide some context for the results, concentrations of constituents measured in the raw groundwater were compared with regulatory and non-regulatory health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and the California Department of Public Health (CDPH), and with aesthetic and technical thresholds established by CDPH. Comparisons between data collected for this study and drinking-water thresholds are for illustrative purposes only, and are not indicative of compliance or non-compliance with regulatory thresholds. The concentrations of most constituents detected in groundwater samples from MADCHOW wells were below drinking-water thresholds. Organic compounds (VOCs and pesticides

Assessing Pearl Quality Using Reflectance UV-Vis Spectroscopy: Does the Same Donor Produce Consistent Pearl Quality?

PubMed Central

Mamangkey, Noldy Gustaf F.; Agatonovic, Snezana; Southgate, Paul C.

2010-01-01

Two groups of commercial quality (“acceptable”) pearls produced using two donors, and a group of “acceptable” pearls from other donors were analyzed using reflectance UV-Vis spectrophotometry. Three pearls with different colors produced by the same donor showed different absorption spectra. Cream and gold colored pearls showed a wide absorption from 320 to about 460 nm, while there was just slight reflectance around 400 nm by the white pearl with a pink overtone. Cream and gold pearls reached a reflectance peak at 560 to 590 nm, while the white pearl with pink overtone showed slightly wider absorption in this region. Both cream and gold pearls showed an absorption peak after the reflectance peak, at about 700 nm for the cream pearl and 750 nm for the gold pearl. Two other pearls produced by the same donor (white with cream overtone and cream with various overtones) showed similar spectra, which differed in their intensity. One of these pearls had very high lustre and its spectrum showed a much higher percentage reflectance than the second pearl with inferior lustre. This result may indicate that reflectance is a useful quantitative indicator of pearl lustre. The spectra of two white pearls resulting from different donors with the same color nacre (silver) showed a reflectance at 260 nm, followed by absorption at 280 nm and another reflectance peak at 340 nm. After this peak the spectra for these pearls remained flat until a slight absorption peak around 700 nm. Throughout the visible region, all white pearls used in this study showed similar reflectance spectra although there were differences in reflectance intensity. Unlike the spectral results from white pearls, the results from yellow and gold pearls varied according to color saturation of the pearl. The results of this study show that similarities between absorption and reflectance spectra of cultured pearls resulting from the same saibo donor are negligible and could not be detected with UV

Assessing pearl quality using reflectance UV-Vis spectroscopy: does the same donor produce consistent pearl quality?

PubMed

Mamangkey, Noldy Gustaf F; Agatonovic, Snezana; Southgate, Paul C

2010-09-20

Two groups of commercial quality ("acceptable") pearls produced using two donors, and a group of "acceptable" pearls from other donors were analyzed using reflectance UV-Vis spectrophotometry. Three pearls with different colors produced by the same donor showed different absorption spectra. Cream and gold colored pearls showed a wide absorption from 320 to about 460 nm, while there was just slight reflectance around 400 nm by the white pearl with a pink overtone. Cream and gold pearls reached a reflectance peak at 560 to 590 nm, while the white pearl with pink overtone showed slightly wider absorption in this region. Both cream and gold pearls showed an absorption peak after the reflectance peak, at about 700 nm for the cream pearl and 750 nm for the gold pearl. Two other pearls produced by the same donor (white with cream overtone and cream with various overtones) showed similar spectra, which differed in their intensity. One of these pearls had very high lustre and its spectrum showed a much higher percentage reflectance than the second pearl with inferior lustre. This result may indicate that reflectance is a useful quantitative indicator of pearl lustre. The spectra of two white pearls resulting from different donors with the same color nacre (silver) showed a reflectance at 260 nm, followed by absorption at 280 nm and another reflectance peak at 340 nm. After this peak the spectra for these pearls remained flat until a slight absorption peak around 700 nm. Throughout the visible region, all white pearls used in this study showed similar reflectance spectra although there were differences in reflectance intensity. Unlike the spectral results from white pearls, the results from yellow and gold pearls varied according to color saturation of the pearl. The results of this study show that similarities between absorption and reflectance spectra of cultured pearls resulting from the same saibo donor are negligible and could not be detected with UV

Green qualities in the neighbourhood and mental health – results from a longitudinal cohort study in Southern Sweden

PubMed Central

2012-01-01

Background Poor mental health is a major issue worldwide and causality is complex. For diseases with multifactorial background synergistic effects of person- and place- factors can potentially be preventive. Nature is suggested as one such positive place-factor. In this cohort study we tested the effect of defined green qualities (Serene, Space, Wild, Culture, Lush) in the environment at baseline on mental health at follow-up. We also studied interaction effects on mental health of those place factors and varied person factors (financial stress, living conditions, and physical activity). Methods Data on person factors were extracted from a longitudinal (years 1999/2000 and 2005) population health survey (n = 24945). The participants were geocoded and linked to data on green qualities from landscape assessments, and stored in the Geographical Information System (GIS). Crude odds ratios (OR) and 95% confidence intervals (CI) were calculated, and multivariate logistic analyses were performed. Results Mental health was not affected by access to the chosen green qualities, neither in terms of amount nor in terms of any specific quality. However, we found a reduced risk for poor mental health at follow-up among women, through a significant interaction effect between physical activity and access to the qualities Serene or Space. For men the tendencies were similar, though not significant. Regarding the other three green qualities, as well as amount of qualities, no statistically certain synergistic effects were found. Likewise, no significant synergies were detected between green qualities and the other person-factors. Only advanced exercise significantly reduced the risk for poor mental health among women, but not for men, compared to physical inactivity. Conclusions The results do not directly support the hypothesis of a preventive mental health effect by access to the green qualities. However, the additive effect of serene nature to physical activity contributed to

Benchmarking the quality of breast cancer care in a nationwide voluntary system: the first five-year results (2003–2007) from Germany as a proof of concept

PubMed Central

Brucker, Sara Y; Schumacher, Claudia; Sohn, Christoph; Rezai, Mahdi; Bamberg, Michael; Wallwiener, Diethelm

2008-01-01

Background The main study objectives were: to establish a nationwide voluntary collaborative network of breast centres with independent data analysis; to define suitable quality indicators (QIs) for benchmarking the quality of breast cancer (BC) care; to demonstrate existing differences in BC care quality; and to show that BC care quality improved with benchmarking from 2003 to 2007. Methods BC centres participated voluntarily in a scientific benchmarking procedure. A generic XML-based data set was developed and used for data collection. Nine guideline-based quality targets serving as rate-based QIs were initially defined, reviewed annually and modified or expanded accordingly. QI changes over time were analysed descriptively. Results During 2003–2007, respective increases in participating breast centres and postoperatively confirmed BCs were from 59 to 220 and from 5,994 to 31,656 (> 60% of new BCs/year in Germany). Starting from 9 process QIs, 12 QIs were developed by 2007 as surrogates for long-term outcome. Results for most QIs increased. From 2003 to 2007, the most notable increases seen were for preoperative histological confirmation of diagnosis (58% (in 2003) to 88% (in 2007)), appropriate endocrine therapy in hormone receptor-positive patients (27 to 93%), appropriate radiotherapy after breast-conserving therapy (20 to 79%) and appropriate radiotherapy after mastectomy (8 to 65%). Conclusion Nationwide external benchmarking of BC care is feasible and successful. The benchmarking system described allows both comparisons among participating institutions as well as the tracking of changes in average quality of care over time for the network as a whole. Marked QI increases indicate improved quality of BC care. PMID:19055735

Results from 15years of quality surveillance for a National Indigenous Point-of-Care Testing Program for diabetes.

PubMed

Shephard, Mark; Shephard, Anne; McAteer, Bridgit; Regnier, Tamika; Barancek, Kristina

2017-12-01

Diabetes is a major health problem for Australia's Aboriginal and Torres Strait Islander peoples. Point-of-care testing for haemoglobin A1c (HbA1c) has been the cornerstone of a long-standing program (QAAMS) to manage glycaemic control in Indigenous people with diabetes and recently, to diagnose diabetes. The QAAMS quality management framework includes monthly testing of quality control (QC) and external quality assurance (EQA) samples. Key performance indicators of quality include imprecision (coefficient of variation [CV%]) and percentage acceptable results. This paper reports on the past 15years of quality testing in QAAMS and examines the performance of HbA1c POC testing at the 6.5% cut-off recommended for diagnosis. The total number of HbA1c EQA results submitted from 2002 to 2016 was 29,093. The median imprecision for EQA testing by QAAMS device operators averaged 2.81% (SD 0.50; range 2.2 to 3.9%) from 2002 to 2016 and 2.44% (SD 0.22; range 2.2 to 2.9%) from 2009 to 2016. No significant difference was observed between the median imprecision achieved in QAAMS and by Australasian laboratories from 2002 to 2016 (p=0.05; two-tailed paired t-test) and from 2009 to 2016 (p=0.17; two-tailed paired t-test). For QC testing from 2009 to 2016, imprecision averaged 2.5% and 3.0% for the two levels of QC tested. Percentage acceptable results averaged 90% for QA testing from 2002 to 2016 and 96% for QC testing from 2009 to 2016. The DCA Vantage was able to measure a patient and an EQA sample with an HbA1c value close to 6.5% both accurately and precisely. HbA1c POC testing in QAAMS has remained analytically sound, matched the quality achieved by Australasian laboratories and met profession-derived analytical goals for 15years. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Impact of Sleep Quality on Cardiovascular Outcomes in Hemodialysis Patients: Results from the Frequent Hemodialysis Network Study

PubMed Central

Unruh, Mark; Tamura, Manjula Kurella; Larive, Brett; Rastogi, Anjay; James, Sam; Schiller, Brigitte; Gassman, Jennifer; Chan, Christopher; Lockridge, Robert; Kliger, Alan

2011-01-01

Background Poor sleep quality is a common, persistent, and important problem to patients with end-stage renal disease (ESRD). This report examines whether sleep quality is associated with dialysis treatment factors and other modifiable clinical factors in a large group of hemodialysis (HD) patients. Methods Cross-sectional analyses were conducted on baseline data collected from participants in the Frequent Hemodialysis Network trials. Sleep quality was measured using the Medical Outcomes Study Sleep Problems Index II (SPI II), a 9-item measure of sleep quality with higher scores reflecting poorer sleep quality. Results The participants had an age of 51.2 ± 13.6 years, 61% were male, 38% were black, and 42% had diabetes. Higher pre-dialysis serum phosphorus (per 0.5 mg/ml) (OR 0.91; 95% CI 0.85, 0.96) and depression (OR 0.16; 95% CI 0.10, 0.25) were independently associated with decrements in sleep quality. There was also a difference in time to recovery from dialysis for the fourth versus the first SPI II quartile (5.1 h; p < 0.0001). Conclusion These findings underscore the link between sleep and daytime function and suggest that improving sleep may provide an opportunity to improve outcomes in ESRD. Whether sleep problems may be improved by reduction of serum phosphorus or treatment of depression in the HD population merits further investigation. PMID:21474924

Surface-water-quality assessment of the upper Illinois River Basin in Illinois, Indiana, and Wisconsin; results of investigations through April 1992

USGS Publications Warehouse

Schmidt, Arthur R.; Blanchard, Stephen F.

1997-01-01

,p'-DDE was the most commonly detected organic compound in biota in both 1989 and 1990. In the nine fish-fillet samples collected in 1989, exceedances of U.S. Environmental Protection Agency (USEPA) fish tissue concentrations were noted for p,p'-DDE in all nine fillets and for dieldrin in five of the nine fillets. Nutrient concentrations in water in the study area generally were larger than concentrations typically found in natural waters. The Des Plaines River Basin contributed approximately 41 percent of the total nitrogen load to the upper Illinois River Basin, whereas the Kankakee River and Iroquois River Basins contributed about 34 and 14 percent of the total load, respectively. Dissolved-oxygen concentrations measured during a 1988 synoptic sampling exceeded State water-quality standards at 76 percent of the sampled sites. Bacteria densities greater than water-quality standards were observed at all of the fixed-monitoring stations, but densities greater than water-quality criteria and standards were observed more often at stations in the Des Plaines River Basin. Results from the analysis of changes in water quality following changes in wastewater-treatment practices indicated that current monitoring programs, although sufficient for their intended purposes, are not suitable for this type of retrospective assessment in large-scale water-quality assessments. Changes were not indicated in fish-community structure and population following changes in wastewater-treatment practices. A strong relation between the quality of the fish community and overall water-quality conditions was observed, although USEPA acute criteria for the protection of freshwater aquatic life were rarely exceeded. Analyses of fish-community data clearly showed that water quality in the urbanized parts of the study area were degraded relative to those in agricultural areas. Total chromium in streambed sediments and total recoverable sodium in water were highly correlated

Stand quality management of a water oak plantation in Louisiana: preliminary results following thinning

Treesearch

James S. Meadows; Daniel A., Jr. Skojac

2010-01-01

Stand quality management is a new guiding principle in which thinning prescriptions are based on tree quality rather than on residual stand density. We recently initiated a series of hardwood thinning studies to determine the effects of four stand quality management thinning prescriptions on both stand-level and individual-tree-level growth, quality, and value: (1) no...

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

Evaluation of outpatient service quality in Eastern Saudi Arabia

PubMed Central

Fraihi, Khalid J. Al; FAMCO, Dip; FAMCO, Fellow; Latif, Shahid A.

2016-01-01

Objectives: To investigate perceptions and expectations of patients regarding hospital outpatient services by using a service quality gap model and factors influencing such gaps. Methods: In this cross-sectional descriptive study conducted between October and November 2014 in the outpatient waiting areas of a hospital in the Eastern Province of Saudi Arabia, a sample of 306 patients was selected by convenience sampling technique. The data was collected through an Arabic version of the service quality (SERVQUAL) questionnaire consisting of 2 parts: patients’ demographic characteristics, and 22 items scales of patients’ expectations and perceptions of SERVQUAL. The data was analyzed by confirmatory factor analysis, independent, and paired t samples tests and one way analysis of variance test. Results: The results showed that the proposed model for service quality dimensions had a good fit by satisfying the recommended values. The patients’ expectations exceeded perceptions in all service quality dimensions indicating statistically significant service quality gaps (t=26.3, p<0.000). Findings revealed that the empathy dimension contributed most patients’ expectations (4.7 ± 0.5) and perceptions (3.7 ± 0.8) scores, and responsiveness contributed least to expectations (4.5 ± 0.6) and perceptions (3.2 ± 0.8) scores. Prompt services showed highest service quality gap, while observation of privacy showed the smallest service quality gap in the statements. The study showed a significant association between gender, age, education, multiple visits, and service quality dimensions. Conclusion: The proposed model is valid and reliable and significant service quality gaps of all 5 dimensions need to be prioritized and addressed by focused improvement efforts of hospital management. PMID:27052285

Effect of ageing time on suckling lamb meat quality resulting from different carcass chilling regimes.

PubMed

Vieira, C; Fernández, A M

2014-02-01

The effect of ageing on suckling lamb carcasses subjected to three chilling treatments was studied: Conventional (2 °C for 24h), ultra-fast (-20 °C for 3.5h then 2 °C until 24h post mortem) and slow chilling (12 °C for 7h then 2 °C until 24h post mortem) treatments. Meat quality measurements were carried out in carcasses at 24h post mortem and also after 5 days of ageing. Carcass chilling losses were not affected by a chilling regime. Aged meat showed higher cooking losses than non-aged meat (p<0.05). Sarcomere length of ultra-fast t was shorter (p<0.05) than conventional and conventional was shorter than slow chilling treatment (p<0.05), at 24h and after 5 days of ageing. Conventional and ultra-fast chilling treatments resulted in higher shear force values at 24h post mortem (p<0.05) compared to slow treatment. All treatments improved sensory scores with ageing (p<0.05), but ultra-fast chilling treatment did not attain higher values as the other two treatments. © 2013.

Are Educational Shows Teaching Our Children to Become Life-Long Learners?

ERIC Educational Resources Information Center

Sullins, Jeremiah; Howard, Tiffany; Goza, Kimberly

2014-01-01

The purpose of this study was to investigate various textual characteristics of popular children television shows. More specifically, researchers examined both the quantity and quality of question asked (i.e., question training). Furthermore, several readability components among the different shows (e.g., narrativity, syntactic simplicity,…

Cost-effective water quality assessment through the integration of monitoring data and modeling results

NASA Astrophysics Data System (ADS)

Lobuglio, Joseph N.; Characklis, Gregory W.; Serre, Marc L.

2007-03-01

Sparse monitoring data and error inherent in water quality models make the identification of waters not meeting regulatory standards uncertain. Additional monitoring can be implemented to reduce this uncertainty, but it is often expensive. These costs are currently a major concern, since developing total maximum daily loads, as mandated by the Clean Water Act, will require assessing tens of thousands of water bodies across the United States. This work uses the Bayesian maximum entropy (BME) method of modern geostatistics to integrate water quality monitoring data together with model predictions to provide improved estimates of water quality in a cost-effective manner. This information includes estimates of uncertainty and can be used to aid probabilistic-based decisions concerning the status of a water (i.e., impaired or not impaired) and the level of monitoring needed to characterize the water for regulatory purposes. This approach is applied to the Catawba River reservoir system in western North Carolina as a means of estimating seasonal chlorophyll a concentration. Mean concentration and confidence intervals for chlorophyll a are estimated for 66 reservoir segments over an 11-year period (726 values) based on 219 measured seasonal averages and 54 model predictions. Although the model predictions had a high degree of uncertainty, integration of modeling results via BME methods reduced the uncertainty associated with chlorophyll estimates compared with estimates made solely with information from monitoring efforts. Probabilistic predictions of future chlorophyll levels on one reservoir are used to illustrate the cost savings that can be achieved by less extensive and rigorous monitoring methods within the BME framework. While BME methods have been applied in several environmental contexts, employing these methods as a means of integrating monitoring and modeling results, as well as application of this approach to the assessment of surface water monitoring networks

An experiment shows that a well-designed report on costs and quality can help consumers choose high-value health care.

PubMed

Hibbard, Judith H; Greene, Jessica; Sofaer, Shoshanna; Firminger, Kirsten; Hirsh, Judith

2012-03-01

Advocates of health reform continue to pursue policies and tools that will make information about comparative costs and resource use available to consumers. Reformers expect that consumers will use the data to choose high-value providers-those who offer higher quality and lower prices-and thus contribute to the broader goal of controlling national health care spending. However, communicating this information effectively is more challenging than it might first appear. For example, consumers are more interested in the quality of health care than in its cost, and many perceive a low-cost provider to be substandard. In this study of 1,421 employees, we examined how different presentations of information affect the likelihood that consumers will make high-value choices. We found that a substantial minority of the respondents shied away from low-cost providers, and even consumers who pay a larger share of their health care costs themselves were likely to equate high cost with high quality. At the same time, we found that presenting cost data alongside easy-to-interpret quality information and highlighting high-value options improved the likelihood that consumers would choose those options. Reporting strategies that follow such a format will help consumers understand that a doctor who provides higher-quality care than other doctors does not necessarily cost more.

Implementation of basic quality control tests for malaria medicines in Amazon Basin countries: results for the 2005-2010 period.

PubMed

Pribluda, Victor S; Barojas, Adrian; Añez, Arletta; López, Cecilia G; Figueroa, Ruth; Herrera, Roxana; Nakao, Gladys; Nogueira, Fernando Ha; Pianetti, Gerson A; Povoa, Marinete M; Viana, Giselle Mr; Gomes, Margarete S Mendonça; Escobar, Jose P; Sierra, Olga L Muñoz; Norena, Susana P Rendon; Veloz, Raúl; Bravo, Marcy Silva; Aldás, Martha R; Hindssemple, Alison; Collins, Marilyn; Ceron, Nicolas; Krishnalall, Karanchand; Adhin, Malti; Bretas, Gustavo; Hernandez, Nelly; Mendoza, Marjorie; Smine, Abdelkrim; Chibwe, Kennedy; Lukulay, Patrick; Evans, Lawrence

2012-06-15

Ensuring the quality of malaria medicines is crucial in working toward malaria control and eventual elimination. Unlike other validated tests that can assess all critical quality attributes, which is the standard for determining the quality of medicines, basic tests are significantly less expensive, faster, and require less skilled labour; yet, these tests provide reproducible data and information on several critical quality attributes, such as identity, purity, content, and disintegration. Visual and physical inspection also provides valuable information about the manufacturing and the labelling of medicines, and in many cases this inspection is sufficient to detect counterfeit medicines. The Promoting the Quality of Medicines (PQM) programme has provided technical assistance to Amazon Malaria Initiative (AMI) countries to implement the use of basic tests as a key screening mechanism to assess the quality of malaria medicines available to patients in decentralized regions. Trained personnel from the National Malaria Control Programmes (NMCPs), often in collaboration with country's Official Medicine Control Laboratory (OMCL), developed country- specific protocols that encompassed sampling methods, sample analysis, and data reporting. Sampling sites were selected based on malaria burden, accessibility, and geographical location. Convenience sampling was performed and countries were recommended to store the sampled medicines under conditions that did not compromise their quality. Basic analytical tests, such as disintegration and thin layer chromatography (TLC), were performed utilizing a portable mini-laboratory. Results were originally presented at regional meetings in a non-standardized format that lacked relevant medicines information. However, since 2008 information has been submitted utilizing a template specifically developed by PQM for that purpose. From 2005 to 2010, the quality of 1,663 malaria medicines from seven AMI countries was evaluated, mostly

Quality of life in chemical warfare survivors with ophthalmologic injuries: the first results form Iran Chemical Warfare Victims Health Assessment Study.

PubMed

Mousavi, Batool; Soroush, Mohammad Reza; Montazeri, Ali

2009-01-19

Iraq used chemical weapons extensively against the Iranians during the Iran-Iraq war (1980-1988). The aim of this study was to assess the health related quality of life (HRQOL) in people who had ophthalmologic complications due to the sulfur mustard gas exposure during the war. The Veterans and Martyrs Affair Foundation (VMAF) database indicated that there were 196 patients with severe ophthalmologic complications due to chemical weapons exposure. Of these, those who gave consent (n = 147) entered into the study. Quality of life was measured using the 36-item Short Form Health Survey (SF-36) and scores were compared to those of the general public. In addition logistic regression analysis was performed to indicate variables that contribute to physical and mental health related quality of life. The mean age of the patients was 44.8 (SD = 8.7) ranging from 21 to 75 years. About one-third of the cases (n= 50) reported exposure to chemical weapons more than once. The mean exposure duration to sulfur mustard gas was 21.6 years (SD = 1.2). The lowest scores on the SF-36 subscales were found to be: the role physical and the general health. Quality of life in chemical warfare victims who had ophthalmologic problems was significantly lower than the general public (P < 0.001). The results obtained from logistic regression analysis indicated that those who did not participate in sport activities suffer from a poorer physical health (OR = 2.93, 95% CI = 1.36 to 6.30, P = 0.006). The analysis also showed that poor mental health was associated with longer time since exposure (OR = 1.58, 95% CI = 1.04 to 2.39, P = 0.03) and lower education (OR = 3.03, 95% CI = 1.21 to 7.56, P = 0.01). The study findings suggest that chemical warfare victims with ophthalmologic complications suffer from poor health related quality of life. It seems that the need for provision of health and support for this population is urgent. In addition, further research is necessary to measure health related

Kennedy Space Center's NASA/Contractor Team-Centered Total Quality Management Seminar: Results, methods, and lessons learned

NASA Technical Reports Server (NTRS)

Kinlaw, Dennis C.; Eads, Jeannette

1992-01-01

It is apparent to everyone associated with the Nation's aeronautics and space programs that the challenge of continuous improvement can be reasonably addressed only if NASA and its contractors act together in a fully integrated and cooperative manner that transcends the traditional boundaries of proprietary interest. It is, however, one thing to assent to the need for such integration and cooperation; it is quite another thing to undertake the hard tasks of turning such a need into action. Whatever else total quality management is, it is fundamentally a team-centered and team-driven process of continuous improvement. The introduction of total quality management at KSC, therefore, has given the Center a special opportunity to translate the need for closer integration and cooperation among all its organizations into specific initiatives. One such initiative that NASA and its contractors have undertaken at KSC is a NASA/Contractor team-centered Total Quality Management Seminar. It is this seminar which is the subject of this paper. The specific purposes of this paper are to describe the following: Background, development, and evolution of Kennedy Space Center's Total Quality Management Seminar; Special characteristics of the seminar; Content of the seminar; Meaning and utility of a team-centered design for TQM training; Results of the seminar; Use that one KSC contractor, EG&G Florida, Inc. has made of the seminar in its Total Quality Management initiative; and Lessons learned.

Implementation of basic quality control tests for malaria medicines in Amazon Basin countries: results for the 2005–2010 period

PubMed Central

2012-01-01

Background Ensuring the quality of malaria medicines is crucial in working toward malaria control and eventual elimination. Unlike other validated tests that can assess all critical quality attributes, which is the standard for determining the quality of medicines, basic tests are significantly less expensive, faster, and require less skilled labour; yet, these tests provide reproducible data and information on several critical quality attributes, such as identity, purity, content, and disintegration. Visual and physical inspection also provides valuable information about the manufacturing and the labelling of medicines, and in many cases this inspection is sufficient to detect counterfeit medicines. The Promoting the Quality of Medicines (PQM) programme has provided technical assistance to Amazon Malaria Initiative (AMI) countries to implement the use of basic tests as a key screening mechanism to assess the quality of malaria medicines available to patients in decentralized regions. Methods Trained personnel from the National Malaria Control Programmes (NMCPs), often in collaboration with country’s Official Medicine Control Laboratory (OMCL), developed country- specific protocols that encompassed sampling methods, sample analysis, and data reporting. Sampling sites were selected based on malaria burden, accessibility, and geographical location. Convenience sampling was performed and countries were recommended to store the sampled medicines under conditions that did not compromise their quality. Basic analytical tests, such as disintegration and thin layer chromatography (TLC), were performed utilizing a portable mini-laboratory. Results Results were originally presented at regional meetings in a non-standardized format that lacked relevant medicines information. However, since 2008 information has been submitted utilizing a template specifically developed by PQM for that purpose. From 2005 to 2010, the quality of 1,663 malaria medicines from seven AMI countries

Quality Assessment of Studies Published in Open Access and Subscription Journals: Results of a Systematic Evaluation

PubMed Central

Pastorino, Roberta; Milovanovic, Sonja; Stojanovic, Jovana; Efremov, Ljupcho; Amore, Rosarita; Boccia, Stefania

2016-01-01

Introduction Along with the proliferation of Open Access (OA) publishing, the interest for comparing the scientific quality of studies published in OA journals versus subscription journals has also increased. With our study we aimed to compare the methodological quality and the quality of reporting of primary epidemiological studies and systematic reviews and meta-analyses published in OA and non-OA journals. Methods In order to identify the studies to appraise, we listed all OA and non-OA journals which published in 2013 at least one primary epidemiologic study (case-control or cohort study design), and at least one systematic review or meta-analysis in the field of oncology. For the appraisal, we picked up the first studies published in 2013 with case-control or cohort study design from OA journals (Group A; n = 12), and in the same time period from non-OA journals (Group B; n = 26); the first systematic reviews and meta-analyses published in 2013 from OA journals (Group C; n = 15), and in the same time period from non-OA journals (Group D; n = 32). We evaluated the methodological quality of studies by assessing the compliance of case-control and cohort studies to Newcastle and Ottawa Scale (NOS) scale, and the compliance of systematic reviews and meta-analyses to Assessment of Multiple Systematic Reviews (AMSTAR) scale. The quality of reporting was assessed considering the adherence of case-control and cohort studies to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist, and the adherence of systematic reviews and meta-analyses to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. Results Among case-control and cohort studies published in OA and non-OA journals, we did not observe significant differences in the median value of NOS score (Group A: 7 (IQR 7–8) versus Group B: 8 (7–9); p = 0.5) and in the adherence to STROBE checklist (Group A, 75% versus Group B, 80%; p = 0.1). The

Blind image quality assessment based on aesthetic and statistical quality-aware features

NASA Astrophysics Data System (ADS)

Jenadeleh, Mohsen; Masaeli, Mohammad Masood; Moghaddam, Mohsen Ebrahimi

2017-07-01

The main goal of image quality assessment (IQA) methods is the emulation of human perceptual image quality judgments. Therefore, the correlation between objective scores of these methods with human perceptual scores is considered as their performance metric. Human judgment of the image quality implicitly includes many factors when assessing perceptual image qualities such as aesthetics, semantics, context, and various types of visual distortions. The main idea of this paper is to use a host of features that are commonly employed in image aesthetics assessment in order to improve blind image quality assessment (BIQA) methods accuracy. We propose an approach that enriches the features of BIQA methods by integrating a host of aesthetics image features with the features of natural image statistics derived from multiple domains. The proposed features have been used for augmenting five different state-of-the-art BIQA methods, which use statistical natural scene statistics features. Experiments were performed on seven benchmark image quality databases. The experimental results showed significant improvement of the accuracy of the methods.

