Climatic factors affecting quantity and quality grade of in vivo derived embryos of cattle.

PubMed

Chinchilla-Vargas, Josué; Jahnke, Marianna M; Dohlman, Tyler M; Rothschild, Max F; Gunn, Patrick J

2018-05-01

The present study investigated the effects of climatic variables on the quality grade and quantity of in vivo derived cattle embryos in the Midwestern United States. Climatic information included greatest and least daily temperature, average daily wind speed and average temperature-humidity index for each of the 765 records. The response variables included the number of ovarian structures, viable embryos, quality grade 1 embryos, quality grade 2 embryos, quality grade 3 embryos, freezable embryos (sum of quality grade 1 and quality grade 2 embryos), transferable embryos (sum of quality grade 1-3 embryos), degenerate embryos and unfertilized ova. Measures for variables among the breeds of donors and sires grouped by geographical origin were compared. A negative effect of greater temperatures during the early embryonic development stage tended (P < 0.10) to be associated with a decrease in the quality of embryos recovered. Interestingly, the greater the Temperature-Humidity Index (THI) during the early ovarian antral follicular development stage 40-45 days prior to ovulation was associated with a tendency for greater numbers of total number of freezable and transferable embryos recovered per uterine flushing (P < 0.10). Increased wind speed at the early antral follicular phase 40-45 days prior to ovulation was associated with an increase in the percentage of quality grade 1 embryos recovered (P < 0.05). Wind speed during the estrous synchronization period was also associated with a lesser number of embryos recovered (P < 0.05). This retrospective study confirms that climatic variables have significant effects on the in vivo production of cattle embryos and that wind speed should be considered in future analyses of factors affecting embryo quality. Copyright © 2018 Elsevier B.V. All rights reserved.

Factors associated with quality of life and caregiver strain amongst frail older adults referred to a community rehabilitation service: implications for service delivery.

PubMed

Comans, Tracy A; Currin, Michelle L; Brauer, Sandra G; Haines, Terry P

2011-01-01

To identify factors contributing to reduced quality of life and increased caregiver strain in an older population referred to a community rehabilitation team and to recommend service delivery models. Analytical cross-sectional study arising from baseline assessments from 107 subjects drawn from a randomised controlled trial of community rehabilitation service delivery models. A community rehabilitation team based in Brisbane, Queensland, Australia. Primary outcome variables include quality of life (EQ-5D & VAS) and Carer Strain Index. Predictor variables include participation in functional activities, history of falls, number of medications, number of co-morbidities, depression, environmental hazards, physical function and nutrition. Association between variables assessed using linear regression. Major factors contributing to reduced quality of life were having reduced participation in daily activities, depression, and having poor vision. Having poor nutrition and no longer driving also contributed to poor quality of life. The major factor contributing to increased caregiver strain was reduced participation in daily activities by the older person. Community rehabilitation services working with older populations must adopt models of care that screen for and address a wide range of factors that contribute to poor quality of life and caregiver strain.

Design, analysis, and interpretation of field quality-control data for water-sampling projects

USGS Publications Warehouse

Mueller, David K.; Schertz, Terry L.; Martin, Jeffrey D.; Sandstrom, Mark W.

2015-01-01

The report provides extensive information about statistical methods used to analyze quality-control data in order to estimate potential bias and variability in environmental data. These methods include construction of confidence intervals on various statistical measures, such as the mean, percentiles and percentages, and standard deviation. The methods are used to compare quality-control results with the larger set of environmental data in order to determine whether the effects of bias and variability might interfere with interpretation of these data. Examples from published reports are presented to illustrate how the methods are applied, how bias and variability are reported, and how the interpretation of environmental data can be qualified based on the quality-control analysis.

Formulation and process factors influencing product quality and in vitro performance of ophthalmic ointments.

PubMed

Xu, Xiaoming; Al-Ghabeish, Manar; Rahman, Ziyaur; Krishnaiah, Yellela S R; Yerlikaya, Firat; Yang, Yang; Manda, Prashanth; Hunt, Robert L; Khan, Mansoor A

2015-09-30

Owing to its unique anatomical and physiological functions, ocular surface presents special challenges for both design and performance evaluation of the ophthalmic ointment drug products formulated with a variety of bases. The current investigation was carried out to understand and identify the appropriate in vitro methods suitable for quality and performance evaluation of ophthalmic ointment, and to study the effect of formulation and process variables on its critical quality attributes (CQA). The evaluated critical formulation variables include API initial size, drug percentage, and mineral oil percentage while the critical process parameters include mixing rate, temperature, time and cooling rate. The investigated quality and performance attributes include drug assay, content uniformity, API particle size in ointment, rheological characteristics, in vitro drug release and in vitro transcorneal drug permeation. Using design of experiments (DoE) as well as a novel principle component analysis approach, five of the quality and performance attributes (API particle size, storage modulus of ointment, high shear viscosity of ointment, in vitro drug release constant and in vitro transcorneal drug permeation rate constant) were found to be highly influenced by the formulation, in particular the strength of API, and to a lesser degree by processing variables. Correlating the ocular physiology with the physicochemical characteristics of acyclovir ophthalmic ointment suggested that in vitro quality metrics could be a valuable predictor of its in vivo performance. Published by Elsevier B.V.

Applications of MIDAS regression in analysing trends in water quality

NASA Astrophysics Data System (ADS)

Penev, Spiridon; Leonte, Daniela; Lazarov, Zdravetz; Mann, Rob A.

2014-04-01

We discuss novel statistical methods in analysing trends in water quality. Such analysis uses complex data sets of different classes of variables, including water quality, hydrological and meteorological. We analyse the effect of rainfall and flow on trends in water quality utilising a flexible model called Mixed Data Sampling (MIDAS). This model arises because of the mixed frequency in the data collection. Typically, water quality variables are sampled fortnightly, whereas the rain data is sampled daily. The advantage of using MIDAS regression is in the flexible and parsimonious modelling of the influence of the rain and flow on trends in water quality variables. We discuss the model and its implementation on a data set from the Shoalhaven Supply System and Catchments in the state of New South Wales, Australia. Information criteria indicate that MIDAS modelling improves upon simplistic approaches that do not utilise the mixed data sampling nature of the data.

Variability in energy density of forage fishes from the Bay of Biscay (north-east Atlantic Ocean): reliability of functional grouping based on prey quality.

PubMed

Spitz, J; Jouma'a, J

2013-06-01

Energy densities of 670 fishes belonging to nine species were measured to evaluate intraspecific variability. Functional groups based on energy density appeared to be sufficiently robust to individual variability to provide a classification of forage fish quality applicable in a variety of ecological fields including ecosystem modelling. © 2013 The Authors. Journal of Fish Biology © 2013 The Fisheries Society of the British Isles.

Empowerment variables for rehabilitation clients on perceived beliefs concerning work quality of life domains.

PubMed

Tschopp, Molly K; Frain, Michael P; Bishop, Malachy

2009-01-01

This article describes and presents an initial analysis of variables generally associated with empowerment towards perceived beliefs concerning quality of life work domains for individuals with disabilities. The model examines the domains of importance, satisfaction, control and degree of interference of disability that an individual feels towards work. The internet based study used results from 70 individuals with disabilities in varying aspects of work. The variables composing empowerment that correlated strongly with the work domains include: self-advocacy, self-efficacy, perceived stigma, and family resiliency as measured through coping. Quality of Life concerning work was measured through the DSC-C a domain specific QOL instrument.

Teacher and child predictors of achieving IEP goals of children with autism.

PubMed

Ruble, Lisa; McGrew, John H

2013-12-01

It is encouraging that children with autism show a strong response to early intervention, yet more research is needed for understanding the variability in responsiveness to specialized programs. Treatment predictor variables from 47 teachers and children who were randomized to receive the COMPASS intervention (Ruble et al. in The collaborative model for promoting competence and success for students with ASD. Springer, New York, 2012a) were analyzed. Predictors evaluated against child IEP goal attainment included child, teacher, intervention practice, and implementation practice variables based on an implementation science framework (Dunst and Trivette in J Soc Sci 8:143-148, 2012). Findings revealed one child (engagement), one teacher (exhaustion), two intervention quality (IEP quality for targeted and not targeted elements), and no implementation quality variables accounted for variance in child outcomes when analyzed separately. When the four significant variables were compared against each other in a single regression analysis, IEP quality accounted for one quarter of the variance in child outcomes.

Teacher and Child Predictors of Achieving IEP Goals of Children with Autism

PubMed Central

Ruble, Lisa; McGrew, John H.

2013-01-01

It is encouraging that children with autism show a strong response to early intervention, yet more research is needed for understanding the variability in responsiveness to specialized programs. Treatment predictor variables from 47 teachers and children who were randomized to receive the COMPASS intervention (Ruble et al. in The collaborative model for promoting competence and success for students with ASD. Springer, New York, 2012a) were analyzed. Predictors evaluated against child IEP goal attainment included child, teacher, intervention practice, and implementation practice variables based on an implementation science framework (Dunst and Trivette in J Soc Sci 8:143–148, 2012). Findings revealed one child (engagement), one teacher (exhaustion), two intervention quality (IEP quality for targeted and not targeted elements), and no implementation quality variables accounted for variance in child outcomes when analyzed separately. When the four significant variables were compared against each other in a single regression analysis, IEP quality accounted for one quarter of the variance in child outcomes. PMID:23838728

Water quality in the Schuylkill River, Pennsylvania: the potential for long-lead forecasts

NASA Astrophysics Data System (ADS)

Block, P. J.; Peralez, J.

2012-12-01

Prior analysis of pathogen levels in the Schuylkill River has led to a categorical daily forecast of water quality (denoted as red, yellow, or green flag days.) The forecast, available to the public online through the Philadelphia Water Department, is predominantly based on the local precipitation forecast. In this study, we explore the feasibility of extending the forecast to the seasonal scale by associating large-scale climate drivers with local precipitation and water quality parameter levels. This advance information is relevant for recreational activities, ecosystem health, and water treatment (energy, chemicals), as the Schuylkill provides 40% of Philadelphia's water supply. Preliminary results indicate skillful prediction of average summertime water quality parameters and characteristics, including chloride, coliform, turbidity, alkalinity, and others, using season-ahead oceanic and atmospheric variables, predominantly from the North Atlantic. Water quality parameter trends, including historic land use changes along the river, association with climatic variables, and prediction models will be presented.

Variables associated with health-related quality of life in a Brazilian sample of patients from a tertiary outpatient clinic for depression and anxiety disorders.

PubMed

Schwab, Bianca; Daniel, Heloisa Silveira; Lutkemeyer, Carine; Neves, João Arthur Lange Lins; Zilli, Louise Nassif; Guarnieri, Ricardo; Diaz, Alexandre Paim; Michels, Ana Maria Maykot Prates

2015-01-01

Health-related quality of life (HRQOL) assessment tools have been broadly used in the medical context. These tools are used to measure the subjective impact of the disease on patients. The objective of this study was to evaluate the variables associated with HRQOL in a Brazilian sample of patients followed up in a tertiary outpatient clinic for depression and anxiety disorders. Cross-sectional study. Independent variables were those included in a sociodemographic questionnaire and the Hospital Anxiety and Depression Scale (HADS) scores. Dependent variables were those included in the short version of the World Health Organization Quality of Life (WHOQOL-BREF) and the scores for its subdomains (overall quality of life and general health, physical health, psychological health, social relationships, and environment). A multiple linear regression analysis was used to find the variables independently associated with each outcome. Seventy-five adult patients were evaluated. After multiple linear regression analysis, the HADS scores were associated with all outcomes, except social relationships (p = 0.08). Female gender was associated with poor total scores, as well as psychological health and environment. Unemployment was associated with poor physical health. Identifying the factors associated with HRQOL and recognizing that depression and anxiety are major factors are essential to improve the care of patients.

Longitudinal assessment of optical quality and intraocular scattering using the double-pass instrument in normal eyes and eyes with short tear breakup time.

PubMed

Kobashi, Hidenaga; Kamiya, Kazutaka; Yanome, Kyohei; Igarashi, Akihito; Shimizu, Kimiya

2013-01-01

To assess the longitudinal changes in optical quality including intraocular scattering in normal eyes and eyes with short tear breakup time (TBUT). We prospectively examined twenty eyes of 20 healthy subjects, and age-matched twenty eyes of 20 short TBUT subjects. The modulation transfer function (MTF) cutoff frequency, the Strehl ratio, and the objective scattering index (OSI) were quantitatively assessed using an Optical Quality Analysis System. We investigated the changes in these variables measured consecutively at the initial examination, 5, and 10 seconds without blinking. We also compared these variables in eyes with short TBUT with those in normal eyes. No significant differences in the MTF cutoff frequency, Strehl ratio, or OSI were detected over a 10-second period in normal eyes. These variables also became significantly degraded even over a 5-second period in eyes with short TBUT (p<0.01). We found significant differences in these variables at 5 and 10 seconds (p<0.05), but none immediately after the blink between normal and short TBUT eyes. Optical quality including intraocular scattering deteriorated significantly with time in eyes with short TBUT, whereas we found significant differences over a 10-second period in normal eyes. Eyes with short TBUT showed greater deterioration in optical quality after the blink than normal eyes. The longitudinal assessment of optical quality may be effective in distinguishing eyes with short TBUT from normal eyes.

Quality of care and variability in lung cancer management across Belgian hospitals: a population-based study using routinely available data.

PubMed

Vrijens, France; De Gendt, Cindy; Verleye, Leen; Robays, Jo; Schillemans, Viki; Camberlin, Cécile; Stordeur, Sabine; Dubois, Cécile; Van Eycken, Elisabeth; Wauters, Isabelle; Van Meerbeeck, Jan P

2018-05-01

To evaluate the quality of care for all patients diagnosed with lung cancer in Belgium based on a set of evidence-based quality indicators and to study the variability of care between hospitals. A retrospective study based on linked data from the cancer registry, insurance claims and vital status for all patients diagnosed with lung cancer between 2010 and 2011. Evidence-based quality indicators were identified from a systematic literature search. A specific algorithm to attribute patients to a centre was developed, and funnel plots were used to assess variability of care between centres. None. The proportion of patients who received appropriate care as defined by the indicator. Secondary outcome included the variability of care between centres. Twenty indicators were measured for a total of 12 839 patients. Good results were achieved for 60-day post-surgical mortality (3.9%), histopathological confirmation of diagnosis (93%) and for the use of PET-CT before treatment with curative intent (94%). Areas to be improved include the reporting of staging information to the Belgian Cancer Registry (80%), the use of brain imaging for clinical stage III patients eligible for curative treatment (79%), and the time between diagnosis and start of first active treatment (median 20 days). High variability between centres was observed for several indicators. Twenty-three indicators were found relevant but could not be measured. This study highlights the feasibility to develop a multidisciplinary set of quality indicators using population-based data. The main advantage of this approach is that not additional registration is required, but the non-measurability of many relevant indicators is a hamper. It allows however to easily point to areas of large variability in care.

