Air Quality Criteria for Ozone and Related Photochemical ...

EPA Pesticide Factsheets

In February 2006, EPA released the final document, Air Quality Criteria for Ozone and Other Photochemical Oxidants. Tropospheric or surface-level ozone (O3) is one of six major air pollutants regulated by National Ambient Air Quality Standards (NAAQS) under the U.S. Clean Air Act. As mandated by the Clean Air Act, the U.S. Environmental Protection Agency (EPA) must periodically review the scientific bases (or criteria) for the various NAAQS by assessing newly available scientific information on a given criteria air pollutant. This document, Air Quality Criteria for Ozone and Other Photochemical Oxidants, is an updated revision of the 1996 Ozone Air Quality Criteria Document (O3 AQCD) that provided scientific bases for the current O3 NAAQS set in 1997. The Clean Air Act mandates periodic review of the National Ambient Air Quality Standards (NAAQS) for six common air pollutants, also referred to as criteria pollutants, including ozone.

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.

Board oversight of patient care quality in community health systems.

PubMed

Prybil, Lawrence D; Peterson, Richard; Brezinski, Paul; Zamba, Gideon; Roach, William; Fillmore, Ammon

2010-01-01

In hospitals and health systems, ensuring that standards for the quality of patient care are established and continuous improvement processes are in place are among the board's most fundamental responsibilities. A recent survey has examined governance oversight of patient care quality at 123 nonprofit community health systems and compared their practices with current benchmarks of good governance. The findings show that 88% of the boards have established standing committees on patient quality and safety, nearly all chief executive officers' performance expectations now include targets related to patient quality and safety, and 96% of the boards regularly receive formal written reports regarding their organizations' performance in relation to quality measures and standards. However, there continue to be gaps between present reality and current benchmarks of good governance in several areas. These gaps are somewhat greater for independent systems than for those affiliated with a larger parent organization.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-21

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

NASIS data base management system - IBM 360/370 OS MVT implementation. 1: Installation standards

NASA Technical Reports Server (NTRS)

1973-01-01

The installation standards for the NASA Aerospace Safety Information System (NASIS) data base management system are presented. The standard approach to preparing systems documentation and the program design and coding rules and conventions are outlined. Included are instructions for preparing all major specifications and suggestions for improving the quality and efficiency of the programming task.

An assessment of scientific and technical aspects of closed investigations of canine forensics DNA – case series from the University of California, Davis, USA

PubMed Central

Scharnhorst, Günther; Kanthaswamy, Sree

2011-01-01

Aim To describe and assess the scientific and technical aspects of animal forensic testing at the University of California, Davis. The findings and recommendations contained in this report are designed to assess the past, evaluate the present, and recommend reforms that will assist the animal forensic science community in providing the best possible services that comply with court standards and bear judicial scrutiny. Methods A batch of 32 closed files of domestic dog DNA cases processed at the University of California, Davis, between August 2003 and July 2005 were reviewed in this study. The case files comprised copies of all original paperwork, copies of the cover letter or final report, laboratory notes, notes on analyses, submission forms, internal chains of custody, printed images and photocopies of evidence, as well as the administrative and technical reviews of those cases. Results While the fundamental aspects of animal DNA testing may be reliable and acceptable, the scientific basis for forensic testing animal DNA needs to be improved substantially. In addition to a lack of standardized and validated genetic testing protocols, improvements are needed in a wide range of topics including quality assurance and quality control measures, sample handling, evidence testing, statistical analysis, and reporting. Conclusion This review implies that although a standardized panel of short tandem repeat and mitochondrial DNA markers and publicly accessible genetic databases for canine forensic DNA analysis are already available, the persistent lack of supporting resources, including standardized quality assurance and quality control programs, still plagues the animal forensic community. This report focuses on closed cases from the period 2003-2005, but extends its scope more widely to include other animal DNA forensic testing services. PMID:21674824

An assessment of scientific and technical aspects of closed investigations of canine forensics DNA--case series from the University of California, Davis, USA.

PubMed

Scharnhorst, Günther; Kanthaswamy, Sree

2011-06-01

To describe and assess the scientific and technical aspects of animal forensic testing at the University of California, Davis. The findings and recommendations contained in this report are designed to assess the past, evaluate the present, and recommend reforms that will assist the animal forensic science community in providing the best possible services that comply with court standards and bear judicial scrutiny. A batch of 32 closed files of domestic dog DNA cases processed at the University of California, Davis, between August 2003 and July 2005 were reviewed in this study. The case files comprised copies of all original paperwork, copies of the cover letter or final report, laboratory notes, notes on analyses, submission forms, internal chains of custody, printed images and photocopies of evidence, as well as the administrative and technical reviews of those cases. While the fundamental aspects of animal DNA testing may be reliable and acceptable, the scientific basis for forensic testing animal DNA needs to be improved substantially. In addition to a lack of standardized and validated genetic testing protocols, improvements are needed in a wide range of topics including quality assurance and quality control measures, sample handling, evidence testing, statistical analysis, and reporting. This review implies that although a standardized panel of short tandem repeat and mitochondrial DNA markers and publicly accessible genetic databases for canine forensic DNA analysis are already available, the persistent lack of supporting resources, including standardized quality assurance and quality control programs, still plagues the animal forensic community. This report focuses on closed cases from the period 2003-2005, but extends its scope more widely to include other animal DNA forensic testing services.

Simulation with standardized patients to prepare undergraduate nursing students for mental health clinical practice: An integrative literature review.

PubMed

Øgård-Repål, Anita; De Presno, Åsne Knutson; Fossum, Mariann

2018-07-01

To evaluate the available evidence supporting the efficacy of using simulation with standardized patients to prepare nursing students for mental health clinical practice. Integrative literature review. A systematic search of the electronic databases CINAHL (EBSCOhost), Embase, MEDLINE, PsycINFO, and SveMed+ was conducted to identify empirical studies published until November 2016. Multiple search terms were used. Original empirical studies published in English and exploring undergraduate nursing students' experiences of simulation with standardized patients as preparation for mental health nursing practice were included. A search of reference lists and gray literature was also conducted. In total, 1677 studies were retrieved; the full texts of 78 were screened by 2 of the authors, and 6 studies reminded in the review. The authors independently reviewed the studies in three stages by screening the titles, abstracts, and full texts, and the quality of the included studies was assessed in the final stage. Design-specific checklists were used for quality appraisal. The thematic synthesizing method was used to summarize the findings of the included studies. The studies used four different research designs, both qualitative and quantitative. All studies scored fairly low in the quality appraisal. The five themes identified were enhanced confidence, clinical skills, anxiety regarding the unknown, demystification, and self-awareness. The findings of this study indicate that simulation with standardized patients could decrease students' anxiety level, shatter pre-assumptions, and increase self-confidence and self-awareness before entering clinical practice in mental health. More high-quality studies with larger sample sizes are required because of the limited evidence provided by the six studies in the present review. Copyright © 2018 Elsevier Ltd. All rights reserved.

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

Nursing Quality Assurance: The Wisconsin System

ERIC Educational Resources Information Center

Hover, Julie; Zimmer, Marie J.

1978-01-01

Evaluation model guidelines for hospital departments of nursing to use in their nursing quality assurance programs are presented as developed in Wisconsin. Four essential components of the Wisconsin outcome evaluation system are criteria, assessment, standards, and improvement of care. Sample tests and charts are included in the article. (MF)

Comparison of the NIST and PTB Air-Kerma Standards for Low-Energy X-Rays.

PubMed

O'Brien, Michelle; Bueermann, Ludwig

2009-01-01

A comparison has been made of the air-kerma standards for low-energy x rays at the National Institute of Standards and Technology (NIST) and the Physikalisch-Technische Bundesanstalt (PTB). The comparison involved a series of measurements at the PTB and the NIST using the air-kerma standards and two NIST reference-class transfer ionization chamber standards. Results are presented for the reference radiation beam qualities in the range from 25 kV to 50 kV for low energy x rays, including the techniques used for mammography dose traceability. The tungsten generated reference radiation qualities, between 25 kV and 50 kV used for this comparison, are new to NIST; therefore this comparison will serve as the preliminary comparison for NIST and a verification of the primary standard correction factors. The mammography comparison will repeat two previously unpublished comparisons between PTB and NIST. The results show the standards to be in reasonable agreement within the standard uncertainty of the comparison of about 0.4 %.

7 CFR 29.3533 - Nested.

Code of Federal Regulations, 2013 CFR

2013-01-01

... INSPECTION Standards Official Standard Grades for Dark Air-Cured Tobacco (u.s. Types 35, 36, 37 and Foreign... arranged to conceal foreign matter or tobacco of inferior grade, quality, or condition. Nested includes: (a) Any lot of tobacco which contains foreign matter or damaged, injured, tangled, or other inferior...

7 CFR 29.3533 - Nested.

Code of Federal Regulations, 2012 CFR

2012-01-01

... INSPECTION Standards Official Standard Grades for Dark Air-Cured Tobacco (u.s. Types 35, 36, 37 and Foreign... arranged to conceal foreign matter or tobacco of inferior grade, quality, or condition. Nested includes: (a) Any lot of tobacco which contains foreign matter or damaged, injured, tangled, or other inferior...

7 CFR 29.3533 - Nested.

Code of Federal Regulations, 2011 CFR

2011-01-01

... INSPECTION Standards Official Standard Grades for Dark Air-Cured Tobacco (u.s. Types 35, 36, 37 and Foreign... arranged to conceal foreign matter or tobacco of inferior grade, quality, or condition. Nested includes: (a) Any lot of tobacco which contains foreign matter or damaged, injured, tangled, or other inferior...

7 CFR 29.3533 - Nested.

Code of Federal Regulations, 2014 CFR

2014-01-01

... INSPECTION Standards Official Standard Grades for Dark Air-Cured Tobacco (u.s. Types 35, 36, 37 and Foreign... arranged to conceal foreign matter or tobacco of inferior grade, quality, or condition. Nested includes: (a) Any lot of tobacco which contains foreign matter or damaged, injured, tangled, or other inferior...

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...

16 CFR § 1031.17 - Background.

Code of Federal Regulations, 2013 CFR

2013-01-01

... voluntary standards Web site be expanded to include information on all standards activities. (d) On August 4... pilot program covered information on CPSC staff participation with respect to a cross-section of... participation would enhance the quality and conclusions of the proposed recommendations made by CPSC staff. (b...

Water quality program elements for Space Station Freedom

NASA Technical Reports Server (NTRS)

Sauer, Richard L.; Ramanathan, Raghupathy; Straub, John E.; Schultz, John R.

1991-01-01

A strategy is outlined for the development of water-quality criteria and standards relevant to recycling and monitoring the in-flight water for the Space Station Freedom (SSF). The water-reclamation subsystem of the SSF's ECLSS is described, and the objectives of the water-quality are set forth with attention to contaminants. Quality parameters are listed for potable and hygiene-related water including physical and organic parameters, inorganic constituents, bactericides, and microbial content. Comparisons are made to the quality parameters established for the Shuttle's potable water and to the EPA's current standards. Specific research is required to develop in-flight monitoring techniques for unique SSF contaminants, ECLSS microbial control, and on- and off-line monitoring. After discussing some of the in-flight water-monitoring hardware it is concluded that water reclamation and recycling are necessary and feasible for the SSF.

[Methodological quality and reporting quality evaluation of randomized controlled trials published in China Journal of Chinese Materia Medica].

PubMed

Yu, Dan-Dan; Xie, Yan-Ming; Liao, Xing; Zhi, Ying-Jie; Jiang, Jun-Jie; Chen, Wei

2018-02-01

To evaluate the methodological quality and reporting quality of randomized controlled trials(RCTs) published in China Journal of Chinese Materia Medica, we searched CNKI and China Journal of Chinese Materia webpage to collect RCTs since the establishment of the magazine. The Cochrane risk of bias assessment tool was used to evaluate the methodological quality of RCTs. The CONSORT 2010 list was adopted as reporting quality evaluating tool. Finally, 184 RCTs were included and evaluated methodologically, of which 97 RCTs were evaluated with reporting quality. For the methodological evaluating, 62 trials(33.70%) reported the random sequence generation; 9(4.89%) trials reported the allocation concealment; 25(13.59%) trials adopted the method of blinding; 30(16.30%) trials reported the number of patients withdrawing, dropping out and those lost to follow-up;2 trials （1.09%） reported trial registration and none of the trial reported the trial protocol; only 8(4.35%) trials reported the sample size estimation in details. For reporting quality appraising, 3 reporting items of 25 items were evaluated with high-quality,including: abstract, participants qualified criteria, and statistical methods; 4 reporting items with medium-quality, including purpose, intervention, random sequence method, and data collection of sites and locations; 9 items with low-quality reporting items including title, backgrounds, random sequence types, allocation concealment, blindness, recruitment of subjects, baseline data, harms, and funding;the rest of items were of extremely low quality(the compliance rate of reporting item<10%). On the whole, the methodological and reporting quality of RCTs published in the magazine are generally low. Further improvement in both methodological and reporting quality for RCTs of traditional Chinese medicine are warranted. It is recommended that the international standards and procedures for RCT design should be strictly followed to conduct high-quality trials. At the same time, in order to improve the reporting quality of randomized controlled trials, CONSORT standards should be adopted in the preparation of research reports and submissions. Copyright© by the Chinese Pharmaceutical Association.

Parasitology: United Kingdom National Quality Assessment Scheme.

PubMed Central

Hawthorne, M.; Chiodini, P. L.; Snell, J. J.; Moody, A. H.; Ramsay, A.

1992-01-01

AIMS: To assess the results from parasitology laboratories taking part in a quality assessment scheme between 1986 and 1991; and to compare performance with repeat specimens. METHODS: Quality assessment of blood parasitology, including tissue parasites (n = 444; 358 UK, 86 overseas), and faecal parasitology, including extra-intestinal parasites (n = 205; 141 UK, 64 overseas), was performed. RESULTS: Overall, the standard of performance was poor. A questionnaire distributed to participants showed that a wide range of methods was used, some of which were considered inadequate to achieve reliable results. Teaching material was distributed to participants from time to time in an attempt to improve standards. CONCLUSIONS: Since the closure of the IMLS fellowship course in 1972, fewer opportunities for specialised training in parasitology are available: more training is needed. Poor performance in the detection of malarial parasites is mainly attributable to incorrect speciation, misidentification, and lack of equipment such as an eyepiece graticule. PMID:1452791

Quality specifications in postgraduate medical e-learning: an integrative literature review leading to a postgraduate medical e-learning model.

PubMed

De Leeuw, R A; Westerman, Michiel; Nelson, E; Ket, J C F; Scheele, F

2016-07-08

E-learning is driving major shifts in medical education. Prioritizing learning theories and quality models improves the success of e-learning programs. Although many e-learning quality standards are available, few are focused on postgraduate medical education. We conducted an integrative review of the current postgraduate medical e-learning literature to identify quality specifications. The literature was thematically organized into a working model. Unique quality specifications (n = 72) were consolidated and re-organized into a six-domain model that we called the Postgraduate Medical E-learning Model (Postgraduate ME Model). This model was partially based on the ISO-19796 standard, and drew on cognitive load multimedia principles. The domains of the model are preparation, software design and system specifications, communication, content, assessment, and maintenance. This review clarified the current state of postgraduate medical e-learning standards and specifications. It also synthesized these specifications into a single working model. To validate our findings, the next-steps include testing the Postgraduate ME Model in controlled e-learning settings.

Water quality of the Garang River, Semarang, Central Java, Indonesia based on the government regulation standard

NASA Astrophysics Data System (ADS)

Ujianti, R. M. D.; Anggoro, S.; Bambang, A. N.; Purwanti, F.

2018-05-01

The Garang watershed composed by three main river streams has been managed by the Regional water company of the Semarang city, Central Java for drinking water supply. A river is often polluted by domestic waste and industrial effluents. Therefore water quality of the river should be keep to meet the Government regulation standard. The study aims to analyze water quality of the Garang’ river using pollution index based on the government regulation. Series data from 2010 to 2016 were derived from the Environmental and Forestry Office of the Central Java Province and sampling of water quality was taken in August 2017 from the middle of watershed area. Water quality parameters include temperature, pH, TDS, DO, COD, Phosphate, Nitrate, Chromium, Copper, Cadmium and H2S. The research indicates that concentration of Copper has exceeds the standard of the Government Regulation No. 82 Year 2001. The water pollution index is 1.23, its means that the river is lightly polluted. Therefore the river should be managed comprehensively for sustainable uses in order to create one river one management concept.

The use of data for process and quality improvement in long term care and home care: a systematic review of the literature.

PubMed

Sales, Anne E; Bostrom, Anne-Marie; Bucknall, Tracey; Draper, Kellie; Fraser, Kimberly; Schalm, Corinne; Warren, Sharon

2012-02-01

Standardized resident or client assessments, including the Resident Assessment Instrument (RAI), have been available in long term care and home care settings (continuing care sector) in many jurisdictions for a number of years. Although using these data can make quality improvement activities more efficient and less costly, there has not been a review of the literature reporting quality improvement interventions using standardized data. To address 2 questions: (1) How have RAI and other standardized data been used in process or quality improvement activities in the continuing care sector? and (2) Has the use of RAI and similar data resulted in improvements to resident or other outcomes? Searches using a combination of keyword and controlled vocabulary term searches were conducted in MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, the Cochrane Library, and PsychINFO. ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: English language publications from database inception to October 2008 were included. Eligibility criteria included the following: (1) set in continuing care (long-term care facility or home care), (2) involved some form of intervention designed to improve quality or process of care, and (3) used standardized data in the quality or process improvement intervention. After reviewing the articles, we grouped the studies according to the type of intervention used to initiate process improvement. Four different intervention types were identified. We organized the results and discussion by these 4 intervention types. Key word searches identified 713 articles, of which we excluded 639 on abstract review because they did not meet inclusion criteria. A further 50 articles were excluded on full-text review, leaving a total of 24 articles. Of the 24 studies, 10 used a defined process improvement model, 8 used a combination of interventions (multimodal), 5 implemented new guidelines or protocols, and 1 used an education intervention. The most frequently cited issues contributing to unsuccessful quality improvement interventions were lack of staff, high staff turnover, and limited time available to train staff in ways that would improve client care. Innovative strategies and supporting research are required to determine how to intervene successfully to improve quality in these settings characterized by low staffing levels and predominantly nonprofessional staff. Research on how to effectively enable practitioners to use data to improve quality of care, and ultimately quality of life, needs to be a priority. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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.

International Organization for Standardization (ISO) 15189.

PubMed

Schneider, Frank; Maurer, Caroline; Friedberg, Richard C

2017-09-01

The College of American Pathologists (CAP) offers a suite of laboratory accreditation programs, including one specific to accreditation to the international organization for standardization (ISO) 15189 standard for quality management specific to medical laboratories. CAP leaders offer an overview of ISO 15189 including its components, internal audits, occurrence management, document control, and risk management. The authors provide a comparison of its own ISO 15189 program, CAP 15189, to the CAP Laboratory Accreditation Program. The authors conclude with why laboratories should use ISO 15189. © The Korean Society for Laboratory Medicine.

Data Quality and Interoperability Challenges for eHealth Exchange Participants: Observations from the Department of Veterans Affairs' Virtual Lifetime Electronic Record Health Pilot Phase.

PubMed

Botts, Nathan; Bouhaddou, Omar; Bennett, Jamie; Pan, Eric; Byrne, Colene; Mercincavage, Lauren; Olinger, Lois; Hunolt, Elaine; Cullen, Theresa

2014-01-01

Authors studied the United States (U.S.) Department of Veterans Affairs' (VA) Virtual Lifetime Electronic Record (VLER) Health pilot phase relative to two attributes of data quality - the adoption of eHealth Exchange data standards, and clinical content exchanged. The VLER Health pilot was an early effort in testing implementation of eHealth Exchange standards and technology. Testing included evaluation of exchange data from the VLER Health pilot sites partners: VA, U.S. Department of Defense (DoD), and private sector health care organizations. Domains assessed data quality and interoperability as it relates to: 1) conformance with data standards related to the underlying structure of C32 Summary Documents (C32) produced by eHealth Exchange partners; and 2) the types of C32 clinical content exchanged. This analysis identified several standards non-conformance issues in sample C32 files and informed further discourse on the methods needed to effectively monitor Health Information Exchange (HIE) data content and standards conformance.

Methodologic quality of meta-analyses and systematic reviews on the Mediterranean diet and cardiovascular disease outcomes: a review.

PubMed

Huedo-Medina, Tania B; Garcia, Marissa; Bihuniak, Jessica D; Kenny, Anne; Kerstetter, Jane

2016-03-01

Several systematic reviews/meta-analyses published within the past 10 y have examined the associations of Mediterranean-style diets (MedSDs) on cardiovascular disease (CVD) risk. However, these reviews have not been evaluated for satisfying contemporary methodologic quality standards. This study evaluated the quality of recent systematic reviews/meta-analyses on MedSD and CVD risk outcomes by using an established methodologic quality scale. The relation between review quality and impact per publication value of the journal in which the article had been published was also evaluated. To assess compliance with current standards, we applied a modified version of the Assessment of Multiple Systematic Reviews (AMSTARMedSD) quality scale to systematic reviews/meta-analyses retrieved from electronic databases that had met our selection criteria: 1) used systematic or meta-analytic procedures to review the literature, 2) examined MedSD trials, and 3) had MedSD interventions independently or combined with other interventions. Reviews completely satisfied from 8% to 75% of the AMSTARMedSD items (mean ± SD: 31.2% ± 19.4%), with those published in higher-impact journals having greater quality scores. At a minimum, 60% of the 24 reviews did not disclose full search details or apply appropriate statistical methods to combine study findings. Only 5 of the reviews included participant or study characteristics in their analyses, and none evaluated MedSD diet characteristics. These data suggest that current meta-analyses/systematic reviews evaluating the effect of MedSD on CVD risk do not fully comply with contemporary methodologic quality standards. As a result, there are more research questions to answer to enhance our understanding of how MedSD affects CVD risk or how these effects may be modified by the participant or MedSD characteristics. To clarify the associations between MedSD and CVD risk, future meta-analyses and systematic reviews should not only follow methodologic quality standards but also include more statistical modeling results when data allow. © 2016 American Society for Nutrition.

Ontology Based Quality Evaluation for Spatial Data

NASA Astrophysics Data System (ADS)

Yılmaz, C.; Cömert, Ç.

2015-08-01

Many institutions will be providing data to the National Spatial Data Infrastructure (NSDI). Current technical background of the NSDI is based on syntactic web services. It is expected that this will be replaced by semantic web services. The quality of the data provided is important in terms of the decision-making process and the accuracy of transactions. Therefore, the data quality needs to be tested. This topic has been neglected in Turkey. Data quality control for NSDI may be done by private or public "data accreditation" institutions. A methodology is required for data quality evaluation. There are studies for data quality including ISO standards, academic studies and software to evaluate spatial data quality. ISO 19157 standard defines the data quality elements. Proprietary software such as, 1Spatial's 1Validate and ESRI's Data Reviewer offers quality evaluation based on their own classification of rules. Commonly, rule based approaches are used for geospatial data quality check. In this study, we look for the technical components to devise and implement a rule based approach with ontologies using free and open source software in semantic web context. Semantic web uses ontologies to deliver well-defined web resources and make them accessible to end-users and processes. We have created an ontology conforming to the geospatial data and defined some sample rules to show how to test data with respect to data quality elements including; attribute, topo-semantic and geometrical consistency using free and open source software. To test data against rules, sample GeoSPARQL queries are created, associated with specifications.

Updating national standards for drinking-water: a Philippine experience.

PubMed

Lomboy, M; Riego de Dios, J; Magtibay, B; Quizon, R; Molina, V; Fadrilan-Camacho, V; See, J; Enoveso, A; Barbosa, L; Agravante, A

2017-04-01

The latest version of the Philippine National Standards for Drinking-Water (PNSDW) was issued in 2007 by the Department of Health (DOH). Due to several issues and concerns, the DOH decided to make an update which is relevant and necessary to meet the needs of the stakeholders. As an output, the water quality parameters are now categorized into mandatory, primary, and secondary. The ten mandatory parameters are core parameters which all water service providers nationwide are obligated to test. These include thermotolerant coliforms or Escherichia coli, arsenic, cadmium, lead, nitrate, color, turbidity, pH, total dissolved solids, and disinfectant residual. The 55 primary parameters are site-specific and can be adopted as enforceable parameters when developing new water sources or when the existing source is at high risk of contamination. The 11 secondary parameters include operational parameters and those that affect the esthetic quality of drinking-water. In addition, the updated PNSDW include new sections: (1) reporting and interpretation of results and corrective actions; (2) emergency drinking-water parameters; (3) proposed Sustainable Development Goal parameters; and (4) standards for other drinking-water sources. The lessons learned and insights gained from the updating of standards are likewise incorporated in this paper.

Designing and Managing Your Digital Library.

ERIC Educational Resources Information Center

Guenther, Kim

2000-01-01

Discusses digital libraries and Web site design issues. Highlights include accessibility issues, including standards, markup languages like HTML and XML, and metadata; building virtual communities; the use of Web portals for customized delivery of information; quality assurance tools, including data mining; and determining user needs, including…

Faculty Sufficiency and AACSB Accreditation Compliance within a Global University: A Mathematical Modeling Approach

ERIC Educational Resources Information Center

Boronico, Jess; Murdy, Jim; Kong, Xinlu

2014-01-01

This manuscript proposes a mathematical model to address faculty sufficiency requirements towards assuring overall high quality management education at a global university. Constraining elements include full-time faculty coverage by discipline, location, and program, across multiple campus locations subject to stated service quality standards of…

Space-Time Fusion Under Error in Computer Model Output: An Application to Modeling Air Quality

EPA Science Inventory

In the last two decades a considerable amount of research effort has been devoted to modeling air quality with public health objectives. These objectives include regulatory activities such as setting standards along with assessing the relationship between exposure to air pollutan...

21 CFR 900.4 - Standards for accreditation bodies.

Code of Federal Regulations, 2014 CFR

2014-04-01

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

21 CFR 900.4 - Standards for accreditation bodies.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

21 CFR 900.4 - Standards for accreditation bodies.

Code of Federal Regulations, 2012 CFR

2012-04-01

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

21 CFR 900.4 - Standards for accreditation bodies.

Code of Federal Regulations, 2013 CFR

2013-04-01

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

Developing Flowcharted Procedures Manuals for School District Administration within the ISO 9000 Context.