Evaluation of Adherence to Quality Measures for Prostate Cancer Radiotherapy in the United States: Results from the Quality Research in Radiation Oncology (QRRO) Survey

PubMed Central

Zelefsky, Michael J.; Lee, W. Robert; Zietman, Anthony; Khalid, Najma; Crozier, Cheryl; Owen, Jean; Wilson, J. Frank

2012-01-01

Purpose To test the feasibility of using proposed quality indicators to assess radiotherapy quality in prostate cancer management based on a 2007 stratified random survey of treating academic and non-academic US institutions. Methods and Materials 414 patients with clinically localized prostate cancer treated with external beam radiotherapy (EBRT) or brachytherapy were selected from 45 institutions. Indicators used as specific measurable clinical performance measures to represent surrogates for quality of radiotherapy delivery included established measures, such as the use of prescription doses ≥75 Gy for intermediate- and high-risk EBRT patients and androgen-deprivation therapy (ADT) in conjunction with EBRT for patients with high-risk disease, and emerging measures, including daily target localization (image-guidance) to correct for organ motion for EBRT patients. Results 167 patients (47%) were treated with 6 MV photons, 31 (9%) were treated with 10 MV, 65 (18%) received 15 MV, and the remaining 90 (26%) 16–23 MV. For intermediate- plus high-risk patients (n=181), 78% were treated to ≥75 Gy. Among favorable-risk patients, 72% were treated to ≥75 Gy. Among high-risk EBRT patients, 60 (87%) were treated with ADT in conjunction with EBRT and 13% (n=9) with radiotherapy alone. Among low- and intermediate-risk patients, 10% and 42%, respectively, were treated with ADT plus EBRT. For 24% of EBRT patients (85/354), weekly electronic portal imaging was obtained as verification films without daily target localization and the remaining 76% were treated with daily localization of the target using various methods. Conclusions Adherence to defined quality indicators was observed in a majority of patients. ≈90% of high-risk patients are treated with ADT plus EBRT and ≈80% of intermediate- and high-risk patients receive prescription doses >=75 Gy, consistent with the published results of randomized trials. PMID:23471563

Semen quality of young adult ICSI offspring: the first results.

PubMed

Belva, F; Bonduelle, M; Roelants, M; Michielsen, D; Van Steirteghem, A; Verheyen, G; Tournaye, H

2016-12-01

What is the semen quality of young adult men who were conceived 18-22 years ago by ICSI for male infertility? In this cohort of 54 young adult ICSI men, median sperm concentration, total sperm count and total motile sperm count were significantly lower than in spontaneously conceived peers. The oldest ICSI offspring cohort worldwide has recently reached adulthood. Hence, their reproductive health can now be investigated. Since these children were conceived by ICSI because of severe male-factor infertility, there is reasonable concern that male offspring have inherited the deficient spermatogenesis from their fathers. Previously normal pubertal development and adequate Sertoli and Leydig cell function have been described in pubertal ICSI boys; however, no information on their sperm quality is currently available. This study was conducted at UZ Brussel between March 2013 and April 2016 and is part of a large follow-up project focussing on reproductive and metabolic health of young adults, between 18 and 22 years and conceived after ICSI with ejaculated sperm. Results of both a physical examination and semen analysis were compared between young ICSI men being part of a longitudinally followed cohort and spontaneously conceived controls who were recruited cross-sectionally. Results of a single semen sample in 54 young adult ICSI men and 57 spontaneously conceived men are reported. All young adults were individually assessed, and the results of their physical examination were completed by questionnaires. Data were analysed by multiple linear and logistic regression, adjusted for covariates. In addition, semen parameters of the ICSI fathers dating back from their ICSI treatment application were analysed for correlations. Young ICSI adults had a lower median sperm concentration (17.7 million/ml), lower median total sperm count (31.9 million) and lower median total motile sperm count (12.7 million) in comparison to spontaneously conceived peers (37.0 million/ml; 86

High-quality compressive ghost imaging

NASA Astrophysics Data System (ADS)

Huang, Heyan; Zhou, Cheng; Tian, Tian; Liu, Dongqi; Song, Lijun

2018-04-01

We propose a high-quality compressive ghost imaging method based on projected Landweber regularization and guided filter, which effectively reduce the undersampling noise and improve the resolution. In our scheme, the original object is reconstructed by decomposing of regularization and denoising steps instead of solving a minimization problem in compressive reconstruction process. The simulation and experimental results show that our method can obtain high ghost imaging quality in terms of PSNR and visual observation.

52. VIEW SHOWING SITE OF ARIZONA FALL POWER PLANT, LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

52. VIEW SHOWING SITE OF ARIZONA FALL POWER PLANT, LOOKING EAST. CURRENT LOCATION OF THE REAL-TIME WATER QUALITY MONITORING STATION Photographer: James Eastwood, July 1990 - Arizona Canal, North of Salt River, Phoenix, Maricopa County, AZ

Associations Between Sibling Relationship Quality and Friendship Quality in Early Adolescence: Looking at the Case of Twins.

PubMed

Bekkhus, Mona; Brendgen, Mara; Czajkowski, Nikolai O; Vitaro, Frank; Dionne, Ginette; Boivin, Michel

2016-04-01

Bidirectional pathways between twin relationship quality and friendship quality were investigated in a large longitudinal twin cohort. We examined negative and positive relationship features in 313 monozygotic (MZ) twins and 238 same-sex dizygotic (DZ) twins from ages 13 to 14 years, using latent structural modeling. Results showed stronger stability of the twin relationship quality compared to friendship quality. Positive features in the sibling relationship were associated with increased positive features in the relationship with the best friend a year later. In contrast, no significant association between negative sibling relationship features and change in negative friendship quality features was found. These findings speak to the important role of the sibling relationship in the development of good quality friendship relations in twins.

Groundwater Quality Data for the Tahoe-Martis Study Unit, 2007: Results from the California GAMA Program

USGS Publications Warehouse

Fram, Miranda S.; Munday, Cathy; Belitz, Kenneth

2009-01-01

results obtained from these samples were used to evaluate the quality of the data for the groundwater samples. Field blanks rarely contained detectable concentrations of any constituent, suggesting that data for the groundwater samples were not compromised by possible contamination during sample collection, handling or analysis. Differences between replicate samples were within acceptable ranges. Matrix spike recoveries were within acceptable ranges for most compounds. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, raw water typically is treated, disinfected, or blended with other waters to maintain water quality. Regulatory thresholds apply to water that is served to the consumer, not to raw groundwater. However, to provide some context for the results, concentrations of constituents measured in the raw groundwater were compared with regulatory and nonregulatory health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and the California Department of Public Health (CDPH), and with aesthetic and technical thresholds established by CDPH. Comparisons between data collected for this study and drinking-water thresholds are for illustrative purposes only and do not indicate of compliance or noncompliance with regulatory thresholds. The concentrations of most constituents detected in groundwater samples from the Tahoe-Martis wells were below drinking-water thresholds. Organic compounds (VOCs and pesticides) were detected in about 40 percent of the samples from grid wells, and most concentrations were less than 1/100th of regulatory and nonregulatory health-based thresholds, although the conentration of perchloroethene in one sample was above the USEPA maximum contaminant level (MCL-US). Concentrations of all trace elements and nutrients in samples from grid wells were below regulatory and nonregulatory health-based thresholds, with five exceptions. Concentra

Groundwater-Quality Data in the Antelope Valley Study Unit, 2008: Results from the California GAMA Program

USGS Publications Warehouse

Schmitt, Stephen J.; Milby Dawson, Barbara J.; Belitz, Kenneth

2009-01-01

-control samples (blanks, replicates, and samples for matrix spikes) were collected at 12 percent of the wells, and the results for these samples were used to evaluate the quality of the data for the groundwater samples. Field blanks rarely contained detectable concentrations of any constituent, suggesting that contamination was not a noticeable source of bias in the data for the groundwater samples. Differences between replicate samples generally were within acceptable ranges, indicating acceptably low variability. Matrix spike recoveries were within acceptable ranges for most compoundsThis study did not evaluate the quality of water delivered to consumers; after withdrawal from the ground, water typically is treated, disinfected, or blended with other waters to maintain water quality. Regulatory thresholds apply to water that is served to the consumer, not to raw groundwater. However, to provide some context for the results, concentrations of constituents measured in the raw groundwater were compared with regulatory and non-regulatory health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and California Department of Public Health (CDPH) and thresholds established for aesthetic concerns (secondary maximum contaminant levels, SMCL-CA) by CDPH. Comparisons between data collected for this study and drinking-water thresholds are for illustrative purposes only, and are not indicative of compliance or non-compliance with drinking water standards. Most constituents that were detected in groundwater samples were found at concentrations below drinking-water thresholds. Volatile organic compounds (VOCs) were detected in about one-half of the samples and pesticides detected in about one-third of the samples; all detections of these constituents were below health-based thresholds. Most detections of trace elements and nutrients in samples from ANT wells were below health-based thresholds. Exceptions include: one detection of nitrite plus nitr

Groundwater-Quality Data in the Colorado River Study Unit, 2007: Results from the California GAMA Program

USGS Publications Warehouse

Goldrath, Dara A.; Wright, Michael T.; Belitz, Kenneth

2010-01-01

approximately 30 percent of the wells, and the results were used to evaluate the quality of the data obtained from the groundwater samples. Field blanks rarely contained detectable concentrations of any constituent, suggesting that contamination was not a significant source of bias in the data. Differences between replicate samples were within acceptable ranges and matrix-spike recoveries were within acceptable ranges for most compounds. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, raw groundwater typically is treated, disinfected, or blended with other waters to maintain acceptable water quality. Regulatory thresholds apply to water that is served to the consumer, not to raw groundwater. However, to provide some context for the results, concentrations of constituents measured in the raw groundwater were compared to regulatory and nonregulatory health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and the California Department of Public Health (CDPH) and to thresholds established for aesthetic concerns by CDPH. Comparisons between data collected for this study and drinking-water thresholds are for illustrative purposes only and do not indicate compliance or noncompliance with those thresholds. The concentrations of most constituents detected in groundwater samples were below drinking-water thresholds. Volatile organic compounds (VOC) were detected in approximately 35 percent of grid well samples; all concentrations were below health-based thresholds. Pesticides and pesticide degradates were detected in about 20 percent of all samples; detections were below health-based thresholds. No concentrations of constituents of special interest or nutrients were detected above health-based thresholds. Most of the major and minor ion constituents sampled do not have health-based thresholds; the exception is chloride. Concentrations of chloride, sulfate, and total dis

Long-Term Trial Results Show No Mortality Benefit from Annual Prostate Cancer Screening

Cancer.gov

Thirteen year follow-up data from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial show higher incidence but similar mortality among men screened annually with the prostate-specific antigen (PSA) test and digital rectal examination

Electronic medical records and diabetes quality of care: results from a sample of family medicine practices.

PubMed

Crosson, Jesse C; Ohman-Strickland, Pamela A; Hahn, Karissa A; DiCicco-Bloom, Barbara; Shaw, Eric; Orzano, A John; Crabtree, Benjamin F

2007-01-01

Care of patients with diabetes requires management of complex clinical information, which may be improved by the use of an electronic medical record (EMR); however, the actual relationship between EMR usage and diabetes care quality in primary care settings is not well understood. We assessed the relationship between EMR usage and diabetes care quality in a sample of family medicine practices. We conducted cross-sectional analyses of baseline data from 50 practices participating in a practice improvement study. Between April 2003 and December 2004 chart auditors reviewed a random sample of medical records from patients with diabetes in each practice for adherence to guidelines for diabetes processes of care, treatment, and achievement of intermediate outcomes. Practice leaders provided medical record system information. We conducted multivariate analyses of the relationship between EMR usage and diabetes care adjusting for potential practice- and patient-level confounders and practice-level clustering. Diabetes care quality in all practices showed room for improvement; however, after adjustment, patient care in the 37 practices not using an EMR was more likely to meet guidelines for process (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.42-3.57) treatment (OR, 1.67; 95% CI, 1.07-2.60), and intermediate outcomes (OR, 2.68; 95% CI, 1.49-4.82) than in the 13 practices using an EMR. The use of an EMR in primary care practices is insufficient for insuring high-quality diabetes care. Efforts to expand EMR use should focus not only on improving technology but also on developing methods for implementing and integrating this technology into practice reality.

Ground-Water Quality Data in the Southern Sacramento Valley, California, 2005 - Results from the California GAMA Program

USGS Publications Warehouse

Milby Dawson, Barbara J.; Bennett, George L.; Belitz, Kenneth

2008-01-01

) were collected at ten percent of the wells, and the results for these samples were used to evaluate the quality of the data for the ground-water samples. Assessment of the quality-control data resulted in censoring of less than 0.03 percent of the analyses of ground-water samples. This study did not evaluate the quality of water delivered to consumers; after withdrawal from the ground, water typically is treated, disinfected, and (or) blended with other waters to maintain acceptable water quality. Regulatory thresholds apply to treated water that is served to the consumer, not to raw ground water. However, to provide some context for the results, concentrations of constituents measured in the raw ground water were compared with health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and California Department of Health Services (CADHS) (Maximum Contaminant Levels [MCLs], notification levels [NLs], or lifetime health advisories [HA-Ls]) and thresholds established for aesthetic concerns (Secondary Maximum Contaminant Levels [SMCLs]). All wells were sampled for organic constituents and selected general water quality parameters; subsets of wells were sampled for inorganic constituents, nutrients, and radioactive constituents. Volatile organic compounds were detected in 49 out of 83 wells sampled and pesticides were detected in 35 out of 82 wells; all detections were below health-based thresholds, with the exception of 1 detection of 1,2,3-trichloropropane above a NL. Of the 43 wells sampled for trace elements, 27 had no detections of a trace element above a health-based threshold and 16 had at least one detection above. Of the 18 trace elements with health-based thresholds, 3 (arsenic, barium, and boron) were detected at concentrations higher an MCL. Of the 43 wells sampled for nitrate, only 1 well had a detection above the MCL. Twenty wells were sampled for radioactive constituents; only 1 (radon-222) was measured at activiti

Improving the quality of healthcare for children: implementing the results of the AHSR research agenda conference.

PubMed Central

Halfon, N; Schuster, M; Valentine, W; McGlynn, E

1998-01-01

OBJECTIVE: To describe the rationale, development, content, and results of the AHSR-sponsored conference on developing a research agenda focused on improving the quality of care for children. DATA SOURCES AND METHODS: Planning documents, background papers, and conference proceedings. PRINCIPAL FINDINGS: The conference developed the research agenda focused on (1) monitoring the health of children; (2) evaluating the efficacy and effectiveness of health services for children; (3) assessing the quality of healthcare provided to children; (4) improving the quality of healthcare within health systems; (5) assessing the performance of community systems for children; (6) exploring the impact of different financial incentives on the provision of pediatric healthcare; and (7) developing and disseminating clinical practice guidelines and other information to physicians, families, and consumers. Specific issues and research questions in each area are also presented. Strategies for implementing the research agenda are presented and include: (1) expanding the child health services research workforce; (2) developing child healthcare quality improvement research centers; (3) conducting research in specific high-priority areas; (4) focusing research on improving the health of vulnerable populations; (5) improving child health data and collection systems at the national level; (6) developing better community health monitoring for children; (7) building and supporting research networks and a consortium of research users; and (8) developing a coordinated interagency federal effort to advance this agenda and to provide accountability for its completion. CONCLUSION: The proposed research agenda should be a national priority so that all Americans can be assured that children are receiving the best quality of care that the United States can provide. PMID:9776945

[The quality of life as perceived by older people. Results of a phenomenological study].

PubMed

Grosso, Silvia; Ambrosi, Elisa; Benagli, Carla; Mortari, Luigina; Canzan, Federica

2018-01-01

Elderly Quality of life (QoL) is vulnerable because of the decline in physical and mental capacity, discharge from work, rupture of the family and isolation. Many QoL Scales are made for adults: there is little research investigating how older people perceive QOL. This study aims to explore and understand the perceptions that older people have about their QOL. A qualitative research hermeneutics-phenomenological was done. Narratives were analyzed by mixed method phenomenological-grounded (Mortari, 2007). 16 elderly were interviewed (aged between 80 and 93 years), residents in their home. The analysis of the interviews confirm that QoL is a multidimensional concept that encompasses several components of life. There were 7 shared themes, reflecting the experience of well-being in older people living at home. The dimensions are: living relationships that drive away loneliness, fill the time with activities that follow their own interests, accept themselves as elderly person, choose how and where to live, think about death. The results of the study show that older people perceive QOL as made of multiple components and variables. Elderly are focused on the remaining capacities, on the acceptance of the positive aspects of their lives rather than on what they can no longer do. This study help to identify some social and health strategies to guarantee the best way to live the last part of life.

Conventional physical therapy and physical therapy based on reflex stimulation showed similar results in children with myelomeningocele.

PubMed

Aizawa, Carolina Y P; Morales, Mariana P; Lundberg, Carolina; Moura, Maria Clara D Soares de; Pinto, Fernando C G; Voos, Mariana C; Hasue, Renata H

2017-03-01

We aimed to investigate whether infants with myelomeningocele would improve their motor ability and functional independence after ten sessions of physical therapy and compare the outcomes of conventional physical therapy (CPT) to a physical therapy program based on reflex stimulation (RPT). Twelve children were allocated to CPT (n = 6, age 18.3 months) or RPT (n = 6, age 18.2 months). The RPT involved proprioceptive neuromuscular facilitation. Children were assessed with the Gross Motor Function Measure and the Pediatric Evaluation of Disability Inventory before and after treatment. Mann-Whitney tests compared the improvement on the two scales of CPT versus RPT and the Wilcoxon test compared CPT to RPT (before vs. after treatment). Possible correlations between the two scales were tested with Spearman correlation coefficients. Both groups showed improvement on self-care and mobility domains of both scales. There were no differences between the groups, before, or after intervention. The CPT and RPT showed similar results after ten weeks of treatment.

Personality Effects on Romantic Relationship Quality through Friendship Quality: A Ten-Year Longitudinal Study in Youths

PubMed Central

Yu, Rongqin; Branje, Susan; Keijsers, Loes; Meeus, Wim H. J.

2014-01-01

This study examined whether individuals with different personality types (i.e., overcontrollers, undercontrollers, resilients) had different friendship quality development throughout adolescence. It also investigated whether personality types were indirectly related to romantic relationship quality in young adulthood, via friendship quality development in adolescence. The study employed six waves of longitudinal questionnaire data from Dutch youths who had a romantic relationship when they were young adults. Two age cohorts were followed, from 12 to 21 years and from 16 to 25 years, respectively. Findings showed that resilients reported higher mean levels of friendship quality during adolescence (i.e., more support from, less negative interaction with and less dominance from their best friend) than both overcontrollers and undercontrollers. Through the mean levels of friendship quality throughout adolescence, resilients indirectly experienced higher romantic relationship quality during young adulthood than both overcontrollers and undercontrollers. Thus, results provide support for a developmental model in which adolescent friendship quality is a mechanism linking personality types with young adulthood romantic relationship quality. PMID:25232964

Ground-Water Quality Data in the Southern Sierra Study Unit, 2006 - Results from the California GAMA Program

USGS Publications Warehouse

Fram, Miranda S.; Belitz, Kenneth

2007-01-01

Ground-water quality in the approximately 1,800 square-mile Southern Sierra study unit (SOSA) was investigated in June 2006 as part of the Statewide Basin Assessment Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The GAMA Statewide Basin Assessment Project was developed in response to the Groundwater Quality Monitoring Act of 2001 and is being conducted by the U.S. Geological Survey (USGS) in cooperation with the California State Water Resources Control Board (SWRCB). The Southern Sierra study was designed to provide a spatially unbiased assessment of raw ground-water quality within SOSA, as well as a statistically consistent basis for comparing water quality throughout California. Samples were collected from fifty wells in Kern and Tulare Counties. Thirty-five of the wells were selected using a randomized grid-based method to provide statistical representation of the study area, and fifteen were selected to evaluate changes in water chemistry along ground-water flow paths. The ground-water samples were analyzed for a large number of synthetic organic constituents [volatile organic compounds (VOCs), pesticides and pesticide degradates, pharmaceutical compounds, and wastewater-indicator compounds], constituents of special interest [perchlorate, N-nitrosodimethylamine (NDMA), and 1,2,3-trichloropropane (1,2,3-TCP)], naturally occurring inorganic constituents [nutrients, major and minor ions, and trace elements], radioactive constituents, and microbial indicators. Naturally occurring isotopes [tritium, and carbon-14, and stable isotopes of hydrogen and oxygen in water], and dissolved noble gases also were measured to help identify the source and age of the sampled ground water. Quality-control samples (blanks, replicates, and samples for matrix spikes) were collected for approximately one-eighth of the wells, and the results for these samples were used to evaluate the quality of the data for the ground-water samples. Assessment of the

Benchmarking the quality of breast cancer care in a nationwide voluntary system: the first five-year results (2003-2007) from Germany as a proof of concept.

PubMed

Brucker, Sara Y; Schumacher, Claudia; Sohn, Christoph; Rezai, Mahdi; Bamberg, Michael; Wallwiener, Diethelm

2008-12-02

The main study objectives were: to establish a nationwide voluntary collaborative network of breast centres with independent data analysis; to define suitable quality indicators (QIs) for benchmarking the quality of breast cancer (BC) care; to demonstrate existing differences in BC care quality; and to show that BC care quality improved with benchmarking from 2003 to 2007. BC centres participated voluntarily in a scientific benchmarking procedure. A generic XML-based data set was developed and used for data collection. Nine guideline-based quality targets serving as rate-based QIs were initially defined, reviewed annually and modified or expanded accordingly. QI changes over time were analysed descriptively. During 2003-2007, respective increases in participating breast centres and postoperatively confirmed BCs were from 59 to 220 and from 5,994 to 31,656 (> 60% of new BCs/year in Germany). Starting from 9 process QIs, 12 QIs were developed by 2007 as surrogates for long-term outcome. Results for most QIs increased. From 2003 to 2007, the most notable increases seen were for preoperative histological confirmation of diagnosis (58% (in 2003) to 88% (in 2007)), appropriate endocrine therapy in hormone receptor-positive patients (27 to 93%), appropriate radiotherapy after breast-conserving therapy (20 to 79%) and appropriate radiotherapy after mastectomy (8 to 65%). Nationwide external benchmarking of BC care is feasible and successful. The benchmarking system described allows both comparisons among participating institutions as well as the tracking of changes in average quality of care over time for the network as a whole. Marked QI increases indicate improved quality of BC care.

Defect Analysis Of Quality Palm Kernel Meal Using Statistical Quality Control In Kernels Factory

NASA Astrophysics Data System (ADS)

Sembiring, M. T.; Marbun, N. J.

2018-04-01

The production quality has an important impact retain the totality of characteristics of a product or service to pay attention to its capabilities to meet the needs that have been established. Quality criteria Palm Kernel Meal (PKM) set Factory kernel is as follows: oil content: max 8.50%, water content: max 12,00% and impurity content: max 4.00% While the average quality of the oil content of 8.94%, the water content of 5.51%, and 8.45% impurity content. To identify the defective product quality PKM produced, then used a method of analysis using Statistical Quality Control (SQC). PKM Plant Quality Kernel shows the oil content was 0.44% excess of a predetermined maximum value, and 4.50% impurity content. With excessive PKM content of oil and dirt cause disability content of production for oil, amounted to 854.6078 kg PKM and 8643.193 kg impurity content of PKM. Analysis of the results of cause and effect diagram and SQC, the factors that lead to poor quality of PKM is Ampere second press oil expeller and hours second press oil expeller.

Landsat Thematic Mapper monitoring of turbid inland water quality

NASA Technical Reports Server (NTRS)

Lathrop, Richard G., Jr.

1992-01-01

This study reports on an investigation of water quality calibration algorithms under turbid inland water conditions using Landsat Thematic Mapper (TM) multispectral digital data. TM data and water quality observations (total suspended solids and Secchi disk depth) were obtained near-simultaneously and related using linear regression techniques. The relationships between reflectance and water quality for Green Bay and Lake Michigan were compared with results for Yellowstone and Jackson Lakes, Wyoming. Results show similarities in the water quality-reflectance relationships, however, the algorithms derived for Green Bay - Lake Michigan cannot be extrapolated to Yellowstone and Jackson Lake conditions.

Improving Library Service Quality to Graduate Students: LibQual+[TM] Survey Results in a Practical Setting

ERIC Educational Resources Information Center

Jankowska, Maria Anna; Hertel, Karen; Young, Nancy J.

2006-01-01

The LibQUAL+[TM] survey was conducted to determine user satisfaction and expectations concerning library service quality. The results of the "22 items and a box" constituted a rich source of information for the University of Idaho (UI) Library's strategic planning process. Focusing on graduate students, this study used three…

An Underwater Color Image Quality Evaluation Metric.

PubMed

Yang, Miao; Sowmya, Arcot

2015-12-01

Quality evaluation of underwater images is a key goal of underwater video image retrieval and intelligent processing. To date, no metric has been proposed for underwater color image quality evaluation (UCIQE). The special absorption and scattering characteristics of the water medium do not allow direct application of natural color image quality metrics especially to different underwater environments. In this paper, subjective testing for underwater image quality has been organized. The statistical distribution of the underwater image pixels in the CIELab color space related to subjective evaluation indicates the sharpness and colorful factors correlate well with subjective image quality perception. Based on these, a new UCIQE metric, which is a linear combination of chroma, saturation, and contrast, is proposed to quantify the non-uniform color cast, blurring, and low-contrast that characterize underwater engineering and monitoring images. Experiments are conducted to illustrate the performance of the proposed UCIQE metric and its capability to measure the underwater image enhancement results. They show that the proposed metric has comparable performance to the leading natural color image quality metrics and the underwater grayscale image quality metrics available in the literature, and can predict with higher accuracy the relative amount of degradation with similar image content in underwater environments. Importantly, UCIQE is a simple and fast solution for real-time underwater video processing. The effectiveness of the presented measure is also demonstrated by subjective evaluation. The results show better correlation between the UCIQE and the subjective mean opinion score.

Preliminary results of water quality assessment using phytoplankton and physicochemical approaches in the Huai River Basin, China.

PubMed

Chen, Hao; Zuo, Qi-Ting; Zhang, Yong-Yong

2017-11-01

Water pollution has been a significant issue in the Huai River Basin (HRB) of China since the late 1970s. In July and December 2013, two field investigations were carried out at 10 sites along the main streams of the basin. The monitoring indices contained both physicochemical variables and the structure and composition of phytoplankton communities. The correlations between communities and physicochemical variables were analyzed using cluster analysis and redundancy analysis. Moreover, water quality was evaluated using the comprehensive nutrition state index (TLI) and Shannon-Wiener diversity index (H). Results indicated that more phytoplankton species were present in December than in July, but total density was less in December. Phytoplankton communities in the midstream of the Shaying River were affected by the same physicochemical factors throughout the year, but ammonia nitrogen and total phosphorus had the greatest influence on these sites in July and December, respectively. The water pollution status of the sampling sites was much greater in the Shaying River midstream than at other sites. TLI was more suitable than H for assessing water quality in the study area. These results provide valuable information for policy makers and stakeholders in water quality assessment, water ecosystem restoration, and sustainable basin management in the HRB.

Variable infiltration and river flooding resulting in changing groundwater quality - A case study from Central Europe

NASA Astrophysics Data System (ADS)

Miotliński, Konrad; Postma, Dieke; Kowalczyk, Andrzej

2012-01-01

SummaryThe changes in groundwater quality occurring in a buried valley aquifer following a reduction in groundwater exploitation and enhanced infiltration due to extensive flooding of the Odra River in 1997 were investigated. Long-time series data for the chemical composition of groundwater in a large well field for drinking water supply indicated the deterioration of groundwater quality in the wells capturing water from the flooded area, which had been intensively cultivated since the 1960s. Infiltration of flooded river water into the aquifer is suggested by an elevated chloride concentration, although salt flushing from the rewatered unsaturated zone due to the enhanced recharge event is much more feasible. Concomitantly with chloride increases in the concentrations of sulphate, ferrous iron, manganese, and nickel imply the oxidation of pyrite (FeS 2) which is abundant in the aquifer. The proton production resulting from pyrite oxidation is buffered by the dissolution of calcite, while the Ca:SO 4 stoichiometry of the groundwater indicates that pyrite oxidation coupled with nitrate reduction is the dominant process occurring in the aquifer. The pyritic origin of SO42- is confirmed by the sulphur isotopic composition. The resultant Fe 2+ increase induces Mn-oxide dissolution and the mobilisation of Ni 2+ previously adsorbed to Mn-oxide surfaces. The study has a major implication for groundwater quality prediction studies where there are considerable variations in water level associated with groundwater management and climate change issues.