Water Quality Variable Estimation using Partial Least Squares Regression and Multi-Scale Remote Sensing.

NASA Astrophysics Data System (ADS)

Peterson, K. T.; Wulamu, A.

2017-12-01

Water, essential to all living organisms, is one of the Earth's most precious resources. Remote sensing offers an ideal approach to monitor water quality over traditional in-situ techniques that are highly time and resource consuming. Utilizing a multi-scale approach, incorporating data from handheld spectroscopy, UAS based hyperspectal, and satellite multispectral images were collected in coordination with in-situ water quality samples for the two midwestern watersheds. The remote sensing data was modeled and correlated to the in-situ water quality variables including chlorophyll content (Chl), turbidity, and total dissolved solids (TDS) using Normalized Difference Spectral Indices (NDSI) and Partial Least Squares Regression (PLSR). The results of the study supported the original hypothesis that correlating water quality variables with remotely sensed data benefits greatly from the use of more complex modeling and regression techniques such as PLSR. The final results generated from the PLSR analysis resulted in much higher R2 values for all variables when compared to NDSI. The combination of NDSI and PLSR analysis also identified key wavelengths for identification that aligned with previous study's findings. This research displays the advantages and future for complex modeling and machine learning techniques to improve water quality variable estimation from spectral data.

National Databases for Neurosurgical Outcomes Research: Options, Strengths, and Limitations.

PubMed

Karhade, Aditya V; Larsen, Alexandra M G; Cote, David J; Dubois, Heloise M; Smith, Timothy R

2017-08-05

Quality improvement, value-based care delivery, and personalized patient care depend on robust clinical, financial, and demographic data streams of neurosurgical outcomes. The neurosurgical literature lacks a comprehensive review of large national databases. To assess the strengths and limitations of various resources for outcomes research in neurosurgery. A review of the literature was conducted to identify surgical outcomes studies using national data sets. The databases were assessed for the availability of patient demographics and clinical variables, longitudinal follow-up of patients, strengths, and limitations. The number of unique patients contained within each data set ranged from thousands (Quality Outcomes Database [QOD]) to hundreds of millions (MarketScan). Databases with both clinical and financial data included PearlDiver, Premier Healthcare Database, Vizient Clinical Data Base and Resource Manager, and the National Inpatient Sample. Outcomes collected by databases included patient-reported outcomes (QOD); 30-day morbidity, readmissions, and reoperations (National Surgical Quality Improvement Program); and disease incidence and disease-specific survival (Surveillance, Epidemiology, and End Results-Medicare). The strengths of large databases included large numbers of rare pathologies and multi-institutional nationally representative sampling; the limitations of these databases included variable data veracity, variable data completeness, and missing disease-specific variables. The improvement of existing large national databases and the establishment of new registries will be crucial to the future of neurosurgical outcomes research. Copyright © 2017 by the Congress of Neurological Surgeons

Musicians, postural quality and musculoskeletal health: A literature's review.

PubMed

Blanco-Piñeiro, Patricia; Díaz-Pereira, M Pino; Martínez, Aurora

2017-01-01

An analysis of the salient characteristics of research papers published between 1989 and 2015 that evaluate the relationship between postural quality during musical performance and various performance quality and health factors, with emphasis on musculoskeletal health variables. Searches of Medline, Scopus and Google Scholar for papers that analysed the subject of the study objective. The following MeSH descriptors were used: posture; postural balance; muscle, skeletal; task performance and analysis; back; and spine and music. A descriptive statistical analysis of their methodology (sample types, temporal design, and postural, health and other variables analysed) and findings has been made. The inclusion criterion was that the body postural quality of the musicians during performance was included among the target study variables. Forty-one relevant empirical studies were found, written in English. Comparison and analysis of their results was hampered by great disparities in measuring instruments and operationalization of variables. Despite the growing interest in the relationships among these variables, the empirical knowledge base still has many limitations, making rigorous comparative analysis difficult. Copyright © 2016 Elsevier Ltd. All rights reserved.

Housing characteristics and their influence on health-related quality of life in persons living with HIV in Ontario, Canada: results from the positive spaces, healthy places study.

PubMed

Rourke, Sean B; Bekele, Tsegaye; Tucker, Ruthann; Greene, Saara; Sobota, Michael; Koornstra, Jay; Monette, LaVerne; Bacon, Jean; Bhuiyan, Shafi; Rueda, Sergio; Watson, James; Hwang, Stephen W; Dunn, James; Hambly, Keith

2012-11-01

Although lack of housing is linked with adverse health outcomes, little is known about the impacts of the qualitative aspects of housing on health. This study examined the association between structural elements of housing, housing affordability, housing satisfaction and health-related quality of life over a 1-year period. Participants were 509 individuals living with HIV in Ontario, Canada. Regression analyses were conducted to examine relationships between housing variables and physical and mental health-related quality of life. We found significant cross-sectional associations between housing and neighborhood variables-including place of residence, housing affordability, housing stability, and satisfaction with material, meaningful and spatial dimensions of housing-and both physical and mental health-related quality of life. Our analyses also revealed longitudinal associations between housing and neighborhood variables and health-related quality of life. Interventions that enhance housing affordability and housing satisfaction may help improve health-related quality of life of people living with HIV.

Development of Water Quality Index for the United States: A Sensitivity Analysis

EPA Science Inventory

Background: Water quality is quantified using several measures, available from various data sources, which can be combined to create a single index of overall water quality. It is necessary to identify appropriate variables to include in an index which could be used for health re...

Quality-control design for surface-water sampling in the National Water-Quality Network

USGS Publications Warehouse

Riskin, Melissa L.; Reutter, David C.; Martin, Jeffrey D.; Mueller, David K.

2018-04-10

The data-quality objectives for samples collected at surface-water sites in the National Water-Quality Network include estimating the extent to which contamination, matrix effects, and measurement variability affect interpretation of environmental conditions. Quality-control samples provide insight into how well the samples collected at surface-water sites represent the true environmental conditions. Quality-control samples used in this program include field blanks, replicates, and field matrix spikes. This report describes the design for collection of these quality-control samples and the data management needed to properly identify these samples in the U.S. Geological Survey’s national database.

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

PubMed

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

2002-07-01

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

The Effect of Experimental Variables on Industrial X-Ray Micro-Computed Sensitivity

NASA Technical Reports Server (NTRS)

Roth, Don J.; Rauser, Richard W.

2014-01-01

A study was performed on the effect of experimental variables on radiographic sensitivity (image quality) in x-ray micro-computed tomography images for a high density thin wall metallic cylinder containing micro-EDM holes. Image quality was evaluated in terms of signal-to-noise ratio, flaw detectability, and feature sharpness. The variables included: day-to-day reproducibility, current, integration time, voltage, filtering, number of frame averages, number of projection views, beam width, effective object radius, binning, orientation of sample, acquisition angle range (180deg to 360deg), and directional versus transmission tube.

Validity test and its consistency in the construction of patient loyalty model

NASA Astrophysics Data System (ADS)

Yanuar, Ferra

2016-04-01

The main objective of this present study is to demonstrate the estimation of validity values and its consistency based on structural equation model. The method of estimation was then implemented to an empirical data in case of the construction the patient loyalty model. In the hypothesis model, service quality, patient satisfaction and patient loyalty were determined simultaneously, each factor were measured by any indicator variables. The respondents involved in this study were the patients who ever got healthcare at Puskesmas in Padang, West Sumatera. All 394 respondents who had complete information were included in the analysis. This study found that each construct; service quality, patient satisfaction and patient loyalty were valid. It means that all hypothesized indicator variables were significant to measure their corresponding latent variable. Service quality is the most measured by tangible, patient satisfaction is the most mesured by satisfied on service and patient loyalty is the most measured by good service quality. Meanwhile in structural equation, this study found that patient loyalty was affected by patient satisfaction positively and directly. Service quality affected patient loyalty indirectly with patient satisfaction as mediator variable between both latent variables. Both structural equations were also valid. This study also proved that validity values which obtained here were also consistence based on simulation study using bootstrap approach.

[The prognostic value of variables from the quality assurance program and of the rehabilitation-discharge report of the LVA Baden-Württemberg for early retirement: results of a retrospective cohort-study].

PubMed

Küpper-Nybelen, J; Rothenbacher, D; Jacobi, E; Brenner, H

2003-12-01

Since 1997 the LVA Baden-Württemberg pension insurance agency has implemented an instrument to measure the outcome quality of in-patient rehabilitation. The objective of this study was to evaluate the prognostic value of various short-term rehabilitation success markers and of variables of the quality assurance program and the rehab-discharge report of the LVA Baden-Württemberg on early retirement by means of a retrospective cohort study. The analysis was based on routinely registered data of patients who underwent in-hospital rehabilitation in a hospital accredited by the LVA Baden-Württemberg between June 1997 and June 1999. Baseline data included information from medical discharge reports and from the quality assurance programme. Follow-up information with regard to disability was collected until July 2000. The prognostic value of the quality assurance programme and of 4 standardized documented items from the medical discharge report was estimated by proportional hazards regression. In this analysis 6,823 patients aged 30-59 years who underwent an in-patient rehab programme between June 1997 and July 1999 in 5 of 6 LVA rehab clinics were included. During follow-up (mean duration: 1.8 years) 908 (13.3%) patients retired because of health-related disability. The variables with the strongest prognostic values were the evaluation of the patient health status by the physician and the patients themselves and the capacity to work. The variables with the highest prognostic value were the evaluation on a 1-6 visual analogue scale; a better assessment by one mark of the health status by physician and patient himself, respectively, was associated with a 53% and 40% reduced risk of disability. Fitness for work at discharge was the most prognostic variable from the discharge report. Patients who were able to work had a 78% reduced risk of disability compared to patients unable to work. Also of prognostic relevance were a positive performance and the duration of the inability to work the year before rehabilitation. The variables of the newly developed quality assurance programme of the LVA clearly demonstrated a prognostic value in terms of risk for subsequent early retirement. It should be considered to include the ability to work at discharge in the programme to further improve its prognostic value.

Health-Related Quality of Life Among Central Appalachian Residents in Mountaintop Mining Counties

PubMed Central

Hendryx, Michael

2011-01-01

Objectives. We examined the health-related quality of life of residents in mountaintop mining counties of Appalachia using the 2006 national Behavioral Risk Factor Surveillance System. Methods. Dependent variables included self-rated health; the number of poor physical, poor mental, and activity limitation days (in the past 30 days); and the Healthy Days Index. Independent variables included metropolitan status, primary care physician supply, and Behavioral Risk Factor Surveillance System behavioral and demographic variables. We compared dependent variables across 3 categories: mountaintop mining (yes or no), other coal mining (yes or no), and a referent nonmining group. We used SUDAAN MULTILOG and multiple linear regression models with post hoc least squares means to test mountaintop mining effects after adjusting for covariates. Results. Residents of mountaintop mining counties reported significantly more days of poor physical, mental, and activity limitation and poorer self-rated health (P < .01) compared with the other county groupings. Results were generally consistent in separate analyses by gender and age. Conclusions. Mountaintop mining areas are associated with the greatest reductions in health-related quality of life even when compared with counties with other forms of coal mining. PMID:21421943

Rotorcraft handling-qualities design criteria development

NASA Technical Reports Server (NTRS)

Aiken, Edwin W.; Lebacqz, J. Victor; Chen, Robert T. N.; Key, David L.

1988-01-01

Joint NASA/Army efforts at the Ames Research Center to develop rotorcraft handling-qualities design criteria began in earnest in 1975. Notable results were the UH-1H VSTOLAND variable stability helicopter, the VFA-2 camera-and-terrain-board simulator visual system, and the generic helicopter real-time mathematical model, ARMCOP. An initial series of handling-qualities studies was conducted to assess the effects of rotor design parameters, interaxis coupling, and various levels of stability and control augmentation. The ability to conduct in-flight handling-qualities research was enhanced by the development of the NASA/Army CH-47 variable-stability helicopter. Research programs conducted using this vehicle include vertical-response investigations, hover augmentation systems, and the effects of control-force characteristics. The handling-qualities data base was judged to be sufficient to allow an update of the military helicopter handling-qualities specification, MIL-H-8501. These efforts, including not only the in-house experimental work but also contracted research and collaborative programs performed under the auspices of various international agreements. The report concludes by reviewing the topics that are currently most in need of work, and the plans for addressing these topics.

A Geographically Variable Water Quality Index Used in Oregon.

ERIC Educational Resources Information Center

Dunnette, D. A.

1979-01-01

Discusses the procedure developed in Oregon to formulate a valid water quality index which accounts for the specific conditions in the water body of interest. Parameters selected include oxygen depletion, BOD, eutrophication, dissolved substances, health hazards, and physical characteristics. (CS)

Epilepsy-related clinical factors and psychosocial functions in pediatric epilepsy.

PubMed

Eom, Soyong; Eun, So-Hee; Kang, Hoon-Chul; Eun, Baik-Lin; Nam, Sang Ook; Kim, Sun Jun; Chung, Hee Jung; Kwon, Soon Hak; Lee, Young-Mock; Lee, Joon Soo; Kim, Dong Wook; Oh, Kyung Ja; Kim, Heung Dong

2014-08-01

The aim of this study was to identify the different influencing patterns of demographic and epilepsy-related variables on various aspects of psychosocial function in pediatric epilepsy. Five hundred ninety-eight patients with pediatric epilepsy between the ages of 4 and 18 years (boys=360, 60% and girls=238, 40%) and their parents participated in the study. Parents completed the Social Maturity Scale (SMS), the Korean version of the Child Behavior Checklist (K-CBCL), and the Korean version of the Quality of Life in Childhood Epilepsy Questionnaire (K-QOLCE) to assess daily living function, behavior, and quality of life. The Children's Global Assessment Scale (CGAS) was completed by clinicians to assess general adaptive function. Demographic variables, such as age and sex of child, and epilepsy-related clinical variables, including seizure type, seizure frequency, duration of epilepsy, and number of medications, were obtained from medical records. Demographic and epilepsy-related clinical variables had a strong influence (22-32%) on the cognition-related domain such as general adaptive function, school/total competence, and quality of life for cognitive function while a comparatively smaller effect (2-16%) on the more psychological domain including behavioral, emotional, and social variables. Younger age, shorter duration of illness, and smaller number of medications showed a strong positive impact on psychosocial function in pediatric epilepsy, particularly for adaptive function, competence, and quality-of-life aspects. Given the wide range of impact of demographic and clinical variables on various facets of psychosocial functions, more specific understanding of the various aspects of factors and their particular pattern of influence may enable more effective therapeutic approaches that address both the medical and psychological needs in pediatric epilepsy. Copyright © 2014 Elsevier Inc. All rights reserved.