ERIC Educational Resources Information Center

Schoch, Robert

2002-01-01

Describes how the School District of Lancaster, Pennsylvania, implemented a districtwide quality-management system based on the Geneva-based International Standards Organization 9001, a major component of which is the documentation of procedures. Includes sections on implementation, procedure manuals, quality management, uniformity, formatting,…

The State of State Prekindergarten Standards in 2003.

ERIC Educational Resources Information Center

Neuman, Susan B.; Roskos, Kathleen; Vukelich, Carol; Clements, Douglas

Currently, an increasing number of states support school readiness programs, recognizing that high quality early childhood education positively affects all children's success in school and the quality of their future. Recent federal initiatives, including Good Start Grow Smart, the revised guidance for the Child Care and Development Fund (CCDF)…

The Math Wizard in Oz

ERIC Educational Resources Information Center

Christy, Donna; Lambe, Karen; Payson, Christine; Carnevale, Patricia

2011-01-01

The crucial need for a mathematically literate society, coupled with a sustained focus on mathematics standards, continues its center-stage presence. At the same time, "Principles and Standards" states that it is imperative to offer "all students high-quality programs that include significant mathematics presented in a manner that respects both…

45 CFR 205.190 - Standard-setting authority for institutions.

Code of Federal Regulations, 2014 CFR

2014-10-01

...(ies) in the development of standards directed toward assuring adequate quality of care; in upgrading... are hazardous to the safety of the patients; and in planning so that institutions may be...(AABD) of the Social Security Act includes aid or assistance to individuals in institutions as defined...

A Case for Standards of Counseling Practice.

ERIC Educational Resources Information Center

Anderson, Donald

1992-01-01

A mature counseling profession has entered the decade of the 1990s. Several factors including professionalism, accountability, health care consumerism, credentialism, and public demands for quality mental health care indicate a need for more definitive statements on standards of practice in counseling. In response to this need, an eight-point…

29 CFR 29.6 - Program performance standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... apprenticeship programs. (1) The tools and factors to be used must include, but are not limited to: (i) Quality assurance assessments; (ii) Equal Employment Opportunity (EEO) Compliance Reviews; and (iii) Completion... 29 Labor 1 2010-07-01 2010-07-01 true Program performance standards. 29.6 Section 29.6 Labor...

Surveying drinking water quality (Balikhlou River, Ardabil Province, Iran)

NASA Astrophysics Data System (ADS)

Aalipour erdi, Mehdi; Gasempour niari, Hassan; Mousavi Meshkini, Seyyed Reza; Foroug, Somayeh

2018-03-01

Considering the importance of Balikhlou River as one of the most important water sources of Ardabil, Nir and Sarein cities, maintaining water quality of this river is the most important goals in provincial and national levels. This river includes a wide area that provides agricultural, industrial and drinking water for the residents. Thus, surveying the quality of this river is important in planning and managing of region. This study examined the quality of river through eight physicochemical parameters (SO4, No3, BOD5, TDS, turbidity, pH, EC, COD) in two high- and low-water seasons by international and national standards in 2013. For this purpose, a review along the river has been done in five stations using t test and SPSS software. Model results showed that the amount difference in TDS and EC with WHO standards, and TDS rates with Iran standards in low-water seasons, pH and EC with WHO standards in high-water seasons, is not significant in high-water season; but for pH and SO4 parameters, turbidity and NO3 in both standards and EC value with WHO standard in low-water season and pH, EC, SO4 parameters and turbidity and NO3 in high-water season have significant difference from 5 to 1%, this shows the ideal limit and lowness of parameters for different usage.

Quality standards for rheumatology outpatient clinic. The EXTRELLA project.

PubMed

Nolla, Joan M; Martínez, Carmen; García-Vicuña, Rosario; Seoane-Mato, Daniel; Rosario Lozano, M Piedad; Alonso, Alberto; Alperi, Mercedes; Barbazán, Ceferino; Calvo, Jaime; Delgado, Concepción; Fernández-Nebro, Antonio; Mateo, Lourdes; Pérez Sandoval, Trinidad; Pérez Venegas, José; Rodríguez Lozano, Carlos; Rosas, José

2016-01-01

In recent years, outpatient clinics have undergone extensive development. At present, patients with rheumatic diseases are mainly assisted in this area. However, the quality standards of care are poorly documented. To develop specific quality criteria and standards for an outpatient rheumatology clinic. The project was based on the two-round Delphi method. The following groups of participants took part: scientific committee (13 rheumatologists), five nominal groups (45 rheumatologists and 12 nurses) and a group of discussion formed by 9 patients. Different drafts were consecutively generated until a final document was obtained that included the standards that received a punctuation equal or over 7 in at least 70% of the participants. 148 standards were developed, grouped into the following 9 dimensions: a) structure (22), b) clinical activity and relationship with the patients (34), c) planning (7), d) levels of priority (5), e) relations with primary care physicians, with Emergency Department and with other clinical departments, f) process (26), g) nursing (13), h) teaching and research (13) and i) activity measures (8). This study established specific quality standards for rheumatology outpatient clinic. It can be a useful tool for organising this area in the Rheumatology Department and as a reference when proposing improvement measures to health administrators. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

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

Assessment of three medical and research laboratories using WHO AFRO_SLIPTA Quality Standards in Southwestern Uganda: a long way to go.

PubMed

Taremwa, Ivan Mugisha; Ampaire, Lucas; Iramiot, Jacob; Muhwezi, Obed; Matte, Aloysius; Itabangi, Herbert; Mbabazi, Hope; Atwebembeire, Jeninah; Kamwine, Monicah; Katawera, Victoria; Mbalibulha, Yona; Orikiriza, Patrick; Boum, Yap

2017-01-01

While the laboratory represents more than 70% of clinical diagnosis and patient management, access to reliable and quality laboratory diagnostics in sub-Saharan Africa remains a challenge. To gain knowledge and suggest evidence based interventions towards laboratory improvement in Southwestern Uganda, we assessed the baseline laboratory quality standards in three medical and research laboratories in Southwestern Uganda. We conducted a cross sectional survey from October, 2013 to April, 2014. Selected laboratories, including one private research, one private for profit and one public laboratory, were assessed using the WHO AFRO_SLIPTA checklist and baseline scores were determined. The three laboratories assessed met basic facility requirements, had trained personnel, and safety measures in place. Sample reception was properly designed and executed with a well designated chain of custody. All laboratories had sufficient equipment for the nature of work they were involved in. However, we found that standard operating procedures were incomplete in all three laboratories, lack of quality audit schemes by two laboratories and only one laboratory enrolled into external quality assurance schemes. The SLIPTA scores were one star for the research laboratory and no star for both the public and private-for-profit laboratories. While most of the laboratory systems were in place, the low scores obtained by the assessed laboratories reflect the need for improvement to reach standards of quality assured diagnostics in the region. Therefore, routine mentorship and regional supportive supervision are necessary to increase the quality of laboratory services.

Still on the Right Trajectory: State Teachers of the Year Compare Former and New State Assessments

ERIC Educational Resources Information Center

McClellan, Catherine; Joe, Jilliam; Bassett, Katherine

2016-01-01

As part of state transitions to college- and career-ready (CCR) standards, including the Common Core State Standards in more than 40 states (NGA & CCSSO, 2010), states are for the first time administering new summative assessments aligned to those standards and aiming for a higher bar in assessment quality. For a majority of states, this means…

A lack of standardization: the basis for the ethical issues surrounding quality and performance reports.

PubMed

Suchy, Kirsten

2010-01-01

Consumers in the United States are taking advantage of the proliferation of publicly available, internet-based performance reports and quality appraisals of health plans, healthcare organizations, hospitals, and physicians to aid in their healthcare decision making. However, these appraisal practices have given rise to controversy and debate over certain distinctive ethical issues. This article advocates a standardized ethical framework to guide current and future development and implementation of performance reports. This framework, which would resolve a number of the major issues, includes the following ethical principles to guide the practice of public reporting on the Internet and facilitate enhanced quality improvement in the healthcare industry: legitimacy, data integrity and quality, transparency, informed understanding, equity, privacy and confidentiality, collaboration, accountability, and evaluation and continuous improvement.

Impact of parenteral nutrition standardization on costs and quality in adult patients.

PubMed

Berlana, David; Barraquer, Anna; Sabin, Pilar; Chicharro, Luisa; Pérez, Agueda; Puiggrós, Carolina; Burgos, Rosa; Martínez-Cutillas, Julio

2014-08-01

Parenteral nutrition (PN) is a costly therapy that can also be associated with serious complications. Therefore, efforts are focusing on reducing rate of complications, and costs related to PN. The aim was to analyze the effect of the implementation of PN standardization on costs and quality criteria. Secondary aim was to assess the use of individualized PN based on patient's clinical condition. We compare the use of PN before and after the implementation of PN standardization. Demographic, clinical and PN characteristics were collected. Costs analysis was performed to study the costs associated to the two different periods. Quality criteria included were: 1) PN administration; 2) nutrition assessment (energy intake between 20-35 kcal/kg/day; protein contribution according to nitrogen balance); 3) safety and complications (hyperglycemia, hypertriglyceridemia, hepatic complications, catheter-related infection); 4) global efficacy (as serum albumin increase). Chi-square test was used to compare percentages; logistic regression analysis was performed to evaluate the use of customized PN. 296 patients were included with a total of 3,167 PN compounded. During the first period standardized PN use was 47.5% vs 85.7% within the second period (p < 0.05). No differences were found in the quality criteria tested. Use of individualized PN was related to critical care patients, hypertriglyceridemia, renal damage, and long-term PN. Mean costs of the PN decreased a 19.5%. Annual costs savings would be € 86,700. The use of customized or standard PN has shown to be efficient and flexible to specific demands; however customized PN was significantly more expensive. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

ASTM Committee C28: International Standards for Properties and Performance of Advanced Ceramics, Three Decades of High-quality, Technically-rigorous Normalization

NASA Technical Reports Server (NTRS)

Jenkins, Michael G.; Salem, Jonathan A.

2016-01-01

Physical and mechanical properties and performance of advanced ceramics and glasses are difficult to measure correctly without the proper techniques. For over three decades, ASTM Committee C28 on Advanced Ceramics, has developed high quality, rigorous, full-consensus standards (e.g., test methods, practices, guides, terminology) to measure properties and performance of monolithic and composite ceramics that may be applied to glasses in some cases. These standards testing particulars for many mechanical, physical, thermal, properties and performance of these materials. As a result these standards provide accurate, reliable, repeatable and complete data. Within Committee C28 users, producers, researchers, designers, academicians, etc. have written, continually updated, and validated through round-robin test programs, nearly 50 standards since the Committees founding in 1986. This paper provides a retrospective review of the 30 years of ASTM Committee C28 including a graphical pictogram listing of C28 standards along with examples of the tangible benefits of advanced ceramics standards to demonstrate their practical applications.

Effectiveness and legitimacy of forest carbon standards in the OTC voluntary carbon market

PubMed Central

2011-01-01

Background In recent years, the voluntary over-the-counter (OTC) carbon market has reached a significant market volume. It is particularly interesting for forest mitigation projects which are either ineligible in compliance markets or confronted with a plethora of technical and financial hurdles and lacking market demand. As the OTC market is not regulated, voluntary standards have been created to secure the social and environmental integrity of the traded mitigation projects and thus to ensure the quality of the resulting carbon credits. Building on a theoretical efficiency-legitimacy framework, this study aims to identify and analyse the characteristics and indicators that determine the efficiency and organisational legitimacy of standards for afforestation/reforestation carbon projects. Results All interviewed market actors consider third-party certification and standards as a crucial component of market functionality, which provide quality assurance mechanisms that reduce information asymmetries and moral hazard between the actors regarding the quality of carbon credits, and thus reduce transaction costs. Despite this development, the recent evolution of many new and differing standards is seen as a major obstacle that renders it difficult for project developers and buyers to select an appropriate standard. According to the interviewed experts the most important legitimating factors of standards are assurance of a sufficient level of quality of carbon credits, scientifically substantiated methodological accounting and independent third-party verification, independence of standard bodies, transparency, wide market acceptance, back-up of the wider community including experts and NGOs, rigorous procedures, and the resemblance to the Afforestation/Reforestation (A/R) CDM due to its international policy endorsements. In addition, standards must provide evidence that projects contribute to a positive social and environmental development, do no harm as a minimum requirement and build a strong track record of successful projects. Project developers require clear, easily and practically applicable standards at lowest possible costs with a high potential in order to achieve good carbon prices, while buyers require that standards are legitimate, credible and that no public criticism arises when carbon credits are purchased from projects certified by a certain standard. Conclusions Despite the fragmented and immature state of the OTC market, standards act as 'market-making' intermediaries and contribute to the quality and transparency of the OTC market. However, the variety of different standards imposes new hurdles for their efficiency and often creates confusion instead of confidence among potential buyers. Despite the lacking legitimacy of the standards, pressures from the institutional environment on standards ensure a minimum quality of carbon credits (including positive social and environmental impacts of carbon credits) that serves as an insurance mechanism for the integrity of standards. Its unregulated nature and the pressure from an increasingly competitive environment provides innovative space to deliver efficient certification procedures without imposing unreasonably high transaction costs on market actors. Furthermore, voluntary standards imply a more innovative certification approach, as one legal authority could do, because standards have to compete for adopters backed by civil society organisations. Thereby, the forest sector in OTC voluntary market bears great opportunities to provide the forest sector with crucial lessons for international climate policy and governmental institutions when designing regulation for forest regulation such as international and national REDDplus schemes. PMID:21849036

21 CFR 900.12 - Quality standards.

Code of Federal Regulations, 2014 CFR

2014-04-01

... to mammography. The training shall include instruction in radiation physics, including radiation physics specific to mammography, radiation effects, and radiation protection. The mammographic... ensure that medical physicists certified by the body are competent to perform physics survey; and (B)(1...

21 CFR 900.12 - Quality standards.

Code of Federal Regulations, 2013 CFR

2013-04-01

... to mammography. The training shall include instruction in radiation physics, including radiation physics specific to mammography, radiation effects, and radiation protection. The mammographic... ensure that medical physicists certified by the body are competent to perform physics survey; and (B)(1...

21 CFR 900.12 - Quality standards.

Code of Federal Regulations, 2012 CFR

2012-04-01

... to mammography. The training shall include instruction in radiation physics, including radiation physics specific to mammography, radiation effects, and radiation protection. The mammographic... ensure that medical physicists certified by the body are competent to perform physics survey; and (B)(1...

21 CFR 900.12 - Quality standards.

Code of Federal Regulations, 2011 CFR

2011-04-01

... to mammography. The training shall include instruction in radiation physics, including radiation physics specific to mammography, radiation effects, and radiation protection. The mammographic... ensure that medical physicists certified by the body are competent to perform physics survey; and (B)(1...

PROPELLER technique to improve image quality of MRI of the shoulder.

PubMed

Dietrich, Tobias J; Ulbrich, Erika J; Zanetti, Marco; Fucentese, Sandro F; Pfirrmann, Christian W A

2011-12-01

The purpose of this article is to evaluate the use of the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique for artifact reduction and overall image quality improvement for intermediate-weighted and T2-weighted MRI of the shoulder. One hundred eleven patients undergoing MR arthrography of the shoulder were included. A coronal oblique intermediate-weighted turbo spin-echo (TSE) sequence with fat suppression and a sagittal oblique T2-weighted TSE sequence with fat suppression were obtained without (standard) and with the PROPELLER technique. Scanning time increased from 3 minutes 17 seconds to 4 minutes 17 seconds (coronal oblique plane) and from 2 minutes 52 seconds to 4 minutes 10 seconds (sagittal oblique) using PROPELLER. Two radiologists graded image artifacts, overall image quality, and delineation of several anatomic structures on a 5-point scale (5, no artifact, optimal diagnostic quality; and 1, severe artifacts, diagnostically not usable). The Wilcoxon signed rank test was used to compare the data of the standard and PROPELLER images. Motion artifacts were significantly reduced in PROPELLER images (p < 0.001). Observer 1 rated motion artifacts with diagnostic impairment in one patient on coronal oblique PROPELLER images compared with 33 patients on standard images. Ratings for the sequences with PROPELLER were significantly better for overall image quality (p < 0.001). Observer 1 noted an overall image quality with diagnostic impairment in nine patients on sagittal oblique PROPELLER images compared with 23 patients on standard MRI. The PROPELLER technique for MRI of the shoulder reduces the number of sequences with diagnostic impairment as a result of motion artifacts and increases image quality compared with standard TSE sequences. PROPELLER sequences increase the acquisition time.

Blockade of the angiotensin system improves mental health domain of quality of life: A meta-analysis of randomized clinical trials.

PubMed

Brownstein, Daniel J; Salagre, Estela; Köhler, Cristiano; Stubbs, Brendon; Vian, João; Pereira, Ciria; Chavarria, Victor; Karmakar, Chandan; Turner, Alyna; Quevedo, João; Carvalho, André F; Berk, Michael; Fernandes, Brisa S

2018-01-01

It is unclear whether blockade of the angiotensin system has effects on mental health. Our objective was to determine the impact of angiotensin converting enzyme inhibitors and angiotensin II type 1 receptor (AT1R) blockers on mental health domain of quality of life. Meta-analysis of published literature. PubMed and clinicaltrials.gov databases. The last search was conducted in January 2017. Randomized controlled trials comparing any angiotensin converting enzyme inhibitor or AT1R blocker versus placebo or non-angiotensin converting enzyme inhibitor or non-AT1R blocker were selected. Study participants were adults without any major physical symptoms. We adhered to meta-analysis reporting methods as per PRISMA and the Cochrane Collaboration. Eleven studies were included in the analysis. When compared with placebo or other antihypertensive medications, AT1R blockers and angiotensin converting enzyme inhibitors were associated with improved overall quality of life (standard mean difference = 0.11, 95% confidence interval = [0.08, 0.14], p < 0.0001), positive wellbeing (standard mean difference = 0.11, 95% confidence interval = [0.05, 0.17], p < 0.0001), mental (standard mean difference = 0.15, 95% confidence interval = [0.06, 0.25], p < 0.0001), and anxiety (standard mean difference = 0.08, 95% confidence interval = [0.01, 0.16], p < 0.0001) domains of QoL. No significant difference was found for the depression domain (standard mean difference = 0.05, 95% confidence interval = [0.02, 0.12], p = 0.15). Use of angiotensin blockers and inhibitors for the treatment of hypertension in otherwise healthy adults is associated with improved mental health domains of quality of life. Mental health quality of life was a secondary outcome in the included studies. Research specifically designed to analyse the usefulness of drugs that block the angiotensin system is necessary to properly evaluate this novel psychiatric target.

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.

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...

SEER*Educate: Use of Abstracting Quality Index Scores to Monitor Improvement of All Employees.

PubMed

Potts, Mary S; Scott, Tim; Hafterson, Jennifer L

2016-01-01

Integral parts of the Seattle-Puget Sound's Cancer Surveillance System registry's continuous improvement model include the incorporation of SEER*Educate into its training program for all staff and analyzing assessment results using the Abstracting Quality Index (AQI). The AQI offers a comprehensive measure of overall performance in SEER*Educate, which is a Web-based application used to personalize learning and diagnostically pinpoint each staff member's place on the AQI continuum. The assessment results are tallied from 6 abstracting standards within 2 domains: incidence reporting and coding accuracy. More than 100 data items are aligned to 1 or more of the 6 standards to build an aggregated score that is placed on a continuum for continuous improvement. The AQI score accurately identifies those individuals who have a good understanding of how to apply the 6 abstracting standards to reliably generate high quality abstracts.

Ensuring Quality in AFRINEST and SATT

PubMed Central

2013-01-01

Background: Three randomized open-label clinical trials [Simplified Antibiotic Therapy Trial (SATT) Bangladesh, SATT Pakistan and African Neonatal Sepsis Trial (AFRINEST)] were developed to test the equivalence of simplified antibiotic regimens compared with the standard regimen of 7 days of parenteral antibiotics. These trials were originally conceived and designed separately; subsequently, significant efforts were made to develop and implement a common protocol and approach. Previous articles in this supplement briefly describe the specific quality control methods used in the individual trials; this article presents additional information about the systematic approaches used to minimize threats to validity and ensure quality across the trials. Methods: A critical component of quality control for AFRINEST and SATT was striving to eliminate variation in clinical assessments and decisions regarding eligibility, enrollment and treatment outcomes. Ensuring appropriate and consistent clinical judgment was accomplished through standardized approaches applied across the trials, including training, assessment of clinical skills and refresher training. Standardized monitoring procedures were also applied across the trials, including routine (day-to-day) internal monitoring of performance and adherence to protocols, systematic external monitoring by funding agencies and external monitoring by experienced, independent trial monitors. A group of independent experts (Technical Steering Committee/Technical Advisory Group) provided regular monitoring and technical oversight for the trials. Conclusions: Harmonization of AFRINEST and SATT have helped to ensure consistency and quality of implementation, both internally and across the trials as a whole, thereby minimizing potential threats to the validity of the trials’ results. PMID:23945575

Probe into Gaseous Pollution and Assessment of Air Quality Benefit under Sector Dependent Emission Control Strategies over Megacities in Yangtze River Delta, China

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

Dong, Xinyi; Gao, Yang; Fu, Joshua S.

On February 29th 2012, China published its new National Ambient Air Quality Standard (CH-NAAQS) aiming at revising the standards and measurements for both gaseous pollutants including ozone (O3), nitrogen dioxide (NO2), and sulfur dioxide (SO2), and also particle pollutants including PM10 and PM2.5. In order to understand the air pollution status regarding this new standard, the integrated MM5/CMAQ modeling system was applied over Yangtze River Delta (YRD) within this study to examine the criteria gaseous pollutants listed in the new CH-NAAQS. Sensitivity simulations were also conducted to assess the responses of gaseous pollutants under 8 different sector-dependent emission reduction scenariosmore » in order to evaluate the potential control strategies. 2006 was selected as the simulation year in order to review the air quality condition at the beginning of China’s 11th Five-Year-Plan (FYP, from 2006 to 2010), and also compared with air quality status in 2010 as the end of 11th FYP to probe into the effectiveness of the national emission control efforts. Base case simulation showed distinct seasonal variation for gaseous pollutants: SO2, and NO2 were found to have higher surface concentrations in winter while O3 was found to have higher concentrations in spring and summer than other seasons. According to the analyses focused on 3 megacities within YRD, Shanghai, Nanjing, and Hangzhou, we found different air quality conditions among the cities: NO2 was the primary pollutant that having the largest number of days exceeding the CH-NAAQS daily standard (80 μg/m3) in Shanghai (59 days) and Nanjing (27 days); SO2 was the primary pollutant with maximum number of days exceeding daily air quality standard (150 μg/m3) in Hangzhou (28 days), while O3 exceeding the daily maximum 8-hour standard (160 μg/m3) for relatively fewer days in all the three cities (9 days in Shanghai, 14 days in Nanjing, and 11 days in Hangzhou). Simulation results from predefined potential applicable emission control scenarios suggested significant air quality improvements from emission reduction: 90% of SO2 emission removed from power plant in YRD would be able to reduce more than 85% of SO2 pollution, 85% NOx emission reduction from power plant would reduce more than 60% of NO2 pollution, in terms of reducing the number of days exceeding daily air quality standard. NOx emission reduction from transportation and industry were also found to effectively reduce NO2 pollution but less efficient than emission control from power plants. We also found that multi-pollutants emission control including both NOx and VOC would be a better strategy than independent NOx control over YRD which is China’s 12th Five-Year-Plan (from 2011 to 2015), because O3 pollution would be increased as a side effect of NOx control and counteract NO2 pollution reduction benefit.« less

Testing the quality of images for permanent magnet desktop MRI systems using specially designed phantoms.

PubMed

Qiu, Jianfeng; Wang, Guozhu; Min, Jiao; Wang, Xiaoyan; Wang, Pengcheng

2013-12-21

Our aim was to measure the performance of desktop magnetic resonance imaging (MRI) systems using specially designed phantoms, by testing imaging parameters and analysing the imaging quality. We designed multifunction phantoms with diameters of 18 and 60 mm for desktop MRI scanners in accordance with the American Association of Physicists in Medicine (AAPM) report no. 28. We scanned the phantoms with three permanent magnet 0.5 T desktop MRI systems, measured the MRI image parameters, and analysed imaging quality by comparing the data with the AAPM criteria and Chinese national standards. Image parameters included: resonance frequency, high contrast spatial resolution, low contrast object detectability, slice thickness, geometrical distortion, signal-to-noise ratio (SNR), and image uniformity. The image parameters of three desktop MRI machines could be measured using our specially designed phantoms, and most parameters were in line with MRI quality control criterion, including: resonance frequency, high contrast spatial resolution, low contrast object detectability, slice thickness, geometrical distortion, image uniformity and slice position accuracy. However, SNR was significantly lower than in some references. The imaging test and quality control are necessary for desktop MRI systems, and should be performed with the applicable phantom and corresponding standards.

A status review of photovoltaic power conversion equipment reliability, safety, and quality assurance protocols

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

Hacke, Peter; Lokanath, Sumanth; Williams, Paul

Data indicate that the inverter is the element of the photovoltaic plant that has the highest number of service calls and the greatest operation and maintenance cost burden. This paper describes the projects and relevant background needed in developing design qualification standards that would serve to establish a minimum level of reliability, along with a review of photovoltaic inverter quality and safety standards, most of which are in their infancy. We compare stresses and levels for accelerated testing of inverters proposed in the standard drafts, and those proposed by manufacturers and purchasers of inverters. We also review bases for themore » methods, stress types, and stress levels for durability testing of key inverter components. Many of the test protocols appear to need more comprehensive inclusion of stress factors existing in the natural environment such as wind driven rain, dust, and grid disturbances. Further understanding of how temperature, humidity ingress, and voltage bias affect the inverters and their components is also required. We provide data indicating inconsistent quality of the inverters and the durability of components leading to greater cost for the photovoltaic plant operator. Accordingly, the recommendation for data collection within quality standards for obtaining cost of ownership metrics is made. Design validation testing using realistic operation, environmental, and connection conditions, including under end-use field conditions with feedback for continuous improvement is recommended for inclusion within a quality standard.« less

A status review of photovoltaic power conversion equipment reliability, safety, and quality assurance protocols

DOE PAGES

Hacke, Peter; Lokanath, Sumanth; Williams, Paul; ...