Electroencephalographic study showing that tactile stimulation by fabrics of different qualities elicit graded event-related potentials.

PubMed

Hoefer, D; Handel, M; Müller, K-M; Hammer, T R

2016-11-01

Neurophysiologic data on reactions of the human brain towards tactile stimuli evoked by fabrics moved on the skin are scarce. Furthermore, evaluation of fabrics' pleasantness using questionnaires suffers subjective biases. That is why we used a 64-channel electroencephalography (EEG) to objectively evaluate real-time brain reactions to fabric-skin interactions. Tactile stimuli were triggered by selected fabrics of different qualities, i.e. modal/polyamide single jersey, cotton double rib and a jute fabric, applied hidden to either the palm or forearm of 24 subjects via a custom-made fabric-to-skin applicator called SOFIA. One-way anova analysis was carried out to verify the EEG data. The modal/polyamide fabric applied to the forearm and palm led to slightly stronger emotional valence scores in the brain than the conventional or baseline fabric. Furthermore, the single jersey elicits significant higher event-related potential (ERP) signals in all subjects when applied to the forearm, suggesting less distraction and better cognitive resources during the fabric/skin interaction. The brain thus reacts with instantaneous ERP to tactile stimulation of fabrics and is able to discriminate different qualities via implicit preferences. The test procedure described here may be a tool to evaluate the fabric feel with the exclusion of subjective biases. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Interventional Arm of the Flexibility In Duty-Hour Requirements for Surgical Trainees Trial: First-Year Data Show Superior Quality In-Training Initiative Outcomes.

PubMed

Mirmehdi, Issa; O'Neal, Cindy-Marie; Moon, Davis; MacNew, Heather; Senkowski, Christopher

With the implementation of strict 80-hour work week in general surgery training, serious questions have been raised concerning the quality of surgical education and the ability of newly trained general surgeons to independently operate. Programs that were randomized to the interventional arm of the Flexibility In duty-hour Requirements for Surgical Trainees (FIRST) Trial were able to decrease transitions and allow for better continuity by virtue of less constraints on duty-hour rules. Using National Surgical Quality Improvement Program Quality In-Training Initiative data along with duty-hour violations compared with old rules, it was hypothesized that quality of care would be improved and outcomes would be equivalent or better than the traditional duty-hour rules. It was also hypothesized that resident perception of compliance with duty hour would not change with implementation of new regulations based on FIRST trial. Flexible work hours were implemented on July 1, 2014. National Surgical Quality Improvement Program Quality In-Training Initiative information was reviewed from July 2014 to January 2015. Patient risk factors and outcomes were compared between institutional resident cases and the national cohort for comparison. Residents' duty-hour logs and violations during this period were compared to the 6-month period before the implementation of the FIRST trial. The annual Accreditation Council for Graduate Medical Education resident survey was used to assess the residents' perception of compliance with duty hours. With respect to the postoperative complications, the only statistically significant measures were higher prevalence of pneumonia (3.4% vs. 1.5%, p < 0.05) and lower prevalence of sepsis (0% vs. 1.5%, p < 0.05) among cases covered by residents with flexible duty hours. All other measures of postoperative surgical complications showed no difference. The total number of duty-hour violations decreased from 54 to 16. Had the institution not been part of the

ReQON: a Bioconductor package for recalibrating quality scores from next-generation sequencing data

PubMed Central

2012-01-01

Background Next-generation sequencing technologies have become important tools for genome-wide studies. However, the quality scores that are assigned to each base have been shown to be inaccurate. If the quality scores are used in downstream analyses, these inaccuracies can have a significant impact on the results. Results Here we present ReQON, a tool that recalibrates the base quality scores from an input BAM file of aligned sequencing data using logistic regression. ReQON also generates diagnostic plots showing the effectiveness of the recalibration. We show that ReQON produces quality scores that are both more accurate, in the sense that they more closely correspond to the probability of a sequencing error, and do a better job of discriminating between sequencing errors and non-errors than the original quality scores. We also compare ReQON to other available recalibration tools and show that ReQON is less biased and performs favorably in terms of quality score accuracy. Conclusion ReQON is an open source software package, written in R and available through Bioconductor, for recalibrating base quality scores for next-generation sequencing data. ReQON produces a new BAM file with more accurate quality scores, which can improve the results of downstream analysis, and produces several diagnostic plots showing the effectiveness of the recalibration. PMID:22946927

[Study on seed quality test and quality standard of Lonicera macranthoides].

PubMed

Zhang, Ying; Xu, Jin; Li, Long-Yun; Cui, Guang-Lin; She, Yue-Hui

2016-04-01

Referring to the rules for agricultural seed testing (GB/T 3543-1995) issued by China, the test of sampling, purity, thousand seed weight, moisture, viability, relative conductivity and germination rate had been studied for seed quality test methods of Lonicera macranthoides. The seed quality from 38 different collection areas was measured to establish quality classification standard by K-means clustering. The results showed that at least 7.5 g seeds should be sampled, and passed 20-mesh sieve for purity analysis.The 500-seed method used to measure thousand seed weight. The moisture was determined by crushed seeds dried in high temperature (130±2) ℃ for 3 h.The viability determined by 25 ℃ 0.1% TTC stained 5h in dark. 1.0 g seeds soaked in 50 ml ultra pure water in 25 ℃ for 12 hours to determine the relative conductivity. The seed by 4 ℃stratification for 80 days were cultured on paper at 15 ℃. Quality of the seeds from different areas was divided into three grades. The primary seed quality classification standard was established.The I grade and II grade were recommend use in production. Copyright© by the Chinese Pharmaceutical Association.

Analysis of quality raw data of second generation sequencers with Quality Assessment Software.

PubMed

Ramos, Rommel Tj; Carneiro, Adriana R; Baumbach, Jan; Azevedo, Vasco; Schneider, Maria Pc; Silva, Artur

2011-04-18

Second generation technologies have advantages over Sanger; however, they have resulted in new challenges for the genome construction process, especially because of the small size of the reads, despite the high degree of coverage. Independent of the program chosen for the construction process, DNA sequences are superimposed, based on identity, to extend the reads, generating contigs; mismatches indicate a lack of homology and are not included. This process improves our confidence in the sequences that are generated. We developed Quality Assessment Software, with which one can review graphs showing the distribution of quality values from the sequencing reads. This software allow us to adopt more stringent quality standards for sequence data, based on quality-graph analysis and estimated coverage after applying the quality filter, providing acceptable sequence coverage for genome construction from short reads. Quality filtering is a fundamental step in the process of constructing genomes, as it reduces the frequency of incorrect alignments that are caused by measuring errors, which can occur during the construction process due to the size of the reads, provoking misassemblies. Application of quality filters to sequence data, using the software Quality Assessment, along with graphing analyses, provided greater precision in the definition of cutoff parameters, which increased the accuracy of genome construction.

Mesh quality control for multiply-refined tetrahedral grids

NASA Technical Reports Server (NTRS)

Biswas, Rupak; Strawn, Roger

1994-01-01

A new algorithm for controlling the quality of multiply-refined tetrahedral meshes is presented in this paper. The basic dynamic mesh adaption procedure allows localized grid refinement and coarsening to efficiently capture aerodynamic flow features in computational fluid dynamics problems; however, repeated application of the procedure may significantly deteriorate the quality of the mesh. Results presented show the effectiveness of this mesh quality algorithm and its potential in the area of helicopter aerodynamics and acoustics.

Do Work Condition Interventions Affect Quality and Errors in Primary Care? Results from the Healthy Work Place Study.

PubMed

Linzer, Mark; Poplau, Sara; Brown, Roger; Grossman, Ellie; Varkey, Anita; Yale, Steven; Williams, Eric S; Hicks, Lanis; Wallock, Jill; Kohnhorst, Diane; Barbouche, Michael

2017-01-01

While primary care work conditions are associated with adverse clinician outcomes, little is known about the effect of work condition interventions on quality or safety. A cluster randomized controlled trial of 34 clinics in the upper Midwest and New York City. Primary care clinicians and their diabetic and hypertensive patients. Quality improvement projects to improve communication between providers, workflow design, and chronic disease management. Intervention clinics received brief summaries of their clinician and patient outcome data at baseline. We measured work conditions and clinician and patient outcomes both at baseline and 6-12 months post-intervention. Multilevel regression analyses assessed the impact of work condition changes on outcomes. Subgroup analyses assessed impact by intervention category. There were no significant differences in error reduction (19 % vs. 11 %, OR of improvement 1.84, 95 % CI 0.70, 4.82, p = 0.21) or quality of care improvement (19 % improved vs. 44 %, OR 0.62, 95 % CI 0.58, 1.21, p = 0.42) between intervention and control clinics. The conceptual model linking work conditions, provider outcomes, and error reduction showed significant relationships between work conditions and provider outcomes (p ≤ 0.001) and a trend toward a reduced error rate in providers with lower burnout (OR 1.44, 95 % CI 0.94, 2.23, p = 0.09). Few quality metrics, short time span, fewer clinicians recruited than anticipated. Work-life interventions improving clinician satisfaction and well-being do not necessarily reduce errors or improve quality. Longer, more focused interventions may be needed to produce meaningful improvements in patient care. ClinicalTrials.gov # NCT02542995.

[Quality management in acute pain therapy: results from a survey of certified hospitals].

PubMed

Böhmer, A B; Poels, M; Simanski, C; Trojan, S; Messer, K; Wirtz, M D; Neugebauer, E A M; Wappler, F; Joppich, R

2012-08-01

Systems for and methods of quality management are increasingly being implemented in public health services. The aim of our study was to analyze the current state of the integrated quality management concept "quality management acute pain therapy" of the TÜV Rheinland® (TÜV) after a 5-year project period. General characteristics of the participating hospitals, number of departments certified by the TÜV and implementation of structures and processes according to the TÜV guidelines were evaluated by a mail questionnaire. Furthermore, positive and negative aspects concerning the effects of certification were evaluated by the hospitals' representatives of certification. A total of 36 questionnaires were returned. Since 2006 the number of certified hospitals (2011: n = 48) and surgical departments (2011: n = 202) has increased continuously. The number of certified medical departments is low (2011: n = 39); however, in the last 3 years, it has increased by about 200-300% annually. Standard operative procedures for pain therapy and measurement of pain intensity at regular intervals were implemented in all certified clinics (100%). Although 41% take part in the benchmarking project QUIPS (Quality Improvement in Postoperative Pain Therapy), 24% do not systematically check the quality of the outcome of pain management. Acceptance of the new pain therapy concepts among nursing staff was rated positively (ratio positive:negative 16:1); however, acceptance among physicians was rated negatively (1:15). Certification by the TÜV leads to sustainable implementation of quality management principles. Future efforts should focus on better integration of physicians in acute pain therapy and the development of an integrated tool to measure patients' outcome.

Quality of Life in Iranian Chemical Warfare Veteran's

PubMed Central

Ebadi, Abbas; Moradian, Tayeb; Mollahadi, Mohsen; Saeed, Yaser; Refahi, Ali Akbar

2014-01-01

Background: Mustard gas has different effects on different body systems such as respiratory tract, blood, gastrointestinal, skin, eye, endocrine and peripheral nervous system. Objectives: The purpose of this study was to determine the quality of life in chemical warfare veterans due to sulfur mustard exposure. Patients and Methods: In a cross-sectional and analytic study, 242 patients who had a chemical injury during the Iran-Iraq war (1980-1983) and their lung damage was proven were investigated in our study. The quality of life was measured in these patients using an extensively validated Iranian version of SF-36. Results: The mean age of veterans was 44.12 ± 4.9 ranging from 22 to 62 years. Our results showed that chemical warfare had a decreased quality of life in all subscales of the SF-36. The lowest scores in SF-36 subscales were related to role physical and general health. The data also showed a significant relationship between the number of organs involved and the quality of life in these patients (P < 0.001, r = − 0.33). So that the patients who had more than three organs involved had lower quality of life. 95.4% of our participants experienced another complication with respiratory complication and the ophthalmologic complications were the most frequent accompanying condition. Conclusions: The results imply that chemical warfare survivors suffering from late complications have a low health related quality of life. PMID:25031863

Using overbooking to manage no-shows in an Italian healthcare center.

PubMed

Parente, Chiara Anna; Salvatore, Domenico; Gallo, Giampiero Maria; Cipollini, Fabrizio

2018-03-15

of a simulation study under different scenarios in terms of number of resources and no-show rates. The same overbooking strategy was also implemented in practice (giving the opportunity to consider it as a quasi-experiment) to reduce the negative impact caused by non attendance in the MR ward. Both the quasi-experiment and the simulation study demonstrated that the strategy improved the center's productivity and reduced idle time of resources, although it increased slightly the patient's waiting time and the staff's overtime. This represents an evidence that overbooking can be suitable to improve the management of healthcare centers without adversely affecting their costs and the quality of cares offered. We shown that a well designed overbooking procedure can improve the management of medical centers, in terms of a significant increase of revenue, while keeping patient's waiting time and overtime under control. This was demonstrated by the results of a quasi-experiment (practical implementation of the strategy in the MR ward) and a simulation study (under different scenarios). Such positive results took advantage from a predictive model of no-show carefully designed around the medical center data.

Cost-effectiveness of a combined physical exercise and psychosocial training intervention for children with cancer: Results from the quality of life in motion study.

PubMed

Braam, K I; van Dijk-Lokkart, E M; van Dongen, J M; van Litsenburg, R R L; Takken, T; Huisman, J; Merks, J H M; Bosmans, J E; Hakkenbrak, N A G; Bierings, M B; van den Heuvel-Eibrink, M M; Veening, M A; van Dulmen-den Broeder, E; Kaspers, G J L

2017-11-01

This study was performed to estimate the cost-effectiveness of a combined physical exercise and psychosocial intervention for children with cancer compared with usual care. Sixty-eight children, aged 8-18 years old, during or within the first year post-cancer treatment were randomised to the intervention (n = 30) and control group (n = 38). Health outcomes included fitness, muscle strength and quality adjusted life years; all administered at baseline, 4- and 12-month follow-up. Costs were gathered by 1 monthly cost questionnaires over 12 months, supplemented by medication data obtained from pharmacies. Results showed no significant differences in costs and effects between the intervention and control group at 12-month follow-up. On average, societal costs were €299 higher in the intervention group than in the control group, but this difference was not significant. Cost-effectiveness acceptability curves indicated that the intervention needs large societal investments to reach reasonable probabilities of cost-effectiveness for quality of life and lower body muscle strength. Based on the results of this study, the intervention is not cost-effective in comparison with usual care. © 2016 John Wiley & Sons Ltd.

The decrease of cylindrical pempek quality during boiling

NASA Astrophysics Data System (ADS)

Karneta, R.; Gultom, N. F.

2017-09-01

The research objective was to study the effects of temperature and formulation on quality of pempek lenjer during boiling. Treatments in this study were four levels of pempek formulation and five levels of temperature. Data was processed by using analysis of variance (Anova). If test results showed that samples were significantly different or highly significantly different, then further test was conducted by using Honestly Significant Different. The results showed that chemical analysis showed that fish dominant formula of cylindrical pempek had higher water content, protein content, lipid content and ash content than that of tapioca starch dominant formula, but it had lower carbohydrate content and fibre content than that of tapioca starch dominant formula.The higher the temperature at center point of cylindrical pempek, the lower the chemical quality of cylindrical pempek. The effect of formula on physical quality of cylindrical pempek showed that tapioca starch dominant formula had more rubbery texture, more neutral pH and brighter color than that of fish dominant formula.The temperature change had no significant effect on texture and pH of cylindrical pempek, but it had significant effect on lightness, intensity and chromatic color especially after exceeding optimum time of boiling.

FQC Dashboard: integrates FastQC results into a web-based, interactive, and extensible FASTQ quality control tool.

PubMed

Brown, Joseph; Pirrung, Meg; McCue, Lee Ann

2017-06-09

FQC is software that facilitates quality control of FASTQ files by carrying out a QC protocol using FastQC, parsing results, and aggregating quality metrics into an interactive dashboard designed to richly summarize individual sequencing runs. The dashboard groups samples in dropdowns for navigation among the data sets, utilizes human-readable configuration files to manipulate the pages and tabs, and is extensible with CSV data. FQC is implemented in Python 3 and Javascript, and is maintained under an MIT license. Documentation and source code is available at: https://github.com/pnnl/fqc . joseph.brown@pnnl.gov. © The Author(s) 2017. Published by Oxford University Press.

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

PubMed

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

2015-07-01

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

Understanding and using quality information for quality improvement: The effect of information presentation.

PubMed

Zwijnenberg, Nicolien C; Hendriks, Michelle; Delnoij, Diana M J; de Veer, Anke J E; Spreeuwenberg, Peter; Wagner, Cordula

2016-12-01

To examine how information presentation affects the understanding and use of information for quality improvement. An experimental design, testing 22 formats, and showing information on patient safety culture. Formats differed in visualization, outcomes and benchmark information. Respondents viewed three randomly selected presentation formats in an online survey, completing several tasks per format. The hospital sector in the Netherlands. A volunteer sample of healthcare professionals, mainly nurses, working in hospitals. Main Outcome Measure(s): The degree to which information is understandable and usable (accurate choice for quality improvement, sense of urgency to change and appraisal of one's own performance). About 115 healthcare professionals participated (response rate 25%), resulting in 345 reviews. Information in tables (P = 0.007) and bar charts (P < 0.0001) was better understood than radars. Presenting outcomes on a 5-point scale (P < 0.001) or as '% positive responders' (P < 0.001) was better understood than '% negative responders'. Formats without benchmarks were better understood than formats with benchmarks. Use: Bar charts resulted in more accurate choices than tables (P = 0.003) and radars (P < 0.001). Outcomes on a 5-point scale resulted in more accurate choices than '% negative responders' (P = 0.007). Presenting '% positive responders' resulted in a higher sense of urgency to change than outcomes on a 5-point scale (P = 0.002). Benchmark information had inconsistent effects on the appraisal of one's own performances. Information presentation affects healthcare professionals' understanding and use of quality information. Our findings supplement the further understanding on how quality information can be best communicated to healthcare professionals for realizing quality improvements. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved

The reporting quality of meta-analysis results of systematic review abstracts in periodontology and implant dentistry is suboptimal.

PubMed

Polychronopoulou, Argy

2014-12-01

Assessment of the quality of reporting in abstracts of systematic reviews with meta-analyses in periodontology and implant dentistry. Faggion CM Jr., Liu J, Huda F, Atieh M. J Periodontal Res 2014; 49(2):137-42. Argy Polychronopoulou, DDS, MS, ScM, ScD PURPOSE/QUESTION: What is the reporting quality of meta-analysis results of abstracts of systematic reviews in periodontology and implant dentistry journals? The authors received no funding for this study Meta-epidemiological study Level 3: Other evidence Not applicable. Copyright © 2014 Elsevier Inc. All rights reserved.

Water-quality assessment of the Kentucky River basin, Kentucky; results of investigations of surface-water quality, 1987-90

USGS Publications Warehouse

Haag, K.H.; Garcia, Rene; Jarrett, G.L.; Porter, S.D.

1995-01-01

The U.S. Geological Survey investigated the water quality of the Kentucky River Basin in Kentucky as part of the National Water-Quality Assessment program. Data collected during 1987-90 were used to describe the spatial and temporal variability of water-quality constituents including metals and trace elements, nutrients, sediments, pesticides, dissolved oxygen, and fecal-coliform bacteria. Oil-production activities were the source of barium, bromide, chloride, magnesium, and sodium in several watersheds. High concentrations of aluminum, iron, and zinc were related to surface mining in the Eastern Coal Field Region. High concentrations of lead and zinc occurred in streambed sediments in urban areas, whereas concentrations of arsenic, strontium, and uranium were associated with natural geologic sources. Concentrations of phosphorus were significantly correlated with urban and agricultural land use. The high phosphorus content of Bluegrass Region soils was an important source of phosphorus in streams. At many sites in urban areas, most of the stream nitrogen load was attributable to wastewater-treatment-plant effluent. Average suspended-sediment concentrations were positively correlated with discharge. There was a downward trend in suspended-sediment concentrations downstream in the Kentucky River main stem during the study. The most frequently detected herbicides in water samples were atrazine, 2,4-D, alachlor, metolachlor, and dicamba. Diazinon, malathion, and parathion were the most frequently detected organophosphate insecticides in water samples. Detectable concentrations of aldrin, chlordane, DDT, DDE, dieldrin, endrin, endosulfan, heptachlor, and lindane were found in streambed-sediment samples. Dissolved-oxygen concentrations were sometimes below the minimum concentration needed to sustain aquatic life. At some sites, high concentrations of fecal-indicator bacteria were found and water samples did not meet sanitary water-quality criteria.

Impacts of Climate Policy on Regional Air Quality, Health, and Air Quality Regulatory Procedures

NASA Astrophysics Data System (ADS)

Thompson, T. M.; Selin, N. E.

2011-12-01

Both the changing climate, and the policy implemented to address climate change can impact regional air quality. We evaluate the impacts of potential selected climate policies on modeled regional air quality with respect to national pollution standards, human health and the sensitivity of health uncertainty ranges. To assess changes in air quality due to climate policy, we couple output from a regional computable general equilibrium economic model (the US Regional Energy Policy [USREP] model), with a regional air quality model (the Comprehensive Air Quality Model with Extensions [CAMx]). USREP uses economic variables to determine how potential future U.S. climate policy would change emissions of regional pollutants (CO, VOC, NOx, SO2, NH3, black carbon, and organic carbon) from ten emissions-heavy sectors of the economy (electricity, coal, gas, crude oil, refined oil, energy intensive industry, other industry, service, agriculture, and transportation [light duty and heavy duty]). Changes in emissions are then modeled using CAMx to determine the impact on air quality in several cities in the Northeast US. We first calculate the impact of climate policy by using regulatory procedures used to show attainment with National Ambient Air Quality Standards (NAAQS) for ozone and particulate matter. Building on previous work, we compare those results with the calculated results and uncertainties associated with human health impacts due to climate policy. This work addresses a potential disconnect between NAAQS regulatory procedures and the cost/benefit analysis required for and by the Clean Air Act.

Quality Improvement Initiatives: The Missed Opportunity for Health Plans

PubMed Central

Fernandez-Lopez, Sara; Lennert, Barbara

2009-01-01

Background The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. Objectives To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. Methods We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. Results The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Conclusion Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations. PMID:25126303

Postgraduate Education in Quality Improvement Methods: Initial Results of the Fellows' Applied Quality Training (FAQT) Curriculum.

PubMed

Winchester, David E; Burkart, Thomas A; Choi, Calvin Y; McKillop, Matthew S; Beyth, Rebecca J; Dahm, Phillipp

2016-06-01

Training in quality improvement (QI) is a pillar of the next accreditation system of the Accreditation Committee on Graduate Medical Education and a growing expectation of physicians for maintenance of certification. Despite this, many postgraduate medical trainees are not receiving training in QI methods. We created the Fellows Applied Quality Training (FAQT) curriculum for cardiology fellows using both didactic and applied components with the goal of increasing confidence to participate in future QI projects. Fellows completed didactic training from the Institute for Healthcare Improvement's Open School and then designed and completed a project to improve quality of care or patient safety. Self-assessments were completed by the fellows before, during, and after the first year of the curriculum. The primary outcome for our curriculum was the median score reported by the fellows regarding their self-confidence to complete QI activities. Self-assessments were completed by 23 fellows. The majority of fellows (15 of 23, 65.2%) reported no prior formal QI training. Median score on baseline self-assessment was 3.0 (range, 1.85-4), which was significantly increased to 3.27 (range, 2.23-4; P = 0.004) on the final assessment. The distribution of scores reported by the fellows indicates that 30% were slightly confident at conducting QI activities on their own, which was reduced to 5% after completing the FAQT curriculum. An interim assessment was conducted after the fellows completed didactic training only; median scores were not different from the baseline (mean, 3.0; P = 0.51). After completion of the FAQT, cardiology fellows reported higher self-confidence to complete QI activities. The increase in self-confidence seemed to be limited to the applied component of the curriculum, with no significant change after the didactic component.

Image quality scaling of electrophotographic prints

NASA Astrophysics Data System (ADS)

Johnson, Garrett M.; Patil, Rohit A.; Montag, Ethan D.; Fairchild, Mark D.

2003-12-01

Two psychophysical experiments were performed scaling overall image quality of black-and-white electrophotographic (EP) images. Six different printers were used to generate the images. There were six different scenes included in the experiment, representing photographs, business graphics, and test-targets. The two experiments were split into a paired-comparison experiment examining overall image quality, and a triad experiment judging overall similarity and dissimilarity of the printed images. The paired-comparison experiment was analyzed using Thurstone's Law, to generate an interval scale of quality, and with dual scaling, to determine the independent dimensions used for categorical scaling. The triad experiment was analyzed using multidimensional scaling to generate a psychological stimulus space. The psychophysical results indicated that the image quality was judged mainly along one dimension and that the relationships among the images can be described with a single dimension in most cases. Regression of various physical measurements of the images to the paired comparison results showed that a small number of physical attributes of the images could be correlated with the psychophysical scale of image quality. However, global image difference metrics did not correlate well with image quality.

Preface; Water quality of large U.S. rivers; results from the U.S. Geological Survey's National Stream Quality Accounting Network

USGS Publications Warehouse

Hirsch, Robert M.; Hooper, Richard P.; Kelly, Valerie J.

2001-01-01

The mission of the US Geological Survey (USGS) is to assess the quantity and quality of the earth resources of the USA and to provide information that will assist resource managers and policymakers at federal, state and local levels in making sound decisions. Characterizing the water quality of the largest rivers of the USA is a daunting prospect, especially given the resources available for the task. The most effective approach is uncertain and is legitimately a research topic. The National Stream Quality Accounting Network (NASQAN) was redesigned in 1995 to estimate the annual mass flux of constituents at a network of fixed stations in the Mississippi, Rio Grande, Colorado, and Columbia River basins. This special volume of Hydrological Processes contains a series of papers evaluating the data collected by NASQAN during its first 3 years of operation under this design. The NASQAN network complements other USGS national programs that are designed to address water quality at different scales. The National Water-Quality Assessment Program (Hirsch et al., 1988) is designed around river basins of 10 000 to 100 000 km2 (versus these NASQAN basins, which are 650 000 to 3 100 000 km2 at their most downstream stations). The USGS also operates the Hydrologic Benchmark Network that is focused on relatively pristine basins of only 10 to 100 km2 (Mast and Turk, 1999a,b; Clark et al., 2000; Mast et al., 2000).

Results From Mars Show Electrostatic Charging of the Mars Pathfinder Sojourner Rover

NASA Technical Reports Server (NTRS)

Kolecki, Joseph C.; Siebert, Mark W.

1998-01-01

Indirect evidence (dust accumulation) has been obtained indicating that the Mars Pathfinder rover, Sojourner, experienced electrostatic charging on Mars. Lander camera images of the Sojourner rover provide distinctive evidence of dust accumulation on rover wheels during traverses, turns, and crabbing maneuvers. The sol 22 (22nd Martian "day" after Pathfinder landed) end-of-day image clearly shows fine red dust concentrated around the wheel edges with additional accumulation in the wheel hubs. A sol 41 image of the rover near the rock "Wedge" (see the next image) shows a more uniform coating of dust on the wheel drive surfaces with accumulation in the hubs similar to that in the previous image. In the sol 41 image, note particularly the loss of black-white contrast on the Wheel Abrasion Experiment strips (center wheel). This loss of contrast was also seen when dust accumulated on test wheels in the laboratory. We believe that this accumulation occurred because the Martian surface dust consists of clay-sized particles, similar to those detected by Viking, which have become electrically charged. By adhering to the wheels, the charged dust carries a net nonzero charge to the rover, raising its electrical potential relative to its surroundings. Similar charging behavior was routinely observed in an experimental facility at the NASA Lewis Research Center, where a Sojourner wheel was driven in a simulated Martian surface environment. There, as the wheel moved and accumulated dust (see the following image), electrical potentials in excess of 100 V (relative to the chamber ground) were detected by a capacitively coupled electrostatic probe located 4 mm from the wheel surface. The measured wheel capacitance was approximately 80 picofarads (pF), and the calculated charge, 8 x 10(exp -9) coulombs (C). Voltage differences of 100 V and greater are believed sufficient to produce Paschen electrical discharge in the Martian atmosphere. With an accumulated net charge of 8 x 10(exp

75 FR 47777 - Certain Cut-to-Length Carbon-Quality Steel Plate Products From Italy: Final Results of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

... DEPARTMENT OF COMMERCE International Trade Administration [A-475-826] Certain Cut-to-Length Carbon... administrative review of the antidumping duty order on certain cut-to-length carbon-quality steel plate products... the preliminary results of the administrative review of the antidumping duty order on certain cut-to...