Personality and Sibling Relationships.

ERIC Educational Resources Information Center

Furman, Wyndol; Lanthier, Richard P.

1996-01-01

This study examined the role personality variables play in sibling relationships. It proposed that the characteristics of sibling relationships are influenced by: family constellation variables such as birth order, gender, and age spacing; parent-child relationships including quality of relationship and parent management of siblings; and the…

Consideration of What May Influence Student Outcomes on Alternate Assessment.

ERIC Educational Resources Information Center

Browder, Diane M.; Fallin, Kathy; Davis, Stephanie; Karvonen, Meagan

2003-01-01

This article describes variables that may influence alternate assessment outcomes for students with disabilities and offers recommendations to enhance student achievement. These variables include technical quality, curriculum access, data collection, instructional effectiveness, risk factors, and resources allocated to instruction. Two of four…

Quality of Life Indicators in the U.S. Metropolitan Areas, 1970 (Summary).

ERIC Educational Resources Information Center

Liu, Ben-Chieh

The empirical results of a 1970 study designed to assess the quality of life in 243 metropolitan areas are provided in this booklet. The quality of life components include 123 variables related to overall economic, political, environmental, health and education, and social conditions. The booklet is divided into five sections which explain the…

Data Sharing Between Providers and Quality Initiatives Eliminate Unnecessary Nursing Home Admissions.

PubMed

Charles, Ryan J; Singal, Bonita M; Urquhart, Andrew G; Masini, Michael A; Hallstrom, Brian R

2017-05-01

The Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI) has monitored discharge disposition, after total hip and knee arthroplasties, since inception in 2012 and found the standardized risk of extended care facility (ECF) placement to be highly variable between hospitals. The variation in standardized risks of ECF placement among MARCQI member sites was reported to the collaborative. At the May 2, 2014 quarterly meeting, a quality initiative was started, emphasizing the wide variability between hospitals, the contribution of hospital and surgeon to that variability using median odds ratios, and the need for outlier hospitals to initiate quality improvement (QI) processes. Patients from 29 hospitals that were members of MARCQI before the intervention were included in this analysis. We compared standardized risks before and after the intervention in the entire cohort, and for 3 hospitals that implemented institution-specific QI projects. We report changes in ECF placement, length of stay, emergency room visits, and readmissions over time. This study includes 31,347 patients before and 20,879 patients after the implementation of the quality initiative. The range in standardized risk dropped from 9.4%-46.1% to 9.4%-32.4% and the average dropped from 23.0% to 19.6%. Three outlier hospitals decreased their absolute risk of ECF placement by 12.2%, 8.9%, and 12.4% after QI, without increases in adverse outcomes. Discharge to ECF after primary hip and knee arthroplasties is highly variable and influenced by hospital and surgeon practices. Hospital-level QI measures can decrease ECF admissions. Copyright © 2016 Elsevier Inc. All rights reserved.

Methods and systems for fabricating high quality superconducting tapes

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

Majkic, Goran; Selvamanickam, Venkat

An MOCVD system fabricates high quality superconductor tapes with variable thicknesses. The MOCVD system can include a gas flow chamber between two parallel channels in a housing. A substrate tape is heated and then passed through the MOCVD housing such that the gas flow is perpendicular to the tape's surface. Precursors are injected into the gas flow for deposition on the substrate tape. In this way, superconductor tapes can be fabricated with variable thicknesses, uniform precursor deposition, and high critical current densities.

An empirical comparison of key statistical attributes among potential ICU quality indicators.

PubMed

Brown, Sydney E S; Ratcliffe, Sarah J; Halpern, Scott D

2014-08-01

Good quality indicators should have face validity, relevance to patients, and be able to be measured reliably. Beyond these general requirements, good quality indicators should also have certain statistical properties, including sufficient variability to identify poor performers, relative insensitivity to severity adjustment, and the ability to capture what providers do rather than patients' characteristics. We assessed the performance of candidate indicators of ICU quality on these criteria. Indicators included ICU readmission, mortality, several length of stay outcomes, and the processes of venous-thromboembolism and stress ulcer prophylaxis provision. Retrospective cohort study. One hundred thirty-eight U.S. ICUs from 2001-2008 in the Project IMPACT database. Two hundred sixty-eight thousand eight hundred twenty-four patients discharged from U.S. ICUs. None. We assessed indicators' (1) variability across ICU-years; (2) degree of influence by patient vs. ICU and hospital characteristics using the Omega statistic; (3) sensitivity to severity adjustment by comparing the area under the receiver operating characteristic curve (AUC) between models including vs. excluding patient variables, and (4) correlation between risk adjusted quality indicators using a Spearman correlation. Large ranges of among-ICU variability were noted for all quality indicators, particularly for prolonged length of stay (4.7-71.3%) and the proportion of patients discharged home (30.6-82.0%), and ICU and hospital characteristics outweighed patient characteristics for stress ulcer prophylaxis (ω, 0.43; 95% CI, 0.34-0.54), venous thromboembolism prophylaxis (ω, 0.57; 95% CI, 0.53-0.61), and ICU readmissions (ω, 0.69; 95% CI, 0.52-0.90). Mortality measures were the most sensitive to severity adjustment (area under the receiver operating characteristic curve % difference, 29.6%); process measures were the least sensitive (area under the receiver operating characteristic curve % differences: venous thromboembolism prophylaxis, 3.4%; stress ulcer prophylaxis, 2.1%). None of the 10 indicators was clearly and consistently correlated with a majority of the other nine indicators. No indicator performed optimally across assessments. Future research should seek to define and operationalize quality in a way that is relevant to both patients and providers.

Demographic, clinical, and quality of life variables related to embarrassment in veterans living with an intestinal stoma.

PubMed

Mitchell, Kimberly A; Rawl, Susan M; Schmidt, C Max; Grant, Marcia; Ko, Clifford Y; Baldwin, Carol M; Wendel, Christopher; Krouse, Robert S

2007-01-01

The study aims were to identify demographic, clinical, and quality of life variables related to embarrassment for people living with ostomies and to determine the experiences and/or feelings of veterans who were embarrassed by their ostomy. This was a cross-sectional, correlational study. A convenience sample of veterans (n = 239) living with ostomies from 3 VA medical centers was studied. The veterans were primarily Caucasian (84%), male (92%), and older (M = 69). The modified City of Hope Quality of Life-Ostomy questionnaire was used. Additionally, an open-ended question related to living with an ostomy was asked. The questionnaire packets were mailed to participants and self-administered. Approximately half of the participants (48%) rated their embarrassment as low, but 26% reported high embarrassment. Participants with high embarrassment were compared to those with low embarrassment on demographic, clinical, and quality of life variables. High embarrassment was associated with poorer total quality of life (P < .001) and poorer quality of life on the physical (P < .001), psychological (P < .001), social (P < .001), and spiritual (P < .001) subscales. Younger (P < .001) and unpartnered veterans (P < .001) were more likely to be highly embarrassed. Veterans with high embarrassment had higher anxiety (P < .001) and depression (P < .001), more difficulty with intimacy (P < .001), and felt more isolated (P < .001). Spiritual domain variables like hopefulness were associated with low embarrassment (P < .001). Sources of embarrassment included leakage, odor, and noise. Embarrassment may negatively impact a person's quality of life; therefore, the variables associated with high embarrassment should be recognized and addressed.

Estimating the Effects of Pre-College Education on College Performance

DTIC Science & Technology

2013-05-10

background information from many variables into a single measure of the expected likelihood of a person receiving treatment. This leads into a discussion of...but do not directly effect outcome variables like academic order of merit, graduation rates, or academic grades. Our model had to not only include the...both indicator variables for whether the individual’s parents ever served in any of the armed forces. High School Quality Measure is a variable

Pharmaceutical quality by design: product and process development, understanding, and control.

PubMed

Yu, Lawrence X

2008-04-01

The purpose of this paper is to discuss the pharmaceutical Quality by Design (QbD) and describe how it can be used to ensure pharmaceutical quality. The QbD was described and some of its elements identified. Process parameters and quality attributes were identified for each unit operation during manufacture of solid oral dosage forms. The use of QbD was contrasted with the evaluation of product quality by testing alone. The QbD is a systemic approach to pharmaceutical development. It means designing and developing formulations and manufacturing processes to ensure predefined product quality. Some of the QbD elements include: Defining target product quality profile; Designing product and manufacturing processes; Identifying critical quality attributes, process parameters, and sources of variability; Controlling manufacturing processes to produce consistent quality over time. Using QbD, pharmaceutical quality is assured by understanding and controlling formulation and manufacturing variables. Product testing confirms the product quality. Implementation of QbD will enable transformation of the chemistry, manufacturing, and controls (CMC) review of abbreviated new drug applications (ANDAs) into a science-based pharmaceutical quality assessment.

The Influence of Social Structure on Cancer Pain and Quality of Life.

PubMed

Ham, Ok-Kyung; Chee, Wonshik; Im, Eun-Ok

2017-12-01

The aim of this study was to investigate whether social structure is associated with cancer pain and quality of life using the Social Structure and Personality Research Framework. This study was a secondary analysis of data from 480 cancer patients. The measurements included socioeconomic variables, self-reported cancer pain using the McGill Pain Questionnaire-Short Form (MPQ-SF), and quality of life measured using the Functional Assessment of Cancer Therapy Scale (FACT-G). The data were analyzed using moderated multiple regression. Cancer pain and quality of life differed significantly with income. The associations between income and pain and quality of life were significant only for the high education group (≥ partial college), and these associations were greater for Caucasians than for their counterparts ( p < .05). When developing interventions, nurses should consider the influence of socioeconomic variables on pain and quality of life while considering possible moderating factors such as education.

An evaluation of the relative quality of dike pools for benthic macroinvertebrates in the Lower Missouri River, USA

USGS Publications Warehouse

Poulton, B.C.; Allert, A.L.

2012-01-01

A habitat-based aquatic macroinvertebrate study was initiated in the Lower Missouri River to evaluate relative quality and biological condition of dike pool habitats. Water-quality and sediment-quality parameters and macroinvertebrate assemblage structure were measured from depositional substrates at 18 sites. Sediment porewater was analysed for ammonia, sulphide, pH and oxidation-reduction potential. Whole sediments were analysed for particle-size distribution, organic carbon and contaminants. Field water-quality parameters were measured at subsurface and at the sediment-water interface. Pool area adjacent and downstream from each dike was estimated from aerial photography. Macroinvertebrate biotic condition scores were determined by integrating the following indicator response metrics: % of Ephemeroptera (mayflies), % of Oligochaeta worms, Shannon Diversity Index and total taxa richness. Regression models were developed for predicting macroinvertebrate scores based on individual water-quality and sediment-quality variables and a water/sediment-quality score that integrated all variables. Macroinvertebrate scores generated significant determination coefficients with dike pool area (R2=0.56), oxidation–reduction potential (R2=0.81) and water/sediment-quality score (R2=0.71). Dissolved oxygen saturation, oxidation-reduction potential and total ammonia in sediment porewater were most important in explaining variation in macroinvertebrate scores. The best two-variable regression models included dike pool size + the water/sediment-quality score (R2=0.84) and dike pool size + oxidation-reduction potential (R2=0.93). Results indicate that dike pool size and chemistry of sediments and overlying water can be used to evaluate dike pool quality and identify environmental conditions necessary for optimizing diversity and productivity of important aquatic macroinvertebrates. A combination of these variables could be utilized for measuring the success of habitat enhancement activities currently being implemented in this system.

Quality of Streams in Johnson County, Kansas, and Relations to Environmental Variables, 2003-07

USGS Publications Warehouse

Rasmussen, Teresa J.; Poulton, Barry C.; Graham, Jennifer L.

2009-01-01

The quality of streams and relations to environmental variables in Johnson County, northeastern Kansas, were evaluated using water, streambed sediment, land use, streamflow, habitat, algal periphyton (benthic algae), and benthic macroinvertebrate data. Water, streambed sediment, and macroinvertebrate samples were collected in March 2007 during base flow at 20 stream sites that represent 11 different watersheds in the county. In addition, algal periphyton samples were collected twice (spring and summer 2007) at one-half of the sites. Environmental data including water and streambed-sediment chemistry data (primarily nutrients, fecal-indicator bacteria, and organic wastewater compounds), land use, streamflow, and habitat data were used in statistical analyses to evaluate relations between biological conditions and variables that may affect them. This report includes an evaluation of water and streambed-sediment chemistry, assessment of habitat conditions, comparison of biological community attributes (such as composition, diversity, and abundance) among sampling sites, placement of sampling sites into impairment categories, evaluation of biological data relative to environmental variables, and evaluation of changes in biological communities and effects of urbanization. This evaluation is useful for understanding factors that affect stream quality, for improving water-quality management programs, and for documenting changing conditions over time. The information will become increasingly important for protecting streams in the future as urbanization continues. Results of this study indicate that the biological quality at nearly all biological sampling sites in Johnson County has some level of impairment. Periphyton taxa generally were indicative of somewhat degraded conditions with small to moderate amounts of organic enrichment. Camp Branch in the Blue River watershed was the only site that met State criteria for full support of aquatic life in 2007. Since 2003, biological quality improved at one rural sampling site, possibly because of changes in wastewater affecting the site, and declined at three urban sites possibly because of the combined effects of ongoing development. Rural streams in the western and southern parts of the county, with land-use conditions similar to those found at the State reference site (Captain Creek), continue to support some organisms normally associated with healthy streams. Several environmental factors contribute to biological indicators of stream quality. The primary factor explaining biological quality at sites in Johnson County was the amount of urbanization upstream in the watershed. Specific conductance of stream water, which is a measure of dissolved solids in water and is determined primarily by the amount of groundwater contributing to streamflow, the amount of urbanization, and discharges from wastewater and industrial sites, was strongly negatively correlated with biological stream quality as indicated by macroinvertebrate metrics. Concentration of polycyclic aromatic hydrocarbons (PAHs) in streambed sediment also was negatively correlated with biological stream quality. Individual habitat variables that most commonly were positively correlated with biological indicators included stream sinuosity, buffer length, and substrate cover diversity. Riffle substrate embeddedness and sediment deposition commonly were negatively correlated with favorable metric scores. Statistical analysis indicated that specific conductance, impervious surface area (a measure of urbanization), and stream sinuosity explained 85 percent of the variance in macroinvertebrate communities. Management practices affecting environmental variables that appear to be most important for Johnson County streams include protection of stream corridors, measures that reduce the effects of impervious surfaces associated with urbanization, reduction of dissolved solids in stream water, reduction of PAHs entering streams and

The role of non-financial performance measures in predicting hospital financial performance: the case of for-profit system hospitals.

