40 CFR Appendix H to Part 50 - Interpretation of the 1-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2014 CFR

2014-07-01

... and Secondary National Ambient Air Quality Standards for Ozone H Appendix H to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General This appendix explains how to... associated examples are contained in the “Guideline for Interpretation of Ozone Air Quality Standards.” For...

7 CFR 160.11 - Quality requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Quality requirements. 160.11 Section 160.11 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... STANDARDS FOR NAVAL STORES General § 160.11 Quality requirements. The several standards for spirits of...

40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2013 CFR

2013-07-01

... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...

40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2012 CFR

2012-07-01

... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...

40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2011 CFR

2011-07-01

... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...

40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2010 CFR

2010-07-01

... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...

40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2014 CFR

2014-07-01

... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data... secondary ambient air quality standards for ozone specified in § 50.10 are met at an ambient ozone air...

40 CFR 131.13 - General policies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... STANDARDS Establishment of Water Quality Standards § 131.13 General policies. States may, at their discretion, include in their State standards, policies generally affecting their application and implementation, such as mixing zones, low flows and variances. Such policies are subject to EPA review and...

Report: Examination of Pilot Peer Review Process for Inspectors General That Follow “Blue Book” Quality Standards for Inspection and Evaluation

EPA Pesticide Factsheets

Report #16-N-0317, Sept 21, 2016. A peer review process that measures adherence to all the quality standards for federal Inspector General Inspection and Evaluation offices provides assurance that participating offices are being adequately evaluated.

Quality Systems and ISO 9000 in Higher Education.

ERIC Educational Resources Information Center

Lundquist, Robert

1997-01-01

Examines quality assurance systems in higher education in general and of ISO 9000, a set of international quality standards, in particular. Reports on a survey of 23 institutions worldwide concerning implementation of quality systems and application of the ISO 9000 standards. Concludes that while institutions have found the quality assurance…

77 FR 58966 - Disapproval and Promulgation of Air Quality Implementation Plans; State of Utah; Revisions To...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-25

... Promulgation of Air Quality Implementation Plans; State of Utah; Revisions To Open Burning Regulations AGENCY... Emission Standards: General Burning authorizes the State to extend the time period for open burning. EPA is... submitted a SIP revision to Rule R307-202 Emission Standards: General Burning. This rule contains the...

40 CFR 131.8 - Requirements for Indian Tribes to administer a water quality standards program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Requirements for Indian Tribes to administer a water quality standards program. 131.8 Section 131.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS General Provisions § 131.8 Requirements for Indian Tribes to administer a wate...

40 CFR 131.8 - Requirements for Indian Tribes to administer a water quality standards program.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Requirements for Indian Tribes to administer a water quality standards program. 131.8 Section 131.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS General Provisions § 131.8 Requirements for Indian Tribes to administer a wate...

7 CFR 51.1140 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... paradisi and C. grandis). Separate U.S. standards apply to tangerines. The standards for internal quality... 7 Agriculture 2 2010-01-01 2010-01-01 false General. 51.1140 Section 51.1140 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing...

Proposed Standards for Medical Education Submissions to the Journal of General Internal Medicine

PubMed Central

Bowen, Judith L.; Gerrity, Martha S.; Kalet, Adina L.; Kogan, Jennifer R.; Spickard, Anderson; Wayne, Diane B.

2008-01-01

To help authors design rigorous studies and prepare clear and informative manuscripts, improve the transparency of editorial decisions, and raise the bar on educational scholarship, the Deputy Editors of the Journal of General Internal Medicine articulate standards for medical education submissions to the Journal. General standards include: (1) quality questions, (2) quality methods to match the questions, (3) insightful interpretation of findings, (4) transparent, unbiased reporting, and (5) attention to human subjects’ protection and ethical research conduct. Additional standards for specific study types are described. We hope these proposed standards will generate discussion that will foster their continued evolution. Electronic supplementary material The online version of this article (doi:10.1007/s11606-008-0676-z) contains supplementary material, which is available to authorized users. PMID:18612716

Quality Matters Rubric Potential for Enhancing Online Foreign Language Education

ERIC Educational Resources Information Center

Al Zumor, Abdul Wahed Q.

2015-01-01

Quality Matters Program is designed to certify the quality of online courses in colleges and universities across and beyond the U.S. The Quality Matters Rubric (QMR) consists of eight general standards and 41 specific standards which are used to evaluate and design online and blended courses. The purpose of this study is to highlight the QMR…

77 FR 20610 - United States Standards for Grades of Cultivated Ginseng

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... ginseng in an evolving global economy. Other changes will include a revised General Section, new... authorizes the Secretary of Agriculture ``to develop and improve standards of quality, condition, quantity... GBW to revise the standards and develop new grades based solely on quality and percentage defects. AMS...

77 FR 13496 - Effective Date for the Water Quality Standards for the State of Florida's Lakes and Flowing Waters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

... Effective Date for the Water Quality Standards for the State of Florida's Lakes and Flowing Waters AGENCY... Protection Agency (EPA) is finalizing an extension of the March 6, 2012 effective date of the ``Water Quality... INFORMATION: I. General Information Does this action apply to me? Citizens concerned with water quality in...

Colorado Air Quality Control Regulations and Ambient Air Quality Standards.

ERIC Educational Resources Information Center

Colorado State Dept. of Health, Denver. Div. of Air Pollution Control.

Regulations and standards relative to air quality control in Colorado are defined in this publication. Presented first are definitions of terms, a statement of intent, and general provisions applicable to all emission control regulations adopted by the Colorado Air Pollution Control Commission. Following this, three regulations are enumerated: (1)…

International Metadata Standards and Enterprise Data Quality Metadata Systems

NASA Technical Reports Server (NTRS)

Habermann, Ted

2016-01-01

Well-documented data quality is critical in situations where scientists and decision-makers need to combine multiple datasets from different disciplines and collection systems to address scientific questions or difficult decisions. Standardized data quality metadata could be very helpful in these situations. Many efforts at developing data quality standards falter because of the diversity of approaches to measuring and reporting data quality. The one size fits all paradigm does not generally work well in this situation. I will describe these and other capabilities of ISO 19157 with examples of how they are being used to describe data quality across the NASA EOS Enterprise and also compare these approaches with other standards.

42 CFR 417.410 - Qualifying conditions: General rules.

Code of Federal Regulations, 2010 CFR

2010-10-01

... groups and to deliver a specified comprehensive range of high quality services efficiently, effectively... services, and a quality assurance program. (c) Standards. Generally, each qualifying condition is... Section 417.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

40 CFR 52.820 - Identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and greenhouse gas are not SIP approved. 567-20.3 Air Quality Forms Generally 4/24/02 3/7/03, 68 FR... Activities 3/14/90 6/29/90, 55 FR 26690 Chapter 28—Ambient Air Quality Standards 567-28.1 Statewide Standards... Stationary Sources—Prevention of Significant Deterioration (PSD) of Air Quality 567-33.1 Purpose 11/1/06 5/14...

40 CFR 52.670 - Identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the Clean Air Act, 42 U.S.C. 7401, and 40 CFR part 51 to meet national ambient air quality standards.../16/03, 68 FR 2217 208 Demonstration of Net Air Quality Benefit 4/5/005/1/94 01/16/03, 68 FR 2217 209... Air Quality Standards and Area Classification 4/5/00 01/16/03, 68 FR 2217 576 General Provisions for...

Assessing Quality of Data Standards: Framework and Illustration Using XBRL GAAP Taxonomy

NASA Astrophysics Data System (ADS)

Zhu, Hongwei; Wu, Harris

The primary purpose of data standards or metadata schemas is to improve the interoperability of data created by multiple standard users. Given the high cost of developing data standards, it is desirable to assess the quality of data standards. We develop a set of metrics and a framework for assessing data standard quality. The metrics include completeness and relevancy. Standard quality can also be indirectly measured by assessing interoperability of data instances. We evaluate the framework using data from the financial sector: the XBRL (eXtensible Business Reporting Language) GAAP (Generally Accepted Accounting Principles) taxonomy and US Securities and Exchange Commission (SEC) filings produced using the taxonomy by approximately 500 companies. The results show that the framework is useful and effective. Our analysis also reveals quality issues of the GAAP taxonomy and provides useful feedback to taxonomy users. The SEC has mandated that all publicly listed companies must submit their filings using XBRL. Our findings are timely and have practical implications that will ultimately help improve the quality of financial data.

Record keeping in Norwegian general practice.

PubMed

Lönberg, N C; Bentsen, B G

1984-11-01

Routines of medical record keeping were studied in a random sample of 50 out of 228 general practitioners in two counties, Möre & Romsdal and Sör-Tröndelag. One doctor refused to participate and one had retired. The 48 physicians were interviewed and a questionnaire was completed with details about their record keeping. The standard of the records was assessed according to legibility, quality of notes, past history and tidiness using a score system. All general practitioners had records for every patient, but the quality of the records varied considerably. More than 50 per cent used handwriting in progress notes, which varied from diagnostic labels to extended reports. Few records contained accessible background information about the patient concerned, and many records contained large amounts of old and irrelevant papers. The record-scores varied from 3 to maximum 10 with an average of 6.7. Higher Standards of recording in general practice are called for, since the quality of records does not only affect the individual patient, but, in the end, the quality of medical care in general.

77 FR 64425 - Approval and Promulgation of Implementation Plans; Alaska: Infrastructure Requirements for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... Ambient Air Quality Standard AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY... the National Ambient Air Quality Standards (NAAQS) promulgated for ozone on July 18, 1997. EPA finds... measuring and monitoring ozone in ambient air, a general definition of ozone, federal Prevention of...

7 CFR 58.139 - Record of tests.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Milk § 58.139 Record of tests. Accurate records listing the results of quality and drug residue tests...

42 CFR 493.643 - Fee for determination of program compliance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... laboratory's scope and volume of testing (excluding tests performed for quality control, quality assurance... procedure or examination for a single analyte. (Tests performed for quality control, quality assurance, and... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS General Administration...

77 FR 67366 - Federal Acquisition Regulation; Information Collection; Quality Assurance Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-09

..., acceptance, warranty, and other measures associated with quality requirements. Standard clauses related to...; Information Collection; Quality Assurance Requirements AGENCY: Department of Defense (DOD), General Services... requirement concerning quality assurance requirements. Public comments are particularly invited on: Whether...

Quality assurance tendering and awarding contracts

NASA Astrophysics Data System (ADS)

1994-12-01

Standards relating to quality control can be significantly useful when tendering for and awarding contracts. However, because it is sometimes difficult to express these standards in palpable economic terms, they can (practically) never be applied as criteria for awarding contracts in accordance with U.A.R. (Uniform General Standards) 1986. Therefore it would be advisable in the future to regard the availability of a (certified) system of quality control as being a standard requirement. To this end, a paragraph setting requirements for a quality control plan should be included in the specification. A quality control plan will be required on awarding a contract. This envisaged scenario can best achieved through a transitional phase. During this period there will be opportunity enough for removing any shortcomings in the wording and for considering standards to be required and assessment procedures.

42 CFR 493.1231 - Standard: Confidentiality of patient information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Standard: Confidentiality of patient information... AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing General Laboratory Systems § 493.1231 Standard: Confidentiality of patient information...

42 CFR 493.1231 - Standard: Confidentiality of patient information.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Standard: Confidentiality of patient information... AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing General Laboratory Systems § 493.1231 Standard: Confidentiality of patient information...

42 CFR 493.1231 - Standard: Confidentiality of patient information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Standard: Confidentiality of patient information... AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing General Laboratory Systems § 493.1231 Standard: Confidentiality of patient information...

42 CFR 493.1231 - Standard: Confidentiality of patient information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Standard: Confidentiality of patient information... AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing General Laboratory Systems § 493.1231 Standard: Confidentiality of patient information...

78 FR 57267 - Approval and Promulgation of Implementation Plans; State of Missouri; Conformity of General...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-18

... actions that may cause or contribute to violations of the National Ambient Air Quality Standards (NAAQS... cause or contribute to violations of the National Ambient Air Quality Standards (NAAQS). This amendment... provide EPA with the discretionary authority to address, as appropriate, disproportionate human health or...

The case of "Miss Jacobs": adolescent simulated patients and the quality of their role playing, feedback, and personal impact.

PubMed

Bokken, Lonneke; van Dalen, Jan; Rethans, Jan-Joost

2010-12-01

Adolescents as standardized patients are relatively new in medical education. Studies have mostly explored the impact of role playing on adolescents trained to perform standardized patient roles for assessment purposes. No studies were found with regard to the quality of adolescents' role playing. We evaluated the effects of performing a patient role on adolescents trained as simulated patients (SPs) for teaching purposes (in contrast to standardized patients) and evaluated the quality of adolescent SPs' role playing and feedback. Nine young women, aged 16 to 18 years, were trained to portray roles of adolescents asking their general practitioner for an oral contraceptive. Three adolescent men were trained to portray roles of some of the girls' boyfriends. Each role was developed in consultation with the individual adolescent and was largely based on her own personal experience. Students rated the quality of the adolescent SP's role playing and feedback after each SP encounter on a previously validated questionnaire (the Maastricht Assessment of Simulated Patients). Both the adolescent SPs and faculty teachers both completed questionnaires on their experiences. Three hundred forty-one students rated the quality of the SPs' role playing and feedback with a mean score of 7.5 of 10. The faculty teachers were also generally positive about the role playing and feedback. Nevertheless, there were some concerns about the quality of the feedback. Adolescent SPs reported no negative effects because of their performance. Generally, students and teachers were satisfied with the quality of the role playing and feedback provided by the adolescent SPs. The adolescent SPs experienced no negative effects related to their performance, which confirms earlier findings among adolescent standardized patients.

Water quality of streams in the Red River of the North Basin, Minnesota, North Dakota, and South Dakota, 1970-2001

USGS Publications Warehouse

Tornes, Lan H.

2005-01-01

Data for the Red River of the North (Red River) Basin in Minnesota, North Dakota, and South Dakota were analyzed to determine whether the water quality of streams in the basin is adequate to meet future needs. For the Red River at Emerson, Manitoba, site, pH values, water temperatures, and dissolved-oxygen concentrations generally were within the criteria established for the protection of aquatic life. Dissolved-solids concentrations ranged from 245 to 1,100 milligrams per liter. Maximum sulfate and chloride concentrations were near, but did not exceed, the established secondary maximum contaminant level. The trace elements considered potentially harmful generally were at concentrations that were less than the established guidelines, standards, and criteria. The concentrations of lead that were detected may have occurred as a result of sample contamination.  For the Red River upstream from Emerson, Manitoba, sites, pH and other field values rarely exceeded the criteria established for the protection of aquatic life. Many constituent concentrations for the Red River below Fargo, N. site exceeded water-quality guidelines, standards, and criteria. However, the trace-element exceedances could be natural or could be related to pollution or sample contamination. Many of the tributaries in the western part of the Red River Basin had median specific-conductance values that were greater than 1,000 microsiemens per centimeter. Sulfate concentrations occasionally exceeded the established drinking-water standard. Median arsenic concentrations were 6 micrograms per liter or less, and maximum concentrations rarely exceeded the 10-microgram-per-liter drinking-water standard that is scheduled to take effect in 2006. The small concentrations of lead, mercury, and selenium that occasionally were detected may have been a result of sample contamination or other factors. The tributaries in the eastern part of the Red River Basin had median specific-conductance values that were less than 1,000 microsiemens per centimeter.  Concentrations of pesticides that were detected and that had regulatory limits were less than the cited water-quality guidelines, standards, and criteria. Concentrations of compounds that were detected generally were less than the sediment- quality standards and criteria. The data considered in this report generally provide a good baseline from which to evaluate changes in water-quality conditions. However, because many of the trace elements detected, including lead and mercury, may have been the result of sample contamination, additional data are needed to confirm that trace-element concentrations generally are low. Concentrations of major ions, including sulfate, and specific conductance may continue to approach drinking-water standards during periods of low flow because the streams, particularly those in the western part of the basin, are sustained mostly by ground-water discharge that generally has large dissolved-solids concentrations.

General Conformity

EPA Pesticide Factsheets

The General Conformity requirements ensure that the actions taken by federal agencies in nonattainment and maintenance areas do not interfere with a state’s plans to meet national standards for air quality.

42 CFR 493.1230 - Condition: General laboratory systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: General laboratory systems. 493.1230... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing General Laboratory Systems § 493.1230 Condition: General laboratory systems. Each laboratory that...

42 CFR 493.1232 - Standard: Specimen identification and integrity.

Code of Federal Regulations, 2011 CFR

2011-10-01

... AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing General Laboratory Systems § 493.1232 Standard: Specimen identification and integrity. The laboratory must establish and follow written policies and procedures that ensure positive identification and...

42 CFR 493.1233 - Standard: Complaint investigations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing General Laboratory Systems § 493.1233 Standard: Complaint investigations. The laboratory must have a system in place to ensure that it documents all complaints and problems reported to the laboratory...

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.

An update on dental imaging.

PubMed

Whaites, E; Brown, J

1998-08-22

This paper reviews recent advances and current trends in dental radiology. Developments in the design of dental x-ray equipment which improve both radiation hygiene and image quality are described. Also discussed are new features which broaden the scope of intra-oral and panoramic radiological diagnosis in the general dental practice setting. The article concludes with the main recommendations from the latest guidelines on quality standards for radiography, selection criteria and quality assurance in general practice.

Setting and Maintaining GCSE and GCE Grading Standards: The Case for Contextualised Cohort-Referencing

ERIC Educational Resources Information Center

Stringer, Neil Simon

2012-01-01

General Certificate of Secondary Education (GCSE) and General Certificate of Education (GCE) grading standards are determined by Awarding Bodies using procedures that adhere to the Code of Practice published by the regulator, Ofqual. Grade boundary marks (cut scores) are set using subject experts' (senior examiners) judgement of the quality of…

Methodology of Clinical Trials Aimed at Assessing Interventions for Cutaneous Leishmaniasis

PubMed Central

Olliaro, Piero; Vaillant, Michel; Arana, Byron; Grogl, Max; Modabber, Farrokh; Magill, Alan; Lapujade, Olivier; Buffet, Pierre; Alvar, Jorge

2013-01-01

The current evidence-base for recommendations on the treatment of cutaneous leishmaniasis (CL) is generally weak. Systematic reviews have pointed to a general lack of standardization of methods for the conduct and analysis of clinical trials of CL, compounded with poor overall quality of several trials. For CL, there is a specific need for methodologies which can be applied generally, while allowing the flexibility needed to cover the diverse forms of the disease. This paper intends to provide clinical investigators with guidance for the design, conduct, analysis and report of clinical trials of treatments for CL, including the definition of measurable, reproducible and clinically-meaningful outcomes. Having unified criteria will help strengthen evidence, optimize investments, and enhance the capacity for high-quality trials. The limited resources available for CL have to be concentrated in clinical studies of excellence that meet international quality standards. PMID:23556016

Standard classification of software documentation

NASA Technical Reports Server (NTRS)

Tausworthe, R. C.

1976-01-01

General conceptual requirements for standard levels of documentation and for application of these requirements to intended usages. These standards encourage the policy to produce only those forms of documentation that are needed and adequate for the purpose. Documentation standards are defined with respect to detail and format quality. Classes A through D range, in order, from the most definitive down to the least definitive, and categories 1 through 4 range, in order, from high-quality typeset down to handwritten material. Criteria for each of the classes and categories, as well as suggested selection guidelines for each are given.

[Analysis of varieties and standards of Leguminosae plants used in Tibetan medicine].

PubMed

Cao, Lan; Du, Xiao-lang; Zhong, Wei-hong; Zhong, Wei-jin; He, Jun-wei; Mu, Ze-jing; Zhong, Guo-yue

2015-12-01

In this paper, the domestic varieties and quality standard of Leguminosae medicinal plants used in Tibetan medicine were analyzed. The results showed that there were 36 genera and 142 species (including varieties), as well as 64 medicinal materials varieties of Leguminosae plants were recorded in relevant literatures. In relevant Tibetan standards and literatures, there are great differences in varieties, sources, used parts, and efficacy of medicinal plants. Among them, about 38.0% (including 54 species) of the endemic plants, about 25.4% (including 36 species) of the original plants have medicinal standard legal records, except 9 kinds of traditional Chinese medicine general quality standard more fairly completed, the most varieties have only description about characters, identification, etc. Therefore it is necessary to reinforce study for the herbal textual, resources and the use present situation, chemical components and biological activity, quality standard, medicinal terms specification, to promote establishment of quality standard system for variety-terminologies-sources of Tibetan medicinal plants.

7 CFR 58.434 - Calcium chloride.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw... Chemical Codex. ...

7 CFR 58.434 - Calcium chloride.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw... Chemical Codex. ...

7 CFR 58.434 - Calcium chloride.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw... Chemical Codex. ...

76 FR 37272 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Royal Fiberglass Pools...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

...EPA is approving into the Illinois State Implementation Plan (SIP) an adjusted standard for Royal Fiberglass Pools (``Royal'') at its Dix, Illinois facility. On November 8, 2010, the Illinois Environmental Protection Agency (IEPA) submitted to EPA for approval an adjustment to the general rule, Use of Organic Material Rule, commonly known as the eight pound per hour (8 lb/hr) rule, as it applies to emissions of volatile organic matter (VOM) from Royal's pool manufacturing facility. The adjusted standard relieves Royal from being subject to the general rule for VOM emissions from its Dix facility. EPA is approving this SIP revision because it will not interfere with attainment or maintenance of the ozone National Ambient Air Quality Standard (NAAQS).

42 CFR 493.1234 - Standard: Communications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing General Laboratory Systems § 493.1234 Standard: Communications. The laboratory must have a system in place to... laboratory and an authorized person who orders or receives test results. [68 FR 3703, Jan. 24, 2003; 68 FR...

76 FR 56694 - Approval and Promulgation of Air Quality Implementation Plans; California; Determinations of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

... ambient air quality monitoring data for the period preceding the applicable attainment deadline. DATES... and certified monitoring data. A violation occurs when the ambient ozone air quality monitoring data... standard, generally based on air quality monitoring data from the 1987 through 1989 period (section 107(d...

Electroplating and stripping copper on molybdenum and niobium

NASA Technical Reports Server (NTRS)

Power, J. L.

1978-01-01

Molybdenum and niobium are often electroplated and subsequently stripped of copper. Since general standard plating techniques produce poor quality coatings, general procedures have been optimized and specified to give good results.

Maintenance quality assurance peer exchange 2.

DOT National Transportation Integrated Search

2009-04-01

This report documents a comprehensive study of twenty three maintenance quality assurance : (MQA) programs throughout the United States and Canada. The policies and standards of : each program were synthesized to create a general assessment on the co...

40 CFR 130.5 - Continuing planning process.

Code of Federal Regulations, 2010 CFR

2010-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.5 Continuing planning process. (a) General. Each State shall... the Act. Each State is responsible for managing its water quality program to implement the processes... quality standards in effect under authority of section 303 of the Act. (2) The process for incorporating...

40 CFR 130.5 - Continuing planning process.

Code of Federal Regulations, 2011 CFR

2011-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.5 Continuing planning process. (a) General. Each State shall... the Act. Each State is responsible for managing its water quality program to implement the processes... quality standards in effect under authority of section 303 of the Act. (2) The process for incorporating...

40 CFR 130.5 - Continuing planning process.

Code of Federal Regulations, 2014 CFR

2014-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.5 Continuing planning process. (a) General. Each State shall... the Act. Each State is responsible for managing its water quality program to implement the processes... quality standards in effect under authority of section 303 of the Act. (2) The process for incorporating...

Standards for University Libraries = Normes pour les bibliotheques universitaires = Richtwerte fur Universitatsbibliotheken = Normas de bibliotecas universitarias. IFLA Professional Reports No. 10.

ERIC Educational Resources Information Center

Lynch, Beverly P., Ed.

This statement prepared by the International Federation of Library Associations' Section of University Libraries and Other General Research Libraries presents standards of general principles designed to accomplish the following: (1) provide a means by which the quality of the library serving a university can be assessed; (2) offer guidance for…

Ground-water quality in east-central New Jersey, and a plan for sampling networks

USGS Publications Warehouse

Harriman, D.A.; Sargent, B.P.

1985-01-01

Groundwater quality was evaluated in seven confined aquifers and the water table aquifer in east-central New Jersey based on 237 analyses of samples collected in 1981-82, and 225 older analyses. Investigation of the effect of land use on water quality and several sampling network proposals for the region are reported. Generally, water in the confined aquifers is of satisfactory quality for human consumption and most other uses. Iron (Fe) and manganese (Mn) concentrations exceed U.S. EPA drinking water standards in some wells screened in the Potomac-Raritan-Magothy aquifer system. Sodium (Na) concentrations in samples from three wells more than 800 ft deep in the Englishtown aquifer exceed the standard. Iron and Mn concentrations in this aquifer may also exceed the standards. Iron concentrations in the Wenonah-Mount Laurel aquifer exceed the standard. Based on 15 analyses of water from the Vincetown aquifer, Mn is the only constituent that exceeds the drinking water standard. In the Manasquan aquifer, 4 of the 16 Na determinations exceed the standard, and 8 of 16 Fe determinations exceed the standard. Water quality in the Atlantic City 800-ft sand is generally satisfactory. However, 12 Fe and 1 of 12 Mn determinations exceed the standards. For the Rio Grande water-bearing zone, 1 of 3 Fe determinations exceed the standard. The Kirkwood-Cohansey aquifer system (the water table aquifer) was the most thoroughly sampled (249 chemical analyses from 209 wells). Dissolved solids, chloride, Fe, nitrate, and Mn concentrations exceed drinking water standards in some areas. The results of chi-square tests of constituent distributions based on analyses from 158 wells in the water table aquifer indicate that calcium is higher in industrial and commercial areas; and Mg, chloride, and nitrate-plus-nitrite is higher in residential areas. (Author 's abstract)

Ground-water quality in selected areas of Wisconsin

USGS Publications Warehouse

Hindall, S.M.

1979-01-01

Analysis of 2,071 ground-water samples from 970 wells throughout Wisconsin indicate large variations in ground-water quality. Ground water in Wisconsin is generally suitable for most uses, but in some areas concentrations of chemical constituents exceed recommended drinking-water standards. Iron, manganese, and nitrate commonly exceed recommended drinking-water standards and dissolved solids, sulfate, heavy metals, and phenolic materials may present local problems. (USGS)

ASVCP quality assurance guidelines: control of general analytical factors in veterinary laboratories.

PubMed

Flatland, Bente; Freeman, Kathy P; Friedrichs, Kristen R; Vap, Linda M; Getzy, Karen M; Evans, Ellen W; Harr, Kendal E

2010-09-01

Owing to lack of governmental regulation of veterinary laboratory performance, veterinarians ideally should demonstrate a commitment to self-monitoring and regulation of laboratory performance from within the profession. In response to member concerns about quality management in veterinary laboratories, the American Society for Veterinary Clinical Pathology (ASVCP) formed a Quality Assurance and Laboratory Standards (QAS) committee in 1996. This committee recently published updated and peer-reviewed Quality Assurance Guidelines on the ASVCP website. The Quality Assurance Guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports on 1) general analytic factors for veterinary laboratory performance and comparisons, 2) hematology and hemostasis, and 3) clinical chemistry, endocrine assessment, and urinalysis. This report documents recommendations for control of general analytical factors within veterinary clinical laboratories and is based on section 2.1 (Analytical Factors Important In Veterinary Clinical Pathology, General) of the newly revised ASVCP QAS Guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimum guidelines for quality assurance and quality control for veterinary laboratory testing. It is hoped that these guidelines will provide a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. ©2010 American Society for Veterinary Clinical Pathology.

7 CFR 205.640 - Fees and other charges for accreditation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED... Marketing Service, through its Quality Systems Certification Program, to certification bodies requesting conformity assessment to the International Organization for Standardization “General Requirements for Bodies...

Spatial Data Transfer Standard (SDTS), part 5 : SDTS raster profile and extensions

DOT National Transportation Integrated Search

1999-02-01

The Spatial Data Transfer Standard (SDTS) defines a general mechanism for the transfer of : geographically referenced spatial data and its supporting metadata, i.e., attributes, data quality reports, : coordinate reference systems, security informati...

9 CFR 3.106 - Water quality.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Water quality. 3.106 Section 3.106... Mammals Animal Health and Husbandry Standards § 3.106 Water quality. (a) General. The primary enclosure shall not contain water which would be detrimental to the health of the marine mammal contained therein...

9 CFR 3.106 - Water quality.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Water quality. 3.106 Section 3.106... Mammals Animal Health and Husbandry Standards § 3.106 Water quality. (a) General. The primary enclosure shall not contain water which would be detrimental to the health of the marine mammal contained therein...

9 CFR 3.106 - Water quality.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Water quality. 3.106 Section 3.106... Mammals Animal Health and Husbandry Standards § 3.106 Water quality. (a) General. The primary enclosure shall not contain water which would be detrimental to the health of the marine mammal contained therein...

9 CFR 3.106 - Water quality.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Water quality. 3.106 Section 3.106... Mammals Animal Health and Husbandry Standards § 3.106 Water quality. (a) General. The primary enclosure shall not contain water which would be detrimental to the health of the marine mammal contained therein...

9 CFR 3.106 - Water quality.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Water quality. 3.106 Section 3.106... Mammals Animal Health and Husbandry Standards § 3.106 Water quality. (a) General. The primary enclosure shall not contain water which would be detrimental to the health of the marine mammal contained therein...

42 CFR 438.240 - Quality assessment and performance improvement program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assessment and performance improvement... Performance Improvement Measurement and Improvement Standards § 438.240 Quality assessment and performance improvement program. (a) General rules. (1) The State must require, through its contracts, that each MCO and...

[Criteria of quality of structure in rehabilitation units with inpatient treatment].

PubMed

Klein, K; Farin, E; Jäckel, W H; Blatt, O; Schliehe, F

2004-04-01

The structure of a rehabilitation unit is an important feature of the quality of care. Adequate and qualitatively good structures provide the basis for appropriate therapy offers and treatment and eventually, a better health for rehabilitants. The quality of structures is generally recorded without any evaluation of the aspects in particular. The definition of standards is the basis for such an evaluation. The project presented is aimed at the definition of relevant structural standards for rehab units with inpatient treatment for musculoskeletal, cardiac, neurological, gastroenterological, oncological, pneumological and dermatological diseases. Here, the distinction between basal criteria which have to be fulfilled by every rehab unit with inpatient treatment and criteria important for a well-aimed assignment of patients with specific needs ("assignment criteria") should be made. Apart from the documentation of structural attributes, the structural quality of a rehab unit can be described individually as well as in comparison with other units. Relevant structural criteria were defined in expert meetings by means of a modified Delphi-technique with five inquiries. Overall, 199 "basal criteria" and "assignment criteria" were defined. All criteria can be assigned to the two domains general structural characteristics (general characteristics and equipment of rooms; medical/technical equipment; therapy, education, care; staff) and process-related structures (conceptual frames; internal quality management; internal communication and personnel development). The structural standards are applicable to units for musculoskeletal, cardiac, neurological, oncological, gastroenterological, dermatological and pneumological rehabilitation financed by the two main providers of rehabilitation, the statutory pension insurance scheme and the statutory health insurance scheme for all other five indications. The definition of structural standards agreed by experts in a formal consensus process, provides comprehensive and concrete requirements for German rehab units with inpatient medical rehabilitation. If the two main providers of rehabilitation both use the standards this can be regarded as a hallmark on the path to a unitary programme for quality management. The results enable units to analyse their weak points not just on an individual basis but allow also for a comparison between units, along with contributing to optimizing the structural quality of rehab units.

[CAS General Standards 2012

ERIC Educational Resources Information Center

Council for the Advancement of Standards in Higher Education, 2011

2011-01-01

The mission of the Council for the Advancement of Standards in Higher Education (CAS) is to promote the improvement of programs and services to enhance the quality of student learning and development. CAS is a consortium of professional associations who work collaboratively to develop and promulgate standards and guidelines and to encourage…

Minimum Essential Requirements and Standards in Medical Education.

ERIC Educational Resources Information Center

Wojtczak, Andrzej; Schwarz, M. Roy

2000-01-01

Reviews the definition of standards in general, and proposes a definition of standards and global minimum essential requirements for use in medical education. Aims to serve as a tool for the improvement of quality and international comparisons of basic medical programs. Explains the IIME (Institute for International Medical Education) project…

"Circumstance and Proper Timing": Context and the Construction of a Standards Framework for School Principals' Performance.

ERIC Educational Resources Information Center

Louden, William; Wildy, Helen

1999-01-01

Professional standards for school principals typically describe an ideal performance in a generalized context. This article describes an alternative method of developing a standards framework, combining qualitative vignettes with probabilistic measurement techniques to provide essential or ideal performance qualities with contextually rich…

76 FR 37300 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Royal Fiberglass Pools...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

...EPA is proposing to approve into the Illinois State Implementation Plan (SIP) an adjusted standard for Royal Fiberglass Pools (``Royal'') at its Dix, Illinois facility. On November 8, 2010, the Illinois Environmental Protection Agency (IEPA) submitted to EPA for approval an adjustment to the general rule, Use of Organic Material Rule, commonly known as the eight pound per hour (8 lb/hr) rule, as it applies to emissions of volatile organic matter (VOM) from Royal's pool manufacturing facility. The adjusted standard relieves Royal from being subject to the general rule for VOM emissions from its Dix facility. EPA is approving this SIP revision because it will not interfere with attainment or maintenance of the ozone National Ambient Air Quality Standard (NAAQS).

International Metadata Standards and Enterprise Data Quality Metadata Systems

NASA Astrophysics Data System (ADS)

Habermann, T.

2016-12-01

Well-documented data quality is critical in situations where scientists and decision-makers need to combine multiple datasets from different disciplines and collection systems to address scientific questions or difficult decisions. Standardized data quality metadata could be very helpful in these situations. Many efforts at developing data quality standards falter because of the diversity of approaches to measuring and reporting data quality. The "one size fits all" paradigm does not generally work well in this situation. The ISO data quality standard (ISO 19157) takes a different approach with the goal of systematically describing how data quality is measured rather than how it should be measured. It introduces the idea of standard data quality measures that can be well documented in a measure repository and used for consistently describing how data quality is measured across an enterprise. The standard includes recommendations for properties of these measures that include unique identifiers, references, illustrations and examples. Metadata records can reference these measures using the unique identifier and reuse them along with details (and references) that describe how the measure was applied to a particular dataset. A second important feature of ISO 19157 is the inclusion of citations to existing papers or reports that describe quality of a dataset. This capability allows users to find this information in a single location, i.e. the dataset metadata, rather than searching the web or other catalogs. I will describe these and other capabilities of ISO 19157 with examples of how they are being used to describe data quality across the NASA EOS Enterprise and also compare these approaches with other standards.

[Analysis of varieties and standards of Scrophulariaceae plants used in Tibetan medicine].

PubMed

Cao, Lan; Mu, Ze-jing; Zhong, Wei-hong; Zhong, Wei-jin; He, Jun-wei; Du, Xiao-lang; Zhong, Guo-yue

2015-12-01

In this paper, the popular domestic varieties and quality standard of Scrophulariaceae plants used in Tibetan medicine were analyzed. The results showed that there were 11 genera and 99 species (including varieties), as well as 28 medicinal materials varieties of Scrophulariaceae plants were recorded in the relevant literatures. In relevant Tibetan standards arid literatures, there are great differences in varieties, sources, parts, and efficacies of medicinal plant. Among them, about 41.4% (including 41 species) of endemic plants, about 15.2% (including 15 species) of the original plants have medicinal standard legal records, except the medicinal materials of Scrophalaria ningpoensis, Lagotis brevituba, Picrorhiza scrophulariiflora, Veronica eriogyne general, most varieties have not completed quality standard. Consequently it is necessary to reinforce the herbal textual, resources and the use present situation investigation, the effects of the species resources material foundation and biological activity, quality standard, specification the medical terms of the plants, and promote Tibetan medicinal vareties-terminologies-sources such as the criterion and quality standard system for enriching the varieties of Tibetan medicinal materials and Chinese medicinal resources.

40 CFR 49.154 - Permit application requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., production rates and operating schedules. (vii) Identification and description of any existing air pollution... pollution prevention techniques, air pollution control devices, design standards, equipment standards, work... ASSISTANCE INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT General Federal Implementation Plan Provisions...

40 CFR 49.154 - Permit application requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., production rates and operating schedules. (vii) Identification and description of any existing air pollution... pollution prevention techniques, air pollution control devices, design standards, equipment standards, work... ASSISTANCE INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT General Federal Implementation Plan Provisions...

40 CFR 49.154 - Permit application requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., production rates and operating schedules. (vii) Identification and description of any existing air pollution... pollution prevention techniques, air pollution control devices, design standards, equipment standards, work... ASSISTANCE INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT General Federal Implementation Plan Provisions...

40 CFR 49.154 - Permit application requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., production rates and operating schedules. (vii) Identification and description of any existing air pollution... pollution prevention techniques, air pollution control devices, design standards, equipment standards, work... ASSISTANCE INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT General Federal Implementation Plan Provisions...

7 CFR 58.736 - Pasteurized process cheese.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for..., and be completely sealed and not broken or soiled. ...

7 CFR 58.736 - Pasteurized process cheese.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for..., and be completely sealed and not broken or soiled. ...

7 CFR 58.736 - Pasteurized process cheese.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for..., and be completely sealed and not broken or soiled. ...

The UK Quality and Outcomes Framework pay-for-performance scheme and spirometry: rewarding quality or just quantity? A cross-sectional study in Rotherham, UK

PubMed Central

Strong, Mark; South, Gail; Carlisle, Robin

2009-01-01

Background Accurate spirometry is important in the management of COPD. The UK Quality and Outcomes Framework pay-for-performance scheme for general practitioners includes spirometry related indicators within its COPD domain. It is not known whether high achievement against QOF spirometry indicators is associated with spirometry to BTS standards. Methods Data were obtained from the records of 3,217 patients randomly sampled from 5,649 patients with COPD in 38 general practices in Rotherham, UK. Severity of airflow obstruction was categorised by FEV1 (% predicted) according to NICE guidelines. This was compared with clinician recorded COPD severity. The proportion of patients whose spirometry met BTS standards was calculated in each practice using a random sub-sample of 761 patients. The Spearman rank correlation between practice level QOF spirometry achievement and performance against BTS spirometry standards was calculated. Results Spirometry as assessed by clinical records was to BTS standards in 31% of cases (range at practice level 0% to 74%). The categorisation of airflow obstruction according to the most recent spirometry results did not agree well with the clinical categorisation of COPD recorded in the notes (Cohen's kappa = 0.34, 0.30 – 0.38). 12% of patients on COPD registers had FEV1 (% predicted) results recorded that did not support the diagnosis of COPD. There was no association between quality, as measured by adherence to BTS spirometry standards, and either QOF COPD9 achievement (Spearman's rho = -0.11), or QOF COPD10 achievement (rho = 0.01). Conclusion The UK Quality and Outcomes Framework currently assesses the quantity, but not the quality of spirometry. PMID:19558719

The UK Quality and Outcomes Framework pay-for-performance scheme and spirometry: rewarding quality or just quantity? A cross-sectional study in Rotherham, UK.

PubMed

Strong, Mark; South, Gail; Carlisle, Robin

2009-06-28

Accurate spirometry is important in the management of COPD. The UK Quality and Outcomes Framework pay-for-performance scheme for general practitioners includes spirometry related indicators within its COPD domain. It is not known whether high achievement against QOF spirometry indicators is associated with spirometry to BTS standards. Data were obtained from the records of 3,217 patients randomly sampled from 5,649 patients with COPD in 38 general practices in Rotherham, UK. Severity of airflow obstruction was categorised by FEV1 (% predicted) according to NICE guidelines. This was compared with clinician recorded COPD severity. The proportion of patients whose spirometry met BTS standards was calculated in each practice using a random sub-sample of 761 patients. The Spearman rank correlation between practice level QOF spirometry achievement and performance against BTS spirometry standards was calculated. Spirometry as assessed by clinical records was to BTS standards in 31% of cases (range at practice level 0% to 74%). The categorisation of airflow obstruction according to the most recent spirometry results did not agree well with the clinical categorisation of COPD recorded in the notes (Cohen's kappa = 0.34, 0.30 - 0.38). 12% of patients on COPD registers had FEV1 (% predicted) results recorded that did not support the diagnosis of COPD. There was no association between quality, as measured by adherence to BTS spirometry standards, and either QOF COPD9 achievement (Spearman's rho = -0.11), or QOF COPD10 achievement (rho = 0.01). The UK Quality and Outcomes Framework currently assesses the quantity, but not the quality of spirometry.

Standards--the common element in providing the safety, quality and performance of the medical practice.

PubMed

Greabu, Maria

2009-01-01

Knowing and applying standards is an opportunity of the years 2007-2008 in any kind of field where a successful activity is intended and this assures a certain way towards competence and quality. The most recent German studies highlighted, to the surprise of the specialists, that standardization holds the second place, after the material means, in the row of the elements considered to be decisive for the success of a business. The existence of standards and the concern for their implementation in the activity provides a high technical and quality level of the products/services offered to the clients and the increase in the level of competence of the personnel, who will be able to cope with all the challenges. This need comes from the process of Romania's accession to the European Union. There are a lot of reasons why standards represent a fundamental part of our daily life. Practically, we are surrounded by standards. Everything is "working" well and it is efficient if the standards used as a base for manufacturing "things" have been correctly developed and applied. Standards open communication channels and commercial channels, promote the understanding of technical products, the compatibility of products and services, facilitate mass production and, most importantly, they are the necessary base for the achievement of the objectives in the fields of health and safety and a better quality of life. The transition towards the global market needs an instrument for the removal of the barriers to the application of the latest discoveries in the field of medical instruments, materials and manual labor. Each medical device, equipment and material used in the Dental and General Medicine is standardized, in fact that leads to their better knowing and provides controllable treatment for manual labor with predictable and repeatable results. This presentation intends to make a survey of some general aspects on standardization as well as a review of the standards in the medical area.

Standardization and quality management in next-generation sequencing.

PubMed

Endrullat, Christoph; Glökler, Jörn; Franke, Philipp; Frohme, Marcus

2016-09-01

DNA sequencing continues to evolve quickly even after > 30 years. Many new platforms suddenly appeared and former established systems have vanished in almost the same manner. Since establishment of next-generation sequencing devices, this progress gains momentum due to the continually growing demand for higher throughput, lower costs and better quality of data. In consequence of this rapid development, standardized procedures and data formats as well as comprehensive quality management considerations are still scarce. Here, we listed and summarized current standardization efforts and quality management initiatives from companies, organizations and societies in form of published studies and ongoing projects. These comprise on the one hand quality documentation issues like technical notes, accreditation checklists and guidelines for validation of sequencing workflows. On the other hand, general standard proposals and quality metrics are developed and applied to the sequencing workflow steps with the main focus on upstream processes. Finally, certain standard developments for downstream pipeline data handling, processing and storage are discussed in brief. These standardization approaches represent a first basis for continuing work in order to prospectively implement next-generation sequencing in important areas such as clinical diagnostics, where reliable results and fast processing is crucial. Additionally, these efforts will exert a decisive influence on traceability and reproducibility of sequence data.

Quality of Life among Patients Undergoing Hemodialysis in Penang, Malaysia.

PubMed

Ramatillah, Diana Laila; Syed Sulaiman, Syed Azhar; Khan, Amer Hayat; Meng, Ong Loke

2017-01-01

Quality of life is one of the parameters to check the improvement of hemodialysis treatment among hemodialysed patients. Those patients will be dealing with this treatment in long term if this treatment is the only way for them to replace their kidney function and this thing will affect their quality of life. To evaluate the quality of life patients on hemodialysis using kidney disease quality of life-short term 24 (KDQoL-SF24) Malaysian Version. Cohort observational study was conducted in this study. The study included 78 hemodialysed patients in HD center Penang, Malaysia. There were 9 components which had the lower of the mean and standard deviation (SD) than the standard form; work status (15.01 ± 35.57), cognitive function (75.66 ± 13.75), quality of life social interaction (76.32 ± 16.11), sleep (55.86 ± 15.30), social support (59.61 ± 22.08), patient satisfaction (43.24 ± 15.32), physical functioning (50.06 ± 42.81), general health (29.62 ± 25.56), and role emotional (54.27 ± 49.92). In this HD center, the group of patient's age who had the lower mean ± SD from the KDQoL-SF Manual Standard were the first and the sixth groups of patient's age (≤20 and 61-70). The study conducted in HD center, Penang, Malaysia showed that the scoring of work status, cognitive function, quality of social interaction, sleep, social support, patient satisfaction, physical functioning, general health, and role emotional were low than standard form.

Standards for Quality? A Citical Appraisal of the Berlin Principles for International Rankings of Universities

ERIC Educational Resources Information Center

Hägg, Ingemund; Wedlin, Linda

2013-01-01

This article discusses the principles developed to assure the quality of international ranking practices for higher education, the so-called Berlin Principles, and the role given to them in the higher education community. While the principles are generally regarded as proper quality assurance principles, they are problematic both in their content…

Does a higher 'quality points' score mean better care in stroke? An audit of general practice medical records.

PubMed

Williams, Peter Huw; de Lusignan, Simon

2006-01-01

The Royal College of Physicians (RCP) have produced guidelines for stroke management in primary care; this guidance is taken to be the gold standard for the care of people with stroke. UK general practitioners now have a quality-based contract which includes a Quality and Outcomes Framework (QOF). This consists of financially remunerated 'quality points' for specific disease areas, including stroke. Achievement of these quality points is measured by extracting a limited list of computer codes from practice computer systems. To investigate whether a high stroke quality score is associated with adherence to RCP guidelines. Examination of computer and written medical records of all patients with a diagnosis of stroke. Two general practices, one in southwest London, one in Surrey, with a combined practice population of over 20 000. Both practices had a similar age-sex profile and prevalence of stroke. One practice scored 93.5% (29/31) of the available stroke quality points. The other practice achieved 73.4% (22.75/31), and only did better in one stroke quality target. However, the practice scoring fewer quality points had much better adherence to RCP guidance: 96% of patients were assessed in secondary care compared with 79% (P=0.001); 64% of stroke patients were seen the same day, compared with 44%; 56% received rehabilitation compared with 37%. Higher quality points did not reflect better adherence to RCP guidance. This audit highlights a gap between relatively simplistic measures of quality in the QOF, dependent on the recording of a narrow range of computer codes, and the actual standard of care being delivered. Research is needed to see whether this finding is generalisable and how the Quality and Outcomes Framework might be better aligned with delivering best practice.

Methodological Choices in the Content Analysis of Textbooks for Measuring Alignment with Standards

ERIC Educational Resources Information Center

Polikoff, Morgan S.; Zhou, Nan; Campbell, Shauna E.

2015-01-01

With the recent adoption of the Common Core standards in many states, there is a need for quality information about textbook alignment to standards. While there are many existing content analysis procedures, these generally have little, if any, validity or reliability evidence. One exception is the Surveys of Enacted Curriculum (SEC), which has…

7 CFR 1710.408 - Quality assurance plan.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE GENERAL AND PRE-LOAN POLICIES AND PROCEDURES COMMON TO ELECTRIC LOANS AND GUARANTEES Energy... accordance with quality assurance plans meeting standards designed to achieve the purposes of this subpart... pump) the new system must be designed and installed by certified and insured professionals acceptable...

Recent progress in the development of ISO 19751

NASA Astrophysics Data System (ADS)

Farnand, Susan P.; Dalal, Edul N.; Ng, Yee S.

2006-01-01

A small number of general visual attributes have been recognized as essential in describing image quality. These include micro-uniformity, macro-uniformity, colour rendition, text and line quality, gloss, sharpness, and spatial adjacency or temporal adjacency attributes. The multiple-part International Standard discussed here was initiated by the INCITS W1 committee on the standardization of office equipment to address the need for unambiguously documented procedures and methods, which are widely applicable over the multiple printing technologies employed in office applications, for the appearance-based evaluation of these visually significant image quality attributes of printed image quality. 1,2 The resulting proposed International Standard, for which ISO/IEC WD 19751-1 3 presents an overview and an outline of the overall procedure and common methods, is based on a proposal that was predicated on the idea that image quality could be described by a small set of broad-based attributes. 4 Five ad hoc teams were established (now six since a sharpness team is in the process of being formed) to generate standards for one or more of these image quality attributes. Updates on the colour rendition, text and line quality, and gloss attributes are provided.

Medicare program; standards for quality of water used in dialysis and revised guidelines on reuse of hemodialysis filters for end-stage renal disease (ESRD) patients--HCFA. Final rule.

PubMed

1995-09-18

This final rule revises the Medicare conditions for coverage of suppliers of end-stage renal disease services. The revisions remove general language in the regulations regarding water quality; incorporate by reference standards for monitoring the quality of water used in dialysis as published by the Association for the Advancement of Medical Instrumentation (AAMI) in its document, "Hemodialysis Systems" (second edition); and update existing regulations to incorporate by reference the second edition of AAMI's voluntary guidelines on "Reuse of Hemodialyzers."

77 FR 38889 - National Ambient Air Quality Standards for Particulate Matter

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... increased protection against health effects associated with long- and short-term exposures (including... against effects associated with short-term exposure to thoracic coarse particles (i.e., PM 10-2.5 ). With... current standards generally to address non-visibility welfare effects. The proposed distinct secondary...

7 CFR 58.135 - Bacterial estimate.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Milk § 58.135 Bacterial estimate. (a) Methods of Testing. Milk shall be tested for bacterial estimate...

Statistical study of air pollutant concentrations via generalized gamma distribution

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

Marani, A.; Lavagnini, I.; Buttazzoni, C.

1986-11-01

This paper deals with modeling observed frequency distributions of air quality data measured in the area of Venice, Italy. The paper discusses the application of the generalized gamma distribution (ggd) which has not been commonly applied to air quality data notwithstanding the fact that it embodies most distribution models used for air quality analyses. The approach yields important simplifications for statistical analyses. A comparison among the ggd and other relevant models (standard gamma, Weibull, lognormal), carried out on daily sulfur dioxide concentrations in the area of Venice underlines the efficiency of ggd models in portraying experimental data.

A Functional Model of Quality Assurance for Psychiatric Hospitals and Corresponding Staffing Requirements.

ERIC Educational Resources Information Center

Kamis-Gould, Edna; And Others

1991-01-01

A model for quality assurance (QA) in psychiatric hospitals is described. Its functions (general QA, utilization review, clinical records, evaluation, management information systems, risk management, and infection control), subfunctions, and corresponding staffing requirements are reviewed. This model was designed to foster standardization in QA…

Statistical Process Control: Going to the Limit for Quality.