Implementation of a quality improvement initiative in Belgian diabetic foot clinics: feasibility and initial results.

PubMed

Doggen, Kris; Van Acker, Kristien; Beele, Hilde; Dumont, Isabelle; Félix, Patricia; Lauwers, Patrick; Lavens, Astrid; Matricali, Giovanni A; Randon, Caren; Weber, Eric; Van Casteren, Viviane; Nobels, Frank

2014-07-01

This article aims to describe the implementation and initial results of an audit-feedback quality improvement initiative in Belgian diabetic foot clinics. Using self-developed software and questionnaires, diabetic foot clinics collected data in 2005, 2008 and 2011, covering characteristics, history and ulcer severity, management and outcome of the first 52 patients presenting with a Wagner grade ≥ 2 diabetic foot ulcer or acute neuropathic osteoarthropathy that year. Quality improvement was encouraged by meetings and by anonymous benchmarking of diabetic foot clinics. The first audit-feedback cycle was a pilot study. Subsequent audits, with a modified methodology, had increasing rates of participation and data completeness. Over 85% of diabetic foot clinics participated and 3372 unique patients were sampled between 2005 and 2011 (3312 with a diabetic foot ulcer and 111 with acute neuropathic osteoarthropathy). Median age was 70 years, median diabetes duration was 14 years and 64% were men. Of all diabetic foot ulcers, 51% were plantar and 29% were both ischaemic and deeply infected. Ulcer healing rate at 6 months significantly increased from 49% to 54% between 2008 and 2011. Management of diabetic foot ulcers varied between diabetic foot clinics: 88% of plantar mid-foot ulcers were off-loaded (P10-P90: 64-100%), and 42% of ischaemic limbs were revascularized (P10-P90: 22-69%) in 2011. A unique, nationwide quality improvement initiative was established among diabetic foot clinics, covering ulcer healing, lower limb amputation and many other aspects of diabetic foot care. Data completeness increased, thanks in part to questionnaire revision. Benchmarking remains challenging, given the many possible indicators and limited sample size. The optimized questionnaire allows future quality of care monitoring in diabetic foot clinics. Copyright © 2014 John Wiley & Sons, Ltd.

Effect of Total Quality Management on the Quality and Productivity of Human Resources

NASA Astrophysics Data System (ADS)

Siregar, I.; Nasution, A. A.; Sari, R. M.

2017-03-01

Human resources is the main factor in improving company performance not only in industrial products but also services. Therefore, all of the organization performers involved must work together to achieve product quality services expected by consumers. Educational institutions are the service industries which are educators and instructor involved in it. Quality of product and services produced depends on the education organization performers. This study did a survey of instructors in public and private universities in North Sumatra to obtain the factors that affect quality of human resources and productivity of human resources. Human resources quality is viewed by the elements of TQM. TQM elements that are discussed in this study are leadership, communication, training and education, support structure, measurement and reward and recognition. The results of this study showed a correlation numbers across the exogenous variables on endogenous variables relationships tend to be strong and be positive. In addition, elements of TQM are discussed except the support structure which has a direct influence on the quality of human resources. Variable leadership, reward and recognition and quality of human resources have a significant effect on productivity.

Water quality study of Sunter River in Jakarta, Indonesia

NASA Astrophysics Data System (ADS)

Martinus, Y.; Astono, W.; Hendrawan, D.

2018-01-01

Sunter River flows in the city of Jakarta with the designation of river water for agricultural purposes, and can be utilized for urban business and hydroelectric power industry. This study aims to determine the Sunter River water quality based on physical and chemical parameters. Water sampling was conducted 2 times which done in April and May with 5 sampling stations for measuring. The samples was analayzed in the laboratory according SNI methods for parameters BOD, COD, PO4 3-, NO3, Oil & Grease and Detergents. The quality status of Sunter River is determined by the Pollutant Index method. The results show that the water quality of Sunter River is influenced by organic parameter as dominant pollutant with COD concentration ranging from 48 mg/l - 182.4 mg/l and BOD concentration ranging from 14.69 mg/L - 98.91 mg/L. The Pollution Index calculation results show that the water quality status of Sunter River is moderate polluted with IP 6.47. The source of pollutants generally comes from the urban drainage channels, tributaries, and slaughtering industry. The results of this study expected to be use by the government to improve the water quality of Sunter River for better environment.

Quality standards for predialysis education: results from a consensus conference

PubMed Central

Isnard Bagnis, Corinne; Crepaldi, Carlo; Dean, Jessica; Goovaerts, Tony; Melander, Stefan; Nilsson, Eva-Lena; Prieto-Velasco, Mario; Trujillo, Carmen; Zambon, Roberto; Mooney, Andrew

2015-01-01

This position statement was compiled following an expert meeting in March 2013, Zurich, Switzerland. Attendees were invited from a spread of European renal units with established and respected renal replacement therapy option education programmes. Discussions centred around optimal ways of creating an education team, setting realistic and meaningful objectives for patient education, and assessing the quality of education delivered. PMID:24957808

The Effect of Central American Smoke Aerosols on the Air Quality and Climate over the Southeastern United States: First Results from RAMS-AROMA

NASA Astrophysics Data System (ADS)

Wang, J.; Christopher, S. A.; Nair, U. S.; Reid, J.; Prins, E. M.; Szykman, J.

2004-12-01

Observation shows that smoke aerosols from biomass burning activities in Central America can be transported to the Southeastern United States (SEUS). In this study, the Regional Atmospheric Modeling System - Assimilation and Radiation Online Modeling of Aerosols (RAMS-AROMA) is used to investigate the effect of transported smoke aerosols on climate and air quality over the SEUS. AROMA is an aerosol transport model with capabilities of online integration of aerosol radiation effects and online assimilation of satellite-derived aerosol and emission products. It is assembled within the RAMS, so two-way interactions between aerosol fields and other meteorology fields are achieved simultaneously during each model time step. RAMS-AROMA is a unique tool that can be used to examine the aerosol radiative impacts on the surface energy budget and atmospheric heating rate and to investigate how atmospheric thermal and dynamical processes respond to such impacts and consequently affect the aerosol distribution (so called feedbacks). First results regarding air quality effects and radiative forcing of transported smoke aerosols will be presented from RAMS-AROMA based on assimilation of smoke emission products from the Fire Locating and Modeling of Burning Emissions (FLAMBE) project and aerosol optical thickness data derived from the MODIS instrument on the Terra and Aqua satellites. Comparisons with PM2.5 data collected from the EPA observation network and the aerosol optical thickness data from the DOE Atmosphere Radiation Measurements in the Southern Great Plains (ARM SGP) showed that RAMS-AROMA can predict the timing and spatial distribution of smoke events very well, with an accuracy useful for air quality forecasts. The smoke radiative effects on the surface temperature and atmospheric heating rate as well as their feedbacks will also be discussed.

Automated image quality assessment for chest CT scans.

PubMed

Reeves, Anthony P; Xie, Yiting; Liu, Shuang

2018-02-01

Medical image quality needs to be maintained at standards sufficient for effective clinical reading. Automated computer analytic methods may be applied to medical images for quality assessment. For chest CT scans in a lung cancer screening context, an automated quality assessment method is presented that characterizes image noise and image intensity calibration. This is achieved by image measurements in three automatically segmented homogeneous regions of the scan: external air, trachea lumen air, and descending aorta blood. Profiles of CT scanner behavior are also computed. The method has been evaluated on both phantom and real low-dose chest CT scans and results show that repeatable noise and calibration measures may be realized by automated computer algorithms. Noise and calibration profiles show relevant differences between different scanners and protocols. Automated image quality assessment may be useful for quality control for lung cancer screening and may enable performance improvements to automated computer analysis methods. © 2017 American Association of Physicists in Medicine.

Physical occupational exposures during working life and quality of life after labour market exit: results from the GAZEL study

PubMed Central

Platts, Loretta; Netuveli, Gopalakrishnan; Webb, Elizabeth; Zins, Marie; Goldberg, Marcel; Blane, David; Wahrendorf, Morten

2013-01-01

Objective To investigate variations in quality of life at older ages we take a life course perspective to analyse long-term effects of physical working conditions upon quality of life after retirement. In doing so, we study to what extent these associations are explained by individuals’ health at older ages. Method We use administrative data and self-administered questionnaire responses from the French GAZEL cohort. Quality of life was assessed with CASP-19 in 2009 and related to three types of physical working conditions during previous working life: (1) ergonomic strain, (2) physical danger and (3) exposures to chemicals. Health was assessed in 2007 with the SF-36 Health Survey. Multiple regressions were calculated in retired men only, controlling for important confounders including social position. Results In contrast to men, few women were exposed to strenuous and dangerous working conditions in this cohort and were not included in subsequent analyses. Negative effects on retired men’s quality of life were found for the physical occupational exposures of ergonomic strain and physical danger, but not for chemical exposures. Effects were attenuated after the introduction of physical and mental health to the models, indicating an indirect effect of physical working conditions upon quality of life via health. Conclusion Adverse physical working conditions have long-term consequences for health and quality of life at older ages. Improvements to physical working conditions may improve individuals’ quality of life over the long term. PMID:23560563

Image quality evaluation of full reference algorithm

NASA Astrophysics Data System (ADS)

He, Nannan; Xie, Kai; Li, Tong; Ye, Yushan

2018-03-01

Image quality evaluation is a classic research topic, the goal is to design the algorithm, given the subjective feelings consistent with the evaluation value. This paper mainly introduces several typical reference methods of Mean Squared Error(MSE), Peak Signal to Noise Rate(PSNR), Structural Similarity Image Metric(SSIM) and feature similarity(FSIM) of objective evaluation methods. The different evaluation methods are tested by Matlab, and the advantages and disadvantages of these methods are obtained by analyzing and comparing them.MSE and PSNR are simple, but they are not considered to introduce HVS characteristics into image quality evaluation. The evaluation result is not ideal. SSIM has a good correlation and simple calculation ,because it is considered to the human visual effect into image quality evaluation,However the SSIM method is based on a hypothesis,The evaluation result is limited. The FSIM method can be used for test of gray image and color image test, and the result is better. Experimental results show that the new image quality evaluation algorithm based on FSIM is more accurate.

End-user perspectives on e-commerce and health care web site quality.

PubMed

Le Rouge, Cynthia; De Leo, Gianluca

2008-11-06

We explore and compare the importance of various quality dimensions for health care and e-commerce web sites. The results show that the importance of various quality attributes for all except four of ten quality dimensions studied differ between health care and e-commerce web sites. These results can help health care managers to improve and/or to guide the design of their web sites.

Health-related Quality of Life of Patients With Chronic Systolic Heart Failure in Spain: Results of the VIDA-IC Study.

PubMed

Comín-Colet, Josep; Anguita, Manuel; Formiga, Francesc; Almenar, Luis; Crespo-Leiro, María G; Manzano, Luis; Muñiz, Javier; Chaves, José; de Frutos, Trinidad; Enjuanes, Cristina

2016-03-01

Although heart failure negatively affects the health-related quality of life of Spanish patients there is little information on the clinical factors associated with this issue. Cross-sectional multicenter study of health-related quality of life. A specific questionnaire (Kansas City Cardiomyopathy Questionnaire) and a generic questionnaire (EuroQoL-5D) were administered to 1037 consecutive outpatients with systolic heart failure. Most patients with poor quality of life had a worse prognosis and increased severity of heart failure. Mobility was more limited and rates of pain/discomfort and anxiety/depression were higher in the study patients than in the general population and patients with other chronic conditions. The scores on both questionnaires were very highly correlated (Pearson r =0.815; P < .001). Multivariable linear regression showed that being older (standardized β=-0.2; P=.03), female (standardized β=-10.3; P < .001), having worse functional class (standardized β=-20.4; P < .001), a higher Charlson comorbidity index (standardized β=-1.2; P=.005), and recent hospitalization for heart failure (standardized β=6.28; P=.006) were independent predictors of worse health-related quality of life. Patients with heart failure have worse quality of life than the general Spanish population and patients with other chronic diseases. Female sex, being older, comorbidity, advanced symptoms, and recent hospitalization are determinant factors in health-related quality of life in these patients. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Ground-Water Quality Data in the Kern County Subbasin Study Unit, 2006 - Results from the California GAMA Program

USGS Publications Warehouse

Shelton, Jennifer L.; Pimentel, Isabel; Fram, Miranda S.; Belitz, Kenneth

2008-01-01

the wells, and the results for these samples were used to evaluate the quality of the data from the ground-water samples. Assessment of the quality-control information resulted in censoring of less than 0.4 percent of the data collected for ground-water samples. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, raw ground water typically is treated, disinfected, or blended with other waters to maintain acceptable water quality. Regulatory thresholds apply, not to the raw ground water, but to treated water that is served to the consumer. However, to provide some context for the results, concentrations of constituents measured in the raw ground water were compared with health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and the California Department of Public Health (CDPH), and as well as with thresholds established for aesthetic concerns (secondary maximum contaminant levels, SMCL-CA) by CDPH. VOCs and pesticides each were detected in approximately 60 percent of the grid wells, and detections of all compounds but one were below health-based thresholds. The fumigant, 1,2-dibromo-3-chloropropane (DBCP), was detected above the USEPA maximum contaminant level (MCL-US) in one sample. Detections of most inorganic constituents were also below health-based thresholds. Constituents detected above health-based thresholds include: nitrate, (MCL-US, 2 samples), arsenic (MCL-US, 2 samples), and vanadium (California notification level, NL-CA, 1 sample). All detections of radioactive constituents were below health-based thresholds, although nine samples had activities of radon-222 above the lower proposed MCL-US. Most of the samples from KERN wells had concentrations of major elements, total dissolved solids, and trace elements below the non-enforceable thresholds set for aesthetic concerns.

Does labour market disadvantage help to explain why childhood circumstances are related to quality of life at older ages? Results from SHARE

PubMed Central

Wahrendorf, Morten; Blane, David

2015-01-01

There is robust evidence that childhood circumstances are related to quality of life in older ages, but the role of possible intermediate factors is less explored. In this paper, we examine to what extent associations between deprived childhood circumstances and quality of life at older ages are due to experienced labour market disadvantage during adulthood. Analyses are based on the Survey of Health Ageing and Retirement in Europe (SHARE), with detailed retrospective information on individual life courses collected among 10,272 retired men and women in 13 European countries (2008–2009). Our assumption is that those who have spent their childhood in deprived circumstances may also have had more labour market disadvantage with negative consequences for quality of life beyond working life. Results demonstrate that advantaged circumstances during childhood are associated with lower levels of labour market disadvantage and higher quality of life in older ages. Furthermore, results of multivariate analyses support the idea that part of the association between childhood circumstances and later quality of life is explained by labour market disadvantage during adulthood. PMID:25033373

Does labour market disadvantage help to explain why childhood circumstances are related to quality of life at older ages? Results from SHARE.

PubMed

Wahrendorf, Morten; Blane, David

2015-07-01

There is robust evidence that childhood circumstances are related to quality of life in older ages, but the role of possible intermediate factors is less explored. In this paper, we examine to what extent associations between deprived childhood circumstances and quality of life at older ages are due to experienced labour market disadvantage during adulthood. Analyses are based on the Survey of Health Ageing and Retirement in Europe (SHARE), with detailed retrospective information on individual life courses collected among 10,272 retired men and women in 13 European countries (2008-2009). Our assumption is that those who have spent their childhood in deprived circumstances may also have had more labour market disadvantage with negative consequences for quality of life beyond working life. Results demonstrate that advantaged circumstances during childhood are associated with lower levels of labour market disadvantage and higher quality of life in older ages. Furthermore, results of multivariate analyses support the idea that part of the association between childhood circumstances and later quality of life is explained by labour market disadvantage during adulthood.

Quality of Diabetes Care: The Challenges of an Increasing Epidemic in Mexico. Results from Two National Health Surveys (2006 and 2012).

PubMed

Flores-Hernández, Sergio; Saturno-Hernández, Pedro J; Reyes-Morales, Hortensia; Barrientos-Gutiérrez, Tonatiuh; Villalpando, Salvador; Hernández-Ávila, Mauricio

2015-01-01

The quality of diabetes care remains suboptimal according to numerous studies assessing the achievement of quality indicators for diabetes care in various healthcare settings. We report about global and specific quality indicators for diabetes care and their association to glycemic control at the population level in two national health surveys in Mexico. We conducted a cross-sectional analysis of the 2006 and 2012 National Health Surveys in Mexico. We examined quality of care for 2,965 and 4,483 adults (≥ 20 years) with diagnosed type 2 diabetes using fourteen simple and two composite indicators derived from self-reported information. In a subsample for both surveys, glycated hemoglobin (HbA1c) was measured at the time of the interview. We obtained survey weight-adjusted estimators using multiple regression models (logistic and linear) with combined data files, including survey year as covariate to assess change. Global quality of care in 2012 was 40.8%, with a relative improvement of 11.7% between 2006 and 2012. Detections of cardiovascular disease risk factors (dyslipidemia and hypertension) were the indicators with the highest improvement, while non-pharmaceutical treatment and diabetic foot exams showed minor changes. We found a significant association between the quality of the process of diabetes care and glycemic control (OR 2.53, 95% CI 1.63-3.94). Age more than 65 years old, the type of health subsystem, gender (males), and high socio-economic status were also significantly associated to glycemic control. Quality diabetes care and glycemic control improved and are significantly associated. However, according to international standards, the current situation remains suboptimal. A more holistic approach is needed, with an emphasis on improving quality in outpatient care.

Quality of Life in Iranian Chemical Warfare Veteran's.

PubMed

Ebadi, Abbas; Moradian, Tayeb; Mollahadi, Mohsen; Saeed, Yaser; Refahi, Ali Akbar

2014-05-01

Mustard gas has different effects on different body systems such as respiratory tract, blood, gastrointestinal, skin, eye, endocrine and peripheral nervous system. The purpose of this study was to determine the quality of life in chemical warfare veterans due to sulfur mustard exposure. In a cross-sectional and analytic study, 242 patients who had a chemical injury during the Iran-Iraq war (1980-1983) and their lung damage was proven were investigated in our study. The quality of life was measured in these patients using an extensively validated Iranian version of SF-36. The mean age of veterans was 44.12 ± 4.9 ranging from 22 to 62 years. Our results showed that chemical warfare had a decreased quality of life in all subscales of the SF-36. The lowest scores in SF-36 subscales were related to role physical and general health. The data also showed a significant relationship between the number of organs involved and the quality of life in these patients (P < 0.001, r = - 0.33). So that the patients who had more than three organs involved had lower quality of life. 95.4% of our participants experienced another complication with respiratory complication and the ophthalmologic complications were the most frequent accompanying condition. The results imply that chemical warfare survivors suffering from late complications have a low health related quality of life.

CUQI: cardiac ultrasound video quality index

PubMed Central

Razaak, Manzoor; Martini, Maria G.

2016-01-01

Abstract. Medical images and videos are now increasingly part of modern telecommunication applications, including telemedicinal applications, favored by advancements in video compression and communication technologies. Medical video quality evaluation is essential for modern applications since compression and transmission processes often compromise the video quality. Several state-of-the-art video quality metrics used for quality evaluation assess the perceptual quality of the video. For a medical video, assessing quality in terms of “diagnostic” value rather than “perceptual” quality is more important. We present a diagnostic-quality–oriented video quality metric for quality evaluation of cardiac ultrasound videos. Cardiac ultrasound videos are characterized by rapid repetitive cardiac motions and distinct structural information characteristics that are explored by the proposed metric. Cardiac ultrasound video quality index, the proposed metric, is a full reference metric and uses the motion and edge information of the cardiac ultrasound video to evaluate the video quality. The metric was evaluated for its performance in approximating the quality of cardiac ultrasound videos by testing its correlation with the subjective scores of medical experts. The results of our tests showed that the metric has high correlation with medical expert opinions and in several cases outperforms the state-of-the-art video quality metrics considered in our tests. PMID:27014715

Radon in Irish Show Caves—Personal Monitoring Data From 2001-2006

NASA Astrophysics Data System (ADS)

Currivan, L.; Murray, M.; O'Colmain, M.; Pollard, D.

2008-08-01

The European Directive 96/29/EURATOM and its transposition into national legislation demands the application of radiation protection measures if the presence of radon and radon decay products leads to significant increase in exposures of workers. Irish legislation further demands that laboratories carrying out radon measurements operate a high level quality assurance programme. As a result of a reconnaissance survey regular measurements of show cave guides have been made in order to assess exposure to radon in such workplaces and to ascertain that the limits set for radon are not exceeded. In 2000, an action level of 400 Bqm-3, was established. Doses in the range 0.3-12.0 mSv have been estimated for workers for the period 2001-2006.

Quality of care for patients with diabetes mellitus type 2 in ‘model practices’ in Slovenia – first results

PubMed Central

Mlakar, Mitja

2016-01-01

Abstract Background A new organisation at the primary level, called model practices, introduces a 0.5 full-time equivalent nurse practitioner as a regular member of the team. Nurse practitioners are in charge of registers of chronic patients, and implement an active approach into medical care. Selected quality indicators define the quality of management. The majority of studies confirm the effectiveness of the extended team in the quality of care, which is similar or improved when compared to care performed by the physician alone. The aim of the study is to compare the quality of management of patients with diabetes mellitus type 2 before and after the introduction of model practices. Methods A cohort retrospective study was based on medical records from three practices. Process quality indicators, such as regularity of HbA1c measurement, blood pressure measurement, foot exam, referral to eye exam, performance of yearly laboratory tests and HbA1c level before and after the introduction of model practices were compared. Results The final sample consisted of 132 patients, whose diabetes care was exclusively performed at the primary care level. The process of care has significantly improved after the delivery of model practices. The most outstanding is the increase of foot exam and HbA1c testing. We could not prove better glycaemic control (p>0.1). Nevertheless, the proposed benchmark for the suggested quality process and outcome indicators were mostly exceeded in this cohort. Conclusion The introduction of a nurse into the team improves the process quality of care. Benchmarks for quality indicators are obtainable. Better outcomes of care need further confirmation. PMID:27703537

Adherence to outpatient epilepsy quality indicators at a tertiary epilepsy center

PubMed Central

Pourdeyhimi, R.; Wolf, B.J.; Simpson, A.N.; Martz, G.U.

2014-01-01

Introduction Quality indicators for the treatment of people with epilepsy were published in 2010. This is the first report of adherence to all measures in routine care of people with epilepsy at a level 4 comprehensive epilepsy center in the US. Methods Two hundred patients with epilepsy were randomly selected from the clinics of our comprehensive epilepsy center, and all visits during 2011 were abstracted for documentation of adherence to the eight quality indicators. Alternative measures were constructed to evaluate failure of adherence. Detailed descriptions of all equations are provided. Results Objective measures (EEG, imaging) showed higher adherence than counseling measures (safety). Initial visits showed higher adherence. Variations in the interpretation of the quality measure result in different adherence values. Advanced practice providers and physicians had different adherence patterns. No patient-specific patterns of adherence were seen. Discussion This is the first report of adherence to all the epilepsy quality indicators for a sample of patients during routine care in a level 4 epilepsy center in the US. Overall adherence was similar to that previously reported on similar measures. Precise definitions of adherence equations are essential for accurate measurement. Complex measures result in lower adherence. Counseling measures showed low adherence, possibly highlighting a difference between practice and documentation. Adherence to the measures as written does not guarantee high quality care. Conclusion The current quality indicators have value in the process of improving quality of care. Future approaches may be refined to eliminate complex measures and incorporate features linked to outcomes. PMID:25171260

Sources of Traffic and Visitors’ Preferences Regarding Online Public Reports of Quality: Web Analytics and Online Survey Results

PubMed Central

Hibbard, Judith H; Greaves, Felix; Dudley, R Adams

2015-01-01

Background In the context of the Affordable Care Act, there is extensive emphasis on making provider quality transparent and publicly available. Online public reports of quality exist, but little is known about how visitors find reports or about their purpose in visiting. Objective To address this gap, we gathered website analytics data from a national group of online public reports of hospital or physician quality and surveyed real-time visitors to those websites. Methods Websites were recruited from a national group of online public reports of hospital or physician quality. Analytics data were gathered from each website: number of unique visitors, method of arrival for each unique visitor, and search terms resulting in visits. Depending on the website, a survey invitation was launched for unique visitors on landing pages or on pages with quality information. Survey topics included type of respondent (eg, consumer, health care professional), purpose of visit, areas of interest, website experience, and demographics. Results There were 116,657 unique visitors to the 18 participating websites (1440 unique visitors/month per website), with most unique visitors arriving through search (63.95%, 74,606/116,657). Websites with a higher percent of traffic from search engines garnered more unique visitors (P=.001). The most common search terms were for individual hospitals (23.25%, 27,122/74,606) and website names (19.43%, 22,672/74,606); medical condition terms were uncommon (0.81%, 605/74,606). Survey view rate was 42.48% (49,560/116,657 invited) resulting in 1755 respondents (participation rate=3.6%). There were substantial proportions of consumer (48.43%, 850/1755) and health care professional respondents (31.39%, 551/1755). Across websites, proportions of consumer (21%-71%) and health care professional respondents (16%-48%) varied. Consumers were frequently interested in using the information to choose providers or assess the quality of their provider (52.7%, 225

Groundwater-Quality Data in the South Coast Interior Basins Study Unit, 2008: Results from the California GAMA Program

USGS Publications Warehouse

Mathany, Timothy M.; Kulongoski, Justin T.; Ray, Mary C.; Belitz, Kenneth

2009-01-01

], and radioactive constituents [gross alpha and gross beta radioactivity and radon-222]. Naturally occurring isotopes [stable isotopes of hydrogen, oxygen, and carbon, and activities of tritium and carbon-14] and dissolved noble gases also were measured to help identify the sources and ages of the sampled groundwater. In total, 288 constituents and water-quality indicators (field parameters) were investigated. Three types of quality-control samples (blanks, replicates, and matrix spikes) each were collected at approximately 4-11 percent of the wells, and the results for these samples were used to evaluate the quality of the data for the groundwater samples. Field blanks rarely contained detectable concentrations of any constituent, suggesting that contamination was not a significant source of bias in the data obtained from the groundwater samples. Differences between replicate samples generally were less than 10 percent relative standard deviation, indicating acceptable analytical reproducibility. Matrix spike recoveries were within the acceptable range (70 to 130 percent) for most compounds. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, untreated groundwater typically is treated, disinfected, and/or blended with other waters to maintain water quality. Regulatory thresholds apply to water that is served to the consumer, not to untreated groundwater. However, to provide some context for the results, concentrations of constituents measured in the untreated groundwater were compared with regulatory and nonregulatory health-based thresholds established by the U.S. Environmental Protection Agency (USEPA) and California Department of Public Health (CDPH), and to nonregulatory thresholds established for aesthetic and technical concerns by CDPH. Comparisons between data collected for this study and thresholds for drinking water are for illustrative purposes only, and are not indicative of complia

[Analysis of the results of the SEIMC External Quality Control Program for HIV-1 and HCV viral loads. Year 2008].

PubMed

Mira, Nieves Orta; Serrano, María del Remedio Guna; Martínez, José Carlos Latorre; Ovies, María Rosario; Pérez, José L; Cardona, Concepción Gimeno

2010-01-01

Human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) viral load determinations are among the most relevant markers for the follow up of patients infected with these viruses. External quality control tools are crucial to ensure the accuracy of results obtained by microbiology laboratories. This article summarized the results obtained from the 2008 SEIMC External Quality Control Program for HIV-1 and HCV viral loads. In the HIV-1 program, a total of five standards were sent. One standard consisted in seronegative human plasma, while the remaining four contained plasma from 3 different viremic patients, in the range of 2-5 log(10) copies/mL; two of these standards were identical aiming to determine repeatability. The specificity was complete for all commercial methods, and no false positive results were reported by the participants. A significant proportion of the laboratories (24% on average) obtained values out of the accepted range (mean +/- 0.2 log(10) copies/mL), depending on the standard and on the method used for quantification. Repeatability was very good, with up to 95% of laboratories reporting results within the limits (D < 0.5 log(10) copias/mL). The HCV program consisted of two standards with different viral load contents. Most of the participants (88,7%) obtained results within the accepted range (mean +/- 1.96 SD log(10) UI/mL). Post-analytical errors due to mistranscription of the results were detected for HCV, but not for the HIV-1 program. Data from this analysis reinforce the utility of proficiency programmes to ensure the quality of the results obtained by a particular laboratory, as well as the importance of the post-analytical phase on the overall quality. Due to the remarkable interlaboratory variability, it is advisable to use the same method and the same laboratory for patient follow up. 2010 Elsevier España S.L. All rights reserved.

[The quality of professional life and the pride in working in public health. The results of a survey].