PubMed

Vélez-González, Heltie; Pradhan, Rohit; Weech-Maldonado, Robert

2011-01-01

Non-financial measures have found increasing acceptance in the business world--however, their application in the health care industry remains limited. The purpose of this article is to understand the influence of non-financial measures (efficiency, productivity, and quality) on the financial performance of for-profit system hospitals. The sample consists of 499 for-profit system hospitals in the United States from 1999 to 2002. Data analyzed include the American Hospital Association's Annual Survey, Medicare Cost Reports, Joint Commission's quality scores, and the Centers for Medicare & Medicaid Services' Hospital Case Mix Index. Dependent variables consist of financial measures (operating and total margins), while independent variables include measures of efficiency, productivity, and quality. Our results suggest the influence of non-financial performance measures on financial performance; occupancy rate positively influences financial performance while greater labor intensity may have negative implications for financial performance. In addition, we show that quality positively influences financial performance thereby offering a potential business case for quality. This result has important managerial and policy implications as it may incentivize capital and human resource investments required to improve hospital quality of care.

Assessing data quality and the variability of source data verification auditing methods in clinical research settings.

PubMed

Houston, Lauren; Probst, Yasmine; Martin, Allison

2018-05-18

Data audits within clinical settings are extensively used as a major strategy to identify errors, monitor study operations and ensure high-quality data. However, clinical trial guidelines are non-specific in regards to recommended frequency, timing and nature of data audits. The absence of a well-defined data quality definition and method to measure error undermines the reliability of data quality assessment. This review aimed to assess the variability of source data verification (SDV) auditing methods to monitor data quality in a clinical research setting. The scientific databases MEDLINE, Scopus and Science Direct were searched for English language publications, with no date limits applied. Studies were considered if they included data from a clinical trial or clinical research setting and measured and/or reported data quality using a SDV auditing method. In total 15 publications were included. The nature and extent of SDV audit methods in the articles varied widely, depending upon the complexity of the source document, type of study, variables measured (primary or secondary), data audit proportion (3-100%) and collection frequency (6-24 months). Methods for coding, classifying and calculating error were also inconsistent. Transcription errors and inexperienced personnel were the main source of reported error. Repeated SDV audits using the same dataset demonstrated ∼40% improvement in data accuracy and completeness over time. No description was given in regards to what determines poor data quality in clinical trials. A wide range of SDV auditing methods are reported in the published literature though no uniform SDV auditing method could be determined for "best practice" in clinical trials. Published audit methodology articles are warranted for the development of a standardised SDV auditing method to monitor data quality in clinical research settings. Copyright © 2018. Published by Elsevier Inc.

Use of Natural Diversity and Biotechnology to Increase the Quality and Nutritional Content of Tomato and Grape

PubMed Central

Gascuel, Quentin; Diretto, Gianfranco; Monforte, Antonio J.; Fortes, Ana M.; Granell, Antonio

2017-01-01

Improving fruit quality has become a major goal in plant breeding. Direct approaches to tackling fruit quality traits specifically linked to consumer preferences and environmental friendliness, such as improved flavor, nutraceutical compounds, and sustainability, have slowly been added to a breeder priority list that already includes traits like productivity, efficiency, and, especially, pest and disease control. Breeders already use molecular genetic tools to improve fruit quality although most advances have been made in producer and industrial quality standards. Furthermore, progress has largely been limited to simple agronomic traits easy-to-observe, whereas the vast majority of quality attributes, specifically those relating to flavor and nutrition, are complex and have mostly been neglected. Fortunately, wild germplasm, which is used for resistance against/tolerance of environmental stresses (including pathogens), is still available and harbors significant genetic variation for taste and health-promoting traits. Similarly, heirloom/traditional varieties could be used to identify which genes contribute to flavor and health quality and, at the same time, serve as a good source of the best alleles for organoleptic quality improvement. Grape (Vitis vinifera L.) and tomato (Solanum lycopersicum L.) produce fleshy, berry-type fruits, among the most consumed in the world. Both have undergone important domestication and selection processes, that have dramatically reduced their genetic variability, and strongly standardized fruit traits. Moreover, more and more consumers are asking for sustainable production, incompatible with the wide range of chemical inputs. In the present paper, we review the genetic resources available to tomato/grape breeders, and the recent technological progresses that facilitate the identification of genes/alleles of interest within the natural or generated variability gene pool. These technologies include omics, high-throughput phenotyping/phenomics, and biotech approaches. Our review also covers a range of technologies used to transfer to tomato and grape those alleles considered of interest for fruit quality. These include traditional breeding, TILLING (Targeting Induced Local Lesions in Genomes), genetic engineering, or NPBT (New Plant Breeding Technologies). Altogether, the combined exploitation of genetic variability and innovative biotechnological tools may facilitate breeders to improve fruit quality tacking more into account the consumer standards and the needs to move forward into more sustainable farming practices. PMID:28553296

A Mixed-Methodological Examination of Investment Model Variables among Abused and Nonabused College Women

ERIC Educational Resources Information Center

Dardis, Christina M.; Kelley, Erika L.; Edwards, Katie M.; Gidycz, Christine A.

2013-01-01

Objective: This study assessed abused and nonabused women's perceptions of Investment Model (IM) variables (ie, relationship investment, satisfaction, commitment, quality of alternatives) utilizing a mixed-methods design. Participants: Participants included 102 college women, approximately half of whom were in abusive dating relationships.…

The Environmental Quality Index: associations of the land and socioeconomic domains with preterm birth in New Jersey.

EPA Science Inventory

Human health is affected by simultaneous exposure to positive and negative area-level features, but research often focuses on single exposures. To address this discontinuity, a county-level environmental quality index (EQI) is being constructed, including variables representin...

Defining process design space for a hydrophobic interaction chromatography (HIC) purification step: application of quality by design (QbD) principles.

PubMed

Jiang, Canping; Flansburg, Lisa; Ghose, Sanchayita; Jorjorian, Paul; Shukla, Abhinav A

2010-12-15

The concept of design space has been taking root under the quality by design paradigm as a foundation of in-process control strategies for biopharmaceutical manufacturing processes. This paper outlines the development of a design space for a hydrophobic interaction chromatography (HIC) process step. The design space included the impact of raw material lot-to-lot variability and variations in the feed stream from cell culture. A failure modes and effects analysis was employed as the basis for the process characterization exercise. During mapping of the process design space, the multi-dimensional combination of operational variables were studied to quantify the impact on process performance in terms of yield and product quality. Variability in resin hydrophobicity was found to have a significant influence on step yield and high-molecular weight aggregate clearance through the HIC step. A robust operating window was identified for this process step that enabled a higher step yield while ensuring acceptable product quality. © 2010 Wiley Periodicals, Inc.

Quality assessment of systematic reviews on alveolar socket preservation.

PubMed

Moraschini, V; Barboza, E Dos S P

2016-09-01

The aim of this overview was to evaluate and compare the quality of systematic reviews, with or without meta-analysis, that have evaluated studies on techniques or biomaterials used for the preservation of alveolar sockets post tooth extraction in humans. An electronic search was conducted without date restrictions using the Medline/PubMed, Cochrane Library, and Web of Science databases up to April 2015. Eligibility criteria included systematic reviews, with or without meta-analysis, focused on the preservation of post-extraction alveolar sockets in humans. Two independent authors assessed the quality of the included reviews using AMSTAR and the checklist proposed by Glenny et al. in 2003. After the selection process, 12 systematic reviews were included. None of these reviews obtained the maximum score using the quality assessment tools implemented, and the results of the analyses were highly variable. A significant statistical correlation was observed between the scores of the two checklists. A wide structural and methodological variability was observed between the systematic reviews published on the preservation of alveolar sockets post tooth extraction. None of the reviews evaluated obtained the maximum score using the two quality assessment tools implemented. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Fermentanomics: Relating quality attributes of a monoclonal antibody to cell culture process variables and raw materials using multivariate data analysis.

PubMed

Rathore, Anurag S; Kumar Singh, Sumit; Pathak, Mili; Read, Erik K; Brorson, Kurt A; Agarabi, Cyrus D; Khan, Mansoor

2015-01-01

Fermentanomics is an emerging field of research and involves understanding the underlying controlled process variables and their effect on process yield and product quality. Although major advancements have occurred in process analytics over the past two decades, accurate real-time measurement of significant quality attributes for a biotech product during production culture is still not feasible. Researchers have used an amalgam of process models and analytical measurements for monitoring and process control during production. This article focuses on using multivariate data analysis as a tool for monitoring the internal bioreactor dynamics, the metabolic state of the cell, and interactions among them during culture. Quality attributes of the monoclonal antibody product that were monitored include glycosylation profile of the final product along with process attributes, such as viable cell density and level of antibody expression. These were related to process variables, raw materials components of the chemically defined hybridoma media, concentration of metabolites formed during the course of the culture, aeration-related parameters, and supplemented raw materials such as glucose, methionine, threonine, tryptophan, and tyrosine. This article demonstrates the utility of multivariate data analysis for correlating the product quality attributes (especially glycosylation) to process variables and raw materials (especially amino acid supplements in cell culture media). The proposed approach can be applied for process optimization to increase product expression, improve consistency of product quality, and target the desired quality attribute profile. © 2015 American Institute of Chemical Engineers.

Dietary self-efficacy predicts AHEI diet quality in women with previous gestational diabetes.

PubMed

Ferranti, Erin Poe; Narayan, K M Venkat; Reilly, Carolyn M; Foster, Jennifer; McCullough, Marjorie; Ziegler, Thomas R; Guo, Ying; Dunbar, Sandra B

2014-01-01

The purpose of this study was to examine the association of intrapersonal influences of diet quality as defined by the Health Belief Model constructs in women with recent histories of gestational diabetes. A descriptive, correlational, cross-sectional design was used to analyze relationships between diet quality and intrapersonal variables, including perceptions of threat of type 2 diabetes mellitus development, benefits and barriers of healthy eating, and dietary self-efficacy, in a convenience sample of 75 community-dwelling women (55% minority; mean age, 35.5 years; SD, 5.5 years) with previous gestational diabetes mellitus. Diet quality was defined by the Alternative Healthy Eating Index (AHEI). Multiple regression was used to identify predictors of AHEI diet quality. Women had moderate AHEI diet quality (mean score, 47.6; SD, 14.3). Only higher levels of education and self-efficacy significantly predicted better AHEI diet quality, controlling for other contributing variables. There is a significant opportunity to improve diet quality in women with previous gestational diabetes mellitus. Improving self-efficacy may be an important component to include in nutrition interventions. In addition to identifying other important individual components, future studies of diet quality in women with previous gestational diabetes mellitus are needed to investigate the scope of influence beyond the individual to potential family, social, and environmental factors. © 2014 The Author(s).

Creating Near-Term Climate Scenarios for AgMIP

NASA Astrophysics Data System (ADS)

Goddard, L.; Greene, A. M.; Baethgen, W.

2012-12-01

For the next assessment report of the IPCC (AR5), attention is being given to development of climate information that is appropriate for adaptation, such as decadal-scale and near-term predictions intended to capture the combined effects of natural climate variability and the emerging climate change signal. While the science and practice evolve for the production and use of dynamic decadal prediction, information relevant to agricultural decision-makers can be gained from analysis of past decadal-scale trends and variability. Statistical approaches that mimic the characteristics of observed year-to-year variability can indicate the range of possibilities and their likelihood. In this talk we present work towards development of near-term climate scenarios, which are needed to engage decision-makers and stakeholders in the regions in current decision-making. The work includes analyses of decadal-scale variability and trends in the AgMIP regions, and statistical approaches that capture year-to-year variability and the associated persistence of wet and dry years. We will outline the general methodology and some of the specific considerations in the regional application of the methodology for different AgMIP regions, such those for Western Africa versus southern Africa. We will also show some examples of quality checks and informational summaries of the generated data, including (1) metrics of information quality such as probabilistic reliability for a suite of relevant climate variables and indices important for agriculture; (2) quality checks relative to the use of this climate data in crop models; and, (3) summary statistics (e.g., for 5-10-year periods or across given spatial scales).

Telepractice for Pediatric Dysphagia: A Case Study

PubMed Central

Malandraki, Georgia A.; Roth, Melissa; Sheppard, Justine Joan

2014-01-01

A closed-ended intensive pediatric swallowing telepractice program was developed and piloted in one pediatric patient with Opitz BBB/G and Asperger’s Syndromes, oropharyngeal dysphagia and aerophagia. The present study is a case report. Outcome variables included behavioral, swallowing and quality of life variables, and were assessed at baseline and at the end of the four-week program. Selective variables were also assessed at a follow-up family interview four weeks post program completion. Over the four-week intervention period, the patient demonstrated substantial improvements in: oral acceptance of eating-related objects and a variety of foods (behavioral variable), timing of voluntary saliva swallows and aerophagia levels (swallowing variables) and quality of life. Follow-up interview analysis showed that most skills were retained or improved one-month post intervention. This intensive telepractice program proved to be feasible and effective for this pediatric patient with dysphagia. PMID:25945217

Reporting the accuracy of biochemical measurements for epidemiologic and nutrition studies.

PubMed

McShane, L M; Clark, L C; Combs, G F; Turnbull, B W

1991-06-01

Procedures for reporting and monitoring the accuracy of biochemical measurements are presented. They are proposed as standard reporting procedures for laboratory assays for epidemiologic and clinical-nutrition studies. The recommended procedures require identification and estimation of all major sources of variability and explanations of laboratory quality control procedures employed. Variance-components techniques are used to model the total variability and calculate a maximum percent error that provides an easily understandable measure of laboratory precision accounting for all sources of variability. This avoids ambiguities encountered when reporting an SD that may taken into account only a few of the potential sources of variability. Other proposed uses of the total-variability model include estimating precision of laboratory methods for various replication schemes and developing effective quality control-checking schemes. These procedures are demonstrated with an example of the analysis of alpha-tocopherol in human plasma by using high-performance liquid chromatography.