2017-10-10

Data indicate that the inverter is the element of the photovoltaic plant that has the highest number of service calls and the greatest operation and maintenance cost burden. This paper describes the projects and relevant background needed in developing design qualification standards that would serve to establish a minimum level of reliability, along with a review of photovoltaic inverter quality and safety standards, most of which are in their infancy. We compare stresses and levels for accelerated testing of inverters proposed in the standard drafts, and those proposed by manufacturers and purchasers of inverters. We also review bases for themore » methods, stress types, and stress levels for durability testing of key inverter components. Many of the test protocols appear to need more comprehensive inclusion of stress factors existing in the natural environment such as wind driven rain, dust, and grid disturbances. Further understanding of how temperature, humidity ingress, and voltage bias affect the inverters and their components is also required. We provide data indicating inconsistent quality of the inverters and the durability of components leading to greater cost for the photovoltaic plant operator. Accordingly, the recommendation for data collection within quality standards for obtaining cost of ownership metrics is made. Design validation testing using realistic operation, environmental, and connection conditions, including under end-use field conditions with feedback for continuous improvement is recommended for inclusion within a quality standard.« less

Opisthotonos

MedlinePlus

... The physical examination will include a complete checkup of the nervous system. Tests may include: Blood and urine tests Cerebrospinal ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is ...

Does Teacher Testing Raise Teacher Quality? Evidence from State Certification Requirements

ERIC Educational Resources Information Center

Angrist, Joshua D.; Guryan, Jonathan

2008-01-01

The education reform movement includes efforts to raise teacher quality through stricter certification and licensing provisions. Most US states now require public school teachers to pass a standardized test such as the Praxis. Although any barrier to entry is likely to raise wages in the affected occupation, the theoretical effects of such…

Factors Affecting Success of Training Companies

ERIC Educational Resources Information Center

Rogala, Piotr; Batko, Roman; Wawak, Slawomir

2017-01-01

This study aims to identify the key factors which influence the functioning quality and success of training companies. Based on an analysis of the requirements included in the quality management system standards for providers of education and training services, a set of twenty factors has been developed. This was followed by a survey for…

40 CFR 403.9 - POTW pretreatment programs and/or authorization to revise pretreatment standards: Submission for...

Code of Federal Regulations, 2010 CFR

2010-07-01

... quality management plans. (1) In order to be approved the POTW Pretreatment Program shall be consistent with any approved water quality management plan developed in accordance with 40 CFR parts 130, 131, as revised, where such 208 plan includes Management Agency designations and addresses pretreatment in a...

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...

HVI Colorimeter and Color Spectrophotometer Relationships and Their Impacts on Developing "Traceable" Cotton Color Standards

USDA-ARS?s Scientific Manuscript database

Color measurements of cotton fiber and cotton textile products are important quality parameters. The Uster® High Volume Instrument (HVI) is an instrument used globally to classify cotton quality, including cotton color. Cotton color by HVI is based on two cotton-specific color parameters—Rd (diffuse...

Making Meaningful Measurement in Survey Research: The Use of Person and Item Maps

ERIC Educational Resources Information Center

Royal, Kenneth D.

2009-01-01

Quality measurement is essential in every form of research, including institutional research and assessment. Unfortunately, most survey research today (both published and unpublished) is lacking with regards to quality measurement. Reporting means and standard deviations based on ordinal measures is an inappropriate, yet widespread practice in the…

Relationships between Observations of Elementary Mathematics Instruction and Student Achievement: Exploring Variability across Districts

ERIC Educational Resources Information Center

Lynch, Kathleen; Chin, Mark; Blazar, David

2017-01-01

Much debate surrounding teacher quality has focused on students' standardized test scores, but recent federal and state initiatives have emphasized the use of multiple measures to evaluate teacher quality, including classroom observations. In this study, we explore differences across school districts in the relationship between student achievement…

A Framework for a Quality Control System for Vendor/Processor Contracts.

ERIC Educational Resources Information Center

Advanced Technology, Inc., Reston, VA.

A framework for monitoring quality control (QC) of processor contracts administered by the Department of Education's Office of Student Financial Assistance (OSFA) is presented and applied to the Pell Grant program. Guidelines for establishing QC measures and standards are included, and the uses of a sampling procedure in the QC system are…

Telecommunications Systems Career Ladder, AFSC 307XO.

DTIC Science & Technology

1981-01-01

standard test tone levels perform impulse noise tests make in-service or out-of- service quality check.s on composite signal transmission levels Even...service or out-of- service quality control (QC) reports maintain trouble and restoration record forms (DD Form 1443) direct circuit or system checks...include: perform fault isolation on analog circuits make in-service or out-of- service quality checks on voice frequency carrier telegraph (VFCT) terminals

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

NONE

The first part covers standards for gaseous fuels. The second part covers standards on coal and coke including the classification of coals, determination of major elements in coal ash and trace elements in coal, metallurgical properties of coal and coke, methods of analysis of coal and coke, petrogrpahic analysis of coal and coke, physical characteristics of coal, quality assurance and sampling.

77 FR 71371 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Redesignation of the Ohio...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-30

....5 , NO X and sulfur dioxide (SO 2 ) emissions inventories as satisfying the requirement in section... control measures include the following. Tier 2 Emission Standards for Vehicles and Gasoline Sulfur... vehicles replace older vehicles. The Tier 2 standards also reduced the sulfur content of gasoline to 30...

Development of a National Education and Training Data Standards Strategy and Implementation Plan. Cat. No. EDU 4

ERIC Educational Resources Information Center

Australian Institute of Health and Welfare, 2015

2015-01-01

The Australian Institute of Health and Welfare developed a national data standards strategy and implementation plan to enhance the comparability, quality and coherence of information across the Australian education and training sectors, including early childhood education, school education, vocational education and training (VET) and higher…

The quality of antimalarials available in Yemen

PubMed Central

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

2005-01-01

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

Data Acceptance Criteria for Standardized Human-Associated Fecal Source Identification Quantitative Real-Time PCR Methods.

PubMed

Shanks, Orin C; Kelty, Catherine A; Oshiro, Robin; Haugland, Richard A; Madi, Tania; Brooks, Lauren; Field, Katharine G; Sivaganesan, Mano

2016-05-01

There is growing interest in the application of human-associated fecal source identification quantitative real-time PCR (qPCR) technologies for water quality management. The transition from a research tool to a standardized protocol requires a high degree of confidence in data quality across laboratories. Data quality is typically determined through a series of specifications that ensure good experimental practice and the absence of bias in the results due to DNA isolation and amplification interferences. However, there is currently a lack of consensus on how best to evaluate and interpret human fecal source identification qPCR experiments. This is, in part, due to the lack of standardized protocols and information on interlaboratory variability under conditions for data acceptance. The aim of this study is to provide users and reviewers with a complete series of conditions for data acceptance derived from a multiple laboratory data set using standardized procedures. To establish these benchmarks, data from HF183/BacR287 and HumM2 human-associated qPCR methods were generated across 14 laboratories. Each laboratory followed a standardized protocol utilizing the same lot of reference DNA materials, DNA isolation kits, amplification reagents, and test samples to generate comparable data. After removal of outliers, a nested analysis of variance (ANOVA) was used to establish proficiency metrics that include lab-to-lab, replicate testing within a lab, and random error for amplification inhibition and sample processing controls. Other data acceptance measurements included extraneous DNA contamination assessments (no-template and extraction blank controls) and calibration model performance (correlation coefficient, amplification efficiency, and lower limit of quantification). To demonstrate the implementation of the proposed standardized protocols and data acceptance criteria, comparable data from two additional laboratories were reviewed. The data acceptance criteria proposed in this study should help scientists, managers, reviewers, and the public evaluate the technical quality of future findings against an established benchmark. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

NASA software documentation standard software engineering program

NASA Technical Reports Server (NTRS)

1991-01-01

The NASA Software Documentation Standard (hereinafter referred to as Standard) can be applied to the documentation of all NASA software. This Standard is limited to documentation format and content requirements. It does not mandate specific management, engineering, or assurance standards or techniques. This Standard defines the format and content of documentation for software acquisition, development, and sustaining engineering. Format requirements address where information shall be recorded and content requirements address what information shall be recorded. This Standard provides a framework to allow consistency of documentation across NASA and visibility into the completeness of project documentation. This basic framework consists of four major sections (or volumes). The Management Plan contains all planning and business aspects of a software project, including engineering and assurance planning. The Product Specification contains all technical engineering information, including software requirements and design. The Assurance and Test Procedures contains all technical assurance information, including Test, Quality Assurance (QA), and Verification and Validation (V&V). The Management, Engineering, and Assurance Reports is the library and/or listing of all project reports.

Natural cycle in vitro fertilisation (IVF) for subfertile couples.

PubMed

Allersma, Thomas; Farquhar, Cindy; Cantineau, Astrid E P

2013-08-30

Subfertility affects 15% to 20% of couples trying to conceive. In vitro fertilisation (IVF) is one of the assisted reproduction techniques developed to improve chances of achieving pregnancy. In the standard IVF method with controlled ovarian hyperstimulation (COH), growth and development of multiple follicles are stimulated by using gonadotrophins, often combined with a gonadotrophin-releasing hormone (GnRH) agonist or antagonist. Although it is an established method of conception for subfertile couples, the treatment is expensive and has a high risk of adverse effects. Studies have shown that IVF in a natural cycle (NC) or a modified natural cycle (MNC) might be a promising low risk and low cost alternative to the standard stimulated IVF treatment since the available dominant follicle of each cycle is used. In this review, we included available randomised controlled studies comparing natural cycle IVF (NC and MNC) with standard IVF. To compare the efficacy and safety of natural cycle IVF (including both NC-IVF and MNC-IVF) with controlled ovarian hyperstimulation IVF (COH-IVF) in subfertile couples. An extended search including of the Menstrual Disorders and Subfertility Group (MDSG) Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, ClinicalTrials.gov, conference abstracts in the Web of Knowledge, the World Health Organization International Trials Registry Platform search portal, LILACS database, PubMed and the OpenSIGLE database was conducted according to Cochrane guidelines. The last search was on 31st July 2013. All randomised controlled trials (RCTs) comparing either natural cycle IVF or modified natural cycle IVF versus standard IVF in subfertile couples were included. Data selection and extraction and risk of bias assessment were carried out independently by two authors (TA and AC). The primary outcome measures were live birth rate and ovarian hyperstimulation syndrome (OHSS) rate per randomised woman. We calculated Mantel-Haenszel odds ratios for each dichotomous outcome and either the mean difference or the standardised mean difference (SMD) for continuous outcomes, with 95% confidence intervals (CIs). A fixed effect model was used unless there was substantial heterogeneity, in which case a random effects model was used. Six randomised controlled trials with a total of 788 women were included. The largest of these trials included 396 women eligible for this review.No evidence of a statistically significant difference was found between natural cycle and standard IVF in live birth rates (OR 0.68, 95% CI 0.46 to 1.01, two studies, 425 women, I(2)= 0%, moderate quality evidence). The evidence suggests that for a woman with a 53% chance of live birth using standard IVF, the chance using natural cycle IVF would range from 34% to 53%. There was no evidence of a statistically significant difference between natural cycle and standard IVF in rates of OHSS (OR 0.19, 95% CI 0.01 to 4.06, one study, 60 women, very low quality evidence), clinical pregnancy (OR 0.52 95% CI 0.17 to 1.61, 4 studies, 351 women, I(2)=63%, low quality evidence), ongoing pregnancy (OR 0.72, 95% CI 0.50 to 1.05, three studies, 485 women, I(2)=0%, moderate quality evidence), multiple pregnancy (OR 0.76, 95% CI 0.25 to 2.31, 2 studies, 527 women, I(2)=0%, very low quality evidence), gestational abnormalities (OR 0.44 95% CI 0.03 to 5.93, 1 study, 18 women, very low quality evidence) or cycle cancellations (OR 8.98, 95% CI 0.20 to 393.66, 2 studies, 159 women, I(2)=83%, very low quality evidence). One trial reported that the oocyte retrieval rate was significantly lower in the natural cycle group (MD -4.40, 95% CI -7.87 to -0.93, 60 women, very low quality evidence). There were insufficient data to draw any conclusions about rates of treatment cancellation. Findings on treatment costs were inconsistent and more data are awaited. The evidence was limited by imprecision. Findings for pregnancy rate and for cycle cancellation were sensitive to the choice of statistical model: for these outcomes, use of a fixed effect model suggested a benefit for the standard IVF group. Moreover the largest trial has not yet completed follow up, though data have been reported for over 95% of women. Further evidence from well conducted large trials is awaited on natural cycle IVF treatment. Future trials should compare natural cycle IVF with standard IVF. Outcomes should include cumulative live birth and pregnancy rates, the number of treatment cycles necessary to reach live birth, treatment costs and adverse effects.

Approaches to quality management and accreditation in a genetic testing laboratory

PubMed Central

Berwouts, Sarah; Morris, Michael A; Dequeker, Elisabeth

2010-01-01

Medical laboratories, and specifically genetic testing laboratories, provide vital medical services to different clients: clinicians requesting a test, patients from whom the sample was collected, public health and medical-legal instances, referral laboratories and authoritative bodies. All expect results that are accurate and obtained in an efficient and effective manner, within a suitable time frame and at acceptable cost. There are different ways of achieving the end results, but compliance with International Organization for Standardization (ISO) 15189, the international standard for the accreditation of medical laboratories, is becoming progressively accepted as the optimal approach to assuring quality in medical testing. We present recommendations and strategies designed to aid genetic testing laboratories with the implementation of a quality management system, including key aspects such as document control, external quality assessment, internal quality control, internal audit, management review, validation, as well as managing the human side of change. The focus is on pragmatic approaches to attain the levels of quality management and quality assurance required for accreditation according to ISO 15189, within the context of genetic testing. Attention is also given to implementing efficient and effective quality improvement. PMID:20720559

VIEW OF THE INTERIOR OF BUILDING 125, THE STANDARDS LABORATORY. ...

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

VIEW OF THE INTERIOR OF BUILDING 125, THE STANDARDS LABORATORY. THE PRIMARY FUNCTION OF THE STANDARDS LABORATORY WAS TO ENSURE AND IMPLEMENT A SYSTEM OF QUALITY CONTROL FOR INCOMING MATERIALS USED IN MANUFACTURING PROCESSES. SEVERAL ENGINEERING CONTROLS WERE USED TO ASSURE ACCURACY OF THE CALIBRATION PROCESSES INCLUDING: FLEX-FREE GRANITE TABLES, AIR LOCKED DOORS, TEMPERATURE CONTROLS, AND A SUPER-CLEAN ENVIRONMENT - Rocky Flats Plant, Standards Laboratory, Immediately north of 215A water tower & adjacent to Third Street, Golden, Jefferson County, CO

Quality beyond compliance.

PubMed

Centanni, N; Monroe, M; White, L; Larson, R

1999-01-01

The service sector within the biopharmaceutical industry has experienced phenomenal growth over the past decade. In the highly regulated Good Laboratory Practices environment, the need for timely, high-quality service, accurate results, and on-time deliverables becomes paramount for the success and profitability of biopharmaceutical companies. The quality assurance process is a vital component of this drug product-development cycle and ensures compliance to the highest domestic and international regulatory standards. Quality-assurance professionals historically have held the role of independent auditors of the processes, who certify that results meet current standards of practice. Covance, a contract research organization that includes Good Laboratory Practices laboratories, reorganized and expanded the functional responsibilities of its quality assurance team in 1997. Auditors and quality assurance professionals have assumed roles beyond traditional compliance auditing and are forging new leadership and mentoring roles as process-improvement specialists. The results have been tangible, measurable benefits for clients and the Covance organization. This article provides an overview of this cultural change and the processes put in place to improve efficiency, productivity, and customer and employee satisfaction.

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...

Effects of Mat Pilates on Physical Functional Performance of Older Adults: A Meta-analysis of Randomized Controlled Trials.

PubMed

Bueno de Souza, Roberta Oliveira; Marcon, Liliane de Faria; Arruda, Alex Sandro Faria de; Pontes Junior, Francisco Luciano; Melo, Ruth Caldeira de

2018-06-01

The present meta-analysis aimed to examine evidence from randomized controlled trials to determine the effects of mat Pilates on measures of physical functional performance in the older population. A search was conducted in the MEDLINE/PubMed, Scopus, Scielo, and PEDro databases between February and March 2017. Only randomized controlled trials that were written in English, included subjects aged 60 yrs who used mat Pilates exercises, included a comparison (control) group, and reported performance-based measures of physical function (balance, flexibility, muscle strength, and cardiorespiratory fitness) were included. The methodological quality of the studies was analyzed according to the PEDro scale and the best-evidence synthesis. The meta-analysis was conducted with the Review Manager 5.3 software. The search retrieved 518 articles, nine of which fulfilled the inclusion criteria. High methodological quality was found in five of these studies. Meta-analysis indicated a large effect of mat Pilates on dynamic balance (standardized mean difference = 1.10, 95% confidence interval = 0.29-1.90), muscle strength (standardized mean difference = 1.13, 95% confidence interval = 0.30-1.96), flexibility (standardized mean difference = 1.22, 95% confidence interval = 0.39-2.04), and cardiorespiratory fitness (standardized mean difference = 1.48, 95% confidence interval = 0.42-2.54) of elderly subjects. There is evidence that mat Pilates improves dynamic balance, lower limb strength, hip and lower back flexibility, and cardiovascular endurance in elderly individuals. Furthermore, high-quality studies are necessary to clarify the effects of mat Pilates on other physical functional measurements among older adults.

EQUAL-quant: an international external quality assessment scheme for real-time PCR.

PubMed

Ramsden, Simon C; Daly, Sarah; Geilenkeuser, Wolf-Jochen; Duncan, Graeme; Hermitte, Fabienne; Marubini, Ettore; Neumaier, Michael; Orlando, Claudio; Palicka, Vladimir; Paradiso, Angelo; Pazzagli, Mario; Pizzamiglio, Sara; Verderio, Paolo

2006-08-01

Quantitative gene expression analysis by real-time PCR is important in several diagnostic areas, such as the detection of minimum residual disease in leukemia and the prognostic assessment of cancer patients. To address quality assurance in this technically challenging area, the European Union (EU) has funded the EQUAL project to develop methodologic external quality assessment (EQA) relevant to diagnostic and research laboratories among the EU member states. We report here the results of the EQUAL-quant program, which assesses standards in the use of TaqMan probes, one of the most widely used assays in the implementation of real-time PCR. The EQUAL-quant reagent set was developed to assess the technical execution of a standard TaqMan assay, including RNA extraction, reverse transcription, and real-time PCR quantification of target DNA copy number. The multidisciplinary EQA scheme included 137 participating laboratories from 29 countries. We demonstrated significant differences in performance among laboratories, with 20% of laboratories reporting at least one result lacking in precision and/or accuracy according to the statistical procedures described. No differences in performance were observed for the >10 different testing platforms used by the study participants. This EQA scheme demonstrated both the requirement and demand for external assessment of technical standards in real-time PCR. The reagent design and the statistical tools developed within this project will provide a benchmark for defining acceptable working standards in this emerging technology.

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.

Disaster Victim Identification: quality management from an odontology perspective.

PubMed

Lake, A W; James, H; Berketa, J W

2012-06-01

The desired outcome of the victim identification component of a mass fatality event is correct identification of deceased persons in a timely manner allowing legal and social closure for relatives of the victims. Quality Management across all aspects of the Disaster Victim Identification (DVI) structure facilitates this process. Quality Management in forensic odontology is the understanding and implementation of a methodology that ensures collection, collation and preservation of the maximum amount of available dental data and the appropriate interpretation of that data to achieve outcomes to a standard expected by the DVI instructing authority, impacted parties and the forensic odontology specialist community. Managerial pre-event planning responsibility, via an odontology coordinator, includes setting a chain of command, developing and reviewing standard operating procedures (SOP), ensuring use of current scientific methodologies and staff training. During a DVI managerial responsibility includes tailoring SOP to the specific situation, ensuring member accreditation, encouraging inter-disciplinary cooperation and ensuring security of odontology data and work site. Individual responsibilities include the ability to work within a team, accept peer review, and share individual members' skill sets to achieve the best outcome. These responsibilities also include adherence to chain of command and the SOP, maintenance of currency of knowledge and recognition of professional boundaries of expertise. This article highlights issues of Quality Management pertaining particularly to forensic odontology but can also be extrapolated to all DVI actions.

Truth in Reporting: How Data Capture Methods Obfuscate Actual Surgical Site Infection Rates within a Health Care Network System.

PubMed

Bordeianou, Liliana; Cauley, Christy E; Antonelli, Donna; Bird, Sarah; Rattner, David; Hutter, Matthew; Mahmood, Sadiqa; Schnipper, Deborah; Rubin, Marc; Bleday, Ronald; Kenney, Pardon; Berger, David

2017-01-01

Two systems measure surgical site infection rates following colorectal surgeries: the American College of Surgeons National Surgical Quality Improvement Program and the Centers for Disease Control and Prevention National Healthcare Safety Network. The Centers for Medicare & Medicaid Services pay-for-performance initiatives use National Healthcare Safety Network data for hospital comparisons. This study aimed to compare database concordance. This is a multi-institution cohort study of systemwide Colorectal Surgery Collaborative. The National Surgical Quality Improvement Program requires rigorous, standardized data capture techniques; National Healthcare Safety Network allows 5 data capture techniques. Standardized surgical site infection rates were compared between databases. The Cohen κ-coefficient was calculated. This study was conducted at Boston-area hospitals. National Healthcare Safety Network or National Surgical Quality Improvement Program patients undergoing colorectal surgery were included. Standardized surgical site infection rates were the primary outcomes of interest. Thirty-day surgical site infection rates of 3547 (National Surgical Quality Improvement Program) vs 5179 (National Healthcare Safety Network) colorectal procedures (2012-2014). Discrepancies appeared: National Surgical Quality Improvement Program database of hospital 1 (N = 1480 patients) routinely found surgical site infection rates of approximately 10%, routinely deemed rate "exemplary" or "as expected" (100%). National Healthcare Safety Network data from the same hospital and time period (N = 1881) revealed a similar overall surgical site infection rate (10%), but standardized rates were deemed "worse than national average" 80% of the time. Overall, hospitals using less rigorous capture methods had improved surgical site infection rates for National Healthcare Safety Network compared with standardized National Surgical Quality Improvement Program reports. The correlation coefficient between standardized infection rates was 0.03 (p = 0.88). During 25 site-time period observations, National Surgical Quality Improvement Program and National Healthcare Safety Network data matched for 52% of observations (13/25). κ = 0.10 (95% CI, -0.1366 to 0.3402; p = 0.403), indicating poor agreement. This study investigated hospitals located in the Northeastern United States only. Variation in Centers for Medicare & Medicaid Services-mandated National Healthcare Safety Network infection surveillance methodology leads to unreliable results, which is apparent when these results are compared with standardized data. High-quality data would improve care quality and compare outcomes among institutions.

Assuring the Quality of Next-Generation Sequencing in Clinical Microbiology and Public Health Laboratories.

PubMed

Gargis, Amy S; Kalman, Lisa; Lubin, Ira M

2016-12-01

Clinical microbiology and public health laboratories are beginning to utilize next-generation sequencing (NGS) for a range of applications. This technology has the potential to transform the field by providing approaches that will complement, or even replace, many conventional laboratory tests. While the benefits of NGS are significant, the complexities of these assays require an evolving set of standards to ensure testing quality. Regulatory and accreditation requirements, professional guidelines, and best practices that help ensure the quality of NGS-based tests are emerging. This review highlights currently available standards and guidelines for the implementation of NGS in the clinical and public health laboratory setting, and it includes considerations for NGS test validation, quality control procedures, proficiency testing, and reference materials. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Economic evaluations and usefulness of standardized nursing terminologies.

PubMed

Stone, Patricia W; Lee, Nam-Ju; Giannini, Melinna; Bakken, Suzanne

2004-01-01

To review different types of economic analyses commonly found in healthcare literature, discuss methodologic considerations in framing economic analyses, identify useful resources for economic evaluations, and describe the current and potential roles of standardized nursing terminologies in providing cost and outcome data for economic analysis. The Advanced Billing Concepts Code Resource-based Relative Value Scale and Nursing Outcomes Classification. Using case studies, the applicability of standardized nursing terminologies in cost-effectiveness analysis is demonstrated. While there is potential to inform specific questions, comparisons across analyses are limited because of the many outcome measures. Including a standardized quality-of-life measure in nursing terminologies would allow for the calculation of accepted outcome measures and dollars per quality adjusted life years gained. The nurse's ability to assess and contribute to all aspects of rigorous economic evidence is an essential competency for responsible practice.

Software assurance standard

NASA Technical Reports Server (NTRS)

1992-01-01

This standard specifies the software assurance program for the provider of software. It also delineates the assurance activities for the provider and the assurance data that are to be furnished by the provider to the acquirer. In any software development effort, the provider is the entity or individual that actually designs, develops, and implements the software product, while the acquirer is the entity or individual who specifies the requirements and accepts the resulting products. This standard specifies at a high level an overall software assurance program for software developed for and by NASA. Assurance includes the disciplines of quality assurance, quality engineering, verification and validation, nonconformance reporting and corrective action, safety assurance, and security assurance. The application of these disciplines during a software development life cycle is called software assurance. Subsequent lower-level standards will specify the specific processes within these disciplines.

PROTECTING ECOLOGICAL RESOURCES WITH THE CLEAN AIR ACT: THE ROLE OF SCIENCE

EPA Science Inventory

The Clean Air Act provides for establishing National Ambient Air Quality Standards (NAAQS) to protect public welfare (including crops, forests, ecosystems, and soils) from adverse effects of air pollutants, including tropospheric ozone. The formulation of policies is science-base...

Methods for assessing the quality of mammalian embryos: How far we are from the gold standard?