ERIC Educational Resources Information Center

Training, 1987

1987-01-01

Defines the concept of statistical process control, a quality control method used especially in manufacturing. Generally, concept users set specific standard levels that must be met. Makes the point that although employees work directly with the method, management is responsible for its success within the plant. (CH)

Diet Quality of Collegiate Athletes

ERIC Educational Resources Information Center

Webber, Kelly; Stoess, Amanda Ireland; Forsythe, Hazel; Kurzynske, Janet; Vaught, Joy Ann; Adams, Bailey

2015-01-01

Background/Objectives: Collegiate athletes generally appear healthy according to weight for height and body fat standards. Despite the fact that there are well known connections between athletic performance and nutrition, little is known about the diets of collegiate athletes. The objective of this study was to determine the diet quality of 138…

The Curriculum Gap

ERIC Educational Resources Information Center

Carroll, Kathleen

2015-01-01

The challenge of updating curriculum to align with Common Core State Standards is a national one felt by states, districts, and teachers alike. Teachers generally express enthusiasm for the Common Core, but consistently cite a lack of high-quality curricula as an impediment to teaching them. The demand for core-aligned quality materials has far…

7 CFR 29.2275 - Group.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Group. 29.2275 Section 29.2275 Agriculture Regulations... INSPECTION Standards Official Standard Grades for Virginia Fire-Cured Tobacco (u.s. Type 21) § 29.2275 Group... usually related to stalk position, body, or the general quality of the tobacco. Groups in this type are...

7 CFR 29.2275 - Group.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Group. 29.2275 Section 29.2275 Agriculture Regulations... INSPECTION Standards Official Standard Grades for Virginia Fire-Cured Tobacco (u.s. Type 21) § 29.2275 Group... usually related to stalk position, body, or the general quality of the tobacco. Groups in this type are...

7 CFR 29.2275 - Group.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Group. 29.2275 Section 29.2275 Agriculture Regulations... INSPECTION Standards Official Standard Grades for Virginia Fire-Cured Tobacco (u.s. Type 21) § 29.2275 Group... usually related to stalk position, body, or the general quality of the tobacco. Groups in this type are...

7 CFR 29.2275 - Group.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 2 2013-01-01 2013-01-01 false Group. 29.2275 Section 29.2275 Agriculture Regulations... INSPECTION Standards Official Standard Grades for Virginia Fire-Cured Tobacco (u.s. Type 21) § 29.2275 Group... usually related to stalk position, body, or the general quality of the tobacco. Groups in this type are...

7 CFR 29.2275 - Group.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Group. 29.2275 Section 29.2275 Agriculture Regulations... INSPECTION Standards Official Standard Grades for Virginia Fire-Cured Tobacco (u.s. Type 21) § 29.2275 Group... usually related to stalk position, body, or the general quality of the tobacco. Groups in this type are...

40 CFR 260.11 - References.

Code of Federal Regulations, 2012 CFR

2012-07-01

...). (7) ASTM E 168-88, “Standard Practices for General Techniques of Infrared Quantitative Analysis,” IBR...-Visible Quantitative Analysis,” IBR approved for § 264.1063. (9) ASTM E 260-85, “Standard Practice for..., Research Triangle Park, NC. (1) “Screening Procedures for Estimating the Air Quality Impact of Stationary...

40 CFR 260.11 - References.

Code of Federal Regulations, 2014 CFR

2014-07-01

...). (7) ASTM E 168-88, “Standard Practices for General Techniques of Infrared Quantitative Analysis,” IBR...-Visible Quantitative Analysis,” IBR approved for § 264.1063. (9) ASTM E 260-85, “Standard Practice for..., Research Triangle Park, NC. (1) “Screening Procedures for Estimating the Air Quality Impact of Stationary...

40 CFR 260.11 - References.

Code of Federal Regulations, 2013 CFR

2013-07-01

...). (7) ASTM E 168-88, “Standard Practices for General Techniques of Infrared Quantitative Analysis,” IBR...-Visible Quantitative Analysis,” IBR approved for § 264.1063. (9) ASTM E 260-85, “Standard Practice for..., Research Triangle Park, NC. (1) “Screening Procedures for Estimating the Air Quality Impact of Stationary...

A potential gender bias in assessing quality of life - a standard gamble experiment among university students.

PubMed

Obaidi, Leath Al; Mahlich, Jörg

2015-01-01

There are several methodologies that can be used for evaluating patients' perception of their quality of life. Most commonly, utilities are directly elicited by means of either the time-trade-off or the standard-gamble method. In both methods, risk attitudes determine the quality of life values. Quality of life values among 31 Austrian undergraduate students were elicited by means of the standard gamble approach. The impact of several variables such as gender, side job, length of study, and living arrangements on the quality of life were identified using different types of regression techniques (ordinary least squares, generalized linear model, Betafit). Significant evidence was found that females are associated with a higher quality of life in all specifications of our estimations. The observed gender differences in quality of life can be attributed to a higher degree of risk aversion of women. A higher risk aversion leads to a higher valuation of given health states and a potential gender bias in health economic evaluations. This result could have implications for health policy planners when it comes to budget allocation decisions.

[ISO 15189 accreditation in clinical microbiology laboratory: general concepts and the status in our laboratory].

PubMed

Akyar, Işin

2009-10-01

One important trend in the laboratory profession and quality management is the global convergence of laboratory operations. The goal of an accredited medical laboratory is to continue "offering useful laboratory service for diagnosis and treatment of the patients and also aid to the health of the nation". An accredited clinical laboratory is managed by a quality control system, it is competent technically and the laboratory service meets the needs of all its patients and physicians by taking the responsibility of all the medical tests and therapies. For this purpose, ISO 15189 international standard has been prepared by 2003. ISO 15189 standard is originated from the arrangement of ISO 17025 and ISO 9001:2000 standards. Many countries such as England, Germany, France, Canada and Australia have preferred ISO 15189 as their own laboratory accreditation programme, meeting all the requirements of their medical laboratories. The accreditation performance of a clinical microbiology laboratory is mainly based on five essential points; preanalytical, analytical, postanalytical, quality control programmes (internal, external, interlaboratory) and audits (internal, external). In this review article, general concepts on ISO 15189 accreditation standards for the clinical microbiology laboratories have been summarized and the status of a private laboratory (Acibadem LabMed, Istanbul) in Turkey has been discussed.

Developing and implementing a computerized nursing quality control system in a tertiary general medical center in Israel.

PubMed

Kagan, Ilya; Cohen, Rachel; Fish, Miri; Mezare, Henia Perry

2014-01-01

This article describes the development and implementation of the Nursing Quality Indicators Scale and a quality control system for hospital nursing care, which allows universal access to all external and internal audit results, thus ensuring complete data transparency. Standardized indicators make departments' performance comparable. Key to the new system is nurses' self-audit and responsibility for making quality improvements at the ward level.

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

PubMed

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

2018-05-12

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

Ten tips for incorporating scientific quality improvement into everyday work.

PubMed

Goldmann, Don

2011-04-01

Healthcare personnel often find it challenging to incorporate disciplined quality improvement into their daily work. Planning, managing and completing improvement projects with sufficient rigour to generate credible evidence and potentially publishable knowledge are even more difficult. Nonetheless, careful set-up and agile leveraging of existing resources and expertise can lead to surprisingly robust results. Project designs that integrate data collection with the work itself are especially helpful. Although the general perception is that top-flight journals are loath to publish the results of quality improvement work, accumulating experience suggests that this hurdle can be overcome. The Standards for Quality Improvement Reporting Excellence guidelines provide a promising framework for crafting publications that can meet the exacting standards of peer-reviewed journals.

Ten tips for incorporating scientific quality improvement into everyday work

PubMed Central

2011-01-01

Healthcare personnel often find it challenging to incorporate disciplined quality improvement into their daily work. Planning, managing and completing improvement projects with sufficient rigour to generate credible evidence and potentially publishable knowledge are even more difficult. Nonetheless, careful set-up and agile leveraging of existing resources and expertise can lead to surprisingly robust results. Project designs that integrate data collection with the work itself are especially helpful. Although the general perception is that top-flight journals are loath to publish the results of quality improvement work, accumulating experience suggests that this hurdle can be overcome. The Standards for Quality Improvement Reporting Excellence guidelines provide a promising framework for crafting publications that can meet the exacting standards of peer-reviewed journals. PMID:21450777

Implementation of Quality Systems in Nuclear Medicine: Why It Matters. An Outcome Analysis (Quality Management Audits in Nuclear Medicine Part III).

PubMed

Dondi, Maurizio; Paez, Diana; Torres, Leonel; Marengo, Mario; Delaloye, Angelika Bischof; Solanki, Kishor; Van Zyl Ellmann, Annare; Lobato, Enrique Estrada; Miller, Rodolfo Nunez; Giammarile, Francesco; Pascual, Thomas

2018-05-01

The International Atomic Energy Agency (IAEA) developed a comprehensive program-Quality Management Audits in Nuclear Medicine (QUANUM). This program covers all aspects of nuclear medicine practices including, but not limited to, clinical practice, management, operations, and services. The QUANUM program, which includes quality standards detailed in relevant checklists, aims at introducing a culture of comprehensive quality audit processes that are patient oriented, systematic, and outcome based. This paper will focus on the impact of the implementation of QUANUM on daily routine practices in audited centers. Thirty-seven centers, which had been externally audited by experts under IAEA auspices at least 1 year earlier, were invited to run an internal audit using the QUANUM checklists. The external audits also served as training in quality management and the use of QUANUM for the local teams, which were responsible of conducting the internal audits. Twenty-five out of the 37 centers provided their internal audit report, which was compared with the previous external audit. The program requires that auditors score each requirement within the QUANUM checklists on a scale of 0-4, where 0-2 means nonconformance and 3-4 means conformance to international regulations and standards on which QUANUM is based. Our analysis covering both general and clinical areas assessed changes on the conformance status on a binary manner and the level of conformance scores. Statistical analysis was performed using nonparametric statistical tests. The evaluation of the general checklists showed a global improvement on both the status and the levels of conformances (P < 0.01). The evaluation of the requirements by checklist also showed a significant improvement in all, with the exception of Hormones and Tumor marker determinations, where changes were not significant. Of the 25 evaluated institutions, 88% (22 of 25) and 92% (23 of 25) improved their status and levels of conformance, respectively. Fifty-five requirements, on average, increased from nonconformance to conformance status. In 8 key areas, the number of improved requirements was well above the average: Administration & Management (checklist 2); Radiation Protection & Safety (checklist 4); General Quality Assurance system (checklist 6); Imaging Equipment Quality Assurance or Quality Control (checklist 7); General Diagnostic (checklist 9); General Therapeutic (checklist 12); Radiopharmacy Level 1 (checklist 14); and Radiopharmacy Level 2 (checklist 15). Analysis of results related to clinical activities showed an overall positive impact on both the status and the level of conformance to international standards. Similar results were obtained for the most frequently performed clinical imaging and therapeutic procedures. Our study shows that the implementation of a comprehensive quality management system through the IAEA QUANUM program has a positive impact on nuclear medicine practices. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Effects of State Minimum Staffing Standards on Nursing Home Staffing and Quality of Care

PubMed Central

Park, Jeongyoung; Stearns, Sally C

2009-01-01

Objective To investigate the impact of state minimum staffing standards on the level of staffing and quality of nursing home care. Data Sources Online Survey and Certification Reporting System (OSCAR) merged with the Area Resource File from 1998 through 2001. Study Design Between 1998 and 2001, 16 states implemented or expanded staffing standards in excess of federal requirements, creating a natural experiment in comparison with facilities in states without new standards. Difference-in-differences models using facility fixed effects were estimated to determine the effect of state standards. Data Collection/Extraction Methods OSCAR data were linked to the data on market conditions and state policies. A total of 55,248 facility-year observations from 15,217 freestanding facilities were analyzed. Principal Findings Increased standards resulted in small staffing increases for facilities with staffing initially below or close to new standards. Yet the standards were associated with reductions in restraint use and the number of total deficiencies at all types of facilities. Conclusions Mandated staffing standards affect only low-staff facilities facing potential for penalties, and effects are small. Selected facility-level outcomes may show improvement at all facilities due to a general response to increased standards or to other quality initiatives implemented at the same time as staffing standards. PMID:18823448

45 CFR 98.51 - Activities to improve the quality of child care.

Code of Federal Regulations, 2012 CFR

2012-10-01

... applicable State, local, and tribal child care standards, including applicable health and safety requirements... 45 Public Welfare 1 2012-10-01 2012-10-01 false Activities to improve the quality of child care. 98.51 Section 98.51 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION...

45 CFR 98.51 - Activities to improve the quality of child care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... applicable State, local, and tribal child care standards, including applicable health and safety requirements... 45 Public Welfare 1 2010-10-01 2010-10-01 false Activities to improve the quality of child care. 98.51 Section 98.51 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION...

45 CFR 98.51 - Activities to improve the quality of child care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... applicable State, local, and tribal child care standards, including applicable health and safety requirements... 45 Public Welfare 1 2011-10-01 2011-10-01 false Activities to improve the quality of child care. 98.51 Section 98.51 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION...

45 CFR 98.51 - Activities to improve the quality of child care.

Code of Federal Regulations, 2014 CFR

2014-10-01

... applicable State, local, and tribal child care standards, including applicable health and safety requirements... 45 Public Welfare 1 2014-10-01 2014-10-01 false Activities to improve the quality of child care. 98.51 Section 98.51 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION...

45 CFR 98.51 - Activities to improve the quality of child care.

Code of Federal Regulations, 2013 CFR

2013-10-01

... applicable State, local, and tribal child care standards, including applicable health and safety requirements... 45 Public Welfare 1 2013-10-01 2013-10-01 false Activities to improve the quality of child care. 98.51 Section 98.51 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION...

77 FR 36443 - Disapproval and Promulgation of Air Quality Implementation Plans; State of Utah; Revisions To...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-19

... Promulgation of Air Quality Implementation Plans; State of Utah; Revisions To Open Burning Regulations AGENCY... Emission Standards: General Burning authorizes the State to extend the time period for open burning. EPA is... Burning. This rule contains the following provisions: definitions and exclusions, community waste disposal...

A systematic review of the PTSD Checklist's diagnostic accuracy studies using QUADAS.

PubMed

McDonald, Scott D; Brown, Whitney L; Benesek, John P; Calhoun, Patrick S

2015-09-01

Despite the popularity of the PTSD Checklist (PCL) as a clinical screening test, there has been no comprehensive quality review of studies evaluating its diagnostic accuracy. A systematic quality assessment of 22 diagnostic accuracy studies of the English-language PCL using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) assessment tool was conducted to examine (a) the quality of diagnostic accuracy studies of the PCL, and (b) whether quality has improved since the 2003 STAndards for the Reporting of Diagnostic accuracy studies (STARD) initiative regarding reporting guidelines for diagnostic accuracy studies. Three raters independently applied the QUADAS tool to each study, and a consensus among the 4 authors is reported. Findings indicated that although studies generally met standards in several quality areas, there is still room for improvement. Areas for improvement include establishing representativeness, adequately describing clinical and demographic characteristics of the sample, and presenting better descriptions of important aspects of test and reference standard execution. Only 2 studies met each of the 14 quality criteria. In addition, study quality has not appreciably improved since the publication of the STARD Statement in 2003. Recommendations for the improvement of diagnostic accuracy studies of the PCL are discussed. (c) 2015 APA, all rights reserved).

World Wide Web Server Standards and Guidelines.

ERIC Educational Resources Information Center

Stubbs, Keith M.

This document defines the specific standards and general guidelines which the U.S. Department of Education (ED) will use to make information available on the World Wide Web (WWW). The purpose of providing such guidance is to ensure high quality and consistent content, organization, and presentation of information on ED WWW servers, in order to…

Consistency Across Standards or Standards in a New Business Model

NASA Technical Reports Server (NTRS)

Russo, Dane M.

2010-01-01

Presentation topics include: standards in a changing business model, the new National Space Policy is driving change, a new paradigm for human spaceflight, consistency across standards, the purpose of standards, danger of over-prescriptive standards, a balance is needed (between prescriptive and general standards), enabling versus inhibiting, characteristics of success-oriented standards, characteristics of success-oriented standards, and conclusions. Additional slides include NASA Procedural Requirements 8705.2B identifies human rating standards and requirements, draft health and medical standards for human rating, what's been done, government oversight models, examples of consistency from anthropometry, examples of inconsistency from air quality and appendices of government and non-governmental human factors standards.

[Regulatory assessment of the "Nutrición Hospitalaria" journal].

PubMed

Iglesias Vázquez, E; Culebras, J M; García de Lorenzo, A

2000-01-01

A study is carried out to determine the degree of compliance by the journal entitled "Nutrición Hospitalaria" with the international standards issued by the ISO (International Standards Organization) by means of the application of a survey questionnaire drawn up in accordance with the guidelines published by national and international standards organizations. In total, 161 parameters are considered. Together with the general aspects of the publication, an analysis is made of its specific sections, decisive in the establishment of its level of compliance. After the analysis carried out, it was seen that the general standardization mean was 64% and the real average was 76.82%. At the same time, the necessary recommendations are given to improve these standardization levels and improve the editorial quality of "Nutrición Hospitalaria".

Mode of Communication, Perceived Level of Understanding, and Perceived Quality of Life in Youth Who Are Deaf or Hard of Hearing

ERIC Educational Resources Information Center

Kushalnagar, P.; Topolski, T. D.; Schick, B.; Edwards, T. C.; Skalicky, A. M.; Patrick, D. L.

2011-01-01

Given the important role of parent-youth communication in adolescent well-being and quality of life, we sought to examine the relationship between specific communication variables and youth perceived quality of life in general and as a deaf or hard-of-hearing (DHH) individual. A convenience sample of 230 youth (mean age = 14.1, standard deviation…

Quality of tuberculosis care in India: a systematic review.

PubMed

Satyanarayana, S; Subbaraman, R; Shete, P; Gore, G; Das, J; Cattamanchi, A; Mayer, K; Menzies, D; Harries, A D; Hopewell, P; Pai, M

2015-07-01

While Indian studies have assessed care providers' knowledge and practices, there is no systematic review on the quality of tuberculosis (TB) care. We searched multiple sources to identify studies (2000-2014) on providers' knowledge and practices. We used the International Standards for TB Care to benchmark quality of care. Of the 47 studies included, 35 were questionnaire surveys and 12 used chart abstraction. None assessed actual practice using standardised patients. Heterogeneity in the findings precluded meta-analysis. Of 22 studies evaluating provider knowledge about using sputum smears for diagnosis, 10 found that less than half of providers had correct knowledge; 3 of 4 studies assessing self-reported practices by providers found that less than a quarter reported ordering smears for patients with chest symptoms. In 11 of 14 studies that assessed treatment, less than one third of providers knew the standard regimen for drug-susceptible TB. Adherence to standards in practice was generally lower than correct knowledge of those standards. Eleven studies with both public and private providers found higher levels of appropriate knowledge/practice in the public sector. Available evidence suggests suboptimal quality of TB care, particularly in the private sector. Improvement of quality of care should be a priority for India.

Data collection automation and total quality management: case studies in the health-service industry.

PubMed

Smith, Alan D; Offodile, O Felix

2008-01-01

The limitations, immeasurable, and seemly unquantifiable aspects of the healthcare service industry, make it imperative that quality assurance programs include total quality management (TQM) and automatic identification and data capture (AIDC)-related technologies. Most of standards used in TQM and AIDC require data, to measure improvement and achieve standardization. Major difference between managing a service firm and managing a product-manufacturing firm is the difficulty of achieving consistently high quality. Examination of two different healthcare service providers in the Pittsburgh, Pennsylvania area offers different views as to the implementation and practice of total quality management techniques and AIDC integration. Since the healthcare service industry must take into account its high customization needs, there are positive steps to make the hospital structure itself more patient friendly and quality related; hence improving its heath-marketing strategies to the general public.

[Audit of general hospitals and private surgical clinics in Israel].

PubMed

Freund, Ruth; Dor, Michael; Lotan, Yoram; Haver, Eitan

2007-12-01

Supervision and inspection of medical facilities are among the responsibilities of the Ministry of Health (MOH) anchored in the "Public Health Act 1940". In order to implement the law, the General Medical Division of the MOH began the process of auditing hospitals and private surgical clinics prior to considering the reissue of their license. The audit aimed to implement the law, activate supervision on general hospitals and private surgical clinics, provide feed-back to the audited institution and upgrade quality assurance, regulate medical activities according to the activities elaborated in the license and recommend the license renewal. Prior to the audits, 20 areas of activity were chosen for inspection. For each activity a check list was developed as a tool for inspection. Each area was inspected during a 4-5 hour visit by a MOH expert, accompanied by the local service manager in the institution under inspection. A comprehensive report, summarizing the findings was sent to the medical institute, requesting correction in those areas where improvements were needed. Recommendation for license renewal was sent to the Director of Licensing Division Ministry of Health. Between June 2003 and July 2006, 91 structured audits took place. A total of 47 general hospitals and 24 private surgical clinics were visited at least once. Most general hospitals were found abiding, functioning according to the required standards and eligible for license renewal. Licenses of institutions that complied with the standards determined by the audit teams, were renewed. Two private hospitals in central Israel, that were given an overall poor evaluation, were issued with a temporary license and subsequently re-audited 4 times over the next two years. Generally, the standards in private surgical clinics were lower than those found in general public hospitals. In one clinic the license was not renewed, and in another an order was issued to cease surgical procedures requiring general anesthesia. The evaluations were mainly qualitative, deliberately avoiding numerical rating. In order to improve the process in the future and facilitate common scale rating to establish an equitable comparison system between institutions, it will be necessary to develop more quality measures and compulsory standards, based on the measures used during the first round of audits. Publication of the results of such comparisons, will elevate medical performance, and ultimately improve the quality of services and medical care in Israel.

Development and pilot of an internationally standardized measure of cardiovascular risk management in European primary care

PubMed Central

2011-01-01

Background Primary care can play an important role in providing cardiovascular risk management in patients with established Cardiovascular Diseases (CVD), patients with a known high risk of developing CVD, and potentially for individuals with a low risk of developing CVD, but who have unhealthy lifestyles. To describe and compare cardiovascular risk management, internationally valid quality indicators and standardized measures are needed. As part of a large project in 9 European countries (EPA-Cardio), we have developed and tested a set of standardized measures, linked to previously developed quality indicators. Methods A structured stepwise procedure was followed to develop measures. First, the research team allocated 106 validated quality indicators to one of the three target populations (established CVD, at high risk, at low risk) and to different data-collection methods (data abstraction from the medical records, a patient survey, an interview with lead practice GP/a practice survey). Secondly, we selected a number of other validated measures to enrich the assessment. A pilot study was performed to test the feasibility. Finally, we revised the measures based on the findings. Results The EPA-Cardio measures consisted of abstraction forms from the medical-records data of established Coronary Heart Disease (CHD)-patients - and high-risk groups, a patient questionnaire for each of the 3 groups, an interview questionnaire for the lead GP and a questionnaire for practice teams. The measures were feasible and accepted by general practices from different countries. Conclusions An internationally standardized measure of cardiovascular risk management, linked to validated quality indicators and tested for feasibility in general practice, is now available. Careful development and pilot testing of the measures are crucial in international studies of quality of healthcare. PMID:21473758

Implementation of an Evidence-Based and Content Validated Standardized Ostomy Algorithm Tool in Home Care: A Quality Improvement Project.

PubMed

Bare, Kimberly; Drain, Jerri; Timko-Progar, Monica; Stallings, Bobbie; Smith, Kimberly; Ward, Naomi; Wright, Sandra

Many nurses have limited experience with ostomy management. We sought to provide a standardized approach to ostomy education and management to support nurses in early identification of stomal and peristomal complications, pouching problems, and provide standardized solutions for managing ostomy care in general while improving utilization of formulary products. This article describes development and testing of an ostomy algorithm tool.

How to Select a Questionnaire with a Good Methodological Quality?

PubMed

Paiva, Saul Martins; Perazzo, Matheus de França; Ortiz, Fernanda Ruffo; Pordeus, Isabela Almeida; Martins-Júnior, Paulo Antônio

2018-01-01

In the last decades, several instruments have been used to evaluate the impact of oral health problems on the oral health-related quality of life (OHRQoL) of individuals. However, some instruments lack thorough methodological validation or present conceptual differences that hinder comparisons with instruments. Thus, it can be difficult to clinicians and researchers to select a questionnaire that accurately reflect what are really meaningful to individuals. This short communication aimed to discuss the importance of use an appropriate checklist to select an instrument with a good methodological quality. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was developed to provide tools for evidence-based instrument selection. The COSMIN checklist comprises ten boxes that evaluate whether a study meets the standard for good methodological quality and two additional boxes to meet studies that use the Item Response Theory method and general requirements for results generalization, resulting in four steps to be followed. In this way, it is required at least some expertise in psychometrics or clinimetrics to a wide-ranging use of this checklist. The COSMIN applications include its use to ensure the standardization of cross-cultural adaptations and safer comparisons between measurement studies and evaluation of methodological quality of systematic reviews of measurement properties. Also, it can be used by students when training about measurement properties and by editors and reviewers when revising manuscripts on this topic. The popularization of COSMIN checklist is therefore necessary to improve the selection and evaluation of health measurement instruments.

[The significance of meat quality in marketing].

PubMed

Kallweit, E

1994-07-01

Food quality in general and meat quality in particular are not only evaluated by means of objective quality traits but the entire production process is gaining more attention by the modern consumer. Due to this development quality programs were developed to define the majority of the processes in all production and marketing steps which are again linked by contracts. Not all of these items are quality relevant, but are concessions to ethic principles (animal welfare etc.). This is demonstrated by the example of Scharrel-pork production. The price differentiation at the pork market is still influenced predominantly by quantitative carcass traits. On the European market quality programs still are of minor significance. Premiums which are paid for high quality standards are more or less compensated by higher production costs and lower lean meat percentages, which must be expected in stress susceptible strains. The high efforts to establish quality programs, however, help to improve the quality level in general, and secure the market shares for local producers.

A standard for measuring metadata quality in spectral libraries

NASA Astrophysics Data System (ADS)

Rasaiah, B.; Jones, S. D.; Bellman, C.

2013-12-01

A standard for measuring metadata quality in spectral libraries Barbara Rasaiah, Simon Jones, Chris Bellman RMIT University Melbourne, Australia barbara.rasaiah@rmit.edu.au, simon.jones@rmit.edu.au, chris.bellman@rmit.edu.au ABSTRACT There is an urgent need within the international remote sensing community to establish a metadata standard for field spectroscopy that ensures high quality, interoperable metadata sets that can be archived and shared efficiently within Earth observation data sharing systems. Metadata are an important component in the cataloguing and analysis of in situ spectroscopy datasets because of their central role in identifying and quantifying the quality and reliability of spectral data and the products derived from them. This paper presents approaches to measuring metadata completeness and quality in spectral libraries to determine reliability, interoperability, and re-useability of a dataset. Explored are quality parameters that meet the unique requirements of in situ spectroscopy datasets, across many campaigns. Examined are the challenges presented by ensuring that data creators, owners, and data users ensure a high level of data integrity throughout the lifecycle of a dataset. Issues such as field measurement methods, instrument calibration, and data representativeness are investigated. The proposed metadata standard incorporates expert recommendations that include metadata protocols critical to all campaigns, and those that are restricted to campaigns for specific target measurements. The implication of semantics and syntax for a robust and flexible metadata standard are also considered. Approaches towards an operational and logistically viable implementation of a quality standard are discussed. This paper also proposes a way forward for adapting and enhancing current geospatial metadata standards to the unique requirements of field spectroscopy metadata quality. [0430] BIOGEOSCIENCES / Computational methods and data processing [0480] BIOGEOSCIENCES / Remote sensing [1904] INFORMATICS / Community standards [1912] INFORMATICS / Data management, preservation, rescue [1926] INFORMATICS / Geospatial [1930] INFORMATICS / Data and information governance [1946] INFORMATICS / Metadata [1952] INFORMATICS / Modeling [1976] INFORMATICS / Software tools and services [9810] GENERAL OR MISCELLANEOUS / New fields

Review of Special Standards in Quality Management Systems Audits in Automotive Production

NASA Astrophysics Data System (ADS)

Šurinová, Yulia

2013-12-01

Quality management systems (QMS) in automotive industry generally have several differences in comparison with other industrial branches. Different customers have their own specific requirements, including requirements for quality audits. Audits are one of the coretools of quality management to make the PDCA (Plan - Do - Check - Act) cycle work. As a matter of fact, compliance with ISO/TS 16949:2009 requirements is a condition for supplying the automotive industry. However, there are some standards which co-exist together with the ISO 9001 based management systems and technical specification for QMS in automotive ISO/TS16949. Which are those specific standards in automotive industry and what standard to use and why - those are the questions to be answered in this paper. The aim of the paper is to review what standards are used for audits implementation in automotive industry in the Slovak Republic, and why the organizations keep following those "extra" standards even if certification for ISO/TS 16949 is required by all the car makers. The paper is structured as follows: after short introduction to the topic and related terms, presented is our methodology. . In the third section, the achieved results are discussed. And finally, the principal findings of the paper, limitations and conclusions are presented.

20 CFR 416.1040 - General.

Code of Federal Regulations, 2010 CFR

2010-04-01

... acceptable. Also, the standards are designed to improve overall State agency performance in the disability... efficient manner. We measure the performance of a State agency in two areas—processing time and quality of...

20 CFR 404.1640 - General.

Code of Federal Regulations, 2010 CFR

2010-04-01

... acceptable. Also, the standards are designed to improve overall State agency performance in the disability... efficient manner. We measure the performance of a State agency in two areas—processing time and quality of...

Quality Control Practices for Chemistry and Immunochemistry in a Cohort of 21 Large Academic Medical Centers.

PubMed

Rosenbaum, Matthew W; Flood, James G; Melanson, Stacy E F; Baumann, Nikola A; Marzinke, Mark A; Rai, Alex J; Hayden, Joshua; Wu, Alan H B; Ladror, Megan; Lifshitz, Mark S; Scott, Mitchell G; Peck-Palmer, Octavia M; Bowen, Raffick; Babic, Nikolina; Sobhani, Kimia; Giacherio, Donald; Bocsi, Gregary T; Herman, Daniel S; Wang, Ping; Toffaletti, John; Handel, Elizabeth; Kelly, Kathleen A; Albeiroti, Sami; Wang, Sihe; Zimmer, Melissa; Driver, Brandon; Yi, Xin; Wilburn, Clayton; Lewandrowski, Kent B

2018-05-29

In the United States, minimum standards for quality control (QC) are specified in federal law under the Clinical Laboratory Improvement Amendment and its revisions. Beyond meeting this required standard, laboratories have flexibility to determine their overall QC program. We surveyed chemistry and immunochemistry QC procedures at 21 clinical laboratories within leading academic medical centers to assess if standardized QC practices exist for chemistry and immunochemistry testing. We observed significant variation and unexpected similarities in practice across laboratories, including QC frequency, cutoffs, number of levels analyzed, and other features. This variation in practice indicates an opportunity exists to establish an evidence-based approach to QC that can be generalized across institutions.

Geohydrology and water quality of the stratified-drift aquifers in Upper Buttermilk Creek and Danby Creek Valleys, Town of Danby, Tompkins County, New York

USGS Publications Warehouse

Miller, Todd S.

2015-11-20

During 2007–10, groundwater samples were collected from 13 wells including 7 wells that are completed in the confined sand and gravel aquifers, 1 well that is completed in the unconfined aquifer, and 5 wells that are completed in the bedrock aquifers. Calcium dominates the cation composition and bicarbonate dominates the anion composition in most groundwater. Water quality in the study area generally meets state and Federal drinking-water standards but concentrations of some constituents exceeded the standards. The standards that were exceeded include sodium (3 samples), dissolved solids (1 sample), iron (3 samples), manganese (8 samples), and arsenic (1 sample).

7 CFR 58.138 - Quality testing of milk from new producers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... a plant for the first time or resuming shipment to a plant after a period of non-shipment. The milk... 7 Agriculture 3 2011-01-01 2011-01-01 false Quality testing of milk from new producers. 58.138... (CONTINUED) GRADING AND INSPECTION, GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF...

7 CFR 58.138 - Quality testing of milk from new producers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... a plant for the first time or resuming shipment to a plant after a period of non-shipment. The milk... 7 Agriculture 3 2010-01-01 2010-01-01 false Quality testing of milk from new producers. 58.138... (CONTINUED) GRADING AND INSPECTION, GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF...

Falling Standard of Education as a Threat to Transformation, Reform and Development in Nigeria

ERIC Educational Resources Information Center

Olukolade, Odekunle; Chinonyerem, Unaeze Ugochi

2013-01-01

Education is a great instrument of importance to every nation. It, therefore, attracts considerable attention. It has been generally conceived that only an educated population can command the skills necessary for sustainable economic growth and a better quality of life. The quality of education received by citizens is therefore important in…

Librarian co-authors correlated with higher quality reported search strategies in general internal medicine systematic reviews.

PubMed

Rethlefsen, Melissa L; Farrell, Ann M; Osterhaus Trzasko, Leah C; Brigham, Tara J

2015-06-01

To determine whether librarian and information specialist authorship was associated with better reported systematic review (SR) search quality. SRs from high-impact general internal medicine journals were reviewed for search quality characteristics and reporting quality by independent reviewers using three instruments, including a checklist of Institute of Medicine Recommended Standards for the Search Process and a scored modification of the Peer Review of Electronic Search Strategies instrument. The level of librarian and information specialist participation was significantly associated with search reproducibility from reported search strategies (Χ(2) = 23.5; P < 0.0001). Librarian co-authored SRs had significantly higher odds of meeting 8 of 13 analyzed search standards than those with no librarian participation and six more than those with mentioned librarian participation. One-way ANOVA showed that differences in total search quality scores between all three groups were statistically significant (F2,267 = 10.1233; P < 0.0001). Problems remain with SR search quality and reporting. SRs with librarian or information specialist co-authors are correlated with significantly higher quality reported search strategies. To minimize bias in SRs, authors and editors could encourage librarian engagement in SRs including authorship as a potential way to help improve documentation of the search strategy. Copyright © 2015 Elsevier Inc. All rights reserved.

Individual music therapy for depression: randomised controlled trial.

PubMed

Erkkilä, Jaakko; Punkanen, Marko; Fachner, Jörg; Ala-Ruona, Esa; Pöntiö, Inga; Tervaniemi, Mari; Vanhala, Mauno; Gold, Christian

2011-08-01

Music therapy has previously been found to be effective in the treatment of depression but the studies have been methodologically insufficient and lacking in clarity about the clinical model employed. Aims To determine the efficacy of music therapy added to standard care compared with standard care only in the treatment of depression among working-age people. Participants (n = 79) with an ICD-10 diagnosis of depression were randomised to receive individual music therapy plus standard care (20 bi-weekly sessions) or standard care only, and followed up at baseline, at 3 months (after intervention) and at 6 months. Clinical measures included depression, anxiety, general functioning, quality of life and alexithymia. ISRCTN84185937. Participants receiving music therapy plus standard care showed greater improvement than those receiving standard care only in depression symptoms (mean difference 4.65, 95% CI 0.59 to 8.70), anxiety symptoms (1.82, 95% CI 0.09 to 3.55) and general functioning (-4.58, 95% CI -8.93 to -0.24) at 3-month follow-up. The response rate was significantly higher for the music therapy plus standard care group than for the standard care only group (odds ratio 2.96, 95% CI 1.01 to 9.02). Individual music therapy combined with standard care is effective for depression among working-age people with depression. The results of this study along with the previous research indicate that music therapy with its specific qualities is a valuable enhancement to established treatment practices.

The Impact of Federal Public Policy on Curriculum and Instruction for Students with Disabilities in the General Classroom

ERIC Educational Resources Information Center

Hardman, Michael L.; Dawson, Shirley

2008-01-01

The promise that all children will achieve higher levels of academic performance is the foundation of the current educational reform movement. Standards-based reform began with financial assistance to the states for the development of content and performance standards, improved teacher quality, and increased school accountability. The reform…

Part 2: Sensitivity comparisons of the insect Centroptilum triangulifer to Ceriodaphnia dubia and Daphnia magna using standard reference toxicants; NaCl, KCl and CuSO4

EPA Science Inventory

Criteria for establishing water quality standards that are protective of all native biota are generally based upon laboratory toxicity tests. These test utilize common model organisms that have established test methods. However, only a small portion of species have established ...

[Status and suggestions for adjuvant standard for Chinese materia medica processing in China].

PubMed

Yang, Chun-Yu; Cao, Hui; Wang, Xiao-Tao; Tu, Jia-Sheng; Qian, Zhong-Zhi; Yu, Zhi-Ling; Shang, Yue; Zhang, Bao-Xian

2017-04-01

In this paper, the status of adjuvant standard for Chinese materia medica processing in the Chinese Pharmacopoeia 2015 edition, the National Specification of Chinese Materia Medica Processing, and the 29 provincial specification of Chinese materia medica was summarized, and the the status including general requirements, specific requirements, and quality standard in the three grade official specifications was collected and analyzed according to the "medicine-adjuvant homology" and "food-adjuvant homology" features of adjuvants. This paper also introduced the research situation of adjuvant standard for Chinese materia medica processing in China; In addition, analyzed and discussed the problems existing in the standard system of adjuvant for Chinese materia medica processing, such as lack of general requirements, low level of standard, inconsistent standard references, and lack of research on the standard, and provided suggestions for the further establishment of the national standards system of adjuvant for Chinese materia medica processing. Copyright© by the Chinese Pharmaceutical Association.

7 CFR 58.721 - Salt.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... The Food Chemical Codex. ...

7 CFR 58.721 - Salt.

Code of Federal Regulations, 2013 CFR

2013-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... The Food Chemical Codex. ...

7 CFR 58.721 - Salt.

Code of Federal Regulations, 2011 CFR

2011-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... The Food Chemical Codex. ...

7 CFR 58.721 - Salt.

Code of Federal Regulations, 2012 CFR

2012-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... The Food Chemical Codex. ...

Primary care quality and safety systems in the English National Health Service: a case study of a new type of primary care provider.

PubMed

Baker, Richard; Willars, Janet; McNicol, Sarah; Dixon-Woods, Mary; McKee, Lorna

2014-01-01

Although the predominant model of general practice in the UK National Health Service (NHS) remains the small partnership owned and run by general practitioners (GPs), new types of provider are emerging. We sought to characterize the quality and safety systems and processes used in one large, privately owned company providing primary care through a chain of over 50 general practices in England. Senior staff with responsibility for policy on quality and safety were interviewed. We also undertook ethnographic observation in non-clinical areas and interviews with staff in three practices. A small senior executive team set policy and strategy on quality and safety, including a systematic incident reporting and investigation system and processes for disseminating learning with a strong emphasis on customer focus. Standardization of systems was possible because of the large number of practices. Policies appeared generally well implemented at practice level. However, there was some evidence of high staff turnover, particularly of GPs. This caused problems for continuity of care and challenges in inducting new GPs in the company's systems and procedures. A model of primary care delivery based on a corporate chain may be useful in standardizing policies and procedures, facilitating implementation of systems, and relieving clinical staff of administrative duties. However, the model also poses some risks, including those relating to stability. Provider forms that retain the long term, personal commitment of staff to their practices, such as federations or networks, should also be investigated; they may offer the benefits of a corporate chain combined with the greater continuity and stability of the more traditional general practice.

[Laboratory accreditation and proficiency testing].

PubMed

Kuwa, Katsuhiko

2003-05-01

ISO/TC 212 covering clinical laboratory testing and in vitro diagnostic test systems will issue the international standard for medical laboratory quality and competence requirements, ISO 15189. This standard is based on the ISO/IEC 17025, general requirements for competence of testing and calibration laboratories and ISO 9001, quality management systems-requirements. Clinical laboratory services are essential to patient care and therefore should be available to meet the needs of all patients and clinical personnel responsible for human health care. If a laboratory seeks accreditation, it should select an accreditation body that operates according to this international standard and in a manner which takes into account the particular requirements of clinical laboratories. Proficiency testing should be available to evaluate the calibration laboratories and reference measurement laboratories in clinical medicine. Reference measurement procedures should be of precise and the analytical principle of measurement applied should ensure reliability. We should be prepared to establish a quality management system and proficiency testing in clinical laboratories.

Wavelet/scalar quantization compression standard for fingerprint images

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

Brislawn, C.M.

1996-06-12

US Federal Bureau of Investigation (FBI) has recently formulated a national standard for digitization and compression of gray-scale fingerprint images. Fingerprints are scanned at a spatial resolution of 500 dots per inch, with 8 bits of gray-scale resolution. The compression algorithm for the resulting digital images is based on adaptive uniform scalar quantization of a discrete wavelet transform subband decomposition (wavelet/scalar quantization method). The FBI standard produces archival-quality images at compression ratios of around 15 to 1 and will allow the current database of paper fingerprint cards to be replaced by digital imagery. The compression standard specifies a class ofmore » potential encoders and a universal decoder with sufficient generality to reconstruct compressed images produced by any compliant encoder, allowing flexibility for future improvements in encoder technology. A compliance testing program is also being implemented to ensure high standards of image quality and interchangeability of data between different implementations.« less

Searching the Internet for information on prostate cancer screening: an assessment of quality.

PubMed

Ilic, Dragan; Risbridger, Gail; Green, Sally

2004-07-01

To identify how on-line information relating to prostate cancer screening (PCS) is best sourced, whether through general, medical, or meta-search engines, and to assess the quality of that information. Websites providing information about PCS were searched across 15 search engines representing three distinct types: general, medical, and meta-search engines. The quality of on-line information was assessed using the DISCERN quality assessment tool. Quality performance characteristics were analyzed by performing Mann-Whitney U tests. Search engine efficiency was measured by each search query as a percentage of the relevant websites included for analysis from the total returned and analyzed by performing Kruskal-Wallis analysis of variance. Of 6690 websites reviewed, 84 unique websites were identified as providing information relevant to PCS. General and meta-search engines were significantly more efficient at retrieving relevant information on PCS compared with medical search engines. The quality of information was variable, with most of a poor standard. Websites that provided referral links to other resources and a citation of evidence provided a significantly better quality of information. In contrast, websites offering a direct service were more likely to provide a significantly poorer quality of information. The current lack of a clear consensus on guidelines and recommendation in published data is also reflected by the variable quality of information found on-line. Specialized medical search engines were no more likely to retrieve relevant, high-quality information than general or meta-search engines.

New York Harbor water quality survey, 1994. Executive summary. Final report

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

Brosnan, T.M.; O`Shea, M.L.

1995-10-24

This summary presents the results of the 1994 survey, followed by a synopsis of recent changes to pollutant loads from NYC facilities. In general, conventional water quality, as indicated by coliform bacterica and DO levels, continues to improve in most areas of NY Harbor. However, violations of the `never less than` DO standards, although improved, are still occasionally recorded at 50-75% of all stations in summer. Therefore, loadings of nutrients and organic carbon, and changes in water column stratification and flushing rate, remain a concern, as does the appropriateness of the current `never the less` DO standards.

New York Harbor water quality survey, 1994. (Includes appendices). Final report

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

Brosnan, T.M.; O`Shea, M.L.

1995-11-15

This summary presents the results of the 1994 survey, followed by a synopsis of recent changes to pollutant loads from NYC facilities. In general, conventional water quality, as indicated by coliform bacterica and DO levels, continues to improve in most areas of NY Harbor. However, violations of the `never less than` DO standards, although improved, are still occasionally recorded at 50-75% of all stations in summer. Therefore, loadings of nutrients and organic carbon, and changes in water column stratification and flushing rate, remain a concern, as does the appropriateness of the current `never the less` DO standards.

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

Harriman, D.A.; Sargent, B.P.

Groundwater quality was evaluated in seven confined aquifers and the water table aquifer in east-central New Jersey based on 237 analyses of samples collected in 1981-82, and 225 older analyses. Investigation of the effect of land use on water quality and several sampling network proposals for the region are reported. Iron (Fe) and manganese (Mn) concentrations exceed US EPA drinking water standards in some wells screened in the Potomac-Raritan-Magothy aquifer system. Sodium (Na) concentrations in samples from three wells more than 800 ft deep in the Englishtown aquifer exceed the standard. Iron and Mn concentrations in this aquifer may alsomore » exceed the standards. Iron concentrations in the Wenonah-Mount Laurel aquifer exceed the standard. Based on 15 analyses of water from the Vincetown aquifer, Mn is the only constituent that exceeds the drinking water standard. In the Manasquan aquifer, 4 of the 16 Na determinations exceed the standard, and 8 of 16 Fe determinations exceed the standard. Water quality in the Atlantic City 800-ft sand is generally satisfactory. However, 12 Fe and 1 of 12 Mn determinations exceed the standards. For the Rio Grande water-bearing zone, 1 of 3 Fe determinations exceed the standard. The Kirkwood-Cohansey aquifer system was the most thoroughly sampled (249 chemical analyses from 209 wells). Dissolved solids, chloride, Fe, nitrate, and Mn concentrations exceed drinking water standards in some areas. 76 refs., 36 figs., 12 tabs.« less

7 CFR 58.328 - Salt.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... requirements of The Food Chemical Codex. ...

7 CFR 58.328 - Salt.

Code of Federal Regulations, 2011 CFR

2011-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... requirements of The Food Chemical Codex. ...

7 CFR 58.328 - Salt.

Code of Federal Regulations, 2013 CFR

2013-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... requirements of The Food Chemical Codex. ...

7 CFR 58.328 - Salt.

Code of Federal Regulations, 2012 CFR

2012-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... requirements of The Food Chemical Codex. ...

42 CFR 493.1227 - Condition: Histocompatibility.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., and §§ 493.1281 through 493.1299. General Laboratory Systems ... (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing § 493.1227 Condition: Histocompatibility. If the laboratory provides services in the specialty of...

42 CFR 493.1227 - Condition: Histocompatibility.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., and §§ 493.1281 through 493.1299. General Laboratory Systems ... (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing § 493.1227 Condition: Histocompatibility. If the laboratory provides services in the specialty of...

Robust Decision Making to Support Water Quality Climate Adaptation: a Case Study in the Chesapeake Bay Watershed

NASA Astrophysics Data System (ADS)

Fischbach, J. R.; Lempert, R. J.; Molina-Perez, E.

2017-12-01

The U.S. Environmental Protection Agency (USEPA), together with state and local partners, develops watershed implementation plans designed to meet water quality standards. Climate uncertainty, along with uncertainty about future land use changes or the performance of water quality best management practices (BMPs), may make it difficult for these implementation plans to meet water quality goals. In this effort, we explored how decision making under deep uncertainty (DMDU) methods such as Robust Decision Making (RDM) could help USEPA and its partners develop implementation plans that are more robust to future uncertainty. The study focuses on one part of the Chesapeake Bay watershed, the Patuxent River, which is 2,479 sq km in area, highly urbanized, and has a rapidly growing population. We simulated the contribution of stormwater contaminants from the Patuxent to the overall Total Maximum Daily Load (TMDL) for the Chesapeake Bay under multiple scenarios reflecting climate and other uncertainties. Contaminants considered included nitrogen, phosphorus, and sediment loads. The assessment included a large set of scenario simulations using the USEPA Chesapeake Bay Program's Phase V watershed model. Uncertainties represented in the analysis included 18 downscaled climate projections (based on 6 general circulation models and 3 emissions pathways), 12 land use scenarios with different population projections and development patterns, and alternative assumptions about BMP performance standards and efficiencies associated with different suites of stormwater BMPs. Finally, we developed cost estimates for each of the performance standards and compared cost to TMDL performance as a key tradeoff for future water quality management decisions. In this talk, we describe how this research can help inform climate-related decision support at USEPA's Chesapeake Bay Program, and more generally how RDM and other DMDU methods can support improved water quality management under climate uncertainty.

40 CFR Appendix H to Part 50 - Interpretation of the 1-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Code of Federal Regulations, 2010 CFR

2010-07-01

... a daily maximum hourly average ozone measurement that is greater than the level of the standard... determining the expected number of annual exceedances relate to accounting for incomplete sampling. In general... measurement. In some cases, a measurement might actually have been missed but in other cases no measurement...

The pancreatic surgery registry (StuDoQ|Pancreas) of the German Society for General and Visceral Surgery (DGAV) - presentation and systematic quality evaluation.

PubMed

Wellner, Ulrich F; Klinger, Carsten; Lehmann, Kai; Buhr, Heinz; Neugebauer, Edmund; Keck, Tobias

2017-04-05

Pancreatic resections are among the most complex procedures in visceral surgery. While mortality has decreased substantially over the past decades, morbidity remains high. The volume-outcome correlation in pancreatic surgery is among the strongest in the field of surgery. The German Society for General and Visceral Surgery (DGAV) established a national registry for quality control, risk assessment and outcomes research in pancreatic surgery in Germany (DGAV SuDoQ|Pancreas). Here, we present the aims and scope of the DGAV StuDoQ|Pancreas Registry. A systematic assessment of registry quality is performed based on the recommendations of the German network for outcomes research (DNVF). The registry quality was assessed by consensus criteria of the DNVF in regard to the domains Systematics and Appropriateness, Standardization, Validity of the sampling procedure, Validity of data collection, Validity of statistical analysis and reports, and General demands for registry quality. In summary, DGAV StuDoQ|Pancreas meets most of the criteria of a high-quality clinical registry. The DGAV StuDoQ|Pancreas provides a valuable platform for quality assessment, outcomes research as well as randomized registry trials in pancreatic surgery.

Quality of tuberculosis care in India: a systematic review

PubMed Central

Satyanarayana, S.; Subbaraman, R.; Shete, P.; Gore, G.; Das, J.; Cattamanchi, A.; Mayer, K.; Menzies, D.; Harries, A. D.; Hopewell, P.; Pai, M.

2015-01-01

SUMMARY BACKGROUND While Indian studies have assessed care providers’ knowledge and practices, there is no systematic review on the quality of tuberculosis (TB) care. METHODS We searched multiple sources to identify studies (2000–2014) on providers’ knowledge and practices. We used the International Standards for TB Care to benchmark quality of care. RESULTS Of the 47 studies included, 35 were questionnaire surveys and 12 used chart abstraction. None assessed actual practice using standardised patients. Heterogeneity in the findings precluded meta-analysis. Of 22 studies evaluating provider knowledge about using sputum smears for diagnosis, 10 found that less than half of providers had correct knowledge; 3 of 4 studies assessing self-reported practices by providers found that less than a quarter reported ordering smears for patients with chest symptoms. In 11 of 14 studies that assessed treatment, less than one third of providers knew the standard regimen for drug-susceptible TB. Adherence to standards in practice was generally lower than correct knowledge of those standards. Eleven studies with both public and private providers found higher levels of appropriate knowledge/practice in the public sector. CONCLUSIONS Available evidence suggests suboptimal quality of TB care, particularly in the private sector. Improvement of quality of care should be a priority for India. PMID:26056098

Dietary supplements quality analysis tools from the United States Pharmacopeia.