PubMed

Clúa Espuny, J L; Aguilar Martín, C

1998-09-30

To find what factors explain best the pride of belonging to a public health enterprise. A descriptive crossover study. One primary care CHS. Staff of 363 from Tortosa's Primary Care administrative staff. All the employees were sent a self-filling questionnaire on the quality of their professional life. 232 returned the questionnaire filled in (63.9%). They showed an average value for the overall quality of professional life (5.40 +/- 2.09). The general profile covered the following perceptions taken together: sufficient intrinsic motivation; in a work-place with sufficient responsibility, training and social support; associated with enough work-load; with some emotional support from the managers; having some inconveniences caused by work. The pride in belonging to the CHS was high (6.86 +/- 2.50), with those over 45 giving a significantly higher average reply. Among doctors, pride was significantly lower. The multiple regression model identified three significant variables which explained 67.5% of the variability in the pride of belonging to the CHS: recognition of effort, being properly trained for their current job and length of service. a) Professionals are quite proud of belonging to the CHS. b) Their perception of the quality of professional life is average.

Water-quality monitoring of Sweetwater Reservoir

USGS Publications Warehouse

Majewski, Michael

2001-01-01

Sweetwater Authority is concerned with the quality of water it provides to its customers. Results from the water-quality monitoring study that the USGS is conducting in the Sweetwater watershed show that the contaminant concentrations in bed sediments, water, and air are reflected in increased urbanization. The bed sediments show the most dramatic evidence of this impact with a sharp increase of persistent organic chemical concentrations over the past 65 years. Water quality is also affected by urbanization in the form of chemicals in the runoff water and deposition of airborne chemicals. The concentrations of the detected organic chemicals in Sweetwater and Loveland Reservoirs are all well below the guidance limits set by State and Federal agencies to protect human health. Many of these compounds are detected only because of the sensitive analytical methods used. This monitoring program provides the Sweetwater Authority with information on what monitored chemicals are present in the reservoirs, and at what concentrations. With this information, the Authority can assess the associated risks, and consider future water treatment and remediation. These results also help focus and support future efforts by Sweetwater Authority to protect the watershed.

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

PubMed

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

2017-10-01

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

Understanding the direction of the relationship between white matter hyperintensities of vascular origin, sleep quality, and chronic kidney disease-Results from the Atahualpa Project.

PubMed

Del Brutto, Oscar H; Mera, Robertino M

2018-02-01

The burden of cerebral small vessel disease, sleep disorders, and chronic kidney disease is on the rise in remote rural settings. However, information on potential links between these conditions is limited. We aimed to assess the relationships between these conditions in community-dwelling older adults living in rural Ecuador. Atahualpa residents aged ≥60 years were offered a brain MRI. A venous blood sample was obtained for serum creatinine determination. Baseline interviews and procedures were directed to assess demographics, cardiovascular risk factors, and sleep quality. Using generalized structural equation modeling (GSEM), we assessed the associations between white matter hyperintensities (WMH) of vascular origin, sleep quality and kidney function, as well as the directions of the relationships between these variables. Of 423 candidates, 314 (74%) were enrolled. Moderate-to-severe WMH were noticed in 74 (24%) individuals, poor sleep quality in 101 (31%), and moderate-to-severe chronic kidney disease in 28 (9%). GSEM showed that the direction of the effect was from kidney function to WMH and from the latter to sleep quality. Of independent variables investigated, worse kidney function was associated with age, high glucose levels and male sex. WMH was associated with cholesterol blood levels, blood pressure, level of education and severe edentulism. Poor sleep quality was associated with poor physical activity. This population based study shows that chronic kidney disease is associated with increased severity of WMH, which, in turn, is associated with a poor sleep quality. Copyright © 2017 Elsevier B.V. All rights reserved.

Comb-Push Ultrasound Shear Elastography of Breast Masses: Initial Results Show Promise

PubMed Central

Song, Pengfei; Fazzio, Robert T.; Pruthi, Sandhya; Whaley, Dana H.; Chen, Shigao; Fatemi, Mostafa

2015-01-01

Purpose or Objective To evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE) for classification of breast masses. Materials and Methods CUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF) beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results. Results Fifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s) in comparison to benign masses (3.65 ± 1.36 m/s). Therefore, the stiffness of the mass quantified by the Young’s modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC), the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC). Conclusion CUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses. PMID:25774978

Quality indicators and their regular use in clinical practice: results from a survey among users of two cardiovascular National Registries in Sweden.

PubMed

Algurén, Beatrix; Andersson-Gäre, Boel; Thor, Johan; Andersson, Ann-Christine

2018-05-14

To examine the regular use of quality indicators from Swedish cardiovascular National Quality Registries (NQRs) by clinical staff; particularly differences in use between the two NQRs and between nurses and physicians. Cross-sectional online survey study. Two Swedish cardiovascular NQRs: (a) Swedish Heart Failure Registry and (b) Swedeheart. Clinicians (n =185; 70% nurses, 26% physicians) via the NQRs' email networks. Frequency of NQR use for (a) producing healthcare activity statistics; (b) comparing results between similar departments; (c) sharing results with colleagues; (d) identifying areas for quality improvement (QI); (e) surveilling the impact of QI efforts; (f) monitoring effects of implementation of new treatment methods; (g) doing research and (h) educating and informing healthcare professionals and patients. Median use of NQRs was 10 times a year (25th and 75th percentiles range: 3-23 times/year). Quality indicators from the NQRs were used mainly for producing healthcare activity statistics. Median use of Swedeheart was six times greater than Swedish Heart Failure Registry (SwedeHF; P < 0.000). Physicians used the NQRs more than twice as often as nurses (18 vs. 7.5 times/year; P < 0.000) and perceived NQR work more often as meaningful. Around twice as many Swedeheart users had the role to participate in data analysis and in QI efforts compared to SwedeHF users. Most respondents used quality indicators from the two cardiovascular NQRs infrequently (<3 times/year). The results indicate that linking registration of quality indicators to using them for QI activities increases their routine use and makes them meaningful tools for professionals.

Effects of manganese on routine semen quality parameters: results from a population-based study in China

PubMed Central

2012-01-01

Background Manganese (Mn) is an essential element in humans but its effect on semen quality is unclear. This study therefore aimed to assess the effects of Mn on semen quality in healthy men with no occupational exposure to Mn. Methods Semen samples were obtained from healthy Chinese men 20–59 years old who were recruited from six provinces in China. Individuals with urogenital tract diseases, tuberculosis, or occupational exposure to heavy metals were excluded. A questionnaire survey was conducted, and the external genitalia, semen quality, and serum Mn levels were examined. Results A total of 1,179 volunteers were enrolled in this study. The median serum Mn concentration was 8.2 μg/L (25th percentile (P25)=3.7 μg/L, P75=16.2μg/L). After adjusted area (six provinces), abstinence interval, season, registered residence, age of subjects, education level, income, smoking, and drinking, the risk of teratospermia was increased at serum Mn concentrations >19.40 μg/L (P80) group, with an adjusted odds ratio of 2.27 (95% confidence interval: 1.18–4.37). Conclusion High serum Mn levels appeared to have harmful effects on sperm morphology and motility among healthy men with no occupational exposure to Mn. PMID:23107312

Dietary quality changes in response to a sugar-sweetened beverage-reduction intervention: results from the Talking Health randomized controlled clinical trial.

PubMed

Hedrick, Valisa E; Davy, Brenda M; You, Wen; Porter, Kathleen J; Estabrooks, Paul A; Zoellner, Jamie M

2017-04-01

Background: The reduction of sugar-sweetened beverage (SSB) intake may be beneficial for weight management and other related health conditions; however, to our knowledge, no data exist regarding the spontaneous changes in other dietary components or the overall dietary quality after an SSB-reduction intervention. Objectives: We explored longitudinal changes within and between an SSB-reduction intervention (SIPsmartER) and a physical activity intervention (MoveMore) with respect to spontaneous changes in 1 ) energy intake and macronutrients and micronutrients, 2 ) dietary quality [Healthy Eating Index-2010 (HEI)], and 3 ) beverage categories. Design: Participants were enrolled in a 6-mo, community-based behavioral trial and randomly assigned into either the SIPsmartER ( n = 149) intervention group or the MoveMore ( n = 143) matched-contact comparison group. Dietary intake was assessed through a mean of three 24-h dietary recalls at baseline and 6 mo. Dietary recalls were analyzed with the use of nutritional analysis software. A multilevel, mixed-effects linear regression with intention-to-treat analyses is presented. Results: SIPsmartER participants showed a significant reduction in total SSBs (mean decrease: -366 mL; P ≤ 0.001). Several spontaneous changes occurred within the SIPsmartER group and, compared with the MoveMore group, included significant HEI improvements for empty calorie, total vegetable, and total HEI scores (mean increases: 2.6, 0.3, and 2.6, respectively; all P ≤ 0.01). Additional positive changes were shown, including significant decreases in total energy intake, trans fat, added sugars, and total beverage energy (all P ≤ 0.05). Few dietary changes were noted in the MoveMore group over the 6-mo intervention. Conclusions: Intervention of the single dietary component SSB resulted in additional spontaneous and beneficial dietary changes. Interventions that target a single dietary change, such as limiting SSB intake to <240 mL/d (<8 fl oz

Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety.

PubMed

McFadden, Kathleen L; Stock, Gregory N; Gowen, Charles R

2014-10-01

Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. The results provide empirical evidence that a safety climate, which is connected to the chief executive officer's transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety.

PubMed

McFadden, Kathleen L; Stock, Gregory N; Gowen, Charles R

2015-01-01

Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. The results provide empirical evidence that a safety climate, which is connected to the chief executive officer's transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

Lichen bioindication of biodiversity, air quality, and climate: baseline results from monitoring in Washington, Oregon, and California.

Treesearch

Sarah Jovan

2008-01-01

Lichens are highly valued ecological indicators known for their sensitivity to a wide variety of environmental stressors like air quality and climate change. This report summarizes baseline results from the U.S. Department of Agriculture, Forest Service, Forest Inventory and Analysis (FIA) Lichen Community Indicator covering the first full cycle of data collection (...

[Analysis of the results of the 2010 External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology].

PubMed

Ruiz de Gopegui Bordes, Enrique; Serrano, M del Remedio Guna; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Cardona, Concepción Gimeno

2011-12-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most important conclusions and lessons of the 2010 controls. As a whole, the results obtained in 2010 confirm the excellent skill and good technical standards found in previous years. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. The results of this program highlight the need to implement both internal and external controls to ensure maximal quality of microbiological tests(1). Copyright © 2011 Elsevier España S.L. All rights reserved.

The effect of image sharpness on quantitative eye movement data and on image quality evaluation while viewing natural images

NASA Astrophysics Data System (ADS)

Vuori, Tero; Olkkonen, Maria

2006-01-01

The aim of the study is to test both customer image quality rating (subjective image quality) and physical measurement of user behavior (eye movements tracking) to find customer satisfaction differences in imaging technologies. Methodological aim is to find out whether eye movements could be quantitatively used in image quality preference studies. In general, we want to map objective or physically measurable image quality to subjective evaluations and eye movement data. We conducted a series of image quality tests, in which the test subjects evaluated image quality while we recorded their eye movements. Results show that eye movement parameters consistently change according to the instructions given to the user, and according to physical image quality, e.g. saccade duration increased with increasing blur. Results indicate that eye movement tracking could be used to differentiate image quality evaluation strategies that the users have. Results also show that eye movements would help mapping between technological and subjective image quality. Furthermore, these results give some empirical emphasis to top-down perception processes in image quality perception and evaluation by showing differences between perceptual processes in situations when cognitive task varies.

Ground-Water Quality Data in the Coastal Los Angeles Basin Study Unit, 2006: Results from the California GAMA Program

USGS Publications Warehouse

Mathany, Timothy M.; Land, Michael; Belitz, Kenneth

2008-01-01

] and dissolved noble gases also were measured to help identify the sources and ages of the sampled ground water. Quality-control samples (blanks, replicates, and samples for matrix spikes) were collected at approximately one-fourth of the wells, and the results for these samples were used to evaluate the quality of the data for the ground-water samples. Field blanks rarely contained detectable concentrations of any constituent, suggesting that contamination was not a significant source of bias. Differences between replicate samples were within acceptable ranges, indicating acceptably low variability. Matrix spike recoveries were within acceptable ranges for most compounds. Assessment of the quality-control information resulted in applying ?V? codes to approximately 0.1 percent of the data collected for ground-water samples (meaning a constituent was detected in blanks as well as the corresponding environmental data). This study did not attempt to evaluate the quality of drinking water delivered to consumers; after withdrawal from the ground, water typically is treated, disinfected, and (or) blended with other waters to maintain acceptable drinking-water quality. Regulatory thresholds are applied to the treated drinking water that is served to the consumer, not to raw ground water. However, to provide some context for the results, concentrations of constituents measured in the raw ground water were compared with regulatory and non-regulatory health-based thresholds established by the U.S. Environmental Protection Agency (USEPA), California Department of Public Health (CDPH, formerly California Department of Health Services [CADHS]) and thresholds established for aesthetic concerns (secondary maximum contaminant levels, SMCL-CA) by CDPH. Comparisons between data collected for this study and drinking-water thresholds are for illustrative purposes only, and are not indicative of compliance or non-compliance with those thresholds. VOCs were detected in alm

A Quality Process Approach to Electronic System Reliability: Supplier Quality Assessment Procedure. Volume 2

DTIC Science & Technology

1993-11-01

AND SUPPORT SERVICE QUALITY ....... 16 3.5.7 SUPPLIER QUALITY ............................................................................. 16 3.6...RESULTS ......................................................................................................... 16 3.6.1 PRODUCT AND SERVICE QUALITY RESULTS...10 5.6 Business Process and Support Service Quality 20 5.7 Supplier Quality 20 6.0 Results 180 6.1 Product and Service Quality Results 90 6.2 Business

Is the maturity of hospitals' quality improvement systems associated with measures of quality and patient safety?

PubMed Central

2011-01-01

Background Previous research addressed the development of a classification scheme for quality improvement systems in European hospitals. In this study we explore associations between the 'maturity' of the hospitals' quality improvement system and clinical outcomes. Methods The maturity classification scheme was developed based on survey results from 389 hospitals in eight European countries. We matched the hospitals from the Spanish sample (113 hospitals) with those hospitals participating in a nation-wide, voluntary hospital performance initiative. We then compared sample distributions and explored associations between the 'maturity' of the hospitals' quality improvement system and a range of composite outcomes measures, such as adjusted hospital-wide mortality, -readmission, -complication and -length of stay indices. Statistical analysis includes bivariate correlations for parametrically and non-parametrically distributed data, multiple robust regression models and bootstrapping techniques to obtain confidence-intervals for the correlation and regression estimates. Results Overall, 43 hospitals were included. Compared to the original sample of 113, this sample was characterized by a higher representation of university hospitals. Maturity of the quality improvement system was similar, although the matched sample showed less variability. Analysis of associations between the quality improvement system and hospital-wide outcomes suggests significant correlations for the indicator adjusted hospital complications, borderline significance for adjusted hospital readmissions and non-significance for the adjusted hospital mortality and length of stay indicators. These results are confirmed by the bootstrap estimates of the robust regression model after adjusting for hospital characteristics. Conclusions We assessed associations between hospitals' quality improvement systems and clinical outcomes. From this data it seems that having a more developed quality improvement

Groundwater-quality data for the Sierra Nevada study unit, 2008: Results from the California GAMA program

USGS Publications Warehouse

Shelton, Jennifer L.; Fram, Miranda S.; Munday, Cathy M.; Belitz, Kenneth

2010-01-01

Nevada study unit: granitic, metamorphic, sedimentary, and volcanic rocks. One natural spring that is not used for drinking water was sampled for comparison with a nearby primary grid well in the same cell. Groundwater samples were analyzed for organic constituents (volatile organic compounds [VOC], pesticides and pesticide degradates, and pharmaceutical compounds), constituents of special interest (N-nitrosodimethylamine [NDMA] and perchlorate), naturally occurring inorganic constituents (nutrients, major ions, total dissolved solids, and trace elements), and radioactive constituents (radium isotopes, radon-222, gross alpha and gross beta particle activities, and uranium isotopes). Naturally occurring isotopes and geochemical tracers (stable isotopes of hydrogen and oxygen in water, stable isotopes of carbon, carbon-14, strontium isotopes, and tritium), and dissolved noble gases also were measured to help identify the sources and ages of the sampled groundwater. Three types of quality-control samples (blanks, replicates, and samples for matrix spikes) each were collected at approximately 10 percent of the wells sampled for each analysis, and the results for these samples were used to evaluate the quality of the data for the groundwater samples. Field blanks rarely contained detectable concentrations of any constituent, suggesting that contamination from sample collection, handling, and analytical procedures was not a significant source of bias in the data for the groundwater samples. Differences between replicate samples were within acceptable ranges, with few exceptions. Matrix-spike recoveries were within acceptable ranges for most compounds. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, groundwater typically is treated, disinfected, or blended with other waters to maintain water quality. Regulatory benchmarks apply to finished drinking water that is served to the consumer, not to untre

Quality Assessment of Studies Published in Open Access and Subscription Journals: Results of a Systematic Evaluation.

PubMed

Pastorino, Roberta; Milovanovic, Sonja; Stojanovic, Jovana; Efremov, Ljupcho; Amore, Rosarita; Boccia, Stefania

2016-01-01

Along with the proliferation of Open Access (OA) publishing, the interest for comparing the scientific quality of studies published in OA journals versus subscription journals has also increased. With our study we aimed to compare the methodological quality and the quality of reporting of primary epidemiological studies and systematic reviews and meta-analyses published in OA and non-OA journals. In order to identify the studies to appraise, we listed all OA and non-OA journals which published in 2013 at least one primary epidemiologic study (case-control or cohort study design), and at least one systematic review or meta-analysis in the field of oncology. For the appraisal, we picked up the first studies published in 2013 with case-control or cohort study design from OA journals (Group A; n = 12), and in the same time period from non-OA journals (Group B; n = 26); the first systematic reviews and meta-analyses published in 2013 from OA journals (Group C; n = 15), and in the same time period from non-OA journals (Group D; n = 32). We evaluated the methodological quality of studies by assessing the compliance of case-control and cohort studies to Newcastle and Ottawa Scale (NOS) scale, and the compliance of systematic reviews and meta-analyses to Assessment of Multiple Systematic Reviews (AMSTAR) scale. The quality of reporting was assessed considering the adherence of case-control and cohort studies to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist, and the adherence of systematic reviews and meta-analyses to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. Among case-control and cohort studies published in OA and non-OA journals, we did not observe significant differences in the median value of NOS score (Group A: 7 (IQR 7-8) versus Group B: 8 (7-9); p = 0.5) and in the adherence to STROBE checklist (Group A, 75% versus Group B, 80%; p = 0.1). The results did not change after adjustment

Association between perceptions of public drinking water quality and actual drinking water quality: A community-based exploratory study in Newfoundland (Canada).

PubMed

Ochoo, Benjamin; Valcour, James; Sarkar, Atanu

2017-11-01

Studying public perception on drinking water quality is crucial for managing of water resources, generation of water quality standards, and surveillance of the drinking-water quality. However, in policy discourse, the reliability of public perception concerning drinking water quality and associated health risks is questionable. Does the public perception of water quality equate with the actual water quality? We investigated public perceptions of water quality and the perceived health risks and associated with the actual quality of public water supplies in the same communities. The study was conducted in 45 communities of Newfoundland (Canada) in 2012. First, a telephone survey of 100 households was conducted to examine public perceptions of drinking water quality of their respective public sources. Then we extracted public water quality reports of the same communities (1988-2011) from the provincial government's water resources portal. These reports contained the analysis of 2091 water samples, including levels of Disinfection By-Products (DBPs), nutrients, metals, ions and physical parameters. The reports showed that colour, manganese, total dissolved solids, iron, turbidity, and DBPs were the major detected parameters in the public water. However, the majority of the respondents (>56%) were either completely satisfied or very satisfied with the quality of drinking water. Older, higher educated and high-income group respondents were more satisfied with water quality than the younger, less educated and low-income group respondents. The study showed that there was no association with public satisfaction level and actual water quality of the respective communities. Even, in the communities, supplied by the same water system, the respondents had differences in opinion. Despite the effort by the provincial government to make the water-test results available on its website for years, the study showed existing disconnectedness between public perception of drinking water

Groundwater-quality data in the Western San Joaquin Valley study unit, 2010 - Results from the California GAMA Program

USGS Publications Warehouse

Mathany, Timothy M.; Landon, Matthew K.; Shelton, Jennifer L.; Belitz, Kenneth

2013-01-01

), constituents of special interest (perchlorate, N-nitrosodimethylamine [NDMA], and 1,2,3-trichloropropane [1,2,3-TCP]), and naturally occurring inorganic constituents (trace elements, nutrients, dissolved organic carbon [DOC], major and minor ions, silica, total dissolved solids [TDS], alkalinity, total arsenic and iron [unfiltered] and arsenic, chromium, and iron species [filtered]). Isotopic tracers (stable isotopes of hydrogen, oxygen, and boron in water, stable isotopes of nitrogen and oxygen in dissolved nitrate, stable isotopes of sulfur in dissolved sulfate, isotopic ratios of strontium in water, stable isotopes of carbon in dissolved inorganic carbon, activities of tritium, and carbon-14 abundance), dissolved standard gases (methane, carbon dioxide, nitrogen, oxygen, and argon), and dissolved noble gases (argon, helium-4, krypton, neon, and xenon) were measured to help identify sources and ages of sampled groundwater. In total, 245 constituents and 8 water-quality indicators were measured. Quality-control samples (blanks, replicates, or matrix spikes) were collected at 16 percent of the wells in the WSJV study unit, and the results for these samples were used to evaluate the quality of the data from the groundwater samples. Blanks rarely contained detectable concentrations of any constituent, suggesting that contamination from sample collection procedures was not a significant source of bias in the data for the groundwater samples. Replicate samples all were within acceptable limits of variability. Matrix-spike recoveries were within the acceptable range (70 to 130 percent) for approximately 87 percent of the compounds. This study did not evaluate the quality of water delivered to consumers. After withdrawal, groundwater typically is treated, disinfected, and (or) blended with other waters to maintain water quality. Regulatory benchmarks apply to water that is delivered to the consumer, not to untreated groundwater. However, to provide some context for the results

Quality standards for predialysis education: results from a consensus conference.

PubMed

Isnard Bagnis, Corinne; Crepaldi, Carlo; Dean, Jessica; Goovaerts, Tony; Melander, Stefan; Nilsson, Eva-Lena; Prieto-Velasco, Mario; Trujillo, Carmen; Zambon, Roberto; Mooney, Andrew

2015-07-01

This position statement was compiled following an expert meeting in March 2013, Zurich, Switzerland. Attendees were invited from a spread of European renal units with established and respected renal replacement therapy option education programmes. Discussions centred around optimal ways of creating an education team, setting realistic and meaningful objectives for patient education, and assessing the quality of education delivered. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA.

Water Quality Evaluation of the Yellow River Basin Based on Gray Clustering Method

NASA Astrophysics Data System (ADS)

Fu, X. Q.; Zou, Z. H.

2018-03-01

Evaluating the water quality of 12 monitoring sections in the Yellow River Basin comprehensively by grey clustering method based on the water quality monitoring data from the Ministry of environmental protection of China in May 2016 and the environmental quality standard of surface water. The results can reflect the water quality of the Yellow River Basin objectively. Furthermore, the evaluation results are basically the same when compared with the fuzzy comprehensive evaluation method. The results also show that the overall water quality of the Yellow River Basin is good and coincident with the actual situation of the Yellow River basin. Overall, gray clustering method for water quality evaluation is reasonable and feasible and it is also convenient to calculate.

Social image quality

NASA Astrophysics Data System (ADS)

Qiu, Guoping; Kheiri, Ahmed

2011-01-01

Current subjective image quality assessments have been developed in the laboratory environments, under controlledconditions, and are dependent on the participation of limited numbers of observers. In this research, with the help of Web 2.0 and social media technology, a new method for building a subjective image quality metric has been developed where the observers are the Internet users. A website with a simple user interface that enables Internet users from anywhere at any time to vote for a better quality version of a pair of the same image has been constructed. Users' votes are recorded and used to rank the images according to their perceived visual qualities. We have developed three rank aggregation algorithms to process the recorded pair comparison data, the first uses a naive approach, the second employs a Condorcet method, and the third uses the Dykstra's extension of Bradley-Terry method. The website has been collecting data for about three months and has accumulated over 10,000 votes at the time of writing this paper. Results show that the Internet and its allied technologies such as crowdsourcing offer a promising new paradigm for image and video quality assessment where hundreds of thousands of Internet users can contribute to building more robust image quality metrics. We have made Internet user generated social image quality (SIQ) data of a public image database available online (http://www.hdri.cs.nott.ac.uk/siq/) to provide the image quality research community with a new source of ground truth data. The website continues to collect votes and will include more public image databases and will also be extended to include videos to collect social video quality (SVQ) data. All data will be public available on the website in due course.

Higher prices, higher quality? Evidence from German nursing homes.

PubMed

Herr, Annika; Hottenrott, Hanna

2016-02-01

This study investigates the relationship between prices and quality of 7400 German nursing homes. We use a cross section of public quality reports for all German nursing homes, which had been evaluated between 2010 and 2013 by external institutions. Our analysis is based on multivariate regressions in a two stage least squares framework, where we instrument prices to explain their effect on quality controlling for income, nursing home density, demographics, labour market characteristics, and infrastructure at the regional level. Descriptive analysis shows that prices and quality do not only vary across nursing homes, but also across counties and federal states and that quality and prices correlate positively. Second, the econometric analysis, which accounts for the endogenous relation between negotiated price and reported quality, shows that quality indeed positively depends on prices. In addition, more places in nursing homes per people in need are correlated with both lower prices and higher quality. Finally, unobserved factors at the federal state level capture some of the variation of reported quality across nursing homes. Our results suggest that higher prices increase quality. Furthermore, since reported quality and prices vary substantially across federal states, we conclude that the quality and prices of long-term care facilities may well be compared within federal states but not across. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Quality of life and vertigo after bilateral cochlear implantation : Questionnaires as tools for quality assurance].

PubMed

Rader, T; Haerterich, M; Ernst, B P; Stöver, T; Strieth, S

2018-03-01

Persistent dizziness symptoms after cochlear implantation have an impact on quality of life. In this study, the effects of bilateral cochlear implants (CI) on quality of life as well as on subjective dizziness complaints are analyzed using questionnaires, some of which have never been applied before in these patient collectives. In this article, questionnaires for the assessment of dizziness symptoms and quality of life are introduced in order to realize quality assurance. A total of 32 patients with bilateral CI were questioned regarding dizziness symptoms and quality of life. The Nijmegen Cochlear Implant Questionnaire (NCIQ) was used. In the case of reported regular dizziness, the Vertigo Handicap Questionnaire (VHQ) and the Vertigo Symptom Scale (VSS) were also assessed. Persistent dizziness symptoms were shown in 8 of 32 patients. Quality of life was measured with the NCIQ and was improved significantly (p < 0.001) by 23.7% after the second CI. The dizziness symptoms changed slightly (VHQ -11.2%; VSS +16.4%) after the second implantation. The results show that the questionnaires are valid instruments for documenting quality of life and dizziness symptoms for quality assurance. These questionnaires may be applied as a complement or an alternative to device-based measurements of peripheral vestibular dysfunction.

Evaluation of Adherence to Quality Measures for Prostate Cancer Radiotherapy in the United States: Results from the Quality Research in Radiation Oncology (QRRO) Survey.

PubMed

Zelefsky, Michael J; Lee, W Robert; Zietman, Anthony; Khalid, Najma; Crozier, Cheryl; Owen, Jean; Wilson, J Frank

2013-01-01

To test the feasibility of using proposed quality indicators to assess radiotherapy quality in prostate cancer management based on a 2007 stratified random survey of treating academic and non-academic US institutions. 414 patients with clinically localized prostate cancer treated with external beam radiotherapy (EBRT) or brachytherapy were selected from 45 institutions. Indicators used as specific measurable clinical performance measures to represent surrogates for quality of radiotherapy delivery included established measures, such as the use of prescription doses ≥75 Gy for intermediate- and high-risk EBRT patients and androgen-deprivation therapy (ADT) in conjunction with EBRT for patients with high-risk disease, and emerging measures, including daily target localization (image-guidance) to correct for organ motion for EBRT patients. 167 patients (47%) were treated with 6 MV photons, 31 (9%) were treated with 10 MV, 65 (18%) received 15 MV, and the remaining 90 (26%) 16-23 MV. For intermediate- plus high-risk patients (n=181), 78% were treated to ≥75 Gy. Among favorable-risk patients, 72% were treated to ≥75 Gy. Among high-risk EBRT patients, 60 (87%) were treated with ADT in conjunction with EBRT and 13% (n=9) with radiotherapy alone. Among low- and intermediate-risk patients, 10% and 42%, respectively, were treated with ADT plus EBRT. For 24% of EBRT patients (85/354), weekly electronic portal imaging was obtained as verification films without daily target localization and the remaining 76% were treated with daily localization of the target using various methods. Adherence to defined quality indicators was observed in a majority of patients. ≈90% of high-risk patients are treated with ADT plus EBRT and ≈80% of intermediate- and high-risk patients receive prescription doses >=75 Gy, consistent with the published results of randomized trials.