PubMed

Rocha, José C; Passalia, Felipe; Matos, Felipe D; Maserati, Marc P; Alves, Mayra F; Almeida, Tamie G de; Cardoso, Bruna L; Basso, Andrea C; Nogueira, Marcelo F G

2016-08-01

Morphological embryo classification is of great importance for many laboratory techniques, from basic research to the ones applied to assisted reproductive technology. However, the standard classification method for both human and cattle embryos, is based on quality parameters that reflect the overall morphological quality of the embryo in cattle, or the quality of the individual embryonic structures, more relevant in human embryo classification. This assessment method is biased by the subjectivity of the evaluator and even though several guidelines exist to standardize the classification, it is not a method capable of giving reliable and trustworthy results. Latest approaches for the improvement of quality assessment include the use of data from cellular metabolism, a new morphological grading system, development kinetics and cleavage symmetry, embryo cell biopsy followed by pre-implantation genetic diagnosis, zona pellucida birefringence, ion release by the embryo cells and so forth. Nowadays there exists a great need for evaluation methods that are practical and non-invasive while being accurate and objective. A method along these lines would be of great importance to embryo evaluation by embryologists, clinicians and other professionals who work with assisted reproductive technology. Several techniques shows promising results in this sense, one being the use of digital images of the embryo as basis for features extraction and classification by means of artificial intelligence techniques (as genetic algorithms and artificial neural networks). This process has the potential to become an accurate and objective standard for embryo quality assessment.

Methods for assessing the quality of mammalian embryos: How far we are from the gold standard?

PubMed Central

Rocha, José C.; Passalia, Felipe; Matos, Felipe D.; Maserati Jr, Marc P.; Alves, Mayra F.; de Almeida, Tamie G.; Cardoso, Bruna L.; Basso, Andrea C.; Nogueira, Marcelo F. G.

2016-01-01

Morphological embryo classification is of great importance for many laboratory techniques, from basic research to the ones applied to assisted reproductive technology. However, the standard classification method for both human and cattle embryos, is based on quality parameters that reflect the overall morphological quality of the embryo in cattle, or the quality of the individual embryonic structures, more relevant in human embryo classification. This assessment method is biased by the subjectivity of the evaluator and even though several guidelines exist to standardize the classification, it is not a method capable of giving reliable and trustworthy results. Latest approaches for the improvement of quality assessment include the use of data from cellular metabolism, a new morphological grading system, development kinetics and cleavage symmetry, embryo cell biopsy followed by pre-implantation genetic diagnosis, zona pellucida birefringence, ion release by the embryo cells and so forth. Nowadays there exists a great need for evaluation methods that are practical and non-invasive while being accurate and objective. A method along these lines would be of great importance to embryo evaluation by embryologists, clinicians and other professionals who work with assisted reproductive technology. Several techniques shows promising results in this sense, one being the use of digital images of the embryo as basis for features extraction and classification by means of artificial intelligence techniques (as genetic algorithms and artificial neural networks). This process has the potential to become an accurate and objective standard for embryo quality assessment. PMID:27584609

Development and implementation of an audit tool for quality control of parenteral nutrition.

PubMed

García-Rodicio, Sonsoles; Abajo, Celia; Godoy, Mercedes; Catalá, Miguel Angel

2009-01-01

The aim of this article is to describe the development of a quality control methodology applied to patients receiving parenteral nutrition (PN) and to present the results obtained over the past 10 years. Development of the audit tool: In 1995, a total of 13 PN quality criteria and their standards were defined based on literature and past experiences. They were applied during 5 different 6-month audits carried out in subsequent years. According to the results of each audit, the criteria with lower validity were eliminated, while others were optimized and new criteria were introduced to complete the monitoring of other areas not previously examined. Currently, the quality control process includes 22 quality criteria and their standards that examine the following 4 different areas: (1) indication and duration of PN; (2) nutrition assessment, adequacy of the nutrition support, and monitoring; (3) metabolic and infectious complications; and (4) global efficacy of the nutrition support regimen. The authors describe the current definition of each criterion and present the results obtained in the 5 audits performed. In the past year, 9 of the 22 criteria reached the predefined standards. The areas detected for further improvements were: indication for PN, nutrition assessment, and management of catheter infections. The definition of quality criteria and their standards is an efficient method of providing a qualitative and quantitative analysis of the clinical care of patients receiving PN. It detects areas for improvement and assists in developing a methodology to work efficiently.

Evidence-based quality indicators for stroke rehabilitation.

PubMed

Grube, Maike M; Dohle, Christian; Djouchadar, Diana; Rech, Petra; Bienek, Karen; Dietz-Fricke, Ursula; Jöbges, Michael; Kohler, Martin; Missala, Isabelle; Schönherr, Bertram; Werner, Cordula; Zeytountchian, Helen; Wissel, Jörg; Heuschmann, Peter U

2012-01-01

Previous stroke performance measures consider aspects of postacute treatment, but there are only few specific quality indicators or standards for poststroke rehabilitation. The purpose of this study was to develop a set of indicators for measuring the quality of postacute stroke rehabilitation in inpatient and outpatient facilities using a standardized evidence-based approach. Quality indicators were developed between January 2009 and February 2010 by an interdisciplinary board of healthcare professionals from rehabilitation centers cooperating in the Berlin Stroke Alliance. The Berlin Stroke Alliance is a regional network of >40 providers of acute treatment, rehabilitation, and aftercare aiming to improve stroke services within Berlin and Brandenburg. The indicators were developed according to published international recommendations and predefined methodological requirements. The applied standards included a systematic literature review, a rating of published evidence, an external peer review, and the evaluation in a pilot study before implementation. Of an initial list of 33 indicators, 20 indicators were rated as being appropriate. After completion of the pilot phase, we agreed on a set of 18 indicators. The indicators measure processes (9 indicators), outcomes (5 indicators), and structures (4 indicators) in the following domains of stroke rehabilitation: completion of diagnostics; secondary prevention; cognition and affect; speech and swallowing; management of complications; sensorimotor functions and mobility; discharge status; and aftercare. Documentation of evidence-based quality indicators for stroke rehabilitation in clinical routine is feasible and can serve as a first step toward implementing standardized cross-institutional quality assurance programs for stroke rehabilitation.

Deriving environmental quality standards for perfluorooctanoic acid (PFOA) and related short chain perfluorinated alkyl acids.

PubMed

Valsecchi, Sara; Conti, Daniela; Crebelli, Riccardo; Polesello, Stefano; Rusconi, Marianna; Mazzoni, Michela; Preziosi, Elisabetta; Carere, Mario; Lucentini, Luca; Ferretti, Emanuele; Balzamo, Stefania; Simeone, Maria Gabriella; Aste, Fiorella

2017-02-05

The evidence that in Northern Italy significant sources of perfluoroalkylacids (PFAA) are present induced the Italian government to establish a Working Group on Environmental Quality Standard (EQS) for PFAA in order to include some of them in the list of national specific pollutants for surface water monitoring according to the Water Framework Directive (2000/60/EC). The list of substances included perfluorooctanoate (PFOA) and related short chain PFAA such as perfluorobutanoate (PFBA), perfluoropentanoate (PFPeA), perfluorohexanoate (PFHxA) and perfluorobutanesulfonate (PFBS), which is a substitute of perfluorooctanesulfonate. For each of them a dossier collects available data on regulation, physico-chemical properties, emission and sources, occurrence, acute and chronic toxicity on aquatic species and mammals, including humans. Quality standards (QS) were derived for the different protection objectives (pelagic and benthic communities, predators by secondary poisoning, human health via consumption of fishery products and water) according to the European guideline. The lowest QS is finally chosen as the relevant EQS. For PFOA a QS for biota was derived for protection from secondary poisoning and the corresponding QS for water was back-calculated, obtaining a freshwater EQS of 0.1μgL -1 . For PFBA, PFPeA, PFHxA and PFBS threshold limits proposed for drinking waters were adopted as EQS. Copyright © 2016 Elsevier B.V. All rights reserved.

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...

Chinese green product standards: international experience and pathway for a unified system

NASA Astrophysics Data System (ADS)

Yun, Fu; Ling, Lin; Dongfeng, Gao; Shuo, Yang

2017-11-01

The establishment of a unified green product standard system is of great importance regarding the effective supply of green products and meeting trend of the consumption upgrade. It also is helpful to reduce the cost of green information disclosure of enterprises, and facilitate the supply-side structural reform. Based on the experience of developing and implementing green product standards in the EU, Germany, America, Japan and so on, combined with current Chinese standard systems including environmental protection, energy conservation, water conservation, low carbon, recycling, regeneration and organic, with the adoption of the life cycle thinking, this paper brings forward basic requirements on organizations including pollutant emissions, establishment of management system, energy conservation and emission reduction technology and green supply chain management, and proposes indicator requirements on product including resource attributes, energy attributes, environmental attributes and quality attributes, so as to guide the establishment of green product evaluation standards in the context of China.

Potential Applications for AQUATOX

EPA Pesticide Factsheets

AQUATOX has a myriad of potential applications to water management issues and programs, including water quality criteria and standards, TMDLs (Total Maximum Daily Loads), and ecological risk assessments of aquatic systems.

AQUATOX Model Validation Reports

EPA Pesticide Factsheets

AQUATOX has a myriad of potential applications to water management issues and programs, including water quality criteria and standards, TMDLs (Total Maximum Daily Loads), and ecological risk assessments of aquatic systems.

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

Groundwater quality in the Upper Susquehanna River Basin, New York, 2009

USGS Publications Warehouse

Reddy, James E.; Risen, Amy J.

2012-01-01

Water samples were collected from 16 production wells and 14 private residential wells in the Upper Susquehanna River Basin from August through December 2009 and were analyzed to characterize the groundwater quality in the basin. Wells at 16 of the sites were completed in sand and gravel aquifers, and 14 were finished in bedrock aquifers. In 2004–2005, six of these wells were sampled in the first Upper Susquehanna River Basin study. Water samples from the 2009 study were analyzed for 10 physical properties and 137 constituents that included nutrients, organic carbon, major inorganic ions, trace elements, radionuclides, pesticides, volatile organic compounds, and 4 types of bacterial analyses. 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 genrally is of acceptable quality, although concentrations of some constituents exceeded at least one drinking-water standard at 28 of the 30 wells. These constituents include: pH, sodium, aluminum, manganese, iron, arsenic, radon-222, residue on evaporation, total and fecal coliform including Escherichia coli and heterotrophic plate count.

Field guide for collecting and processing stream-water samples for the National Water-Quality Assessment Program

USGS Publications Warehouse

Shelton, Larry R.

1994-01-01

The U.S. Geological Survey's National Water-Quality Assessment program includes extensive data- collection efforts to assess the quality of the Nations's streams. These studies require analyses of stream samples for major ions, nutrients, sediments, and organic contaminants. For the information to be comparable among studies in different parts of the Nation, consistent procedures specifically designed to produce uncontaminated samples for trace analysis in the laboratory are critical. This field guide describes the standard procedures for collecting and processing samples for major ions, nutrients, organic contaminants, sediment, and field analyses of conductivity, pH, alkalinity, and dissolved oxygen. Samples are collected and processed using modified and newly designed equipment made of Teflon to avoid contamination, including nonmetallic samplers (D-77 and DH-81) and a Teflon sample splitter. Field solid-phase extraction procedures developed to process samples for organic constituent analyses produce an extracted sample with stabilized compounds for more accurate results. Improvements to standard operational procedures include the use of processing chambers and capsule filtering systems. A modified collecting and processing procedure for organic carbon is designed to avoid contamination from equipment cleaned with methanol. Quality assurance is maintained by strict collecting and processing procedures, replicate sampling, equipment blank samples, and a rigid cleaning procedure using detergent, hydrochloric acid, and methanol.

Development of quality standards in inflammatory bowel disease management and design of an evaluation tool of nursing care.

PubMed

Torrejón, Antonio; Oltra, Lorena; Hernández-Sampelayo, Paloma; Marín, Laura; García-Sánchez, Valle; Casellas, Francesc; Alfaro, Noelia; Lázaro, Pablo; Vera, María Isabel

2013-01-01

nursing management of inflammatory bowel disease (IBD) is highly relevant for patient care and outcomes. However, there is evidence of substantial variability in clinical practices. The objectives of this study were to develop standards of healthcare quality for nursing management of IBD and elaborate the evaluation tool "Nursing Care Quality in IBD Assessment" (NCQ-IBD) based on these standards. a 178-item healthcare quality questionnaire was developed based on a systematic review of IBD nursing management literature. The questionnaire was used to perform two 2-round Delphi studies: Delphi A included 27 IBD healthcare professionals and Delphi B involved 12 patients. The NCQ-IBD was developed from the list of items resulting from both Delphi studies combined with the Scientific Committee´s expert opinion. the final NCQ-IBD consists of 90 items, organized in13 sections measuring the following aspects of nursing management of IBD: infrastructure, services, human resources, type of organization, nursing responsibilities, nurse-provided information to the patient, nurses training, annual audits of nursing activities, and nursing research in IBD. Using the NCQ-IBD to evaluate these components allows the rating of healthcare quality for nursing management of IBD into 4 categories: A (highest quality) through D (lowest quality). the use of the NCQ-IBD tool to evaluate nursing management quality of IBD identifies areas in need of improvement and thus contribute to an enhancement of care quality and reduction in clinical practice variations.

International water and steam quality standards on thermal power plants at all-volatile treatment

NASA Astrophysics Data System (ADS)

Petrova, T. I.; Orlov, K. A.; Dooley, R. B.

2016-12-01

One of the methods for the improvement of reliability and efficiency of the equipment at heat power plants is the decrease in the rate of corrosion of structural materials and sedimentation in water/steam circuit. These processes can be reduced to minimum by using the water with low impurity content and coolant treatment. For many years, water and steam quality standards were developed in various countries (United States, Germany, Japan, etc.) for specific types of equipment. The International Association for the Properties of Water and Steam (IAPWS), which brings together specialists from 21 countries, developed the water and steam quality standards for various types of power equipment based on theoretical studies and long-term operating experience of power equipment. Recently, various water-chemistry conditions are applied on heatpower equipment including conventional boilers and HRSGs with combined cycle power plants (Combined Cycle Power Plants (CCPP)). In paper, the maintenance conditions of water chemistry with ammonia or volatile amine dosing are described: reducing AVT(R), oxidizing AVT(O), and oxygen OT. Each of them is provided by the water and steam quality standards and recommendations are given on their maintenance under various operation conditions. It is noted that the quality control of heat carrier must be carried out with a particular care on the HPPs with combined cycle gas turbine units, where frequent starts and halts are performed.

Improving transition of care for veterans after total joint replacement.

PubMed

Green, Uthona R; Dearmon, Valorie; Taggart, Helen

2015-01-01

Patients transitioning from hospital to home are at risk for readmission to the hospital. Readmissions are costly and occur too often. Standardized discharge education processes have shown to decrease readmissions. The purpose of this quality improvement project was to utilize evidence-based practice changes to decrease 30-day all-cause readmissions after total joint replacement. Review of literature revealed that improved discharge education can decrease unnecessary readmissions after discharge. A quality improvement project was developed including standardized total joint replacement discharge education, teach-back education methodology, and improved postdischarge telephone follow-up. The quality improvement project was initiated and outcomes were evaluated. Improving coordination of the discharge process, enhanced education for patients/caregivers, and postdischarge follow-up decreased total joint replacement readmissions.

Critical Need for Plutonium and Uranium Isotopic Standards with Lower Uncertainties

DOE PAGES

Mathew, Kattathu Joseph; Stanley, Floyd E.; Thomas, Mariam R.; ...

2016-09-23

Certified reference materials (CRMs) traceable to national and international safeguards database are a critical prerequisite for ensuring that nuclear measurement systems are free of systematic biases. CRMs are used to validate measurement processes associated with nuclear analytical laboratories. Diverse areas related to nuclear safeguards are impacted by the quality of the CRM standards available to analytical laboratories. These include: nuclear forensics, radio-chronometry, national and international safeguards, stockpile stewardship, nuclear weapons infrastructure and nonproliferation, fuel fabrication, waste processing, radiation protection, and environmental monitoring. For the past three decades the nuclear community is confronted with the strange situation that improvements in measurementmore » data quality resulting from the improved accuracy and precision achievable with modern multi-collector mass spectrometers could not be fully exploited due to large uncertainties associated with CRMs available from New Brunswick Laboratory (NBL) that are used for instrument calibration and measurement control. Similar conditions prevail for both plutonium and uranium isotopic standards and for impurity element standards in uranium matrices. Herein, the current status of U and Pu isotopic standards available from NBL is reviewed. Critical areas requiring improvement in the quality of the nuclear standards to enable the U. S. and international safeguards community to utilize the full potential of modern multi-collector mass spectrometer instruments are highlighted.« less

Critical Need for Plutonium and Uranium Isotopic Standards with Lower Uncertainties

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

Mathew, Kattathu Joseph; Stanley, Floyd E.; Thomas, Mariam R.

Certified reference materials (CRMs) traceable to national and international safeguards database are a critical prerequisite for ensuring that nuclear measurement systems are free of systematic biases. CRMs are used to validate measurement processes associated with nuclear analytical laboratories. Diverse areas related to nuclear safeguards are impacted by the quality of the CRM standards available to analytical laboratories. These include: nuclear forensics, radio-chronometry, national and international safeguards, stockpile stewardship, nuclear weapons infrastructure and nonproliferation, fuel fabrication, waste processing, radiation protection, and environmental monitoring. For the past three decades the nuclear community is confronted with the strange situation that improvements in measurementmore » data quality resulting from the improved accuracy and precision achievable with modern multi-collector mass spectrometers could not be fully exploited due to large uncertainties associated with CRMs available from New Brunswick Laboratory (NBL) that are used for instrument calibration and measurement control. Similar conditions prevail for both plutonium and uranium isotopic standards and for impurity element standards in uranium matrices. Herein, the current status of U and Pu isotopic standards available from NBL is reviewed. Critical areas requiring improvement in the quality of the nuclear standards to enable the U. S. and international safeguards community to utilize the full potential of modern multi-collector mass spectrometer instruments are highlighted.« less

Success, failures and costs of implementing standards in the USA--lessons for infection control.

PubMed

McGowan, J E

1995-06-01

In the US, extensive standards for performance and 'guidelines for practice' have been instituted by a number of governmental and non-governmental agencies. New governmental plans for health care depend heavily on practice guidelines, and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has been especially enthusiastic about continuous quality improvement. Monitoring the appropriateness of care and altering physician practice appeals to insurance carriers and health care management organizations. Some initial data exist to show that the quality of health care has been enhanced by these regulations. The total cost for health care administration in 1990 in the USA was 24.8% of each hospital's spending for health care. Much of this was associated with spending for new initiatives in practice guidelines, physician profiling, quality assurance, and the like. Few data exist to show that the quality of health care or hospital infection control has been enhanced by these expenditures. Regulations and guidelines also have proliferated in infection control. Guides from the JCAHO have been expanded, and recent mandates from the Occupational Health and Safety Administration (OSHA) for protecting employees from blood-borne and respiratory pathogens promise to be especially costly for health care organizations to implement. Little data exist to show that the quality of infection control has been enhanced by these regulations. Standards are difficult to develop, because the science to back them up often is lacking, interpretation of validating data is imprecise, and inherent biological variation makes exceptions common. Seven lessons are important for those developing standards today. These include focusing on objective measures of the impact of the standard, clearly indicating the degree of scientific validity, making the development process inclusive, allowing for local variation, making sure that funding is provided for mandated standards, considering non-scientific implications of standards, and remaining involved in the process after the guideline is developed. Infection control workers should make sure that standards developed take the lessons above into account before they are promulgated.

Dishwashing water recycling system and related water quality standards for military use.

PubMed

Church, Jared; Verbyla, Matthew E; Lee, Woo Hyoung; Randall, Andrew A; Amundsen, Ted J; Zastrow, Dustin J

2015-10-01

As the demand for reliable and safe water supplies increases, both water quality and available quantity are being challenged by population growth and climate change. Greywater reuse is becoming a common practice worldwide; however, in remote locations of limited water supply, such as those encountered in military installations, it is desirable to expand its classification to include dishwashing water to maximize the conservation of fresh water. Given that no standards for dishwashing greywater reuse by the military are currently available, the current study determined a specific set of water quality standards for dishwater recycling systems for U.S. military field operations. A tentative water reuse standard for dishwashing water was developed based on federal and state regulations and guidelines for non-potable water, and the developed standard was cross-evaluated by monitoring water quality data from a full-scale dishwashing water recycling system using an innovative electrocoagulation and ultrafiltration process. Quantitative microbial risk assessment (QMRA) was also performed based on exposure scenarios derived from literature data. As a result, a specific set of dishwashing water reuse standards for field analysis (simple, but accurate) was finalized as follows: turbidity (<1 NTU), Escherichia coli (<50 cfu mL(-1)), and pH (6-9). UV254 was recommended as a surrogate for organic contaminants (e.g., BOD5), but requires further calibration steps for validation. The developed specific water standard is the first for dishwashing water reuse and will be expected to ensure that water quality is safe for field operations, but not so stringent that design complexity, cost, and operational and maintenance requirements will not be feasible for field use. In addition the parameters can be monitored using simple equipment in a field setting with only modest training requirements and real-time or rapid sample turn-around. This standard may prove useful in future development of civilian guidelines. Copyright © 2015 Elsevier B.V. All rights reserved.

Updating contextualized clinical practice guidelines on stroke rehabilitation and low back pain management using a novel assessment framework that standardizes decisions.

PubMed

Gambito, Ephraim D V; Gonzalez-Suarez, Consuelo B; Grimmer, Karen A; Valdecañas, Carolina M; Dizon, Janine Margarita R; Beredo, Ma Eulalia J; Zamora, Marcelle Theresa G

2015-11-04

Clinical practice guidelines need to be regularly updated with current literature in order to remain relevant. This paper reports on the approach taken by the Philippine Academy of Rehabilitation Medicine (PARM). This dovetails with its writing guide, which underpinned its foundational work in contextualizing guidelines for stroke and low back pain (LBP) in 2011. Working groups of Filipino rehabilitation physicians and allied health practitioners met to reconsider and modify, where indicated, the 'typical' Filipino patient care pathways established in the foundation guidelines. New clinical guidelines on stroke and low back pain which had been published internationally in the last 3 years were identified using a search of electronic databases. The methodological quality of each guideline was assessed using the iCAHE Guideline Quality Checklist, and only those guidelines which provided full text references, evidence hierarchy and quality appraisal of the included literature, were included in the PARM update. Each of the PARM-endorsed recommendations was then reviewed, in light of new literature presented in the included clinical guidelines. A novel standard updating approach was developed based on the criteria reported by Johnston et al. (Int J Technol Assess Health Care 19(4):646-655, 2003) and then modified to incorporate wording from the foundational PARM writing guide. The new updating tool was debated, pilot-tested and agreed upon by the PARM working groups, before being applied to the guideline updating process. Ten new guidelines on stroke and eleven for low back pain were identified. Guideline quality scores were moderate to good, however not all guidelines comprehensively linked the evidence body underpinning recommendations with the literature. Consequently only five stroke and four low back pain guidelines were included. The modified PARM updating guide was applied by all working groups to ensure standardization of the wording of updated recommendations and the underpinning evidence bases. The updating tool provides a simple, standard and novel approach that incorporates evidence hierarchy and quality, and wordings of recommendations. It could be used efficiently by other guideline updaters particularly in developing countries, where resources for guideline development and updates are limited. When many people are involved in guideline writing, there is always the possibility of 'slippage' in use of wording and interpretation of evidence. The PARM updating tool provides a mechanism for maintaining a standard process for guideline updating processes that can be followed by clinicians with basic training in evidence-based practice principles.

Effectiveness of external inspection of compliance with standards in improving healthcare organisation behaviour, healthcare professional behaviour or patient outcomes

PubMed Central

Flodgren, Gerd; Pomey, Marie-Pascale; Taber, Sarah A; Eccles, Martin P

2014-01-01

Background Inspection systems are used in health care to promote quality improvements, i.e. to achieve changes in organisational structures or processes, healthcare provider behaviour and patient outcomes. These systems are based on the assumption that externally promoted adherence to evidence-based standards (through inspection/assessment) will result in higher quality of health care. However, the benefits of external inspection in terms of organisational, provider and patient level outcomes are not clear. Objectives To evaluate the effectiveness of external inspection of compliance with standards in improving healthcare organisation behaviour, healthcare professional behaviour and patient outcomes. Search methods We searched the following electronic databases for studies: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness, Scopus, HMIC, Index to Theses and Intute from their inception dates up to May 2011. There was no language restriction and studies were included regardless of publication status. We searched the reference lists of included studies and contacted authors of relevant papers, accreditation bodies and the International Organization for Standardisation (ISO), regarding any further published or unpublished work. Selection criteria We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), interrupted time-series (ITSs) and controlled before and after studies (CBAs) evaluating the effect of external inspection against external standards on healthcare organisation change, healthcare professional behaviour or patient outcomes in hospitals, primary healthcare organisations and other community-based healthcare organisations. Data collection and analysis Two review authors independently applied eligibility criteria, extracted data and assessed the risk of bias of each included study. Since meta-analysis was not possible, we produced a narrative results summary. Main results We identified one cluster-RCT involving 20 South African public hospitals (Salmon 2003) and one ITS involving all acute trusts in England (OPM 2009) for inclusion in this review. Salmon and colleagues (Salmon 2003) showed mixed effects of a hospital accreditation system on the compliance with COHSASA (the Council for Health Services Accreditation for South Africa) accreditation standards and eight indicators of hospital quality. Significantly improved total mean compliance score with COHSASA accreditation standards was found for 21/28 service elements: mean intervention effect (95% confidence interval (CI)) was 30% (23% to 57%) (P < 0.001). The score increased from 48% to 78% in intervention hospitals, while remaining the same in control hospitals (43%). A sub-analysis of 424 a priori identified critical criteria (19 service elements) showed significantly improved compliance with the critical standards (P < 0.001). The score increased from 41% (21% to 46%) to 75% (55% to 96%) in intervention hospitals, but was unchanged in control hospitals (37%). Only one of the nine intervention hospitals gained full accreditation status at the end of the study period, with two others reached pre-accreditation status.The median intervention effect (range) for the indicators of hospital quality of care was 2.4 (−1.9 to +11.8) and only one of the eight indicators: ‘nurses perception of clinical quality, participation and teamwork’ was significantly improved (mean intervention effect 5.7, P = 0.03). Re-analysis of the MRSA (methicillin-resistant Staphylococcus aureus) data showed statistically non-significant effects of the Healthcare Commissions Infection Inspection programme. Authors’ conclusions We only identified two studies for inclusion in this review, which highlights the paucity of high-quality controlled evaluations of the effectiveness of external inspection systems. No firm conclusions could therefore be drawn about the effectiveness of external inspection on compliance with standards. PMID:22071861

Scientific and Legal Perspectives on Science Generated for Regulatory Activities

PubMed Central

Henry, Carol J.; Conrad, James W.