PubMed

Sarma, Nandakumara; Giancaspro, Gabriel; Venema, Jaap

2016-01-01

The United States Food and Drug Administration (FDA) issued the dietary supplement (DS) current good manufacturing practice (GMP) regulations in compliance with the mandate from the Dietary Supplements Health and Education Act (DSHEA), with the intention of protecting public health by ensuring the quality of DS. The GMP regulations require manufacturers to establish their own quality specifications for identity, purity, strength, composition, and absence of contaminants. Numerous FDA-conducted GMP inspections found that the private specifications set by these manufacturers are often insufficient to ensure adequate quality of dietary ingredients and DS. Wider use of the public standards developed by the United States Pharmacopeial Convention (USP), in conjunction with GMP compliance, can help ensure quality and consistency of DS as they do for medicines. Public health protection could be enhanced by strengthening the GMP provisions to require conformance with relevant United States Pharmacopeia-National Formulary (USP-NF) standards, or in the absence of USP standards, other public compendial standards. Another serious concern is the presence of synthetic drugs and drug analogues in products marketed as DS. Use of the new USP General Chapter Adulteration of Dietary Supplements with Drugs and Drug Analogs <2251> may reduce the exposure of consumers to dangerous drugs disguised as DS. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Quality assurance program requirements, Amendment 5 (9-26-79) to August 1973 issue

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

Not Available

This standard sets forth general requirements for planning, managing, conducting, and evaluating quality assurance programs for reactor development and test facility projects and associated processes, structures, components, and systems. These quality assurance requirements are based on proven practices and provide the means of control and verification whereby those responsible fo poject management can assure that the quality required for safe, reliable, and economical operation will be achieved. The objective of the program of the programs covered by this standard is to assure that structures, components, systems, and facilities are designed, developed, manufactured, constructed, operated, and maintained in compliance with establishedmore » engineering criteria. To achieve this objective, controls are to be established and implemented at predetermined points, and necessary action taken to prevent, detect, and correct any deficiencies.« less

WHO Expert Committee on Specifications for Pharmaceutical Preparations.

PubMed

2014-01-01

The Expert Committee on Specifications for Pharmaceutical Preparations works towards clear, independent and practical standards and guidelines for the quality assurance of medicines. Standards are developed by the Committee through worldwide consultation and an international consensus-building process. The following new guidelines were adopted and recommended for use, in addition to 20 monographs and general texts for inclusion in The International Pharmacopoeia and 11 new International Chemical Reference Substances. The International Pharmacopoeia--updating mechanism for the section on radiopharmaceuticals; WHO good manufacturing practices for pharmaceutical products: main principles; Model quality assurance system for procurement agencies; Assessment tool based on the model quality assurance system for procurement agencies: aide-memoire for inspection; Guidelines on submission of documentation for prequalification of finished pharmaceutical products approved by stringent regulatory authorities; and Guidelines on submission of documentation for a multisource (generic) finished pharmaceutical product: quality part.

VQone MATLAB toolbox: A graphical experiment builder for image and video quality evaluations: VQone MATLAB toolbox.

PubMed

Nuutinen, Mikko; Virtanen, Toni; Rummukainen, Olli; Häkkinen, Jukka

2016-03-01

This article presents VQone, a graphical experiment builder, written as a MATLAB toolbox, developed for image and video quality ratings. VQone contains the main elements needed for the subjective image and video quality rating process. This includes building and conducting experiments and data analysis. All functions can be controlled through graphical user interfaces. The experiment builder includes many standardized image and video quality rating methods. Moreover, it enables the creation of new methods or modified versions from standard methods. VQone is distributed free of charge under the terms of the GNU general public license and allows code modifications to be made so that the program's functions can be adjusted according to a user's requirements. VQone is available for download from the project page (http://www.helsinki.fi/psychology/groups/visualcognition/).

A method for tailoring the information content of a software process model

NASA Technical Reports Server (NTRS)

Perkins, Sharon; Arend, Mark B.

1990-01-01

The framework is defined for a general method for selecting a necessary and sufficient subset of a general software life cycle's information products, to support new software development process. Procedures for characterizing problem domains in general and mapping to a tailored set of life cycle processes and products is presented. An overview of the method is shown using the following steps: (1) During the problem concept definition phase, perform standardized interviews and dialogs between developer and user, and between user and customer; (2) Generate a quality needs profile of the software to be developed, based on information gathered in step 1; (3) Translate the quality needs profile into a profile of quality criteria that must be met by the software to satisfy the quality needs; (4) Map the quality criteria to set of accepted processes and products for achieving each criterion; (5) Select the information products which match or support the accepted processes and product of step 4; and (6) Select the design methodology which produces the information products selected in step 5.

A method for tailoring the information content of a software process model

NASA Technical Reports Server (NTRS)

Perkins, Sharon; Arend, Mark B.

1990-01-01

The framework is defined for a general method for selecting a necessary and sufficient subset of a general software life cycle's information products, to support new software development process. Procedures for characterizing problem domains in general and mapping to a tailored set of life cycle processes and products is presented. An overview of the method is shown using the following steps: (1) During the problem concept definition phase, perform standardized interviews and dialogs between developer and user, and between user and customer; (2) Generate a quality needs profile of the software to be developed, based on information gathered in step 1; (3) Translate the quality needs profile into a profile of quality criteria that must be met by the software to satisfy the quality needs; (4) Map the quality criteria to a set of accepted processes and products for achieving each criterion; (5) select the information products which match or support the accepted processes and product of step 4; and (6) Select the design methodology which produces the information products selected in step 5.

Global trends in milk quality: implications for the Irish dairy industry

PubMed Central

2009-01-01

The quality of Irish agricultural product will become increasingly important with the ongoing liberalisation of international trade. This paper presents a review of the global and Irish dairy industries; considers the impact of milk quality on farm profitability, food processing and human health, examines global trends in quality; and explores several models that are successfully being used to tackle milk quality concerns. There is a growing global demand for dairy products, fuelled in part by growing consumer wealth in developing countries. Global dairy trade represents only 6.2% of global production and demand currently outstrips supply. Although the Irish dairy industry is small by global standards, approximately 85% of annual production is exported annually. It is also the world's largest producer of powdered infant formula. Milk quality has an impact on human health, milk processing and on-farm profitability. Somatic cell count (SCC) is a key measure of milk quality, with a SCC not exceeding 400,000 cells/ml (the EU milk quality standard) generally accepted as the international export standard. There have been ongoing improvements in milk quality among both established and emerging international suppliers. A number of countries have developed successful industry-led models to tackle milk quality concerns. Based on international experiences, it is likely that problems with effective translation of knowledge to practice, rather than incomplete knowledge per se, are the more important constraints to national progress towards improved milk quality. PMID:22081986

Historical development and current status of emergency nursing in Turkey.

PubMed

Selimen, Deniz; Gürkan, Aysel

2009-09-01

As the demand for high quality Accident and Emergency Departments and nursing staff increases throughout Turkey, the need for more specialized emergency nurse training has also increased. Although there have been a number of positive developments regarding emergency nursing standards, the general quality of emergency nurse training needs to be improved and job definitions amended to better reflect the specialist duties of emergency nurses.

KPMG Peat Marwick LLP Corporation of Mercer University Fiscal Year Ended June 30, 1995

DTIC Science & Technology

1997-06-11

The objective of a quality control review is to ensure that the audit was conducted in accordance with applicable standards and meets the auditing...requirements of the OMB Circular A-133. We conducted a quality control review of the audit working papers. We focused our review on the following...qualitative aspects of the audit : due professional care, planning, supervision, independence, quality control, internal controls, substantive testing, general and specific compliance testing, and the Schedule of Federal Awards.

Reconciling an Ecological Curricular Framework Focusing on Quality of Life Outcomes with the Development and Instruction of Standards-Based Academic Goals

ERIC Educational Resources Information Center

Hunt, Pam; McDonnell, John; Crockett, Margret A.

2012-01-01

The emergence of the standards-based reform movement has raised a number of issues related to the design of educational programs for students with severe disabilities, and a debate has arisen that presents an "either/or" choice between the general education curriculum and an ecological curricular framework that has traditionally guided…

The Impact of Adapting a General Professional Development Framework to the Constraints of In-Service Professional Development on the Next Generation Science Standards in Urban Settings

ERIC Educational Resources Information Center

McGee, Steven; Nutakki, Nivedita

2017-01-01

Urban school districts face a dilemma in providing professional development support for teachers in transition to the Next Generation Science Standards (NGSS). Districts need to maximize the quality and amount of professional development within practical funding constraints. In this paper, we discuss preliminary results from a…

Enhancing Defense Standardization Specifications and Standards: Cornerstones of Quality

DTIC Science & Technology

1988-11-01

Aerospace technical void f/iat is 11uIn irh’s AssNociatlonl ent it led Inipw IIc o / Iflh’rnational Standlardi_-a- ool I/ irc’,i (on /he 1..Avro.spwcc Indust...o’Defense Index oj*Spec~ fica - tions and Standards. While there are nearly 50,000 documents listed. there are only about 27,000 military specifications and...authority of the General Services Administra - tion, their assistance is necessary for full implementation; as is the assistance of the National

Scientific computation systems quality branch manual

NASA Technical Reports Server (NTRS)

1972-01-01

A manual is presented which is designed to familiarize the GE 635 user with the configuration and operation of the overall system. Work submission, programming standards, restrictions, testing and debugging, and related general information is provided for GE 635 programmer.

7 CFR 58.437 - Salt.

Code of Federal Regulations, 2012 CFR

2012-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... requirements of the Food Chemical Codex. Operations and Operating Procedures ...

7 CFR 58.437 - Salt.

Code of Federal Regulations, 2013 CFR

2013-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... requirements of the Food Chemical Codex. Operations and Operating Procedures ...

7 CFR 58.437 - Salt.

Code of Federal Regulations, 2011 CFR

2011-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... requirements of the Food Chemical Codex. Operations and Operating Procedures ...

7 CFR 58.437 - Salt.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... requirements of the Food Chemical Codex. Operations and Operating Procedures ...

PERFORMANCE OF TRICKLING FILTER PLANTS: RELIABILITY, STABILITY, VARIABILITY

EPA Science Inventory

Effluent quality variability from trickling filters was examined in this study by statistically analyzing daily effluent BOD5 and suspended solids data from 11 treatment plants. Summary statistics (mean, standard deviation, etc.) were examined to determine the general characteris...

42 CFR 493.1200 - Introduction.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (that is, preanalytic, analytic, and postanalytic) as well as general laboratory systems. (b) The...) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing § 493.1200 Introduction. (a) Each laboratory that performs nonwaived testing must establish and maintain written policies...

Practical semen analysis: from A to Z

PubMed Central

Brazil, Charlene

2010-01-01

Accurate semen analysis is critical for decisions about patient care, as well as for studies addressing overall changes in semen quality, contraceptive efficacy and effects of toxicant exposure. The standardization of semen analysis is very difficult for many reasons, including the use of subjective techniques with no standards for comparison, poor technician training, problems with proficiency testing and a reluctance to change techniques. The World Health Organization (WHO) Semen handbook (2010) offers a vastly improved set of standardized procedures, all at a level of detail that will preclude most misinterpretations. However, there is a limit to what can be learned from words and pictures alone. A WHO-produced DVD that offers complete demonstrations of each technique along with quality assurance standards for motility, morphology and concentration assessments would enhance the effectiveness of the manual. However, neither the manual nor a DVD will help unless there is general acknowledgement of the critical need to standardize techniques and rigorously pursue quality control to ensure that laboratories actually perform techniques 'according to WHO' instead of merely reporting that they have done so. Unless improvements are made, patient results will continue to be compromised and comparison between studies and laboratories will have limited merit. PMID:20111076

Optimization of light quality from color mixing light-emitting diode systems for general lighting

NASA Astrophysics Data System (ADS)

Thorseth, Anders

2012-03-01

Given the problem of metamerisms inherent in color mixing in light-emitting diode (LED) systems with more than three distinct colors, a method for optimizing the spectral output of multicolor LED system with regards to standardized light quality parameters has been developed. The composite spectral power distribution from the LEDs are simulated using spectral radiometric measurements of single commercially available LEDs for varying input power, to account for the efficiency droop and other non-linear effects in electrical power vs. light output. The method uses electrical input powers as input parameters in a randomized steepest decent optimization. The resulting spectral power distributions are evaluated with regard to the light quality using the standard characteristics: CIE color rendering index, correlated color temperature and chromaticity distance. The results indicate Pareto optimal boundaries for each system, mapping the capabilities of the simulated lighting systems with regard to the light quality characteristics.

Measurement standards for interdisciplinary medical rehabilitation.

PubMed

Johnston, M V; Keith, R A; Hinderer, S R

1992-12-01

Rehabilitation must address problems inherent in the measurement of human function and health-related quality of life, as well as problems in diagnosis and measurement of impairment. This educational document presents an initial set of standards to be used as guidelines for development and use of measurement and evaluation procedures and instruments for interdisciplinary, health-related rehabilitation. Part I covers general measurement principles and technical standards, beginning with validity, the central consideration for use of measures. Subsequent sections focus on reliability and errors of measurement, norms and scaling, development of measures, and technical manuals and guides. Part II covers principles and standards for use of measures. General principles of application of measures in practice are discussed first, followed by standards to protect persons being measured and then by standards for administrative applications. Many explanations, examples, and references are provided to help professionals understand measurement principles. Improved measurement will ensure the basis of rehabilitation as a science and nourish its success as a clinical service.

Quality of water in the alluvial aquifer, American Bottoms, East St Louis, Illinois

USGS Publications Warehouse

Voelker, David C.

1984-01-01

Ground-water levels in the American Bottoms regions around East St. Louis, Illinois, have risen several feet since the early 1970's. Artificial dewatering of the aquifer by increased pumping is being investigated by the U.S. Army Corps of Engineers to alleviate economic and health concerns resulting from elevated ground-water levels. A ground-water quality evaluation is necessary for selecting a feasible dewatering scheme. Analyses of water samples from 63 wells show that except for iron, manganese, and dissolved solids, constituent concentrations do not exceed Illinois water-quality standards. The waters are primarily of the calcium-magnesium-bicarbonate type with some calcium-sulfate type water. Iron concentrations ranged from less than 3 to 82,000 micrograms per liter, manganese from 5 to 5,300 micrograms per liter, and dissolved solids from 140 to 3,000 milligrams per liter. These constituent concentrations exceed Illinois ' public water supply, effluent, and general water-quality standards in most samples and analysis indicates the concentrations are representative of the ambient water quality. Concentrations of nitrite + nitrate nitrogen fluoride, zinc, lead, and sulfate also exceeded Illinois water-quality standards in a few samples. Concentrations of organic pesticides, polychlorinated biphenyls, and polychlorinated naphthalenes were below analytical detection limits. (USGS)

Does standardised structured reporting contribute to quality in diagnostic pathology? The importance of evidence-based datasets.

PubMed

Ellis, D W; Srigley, J

2016-01-01

Key quality parameters in diagnostic pathology include timeliness, accuracy, completeness, conformance with current agreed standards, consistency and clarity in communication. In this review, we argue that with worldwide developments in eHealth and big data, generally, there are two further, often overlooked, parameters if our reports are to be fit for purpose. Firstly, population-level studies have clearly demonstrated the value of providing timely structured reporting data in standardised electronic format as part of system-wide quality improvement programmes. Moreover, when combined with multiple health data sources through eHealth and data linkage, structured pathology reports become central to population-level quality monitoring, benchmarking, interventions and benefit analyses in public health management. Secondly, population-level studies, particularly for benchmarking, require a single agreed international and evidence-based standard to ensure interoperability and comparability. This has been taken for granted in tumour classification and staging for many years, yet international standardisation of cancer datasets is only now underway through the International Collaboration on Cancer Reporting (ICCR). In this review, we present evidence supporting the role of structured pathology reporting in quality improvement for both clinical care and population-level health management. Although this review of available evidence largely relates to structured reporting of cancer, it is clear that the same principles can be applied throughout anatomical pathology generally, as they are elsewhere in the health system.

[Implementation of quality standard UNE-EN ISO/IEC 17043 in the External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology].

PubMed

Poveda Gabaldón, Marta; Ovies, María Rosario; Orta Mira, Nieves; Serrano, M del Remedio Guna; Avila, Javier; Giménez, Alicia; Cardona, Concepción Gimeno

2011-12-01

The quality standard "UNE-EN-ISO 17043: 2010. Conformity assessment. General requirements for proficiency testing" applies to centers that organize intercomparisons in all areas. In the case of clinical microbiology laboratories, these intercomparisons must meet the management and technical standards required to achieve maximum quality in the performance of microbiological analysis and the preparation of test items (sample, product, data or other information used in the proficiency test) to enable them to be accredited. Once accredited, these laboratories can operate as a tool for quality control laboratories and competency assessment. In Spain, accreditation is granted by the Spanish Accreditation Body [Entidad Nacional de Acreditación (ENAC)]. The objective of this review is to explain how to apply the requirements of the standard to laboratories providing intercomparisons in the field of clinical microbiology (the organization responsible for all the tasks related to the development and operation of a proficiency testing program). This requires defining the scope and specifying the technical requirements (personnel management, control of equipment, facilities and environment, the design of the proficiency testing and data analysis for performance evaluation, communication with participants and confidentiality) and management requirements (document control, purchasing control, monitoring of complaints / claims, non-compliance, internal audits and management reviews). Copyright © 2011 Elsevier España S.L. All rights reserved.

Music therapy for people with schizophrenia and schizophrenia-like disorders.

PubMed

Geretsegger, Monika; Mössler, Karin A; Bieleninik, Łucja; Chen, Xi-Jing; Heldal, Tor Olav; Gold, Christian

2017-05-29

Music therapy is a therapeutic approach that uses musical interaction as a means of communication and expression. Within the area of serious mental disorders, the aim of the therapy is to help people improve their emotional and relational competencies, and address issues they may not be able to using words alone. To review the effects of music therapy, or music therapy added to standard care, compared with placebo therapy, standard care or no treatment for people with serious mental disorders such as schizophrenia. We searched the Cochrane Schizophrenia Group's Trials Study-Based Register (December 2010 and 15 January, 2015) and supplemented this by contacting relevant study authors, handsearching of music therapy journals and manual searches of reference lists. All randomised controlled trials (RCTs) that compared music therapy with standard care, placebo therapy, or no treatment. Review authors independently selected, quality assessed and data extracted studies. We excluded data where more than 30% of participants in any group were lost to follow-up. We synthesised non-skewed continuous endpoint data from valid scales using a standardised mean difference (SMD). We employed a fixed-effect model for all analyses. If statistical heterogeneity was found, we examined treatment dosage (i.e. number of therapy sessions) and treatment approach as possible sources of heterogeneity. Ten new studies have been added to this update; 18 studies with a total 1215 participants are now included. These examined effects of music therapy over the short, medium, and long-term, with treatment dosage varying from seven to 240 sessions. Overall, most information is from studies at low or unclear risk of biasA positive effect on global state was found for music therapy compared to standard care (medium term, 2 RCTs, n = 133, RR 0.38 95% confidence interval (CI) 0.24 to 0.59, low-quality evidence, number needed to treat for an additional beneficial outcome NNTB 2, 95% CI 2 to 4). No binary data were available for other outcomes. Medium-term continuous data identified good effects for music therapy on negative symptoms using the Scale for the Assessment of Negative Symptoms (3 RCTs, n = 177, SMD - 0.55 95% CI -0.87 to -0.24, low-quality evidence). General mental state endpoint scores on the Positive and Negative Symptoms Scale were better for music therapy (2 RCTs, n = 159, SMD -0.97 95% CI -1.31 to -0.63, low-quality evidence), as were average endpoint scores on the Brief Psychiatric Rating Scale (1 RCT, n = 70, SMD -1.25 95% CI -1.77 to -0.73, moderate-quality evidence). Medium-term average endpoint scores using the Global Assessment of Functioning showed no effect for music therapy on general functioning (2 RCTs, n = 118, SMD -0.19 CI -0.56 to 0.18, moderate-quality evidence). However, positive effects for music therapy were found for both social functioning (Social Disability Screening Schedule scores; 2 RCTs, n = 160, SMD -0.72 95% CI -1.04 to -0.40), and quality of life (General Well-Being Schedule scores: 1 RCT, n = 72, SMD 1.82 95% CI 1.27 to 2.38, moderate-quality evidence). There were no data available for adverse effects, service use, engagement with services, or cost. Moderate- to low-quality evidence suggests that music therapy as an addition to standard care improves the global state, mental state (including negative and general symptoms), social functioning, and quality of life of people with schizophrenia or schizophrenia-like disorders. However, effects were inconsistent across studies and depended on the number of music therapy sessions as well as the quality of the music therapy provided. Further research should especially address the long-term effects of music therapy, dose-response relationships, as well as the relevance of outcome measures in relation to music therapy.

WHO Expert Committee on Specifications for Pharmaceutical Preparations.

PubMed

2011-01-01

The Expert Committee on Specifications for Pharmaceutical Preparations works towards clear, independent and practical standards and guidelines for the quality assurance of medicines. Standards are developed by the Committee through worldwide consultation and an international consensus-building process. The following new guidelines were adopted and recommended for use: procedure for adoption of International Chemical Reference Substances; WHO good practices for pharmaceutical microbiology laboratories; good manufacturing practices: main principles for pharmaceutical products; good manufacturing practices for blood establishments (jointly with the Expert Committee on Biological Standardization); guidelines on good manufacturing practices for heating, ventilation and air-conditioning systems for non-sterile pharmaceutical dosage forms; good manufacturing practices for sterile pharmaceutical products; guidelines on transfer of technology in pharmaceutical manufacturing; good pharmacy practice: standards for quality of pharmacy services (joint FIP/WHO); model guidance for the storage and transport of time- and temperature-sensitive pharmaceutical products (jointly with the Expert Committee on Biological Standardization); procedure for prequalification of pharmaceutical products; guide on submission of documentation for prequalification of innovator finished pharmaceutical products approved by stringent regulatory authorities; prequalification of quality control laboratories: procedure for assessing the acceptability, in principle, of quality control laboratories for use by United Nations agencies; guidelines for preparing a laboratory information file; guidelines for drafting a site master file; guidelines on submission of documentation for a multisource (generic) finished product: general format: preparation of product dossiers in common technical document format.

Ground-water-quality assessment of the Carson River basin, Nevada and California; analysis of available water-quality data through 1987

USGS Publications Warehouse

Welch, A.H.; Plume, R.W.; Frick, E.A.; Hughes, J.L.

1989-01-01

Data on groundwater quality, hydrogeology, and land and water use for the Carson River basin, Nevada and California were analyzed as part of the U. S. Geological Survey National Water-Quality Assessment program. The basin consists of six hydrographic areas--a mountainous headwaters area and five downstream areas interconnected by the Carson River. Each valley contains one or more basin-fill aquifers. The data on groundwater quality came from several agencies and were screened to verify site location and to avoid analyses of treated water. The screened data are stored in the U. S. Geological Survey National Water Information System data base. Differences in sample-collection and preservation procedures among some of the data-collection agencies restrict use of the data to a descriptive analysis. Drinking water standards were employed as the basis for evaluating reported concentrations. Frequencies with which primary or secondary standards are exceeded increase from upstream parts of the basin to downstream parts. Primary standards commonly exceeded are fluoride in upstream areas and arsenic and fluoride in downstream areas. Secondary standards commonly exceeded are iron and manganese in upstream areas and chloride, dissolved solids, iron, manganese, and sulfate in downstream areas. The poorer-quality groundwater generally is a result of natural geochemical reactions, rather than the introduction of chemicals by man. Limited data indicate, however , that manmade organic compounds are present, mostly at or near urban land. (USGS)

7 CFR 2900.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AGRICULTURE ESSENTIAL AGRICULTURAL USES AND VOLUMETRIC REQUIREMENTS-NATURAL GAS POLICY ACT § 2900.2... maintenance of food quality after processing. (b) Establishment means an economic unit, generally at a single... definition used in the Standard Industrial Classification Manual, 1972 edition). (c) Essential Agricultural...

7 CFR 58.633 - Color.

Code of Federal Regulations, 2011 CFR

2011-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... and Drug Administration as safe for human consumption. Operations and Operating Procedures ...

Virtual reality exposure therapy for the treatment of anxiety disorders: an evaluation of research quality.

PubMed

McCann, Russell A; Armstrong, Christina M; Skopp, Nancy A; Edwards-Stewart, Amanda; Smolenski, Derek J; June, Jennifer D; Metzger-Abamukong, Melinda; Reger, Greg M

2014-08-01

Randomized controlled trials (RCTs) support the effectiveness of virtual reality exposure therapy (VRET) for anxiety disorders; however, the overall quality of the VRET RCT literature base has yet to be evaluated. This study reviewed 27 VRET RCTs and the degree of adherence to 8 RCT research design criteria derived from existing standards. Adherence to the study quality criteria was generally low as the articles met an average 2.85 criteria (SD=1.56). None of the studies met more than six quality criteria. Study quality did not predict effect size; however, a reduction in effect size magnitude was observed for studies with larger sample sizes when comparing VRET to non-active control groups. VRET may be an effective method of treatment but caution should be exercised in interpreting the existing body of literature supporting VRET relative to existing standards of care. The need for well-designed VRET research is discussed. Copyright © 2014. Published by Elsevier Ltd.

Development of EPA aircraft piston engine emission standards. [for air quality

NASA Technical Reports Server (NTRS)

Houtman, W.

1976-01-01

Piston engine light aircraft are significant sources of carbon monoxide in the vicinity of high activity general aviation airports. Substantial reductions in carbon monoxide were achieved by fuel mixture leaning using improved fuel management systems. The air quality impact of the hydrocarbon and oxides of nitrogen emissions from piston engine light aircraft were insufficient to justify the design constraints being confronted in present control system developments.

A prospective study using Hatha Yoga for stress reduction among women waiting for IVF treatment.

PubMed

Oron, Galia; Allnutt, Erica; Lackman, Tasha; Sokal-Arnon, Tamar; Holzer, Hananel; Takefman, Janet

2015-05-01

Yoga has been found to be effective in treating anxiety and depression, reducing stress and improving the overall quality of life in the general population. Minimal research is available on the effect of stress-management programmes with IVF patients. Owing to the diversity of conditions treated, the poor quality of most studies, and the different assessment tools used to evaluate the psychological state, it is difficult to draw definite conclusions. Previous studies have used different mind-body interventions and general measures of stress without evaluation of specific stresses known to result from infertility and its treatment using standardized measures. In this single-centre study, 49 infertile women were recruited to participate in a 6-week Yoga class during 2013 while awaiting their IVF treatment. Study participants were asked to complete standardized questionnaires assessing fertility-related quality of life (FertiQoL), marital harmony (Dyadic Adjustment Scale [DAS]), state and trait anxiety (State-Trait Anxiety Inventory [STAI]) and depression (Beck Depression Inventory [BDI]) before commencing and after completing the Yoga workshops. Anxiety, depression and fertility-specific quality of life showed improvement over time in association with participation in a 6-week Yoga programme in women awaiting their treatment with IVF. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Quantifying short-term and long-term health benefits of attaining ambient fine particulate pollution standards in Guangzhou, China

NASA Astrophysics Data System (ADS)

Lin, Hualiang; Liu, Tao; Xiao, Jianpeng; Zeng, Weilin; Li, Xing; Guo, Lingchuan; Xu, Yanjun; Zhang, Yonghui; Vaughn, Michael G.; Nelson, Erik J.; Qian, Zhengmin (Min); Ma, Wenjun

2016-07-01

In 2012, Chinese Environmental Bureau modified its National Ambient Air Quality Standards to include fine particulate matter (PM2.5). Recent air pollution monitoring data shows that numerous locations have exceeded this standard, which may have resulted in avoidable adverse health effects. For example, among the 74 Chinese cities with PM2.5 monitoring data in 2013, only three cities attained the annual air quality standard (35 μg/m3). This study aimed to quantify the potential short- and long-term health benefits from achieving the Chinese ambient air quality standard and WHO's air quality objectives. A generalized additive model was used to estimate the short-term association of mortality with changes in daily PM2.5 concentrations, based on which we estimated the potential premature mortality reduction that would have been achieved during the period of 2012-2015 if the daily air quality standard had been met in Guangzhou, China; we also estimated the avoidable deaths if attaining the annual air quality standard using the relative risk obtained from a previous cohort study. During the study period, there were 160 days exceeding the national daily PM2.5 standard (75 μg/m3) in Guangzhou, and the annual average concentration (47.7 μg/m3) was higher than the air quality standard of 35 μg/m3. Significant associations between PM2.5 and mortality were observed. An increase of 10 μg/m3 in PM2.5 was associated with increases in daily death counts of 0.95% (95% CI: 0.56%, 1.34%) in natural mortality, 1.31% (95% CI: 0.75%, 1.87%) in cardiovascular mortality, and 1.06% (95% CI: 0.19%, 1.94%) in respiratory mortality. The health benefits of attaining the national daily air quality standard of PM2.5 (75 μg/m3) would have prevented 143 [95% confidence interval (CI): 84, 203] fewer natural deaths, including 84 (95% CI: 48, 121) fewer cardiovascular deaths and 27 (95% CI: 5, 49) fewer respiratory deaths. Had the annual PM2.5 levels been reduced to 35 μg/m3, an estimated 3875 (95% CI: 1852, 6074) natural deaths, 2378 (95% CI: 800, 4230) cardiovascular deaths, and 227 (95% CI: -437, 1033) respiratory deaths could have been prevented. Even greater substantial mortality reductions could be achieved if the WHO's air quality objectives were met. Our study suggests that air pollution is significantly associated with mortality in Guangzhou, and more stringent air quality standards would significantly reduce air pollution-related premature mortality.

Mental and social health in disasters: the Sphere standards and post-tsunami psychosocial interventions in Asia.

PubMed

Henderson, Silja E K; Elsass, Peter; Berliner, Peter

2016-07-01

The primary objective of this paper is to examine and inform the mental health and psychosocial support standards of the 2011 edition of the Sphere Project's Humanitarian Charter and Minimum Standards in Humanitarian Response. This is done through a qualitative analysis of internal evaluation documents, reflecting four long-term humanitarian psychosocial programmes in different countries in post-tsunami Asia. The analysis yielded three overall conclusions. First, the Sphere standards on mental health and psychosocial support generally are highly relevant to long-term psychosocial interventions after disasters such as the Indian Ocean tsunami of 26 December 2004, and their application in such settings may improve the quality of the response. Second, some of the standards in the current Sphere handbook may lack sufficient guidance to ensure the quality of humanitarian response required. Third, the long-term intervention approach poses specific challenges to programming, a problem that could be addressed by including additional guidance in the publication. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

An evaluation of eco-friendly naturally coloured cottons regarding seed cotton yield, yield components and major lint quality traits under conditions of East Mediterranean region of Turkey.

PubMed

Efe, Lale; Killi, Fatih; Mustafayev, Sefer A

2009-10-15

In the study carried out in 2002-2003 in the East Mediterranean region of Turkey (in Kahramanmaras Province), four different naturally coloured cotton (Gossypium hirsutum L.) (dark brown, light brown, cream and green) lines from Azerbaijan and two white linted cotton varieties (Maras-92 and Sayar-314 (G. hirsutum L.)) of the region were used as material. The aim of this study was to determine seed cotton yield and yield components and major lint quality traits of investigated coloured cotton lines comprising white linted local standard cotton varieties. Field trials were established in randomized block design with four blocks. According to two year's results, it was determined that naturally coloured cottons were found similar to both white linted standard cotton varieties for sympodia number and seed cotton yield. For boll number per plant, except green cotton line all coloured cotton lines were similar to standard varieties or even some of them were better than standards. For ginning outturn, dark brown, cream and green cotton lines were found statistically similar to standard Maras-92. But all naturally coloured cotton lines had lower seed cotton weight per boll and generally lower fiber quality than white linted standard varieties. For fiber length and fiber strength cream cotton line was the best coloured cotton. And for fiber fineness only green cotton line was better than both standards. It can be said that naturally coloured cotton lines need to be improved especially for fiber quality characters in the East Mediterranean region of Turkey.

Client perception of service quality at the outpatient clinics of a General hospital in Lagos, Nigeria.

PubMed

Ogunnowo, Babatunde Enitan; Olufunlayo, Tolulope Florence; Sule, Salami Suberu

2015-01-01

Service quality assessments have assumed increasing importance in the last two decades. They are useful in identifying gaps in services been provided with the ultimate aim of guaranteeing quality assurance. The objective of this study was to assess the client perception of service quality at the outpatient clinics of Randle General hospital, Lagos. A descriptive cross sectional study was conducted from March to May 2013. A multistage sampling technique was used to select respondents and data was collected with the aid of modified SERVQUAL questionnaires. The data was analysed with aid of EPI-INFO 2002 and statistical significance was set at a P value 0.05 for statistical significance. Total of 400 respondents were interviewed. The mean age was 40 years with a standard deviation of 15.2 yrs. The highest mean score of 4.35 out of a possible maximum of 5 was recorded in assurance domain while the lowest mean score of 4.00 was recorded in the responsiveness domain. The overall mean score of all the domains was 4.20 with standard deviation of 0.51. Overall majority (80.8%) of respondents rated the overall service quality as good/ very good. After linear regression, the assurance domain was the most important predictor of the overall perceived service quality (p< 0.001). The overall perceived service quality was good. The major deficiencies were in the responsiveness domain and especially the waiting time. The hospital management should implement measures to improve the responsiveness of services by ensuring prompt delivery of services.

Fecal-indicator bacteria in the Allegheny, Monongahela, and Ohio Rivers and selected tributaries, Allegheny County, Pennsylvania, 2001-2005

USGS Publications Warehouse

Buckwalter, Theodore F.; Zimmerman, Tammy M.; Fulton, John W.

2006-01-01

Concentrations of fecal-indicator bacteria were determined in 1,027 water-quality samples collected from July 2001 through August 2005 during dry- (72-hour dry antecedent period) and wet-weather (48-hour dry antecedent period and at least 0.3 inch of rain in a 24-hour period) conditions in the Allegheny, Monongahela, and Ohio Rivers (locally referred to as the Three Rivers) and selected tributaries in Allegheny County. Samples were collected at five sampling sites on the Three Rivers and at eight sites on four tributaries to the Three Rivers having combined sewer overflows. Water samples were analyzed for three fecal-indicator organisms fecal coliform, Escherichia coli (E. coli), and enterococci bacteria. Left-bank and right-bank surface-water samples were collected in addition to a cross-section composite sample at each site. Concentrations of fecal coliform, E. coli, and enterococci were detected in 98.6, 98.5, and 87.7 percent of all samples, respectively. The maximum fecal-indicator bacteria concentrations were collected from Sawmill Run, a tributary to the Ohio River; Sawmill Run at Duquesne Heights had concentrations of fecal coliform, E. coli, and enterococci of 410,000, 510,000, and 180,000 col/100 mL, respectively, following a large storm. The samples collected in the Three Rivers and selected tributaries frequently exceeded established recreational standards and criteria for bacteria. Concentrations of fecal coliform exceeded the Pennsylvania water-quality standard (200 col/100 mL) in approximately 63 percent of the samples. Sample concentrations of E. coli and enterococci exceeded the U.S. Environmental Protection Agency (USEPA) water-quality criteria (235 and 61 col/100 mL, respectively) in about 53 and 47 percent, respectively, of the samples. Fecal-indicator bacteria were most strongly correlated with streamflow, specific conductance, and turbidity. These correlations most frequently were observed in samples collected from tributary sites. Fecal-indicator bacteria concentrations and turbidity were correlated to the location of sample collection in the cross section. Most differences were between bank and composite samples; differences between right-bank and left-bank samples were rarely observed. The Allegheny River sites had more significant correlations than the Monongahela or Ohio River sites. Comparisons were made between fecal-indicator bacteria in composite samples collected during dry-weather, wet-weather day-one, wet-weather day-two (tributary sites only), and wet-weather day-three (Three Rivers sites only) events in the Three Rivers and selected tributary sites. The lowest median bacteria concentrations generally were observed in the dry-weather composite samples. All median bacteria concentrations in dry-weather composite samples in the five Three Rivers sites were below water-quality standards and criteria; bacteria concentrations in the upstream tributary sites rarely met all standards or criteria. Only Turtle Creek, Thompson Run, and Chartiers Creek had at least one median bacteria concentration below water-quality standards or criteria. Median bacteria concentrations in the composite samples generally were higher the day after a wet-weather event compared to dry-weather composite samples and other wet-weather composite samples collected. In the five Three Rivers sites, median bacteria concentrations 3 days after a wet-weather event in composite samples tended to fall below the water-quality standards and criteria; in the eight tributary sites, median bacteria concentrations in the dry-weather and wet-weather composite samples generally were above the water-quality standards or criteria. Composite samples collected at the upstream sites on the Three Rivers and selected tributaries generally had lower median bacteria concentrations than composite samples collected at the downstream sites during dry- and wet-weather events. Higher concentrations downstream may be because o

36 CFR 910.31 - High architectural quality.

Code of Federal Regulations, 2010 CFR

2010-07-01

... GENERAL GUIDELINES AND UNIFORM STANDARDS FOR URBAN PLANNING AND DESIGN OF DEVELOPMENT WITHIN THE... the best contemporary design and planning concepts. Great care and sensitivity must be shown in the architectural treatment of new buildings, particularly in terms of massing, facade design (including materials...

36 CFR 910.31 - High architectural quality.

Code of Federal Regulations, 2011 CFR

2011-07-01

... GENERAL GUIDELINES AND UNIFORM STANDARDS FOR URBAN PLANNING AND DESIGN OF DEVELOPMENT WITHIN THE... the best contemporary design and planning concepts. Great care and sensitivity must be shown in the... provisions for pedestrian and vehicular access. Special design considerations for each coordinated planning...

NHEXAS PHASE I ARIZONA STUDY--LIST OF STANDARD OPERATING PROCEDURES

EPA Science Inventory

This document lists available protocols and SOPs for the NHEXAS Phase I Arizona study. It identifies protocols and SOPs for the following study components: (1) Sample collection and field operations, (2) Sample analysis, (3) General laboratory procedures, (4) Quality Assurance, (...

48 CFR 37.601 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

... a performance work statement or a statement of objectives (see 37.602). (b) Performance-based contracts for services shall include— (1) A performance work statement (PWS); (2) Measurable performance standards (i.e., in terms of quality, timeliness, quantity, etc.) and the method of assessing contractor...

48 CFR 37.601 - General.

Code of Federal Regulations, 2012 CFR

2012-10-01

... a performance work statement or a statement of objectives (see 37.602). (b) Performance-based contracts for services shall include— (1) A performance work statement (PWS); (2) Measurable performance standards (i.e., in terms of quality, timeliness, quantity, etc.) and the method of assessing contractor...

48 CFR 37.601 - General.

Code of Federal Regulations, 2014 CFR

2014-10-01

... a performance work statement or a statement of objectives (see 37.602). (b) Performance-based contracts for services shall include— (1) A performance work statement (PWS); (2) Measurable performance standards (i.e., in terms of quality, timeliness, quantity, etc.) and the method of assessing contractor...

A standards-based approach to quality improvement for HIV services at Zambia Defence Force facilities: results and lessons learned.

PubMed

Kols, Adrienne; Kim, Young-Mi; Bazant, Eva; Necochea, Edgar; Banda, Joseph; Stender, Stacie

2015-07-01

The Zambia Defence Force adopted the Standards-Based Management and Recognition approach to improve the quality of the HIV-related services at its health facilities. This quality improvement intervention relies on comprehensive, detailed assessment tools to communicate and verify adherence to national standards of care, and to test and implement changes to improve performance. A quasi-experimental evaluation of the intervention was conducted at eight Zambia Defence Force primary health facilities (four facilities implemented the intervention and four did not). Data from three previous analyses are combined to assess the effect of Standards-Based Management and Recognition on three domains: facility readiness to provide services; observed provider performance during antiretroviral therapy (ART) and antenatal care consultations; and provider perceptions of the work environment. Facility readiness scores for ART improved on four of the eight standards at intervention sites, and one standard at comparison sites. Facility readiness scores for prevention of mother-to-child transmission (PMTCT) of HIV increased by 15 percentage points at intervention sites and 7 percentage points at comparison sites. Provider performance improved significantly at intervention sites for both ART services (from 58 to 84%; P < 0.01) and PMTCT services (from 58 to 73%; P = 0.003); there was no significant change at comparison sites. Providers' perceptions of the work environment generally improved at intervention sites and declined at comparison sites; differences in trends between study groups were significant for eight items. A standards-based approach to quality improvement proved effective in supporting healthcare managers and providers to deliver ART and PMTCT services in accordance with evidence-based standards in a health system suffering from staff shortages.

The Risk of Bias in Randomized Trials in General Dentistry Journals.

PubMed

Hinton, Stephanie; Beyari, Mohammed M; Madden, Kim; Lamfon, Hanadi A

2015-01-01

The use of a randomized controlled trial (RCT) research design is considered the gold standard for conducting evidence-based clinical research. In this present study, we aimed to assess the quality of RCTs in dentistry and create a general foundation for evidence-based dentistry on which to perform subsequent RCTs. We conducted a systematic assessment of bias of RCTs in seven general dentistry journals published between January 2011 and March 2012. We extracted study characteristics in duplicate and assessed each trial's quality using the Cochrane Risk of Bias tool. We compared risk of bias across studies graphically. Among 1,755 studies across seven journals, we identified 67 RCTs. Many included studies were conducted in Europe (39%), with an average sample size of 358 participants. These studies included 52% female participants and the maximum follow-up period was 13 years. Overall, we found a high percentage of unclear risk of bias among included RCTs, indicating poor quality of reporting within the included studies. An overall high proportion of trials with an "unclear risk of bias" suggests the need for better quality of reporting in dentistry. As such, key concepts in dental research and future trials should focus on high-quality reporting.

Nursing concerns and hospital product sterilization

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

Rock, R.B. Jr.; Anderson, N.A.

Nurses and other health care professionals must be aware of the rationale and methodology for in-hospital health care product standardization, including consideration of the hospital standardization committee composition, pilot-study prerequisites, and general evaluation criteria. They must be familiar with the techniques of product sterilization, their effectiveness, and the materials required to maintain sterile product shelf-life until a product is used. Hospital standardization committees can assist in the product-use decisionmaking process. Product evaluation criteria should include considerations pertaining to cost, quality, service, and comparison to similar products.

NGSS and the Next Generation of Science Teachers

NASA Astrophysics Data System (ADS)

Bybee, Rodger W.

2014-03-01

This article centers on the Next Generation Science Standards (NGSS) and their implications for teacher development, particularly at the undergraduate level. After an introduction to NGSS and the influence of standards in the educational system, the article addresses specific educational shifts—interconnecting science and engineering practices, disciplinary core ideas, crosscutting concepts; recognizing learning progressions; including engineering; addressing the nature of science, coordinating with Common Core State Standards. The article continues with a general discussion of reforming teacher education programs and a concluding discussion of basic competencies and personal qualities of effective science teachers.

A new approach in the development of quality management systems for (micro)electronics

NASA Astrophysics Data System (ADS)

Bacivarov, Ioan C.; Bacivarov, Angelica; Gherghina, Cǎtǎlina

2016-12-01

This paper presents the new approach in the analysis of the Quality Management Systems (QMS) of companies, based on the revised standard ISO 9001:2015. In the first part of the paper, QMS based on ISO 9001 certification are introduced; the changes and the updates proposed for the new version of ISO 9001:2015 are critically analyzed, based on the documents elaborated by ISO/TC 176. The approach based on ISO 9001:2015 could be considered as "beginning of a new era in development of quality management systems". A comparison between the between the "old" standard ISO 9001:2008 and the "new" standard ISO 9001:2015 is made. In the second part of the paper, steps to be followed in a company to implement this new standard are presented. A peculiar attention is given to the new concept of risk-based thinking in order to support and improve application of the process based approach. The authors conclude that, by considering risk throughout the organization the likelihood of achieving stated objectives is improved, output is more consistent and customers can be confident that they will receive the expected results. Finally, the benefits of the new approach in the development of quality management systems are outlined, as well as how they are reflected in the management of companies in general and those in electronics field, in particular. As demonstrated in this paper, well understood and properly applied, the new approach based on the revised standard ISO9001:2015 could offer a better quality management for companies operating in electronics and beyond.

A probabilistic assessment of health risks associated with short-term exposure to tropospheric ozone

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

Whitfield, R.G; Biller, W.F.; Jusko, M.J.

1996-06-01

The work described in this report is part of a larger risk assessment sponsored by the U.S. Environmental Protection Agency. Earlier efforts developed exposure-response relationships for acute health effects among populations engaged in heavy exertion. Those efforts also developed a probabilistic national ambient air quality standards exposure model and a general methodology for integrating probabilistic exposure-response relation- ships and exposure estimates to calculate overall risk results. Recently published data make it possible to model additional health endpoints (for exposure at moderate exertion), including hospital admissions. New air quality and exposure estimates for alternative national ambient air quality standards for ozonemore » are combined with exposure-response models to produce the risk results for hospital admissions and acute health effects. Sample results explain the methodology and introduce risk output formats.« less

Endoscopy in Canada: Proceedings of the National Roundtable

PubMed Central

Switzer, Noah; Dixon, Elijah; Tinmouth, Jill; Bradley, Nori; Vassiliou, Melina; Schwaitzberg, Steve; Gomes, Anthony; Ellsmere, James; de Gara, Chris

2015-01-01

This 2014 roundtable discussion, hosted by the Canadian Association of General Surgeons, brought together general surgeons and gastroenterologists with expertise in endoscopy from across Canada to discuss the state of endoscopy in Canada. The focus of the roundtable was the evaluation of the competence of general surgeons at endoscopy, reviewing quality assurance parameters for high-quality endoscopy, measuring and assessing surgical resident preparedness for endoscopy practice, evaluating credentialing programs for the endosuite and predicting the future of endoscopic services in Canada. The roundtable noted several important observations. There exist inadequacies in both resident training and the assessment of competency in endoscopy. From these observations, several collaborative recommendations were then stated. These included the need for a formal and standardized system of both accreditation and training endoscopists. PMID:25886520

Prospective surveillance of semen quality in the workplace

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

Schenker, M.B.; Samuels, S.J.; Perkins, C.

We performed a prospective surveillance of semen quality among workers in the plant where 1,2-dibromo-3-chloropropane was first recognized as an occupational cause of impaired semen quality and of infertility. All male employees of the Agricultural Chemical Division were required to participate. Ninety-seven workers (92% participation) provided 258 semen samples over the 4 years of the program. Most samples were analyzed at the plant with a mini-laboratory designed for the study. Motility and shape measures were made objectively. Sixty-six subjects (68%) were non-azoospermic. Generalized multiple regression showed no significant predictors for any response, with the exception of the motility measures, whichmore » were reduced with longer times between ejaculation and assay. Between- and within-person standard deviations and correlations were calculated. Comparison of this population with fertile artificial insemination donors (16 men, 498 ejaculates) revealed generally higher ejaculate-to-ejaculate standard deviations in the worker samples. This is probably due to less well controlled conditions of sperm collection in the workplace setting. For cross-sectional studies, one ejaculate per worker is recommended as sufficient; for estimating an individual worker's mean, even three ejaculates may not provide enough precision.« less

Pocket-sized versus standard ultrasound machines in abdominal imaging.

PubMed

Tse, K H; Luk, W H; Lam, M C

2014-06-01

The pocket-sized ultrasound machine has emerged as an invaluable tool for quick assessment in emergency and general practice settings. It is suitable for instant and quick assessment in cardiac imaging. However, its applicability in the imaging of other body parts has yet to be established. In this pictorial review, we compared the performance of the pocketsized ultrasound machine against the standard ultrasound machine for its image quality in common abdominal pathology.

DOE limited standard: Operations assessments

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

NONE

1996-05-01

Purpose of this standard is to provide DOE Field Element assessors with a guide for conducting operations assessments, and provide DOE Field Element managers with the criteria of the EM Operations Assessment Program. Sections 6.1 to 6.21 provide examples of how to assess specific areas; the general techniques of operations assessments (Section 5) may be applied to other areas of health and safety (e.g. fire protection, criticality safety, quality assurance, occupational safety, etc.).

Technical standards and guidelines: prenatal screening for Down syndrome that includes first-trimester biochemistry and/or ultrasound measurements.

PubMed

Palomaki, Glenn E; Lee, Jo Ellen S; Canick, Jacob A; McDowell, Geraldine A; Donnenfeld, Alan E

2009-09-01

This statement is intended to augment the current general ACMG Standards and Guidelines for Clinical Genetics Laboratories and to address guidelines specific to first-trimester screening for Down syndrome. The aim is to provide the laboratory the necessary information to ensure accurate and reliable Down syndrome screening results given a screening protocol (e.g., combined first trimester and integrated testing). Information about various test combinations and their expected performance are provided, but other issues such as availability of reagents, patient interest in early test results, access to open neural tube defect screening, and availability of chorionic villus sampling are all contextual factors in deciding which screening protocol(s) will be selected by individual health care providers. Individual laboratories are responsible for meeting the quality assurance standards described by the Clinical Laboratory Improvement Act, the College of American Pathologists, and other regulatory agencies, with respect to appropriate sample documentation, assay validation, general proficiency, and quality control measures. These guidelines address first-trimester screening that includes ultrasound measurement and interpretation of nuchal translucency thickness and protocols that combine markers from both the first and second trimesters. Laboratories can use their professional judgment to make modification or additions.

7 CFR 51.1413 - Damage.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... marketing quality of the individual pecan or the general appearance of the pecans in the lot. The following... surface of the kernel and contrasting in color with the skin of the kernel; and, (i) Internal flesh...

The Future of Principal Evaluation

ERIC Educational Resources Information Center

Clifford, Matthew; Ross, Steven

2012-01-01

The need to improve the quality of principal evaluation systems is long overdue. Although states and districts generally require principal evaluations, research and experience tell that many state and district evaluations do not reflect current standards and practices for principals, and that evaluation is not systematically administered. When…

15 CFR 280.210 - Discovery.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Discovery. 280.210 Section 280.210... STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE ACCREDITATION AND ASSESSMENT PROGRAMS FASTENER QUALITY Enforcement § 280.210 Discovery. (a) General. The parties are encouraged to engage in voluntary discovery...

28 CFR 345.40 - General.

Code of Federal Regulations, 2014 CFR

2014-07-01

... or others. (2) Quality assurance—ensuring that work is done as directed by the supervisor in an... Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK... establishment of minimum work standards for inmate workers assigned to the Industries program at all field...

28 CFR 345.40 - General.

Code of Federal Regulations, 2011 CFR

2011-07-01

... or others. (2) Quality assurance—ensuring that work is done as directed by the supervisor in an... Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK... establishment of minimum work standards for inmate workers assigned to the Industries program at all field...

Evaluation of medical record quality and communication skills among pediatric interns after standardized parent training history-taking in China.