The Relationship between Costs and Quality in Veterans Health Administration Community Living Centers: An Analysis Using Longitudinal Data.

PubMed

Burgess, James F; Shwartz, Michael; Stolzmann, Kelly; Sullivan, Jennifer L

2018-05-18

To examine the relationship between cost and quality in Veterans Health Administration (VA) nursing homes (called Community Living Centers, CLCs) using longitudinal data. One hundred and thirty CLCs over 13 quarters (from FY2009 to FY2012) were studied. Costs, resident days, and resident severity (RUGs score) were obtained from the VA Managerial Cost Accounting System. Clinical quality measures were obtained from the Minimum Data Set, and resident-centered care (RCC) was measured using the Artifacts of Culture Change Tool. We used a generalized estimating equation model with facilities included as fixed effects to examine the relationship between total cost and quality after controlling for resident days and severity. The model included linear and squared terms for all independent variables and interactions with resident days. With the exception of RCC, all other variables had a statistically significant relationship with total costs. For most poorer performing smaller facilities (lower size quartile), improvements in quality were associated with higher costs. For most larger facilities, improvements in quality were associated with lower costs. The relationship between cost and quality depends on facility size and current level of performance. © Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Effects of night-time on-call work on heart rate variability before bed and sleep quality in visiting nurses.

PubMed

Kikuchi, Yukiko; Ishii, Noriko; Kodama, Hideya

2018-05-28

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

The quest to standardize hemodialysis care.

PubMed

Hegbrant, Jörgen; Gentile, Giorgio; Strippoli, Giovanni F M

2011-01-01

A large global dialysis provider's core activities include providing dialysis care with excellent quality, ensuring a low variability across the clinic network and ensuring strong focus on patient safety. In this article, we summarize the pertinent components of the quality assurance and safety program of the Diaverum Renal Services Group. Concerning medical performance, the key components of a successful quality program are setting treatment targets; implementing evidence-based guidelines and clinical protocols; consistently, regularly, prospectively and accurately collecting data from all clinics in the network; processing collected data to provide feedback to clinics in a timely manner, incorporating information on interclinic and intercountry variations; and revising targets, guidelines and clinical protocols based on sound scientific data. The key activities for ensuring patient safety include a standardized approach to education, i.e. a uniform education program including control of theoretical knowledge and clinical competencies; implementation of clinical policies and procedures in the organization in order to reduce variability and potential defects in clinic practice; and auditing of clinical practice on a regular basis. By applying a standardized and systematic continuous quality improvement approach throughout the entire organization, it has been possible for Diaverum to progressively improve medical performance and ensure patient safety. Copyright © 2011 S. Karger AG, Basel.

The Challenges of Measuring Glycemic Variability

PubMed Central

Rodbard, David

2012-01-01

This commentary reviews several of the challenges encountered when attempting to quantify glycemic variability and correlate it with risk of diabetes complications. These challenges include (1) immaturity of the field, including problems of data accuracy, precision, reliability, cost, and availability; (2) larger relative error in the estimates of glycemic variability than in the estimates of the mean glucose; (3) high correlation between glycemic variability and mean glucose level; (4) multiplicity of measures; (5) correlation of the multiple measures; (6) duplication or reinvention of methods; (7) confusion of measures of glycemic variability with measures of quality of glycemic control; (8) the problem of multiple comparisons when assessing relationships among multiple measures of variability and multiple clinical end points; and (9) differing needs for routine clinical practice and clinical research applications. PMID:22768904

Effects of poor asthma control, insomnia, anxiety and depression on quality of life in young asthmatics.

PubMed

Sundbom, Fredrik; Malinovschi, Andrei; Lindberg, Eva; Alving, Kjell; Janson, Christer

2016-01-01

Asthma-related quality of life has previously been shown to be associated with asthma control. The aims of the present study were to further analyze this correlation, identify other variables with impact on asthma-related quality of life and investigate the covariance among these variables. Information was retrieved from a cohort of 369 patients, aged 12-35, with physician-diagnosed asthma requiring anti-inflammatory treatment for at least 3 months per year. Questionnaire data [including the mini-Asthma Quality of Life Questionnaire (mAQLQ), asthma control test (ACT) and Hospital Anxiety and Depression Scale (HADS)], quality of sleep, lung function data and blood samples were analyzed. Linear regression models with the mAQLQ score as the dependent scalar variable were calculated. ACT was the single variable that had the highest explanatory value for the mAQLQ score (51.5%). High explanatory power was also observed for anxiety and depression (17.0%) and insomnia (14.1%). The population was divided into groups depending on the presence of anxiety and depression, uncontrolled asthma and insomnia. The group that reported none of these conditions had the highest mean mAQLQ score (6.3 units), whereas the group reporting all of these conditions had the lowest mAQLQ score (3.8 units). The ACT score was the single most important variable in predicting asthma-related quality of life. Combining the ACT score with the data on insomnia, anxiety and depression showed considerable additive effects of the conditions. Hence, we recommend the routine use of the ACT and careful attention to symptoms of insomnia, anxiety or depression in the clinical evaluation of asthma-related quality of life.

College Quality and Early Adult Outcomes

ERIC Educational Resources Information Center

Long, Mark C.

2008-01-01

This paper estimates the effects of various college qualities on several early adult outcomes, using panel data from the National Education Longitudinal Study. I compare the results using ordinary least squares with three alternative methods of estimation, including instrumental variables, and the methods used by Dale and Krueger [(2002).…

Water quality parameters of harbors of Charlotte Amalie, St. Thomas, Virgin Islands: Acquisition of in situ water data, intercorrelation of selected water parameters, and initial correlation of these in situ biological, chemical and physical data with ERTS-1 bulk CCT MSS band 5 data

NASA Technical Reports Server (NTRS)

Coulbourn, W. C.; Olsen, D. A. (Principal Investigator)

1973-01-01

The author has identified the following significant results. Remote sensing by the ERTS-1 satellite was compared with selected water quality parameters including pH, salinity, conductivity, dissolved oxygen, water depth, water temperature, turbidity, plankton concentration, current variables, chlorophylla, total carotenoids, and species diversity of the benthic community. Strong correlation between turbidity and MSS-sensed radiance was recorded and less strong correlations between the two plankton pigments and radiance. Turbidity and benthic species diversity were highly correlated furnishing an inferential tie between an easily sensed water quality variable and a sensitive indicator of average water quality conditions.

Incorporating wind availability into land use regression modelling of air quality in mountainous high-density urban environment.

PubMed

Shi, Yuan; Lau, Kevin Ka-Lun; Ng, Edward

2017-08-01

Urban air quality serves as an important function of the quality of urban life. Land use regression (LUR) modelling of air quality is essential for conducting health impacts assessment but more challenging in mountainous high-density urban scenario due to the complexities of the urban environment. In this study, a total of 21 LUR models are developed for seven kinds of air pollutants (gaseous air pollutants CO, NO 2 , NO x , O 3 , SO 2 and particulate air pollutants PM 2.5 , PM 10 ) with reference to three different time periods (summertime, wintertime and annual average of 5-year long-term hourly monitoring data from local air quality monitoring network) in Hong Kong. Under the mountainous high-density urban scenario, we improved the traditional LUR modelling method by incorporating wind availability information into LUR modelling based on surface geomorphometrical analysis. As a result, 269 independent variables were examined to develop the LUR models by using the "ADDRESS" independent variable selection method and stepwise multiple linear regression (MLR). Cross validation has been performed for each resultant model. The results show that wind-related variables are included in most of the resultant models as statistically significant independent variables. Compared with the traditional method, a maximum increase of 20% was achieved in the prediction performance of annual averaged NO 2 concentration level by incorporating wind-related variables into LUR model development. Copyright © 2017 Elsevier Inc. All rights reserved.

The Impact of Community Disadvantage on the Relationship between the Family and Juvenile Crime

ERIC Educational Resources Information Center

Hay, Carter; Fortson, Edward N.; Hollist, Dusten R.; Altheimer, Irshad; Schaible, Lonnie M.

2006-01-01

Prior research on the family has identified many variables significantly associated with criminal involvement, including such things as parental supervision and discipline and the quality of the parent-child relationship. However, little attention has been devoted to the possibility that the effects of these variables on crime depend on…

The Patient Protection and Affordable Care Act's provisions regarding medical loss ratios and quality: evidence from Texas.

PubMed

Quast, Troy

2013-01-01

The Patient Protection and Affordable Care Act (PPACA) includes a provision that penalizes insurance companies if their Medical Loss Ratio (MLR) falls below a specified threshold. The MLR is roughly measured as the ratio of health care expenses to premiums paid by enrollees. I investigate whether there is a relationship between MLRs and the quality of care provided by insurance companies. I employ a ten-year sample of market-level financial data and quality variables for Texas insurers, as well as relevant control variables, in regression analyses that utilize insurer and market fixed effects. Of the 15 quality measures, only one has a statistically significant relationship with the MLR. For this measure, the relationship is negative. Although the MLR provision may provide incentives for insurance companies to lower premiums, this sample does not suggest that there is likely to be a beneficial effect on quality.

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

Penna, M.L.; Duchiade, M.P.

The authors report the results of an investigation into the possible association between air pollution and infant mortality from pneumonia in the Rio de Janeiro Metropolitan Area. This investigation employed multiple linear regression analysis (stepwise method) for infant mortality from pneumonia in 1980, including the study population's areas of residence, incomes, and pollution exposure as independent variables. With the income variable included in the regression, a statistically significant association was observed between the average annual level of particulates and infant mortality from pneumonia. While this finding should be accepted with caution, it does suggest a biological association between these variables.more » The authors' conclusion is that air quality indicators should be included in studies of acute respiratory infections in developing countries.« less

[Burnout and quality of life in medical residents].

PubMed

Prieto-Miranda, Sergio Emilio; Rodríguez-Gallardo, Gisela Bethsabé; Jiménez-Bernardino, Carlos Alberto; Guerrero-Quintero, Laura Guadalupe

2013-01-01

burnout and quality of life are poorly studied phenomena in postgraduate students, and its effects are unknown. The aim was to investigate the relationship between quality of life and burnout in medical residents. a longitudinal study was performed. We included medical residents who began their postgraduate studies in 2010. The Spanish version of the Quality of Life Profile for the Chronically Ill (PLC, according to its initials in German), and the Maslach Burnout Inventory specific to physicians were applied at the beginning, and six and 12 months later. Descriptive statistics were used for nominal variables. Chi-square and ANOVA were applied to numerical variables. we included 45 residents, the average age was 26.9 ± 2.93 years, 18 (40 %) were female and 27 (60 %) were male. The PLC survey found significant decrease in four of the six scales assessed in the three measurements. The Maslach Burnout Inventory found high levels of emotional exhaustion in the three tests, low levels of depersonalization and low personal gains at the beginning, rising at six and 12 months. The most affected specialty was Internal Medicine. burnout and impaired quality of life for residents exist in postgraduate physicians and it is maintained during the first year of residency.

Expanding the scope of quality measurement in surgery to include nonoperative care: Results from the American College of Surgeons National Surgical Quality Improvement Program emergency general surgery pilot.

PubMed

Wandling, Michael W; Ko, Clifford Y; Bankey, Paul E; Cribari, Chris; Cryer, H Gill; Diaz, Jose J; Duane, Therese M; Hameed, S Morad; Hutter, Matthew M; Metzler, Michael H; Regner, Justin L; Reilly, Patrick M; Reines, H David; Sperry, Jason L; Staudenmayer, Kristan L; Utter, Garth H; Crandall, Marie L; Bilimoria, Karl Y; Nathens, Avery B

2017-11-01

Patients managed nonoperatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where nonoperative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed nonoperatively to evaluate variability in nonoperative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered. Using ACS NSQIP infrastructure and methodology, surgical consultations for acute appendicitis, acute cholecystitis, and small bowel obstruction (SBO) were sampled at 13 hospitals that volunteered to participate in the EGS clinical data registry. Standard NSQIP variables and 16 EGS-specific variables were abstracted with 30-day follow-up. To determine the influence of complications in nonoperative patients, rates of adverse outcomes were identified, and hospitals were ranked by performance with and then without including nonoperative cases. Two thousand ninety-one patients with EGS diagnoses were included, 46.6% with appendicitis, 24.3% with cholecystitis, and 29.1% with SBO. The overall rate of nonoperative management was 27.4%, 6.6% for appendicitis, 16.5% for cholecystitis, and 69.9% for SBO. Despite comprising only 27.4% of patients in the EGS pilot, nonoperative management accounted for 67.7% of deaths, 34.3% of serious morbidities, and 41.8% of hospital readmissions. After adjusting for patient characteristics and hospital diagnosis mix, addition of nonoperative management to hospital performance assessment resulted in 12 of 13 hospitals changing performance rank, with four hospitals changing by three or more positions. This study identifies a gap in performance evaluation when nonoperative patients are excluded from surgical quality assessment and demonstrates the feasibility of incorporating nonoperative care into existing surgical quality initiatives. Broadening the scope of hospital performance assessment to include nonoperative management creates an opportunity to improve the care of all surgical patients, not just those who have an operation. Care management, level IV; Epidemiologic, level III.

Variability of Virgin Olive Oil Phenolic Compounds in a Segregating Progeny from a Single Cross in Olea europaea L. and Sensory and Nutritional Quality Implications

PubMed Central

Pérez, Ana G.; León, Lorenzo; Pascual, Mar; Romero-Segura, Carmen; Sánchez-Ortiz, Araceli; de la Rosa, Raúl; Sanz, Carlos

2014-01-01

Virgin olive oil phenolic compounds are responsible for its nutritional and sensory quality. The synthesis of phenolic compounds occurs when enzymes and substrates meet as olive fruit is crushed during the industrial process to obtain the oil. The genetic variability of the major phenolic compounds of virgin olive oil was studied in a progeny of the cross of Picual x Arbequina olive cultivars (Olea europaea L.). They belong to four different groups: compounds that included tyrosol or hydroxytyrosol in their molecules, lignans, flavonoids, and phenolic acids. Data of phenolics in the oils showed that the progeny displayed a large degree of variability, widely transgressing the genitor levels. This high variability can be of interest on breeding programs. Thus, multivariate analysis allowed to identify genotypes within the progeny particularly interesting in terms of phenolic composition and deduced organoleptic and nutritional quality. The present study has demonstrated that it is possible to obtain enough degree of variability with a single cross of olive cultivars for compounds related to the nutritional and organoleptic properties of virgin olive oil. PMID:24651694

Variability of virgin olive oil phenolic compounds in a segregating progeny from a single cross in Olea europaea L. and sensory and nutritional quality implications.