2008-01-01

This article originated from a conference that asked “Should scientific work conducted for purposes of advocacy before regulatory agencies or courts be judged by the same standards as science conducted for other purposes?” In the article, which focuses on the regulatory advocacy context, we argue that it can be and should be. First, we describe a set of standards and practices currently being used to judge the quality of scientific research and testing and explain how these standards and practices assist in judging the quality of research and testing regardless of why the work was conducted. These standards and practices include the federal Information Quality Act, federal Good Laboratory Practice standards, peer review, disclosure of funding sources, and transparency in research policies. The more that scientific information meets these standards and practices, the more likely it is to be of high quality, reliable, reproducible, and credible. We then explore legal issues that may be implicated in any effort to create special rules for science conducted specifically for a regulatory proceeding. Federal administrative law does not provide a basis for treating information in a given proceeding differently depending on its source or the reason for which it was generated. To the contrary, this law positively assures that interested persons have the right to offer their technical expertise toward the solution of regulatory problems. Any proposal to subject scientific information generated for the purpose of a regulatory proceeding to more demanding standards than other scientific information considered in that proceeding would clash with this law and would face significant administrative complexities. In a closely related example, the U.S. Environmental Protection Agency considered but abandoned a program to implement standards aimed at “external” information. PMID:18197313

Scientific and legal perspectives on science generated for regulatory activities.

PubMed

Henry, Carol J; Conrad, James W

2008-01-01

This article originated from a conference that asked "Should scientific work conducted for purposes of advocacy before regulatory agencies or courts be judged by the same standards as science conducted for other purposes?" In the article, which focuses on the regulatory advocacy context, we argue that it can be and should be. First, we describe a set of standards and practices currently being used to judge the quality of scientific research and testing and explain how these standards and practices assist in judging the quality of research and testing regardless of why the work was conducted. These standards and practices include the federal Information Quality Act, federal Good Laboratory Practice standards, peer review, disclosure of funding sources, and transparency in research policies. The more that scientific information meets these standards and practices, the more likely it is to be of high quality, reliable, reproducible, and credible. We then explore legal issues that may be implicated in any effort to create special rules for science conducted specifically for a regulatory proceeding. Federal administrative law does not provide a basis for treating information in a given proceeding differently depending on its source or the reason for which it was generated. To the contrary, this law positively assures that interested persons have the right to offer their technical expertise toward the solution of regulatory problems. Any proposal to subject scientific information generated for the purpose of a regulatory proceeding to more demanding standards than other scientific information considered in that proceeding would clash with this law and would face significant administrative complexities. In a closely related example, the U.S. Environmental Protection Agency considered but abandoned a program to implement standards aimed at "external" information.

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.

Evaluating the Quality and Usability of Open Data for Public Health Research: A Systematic Review of Data Offerings on 3 Open Data Platforms.

PubMed

Martin, Erika G; Law, Jennie; Ran, Weijia; Helbig, Natalie; Birkhead, Guthrie S

Government datasets are newly available on open data platforms that are publicly accessible, available in nonproprietary formats, free of charge, and with unlimited use and distribution rights. They provide opportunities for health research, but their quality and usability are unknown. To describe available open health data, identify whether data are presented in a way that is aligned with best practices and usable for researchers, and examine differences across platforms. Two reviewers systematically reviewed a random sample of data offerings on NYC OpenData (New York City, all offerings, n = 37), Health Data NY (New York State, 25% sample, n = 71), and HealthData.gov (US Department of Health and Human Services, 5% sample, n = 75), using a standard coding guide. Three open health data platforms at the federal, New York State, and New York City levels. Data characteristics from the coding guide were aggregated into summary indices for intrinsic data quality, contextual data quality, adherence to the Dublin Core metadata standards, and the 5-star open data deployment scheme. One quarter of the offerings were structured datasets; other presentation styles included charts (14.7%), documents describing data (12.0%), maps (10.9%), and query tools (7.7%). Health Data NY had higher intrinsic data quality (P < .001), contextual data quality (P < .001), and Dublin Core metadata standards adherence (P < .001). All met basic "web availability" open data standards; fewer met higher standards of "hyperlinked to other data." Although all platforms need improvement, they already provide readily available data for health research. Sustained effort on improving open data websites and metadata is necessary for ensuring researchers use these data, thereby increasing their research value.

Benefits of a Pharmacology Antimalarial Reference Standard and Proficiency Testing Program Provided by the Worldwide Antimalarial Resistance Network (WWARN)

PubMed Central

Lourens, Chris; Lindegardh, Niklas; Barnes, Karen I.; Guerin, Philippe J.; Sibley, Carol H.; White, Nicholas J.

2014-01-01

Comprehensive assessment of antimalarial drug resistance should include measurements of antimalarial blood or plasma concentrations in clinical trials and in individual assessments of treatment failure so that true resistance can be differentiated from inadequate drug exposure. Pharmacometric modeling is necessary to assess pharmacokinetic-pharmacodynamic relationships in different populations to optimize dosing. To accomplish both effectively and to allow comparison of data from different laboratories, it is essential that drug concentration measurement is accurate. Proficiency testing (PT) of laboratory procedures is necessary for verification of assay results. Within the Worldwide Antimalarial Resistance Network (WWARN), the goal of the quality assurance/quality control (QA/QC) program is to facilitate and sustain high-quality antimalarial assays. The QA/QC program consists of an international PT program for pharmacology laboratories and a reference material (RM) program for the provision of antimalarial drug standards, metabolites, and internal standards for laboratory use. The RM program currently distributes accurately weighed quantities of antimalarial drug standards, metabolites, and internal standards to 44 pharmacology, in vitro, and drug quality testing laboratories. The pharmacology PT program has sent samples to eight laboratories in four rounds of testing. WWARN technical experts have provided advice for correcting identified problems to improve performance of subsequent analysis and ultimately improved the quality of data. Many participants have demonstrated substantial improvements over subsequent rounds of PT. The WWARN QA/QC program has improved the quality and value of antimalarial drug measurement in laboratories globally. It is a model that has potential to be applied to strengthening laboratories more widely and improving the therapeutics of other infectious diseases. PMID:24777099

A novel strategy with standardized reference extract qualification and single compound quantitative evaluation for quality control of Panax notoginseng used as a functional food.

PubMed

Li, S P; Qiao, C F; Chen, Y W; Zhao, J; Cui, X M; Zhang, Q W; Liu, X M; Hu, D J

2013-10-25

Root of Panax notoginseng (Burk.) F.H. Chen (Sanqi in Chinese) is one of traditional Chinese medicines (TCMs) based functional food. Saponins are the major bioactive components. The shortage of reference compounds or chemical standards is one of the main bottlenecks for quality control of TCMs. A novel strategy, i.e. standardized reference extract based qualification and single calibrated components directly quantitative estimation of multiple analytes, was proposed to easily and effectively control the quality of natural functional foods such as Sanqi. The feasibility and credibility of this methodology were also assessed with a developed fast HPLC method. Five saponins, including ginsenoside Rg1, Re, Rb1, Rd and notoginsenoside R1 were rapidly separated using a conventional HPLC in 20 min. The quantification method was also compared with individual calibration curve method. The strategy is feasible and credible, which is easily and effectively adapted for improving the quality control of natural functional foods such as Sanqi. Copyright © 2013 Elsevier B.V. All rights reserved.

12 CFR 1815.104 - Specific responsibilities of the designated Fund official.

Code of Federal Regulations, 2010 CFR

2010-01-01

... and maintain working relationships with relevant government agencies (including Federal, state and... standards, procedures, and working relationships for protection and enhancement of environmental quality and...

36 CFR 228.8 - Requirements for environmental protection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... State water quality standards, including regulations issued pursuant to the Federal Water Pollution... to minimize or, where practicable, eliminate damage to soil, water, and other resource values. Unless...

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.

Antisense long non-coding RNAs in rainbow trout: Discovery and potential role in muscle growth and quality traits

USDA-ARS?s Scientific Manuscript database

Endogenous mRNA-antisense transcripts are involved in regulation of a wide range of biological processes including muscle development and quality traits of farm animals. Standard RNA-Seq can be used to identify sense-antisense transcripts. However, strand-specific RNA-Seq is required to resolve ambi...

Design Aids for Real-Time Systems (DARTS)

NASA Technical Reports Server (NTRS)

Szulewski, P. A.

1982-01-01

Design-Aids for Real-Time Systems (DARTS) is a tool that assists in defining embedded computer systems through tree structured graphics, military standard documentation support, and various analyses including automated Software Science parameter counting and metrics calculation. These analyses provide both static and dynamic design quality feedback which can potentially aid in producing efficient, high quality software systems.

40 CFR 266.103 - Interim status standards for burners.

Code of Federal Regulations, 2014 CFR

2014-07-01

... complying with the CO controls of § 266.104(c), the CO limit is established based on the compliance test... testing planned, including a complete copy of the test protocol and Quality Assurance/Quality Control (QA...; (vi) In subpart G (Closure and post-closure), §§ 265.111-265.115; (vii) In subpart H (Financial...

40 CFR 266.103 - Interim status standards for burners.

Code of Federal Regulations, 2011 CFR

2011-07-01

... complying with the CO controls of § 266.104(c), the CO limit is established based on the compliance test... testing planned, including a complete copy of the test protocol and Quality Assurance/Quality Control (QA...; (vi) In subpart G (Closure and post-closure), §§ 265.111-265.115; (vii) In subpart H (Financial...

40 CFR 266.103 - Interim status standards for burners.

Code of Federal Regulations, 2010 CFR

2010-07-01

... complying with the CO controls of § 266.104(c), the CO limit is established based on the compliance test... testing planned, including a complete copy of the test protocol and Quality Assurance/Quality Control (QA...; (vi) In subpart G (Closure and post-closure), §§ 265.111-265.115; (vii) In subpart H (Financial...

40 CFR 266.103 - Interim status standards for burners.

Code of Federal Regulations, 2012 CFR

2012-07-01

... complying with the CO controls of § 266.104(c), the CO limit is established based on the compliance test... testing planned, including a complete copy of the test protocol and Quality Assurance/Quality Control (QA...; (vi) In subpart G (Closure and post-closure), §§ 265.111-265.115; (vii) In subpart H (Financial...

40 CFR 266.103 - Interim status standards for burners.

Code of Federal Regulations, 2013 CFR

2013-07-01

... complying with the CO controls of § 266.104(c), the CO limit is established based on the compliance test... testing planned, including a complete copy of the test protocol and Quality Assurance/Quality Control (QA...; (vi) In subpart G (Closure and post-closure), §§ 265.111-265.115; (vii) In subpart H (Financial...

Preliminary Final Environmental Impact Statement

DTIC Science & Technology

2000-12-01

Suitabilities - Brooks AFB .................................................................... 3-49 3.5-2 National and Texas Ambient Air Quality...night average sound level NAAQS = National Ambient Air Quality Standards NPDES = National Pollutant Discharge Elimination System ROI = region of...Dos Rios, and Medio Creek plants. These plants treat an average of 130 MG of wastewater per day, with a total capacity (including an excess margin

Effects of a Teacher Incentive Program on 4th Grade State Assessment

ERIC Educational Resources Information Center

Alfaro, Moises; Jones, Don; Holland, Glenda; Mundy, Marie-Anne

2012-01-01

Recent national and state standards of accountability have focused on increasing student performance and achievement as well as teacher quality. Included in this challenge is the issue of teacher compensation and how it has evolved with the efforts of providing quality instruction in order to improve the performance of students. Texas has…

Developing product quality standards for wheelchairs used in less-resourced environments

PubMed Central

McCambridge, Matt; Reese, Norman; Schoendorfer, Don; Wunderlich, Eric; Rushman, Chris; Mahilo, Dave

2017-01-01

Background Premature failures of wheelchairs in less-resourced environments (LREs) may be because of shortcomings in product regulation and quality standards. The standards published by the International Organization for Standardization (ISO) specify wheelchair tests for durability, safety and performance, but their applicability to products used in the rugged conditions of LREs is unclear. Because of this, wheelchair-related guidelines published by the World Health Organization recommended developing more rigorous durability tests for wheelchairs. Objectives This study was performed to identify the additional tests needed for LREs. Methods First, a literature review of the development of ISO test standards, wheelchair standards testing studies and wheelchair evaluations in LREs was performed. Second, expert advice from members of the Standards Working Group of the International Society of Wheelchair Professionals (ISWP) was compiled and reviewed. Results A total of 35 articles were included in the literature review. Participation from LREs was not observed in the ISO standards development. As per wheelchair testing study evidence, wheelchair models delivered in LREs did not meet the minimum standards requirement. Multiple part failures and repairs were observed with reviewed field evaluation studies. ISWP experts noted that several testing factors responsible for premature failures with wheelchair parts are not included in the standards and accordingly provided advice for additional test development. Conclusion The study findings indicate the need to develop a wide range of tests, with specific tests for measuring corrosion resistance of the entire wheelchair, rolling resistance of castors and rear wheels, and durability of whole wheelchair and castor assemblies. PMID:28936410

Derivation and Validation of a Risk Standardization Model for Benchmarking Hospital Performance for Health-Related Quality of Life Outcomes after Acute Myocardial Infarction

PubMed Central

Arnold, Suzanne V.; Masoudi, Frederick A.; Rumsfeld, John S.; Li, Yan; Jones, Philip G.; Spertus, John A.

2014-01-01

Background Before outcomes-based measures of quality can be used to compare and improve care, they must be risk-standardized to account for variations in patient characteristics. Despite the importance of health-related quality of life (HRQL) outcomes among patients with acute myocardial infarction (AMI), no risk-standardized models have been developed. Methods and Results We assessed disease-specific HRQL using the Seattle Angina Questionnaire at baseline and 1 year later in 2693 unselected AMI patients from 24 hospitals enrolled in the TRIUMPH registry. Using 57 candidate sociodemographic, economic, and clinical variables present on admission, we developed a parsimonious, hierarchical linear regression model to predict HRQL. Eleven variables were independently associated with poor HRQL after AMI, including younger age, prior CABG, depressive symptoms, and financial difficulties (R2=20%). The model demonstrated excellent internal calibration and reasonable calibration in an independent sample of 1890 AMI patients in a separate registry, although the model slightly over-predicted HRQL scores in the higher deciles. Among the 24 TRIUMPH hospitals, 1-year unadjusted HRQL scores ranged from 67–89. After risk-standardization, HRQL scores variability narrowed substantially (range=79–83), and the group of hospital performance (bottom 20%/middle 60%/top 20%) changed in 14 of the 24 hospitals (58% reclassification with risk-standardization). Conclusions In this predictive model for HRQL after AMI, we identified risk factors, including economic and psychological characteristics, associated with HRQL outcomes. Adjusting for these factors substantially altered the rankings of hospitals as compared with unadjusted comparisons. Using this model to compare risk-standardized HRQL outcomes across hospitals may identify processes of care that maximize this important patient-centered outcome. PMID:24163068

Do Health Care Delivery System Reforms Improve Value? The Jury Is Still Out.

PubMed

Korenstein, Deborah; Duan, Kevin; Diaz, Manuel J; Ahn, Rosa; Keyhani, Salomeh

2016-01-01

Widespread restructuring of health delivery systems is underway in the United States to reduce costs and improve the quality of health care. To describe studies evaluating the impact of system-level interventions (incentives and delivery structures) on the value of US health care, defined as the balance between quality and cost. We identified articles in PubMed (2003 to July 2014) using keywords identified through an iterative process, with reference and author tracking. We searched tables of contents of relevant journals from August 2014 through 11 August 2015 to update our sample. We included prospective or retrospective studies of system-level changes, with a control, reporting both quality and either cost or utilization of resources. Data about study design, study quality, and outcomes was extracted by one reviewer and checked by a second. Thirty reports of 28 interventions were included. Interventions included patient-centered medical home implementations (n=12), pay-for-performance programs (n=10), and mixed interventions (n=6); no other intervention types were identified. Most reports (n=19) described both cost and utilization outcomes. Quality, cost, and utilization outcomes varied widely; many improvements were small and process outcomes predominated. Improved value (improved quality with stable or lower cost/utilization or stable quality with lower cost/utilization) was seen in 23 reports; 1 showed decreased value, and 6 showed unchanged, unclear, or mixed results.Study limitations included variability among specific endpoints reported, inconsistent methodologies, and lack of full adjustment in some observational trials. Lack of standardized MeSH terms was also a challenge in the search. On balance, the literature suggests that health system reforms can improve value. However, this finding is tempered by the varying outcomes evaluated across studies with little documented improvement in outcome quality measures. Standardized measures of value would facilitate assessment of the impact of interventions across studies and better estimates of the broad impact of system change.

14 CFR Appendix A to Part 60 - Qualification Performance Standards for Airplane Full Flight Simulators

Code of Federal Regulations, 2010 CFR

2010-01-01

.... Qualification Performance Standards (§ 60.4). 5. Quality Management System (§ 60.5). 6. Sponsor Qualification... inquiries on system compatibility, and minimum system requirements are also included on the NSP Web site. d... Flight Guidance Systems. (15) AC 120-57, as amended, Surface Movement Guidance and Control System (SMGCS...

Spatial Data Transfer Standard (SDTS)

USGS Publications Warehouse

,

1995-01-01

The Spatial Data Transfer Standard (SOTS) is a mechanism for the transfer of spatial data between dissimilar computer systems. The SOTS specifies exchange constructs, addressing formats, structure, and content for spatially referenced vector and raster (including gridded) data. SOTS components are a conceptual model, specifications for a quality report, transfer module specifications, data dictionary specifications, and definitions of spatial features and attributes.

Field Evaluation of Portable and Central Site PM Samplers Emphasizing Additive and Differential Mass Concentration Estimates

EPA Science Inventory

The US Environmental Protection Agency (EPA) published a National Ambient Air Quality Standard (NAAQS) and the accompanying Federal Reference Method (FRM) for PM₁₀ in 1987. The EPA revised the particle standards and FRM in 1997 to include PM_2.5. In 2005, EPA...

Mobility in Higher Education: Cross-Cultural Communication Issues.

ERIC Educational Resources Information Center

Baumgratz, Gisela

1993-01-01

A study of the role of foreign languages in European higher education focused on the influence of institutional culture, including that of the discipline, on quality of professional communication. Findings are discussed, and related issues are examined, including student/professional mobility, interinstitutional cooperation, standards for…

48 CFR 3452.224-70 - Release of information under the Freedom of Information Act.

Code of Federal Regulations, 2014 CFR

2014-10-01

...: (1) Unit prices, including labor rates; (2) Statements of Work/Performance Work Statements generated by the contractor; (3) Performance requirements, including incentives, performance standards, quality levels, and service level agreements; (4) Reports, deliverables, and work products delivered in...

48 CFR 3452.224-70 - Release of information under the Freedom of Information Act.

Code of Federal Regulations, 2012 CFR

2012-10-01

...: (1) Unit prices, including labor rates; (2) Statements of Work/Performance Work Statements generated by the contractor; (3) Performance requirements, including incentives, performance standards, quality levels, and service level agreements; (4) Reports, deliverables, and work products delivered in...

48 CFR 3452.224-70 - Release of information under the Freedom of Information Act.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: (1) Unit prices, including labor rates; (2) Statements of Work/Performance Work Statements generated by the contractor; (3) Performance requirements, including incentives, performance standards, quality levels, and service level agreements; (4) Reports, deliverables, and work products delivered in...

Analysis of postfire hydrology, water quality, and sediment transport for selected streams in areas of the 2002 Hayman and Hinman fires, Colorado

USGS Publications Warehouse

Stevens, Michael R.

2013-01-01

The U.S. Geological Survey (USGS) began a 5-year study in 2003 that focused on postfire stream-water quality and postfire sediment load in streams within the Hayman and Hinman fire study areas. This report compares water quality of selected streams receiving runoff from unburned areas and burned areas using concentrations and loads, and trend analysis, from seasonal data (approximately April–November) collected 2003–2007 at the Hayman fire study area, and data collected from 1999–2000 (prefire) and 2003 (postfire) at the Hinman fire study area. The water-quality data collected during this study include onsite measurements of streamflow, specific conductance, and turbidity, laboratory-determined pH, and concentrations of major ions, nutrients, organic carbon, trace elements, and suspended sediment. Postfire floods and effects on water quality of streams, lakes and reservoirs, drinking-water treatment, and the comparison of measured concentrations to applicable water quality standards also are discussed. Exceedances of Colorado water-quality standards in streams of both the Hayman and Hinman fire study areas only occurred for concentrations of five trace elements (not all trace-element exceedances occurred in every stream). Selected samples analyzed for total recoverable arsenic (fixed), dissolved copper (acute and chronic), total recoverable iron (chronic), dissolved manganese (acute, chronic, and fixed) and total recoverable mercury (chronic) exceeded Colorado aquatic-life standards.

The Status of the Quality Control in Acupuncture-Neuroimaging Studies

PubMed Central

Qiu, Ke; Jing, Miaomiao; Liu, Xiaoyan; Gao, Feifei; Liang, Fanrong; Zeng, Fang

2016-01-01

Using neuroimaging techniques to explore the central mechanism of acupuncture gains increasing attention, but the quality control of acupuncture-neuroimaging study remains to be improved. We searched the PubMed Database during 1995 to 2014. The original English articles with neuroimaging scan performed on human beings were included. The data involved quality control including the author, sample size, characteristics of the participant, neuroimaging technology, and acupuncture intervention were extracted and analyzed. The rigorous inclusion and exclusion criteria are important guaranty for the participants' homogeneity. The standard operation process of acupuncture and the stricter requirement for acupuncturist play significant role in quality control. More attention should be paid to the quality control in future studies to improve the reproducibility and reliability of the acupuncture-neuroimaging studies. PMID:27242911

Implementation and results of an integrated data quality assurance protocol in a randomized controlled trial in Uttar Pradesh, India.

PubMed

Gass, Jonathon D; Misra, Anamika; Yadav, Mahendra Nath Singh; Sana, Fatima; Singh, Chetna; Mankar, Anup; Neal, Brandon J; Fisher-Bowman, Jennifer; Maisonneuve, Jenny; Delaney, Megan Marx; Kumar, Krishan; Singh, Vinay Pratap; Sharma, Narender; Gawande, Atul; Semrau, Katherine; Hirschhorn, Lisa R

2017-09-07

There are few published standards or methodological guidelines for integrating Data Quality Assurance (DQA) protocols into large-scale health systems research trials, especially in resource-limited settings. The BetterBirth Trial is a matched-pair, cluster-randomized controlled trial (RCT) of the BetterBirth Program, which seeks to improve quality of facility-based deliveries and reduce 7-day maternal and neonatal mortality and maternal morbidity in Uttar Pradesh, India. In the trial, over 6300 deliveries were observed and over 153,000 mother-baby pairs across 120 study sites were followed to assess health outcomes. We designed and implemented a robust and integrated DQA system to sustain high-quality data throughout the trial. We designed the Data Quality Monitoring and Improvement System (DQMIS) to reinforce six dimensions of data quality: accuracy, reliability, timeliness, completeness, precision, and integrity. The DQMIS was comprised of five functional components: 1) a monitoring and evaluation team to support the system; 2) a DQA protocol, including data collection audits and targets, rapid data feedback, and supportive supervision; 3) training; 4) standard operating procedures for data collection; and 5) an electronic data collection and reporting system. Routine audits by supervisors included double data entry, simultaneous delivery observations, and review of recorded calls to patients. Data feedback reports identified errors automatically, facilitating supportive supervision through a continuous quality improvement model. The five functional components of the DQMIS successfully reinforced data reliability, timeliness, completeness, precision, and integrity. The DQMIS also resulted in 98.33% accuracy across all data collection activities in the trial. All data collection activities demonstrated improvement in accuracy throughout implementation. Data collectors demonstrated a statistically significant (p = 0.0004) increase in accuracy throughout consecutive audits. The DQMIS was successful, despite an increase from 20 to 130 data collectors. In the absence of widely disseminated data quality methods and standards for large RCT interventions in limited-resource settings, we developed an integrated DQA system, combining auditing, rapid data feedback, and supportive supervision, which ensured high-quality data and could serve as a model for future health systems research trials. Future efforts should focus on standardization of DQA processes for health systems research. ClinicalTrials.gov identifier, NCT02148952 . Registered on 13 February 2014.

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.

Does the addition of specific acupuncture to standard swallowing training improve outcomes in patients with dysphagia after stroke? a randomized controlled trial

PubMed Central

Xia, Wenguang; Zheng, Chanjuan; Zhu, Suiqiang; Tang, Zhouping

2015-01-01

Objective: To assess the effect of adding acupuncture to standard swallowing training for patients with dysphagia after stroke. Design: Single-blind randomized controlled trial. Setting: Inpatient and outpatient clinics. Subjects: A total of 124 patients with dysphagia after stroke were randomly divided into two groups: acupuncture and control. Interventions: The acupuncture group received standard swallowing training and acupuncture treatment. In comparison, the control group only received standard swallowing training. Participants in both groups received six days of therapy per week for a four-week period. Main measures: The primary outcome measures included the Standardized Swallowing Assessment and the Dysphagia Outcome Severity Scale. The secondary outcome measures included the Modified Barthel Index and Swallowing-Related Quality of Life, which were assessed before and after the four-week therapy period. Results: A total of 120 dysphagic subjects completed the study (60 in acupuncture group and 60 in control group). Significant differences existed in the Standardized Swallowing Assessment, Dysphagia Outcome Severity Scale, Modified Barthel Index, and Swallowing-Related Quality of Life scores of each group after the treatment (P < 0.01). After the four-week treatment, the Standardized Swallowing Assessment (mean difference − 2.9; 95% confidence interval (CI) – 5.0 to − 0.81; P < 0.01), Dysphagia Outcome Severity Scale (mean difference 2.3; 95% CI 0.7 to 1.2; P < 0.01), Modified Barthel Index (mean difference 17.2; 95% CI 2.6 to 9.3; P < 0.05) and Swallowing-Related Quality of Life scores (mean difference 31.4; 95% CI 3.2 to 11.4; P < 0.01) showed more significant improvement in the acupuncture group than the control group. Conclusions: Acupuncture combined with the standard swallowing training may be beneficial for dysphagic patients after stroke. PMID:25819076

Groundwater conditions in Utah, spring of 2011

USGS Publications Warehouse

Burden, Carole B.