PubMed

Yu, Mu Xue; Jiang, Xiao Yun; Li, Yi Juan; Shen, Zhen Yu; Zhuang, Si Qi; Gu, Yu Fen

2018-02-01

The effect of using standardized parent training history-taking on the quality of medical records and communication skills among pediatric interns was determined. Fifth-year interns who were undertaking a pediatric clinical practice rotation were randomized to intervention and control groups. All of the pediatric interns received history-taking training by lecture and bedside teaching. The pediatric interns in the intervention group also received standardized parent history-taking training. The following two outcome measures were used: the scores of medical records, which were written by the pediatric interns after history-taking from real parents of pediatric patients; and the communication assessment tool (CAT) assessed by real parents. The general information, history of present illness (HPI), past medical history, personal history, family history, diagnosis, diagnostic analysis, and differential diagnosis scores in the intervention group were significantly higher than the control group (p < 0.05). Assessment of the CAT indicated that the real parents were more satisfied with the pediatric interns in the intervention group. Standardized parent training history-taking is effective in improving the quality of medical records by pediatric interns. Standardized parent training history-taking is a superior teaching tool for clinical reasoning ability, as well as communication skills in clinical pediatric practice.

Analytical performance of 17 general chemistry analytes across countries and across manufacturers in the INPUtS project of EQA organizers in Italy, the Netherlands, Portugal, United Kingdom and Spain.

PubMed

Weykamp, Cas; Secchiero, Sandra; Plebani, Mario; Thelen, Marc; Cobbaert, Christa; Thomas, Annette; Jassam, Nuthar; Barth, Julian H; Perich, Carmen; Ricós, Carmen; Faria, Ana Paula

2017-02-01

Optimum patient care in relation to laboratory medicine is achieved when results of laboratory tests are equivalent, irrespective of the analytical platform used or the country where the laboratory is located. Standardization and harmonization minimize differences and the success of efforts to achieve this can be monitored with international category 1 external quality assessment (EQA) programs. An EQA project with commutable samples, targeted with reference measurement procedures (RMPs) was organized by EQA institutes in Italy, the Netherlands, Portugal, UK, and Spain. Results of 17 general chemistry analytes were evaluated across countries and across manufacturers according to performance specifications derived from biological variation (BV). For K, uric acid, glucose, cholesterol and high-density density (HDL) cholesterol, the minimum performance specification was met in all countries and by all manufacturers. For Na, Cl, and Ca, the minimum performance specifications were met by none of the countries and manufacturers. For enzymes, the situation was complicated, as standardization of results of enzymes toward RMPs was still not achieved in 20% of the laboratories and questionable in the remaining 80%. The overall performance of the measurement of 17 general chemistry analytes in European medical laboratories met the minimum performance specifications. In this general picture, there were no significant differences per country and no significant differences per manufacturer. There were major differences between the analytes. There were six analytes for which the minimum quality specifications were not met and manufacturers should improve their performance for these analytes. Standardization of results of enzymes requires ongoing efforts.

Improving urban air quality in China: Beijing case study

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

Jiming Hao; Litao Wang

2005-09-01

China is undergoing rapid urbanization because of unprecedented economic growth. As a result, many cities suffer from air pollution. Two-thirds of China's cities have not attained the ambient air quality standards applicable to urban residential areas (Grade II). Particulate matter (PM), rather than sulfur dioxide (SO{sub 2}), is the major pollutant reflecting the shift from coal burning to mixed source pollution. In 2002, 63.2 and 22.4% of the monitored cities have PM and SO{sub 2} concentrations exceeding the Grade II standard, respectively. Nitrogen oxides (NOx) concentration kept a relatively stable level near the Grade II standard in the last decademore » and had an increasing potential in recent years because of the rapid motorization. In general, the air pollutants emission did not increase as quickly as the economic growth and energy consumption, and air quality in Chinese cities has improved to some extent. Beijing, a typical representative of rapidly developing cities, is an example to illustrate the possible options for urban air pollution control. Beijing's case provides hope that the challenges associated with improving air quality can be met during a period of explosive development and motorization. 21 refs., 19 figs., 6 tabs.« less

Prevalence of impairments, disabilities, handicaps and quality of life in the general population: a review of recent literature.

PubMed Central

Barbotte, E.; Guillemin, F.; Chau, N.

2001-01-01

OBJECTIVE: To determine the prevalence rates of morbidity in the general population through bibliographic research. METHODS: Articles relating to impairment, disability, handicap, quality of life and their prevalence in the general population, published between January 1990 and March 1998, were selected on the MEDLINE database. FINDINGS: The 20 articles retained out of 433 used 41 different indicators. Indicators of impairment, disability, handicap and low quality of life showed prevalence rates of 0.1-92%, 3.6-66%, 0.6-56% and 1.8-26% respectively, depending on age and the accuracy of indicators. The heterogeneity of the conceptual framework and insufficient recognition of the importance of indicator accuracy, the age factor and the socioeconomic characteristics of the studied populations impede reliable international comparison. CONCLUSION: Further standardization of indicators is therefore required. The revision of the International Classification of Impairments, Disabilities and Handicaps may make it possible to resolve some of the difficulties encountered. PMID:11731812

The impact of the Quality and Outcomes Framework on practice organisation and service delivery: summary of evidence from two qualitative studies.

PubMed

Checkland, Kath; Harrison, Stephen

2010-01-01

In 2003, the new General Medical Services Contract introduced a pay-for-performance programme know as the Quality and Outcomes Framework (QOF) into UK general practice, with payment for meeting a number of both clinical and organisational quality standards. To investigate in detail the impact of the QOF on practice organisation and service delivery. Two linked qualitative case studies in England and Scotland, using interviews and observation to investigate in depth the impact of the QOF in four general medical practices. A number of significant changes to practice organisation and service delivery were observed, including: changes to practice organisational structures; an increased role for information technology; a move towards a more biomedical form of medical care; and changes to roles and relationships, including the introduction of internal peer-review and surveillance. In spite of this, the practices maintained a narrative of 'no change', arguing that they had 'fitted QOF in' to their routines with little trouble.

Measuring the quality of melanoma surgery - Highlighting issues with standardization and quality assurance of care in surgical oncology.

PubMed

Pasquali, S; Sommariva, A; Spillane, A J; Bilimoria, K Y; Rossi, C R

2017-03-01

In an attempt to ensure high standards of cancer care, there is increasing interest in determining and monitoring the quality of interventions in surgical oncology. In recent years, this has been particularly the case for melanoma surgery. The vast majority of patients with melanoma undergo surgery. Usually, this is with combinations of wide excision, sentinel lymph node biopsy and lymphadenectomy. The indications for these procedures evolved during a time when no effective systemic adjuvant therapy was available, and whilst the rationale has been sound, the justification for differences in extent and thoroughness has generally been supported by inadequate or low-level evidence. This has led to a substantial variation among melanoma centres or even among surgeons within a centre in how these procedures are done. With recent rapid progress in the efficacy of systemic treatments that are impacting on overall survival, the prospect of long-term survival in these previously high risk patients means that more than ever long-term locoregional control of melanoma is imperative. Furthermore, the understanding of effects of systemic therapy on locoregional disease will only be interpretable if surgeons use standardized, high quality techniques. This article focuses on standardization and evolution of quality indicators for melanoma surgery and how these might have a positive impact on patient care. Copyright © 2016 Elsevier Ltd, BASO ~ the Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Do residents in a northern program have better quality lives than their counterparts in a city?

PubMed Central

Johnsen, J. H.

2001-01-01

OBJECTIVE: To determine whether McMaster University's family medicine residents training in the Family Medicine North (FMN) program have better quality lives than those based in Hamilton, Ont (urban). DESIGN: Residents at both sites were simultaneously given the Quality of Life Questionnaire, a standardized measurement tool. They were asked to complete the questionnaire anonymously and to provide demographic data. SETTING: Family practice residencies in Ontario. PARTICIPANTS: McMaster University's family medicine residents. Of 66 residents living in Hamilton, 36 completed the questionnaire; five respondents were ineligible. Of 25 residents living in Thunder Bay, Ont, 24 completed the questionnaire; none were ineligible. MAIN OUTCOME MEASURES: Total quality-of-life score. Score was divided into five major domains, each with several subdomains: general well-being (material, physical, and personal growth), interpersonal relations (marital, parent-child, extended family, and extramarital), organizational activity (altruistic and political behaviour), occupational activity (job characteristics, occupational relations, and job satisfiers), and leisure and recreational activity (creative/esthetic behaviour, sports activity, vacation behaviour). RESULTS: The FMN residents scored significantly higher than the Hamilton-based residents on overall quality of life (124.7 vs 112.5, P < .05) and tended to score higher in the five major domains. The trend reached statistical significance in general well-being and occupational activity; it was also apparent in various subdomains, with statistically significant differences in material well-being, marital relations, job characteristics, job satisfiers, and vacation behaviour. CONCLUSION: Family Medicine North residents enjoy better quality of life than their urban counterparts based on responses to a standardized questionnaire. PMID:11398733

Are food and drink retailers within NHS venues adhering to NICE Quality standard 94 guidance on childhood obesity? A cross-sectional study of two large secondary care NHS hospitals in England

PubMed Central

James, Alice; Birch, Laura; Fletcher, Peter; Pearson, Sally; Boyce, Catherine; Ness, Andy R; Hamilton-Shield, Julian P; Lithander, Fiona E

2017-01-01

Objective To assess whether the food and drink retail outlets in two major National Health Service (NHS) district general hospitals in England adhere to quality statements 1–3 of the UK National Institute for Health and Care Excellence (NICE) quality standard 94. Design Cross-sectional, descriptive study to assess the food and drink options available in vending machines, restaurants, cafes and shops in two secondary care hospitals. Main outcome measures Adherence to quality statement 1 whereby the food and drink items available in the vending machines were classified as either healthy or less healthy using the Nutrient Profiling Model (NPM). Compliance with quality statements 2 and 3 was assessed through the measurement of how clearly the shops, cafes and restaurants displayed nutrition information on menus, and the availability and prominent display of healthy food and drink options in retail outlets, respectively. Results Adherence to quality statement 1 was poor. Of the 18 vending machines assessed, only 7 (39%) served both a healthy food and a healthy drink option. Neither hospital was compliant with quality statement 2 wherein nutritional information was not available on menus of food providers in either hospital. There was inconsistent compliance with quality standard 3 whereby healthy food and drink options were prominently displayed in the two main hospital restaurants, but all shops and cafes prioritised the display of unhealthy items. Conclusions Neither hospital was consistently compliant with quality statements 1–3 of the NICE quality standard 94. Improving the availability of healthy foods and drinks while reducing the display and accessibility to less healthy options in NHS venues may improve family awareness of healthy alternatives. Making it easier for parents to direct their children to healthier choices is an ostensibly central component of our healthcare system. PMID:29150472

Providing Data Quality Information for Remote Sensing Applications

NASA Astrophysics Data System (ADS)

Albrecht, F.; Blaschke, T.; Lang, S.; Abdulmutalib, H. M.; Szabó, G.; Barsi, Á.; Batini, C.; Bartsch, A.; Kugler, Zs.; Tiede, D.; Huang, G.

2018-04-01

The availability and accessibility of remote sensing (RS) data, cloud processing platforms and provided information products and services has increased the size and diversity of the RS user community. This development also generates a need for validation approaches to assess data quality. Validation approaches employ quality criteria in their assessment. Data Quality (DQ) dimensions as the basis for quality criteria have been deeply investigated in the database area and in the remote sensing domain. Several standards exist within the RS domain but a general classification - established for databases - has been adapted only recently. For an easier identification of research opportunities, a better understanding is required how quality criteria are employed in the RS lifecycle. Therefore, this research investigates how quality criteria support decisions that guide the RS lifecycle and how they relate to the measured DQ dimensions. Subsequently follows an overview of the relevant standards in the RS domain that is matched to the RS lifecycle. Conclusively, the required research needs are identified that would enable a complete understanding of the interrelationships between the RS lifecycle, the data sources and the DQ dimensions, an understanding that would be very valuable for designing validation approaches in RS.

Evaluating fundamentals of care: The development of a unit-level quality measurement and improvement programme.

PubMed

Parr, Jenny M; Bell, Jeanette; Koziol-McLain, Jane

2018-06-01

The project aimed to develop a unit-level quality measurement and improvement programme using evidence-based fundamentals of care. Feedback from patients, families, whānau, staff and audit data in 2014 indicated variability in the delivery of fundamental aspects of care such as monitoring, nutrition, pain management and environmental cleanliness at a New Zealand District Health Board. A general inductive approach was used to explore the fundamentals of care and design a measurement and improvement programme, the Patient and Whānau Centred Care Standards (PWCCS), focused on fundamental care. Five phases were used to explore the evidence, and design and test a measurement and improvement framework. Nine identified fundamental elements of care were used to define expected standards of care and develop and test a measurement and improvement framework. Four six-monthly peer reviews have been undertaken since June 2015. Charge Nurse Managers used results to identify quality improvements. Significant improvement was demonstrated overall, in six of the 27 units, in seven of the nine standards and three of the four measures. In all, 89% (n = 24) of units improved their overall result. The PWCCS measurement and improvement framework make visible nursing fundamentals of care in line with continuous quality improvement to increase quality of care. Delivering fundamentals of care is described by nurses as getting ?back to basics'. Patient and family feedback supports the centrality of fundamentals of care to their hospital experience. Implementing a unit-level fundamentals of care quality measurement and improvement programme clarifies expected standards of care, highlights the contribution of fundamentals of care to quality and provides a mechanism for ongoing improvements. © 2018 John Wiley & Sons Ltd.

Quality of reporting and risk of bias in therapeutic otolaryngology publications.

PubMed

Kaper, N M; Swart, K M A; Grolman, W; Van Der Heijden, G J M G

2018-01-01

High-quality trials have the potential to influence clinical practice. Ten otolaryngology journals with the highest 2011 impact factors were selected and publications from 2010 were extracted. From all medical journals, the 20 highest impact factor journals were selected, and publications related to otolaryngology for 2010 and 2011 were extracted. For all publications, the reporting quality and risk of bias were assessed. The impact factor was 1.8-2.8 for otolaryngology journals and 6.0-101.8 for medical journals. Of 1500 otolaryngology journal articles, 262 were therapeutic studies; 94 had a high reporting quality and 5 a low risk of bias. Of 10 967 medical journal articles, 76 were therapeutic studies; 57 had a high reporting quality and 8 a low risk of bias. Reporting quality was high for 45 per cent of otolaryngology-related publications and 9 per cent met quality standards. General journals had higher impact factors than otolaryngology journals. Reporting quality was higher and risk of bias lower in general journals than in otolaryngology journals. Nevertheless, 76 per cent of articles in high impact factor journals carried a high risk of bias. Better reported and designed studies are the goal, with less risk of bias, especially in otolaryngology journals.

Monitoring design for assessing compliance with numeric nutrient standards for rivers and streams using geospatial variables.

PubMed

Williams, Rachel E; Arabi, Mazdak; Loftis, Jim; Elmund, G Keith

2014-09-01

Implementation of numeric nutrient standards in Colorado has prompted a need for greater understanding of human impacts on ambient nutrient levels. This study explored the variability of annual nutrient concentrations due to upstream anthropogenic influences and developed a mathematical expression for the number of samples required to estimate median concentrations for standard compliance. A procedure grounded in statistical hypothesis testing was developed to estimate the number of annual samples required at monitoring locations while taking into account the difference between the median concentrations and the water quality standard for a lognormal population. For the Cache La Poudre River in northern Colorado, the relationship between the median and standard deviation of total N (TN) and total P (TP) concentrations and the upstream point and nonpoint concentrations and general hydrologic descriptors was explored using multiple linear regression models. Very strong relationships were evident between the upstream anthropogenic influences and annual medians for TN and TP ( > 0.85, < 0.001) and corresponding standard deviations ( > 0.7, < 0.001). Sample sizes required to demonstrate (non)compliance with the standard depend on the measured water quality conditions. When the median concentration differs from the standard by >20%, few samples are needed to reach a 95% confidence level. When the median is within 20% of the corresponding water quality standard, however, the required sample size increases rapidly, and hundreds of samples may be required. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

12. Children and Adolescents: Standards of Medical Care in Diabetes-2018.

PubMed

2018-01-01

The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC. © 2017 by the American Diabetes Association.

Proposed minimum reporting standards for chemical analysis Chemical Analysis Working Group (CAWG) Metabolomics Standards Initiative (MSI)

PubMed Central

Amberg, Alexander; Barrett, Dave; Beale, Michael H.; Beger, Richard; Daykin, Clare A.; Fan, Teresa W.-M.; Fiehn, Oliver; Goodacre, Royston; Griffin, Julian L.; Hankemeier, Thomas; Hardy, Nigel; Harnly, James; Higashi, Richard; Kopka, Joachim; Lane, Andrew N.; Lindon, John C.; Marriott, Philip; Nicholls, Andrew W.; Reily, Michael D.; Thaden, John J.; Viant, Mark R.

2013-01-01

There is a general consensus that supports the need for standardized reporting of metadata or information describing large-scale metabolomics and other functional genomics data sets. Reporting of standard metadata provides a biological and empirical context for the data, facilitates experimental replication, and enables the re-interrogation and comparison of data by others. Accordingly, the Metabolomics Standards Initiative is building a general consensus concerning the minimum reporting standards for metabolomics experiments of which the Chemical Analysis Working Group (CAWG) is a member of this community effort. This article proposes the minimum reporting standards related to the chemical analysis aspects of metabolomics experiments including: sample preparation, experimental analysis, quality control, metabolite identification, and data pre-processing. These minimum standards currently focus mostly upon mass spectrometry and nuclear magnetic resonance spectroscopy due to the popularity of these techniques in metabolomics. However, additional input concerning other techniques is welcomed and can be provided via the CAWG on-line discussion forum at http://msi-workgroups.sourceforge.net/ or http://Msi-workgroups-feedback@lists.sourceforge.net. Further, community input related to this document can also be provided via this electronic forum. PMID:24039616

Adopting Extensible Business Reporting Language (XBRL): A Grounded Theory

ERIC Educational Resources Information Center

Cruz, Marivic

2010-01-01

In 2007 and 2008, government challenges consisted of error prone, manually intensive, and inefficient environments for financial reporting. Banking regulators worldwide faced issues with respect to transparency, timeliness, quality, and managing risks associated with accounting opacity. The general problem was the existing reporting standards and…

45 CFR 156.1125 - Enrollee satisfaction survey system.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Enrollee satisfaction survey system. 156.1125... RELATED TO EXCHANGES Quality Standards § 156.1125 Enrollee satisfaction survey system. (a) General requirement. A QHP issuer must contract with an HHS-approved enrollee satisfaction survey (ESS) vendor, as...

TEQSA Annual Report 2014-15

ERIC Educational Resources Information Center

Australian Government Tertiary Education Quality and Standards Agency, 2015

2015-01-01

This report informs Senator the Hon. Simon Birmingham, Minister for Education and Training, the Parliament of Australia, the Australian higher education community and the general public about the performance of the Tertiary Education Quality and Standards Agency (TEQSA or the Agency) during the financial year ending 30 June 2015. Prepared…

7 CFR 58.133 - Methods for quality and wholesomeness determination.

Code of Federal Regulations, 2013 CFR

2013-01-01

... FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection... any other method approved by Standard Methods for the Examination of Dairy Products (confirmatory test... and Applied Nutrition, 200 C Street SW., Washington, DC 20204. (2) Individual producer milk samples...

7 CFR 58.133 - Methods for quality and wholesomeness determination.

Code of Federal Regulations, 2012 CFR

2012-01-01

... FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection... any other method approved by Standard Methods for the Examination of Dairy Products (confirmatory test... and Applied Nutrition, 200 C Street SW., Washington, DC 20204. (2) Individual producer milk samples...

7 CFR 58.133 - Methods for quality and wholesomeness determination.

Code of Federal Regulations, 2014 CFR

2014-01-01

... FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection... any other method approved by Standard Methods for the Examination of Dairy Products (confirmatory test... and Applied Nutrition, 200 C Street SW., Washington, DC 20204. (2) Individual producer milk samples...

TEQSA Annual Report 2015-2016

ERIC Educational Resources Information Center

Australian Government Tertiary Education Quality and Standards Agency, 2016

2016-01-01

This report informs Senator the Hon. Simon Birmingham, Minister for Education and Training, the Parliament of Australia, the Australian higher education community and the general public about the performance of the Tertiary Education Quality and Standards Agency (TEQSA or the Agency) during the financial year ending 30 June 2016. Prepared…

45 CFR 800.401 - Contract performance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 3 2014-10-01 2014-10-01 false Contract performance. 800.401 Section 800.401...-STATE PLAN PROGRAM Compliance § 800.401 Contract performance. (a) General. An MSPP issuer must perform... MSPP contract; (7) Applying performance standards for assuring contract quality as outlined at § 800...

45 CFR 800.401 - Contract performance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false Contract performance. 800.401 Section 800.401...-STATE PLAN PROGRAM Compliance § 800.401 Contract performance. (a) General. An MSPP issuer must perform... MSPP contract; (7) Applying performance standards for assuring contract quality as outlined at § 800...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--LIST OF STANDARD OPERATING PROCEDURES

EPA Science Inventory

This document lists available protocols and SOPs for the U.S.-Mexico Border Program study. It identifies protocols and SOPs for the following study components: (1) Sample collection and field operations, (2) Sample analysis, (3) General laboratory procedures, (4) Quality Assuranc...

Spectral entropy monitoring for adults and children undergoing general anaesthesia.

PubMed

Chhabra, Anjolie; Subramaniam, Rajeshwari; Srivastava, Anurag; Prabhakar, Hemanshu; Kalaivani, Mani; Paranjape, Saloni

2016-03-14

Anaesthetic drugs during general anaesthesia are titrated according to sympathetic or somatic responses to surgical stimuli. It is now possible to measure depth of anaesthesia using electroencephalography (EEG). Entropy, an EEG-based monitor can be used to assess the depth of anaesthesia using a strip of electrodes applied to the forehead, and this can guide intraoperative anaesthetic drug administration. The primary objective of this review was to assess the effectiveness of entropy monitoring in facilitating faster recovery from general anaesthesia. We also wanted to assess mortality at 24 hours, 30 days, and one year following general anaesthesia with entropy monitoring.The secondary objectives were to assess the effectiveness of the entropy monitor in: preventing postoperative recall of intraoperative events (awareness) following general anaesthesia; reducing the amount of anaesthetic drugs used; reducing cost of the anaesthetic as well as in reducing time to readiness to leave the postanaesthesia care unit (PACU). We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 10), MEDLINE via Ovid SP (1990 to September 2014) and EMBASE via Ovid SP (1990 to September 2014). We reran the search in CENTRAL, MEDLINE via Ovid SP and EMBASE via Ovid SP in January 2016. We added one potential new study of interest to the list of 'Studies awaiting Classification' and we will incorporate this study into the formal review findings during the review update. We included randomized controlled trials (RCTs) conducted in adults and children (aged greater than two years of age), where in one arm entropy monitoring was used for titrating anaesthesia, and in the other standard practice (increase in heart rate, mean arterial pressure, lacrimation, movement in response to noxious surgical stimuli) was used for titrating anaesthetic drug administration. We also included trials with an additional third arm, wherein another EEG monitor, the Bispectral index (BIS) monitor was used to assess anaesthetic depth. We used standard methodological procedures expected by Cochrane. Two review authors independently extracted details of trial methodology and outcome data from trials considered eligible for inclusion. All analyses were made on an intention-to-treat basis. We used a random-effect model where there was heterogeneity. For assessments of the overall quality of evidence for each outcome that included pooled data from RCTs, we downgraded evidence from 'high quality' by one level for serious (or by two for very serious) study limitations (risk of bias, indirectness of evidence, serious inconsistency, imprecision of effect or potential publication bias). We included 11 RCTs (962 participants). Eight RCTs (762 participants) were carried out on adults (18 to 80 years of age), two (128 participants) involved children (two to 16 years) and one RCT (72 participants) included patients aged 60 to 75 years. Of the 11 included studies, we judged three to be at low risk of bias, and the remaining eight RCTs at unclear or high risk of bias.Six RCTs (383 participants) estimated the primary outcome, time to awakening after stopping general anaesthesia, which was reduced in the entropy as compared to the standard practice group (mean difference (MD) -5.42 minutes, 95% confidence interval (CI) -8.77 to -2.08; moderate quality of evidence). We noted heterogeneity for this outcome; on performing subgroup analysis this was found to be due to studies that included participants undergoing major, long duration surgeries (off-pump coronary artery bypass grafting, major urological surgery). The MD for time to awakening with four studies on ambulatory procedures was -3.20 minutes (95% CI -3.94 to -2.45). No trial reported the second primary outcome, mortality at 24 hours, 30 days, and one year with the use of entropy monitoring.Eight trials (797 participants) compared the secondary outcome, postoperative recall of intraoperative events (awareness) in the entropy and standard practice groups. Awareness was reported by only one patient in the standard practice group, making meaningful estimation of benefit of entropy monitoring difficult; moderate quality of evidence.All 11 RCTs compared the amount of anaesthetic agent used between the entropy and standard practice groups. Six RCTs compared the amount of propofol, four compared the amount of sevoflurane and one the amount of isoflurane used between the groups. Analysis of three studies (166 participants) revealed that the MD of propofol consumption between the entropy group and control group was -11.56 mcg/kg/min (95% CI -24.05 to 0.92); low quality of evidence. Analysis of another two studies (156 participants) showed that the MD in sevoflurane consumption in the entropy group compared to the control group was -3.42 mL (95% CI -6.49 to -0.35); moderate quality of evidence.No trial reported on the secondary outcome of the cost of general anaesthesia.Three trials (170 participants) estimated MD in time to readiness to leave the PACU of the entropy group as compared to the control group (MD -5.94 minutes, 95% CI -16.08 to 4.20; low quality of evidence). Heterogeneity was noted, which was due to the difference in anaesthetic technique (propofol-based general anaesthesia) in one study. The remaining two studies had used volatile-based general anaesthesia. The MD in time to readiness to leave the PACU was -4.17 minutes (95% CI -6.84 to -1.51) with these two studies. The evidence as regards time to awakening, recall of intraoperative awareness and reduction in inhalational anaesthetic agent use was of moderate quality. The quality of evidence of as regards reduction in intravenous anaesthetic agent (propofol) use, as well as time to readiness to leave the PACU was found to be of low quality. As the data are limited, further studies consisting of more participants will be required for ascertaining benefits of entropy monitoring.Further studies are needed to assess the effect of entropy monitoring on focal issues such as short-term and long-term mortality, as well as cost of general anaesthesia.

The swiss neonatal quality cycle, a monitor for clinical performance and tool for quality improvement

PubMed Central

2013-01-01

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

The 2017 International Joint Working Group White Paper by INDUSEM, the Emergency Medicine Association and the Academic College of Emergency Experts on Establishing Standardized Regulations, Operational Mechanisms, and Accreditation Pathways for Education and Care Provided by the Prehospital Emergency Medical Service Systems in India

PubMed Central

Sikka, Veronica; Gautam, V.; Galwankar, Sagar; Guleria, Randeep; Stawicki, Stanislaw P.; Paladino, Lorenzo; Chauhan, Vivek; Menon, Geetha; Shah, Vijay; Srivastava, R. P.; Rana, B. K.; Batra, Bipin; Kalra, OP.; Aggarwal, P.; Bhoi, Sanjeev; Krishnan, S. Vimal

2017-01-01

The government of India has done remarkable work on commissioning a government funded prehospital emergency ambulance service in India. This has both public health implications and an economic impact on the nation. With the establishment of these services, there is an acute need for standardization of education and quality assurance regarding prehospital care provided. The International Joint Working Group has been actively involved in designing guidelines and establishing a comprehensive framework for ensuring high-quality education and clinical standards of care for prehospital services in India. This paper provides an independent expert opinion and a proposed framework for general operations and administration of a standardized, national prehospital emergency medical systems program. Program implementation, operational details, and regulations will require close collaboration between key stakeholders, including local, regional, and national governmental agencies of India. PMID:28855780

Standards for reporting randomized controlled trials in medical informatics: a systematic review of CONSORT adherence in RCTs on clinical decision support

PubMed Central

Berntsen, G; Lassen, K; Bellika, J G; Wootton, R; Lindsetmo, R O

2011-01-01

Introduction The Consolidated Standards for Reporting Trials (CONSORT) were published to standardize reporting and improve the quality of clinical trials. The objective of this study is to assess CONSORT adherence in randomized clinical trials (RCT) of disease specific clinical decision support (CDS). Methods A systematic search was conducted of the Medline, EMBASE, and Cochrane databases. RCTs on CDS were assessed against CONSORT guidelines and the Jadad score. Result 32 of 3784 papers identified in the primary search were included in the final review. 181 702 patients and 7315 physicians participated in the selected trials. Most trials were performed in primary care (22), including 897 general practitioner offices. RCTs assessing CDS for asthma (4), diabetes (4), and hyperlipidemia (3) were the most common. Thirteen CDS systems (40%) were implemented in electronic medical records, and 14 (43%) provided automatic alerts. CONSORT and Jadad scores were generally low; the mean CONSORT score was 30.75 (95% CI 27.0 to 34.5), median score 32, range 21–38. Fourteen trials (43%) did not clearly define the study objective, and 11 studies (34%) did not include a sample size calculation. Outcome measures were adequately identified and defined in 23 (71%) trials; adverse events or side effects were not reported in 20 trials (62%). Thirteen trials (40%) were of superior quality according to the Jadad score (≥3 points). Six trials (18%) reported on long-term implementation of CDS. Conclusion The overall quality of reporting RCTs was low. There is a need to develop standards for reporting RCTs in medical informatics. PMID:21803926

Quality Measurement Recommendations Relevant to Clinical Guidelines in Germany and the United Kingdom: (What) Can We Learn From Each Other?

PubMed Central

Petzold, Thomas; Deckert, Stefanie; Williamson, Paula R.; Schmitt, Jochen

2018-01-01

We conducted a systematic review of clinical guidelines (CGs) to examine the methodological approaches of quality indicator derivation in CGs, the frequency of quality indicators to check CG recommendations in routine care, and clinimetric properties of quality indicators. We analyzed the publicly available CG databases of the Association of the Scientific Medical Societies in Germany (AWMF) and National Institute for Health and Care Excellence (NICE). Data on the methodology of subsequent quality indicator derivation, the content and definition of recommended quality indicators, and clinimetric properties of measurement instruments were extracted. In Germany, no explicit methodological guidance exists, but 3 different approaches are used. For NICE, a general approach is used for the derivation of quality indicators out of quality standards. Quality indicators were defined in 34 out of 87 CGs (39%) in Germany and for 58 out of 133 (43%) NICE CGs. Statements regarding measurement properties of instruments for quality indicator assessment were missing in German and NICE documents. Thirteen pairs of CGs (32%) have associated quality indicators. Thirty-four quality indicators refer to the same aspect of the quality of care, which corresponds to 27% of the German and 7% of NICE quality indicators. The development of a standardized and internationally accepted methodology for the derivation of quality indicators relevant to CGs is needed to measure and compare quality of care in health care systems. PMID:29591538

Medical Abortion Provision by Pharmacies and Drug Sellers in Low- and Middle-Income Countries: A Systematic Review.

PubMed

Footman, Katharine; Keenan, Katherine; Reiss, Kate; Reichwein, Barbara; Biswas, Pritha; Church, Kathryn

2018-03-01

We undertook a systematic review to assess 1) the level and quality of pharmacy and drug shop provision of medical abortion (MA) in low- and middle-income countries (LMICs) and 2) interventions to improve quality of provision. We used standardized terms to search six databases for peer-reviewed and grey literature. We double-extracted data using a standardized template, and double-graded studies for methodological quality. We identified 22 studies from 16 countries reporting on level and quality of MA provision through pharmacies and drug sellers, and three intervention studies. Despite widespread awareness and provision of MA drugs, even in legally restricted contexts, most studies found that pharmacy workers and drug sellers had poor knowledge of effective regimens. Evidence on interventions to improve pharmacy and drug shop provision of MA was limited and generally low quality, but indicated that training could be effective in improving knowledge. Programmatic attention should focus on the development and rigorous evaluation of innovative interventions to improve women's access to information about MA self-management in low-and middle-income countries. © 2018 The Population Council, Inc.

Groundwater quality in the Lake Champlain and Susquehanna River basins, New York, 2014

USGS Publications Warehouse

Scott, Tia-Marie; Nystrom, Elizabeth A.; Reddy, James E.

2016-11-04

In a study conducted by the U.S. Geological Survey in cooperation with the New York State Department of Environmental Conservation, groundwater samples were collected from 6 production wells and 7 domestic wells in the Lake Champlain Basin and from 11 production wells and 9 domestic wells in the Susquehanna River Basin in New York. All samples were collected from June through December 2014 to characterize groundwater quality in these basins. The samples were collected and processed using standard procedures of the U.S. Geological Survey and were analyzed for 148 physiochemical properties and constituents, including dissolved gases, major ions, nutrients, trace elements, pesticides, volatile organic compounds, radionuclides, and indicator bacteria.The Lake Champlain Basin study area covers the 3,050 square miles of the basin in northeastern New York; the remaining part of the basin is in Vermont and Canada. Of the 13 wells sampled in the Lake Champlain Basin, 6 are completed in sand and gravel, and 7 are completed in bedrock. Groundwater in the Lake Champlain Basin was generally of good quality, although properties and concentrations of some constituents— fluoride, iron, manganese, dissolved solids, sodium, radon-222, total coliform bacteria, fecal coliform bacteria, and Escherichia coli bacteria—sometimes equaled or exceeded primary, secondary, or proposed drinking-water standards. The constituent most frequently detected in concentrations exceeding drinking-water standards (5 of 13 samples) was radon-222.The Susquehanna River Basin study area covers the entire 4,522 square miles of the basin in south-central New York; the remaining part of the basin is in Pennsylvania. Of the 20 wells sampled in the Susquehanna River Basin, 11 are completed in sand and gravel, and 9 are completed in bedrock. Groundwater in the Susquehanna River Basin was generally of good quality, although properties and concentrations of some constituents—pH, chloride, sodium, dissolved solids, iron, manganese, aluminum, arsenic, barium, gross-alpha radioactivity, radon-222, methane, total coliform bacteria, and fecal coliform bacteria—sometimes equaled or exceeded primary, secondary, or proposed drinking-water standards. As in the Lake Champlain Basin, the constituent most frequently detected in concentrations exceeding drinking-water standards (13 of 20 samples) was radon-222.

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

PubMed

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

2012-01-01

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

Products cooked in preheated versus non-preheated ovens. Baking times, calculated energy consumption, and product quality compared.

PubMed

Odland, D; Davis, C

1982-08-01

Plain muffins, yellow cake, baked custard, apple pie, tuna casserole, frozen tuna casserole, cheese soufflé, and meat loaf were baked in preheated and non-preheated standard gas, continuous-clean gas, standard electric, and self-cleaning electric ovens. Products generally required 5 min. or less extra baking time when cooked in non-preheated rather than in preheated ovens. The variability in baking times often was less between preheated and non-preheated ovens than among oven types. Calculated energy consumption values showed that usually less energy was required to bake products in non-preheated than in preheated ovens; savings averaged about 10 percent. Few significant differences were found in physical measurements or eating quality either between preheated and non-preheated ovens or among oven types. Overall, for the products tested, findings confirmed that preheating the oven is not essential for good product quality and, therefore, is an unnecessary use of energy.

Structured data quality reports to improve EHR data quality.

PubMed

Taggart, Jane; Liaw, Siaw-Teng; Yu, Hairong

2015-12-01

To examine whether a structured data quality report (SDQR) and feedback sessions with practice principals and managers improve the quality of routinely collected data in EHRs. The intervention was conducted in four general practices participating in the Fairfield neighborhood electronic Practice Based Research Network (ePBRN). Data were extracted from their clinical information systems and summarised as a SDQR to guide feedback to practice principals and managers at 0, 4, 8 and 12 months. Data quality (DQ) metrics included completeness, correctness, consistency and duplication of patient records. Information on data recording practices, data quality improvement, and utility of SDQRs was collected at the feedback sessions at the practices. The main outcome measure was change in the recording of clinical information and level of meeting Royal Australian College of General Practice (RACGP) targets. Birth date was 100% and gender 99% complete at baseline and maintained. DQ of all variables measured improved significantly (p<0.01) over 12 months, but was not sufficient to comply with RACGP standards. Improvement was greatest with allergies. There was no significant change in duplicate records. SDQRs and feedback sessions support general practitioners and practice managers to focus on improving the recording of patient information. However, improved practice DQ, was not sufficient to meet RACGP targets. Randomised controlled studies are required to evaluate strategies to improve data quality and any associated improved safety and quality of care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Criteria for clinical audit of women friendly care and providers' perception in Malawi.

PubMed

Kongnyuy, Eugene J; van den Broek, Nynke

2008-07-22

There are two dimensions of quality of maternity care, namely quality of health outcomes and quality as perceived by clients. The feasibility of using clinical audit to assess and improve the quality of maternity care as perceived by women was studied in Malawi. We sought to (a) establish standards for women friendly care and (b) explore attitudinal barriers which could impede the proper implementation of clinical audit. We used evidence from Malawi national guidelines and World Health Organisation manuals to establish local standards for women friendly care in three districts. We equally conducted a survey of health care providers to explore their attitudes towards criterion based audit. The standards addressed different aspects of care given to women in maternity units, namely (i) reception, (ii) attitudes towards women, (iii) respect for culture, (iv) respect for women, (v) waiting time, (vi) enabling environment, (vii) provision of information, (viii) individualised care, (ix) provision of skilled attendance at birth and emergency obstetric care, (x) confidentiality, and (xi) proper management of patient information. The health providers in Malawi generally held a favourable attitude towards clinical audit: 100.0% (54/54) agreed that criterion based audit will improve the quality of care and 92.6% believed that clinical audit is a good educational tool. However, there are concerns that criterion based audit would create a feeling of blame among providers (35.2%), and that manager would use clinical audit to identify and punish providers who fail to meet standards (27.8%). Developing standards of maternity care that are acceptable to, and valued by, women requires consideration of both the research evidence and cultural values. Clinical audit is acceptable to health professionals in Malawi although there are concerns about its negative implications to the providers.

Criteria for clinical audit of women friendly care and providers' perception in Malawi

PubMed Central

Kongnyuy, Eugene J; van den Broek, Nynke

2008-01-01

Background There are two dimensions of quality of maternity care, namely quality of health outcomes and quality as perceived by clients. The feasibility of using clinical audit to assess and improve the quality of maternity care as perceived by women was studied in Malawi. Objective We sought to (a) establish standards for women friendly care and (b) explore attitudinal barriers which could impede the proper implementation of clinical audit. Methods We used evidence from Malawi national guidelines and World Health Organisation manuals to establish local standards for women friendly care in three districts. We equally conducted a survey of health care providers to explore their attitudes towards criterion based audit. Results The standards addressed different aspects of care given to women in maternity units, namely (i) reception, (ii) attitudes towards women, (iii) respect for culture, (iv) respect for women, (v) waiting time, (vi) enabling environment, (vii) provision of information, (viii) individualised care, (ix) provision of skilled attendance at birth and emergency obstetric care, (x) confidentiality, and (xi) proper management of patient information. The health providers in Malawi generally held a favourable attitude towards clinical audit: 100.0% (54/54) agreed that criterion based audit will improve the quality of care and 92.6% believed that clinical audit is a good educational tool. However, there are concerns that criterion based audit would create a feeling of blame among providers (35.2%), and that manager would use clinical audit to identify and punish providers who fail to meet standards (27.8%). Conclusion Developing standards of maternity care that are acceptable to, and valued by, women requires consideration of both the research evidence and cultural values. Clinical audit is acceptable to health professionals in Malawi although there are concerns about its negative implications to the providers. PMID:18647388

43 CFR 3802.3-2 - Requirements for environmental protection.

Code of Federal Regulations, 2014 CFR

2014-10-01

... prevent adverse impact upon plants, fish, and wildlife, including threatened or endangered species, and... GENERAL MINING LAWS Exploration and Mining, Wilderness Review Program § 3802.3-2 Requirements for... quality standards, including the requirements of the Clean Air Act (42 U.S.C. 1857 et seq.). (b) Water...

43 CFR 3802.3-2 - Requirements for environmental protection.

Code of Federal Regulations, 2012 CFR

2012-10-01

... prevent adverse impact upon plants, fish, and wildlife, including threatened or endangered species, and... GENERAL MINING LAWS Exploration and Mining, Wilderness Review Program § 3802.3-2 Requirements for... quality standards, including the requirements of the Clean Air Act (42 U.S.C. 1857 et seq.). (b) Water...

43 CFR 3802.3-2 - Requirements for environmental protection.

Code of Federal Regulations, 2011 CFR

2011-10-01

... prevent adverse impact upon plants, fish, and wildlife, including threatened or endangered species, and... GENERAL MINING LAWS Exploration and Mining, Wilderness Review Program § 3802.3-2 Requirements for... quality standards, including the requirements of the Clean Air Act (42 U.S.C. 1857 et seq.). (b) Water...

43 CFR 3802.3-2 - Requirements for environmental protection.

Code of Federal Regulations, 2013 CFR

2013-10-01

... prevent adverse impact upon plants, fish, and wildlife, including threatened or endangered species, and... GENERAL MINING LAWS Exploration and Mining, Wilderness Review Program § 3802.3-2 Requirements for... quality standards, including the requirements of the Clean Air Act (42 U.S.C. 1857 et seq.). (b) Water...

7 CFR 29.6020 - Group.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Group. 29.6020 Section 29.6020 Agriculture Regulations... INSPECTION Standards Definitions § 29.6020 Group. A type division consisting of one or more grades based on the general quality of tobacco. Groups in these types are: Binder (B), Stripper (C), Straight Stripped...

7 CFR 29.6020 - Group.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Group. 29.6020 Section 29.6020 Agriculture Regulations... INSPECTION Standards Definitions § 29.6020 Group. A type division consisting of one or more grades based on the general quality of tobacco. Groups in these types are: Binder (B), Stripper (C), Straight Stripped...

7 CFR 29.6020 - Group.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 2 2013-01-01 2013-01-01 false Group. 29.6020 Section 29.6020 Agriculture Regulations... INSPECTION Standards Definitions § 29.6020 Group. A type division consisting of one or more grades based on the general quality of tobacco. Groups in these types are: Binder (B), Stripper (C), Straight Stripped...

7 CFR 29.6020 - Group.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Group. 29.6020 Section 29.6020 Agriculture Regulations... INSPECTION Standards Definitions § 29.6020 Group. A type division consisting of one or more grades based on the general quality of tobacco. Groups in these types are: Binder (B), Stripper (C), Straight Stripped...

Applying Tacit Knowledge Management Techniques for Performance Assessment

ERIC Educational Resources Information Center

Mitri, Michel

2003-01-01

Performance assessment is an important task in all levels of education, both as input for identifying remedial needs of individual students and for improving general quality of education. Although explicit assessment measures can be obtained through objective standardized testing, it is much more difficult to capture fuzzier, or tacit, performance…

7 CFR 29.6020 - Group.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Group. 29.6020 Section 29.6020 Agriculture Regulations... INSPECTION Standards Definitions § 29.6020 Group. A type division consisting of one or more grades based on the general quality of tobacco. Groups in these types are: Binder (B), Stripper (C), Straight Stripped...

TEQSA Annual Report 2016-2017

ERIC Educational Resources Information Center

Australian Government Tertiary Education Quality and Standards Agency, 2017

2017-01-01

This report informs Senator the Hon Simon Birmingham, Minister for Education and Training, the Parliament of Australia, the Australian higher education community and the general public about the performance of the Tertiary Education Quality and Standards Agency (TEQSA or the agency) during the financial year ending 30 June 2017. Prepared according…

Inter-laboratory Comparison of Real-time PCR Methods for Quantification of General Fecal Indicator Bacteria

EPA Science Inventory

The application of quantitative real-time PCR (qPCR) technologies for the rapid identification of fecal bacteria in environmental waters is being considered for use as a national water quality metric in the United States. The transition from research tool to a standardized prot...

Interlaboratory Comparison of Real-time PCR Protocols for Quantification of General Fecal Indicator Bacteria

EPA Science Inventory

The application of quantitative real-time PCR (qPCR) technologies for the rapid identification of fecal bacteria in environmental waters is being considered for use as a national water quality metric in the United States. The transition from research tool to a standardized proto...

Physics in One Dimension

ERIC Educational Resources Information Center

Bertel, Erminald

2013-01-01

Due to progress in nanotechnology high-quality quantum wires can nowadays be fabricated. The behavior of particles in one dimension differs significantly from that in three-dimensional (3D) systems, yet the physics of such low-dimensional systems is generally not very well represented in standard undergraduate or graduate curricula. For instance,…

42 CFR 438.360 - Nonduplication of mandatory activities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Nonduplication of mandatory activities. (a) General rule. To avoid duplication, the State may use, in place of a... quality strategy, the State identifies the standards for which the EQR will use information from Medicare... information obtained from the Medicare program in place of information produced by the State, its agent, or...

Are Universities Really Out of Touch?

ERIC Educational Resources Information Center

Farquhar, Robin H.

It is proposed that there are three common misconceptions and criticisms held by the general public concerning Canadian universities: (1) the view that universities are hotbeds of radicalism, alcoholism, and sexism, (2) that there is a decline in the quality of work produced by universities and in their academic standards, and (3) that…

Health System Perspective: Variation, Costs, and Physician Behavior.

PubMed

Jevsevar, David S

2015-01-01

With the generalized rise in cost of US health care, renewed emphasis has been placed on defining the relationship between costs and outcome. The quality of health care delivery has been uneven, as measured by existing quality and performance measures, significant variation in the delivery of care, lack of standardization of care leading to avoidable error, lack of meaningful outcomes measurement, and apparent disconnect with cost. Orthopaedic surgeons are at the nexus of implementing change, as we are the primary decision makers regarding care of our patients. This summary will review efforts that address quality, cost, outcome, safety, and variation in care.

C++ software quality in the ATLAS experiment: tools and experience

NASA Astrophysics Data System (ADS)

Martin-Haugh, S.; Kluth, S.; Seuster, R.; Snyder, S.; Obreshkov, E.; Roe, S.; Sherwood, P.; Stewart, G. A.

2017-10-01

In this paper we explain how the C++ code quality is managed in ATLAS using a range of tools from compile-time through to run time testing and reflect on the substantial progress made in the last two years largely through the use of static analysis tools such as Coverity®, an industry-standard tool which enables quality comparison with general open source C++ code. Other available code analysis tools are also discussed, as is the role of unit testing with an example of how the GoogleTest framework can be applied to our codebase.

Web 2.0-Based Crowdsourcing for High-Quality Gold Standard Development in Clinical Natural Language Processing

PubMed Central

Deleger, Louise; Li, Qi; Kaiser, Megan; Stoutenborough, Laura

2013-01-01

Background A high-quality gold standard is vital for supervised, machine learning-based, clinical natural language processing (NLP) systems. In clinical NLP projects, expert annotators traditionally create the gold standard. However, traditional annotation is expensive and time-consuming. To reduce the cost of annotation, general NLP projects have turned to crowdsourcing based on Web 2.0 technology, which involves submitting smaller subtasks to a coordinated marketplace of workers on the Internet. Many studies have been conducted in the area of crowdsourcing, but only a few have focused on tasks in the general NLP field and only a handful in the biomedical domain, usually based upon very small pilot sample sizes. In addition, the quality of the crowdsourced biomedical NLP corpora were never exceptional when compared to traditionally-developed gold standards. The previously reported results on medical named entity annotation task showed a 0.68 F-measure based agreement between crowdsourced and traditionally-developed corpora. Objective Building upon previous work from the general crowdsourcing research, this study investigated the usability of crowdsourcing in the clinical NLP domain with special emphasis on achieving high agreement between crowdsourced and traditionally-developed corpora. Methods To build the gold standard for evaluating the crowdsourcing workers’ performance, 1042 clinical trial announcements (CTAs) from the ClinicalTrials.gov website were randomly selected and double annotated for medication names, medication types, and linked attributes. For the experiments, we used CrowdFlower, an Amazon Mechanical Turk-based crowdsourcing platform. We calculated sensitivity, precision, and F-measure to evaluate the quality of the crowd’s work and tested the statistical significance (P<.001, chi-square test) to detect differences between the crowdsourced and traditionally-developed annotations. Results The agreement between the crowd’s annotations and the traditionally-generated corpora was high for: (1) annotations (0.87, F-measure for medication names; 0.73, medication types), (2) correction of previous annotations (0.90, medication names; 0.76, medication types), and excellent for (3) linking medications with their attributes (0.96). Simple voting provided the best judgment aggregation approach. There was no statistically significant difference between the crowd and traditionally-generated corpora. Our results showed a 27.9% improvement over previously reported results on medication named entity annotation task. Conclusions This study offers three contributions. First, we proved that crowdsourcing is a feasible, inexpensive, fast, and practical approach to collect high-quality annotations for clinical text (when protected health information was excluded). We believe that well-designed user interfaces and rigorous quality control strategy for entity annotation and linking were critical to the success of this work. Second, as a further contribution to the Internet-based crowdsourcing field, we will publicly release the JavaScript and CrowdFlower Markup Language infrastructure code that is necessary to utilize CrowdFlower’s quality control and crowdsourcing interfaces for named entity annotations. Finally, to spur future research, we will release the CTA annotations that were generated by traditional and crowdsourced approaches. PMID:23548263

Water Quality Assessment for Deep-water Channel area of Guangzhou Port based on the Comprehensive Water Quality Identification Index Method

NASA Astrophysics Data System (ADS)

Chen, Yi

2018-03-01

The comprehensive water quality identification index method is able to assess the general water quality situation comprehensively and represent the water quality classification; water environment functional zone achieves pollution level and standard objectively and systematically. This paper selects 3 representative zones along deep-water channel of Guangzhou port and applies comprehensive water quality identification index method to calculate sea water quality monitoring data for different selected zones from year 2006 to 2014, in order to investigate the temporal variation of water quality along deep-water channel of Guangzhou port. The comprehensive water quality level from north to south presents an increased trend, and the water quality of the three zones in 2014 is much better than in 2006. This paper puts forward environmental protection measurements and suggestions for Pearl River Estuary, provides data support and theoretical basis for studied sea area pollution prevention and control.

[Quality Management and Quality Specifications of Laboratory Tests in Clinical Studies--Challenges in Pre-Analytical Processes in Clinical Laboratories].

PubMed

Ishibashi, Midori

2015-01-01

The cost, speed, and quality are the three important factors recently indicated by the Ministry of Health, Labour and Welfare (MHLW) for the purpose of accelerating clinical studies. Based on this background, the importance of laboratory tests is increasing, especially in the evaluation of clinical study participants' entry and safety, and drug efficacy. To assure the quality of laboratory tests, providing high-quality laboratory tests is mandatory. For providing adequate quality assurance in laboratory tests, quality control in the three fields of pre-analytical, analytical, and post-analytical processes is extremely important. There are, however, no detailed written requirements concerning specimen collection, handling, preparation, storage, and shipping. Most laboratory tests for clinical studies are performed onsite in a local laboratory; however, a part of laboratory tests is done in offsite central laboratories after specimen shipping. As factors affecting laboratory tests, individual and inter-individual variations are well-known. Besides these factors, standardizing the factors of specimen collection, handling, preparation, storage, and shipping, may improve and maintain the high quality of clinical studies in general. Furthermore, the analytical method, units, and reference interval are also important factors. It is concluded that, to overcome the problems derived from pre-analytical processes, it is necessary to standardize specimen handling in a broad sense.