PubMed

Pérez, Ana G; León, Lorenzo; Pascual, Mar; Romero-Segura, Carmen; Sánchez-Ortiz, Araceli; de la Rosa, Raúl; Sanz, Carlos

2014-01-01

Virgin olive oil phenolic compounds are responsible for its nutritional and sensory quality. The synthesis of phenolic compounds occurs when enzymes and substrates meet as olive fruit is crushed during the industrial process to obtain the oil. The genetic variability of the major phenolic compounds of virgin olive oil was studied in a progeny of the cross of Picual x Arbequina olive cultivars (Olea europaea L.). They belong to four different groups: compounds that included tyrosol or hydroxytyrosol in their molecules, lignans, flavonoids, and phenolic acids. Data of phenolics in the oils showed that the progeny displayed a large degree of variability, widely transgressing the genitor levels. This high variability can be of interest on breeding programs. Thus, multivariate analysis allowed to identify genotypes within the progeny particularly interesting in terms of phenolic composition and deduced organoleptic and nutritional quality. The present study has demonstrated that it is possible to obtain enough degree of variability with a single cross of olive cultivars for compounds related to the nutritional and organoleptic properties of virgin olive oil.

Comparison of broiler litter and commercial fertilizer at equivalent N rates on soil quality

USDA-ARS?s Scientific Manuscript database

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

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…

Factors Affecting School Quality in Florida

ERIC Educational Resources Information Center

Thornton, Barry; Arbogast, Gordon

2014-01-01

This paper examines the factors that are theorized to be determinants of school quality in the 67 counties of Florida from 2000 to 2011. The model constructed for this purpose is comprised of a mix of independent variables that include county educational attainment (number of high school graduates and State University System enrollees) and…

Eye Movements Reveal Readers' Lexical Quality and Reading Experience

ERIC Educational Resources Information Center

Taylor, Jessica Nelson; Perfetti, Charles A.

2016-01-01

Two experiments demonstrate that individual differences among normal adult readers, including lexical quality, are expressed in silent reading at the word level. In the first of two studies we identified major dimensions of variability among college readers and among words using factor analysis. We then examined the effects of these dimensions of…

Glomerular disease: why is there a dearth of high quality clinical trials?

PubMed

Leaf, David E; Appel, Gerald B; Radhakrishnan, Jai

2010-08-01

There is a paucity of high quality clinical trials in glomerular disease, particularly in non-diabetic kidney disease. The aims of this review include quantifying the extent of this problem and exploring reasons for the scarcity of such trials in primary glomerular disease, with an emphasis on immunoglobulin A nephropathy, minimal change disease, focal segmental glomerulosclerosis, and membranous nephropathy in comparison with the more common diseases of diabetic nephropathy and lupus nephritis. Reasons for the dearth of high quality clinical trials in primary glomerular disease include (1) low prevalence of disease; (2) variability in clinical presentation; (3) variability in treatment response; (4) lack of consensus in definitions; (5) difficulty in recruiting patients; (6) high costs of randomized controlled trials; and (7) lack of collaborative efforts. To facilitate greater numbers of high quality clinical trials in glomerular disease, practice guidelines should establish common classification systems of disease and common clinical end points, industry and non-industry sponsored research should find common ground and work together toward advancing science, and national registries should be created to encourage collaborations across institutions and across nations.

Socioeconomic dynamics of water quality in the Egyptian Nile

NASA Astrophysics Data System (ADS)

Malik, Maheen; Nisar, Zainab; Karakatsanis, Georgios

2016-04-01

The Nile River remains the most important source of freshwater for Egypt as it accounts for nearly all of the country's drinking and irrigation water. About 95% of the total population is accounted to live along the Banks of the Nile(1). Therefore, water quality deterioration in addition to general natural scarcity of water in the region(2) is the main driver for carrying out this study. What further aggravates this issue is the water conflict in the Blue Nile region. The study evaluates different water quality parameters and their concentrations in the Egyptian Nile; further assessing the temporal dynamics of water quality in the area with (a) the Environmental Kuznets Curve (EKC)(3) and (b) the Jevons Paradox (JP)(4) in order to identify water quality improvements or degradations using selected socioeconomic variables(5). For this purpose various environmental indicators including BOD, COD, DO, Phosphorus and TDS were plotted against different economic variables including Population, Gross Domestic Product (GDP), Annual Fresh Water Withdrawal and Improved Water Source. Mathematically, this was expressed by 2nd and 3rd degree polynomial regressions generating the EKC and JP respectively. The basic goal of the regression analysis is to model and highlight the dynamic trend of water quality indicators in relation to their established permissible limits, which will allow the identification of optimal future water quality policies. The results clearly indicate that the dependency of water quality indicators on socioeconomic variables differs for every indicator; while COD was above the permissible limits in all the cases despite of its decreasing trend in each case, BOD and phosphate signified increasing concentrations for the future, if they continue to follow the present trend. This could be an indication of rebound effect explained by the Jevons Paradox i.e. water quality deterioration after its improvement, either due to increase of population or intensification of economic activities related to these indicators. Keywords: Water quality dynamics, Environmental Kuznets Curve (EKC), Jevons Paradox (JP), economic variables, polynomial regressions, environmental indicators, permissible limit References: (1)Evans, A. (2007). River of Life River Nile. (2)Egypt's Water Crisis - Recipe for Disaster. (2016). [Blog] EcoMENA- Echoing Sustainability. (3)Alstine, J. and Neumayer, E. (2010). The Environmental Kuznets Curve. (4)Garrett, T. (2014). Rebound, Backfire, and the Jevons Paradox. [Blog] (5)Data.worldbank.org

Needs Assessment for the Use of NASA Remote Sensing Data in the Development and Implementation of Estuarine and Coastal Water Quality Standards

NASA Technical Reports Server (NTRS)

Spiering, Bruce; Underwood, Lauren; Ellis, Chris; Lehrter, John; Hagy, Jim; Schaeffer, Blake

2010-01-01

The goals of the project are to provide information from satellite remote sensing to support numeric nutrient criteria development and to determine data processing methods and data quality requirements to support nutrient criteria development and implementation. The approach is to identify water quality indicators that are used by decision makers to assess water quality and that are related to optical properties of the water; to develop remotely sensed data products based on algorithms relating remote sensing imagery to field-based observations of indicator values; to develop methods to assess estuarine water quality, including trends, spatial and temporal variability, and seasonality; and to develop tools to assist in the development and implementation of estuarine and coastal nutrient criteria. Additional slides present process, criteria development, typical data sources and analyses for criteria process, the power of remote sensing data for the process, examples from Pensacola Bay, spatial and temporal variability, pixel matchups, remote sensing validation, remote sensing in coastal waters, requirements for remotely sensed data products, and needs assessment. An additional presentation examines group engagement and information collection. Topics include needs assessment purpose and objectives, understanding water quality decision making, determining information requirements, and next steps.

Depression and anxiety symptoms in bronchiectasis: associations with health-related quality of life.

PubMed

Olveira, Casilda; Olveira, Gabriel; Gaspar, Inmaculada; Dorado, Antonio; Cruz, Ivette; Soriguer, Federico; Quittner, Alexandra L; Espildora, Francisco

2013-04-01

Bronchiectasis causes pulmonary infections and loss of lung function, resulting in chronic respiratory symptoms and worsening health-related quality of life. The aims of this study were to measure symptoms of depression and anxiety in a sample of patients with bronchiectasis and evaluate their relationship to health outcomes and health-related quality of life. This cross-sectional study included adolescents and adults with bronchiectasis. Patients completed the hospital anxiety and depression scale and the St. George respiratory questionnaire. Health outcome data, including clinical, radiological and spirometric values, were recorded from medical charts. Ninety-three participants with bronchiectasis of any aetiology were recruited: 20 % had elevated depression-related scores and 38 % had elevated anxiety-related scores. Increased symptoms of depression and anxiety were significantly associated with age; anxiety was associated with more frequent exacerbations. Regression analyses indicated that after controlling for demographic (gender and age) and clinical variables (exacerbations frequency, daily sputum, aetiology and spirometry), both depression and anxiety symptoms predicted significantly worse health-related quality of life. In comparison with other predictors, psychological symptoms explained the largest amount of variance in health-related quality of life. Symptoms of depression and anxiety were significant predictors of health-related quality of life in patients with bronchiectasis, independently of respiratory involvement, gender, age or other variables.

Fish communities and their associations with environmental variables, lower San Joaquin River drainage, California

USGS Publications Warehouse

Brown, L.R.

2000-01-01

Twenty sites in the lower San Joaquin River drainage, California, were sampled from 1993 to 1995 to characterize fish communities and their associations with measures of water quality and habitat quality. The feasibility of developing an Index of Biotic Integrity was assessed by evaluating four fish community metrics, including percentages of native fish, omnivorous fish, fish intolerant of environmental degradation, and fish with external anomalies. Of the thirty-one taxa of fish captured during the study, only 10 taxa were native to the drainage. Multivariate analyses of percentage data identified four site groups characterized by different groups of species. The distributions of fish species were related to specific conductance, gradient, and mean depth; however, specific conductance acted as a surrogate variable for a large group of correlated variables. Two of the fish community metrics - percentage of introduced fish and percentage of intolerant fish - appeared to be responsive to environmental quality but the responses of the other two metrics - percentage of omnivorous fish and percentage of fish with anomalies - were less direct. The conclusion of the study is that fish communities are responsive to environmental conditions, including conditions associated with human-caused disturbances, particularly agriculture and water development. The results suggest that changes in water management and water quality could result in changes in species distributions. Balancing the costs and benefits of such changes poses a considerable challenge to resource managers.

Assemblages of fishes and their associations with environmental variables, lower San Joaquin River drainage, California

USGS Publications Warehouse

Brown, Larry R.

1998-01-01

Twenty sites in the lower San Joaquin River drainage, California, were sampled from 1993 to 1995 to characterize fish assemblages and their associations with measures of water quality and habitat quality. In addition, four fish community metrics were assessed, including percentages of native fish, omnivorous fish, fish intolerant of environmental degradation, and fish with external anomalies. Of the 31 taxa of fish captured during the study, only 10 taxa were native to the drainage. Multivariate analyses of percentage data identified four site groups characterized by characterized by different groups of species. The distributions of fish species were related to specific conductance, gradient, and mean depth; however, specific conductance acted as a surrogate variable for a large group of correlated variables. Two of the fish community metrics--percentage of introduced fish and percentage of intolerant fish--appeared to be responsive to environmental quality but the responses of the other two metrics--percentage of omnivorous fish and percentage of fish with anomalies--were less direct. The conclusion of the study is that fish assemblages are responsive to environmental conditions, including conditions associated with human-caused disturbances, particularly agriculture and water development. The results suggest that changes in water management and water quality could result in changes in species distributions. Balancing the costs and benefits of such changes poses a considerable challenge to resource managers. different groups of species.

Phytoplankton dynamics of a subtropical reservoir controlled by the complex interplay among hydrological, abiotic, and biotic variables.

PubMed

Kuo, Yi-Ming; Wu, Jiunn-Tzong

2016-12-01

This study was conducted to identify the key factors related to the spatiotemporal variations in phytoplankton abundance in a subtropical reservoir from 2006 to 2010 and to assist in developing strategies for water quality management. Dynamic factor analysis (DFA), a dimension-reduction technique, was used to identify interactions between explanatory variables (i.e., environmental variables) and abundance (biovolume) of predominant phytoplankton classes. The optimal DFA model significantly described the dynamic changes in abundances of predominant phytoplankton groups (including dinoflagellates, diatoms, and green algae) at five monitoring sites. Water temperature, electrical conductivity, water level, nutrients (total phosphorus, NO 3 -N, and NH 3 -N), macro-zooplankton, and zooplankton were the key factors affecting the dynamics of aforementioned phytoplankton. Therefore, transformations of nutrients and reactions between water quality variables and aforementioned processes altered by hydrological conditions may also control the abundance dynamics of phytoplankton, which may represent common trends in the DFA model. The meandering shape of Shihmen Reservoir and its surrounding rivers caused a complex interplay between hydrological conditions and abiotic and biotic variables, resulting in phytoplankton abundance that could not be estimated using certain variables. Additional water quality and hydrological variables at surrounding rivers and monitoring plans should be executed a few days before and after reservoir operations and heavy storm, which would assist in developing site-specific preventive strategies to control phytoplankton abundance.

The Impact of Tic Severity, Comorbidity and Peer Attachment on Quality of Life Outcomes and Functioning in Tourette's Syndrome: Parental Perspectives.

PubMed

O'Hare, Deirdre; Helmes, Edward; Eapen, Valsamma; Grove, Rachel; McBain, Kerry; Reece, John

2016-08-01

The aim of this controlled, community-based study based on data from parents of youth (aged 7-16 years) with Tourette's syndrome (TS; n = 86) and parents of age and gender matched peers (n = 108) was to test several hypotheses involving a range of variables salient to the TS population, including peer attachment, quality of life, severity of tics, comorbidity, and psychological, behavioural and social dysfunction. Multivariate between-group analyses confirmed that TS group youth experienced lower quality of life, increased emotional, behavioural and social difficulties, and elevated rates of insecure peer attachment relative to controls, as reported by their primary caregiver. Results also confirmed the main hypothesis that security of peer attachment would be associated with individual variability in outcomes for youth with TS. As predicted, multivariate within-TS group analyses determined strong relationships among adverse quality of life outcomes and insecure attachment to peers, increased tic severity, and the presence of comorbid disorder. Findings suggest that youth with TS are at increased risk for insecure peer attachment and that this might be an important variable impacting the quality of life outcomes for those diagnosed.

Relational-database model for improving quality assurance and process control in a composite manufacturing environment

NASA Astrophysics Data System (ADS)

Gentry, Jeffery D.