2011-01-01

This is the forty-eighth in a series of annual reports that describe groundwater conditions in Utah. Reports in this series, published cooperatively by the U.S. Geological Survey and the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality, provide data to enable interested parties to maintain awareness of changing groundwater conditions. This report, like the others in the series, contains information on well construction, groundwater withdrawal from wells, water-level changes, precipitation, streamflow, and chemical quality of water. Information on well construction included in this report refers only to wells constructed for new appropriations of groundwater. Supplementary data are included in reports of this series only for those years or areas that are important to a discussion of changing groundwater conditions and for which applicable data are available.This report includes individual discussions of selected significant areas of groundwater development in the State for calendar year 2010. Most of the reported data were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality. This report is also available online at http:// www.waterrights.utah.gov/techinfo/ and http://ut.water.usgs. gov/publications/GW2011.pdf. Groundwater conditions in Utah for calendar year 2009 are reported in Burden and others (2010) and available online at http://ut.water.usgs.gov/ publications/GW2010.pdf.Analytical results associated with water samples collected from each area of groundwater development were compared to State of Utah Maximum Contaminant Levels (MCLs) and secondary drinking-water standards of routinely measureable substances present in water supplies. The MCLs and secondary drinking-water standards can be accessed online at http://www.rules.utah.gov/publicat/code/r309/r309-200. htm#T5. The U.S. Environmental Protection Agency (EPA) drinking-water standards can be accessed at http://www.epa. gov/safewater/mcl.html#mcls. Maximum Contaminant Levels and secondary drinking-water standards were developed for public water systems and do not apply to the majority of wells sampled during this study.

A systematic scoping review of adherence to reporting guidelines in health care literature

PubMed Central

Samaan, Zainab; Mbuagbaw, Lawrence; Kosa, Daisy; Debono, Victoria Borg; Dillenburg, Rejane; Zhang, Shiyuan; Fruci, Vincent; Dennis, Brittany; Bawor, Monica; Thabane, Lehana

2013-01-01

Background Reporting guidelines have been available for the past 17 years since the inception of the Consolidated Standards of Reporting Trials statement in 1996. These guidelines were developed to improve the quality of reporting of studies in medical literature. Despite the widespread availability of these guidelines, the quality of reporting of medical literature remained suboptimal. In this study, we assess the current adherence practice to reporting guidelines; determine key factors associated with better adherence to these guidelines; and provide recommendations to enhance adherence to reporting guidelines for future studies. Methods We undertook a systematic scoping review of systematic reviews of adherence to reporting guidelines across different clinical areas and study designs. We searched four electronic databases (Cumulative Index to Nursing and Allied Health Literature, Web of Science, Embase, and Medline) from January 1996 to September 2012. Studies were included if they addressed adherence to one of the following guidelines: Consolidated Standards of Reporting Trials (CONSORT), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), Quality of Reporting of Meta-analysis (QUOROM), Transparent Reporting of Evaluations with Nonrandomized Designs (TREND), Meta-analysis Of Observational Studies in Epidemiology (MOOSE) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). A protocol for this study was devised. A literature search, data extraction, and quality assessment were performed independently by two authors in duplicate. This study reporting follows the PRISMA guidelines. Results Our search retrieved 5159 titles, of which 50 were eligible. Overall, 86.0% of studies reported suboptimal levels of adherence to reporting guidelines. Factors associated with better adherence included journal impact factor and endorsement of guidelines, publication date, funding source, multisite studies, pharmacological interventions and larger studies. Conclusion Reporting guidelines in the clinical literature are important to improve the standards of reporting of clinical studies; however, adherence to these guidelines remains suboptimal. Action is therefore needed to enhance the adherence to these standards. Strategies to enhance adherence include journal editorial policies endorsing these guidelines. PMID:23671390

Impact of iterative metal artifact reduction on diagnostic image quality in patients with dental hardware.

PubMed

Weiß, Jakob; Schabel, Christoph; Bongers, Malte; Raupach, Rainer; Clasen, Stephan; Notohamiprodjo, Mike; Nikolaou, Konstantin; Bamberg, Fabian

2017-03-01

Background Metal artifacts often impair diagnostic accuracy in computed tomography (CT) imaging. Therefore, effective and workflow implemented metal artifact reduction algorithms are crucial to gain higher diagnostic image quality in patients with metallic hardware. Purpose To assess the clinical performance of a novel iterative metal artifact reduction (iMAR) algorithm for CT in patients with dental fillings. Material and Methods Thirty consecutive patients scheduled for CT imaging and dental fillings were included in the analysis. All patients underwent CT imaging using a second generation dual-source CT scanner (120 kV single-energy; 100/Sn140 kV in dual-energy, 219 mAs, gantry rotation time 0.28-1/s, collimation 0.6 mm) as part of their clinical work-up. Post-processing included standard kernel (B49) and an iterative MAR algorithm. Image quality and diagnostic value were assessed qualitatively (Likert scale) and quantitatively (HU ± SD) by two reviewers independently. Results All 30 patients were included in the analysis, with equal reconstruction times for iMAR and standard reconstruction (17 s ± 0.5 vs. 19 s ± 0.5; P > 0.05). Visual image quality was significantly higher for iMAR as compared with standard reconstruction (3.8 ± 0.5 vs. 2.6 ± 0.5; P < 0.0001, respectively) and showed improved evaluation of adjacent anatomical structures. Similarly, HU-based measurements of degree of artifacts were significantly lower in the iMAR reconstructions as compared with the standard reconstruction (0.9 ± 1.6 vs. -20 ± 47; P < 0.05, respectively). Conclusion The tested iterative, raw-data based reconstruction MAR algorithm allows for a significant reduction of metal artifacts and improved evaluation of adjacent anatomical structures in the head and neck area in patients with dental hardware.

WHO Working Group on revision of the Manual of Laboratory Methods for Testing DTP Vaccines-Report of two meetings held on 20-21 July 2006 and 28-30 March 2007, Geneva, Switzerland.

PubMed

Corbel, Michael J; Das, Rose Gaines; Lei, Dianliang; Xing, Dorothy K L; Horiuchi, Yoshinobu; Dobbelaer, Roland

2008-04-07

This report reflects the discussion and conclusions of a WHO group of experts from National Regulatory Authorities (NRAs), National Control Laboratories (NCLs), vaccine industries and other relevant institutions involved in standardization and control of diphtheria, tetanus and pertussis vaccines (DTP), held on 20-21 July 2006 and 28-30 March 2007, in Geneva Switzerland for the revision of WHO Manual for quality control of DTP vaccines. Taking into account recent developments and standardization in quality control methods and the revision of WHO recommendations for D, T, P vaccines, and a need for updating the manual has been recognized. In these two meetings the current situation of quality control methods in terms of potency, safety and identity tests for DTP vaccines and statistical analysis of data were reviewed. Based on the WHO recommendations and recent validation of testing methods, the content of current manual were reviewed and discussed. The group agreed that the principles to be observed in selecting methods included identifying those critical for assuring safety, efficacy and quality and which were consistent with WHO recommendations/requirements. Methods that were well recognized but not yet included in current Recommendations should be taken into account. These would include in vivo and/or in vitro methods for determining potency, safety testing and identity. The statistical analysis of the data should be revised and updated. It was noted that the mouse based assays for toxoid potency were still quite widely used and it was desirable to establish appropriate standards for these to enable the results to be related to the standard guinea pig assays. The working group was met again to review the first drafts and to input further suggestions or amendments to the contributions of the drafting groups. The revised manual was to be finalized and published by WHO.

ASTM Committee C28: International Standards for Properties and Performance of Advanced Ceramics-Three Decades of High-Quality, Technically-Rigorous Normalization

NASA Technical Reports Server (NTRS)

Jenkins, Michael G.; Salem, Jonathan A.

2016-01-01

Physical and mechanical properties and performance of advanced ceramics and glasses are difficult to measure correctly without the proper techniques. For over three decades, ASTM Committee C28 on Advanced Ceramics, has developed high-quality, technically-rigorous, full-consensus standards (e.g., test methods, practices, guides, terminology) to measure properties and performance of monolithic and composite ceramics that may be applied to glasses in some cases. These standards contain testing particulars for many mechanical, physical, thermal, properties and performance of these materials. As a result these standards are used to generate accurate, reliable, repeatable and complete data. Within Committee C28, users, producers, researchers, designers, academicians, etc. have written, continually updated, and validated through round-robin test programs, 50 standards since the Committee's founding in 1986. This paper provides a detailed retrospective of the 30 years of ASTM Committee C28 including a graphical pictogram listing of C28 standards along with examples of the tangible benefits of standards for advanced ceramics to demonstrate their practical applications.

Interstitial lung disease

MedlinePlus

... for lung disease. These jobs include coal mining, sand blasting, and working on a ship. Treatment Treatment ... A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among ...

Randomized trials and quality assurance in gastric cancer surgery.

PubMed

Dikken, Johan L; Cats, Annemieke; Verheij, Marcel; van de Velde, Cornelis J H

2013-03-01

A D2 lymphadenectomy can be considered standard of surgical care for advanced resectable gastric cancer. Currently, several multimodality strategies are used, including postoperative monochemotherapy in Asia, postoperative chemoradiotherapy in the United States, and perioperative chemotherapy in Europe. As the majority of gastric cancer patients are treated outside the framework of clinical trials, quality assurance programs, including referral to high-volume centers and clinical auditing are needed to improve gastric cancer care on a nationwide level. Copyright © 2012 Wiley Periodicals, Inc.

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...

Water quality standards for the protection of human health and aquatic ecosystems in Korea: current state and future perspective.

PubMed

Kwak, Jin Il; Nam, Sun-Hwa; An, Youn-Joo

2018-02-01

Since the Korean Ministry of the Environment established the Master Plan for Water Environment (2006-2015), the need to revise the water quality standards (WQSs) has driven government projects to expand the standards for the protection of human health and aquatic ecosystems. This study aimed to provide an historical overview of how these WQSs were established, amended, and expanded over the past 10 years in Korea. Here, major projects related to national monitoring in rivers and the amendment of WQSs were intensely reviewed, including projects on the categorization of hazardous chemicals potentially discharged into surface water, the chemical ranking and scoring methodology for surface water (CRAFT, Chemical RAnking of surFace water polluTants), whole effluent toxicity (WET) management systems, the 4th, 5th, and 6th revisions of the water quality standards for the protection of human health, and efforts toward developing the 7th revision. In this review, we assimilated the past and current status as well as future perspectives of Korean surface WQSs. This research provides information that aids our understanding of how surface WQSs have been expanded, and how scientific approaches to ensure water quality have been applied at each step of the process in Korea.

Data management in clinical research: An overview

PubMed Central

Krishnankutty, Binny; Bellary, Shantala; Kumar, Naveen B.R.; Moodahadu, Latha S.

2012-01-01

Clinical Data Management (CDM) is a critical phase in clinical research, which leads to generation of high-quality, reliable, and statistically sound data from clinical trials. This helps to produce a drastic reduction in time from drug development to marketing. Team members of CDM are actively involved in all stages of clinical trial right from inception to completion. They should have adequate process knowledge that helps maintain the quality standards of CDM processes. Various procedures in CDM including Case Report Form (CRF) designing, CRF annotation, database designing, data-entry, data validation, discrepancy management, medical coding, data extraction, and database locking are assessed for quality at regular intervals during a trial. In the present scenario, there is an increased demand to improve the CDM standards to meet the regulatory requirements and stay ahead of the competition by means of faster commercialization of product. With the implementation of regulatory compliant data management tools, CDM team can meet these demands. Additionally, it is becoming mandatory for companies to submit the data electronically. CDM professionals should meet appropriate expectations and set standards for data quality and also have a drive to adapt to the rapidly changing technology. This article highlights the processes involved and provides the reader an overview of the tools and standards adopted as well as the roles and responsibilities in CDM. PMID:22529469

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

Quality improvement: the nurse's role.

PubMed

Moran, M J; Johnson, J E

1992-06-01

Continuous quality improvement is a concept which includes: Quality assurance--the provision of services that meet an appropriate standard. Problem resolution--including all departments involved in the issue at hand. Quality improvement--a continuous process involving all levels of the organization working together across departmental lines to produce better services for health care clients. Deming (1982b) and others have espoused total system reform to achieve quality improvement--not merely altering the current system, but radically changing it. It must be assumed that those who provide services at the staff level are acting in good faith and are not willfully failing to do what is correct (Berwick, 1991). Those who perform direct services are in an excellent position to identify the need for change in service delivery processes. Based on this premise, the staff nurse--who is at the heart of the system--is the best person to assess the status of health care services and to work toward improving the processes by which these services are provided to clients in the health care setting. The nurse manager must structure the work setting to facilitate the staff nurse's ability to undertake constructive action for improving care. The use of quality circles, quality councils, or quality improvement forums to facilitate the coordination of quality improvement efforts is an effective way to achieve success. The QA coordinator assists departments in documenting that the quality improvement efforts are effective across all departments of the organization, and aggregates data to demonstrate that they meet the requirements of external regulatory agencies, insurers, and professional standards. The nurse executive provides the vision and secures the necessary resources to ensure that the organization's quality improvement efforts are successful. By inspiring and empowering the staff in their efforts to improve the process by which health care is provided, nurse managers participate in reshaping the health care environment. The professional nurse plays a vital role in the quality improvement of health care services. However, nurses cannot make these improvements in a vacuum; they must include other professionals and ancillary personnel in their efforts. Total quality commitment must include all levels of an organization's structure. Quality patient care services will be achieved as the result of positive interactions among departments working together to build a dynamic mechanism that continuously improves the processes and outcomes of health care services.

Reporting Quality Assessment of Randomized Controlled Trials Published in Nephrology Urology Monthly Journal.

PubMed

Mehrazmay, Alireza; Karambakhsh, Alireza; Salesi, Mahmood

2015-07-01

Randomized controlled trials (RCTs) are important tools for evidence-based health care decisions. It is, therefore, important that they be conducted and reported with the highest possible standards. The aim of this study was to evaluate the reporting quality of the RCTs published in nephrology urology monthly journal and to examine whether there was a change over time in the reporting quality. The quality of each report was assessed using the Consolidated Standards of Reporting Trials (CONSORT) 2010 Statement checklist and a 5-point quality assessment instrument, i.e. the Jadad scale. Eighteen (14 Iranian and 4 non-Iranian) RCTs were published from 2012 to 2014 on topics including renal stone (16.6%), hemodialysis and transplantation (38.8%), and prostate conditions (11.1%). Interventions comprised surgery, drugs, and teaching method in 7 (38 %), 10 (55%), and 1 (5%) of them, respectively. According to the CONSORT checklist, the weakest reported items were registration number, identification as a randomized trial in the title, and settings and locations where the data were collected. The mean Jadad score of the reports was 2.72 ± 1.36 (54% of their maximum possible total score). According to the Jadad and CONSORT scales, there was an increase in the quality of reporting from 2012 to 2014. This assessment shows low reporting quality scores in reports. Training courses for researchers, using standard reporting tools (e.g. CONSORT 2010 Statement checklist), and consultation with methodologists can improve the quality of published RCTs.

36 CFR 228.112 - Compliance and inspection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Forest officer shall give prompt written notice to an operator whenever reclamation of a portion of the... and State water quality standards, including the requirements of the Federal Water Pollution Control...

Role of Science at EPA

EPA Pesticide Factsheets

Decision-making is driven by research with the highest standards for integrity, peer review, transparency, and ethics. Ongoing positive impacts include reducing pollution, improving air quality, defining exposure pathways, and protecting water sources.

2007 Children's Health Protection Advisory Committee Meeting Agendas

EPA Pesticide Factsheets

Objectives for the three meetings in 2007 include discussing mutagenic mode of action, National Ambient Air Quality Standard for lead, Pediatric Environmental Health Specialty Units, and emerging chemicals of concern.

Hydrologic and chemical-quality data from four rural basins in Guilford County, North Carolina, 1985-88

USGS Publications Warehouse

Hill, C.L.

1989-01-01

An investigation was begun in 1984 in Guilford County, North Carolina, to monitor water quality and soil erosion in basins with various land-management practices. Hydrologic and chemical-quality data were collected from four rural drainage basins, including two agricultural basins (7.4 and 4.8 acres) cultivated in tobacco and small grains, a mixed rural land-use basin (665 acres) currently under standard land-management practices, and a forested control basin (44 acres) characterizing background conditions. Mean concentrations of total nitrite plus nitrate were 1.0 milligrams per liter from the agricultural basin under standard land-management practices. This was nearly 10 times greater than concentrations from the forested basin. Records of streamflow discharge, chemical quality, ground-water levels, precipitation, and farming activities collected from October 1984 through September 1988 at one or more of the basins are also presented in this report.

TRACKING FRESHWATER DIVERSIONS AND ALGAL BLOOMS THAT IMPACT THE NEW ORLEANS STANDARD METROPOLITAN STATISTICAL AREA -

EPA Science Inventory

This project will monitor selected water quality parameters, including water temperature, turbidity, salinity, and algal blooms to assess the impacts of freshwater diversions for several selected areas within the New Orleans metropolitan area. The specific areas of study include ...

Standardized Methods for Enhanced Quality and Comparability of Tuberculous Meningitis Studies.

PubMed

Marais, Ben J; Heemskerk, Anna D; Marais, Suzaan S; van Crevel, Reinout; Rohlwink, Ursula; Caws, Maxine; Meintjes, Graeme; Misra, Usha K; Mai, Nguyen T H; Ruslami, Rovina; Seddon, James A; Solomons, Regan; van Toorn, Ronald; Figaji, Anthony; McIlleron, Helen; Aarnoutse, Robert; Schoeman, Johan F; Wilkinson, Robert J; Thwaites, Guy E

2017-02-15

Tuberculous meningitis (TBM) remains a major cause of death and disability in tuberculosis-endemic areas, especially in young children and immunocompromised adults. Research aimed at improving outcomes is hampered by poor standardization, which limits study comparison and the generalizability of results. We propose standardized methods for the conduct of TBM clinical research that were drafted at an international tuberculous meningitis research meeting organized by the Oxford University Clinical Research Unit in Vietnam. We propose a core dataset including demographic and clinical information to be collected at study enrollment, important aspects related to patient management and monitoring, and standardized reporting of patient outcomes. The criteria proposed for the conduct of observational and intervention TBM studies should improve the quality of future research outputs, can facilitate multicenter studies and meta-analyses of pooled data, and could provide the foundation for a global TBM data repository.

A Strategy to Establish a Quality Assurance/Quality Control Plan for the Application of Biosensors for the Detection of E. coli in Water.

PubMed

Hesari, Nikou; Kıratlı Yılmazçoban, Nursel; Elzein, Mohamad; Alum, Absar; Abbaszadegan, Morteza

2017-01-03

Rapid bacterial detection using biosensors is a novel approach for microbiological testing applications. Validation of such methods is an obstacle in the adoption of new bio-sensing technologies for water testing. Therefore, establishing a quality assurance and quality control (QA/QC) plan is essential to demonstrate accuracy and reliability of the biosensor method for the detection of E. coli in drinking water samples. In this study, different reagents and assay conditions including temperatures, holding time, E. coli strains and concentrations, dissolving agents, salinity and pH effects, quality of substrates of various suppliers of 4-methylumbelliferyl glucuronide (MUG), and environmental water samples were included in the QA/QC plan and used in the assay optimization and documentation. Furthermore, the procedural QA/QC for the monitoring of drinking water samples was established to validate the performance of the biosensor platform for the detection of E. coli using a culture-based standard technique. Implementing the developed QA/QC plan, the same level of precision and accuracy was achieved using both the standard and the biosensor methods. The established procedural QA/QC for the biosensor will provide a reliable tool for a near real-time monitoring of E. coli in drinking water samples to both industry and regulatory authorities.

A Strategy to Establish a Quality Assurance/Quality Control Plan for the Application of Biosensors for the Detection of E. coli in Water

PubMed Central

Hesari, Nikou; Kıratlı Yılmazçoban, Nursel; Elzein, Mohamad; Alum, Absar; Abbaszadegan, Morteza

2017-01-01

Rapid bacterial detection using biosensors is a novel approach for microbiological testing applications. Validation of such methods is an obstacle in the adoption of new bio-sensing technologies for water testing. Therefore, establishing a quality assurance and quality control (QA/QC) plan is essential to demonstrate accuracy and reliability of the biosensor method for the detection of E. coli in drinking water samples. In this study, different reagents and assay conditions including temperatures, holding time, E. coli strains and concentrations, dissolving agents, salinity and pH effects, quality of substrates of various suppliers of 4-methylumbelliferyl glucuronide (MUG), and environmental water samples were included in the QA/QC plan and used in the assay optimization and documentation. Furthermore, the procedural QA/QC for the monitoring of drinking water samples was established to validate the performance of the biosensor platform for the detection of E. coli using a culture-based standard technique. Implementing the developed QA/QC plan, the same level of precision and accuracy was achieved using both the standard and the biosensor methods. The established procedural QA/QC for the biosensor will provide a reliable tool for a near real-time monitoring of E. coli in drinking water samples to both industry and regulatory authorities. PMID:28054956

Water quality data for national-scale aquatic research: The Water Quality Portal

USGS Publications Warehouse

Read, Emily K.; Carr, Lindsay; DeCicco, Laura; Dugan, Hilary; Hanson, Paul C.; Hart, Julia A.; Kreft, James; Read, Jordan S.; Winslow, Luke

2017-01-01

Aquatic systems are critical to food, security, and society. But, water data are collected by hundreds of research groups and organizations, many of which use nonstandard or inconsistent data descriptions and dissemination, and disparities across different types of water observation systems represent a major challenge for freshwater research. To address this issue, the Water Quality Portal (WQP) was developed by the U.S. Environmental Protection Agency, the U.S. Geological Survey, and the National Water Quality Monitoring Council to be a single point of access for water quality data dating back more than a century. The WQP is the largest standardized water quality data set available at the time of this writing, with more than 290 million records from more than 2.7 million sites in groundwater, inland, and coastal waters. The number of data contributors, data consumers, and third-party application developers making use of the WQP is growing rapidly. Here we introduce the WQP, including an overview of data, the standardized data model, and data access and services; and we describe challenges and opportunities associated with using WQP data. We also demonstrate through an example the value of the WQP data by characterizing seasonal variation in lake water clarity for regions of the continental U.S. The code used to access, download, analyze, and display these WQP data as shown in the figures is included as supporting information.

Federal standards and procedures for the National Watershed Boundary Dataset (WBD)

USGS Publications Warehouse

,; ,; ,

2009-03-11

Terminology, definitions, and procedural information are provided to ensure uniformity in hydrologic unit boundaries, names, and numerical codes. Detailed standards and specifications for data are included. The document also includes discussion of objectives, communications required for revising the data resolution in the United States and the Caribbean, as well as final review and data-quality criteria. Instances of unusual landforms or artificial features that affect the hydrologic units are described with metadata standards. Up-to-date information and availability of the hydrologic units are listed athttp://www.nrcs.usda.gov/wps/portal/nrcs/detail/national/technical/nra/dma/?&cid=nrcs143_021630/.

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...

Valerian for sleep: a systematic review and meta-analysis.

PubMed

Bent, Stephen; Padula, Amy; Moore, Dan; Patterson, Michael; Mehling, Wolf

2006-12-01

Insomnia affects approximately one-third of the adult population and contributes to increased rates of absenteeism, health care use, and social disability. Extracts of the roots of valerian (Valeriana officinalis) are widely used for inducing sleep and improving sleep quality. A systematic review of randomized, placebo-controlled trials of valerian for improving sleep quality is presented. An extensive literature search identified 16 eligible studies examining a total of 1093 patients. Most studies had significant methodologic problems, and the valerian doses, preparations, and length of treatment varied considerably. A dichotomous outcome of sleep quality (improved or not) was reported by 6 studies and showed a statistically significant benefit (relative risk of improved sleep = 1.8, 95% confidence interval, 1.2-2.9), but there was evidence of publication bias in this summary measure. The available evidence suggests that valerian might improve sleep quality without producing side effects. Future studies should assess a range of doses of standardized preparations of valerian and include standard measures of sleep quality and safety.

Valerian for Sleep: A Systematic Review and Meta-Analysis

PubMed Central

Bent, Stephen; Padula, Amy; Moore, Dan; Patterson, Michael; Mehling, Wolf

2014-01-01

Insomnia affects approximately one-third of the adult population and contributes to increased rates of absenteeism, health care use, and social disability. Extracts of the roots of valerian (Valeriana officinalis) are widely used for inducing sleep and improving sleep quality. A systematic review of randomized, placebo-controlled trials of valerian for improving sleep quality is presented. An extensive literature search identified 16 eligible studies examining a total of 1093 patients. Most studies had significant methodologic problems, and the valerian doses, preparations, and length of treatment varied considerably. A dichotomous outcome of sleep quality (improved or not) was reported by 6 studies and showed a statistically significant benefit (relative risk of improved sleep = 1.8, 95% confidence interval, 1.2-2.9), but there was evidence of publication bias in this summary measure. The available evidence suggests that valerian might improve sleep quality without producing side effects. Future studies should assess a range of doses of standardized preparations of valerian and include standard measures of sleep quality and safety. PMID:17145239

Assessing quality of reports on randomized clinical trials in nursing journals.