Why is quality estimation judgment fast? Comparison of gaze control strategies in quality and difference estimation tasks

NASA Astrophysics Data System (ADS)

Radun, Jenni; Leisti, Tuomas; Virtanen, Toni; Nyman, Göte; Häkkinen, Jukka

2014-11-01

To understand the viewing strategies employed in a quality estimation task, we compared two visual tasks-quality estimation and difference estimation. The estimation was done for a pair of natural images having small global changes in quality. Two groups of observers estimated the same set of images, but with different instructions. One group estimated the difference in quality and the other the difference between image pairs. The results demonstrated the use of different visual strategies in the tasks. The quality estimation was found to include more visual planning during the first fixation than the difference estimation, but afterward needed only a few long fixations on the semantically important areas of the image. The difference estimation used many short fixations. Salient image areas were mainly attended to when these areas were also semantically important. The results support the hypothesis that these tasks' general characteristics (evaluation time, number of fixations, area fixated on) show differences in processing, but also suggest that examining only single fixations when comparing tasks is too narrow a view. When planning a subjective experiment, one must remember that a small change in the instructions might lead to a noticeable change in viewing strategy.

[Study of the relationship between human quality and reliability].

PubMed

Long, S; Wang, C; Wang, L i; Yuan, J; Liu, H; Jiao, X

1997-02-01

To clarify the relationship between human quality and reliability, 1925 experiments in 20 subjects were carried out to study the relationship between disposition character, digital memory, graphic memory, multi-reaction time and education level and simulated aircraft operation. Meanwhile, effects of task difficulty and enviromental factor on human reliability were also studied. The results showed that human quality can be predicted and evaluated through experimental methods. The better the human quality, the higher the human reliability.

Multicenter Collaborative Quality Assurance Program for the Province of Ontario, Canada: First-Year Results

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

Létourneau, Daniel, E-mail: daniel.letourneau@rmp.uh.on.ca; Department of Radiation Oncology, University of Toronto, Toronto, Ontario; McNiven, Andrea

2013-05-01

Purpose: The objective of this work was to develop a collaborative quality assurance (CQA) program to assess the performance of intensity modulated radiation therapy (IMRT) planning and delivery across the province of Ontario, Canada. Methods and Materials: The CQA program was designed to be a comprehensive end-to-end test that can be completed on multiple planning and delivery platforms. The first year of the program included a head-and-neck (H and N) planning exercise and on-site visit to acquire dosimetric measurements to assess planning and delivery performance. A single dosimeter was used at each institution, and the planned to measured dose agreementmore » was evaluated for both the H and N plan and a standard plan (linear-accelerator specific) that was created to enable a direct comparison between centers with similar infrastructure. Results: CQA program feasibility was demonstrated through participation of all 13 radiation therapy centers in the province. Planning and delivery was completed on a variety of infrastructure (treatment planning systems and linear accelerators). The planning exercise was completed using both static gantry and rotational IMRT, and planned-to-delivered dose agreement (pass rates) for 3%/3-mm gamma evaluation were greater than 90% (92.6%-99.6%). Conclusions: All centers had acceptable results, but variation in planned to delivered dose agreement for the same planning and delivery platform was noted. The upper end of the range will provide an achievable target for other centers through continued quality improvement, aided by feedback provided by the program through the use of standard plans and simple test fields.« less

Quality Seen as Job One for Charters: Sector Explores Ways to Spur Rising Tide of Strong Results

ERIC Educational Resources Information Center

Robelen, Erik W.

2009-01-01

When President Barack Obama pledged on the campaign trail last September to step up federal aid for "successful" charter schools, he was touching on a matter of mounting concern: how to ensure better and more consistent quality across the growing charter sector. Amid worry about the mixed academic results for charter schools--and a belief that too…

Assessment of air quality benefits from national air pollution control policies in China. Part II: Evaluation of air quality predictions and air quality benefits assessment

NASA Astrophysics Data System (ADS)

Wang, Litao; Jang, Carey; Zhang, Yang; Wang, Kai; Zhang, Qiang; Streets, David; Fu, Joshua; Lei, Yu; Schreifels, Jeremy; He, Kebin; Hao, Jiming; Lam, Yun-Fat; Lin, Jerry; Meskhidze, Nicholas; Voorhees, Scott; Evarts, Dale; Phillips, Sharon

2010-09-01

Following the meteorological evaluation in Part I, this Part II paper presents the statistical evaluation of air quality predictions by the U.S. Environmental Protection Agency (U.S. EPA)'s Community Multi-Scale Air Quality (Models-3/CMAQ) model for the four simulated months in the base year 2005. The surface predictions were evaluated using the Air Pollution Index (API) data published by the China Ministry of Environmental Protection (MEP) for 31 capital cities and daily fine particulate matter (PM 2.5, particles with aerodiameter less than or equal to 2.5 μm) observations of an individual site in Tsinghua University (THU). To overcome the shortage in surface observations, satellite data are used to assess the column predictions including tropospheric nitrogen dioxide (NO 2) column abundance and aerosol optical depth (AOD). The result shows that CMAQ gives reasonably good predictions for the air quality. The air quality improvement that would result from the targeted sulfur dioxide (SO 2) and nitrogen oxides (NO x) emission controls in China were assessed for the objective year 2010. The results show that the emission controls can lead to significant air quality benefits. SO 2 concentrations in highly polluted areas of East China in 2010 are estimated to be decreased by 30-60% compared to the levels in the 2010 Business-As-Usual (BAU) case. The annual PM 2.5 can also decline by 3-15 μg m -3 (4-25%) due to the lower SO 2 and sulfate concentrations. If similar controls are implemented for NO x emissions, NO x concentrations are estimated to decrease by 30-60% as compared with the 2010 BAU scenario. The annual mean PM 2.5 concentrations will also decline by 2-14 μg m -3 (3-12%). In addition, the number of ozone (O 3) non-attainment areas in the northern China is projected to be much lower, with the maximum 1-h average O 3 concentrations in the summer reduced by 8-30 ppb.

["Healthy cities"--requirements and performance. Questionnaire results and a suggestion on quality monitoring (healthy-cities-barometer)].

PubMed

Plümer, K D; Trojan, A

2004-03-01

The overall goal of the WHO Healthy Cities Project was to translate some key points of the Ottawa Charter for Health Promotion (1986) into reality such as public health policies, creating health-promoting environments, strengthening community action through active public participation (empowerment of communities) and equity in health at the local level. These should be anchored within the local political administrative system (PAS), which means health should be on the agenda of policymakers in all sectors. To figure out how far this has been attained after almost 15 years of "healthy cities" policy in Germany was the focal point of the first questioning of local project coordinators. A written questionnaire containing 128 items has been developed in collaboration with the Healthy Cities Network-Coordinator. The questionnaire consists of 78 standardised questions and some (23) open-ended questions for more specific qualitative information. Also included are 27 ten-point rating scales to evaluate the coordinators' view of some aspects of their healthy cities work and to assess its progress. Based on 30 questions of the questionnaire we generated six quality indices, summarised to a quality index for a monitoring model. 47 (90 %) project-coordinators from a list of 52 took part in the first German Healthy Cities survey in the spring 2002. Selected results of the network questioning concerning the local "healthy cities" offices, work priorities and methods demonstrate differences between East and West Germany and general weakpoints of the "healthy cities" projects. Data analysis based on six quality dimensions of the "Healthy Cities" work, Programme Equipment and Commitment (Structure), Concept Quality and Integration within the Network (Process), Self-reported Success and Integration within the City/Municipality (Outcome), revealed some weak points of the " Healthy Cities" work as follows: Basing on the six quality dimensions we present a monitoring model (Healthy

Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results*

PubMed Central

Maciel, Paula Curitiba; Veiga-Filho, Joel; de Carvalho, Marcelo Prado; Fonseca, Fernando Elias Martins; Ferreira, Lydia Masako; Veiga, Daniela Francescato

2014-01-01

BACKGROUND Cancer is a multifactorial disease and skin carcinomas are the most common type of cancer. Assessing quality of life and self-esteem outcomes in skin cancer patients is important because these are indicators of the results of the treatment, translating how patients face their lives and their personal relationships. OBJECTIVE To assess the late impact of the surgical treatment of head and/or neck skin carcinomas on quality of life and self-esteem of the patients. METHODS Fifty patients with head or neck skin carcinomas were enrolled. Their age ranged between 30 and 75 years, 27 were men and 23 were women. Patients were assessed with regard to quality of life and self-esteem, preoperatively and five years postoperatively. Validated instruments were used: the MOS 36-item Short-form Health Survey (SF-36) and the Rosenberg Self-esteem/EPM-UNIFESP Scale. The Wilcoxon signed-rank test was used for the statistical analysis. RESULTS Twenty-two patients completed the five-year follow-up, 54.5% women and 45.5% men. Compared to the preoperative assessment, patients had an improvement in mental health (p=0.011) and in self-esteem (p=0.002). There was no statistical difference with regard to the other domains of the SF-36. CONCLUSION Patients submitted to surgical treatment of skin carcinoma improved mental health and self-esteem in the late postsurgical testing. PMID:25054746

The Impact of Applying Quality Management Practices on Patient Centeredness in Jordanian Public Hospitals: Results of Predictive Modeling

PubMed Central

Hijazi, Heba H.; Harvey, Heather L.; Alyahya, Mohammad S.; Alshraideh, Hussam A.; Al abdi, Rabah M.; Parahoo, Sanjai K.

2018-01-01

Targeting the patient’s needs and preferences has become an important contributor for improving care delivery, enhancing patient satisfaction, and achieving better clinical outcomes. This study aimed to examine the impact of applying quality management practices on patient centeredness within the context of health care accreditation and to explore the differences in the views of various health care workers regarding the attributes affecting patient-centered care. Our study followed a cross-sectional survey design wherein 4 Jordanian public hospitals were investigated several months after accreditation was obtained. Total 829 clinical/nonclinical hospital staff members consented for study participation. This sample was divided into 3 main occupational categories to represent the administrators, nurses, as well as doctors and other health professionals. Using a structural equation modeling, our results indicated that the predictors of patient-centered care for both administrators and those providing clinical care were participation in the accreditation process, leadership commitment to quality improvement, and measurement of quality improvement outcomes. In particular, perceiving the importance of the hospital’s engagement in the accreditation process was shown to be relevant to the administrators (gamma = 0.96), nurses (gamma = 0.80), as well as to doctors and other health professionals (gamma = 0.71). However, the administrator staff (gamma = 0.31) was less likely to perceive the influence of measuring the quality improvement outcomes on the delivery of patient-centered care than nurses (gamma = 0.59) as well as doctors and other health care providers (gamma = 0.55). From the nurses’ perspectives only, patient centeredness was found to be driven by building an institutional framework that supports quality assurance in hospital settings (gamma = 0.36). In conclusion, accreditation is a leading factor for delivering patient-centered care and should be on a

The Impact of Applying Quality Management Practices on Patient Centeredness in Jordanian Public Hospitals: Results of Predictive Modeling.

PubMed

Hijazi, Heba H; Harvey, Heather L; Alyahya, Mohammad S; Alshraideh, Hussam A; Al Abdi, Rabah M; Parahoo, Sanjai K

2018-01-01

Targeting the patient's needs and preferences has become an important contributor for improving care delivery, enhancing patient satisfaction, and achieving better clinical outcomes. This study aimed to examine the impact of applying quality management practices on patient centeredness within the context of health care accreditation and to explore the differences in the views of various health care workers regarding the attributes affecting patient-centered care. Our study followed a cross-sectional survey design wherein 4 Jordanian public hospitals were investigated several months after accreditation was obtained. Total 829 clinical/nonclinical hospital staff members consented for study participation. This sample was divided into 3 main occupational categories to represent the administrators, nurses, as well as doctors and other health professionals. Using a structural equation modeling, our results indicated that the predictors of patient-centered care for both administrators and those providing clinical care were participation in the accreditation process, leadership commitment to quality improvement, and measurement of quality improvement outcomes. In particular, perceiving the importance of the hospital's engagement in the accreditation process was shown to be relevant to the administrators (gamma = 0.96), nurses (gamma = 0.80), as well as to doctors and other health professionals (gamma = 0.71). However, the administrator staff (gamma = 0.31) was less likely to perceive the influence of measuring the quality improvement outcomes on the delivery of patient-centered care than nurses (gamma = 0.59) as well as doctors and other health care providers (gamma = 0.55). From the nurses' perspectives only, patient centeredness was found to be driven by building an institutional framework that supports quality assurance in hospital settings (gamma = 0.36). In conclusion, accreditation is a leading factor for delivering patient-centered care and should be on a hospital

Ground-Water Quality Data in the Southeast San Joaquin Valley, 2005-2006 - Results from the California GAMA Program

USGS Publications Warehouse

Burton, Carmen A.; Belitz, Kenneth

2008-01-01

Ground-water quality in the approximately 3,800 square-mile Southeast San Joaquin Valley study unit (SESJ) was investigated from October 2005 through February 2006 as part of the Priority Basin Assessment Project of Ground-Water Ambient Monitoring and Assessment (GAMA) Program. The GAMA Statewide Basin Assessment project was developed in response to the Ground-Water Quality Monitoring Act of 2001 and is being conducted by the California State Water Resources Control Board (SWRCB) in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory (LLNL). The SESJ study was designed to provide a spatially unbiased assessment of raw ground-water quality within SESJ, as well as a statistically consistent basis for comparing water quality throughout California. Samples were collected from 99 wells in Fresno, Tulare, and Kings Counties, 83 of which were selected using a spatially distributed, randomized grid-based method to provide statistical representation of the study area (grid wells), and 16 of which were sampled to evaluate changes in water chemistry along ground-water flow paths or across alluvial fans (understanding wells). The ground-water samples were analyzed for a large number of synthetic organic constituents (volatile organic compounds [VOCs], pesticides and pesticide degradates, and pharmaceutical compounds), constituents of special interest (perchlorate, N-nitrosodimethylamine, and 1,2,3-trichloropropane), naturally occurring inorganic constituents (nutrients, major and minor ions, and trace elements), radioactive constituents, and microbial indicators. Naturally occurring isotopes (tritium, and carbon-14, and stable isotopes of hydrogen, oxygen, nitrogen, and carbon), and dissolved noble gases also were measured to help identify the source and age of the sampled ground water. Quality-control samples (blanks, replicates, samples for matrix spikes) were collected at approximately 10 percent of the wells, and the results

Drinking water quality assessment.

PubMed

Aryal, J; Gautam, B; Sapkota, N

2012-09-01

Drinking water quality is the great public health concern because it is a major risk factor for high incidence of diarrheal diseases in Nepal. In the recent years, the prevalence rate of diarrhoea has been found the highest in Myagdi district. This study was carried out to assess the quality of drinking water from different natural sources, reservoirs and collection taps at Arthunge VDC of Myagdi district. A cross-sectional study was carried out using random sampling method in Arthunge VDC of Myagdi district from January to June,2010. 84 water samples representing natural sources, reservoirs and collection taps from the study area were collected. The physico-chemical and microbiological analysis was performed following standards technique set by APHA 1998 and statistical analysis was carried out using SPSS 11.5. The result was also compared with national and WHO guidelines. Out of 84 water samples (from natural source, reservoirs and tap water) analyzed, drinking water quality parameters (except arsenic and total coliform) of all water samples was found to be within the WHO standards and national standards.15.48% of water samples showed pH (13) higher than the WHO permissible guideline values. Similarly, 85.71% of water samples showed higher Arsenic value (72) than WHO value. Further, the statistical analysis showed no significant difference (P<0.05) of physico-chemical parameters and total coliform count of drinking water for collection taps water samples of winter (January, 2010) and summer (June, 2010). The microbiological examination of water samples revealed the presence of total coliform in 86.90% of water samples. The results obtained from physico-chemical analysis of water samples were within national standard and WHO standards except arsenic. The study also found the coliform contamination to be the key problem with drinking water.

Care quality following intrauterine death in Spanish hospitals: results from an online survey.

PubMed

Cassidy, Paul Richard

2018-01-10

other high-income countries are not routine in Spanish hospitals. Providing such care is a relatively new phenomenon in the Spanish health system, the results provide a quality benchmark and identify a number of areas where hospitals could make improvements to care practices that should have important psychosocial benefits for women and their families.

Groundwater-quality data in the Klamath Mountains study unit, 2010: results from the California GAMA Program

USGS Publications Warehouse

Mathany, Timothy M.; Belitz, Kenneth

2014-01-01

radioactivity, and microbial indicators (total coliform and Escherichia coli [E. coli]). Isotopic tracers (stable isotopes of hydrogen and oxygen in water, isotopic ratios of dissolved strontium in water, and stable isotopes of carbon in dissolved inorganic carbon), dissolved noble gases, and age-dating tracers (tritium and carbon-14) were measured to help identify sources and ages of sampled groundwater. Quality-control samples (field blanks, replicate sample pairs, and matrix spikes) were collected at 13 percent of the sites in the KLAM study unit, and the results were used to evaluate the quality of the data from the groundwater samples. Field blank samples rarely contained detectable concentrations of any constituent, indicating that contamination from sample collection or analysis was not a significant source of bias in the data for the groundwater samples. More than 99 percent of the replicate pair samples were within acceptable limits of variability. Matrix-spike sample recoveries were within the acceptable range (70 to 130 percent) for approximately 91 percent of the compounds. This study did not evaluate the quality of water delivered to consumers. After withdrawal, groundwater typically is treated, disinfected, and (or) blended with other waters to maintain water quality. Regulatory benchmarks apply to water that is delivered to the consumer, not to untreated groundwater. However, to provide some context for the results, concentrations of constituents measured in the untreated groundwater were compared with regulatory and non-regulatory health-based benchmarks established by the U.S. Environmental Protection Agency (USEPA) and CDPH, and to non-health-based benchmarks established for aesthetic concerns by the CDPH. Comparisons between data collected for this study and benchmarks for drinking water are for illustrative purposes only and are not indicative of compliance or non-compliance with those benchmarks. All concentrations of organic constituents from grid sites

Objectification of perceptual image quality for mobile video

NASA Astrophysics Data System (ADS)

Lee, Seon-Oh; Sim, Dong-Gyu

2011-06-01

This paper presents an objective video quality evaluation method for quantifying the subjective quality of digital mobile video. The proposed method aims to objectify the subjective quality by extracting edgeness and blockiness parameters. To evaluate the performance of the proposed algorithms, we carried out subjective video quality tests with the double-stimulus continuous quality scale method and obtained differential mean opinion score values for 120 mobile video clips. We then compared the performance of the proposed methods with that of existing methods in terms of the differential mean opinion score with 120 mobile video clips. Experimental results showed that the proposed methods were approximately 10% better than the edge peak signal-to-noise ratio of the J.247 method in terms of the Pearson correlation.

Protein single-model quality assessment by feature-based probability density functions.

PubMed

Cao, Renzhi; Cheng, Jianlin

2016-04-04

Protein quality assessment (QA) has played an important role in protein structure prediction. We developed a novel single-model quality assessment method-Qprob. Qprob calculates the absolute error for each protein feature value against the true quality scores (i.e. GDT-TS scores) of protein structural models, and uses them to estimate its probability density distribution for quality assessment. Qprob has been blindly tested on the 11th Critical Assessment of Techniques for Protein Structure Prediction (CASP11) as MULTICOM-NOVEL server. The official CASP result shows that Qprob ranks as one of the top single-model QA methods. In addition, Qprob makes contributions to our protein tertiary structure predictor MULTICOM, which is officially ranked 3rd out of 143 predictors. The good performance shows that Qprob is good at assessing the quality of models of hard targets. These results demonstrate that this new probability density distribution based method is effective for protein single-model quality assessment and is useful for protein structure prediction. The webserver of Qprob is available at: http://calla.rnet.missouri.edu/qprob/. The software is now freely available in the web server of Qprob.

Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

PubMed Central

Uchôa, Severina Alice da Costa; Arcêncio, Ricardo Alexandre; Fronteira, Inês Santos Estevinho; Coêlho, Ardigleusa Alves; Martiniano, Claudia Santos; Brandão, Isabel Cristina Araújo; Yamamura, Mellina; Maroto, Renata Melo

2016-01-01

Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil. PMID:26959332

External quality-assurance results for the National Atmospheric Deposition Program/National Trends Network, 2002-03

USGS Publications Warehouse

Wetherbee, Gregory A.; Latysh, Natalie E.; Burke, Kevin P.

2005-01-01

to onsite conditions tended to neutralize the acidity of the samples by less than 1.0 microequivalent per liter. Onsite exposure of the sampling bucket appeared to slightly increase the concentration of most of the analytes but not to an extent that was environmentally significant to NADP data users. An interlaboratory-comparison program was used to estimate the analytical variability and bias of the NADP Central Analytical Laboratory (CAL) during 2002-03. Bias was identified in the CAL data for calcium, magnesium, sodium, potassium, ammonium, chloride, nitrate, sulfate, hydrogen ion, and specific conductance, but the absolute value of the bias was less than analytical minimum detection limits for all constituents except magnesium, nitrate, sulfate, and specific conductance. Control charts showed that CAL results were within statistical control approximately 90 percent of the time. Data for the analysis of ultrapure deionized-water samples indicated that CAL did not have problems with laboratory contamination. During 2002-03, the overall variability of data from the NADP/NTN precipitation-monitoring system was estimated using data from three collocated monitoring sites. Measurement differences of constituent concentration and deposition for paired samples from the collocated samplers were evaluated to compute error terms. The medians of the absolute percentage errors (MAEs) for the paired samples generally were larger for cations (approximately 8 to 50 percent) than for anions (approximately 3 to 33 percent). MAEs were approximately 16 to 30 percent for hydrogen-ion concentration, less than 10 percent for specific conductance, less than 5 percent for sample volume, and less than 8 percent for precipitation depth. The variability attributed to each component of the sample-collection and analysis processes, as estimated by USGS quality-assurance programs, varied among analytes. Laboratory analysis variability accounted for approximately 2 percent of the

Quality Issues in Propulsion

NASA Technical Reports Server (NTRS)

McCarty, John P.; Lyles, Garry M.

1997-01-01

Propulsion system quality is defined in this paper as having high reliability, that is, quality is a high probability of within-tolerance performance or operation. Since failures are out-of-tolerance performance, the probability of failures and their occurrence is the difference between high and low quality systems. Failures can be described at 3 levels: the system failure (which is the detectable end of a failure), the failure mode (which is the failure process), and the failure cause (which is the start). Failure causes can be evaluated & classified by type. The results of typing flight history failures shows that most failures are in unrecognized modes and result from human error or noise, i.e. failures are when engineers learn how things really work. Although the study based on US launch vehicles, a sampling of failures from other countries indicates the finding has broad application. The parameters of the design of a propulsion system are not single valued, but have dispersions associated with the manufacturing of parts. Many tests are needed to find failures, if the dispersions are large relative to tolerances, which could contribute to the large number of failures in unrecognized modes.

Earnings Quality Measures and Excess Returns

PubMed Central

Perotti, Pietro; Wagenhofer, Alfred

2014-01-01

This paper examines how commonly used earnings quality measures fulfill a key objective of financial reporting, i.e., improving decision usefulness for investors. We propose a stock-price-based measure for assessing the quality of earnings quality measures. We predict that firms with higher earnings quality will be less mispriced than other firms. Mispricing is measured by the difference of the mean absolute excess returns of portfolios formed on high and low values of a measure. We examine persistence, predictability, two measures of smoothness, abnormal accruals, accruals quality, earnings response coefficient and value relevance. For a large sample of US non-financial firms over the period 1988–2007, we show that all measures except for smoothness are negatively associated with absolute excess returns, suggesting that smoothness is generally a favorable attribute of earnings. Accruals measures generate the largest spread in absolute excess returns, followed by smoothness and market-based measures. These results lend support to the widespread use of accruals measures as overall measures of earnings quality in the literature. PMID:26300582

Earnings Quality Measures and Excess Returns.

PubMed

Perotti, Pietro; Wagenhofer, Alfred

2014-06-01

This paper examines how commonly used earnings quality measures fulfill a key objective of financial reporting, i.e., improving decision usefulness for investors. We propose a stock-price-based measure for assessing the quality of earnings quality measures. We predict that firms with higher earnings quality will be less mispriced than other firms. Mispricing is measured by the difference of the mean absolute excess returns of portfolios formed on high and low values of a measure. We examine persistence, predictability, two measures of smoothness, abnormal accruals, accruals quality, earnings response coefficient and value relevance. For a large sample of US non-financial firms over the period 1988-2007, we show that all measures except for smoothness are negatively associated with absolute excess returns, suggesting that smoothness is generally a favorable attribute of earnings. Accruals measures generate the largest spread in absolute excess returns, followed by smoothness and market-based measures. These results lend support to the widespread use of accruals measures as overall measures of earnings quality in the literature.

[Analysis of the results of the HIV-1, HCV and HBV viral load of SEIMC External Quality Control Program. Year 2013].

PubMed

Orta Mira, Nieves; Del Remedio Guna Serrano, María; Latorre Martínez, José-Carlos; Medina González, Rafael; Rosario Ovies, María; Poveda, Marta; Ruiz de Gopegui, Enrique; Gimeno Cardona, Concepción

2015-07-01

Human immunodeficiency virus type 1 (HIV-1) and hepatitis B (HBV) and C virus (HCV) viral load determinations are among the most relevant markers for the follow up of patients infected with these viruses. External quality control tools are crucial to ensure the accuracy of results obtained by microbiology laboratories. This article summarized the results obtained from the 2013 SEIMC External Quality Control Programme for HIV-1, HCV, and HBV viral loads. In the HIV-1 program, a total of five standards were sent. One standard consisted in seronegative human plasma, while the remaining four contained plasma from three different viremic patients, in the range of 2-5 log10 copies/mL; two of these standards were identical aiming to determine repeatability. A significant proportion of the laboratories (25% on average) obtained values out of the accepted range (mean ± 0.25 log10 copies/mL), depending on the standard and on the method used for quantification. Repeatability was excellent, with up to 98.9% of laboratories reporting results within the limits (D < 0.5 log10 copies/mL). The HBV and HCV program consisted of two standards with different viral load contents. Most of the participants, 82% in the case of HCV and 78% in the HBV, obtained all the results within the accepted range (mean ± 1.96 SD log10 UI/mL). Data from this analysis reinforce the utility of proficiency programmes to ensure the quality of the results obtained by a particular laboratory, as well as the importance of the post-analytical phase on the overall quality. Due to the remarkable interlaboratory variability, it is advisable to use the same method and the same laboratory for patient follow up. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

The identification and measurement of quality dimensions in health care: focus group interview results.

PubMed

Jun, M; Peterson, R T; Zsidisin, G A

1998-01-01

The identification and measurement of service quality are critical factors that are responsible for customer satisfaction. This article identifies 11 attributes that define quality of care and patient satisfaction and reveals various gaps among the patient, physician, and administrator groups in the perceived importance of those dimensions. Managerial implications for patient-focused health care are discussed.

Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study

PubMed Central

Goetz, Katja; Hess, Sigrid; Jossen, Marianne; Huber, Felix; Rosemann, Thomas; Brodowski, Marc; Künzi, Beat; Szecsenyi, Joachim

2015-01-01

Objectives To examine the effectiveness of the quality management programme—European Practice Assessment—in primary care in Switzerland. Design Longitudinal study with three points of measurement. Setting Primary care practices in Switzerland. Participants In total, 45 of 91 primary care practices completed European Practice Assessment three times. Outcomes The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: ‘infrastructure’, ‘information’, ‘finance’, and ‘quality and safety’ to examine changes over time. Results Significant improvements were found in three of four domains: ‘quality and safety’ (F=22.81, p<0.01), ‘information’ (F=27.901, p<0.01) and ‘finance’ (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01). Conclusions The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care. PMID:25900466

Influences of water and sediment quality and hydrologic processes on mussels in the Clinch River

USGS Publications Warehouse

Johnson, Gregory C.; Krstolic, Jennifer L.; Ostby, Brett J.K.