Evaluation of haptotherapy for patients with cancer treated with chemotherapy at a day clinic.

PubMed

van den Berg, Machteld; Visser, Adriaan; Schoolmeesters, Alexandra; Edelman, Petra; van den Borne, Bart

2006-03-01

The purpose of this study was to evaluate a haptotherapeutic treatment and its effects on the perceived well-being of patients with cancer treated with chemotherapy in day care. The study had a pre-test-post-test semi-experimental design, with 31 patients in the intervention group and 26 in the control group. Patients in the control group were matched with patients in the experimental condition with respect to age, gender, type of cancer, type of chemotherapy, prognosis and the period between pre- and post-test. Standardized questionnaires were used measuring perceived well-being and satisfaction with care (haptotherapy). Indicators of well-being measured were quality of life, mood, meaning in life, general functioning, physical and psychological symptoms, sleep quality and body awareness. The intervention consisted of five haptotherapy sessions of 45 minutes each. Patients in the control condition received standard medical care. Patients were highly satisfied with the haptotherapy treatment, and especially valued the personal attention and the relaxation they experienced. The haptotherapy treatment improved both the perceived general quality of life and the perceived cognitive and social functioning of patients. No improvement was found for mood, meaning in life, general functioning, physical symptoms, sleep quality and body awareness. It may be concluded that haptotherapy positively contributes to several indicators of perceived well-being of patients with cancer during the period they receive chemotherapy. More rigorous experimental studies are necessary in this field, especially concerning randomization, number of participants and homogeneity of the sample. Haptotherapy as a type of complementary medicine is a potentially valuable and effective intervention to raise the well-being of patients with cancer undergoing invasive treatments like chemotherapy.

Patient-reported quality indicators for osteoarthritis: a patient and public generated self-report measure for primary care.

PubMed

Blackburn, Steven; Higginbottom, Adele; Taylor, Robert; Bird, Jo; Østerås, Nina; Hagen, Kåre Birger; Edwards, John J; Jordan, Kelvin P; Jinks, Clare; Dziedzic, Krysia

2016-01-01

People with osteoarthritis desire high quality care, support and information. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators can be used to benefit patients by measuring whether minimum standards of quality care are being met from a patient perspective. The aim of this study was to describe how a Research User Group (RUG) worked alongside researchers to co-produce a set of self-reported quality indicators for people with osteoarthritis when visiting their general practitioner or practice nurse (primary care). These were required in the MOSAICS study, which developed and evaluated a new model of supported self-management of OA to implement the NICE quality standards for OA. This article describes the public involvement in the MOSAICS study. This was 1) the co-development by RUG members and researchers of an Osteoarthritis Quality Indicators United Kingdom (OA QI (UK)) questionnaire for use in primary care, and 2) the comparison of the OA QI (UK) with a similar questionnaire developed in Norway. This study shows how important and effective a research user group can be in working with researchers in developing quality care indicators for osteoarthritis for use in a research study and, potentially, routine use in primary care. The questionnaire is intended to benefit patients by enabling the assessment of the quality of primary care for osteoarthritis from a patient's perspective. The OA QI (UK) has been used to examine differences in the quality of osteoarthritis care in four European countries. Background People with osteoarthritis (OA) desire high quality care, support and information about OA. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators (QI) can be used to benefit patients by measuring whether minimum standards of quality care (e.g. NICE quality standards) are being met from a patient perspective. A Research User Group (RUG) worked with researchers to co-produce a set of self-report, patient-generated QIs for OA. The QIs were intended for use in the MOSAICS study, which developed and evaluated a new model of supported self-management of OA to implement the NICE guidelines. We report on 1) the co-development of the OA QI (UK) questionnaire for primary care; and 2) the comparison of the content of the OA QI (UK) questionnaire with a parallel questionnaire developed in Norway for the Musculoskeletal Pain in Ullensaker (MUST) study. Methods Researchers were invited to OA RUG meetings. Firstly, RUG members were asked to consider factors important to patients consulting their general practitioner (GP) for OA and then each person rated their five most important. RUG members then discussed these in relation to a systematic review of OA QIs in order to form a list of OA QIs from a patient perspective. RUG members suggested wording and response options for a draft OA QI (UK) questionnaire to assess the QIs. Finally RUG members commented on draft and final versions of the questionnaire and how it compared with a translated Norwegian OA-QI questionnaire. Results RUG members (5 males, 5 females; aged 52-80 years) attended up to four meetings. RUG members ranked 20 factors considered most important to patients consulting their GP for joint pain. Following discussion, a list of eleven patient-reported QIs for OA consultations were formed. RUG members then suggested the wording and response options of 16 draft items - four QIs were split into two or more questionnaire items to avoid multiple dimensions of care quality within a single item. On comparison of this to the Norwegian OA-QI questionnaire, RUG members commented that both questionnaires contained seven similar QIs. The RUG members and researchers agreed to adopt the Norwegian OA-QI wording for four of these items. RUG members also recommended adopting an additional seven items from the Norwegian OA-QI with some minor word changes to improve their suitability for patients in the UK. One other item from the draft OA QI (UK) questionnaire was retained and eight items were excluded, resulting in a 15-item final version. Conclusions This study describes the development of patient-reported quality indicators for OA primary care derived by members of a RUG group, working in partnership with the research team throughout the study. The OA QI (UK) supports the NICE quality standards for OA and they have been successfully used to assess the quality of OA consultations in primary care in the MOSAICS study. The OA QI (UK) has the potential for routine use in primary care to assess the quality of OA care provided to patients. Ongoing research using both the UK and Norwegian OA-QI questionnaires is assessing the self-reported quality of OA care in different European populations.

[Evidence-based quality assessment of 10-year orthodontic clinical trials in 4 major dental journals].

PubMed

Sun, Yan-nan; Lei, Fei-fei; Cao, Yan-li; Fu, Min-kui

2010-02-01

To assess the quality of orthodontic clinical trials published in 4 major dental journals in the past 10 years and establish the reference standard for orthodontic clinical trials and quality control of dental journals. All the clinical trials published in Chinese Journal of Stomatology, West China Journal of Stomatology, Journal of Practice Stomatology and Chinese Journal of Orthodontics from 1999 to 2008 were searched. The demographic information of the papers was extracted and the quality of the clinical trials according to the consolidated standards of reporting trials (CONSORT) was assessed. Four hundred and ninety-four clinical trials were retrieved, and 21.3% (105/494) of them were supported by grants. For the study design, only 26.1% (129/494) were prospective studies, and 3.8% (19/494) were randomized clinical trials. It was hard to evaluate precisely due to the lack of information about the details of the study designs. For the randomized clinical trials, the lack of details for randomization, allocation concealment, blinding and intention to treat compromised the quality. The general quality of clinical trials in orthodontics is poor. It needs to be improved both in the clinical study design and the paper writing.

The European general thoracic surgery database project.

PubMed

Falcoz, Pierre Emmanuel; Brunelli, Alessandro

2014-05-01

The European Society of Thoracic Surgeons (ESTS) Database is a free registry created by ESTS in 2001. The current online version was launched in 2007. It runs currently on a Dendrite platform with extensive data security and frequent backups. The main features are a specialty-specific, procedure-specific, prospectively maintained, periodically audited and web-based electronic database, designed for quality control and performance monitoring, which allows for the collection of all general thoracic procedures. Data collection is the "backbone" of the ESTS database. It includes many risk factors, processes of care and outcomes, which are specially designed for quality control and performance audit. The user can download and export their own data and use them for internal analyses and quality control audits. The ESTS database represents the gold standard of clinical data collection for European General Thoracic Surgery. Over the past years, the ESTS database has achieved many accomplishments. In particular, the database hit two major milestones: it now includes more than 235 participating centers and 70,000 surgical procedures. The ESTS database is a snapshot of surgical practice that aims at improving patient care. In other words, data capture should become integral to routine patient care, with the final objective of improving quality of care within Europe.

Do written mandatory accreditation standards for residential care positively model learning organizations? Textual and critical discourse analysis.

PubMed

Bell, Erica; Robinson, Andrew; See, Catherine

2013-11-01

Unprecedented global population ageing accompanied by increasing complexity of aged care present major challenges of quality in aged care. In the business literature, Senge's theory of adaptive learning organisations offers a model of organisational quality. However, while accreditation of national standards is an increasing mechanism for achieving quality in aged care, there are anecdotal concerns it creates a 'minimum standards compliance mentality' and no evidence about whether it reinforces learning organisations. The research question was 'Do mandatory national accreditation standards for residential aged care, as they are written, positively model learning organisations?'. Automatic text analysis was combined with critical discourse analysis to analyse the presence of learning concepts from Senge's learning organisation theory in an exhaustive sample of national accreditation standards from 7 countries. The two stages of analysis were: (1) quantitative mapping of the presence of learning organisation concepts in standards using Bayesian-based textual analytics software and (2) qualitative critical discourse analysis to further examine how the language of standards so identified may be modelling learning organisation concepts. The learning concepts 'training', 'development', 'knowledge', and 'systems' are present with relative frequencies of 19%, 11%, 10%, and 10% respectively in the 1944 instances, in paragraph-sized text blocks, considered. Concepts such as 'team', 'integration', 'learning', 'change' and 'innovation' occur with 7%, 6%, 5%, 5%, and 1% relative frequencies respectively. Learning concepts tend to co-occur with negative rather than positive sentiment language in the 3176 instances in text blocks containing sentiment language. Critical discourse analysis suggested that standards generally use the language of organisational change and learning in limited ways that appear to model 'learning averse' communities of practice and organisational cultures. The aged care quality challenge and the role of standards need rethinking. All standards implicitly or explicitly model an organisation of some type. If standards can model a limited and negative learning organisation language, they could model a well-developed and positive learning organisation language. In the context of the global aged care crisis, the modelling of learning organisations is probably critical for minimal competence in residential aged care and certainly achievable in the language of standards. Copyright © 2013 Elsevier Ltd. All rights reserved.

Model for integrated management of quality, labor risks prevention, environment and ethical aspects, applied to R&D&I and production processes in an organization

NASA Astrophysics Data System (ADS)

González, M. R.; Torres, F.; Yoldi, V.; Arcega, F.; Plaza, I.

2012-04-01

It is proposed an integrated management model for an organization. This model is based on the continuous improvement Plan-Do-Check-Act cycle and it intends to integrate the environmental, risk prevention and ethical aspects as well as research, development and innovation projects management in the general quality management structure proposed by ISO 9001:2008. It aims to fulfill the standards ISO 9001, ISO 14001, OSHAS 18001, SGE 21 y 166002.

Justification of system of assessment of ecological safety degree of housing construction objects

NASA Astrophysics Data System (ADS)

Kankhva, Vadim

2017-10-01

In article characteristics and properties of competitiveness of housing construction objects are investigated, criteria and points of national systems of ecological building’s standardization are structured, the compliance assessment form on stages of life cycle of a capital construction project is developed. The main indicators of level of ecological safety considering requirements of the international ISO standards 9000 and ISO 14000 and which are based on the basic principles of general quality management (TQM) are presented.

A Comparison of Assertive Community Treatment Fidelity Measures and Patient-Centered Medical Home Standards

PubMed Central

Vanderlip, Erik R.; Cerimele, Joseph M.; Monroe-DeVita, Maria

2014-01-01

Objective This study compared program measures of assertive community treatment (ACT) with standards of accreditation for the patient-centered medical home (PCMH) to determine whether there were similarities in the infrastructure of the two methods of service delivery and whether high-fidelity ACT teams would qualify for medical home accreditation. Methods The authors compared National Committee for Quality Assurance PCMH standards with two ACT fidelity measures (the Dartmouth Assertive Community Treatment Scale and the Tool for Measurement of Assertive Community Treatment [TMACT]) and with national ACT program standards. Results PCMH standards pertaining to enhanced access and continuity, management of care, and self-care support demonstrated strong overlap across ACT measures. Standards for identification and management of populations, care coordination and follow-up, and quality improvement demonstrated less overlap. The TMACT and the program standards had sufficient overlap to score in the range of a level 1 PCMH, but no ACT measure sufficiently detailed methods of population-based screening and tracking of referrals to satisfy “must-pass” elements of the standards. Conclusions ACT measures and medical home standards had significant overlap in innate infrastructure. ACT teams following the program standards or undergoing TMACT fidelity review could have the necessary infrastructure to serve as medical homes if they were properly equipped to supervise general medical care and administer activities to improve management of chronic diseases. PMID:23820753

Mental health is the most important factor influencing quality of life in elderly left behind when families migrate out of rural China.

PubMed

Xie, Jian-fei; Ding, Si-qing; Zhong, Zhu-qing; Yi, Qi-feng; Zeng, Sai-nan; Hu, Jun-hua; Zhou, Jian-da

2014-01-01

to investigate the quality of life and the associated factors on left behind elderly in rural China. the research was conducted cluster sampling to select 456 elderly left behind when family members migrated out of rural China to participate in a cross-sectional study by completing a general data questionnaire and Quality of Life questionnaire. 91.5% of the elderly requested psychological counseling and education. For the elderly, scores for mental health (39.56±13.73) were significantly lower compared with Chinese standard data (61.6±13.7) (P<0.001). Age, chronic disease type, gender, residence pattern and economic support from children were the main psychological factors influencing this population. mental health is the most important factor influencing quality of life of elderly left behind when family members migrated out of rural China. Our study suggested a need to widely establish a general practitioner team for psychological intervention for improving rural elderly people's Quality of Life level, especially in the psychological domain.

An evaluation of freshwater mussel toxicity data in the derivation of water quality guidance and standards for copper

USGS Publications Warehouse

March, F.A.; Dwyer, F.J.; Augspurger, T.; Ingersoll, C.G.; Wang, N.; Mebane, C.A.

2007-01-01

The state of Oklahoma has designated several areas as freshwater mussel sanctuaries in an attempt to provide freshwater mussel species a degree of protection and to facilitate their reproduction. We evaluated the protection afforded freshwater mussels by the U.S. Environmental Protection Agency (U.S. EPA) hardness-based 1996 ambient copper water quality criteria, the 2007 U.S. EPA water quality criteria based on the biotic ligand model and the 2005 state of Oklahoma copper water quality standards. Both the criterion maximum concentration and criterion continuous concentration were evaluated. Published acute and chronic copper toxicity data that met American Society for Testing and Materials guidance for test acceptability were obtained for exposures conducted with glochidia or juvenile freshwater mussels. We tabulated toxicity data for glochidia and juveniles to calculate 20 species mean acute values for freshwater mussels. Generally, freshwater mussel species mean acute values were similar to those of the more sensitive species included in the U.S. EPA water quality derivation database. When added to the database of genus mean acute values used in deriving 1996 copper water quality criteria, 14 freshwater mussel genus mean acute values included 10 of the lowest 15 genus mean acute values, with three mussel species having the lowest values. Chronic exposure and sublethal effects freshwater mussel data available for four species and acute to chronic ratios were used to evaluate the criterion continuous concentration. On the basis of the freshwater mussel toxicity data used in this assessment, the hardness-based 1996 U.S. EPA water quality criteria, the 2005 Oklahoma water quality standards, and the 2007 U.S. EPA water quality criteria based on the biotic ligand model might need to be revised to afford protection to freshwater mussels. ?? 2007 SETAC.

HON label and DISCERN as content quality indicators of health-related websites.

PubMed

Khazaal, Yasser; Chatton, Anne; Zullino, Daniele; Khan, Riaz

2012-03-01

Content quality indicators are warranted in order to help patients and consumers to judge the content quality of health-related on-line information. The aim of the present study is to evaluate web-based information on health topics and to assess particular content quality indicators like HON (Health on the Net) and DISCERN. The present study is based on the analysis of data issued from six previous studies which assessed with a standardized tool the general and content quality (evidence-based health information) of health-related websites. Keywords related to Social phobia, bipolar disorders, pathological gambling as well as cannabis, alcohol and cocaine addiction were entered into popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality (evidence-based information). "Health on the Net" (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. Of 874 websites identified, 388 were included. Despite an observed association with higher content quality scores, the HON label fails to predict good content quality websites when used in a multiple regression. Sensibility and specificity of a DISCERN score >40 in the detection of good content quality websites were, respectively, 0.45 and 0.96. The DISCERN is a potential quality indicator with a relatively high specificity. Further developments in this domain are warranted in order to facilitate the identification of high-quality information on the web by patients.

Indoor Air Quality Assessment of the San Francisco Federal Building

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

Apte, Michael; Bennett, Deborah H.; Faulkner, David

2008-07-01

An assessment of the indoor air quality (IAQ) of the San Francisco Federal Building (SFFB) was conducted on May 12 and 14, 2009 at the request of the General Services Administration (GSA). The purpose of the assessment was for a general screening of IAQ parameters typically indicative of well functioning building systems. One naturally ventilated space and one mechanically ventilated space were studied. In both zones, the levels of indoor air contaminants, including CO2, CO, particulate matter, volatile organic compounds, and aldehydes, were low, relative to reference exposure levels and air quality standards for comparable office buildings. We found slightlymore » elevated levels of volatile organic compounds (VOCs) including two compounds often found in"green" cleaning products. In addition, we found two industrial solvents at levels higher than typically seen in office buildings, but the levels were not sufficient to be of a health concern. The ventilation rates in the two study spaces were high by any standard. Ventilation rates in the building should be further investigated and adjusted to be in line with the building design. Based on our measurements, we conclude that the IAQ is satisfactory in the zone we tested, but IAQ may need to be re-checked after the ventilation rates have been lowered.« less

Environmental impact of the Midia Port - Black Sea (Romania), on the coastal sediment quality

NASA Astrophysics Data System (ADS)

Catianis, Irina; Ungureanu, Constantin; Magagnini, Luca; Ulazzi, Elisa; Campisi, Tiziana; Stanica, Adrian

2016-03-01

The aim of the study was to evaluate the impact of potential pollution sources, mainly from the upstream anthropogenic sources and port-related activities. The in-vestigated area covered a wide range of anthropogenic im-pacts (e.g., industrial wastes, storm water runoff, acciden-tal oil spills, intentional discharges and shipping activities). The quality of water and Sediments was assessed us-ing Standard methods, as physical-chemical parameters, chemistry and biology (microbiology, ecotoxicology) aim-ing to figure the level of pollution and the effect of port-related activities. Seawater quality results agreed generally with environmental Standards. Though, in some samples the concentrations of sulphates (mg/1) and heavy metals (μg/1), as B, As and Se exceeded the recommended lim-its, without posing a serious environmental concern. Most of the surface sediment samples contain critical levels of hydrocarbons (C>12), (mg/kg), polycyclic aromatic hydrocarbons (ng/g) and polychlorobiphenyls (ng/g). For some heavy metals (mg/kg), exchangeable concentrations were found to be very close or above the regulations. The signifi-cance of this study is incontestable taking into account the lack of previous relevant historical data of this area. In this sense, it was possible to indicate, in general, good environmental conditions, despite the industrial and concentrated local port-related activities in the investigated area.

75 FR 48880 - Approval and Promulgation of Gila River Indian Community's Tribal Implementation Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

...The Environmental Protection Agency (EPA) proposes to approve the Gila River Indian Community's (GRIC or the Tribe) Tribal Implementation Plan (TIP) under the Clean Air Act (CAA) to regulate air pollution within the exterior boundaries of the Tribe's reservation. The proposed TIP is one of four CAA regulatory programs that comprise the Tribe's Air Quality Management Plan (AQMP). EPA approved the Tribe for treatment in the same manner as a State (Treatment as State or TAS) for purposes of administering the AQMP and other CAA authorities on October 21, 2009. In this action we propose to act only on those portions of the AQMP that constitute a TIP containing severable elements of an implementation plan under CAA section 110(a). The proposed TIP includes general and emergency authorities, ambient air quality standards, permitting requirements for minor sources of air pollution, enforcement authorities, procedures for administrative appeals and judicial review in Tribal court, requirements for area sources of fugitive dust and fugitive particulate matter, general prohibitory rules, and source category-specific emission limitations. The purpose of the proposed TIP is to implement, maintain, and enforce the National Ambient Air Quality Standards (NAAQS) in the GRIC reservation. The intended effect of today's proposed action is to make the GRIC TIP federally enforceable.

Quality indicators for initial licensure and discipline in nursing laws in South Korea and North Carolina.

PubMed

Kim, K K; Kjervik, D K; Foster, B

2014-03-01

The Korean regulatory framework of nursing licensure reflects that of the USA, but its content differs in some of the powers related to quality assurance. This article compares regulatory quality indicators and describes core standards in nursing regulations that are related to both initial licensure and discipline for three groups: the National Council of State Boards of Nursing, the North Carolina and the South of Korea. A descriptive, comparative law design is used to examine the differences and similarities in the quality indicators and core standards found in three documents: the National Council of State Boards of Nursing Model Act, the North Carolina Nursing Practice Act and the Korean Medical Service Act for registered nurses. The findings indicate that ten quality indicators and two standards appear in study objects. Although most of the quality indicators are common to all documents, some differences are found in terms of the scope of criminal background checks and the range of grounds for disciplinary action. These findings cannot be generalized in the USA because although the North Carolina nursing act was selected as an example of US nursing laws, nursing laws differ somewhat across states. This comparative study shows a clear opportunity to develop indicators that acknowledge the important areas of competence and good moral character and how they can improve patient safety in Korea. This study provides recommendations for Korean nursing legislative redesign and pointers for other jurisdictions to consider. © 2013 International Council of Nurses.

Change in quality of malnutrition surveys between 1986 and 2015.

PubMed

Grellety, Emmanuel; Golden, Michael H

2018-01-01

Representative surveys collecting weight, height and MUAC are used to estimate the prevalence of acute malnutrition. The results are then used to assess the scale of malnutrition in a population and type of nutritional intervention required. There have been changes in methodology over recent decades; the objective of this study was to determine if these have resulted in higher quality surveys. In order to examine the change in reliability of such surveys we have analysed the statistical distributions of the derived anthropometric parameters from 1843 surveys conducted by 19 agencies between 1986 and 2015. With the introduction of standardised guidelines and software by 2003 and their more general application from 2007 the mean standard deviation, kurtosis and skewness of the parameters used to assess nutritional status have each moved to now approximate the distribution of the WHO standards when the exclusion of outliers from analysis is based upon SMART flagging procedure. Where WHO flags, that only exclude data incompatible with life, are used the quality of anthropometric surveys has improved and the results now approach those seen with SMART flags and the WHO standards distribution. Agencies vary in their uptake and adherence to standard guidelines. Those agencies that fully implement the guidelines achieve the most consistently reliable results. Standard methods should be universally used to produce reliable data and tests of data quality and SMART type flagging procedures should be applied and reported to ensure that the data are credible and therefore inform appropriate intervention. Use of SMART guidelines has coincided with reliable anthropometric data since 2007.

The standard calibration instrument automation system for the atomic absorption spectrophotometer. Part 3: Program documentation

NASA Astrophysics Data System (ADS)

Ryan, D. P.; Roth, G. S.

1982-04-01

Complete documentation of the 15 programs and 11 data files of the EPA Atomic Absorption Instrument Automation System is presented. The system incorporates the following major features: (1) multipoint calibration using first, second, or third degree regression or linear interpolation, (2) timely quality control assessments for spiked samples, duplicates, laboratory control standards, reagent blanks, and instrument check standards, (3) reagent blank subtraction, and (4) plotting of calibration curves and raw data peaks. The programs of this system are written in Data General Extended BASIC, Revision 4.3, as enhanced for multi-user, real-time data acquisition. They run in a Data General Nova 840 minicomputer under the operating system RDOS, Revision 6.2. There is a functional description, a symbol definitions table, a functional flowchart, a program listing, and a symbol cross reference table for each program. The structure of every data file is also detailed.

Assessing indoor air quality in New York City nail salons.

PubMed

Pavilonis, Brian; Roelofs, Cora; Blair, Carly

2018-05-01

Nail salons are an important business and employment sector for recent immigrants offering popular services to a diverse range of customers across the United States. However, due to the nature of nail products and services, salon air can be burdened with a mix of low levels of hazardous airborne contaminants. Surveys of nail technicians have commonly found increased work-related symptoms, such as headaches and respiratory irritation, that are consistent with indoor air quality problems. In an effort to improve indoor air quality in nail salons, the state of New York recently promulgated regulations to require increased outdoor air and "source capture" of contaminants. Existing indoor air quality in New York State salons is unknown. In advance of the full implementation of the rules by 2021, we sought to establish reliable and usable baseline indoor air quality metrics to determine the feasibility and effectiveness of the requirement. In this pilot study, we measured total volatile organic compounds (TVOC) and carbon dioxide (CO 2 ) concentrations in 10 nail salons located in New York City to assess temporal and spatial trends. Within salon contaminant variation was generally minimal, indicating a well-mixed room and similar general exposure despite the task being performed. TVOC and CO 2 concentrations were strongly positively correlated (ρ = 0.81; p < 0.01) suggesting that CO 2 measurements could potentially be used to provide an initial determination of acceptable indoor air quality for the purposes of compliance with the standard. An almost tenfold increase in TVOC concentration was observed when the American National Standards Institute/American Society of Heating, Refrigerating and Air-Conditioning Engineers (ANSI/ASHRAE) target CO 2 concentration of 850 ppm was exceeded compared to when this target was met.

Skin-sparing mastectomy: a survey based approach to defining standard of care.

PubMed

Shen, Jeannie; Ellenhorn, Joshua; Qian, Dajun; Kulber, David; Aronowitz, Joel

2008-10-01

Skin-sparing mastectomy (SSM) followed by immediate reconstruction has been advocated as an effective treatment option for patients with early-stage breast carcinoma. It markedly improves the quality of breast reconstruction through preservation of the natural skin envelope and a smaller incision. The purpose of this study was to investigate general surgeons' attitudes towards SSM. A postal questionnaire survey of California general surgeons was conducted regarding SSM. Of 370 respondents who stated they performed breast cancer surgery, 331 perform mastectomy for cancer with planned immediate reconstruction. Ninety per cent of respondents did not feel that SSM resulted in higher rates of local recurrence. In addition, 70 per cent felt that the cosmetic results of immediate breast reconstruction after SSM were better than those after a standard mastectomy. Despite this, only 61 per cent perform SSM in most cases when immediate breast reconstruction is planned. The majority of general surgeons perform SSM and therefore it should be considered standard of care. Despite a growing body of literature demonstrating high rates of patient satisfaction and long-term oncologic safety with SSM, there remains significant variation in practice patterns among general surgeons. Additional effort in general surgery education regarding the feasibility and safety of SSM is needed.

Meat standards and grading: a world view.

PubMed

Polkinghorne, R J; Thompson, J M

2010-09-01

This paper addresses the principles relating to meat standards and grading of beef and advances the concept that potential exists to achieve significant desirable change from adopting more consumer focused systems within accurate value-based payment frameworks. The paper uses the definitions that classification is a set of descriptive terms describing features of the carcass that are useful to those involved in the trading of carcasses, whereas grading is the placing of different values on carcasses for pricing purposes, depending on the market and requirements of traders. A third definition is consumer grading, which refers to grading systems that seek to define or predict consumer satisfaction with a cooked meal. The development of carcass classification and grading schemes evolved from a necessity to describe the carcass using standard terms to facilitate trading. The growth in world trade of meat and meat products and the transition from trading carcasses to marketing individual meal portions raises the need for an international language that can service contemporary needs. This has in part been addressed by the United Nations promoting standard languages on carcasses, cuts, trim levels and cutting lines. Currently no standards exist for describing consumer satisfaction. Recent Meat Standards Australia (MSA) research in Australia, Korea, Ireland, USA, Japan and South Africa showed that consumers across diverse cultures and nationalities have a remarkably similar view of beef eating quality, which could be used to underpin an international language on palatability. Consumer research on the willingness to pay for eating quality shows that consumers will pay higher prices for better eating quality grades and generally this was not affected by demographic or meat preference traits of the consumer. In Australia the MSA eating quality grading system has generated substantial premiums to retailers, wholesalers and to the producer. Future grading schemes which measure both carcass yield and eating quality have the potential to underpin the development and implementation of transparent value-based payment systems which will encourage improved production efficiency throughout the supply chain.

Evaluation of surface resistivity measurements as an alternative to the rapid chloride permeability test for quality assurance and acceptance : LTRC research project capsule 10-1C.

DOT National Transportation Integrated Search

2010-02-01

Many entities currently use permeability specifications in Portland cement : concrete (PCC) pavements and structures. For those states using : permeability specifications, two test methods are generally used and include : ASTM C 1202 (Standard Test M...

40 CFR 131.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... General Provisions § 131.3 Definitions. (a) The Act means the Clean Water Act (Pub. L. 92-500, as amended... under section 307(a) of the Act. (e) Existing uses are those uses actually attained in the water body on... effluent limitations required by sections 301(b) and 306 of the Act. (i) Water quality standards are...

40 CFR 131.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... General Provisions § 131.3 Definitions. (a) The Act means the Clean Water Act (Pub. L. 92-500, as amended... under section 307(a) of the Act. (e) Existing uses are those uses actually attained in the water body on... effluent limitations required by sections 301(b) and 306 of the Act. (i) Water quality standards are...

40 CFR 131.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... General Provisions § 131.3 Definitions. (a) The Act means the Clean Water Act (Pub. L. 92-500, as amended... under section 307(a) of the Act. (e) Existing uses are those uses actually attained in the water body on... effluent limitations required by sections 301(b) and 306 of the Act. (i) Water quality standards are...

40 CFR 131.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... General Provisions § 131.3 Definitions. (a) The Act means the Clean Water Act (Pub. L. 92-500, as amended... under section 307(a) of the Act. (e) Existing uses are those uses actually attained in the water body on... effluent limitations required by sections 301(b) and 306 of the Act. (i) Water quality standards are...

16 CFR 1512.4 - Mechanical requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of edges, or any burrs or spurs caused during the shearing process. (c) Integrity. There shall be no.... Recommended quality thread form is specified in Handbook H28, “Screw Thread Standards for Federal Service,” 1..., 262, and 263, “General Purpose Screw Threads.” 2 1 Copies may be obtained from: Superintendent of...

16 CFR 1512.4 - Mechanical requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... burrs of spurs caused during the shearing process. (c) Integrity. There shall be no visible fracture of... quality thread form is specified in Handbook H28, “Screw Thread Standards for Federal Service,” 1 issued..., 262, and 263, “General Purpose Screw Threads.” 2 1 Copies may be obtained from: Superintendent of...

16 CFR 1512.4 - Mechanical requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... of edges, or any burrs or spurs caused during the shearing process. (c) Integrity. There shall be no.... Recommended quality thread form is specified in Handbook H28, “Screw Thread Standards for Federal Service,” 1..., 262, and 263, “General Purpose Screw Threads.” 2 1 Copies may be obtained from: Superintendent of...

ARE CARS OR TREES MORE IMPORTANT TO PARTICULATE MATTER AIR POLUTION? WHAT RADIOCARBON MEASUREMENTS HAVE TO SAY

EPA Science Inventory

Air pollution in the form of particulate matter (PM) originates from both human activities and "natural" phenomena. Setting and achieving National Ambient Air Quality Standards (NAAQS) for PM has to take into account the latter since they are in general less controllable than th...

Aspiring School Administrators' Perceived Ability to Meet Technology Standards and Technological Needs for Professional Development

ERIC Educational Resources Information Center

Yu, Chien; Prince, Debra Lindsey

2016-01-01

The merits of technology in general and of educational technology specifically are well documented. The use of educational technology has been shown to improve teaching and learning and the overall educational quality of schools. However, the successful integration of educational technology in schools hinges on school administrators' technology…

Developing Pre-Professional Identity in Undergraduates through Work-Integrated Learning

ERIC Educational Resources Information Center

Jackson, Denise

2017-01-01

Pre-professional identity is a complex phenomenon spanning awareness of and connection with the skills, qualities, behaviours, values and standards of a student's chosen profession, as well as one's understanding of professional self in relation to the broader general self. It is an important, yet under-explored, aspect of graduate employability…

77 FR 63234 - Approval and Promulgation of Implementation Plans; North Carolina 110(a)(1) and (2...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-16

... and 2006 Fine Particulate Matter National Ambient Air Quality Standards AGENCY: Environmental... SIP addresses emissions of particulate matter generally, and does not distinguish between PM 10 and PM 2.5. The Commenter also references the particulate matter maximum emission rates for two coal-fired...

Student Complaints: An Accurate Measure of Student Dissatisfaction?

ERIC Educational Resources Information Center

Cooper-Hind, Heidi; Taylor, John

2012-01-01

Recent interest in the number of complaints being raised by students in higher education may be attributed both to a general concern about quality and standards in universities and to the emerging role of the student as a "consumer". However, partly because of the highly sensitive nature of this topic, for students, staff and…

The (Im)possibility of Gay Teachers for Young Children

ERIC Educational Resources Information Center

King, James R.

2004-01-01

Those who teach, or intend to teach, young children undergo careful scrutiny as to their suitability for the role of teacher. In general, professional monitoring of teaching standards and teacher qualities are reasonable expectations. However, a set of related cultural practices embedded in such monitoring purposefully and unjustly impact men who…

Establishment of northern red oak genetic tests with nursery-graded seedlings

Treesearch

S. A. Lay; M. A. Remaley; S. E. Schlarbaum; P. P. Kormanik; T. Tibbs; R. A. Cox; T. LaFarge; A. M. Saxton

1997-01-01

Artificial regeneration of northern red oak (Quercus rubra L.) has had variable success over time. Current nursery practices generally involve the growth of seedlings to a standardized height and form with little regard to seed source, seedling quality, or subsequent field performance. Additionally, there is not an accepted culling criteria for...

Quality standards of the European Pharmacopoeia.

PubMed

Bouin, Anne-Sophie; Wierer, Michael

2014-12-02

The European Pharmacopoeia (Ph. Eur.) provides a legal and scientific reference for the quality control of medicines. It is legally binding in the 38 signatory parties of the Convention on the elaboration of a European Pharmacopoeia (37 member states and the European Union). The requirements for a specific herbal drug are prescribed in the corresponding individual monograph and the relevant general monographs. Criteria for pesticides and heavy metals for example are defined in the general monograph on Herbal drugs. The Ph. Eur. also provides general methods including methods for determination of aflatoxins B1 and ochratoxin A. Screening methods for aristolochic acids are applied for herbal drugs that may be subject to adulteration or substitution with plant material containing aristolochic acids. The Ph. Eur. collaborate in many areas with the European Medicines Agency (EMA) to ensure close collaboration as regards the respective work programmes and approach. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

FDA and NIST collaboration on standards development activities supporting innovation and translation of regenerative medicine products.

PubMed

Arcidiacono, Judith A; Bauer, Steven R; Kaplan, David S; Allocca, Clare M; Sarkar, Sumona; Lin-Gibson, Sheng

2018-06-01

The development of standards for the field of regenerative medicine has been noted as a high priority by several road-mapping activities. Additionally, the U.S. Congress recognizes the importance of standards in the 21st Century Cure Act. Standards will help to accelerate and streamline cell and gene therapy product development, ensure the quality and consistency of processes and products, and facilitate their regulatory approval. Although there is general agreement for the need of additional standards for regenerative medicine products, a shared understanding of standards is required for real progress toward the development of standards to advance regenerative medicine. Here, we describe the roles of standards in regenerative medicine as well as the process for standards development and the interactions of different entities in the standards development process. Highlighted are recent coordinated efforts between the U.S. Food and Drug Administration and the National Institute of Standards and Technology to facilitate standards development and foster science that underpins standards development. Published by Elsevier Inc.

A survey exploring knowledge and perceptions of general practitioners towards the use of generic medicines in the northern state of Malaysia.

PubMed

Chua, Gin Nie; Hassali, Mohamed Azmi; Shafie, Asrul Akmal; Awaisu, Ahmed

2010-05-01

The objective of this study was to evaluate the general practitioners' (GPs') knowledge and perceptions towards generic medicines in a northern state of Malaysia. A postal cross-sectional survey involving registered GPs in Penang, Malaysia was undertaken. A 23-item questionnaire was developed, validated and administered on the GPs. Eighty-seven GPs responded to the survey (response rate 26.8%). The majority of the respondents (85.1%) claimed that they actively prescribed generic medicines in their practice. On the other hand, only 4.6% of the respondents correctly identified the Malaysia's National Pharmaceutical Control Bureau's bioequivalence standard for generic products. There were misconceptions among the respondents about the concepts of "bioequivalence", "efficacy", "safety", and "manufacturing standards" of generic medicines. GPs in this survey believed that a standard guideline on brand substitution process, collaboration with pharmacists, patient education and information on safety and efficacy of generic medicines were necessary to ensure quality use of generics. Furthermore, advertisements and product bonuses offered by pharmaceutical companies, patient's socio-economic factors as well as credibility of manufacturers were factors reported to influence their choice of medicine. Although it appeared that GPs have largely accepted the use of generic medicines, they still have concerns regarding the reliability and quality of such products. GPs need to be educated and reassured about generic products approval system in Malaysia concerning bioequivalence, quality, and safety. The current findings have important implications in establishing generic medicines policy in Malaysia. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Quality of Web-based Information for the 10 Most Common Fractures.

PubMed

Memon, Muzammil; Ginsberg, Lydia; Simunovic, Nicole; Ristevski, Bill; Bhandari, Mohit; Kleinlugtenbelt, Ydo Vincent

2016-06-17

In today's technologically advanced world, 75% of patients have used Google to search for health information. As a result, health care professionals fear that patients may be misinformed. Currently, there is a paucity of data on the quality and readability of Web-based health information on fractures. In this study, we assessed the quality and readability of Web-based health information related to the 10 most common fractures. Using the Google search engine, we assessed websites from the first results page for the 10 most common fractures using lay search terms. Website quality was measured using the DISCERN instrument, which scores websites as very poor (15-22.5), poor (22.5-37.5), fair (37.5-52.5), good (52.5-67.5), or excellent (67.5-75). The presence of Health on the Net code (HONcode) certification was assessed for all websites. Website readability was measured using the Flesch Reading Ease Score (0-100), where 60-69 is ideal for the general public, and the Flesch-Kincaid Grade Level (FKGL; -3.4 to ∞), where the mean FKGL of the US adult population is 8. Overall, website quality was "fair" for all fractures, with a mean (standard deviation) DISCERN score of 50.3 (5.8). The DISCERN score correlated positively with a higher website position on the search results page (r(2)=0.1, P=.002) and with HONcode certification (P=.007). The mean (standard deviation) Flesch Reading Ease Score and FKGL for all fractures were 62.2 (9.1) and 6.7 (1.6), respectively. The quality of Web-based health information on fracture care is fair, and its readability is appropriate for the general public. To obtain higher quality information, patients should select HONcode-certified websites. Furthermore, patients should select websites that are positioned higher on the results page because the Google ranking algorithms appear to rank the websites by quality.

Quality of Web-based Information for the 10 Most Common Fractures

PubMed Central

Ginsberg, Lydia; Simunovic, Nicole; Ristevski, Bill; Bhandari, Mohit; Kleinlugtenbelt, Ydo Vincent

2016-01-01

Background In today's technologically advanced world, 75% of patients have used Google to search for health information. As a result, health care professionals fear that patients may be misinformed. Currently, there is a paucity of data on the quality and readability of Web-based health information on fractures. Objectives In this study, we assessed the quality and readability of Web-based health information related to the 10 most common fractures. Methods Using the Google search engine, we assessed websites from the first results page for the 10 most common fractures using lay search terms. Website quality was measured using the DISCERN instrument, which scores websites as very poor (15-22.5), poor (22.5-37.5), fair (37.5-52.5), good (52.5-67.5), or excellent (67.5-75). The presence of Health on the Net code (HONcode) certification was assessed for all websites. Website readability was measured using the Flesch Reading Ease Score (0-100), where 60-69 is ideal for the general public, and the Flesch-Kincaid Grade Level (FKGL; −3.4 to ∞), where the mean FKGL of the US adult population is 8. Results Overall, website quality was “fair” for all fractures, with a mean (standard deviation) DISCERN score of 50.3 (5.8). The DISCERN score correlated positively with a higher website position on the search results page (r2=0.1, P=.002) and with HONcode certification (P=.007). The mean (standard deviation) Flesch Reading Ease Score and FKGL for all fractures were 62.2 (9.1) and 6.7 (1.6), respectively. Conclusion The quality of Web-based health information on fracture care is fair, and its readability is appropriate for the general public. To obtain higher quality information, patients should select HONcode-certified websites. Furthermore, patients should select websites that are positioned higher on the results page because the Google ranking algorithms appear to rank the websites by quality. PMID:27317159

Process mapping as a framework for performance improvement in emergency general surgery.

PubMed

DeGirolamo, Kristin; D'Souza, Karan; Hall, William; Joos, Emilie; Garraway, Naisan; Sing, Chad Kim; McLaughlin, Patrick; Hameed, Morad

2017-12-01

Emergency general surgery conditions are often thought of as being too acute for the development of standardized approaches to quality improvement. However, process mapping, a concept that has been applied extensively in manufacturing quality improvement, is now being used in health care. The objective of this study was to create process maps for small bowel obstruction in an effort to identify potential areas for quality improvement. We used the American College of Surgeons Emergency General Surgery Quality Improvement Program pilot database to identify patients who received nonoperative or operative management of small bowel obstruction between March 2015 and March 2016. This database, patient charts and electronic health records were used to create process maps from the time of presentation to discharge. Eighty-eight patients with small bowel obstruction (33 operative; 55 nonoperative) were identified. Patients who received surgery had a complication rate of 32%. The processes of care from the time of presentation to the time of follow-up were highly elaborate and variable in terms of duration; however, the sequences of care were found to be consistent. We used data visualization strategies to identify bottlenecks in care, and they showed substantial variability in terms of operating room access. Variability in the operative care of small bowel obstruction is high and represents an important improvement opportunity in general surgery. Process mapping can identify common themes, even in acute care, and suggest specific performance improvement measures.

Process mapping as a framework for performance improvement in emergency general surgery.

PubMed

DeGirolamo, Kristin; D'Souza, Karan; Hall, William; Joos, Emilie; Garraway, Naisan; Sing, Chad Kim; McLaughlin, Patrick; Hameed, Morad

2018-02-01

Emergency general surgery conditions are often thought of as being too acute for the development of standardized approaches to quality improvement. However, process mapping, a concept that has been applied extensively in manufacturing quality improvement, is now being used in health care. The objective of this study was to create process maps for small bowel obstruction in an effort to identify potential areas for quality improvement. We used the American College of Surgeons Emergency General Surgery Quality Improvement Program pilot database to identify patients who received nonoperative or operative management of small bowel obstruction between March 2015 and March 2016. This database, patient charts and electronic health records were used to create process maps from the time of presentation to discharge. Eighty-eight patients with small bowel obstruction (33 operative; 55 nonoperative) were identified. Patients who received surgery had a complication rate of 32%. The processes of care from the time of presentation to the time of follow-up were highly elaborate and variable in terms of duration; however, the sequences of care were found to be consistent. We used data visualization strategies to identify bottlenecks in care, and they showed substantial variability in terms of operating room access. Variability in the operative care of small bowel obstruction is high and represents an important improvement opportunity in general surgery. Process mapping can identify common themes, even in acute care, and suggest specific performance improvement measures.

Water quality and benthic macroinvertebrate bioassessment of Gallinas Creek, San Miguel County, New Mexico, 1987-90

USGS Publications Warehouse

Garn, H.S.; Jacobi, G.Z.

1996-01-01

Upper Gallinas Creek in north-central New Mexico serves as the public water supply for the City of Las Vegas. The majority of this 84-square-mile watershed is within national forest lands managed by the U.S. Forest Service. In 1985, the Forest Service planned to conduct timber harvesting in the headwaters of Gallinas Creek. The City of Las Vegas was concerned about possible effects from logging on water quality and on water-supply treatment costs. The U.S. Geological Survey began a cooperative study in 1987 to (1) assess the baseline water-quality characteristics of Gallinas Creek upstream from the Las Vegas water-supply diversion, (2) relate water quality to State water- quality standards, and (3) determine possible causes for spatial differences in quality. During 1987-90, water-quality constituents and aquatic benthic macroinvertebrates were collected and analyzed at five sampling sites in the watershed. Specific conductance, pH, total hardness, total alkalinity, and calcium concentrations increased in a downstream direction, probably in response to differences in geology in the watershed. The water-quality standard for temperature was exceeded at the two most downstream sites probably due to a lack of riparian vegetation and low streamflow conditions. The standards for pH and turbidity were exceeded at all sites except the most upstream one. Concentrations of nitrogen species and phosphorus generally were small at all sites. The maximum total nitrogen concentration of 2.1 milligrams per liter was at the mouth of Porvenir Canyon; only one sample at this site exceeded the water-quality standard for total inorganic nitrogen. At each of the sites, 10 to 15 percent of the samples exceeded the total phosphorus standard of less than 0.1 milligram per liter. Except for aluminum and iron, almost all samples tested for trace elements contained concentrations less than the laboratory detection limit. No trace-element concentrations exceeded the State standard for domestic water supplies. Suspended-sediment concentrations appeared to increase with distance downstream; suspended sediment increased significantly from the uppermost site to the second site near the national forest boundary, most probably caused by runoff from the unpaved forest road adjacent to Gallinas Creek. The aquatic macroinvertebrate assessment indicated that the three upstream sites had good biological conditions and were nonimpaired, whereas the two downstream sites had lowered biological conditions and were slightly impaired. The water- quality and biological assessments provided similar results.

Preliminary water-quality assessment of the upper White River near Indianapolis, Marion County, Indiana

USGS Publications Warehouse

Wangsness, David J.; Eikenberry, S.E.; Wilber, W.G.; Crawford, Charles G.

1981-01-01

The White River Park Commission is planning the development of park facilities along the White River through Indianapolis, Ind. A key element in the planning is the determination of whether water quality of the river is suitable for recreation. A preliminary water-quality assessment conducted August 4-5, 1980, indicated that, during low-flow steady-state conditions, the river is suitable for partial body contact recreation (any contact with water up to, but not including complete submergence). Dissolved-oxygen concentrations varied but were higher than the Indiana water-quality standards established to ensure conditions for the maintenance of a well-balanced, warm-water fish community. High fecal-coliform densities that have been observed in the White River during high streamflow are probably caused by stormwater runoff carried by combined storm and sanitary sewers. However, during the low-flow, steady-state conditions on August 4-5, 1980, fecal-coliform densities were within the Indiana standards for partial body contact recreation. Quantities of organic matter and concentrations of nutrients and heavy metals in the White River were generally within the limits recommended by the U.S. Environmental Protection Agency and were generally similar to values for other Indiana rivers. Chromium, copper, lead, zinc, and mercury are accumulating in bottom materials downstream from 30th Street. The phytoplankton concentrations in the White River were high. The dominant phytoplankton species were indicative of rivers moderately affected by organic wastes. (USGS)

Long-Term Follow-Up of Quality of Life following DIEP Flap Breast Reconstruction.

PubMed

Hunsinger, Vincent; Hivelin, Mikael; Derder, Mohamed; Klein, Delphine; Velten, Michel; Lantieri, Laurent

2016-05-01

Sequelae resulting from breast cancer negatively impact patients' quality of life. Although the deep inferior epigastric perforator (DIEP) flap has become a standard for autologous breast reconstruction, there are limited data regarding long-term quality of life. The authors studied patients' quality of life more than 5 years after DIEP flap breast reconstruction and compare it with two French reference samples. A cross-sectional study of quality of life was performed in women who underwent DIEP flap breast reconstruction between 1995 and 2007 using the Medical Outcomes Study 36-Item Health Survey (Short Form-36). The first reference sample included subjects from the French general population (n = 3308), and the second included cancer survivors who underwent mastectomy with (n = 70) or without (n = 135) breast reconstruction. One hundred eleven respondents were analyzed among 186 eligible women. The mean follow-up period after reconstruction was 8.6 years (range, 5 to 15 years). There were no statistically significant differences in the quality of life between women from 45 to 64 years old who underwent DIEP flap breast reconstruction and from the French general population. Five of the eight Short Form-36 dimensions were significantly better in the DIEP flap breast reconstruction group in the 65- to 74-year-old cohort. In addition, quality of life of our study population was significantly higher than that of women who underwent mastectomy with or without any type of breast reconstruction. These results indicate that DIEP flap breast reconstruction allows patients with breast cancer to maintain a good postoperative quality of life comparable to that of the general population. Therapeutic, III.

Photogrammetry and Remote Sensing: New German Standards (din) Setting Quality Requirements of Products Generated by Digital Cameras, Pan-Sharpening and Classification

NASA Astrophysics Data System (ADS)

Reulke, R.; Baltrusch, S.; Brunn, A.; Komp, K.; Kresse, W.; von Schönermark, M.; Spreckels, V.

2012-08-01

10 years after the first introduction of a digital airborne mapping camera in the ISPRS conference 2000 in Amsterdam, several digital cameras are now available. They are well established in the market and have replaced the analogue camera. A general improvement in image quality accompanied the digital camera development. The signal-to-noise ratio and the dynamic range are significantly better than with the analogue cameras. In addition, digital cameras can be spectrally and radiometrically calibrated. The use of these cameras required a rethinking in many places though. New data products were introduced. In the recent years, some activities took place that should lead to a better understanding of the cameras and the data produced by these cameras. Several projects, like the projects of the German Society for Photogrammetry, Remote Sensing and Geoinformation (DGPF) or EuroSDR (European Spatial Data Research), were conducted to test and compare the performance of the different cameras. In this paper the current DIN (Deutsches Institut fuer Normung - German Institute for Standardization) standards will be presented. These include the standard for digital cameras, the standard for ortho rectification, the standard for classification, and the standard for pan-sharpening. In addition, standards for the derivation of elevation models, the use of Radar / SAR, and image quality are in preparation. The OGC has indicated its interest in participating that development. The OGC has already published specifications in the field of photogrammetry and remote sensing. One goal of joint future work could be to merge these formerly independent developments and the joint development of a suite of implementation specifications for photogrammetry and remote sensing.

Economic Evaluation of a General Hospital Unit for Older People with Delirium and Dementia (TEAM Randomised Controlled Trial).