PubMed

Parent, Nicole; Hanley, James A

2009-01-01

Several surveys have presented the quality of reports on randomized clinical trials (RCTs) published in general and specialty medical journals. The aim of these surveys was to raise scientific consciousness on methodological aspects pertaining to internal and external validity. These reviews have suggested that the methodological quality could be improved. We conducted a survey of reports on RCTs published in nursing journals to assess their methodological quality. The features we considered included sample size, flow of participants, assessment of baseline comparability, randomization, blinding, and statistical analysis. We collected data from all reports of RCTs published between January 1994 and December 1997 in Applied Nursing Research, Heart & Lung and Nursing Research. We hand-searched the journals and included all 54 articles in which authors reported that individuals have been randomly allocated to distinct groups. We collected data using a condensed form of the Consolidated Standards of Reporting Trials (CONSORT) statement for structured reporting of RCTs (Begg et al., 1996). Sample size calculations were included in only 22% of the reports. Only 48% of the reports provided information about the type of randomization, and a mere 22% described blinding strategies. Comparisons of baseline characteristics using hypothesis tests were abusively produced in more than 76% of the reports. Excessive use and unstructured reports of significance testing were common (59%), and all reports failed to provide magnitude of treatment differences with confidence intervals. Better methodological quality in reports of RCTs will contribute to increase the standards of nursing research.

The relationship between patient safety climate and standard precaution adherence: a systematic review of the literature

PubMed Central

Hessels, Amanda; Larson, Elaine

2015-01-01

SUMMARY Standard precaution (SP) adherence is universally suboptimal, despite being a core component of healthcare-associated infection (HCAI) prevention and healthcare worker (HCW) safety. Emerging evidence suggests that patient safety climate (PSC) factors may improve HCW behaviours. Our aim was to examine the relationship between PSC and SP adherence by HCWs in acute care hospitals. A systematic review was conducted as guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Three electronic databases were comprehensively searched for literature published or available in English between 2000 and 2014. Seven of 888 articles identified were eligible for final inclusion in the review. Two reviewers independently assessed study quality using a validated quality tool. The seven articles were assigned quality scores ranging from 7 to 10 of 10 possible points. Five measured all aspects of SP and two solely measured needlestick and sharps handling. Three included a secondary outcome of HCW exposure; none included HCAIs. All reported a statistically significant relationship between better PSC and greater SP adherence and used data from self-report surveys including validated PSC measures or measures of management support and leadership. Although limited in number, studies were of high quality and confirmed that PSC and SP adherence were correlated, suggesting that efforts to improve PSC may enhance adherence to a core component of HCAI prevention and HCW safety. More clearly evident is the need for additional high-quality research. PMID:26549480

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.

Modeling of lead air pollution. [Baton Rouge, Louisiana

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

Monteith, C.S.; Henry, J.M.

1982-05-01

A study was performed to determine whether vehicular emissions should be included with industrial emissions when demonstrating attainment of the ambient air quality standard for lead. The impact on ambient lead concentrations of the phaseout of leaded gasoline and improved automobile fuel economy was examined by modeling vehicular emissions for 1972 and 1978. Results show that while automobiles in the Baton Rouge area were a significant source of lead in 1972, the phaseout of leaded gasoline and the increase in fuel economy have resulted in a lower contribution (0.20 ..mu..g/m/sup 3/) by automobiles to the ambient lead concentration in 1978.more » The areas having the greatest potential for exceeding the ambient air quality standard can be identified using CDM (EPA's Climatological Dispersion Model). This information can be used to determine the optimal location for an ambient air monitor to demonstrate compliance with the ambient air quality standard. 9 references, 4 figures, 5 tables. (JMT)« less

KSC-98pc908

NASA Image and Video Library

1998-08-11

Center Director Roy Bridges (right) displays the 2000th ISO Certificate Plaque he was given by Dalton Lyon (left) of Det Norske Veritas (DNV), Inc., an international ISO certification organization, at a ceremony at KSC. The plaque is a representation of the ISO 9001 certification awarded to KSC by DNV. ISO 9001 comprises the most detailed, comprehensive set of standard requirements for quality programs established by the International Standards Organization. The presentation followed a successful independent audit by DNV of the KSC Management System in May of this year. The third-party auditors examined about 20 elements of KSC's system, including management responsibility, design control, documentation, test and inspection, and corrective action procedures. DNV found that KSC met or exceeded the stringent quality standards in all areas. KSC will use this certification as a tool to improve an already worldclass team. All NASA centers are required by NASA Administrator Daniel S. Goldin to be ISO 9001 registered by September 1999. NASA is the first federal agency to seek the quality certification

Lead and tap water

MedlinePlus

... EPA) to set and enforce standards to protect public drinking water systems. The Agency requires water suppliers to produce annual water quality reports. These reports include information about lead amounts. The reports are available to ...

A randomized trial of adjunct testosterone for cancer‐related muscle loss in men and women

PubMed Central

Wright, Traver J.; Dillon, E. Lichar; Durham, William J.; Chamberlain, Albert; Randolph, Kathleen M.; Danesi, Christopher; Horstman, Astrid M.; Gilkison, Charles R.; Willis, Maurice; Richardson, Gwyn; Hatch, Sandra S.; Jupiter, Daniel C.; McCammon, Susan; Urban, Randall J.

2018-01-01

Abstract Background Cancer cachexia negatively impacts cancer‐related treatment options, quality of life, morbidity, and mortality, yet no established therapies exist. We investigated the anabolic properties of testosterone to limit the loss of body mass in late stage cancer patients undergoing standard of care cancer treatment. Methods A randomized, double‐blind, placebo‐controlled phase II clinical trial was undertaken to assess the potential therapeutic role of adjunct testosterone to limit loss of body mass in patients with squamous cell carcinoma of the cervix or head and neck undergoing standard of care treatment including chemotherapy and chemoradiation. Patients were randomly assigned in blocks to receive weekly injections of either 100 mg testosterone enanthate or placebo for 7 weeks. The primary outcome was per cent change in lean body mass, and secondary outcomes included assessment of quality of life, tests of physical performance, muscle strength, daily activity levels, resting energy expenditure, nutritional intake, and overall survival. Results A total of 28 patients were enrolled, 22 patients were studied to completion, and 21 patients were included in the final analysis (12 placebo, nine testosterone). Adjunct testosterone increased lean body mass by 3.2% (95% confidence interval [CI], 0–7%) whereas those receiving placebo lost 3.3% (95% CI, −7% to 1%, P = 0.015). Although testosterone patients maintained more favourable body condition, sustained daily activity levels, and showed meaningful improvements in quality of life and physical performance, overall survival was similar in both treatment groups. Conclusions In patients with advanced cancer undergoing the early phase of standard of care therapy, adjunct testosterone improved lean body mass and was also associated with increased quality of life, and physical activity compared with placebo. PMID:29654645

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.

Concept of Draft International Standard for a Unified Approach to Space Program Quality Assurance

NASA Astrophysics Data System (ADS)

Stryzhak, Y.; Vasilina, V.; Kurbatov, V.

2002-01-01

For want of the unified approach to guaranteed space project and product quality assurance, implementation of many international space programs has become a challenge. Globalization of aerospace industry and participation of various international ventures with diverse quality assurance requirements in big international space programs requires for urgent generation of unified international standards related to this field. To ensure successful fulfillment of space missions, aerospace companies should design and process reliable and safe products with properties complying or bettering User's (or Customer's) requirements. Quality of the products designed or processed by subcontractors (or other suppliers) should also be in compliance with the main user (customer)'s requirements. Implementation of this involved set of unified requirements will be made possible by creating and approving a system (series) of international standards under a generic title Space Product Quality Assurance based on a system consensus principle. Conceptual features of the baseline standard in this system (series) should comprise: - Procedures for ISO 9000, CEN and ECSS requirements adaptation and introduction into space product creation, design, manufacture, testing and operation; - Procedures for quality assurance at initial (design) phases of space programs, with a decision on the end product made based on the principle of independence; - Procedures to arrange incoming inspection of products delivered by subcontractors (including testing, audit of supplier's procedures, review of supplier's documentation), and space product certification; - Procedures to identify materials and primary products applied; - Procedures for quality system audit at the component part, primary product and materials supplier facilities; - Unified procedures to form a list of basic performances to be under configuration management; - Unified procedures to form a list of critical space product components, and unified procedures to define risks related to the specific component application and evaluate safety for the entire program implementation. In the eyes of the authors, those features together with a number of other conceptual proposals should constitute a unified standard-technical basis for implementing international space programs.

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

A one-dimensional, steady-state, dissolved-oxygen model and waste-load assimilation study for Silver Creek, Clark and Floyd counties, Indiana

USGS Publications Warehouse

Wilber, William G.; Crawford, Charles G.; Peters, James G.

1979-01-01

The Indiana State Board of Health is developing a State water-quality management plan that includes establishing limits for wastewater effluents discharged into Indiana streams. A digital model calibrated to conditions in Silver Creek was used to develop alternatives for future waste loadings that would be compatible with Indiana stream water-quality standards defined for two critical hydrologic conditions, summer and winter low flows. Effluents from the Sellersburg and Clarksville-North wastewater-treatment facilities are the only point-source waste loads that significantly affect the water quality in the modeled segment of Silver Creek. Model simulations indicate that nitrification is the most significant factor affecting the dissolved-oxygen concentration in Silver Creek during summer and winter low flows. Natural streamflow in Silver Creek during the summer and annual 7-day, 10-year low flow is zero, so no benefit from dilution is provided. Present ammonia-nitrogen and dissolved-oxygen concentrations of effluent from the Sellersburg and Clarksville-North wastewater-treatment facilities will violate current Indiana water-quality standards for ammonia toxicity and dissolved oxygen during summer and winter low flows. The current biochemical-oxygen demand limits for the Sellersburg and Clarksville-North wastewater-treatment facilities are not sufficient to maintain an average dissolved-oxygen concentration of at least 5 milligrams per liter, the State 's water-quality standard for streams. Calculations of the stream 's assimilative capacity indicate that Silver Creek cannot assimilate additional waste loadings and meet current Indiana water-quality standards. (Kosco-USGS)

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

Swedish snus and the GothiaTek® standard

PubMed Central

2011-01-01

Some smokeless tobacco products, such as Swedish snus, are today considered to be associated with substantially fewer health hazards than cigarettes. This risk differential has contributed to the scientific debate about the possibilities of harm reduction within the tobacco area. Although current manufacturing methods for snus build on those that were introduced more than a century ago, the low levels of unwanted substances in modern Swedish snus are largely due to improvements in production techniques and selection of raw materials in combination with several programs for quality assurance and quality control. These measures have been successively introduced during the past 30-40 years. In the late 1990s they formed the basis for a voluntary quality standard for Swedish snus named GothiaTek®. In recent years the standard has been accepted by the members of the trade organization European Smokeless Tobacco Council (ESTOC) so it has now evolved into an industrial standard for all smokeless tobacco products in Europe. The initial impetus for the mentioned changes of the production was quality problems related to microbial activity and formation of ammonia and nitrite in the finished products. Other contributing factors were that snus came under the jurisdiction of the Swedish Food Act in 1971, and concerns that emerged in the 1960s and 1970s about health effects of tobacco, and the significance of agrochemical residues and other potential toxicants in food stuffs. This paper summarizes the historical development of the manufacture of Swedish snus, describes the chemical composition of modern snus, and gives the background and rationale for the GothiaTek® standard, including the selection of constituents for which the standard sets limits. The paper also discusses the potential future of this voluntary standard in relation to current discussions about tobacco harm reduction and regulatory science in tobacco control. PMID:21575206

Continental United States Military Housing Inspections Southeast

DTIC Science & Technology

2015-09-24

and safety, including focus on mold, asbestos , radon, lead-based paint, drinking water quality, and pest management. We conducted this inspection in...electrical system safety inspections. In addition, we inspected to EPA standards governing safe drinking water and toxic substances, radon, asbestos , and...inspections focused on mold, asbestos , radon, lead-based paint, drinking water quality, and pest management. We evaluated the associated plans and

Shaky Methods, Shaky Motives: A Critique of the National Council of Teacher Quality's Review of Teacher Preparation Programs

ERIC Educational Resources Information Center

Fuller, Edward J.

2014-01-01

The National Council on Teacher Quality's (NCTQ) recent review of university-based teacher preparation programs concluded the vast majority of such programs were inadequately preparing the nation's teachers. The study, however, has a number of serious flaws that include narrow focus on inputs, lack of a strong research base, missing standards,…

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...

Quality Early Education and Child Care From Birth to Kindergarten.

PubMed

Donoghue, Elaine A

2017-08-01

High-quality early education and child care for young children improves physical and cognitive outcomes for the children and can result in enhanced school readiness. Preschool education can be viewed as an investment (especially for at-risk children), and studies show a positive return on that investment. Barriers to high-quality early childhood education include inadequate funding and staff education as well as variable regulation and enforcement. Steps that have been taken to improve the quality of early education and child care include creating multidisciplinary, evidence-based child care practice standards; establishing state quality rating and improvement systems; improving federal and state regulations; providing child care health consultation; as well as initiating other innovative partnerships. Pediatricians have a role in promoting quality early education and child care for all children not only in the medical home but also at the community, state, and national levels. Copyright © 2017 by the American Academy of Pediatrics.

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...

Social skills programmes for schizophrenia.

PubMed

Almerie, Muhammad Qutayba; Okba Al Marhi, Muhammad; Jawoosh, Muhammad; Alsabbagh, Mohamad; Matar, Hosam E; Maayan, Nicola; Bergman, Hanna

2015-06-09

Social skills programmes (SSP) are treatment strategies aimed at enhancing the social performance and reducing the distress and difficulty experienced by people with a diagnosis of schizophrenia and can be incorporated as part of the rehabilitation package for people with schizophrenia. The primary objective is to investigate the effects of social skills training programmes, compared to standard care, for people with schizophrenia. We searched the Cochrane Schizophrenia Group's Trials Register (November 2006 and December 2011) which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO, and registries of clinical trials. We inspected references of all identified studies for further trials.A further search for studies has been conducted by the Cochrane Schizophrenia Group in 2015, 37 citations have been found and are currently being assessed by review authors. We included all relevant randomised controlled trials for social skills programmes versus standard care involving people with serious mental illnesses. We extracted data independently. For dichotomous data we calculated risk ratios (RRs) and their 95% confidence intervals (CI) on an intention-to-treat basis. For continuous data, we calculated mean differences (MD) and 95% CIs. We included 13 randomised trials (975 participants). These evaluated social skills programmes versus standard care, or discussion group. We found evidence in favour of social skills programmes compared to standard care on all measures of social functioning. We also found that rates of relapse and rehospitalisation were lower for social skills compared to standard care (relapse: 2 RCTs, n = 263, RR 0.52 CI 0.34 to 0.79, very low quality evidence), (rehospitalisation: 1 RCT, n = 143, RR 0.53 CI 0.30 to 0.93, very low quality evidence) and participants' mental state results (1 RCT, n = 91, MD -4.01 CI -7.52 to -0.50, very low quality evidence) were better in the group receiving social skill programmes. Global state was measured in one trial by numbers not experiencing a clinical improvement, results favoured social skills (1 RCT, n = 67, RR 0.29 CI 0.12 to 0.68, very low quality evidence). Quality of life was also improved in the social skills programme compared to standard care (1 RCT, n = 112, MD -7.60 CI -12.18 to -3.02, very low quality evidence). However, when social skills programmes were compared to a discussion group control, we found no significant differences in the participants social functioning, relapse rates, mental state or quality of life, again the quality of evidence for these outcomes was very low. Compared to standard care, social skills training may improve the social skills of people with schizophrenia and reduce relapse rates, but at present, the evidence is very limited with data rated as very low quality. When social skills training was compared to discussion there was no difference on patients outcomes. Cultural differences might limit the applicability of the current results, as most reported studies were conducted in China. Whether social skills training can improve social functioning of people with schizophrenia in different settings remains unclear and should be investigated in a large multi-centre randomised controlled trial.

Aerosol distribution during open suctioning and long-term surveillance of air quality in a respiratory care center within a medical center.

PubMed

Chung, Fen-Fang; Lin, Hui-Ling; Liu, Hsueh-Erh; Lien, Angela Shin-Yu; Hsiao, Hsiu-Feng; Chou, Lan-Ti; Wan, Gwo-Hwa

2015-01-01

The investigation of hospital air quality has been conducted in wards, ICUs, operating theaters, and public areas. Few studies have assessed air quality in respiratory care centers (RCCs), especially in mechanically ventilated patients with open suctioning. The RCC air quality indices (temperature, relative humidity, levels of CO2, total volatile organic compounds, particulate matter [PM], bacteria, and fungi) were monitored over 1 y. The air around the patient's head was sampled during open suctioning to examine the probability of bioaerosol exposure affecting health-care workers. This investigation found that the levels of indoor air pollutants (CO2, PM, bacteria, and fungi) were below the indoor air quality standard set by the Taiwan Environmental Protection Agency. Meanwhile, the levels of total volatile organic compounds sometimes exceeded the indoor air quality standard, particularly in August. The identified bacterial genera included Micrococcus species, Corynebacterium species, and Staphylococcus species, and the predominant fungal genera included yeast, Aspergillus species, Scopulariopsis species, and Trichoderma species. Additionally, airborne PM2.5, PM1, and bacteria were clearly raised during open suctioning in mechanically ventilated patients. This phenomenon demonstrated that open suctioning may increase the bacterial exposure risk of health-care workers. RCC air quality deserves long-term monitoring and evaluation. Health-care workers must implement self-protection strategies during open suctioning to ensure their occupational health and safety in health-care settings. Copyright © 2015 by Daedalus Enterprises.

40 CFR Appendix R to Part 50 - Interpretation of the National Ambient Air Quality Standards for Lead

Code of Federal Regulations, 2012 CFR

2012-07-01

... determine the design value. (B) The “below NAAQS level” test is as follows: Data substitution will be... the recalculated (“test”) result including the high values, shall be used to determine the design... (local standard time), that are used in NAAQS computations. Design value is the site-level metric (i.e...

40 CFR Appendix R to Part 50 - Interpretation of the National Ambient Air Quality Standards for Lead

Code of Federal Regulations, 2013 CFR

2013-07-01

... determine the design value. (B) The “below NAAQS level” test is as follows: Data substitution will be... the recalculated (“test”) result including the high values, shall be used to determine the design... (local standard time), that are used in NAAQS computations. Design value is the site-level metric (i.e...

40 CFR Appendix R to Part 50 - Interpretation of the National Ambient Air Quality Standards for Lead

Code of Federal Regulations, 2014 CFR

2014-07-01

... determine the design value. (B) The “below NAAQS level” test is as follows: Data substitution will be... the recalculated (“test”) result including the high values, shall be used to determine the design... (local standard time), that are used in NAAQS computations. Design value is the site-level metric (i.e...

40 CFR Appendix R to Part 50 - Interpretation of the National Ambient Air Quality Standards for Lead

Code of Federal Regulations, 2010 CFR

2010-07-01

... determine the design value. (B) The “below NAAQS level” test is as follows: Data substitution will be... the recalculated (“test”) result including the high values, shall be used to determine the design... (local standard time), that are used in NAAQS computations. Design value is the site-level metric (i.e...

40 CFR Appendix R to Part 50 - Interpretation of the National Ambient Air Quality Standards for Lead

Code of Federal Regulations, 2011 CFR

2011-07-01

... determine the design value. (B) The “below NAAQS level” test is as follows: Data substitution will be... the recalculated (“test”) result including the high values, shall be used to determine the design... (local standard time), that are used in NAAQS computations. Design value is the site-level metric (i.e...

Environmental Law Deskbook

DTIC Science & Technology

1998-06-12

public health threats posed by water pollution. (b) More effective control of polluted runoff (including a strategy for achieving a net gain of... Control Strategies for Toxic Pollutants. a. The CWA requires states to identify "impaired" water bodies within their boundaries. For water...standards. Thereafter, states must develop "individual control strategies " (ICSs) to regulate such pollutants and achieve water quality standards

EVALUATION OF AN ANNUAL SIMULATION OF OZONE AND FINE PARTICULATE MATTER OVER THE CONTINENTAL UNITED STATES - WHICH TEMPORAL FEATURES ARE CAPTURED?

EPA Science Inventory

Motivated by growing concerns about the detrimental effects of fine particulate matter (PM2.5) on human health, the U.S. Environmental Protection Agency (EPA) recently promulgated a National Ambient Air Quality Standard (NAAQS) for PM2.5. The PM2.5 standard includes a 24-hour li...

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

Implementing a Quality Management System in the Medical Microbiology Laboratory.

PubMed

Carey, Roberta B; Bhattacharyya, Sanjib; Kehl, Sue C; Matukas, Larissa M; Pentella, Michael A; Salfinger, Max; Schuetz, Audrey N

2018-07-01

This document outlines a comprehensive practical approach to a laboratory quality management system (QMS) by describing how to operationalize the management and technical requirements described in the ISO 15189 international standard. It provides a crosswalk of the ISO requirements for quality and competence for medical laboratories to the 12 quality system essentials delineated by the Clinical and Laboratory Standards Institute. The quality principles are organized under three main categories: quality infrastructure, laboratory operations, and quality assurance and continual improvement. The roles and responsibilities to establish and sustain a QMS are outlined for microbiology laboratory staff, laboratory management personnel, and the institution's leadership. Examples and forms are included to assist in the real-world implementation of this system and to allow the adaptation of the system for each laboratory's unique environment. Errors and nonconforming events are acknowledged and embraced as an opportunity to improve the quality of the laboratory, a culture shift from blaming individuals. An effective QMS encourages "systems thinking" by providing a process to think globally of the effects of any type of change. Ultimately, a successful QMS is achieved when its principles are adopted as part of daily practice throughout the total testing process continuum. Copyright © 2018 American Society for Microbiology.

MrEnt: an editor for publication-quality phylogenetic tree illustrations.

PubMed

Zuccon, Alessandro; Zuccon, Dario

2014-09-01

We developed MrEnt, a Windows-based, user-friendly software that allows the production of complex, high-resolution, publication-quality phylogenetic trees in few steps, directly from the analysis output. The program recognizes the standard Nexus tree format and the annotated tree files produced by BEAST and MrBayes. MrEnt combines in a single software a large suite of tree manipulation functions (e.g. handling of multiple trees, tree rotation, character mapping, node collapsing, compression of large clades, handling of time scale and error bars for chronograms) with drawing tools typical of standard graphic editors, including handling of graphic elements and images. The tree illustration can be printed or exported in several standard formats suitable for journal publication, PowerPoint presentation or Web publication. © 2014 John Wiley & Sons Ltd.

A suite of phantom-based test methods for assessing image quality of photoacoustic tomography systems

NASA Astrophysics Data System (ADS)

Vogt, William C.; Jia, Congxian; Wear, Keith A.; Garra, Brian S.; Pfefer, T. Joshua

2017-03-01

As Photoacoustic Tomography (PAT) matures and undergoes clinical translation, objective performance test methods are needed to facilitate device development, regulatory clearance and clinical quality assurance. For mature medical imaging modalities such as CT, MRI, and ultrasound, tissue-mimicking phantoms are frequently incorporated into consensus standards for performance testing. A well-validated set of phantom-based test methods is needed for evaluating performance characteristics of PAT systems. To this end, we have constructed phantoms using a custom tissue-mimicking material based on PVC plastisol with tunable, biologically-relevant optical and acoustic properties. Each phantom is designed to enable quantitative assessment of one or more image quality characteristics including 3D spatial resolution, spatial measurement accuracy, ultrasound/PAT co-registration, uniformity, penetration depth, geometric distortion, sensitivity, and linearity. Phantoms contained targets including high-intensity point source targets and dye-filled tubes. This suite of phantoms was used to measure the dependence of performance of a custom PAT system (equipped with four interchangeable linear array transducers of varying design) on design parameters (e.g., center frequency, bandwidth, element geometry). Phantoms also allowed comparison of image artifacts, including surface-generated clutter and bandlimited sensing artifacts. Results showed that transducer design parameters create strong variations in performance including a trade-off between resolution and penetration depth, which could be quantified with our method. This study demonstrates the utility of phantom-based image quality testing in device performance assessment, which may guide development of consensus standards for PAT systems.

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...

WASP7 Stream Transport - Model Theory and User's Guide: Supplement to Water Quality Analysis Simulation Program (WASP) User Documentation

EPA Science Inventory

The standard WASP7 stream transport model calculates water flow through a branching stream network that may include both free-flowing and ponded segments. This supplemental user manual documents the hydraulic algorithms, including the transport and hydrogeometry equations, the m...

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

ERIC Educational Resources Information Center

Theisen, Gary; And Others

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

Culturally Diverse Literature: Enriching Variety in an Era of Common Core State Standards

ERIC Educational Resources Information Center

Boyd, Fenice B.; Causey, Lauren L.; Galda, Lee

2015-01-01

The authors argue for the overwhelming importance of finding and including culturally diverse literature into the curricula teachers are authorized to teach. They discuss the implications of use and offer ideas on how to identify quality literature to include in classroom and school libraries.

Functions of standard CPR training on performance qualities of medical volunteers for Mt. Taishan International Mounting Festival.

PubMed

Fanshan, Meng; Lin, Zhao; Wenqing, Liu; Chunlei, Lu; Yongqiang, Liu; Naiyi, Li

2013-01-01

Cardiopulmonary resuscitation (CPR) is a sudden emergency procedure that requires a rapid and efficient response, and personnel training in lifesaving procedures. Regular practice and training are necessary to improve resuscitation skills and reduce anxiety among the staff. As one of the most important skills mastered by medical volunteers serving for Mt. Taishan International Mounting Festival, we randomly selected some of them to evaluate the quality of CPR operation and compared the result with that of the untrained doctors and nurses. In order to evaluate the functions of repeating standard CPR training on performance qualities of medical volunteers for Mt. Taishan International Mounting Festival, their performance qualities of CPR were compared with those of the untrained medical workers working in emergency departments of hospitals in Taian. The CPR performance qualities of 52 medical volunteers (Standard Training Group), who had continually taken part in standard CPR technical training for six months, were tested at random and were compared with those of 68 medical workers (Compared Group) working in emergency departments of hospitals in Taian who hadn't attended CPR training within a year. The QCPR 3535 monitor (provided by Philips Company) was used to measure the standard degree of single simulated CPR performance, including the chest compression depth, frequency, released pressure between compressions and performance time of compression and ventilation, the results of which were recorded in the table and the number of practical compression per minute was calculated. The data were analyzed by x2 Test and t Test. The factors which would influence CPR performance, including gender, age, placement, hand skill, posture of compression and frequency of training, were classified and given parameters, and were put to Logistic repression analysis. The CPR performance qualities of volunteers were much higher than those of the compared group. The overall pass rates were respectively 86.4% and 31.9%; the pass rates of medical volunteers in terms of the chest compression depth, frequency, released pressure between compressions were higher than those of the compared group, which were 89.6%, 94.2%, 95.8% vs 50.3%, 53.0%, 83.1%, P<0.01; there were few differences in overall performance time, which were (118.4 ± 13.5s) vs (116.0 ± 10.4s), P>0.05; the duration time of ventilation in each performance section was much shorter than that in the compared group, which were (6.38 ± 1.2) vs (7.47 ± 1.7), P<0.01; there were few differences in the number of practical compression per minute, which were (78.2 ± 3.5) vs (78.8 ± 12.2), P>0.05); the time proportion of compression and ventilation was 2.6:1 vs 2.1:1. The Logistic repression analysis showed that CPR performance qualities were clearly related to hand skill, posture of compression and repeating standard training, which were respectively OR 13.12 and 95%CI (2.35~73.2); OR 30.89, 95%CI (3.62~263.5); OR 4.07,95%CI (1.16~14.2). The CPR performance qualities of volunteers who had had repeating standard training were much higher than those of untrained medical workers, which proved that standard training helped improve CPR performance qualities.