2014-01-01

Segments of the Clinch River in Virginia have experienced declining freshwater mussel populations during the past 40 years, while other segments of the river continue to support some of the richest mussel communities in the country. The close proximity of these contrasting reaches provides a study area where differences in climate, hydrology, and historic mussel distribution are minimal. The USGS conducted a study between 2009 and 2011 to evaluate possible causes of the mussel declines. Evaluation of mussel habitat showed no differences in physical habitat quality, leaving water and sediment quality as possible causes for declines. Three years of continuous water-quality data showed higher turbidity and specific conductance in the reaches with low-quality mussel assemblages compared to reaches with high-quality mussel assemblages. Discrete water-quality samples showed higher major ions and metals concentrations in the low-quality reach. Base-flow samples contained high major ion and metal concentrations coincident to low-quality mussel populations. These results support a conceptual model of dilution and augmentation where increased concentrations of major ions and other dissolved constituents from mined tributaries result in reaches with declining mussel populations. Tributaries from unmined basins provide water with low concentrations of dissolved constituents, diluting reaches of the Clinch River where high-quality mussel populations occur.

Air Quality and Road Emission Results for Fort Stewart, Georgia

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

Kirkham, Randy R.; Driver, Crystal J.; Chamness, Mickie A.

2004-02-02

The Directorate of Public Works Environmental & Natural Resources Division (Fort Stewart /Hunter Army Airfield) contracted with the Pacific Northwest National Laboratory (PNNL) to monitor particulate matter (PM) concentrations on Fort Stewart, Georgia. The purpose of this investigation was to establish a PM sampling network using monitoring equipment typically used in U.S. Environmental Protection Agency (EPA) ''saturation sampling'', to determine air quality on the installation. In this initial study, the emphasis was on training-generated PM, not receptor PM loading. The majority of PM samples were 24-hr filter-based samples with sampling frequency ranging from every other day, to once every sixmore » days synchronized with the EPA 6th day national sampling schedule. Eight measurement sites were established and used to determine spatial variability in PM concentrations and evaluate whether fluctuations in PM appear to result from training activities and forest management practices on the installation. Data collected to date indicate the average installation PM2.5 concentration is lower than that of nearby urban Savannah, Georgia. At three sites near the installation perimeter, analyses to segregate PM concentrations by direction of air flow across the installation boundary indicate that air (below 80 ft) leaving the installation contains less PM2.5 than that entering the installation. This is reinforced by the observation that air near the ground is cleaner on average than the air at the top of the canopy.« less

Loneliness and sleep quality: dyadic effects and stress effects.

PubMed

Segrin, Chris; Burke, Tricia J

2015-01-01

The aims of this investigation are to determine whether loneliness is associated with a person's own sleep quality and sleep quality of their partner, and to test stress as a potential mediator. Participants were 255 couples in married (75%) or cohabiting relationships who completed self-report measures of loneliness, sleep quality, stress, and depression. Results of Actor-Partner Interdependence analyses replicated findings in the literature showing an association between loneliness and poor sleep quality. The more lonely a male participant was, the lower his partner's sleep quality. In addition, the more lonely participants were, the higher they rated their partner's sleep disturbance. There were significant indirect effects of loneliness on poor sleep quality through increased stress, even after controlling for depression.

Different roles and different results: how activity orientations correspond to relationship quality and student outcomes in school-based mentoring.

PubMed

Keller, Thomas E; Pryce, Julia M

2012-02-01

This prospective, mixed-methods study investigated how the nature of joint activities between volunteer mentors and student mentees corresponded to relationship quality and youth outcomes. Focusing on relationships in school-based mentoring programs in low-income urban elementary schools, data were obtained through pre-post assessments, naturalistic observations, and in-depth interviews with mentors and mentees. Adopting an exploratory approach, the study employed qualitative case study methods to inductively identify distinctive patterns reflecting the focus of mentoring activities. The activity orientations of relationships were categorized according to the primary functional role embodied by the mentor and the general theme of interactions: teaching assistant/tutoring, friend/engaging, sage/counseling, acquaintance/floundering. Next, these categories were corroborated by comparing the groups on quantitative assessments of relationship quality and change in child outcomes over time. Relationships characterized by sage mentoring, which balanced amicable engagement with adult guidance, were rated most favorably by mentees on multiple measures of relationship quality. Furthermore, students involved in sage mentoring relationships showed declines in depressive symptoms and aggressive behaviors. For disconnected pairs (acquaintances), students reported more negative relationship experiences. Findings suggest effective mentoring relationships represent a hybrid between the friendly mutuality of horizontal relationships and the differential influence of vertical relationships.

Quality improvement initiatives: the missed opportunity for health plans.

PubMed

Fernandez-Lopez, Sara; Lennert, Barbara

2009-11-01

The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations.

Study on an Air Quality Evaluation Model for Beijing City Under Haze-Fog Pollution Based on New Ambient Air Quality Standards

PubMed Central

Li, Li; Liu, Dong-Jun

2014-01-01

Since 2012, China has been facing haze-fog weather conditions, and haze-fog pollution and PM2.5 have become hot topics. It is very necessary to evaluate and analyze the ecological status of the air environment of China, which is of great significance for environmental protection measures. In this study the current situation of haze-fog pollution in China was analyzed first, and the new Ambient Air Quality Standards were introduced. For the issue of air quality evaluation, a comprehensive evaluation model based on an entropy weighting method and nearest neighbor method was developed. The entropy weighting method was used to determine the weights of indicators, and the nearest neighbor method was utilized to evaluate the air quality levels. Then the comprehensive evaluation model was applied into the practical evaluation problems of air quality in Beijing to analyze the haze-fog pollution. Two simulation experiments were implemented in this study. One experiment included the indicator of PM2.5 and was carried out based on the new Ambient Air Quality Standards (GB 3095-2012); the other experiment excluded PM2.5 and was carried out based on the old Ambient Air Quality Standards (GB 3095-1996). Their results were compared, and the simulation results showed that PM2.5 was an important indicator for air quality and the evaluation results of the new Air Quality Standards were more scientific than the old ones. The haze-fog pollution situation in Beijing City was also analyzed based on these results, and the corresponding management measures were suggested. PMID:25170682

Quality of Artemisinin-Containing Antimalarials in Tanzania's Private Sector—Results from a Nationally Representative Outlet Survey

PubMed Central

2015-01-01

Ensuring that artemisinin-containing antimalarials (ACAs) are of good quality is a key component of effective malaria treatment. There are concerns that a high proportion of ACAs are falsified or substandard, though estimates are rarely based on representative data. During a nationally representative survey in Tanzania, ACAs were purchased from private retail drug outlets, and the active pharmaceutical ingredient (API) was measured. All 1,737 ACAs contained the labeled artemisinin derivative, with 4.1% being outside the 85–115% artemisinin API range defined as acceptable quality. World Health Organization (WHO) prequalified drugs had 0.1 times the odds of being poor quality compared with non-prequalified ACAs for the artemisinin component. When partner components of combination therapies were also considered, 12.1% were outside the acceptable API range, and WHO prequalified ACAs had 0.04 times the odds of being poor quality. Although the prevalence of poor quality ACAs was lower than reported elsewhere, the minority of samples found to be substandard is a cause for concern. Improvements in quality could be achieved by increasing the predominance of WHO prequalified products in the market. Continued monitoring of quality standards is essential. PMID:25897065

Effects of different storage time on hatching results and some egg quality characteristics of rock partridge (A. graeca) (management and production).

PubMed

Günhan, S; Kirikçi, K

2017-06-01

In this research, partridge eggs were stored during zero to 7, 8 to 14, 15 to 21, 22 to 28, 29 to 35 and 36 to 42 d, respectively. The effect of different egg storage periods on egg protein and moisture rates, mineral contents, and some egg quality and hatching characteristics were investigated. The extension of egg storage times didn't affect the external quality features like shell weight, shell thickness, and albumen rate, but it affected the yolk weight, yolk index, albumen index, and Haugh unit (P < 0.05). Yolk weight was increased and yolk index, albumen index, and Haugh unit values were decreased with the extension of storage time. Different storage times of partridge eggs did not have important effects on the protein rates. Protein and humidity rate of the eggs were 14.21 and 67.64%, respectively. There were some elements such as S, P, Na, K, and Ca, but Al, Cd, Co, Mo, and Pb could not be found in the partridge eggs. There is no effect of the storage time on the mineral content of the egg. Storage time had negative effect on fertility and hatchability after 21 d of storage d, but no effect on hatchability of fertile eggs. As this study showed, partridge eggs are resistant to long storage times, as partridge egg proteins can resist degradation in the optimum storage times. To determine egg degradation, the study should be focused on partridge eggshell features, which are responsible for degradation. As a result of this research, partridge eggs can be stored for 21 d under optimum storage conditions without any negative hatchability results. © 2017 Poultry Science Association Inc.

Quality of life after TIA and stroke: ten-year results of the Oxford Vascular Study.

PubMed

Luengo-Fernandez, Ramon; Gray, Alastair M; Bull, Linda; Welch, Sarah; Cuthbertson, Fiona; Rothwell, Peter M

2013-10-29

To evaluate the 5-year impact of stroke and TIA on utility and quality-adjusted survival. TIA and stroke patients from a UK population-based study (Oxford Vascular Study) were recruited from 2002 to 2007, and followed up until 2012. Quality of life was assessed over 5 years using the EQ-5D (EuroQol-5 Dimensions), with responses converted into utilities ranging from -0.59 (worse than death) to 1 (perfect health), using UK population valuations. Utilities for stroke and TIA patients were compared with those in matched controls obtained from the 2006 Health Survey for England. Five-year quality-adjusted life years were estimated by combining utility and survival information. Four hundred forty TIA and 748 stroke patients were ascertained and included. Utility remained constant at approximately 0.78 over the 5 years after TIA. Utility improved from 0.64 one month after stroke to 0.70 at 6 months (p = 0.006), remaining at approximately 0.70 thereafter. Matched controls had considerably higher utility levels than stroke/TIA patients (0.85, p < 0.001). Event severity and recurrent stroke were significant predictors of decreased long-term utility. Five-year quality-adjusted life expectancy was 3.32 (95% confidence interval: 3.22-3.48) quality-adjusted life years after TIA and 2.21 (2.15-2.37) after stroke, varying considerably by severity (minor: 2.94; moderate: 1.65; and severe: 0.70). Quality-adjusted survival is low over the 5 years after stroke and TIA, with severity and recurrent stroke being major predictors. There remains considerable scope for improvements in acute treatment and secondary prevention to improve the quality of life after TIA and stroke.

3D Air Quality and the Clean Air Interstate Rule: Lagrangian Sampling of CMAQ Model Results to Aid Regional Accountability Metrics

NASA Technical Reports Server (NTRS)

Fairlie, T. D.; Szykman, Jim; Pierce, Robert B.; Gilliland, A. B.; Engel-Cox, Jill; Weber, Stephanie; Kittaka, Chieko; Al-Saadi, Jassim A.; Scheffe, Rich; Dimmick, Fred;

Comb-push ultrasound shear elastography of breast masses: initial results show promise.

PubMed

Denis, Max; Mehrmohammadi, Mohammad; Song, Pengfei; Meixner, Duane D; Fazzio, Robert T; Pruthi, Sandhya; Whaley, Dana H; Chen, Shigao; Fatemi, Mostafa; Alizad, Azra

2015-01-01

To evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE) for classification of breast masses. CUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF) beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results. Fifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s) in comparison to benign masses (3.65 ± 1.36 m/s). Therefore, the stiffness of the mass quantified by the Young's modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC), the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC). CUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses.

Incorporating health care quality into health antitrust law

PubMed Central

2008-01-01

Background Antitrust authorities treat price as a proxy for hospital quality since health care quality is difficult to observe. As the ability to measure quality improved, more research became necessary to investigate the relationship between hospital market power and patient outcomes. This paper examines the impact of hospital competition on the quality of care as measured by the risk-adjusted mortality rates with the hospital as the unit of analysis. The study separately examines the effect of competition on non-profit hospitals. Methods We use California Office of Statewide Health Planning and Development (OSHPD) data from 1997 through 2002. Empirical model is a cross-sectional study of 373 hospitals. Regression analysis is used to estimate the relationship between Coronary Artery Bypass Graft (CABG) risk-adjusted mortality rates and hospital competition. Results Regression results show lower risk-adjusted mortality rates in the presence of a more competitive environment. This result holds for all alternative hospital market definitions. Non-profit hospitals do not have better patient outcomes than investor-owned hospitals. However, they tend to provide better quality in less competitive environments. CABG volume did not have a significant effect on patient outcomes. Conclusion Quality should be incorporated into the antitrust analysis. When mergers lead to higher prices and lower quality, thus lower social welfare, the antitrust challenge of hospital mergers is warranted. The impact of lower hospital competition on quality of care delivered by non-profit hospitals is ambiguous. PMID:18430219

Quality Management in Education.

ERIC Educational Resources Information Center

Tribus, Myron

When transferring the methods of quality management from industry to academia, there are important differences that must be considered. This paper describes the differences between traditional management and quality management, and shows how Deming's principles of Total Quality Management (TQM) can be applied to education. Some of these principles…

Appraisal of long term groundwater quality of peninsular India using water quality index and fractal dimension

NASA Astrophysics Data System (ADS)

Rawat, Kishan Singh; Singh, Sudhir Kumar; Jacintha, T. German Amali; Nemčić-Jurec, Jasna; Tripathi, Vinod Kumar

2017-12-01

A review has been made to understand the hydrogeochemical behaviour of groundwater through statistical analysis of long term water quality data (year 2005-2013). Water Quality Index ( WQI), descriptive statistics, Hurst exponent, fractal dimension and predictability index were estimated for each water parameter. WQI results showed that majority of samples fall in moderate category during 2005-2013, but monitoring site four falls under severe category (water unfit for domestic use). Brownian time series behaviour (a true random walk nature) exists between calcium (Ca^{2+}) and electric conductivity (EC); magnesium (Mg^{2+}) with EC; sodium (Na+) with EC; sulphate (SO4^{2-}) with EC; total dissolved solids (TDS) with chloride (Cl-) during pre- (2005-2013) and post- (2006-2013) monsoon season. These parameters have a closer value of Hurst exponent ( H) with Brownian time series behaviour condition (H=0.5). The result of times series analysis of water quality data shows a persistent behaviour (a positive autocorrelation) that has played a role between Cl- and Mg^{2+}, Cl- and Ca^{2+}, TDS and Na+, TDS and SO4^{2-}, TDS and Ca^{2+} in pre- and post-monsoon time series because of the higher value of H (>1). Whereas an anti-persistent behaviour (or negative autocorrelation) was found between Cl- and EC, TDS and EC during pre- and post-monsoon due to low value of H. The work outline shows that the groundwater of few areas needs treatment before direct consumption, and it also needs to be protected from contamination.

Mediterranean climate patterns and wine quality in North and Central Italy.

PubMed

Dalu, John David; Baldi, Marina; Marta, Anna Dalla; Orlandini, Simone; Maracchi, Gianpiero; Dalu, Giovanni; Grifoni, Daniele; Mancini, Marco

2013-09-01

Results show that the year-to-year quality variation of wines produced in North and Central Italy depends on the large-scale climate variability, and that the wine quality improvement in the last four decades is partially due to an increase of temperature and to a decrease of precipitation in West and Central Mediterranean Europe (WME; CME). In addition, wine quality is positively correlated with air temperature throughout the entire active period of the grapevine, weakly negatively correlated with precipitation in spring, and well negatively correlated in summer and fall. The month-to-month composites of the NAO anomaly show that, in years of good quality wine, this anomaly is negative in late spring, oscillates around zero in summer, and is positive in early fall; while, in years of bad quality wine, it is positive in late spring and summer, and negative in early fall, i.e. its polarity has an opposite sign in spring and fall in good versus bad years. The composite seasonal maps show that good wines are produced when the spring jet stream over the Atlantic diverts most of the weather perturbations towards North Europe, still providing a sufficient amount of rainwater to CME; when summer warming induced by southerly winds is balanced by the cooling induced by westerly winds; and when a positive geopotential anomaly over WME shelters CME from fall Atlantic storms. Bad quality wines are produced when the jet stream favors the intrusion of the Atlantic weather perturbations into the Mediterranean. Results suggest that atmospheric pattern persistencies can be used as precursors for wine quality forecast.

Adherence to outpatient epilepsy quality indicators at a tertiary epilepsy center.

PubMed

Pourdeyhimi, R; Wolf, B J; Simpson, A N; Martz, G U

2014-10-01

Quality indicators for the treatment of people with epilepsy were published in 2010. This is the first report of adherence to all measures in routine care of people with epilepsy at a level 4 comprehensive epilepsy center in the US. Two hundred patients with epilepsy were randomly selected from the clinics of our comprehensive epilepsy center, and all visits during 2011 were abstracted for documentation of adherence to the eight quality indicators. Alternative measures were constructed to evaluate failure of adherence. Detailed descriptions of all equations are provided. Objective measures (EEG, imaging) showed higher adherence than counseling measures (safety). Initial visits showed higher adherence. Variations in the interpretation of the quality measure result in different adherence values. Advanced practice providers and physicians had different adherence patterns. No patient-specific patterns of adherence were seen. This is the first report of adherence to all the epilepsy quality indicators for a sample of patients during routine care in a level 4 epilepsy center in the US. Overall adherence was similar to that previously reported on similar measures. Precise definitions of adherence equations are essential for accurate measurement. Complex measures result in lower adherence. Counseling measures showed low adherence, possibly highlighting a difference between practice and documentation. Adherence to the measures as written does not guarantee high quality care. The current quality indicators have value in the process of improving quality of care. Future approaches may be refined to eliminate complex measures and incorporate features linked to outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

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.

Characterizations of a Quality Certified Athletic Trainer

PubMed Central

Raab, Scot; Wolfe, Brent D.; Gould, Trenton E.; Piland, Scott G.

2011-01-01

Context: Didactic proficiency does not ensure clinical aptitude. Quality athletic health care requires clinical knowledge and affective traits. Objective: To develop a grounded theory explaining the constructs of a quality certified athletic trainer (AT). Design: Delphi study. Setting: Interviews in conference rooms or business offices and by telephone. Patients or Other Participants: Thirteen ATs (men = 8, women = 5) stratified across the largest employment settings (high school, college, clinical) in the 4 largest districts of the National Athletic Trainers' Association (2, 3, 4, 9). Data Collection and Analysis: Open-ended interview questions were audio recorded, transcribed, and reviewed before condensing. Two member checks ensured trustworthiness. Open coding reduced text to descriptive adjectives. Results: We grouped adjectives into 5 constructs (care, communication, commitment, integrity, knowledge) and grouped these constructs into 2 higher-order constructs (affective traits, effective traits). Conclusions: According to participants, ATs who demonstrate the ability to care, show commitment and integrity, value professional knowledge, and communicate effectively with others can be identified as quality ATs. These abilities facilitate the creation of positive relationships. These relationships allow the quality AT to interact with patients and other health care professionals on a knowledgeable basis that ultimately improves health care delivery. Our resulting theory supported the examination of characteristics not traditionally assessed in an athletic training education program. If researchers can show that these characteristics develop ATs into quality ATs (eg, those who work better with others, relate meaningfully with patients, and improve the standard of health care), they must be cultivated in the educational setting. PMID:22488194

Numerical simulation of deformation and figure quality of precise mirror

NASA Astrophysics Data System (ADS)

Vit, Tomáš; Melich, Radek; Sandri, Paolo

2015-01-01

The presented paper shows results and a comparison of FEM numerical simulations and optical tests of the assembly of a precise Zerodur mirror with a mounting structure for space applications. It also shows how the curing of adhesive film can impact the optical surface, especially as regards deformations. Finally, the paper shows the results of the figure quality analysis, which are based on data from FEM simulation of optical surface deformations.

Quality of care of patients with type 1 diabetes: population-based results in a French region.

PubMed

Penfornis, A; Personeni, E; Tiv, M; Monnier, C; Meillet, L; Combes, J; Mouret, C; Picard, S

2012-11-01

Although the incidence of type 1 diabetes (T1D) has been increasing, little is known of its quality of care. Thus, our survey was designed to retrospectively evaluate this issue in French patients. Patients with T1D living in northeastern France were identified thanks to the healthcare system (CPAM) database, and the resulting list reviewed by local diabetes specialists. All of the listed patients and their primary physicians were asked to fill in a questionnaire including clinical data, laboratory results and follow-up habits. The 'optimized results' included CPAM-based results plus any specialized care provided during hospitalizations in diabetes and non-diabetes units, according to questionnaire data. A total of 227 individuals, for whom CPAM data were available, were identified as having T1D. From these patients, 174 questionnaires were answered, and optimized results (having both CPAM data and a completely filled-in questionnaire) were available for 149 patients. Of the 169 patients who responded, 71.3% reported at least a yearly visit with a diabetologist. This number reached 77.9% when optimized results were considered. Patients who received specialized care were younger, underwent HbA(1c) tests more often and were more frequently on optimal treatment; however, there was no difference in HbA(1c) values or in the prevalence of complications. Eye examinations and kidney tests had been performed at least once over the 2-year period in more than 87% of the patients, whereas around 30%, 21% and 23% had an eye exam, creatinine test and urinary albumin excretion measurement, respectively, only once over the same time period. This is the first large-scale study of the quality of care in patients with T1DM in France, and it could serve as a preliminary survey for a national study. Although the follow-up was better than previously reported, there is still considerable room for improvement. Copyright © 2012. Published by Elsevier Masson SAS.

Survey of the prevalence and methodology of quality assurance for B-mode ultrasound image quality among veterinary sonographers.

PubMed

Hoscheit, Larry P; Heng, Hock Gan; Lim, Chee Kin; Weng, Hsin-Yi

2018-05-01

Image quality in B-mode ultrasound is important as it reflects the diagnostic accuracy and diagnostic information provided during clinical scanning. Quality assurance programs for B-mode ultrasound systems/components are comprised of initial quality acceptance testing and subsequent regularly scheduled quality control testing. The importance of quality assurance programs for B-mode ultrasound image quality using ultrasound phantoms is well documented in the human medical and medical physics literature. The purpose of this prospective, cross-sectional, survey study was to determine the prevalence and methodology of quality acceptance testing and quality control testing of image quality for ultrasound system/components among veterinary sonographers. An online electronic survey was sent to 1497 members of veterinary imaging organizations: the American College of Veterinary Radiology, the Veterinary Ultrasound Society, and the European Association of Veterinary Diagnostic Imaging, and a total of 167 responses were received. The results showed that the percentages of veterinary sonographers performing quality acceptance testing and quality control testing are 42% (64/151; 95% confidence interval 34-52%) and 26% (40/156: 95% confidence interval 19-33%) respectively. Of the respondents who claimed to have quality acceptance testing or quality control testing of image quality in place for their ultrasound system/components, 0% have performed quality acceptance testing or quality control testing correctly (quality acceptance testing 95% confidence interval: 0-6%, quality control testing 95% confidence interval: 0-11%). Further education and guidelines are recommended for veterinary sonographers in the area of quality acceptance testing and quality control testing for B-mode ultrasound equipment/components. © 2018 American College of Veterinary Radiology.

A new air quality monitoring and early warning system: Air quality assessment and air pollutant concentration prediction.

PubMed

Yang, Zhongshan; Wang, Jian

2017-10-01

Air pollution in many countries is worsening with industrialization and urbanization, resulting in climate change and affecting people's health, thus, making the work of policymakers more difficult. It is therefore both urgent and necessary to establish amore scientific air quality monitoring and early warning system to evaluate the degree of air pollution objectively, and predict pollutant concentrations accurately. However, the integration of air quality assessment and air pollutant concentration prediction to establish an air quality system is not common. In this paper, we propose a new air quality monitoring and early warning system, including an assessment module and forecasting module. In the air quality assessment module, fuzzy comprehensive evaluation is used to determine the main pollutants and evaluate the degree of air pollution more scientifically. In the air pollutant concentration prediction module, a novel hybridization model combining complementary ensemble empirical mode decomposition, a modified cuckoo search and differential evolution algorithm, and an Elman neural network, is proposed to improve the forecasting accuracy of six main air pollutant concentrations. To verify the effectiveness of this system, pollutant data for two cities in China are used. The result of the fuzzy comprehensive evaluation shows that the major air pollutants in Xi'an and Jinan are PM 10 and PM 2.5 respectively, and that the air quality of Xi'an is better than that of Jinan. The forecasting results indicate that the proposed hybrid model is remarkably superior to all benchmark models on account of its higher prediction accuracy and stability. Copyright © 2017 Elsevier Inc. All rights reserved.

Sources of traffic and visitors' preferences regarding online public reports of quality: web analytics and online survey results.

PubMed

Bardach, Naomi S; Hibbard, Judith H; Greaves, Felix; Dudley, R Adams

2015-05-01

In the context of the Affordable Care Act, there is extensive emphasis on making provider quality transparent and publicly available. Online public reports of quality exist, but little is known about how visitors find reports or about their purpose in visiting. To address this gap, we gathered website analytics data from a national group of online public reports of hospital or physician quality and surveyed real-time visitors to those websites. Websites were recruited from a national group of online public reports of hospital or physician quality. Analytics data were gathered from each website: number of unique visitors, method of arrival for each unique visitor, and search terms resulting in visits. Depending on the website, a survey invitation was launched for unique visitors on landing pages or on pages with quality information. Survey topics included type of respondent (eg, consumer, health care professional), purpose of visit, areas of interest, website experience, and demographics. There were 116,657 unique visitors to the 18 participating websites (1440 unique visitors/month per website), with most unique visitors arriving through search (63.95%, 74,606/116,657). Websites with a higher percent of traffic from search engines garnered more unique visitors (P=.001). The most common search terms were for individual hospitals (23.25%, 27,122/74,606) and website names (19.43%, 22,672/74,606); medical condition terms were uncommon (0.81%, 605/74,606). Survey view rate was 42.48% (49,560/116,657 invited) resulting in 1755 respondents (participation rate=3.6%). There were substantial proportions of consumer (48.43%, 850/1755) and health care professional respondents (31.39%, 551/1755). Across websites, proportions of consumer (21%-71%) and health care professional respondents (16%-48%) varied. Consumers were frequently interested in using the information to choose providers or assess the quality of their provider (52.7%, 225/427); the majority of those choosing a

Quality of Artemisinin-Containing Antimalarials in Tanzania's Private Sector--Results from a Nationally Representative Outlet Survey.

PubMed

Act Consortium Drug Quality Project Team And The Impact Study Team

2015-06-01

Ensuring that artemisinin-containing antimalarials (ACAs) are of good quality is a key component of effective malaria treatment. There are concerns that a high proportion of ACAs are falsified or substandard, though estimates are rarely based on representative data. During a nationally representative survey in Tanzania, ACAs were purchased from private retail drug outlets, and the active pharmaceutical ingredient (API) was measured. All 1,737 ACAs contained the labeled artemisinin derivative, with 4.1% being outside the 85-115% artemisinin API range defined as acceptable quality. World Health Organization (WHO) prequalified drugs had 0.1 times the odds of being poor quality compared with non-prequalified ACAs for the artemisinin component. When partner components of combination therapies were also considered, 12.1% were outside the acceptable API range, and WHO prequalified ACAs had 0.04 times the odds of being poor quality. Although the prevalence of poor quality ACAs was lower than reported elsewhere, the minority of samples found to be substandard is a cause for concern. Improvements in quality could be achieved by increasing the predominance of WHO prequalified products in the market. Continued monitoring of quality standards is essential. © The American Society of Tropical Medicine and Hygiene.

Process perspective on image quality evaluation

NASA Astrophysics Data System (ADS)

Leisti, Tuomas; Halonen, Raisa; Kokkonen, Anna; Weckman, Hanna; Mettänen, Marja; Lensu, Lasse; Ritala, Risto; Oittinen, Pirkko; Nyman, Göte

2008-01-01

The psychological complexity of multivariate image quality evaluation makes it difficult to develop general image quality metrics. Quality evaluation includes several mental processes and ignoring these processes and the use of a few test images can lead to biased results. By using a qualitative/quantitative (Interpretation Based Quality, IBQ) methodology, we examined the process of pair-wise comparison in a setting, where the quality of the images printed by laser printer on different paper grades was evaluated. Test image consisted of a picture of a table covered with several objects. Three other images were also used, photographs of a woman, cityscape and countryside. In addition to the pair-wise comparisons, observers (N=10) were interviewed about the subjective quality attributes they used in making their quality decisions. An examination of the individual pair-wise comparisons revealed serious inconsistencies in observers' evaluations on the test image content, but not on other contexts. The qualitative analysis showed that this inconsistency was due to the observers' focus of attention. The lack of easily recognizable context in the test image may have contributed to this inconsistency. To obtain reliable knowledge of the effect of image context or attention on subjective image quality, a qualitative methodology is needed.

Quality control of fireproof coatings for reinforced concrete structures

NASA Astrophysics Data System (ADS)

Gravit, Marina; Dmitriev, Ivan; Ishkov, Alexander

2017-10-01

The article analyzes methods of quality inspection of fireproof coatings (work flow, measuring, laboratory, etc.). In modern construction there is a problem of lack of distinct monitoring for the fire protection testing. There is a description of this testing for reinforced concrete structures. The article shows the results of calculation quality control of hatches as an example of fireproof coating for reinforced concrete structures.