PubMed

Tanajewski, Lukasz; Franklin, Matthew; Gkountouras, Georgios; Berdunov, Vladislav; Harwood, Rowan H; Goldberg, Sarah E; Bradshaw, Lucy E; Gladman, John R F; Elliott, Rachel A

2015-01-01

One in three hospital acute medical admissions is of an older person with cognitive impairment. Their outcomes are poor and the quality of their care in hospital has been criticised. A specialist unit to care for older people with delirium and dementia (the Medical and Mental Health Unit, MMHU) was developed and then tested in a randomised controlled trial where it delivered significantly higher quality of, and satisfaction with, care, but no significant benefits in terms of health status outcomes at three months. To examine the cost-effectiveness of the MMHU for older people with delirium and dementia in general hospitals, compared with standard care. Six hundred participants aged over 65 admitted for acute medical care, identified on admission as cognitively impaired, were randomised to the MMHU or to standard care on acute geriatric or general medical wards. Cost per quality adjusted life year (QALY) gained, at 3-month follow-up, was assessed in trial-based economic evaluation (599/600 participants, intervention: 309). Multiple imputation and complete-case sample analyses were employed to deal with missing QALY data (55%). The total adjusted health and social care costs, including direct costs of the intervention, at 3 months was £7714 and £7862 for MMHU and standard care groups, respectively (difference -£149 (95% confidence interval [CI]: -298, 4)). The difference in QALYs gained was 0.001 (95% CI: -0.006, 0.008). The probability that the intervention was dominant was 58%, and the probability that it was cost-saving with QALY loss was 39%. At £20,000/QALY threshold, the probability of cost-effectiveness was 94%, falling to 59% when cost-saving QALY loss cases were excluded. The MMHU was strongly cost-effective using usual criteria, although considerably less so when the less acceptable situation with QALY loss and cost savings were excluded. Nevertheless, this model of care is worthy of further evaluation. ClinicalTrials.gov NCT01136148.

Statistical summary of air quality data for metropolitian Cleveland, Ohio, 1967 - 1972: Total suspended particulates, nitrogen dioxide, and sulfur dioxide

NASA Technical Reports Server (NTRS)

King, R. B.; Neustadter, H. E.; Fordyce, J. S.; Burr, J. C., Jr.; Cornett, C. L.

1974-01-01

Air-quality data for metropolitan Cleveland, Ohio, from 1967 through 1972 were collated and statistically analyzed. Total suspended particulates (TSP) departed from lognormal distribution in 1972. Nitrogen dioxide and sulfur dioxide, departed significantly from lognormal distributions in 1972. In Cleveland the Ohio standards were not met. However, the data indicate a general improvement in air quality. Unusually high precipitation (43% above the average in 1972) may be responsible in lowering these values from the 1971 levels. The mean values of TSP, NO2, and SO2 are 104, 191, and 83 microgram/cu m respectively.

HEVC optimizations for medical environments

NASA Astrophysics Data System (ADS)

Fernández, D. G.; Del Barrio, A. A.; Botella, Guillermo; García, Carlos; Meyer-Baese, Uwe; Meyer-Baese, Anke

2016-05-01

HEVC/H.265 is the most interesting and cutting-edge topic in the world of digital video compression, allowing to reduce by half the required bandwidth in comparison with the previous H.264 standard. Telemedicine services and in general any medical video application can benefit from the video encoding advances. However, the HEVC is computationally expensive to implement. In this paper a method for reducing the HEVC complexity in the medical environment is proposed. The sequences that are typically processed in this context contain several homogeneous regions. Leveraging these regions, it is possible to simplify the HEVC flow while maintaining a high-level quality. In comparison with the HM16.2 standard, the encoding time is reduced up to 75%, with a negligible quality loss. Moreover, the algorithm is straightforward to implement in any hardware platform.

Ground-Water Quality and Potential Effects of Individual Sewage Disposal System Effluent on Ground-Water Quality in Park County, Colorado, 2001-2004

USGS Publications Warehouse

Miller, Lisa D.; Ortiz, Roderick F.

2007-01-01

In 2000, the U.S. Geological Survey, in cooperation with Park County, Colorado, began a study to evaluate ground-water quality in the various aquifers in Park County that supply water to domestic wells. The focus of this study was to identify and describe the principal natural and human factors that affect ground-water quality. In addition, the potential effects of individual sewage disposal system (ISDS) effluent on ground-water quality were evaluated. Ground-water samples were collected from domestic water-supply wells from July 2001 through October 2004 in the alluvial, crystalline-rock, sedimentary-rock, and volcanic-rock aquifers to assess general ground-water quality and effects of ISDS's on ground-water quality throughout Park County. Samples were analyzed for physical properties, major ions, nutrients, bacteria, and boron; and selected samples also were analyzed for dissolved organic carbon, human-related (wastewater) compounds, trace elements, radionuclides, and age-dating constituents (tritium and chlorofluorocarbons). Drinking-water quality is adequate for domestic use throughout Park County with a few exceptions. Only about 3 percent of wells had concentrations of fluoride, nitrate, and (or) uranium that exceeded U.S. Environmental Protection Agency national, primary drinking-water standards. These primary drinking-water standards were exceeded only in wells completed in the crystalline-rock aquifers in eastern Park County. Escherichia coli bacteria were detected in one well near Guffey, and total coliform bacteria were detected in about 11 percent of wells sampled throughout the county. The highest total coliform concentrations were measured southeast of the city of Jefferson and west of Tarryall Reservoir. Secondary drinking-water standards were exceeded more frequently. About 19 percent of wells had concentrations of one or more constituents (pH, chloride, fluoride, sulfate, and dissolved solids) that exceeded secondary drinking-water standards. Currently (2004), there is no federally enforced drinking-water standard for radon in public water-supply systems, but proposed regulations suggest a maximum contaminant level of 300 picocuries per liter (pCi/L) and an alternative maximum contaminant level of 4,000 pCi/L contingent on other mitigating remedial activities to reduce radon levels in indoor air. Radon concentrations in about 91 percent of ground-water samples were greater than or equal to 300 pCi/L, and about 25 percent had radon concentrations greater than or equal to 4,000 pCi/L. Generally, the highest radon concentrations were measured in samples collected from wells completed in the crystalline-rock aquifers. Analyses of ground-water-quality data indicate that recharge from ISDS effluent has affected some local ground-water systems in Park County. Because roughly 90 percent of domestic water used is assumed to be recharged by ISDS's, detections of human-related (wastewater) compounds in ground water in Park County are not surprising; however, concentrations of constituents associated with ISDS effluent generally are low (concentrations near the laboratory reporting levels). Thirty-eight different organic wastewater compounds were detected in 46 percent of ground-water samples, and the number of compounds detected per sample ranged from 1 to 17 compounds. Samples collected from wells with detections of wastewater compounds also had significantly higher (p-value < 0.05) chloride and boron concentrations than samples from wells with no detections of wastewater compounds. ISDS density (average subdivision lot size used to estimate ISDS density) was related to ground-water quality in Park County. Chloride and boron concentrations were significantly higher in ground-water samples collected from wells located in areas that had average subdivision lot sizes of less than 1 acre than in areas that had average subdivision lot sizes greater than or equal to 1 acre. For wells completed in the crystalline-

Prospective, randomized, blinded evaluation of donor semen quality provided by seven commercial sperm banks.

PubMed

Carrell, Douglas T; Cartmill, Deborah; Jones, Kirtly P; Hatasaka, Harry H; Peterson, C Matthew

2002-07-01

To evaluate variability in donor semen quality between seven commercial donor sperm banks, within sperm banks, and between intracervical insemination and intrauterine insemination. Prospective, randomized, blind evaluation of commercially available donor semen samples. An academic andrology laboratory. Seventy-five cryopreserved donor semen samples were evaluated. Samples were coded, then blindly evaluated for semen quality. Standard semen quality parameters, including concentration, motility parameters, World Health Organization criteria morphology, and strict criteria morphology. Significant differences were observed between donor semen banks for most semen quality parameters analyzed in intracervical insemination samples. In general, the greatest variability observed between banks was in percentage progressive sperm motility (range, 8.8 +/- 5.8 to 42.4 +/- 5.5) and normal sperm morphology (strict criteria; range, 10.1 +/- 3.3 to 26.6 +/- 4.7). Coefficients of variation within sperm banks were generally high. These data demonstrate the variability of donor semen quality provided by commercial sperm banks, both between banks and within a given bank. No relationship was observed between the size or type of sperm bank and the degree of variability. The data demonstrate the lack of uniformity in the criteria used to screen potential semen donors and emphasize the need for more stringent screening criteria and strict quality control in processing samples.

Public perception and economic implications of bottled water consumption in underprivileged urban areas.

PubMed

Massoud, M A; Maroun, R; Abdelnabi, H; Jamali, I I; El-Fadel, M

2013-04-01

This paper presents a comparative assessment of public perception of drinking water quality in two underprivileged urban areas in Lebanon and Jordan with nearly similar cultural and demographic characteristics. It compares the quality of bottled water to the quality of the drinking water supplied through the public network and examines the economic implications of bottled water consumption in the two study areas. Participants' perception of the quality of drinking water provided via the public network was generally negative, and bottled water was perceived to be of better quality in both areas, thus affecting drinking water preferences and consumption patterns. The results reveal that the quality of bottled water is questionable in areas that lack enforcement of water quality standards, thus adding to the burden of an already disadvantaged community. Both areas demonstrated a considerable cost incurred for purchasing bottled water in low income communities reaching up to 26 % of total income.

Unannounced versus announced hospital surveys: a nationwide cluster-randomized controlled trial.

PubMed

Ehlers, Lars Holger; Simonsen, Katherina Beltoft; Jensen, Morten Berg; Rasmussen, Gitte Sand; Olesen, Anne Vingaard

2017-06-01

To evaluate the effectiveness of unannounced versus announced surveys in detecting non-compliance with accreditation standards in public hospitals. A nationwide cluster-randomized controlled trial. All public hospitals in Denmark were invited. Twenty-three hospitals (77%) (3 university hospitals, 5 psychiatric hospitals and 15 general hospitals) agreed to participate. Twelve hospitals were randomized to receive unannounced surveys (intervention group) and eleven hospitals to receive announced surveys (control group). We hypothesized that the hospitals receiving the unannounced surveys would reveal a higher degree of non-compliance with accreditation standards than the hospitals receiving announced surveys. Nine surveyors trained and employed by the Danish Institute for Quality and Accreditation in Healthcare (IKAS) were randomized into teams and conducted all surveys. The outcome was the surveyors' assessment of the hospitals' level of compliance with 113 performance indicators-an abbreviated set of the Danish Healthcare Quality Programme (DDKM) version 2, covering organizational standards, patient pathway standards and patient safety standards. Compliance with performance indicators was analyzed using binomial regression analysis with bootstrapped robust standard errors. In all, 16 202 measurements were acceptable for data analysis. The risk of observing non-compliance with performance indicators for the intervention group compared with the control group was statistically insignificant (risk difference (RD) = -0.6 percentage points [-2.51-1.31], P = 0.54). A converged analysis of the six patient safety critical standards, requiring 100% compliance to gain accreditation status revealed no statistically significant difference (RD = -0.78 percentage points [-4.01-2.44], P = 0.99). Unannounced hospital surveys were not more effective than announced surveys in detecting quality problems in Danish hospitals. ClinicalTrials.gov NCT02348567, https://clinicaltrials.gov/ct2/show/NCT02348567?term=NCT02348567. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care.

Value-Based Medicine and Pharmacoeconomics.

PubMed

Brown, Gary C; Brown, Melissa M

2016-01-01

Pharmacoeconomics is assuming increasing importance in the pharmaceutical field since it is entering the public policy arena in many countries. Among the variants of pharmacoeconomic analysis are cost-minimization, cost-benefit, cost-effectiveness and cost-utility analyses. The latter is the most versatile and sophisticated in that it integrates the patient benefit (patient value) conferred by a drug in terms of improvement in length and/or quality of life. It also incorporates the costs expended for that benefit, as well as the dollars returned to patients and society from the use of a drug (financial value). Unfortunately, one cost-utility analysis in the literature is generally not comparable to another because of the lack of standardized formats and standardized input variables (costs, cost perspective, quality-of-life measurement instruments, quality-of-life respondents, discounting and so forth). Thus, millions of variants can be used. Value-based medicine® (VBM) cost-utility analysis standardizes these variants so that one VBM analysis is comparable to another. This system provides a highly rational methodology that allows providers and patients to quantify and compare the patient value and financial value gains associated with the use of pharmaceutical agents for example. © 2016 S. Karger AG, Basel.

Ground-water quality in Douglas County, western Nevada

USGS Publications Warehouse

Garcia, K.T.

1989-01-01

A 182% increase in population within the last 10 years in Douglas County, Nevada, has raised concerns by county officials as to the possible effects land development may have on groundwater quality. Most groundwater in Douglas County meets the State of Nevada drinking water standards. Of the 333 water samples used in this analysis, 6 equaled or were greater than the drinking water standards for sulfates, 44 for fluoride, 4 for dissolved solids, 5 for nitrate as nitrate, 12 for arsenic, 33 for iron, and 18 for manganese. Groundwater in the west-central, northern, and northeastern part of Carson Valley is influenced by geothermal water. Some areas in the county may have septic-tank effluent contaminating the groundwater. Temporal changes in most municipal wells showed no overall trend for dissolved-solids and nitrate concentrations spanning the years 1969-83. However, a municipal well in the Topaz Lake area has shown a general increases in the nitrate concentration from 1961 to 1984, but the concentration does not exceed the drinking-water standard. A future groundwater quality monitoring program in Douglas County would include periodic sampling of primary or heavily pumped wells, long-term trend wells, and supplemental wells. (Thacker-USGS)

Colposcopy audit for improving quality of service in areas with a high incidence of cervical cancer.

PubMed

Manopunya, Manatsawee; Suprasert, Prapaporn; Srisomboon, Jatupol; Kietpeerakool, Chumnan

2010-01-01

To audit routine colposcopy performance using 8 standard requirements of the National Health Service Cervical Screening Programme (NHSCSP). Records of women who underwent colposcopy for abnormal cervical cytology between January and December 2008 at Chiang Mai University Hospital, Thailand, were reviewed. The standard requirements were not achieved in 2 practices: (1) the proportion of women who had recordings of visibility of the transformation zone (96.6%) did not achieve the NHSCSP requirement of 100%; and (2) the rate of excisional biopsy (87.8%) was lower than the 95% minimum required. Colposcopic performance at Chiang Mai University Hospital was generally favorable. However, re-audit is necessary to ensure that unmet standards of performance are improved and achieved standards are maintained.

[Report quality of randomized controlled trials of moxibustion for knee osteoarthritis based on CONSORT and STRICTOM].

PubMed

Xiong, Jun; Zhu, Daocheng; Chen, Rixin; Ye, Wenguo

2015-08-01

The report quality of randomized controlled trials (RCTs) of moxibustion for knee osteoarthritis (KOA) in China was evaluated by Consolidated Standards for Reporting of Trials (CONSORT) and Standards for Reporting Interventions in Controlled Trials of Moxibustion (STRICTOM). Computer and manual retrieval was used. Four databases of China National Knowledge Infrastructure (CNKD, China Biomedicine (CBM), VIP and WNFANG were searched in combination with manual retrieval for relevant journals to screen the literature that: met the inclusive criteria, and CONSORT and STRICTOM were used to assess the report quality. A total of 52 RCTs were included. It was found that unclear description of random methods, low use of blind methods, no allocation concealment, no sample size calculation, no intention-to-treat analysis,inadequate report of moxibustion details and no mention of practitioners background existed in the majority of the RCTs. Although the quality of RCTs of moxibustion for KOA was generally low, reducing the reliability and homogeneous comparability of the reports ,the quality of heat-sensitive moxibustion RCTs was high. It was believed that in order to improve the reliability and quality of RCTs of moxibustion, CONSORT and STRICTOM should be introduced into the RCT design of moxibustion and be strictly performed.

Quality management in in vivo proton MRS.

PubMed

Pedrosa de Barros, Nuno; Slotboom, Johannes

2017-07-15

The quality of MR-Spectroscopy data can easily be affected in in vivo applications. Several factors may produce signal artefacts, and often these are not easily detected, not even by experienced spectroscopists. Reliable and reproducible in vivo MRS-data requires the definition of quality requirements and goals, implementation of measures to guarantee quality standards, regular control of data quality, and a continuous search for quality improvement. The first part of this review includes a general introduction to different aspects of quality management in MRS. It is followed by the description of a series of tests and phantoms that can be used to assure the quality of the MR system. In the third part, several methods and strategies used for quality control of the spectroscopy data are presented. This review concludes with a reference to a few interesting techniques and aspects that may help to further improve the quality of in vivo MR-spectra. Copyright © 2017 Elsevier Inc. All rights reserved.

A methodology model for quality management in a general hospital.

PubMed

Stern, Z; Naveh, E

1997-01-01

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

Association between the application of ISO 9001:2008 alone or in combination with health-specific standards and quality-related activities in Hungarian hospitals.

PubMed

Dombrádi, Viktor; Csenteri, Orsolya Karola; Sándor, János; Godény, Sándor

2017-04-01

To investigate how International Organization for Standardization (ISO) 9001 and the Hungarian Health Care Standards (HHCS) certifications are associated with quality management, patient safety, patient rights and human resource management activities. A cross-sectional study was implemented using the 2009 Hungarian hospital survey's database. Hungary. Fifty-three general hospitals were included in the statistical analysis. No intervention was carried out in the study. The outcomes included the percentage of compliance in the dimensions of quality management, patient safety, patient rights, human resource management and the overall score for each hospital, and they were grouped according to the hospitals' certifications. Sixteen hospitals did not have either ISO 9001 or HHCS certifications, 19 had ISO 9001 certification only and 18 had both. Hospitals with ISO 9001 alone or in combination with the HHCS significantly outperformed hospitals with no certifications in terms of quality management and human resource management activities but not in terms of patient safety or patient rights activities. Combined, the two models provided the highest median levels in all cases. Nevertheless, no significant differences were observed when the hospitals with both certifications were compared with hospitals with ISO 9001 only. Although the combination of ISO 9001 and the HHCS showed the best results, the benefits were not decisive. Furthermore, although the HHCS include standards addressing patient safety, no direct association was found with regard to compliance. Thus, further investigation is required to understand this enigma. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Official USP Reference Standards: metrology concepts, overview, and scientific issues and opportunities.

PubMed

Williams, Roger L

2006-01-23

The United States Pharmacopeia (USP) is a private standards-setting body created in 1820 by practitioners who wished to promote the quality of therapeutic products in commerce. The principal product of USP, then and now, is the United StatesPharmacopeia (USP), to which was added the National Formulary (NF) in 1975. The two compendia are published as a combined text annually (USP-NF). Originally a book of process standards, USP-NF evolved over time into compendia containing primarily product standards that are expressed in monographs for therapeutic ingredients, products, and excipients. As a public health service, USP supplies official USP Reference Standards to manufacturers and others who wish to test an article according to selected procedures of a monograph or General Chapter. During the past decade, understanding of USP monographs and official USP Reference Standards as a means of controlling the quality of a therapeutic article has evolved, based on advances in metrology, on activities in the International Conference on Harmonization of Technical Requirements for the Registration of Pharmaceuticals for Human Use (ICH), and on considerations by the USP Council of Experts and its Expert Committees and USP staff. This article discusses the evolution of this understanding, focusing on drug substances and excipients for well-characterized small molecules and their corresponding dosage forms.

Evaluation of the environmental epidemiologic data and methodology for the air quality standard in Beijing

NASA Astrophysics Data System (ADS)

Li, Xu; Jiang, Yanfeng; Yin, Ling; Liu, Bo; Du, Pengfei; Hassan, Mujtaba; Wang, Shigong; Li, Tanshi

2017-09-01

To evaluate the relationship between exposure to air pollutants and respiratory emergency room visits, a generalized additive model (GAM) was used to analyze the exposure-effect relationship between air pollutants and respiratory emergency room visits. The results showed that NO2, SO2, and PM10 have positive relationships with respiratory disease. Concentration increases of 10 μg/m3 in NO2, SO2, and PM10 corresponded to 3.90% (95%CI 3.56-4.25), 0.81% (95%CI -0.09-1.72), and 0.64% (95%CI 0.55-0.74) increases in respiratory emergency room visits. In addition, there is a strong synergic effect of PM10 and NO2 on respiratory diseases. The threshold values of the national standard grade II limits used in Beijing should be adjusted. An appropriate standard could effectively promote a significant decline in respiratory room visits and would eventually be beneficial to air quality management in residential areas.

12 CFR Appendix A to Part 1010 - Standard and Model Forms and Clauses

Code of Federal Regulations, 2013 CFR

2013-01-01

....114 Subdivision Characteristics and Climate 1010.115 (a) General Topography (b) Water Coverage (c) Drainage and Fill (d) Flood Plain (e) Flooding and Soil Erosion (f) Nuisances (g) Hazards (h) Climate (i... of the land. Changes in plant and animal life, air and water quality and noise levels may affect your...

12 CFR Appendix A to Part 1010 - Standard and Model Forms and Clauses

Code of Federal Regulations, 2012 CFR

2012-01-01

....114 Subdivision Characteristics and Climate 1010.115 (a) General Topography (b) Water Coverage (c) Drainage and Fill (d) Flood Plain (e) Flooding and Soil Erosion (f) Nuisances (g) Hazards (h) Climate (i... of the land. Changes in plant and animal life, air and water quality and noise levels may affect your...

12 CFR Appendix A to Part 1010 - Standard and Model Forms and Clauses

Code of Federal Regulations, 2014 CFR

2014-01-01

....114 Subdivision Characteristics and Climate 1010.115 (a) General Topography (b) Water Coverage (c) Drainage and Fill (d) Flood Plain (e) Flooding and Soil Erosion (f) Nuisances (g) Hazards (h) Climate (i... of the land. Changes in plant and animal life, air and water quality and noise levels may affect your...

16 CFR § 1512.4 - Mechanical requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... of edges, or any burrs or spurs caused during the shearing process. (c) Integrity. There shall be no.... Recommended quality thread form is specified in Handbook H28, “Screw Thread Standards for Federal Service,” 1..., 262, and 263, “General Purpose Screw Threads.” 2 1 Copies may be obtained from: Superintendent of...

24 CFR 574.310 - General standards for eligible housing activities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... quality. Every room or space must be provided with natural or mechanical ventilation. Structures must be... syndrome or related diseases: (i) For a period of not less than 10 years, in the case of assistance... rehabilitation or acquisition of a building or structure; or (ii) For a period of not less than 3 years in the...

24 CFR 574.310 - General standards for eligible housing activities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... quality. Every room or space must be provided with natural or mechanical ventilation. Structures must be... syndrome or related diseases: (i) For a period of not less than 10 years, in the case of assistance... rehabilitation or acquisition of a building or structure; or (ii) For a period of not less than 3 years in the...

24 CFR 574.310 - General standards for eligible housing activities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... quality. Every room or space must be provided with natural or mechanical ventilation. Structures must be... syndrome or related diseases: (i) For a period of not less than 10 years, in the case of assistance... rehabilitation or acquisition of a building or structure; or (ii) For a period of not less than 3 years in the...

Commercial lumber, round timbers, and ties

Treesearch

David E. Kretschmann

2010-01-01

When sawn, a log yields round timber, ties, or lumber of varying quality. This chapter presents a general discussion of grading, standards, and specifications for these commercial products. In a broad sense, commercial lumber is any lumber that is bought or sold in the normal channels of commerce. Commercial lumber may be found in a variety of forms, species, and types...

Library Standards and Guidelines for Institutions Affiliated with or Offering Extension Programs of Andrews University.

ERIC Educational Resources Information Center

Brenneise, Harvey, Ed.; And Others

Andrews University (Michigan), which is sponsored by the General Conference of Seventh-Day Adventists, extends its academic program to 14 other institutions, three in the United States and abroad. The program permits students in other countries to obtain a recognized, quality tertiary or graduate education. Andrews' research library, the James…

Preschool Racial Attitude Measure II (PRAM II): Technical Report #1: 1970-71 Standardization Study.

ERIC Educational Resources Information Center

Williams, John E.

This report provides detailed technical information concerning the Preschool Racial Attitude Measure II (PRAM II) a method for assessing the attitudes of pre-literate children toward light- and dark-skinned individuals. Several major changes were involved in the PRAM II revision: (1) the length was doubled, (2) the general artistic quality of the…

National Medical Terminology Server in Korea

NASA Astrophysics Data System (ADS)

Lee, Sungin; Song, Seung-Jae; Koh, Soonjeong; Lee, Soo Kyoung; Kim, Hong-Gee

Interoperable EHR (Electronic Health Record) necessitates at least the use of standardized medical terminologies. This paper describes a medical terminology server, LexCare Suite, which houses terminology management applications, such as a terminology editor, and a terminology repository populated with international standard terminology systems such as Systematized Nomenclature of Medicine (SNOMED). The server is to satisfy the needs of quality terminology systems to local primary to tertiary hospitals. Our partner general hospitals have used the server to test its applicability. This paper describes the server and the results of the applicability test.

Python tools for rapid development, calibration, and analysis of generalized groundwater-flow models

NASA Astrophysics Data System (ADS)

Starn, J. J.; Belitz, K.

2014-12-01

National-scale water-quality data sets for the United States have been available for several decades; however, groundwater models to interpret these data are available for only a small percentage of the country. Generalized models may be adequate to explain and project groundwater-quality trends at the national scale by using regional scale models (defined as watersheds at or between the HUC-6 and HUC-8 levels). Coast-to-coast data such as the National Hydrologic Dataset Plus (NHD+) make it possible to extract the basic building blocks for a model anywhere in the country. IPython notebooks have been developed to automate the creation of generalized groundwater-flow models from the NHD+. The notebook format allows rapid testing of methods for model creation, calibration, and analysis. Capabilities within the Python ecosystem greatly speed up the development and testing of algorithms. GeoPandas is used for very efficient geospatial processing. Raster processing includes the Geospatial Data Abstraction Library and image processing tools. Model creation is made possible through Flopy, a versatile input and output writer for several MODFLOW-based flow and transport model codes. Interpolation, integration, and map plotting included in the standard Python tool stack also are used, making the notebook a comprehensive platform within on to build and evaluate general models. Models with alternative boundary conditions, number of layers, and cell spacing can be tested against one another and evaluated by using water-quality data. Novel calibration criteria were developed by comparing modeled heads to land-surface and surface-water elevations. Information, such as predicted age distributions, can be extracted from general models and tested for its ability to explain water-quality trends. Groundwater ages then can be correlated with horizontal and vertical hydrologic position, a relation that can be used for statistical assessment of likely groundwater-quality conditions. Convolution with age distributions can be used to quickly ascertain likely future water-quality conditions. Although these models are admittedly very general and are still being tested, the hope is that they will be useful for answering questions related to water quality at the regional scale.

Quality evaluation of no-reference MR images using multidirectional filters and image statistics.

PubMed

Jang, Jinseong; Bang, Kihun; Jang, Hanbyol; Hwang, Dosik

2018-09-01

This study aimed to develop a fully automatic, no-reference image-quality assessment (IQA) method for MR images. New quality-aware features were obtained by applying multidirectional filters to MR images and examining the feature statistics. A histogram of these features was then fitted to a generalized Gaussian distribution function for which the shape parameters yielded different values depending on the type of distortion in the MR image. Standard feature statistics were established through a training process based on high-quality MR images without distortion. Subsequently, the feature statistics of a test MR image were calculated and compared with the standards. The quality score was calculated as the difference between the shape parameters of the test image and the undistorted standard images. The proposed IQA method showed a >0.99 correlation with the conventional full-reference assessment methods; accordingly, this proposed method yielded the best performance among no-reference IQA methods for images containing six types of synthetic, MR-specific distortions. In addition, for authentically distorted images, the proposed method yielded the highest correlation with subjective assessments by human observers, thus demonstrating its superior performance over other no-reference IQAs. Our proposed IQA was designed to consider MR-specific features and outperformed other no-reference IQAs designed mainly for photographic images. Magn Reson Med 80:914-924, 2018. © 2018 International Society for Magnetic Resonance in Medicine. © 2018 International Society for Magnetic Resonance in Medicine.

Quality of alcohol-based hand disinfectants and their regulatory status. Development and marketing authorisation.

PubMed

Stengele, Michael

2008-10-01

A 2005 survey showed that there are at least four legal product classifications for hand disinfectants in the European Union: medicinal products, biocidal products, cosmetics and medical devices. An internationally harmonized classification does not exist. The regulatory status of those products is defined at national level. In order to assure compliance with the regulations these four classifications provide different levels of official surveillance varying from product-specific marketing authorisations and production site audits to the obligation to just work in accordance with certain general guidelines. Biocidal product regulations cover eco-toxicological and toxicological aspects, but do not very much address to the customers' quality and efficacy expectations. In contrast, the medicinal product legislation is the most ambitious one claiming quality, safety, efficacy, and an independent benefit risk-assessment by an authority. In respect of ambition, the two remaining product categories--cosmetics and medical devices--rank between the both classifications mentioned above. For medical devices, it is the responsibility of the manufacturer to make sure the products meet defined essential requirements regarding quality, safety and performance and to have an appropriate quality assurance system implemented under third party control. For cosmetics there are some legal restrictions, but within these it is the sole responsibility of the manufacturer to ensure that the products are safe and fulfil their claims. This paper describes one way out of this increasingly complex situation, the definition of a single quality standard meeting the users' expectations as well as all legal requirements regardless of the specific sales country. This international quality standard for products would take priority over any individual national standard, to the benefit of users.

An oral health intervention for people with serious mental illness (Three Shires Early Intervention Dental Trial): study protocol for a randomised controlled trial.

PubMed

Jones, Hannah F; Adams, Clive E; Clifton, Andrew; Simpson, Jayne; Tosh, Graeme; Liddle, Peter F; Callaghan, Patrick; Yang, Min; Guo, Boliang; Furtado, Vivek

2013-05-29

Oral health is an important part of general physical health and is essential for self-esteem, self-confidence and overall quality of life. There is a well-established link between mental illness and poor oral health. Oral health problems are not generally well recognized by mental health professionals and many patients experience barriers to treatment. This is the protocol for a pragmatic cluster randomised trial that has been designed to fit within standard care. Dental awareness training for care co-ordinators plus a dental checklist for service users in addition to standard care will be compared with standard care alone for people with mental illness. The checklist consists of questions about service users' current oral health routine and condition. Ten Early Intervention in Psychosis (EIP) teams in Nottinghamshire, Derbyshire and Lincolnshire will be cluster randomised (five to intervention and five to standard care) in blocks accounting for location and size of caseload. The oral health of the service users will be monitored for one year after randomisation. Current Controlled Trials ISRCTN63382258.

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.

Non-Hodgkin's lymphomas: clinical governance issues.

PubMed

Fields, P A; Goldstone, A H

2002-09-01

Every patient in every part of the world has the right to expect the best possible quality of care from health care providers. Non-Hodgkin's lymphomas (NHL) are an extremely heterogeneous group of conditions which require important decisions to be taken at many points along the treatment pathway. To get this right every time requires that high-quality standards are instituted and adhered to, so that the best possible outcome is achieved. In the past this has not always been the case because of the failure of clinicians sometimes to adhere to an optimal management plan. In 1995, the UK government commissioned an inquiry into the running of cancer services in the United Kingdom, which culminated in a series of recommendations to improve them. Subsequently, these recommendations were implemented as objectives of the NHS Cancer Plan which is the framework by which the UK government wishes to improve cancer services. Concurrently another general concept has emerged which is designed to ensure that the highest quality standards may be achieved for all patients across the whole National Health Service (NHS). This concept, termed 'clinical governance', brings together a corporate responsibility of all health care workers to deliver high quality standards, in the hope that this will translate into better long-term survival of patients with malignant disease. This chapter focuses on the issues surrounding clinical governance and how the principles of this concept relate to non-Hodgkin's lymphomas.

Bacteriological quality and risk assessment of the imported and domestic bottled mineral water sold in Fiji.

PubMed

Zeenat, A; Hatha, A A M; Viola, L; Vipra, K

2009-12-01

Considering the popularity of bottled mineral water among indigenous Fijians and tourists alike, a study was carried out to determine the bacteriological quality of different bottled waters. A risk assessment was also carried out. Seventy-five samples of bottled mineral water belonging to three domestic brands and 25 samples of one imported brand were analysed for heterotrophic plate count (HPC) bacteria and faecal coliforms. HPC counts were determined at 22 degrees C and 37 degrees C using R2A medium and a membrane filtration technique was used to determine the faecal coliform (FC) load in 100 ml of water on mFC agar. Between 28 and 68% of the samples of the various domestic brands failed to meet the WHO standard of 100 colony forming units (cfu) per 100 ml at 22 degrees C and 7% of these also tested positive for faecal coliforms. All imported bottled mineral water samples were within WHO standards. A risk assessment of the HPC bacteria was carried out in terms of beta haemolytic activity and antibiotic resistance. More than 50% of the isolates showed beta haemolytic activity and were multi-drug resistant. While the overall quality of the product was generally good, there is a need to enforce stringent quality standards for the domestic bottlers to ensure the safety of consumers.

New approaches for the standardization and validation of a real-time qPCR assay using TaqMan probes for quantification of yellow fever virus on clinical samples with high quality parameters

PubMed Central

Fernandes-Monteiro, Alice G; Trindade, Gisela F; Yamamura, Anna MY; Moreira, Otacilio C; de Paula, Vanessa S; Duarte, Ana Cláudia M; Britto, Constança; Lima, Sheila Maria B

2015-01-01

The development and production of viral vaccines, in general, involve several steps that need the monitoring of viral load throughout the entire process. Applying a 2-step quantitative reverse transcription real time PCR assay (RT-qPCR), viral load can be measured and monitored in a few hours. In this context, the development, standardization and validation of a RT-qPCR test to quickly and efficiently quantify yellow fever virus (YFV) in all stages of vaccine production are extremely important. To serve this purpose we used a plasmid construction containing the NS5 region from 17DD YFV to generate the standard curve and to evaluate parameters such as linearity, precision and specificity against other flavivirus. Furthermore, we defined the limits of detection as 25 copies/reaction, and quantification as 100 copies/reaction for the test. To ensure the quality of the method, reference controls were established in order to avoid false negative results. The qRT-PCR technique based on the use of TaqMan probes herein standardized proved to be effective for determining yellow fever viral load both in vivo and in vitro, thus becoming a very important tool to assure the quality control for vaccine production and evaluation of viremia after vaccination or YF disease. PMID:26011746

New approaches for the standardization and validation of a real-time qPCR assay using TaqMan probes for quantification of yellow fever virus on clinical samples with high quality parameters.

PubMed

Fernandes-Monteiro, Alice G; Trindade, Gisela F; Yamamura, Anna M Y; Moreira, Otacilio C; de Paula, Vanessa S; Duarte, Ana Cláudia M; Britto, Constança; Lima, Sheila Maria B

2015-01-01

The development and production of viral vaccines, in general, involve several steps that need the monitoring of viral load throughout the entire process. Applying a 2-step quantitative reverse transcription real time PCR assay (RT-qPCR), viral load can be measured and monitored in a few hours. In this context, the development, standardization and validation of a RT-qPCR test to quickly and efficiently quantify yellow fever virus (YFV) in all stages of vaccine production are extremely important. To serve this purpose we used a plasmid construction containing the NS5 region from 17DD YFV to generate the standard curve and to evaluate parameters such as linearity, precision and specificity against other flavivirus. Furthermore, we defined the limits of detection as 25 copies/reaction, and quantification as 100 copies/reaction for the test. To ensure the quality of the method, reference controls were established in order to avoid false negative results. The qRT-PCR technique based on the use of TaqMan probes herein standardized proved to be effective for determining yellow fever viral load both in vivo and in vitro, thus becoming a very important tool to assure the quality control for vaccine production and evaluation of viremia after vaccination or YF disease.

Quality of care provided to patients with diabetes mellitus in Puerto Rico; managed care versus fee-for-service experience.

PubMed

Rodríguez-Vigil, Efraín; Kianes-Pérez, Zaira

2005-01-01

To evaluate and compare the quality of diabetes care in a large managed care system and fee-for-service payment system in Puerto Rico. This retrospective cross-sectional study assessed the adherence to standards of diabetes care in 1,687,202 subjects--226,210 from a fee-for-service population and 1,460,992 from a managed care group. Patients with diabetes mellitus were identified from insurance claims reports. Type of health-care provider, service location, number of visits, and laboratory utilization were also assessed. From the analysis, we identified 90,616 patients with diabetes (5.4% of the overall study group). Of these, 66,587 (73.5%) were found to have at least one encounter with a physician in a medical visit. Of the 66,586 patients with diabetes who visited a physician, only 4% were treated by an endocrinologist. General laboratory utilization was 34% for the entire population of patients with diabetes studied. In the group of patients with documented laboratory tests, 93% had a documented fasting blood glucose test; in contrast, hemoglobin A lc testing was performed in only 9% of the patients. The fee-for-service group had a higher rate of visits to medical specialists and general laboratory utilization, whereas the managed care group had a higher rate of hospital admissions and emergency department visits. The quality of diabetes management and the subsequent outcomes are related to patient and health-care provider adherence to standards of care. In this analysis, we found that patients and physicians are responsible for low compliance with recognized standards of diabetes care in Puerto Rico. The lack of adequate management will lead to increased mortality, development and severity of chronic complications, and increased emergency department utilization. Therefore, health-care providers and payers should find ways to achieve more effective promotion of adherence to accepted standards of care for patients with diabetes.

Water-quality characteristics of quaternary unconsolidated-deposit aquifers and lower tertiary aquifers of the Bighorn Basin, Wyoming and Montana, 1999-2001

USGS Publications Warehouse

Bartos, Timothy T.; Eddy-Miller, Cheryl A.; Norris, Jody R.; Gamper, Merry E.; Hallberg, Laura L.

2004-01-01

As part of the Yellowstone River Basin National Water Quality Assessment study, ground-water samples were collected from Quaternary unconsolidated-deposit and lower Tertiary aquifers in the Bighorn Basin of Wyoming and Montana from 1999 to 2001. Samples from 54 wells were analyzed for physical characteristics, major ions, trace elements, nutrients, dissolved organic carbon, radionuclides, pesticide compounds, and volatile organic compounds (VOCs) to evaluate current water-quality conditions in both aquifers. Water-quality samples indicated that waters generally were suitable for most uses, and that natural conditions, rather than the effects of human activities, were more likely to limit uses of the waters. Waters in both types of aquifers generally were highly mineralized, and total dissolved-solids concentrations frequently exceeded the U.S. Environmental Protection Agency (USEPA) Secondary Maximum Contaminant Level (SMCL) of 500 milligrams per liter (mg/L). Because of generally high mineralization, waters from nearly one-half of the samples from Quaternary aquifers and more than one-half of the samples from lower Tertiary aquifers were not classified as fresh (dissolved-solids concentration were not less than 1,000 mg/L). The anions sulfate, fluoride, and chloride were measured in some ground-water samples at concentrations greater than SMCLs. Most waters from the Quaternary aquifers were classified as very hard (hardness greater than 180 mg/L), but hardness varied much more in waters from the lower Tertiary aquifers and ranged from soft (less than 60 mg/L) to very hard (greater than 180 mg/L). Major-ion chemistry varied with dissolved-solids concentrations. In both types of aquifers, the predominant anion changes from bicarbonate to sulfate with increasing dissolved-solids concentrations. Samples from Quaternary aquifers with fresh waters generally were calcium-bicarbonate, calcium-sodium-bicarbonate, and calcium-sodium-sulfate-bicarbonate type waters, whereas samples with larger concentrations generally were calcium-sodium-sulfate, calcium-sulfate, or sodium-sulfate-type waters. In the lower Tertiary aquifers, samples with fresh waters generally were sodium-bicarbonate or sodium-bicarbonate-sulfate type waters, whereas samples with larger concentrations were sodium-sulfate or calcium-sodium-sulfate types. Concentrations of most trace elements in both types of aquifers generally were small and most were less than applicable USEPA standards. The trace elements that most often did not meet USEPA secondary drinking-water standards were iron and manganese. In fact, the SMCL for manganese was the most frequently exceeded standard; 68 percent of the samples from the Quaternary aquifers and 31 percent of the samples from the lower Tertiary aquifers exceeded the manganese standard. Geochemical conditions may control manganese in both aquifers as concentrations in Quaternary aquifers were negatively correlated with dissolved oxygen concentrations and concentrations in lower Tertiary aquifers decreased with increasing pH. Elevated nitrate concentrations, in addition to detection of pesticides and VOCs in both aquifers, indicated some effects of human activities on ground-water quality. Nitrate concentrations in 36 percent of the wells in Quaternary aquifers and 28 percent of the wells in lower Tertiary aquifers were greater than 1 mg/L, which may indicate ground-water contamination from human sources. The USEPA drinking-water Maximum Contaminant Level (MCL) for nitrate, 10 mg/L, was exceeded in 8 percent of samples collected from Quaternary aquifers and 3 percent from lower Tertiary aquifers. Nitrate concentrations in Quaternary aquifers were positively correlated with the percentage of cropland and other agricultural land (non-cropland), and negatively correlated with rangeland and riparian land. In the lower Tertiary aquifers, nitrate concentrations only were correlated with the percentage of cropland. Concentratio

a Representation-Driven Ontology for Spatial Data Quality Elements, with Orthoimagery as Running Example

NASA Astrophysics Data System (ADS)

Hangouët, J.-F.

2015-08-01

The many facets of what is encompassed by such an expression as "quality of spatial data" can be considered as a specific domain of reality worthy of formal description, i.e. of ontological abstraction. Various ontologies for data quality elements have already been proposed in literature. Today, the system of quality elements is most generally used and discussed according to the configuration exposed in the "data dictionary for data quality" of international standard ISO 19157. Our communication proposes an alternative view. This is founded on a perspective which focuses on the specificity of spatial data as a product: the representation perspective, where data in the computer are meant to show things of the geographic world and to be interpreted as such. The resulting ontology introduces new elements, the usefulness of which will be illustrated by orthoimagery examples.

Corruption, inequality and population perception of healthcare quality in Europe

PubMed Central

2013-01-01

Background Evaluating the quality of healthcare and patient safety using general population questionnaires is important from research and policy perspective. Using a special wave of the Eurobarometer survey, we analysed the general population’s perception of health care quality and patient safety in a cross-country setting. Methods We used ordered probit, ordinary least squares and probit analysis to estimate the determinants of health care quality, and ordered logit analysis to analyse the likelihood of being harmed by a specific medical procedure. The models used population weights as well as country-clustered standard errors. Results We found robust evidence for the impact of socio-demographic variables on the perception of quality of health care. More specifically, we found a non-linear impact of age on the perception of quality of health care and patient safety, as well as a negative impact of poverty on both perception of quality and patient safety. We also found robust evidence that countries with higher corruption levels were associated with worse perceptions of quality of health care. Finally, we found evidence that income inequality affects patients’ perception vis-à-vis safety, thus feeding into the poverty/health care quality nexus. Conclusions Socio-demographic factors and two macro variables (corruption and income inequality) explain the perception of quality of health care and likelihood of being harmed by adverse events. The results carry significant policy weight and could explain why targeting only the health care sector (without an overall reform of the public sector) could potentially be challenging. PMID:24215401

Corruption, inequality and population perception of healthcare quality in Europe.

PubMed

Nikoloski, Zlatko; Mossialos, Elias

2013-11-11

Evaluating the quality of healthcare and patient safety using general population questionnaires is important from research and policy perspective. Using a special wave of the Eurobarometer survey, we analysed the general population's perception of health care quality and patient safety in a cross-country setting. We used ordered probit, ordinary least squares and probit analysis to estimate the determinants of health care quality, and ordered logit analysis to analyse the likelihood of being harmed by a specific medical procedure. The models used population weights as well as country-clustered standard errors. We found robust evidence for the impact of socio-demographic variables on the perception of quality of health care. More specifically, we found a non-linear impact of age on the perception of quality of health care and patient safety, as well as a negative impact of poverty on both perception of quality and patient safety. We also found robust evidence that countries with higher corruption levels were associated with worse perceptions of quality of health care. Finally, we found evidence that income inequality affects patients' perception vis-à-vis safety, thus feeding into the poverty/health care quality nexus. Socio-demographic factors and two macro variables (corruption and income inequality) explain the perception of quality of health care and likelihood of being harmed by adverse events. The results carry significant policy weight and could explain why targeting only the health care sector (without an overall reform of the public sector) could potentially be challenging.

Future impacts of distributed power generation on ambient ozone and particulate matter concentrations in the San Joaquin Valley of California.

PubMed

Vutukuru, Satish; Carreras-Sospedra, Marc; Brouwer, Jacob; Dabdub, Donald

2011-12-01

Distributed power generation-electricity generation that is produced by many small stationary power generators distributed throughout an urban air basin-has the potential to supply a significant portion of electricity in future years. As a result, distributed generation may lead to increased pollutant emissions within an urban air basin, which could adversely affect air quality. However, the use of combined heating and power with distributed generation may reduce the energy consumption for space heating and air conditioning, resulting in a net decrease of pollutant and greenhouse gas emissions. This work used a systematic approach based on land-use geographical information system data to determine the spatial and temporal distribution of distributed generation emissions in the San Joaquin Valley Air Basin of California and simulated the potential air quality impacts using state-of-the-art three-dimensional computer models. The evaluation of the potential market penetration of distributed generation focuses on the year 2023. In general, the air quality impacts of distributed generation were found to be small due to the restrictive 2007 California Air Resources Board air emission standards applied to all distributed generation units and due to the use of combined heating and power. Results suggest that if distributed generation units were allowed to emit at the current Best Available Control Technology standards (which are less restrictive than the 2007 California Air Resources Board standards), air quality impacts of distributed generation could compromise compliance with the federal 8-hr average ozone standard in the region.

Future Impacts of Distributed Power Generation on Ambient Ozone and Particulate Matter Concentrations in the San Joaquin Valley of California.

PubMed

Vutukuru, Satish; Carreras-Sospedra, Marc; Brouwer, Jacob; Dabdub, Donald

2011-12-01

Distributed power generation-electricity generation that is produced by many small stationary power generators distributed throughout an urban air basin-has the potential to supply a significant portion of electricity in future years. As a result, distributed generation may lead to increased pollutant emissions within an urban air basin, which could adversely affect air quality. However, the use of combined heating and power with distributed generation may reduce the energy consumption for space heating and air conditioning, resulting in a net decrease of pollutant and greenhouse gas emissions. This work used a systematic approach based on land-use geographical information system data to determine the spatial and temporal distribution of distributed generation emissions in the San Joaquin Valley Air Basin of California and simulated the potential air quality impacts using state-of-the-art three-dimensional computer models. The evaluation of the potential market penetration of distributed generation focuses on the year 2023. In general, the air quality impacts of distributed generation were found to be small due to the restrictive 2007 California Air Resources Board air emission standards applied to all distributed generation units and due to the use of combined heating and power. Results suggest that if distributed generation units were allowed to emit at the current Best Available Control Technology standards (which are less restrictive than the 2007 California Air Resources Board standards), air quality impacts of distributed generation could compromise compliance with the federal 8-hr average ozone standard in the region. [Box: see text].

Groundwater quality in the Genesee River Basin, New York, 2010

USGS Publications Warehouse

Reddy, James E.

2012-01-01

Water samples collected from eight production wells and eight private residential wells in the Genesee River Basin from September through December 2010 were analyzed to characterize the groundwater quality in the basin. Eight of the wells were completed in sand and gravel aquifers, and eight were finished in bedrock aquifers. Three of the 16 wells were sampled in the first Genesee River Basin study during 2005-2006. Water samples from the 2010 study were analyzed for 147 physiochemical properties and constituents that included major ions, nutrients, trace elements, radionuclides, pesticides, volatile organic compounds (VOCs), and indicator bacteria. Results of the water-quality analyses are presented in tabular form for individual wells, and summary statistics for specific constituents are presented by aquifer type. The results are compared with Federal and New York State drinking-water standards, which typically are identical. The results indicate that groundwater generally is of acceptable quality, although concentrations of the following constituents exceeded current or proposed Federal or New York State drinking-water standards at each of the 16 wells sampled: color (one sample), sodium (three samples), sulfate (three samples), total dissolved solids (four samples), aluminum (one sample), arsenic (two samples), copper (one sample), iron (nine samples), manganese (eight samples), radon-222 (nine samples), and total coliform bacteria (six samples). Existing drinking-water standards for pH, chloride, fluoride, nitrate, nitrite, antimony, barium, beryllium, cadmium, chromium, lead, mercury, selenium, silver, thallium, zinc, gross alpha radioactivity, uranium, fecal coliform, Escherichia coli, and heterotrophic bacteria were not exceeded in any of the samples collected. None of the pesticides and VOCs analyzed exceeded existing drinking-water standards.

Validity of self-assessment in a quality improvement collaborative in Ecuador.

PubMed

Hermida, Jorge; Broughton, Edward I; Miller Franco, Lynne

2011-12-01

Health care quality improvement (QI) efforts commonly use self-assessment to measure compliance with quality standards. This study investigates the validity of self-assessment of quality indicators. Cross sectional. A maternal and newborn care improvement collaborative intervention conducted in health facilities in Ecuador in 2005. Four external evaluators were trained in abstracting medical records to calculate six indicators reflecting compliance with treatment standards. About 30 medical records per month were examined at 12 participating health facilities for a total of 1875 records. The same records had already been reviewed by QI teams at these facilities (self-assessment). Overall compliance, agreement (using the Kappa statistic), sensitivity and specificity were analyzed. We also examined patterns of disagreement and the effect of facility characteristics on levels of agreement. External evaluators reported compliance of 69-90%, while self-assessors reported 71-92%, with raw agreement of 71-95% and Kappa statistics ranging from fair to almost perfect agreement. Considering external evaluators as the gold standard, sensitivity of self-assessment ranged from 90 to 99% and specificity from 48 to 86%. Simpler indicators had fewer disagreements. When disagreements occurred between self-assessment and external valuators, the former tended to report more positive findings in five of six indicators, but this tendency was not of a magnitude to change program actions. Team leadership, understanding of the tools and facility size had no overall impact on the level of agreement. When compared with external evaluation (gold standard), self-assessment was found to be sufficiently valid for tracking QI team performance. Sensitivity was generally higher than specificity. Simplifying indicators may improve validity.

Groundwater quality in western New York, 2011

USGS Publications Warehouse

Reddy, James E.

2013-01-01

Water samples collected from 16 production wells and 15 private residential wells in western New York from July through November 2011 were analyzed to characterize the groundwater quality. Fifteen of the wells were finished in sand and gravel aquifers, and 16 were finished in bedrock aquifers. Six of the 31 wells were sampled in a previous western New York study, which was conducted in 2006. Water samples from the 2011 study were analyzed for 147 physiochemical properties and constituents that included major ions, nutrients, trace elements, radionuclides, pesticides, volatile organic compounds (VOCs), and indicator bacteria. Results of the water-quality analyses are presented in tabular form for individual wells, and summary statistics for specific constituents are presented by aquifer type. The results are compared with Federal and New York State drinking-water standards, which typically are identical. The results indicate that groundwater generally is of acceptable quality, although at 30 of the 31 wells sampled, at least one of the following constituents was detected at a concentration that exceeded current or proposed Federal or New York State drinking-water standards: pH (two samples), sodium (eight samples), sulfate (three samples), total dissolved solids (nine samples), aluminum (two samples), arsenic (one sample), iron (ten samples), manganese (twelve samples), radon-222 (sixteen samples), benzene (one sample), and total coliform bacteria (nine samples). Existing drinking-water standards for color, chloride, fluoride, nitrate, nitrite, antimony, barium, beryllium, cadmium, chromium, copper, lead, mercury, selenium, silver, thallium, zinc, gross alpha radioactivity, uranium, fecal coliform, Escherichia coli, and heterotrophic bacteria were not exceeded in any of the samples collected. None of the pesticides analyzed exceeded existing drinking-water standards.