2000-05-01

A relational database is a powerful tool for collecting and analyzing the vast amounts of inner-related data associated with the manufacture of composite materials. A relational database contains many individual database tables that store data that are related in some fashion. Manufacturing process variables as well as quality assurance measurements can be collected and stored in database tables indexed according to lot numbers, part type or individual serial numbers. Relationships between manufacturing process and product quality can then be correlated over a wide range of product types and process variations. This paper presents details on how relational databases are used to collect, store, and analyze process variables and quality assurance data associated with the manufacture of advanced composite materials. Important considerations are covered including how the various types of data are organized and how relationships between the data are defined. Employing relational database techniques to establish correlative relationships between process variables and quality assurance measurements is then explored. Finally, the benefits of database techniques such as data warehousing, data mining and web based client/server architectures are discussed in the context of composite material manufacturing.

Validation of the ICU-DaMa tool for automatically extracting variables for minimum dataset and quality indicators: The importance of data quality assessment.

PubMed

Sirgo, Gonzalo; Esteban, Federico; Gómez, Josep; Moreno, Gerard; Rodríguez, Alejandro; Blanch, Lluis; Guardiola, Juan José; Gracia, Rafael; De Haro, Lluis; Bodí, María

2018-04-01

Big data analytics promise insights into healthcare processes and management, improving outcomes while reducing costs. However, data quality is a major challenge for reliable results. Business process discovery techniques and an associated data model were used to develop data management tool, ICU-DaMa, for extracting variables essential for overseeing the quality of care in the intensive care unit (ICU). To determine the feasibility of using ICU-DaMa to automatically extract variables for the minimum dataset and ICU quality indicators from the clinical information system (CIS). The Wilcoxon signed-rank test and Fisher's exact test were used to compare the values extracted from the CIS with ICU-DaMa for 25 variables from all patients attended in a polyvalent ICU during a two-month period against the gold standard of values manually extracted by two trained physicians. Discrepancies with the gold standard were classified into plausibility, conformance, and completeness errors. Data from 149 patients were included. Although there were no significant differences between the automatic method and the manual method, we detected differences in values for five variables, including one plausibility error and two conformance and completeness errors. Plausibility: 1) Sex, ICU-DaMa incorrectly classified one male patient as female (error generated by the Hospital's Admissions Department). Conformance: 2) Reason for isolation, ICU-DaMa failed to detect a human error in which a professional misclassified a patient's isolation. 3) Brain death, ICU-DaMa failed to detect another human error in which a professional likely entered two mutually exclusive values related to the death of the patient (brain death and controlled donation after circulatory death). Completeness: 4) Destination at ICU discharge, ICU-DaMa incorrectly classified two patients due to a professional failing to fill out the patient discharge form when thepatients died. 5) Length of continuous renal replacement therapy, data were missing for one patient because the CRRT device was not connected to the CIS. Automatic generation of minimum dataset and ICU quality indicators using ICU-DaMa is feasible. The discrepancies were identified and can be corrected by improving CIS ergonomics, training healthcare professionals in the culture of the quality of information, and using tools for detecting and correcting data errors. Copyright © 2018 Elsevier B.V. All rights reserved.

Measured Mercury Contamination in Freshwater Fish in Rhode Island Compared with Predictions From a Regional Environmental Mercury Model

EPA Science Inventory

Edible tissue of largemouth bass collected at 29 freshwater sites across the variable landscape of Rhode Island, USA showed a 27 fold range in total mercury concentrations [Hg], from 0.04 to 1.0 ppm (wet). Twenty-one variables, including water quality data and geographic informat...

Self-care resources and activity as predictors of quality of life in persons after myocardial infarction.

PubMed

Baas, Linda S

2004-01-01

An ex post facto correlational study was conducted to examine predictors of quality of life in persons 3 to 6 months after a myocardial infarction. Self-care resources, self-care knowledge (needs), activity level, and selected demographic variables were examined as predictor variables. A convenience sample of 86 subjects with a mean age of 61 years, was recruited for participation in this study. The study that explained 35% of the variance in quality of life included self-care resources available, activity level, and self-care needs. Modeling and Role Modeling Paradigm provided a useful explanation of how self-care resources and self-care knowledge can be applied to persons recovering from myocardial infarction.

Comparison of laboratory and field remote sensing methods to measure forage quality.

PubMed

Guo, Xulin; Wilmshurst, John F; Li, Zhaoqin

2010-09-01

Recent research in range ecology has emphasized the importance of forage quality as a key indicator of rangeland condition. However, we lack tools to evaluate forage quality at scales appropriate for management. Using canopy reflectance data to measure forage quality has been conducted at both laboratory and field levels separately, but little work has been conducted to evaluate these methods simultaneously. The objective of this study is to find a reliable way of assessing grassland quality through measuring forage chemistry with reflectance. We studied a mixed grass ecosystem in Grasslands National Park of Canada and surrounding pastures, located in southern Saskatchewan. Spectral reflectance was collected at both in-situ field level and in the laboratory. Vegetation samples were collected at each site, sorted into the green grass portion, and then sent to a chemical company for measuring forage quality variables, including protein, lignin, ash, moisture at 135 °C, Neutral Detergent Fiber (NDF), Acid Detergent Fiber (ADF), Total Digestible, Digestible Energy, Net Energy for Lactation, Net Energy for Maintenance, and Net Energy for Gain. Reflectance data were processed with the first derivative transformation and continuum removal method. Correlation analysis was conducted on spectral and forage quality variables. A regression model was further built to investigate the possibility of using canopy spectral measurements to predict the grassland quality. Results indicated that field level prediction of protein of mixed grass species was possible (r² = 0.63). However, the relationship between canopy reflectance and the other forage quality variables was not strong.

Adolescent suicidal ideation.

PubMed

Field, T; Diego, M; Sanders, C E

2001-01-01

Adolescent suicidal ideation and its relationship to other variables was tapped by a self-report questionnaire administered to 88 high school seniors. Eighteen percent responded positively to the statement "sometimes I feel suicidal." Those who reported suicidal ideation were found to differ from those who did not on a number of variables, including family relationships (quality of relationship with mother, intimacy with parents, and closeness to siblings), family history of depression (maternal depression), peer relations (quality of peer relationships, popularity, and number of friends), emotional well-being (happiness, anger, and depression), drug use (cigarettes, marijuana, and cocaine), and grade point average. Stepwise regression indicated that happiness explained 46% of the variance in suicidal ideation, and number of friends, anger, and marijuana use explained an additional 20%, for a total of 66% of the variance. While 34% of the variance remained unexplained, it is suggested that the questions used to measure these four variables be included in global screenings to identify adolescents at risk for suicidal ideation.

[Factors Influencing Quality of Life of Alcoholics Anonymous Members in Korea].

PubMed

Yoo, Jae Soon; Lee, Jongeun; Park, Woo Young

2016-04-01

The purpose of this study was to determine quality of life (QOL) related factors in Alcoholics Anonymous (AA) members based on PRECEDE Model. A cross sectional survey was conducted with participants (N =203) from AA meeting in 11 alcohol counsel centers all over South Korea. Data were collected using a specially designed questionnaire based on the PRECEDE model and including QOL, epidemiological factors (including depression and perceived health status), behavioral factors (continuous abstinence and physical health status and practice), predisposing factors (abstinence self-efficacy and self-esteem), reinforcing factors (social capital and family functioning), and enabling factors. Data were analyzed using t-test, one way ANOVA, Tukey HSD test and hierarchical multiple regression analysis with SPSS (ver. 21.0). Of the educational diagnostic variables, self-esteem (β=.23), family functioning (β=.12), abstinence self-efficacy (β=.12) and social capital (β=.11) were strong influential factors in AA members' QOL. In addition, epidemiological diagnostic variables such as depression (β=-.44) and perceived health status (β=.35) were the main factors in QOL. Also, physical health status and practice (β=.106), one of behavioral diagnostic variables was a beneficial factor in QOL. Hierarchical multiple regression analysis showed the determinant variables accounted for 44.0% of the variation in QOL (F=25.76, p<.001). The finding of the study can be used as a framework for planning interventions in order to promote the quality of life of AA members. It is necessary to develop nursing intervention strategies for strengthening educational and epidemiological diagnostic variables in order to improve AA members' QOL.

Variables affecting the propensity to buy branded beef among groups of Australian beef buyers.

PubMed

Morales, L Emilio; Griffith, Garry; Wright, Victor; Fleming, Euan; Umberger, Wendy; Hoang, Nam

2013-06-01

Australian beef consumers have different preferences given their characteristics and the effect on expected quality of cues related to health, production process and eating experience. Beef brands using Meat Standards Australia (MSA) grades can help to signal quality and reduce consumers' uncertainty when shopping. The objective of this study is to identify the characteristics of beef buyers and their perceptions about product attributes that affect the propensity to buy branded beef. Binary logistic models were applied identifying differences between all respondents and the potential target market, including buyers in medium to high income segments, and between buyers in the target market who would buy branded beef for taste and health reasons. Variables increasing the propensity to buy branded beef include previous experience, appreciation for branded cuts and concern about quality more than size. Finally, variations in preferences for marbling and cut were found between buyers who would buy branded beef for taste and health reasons. Copyright © 2013 Elsevier Ltd. All rights reserved.

Strategic Orientation and Nursing Home Response to Public Reporting of Quality Measures: An Application of the Miles and Snow Typology

PubMed Central

Zinn, Jacqueline S; Spector, William D; Weimer, David L; Mukamel, Dana B

2008-01-01

Objective To assess whether differences in strategic orientation of nursing homes as identified by the Miles and Snow typology are associated with differences in their response to the publication of quality measures on the Nursing Home Compare website. Data Sources Administrator survey of a national 10 percent random sample (1,502 nursing homes) of all facilities included in the first publication of the Nursing Home Compare report conducted in May–June 2004; 724 responded, yielding a response rate of 48.2 percent. Study Design The dependent variables are dichotomous, indicating whether or not action was taken and the type of action taken. Four indicator variables were created for each of the four strategic types: Defender, Analyzer, Prospector, and Reactor. Other variables were included in the seven logistic regression models to control for factors other than strategic type that could influence nursing home response to public disclosure of their quality of care. Data Collection/Extraction Methods Survey data were merged with data on quality measures and organizational characteristics from the first report (November 2002). Principal Findings About 43 percent of surveyed administrators self-typed as Defenders, followed by Analyzers (33 percent), and Prospectors (19 percent). The least self-selected strategic type was the Reactor (6.6 percent). In general, results of the regression models indicate differences in response to quality measure publication by strategic type, with Prospectors and Analyzers more likely, and Reactors less likely, to respond than Defenders. Conclusions While almost a third of administrators took no action at all, our results indicate that whether, when, and how nursing homes reacted to publication of federally reported quality measures is associated with strategic orientation. PMID:18370969

Quality of radiotherapy reporting in randomized controlled trials of prostate cancer.

PubMed

Soon, Yu Yang; Chen, Desiree; Tan, Teng Hwee; Tey, Jeremy

2018-06-07

Good radiotherapy reporting in clinical trials of prostate radiotherapy is important because it will allow accurate reproducibility of radiotherapy treatment and minimize treatment variations that can affect patient outcomes. The aim of our study is to assess the quality of prostate radiotherapy (RT) treatment reporting in randomized controlled trials in prostate cancer. We searched MEDLINE for randomized trials of prostate cancer, published from 1996 to 2016 and included prostate RT as one of the intervention arms. We assessed if the investigators reported the ten criteria adequately in the trial reports: RT dose prescription method; RT dose-planning procedures; organs at risk (OAR) dose constraints; target volume definition, simulation procedures; treatment verification procedures; total RT dose; fractionation schedule; conduct of quality assurance (QA) as well as presence or absence of deviations in RT treatment planning and delivery. We performed multivariate logistic regression to determine the factors that may influence the quality of reporting. We found 59 eligible trials. There was significant variability in the quality of reporting. Target volume definition, total RT dose and fractionation schedule were reported adequately in 97% of included trials. OAR constraints, simulation procedures and presence or absence of deviations in RT treatment planning and delivery were reported adequately in 30% of included trials. Twenty-four trials (40%) reported seven criteria or more adequately. Multivariable logistic analysis showed that trials that published their quality assurance results and cooperative group trials were more likely to have adequate quality in reporting in at least seven criteria. There is significant variability in the quality of reporting on prostate radiotherapy treatment in randomized trials of prostate cancer. We need to have consensus guidelines to standardize the reporting of radiotherapy treatment in randomized trials.

Data Processing Aspects of MEDLARS

PubMed Central

Austin, Charles J.

1964-01-01

The speed and volume requirements of MEDLARS necessitate the use of high-speed data processing equipment, including paper-tape typewriters, a digital computer, and a special device for producing photo-composed output. Input to the system is of three types: variable source data, including citations from the literature and search requests; changes to such master files as the medical subject headings list and the journal record file; and operating instructions such as computer programs and procedures for machine operators. MEDLARS builds two major stores of data on magnetic tape. The Processed Citation File includes bibliographic citations in expanded form for high-quality printing at periodic intervals. The Compressed Citation File is a coded, time-sequential citation store which is used for high-speed searching against demand request input. Major design considerations include converting variable-length, alphanumeric data to mechanical form quickly and accurately; serial searching by the computer within a reasonable period of time; high-speed printing that must be of graphic quality; and efficient maintenance of various complex computer files. PMID:14119287

DATA PROCESSING ASPECTS OF MEDLARS.

PubMed

AUSTIN, C J

1964-01-01

The speed and volume requirements of MEDLARS necessitate the use of high-speed data processing equipment, including paper-tape typewriters, a digital computer, and a special device for producing photo-composed output. Input to the system is of three types: variable source data, including citations from the literature and search requests; changes to such master files as the medical subject headings list and the journal record file; and operating instructions such as computer programs and procedures for machine operators. MEDLARS builds two major stores of data on magnetic tape. The Processed Citation File includes bibliographic citations in expanded form for high-quality printing at periodic intervals. The Compressed Citation File is a coded, time-sequential citation store which is used for high-speed searching against demand request input. Major design considerations include converting variable-length, alphanumeric data to mechanical form quickly and accurately; serial searching by the computer within a reasonable period of time; high-speed printing that must be of graphic quality; and efficient maintenance of various complex computer files.

Aircraft model prototypes which have specified handling-quality time histories

NASA Technical Reports Server (NTRS)

Johnson, S. H.

1976-01-01

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

Influence of packaging on the quality of cold-stored grapes packed into boxes for later repacking

USDA-ARS?s Scientific Manuscript database

A two-year study was conducted to examine various commercial practices associated with the cold storage of table grapes that are to be later re-packed for final shipment to provide information on the impact on fruit quality. Variables examined included the use of box types with vent areas ranging f...