Groundwater quality assessment and pollution source apportionment in an intensely exploited region of northern China.

PubMed

Zhang, Qianqian; Wang, Huiwei; Wang, Yanchao; Yang, Mingnan; Zhu, Liang

2017-07-01

Deterioration in groundwater quality has attracted wide social interest in China. In this study, groundwater quality was monitored during December 2014 at 115 sites in the Hutuo River alluvial-pluvial fan region of northern China. Results showed that 21.7% of NO 3 - and 51.3% of total hardness samples exceeded grade III of the national quality standards for Chinese groundwater. In addition, results of gray relationship analysis (GRA) show that 64.3, 10.4, 21.7, and 3.6% of samples were within the I, II, IV, and V grades of groundwater in the Hutuo River region, respectively. The poor water quality in the study region is due to intense anthropogenic activities as well as aquifer vulnerability to contamination. Results of principal component analysis (PCA) revealed three major factors: (1) domestic wastewater and agricultural runoff pollution (anthropogenic activities), (2) water-rock interactions (natural processes), and (3) industrial wastewater pollution (anthropogenic activities). Using PCA and absolute principal component scores-multivariate linear regression (APCS-MLR), results show that domestic wastewater and agricultural runoff are the main sources of groundwater pollution in the Hutuo River alluvial-pluvial fan area. Thus, the most appropriate methods to prevent groundwater quality degradation are to improve capacities for wastewater treatment and to optimize fertilization strategies.

Low-cost oblique illumination: an image quality assessment.

PubMed

Ruiz-Santaquiteria, Jesus; Espinosa-Aranda, Jose Luis; Deniz, Oscar; Sanchez, Carlos; Borrego-Ramos, Maria; Blanco, Saul; Cristobal, Gabriel; Bueno, Gloria

2018-01-01

We study the effectiveness of several low-cost oblique illumination filters to improve overall image quality, in comparison with standard bright field imaging. For this purpose, a dataset composed of 3360 diatom images belonging to 21 taxa was acquired. Subjective and objective image quality assessments were done. The subjective evaluation was performed by a group of diatom experts by psychophysical test where resolution, focus, and contrast were assessed. Moreover, some objective nonreference image quality metrics were applied to the same image dataset to complete the study, together with the calculation of several texture features to analyze the effect of these filters in terms of textural properties. Both image quality evaluation methods, subjective and objective, showed better results for images acquired using these illumination filters in comparison with the no filtered image. These promising results confirm that this kind of illumination filters can be a practical way to improve the image quality, thanks to the simple and low cost of the design and manufacturing process. (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

Organizational Attributes Associated With Medicare ACO Quality Performance.

PubMed

Zhu, Xi; Mueller, Keith; Huang, Huang; Ullrich, Fred; Vaughn, Thomas; MacKinney, A Clinton

2018-05-08

To evaluate associations between geographic, structural, and service-provision attributes of Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) and the ACOs' quality performance. We conducted cross-sectional and longitudinal analyses of ACO quality performance using data from the Centers for Medicare and Medicaid Services and additional sources. The sample included 322 and 385 MSSP ACOs that had successfully reported quality measures in 2014 and 2015, respectively. Results show that after adjusting for other organizational factors, rural ACOs' average quality score was comparable to that of ACOs serving other geographic categories. ACOs with hospital-system sponsorship, larger beneficiary panels, and higher posthospitalization follow-up rates achieved better quality performance. There is no significant difference in average quality performance between rural ACOs and other ACOs after adjusting for structural and service-provision factors. MSSP ACO quality performance is positively associated with hospital-system sponsorship, beneficiary panel size, and posthospitalization follow-up rate. © 2018 National Rural Health Association.

Putting people into water quality modelling.

NASA Astrophysics Data System (ADS)

Strickert, G. E.; Hassanzadeh, E.; Noble, B.; Baulch, H. M.; Morales-Marin, L. A.; Lindenschmidt, K. E.

2017-12-01

Water quality in the Qu'Appelle River Basin, Saskatchewan is under pressure due to nutrient pollution entering the river system from major cities, industrial zones and agricultural areas. Among these stressors, agricultural activities are basin-wide; therefore, they are the largest non-point source of water pollution in this region. The dynamics of agricultural impacts on water quality are complex and stem from decisions and activities of two distinct stakeholder groups, namely grain farmers and cattle producers, which have different business plans, values, and attitudes towards water quality. As a result, improving water quality in this basin requires engaging with stakeholders to: (1) understand their perspectives regarding a range of agricultural Beneficial Management Practices (BMPs) that can improve water quality in the region, (2) show them the potential consequences of their selected BMPs, and (3) work with stakeholders to better understand the barriers and incentives to implement the effective BMPs. In this line, we held a series of workshops in the Qu'Appelle River Basin with both groups of stakeholders to understand stakeholders' viewpoints about alternative agricultural BMPs and their impact on water quality. Workshop participants were involved in the statement sorting activity (Q-sorts), group discussions, as well as mapping activity. The workshop outcomes show that stakeholder had four distinct viewpoints about the BMPs that can improve water quality, i.e., flow and erosion control, fertilizer management, cattle site management, as well as mixed cattle and wetland management. Accordingly, to simulate the consequences of stakeholder selected BMPs, a conceptual water quality model was developed using System Dynamics (SD). The model estimates potential changes in water quality at the farm, tributary and regional scale in the Qu'Appelle River Basin under each and/or combination of stakeholder selected BMPs. The SD model was then used for real

Study of the Relevance of the Quality of Care, Operating Efficiency and Inefficient Quality Competition of Senior Care Facilities.

PubMed

Lin, Jwu-Rong; Chen, Ching-Yu; Peng, Tso-Kwei

2017-09-11

The purpose of this research is to examine the relation between operating efficiency and the quality of care of senior care facilities. We designed a data envelopment analysis, combining epsilon-based measure and metafrontier efficiency analyses to estimate the operating efficiency for senior care facilities, followed by an iterative seemingly unrelated regression to evaluate the relation between the quality of care and operating efficiency. In the empirical studies, Taiwan census data was utilized and findings include the following: Despite the greater operating scale of the general type of senior care facilities, their average metafrontier technical efficiency is inferior to that of nursing homes. We adopted senior care facility accreditation results from Taiwan as a variable to represent the quality of care and examined the relation of accreditation results and operating efficiency. We found that the quality of care of general senior care facilities is negatively related to operating efficiency; however, for nursing homes, the relationship is not significant. Our findings show that facilities invest more in input resources to obtain better ratings in the accreditation report. Operating efficiency, however, does not improve. Quality competition in the industry in Taiwan is inefficient, especially for general senior care facilities.

Study of the Relevance of the Quality of Care, Operating Efficiency and Inefficient Quality Competition of Senior Care Facilities

PubMed Central

Lin, Jwu-Rong; Chen, Ching-Yu; Peng, Tso-Kwei

2017-01-01

The purpose of this research is to examine the relation between operating efficiency and the quality of care of senior care facilities. We designed a data envelopment analysis, combining epsilon-based measure and metafrontier efficiency analyses to estimate the operating efficiency for senior care facilities, followed by an iterative seemingly unrelated regression to evaluate the relation between the quality of care and operating efficiency. In the empirical studies, Taiwan census data was utilized and findings include the following: Despite the greater operating scale of the general type of senior care facilities, their average metafrontier technical efficiency is inferior to that of nursing homes. We adopted senior care facility accreditation results from Taiwan as a variable to represent the quality of care and examined the relation of accreditation results and operating efficiency. We found that the quality of care of general senior care facilities is negatively related to operating efficiency; however, for nursing homes, the relationship is not significant. Our findings show that facilities invest more in input resources to obtain better ratings in the accreditation report. Operating efficiency, however, does not improve. Quality competition in the industry in Taiwan is inefficient, especially for general senior care facilities. PMID:28892019

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

PubMed Central

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

2016-01-01

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

FIRST RESULTS FROM OPERATIONAL TESTING OF THE U.S. EPA MODELS-3 COMMUNITY MULTISCALE MODEL FOR AIR QUALITY (CMAQ)

EPA Science Inventory

The Models 3 / Community Multiscale Model for Air Quality (CMAQ) has been designed for one-atmosphere assessments for multiple pollutants including ozone (O3), particulate matter (PM10, PM2.5), and acid / nutrient deposition. In this paper we report initial results of our evalu...

Cultural values and health service quality in China.

PubMed

Polsa, Pia; Fuxiang, Wei; Sääksjärvi, Maria; Shuyuan, Pei

2013-01-01

Several service quality studies show how cultural features may influence the way service quality is perceived. However, few studies specifically describe culture's influence on health service quality. Also, there are few studies that take into account patients' health service quality perceptions. This article seeks to present a first step to fill these gaps by examining patients' cultural values and their health service quality assessments. The study draws on published work and applies its ideas to Chinese healthcare settings. Data consist of hospital service perceptions in the People's Republic of China (PRC), a society that is socially, economically and culturally undergoing major changes. In total, 96 patients were surveyed. Data relationships were tested using partial least square (PLS) analysis. Findings show that Chinese patients' cultural values and their health service assessments are related and that the cultural values themselves seem to be changing. Additionally, further analyses provided interesting results pointing to which cultural values influenced service quality perceptions. The strongest service quality predictor was power distance. The sample is relatively small and collected from only one major hospital in China. Therefore, future research should extend the sample size and scope. Follow-up research could also include cross-cultural investigations of perceived health service quality to substantiate cultural influences on health service quality perceptions. In line with similar research in other contexts, the study confirms that power distance has a significant relationship with service quality perceptions. The study contributes to existing health service literature by offering patients' views on health service quality and by describing relationships between health service perceptions and cultural values--the study's main contribution.

Selected water-quality characteristics in the upper Mississippi River basin, Royalton to Hastings, Minnesota

USGS Publications Warehouse

Have, M.R.

1991-01-01

Results of this study show that the quality of water in the Mississippi River as it leaves the accounting unit at Hastings is not representative of water quality in most of the accounting unit. Three water-quality regions have been identified, and sampling sites are needed in each region to assess the quality of streams throughout the study area adequately.

Impact of quality circles for improvement of asthma care: results of a randomized controlled trial

PubMed Central

Schneider, Antonius; Wensing, Michel; Biessecker, Kathrin; Quinzler, Renate; Kaufmann-Kolle, Petra; Szecsenyi, Joachim

2008-01-01

Rationale and aims Quality circles (QCs) are well established as a means of aiding doctors. New quality improvement strategies include benchmarking activities. The aim of this paper was to evaluate the efficacy of QCs for asthma care working either with general feedback or with an open benchmark. Methods Twelve QCs, involving 96 general practitioners, were organized in a randomized controlled trial. Six worked with traditional anonymous feedback and six with an open benchmark; both had guided discussion from a trained moderator. Forty-three primary care practices agreed to give out questionnaires to patients to evaluate the efficacy of QCs. Results A total of 256 patients participated in the survey, of whom 185 (72.3%) responded to the follow-up 1 year later. Use of inhaled steroids at baseline was high (69%) and self-management low (asthma education 27%, individual emergency plan 8%, and peak flow meter at home 21%). Guideline adherence in drug treatment increased (P = 0.19), and asthma steps improved (P = 0.02). Delivery of individual emergency plans increased (P = 0.008), and unscheduled emergency visits decreased (P = 0.064). There was no change in asthma education and peak flow meter usage. High medication guideline adherence was associated with reduced emergency visits (OR 0.24; 95% CI 0.07–0.89). Use of theophylline was associated with hospitalization (OR 7.1; 95% CI 1.5–34.3) and emergency visits (OR 4.9; 95% CI 1.6–14.7). There was no difference between traditional and benchmarking QCs. Conclusions Quality circles working with individualized feedback are effective at improving asthma care. The trial may have been underpowered to detect specific benchmarking effects. Further research is necessary to evaluate strategies for improving the self-management of asthma patients. PMID:18093108

Quality of life following hip fractures: results from the Norwegian hip fracture register.

PubMed

Gjertsen, Jan-Erik; Baste, Valborg; Fevang, Jonas M; Furnes, Ove; Engesæter, Lars Birger

2016-07-07

Patient-reported health-related quality of life is an important outcome measure when assessing the quality of hip fracture surgery. The frequently used EQ-5D index score has unfortunately important limitations. One alternative can be to assess the distribution of each of the five dimensions of the patients' descriptive health profile. The objective of this paper was to investigate health-related quality of life (HRQoL) after hip fractures. Data from hip fracture operations from 2005 through 2012 were obtained from The Norwegian Hip Fracture Register. Patient reported HRQoL, (EQ-5D-3L) was collected from patients preoperatively and at four and twelve months postoperatively n = 10325. At each follow-up the distribution of the EQ-5D-3L and mean pain VAS was calculated. Generally, a higher proportion of patients reported problems in all 5 dimensions of the EQ-5D-3L at all follow-ups compared to preoperative. Also a high proportion of patients with no preoperative problems reported problems after surgery; At 4 and 12 months follow-ups 71 % and 58 % of the patients reported walking problems, and 65 % and 59 % of the patients reported pain respectively. Patients with femoral neck fractures and the youngest patients (age < 70 years) reported least problems both preoperatively and at all follow-ups. A hip fracture has a dramatic impact on the patients' HRQoL, and the deterioration in HRQoL sustained also one year after the fracture. Separate use of the descriptive profile of the EQ-5D is informative when assessing quality of life after hip fracture surgery.

[The patient with OSA underwent NIV: measurement of quality of life].

PubMed

Cavaleiro Saraiva, Paula Cristina Dias Rocha

2013-01-01

Noninvasive ventilation (NIV) is a therapeutic option which is in increasingly use. Its importance is recognized in the treatment of both acute respiratory pathology and chronic respiratory pathology, taking on a vital importance in the context of the evolution of respiratory pathologies, giving the patient a better quality of life. The term quality of life has become increasingly important in the scientific context, expressing the level of limitation and discomfort caused by a particular disease. Allied to this, specific instruments for assessing the quality of life of people with respiratory diseases have emerged, and its use is increasing all over the world. This study aimed at assessing the quality of life of patients on NIV. The empirical research was based on a transversal study, adopting a correlational orientation and on a quantitative approach through the application of the specific SGRQ questionnaire to each participant. The study included 30 people with OSA, which perform NIV. The results were processed in SPSS (version 19). The results from the SGRQ questionnaire showed a compromised quality of life in all its domains (symptoms, activities, impact), and the most affected area for this sample was "Activity", in which 24 people show disturbances in their quality of life.

Implementation and results of an integrated data quality assurance protocol in a randomized controlled trial in Uttar Pradesh, India.

PubMed

Gass, Jonathon D; Misra, Anamika; Yadav, Mahendra Nath Singh; Sana, Fatima; Singh, Chetna; Mankar, Anup; Neal, Brandon J; Fisher-Bowman, Jennifer; Maisonneuve, Jenny; Delaney, Megan Marx; Kumar, Krishan; Singh, Vinay Pratap; Sharma, Narender; Gawande, Atul; Semrau, Katherine; Hirschhorn, Lisa R

2017-09-07

There are few published standards or methodological guidelines for integrating Data Quality Assurance (DQA) protocols into large-scale health systems research trials, especially in resource-limited settings. The BetterBirth Trial is a matched-pair, cluster-randomized controlled trial (RCT) of the BetterBirth Program, which seeks to improve quality of facility-based deliveries and reduce 7-day maternal and neonatal mortality and maternal morbidity in Uttar Pradesh, India. In the trial, over 6300 deliveries were observed and over 153,000 mother-baby pairs across 120 study sites were followed to assess health outcomes. We designed and implemented a robust and integrated DQA system to sustain high-quality data throughout the trial. We designed the Data Quality Monitoring and Improvement System (DQMIS) to reinforce six dimensions of data quality: accuracy, reliability, timeliness, completeness, precision, and integrity. The DQMIS was comprised of five functional components: 1) a monitoring and evaluation team to support the system; 2) a DQA protocol, including data collection audits and targets, rapid data feedback, and supportive supervision; 3) training; 4) standard operating procedures for data collection; and 5) an electronic data collection and reporting system. Routine audits by supervisors included double data entry, simultaneous delivery observations, and review of recorded calls to patients. Data feedback reports identified errors automatically, facilitating supportive supervision through a continuous quality improvement model. The five functional components of the DQMIS successfully reinforced data reliability, timeliness, completeness, precision, and integrity. The DQMIS also resulted in 98.33% accuracy across all data collection activities in the trial. All data collection activities demonstrated improvement in accuracy throughout implementation. Data collectors demonstrated a statistically significant (p = 0.0004) increase in accuracy throughout

Water quality assessment with hierarchical cluster analysis based on Mahalanobis distance.

PubMed

Du, Xiangjun; Shao, Fengjing; Wu, Shunyao; Zhang, Hanlin; Xu, Si

2017-07-01

Water quality assessment is crucial for assessment of marine eutrophication, prediction of harmful algal blooms, and environment protection. Previous studies have developed many numeric modeling methods and data driven approaches for water quality assessment. The cluster analysis, an approach widely used for grouping data, has also been employed. However, there are complex correlations between water quality variables, which play important roles in water quality assessment but have always been overlooked. In this paper, we analyze correlations between water quality variables and propose an alternative method for water quality assessment with hierarchical cluster analysis based on Mahalanobis distance. Further, we cluster water quality data collected form coastal water of Bohai Sea and North Yellow Sea of China, and apply clustering results to evaluate its water quality. To evaluate the validity, we also cluster the water quality data with cluster analysis based on Euclidean distance, which are widely adopted by previous studies. The results show that our method is more suitable for water quality assessment with many correlated water quality variables. To our knowledge, it is the first attempt to apply Mahalanobis distance for coastal water quality assessment.

Quality assurance in transition.

PubMed

Blumenfeld, S N

1993-06-01

This paper outlines the early approaches to quality assurance, and its transition from business to health care. It then describes the development of the more recent trends in quality assurance of Total Quality Management and Continuous Quality Improvement and discusses the strengths and weaknesses of these approaches. The paper then goes on to show how these approaches have been modified for application to peripheral health services in developing countries through the work of the Primary Health Care Operations Research Project and the Quality Assurance Project.

PROTECTING HEALTH WITH SAME DAY WATER QUALITY MONITORING RESULTS FOR BATHING BEACHES

EPA Science Inventory

Current US Environmental Protection Agency guidelines recommend the use of cultural methods for E. coli and enterococci to monitor beach water quality. The guidelines recommend a single sample value or a geometric mean value from at least five samples. The single sample guideli...

Can physiotherapy after stroke based on the Bobath concept result in improved quality of movement compared to the motor relearning programme.

PubMed

Langhammer, Birgitta; Stanghelle, Johan K

2011-06-01

The primary aim of the present study was to investigate, based on data from our study in 2000, whether the Bobath approach enhanced quality of movement better than the Motor Relearning Programme (MRP) during rehabilitation of stroke patients. A randomized controlled stratified trial of acute stroke patients. The patients were treated according to Motor Relearning Programme and Bobath approach and assessed with Motor Assessment Scale, Sødring Motor Evaluation Scale, Nottingham Health Profile and the Barthel Index. A triangulation of the test scores was made in reference to the Movement Quality Model and biomechanical, physiological, psycho-socio-cultural, and existential themes. The items arm (p = 0.02-0.04) sitting (p = 0.04) and hand (p = 0.01-0.03) were significantly better in the Motor Relearning Programme group than in the Bobath group, in both Sødring Motor Evaluation Scale and Motor Assessment Scale. Leg function, balance, transfer, walking and stair climbing did not differ between the groups. The Movement Quality Model and the movement qualities biomechanical, physiological and psycho-socio-cultural showed higher scoring in the Motor Relearning Programme group, indicating better quality of movement in all items. Regression models established the relationship with significant models of motor performance and self reported physical mobility (adjusted R(2) 0.30-0.68, p < 0.0001), energy (adjusted R(2) 0.13-0.14, p = 0.03-0.04, emotion (adjusted R(2) 0.30-0.38, p < 0.0001) and social interaction (arm function, adjusted R(2) 0.25, p = 0.0001). These analyses confirm that task oriented exercises of the Motor Relearning Programme type are preferable regarding quality of movement in the acute rehabilitation of patients with stroke. Copyright © 2010 John Wiley & Sons, Ltd.

Quality of life and anxiety disorders: a population study.

PubMed

Cramer, Victoria; Torgersen, Svenn; Kringlen, Einar

2005-03-01

The study of quality of life has increased in importance in the area of mental disorders during the last decade. The aim of the present study was to investigate the effect of specific anxiety disorders on specific quality of life indicators in the common population. More than 2000 individuals between 18 and 65 years old were studied by means of structured interviews. The results showed that social phobia and panic disorder within the past year and lifetime, and generalized anxiety disorder within the past year, had an independent effect on quality of life when controlling for a number of sociodemographic variables, somatic health, and other DSM-III-R Axis I mental disorders. Specific phobias and obsessive compulsive disorder had only a small effect, and agoraphobia showed no effect. The effect was strongest for self-realization and contact with friends, but anxiety disorders also influenced subjective well-being, social support, negative life events, contact with family of origin, and neighborhood quality.

Feed addition of curcumin to laying hens showed anticoccidial effect, and improved egg quality and animal health.

PubMed

Galli, Gabriela M; Da Silva, Aleksandro S; Biazus, Angelisa H; Reis, João H; Boiago, Marcel M; Topazio, Josué P; Migliorini, Marcos J; Guarda, Naiara S; Moresco, Rafael N; Ourique, Aline F; Santos, Cayane G; Lopes, Leandro S; Baldissera, Matheus D; Stefani, Lenita M

2018-06-01

The aim of this study was to evaluate whether the addition of curcumin in the diet of commercial laying hens could have an anticoccidial action and improve egg quality. For this, 60 laying hens were divided into three groups: T0 (the control group); T30 and T50 (30 and 50 mg/kg of curcumin in the feed, respectively). Eggs recently laid were collected on days 14 and 21 of the experiment, and stored for 21 days. It was observed increased specific gravity and yolk index in stored eggs of the groups T30 and T50 compared to T0. The yolk color reduced in the eggs stored from groups T30 and T50 compared to T0. Moreover, TBARS levels were lower in fresh and stored eggs from groups T30 and T50. It was observed increased TAC levels in fresh eggs from groups T30 and T50 and in stored eggs from the group T50. The presence of curcumin was not detected by HPLC in the yolk and albumen. Seric levels of albumin and uric acid did not differ between groups, while seric levels of total proteins increased on day 21 on groups T30 and T50. Finally, it was observed a significant reduction on the number of oocysts in fecal samples on days 14 and 21 of T30 and T50 compared to T0. Based on these evidences, it is possible to conclude that the addition of curcumin in the diet of laying hens has an anticoccidial effect and improves egg quality. Copyright © 2018 Elsevier Ltd. All rights reserved.

Landowner values, water quality, and recreation in the Lake Champlain Basin

Treesearch

Walter F. Kuentzel; Donald F. Dennis

1998-01-01

This study describes landowner values about water quality among resident landowners in the LaPlatte River watershed, tests whether suburbanization is producing a new mix of social values, analyzes the relationship between values and behaviors, and explores the link between recreation and water quality advocacy. Results showed that residents hold pro-environmental...

Quality of in-hospital stroke care according to evidence-based performance measures: results from the first audit of stroke, Catalonia, Spain.

PubMed

Abilleira, Sònia; Gallofré, Miquel; Ribera, Aida; Sánchez, Emília; Tresserras, Ricard

2009-04-01

Evidence-based standards are used worldwide to determine quality of care. We assessed quality of in-hospital stroke care in all acute-care hospitals in Catalonia by determining adherence to 13 evidence-based performance measures (PMs) of process of care. Data on PMs were collected by retrospective review of medical records of consecutive stroke admissions (January to June, 2005). Compliance with PMs was calculated according to 3 hospital levels determined by their annual stroke case-load (level 1, <150 admissions/yr; level 2, 150 to 350; and level 3, >350). We defined sampling weights that represented each patient's inverse probability of inclusion in the study sample. Sampling weights were applied to produce estimates of compliance. Factors that predicted good/bad compliance were determined by multivariate weighted logistic regression models. An external monitoring of 10% of cases recruited at each hospital was undertaken, after random selection, to assess quality of data. We analyzed data from 1791 stroke cases (17% of all stroke admissions). Global interobserver agreement was 0.7. Eight PMs achieved compliances >or=75%, 4 of which were more than 90%, and the remaining showed adherences showed poor compliances compared to acute care-related ones, which achieved more satisfactory adherences.

Quality-of-life results for accelerated partial breast irradiation with interstitial brachytherapy versus whole-breast irradiation in early breast cancer after breast-conserving surgery (GEC-ESTRO): 5-year results of a randomised, phase 3 trial.

PubMed

Schäfer, Rebekka; Strnad, Vratislav; Polgár, Csaba; Uter, Wolfgang; Hildebrandt, Guido; Ott, Oliver J; Kauer-Dorner, Daniela; Knauerhase, Hellen; Major, Tibor; Lyczek, Jaroslaw; Guinot, Jose Luis; Dunst, Jürgen; Miguelez, Cristina Gutierrez; Slampa, Pavel; Allgäuer, Michael; Lössl, Kristina; Kovács, György; Fischedick, Arnt-René; Fietkau, Rainer; Resch, Alexandra; Kulik, Anna; Arribas, Leo; Niehoff, Peter; Guedea, Ferran; Schlamann, Annika; Gall, Christine; Polat, Bülent

2018-04-20

Previous results from the GEC-ESTRO trial showed that accelerated partial breast irradiation (APBI) using multicatheter brachytherapy in the treatment of early breast cancer after breast-conserving surgery was non-inferior to whole-breast irradiation in terms of local control and overall survival. Here, we present 5-year results of patient-reported quality of life. We did this randomised controlled phase 3 trial at 16 hospitals and medical centres in seven European countries. Patients aged 40 years or older with 0-IIA breast cancer were randomly assigned (1:1) after breast-conserving surgery (resection margins ≥2 mm) to receive either whole-breast irradiation of 50 Gy with a boost of 10 Gy or APBI using multicatheter brachytherapy. Randomisation was stratified by study centre, tumour type, and menopausal status, with a block size of ten and an automated dynamic algorithm. There was no masking of patients or investigators. The primary endpoint of the trial was ipsilateral local recurrence. Here, we present 5-year results of quality of life (a prespecified secondary endpoint). Quality-of-life questionnaires (European Organisation for Research and Treatment of Cancer QLQ-C30, breast cancer module QLQ-BR23) were completed before radiotherapy (baseline 1), immediately after radiotherapy (baseline 2), and during follow-up. We analysed the data according to treatment received (as-treated population). Recruitment was completed in 2009, and long-term follow-up is continuing. The trial is registered at ClinicalTrials.gov, number NCT00402519. Between April 20, 2004, and July 30, 2009, 633 patients had accelerated partial breast irradiation and 551 patients had whole-breast irradiation. Quality-of-life questionnaires at baseline 1 were available for 334 (53%) of 663 patients in the APBI group and 314 (57%) of 551 patients in the whole-breast irradiation group; the response rate was similar during follow-up. Global health status (range 0-100) was stable in both groups: at

A multicentre randomised controlled trial of reciprocal lung cancer peer review and supported quality improvement: results from the improving lung cancer outcomes project

PubMed Central

Russell, G K; Jimenez, S; Martin, L; Stanley, R; Peake, M D; Woolhouse, I

2014-01-01

Background: Results from the National Lung Cancer Audit demonstrate unexplained variation in outcomes. Peer review with supported quality improvement has been shown to reduce variation in other areas of health care but has not been formally tested in cancer multidisciplinary teams. The aim of the current study is to assess the impact of reciprocal peer-to-peer review visits with supported quality improvement and collaborative working on lung cancer process and outcome measures. Methods: English lung cancer teams were randomised to usual care or facilitated reciprocal peer review visits followed by 12 months of supported quality improvement. The primary outcome was change in the following national audit indicators; mulitdisciplinary team discussion, histological confirmation, active treatment, surgical resection, small-cell chemotherapy and specialist nurse review. Patient experience was measured using a new lung cancer patient questionnaire in the intervention group. Results: Thirty teams (31 trusts) entered the intervention group and 29 of these submitted a total of 67 quality improvement plans. Active treatment increased in the intervention group (n=31) by 5.2% compared with 1.2% in the control group (n=48, mean difference 4.1%, 95% CI −0.1 to 8.2%, P=0.055). The remaining audit indicators improved similarly in all groups. Mean patient experience scores in the intervention group did not change significantly during the study but a significant improvement was seen in the scores for the five teams with the worst baseline scores (0.86 to 0.22, P<0.001). Conclusions: Reciprocal peer review with supported quality improvement was feasible and effective in stimulating quality improvement activity but resulted in only modest improvements in lung cancer treatment rates and patient experience. PMID:24651386