Scan-To Output Validation: Towards a Standardized Geometric Quality Assessment of Building Information Models Based on Point Clouds

NASA Astrophysics Data System (ADS)

Bonduel, M.; Bassier, M.; Vergauwen, M.; Pauwels, P.; Klein, R.

2017-11-01

The use of Building Information Modeling (BIM) for existing buildings based on point clouds is increasing. Standardized geometric quality assessment of the BIMs is needed to make them more reliable and thus reusable for future users. First, available literature on the subject is studied. Next, an initial proposal for a standardized geometric quality assessment is presented. Finally, this method is tested and evaluated with a case study. The number of specifications on BIM relating to existing buildings is limited. The Levels of Accuracy (LOA) specification of the USIBD provides definitions and suggestions regarding geometric model accuracy, but lacks a standardized assessment method. A deviation analysis is found to be dependent on (1) the used mathematical model, (2) the density of the point clouds and (3) the order of comparison. Results of the analysis can be graphical and numerical. An analysis on macro (building) and micro (BIM object) scale is necessary. On macro scale, the complete model is compared to the original point cloud and vice versa to get an overview of the general model quality. The graphical results show occluded zones and non-modeled objects respectively. Colored point clouds are derived from this analysis and integrated in the BIM. On micro scale, the relevant surface parts are extracted per BIM object and compared to the complete point cloud. Occluded zones are extracted based on a maximum deviation. What remains is classified according to the LOA specification. The numerical results are integrated in the BIM with the use of object parameters.

40 CFR 131.21 - EPA review and approval of water quality standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.21 EPA review and approval of water quality standards. (a) After the State submits its... analysis. (b) The Regional Administrator's approval or disapproval of a State water quality standard shall...

40 CFR 131.20 - State review and revision of water quality standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... quality standards. 131.20 Section 131.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.20 State review and revision of water quality standards. (a) State review. The State shall...

40 CFR 131.20 - State review and revision of water quality standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... quality standards. 131.20 Section 131.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.20 State review and revision of water quality standards. (a) State review. The State shall...

40 CFR 131.20 - State review and revision of water quality standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... quality standards. 131.20 Section 131.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.20 State review and revision of water quality standards. (a) State review. The State shall...

Does the scientific underpinning of regulatory tools to estimate bioavailability of nickel in freshwaters matter? The European-wide environmental quality standard for nickel.

PubMed

Peters, Adam; Schlekat, Christian E; Merrington, Graham

2016-10-01

A bioavailability-based environmental quality standard (EQS) was established for nickel in freshwaters under the European Union's Water Framework Directive. Bioavailability correction based on pH, water hardness, and dissolved organic carbon is a demonstrable improvement on existing hardness-based quality standards, which may be underprotective in high-hardness waters. The present study compares several simplified bioavailability tools developed to implement the Ni EQS (biomet, M-BAT, and PNECPro) against the full bioavailability normalization procedure on which the EQS was based. Generally, all tools correctly distinguished sensitive waters from insensitive waters, although with varying degrees of accuracy compared with full normalization. Biomet and M-BAT predictions were consistent with, but less accurate than, full bioavailability normalization results, whereas PNECpro results were generally more conservative. The comparisons revealed important differences in tools in development, which results in differences in the predictions. Importantly, the models used for the development of PNECpro use a different ecotoxicity dataset, and a different bioavailability normalization approach using fewer biotic ligand models (BLMs) than that used for the derivation of the Ni EQS. The failure to include all of the available toxicity data, and all of the appropriate NiBLMs, has led to some significant differences between the predictions provided by PNECpro and those calculated using the process agreed to in Europe under the Water Framework Directive and other chemicals management programs (such as REACH). These considerable differences mean that PNECpro does not reflect the behavior, fate, and ecotoxicity of nickel, and raises concerns about its applicability for checking compliance against the Ni EQS. Environ Toxicol Chem 2016;35:2397-2404. © 2016 SETAC. © 2016 SETAC.

[Effects of inpatient treatment on eating disorder symptoms, health-related quality of life and personal resources in anorexia and bulimia nervosa].

PubMed

Tagay, Sefik; Düllmann, Sonja; Schlegl, Sandra; Nater-Mewes, Ricarda; Repic, Nevena; Hampke, Christian; Brähler, Elmar; Gerlach, Gabriele; Senf, Wolfgang

2011-07-01

The aim of the present prospective-naturalistic study was the evaluation of psychosomatic inpatient treatment for anorexia nervosa (AN) and bulimia nervosa (BN). 128 patients with eating disorders (n=59 AN and n=69 BN) were investigated on admission and discharge using the following standardized questionnaires: eating disorder symptoms (EDI), general psychopathology (BSI), quality of life (SF-12), and personal resources (SOC-13, SWE). Moderate to large effect sizes were achieved for the eating disorder symptoms; in addition, general psychopathology was substantially reduced at the end of treatment, and quality of life as well as personal resources were enhanced. Personal resources were found to be the strongest predictors for therapy outcome. Based on our data, important insights and recommendations may be gained for the inpatient treatment of eating disorders, especially with regard to the potential influence of personal resources. © Georg Thieme Verlag KG Stuttgart · New York.

Halogenated peptides as internal standards (H-PINS): introduction of an MS-based internal standard set for liquid chromatography-mass spectrometry.

PubMed

Mirzaei, Hamid; Brusniak, Mi-Youn; Mueller, Lukas N; Letarte, Simon; Watts, Julian D; Aebersold, Ruedi

2009-08-01

As the application for quantitative proteomics in the life sciences has grown in recent years, so has the need for more robust and generally applicable methods for quality control and calibration. The reliability of quantitative proteomics is tightly linked to the reproducibility and stability of the analytical platforms, which are typically multicomponent (e.g. sample preparation, multistep separations, and mass spectrometry) with individual components contributing unequally to the overall system reproducibility. Variations in quantitative accuracy are thus inevitable, and quality control and calibration become essential for the assessment of the quality of the analyses themselves. Toward this end, the use of internal standards cannot only assist in the detection and removal of outlier data acquired by an irreproducible system (quality control) but can also be used for detection of changes in instruments for their subsequent performance and calibration. Here we introduce a set of halogenated peptides as internal standards. The peptides are custom designed to have properties suitable for various quality control assessments, data calibration, and normalization processes. The unique isotope distribution of halogenated peptides makes their mass spectral detection easy and unambiguous when spiked into complex peptide mixtures. In addition, they were designed to elute sequentially over an entire aqueous to organic LC gradient and to have m/z values within the commonly scanned mass range (300-1800 Da). In a series of experiments in which these peptides were spiked into an enriched N-glycosite peptide fraction (i.e. from formerly N-glycosylated intact proteins in their deglycosylated form) isolated from human plasma, we show the utility and performance of these halogenated peptides for sample preparation and LC injection quality control as well as for retention time and mass calibration. Further use of the peptides for signal intensity normalization and retention time synchronization for selected reaction monitoring experiments is also demonstrated.

Stainless steel welding and semen quality.

PubMed

Jelnes, J E; Knudsen, L E

1988-01-01

Questionnaire studies of patients from fertility clinics suggest that welders may have an increased risk of reduced semen quality. In this study, welders and nonwelders from the same plants were asked to provide blood, urine, and semen samples. Urine was analyzed for chromium and nickel, and for mutagenic activity and metal concentration; blood for metal concentrations, immunoglobulin G, total protein, and measures of genotoxicity in lymphocytes; and semen was evaluated by standard semen analysis. Results of the semen evaluation, presented here, showed no difference in semen quality between welders and nonwelders. Because the metal dust exposure of nonwelders in the plant may be higher than that in the general population, welders were also compared to referents not working in the metal industry. Again, no decrease in semen quality associated with welding was demonstrated.

The Value of Non-Work Time in Cross-National Quality of Life Comparisons: The Case of the United States vs. the Netherlands

ERIC Educational Resources Information Center

Verbakel, Ellen; DiPrete, Thomas A.

2008-01-01

Comparisons of wellbeing between the United States and Western Europe generally show that most Americans have higher standards of living than do Western Europeans at comparable locations in their national income distributions. These comparisons of wellbeing typically privilege disposable income and cash transfers while ignoring other aspects of…

40 CFR 51.910 - What requirements for reasonable further progress (RFP) under sections 172(c)(2) and 182 apply...

Code of Federal Regulations, 2010 CFR

2010-07-01

...-hour ozone NAAQS? 51.910 Section 51.910 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Provisions for Implementation of 8-hour Ozone National Ambient Air Quality Standard § 51.910 What... nonattainment for the 8-hour ozone NAAQS? (a) What are the general requirements for RFP for an area classified...

40 CFR 51.916 - What are the requirements for an Ozone Transport Region under the 8-hour NAAQS?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 2 2011-07-01 2011-07-01 false What are the requirements for an Ozone... IMPLEMENTATION PLANS Provisions for Implementation of 8-hour Ozone National Ambient Air Quality Standard § 51.916 What are the requirements for an Ozone Transport Region under the 8-hour NAAQS? (a) In General...

40 CFR 51.916 - What are the requirements for an Ozone Transport Region under the 8-hour NAAQS?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 2 2012-07-01 2012-07-01 false What are the requirements for an Ozone... IMPLEMENTATION PLANS Provisions for Implementation of 8-hour Ozone National Ambient Air Quality Standard § 51.916 What are the requirements for an Ozone Transport Region under the 8-hour NAAQS? (a) In General...

40 CFR 51.916 - What are the requirements for an Ozone Transport Region under the 8-hour NAAQS?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 2 2013-07-01 2013-07-01 false What are the requirements for an Ozone... IMPLEMENTATION PLANS Provisions for Implementation of 8-hour Ozone National Ambient Air Quality Standard § 51.916 What are the requirements for an Ozone Transport Region under the 8-hour NAAQS? (a) In General...

40 CFR 51.916 - What are the requirements for an Ozone Transport Region under the 8-hour NAAQS?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false What are the requirements for an Ozone... IMPLEMENTATION PLANS Provisions for Implementation of 8-hour Ozone National Ambient Air Quality Standard § 51.916 What are the requirements for an Ozone Transport Region under the 8-hour NAAQS? (a) In General...

40 CFR 51.910 - What requirements for reasonable further progress (RFP) under sections 172(c)(2) and 182 apply...

Code of Federal Regulations, 2011 CFR

2011-07-01

...-hour ozone NAAQS? 51.910 Section 51.910 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Provisions for Implementation of 8-hour Ozone National Ambient Air Quality Standard § 51.910 What... nonattainment for the 8-hour ozone NAAQS? (a) What are the general requirements for RFP for an area classified...

40 CFR 51.910 - What requirements for reasonable further progress (RFP) under sections 172(c)(2) and 182 apply...

Code of Federal Regulations, 2013 CFR

2013-07-01

...-hour ozone NAAQS? 51.910 Section 51.910 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Provisions for Implementation of 8-hour Ozone National Ambient Air Quality Standard § 51.910 What... nonattainment for the 8-hour ozone NAAQS? (a) What are the general requirements for RFP for an area classified...

40 CFR 51.910 - What requirements for reasonable further progress (RFP) under sections 172(c)(2) and 182 apply...

Code of Federal Regulations, 2012 CFR

2012-07-01

...-hour ozone NAAQS? 51.910 Section 51.910 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Provisions for Implementation of 8-hour Ozone National Ambient Air Quality Standard § 51.910 What... nonattainment for the 8-hour ozone NAAQS? (a) What are the general requirements for RFP for an area classified...

40 CFR 51.916 - What are the requirements for an Ozone Transport Region under the 8-hour NAAQS?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 2 2014-07-01 2014-07-01 false What are the requirements for an Ozone... IMPLEMENTATION PLANS Provisions for Implementation of 8-hour Ozone National Ambient Air Quality Standard § 51.916 What are the requirements for an Ozone Transport Region under the 8-hour NAAQS? (a) In General...

40 CFR 51.910 - What requirements for reasonable further progress (RFP) under sections 172(c)(2) and 182 apply...

Code of Federal Regulations, 2014 CFR

2014-07-01

...-hour ozone NAAQS? 51.910 Section 51.910 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Provisions for Implementation of 8-hour Ozone National Ambient Air Quality Standard § 51.910 What... nonattainment for the 8-hour ozone NAAQS? (a) What are the general requirements for RFP for an area classified...

Russian Higher Educational Institutions' Ability to Compete and the Strict Standards of "Hamburg Scoring"

ERIC Educational Resources Information Center

Plaksii, S.

2009-01-01

Russian universities rank poorly in international comparisons, and recent suggested reforms will not change this situation. There is an urgent need to find ways to improve the quality of Russia's higher education and to make it more appealing to scientists and to international students. In general, in order for the world to begin to appreciate and…

76 FR 3159 - Notice of Lodging of a Consent Decree Under the Clean Water Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-19

... untreated sewage in such a way as to cause violations of applicable water quality standards for E. coli in... Assistant Attorney General, Environment and Natural Resources Division, and either e-mailed to pubcomment... Library, P.O. Box 7611, U.S. Department of Justice, Washington, DC 20044-7611 or by faxing or e-mailing a...

76 FR 28776 - Re-Proposal of Effluent Limits Under the NPDES General Permit for Oil and Gas Exploration...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-18

...: Notice. SUMMARY: EPA Region 10 today re-proposes six effluent limits for produced water under the... Source Category as authorized by Section 402 of the Clean Water Act (CWA or ``the Act''), 33 U.S.C. 1342... water quality standards. EPA obtained a draft certification from the Alaska Department of Environmental...

Sri Lankan English O Level: Lever for Change. Practical Considerations.

ERIC Educational Resources Information Center

Nanayakkara, Ethel; Webber, Richard

A discussion of the new Sri Lankan General Certificate of Education (GCE) O-Level standardized test of English focuses on how new ideas in testing have been implemented in the test and on their effect on classroom practice and the quality of English instruction. The discussion begins with a brief outline of the history and context in which the new…

Factors affecting job satisfaction and their correlation with educational standards among dental assistants.

PubMed

Al Jazairy, Yousra H; Halawany, Hassan Suliman; Hussainan, Nawaf Al; Maflehi, Nassr Al; Abraham, Nimmi Biju; Jacob, Vimal

2014-01-01

A disparity exists in the educational qualifications of dental assistants working in various public and private institutions in Riyadh, Saudi Arabia. The aim of this study was to assess the influence of professional and personal characteristics on job satisfaction among dental assistants. A cross-sectional survey was performed among dental assistants using a 24-item self-administered questionnaire. Multinomial logistic regression was used to assess the relationship between overall job satisfaction and other variables. The overall response rate was 72.1%. Factor analysis suggested that five underlying factors were related to job satisfaction. The mean score for overall job satisfaction was 3.86 (satisfied) out of 5. Among the work environment factors, the highest mean score, 4.26 (satisfied), was obtained for quality of service, and the lowest mean score, 2.78 (neutral), was obtained for the perception of income. The income and general prospects of the profession was significantly associated with overall job satisfaction. This study suggests that for dental assistants, professional and personal life, quality of service, perception of income and prestige and self-respect are important factors for job satisfaction. Despite differences in professional formation standards, in general, the study participants were considerably satisfied with their jobs.

Factors Affecting Job Satisfaction and Their Correlation with Educational Standards among Dental Assistants

PubMed Central

JAZAIRY, Yousra H. AL; HALAWANY, Hassan Suliman; HUSSAINAN, Nawaf AL; MAFLEHI, Nassr AL; ABRAHAM, Nimmi Biju; JACOB, Vimal

2014-01-01

A disparity exists in the educational qualifications of dental assistants working in various public and private institutions in Riyadh, Saudi Arabia. The aim of this study was to assess the influence of professional and personal characteristics on job satisfaction among dental assistants. A cross-sectional survey was performed among dental assistants using a 24-item self-administered questionnaire. Multinomial logistic regression was used to assess the relationship between overall job satisfaction and other variables. The overall response rate was 72.1%. Factor analysis suggested that five underlying factors were related to job satisfaction. The mean score for overall job satisfaction was 3.86 (satisfied) out of 5. Among the work environment factors, the highest mean score, 4.26 (satisfied), was obtained for quality of service, and the lowest mean score, 2.78 (neutral), was obtained for the perception of income. The income and general prospects of the profession was significantly associated with overall job satisfaction. This study suggests that for dental assistants, professional and personal life, quality of service, perception of income and prestige and self-respect are important factors for job satisfaction. Despite differences in professional formation standards, in general, the study participants were considerably satisfied with their jobs. PMID:24747371

Evaluation of the quality of life of pregnant women from 2005 to 2015.

PubMed

Morin, M; Vayssiere, C; Claris, O; Irague, F; Mallah, S; Molinier, L; Matillon, Y

2017-07-01

Over the past two decades, quality of life has become an essential preoccupation in the care of patients. Many measuring instruments are available to assess physical, psychological and social quality of life. These tools allow healthcare professionals to determine the best quality of their patients. However, the quality of life for the pregnant woman seems to be little studied. This article presents the results of a bibliographic review of publications between 2005 and 2015 - referenced in PUBMED and COCHRANE - on the quality of life of pregnant women giving birth after the 22nd week of amenorrhea. The articles were selected by a reading committee. 195 publications responding to keywords were identified. 75 articles on the problem were selected. The main countries that have published on this subject are Iran (n=11) and Brazil (n=9). France ranks 17th with only one publication. 74% of articles deal with quality of life for pathological pregnancies (gestational or pre-existing pathologies). 23 pathologies were identified, mainly depression (20% of items). This review reveals a growing global interest in quality of life in pregnant women. However, few studies evaluate the impact of care in terms of quality of life in pregnant women, contrary to the recommendations of different health authorities. Finally, the analysis of the various articles shows that, in general, few measurements are made to evaluate the quality of life, not requiring a standardized curve of quality of life during pregnancy. There is thus a significant lack of data to establish a standardized curve for the quality of life of pregnant women, which allows a simple comparison of quality of life measures according to the different clinical management. Copyright © 2017 Elsevier B.V. All rights reserved.

Assessment of water quality, road runoff, and bulk atmospheric deposition, Guanella Pass area, Clear Creek and Park Counties, Colorado, water years 1995-97

USGS Publications Warehouse

Stevens, Michael R.

2001-01-01

The Guanella Pass road, located about 40 miles west of Denver, Colorado, between the towns of Georgetown and Grant, has been designated a scenic byway and is being considered for reconstruction. The purpose of this report is to present an assessment of hydrologic and water-quality conditions in the Guanella Pass area and provide baseline data for evaluation of the effects of the proposed road reconstruction. The data were collected during water years 1995-97 (October 1, 1995, to September 30, 1997).Based on Colorado water-quality standards, current surface-water quality near Guanella Pass road was generally acceptable for specified use classifications of recreation, water supply, agriculture, and aquatic life. Streams had small concentrations of dissolved solids, nutrients, trace elements, and suspended sediment. An exception was upper Geneva Creek, which was acidic and had relatively large concentrations of iron, zinc, and other trace elements related to acid-sulfate weathering. Concentrations of many water-quality constituents, especially particle-related phases and suspended sediment, increased during peak snowmelt and rainstorm events and decreased to prerunoff concentrations at the end of runoff periods. Some dissolved (filtered) trace-element loads in Geneva Creek decreased during rainstorms when total recoverable loads remained generally static or increased, indicating a phase change that might be explained by adsorption of trace elements to suspended sediment during storm runoff.Total recoverable iron and dissolved zinc exceeded Colorado stream-water-quality standards most frequently. Exceedances for iron generally occurred during periods of high suspended-sediment transport in several streams. Zinc standards were exceeded in about one-half the samples collected in Geneva Creek 1.5 miles upstream from Grant.Lake-water quality was generally similar to that of area streams. Nitrogen and phosphorus ratios calculated for Clear and Duck Lakes indicated that phytoplankton in the lakes were probably phosphorus-limited. Measures of trophic status (secchi depth, total phosphorus, and chlorophyll-a) indicated that Duck and Clear Lakes were oligotrophic in 1997.Ground water had relatively low specific conductance (range 24 to 584 microsiemens per centimeter) and did not exceed U.S. Environmental Protection Agency drinking-water standards, except for samples collected from a single well, which exceeded the Proposed Maximum Contaminant Level for uranium.Runoff from the Guanella Pass road enters streams through surface channels connected to culverts and roadside ditches. Fifty-six percent of the total number of culvert and roadside-ditch drainage features on the Guanella Pass road showed evidence of recent surface runoff connection to an adjacent stream. Road runoff is generated during snowmelt and during summer rainstorms.At a road cross-drain culvert monitored continuously for discharge (water years 1996-97), most runoff (77 to 96 percent) was a result of snowmelt, and runoff from the road preceded the basinwide peak streamflow, resulting in sediment and water-quality constituent inputs to the stream when the stream?s capacity for dilution of the road runoff was low. Specific conductance of road-runoff samples ranged from 14 to 468 microsiemens per centimeter. Major-ion composition of some samples indicated effects from deicing salt (sodium chloride) and dust inhibitor (magnesium chloride) applied to sections of the road, but changes in the stream concentrations that might be attributed to the runoff were brief and relatively small.Nutrients were commonly measured in road-runoff samples at larger concentrations than in streamflow. Concentrations of nitrate and ammonia, especially during rainfall-generated road runoff, were more similar to the concentrations in precipitation than to the concentrations in stream water. Concentrations of ammonia plus organic nitrogen (total as N) (range less than 0.2 to 24 milligrams per liter) and t

Evaluation of water quality, suspended sediment, and stream morphology with an emphasis on effects of stormwater on Fountain and Monument Creek basins, Colorado Springs and vicinity, Colorado, 1981-2001

USGS Publications Warehouse

Edelmann, Patrick; Ferguson, Sheryl A.; Stogner, Sr., Robert W.; August, Marianne; Payne, William F.; Bruce, James F.

2002-01-01

This report documents water quality and suspended sediment with an emphasis on evaluating the effects of stormflow on Fountain Creek Basin in the vicinity of Colorado Springs, Colorado. Water-quality data collected at 11 sites between 1981 and 2001 were used to evaluate the effects of stormflow on water quality. Suspended-sediment data collected at seven sites from 1998 through 2001 were used to evaluate effects of stormflow on suspended-sediment concentrations, discharges, and yields. Data were separated into three flow regimes: base flow, normal flow, and stormflow. A comparison of stormwater-quality concentrations measured between 1981 and 2001 to Colorado acute instream standards indicated that, except for isolated occurrences, stormwater quality met acute instream standards. At several sites, 5-day biochemical oxygen demand, fecal coliform, and selected nutrient concentrations tended to be highest during stormflow and lowest during base flow. Dissimilar to the other nutrients, dissolved nitrite plus nitrate concentrations generally were highest during base flow and lowest during stormflow. Most dissolved trace-element concentrations associated with stormflow decreased or showed little change compared to base flow. However, median concentrations of total copper, iron, lead, nickel, manganese, and zinc for stormflow samples generally were much larger than nonstorm samples. The substantially larger concentrations of total copper, iron, lead, nickel, manganese, and zinc measured at site 5800 during stormflow as compared to other sites indicates a relatively large source of these metals in the reach between sites 5530 and 5800. Semi-volatile organic compounds in samples collected during stormflow were detected relatively infrequently at the four sites monitored; however, analysis of pesticide data collected during stormflow showed a relatively frequent detection of pesticides at low levels. Nitrogen, phosphorus, and particulate trace-element loads substantially increased during stormflow. Suspended-sediment concentrations, discharges, and yields associated with stormflow were significantly greater than during normal flow. Depending on the site and year, suspended-sediment concentrations associated with storm-flow generally were 3 to10 times greater than concentrations measured during normal flow, and suspended-sediment discharges were usually more than 10 times greater during stormflow. The April through October cumulative suspended-sediment discharges and streamflows were largest in 1999 at all sites. Although large spatial variations in suspended-sediment yields occurred during normal flows, the suspended-sediment yields associated with stormflow generally were more than 10 times greater than the suspended-sediment yields that occurred during normal flow. The smallest suspended-sediment yields generally were less than 1 ton per day per square mile during stormflow. The largest suspended-sediment yields occurred at sites located in the Cottonwood Creek Basin and were greater than 10 tons per day per square mile.

40 CFR 131.35 - Colville Confederated Tribes Indian Reservation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS WATER QUALITY STANDARDS Federally Promulgated Water Quality Standards § 131.35 Colville Confederated Tribes Indian Reservation. The water quality standards applicable to the waters within the... these Federal water quality standards to prescribe minimum water quality requirements for the surface...

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.3 Water quality standards. A water quality standard (WQS) defines the water quality goals of a water body, or portion thereof, by designating the use or uses to be made... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Water quality standards. 130.3 Section...

The tissue bank at the Instituto Nacional de Investigaciones Nucleares: ISO 9001:2000 certification of its quality management system.

PubMed

Martínez-Pardo, María Esther; Mariano-Magaña, David

2007-01-01

Tissue banking is a complex operation concerned with the organisation and coordination of all the steps, that is, from donor selection up to storage and distribution of the final products for therapeutic, diagnostic, instruction and research purposes. An appropriate quality framework should be established in order to cover all the specific methodology as well as the general aspects of quality management, such as research and development, design, instruction and training, specific documentation, traceability, corrective action, client satisfaction, and the like. Such a framework can be obtained by developing a quality management system (QMS) in accordance with a suitable international standard: ISO 9001:2000. This paper presents the implementation process of the tissue bank QMS at the Instituto Nacional de Investigaciones Nucleares in Mexico. The objective of the paper is to share the experience gained by the tissue bank personnel [radiosterilised tissue bank (BTR)] at the Instituto Nacional de Investigaciones Nucleares (ININ, National Institute of Nuclear Research), during implementation of the ISO 9001:2000 certification process. At present, the quality management system (QMS) of ININ also complies with the Mexican standard NMX-CC-9001:2000. The scope of this QMS is Research, Development and Processing of Biological Tissues Sterilised by Gamma Radiation, among others.

[Handbook for the preparation of evidence-based documents. Tools derived from scientific knowledge].

PubMed

Carrión-Camacho, M R; Martínez-Brocca, M A; Paneque-Sánchez-Toscano, I; Valencia-Martín, R; Palomino-García, A; Muñoz-Durán, C; Tamayo-López, M J; González-Eiris-Delgado, C; Otero-Candelera, R; Ortega-Ruiz, F; Sobrino-Márquez, J M; Jiménez-García-Bóveda, R; Fernández-Quero, M; Campos-Pareja, A M

2013-01-01

This handbook is intended to be an accessible, easy-to-consult guide to help professionals produce or adapt Evidence-Based Documents. Such documents will help standardize both clinical practice and decision-making, the quality always being monitored in such a way that established references are complied with. Evidence-Based Health Care Committee, a member of "Virgen del Rocío" University Hospital quality structure, proposed the preparation of a handbook to produce Evidence-Based Documents including: a description of products, characteristics, qualities, uses, methodology of production, and application scope of every one of them. The handbook consists of seven Evidence-Based tools, one chapter on critical analysis methodology of scientific literature, one chapter with internet resources, and some appendices with different assessment tools. This Handbook provides general practitioners with a great opportunity to improve quality and as a guideline to standardize clinical healthcare, and managers with a strategy to promote and encourage the development of documents in an effort to reduce clinical practice variability, as well as giving patients the opportunity of taking part in planning their own care. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

Testing and validation of computerized decision support systems.

PubMed

Sailors, R M; East, T D; Wallace, C J; Carlson, D A; Franklin, M A; Heermann, L K; Kinder, A T; Bradshaw, R L; Randolph, A G; Morris, A H

1996-01-01

Systematic, through testing of decision support systems (DSSs) prior to release to general users is a critical aspect of high quality software design. Omission of this step may lead to the dangerous, and potentially fatal, condition of relying on a system with outputs of uncertain quality. Thorough testing requires a great deal of effort and is a difficult job because tools necessary to facilitate testing are not well developed. Testing is a job ill-suited to humans because it requires tireless attention to a large number of details. For these reasons, the majority of DSSs available are probably not well tested prior to release. We have successfully implemented a software design and testing plan which has helped us meet our goal of continuously improving the quality of our DSS software prior to release. While requiring large amounts of effort, we feel that the process of documenting and standardizing our testing methods are important steps toward meeting recognized national and international quality standards. Our testing methodology includes both functional and structural testing and requires input from all levels of development. Our system does not focus solely on meeting design requirements but also addresses the robustness of the system and the completeness of testing.

Data Mining Methods Applied to Flight Operations Quality Assurance Data: A Comparison to Standard Statistical Methods

NASA Technical Reports Server (NTRS)

Stolzer, Alan J.; Halford, Carl

2007-01-01

In a previous study, multiple regression techniques were applied to Flight Operations Quality Assurance-derived data to develop parsimonious model(s) for fuel consumption on the Boeing 757 airplane. The present study examined several data mining algorithms, including neural networks, on the fuel consumption problem and compared them to the multiple regression results obtained earlier. Using regression methods, parsimonious models were obtained that explained approximately 85% of the variation in fuel flow. In general data mining methods were more effective in predicting fuel consumption. Classification and Regression Tree methods reported correlation coefficients of .91 to .92, and General Linear Models and Multilayer Perceptron neural networks reported correlation coefficients of about .99. These data mining models show great promise for use in further examining large FOQA databases for operational and safety improvements.

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 23 2012-07-01 2012-07-01 false Water quality standards. 130.3 Section 130.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.3 Water quality standards. A water quality standard (WQS) defines...

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 22 2014-07-01 2013-07-01 true Water quality standards. 130.3 Section 130.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.3 Water quality standards. A water quality standard (WQS) defines...

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 23 2013-07-01 2013-07-01 false Water quality standards. 130.3 Section 130.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.3 Water quality standards. A water quality standard (WQS) defines...

40 CFR 130.3 - Water quality standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Water quality standards. 130.3 Section 130.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.3 Water quality standards. A water quality standard (WQS) defines...

Use of low-coverage, large-insert, short-read data for rapid and accurate generation of enhanced-quality draft Pseudomonas genome sequences.

PubMed

O'Brien, Heath E; Gong, Yunchen; Fung, Pauline; Wang, Pauline W; Guttman, David S

2011-01-01

Next-generation genomic technology has both greatly accelerated the pace of genome research as well as increased our reliance on draft genome sequences. While groups such as the Genomics Standards Consortium have made strong efforts to promote genome standards there is a still a general lack of uniformity among published draft genomes, leading to challenges for downstream comparative analyses. This lack of uniformity is a particular problem when using standard draft genomes that frequently have large numbers of low-quality sequencing tracts. Here we present a proposal for an "enhanced-quality draft" genome that identifies at least 95% of the coding sequences, thereby effectively providing a full accounting of the genic component of the genome. Enhanced-quality draft genomes are easily attainable through a combination of small- and large-insert next-generation, paired-end sequencing. We illustrate the generation of an enhanced-quality draft genome by re-sequencing the plant pathogenic bacterium Pseudomonas syringae pv. phaseolicola 1448A (Pph 1448A), which has a published, closed genome sequence of 5.93 Mbp. We use a combination of Illumina paired-end and mate-pair sequencing, and surprisingly find that de novo assemblies with 100x paired-end coverage and mate-pair sequencing with as low as low as 2-5x coverage are substantially better than assemblies based on higher coverage. The rapid and low-cost generation of large numbers of enhanced-quality draft genome sequences will be of particular value for microbial diagnostics and biosecurity, which rely on precise discrimination of potentially dangerous clones from closely related benign strains.

Use of MODIS Terra Imagery to Estimate Surface Water Quality Standards, Using Lake Thonotosassa, Florida, as a Case Study

NASA Technical Reports Server (NTRS)

Moreno, Max J.; Al-Hamdan, Mohammad Z.; Estes, Maurice G., Jr.; Rickman, Douglas L.

2010-01-01

Lake Thonotosassa is a highly eutrophied lake located in an area with rapidly growing population in the Tampa Bay watershed, Florida. The Florida Administrative Code has designated its use for "recreation, propagation and maintenance of a healthy, well-balanced population of fish and wildlife." Although this lake has been the subject of efforts to improve water quality since 1970, overall water quality has remained below the acceptable state standards, and has a high concentration of nutrients. This condition is of great concern to public health since it has favored episodic blooms of Cyanobacteria. Some Cyanobacterial species release toxins that can reach humans through drinking water, fish consumption, and direct contact with contaminated water. The lake has been historically popular for fishing and water sports, and its overflow water drains into the Hillsborough River, the main supply of municipal water for the City of Tampa, this explains why it has being constantly monitored in situ for water quality by the Environmental Protection Commission of Hillsborough County (EPC). Advances in remote sensing technology, however, open the possibility of facilitating similar types of monitoring in this and similar lakes, further contributing to the implementation of surveillance systems that would benefit not just public health, but also tourism and ecosystems. Although traditional application of this technology to water quality has been focused on much larger coastal water bodies like bays and estuaries, this study evaluates the feasibility of its application on a 46.6 km2 freshwater lake. Using surface reflectance products from Moderate-Resolution Imaging Spectroradiometer (MODIS) Terra, this study evaluates associations between remotely sensed data and in situ data from the EPC. The parameters analyzed are the surface water quality standards used by the State of Florida and general indicators of trophic status.

Identification of features of electronic prescribing systems to support quality and safety in primary care using a modified Delphi process.

PubMed

Sweidan, Michelle; Williamson, Margaret; Reeve, James F; Harvey, Ken; O'Neill, Jennifer A; Schattner, Peter; Snowdon, Teri

2010-04-15

Electronic prescribing is increasingly being used in primary care and in hospitals. Studies on the effects of e-prescribing systems have found evidence for both benefit and harm. The aim of this study was to identify features of e-prescribing software systems that support patient safety and quality of care and that are useful to the clinician and the patient, with a focus on improving the quality use of medicines. Software features were identified by a literature review, key informants and an expert group. A modified Delphi process was used with a 12-member multidisciplinary expert group to reach consensus on the expected impact of the features in four domains: patient safety, quality of care, usefulness to the clinician and usefulness to the patient. The setting was electronic prescribing in general practice in Australia. A list of 114 software features was developed. Most of the features relate to the recording and use of patient data, the medication selection process, prescribing decision support, monitoring drug therapy and clinical reports. The expert group rated 78 of the features (68%) as likely to have a high positive impact in at least one domain, 36 features (32%) as medium impact, and none as low or negative impact. Twenty seven features were rated as high positive impact across 3 or 4 domains including patient safety and quality of care. Ten features were considered "aspirational" because of a lack of agreed standards and/or suitable knowledge bases. This study defines features of e-prescribing software systems that are expected to support safety and quality, especially in relation to prescribing and use of medicines in general practice. The features could be used to develop software standards, and could be adapted if necessary for use in other settings and countries.

Identification of features of electronic prescribing systems to support quality and safety in primary care using a modified Delphi process

PubMed Central

2010-01-01

Background Electronic prescribing is increasingly being used in primary care and in hospitals. Studies on the effects of e-prescribing systems have found evidence for both benefit and harm. The aim of this study was to identify features of e-prescribing software systems that support patient safety and quality of care and that are useful to the clinician and the patient, with a focus on improving the quality use of medicines. Methods Software features were identified by a literature review, key informants and an expert group. A modified Delphi process was used with a 12-member multidisciplinary expert group to reach consensus on the expected impact of the features in four domains: patient safety, quality of care, usefulness to the clinician and usefulness to the patient. The setting was electronic prescribing in general practice in Australia. Results A list of 114 software features was developed. Most of the features relate to the recording and use of patient data, the medication selection process, prescribing decision support, monitoring drug therapy and clinical reports. The expert group rated 78 of the features (68%) as likely to have a high positive impact in at least one domain, 36 features (32%) as medium impact, and none as low or negative impact. Twenty seven features were rated as high positive impact across 3 or 4 domains including patient safety and quality of care. Ten features were considered "aspirational" because of a lack of agreed standards and/or suitable knowledge bases. Conclusions This study defines features of e-prescribing software systems that are expected to support safety and quality, especially in relation to prescribing and use of medicines in general practice. The features could be used to develop software standards, and could be adapted if necessary for use in other settings and countries. PMID:20398294

The Metadata Coverage Index (MCI): A standardized metric for quantifying database metadata richness.

PubMed

Liolios, Konstantinos; Schriml, Lynn; Hirschman, Lynette; Pagani, Ioanna; Nosrat, Bahador; Sterk, Peter; White, Owen; Rocca-Serra, Philippe; Sansone, Susanna-Assunta; Taylor, Chris; Kyrpides, Nikos C; Field, Dawn

2012-07-30

Variability in the extent of the descriptions of data ('metadata') held in public repositories forces users to assess the quality of records individually, which rapidly becomes impractical. The scoring of records on the richness of their description provides a simple, objective proxy measure for quality that enables filtering that supports downstream analysis. Pivotally, such descriptions should spur on improvements. Here, we introduce such a measure - the 'Metadata Coverage Index' (MCI): the percentage of available fields actually filled in a record or description. MCI scores can be calculated across a database, for individual records or for their component parts (e.g., fields of interest). There are many potential uses for this simple metric: for example; to filter, rank or search for records; to assess the metadata availability of an ad hoc collection; to determine the frequency with which fields in a particular record type are filled, especially with respect to standards compliance; to assess the utility of specific tools and resources, and of data capture practice more generally; to prioritize records for further curation; to serve as performance metrics of funded projects; or to quantify the value added by curation. Here we demonstrate the utility of MCI scores using metadata from the Genomes Online Database (GOLD), including records compliant with the 'Minimum Information about a Genome Sequence' (MIGS) standard developed by the Genomic Standards Consortium. We discuss challenges and address the further application of MCI scores; to show improvements in annotation quality over time, to inform the work of standards bodies and repository providers on the usability and popularity of their products, and to assess and credit the work of curators. Such an index provides a step towards putting metadata capture practices and in the future, standards compliance, into a quantitative and objective framework.

Are "part-time" general practitioners workforce idlers or committed professionals?

PubMed

Dwan, Kathryn M; Douglas, Kirsty A; Forrest, Laura E

2014-09-19

The traditional view of general practice holds that only general practitioners (GPs) in full-time clinical practice can provide quality patient care. Nevertheless, increasing numbers of GPs are choosing to work sessionally, that is, ostensibly "part-time". There are concerns about the health workforce's ability to meet demand and also fears that patient care may be compromised. We sought answers to a) what activities do GPs undertake when not consulting patients, b) why do they choose to work sessionally, and c) does sessional general practice reflect a lack of commitment to patients and the profession? Semi-structured interviews were conducted with GPs who worked sessionally, (i.e. six or fewer sessions a week in clinical general practice, where a session comprises four consecutive hours of patient care). These data were analysed qualitatively and saturation was reached. The majority of participants were in full-time paid employment, while part-time in clinical general practice. They reported that consultations increasingly required the management of patients with complex, chronic conditions who also required psychological management. Coupled with unrealistic patient expectations, these factors led GPs to be concerned about maintaining the quality patient care they considered professionally desirable. Many diversified their work activities to ensure that they retained their professional standards. "Part-time" general practice is a misnomer that masks the contribution these GPs make as part of the health workforce. Sessional practice more accurately describes the nature of our participants' clinical work. Their choice of sessional work is a professional response to the increasing demands within the consultation. It enables GPs to maintain their commitment to quality patient care and their profession, while attenuating the challenges of demanding consultations. Sessional general practitioners demonstrate strong commitment to their patients and the profession.

Modeling Canadian Quality Control Test Program for Steroid Hormone Receptors in Breast Cancer: Diagnostic Accuracy Study.

PubMed

Pérez, Teresa; Makrestsov, Nikita; Garatt, John; Torlakovic, Emina; Gilks, C Blake; Mallett, Susan

The Canadian Immunohistochemistry Quality Control program monitors clinical laboratory performance for estrogen receptor and progesterone receptor tests used in breast cancer treatment management in Canada. Current methods assess sensitivity and specificity at each time point, compared with a reference standard. We investigate alternative performance analysis methods to enhance the quality assessment. We used 3 methods of analysis: meta-analysis of sensitivity and specificity of each laboratory across all time points; sensitivity and specificity at each time point for each laboratory; and fitting models for repeated measurements to examine differences between laboratories adjusted by test and time point. Results show 88 laboratories participated in quality control at up to 13 time points using typically 37 to 54 histology samples. In meta-analysis across all time points no laboratories have sensitivity or specificity below 80%. Current methods, presenting sensitivity and specificity separately for each run, result in wide 95% confidence intervals, typically spanning 15% to 30%. Models of a single diagnostic outcome demonstrated that 82% to 100% of laboratories had no difference to reference standard for estrogen receptor and 75% to 100% for progesterone receptor, with the exception of 1 progesterone receptor run. Laboratories with significant differences to reference standard identified with Generalized Estimating Equation modeling also have reduced performance by meta-analysis across all time points. The Canadian Immunohistochemistry Quality Control program has a good design, and with this modeling approach has sufficient precision to measure performance at each time point and allow laboratories with a significantly lower performance to be targeted for advice.

EMQN/CMGS best practice guidelines for the molecular genetic testing of Huntington disease.

PubMed

Losekoot, Monique; van Belzen, Martine J; Seneca, Sara; Bauer, Peter; Stenhouse, Susan A R; Barton, David E

2013-05-01

Huntington disease (HD) is caused by the expansion of an unstable polymorphic trinucleotide (CAG)n repeat in exon 1 of the HTT gene, which translates into an extended polyglutamine tract in the protein. Laboratory diagnosis of HD involves estimation of the number of CAG repeats. Molecular genetic testing for HD is offered in a wide range of laboratories both within and outside the European community. In order to measure the quality and raise the standard of molecular genetic testing in these laboratories, the European Molecular Genetics Quality Network has organized a yearly external quality assessment (EQA) scheme for molecular genetic testing of HD for over 10 years. EQA compares a laboratory's output with a fixed standard both for genotyping and reporting of the results to the referring physicians. In general, the standard of genotyping is very high but the clarity of interpretation and reporting of the test result varies more widely. This emphasizes the need for best practice guidelines for this disorder. We have therefore developed these best practice guidelines for genetic testing for HD to assist in testing and reporting of results. The analytical methods and the potential pitfalls of molecular genetic testing are highlighted and the implications of the different test outcomes for the consultand and his or her family members are discussed.

Phytotoxicity and accumulation of chromium in carrot plants and the derivation of soil thresholds for Chinese soils.

PubMed

Ding, Changfeng; Li, Xiaogang; Zhang, Taolin; Ma, Yibing; Wang, Xingxiang

2014-10-01

Soil environmental quality standards in respect of heavy metals for farmlands should be established considering both their effects on crop yield and their accumulation in the edible part. A greenhouse experiment was conducted to investigate the effects of chromium (Cr) on biomass production and Cr accumulation in carrot plants grown in a wide range of soils. The results revealed that carrot yield significantly decreased in 18 of the total 20 soils with Cr addition being the soil environmental quality standard of China. The Cr content of carrot grown in the five soils with pH>8.0 exceeded the maximum allowable level (0.5mgkg(-1)) according to the Chinese General Standard for Contaminants in Foods. The relationship between carrot Cr concentration and soil pH could be well fitted (R(2)=0.70, P<0.0001) by a linear-linear segmented regression model. The addition of Cr to soil influenced carrot yield firstly rather than the food quality. The major soil factors controlling Cr phytotoxicity and the prediction models were further identified and developed using path analysis and stepwise multiple linear regression analysis. Soil Cr thresholds for phytotoxicity meanwhile ensuring food safety were then derived on the condition of 10 percent yield reduction. Copyright © 2014 Elsevier Inc. All rights reserved.

Experimental study of biological effects of leads and aluminum following oral administration.

PubMed Central

Krasovskiĭ, G N; Vasukovich, L Y; Chariev, O G

1979-01-01

A wide spectrum of the biological effects of lead and aluminum ions is noted during short-term and long-term oral administration to laboratory animals. The general toxic and gonadotoxic effects of these metals during a short-term experiment appeared to be identical, and the correlation of these effects was preserved during chronic experiments. Lead (0.03 mg/l.) and aluminum (0.5 mg/l.) concentrations in water may be dangerous to the health of the population, and hygienic standards are recommended for inclusion in the standard for drinking water quality. PMID:446457

The robust design for improving crude palm oil quality in Indonesian Mill

NASA Astrophysics Data System (ADS)

Maretia Benu, Siti; Sinulingga, Sukaria; Matondang, Nazaruddin; Budiman, Irwan

2018-04-01

This research was conducted in palm oil mill in Sumatra Utara Province, Indonesia. Currently, the main product of this mill is Crude Palm Oil (CPO) and hasn’t met the expected standard quality. CPO is the raw material for many fat derivative products. The generally stipulated quality criteria are dirt count, free fatty acid, and moisture of CPO. The aim of this study is to obtain the optimal setting for factor’s affect the quality of CPO. The optimal setting will result in an improvement of product’s quality. In this research, Experimental Design with Taguchi Method is used. Steps of this method are identified influence factors, select the orthogonal array, processed data using ANOVA test and signal to noise ratio, and confirmed the research using Quality Loss Function. The result of this study using Taguchi Method is to suggest to set fruit maturity at 75.4-86.9%, digester temperature at 95°C and press at 21 Ampere to reduce quality deviation until 42.42%.

Evaluating confidence in the impact of regulatory nutrient reduction and assessing the competing impact of climate change

NASA Astrophysics Data System (ADS)

Irby, I.; Friedrichs, M. A. M.

2017-12-01

Human impacts on the Chesapeake Bay through increased nutrient run-off as a result of land-use change, urbanization, and industrialization, have resulted in a degradation of water quality over the last half-century. These direct impacts, compounded with human-induced climate changes such as warming, rising sea level, and changes in precipitation, have elevated the conversation surrounding the future of the Bay's water quality. As a result, in 2010, a Total Maximum Daily Load (TMDL) was established for the Chesapeake Bay that limited nutrient and sediment input in an effort to increase dissolved oxygen. This research utilizes a multiple model approach to evaluate confidence in the estuarine water quality modeling portion of the TMDL. One of the models is then used to assess the potential impact climate change may have on the success of currently mandated nutrient reduction levels in 2050. Results demonstrate that although the models examined differ structurally and in biogeochemical complexity, they project a similar attainment of regulatory water quality standards after nutrient reduction, while also establishing that meeting water quality standards is relatively independent of hydrologic conditions. By developing a Confidence Index, this research identifies the locations and causes of greatest uncertainty in modeled projections of water quality. Although there are specific locations and times where the models disagree, this research lends an increased degree of confidence in the appropriateness of the TMDL levels and in the general impact nutrient reductions will have on Chesapeake Bay water quality under current environmental conditions. However, when examining the potential impacts of climate change, this research shows that the combined impacts of increasing temperature, sea level, and river flow negatively affect dissolved oxygen throughout the Chesapeake Bay and impact progress towards meeting the water quality standards associated with the TMDL with increased temperature as the primary culprit. These results, having been continually shared with the regulatory TMDL modelers, will aid in the decision making for the 2017 TMDL Mid-Point Assessment.

Quality of surface-water supplies in the Triangle Area of North Carolina, water years 2012–13

USGS Publications Warehouse

Pfeifle, C.A.; Cain, J.L.; Rasmussen, R.B.

2016-09-07

Surface-water supplies are important sources of drinking water for residents in the Triangle area of North Carolina, which is located within the upper Cape Fear and Neuse River Basins. Since 1988, the U.S. Geological Survey and a consortium of local governments have tracked water-quality conditions and trends in several of the area’s water-supply lakes and streams. This report summarizes data collected through this cooperative effort, known as the Triangle Area Water Supply Monitoring Project, during October 2011 through September 2012 (water year 2012) and October 2012 through September 2013 (water year 2013). Major findings for this period include:Annual precipitation was approximately 2 percent above the long-term mean (average) annual precipitation in 2012 and approximately 3 percent below the long-term mean in 2013.In water year 2012, streamflow was generally below the long-term mean during most of the period for the 10 project streamflow gaging stations. Streamflow was near or above the long-term mean at the same streamflow gaging stations during the 2013 water year.More than 7,000 individual measurements of water quality were made at a total of 17 sites—6 in the Neuse River Basin and 11 in the Cape Fear River Basin. Forty-three water-quality properties or constituents were measured; State water-quality standards exist for 23 of these.All observations met State water-quality standards for pH, temperature, hardness, chloride, fluoride, sulfate, nitrate, arsenic, cadmium, chromium, lead, nickel, and selenium.North Carolina water-quality standards were exceeded one or more times for dissolved oxygen, dissolved-oxygen percent saturation, turbidity, chlorophyll a, copper, iron, manganese, mercury, silver, and zinc. Exceedances occurred at all 17 sites.Stream samples collected during storm events contained elevated concentrations of 19 water-quality constituents relative to non-storm events.

Private Health Plans’ Contracts with Managed Behavioral Healthcare Organizations

PubMed Central

Garnick, Deborah W.; Horgan, Constance M.; Merrick, Elizabeth L.; Hodgkin, Dominic; Reif, Sharon; Quinn, Amity E.; Stewart, Maureen; Creedon, Timothy B.

2015-01-01

Contracts between health plans and managed behavioral health care organizations (MBHOs) influence access and quality of behavioral health care. This report presents information on performance requirements, information sharing, and financial risk from a nationally representative survey of private health plans. Most contracts include geographic access to providers (93.3%) and NCQA’s performance standards (84.2%). Health plans and MBHOs share data (99.0%), generally by the MBHO sending information to the health plan (96.3%). About a quarter of contracts impose financial penalties (23.0%), but few include incentives related to performance standards (<1.0%). Contract terms can shape the provision of behavioral health services in response to changes such as parity legislation or health reform. If current trends continue towards increases in value-based purchasing in the privately financed behavioral health sector, the focus on quality in contracts between health plans and MBHOs will be critical to understand. PMID:26276421

A post-assembly genome-improvement toolkit (PAGIT) to obtain annotated genomes from contigs.

PubMed

Swain, Martin T; Tsai, Isheng J; Assefa, Samual A; Newbold, Chris; Berriman, Matthew; Otto, Thomas D

2012-06-07

Genome projects now produce draft assemblies within weeks owing to advanced high-throughput sequencing technologies. For milestone projects such as Escherichia coli or Homo sapiens, teams of scientists were employed to manually curate and finish these genomes to a high standard. Nowadays, this is not feasible for most projects, and the quality of genomes is generally of a much lower standard. This protocol describes software (PAGIT) that is used to improve the quality of draft genomes. It offers flexible functionality to close gaps in scaffolds, correct base errors in the consensus sequence and exploit reference genomes (if available) in order to improve scaffolding and generating annotations. The protocol is most accessible for bacterial and small eukaryotic genomes (up to 300 Mb), such as pathogenic bacteria, malaria and parasitic worms. Applying PAGIT to an E. coli assembly takes ∼24 h: it doubles the average contig size and annotates over 4,300 gene models.