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...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 8 2013-01-01 2013-01-01 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...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 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...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 8 2014-01-01 2014-01-01 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...

7 CFR 953.43 - Minimum standards of quality.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 8 2012-01-01 2012-01-01 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...

24 CFR 983.101 - 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 Housing quality standards. 983.101... DEVELOPMENT PROJECT-BASED VOUCHER (PBV) PROGRAM Dwelling Units § 983.101 Housing quality standards. (a) HQS applicability. Except as otherwise provided in this section, 24 CFR 982.401 (housing quality standards) applies...

40 CFR 52.14 - State ambient air quality standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 3 2014-07-01 2014-07-01 false State ambient air quality standards. 52.14 Section 52.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality standards. Any ambient air quality standard submitted with a plan which is less stringent than a...

40 CFR 52.14 - State ambient air quality standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 3 2012-07-01 2012-07-01 false State ambient air quality standards. 52.14 Section 52.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality standards. Any ambient air quality standard submitted with a plan which is less stringent than a...

40 CFR 52.14 - State ambient air quality standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 3 2011-07-01 2011-07-01 false State ambient air quality standards. 52.14 Section 52.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality standards. Any ambient air quality standard submitted with a plan which is less stringent than a...

40 CFR 52.14 - State ambient air quality standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 3 2013-07-01 2013-07-01 false State ambient air quality standards. 52.14 Section 52.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality standards. Any ambient air quality standard submitted with a plan which is less stringent than a...

75 FR 16459 - Draft Document Related to the Review of the National Ambient Air Quality Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-01

... Review of the National Ambient Air Quality Standards for Particulate Matter AGENCY: Environmental... Review of the Particulate Matter National Ambient Air Quality Standards--First External Review Draft (75... Particulate Matter National Ambient Air Quality Standards--First External Review Draft (March 2010), please...

40 CFR 52.14 - State ambient air quality standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 3 2010-07-01 2010-07-01 false State ambient air quality standards. 52.14 Section 52.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality standards. Any ambient air quality standard submitted with a plan which is less stringent than a...

Is My Small School Really Just a Business.

ERIC Educational Resources Information Center

Ross, Lee A.; Chance, W. G.

1984-01-01

Discusses steps necessary to running small schools on a more business-like basis, including quality control, product (student) evaluation, production process monitoring, establishment of standards, improved recruitment, market research, and sales promotion. (MH)

Simple solution to the medical instrumentation software problem

NASA Astrophysics Data System (ADS)

Leif, Robert C.; Leif, Suzanne B.; Leif, Stephanie H.; Bingue, E.

1995-04-01

Medical devices now include a substantial software component, which is both difficult and expensive to produce and maintain. Medical software must be developed according to `Good Manufacturing Practices', GMP. Good Manufacturing Practices as specified by the FDA and ISO requires the definition and compliance to a software processes which ensures quality products by specifying a detailed method of software construction. The software process should be based on accepted standards. US Department of Defense software standards and technology can both facilitate the development and improve the quality of medical systems. We describe the advantages of employing Mil-Std-498, Software Development and Documentation, and the Ada programming language. Ada provides the very broad range of functionalities, from embedded real-time to management information systems required by many medical devices. It also includes advanced facilities for object oriented programming and software engineering.

A new quality assurance package for hospital palliative care teams: the Trent Hospice Audit Group model.

PubMed

Hunt, J; Keeley, V L; Cobb, M; Ahmedzai, S H

2004-07-19

Cancer patients in hospitals are increasingly cared for jointly by palliative care teams, as well as oncologists and surgeons. There has been a considerable growth in the number and range of hospital palliative care teams (HPCTs) in the United Kingdom. HPCTs can include specialist doctors and nurses, social workers, chaplains, allied health professionals and pharmacists. Some teams work closely with existing cancer multidisciplinary teams (MDTs) while others are less well integrated. Quality assurance and clinical governance requirements have an impact on the monitoring of such teams, but so far there is no standardised way of measuring the amount and quality of HPCTs' workload. Trent Hospice Audit Group (THAG) is a multiprofessional research group, which has been developing standards and audit tools for palliative care since the 1990s. These follow a format of structure-process-outcome for standards and measures. We describe a collaborative programme of work with HPCTs that has led to a new set of standards and audit tools. Nine HPCTs participated in three rounds of consultation, piloting and modification of standard statements and tools. The final pack of HPCT quality assurance tools covers: policies and documentation; medical notes review; questionnaires for ward-based staff. The tools measure the HPCT workload and casemix; the views of ward-based staff on the supportive role of the HPCT and the effectiveness of HPCT education programmes, particularly in changing practice. The THAG HPCT quality assurance pack is now available for use in cancer peer review.

Rating methodological quality: toward improved assessment and investigation.

PubMed

Moyer, Anne; Finney, John W

2005-01-01

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

Quality assurance in military medical research and medical radiation accident management.

PubMed

Hotz, Mark E; Meineke, Viktor

2012-08-01

The provision of quality radiation-related medical diagnostic and therapeutic treatments cannot occur without the presence of robust quality assurance and standardization programs. Medical laboratory services are essential in patient treatment and must be able to meet the needs of all patients and the clinical personnel responsible for the medical care of these patients. Clinical personnel involved in patient care must embody the quality assurance process in daily work to ensure program sustainability. In conformance with the German Federal Government's concept for modern departmental research, the international standard ISO 9001, one of the relevant standards of the International Organization for Standardization (ISO), is applied in quality assurance in military medical research. By its holistic approach, this internationally accepted standard provides an excellent basis for establishing a modern quality management system in line with international standards. Furthermore, this standard can serve as a sound basis for the further development of an already established quality management system when additional standards shall apply, as for instance in reference laboratories or medical laboratories. Besides quality assurance, a military medical facility must manage additional risk events in the context of early recognition/detection of health risks of military personnel on deployment in order to be able to take appropriate preventive and protective measures; for instance, with medical radiation accident management. The international standard ISO 31000:2009 can serve as a guideline for establishing risk management. Clear organizational structures and defined work processes are required when individual laboratory units seek accreditation according to specific laboratory standards. Furthermore, international efforts to develop health laboratory standards must be reinforced that support sustainable quality assurance, as in the exchange and comparison of test results within the scope of external quality assurance, but also in the exchange of special diagnosis data among international research networks. In summary, the acknowledged standard for a quality management system to ensure quality assurance is the very generic standard ISO 9001.Health Phys. 103(2):221-225; 2012.

International standards for tuberculosis care: relevance and implications for laboratory professionals.

PubMed

Pai, M; Daley, P; Hopewell, P C

2007-04-01

On World Tuberculosis (TB) Day 2006, the International Standards for Tuberculosis Care (ISTC) was officially released and widely endorsed by several agencies and organizations. The ISTC release was the culmination of a year long global effort to develop and set internationally acceptable, evidence-based standards for tuberculosis care. The ISTC describes a widely endorsed level of care that all practitioners, public and private, should seek to achieve in managing individuals who have or are suspected of having, TB and is intended to facilitate the effective engagement of all healthcare providers in delivering high quality care for patients of all ages, including those with smear-positive, smear-negative and extra-pulmonary TB, TB caused by drug-resistant Mycobacterium tuberculosis and TB/HIV coinfection. In this article, we present the ISTC, with a special focus on the diagnostic standards and describe their implications and relevance for laboratory professionals in India and worldwide. Laboratory professionals play a critical role in ensuring that all the standards are actually met by providing high quality laboratory services for smear microscopy, culture and drug susceptibility testing and other services such as testing for HIV infection. In fact, if the ISTC is widely followed, it can be expected that there will be a greater need and demand for quality assured laboratory services and this will have obvious implications for all laboratories in terms of work load, requirement for resources and trained personnel and organization of quality assurance systems.

A risk analysis for production processes with disposable bioreactors.

PubMed

Merseburger, Tobias; Pahl, Ina; Müller, Daniel; Tanner, Markus

2014-01-01

: Quality management systems are, as a rule, tightly defined systems that conserve existing processes and therefore guarantee compliance with quality standards. But maintaining quality also includes introducing new enhanced production methods and making use of the latest findings of bioscience. The advances in biotechnology and single-use manufacturing methods for producing new drugs especially impose new challenges on quality management, as quality standards have not yet been set. New methods to ensure patient safety have to be established, as it is insufficient to rely only on current rules. A concept of qualification, validation, and manufacturing procedures based on risk management needs to be established and realized in pharmaceutical production. The chapter starts with an introduction to the regulatory background of the manufacture of medicinal products. It then continues with key methods of risk management. Hazards associated with the production of medicinal products with single-use equipment are described with a focus on bioreactors, storage containers, and connecting devices. The hazards are subsequently evaluated and criteria for risk evaluation are presented. This chapter concludes with aspects of industrial application of quality risk management.

Love is a pain? Quality of sex life after surgical resection of endometriosis: a review.

PubMed

Fritzer, N; Hudelist, G

2017-02-01

Dyspareunia, a common symptom of endometriosis and may severely affect quality of sex life in affected patients. The objective of the present work was to review the effect of surgical resection of endometriosis on pain intensity and quality of sex life. MEDLINE and EMBASE databases were searched for papers investigating the outcome after surgical endometriosis resection on dyspareunia and quality of sex life measured via VAS/NAS respectively via standardized measuring instruments. However, data did not permit a meaningful meta-analysis according to current standards. However, out of 69 papers, four studies fulfilled the predefined inclusion criteria involving 321 patients with endometriosis and dyspareunia preoperatively. All included studies showed a significant postoperative reduction of dyspareunia after a follow-up period of 10 up to 60 months. Sex life as well as predominantly evaluated parameters like quality of life and mental health improved significantly. We therefore conclude that surgical excision of endometriosis is a feasible and good treatment option for pain relief and improvement of quality of sex life in symptomatic women with endometriosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Construction and application of economy-pollution-environment three-dimensional evaluation model for district].

PubMed

Fan, Xin-Gang; Mi, Wen-Bao; Ma, Zhen-Ning

2015-02-01

For deep analysis on the regional environmental economic system, the paper analyzes the mutual relation of regional economy development, environmental quality, environmental pollution, and builds the theoretical basis. Then, the economy-pollution-environment quality three-dimensional coupling evaluation model for district is constructed. It includes economic development level index, environmental pollution index, and environmental quality index. The model is a cube, which has spatialization and visualization characteristics. The model includes 8 sub cubes, which expresses 8 types of state, e. g. low pollution-inferior quality-low level of economic development etc. The model can be used to evaluate the status of region, divide development phase, analyze evolution trend etc. It has two ways including relative meaning evaluation (RME) and absolute meaning evaluation (AME). Based on the model, Yinchuan City in the Ningxia Hui Autonomous Region is used as an example for the empirical study. Using RME, compared with Guangzhou city, The result shows that the Yinchuan City has been a high pollution-low quality-low level of economic development state for a long period during 1996-2010. After 2007, the state changed to a high pollution-high quality-low level of economic development. Now, the environmental quality of Yinchuan city gets better, but pollutant discharge pressure is high, and tends to be the break point of high environment quality and low environment. With AME, using national standard, the Yinchuan City remains a high pollution-low quality-low level of economic development state during 1996-2010. Empirical research verifies that different target reference areas and relevant national standards have different main parameters, the evaluating result has an flexible range. The dimensionless data enhances the coupling of index. The data position in model increases the visibility to the environmental management decisions. The model improves mismatches of calculated data size, time asymmetry of spatial data, verification of the former multi-target coupling model.

Music therapy for end-of-life care.

PubMed

Bradt, Joke; Dileo, Cheryl

2010-01-20

Music therapy in end-of-life care aims to improve a person's quality of life by helping relieve symptoms, addressing psychological needs, offering support, facilitating communication, and meeting spiritual needs. In addition, music therapists assist family and caregivers with coping, communication, and grief/bereavement. To examine effects of music therapy with standard care versus standard care alone or standard care combined with other therapies on psychological, physiological, and social responses in end-of-life care. We searched CENTRAL, MEDLINE, CINAHL, EMBASE, PSYCINFO, LILACS, CancerLit, Science Citation Index, www.musictherapyworld.de, CAIRSS for Music, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, and the National Research Register to September 2009. We handsearched music therapy journals and reference lists, and contacted experts to identify unpublished manuscripts. There was no language restriction. We included all randomized and quasi-randomized controlled trials that compared music interventions and standard care with standard care alone or combined with other therapies in any care setting with a diagnosis of advanced life-limiting illness being treated with palliative intent and with a life expectancy of less than two years. Data were extracted, and methodological quality was assessed, independently by review authors. Additional information was sought from study authors when necessary. Results are presented using weighted mean differences for outcomes measured by the same scale and standardized mean differences for outcomes measured by different scales. Posttest scores were used. In cases of statistically significant baseline difference, we used change scores. Five studies (175 participants) were included. There is insufficient evidence of high quality to support the effect of music therapy on quality of life of people in end-of-life care. Given the limited number of studies and small sample sizes, more research is needed.No strong evidence was found for the effect of music therapy on pain or anxiety.These results were based on two small studies. There were insufficient data to examine the effect of music therapy on other physical, psychological, or social outcomes. A limited number of studies suggest there may be a benefit of music therapy on the quality of life of people in end-of-life care. However, the results stem from studies with a high risk of bias. More research is needed.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-09-30

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

Carpal tunnel syndrome: Analysis of online patient information with the EQIP tool.

PubMed

Frueh, F S; Palma, A F; Raptis, D A; Graf, C P; Giovanoli, P; Calcagni, M

2015-06-01

Patients suffering from carpal tunnel syndrome (CTS) actively search for medical information on the Internet. The World Wide Web represents the main source of patient information. The aim of this study was to systematically assess the quality of patient information about CTS in the Internet. A qualitative and quantitative assessment of websites was performed with the modified Ensuring Quality Information for Patients (EQIP) tool that contains 36 standardized items. Five hundred websites with information on CTS treatment options were identified through Google, Bing, Yahoo, Ask.com and AOL. Duplicates and irrelevant websites were excluded. One hundred and ten websites were included. Only five websites addressed more than 20 items; quality scores were not significantly different between the various providing groups. A median of 15 EQIP items was found, with the top website addressing 26 out of 36 items. Major complications such as median nerve injury were reported in 27% of the websites and their treatment in only 3%. This analysis revealed several critical shortcomings in the quality of the information provided to patients suffering from CTS. There is a collective need to provide interactive, informative and educational websites for standard procedures in hand surgery. These websites should be compatible with international quality standards for hand surgery procedures. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Modeling and evaluation of compliance to water quality regulations in bathing areas on the Daoulas catchment and estuary (France).

PubMed

Bougeard, M; Le Saux, J C; Jouan, M; Durand, G; Pommepuy, M

2010-01-01

The microbiological quality of waters in estuaries determines their acceptability for recreational uses. Microbiological contamination often results from urban wastewater discharges or non-point source pollution (manure spreading), and can cause bathing zones to be closed. European regulations (EC/7/2006) have proposed standards (500 E. coli/100 ml) for the acceptability areas for bathing. In this study, two models were associated to simulate contamination: SWAT on a catchment and MARS 2D in the downstream estuary. After river flow calibration and validation, two scenarios were simulated in SWAT, and E. coli fluxes obtained at the main outlet of the catchment were then introduced into MARS 2D to follow E. coli concentrations in the estuary. An annual evaluation of compliance to bathing area water quality standards was then calculated, linked with daily rainfall classes. Water quality in the estuary was below the standard on 13 days, including 5 days with rainfall superior to 10 mm, due to faecal contamination from soil leaching by rain, and 5 days with rainfall ranging from 0.1 to 5 mm/day, due to the high frequency of this level of rainfall. To conclude, this study allowed us to demonstrate the efficiency of models to gain a better understanding on water quality degradation factors.

AirNow Information Management System - Global Earth Observation System of Systems Data Processor for Real-Time Air Quality Data Products

NASA Astrophysics Data System (ADS)

Haderman, M.; Dye, T. S.; White, J. E.; Dickerson, P.; Pasch, A. N.; Miller, D. S.; Chan, A. C.

2012-12-01

Built upon the success of the U.S. Environmental Protection Agency's (EPA) AirNow program (www.AirNow.gov), the AirNow-International (AirNow-I) system contains an enhanced suite of software programs that process and quality control real-time air quality and environmental data and distribute customized maps, files, and data feeds. The goals of the AirNow-I program are similar to those of the successful U.S. program and include fostering the exchange of environmental data; making advances in air quality knowledge and applications; and building a community of people, organizations, and decision makers in environmental management. In 2010, Shanghai became the first city in China to run this state-of-the-art air quality data management and notification system. AirNow-I consists of a suite of modules (software programs and schedulers) centered on a database. One such module is the Information Management System (IMS), which can automatically produce maps and other data products through the use of GIS software to provide the most current air quality information to the public. Developed with Global Earth Observation System of Systems (GEOSS) interoperability in mind, IMS is based on non-proprietary standards, with preference to formal international standards. The system depends on data and information providers accepting and implementing a set of interoperability arrangements, including technical specifications for collecting, processing, storing, and disseminating shared data, metadata, and products. In particular, the specifications include standards for service-oriented architecture and web-based interfaces, such as a web mapping service (WMS), web coverage service (WCS), web feature service (WFS), sensor web services, and Really Simple Syndication (RSS) feeds. IMS is flexible, open, redundant, and modular. It also allows the merging of data grids to create complex grids that show comprehensive air quality conditions. For example, the AirNow Satellite Data Processor (ASDP) was recently developed to merge PM2.5 estimates from National Aeronautics and Space Administration (NASA) satellite data and AirNow observational data, creating more precise maps and gridded data products for under-monitored areas. The ASDP can easily incorporate other data feeds, including fire and smoke locations, to build enhanced real-time air quality data products. In this presentation, we provide an overview of the features and functions of IMS, an explanation of how data moves through IMS, the rationale of the system architecture, and highlights of the ASDP as an example of the modularity and scalability of IMS.

Moving Forward--Shaping a Career Development Culture: Quality Standards, Quality Practice, Quality Outcomes

ERIC Educational Resources Information Center

McMahon, Mary

2004-01-01

This paper represents the second of two papers written as part of the National Standards and Accreditation of Career Practitioners project. The first, a scoping paper titled Shaping a career development culture: Quality standards, quality practice, quality outcomes (McMahon, 2004), provided information for and guided discussion at the National…

78 FR 19990 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-03

... Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality Standards; Correction AGENCY... approved revisions to Ohio regulations that consolidated air quality standards in a new chapter of rules... State's air quality standards into Ohio Administrative Code (OAC) 3745-25 and modifying an assortment of...

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

Code of Federal Regulations, 2011 CFR

2011-07-01

... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...

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

Code of Federal Regulations, 2014 CFR

2014-07-01

... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...

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

Code of Federal Regulations, 2013 CFR

2013-07-01

... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...

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

Code of Federal Regulations, 2012 CFR

2012-07-01

... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...

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

Code of Federal Regulations, 2010 CFR

2010-07-01

... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment... Air Quality Standards for Ozone 1. General (a) This appendix explains the data handling conventions... air quality standards for ozone (O3) specified in § 50.15 are met at an ambient O3 air quality...

Ankle arthritis: review of diagnosis and operative management.

PubMed

Grunfeld, Robert; Aydogan, Umur; Juliano, Paul

2014-03-01

The diagnostic and therapeutic options for ankle arthritis are reviewed. The current standard of care for nonoperative options include the use of nonsteroidal antiinflammatory drugs, corticosteroid injections, orthotics, and ankle braces. Other modalities lack high-quality research studies to delineate their appropriateness and effectiveness. The gold standard for operative intervention in end-stage degenerative arthritis remains arthrodesis, but evidence for the superiority in functional outcomes of total ankle arthroplasty is increasing. The next few years will enable more informed decisions and, with more prospective high-quality studies, the most appropriate patient population for total ankle arthroplasty can be identified. Copyright © 2014 Elsevier Inc. All rights reserved.

The Development of a Quality Management Framework for Evaluating Medical Device Reprocessing Practice in Healthcare Facilities.

PubMed

Lorv, Bailey; Horodyski, Robin; Welton, Cynthia; Vail, John; Simonetto, Luca; Jokanovic, Danilo; Sharma, Richa; Mahoney, Angela Rea; Savoy-Bird, Shay; Bains, Shalu

2017-01-01

There is increasing awareness of the importance of medical device reprocessing (MDR) for the provision of safe patient care. Although industry service standards are available to guide MDR practices, there remains a lack of published key performance indicators (KPIs) and targets that are necessary to evaluate MDR quality for feedback and improvement. This article outlines the development of an initial framework that builds on established guidelines and includes service standards, KPIs and targets for evaluating MDR operations. This framework can support healthcare facilities in strengthening existing practices and enables a platform for collaboration towards better MDR performance management.

Environmental toxicology and risk assessment: Standardization of biomarkers for endocrine disruption and environmental assessment: Eighth volume. Special technical publication 1364

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

Henshel, D.S.; Black, M.C.; Harrass, M.C.

1999-07-01

This conference was held April 20--22, 1998 in Atlanta, Georgia. The purpose of this conference was to provide a multidisciplinary forum for exchange of state-of-the-art information on biological markers in toxicology and risk assessment, including endocrine disrupter screening assays. Attention is focused on the following: aquatic toxicology; behavioral toxicology; biochemical indicators; developmental indicators; endocrine indicators; biodegradation and fate of chemicals; quality assurance and quality control within laboratory and field studies; risk assessment and communication, and harmonization of standards development. Individual papers have been processed separately for inclusion in the appropriate data bases.

[(Re)habilitation after cochlear implantation].

PubMed

Diller, G

2009-07-01

Over the last years, indications for cochlear implants (CIs) have changed dramatically. The benefits depend on the preconditions of the individual patient as well as on the subsequent (re)habilitation. Therefore, many variables influencing the hearing and speech perception of a CI user must be kept in mind. As an example, the special situation of children having Turkish as their mother tongue is described. The most convincing argument concerning (re)habilitation is its benefit. Indeed, this benefit represents the final standard of quality and serves as the yardstick for standard assessments of (re)habilitation quality. CI (re)habilitation includes medical, pedagogical, audiological, hearing and speech, and psychological therapeutic aspects.

Materials for Heated Head Automated Thermoplastic Tape Placement

NASA Technical Reports Server (NTRS)

Jensen, Brian J.; Kinney, Megan C.; Cano, Roberto J.; Grimsley, Brian W.

2012-01-01

NASA Langley Research Center (LaRC) is currently pursuing multiple paths to develop out of autoclave (OOA) polymeric composite materials and processes. Polymeric composite materials development includes the synthesis of new and/or modified thermosetting and thermoplastic matrix resins designed for specific OOA processes. OOA processes currently under investigation include vacuum bag only (VBO) prepreg/composite fabrication, resin transfer molding (RTM), vacuum assisted resin transfer molding (VARTM) and heated head automated thermoplastic tape placement (HHATP). This paper will discuss the NASA Langley HHATP facility and capabilities and recent work on characterizing thermoplastic tape quality and requirements for quality part production. Samples of three distinct versions of APC-2 (AS4/PEEK) thermoplastic dry tape were obtained from two materials vendors, TENCATE, Inc. and CYTEC Engineered Materials** (standard grade and an experimental batch). Random specimens were taken from each of these samples and subjected to photo-microscopy and surface profilometry. The CYTEC standard grade of APC-2 tape had the most voids and splits and the highest surface roughness and/or waviness. Since the APC-2 tape is composed of a thermoplastic matrix, it offers the flexibility of reprocessing to improve quality, and thereby improve final quality of HHATP laminates. Discussions will also include potential research areas and future work that is required to advance the state of the art in the HHATP process for composite fabrication.

Quality control of commercial bovine lactoferrin.

PubMed

Wakabayashi, Hiroyuki; Yamauchi, Koji; Abe, Fumiaki

2018-06-01

Herein we review commercial bovine lactoferrin quality issues by describing an example of industrial production, the current status of global quality standardization, and quality-activity concerns for further discussion. Morinaga Milk Industry has been industrially producing bovine lactoferrin in Milei GmbH, Germany, since 1989. We delineate its production and quality as an example of safe and high-quality manufacturing. Currently, global standardization in the quality of bovine lactoferrin is progressing through Novel Food and GRAS in the EU and USA, respectively. Novel Food was applied or notified to seven lactoferrin manufacturers and GRAS was notified to three manufacturers, two of which are for infant use and one is for adult use, by the end of 2017. The specifications of these regulations are relatively high, including more than 95% lactoferrin purity in protein, which means that such companies can supply relatively high-grade lactoferrin. There appear to be several concerns regarding lactoferrin quality affecting activities, including contamination of lipopolysaccharide (LPS) and angiogenin, purity, and degradation of lactoferrin sample. Although LPS is immunologically toxic when invading the body, it is distributed normally in foods and the gut. However, an industrial lactoferrin sample may contain LPS at a maximum LPS/lactoferrin molecule ratio = 1/1724, which means 99.9% of the lactoferrin molecule is LPS-free. It is difficult to speculate that LPS contained in a lactoferrin sample affects its activities. Finally in order to achieve good and reproducible results, we make proposals to researchers a use of high-grade lactoferrin, careful storage, and indication the manufacturers' names and specifications in the paper.