CAC-DRS: Coronary Artery Calcium Data and Reporting System. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT).

PubMed

Hecht, Harvey S; Blaha, Michael J; Kazerooni, Ella A; Cury, Ricardo C; Budoff, Matt; Leipsic, Jonathon; Shaw, Leslee

2018-03-30

The goal of CAC-DRS: Coronary Artery Calcium Data and Reporting System is to create a standardized method to communicate findings of CAC scanning on all noncontrast CT scans, irrespective of the indication, in order to facilitate clinical decision-making, with recommendations for subsequent patient management. The CAC-DRS classification is applied on a per-patient basis and represents the total calcium score and the number of involved arteries. General recommendations are provided for further management of patients with different degrees of calcified plaque burden based on CAC-DRS classification. In addition, CAC-DRS will provide a framework of standardization that may benefit quality assurance and tracking patient outcomes with the potential to ultimately result in improved quality of care. Copyright © 2018 Society of Cardiovascular Computed Tomography. All rights reserved.

Groundwater quality in the Chemung River, Eastern Lake Ontario, and Lower Hudson River Basins, New York, 2013

USGS Publications Warehouse

Scott, Tia-Marie; Nystrom, Elizabeth A.; Reddy, James E.

2015-11-10

The Lower Hudson River Basin study area covers 5,607 square miles and encompasses the part of the Lower Hudson River Basin that lies within New York plus the parts of the Housatonic, Hackensack, Bronx, and Saugatuck River Basins that are in New York. Twelve of the wells sampled in the Lower Hudson River Basin are completed in sand-and-gravel deposits, and 13 are completed in bedrock. Groundwater in the Lower Hudson River Basin was generally of good quality, although properties and concentrations of some constituents—pH, sodium, chloride, dissolved solids, arsenic, aluminum, iron, manganese, radon-222, total coliform bacteria, fecal coliform bacteria, Escherichia coli bacteria, and heterotrophic plate count—equaled or exceeded primary, secondary, or proposed drinking-water standards. The constituent most frequently detected in concentrations exceeding drinking-water standards (20 of 25 samples) was radon-222.

Quality of ground water in Idaho

USGS Publications Warehouse

Yee, Johnson J.; Souza, William R.

1987-01-01

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

[Development of methods and instruments for external quality assurance in inpatient parent-child rehabilitation and prevention].

PubMed

Neuderth, S; Lukasczik, M; Musekamp, G; Gerlich, C; Saupe-Heide, M; Löbmann, R; Vogel, H

2013-02-01

There so far is no standardized program for external quality assurance in inpatient parent-child prevention and rehabilitation in Germany. Therefore, instruments and methods of external quality assurance were developed and evaluated on behalf of the federal-level health insurance institutions. On the level of structure quality, a modular questionnaire for assessing structural features of rehabilitation/prevention centers, basic and allocation criteria as well as a checklist for visitations were developed. Structural data were collected in a nationwide survey of parent-child prevention and rehabilitation centers. Process and outcome quality data were collected in n=38 centers. Process quality was assessed using multiple methods (process-related structural features, case-related routine documentation, and incident-related patient questionnaires). Outcome quality was measured via patient questionnaires (n=1 799 patients). We used a multi-level modelling approach by adjusting relevant confounders on institutional and patient levels. The methods, instruments and analyzing procedures developed for measuring quality on the level of structure, processes and outcomes were adjusted in cooperation with all relevant stakeholders. Results are exemplarily presented for all quality assurance tools. For most of the risk-adjusted outcome parameters, we found no significant differences between institutions. For the first time, a comprehensive, standardized and generally applicable set of methods and instruments for routine use in comparative quality measurement of inpatient parent-child prevention and rehabilitation is available. However, it should be considered that the very heterogeneous field of family-oriented measures can not be covered entirely by an external quality assurance program. Therefore, methods and instruments have to be adapted continuously to the specifics of this area of health care and to new developments. © Georg Thieme Verlag KG Stuttgart · New York.

Evaluating the Quality and Readability of Internet Information on Meningiomas.

PubMed

Saeed, Fozia; Anderson, Ian

2017-01-01

The Internet is a highly powerful resource for patients and provides an extensive amount of information on medical conditions. It is therefore important that the information accessible is accurate, up to date, and at an appropriate comprehensive level for the general public. This article aims to evaluate the quality of patient information on meningiomas. The term meningioma was searched using the following search engines: Google, Bing, Yahoo, Ask, and AOL. The top 100 meningioma Web sites were analyzed for readability using the Flesch Reading Ease score and the Flesch-Kincaid grade level. The quality of each Web page was assessed with the DISCERN instrument and the Centers for Disease Control and Prevention (CDC) Clear Communication Index (CCI). The quality of information on the Internet on meningiomas is highly variable. The overall mean Flesch Reading Ease score was 43.1 (standard deviation = 13.3) and the mean Flesch-Kincaid grade of all the Web sites was 11.2 (standard deviation = 2.3). This finding suggests that the information is on average difficult to read. Only one Web site was at the recommended seventh-grade level and the remainder were above this grade. Only one third of the Web pages had Health On the Net Code of Conduct or The Information Standard certification and were found to be significantly of higher quality: DISCERN (P = 0.022) and CDC CCI (P = 0.027). More than 50% of the Web sites had significantly poor or average DISCERN scores and only 2 Web sites fulfilled the CDC CCI criteria. It is recommended that clinicians personally research material for their patients to be able to guide them to reliable and accurate Web sites. It is also encouraged to become Health On the Net Code of Conduct/The Information Standard certified because this may indicate information of high quality. In addition, it is also recommended that authors of existing information assess the quality of their online health information against the CDC CCI criteria. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Do European hospitals have quality and safety governance systems and structures in place?

PubMed

Shaw, C; Kutryba, B; Crisp, H; Vallejo, P; Suñol, R

2009-02-01

Internal systems for quality and safety were assessed in 89 hospitals in six European states, by external teams using standardised criteria and procedures, as part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The assessments were made primarily to identify the current use of quality management systems in the sample hospitals, and also to demonstrate a potential tool for comparable assessment of hospitals in general. The large majority of the hospitals had a formal, documented infrastructure to manage quality and safety, but a significant minority had no designated mission, programme or coordination. In two-thirds of hospitals, the governing body was active in defining policy and programmes for improvement, and received reports on quality, safety and patient satisfaction at least once a year. The brief on-site assessments identified systematic variations, within and between countries, in structures and processes of governance and to document the uptake of best practice. Unacceptable variations in practice could be reduced, to the benefit of consumers and providers, by developing and publishing basic organisational standards relevant to all European states. The simple assessment criteria designed for this project could be developed into a practical tool for self-assessment, peer review or benchmarking of hospitals across national borders. This assessment, combined with explicit, relevant and achievable standards, could provide a vehicle to promote the voluntary uptake of best practice and consistency in quality and safety among hospitals in Europe.

Abdominal CT with model-based iterative reconstruction (MBIR): initial results of a prospective trial comparing ultralow-dose with standard-dose imaging.

PubMed

Pickhardt, Perry J; Lubner, Meghan G; Kim, David H; Tang, Jie; Ruma, Julie A; del Rio, Alejandro Muñoz; Chen, Guang-Hong

2012-12-01

The purpose of this study was to report preliminary results of an ongoing prospective trial of ultralow-dose abdominal MDCT. Imaging with standard-dose contrast-enhanced (n = 21) and unenhanced (n = 24) clinical abdominal MDCT protocols was immediately followed by ultralow-dose imaging of a matched series of 45 consecutively registered adults (mean age, 57.9 years; mean body mass index, 28.5). The ultralow-dose images were reconstructed with filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and model-based iterative reconstruction (MBIR). Standard-dose series were reconstructed with FBP (reference standard). Image noise was measured at multiple predefined sites. Two blinded abdominal radiologists interpreted randomly presented ultralow-dose images for multilevel subjective image quality (5-point scale) and depiction of organ-based focal lesions. Mean dose reduction relative to the standard series was 74% (median, 78%; range, 57-88%; mean effective dose, 1.90 mSv). Mean multiorgan image noise for low-dose MBIR was 14.7 ± 2.6 HU, significantly lower than standard-dose FBP (28.9 ± 9.9 HU), low-dose FBP (59.2 ± 23.3 HU), and ASIR (45.6 ± 14.1 HU) (p < 0.001). The mean subjective image quality score for low-dose MBIR (3.0 ± 0.5) was significantly higher than for low-dose FBP (1.6 ± 0.7) and ASIR (1.8 ± 0.7) (p < 0.001). Readers identified 213 focal noncalcific lesions with standard-dose FBP. Pooled lesion detection was higher for low-dose MBIR (79.3% [169/213]) compared with low-dose FBP (66.2% [141/213]) and ASIR (62.0% [132/213]) (p < 0.05). MBIR shows great potential for substantially reducing radiation doses at routine abdominal CT. Both FBP and ASIR are limited in this regard owing to reduced image quality and diagnostic capability. Further investigation is needed to determine the optimal dose level for MBIR that maintains adequate diagnostic performance. In general, objective and subjective image quality measurements do not necessarily correlate with diagnostic performance at ultralow-dose CT.

Economic Evaluation of a General Hospital Unit for Older People with Delirium and Dementia (TEAM Randomised Controlled Trial)

PubMed Central

Tanajewski, Lukasz; Franklin, Matthew; Gkountouras, Georgios; Berdunov, Vladislav; Harwood, Rowan H.; Goldberg, Sarah E.; Bradshaw, Lucy E.; Gladman, John R. F.; Elliott, Rachel A.

2015-01-01

Background One in three hospital acute medical admissions is of an older person with cognitive impairment. Their outcomes are poor and the quality of their care in hospital has been criticised. A specialist unit to care for older people with delirium and dementia (the Medical and Mental Health Unit, MMHU) was developed and then tested in a randomised controlled trial where it delivered significantly higher quality of, and satisfaction with, care, but no significant benefits in terms of health status outcomes at three months. Objective To examine the cost-effectiveness of the MMHU for older people with delirium and dementia in general hospitals, compared with standard care. Methods Six hundred participants aged over 65 admitted for acute medical care, identified on admission as cognitively impaired, were randomised to the MMHU or to standard care on acute geriatric or general medical wards. Cost per quality adjusted life year (QALY) gained, at 3-month follow-up, was assessed in trial-based economic evaluation (599/600 participants, intervention: 309). Multiple imputation and complete-case sample analyses were employed to deal with missing QALY data (55%). Results The total adjusted health and social care costs, including direct costs of the intervention, at 3 months was £7714 and £7862 for MMHU and standard care groups, respectively (difference -£149 (95% confidence interval [CI]: -298, 4)). The difference in QALYs gained was 0.001 (95% CI: -0.006, 0.008). The probability that the intervention was dominant was 58%, and the probability that it was cost-saving with QALY loss was 39%. At £20,000/QALY threshold, the probability of cost-effectiveness was 94%, falling to 59% when cost-saving QALY loss cases were excluded. Conclusions The MMHU was strongly cost-effective using usual criteria, although considerably less so when the less acceptable situation with QALY loss and cost savings were excluded. Nevertheless, this model of care is worthy of further evaluation. Trial Registration ClinicalTrials.gov NCT01136148 PMID:26684872

40 CFR 131.22 - EPA promulgation of water quality standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false EPA promulgation of water quality standards. 131.22 Section 131.22 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.22 EPA promulgation of water quality...

40 CFR 131.22 - EPA promulgation of water quality standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false EPA promulgation of water quality standards. 131.22 Section 131.22 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.22 EPA promulgation of water quality...

24 CFR 982.605 - SRO: Housing quality standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false SRO: Housing quality standards. 982... Types Single Room Occupancy (sro) § 982.605 SRO: Housing quality standards. (a) HQS standards for SRO...) (space and security). Since the SRO units will not house children, the housing quality standards in § 982...

Guidelines for the collection of continuous stream water-temperature data in Alaska

USGS Publications Warehouse

Toohey, Ryan C.; Neal, Edward G.; Solin, Gary L.

2014-01-01

Objectives of stream monitoring programs differ considerably among many of the academic, Federal, state, tribal, and non-profit organizations in the state of Alaska. Broad inclusion of stream-temperature monitoring can provide an opportunity for collaboration in the development of a statewide stream-temperature database. Statewide and regional coordination could reduce overall monitoring cost, while providing better analyses at multiple spatial and temporal scales to improve resource decision-making. Increased adoption of standardized protocols and data-quality standards may allow for validation of historical modeling efforts with better projection calibration. For records of stream water temperature to be generally consistent, unbiased, and reproducible, data must be collected and analyzed according to documented protocols. Collection of water-temperature data requires definition of data-quality objectives, good site selection, proper selection of instrumentation, proper installation of sensors, periodic site visits to maintain sensors and download data, pre- and post-deployment verification against an NIST-certified thermometer, potential data corrections, and proper documentation, review, and approval. A study created to develop a quality-assurance project plan, data-quality objectives, and a database management plan that includes procedures for data archiving and dissemination could provide a means to standardize a statewide stream-temperature database in Alaska. Protocols can be modified depending on desired accuracy or specific needs of data collected. This document is intended to guide users in collecting time series water-temperature data in Alaskan streams and draws extensively on the broader protocols already published by the U.S. Geological Survey.

Preoperative nutritional interventions in morbid obesity: impact on body weight, energy intake, and eating quality.

PubMed

Melendez-Araújo, Mariana Silva; de Matos Arruda, Sérgio Lincoln; de Oliveira Kelly, Emily; de Carvalho, Kênia Mara Baiocchi

2012-12-01

Although the benefits of preoperative weight loss and adequacy of dietary patterns in bariatric surgery is well-recognized, the nutritional strategies in the preoperative period have been scarcely investigated. We aimed to evaluate the impact of intensive and standard nutritional interventions on body weight, energy intake, and eating quality. This is a retrospective study in which 32 patients undergoing intensive nutritional intervention, with low-calorie diet (10 kcal/kg) and biweekly visits, were pair-matched by age, sex, and body mass index with 32 patients under a standard nutritional intervention, based on a general dietary counseling. Twenty-four-hour food recall was used to assess energy intake and to derive healthy eating index (HEI). The follow-up preoperative period varied from 8 to 16 weeks. Weight loss was observed in 72% of the patients from the intensive intervention group and 75% of the patients from the standard intervention group. According to the mixed model analysis, time effect on weight loss in both groups was significant (P = 0.0002); however, no difference was found between the intervention groups (P = 0.71). The time effect was significant in both groups for energy intake reduction as well (P < 0.0001), but no difference was found between the intervention groups (P = 0.25). Improvement of eating quality was expressed by the nutrient score of the HEI that increased significantly overtime (P = 0.02), also without distinction between the groups (P = 0.61). Both intensive and standard nutritional interventions promoted weight loss, energy intake reduction, and improvement of eating quality in morbidly obese patients during preoperative period.

A low emission vehicle procurement approach for Washington state

NASA Astrophysics Data System (ADS)

McCoy, G. A.; Lyons, J. K.; Ware, G.

1992-06-01

The Clean Air Washington Act of 1991 directs the Department of Ecology to establish a clean-fuel vehicle standard. The Department of General Administration shall purchase vehicles based on this standard beginning in the Fall of 1992. The following summarizes the major issues effecting vehicle emissions and their regulation, and present a methodology for procuring clean-fuel vehicles for the State of Washington. Washington State's air quality problems are much less severe than in other parts of the country such as California, the East Coast and parts of the Mid West. Ozone, which is arguably the dominant air quality problem in the US, is a recent and relatively minor issue in Washington. Carbon monoxide (CO) represents a more immediate problem in Washington, with most of the state's urban areas exceeding national CO air quality standards. Since the mid-1960's, vehicle tailpipe hydrocarbon and carbon monoxide emissions have been reduced by 96 percent relative to precontrol vehicles. Nitrogen oxide emissions have been reduced by 76 percent. Emissions from currently available vehicles are quite low with respect to in-place exhaust emission standards. Cold-start emissions constitute about 75 percent of the total emissions measured with the Federal Test Procedure used to certify motor vehicles. There is no currently available 'inherently clean burning fuel'. In 1991, 3052 vehicles were purchased under Washington State contract. Provided that the same number are acquired in 1993, the state will need to purchase 915 vehicles which meet the definition of a 'clean-fueled vehicle'.

The psychosocial benefits of secondary hydroxyapatite orbital implant insertion and prosthesis wearing for patients with anophthalmia.

PubMed

Wang, Junming; Zhang, Hong; Chen, Wei; Li, Guigang

2012-01-01

Anophthalmia is associated with a range of psychosocial difficulties and hydroxyapatite orbital implant insertion and prosthesis wearing is the predominant rehabilitation therapy for anophthalmia. However, few articles have compared preoperative and postoperative psychosocial outcomes using standardized questionnaires. This study aimed to investigate the psychosocial benefits of hydroxyapatite orbital implant insertion and prosthesis wearing in this patient population. In all, 36 participants were tested preoperatively and 6-months postoperatively using standardized measures of anxiety and depression (Hospital Anxiety and Depression Scale), social anxiety and social avoidance (Derriford Appearance Scale-Short Form), and quality of life (World Health Organization Quality of Life Scale-Short Form). Before treatment, levels of depression were comparable with population norms; however, levels of general anxiety were slightly raised, levels of social anxiety, social avoidance, and quality of life were significantly poorer than population norms. Treatment resulted in significant improvement in psychosocial adjustment with improvements in all study variables for the participant group as a whole. Hydroxyapatite orbital implant insertion and prosthesis wearing offers significant improvements in psychological and physical functioning for patients with anophthalmia.

British Thoracic Society quality standards for home oxygen use in adults

PubMed Central

Suntharalingam, Jay; Wilkinson, Tom; Annandale, Joseph; Davey, Claire; Fielding, Rhea; Freeman, Daryl; Gibbons, Michael; Hardinge, Maxine; Hippolyte, Sabrine; Knowles, Vikki; Lee, Cassandra; MacNee, William; Pollington, Jacqueline; Vora, Vandana; Watts, Trefor; Wijesinghe, Meme

2017-01-01

Introduction The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for home oxygen provision in the UK, together with measurable markers of good practice. Quality statements are based on the British Thoracic Society (BTS) Guideline for Home Oxygen Use in Adults. Methods Development of BTS Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards. Results 10 quality statements have been developed, each describing a key marker of high-quality, cost-effective care for home oxygen use, and each statement is supported by quality measures that aim to improve the structure, process and outcomes of healthcare. Discussion BTS Quality Standards for home oxygen use in adults form a key part of the range of supporting materials that the society produces to assist in the dissemination and implementation of a guideline’s recommendations. PMID:29018527

A new system for understanding modes of mechanical ventilation.

PubMed

Chatburn, R L; Primiano, F P

2001-06-01

Numerous ventilation modes and ventilation options have become available as new mechanical ventilators have reached the market. Ventilator manufacturers have no standardized terminology for ventilator modes and ventilation options, and ventilator operator's manuals do not help the clinician compare the modes of ventilators from different manufacturers. This article proposes a standardized system for classifying ventilation modes, based on general engineering principles and a small set of explicit definitions. Though there may be resistance by ventilator manufacturers to a standardized system of ventilation terminology, clinicians and health care equipment purchasers should adopt such a system in the interest of clear communication--the lack of which prevents clinicians from fully understanding the therapies they administer and could compromise the quality of patient care.

Environmental Health Standards for Human Spacecraft

NASA Technical Reports Server (NTRS)

James John T.

2010-01-01

The discussion of air and water quality standards includes evidence-based standards, factors unique to spaceflight, effects from exposures to combinations of compounds, contingency versus nominal standards, tables of ISO standards for air quality (ppm) and water quality (mg/L), and updating of standards.

Evaluation of features to support safety and quality in general practice clinical software

PubMed Central

2011-01-01

Background Electronic prescribing is now the norm in many countries. We wished to find out if clinical software systems used by general practitioners in Australia include features (functional capabilities and other characteristics) that facilitate improved patient safety and care, with a focus on quality use of medicines. Methods Seven clinical software systems used in general practice were evaluated. Fifty software features that were previously rated as likely to have a high impact on safety and/or quality of care in general practice were tested and are reported here. Results The range of results for the implementation of 50 features across the 7 clinical software systems was as follows: 17-31 features (34-62%) were fully implemented, 9-13 (18-26%) partially implemented, and 9-20 (18-40%) not implemented. Key findings included: Access to evidence based drug and therapeutic information was limited. Decision support for prescribing was available but varied markedly between systems. During prescribing there was potential for medicine mis-selection in some systems, and linking a medicine with its indication was optional. The definition of 'current medicines' versus 'past medicines' was not always clear. There were limited resources for patients, and some medicines lists for patients were suboptimal. Results were provided to the software vendors, who were keen to improve their systems. Conclusions The clinical systems tested lack some of the features expected to support patient safety and quality of care. Standards and certification for clinical software would ensure that safety features are present and that there is a minimum level of clinical functionality that clinicians could expect to find in any system.

Performing well in financial management and quality of care: evidence from hospital process measures for treatment of cardiovascular disease.

PubMed

Dong, Gang Nathan

2015-02-01

Fiscal constraints faced by U.S. hospitals as a result of the recent economic downturn are leading to business practices that reduce costs and improve financial and operational efficiency in hospitals. There naturally arises the question of how this finance-driven management culture could affect the quality of care. This paper attempts to determine whether the process measures of treatment quality are correlated with hospital financial performance. Panel study of hospital care quality and financial condition between 2005 and 2010 for cardiovascular disease treatment at acute care hospitals in the United States. Process measures for condition-specific treatment of heart attack and heart failure and hospital-level financial condition ratios were collected from the CMS databases of Hospital Compare and Cost Reports. There is a statistically significant relationship between hospital financial performance and quality of care. Hospital profitability, financial leverage, asset liquidity, operating efficiency, and costs appear to be important factors of health care quality. In general, public hospitals provide lower quality care than their nonprofit counterparts, and urban hospitals report better quality score than those located in rural areas. Specifically, the first-difference regression results indicate that the quality of treatment for cardiovascular patients rises in the year following an increase in hospital profitability, financial leverage, and labor costs. The results suggest that, when a hospital made more profit, had the capacity to finance investment using debt, paid higher wages presumably to attract more skilled nurses, its quality of care would generally improve. While the pursuit of profit induces hospitals to enhance both quantity and quality of services they offer, the lack of financial strength may result in a lower standard of health care services, implying the importance of monitoring the quality of care among those hospitals with poor financial health.

How does employment quality relate to health and job satisfaction in Europe? A typological approach.

PubMed

Van Aerden, Karen; Puig-Barrachina, Vanessa; Bosmans, Kim; Vanroelen, Christophe

2016-06-01

The changing nature of employment in recent decades, due to an increased emphasis on flexibility and competitiveness in European labour markets, compels the need to assess the consequences of contemporary employment situations for workers. This article aims to study the relation between the quality of employment and the health and well-being of European workers, using data from the 2010 European Working Conditions Survey. A typology of employment arrangements, mapping out employment quality in the European labour force, is constructed by means of a Latent Class Cluster Analysis. This innovative approach shows that it is possible to condense multiple factors characterising the employment situation into five job types: Standard Employment Relationship-like (SER-like), instrumental, precarious unsustainable, precarious intensive and portfolio jobs. Binary logistic regression analyses show that, controlling for other work quality characteristics, this employment quality typology is related to self-perceived job satisfaction, general health and mental health. Precarious intensive jobs are associated with the worst and SER-like jobs with the best health and well-being situation. The findings presented in this study indicate that, among European wage workers, flexible and de-standardised employment tends to be related to lower job satisfaction, general health and mental health. The quality of employment is thus identified as an important social determinant of health (inequalities) in Europe. Copyright © 2016 Elsevier Ltd. All rights reserved.

How standard is standard care? Exploring control group outcomes in behaviour change interventions for young people with type 1 diabetes.

PubMed

Ayling, K; Brierley, S; Johnson, B; Heller, S; Eiser, C

2015-01-01

Poor descriptions of standard care may compromise interpretation of results in randomised controlled trials (RCTs) of health interventions. We investigated quality of standard care in RCTs of behaviour change interventions for young people with type 1 diabetes and consider implications for evaluating trial outcomes. We conducted systematic searches for articles published between 1999 and 2012. We extracted standard care descriptions and contacted trial authors to complete a checklist of standard care activities. The relationship between standard care quality and outcomes was examined via subgroup meta-analyses and meta-regression. Standard care descriptions, standard care quality, and relationships between standard care quality with medical and psychological outcomes. We identified 20 RCTs described across 26 articles. Published descriptions of standard care were limited to service-level features. Author responses indicated standard care provision extended beyond published accounts. Subgroup analyses suggested control groups receiving higher standard care quality showed larger improvements in both medical and psychological outcomes, although standard care quality did not predict outcomes significantly. The quality of care delivered to control group participants can influence outcomes of RCTs. Inadequate reporting exacerbates this issue by masking variations between trials. We argue for increased clarity in reporting standard care in future trials.

British Thoracic Society Quality Standards for acute non-invasive ventilation in adults

PubMed Central

Davies, Michael; Allen, Martin; Bentley, Andrew; Bourke, Stephen C; Creagh-Brown, Ben; D’Oliveiro, Rachel; Glossop, Alastair; Gray, Alasdair; Jacobs, Phillip; Mahadeva, Ravi; Moses, Rachael; Setchfield, Ian

2018-01-01

Introduction The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for the provision of acute non-invasive ventilation in adults together with measurable markers of good practice. Methods Development of British Thoracic Society (BTS) Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards. Results 6 quality statements have been developed, each describing a standard of care for the provision of acute non-invasive ventilation in the UK, together with measurable markers of good practice. Conclusion BTS Quality Standards for acute non-invasive ventilation in adults form a key part of the range of supporting materials that the Society produces to assist in the dissemination and implementation of guideline’s recommendations. PMID:29636979

7 CFR 996.30 - Incoming quality standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Incoming quality standards. 996.30 Section 996.30... Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE MINIMUM QUALITY AND HANDLING STANDARDS FOR DOMESTIC AND IMPORTED PEANUTS MARKETED IN THE UNITED STATES Quality and Handling Standards...

Comparing the importance of quality measurement themes in juvenile idiopathic inflammatory myositis between patients and families and healthcare professionals.

PubMed

Tory, Heather O; Carrasco, Ruy; Griffin, Thomas; Huber, Adam M; Kahn, Philip; Robinson, Angela Byun; Zurakowski, David; Kim, Susan

2018-04-19

A standardized set of quality measures for juvenile idiopathic inflammatory myopathies (JIIM) is not in use. Discordance has been shown between the importance ascribed to quality measures between patients and families and physicians. The objective of this study was to assess and compare the importance of various aspects of high quality care to patients with JIIM and their families with healthcare providers, to aid in future development of comprehensive quality measures. Surveys were developed by members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Juvenile Dermatomyositis Workgroup through a consensus process and administered to patients and families through the CureJM Foundation and to healthcare professionals through CARRA. The survey asked respondents to rate the importance of 19 items related to aspects of high quality care, using a Likert scale. Patients and families gave generally higher scores for importance to most of the quality measurement themes compared with healthcare professionals, with ratings of 13 of the 19 measures reaching statistical significance (p < 0.05). Of particular importance, however, was consensus between the groups on the top five most important items: quality of life, timely diagnosis, access to rheumatology, normalization of functioning/strength, and ability for self care. Despite overall differences in the rating of importance of quality indicators between patients and families and healthcare professionals, the groups agreed on the most important aspects of care. Recognizing areas of particular importance to patients and families, and overlapping in importance with providers, will promote the development of standardized quality measures with the greatest potential for improving care and outcomes for children with JIIM.

Quality of life, postnatal depression and baby gender.

PubMed

de Tychey, Claude; Briançon, Serge; Lighezzolo, Joëlle; Spitz, Elisabeth; Kabuth, Bernard; de Luigi, Valerie; Messembourg, Catherine; Girvan, Françoise; Rosati, Aurore; Thockler, Audrey; Vincent, Stephanie

2008-02-01

To study the impact of postnatal depression on the quality of life of young French mothers and to evaluate if the gender of their child influences this. Postnatal depression (PND) constitutes a major public health problem considering its high prevalence and consequences upon quality of life and parental skills. This research is a cross-sectional study during the postnatal period. This study was carried out during a two-month period. Data were collected by interview and questionnaires. The authors compared the prevalence rate of PND and life quality in a cohort of 181 women and measured the short-term impact of the child's birth. Postnatal depression strongly negatively influences all dimensions of life quality explored through the SF36, e.g. physical functioning (PF), physical Role (RP), bodily pain (BP), mental health (MH), emotional role (RE), social functioning (SF), vitality (VT), general health (GH), standardized physical component (PCS) and standardized mental component (MCS). The baby's gender (having a boy) also significantly reduces quality of life, irrespective of depressive state. There is a relationship between baby gender and PND. This research is the first to show that the birth of a boy reduces several dimensions of the mothers' quality of life. The importance of the impairment of quality of life in case of PND, as well as its effects on mother-child interaction, could justify prevention programs and early psychotherapeutic care. Further research needs to explore the effectiveness of programmes targeting the construction of parenting skills as a preventative measure against PND, especially for parents of boys.

Limited Documentation and Treatment Quality of Glycemic Inpatient Care in Relation to Structural Deficits of Heterogeneous Insulin Charts at a Large University Hospital.

PubMed

Kopanz, Julia; Lichtenegger, Katharina M; Sendlhofer, Gerald; Semlitsch, Barbara; Cuder, Gerald; Pak, Andreas; Pieber, Thomas R; Tax, Christa; Brunner, Gernot; Plank, Johannes

2018-02-09

Insulin charts represent a key component in the inpatient glycemic management process. The aim was to evaluate the quality of structure, documentation, and treatment of diabetic inpatient care to design a new standardized insulin chart for a large university hospital setting. Historically grown blank insulin charts in use at 39 general wards were collected and evaluated for quality structure features. Documentation and treatment quality were evaluated in a consecutive snapshot audit of filled-in charts. The primary end point was the percentage of charts with any medication error. Overall, 20 different blank insulin charts with variable designs and significant structural deficits were identified. A medication error occurred in 55% of the 102 audited filled-in insulin charts, consisting of prescription and management errors in 48% and 16%, respectively. Charts of insulin-treated patients had more medication errors relative to patients treated with oral medication (P < 0.01). Chart design did support neither clinical authorization of individual insulin prescription (10%), nor insulin administration confirmed by nurses' signature (25%), nor treatment of hypoglycemia (0%), which resulted in a reduced documentation and treatment quality in clinical practice 7%, 30%, 25%, respectively. A multitude of charts with variable design characteristics and structural deficits were in use across the inpatient wards. More than half of the inpatients had a chart displaying a medication error. Lack of structure quality features of the charts had an impact on documentation and treatment quality. Based on identified deficits and international standards, a new insulin chart was developed to overcome these quality hurdles.

Headache service quality: evaluation of quality indicators in 14 specialist-care centres.

PubMed

Schramm, Sara; Uluduz, Derya; Gouveia, Raquel Gil; Jensen, Rigmor; Siva, Aksel; Uygunoglu, Ugur; Gvantsa, Giorgadze; Mania, Maka; Braschinsky, Mark; Filatova, Elena; Latysheva, Nina; Osipova, Vera; Skorobogatykh, Kirill; Azimova, Julia; Straube, Andreas; Eren, Ozan Emre; Martelletti, Paolo; De Angelis, Valerio; Negro, Andrea; Linde, Mattias; Hagen, Knut; Radojicic, Aleksandra; Zidverc-Trajkovic, Jasna; Podgorac, Ana; Paemeleire, Koen; De Pue, Annelien; Lampl, Christian; Steiner, Timothy J; Katsarava, Zaza

2016-12-01

The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). Employing previously-developed instruments in 14 such centres, we made enquiries, in each, of health-care providers (doctors, nurses, psychologists, physiotherapists) and 50 patients, and analysed the medical records of 50 other patients. Enquiries were in 9 domains: diagnostic accuracy, individualized management, referral pathways, patient's education and reassurance, convenience and comfort, patient's satisfaction, equity and efficiency of the headache care, outcome assessment and safety. Our study showed that highly experienced headache centres treated their patients in general very well. The centres were content with their work and their patients were content with their treatment. Including disability and quality-of-life evaluations in clinical assessments, and protocols regarding safety, proved problematic: better standards for these are needed. Some centres had problems with follow-up: many specialised centres operated in one-touch systems, without possibility of controlling long-term management or the success of treatments dependent on this. This first Europe-wide quality study showed that the quality indicators were workable in specialist care. They demonstrated common trends, producing evidence of what is majority practice. They also uncovered deficits that might be remedied in order to improve quality. They offer the means of setting benchmarks against which service quality may be judged. The next step is to take the evaluation process into non-specialist care (EHF/LTB levels 1 and 2).

Health-related quality of life among community-dwelling patients with intractable neurological diseases and their caregivers in Japan.

PubMed

Miyashita, Mitsunori; Narita, Yugo; Sakamoto, Aki; Kawada, Norikazu; Akiyama, Miki; Kayama, Mami; Suzukamo, Yoshimi; Fukuhara, Shunichi

2011-02-01

The aims of this study were: (i) to clarify the general quality of life (QOL) of patients with intractable neurological disease; (ii) to clarify the general QOL of the caregivers of these patients; and (iii) to explore the association of QOL in patient-caregiver pairs. A cross-sectional survey was conducted between November 2003 and May 2004 among community-dwelling patients diagnosed with Parkinson's disease (PD), spinocerebellar degeneration (SCD), multiple system atrophy (MSA), and amyotrophic lateral sclerosis (ALS) and their caregivers using a mailed, self-administered questionnaire. To measure QOL, we used the Medical Outcome Study 36-Item Short Form (SF-36) for patients and the short form of the health-related QOL scale SF-36 (SF-8) for caregivers. A total of 418 questionnaires were analyzed. For the patients, all of the general QOL domains of the SF-36 were significantly lower than the national standard value for all of the diagnoses. Physical function, role physical, and role emotional domains were also low. For caregivers, all of the QOL summary scores of the SF-8 for all diagnoses were significantly lower than the national standard value. Although there were several significant correlations of QOL between patients and caregivers, overall the correlations were low. Support for patients with neurological diseases and their caregivers is needed in order to maintain physical and mental QOL. © 2010 The Authors. Psychiatry and Clinical Neurosciences © 2010 Japanese Society of Psychiatry and Neurology.

The Harvard Automated Processing Pipeline for Electroencephalography (HAPPE): Standardized Processing Software for Developmental and High-Artifact Data.

PubMed

Gabard-Durnam, Laurel J; Mendez Leal, Adriana S; Wilkinson, Carol L; Levin, April R

2018-01-01

Electroenchephalography (EEG) recordings collected with developmental populations present particular challenges from a data processing perspective. These EEGs have a high degree of artifact contamination and often short recording lengths. As both sample sizes and EEG channel densities increase, traditional processing approaches like manual data rejection are becoming unsustainable. Moreover, such subjective approaches preclude standardized metrics of data quality, despite the heightened importance of such measures for EEGs with high rates of initial artifact contamination. There is presently a paucity of automated resources for processing these EEG data and no consistent reporting of data quality measures. To address these challenges, we propose the Harvard Automated Processing Pipeline for EEG (HAPPE) as a standardized, automated pipeline compatible with EEG recordings of variable lengths and artifact contamination levels, including high-artifact and short EEG recordings from young children or those with neurodevelopmental disorders. HAPPE processes event-related and resting-state EEG data from raw files through a series of filtering, artifact rejection, and re-referencing steps to processed EEG suitable for time-frequency-domain analyses. HAPPE also includes a post-processing report of data quality metrics to facilitate the evaluation and reporting of data quality in a standardized manner. Here, we describe each processing step in HAPPE, perform an example analysis with EEG files we have made freely available, and show that HAPPE outperforms seven alternative, widely-used processing approaches. HAPPE removes more artifact than all alternative approaches while simultaneously preserving greater or equivalent amounts of EEG signal in almost all instances. We also provide distributions of HAPPE's data quality metrics in an 867 file dataset as a reference distribution and in support of HAPPE's performance across EEG data with variable artifact contamination and recording lengths. HAPPE software is freely available under the terms of the GNU General Public License at https://github.com/lcnhappe/happe.

The Harvard Automated Processing Pipeline for Electroencephalography (HAPPE): Standardized Processing Software for Developmental and High-Artifact Data

PubMed Central

Gabard-Durnam, Laurel J.; Mendez Leal, Adriana S.; Wilkinson, Carol L.; Levin, April R.

2018-01-01

Electroenchephalography (EEG) recordings collected with developmental populations present particular challenges from a data processing perspective. These EEGs have a high degree of artifact contamination and often short recording lengths. As both sample sizes and EEG channel densities increase, traditional processing approaches like manual data rejection are becoming unsustainable. Moreover, such subjective approaches preclude standardized metrics of data quality, despite the heightened importance of such measures for EEGs with high rates of initial artifact contamination. There is presently a paucity of automated resources for processing these EEG data and no consistent reporting of data quality measures. To address these challenges, we propose the Harvard Automated Processing Pipeline for EEG (HAPPE) as a standardized, automated pipeline compatible with EEG recordings of variable lengths and artifact contamination levels, including high-artifact and short EEG recordings from young children or those with neurodevelopmental disorders. HAPPE processes event-related and resting-state EEG data from raw files through a series of filtering, artifact rejection, and re-referencing steps to processed EEG suitable for time-frequency-domain analyses. HAPPE also includes a post-processing report of data quality metrics to facilitate the evaluation and reporting of data quality in a standardized manner. Here, we describe each processing step in HAPPE, perform an example analysis with EEG files we have made freely available, and show that HAPPE outperforms seven alternative, widely-used processing approaches. HAPPE removes more artifact than all alternative approaches while simultaneously preserving greater or equivalent amounts of EEG signal in almost all instances. We also provide distributions of HAPPE's data quality metrics in an 867 file dataset as a reference distribution and in support of HAPPE's performance across EEG data with variable artifact contamination and recording lengths. HAPPE software is freely available under the terms of the GNU General Public License at https://github.com/lcnhappe/happe. PMID:29535597

British Thoracic Society quality standards for the investigation and management of pulmonary nodules.

PubMed

Baldwin, David; Callister, Matthew; Akram, Ahsan; Cane, Paul; Draffan, Jeanette; Franks, Kevin; Gleeson, Fergus; Graham, Richard; Malhotra, Puneet; Pearson, Philip; Subesinghe, Manil; Waller, David; Woolhouse, Ian

2018-01-01

The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for the investigation and management of pulmonary nodules in the UK, together with measurable markers of good practice. Development of British Thoracic Society (BTS) Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards. 7 quality statements have been developed, each describing a key marker of high-quality, cost-effective care for the investigation and management of pulmonary nodules, and each statement is supported by quality measures that aim to improve the structure, process and outcomes of healthcare. BTS Quality Standards for the investigation and management of pulmonary nodules form a key part of the range of supporting materials that the Society produces to assist in the dissemination and implementation of guideline recommendations.

British Thoracic Society quality standards for the investigation and management of pulmonary nodules

PubMed Central

Baldwin, David; Callister, Matthew; Akram, Ahsan; Cane, Paul; Draffan, Jeanette; Franks, Kevin; Gleeson, Fergus; Graham, Richard; Malhotra, Puneet; Pearson, Philip; Subesinghe, Manil; Waller, David; Woolhouse, Ian

2018-01-01

Introduction The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for the investigation and management of pulmonary nodules in the UK, together with measurable markers of good practice. Methods Development of British Thoracic Society (BTS) Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards. Results 7 quality statements have been developed, each describing a key marker of high-quality, cost-effective care for the investigation and management of pulmonary nodules, and each statement is supported by quality measures that aim to improve the structure, process and outcomes of healthcare. Discussion BTS Quality Standards for the investigation and management of pulmonary nodules form a key part of the range of supporting materials that the Society produces to assist in the dissemination and implementation of guideline recommendations. PMID:29682290

Lessons Learned on Quality (of) Standards

NASA Astrophysics Data System (ADS)

Gerlich, Rainer; Gerlich, Ralf

2011-08-01

Standards are used to describe and ensure the quality of products, services and processes throughout almost all branches of industry, including the field of software engineering. Contractors and suppliers are obligated by their customers and certification authorities to follow a certain set of standards during development. For example, a customer can easier actively participate in and control the contractor's process when enforcing a standard process..However, as with any requirement, a standard may also impede the contractor or supplier in assuring actual quality of the product in the sense of fitness for the purpose intended by the customer.This is the case when a standard defines specific quality assurance activities requiring a considerable amount of effort while other more efficient but equivalent or even superior approaches are blocked. Then improvement of the ratio between cost and quality exceeding miniscule advances is heavily impeded.While in some parts being too specific in defining the mechanisms of the enforced process, standards are sometimes too weak in defining the principles or goals on control of product quality.Therefore this paper addresses the following issues: (1) Which conclusions can be drawn on the quality and efficiency of a standard? (2) If and how is it possible to improve or evolve a standard? (3) How well does a standard guide a user towards high quality of the end product?One conclusion is that the analyzed standards do interfere with technological innovation, though the standards leave a lot of freedom for concretization and are understood as technology-independent.Another conclusion is that standards are not only a matter of quality but also a matter of competitiveness of the industry depending on resulting costs and time-to- market. When the costs induced by a standard are not adequate to the achievable quality, industry encounters a significant disadvantage.

40 CFR 131.10 - Designation of uses.

Code of Federal Regulations, 2012 CFR

2012-07-01

... QUALITY STANDARDS Establishment of Water Quality Standards § 131.10 Designation of uses. (a) Each State... and the appropriate criteria for those uses, the State shall take into consideration the water quality standards of downstream waters and shall ensure that its water quality standards provide for the attainment...

40 CFR 131.10 - Designation of uses.

Code of Federal Regulations, 2013 CFR

2013-07-01

... QUALITY STANDARDS Establishment of Water Quality Standards § 131.10 Designation of uses. (a) Each State... and the appropriate criteria for those uses, the State shall take into consideration the water quality standards of downstream waters and shall ensure that its water quality standards provide for the attainment...

75 FR 44930 - Stakeholder Input; Revisions to Water Quality Standards Regulation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-30

... Input; Revisions to Water Quality Standards Regulation AGENCY: Environmental Protection Agency. ACTION... national rulemaking to make a limited set of targeted changes to EPA's water quality standards regulation... rulemaking, and to hear views from the public regarding possible changes to EPA's water quality standards...

Review of Selected References and Data sets on Ambient Ground- and Surface-Water Quality in the Metedeconk River, Toms River, and Kettle Creek Basins, New Jersey, 1980-2001

USGS Publications Warehouse

Nicholson, Robert S.; Hunchak-Kariouk, Kathryn; Cauller, Stephen J.

2003-01-01

Surface water and ground water from unconfined aquifers are the primary sources of drinking water for much of the population, about 391,000, in the Metedeconk River, Toms River, and Kettle Creek watersheds in the New Jersey Coastal Plain. The quality of these sources of drinking water is a concern because they are vulnerable to contamination. Indications of the occurrence, distribution, and likely sources and transport mechanisms of certain contaminants were obtained from 48 selected reports and 2 selected data sets on water quality in or near the watersheds (1980-2001). These indications are described and briefly summarized in this report. The findings of studies on ground-water quality indicate that shallow ground water within the study area generally meets primary drinking-water standards, with notable exceptions. Volatile organic compounds, mercury, arsenic, radionuclides, nitrate, and coliform bacteria have been detected in shallow ground water in some areas at levels that exceed Federal and State drinking-water standards. For example, results of analyses of untreated samples collected from more than 13,000 private wells during 1983-99 indicated that concentrations of volatile organic compounds in samples from 7.3 percent of the wells exceeded at least 1 of 11 drinking-water standards, according to records maintained by the Ocean County Health Department. In cases of exceedances, however, water treatment, well replacement, and (or) retesting assured that applicable drinking-water standards were being met at the tap. Reported concentrations of the pesticide chlordane in some areas exceeded the drinking-water standard; few data are available on the occurrence of other pesticides. Studies of nearby areas, however, indicate that pesticide concentrations generally could be expected to be below drinking-water standards. The combination of low pH and low dissolved solids in many areas results in shallow ground water that is highly corrosive and, if untreated, able to leach trace elements and release asbestos fibers from plumbing materials. Reported concentrations of nitrate, volatile organic compounds, trace elements, and pesticides in samples from the monitored mainstem and tributary streams within the study area generally are below maximum contaminant levels for drinking water or below detection limits. Results of studies in other areas indicate that pesticide concentrations in surface water could be considerably higher during high flows soon after the application of pesticides to crops than during low flows. Fecal coliform bacteria counts in streams vary considerably. Concentrations or counts of these classes of surface-water-quality constituents likely are functions of the intensity and type of upstream development. Results of limited monitoring for radionuclide concentrations reported by the Brick Township Municipal Utilities Authority of the Metedeconk River indicate that radionuclide concentrations or activities do not exceed maximum contaminant levels for drinking water. As a consequence of organic matter in surface water, the formati ultraviolet absorbance in samples from the Metedeconk River and the Toms River exceeded the alternative compliance criteria for source water (2.0 milligrams per liter for total organic carbon and 0.02 absorbance units-liters per milligram-centimeter for specific ultraviolet absorbance) with respect to treatment requirements for preventing elevated concentrations of disinfection by-products in treated water. Water-quality and treatment issues associated with use of ground and surface water for potable supply in the study area are related to human activities and naturally occurring factors. Additional monitoring and analysis of ground and surface water would be needed to determine conclusively the occurrence and distribution of some contaminants and the relative importance of various potential contaminant sources, transport and attenuation mechanisms, and transport pathways.

Quality and market chain of Aceh Cocoa Beans

NASA Astrophysics Data System (ADS)

Irfan; Sulaiman, I.; Ikhsan, CN; Faizun, N.

2018-05-01

After long-lasting conflict and tsunami on December 26, 2004, some international donors/NGOs supported Aceh on cocoa development. Aceh cocoa sector has experienced tremendous growth in Indonesia. This study aims to investigate quality and market chain of Aceh cocoa beans. The survey was conducted in Pidie District. A number of 21 farmers and 1 exporter were interviewed; the beans from farmer’s warehouses were analyzed and compared to Indonesia National Standard (INS). The result showed that the beans were generally produced from 6 Sub-Districts: Keumala, Titeue, Glumpang Tiga, Padang Tiji, and Tangse. They were not fermented; most were exported to the USA. Based on bean count, quality was mainly included in I/A and II/B. The main quality problem was high moisture content. Presumably, the beans were bought by wholesalers with lower price although not been sufficiently dried. Other quality parameters were good: no moldy bean and contaminant, very low insect damage/hollow-/germinated beans, and tiny broken beans (quality I)

78 FR 30770 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards Revision AGENCY... Illinois state implementation plan (SIP) to reflect current National Ambient Air Quality Standards (NAAQS... Implementation Plan at 35 Illinois Administrative Code part 243, which updates National Ambient Air Quality...

75 FR 65572 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality Standards AGENCY... Ohio Administrative Code (OAC) relating to the consolidation of Ohio's Ambient Air Quality Standards... apply to Ohio's SIP. Incorporating the air quality standards into Ohio's SIP helps assure that...

What do we really know about UK paediatric dental general anaesthesia services?

PubMed

Robertson, S; Ní Chaollaí, A; Dyer, T A

2012-02-24

Dental general anaesthesia (DGA) is only permitted within a hospital setting where critical care facilities are available. Recently, concern has been expressed about the number of hospital admissions for the dental care of children following the publication of a high profile paper which highlighted an apparent increase in children being admitted for extractions due to caries under DGA. Coincidentally new best practice standards for paediatric DGA services have been published. An evaluation of DGA services in Yorkshire and the Humber suggested that existing monitoring was inadequate and is unlikely to represent true levels of activity and that any apparent increase may reflect the method of remuneration for services. In fact, recent changes in service structure and changes to improve quality have reduced DGA activity in some areas. In addition, the evaluation revealed that many services were not meeting standards of best practice.

Reliability of Real-time Ultrasound Imaging for the Assessment of Trunk Stabilizer Muscles: A Systematic Review of the Literature.

PubMed

Taghipour, Morteza; Mohseni-Bandpei, Mohammad Ali; Behtash, Hamid; Abdollahi, Iraj; Rajabzadeh, Fatemeh; Pourahmadi, Mohammad Reza; Emami, Mahnaz

2018-04-24

Rehabilitative ultrasound (US) imaging is one of the popular methods for investigating muscle morphologic characteristics and dimensions in recent years. The reliability of this method has been investigated in different studies. As studies have been performed with different designs and quality, reported values of rehabilitative US have a wide range. The objective of this study was to systematically review the literature conducted on the reliability of rehabilitative US imaging for the assessment of deep abdominal and lumbar trunk muscle dimensions. The PubMed/MEDLINE, Scopus, Google Scholar, Science Direct, Embase, Physiotherapy Evidence, Ovid, and CINAHL databases were searched to identify original research articles conducted on the reliability of rehabilitative US imaging published from June 2007 to August 2017. The articles were qualitatively assessed; reliability data were extracted; and the methodological quality was evaluated by 2 independent reviewers. Of the 26 included studies, 16 were considered of high methodological quality. Except for 2 studies, all high-quality studies reported intraclass correlation coefficients (ICCs) for intra-rater reliability of 0.70 or greater. Also, ICCs reported for inter-rater reliability in high-quality studies were generally greater than 0.70. Among low-quality studies, reported ICCs ranged from 0.26 to 0.99 and 0.68 to 0.97 for intra- and inter-rater reliability, respectively. Also, the reported standard error of measurement and minimal detectable change for rehabilitative US were generally in an acceptable range. Generally, the results of the reviewed studies indicate that rehabilitative US imaging has good levels of both inter- and intra-rater reliability. © 2018 by the American Institute of Ultrasound in Medicine.

78 FR 34964 - Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

...] Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation Plan... Ambient Air Quality Standards for Ozone: State Implementation Plan Requirements'' which published in the... the 2008 ozone national ambient air quality standards (NAAQS) (the ``2008 ozone NAAQS'') that were...

78 FR 54517 - Water Quality Standards Regulatory Clarifications

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-04

... 131 Water Quality Standards Regulatory Clarifications; Proposed Rule #0;#0;Federal Register / Vol. 78... AGENCY 40 CFR Part 131 [EPA-HQ-OW-2010-0606; FRL-9839-7] RIN 2040-AF 16 Water Quality Standards... Environmental Protection Agency (EPA) is proposing changes to the federal water quality standards (WQS...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Minimum standards of quality. 953.43 Section 953.43... SOUTHEASTERN STATES Order Regulating Handling Regulations § 953.43 Minimum standards of quality. (a) Recommendation. Whenever the committee deems it advisable to establish and maintain minimum standards of quality...