The Cross-Sectional Association between Diet Quality and Depressive Symptomology amongst Fijian Adolescents

PubMed Central

Sinclair, Rachael; Millar, Lynne; Allender, Steven; Snowdon, Wendy; Waqa, Gade; Jacka, Felice; Moodie, Marj; Petersen, Solveig; Swinburn, Boyd

2016-01-01

Objective To examine the relationship between diet quality and depressive symptomology amongst a community-based sample of Fijian adolescents. Methods Participants included 7,237 adolescents (52.6% girls; mean age 15.6 years) at baseline (2005) and 2,948 (56% girls; mean age 17.4 years) at follow-up (2007/2008), from the Pacific Obesity Prevention in Communities Project. Intervention schools (n = 7) were selected from Nasinu, near Suva on the main Fijian island Viti Levu, and comparison schools (n = 11) were chosen from towns on the opposite, west side of the island. A dietary questionnaire was used to measure diet quality. Factor analysis clustered dietary variables into two unique and independent factors, referred to as healthy diet quality and unhealthy diet quality. Depressive symptomology was assessed via the emotional subscale of the Paediatric Quality of Life Inventory. Both measures were self-reported and self-administered. Multiple linear regression was used to test cross-sectional associations (at baseline and follow-up) between diet quality and depressive symptomology. Variables controlled for included gender, age, ethnicity, study condition, BMI-z scores, and physical activity. Findings Strong, positive dose-response associations between healthy diet and high emotional scores (lower depressive symptomology) were found in cross-sectional analyses at baseline and follow-up, among boys and girls. No association was found between emotional health and unhealthy diet. Conclusions This study suggests that cross-sectional relationships exist between a high quality diet during adolescence and less depressive symptoms, however more evidence is required to determine if these two variables are linked causally. Trial population health strategies that use dietary interventions as a mechanism for mental health promotion provide an opportunity to further test these associations. If this is indeed a true relationship, these forms of interventions have the potential to be inexpensive and have substantial reach, especially in Low and Middle Income Countries. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12608000345381 PMID:27560960

[To evaluate the quality of life and peristomal skin ostomy patient with the new device Sensura].

PubMed

Crespo Fontán, Beatriz; Caparrós Sanz, María Rosario; Lainez Pardos, Pilar Lourdes; Davín Durban, Inmaculada

2010-10-01

In 2006, Coloplast launched in several European countries a new device for ostomy care called Sensura. This clinical research report includes only the results of the subpopulation included in Spain as a part of an international study involving many countries such as Denmark, United States, Canada, Australia, Poland, Netherlands, France, Slovakia, Germany, UK, Italy, Iceland, Japan, Czech Republic, Portugal, South Korea and Argentina. OBJECTIVES AND STUDY VARIABLES: The main purpose of the study is to evaluate the experience with Sensura, under normal conditions of use, with special attention to skin condition and quality of life. The main objective of the study is to evaluate the quality of life, through Quality of Life Questionnaire called "Stoma QoL". A secondary objective, is to study the correlation between quality of life and the peristomal skin condition. Other Secondary objectives include the evaluation of the patient's current device at the time of entering the study and by the other hand, the device Sensura and safety evaluation throughout the study. The study was designed as an open label non-comparative, multi-national Post Market study. The study period for each patient is 6 to 8 weeks +/- 4 days, which includes an initial visit and a final visit. The study population included people who carry a colostomy or ileostomy. Regarding Spain, a total of 10 sites participated and included a total of 131 patients. This report only presents results for nine sites and a total of 123 patients. The reason is that the last participating site began the study with a considerable delay The remaining subjects included in this site together with the other centers in Spain and the other participating countries will be included in the final international report, that will present the overall results. MEASUREMENT TOOLS. Stoma-QoL (Quality of Life Questionnaire for people with an ostomy). OST (Ostomy Skin Tool) instrument for the assessment of peristomal skin. As for the quality of life, at baseline we found a mean of 59 out of 100 (SD = 8.8), while the final study visit, mean score was 59.6 out of 100 (SD = 9.3), although the final results on this variable will be presented in the global report, since it has not reached sufficient population in Spain for the analysis of this variable. The study revealed a significant improvement in the peristomal skin condition at the end of the study, measured by the tool OST (Ostomy Skin Tool). Regarding the evaluation of the SenSura device, there was a significant improvement related to the appearance of leakage of effluent, as well as other items evaluated in relation with the device.

Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables

PubMed Central

Juenger, J; Schellberg, D; Kraemer, S; Haunstetter, A; Zugck, C; Herzog, W; Haass, M

2002-01-01

Objective: To assess health related quality of life of patients with congestive heart failure; to compare their quality of life with the previously characterised general population and in those with other chronic diseases; and to correlate the different aspects of quality of life with relevant somatic variables. Setting: University hospital. Patients and design: A German version of the generic quality of life measure (SF-36) containing eight dimensions was administered to 205 patients with congestive heart failure and systolic dysfunction. Cardiopulmonary evaluation included assessment of New York Heart Association (NYHA) functional class, left ventricular ejection fraction, peak oxygen uptake, and the distance covered during a standardised six minute walk test. Results: Quality of life significantly decreased with NYHA functional class (linear trend: p < 0.0001). In NYHA class III, the scores of five of the eight quality of life domains were reduced to around one third of those in the general population. The pattern of reduction was different in patients with chronic hepatitis C and major depression, and similar in patients on chronic haemodialysis. Multiple regression analysis showed that only the NYHA functional class was consistently and closely associated with all quality of life scales. The six minute walk test and peak oxygen uptake added to the explanation of the variance in only one of the eight quality of life domains (physical functioning). Left ventricular ejection fraction, duration of disease, and age showed no clear association with quality of life. Conclusions: In congestive heart failure, quality of life decreases as NYHA functional class worsens. Though NYHA functional class was the most dominant predictor among the somatic variables studied, the major determinants of reduced quality of life remain unknown. PMID:11847161

Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables.

PubMed

Juenger, J; Schellberg, D; Kraemer, S; Haunstetter, A; Zugck, C; Herzog, W; Haass, M

2002-03-01

To assess health related quality of life of patients with congestive heart failure; to compare their quality of life with the previously characterised general population and in those with other chronic diseases; and to correlate the different aspects of quality of life with relevant somatic variables. University hospital. A German version of the generic quality of life measure (SF-36) containing eight dimensions was administered to 205 patients with congestive heart failure and systolic dysfunction. Cardiopulmonary evaluation included assessment of New York Heart Association (NYHA) functional class, left ventricular ejection fraction, peak oxygen uptake, and the distance covered during a standardised six minute walk test. Quality of life significantly decreased with NYHA functional class (linear trend: p < 0.0001). In NYHA class III, the scores of five of the eight quality of life domains were reduced to around one third of those in the general population. The pattern of reduction was different in patients with chronic hepatitis C and major depression, and similar in patients on chronic haemodialysis. Multiple regression analysis showed that only the NYHA functional class was consistently and closely associated with all quality of life scales. The six minute walk test and peak oxygen uptake added to the explanation of the variance in only one of the eight quality of life domains (physical functioning). Left ventricular ejection fraction, duration of disease, and age showed no clear association with quality of life. In congestive heart failure, quality of life decreases as NYHA functional class worsens. Though NYHA functional class was the most dominant predictor among the somatic variables studied, the major determinants of reduced quality of life remain unknown.

Temporal variability and climatology of hydrodynamic, water property and water quality parameters in the West Johor Strait of Singapore.

PubMed

Behera, Manasa Ranjan; Chun, Cui; Palani, Sundarambal; Tkalich, Pavel

2013-12-15

The study presents a baseline variability and climatology study of measured hydrodynamic, water properties and some water quality parameters of West Johor Strait, Singapore at hourly-to-seasonal scales to uncover their dependency and correlation to one or more drivers. The considered parameters include, but not limited by sea surface elevation, current magnitude and direction, solar radiation and air temperature, water temperature, salinity, chlorophyll-a and turbidity. FFT (Fast Fourier Transform) analysis is carried out for the parameters to delineate relative effect of tidal and weather drivers. The group and individual correlations between the parameters are obtained by principal component analysis (PCA) and cross-correlation (CC) technique, respectively. The CC technique also identifies the dependency and time lag between driving natural forces and dependent water property and water quality parameters. The temporal variability and climatology of the driving forces and the dependent parameters are established at the hourly, daily, fortnightly and seasonal scales. Copyright © 2013 Elsevier Ltd. All rights reserved.

Factor analysis and cluster analysis applied to assess the water quality of middle and lower Han River in Central China

NASA Astrophysics Data System (ADS)

Kuo, Yi-Ming; Liu, Wen-Wen

2015-04-01

The Han River basin is one of the most important industrial and grain production bases in the central China. A lot of factories and towns have been established along the river where large farmlands are located nearby. In the last few decades the water quality of the Han River, specifically in middle and lower reaches, has gradually declined. The agricultural nonpoint pollution and municipal and industrial point pollution significantly degrade the water quality of the Han River. Factor analysis can be applied to reduce the dimensionality of a data set consisting of a large number of inter-related variables. Cluster analysis can classify the samples according to their similar characters. In this study, factor analysis is used to identify major pollution indicators, and cluster analysis is employed to classify the samples based on the sample locations and hydrochemical variables. Water samples were collected from 12 sample sites collected from Xiangyang City (middle Han River) to Wuhan City (lower Han River). Correlations among 25 hydrochemical variables are statistically examined. The important pollutants are determined by factor analysis. A three-factor model is determined and explains over 85% of the total river water quality variation. Factor 1, including SS, Chl-a, TN and TP, can be considered as the nonpoint source pollution. Factor 2, including Cl-, Br-, SO42-, Ca2+, Mg2+, K+, Fe2+ and PO43-, can be treated as the industrial pollutant pollution. Factor 3, including F- and NO3-, reflects the influence of the groundwater or self-purification capability of the river water. The various land uses along the Han River correlate well with the pollution types. In addition, the result showed that the water quality of Han River deteriorated gradually from middle to lower Han River. Some tributaries have been seriously polluted and significantly influence the mainstream water quality of the Han River. Finally, the result showed that the nonpoint pollution and the point pollution both significantly influence water quality in the middle and lower Han River. This study provides an effective method for watershed management and pollution control in Han River.

Variables that Predict Serve Efficacy in Elite Men’s Volleyball with Different Quality of Opposition Sets

PubMed Central

Valhondo, Álvaro; Fernández-Echeverría, Carmen; González-Silva, Jara; Claver, Fernando; Moreno, M. Perla

2018-01-01

Abstract The objective of this study was to determine the variables that predicted serve efficacy in elite men’s volleyball, in sets with different quality of opposition. 3292 serve actions were analysed, of which 2254 were carried out in high quality of opposition sets and 1038 actions were in low quality of opposition sets, corresponding to a total of 24 matches played during the Men’s European Volleyball Championships held in 2011. The independent variables considered in this study were the serve zone, serve type, serving player, serve direction, reception zone, receiving player and reception type; the dependent variable was serve efficacy and the situational variable was quality of opposition sets. The variables that acted as predictors in both high and low quality of opposition sets were the serving player, reception zone and reception type. The serve type variable only acted as a predictor in high quality of opposition sets, while the serve zone variable only acted as a predictor in low quality of opposition sets. These results may provide important guidance in men’s volleyball training processes. PMID:29599869

Extreme learning machines: a new approach for modeling dissolved oxygen (DO) concentration with and without water quality variables as predictors.

PubMed

Heddam, Salim; Kisi, Ozgur

2017-07-01

In this paper, several extreme learning machine (ELM) models, including standard extreme learning machine with sigmoid activation function (S-ELM), extreme learning machine with radial basis activation function (R-ELM), online sequential extreme learning machine (OS-ELM), and optimally pruned extreme learning machine (OP-ELM), are newly applied for predicting dissolved oxygen concentration with and without water quality variables as predictors. Firstly, using data from eight United States Geological Survey (USGS) stations located in different rivers basins, USA, the S-ELM, R-ELM, OS-ELM, and OP-ELM were compared against the measured dissolved oxygen (DO) using four water quality variables, water temperature, specific conductance, turbidity, and pH, as predictors. For each station, we used data measured at an hourly time step for a period of 4 years. The dataset was divided into a training set (70%) and a validation set (30%). We selected several combinations of the water quality variables as inputs for each ELM model and six different scenarios were compared. Secondly, an attempt was made to predict DO concentration without water quality variables. To achieve this goal, we used the year numbers, 2008, 2009, etc., month numbers from (1) to (12), day numbers from (1) to (31) and hour numbers from (00:00) to (24:00) as predictors. Thirdly, the best ELM models were trained using validation dataset and tested with the training dataset. The performances of the four ELM models were evaluated using four statistical indices: the coefficient of correlation (R), the Nash-Sutcliffe efficiency (NSE), the root mean squared error (RMSE), and the mean absolute error (MAE). Results obtained from the eight stations indicated that: (i) the best results were obtained by the S-ELM, R-ELM, OS-ELM, and OP-ELM models having four water quality variables as predictors; (ii) out of eight stations, the OP-ELM performed better than the other three ELM models at seven stations while the R-ELM performed the best at one station. The OS-ELM models performed the worst and provided the lowest accuracy; (iii) for predicting DO without water quality variables, the R-ELM performed the best at seven stations followed by the S-ELM in the second place and the OP-ELM performed the worst with low accuracy; (iv) for the final application where training ELM models with validation dataset and testing with training dataset, the OP-ELM provided the best accuracy using water quality variables and the R-ELM performed the best at all eight stations without water quality variables. Fourthly, and finally, we compared the results obtained from different ELM models with those obtained using multiple linear regression (MLR) and multilayer perceptron neural network (MLPNN). Results obtained using MLPNN and MLR models reveal that: (i) using water quality variables as predictors, the MLR performed the worst and provided the lowest accuracy in all stations; (ii) MLPNN was ranked in the second place at two stations, in the third place at four stations, and finally, in the fourth place at two stations, (iii) for predicting DO without water quality variables, MLPNN is ranked in the second place at five stations, and ranked in the third, fourth, and fifth places in the remaining three stations, while MLR was ranked in the last place with very low accuracy at all stations. Overall, the results suggest that the ELM is more effective than the MLPNN and MLR for modelling DO concentration in river ecosystems.

Home food environment in relation to children's diet quality and weight status.

PubMed

Couch, Sarah C; Glanz, Karen; Zhou, Chuan; Sallis, James F; Saelens, Brian E

2014-10-01

The objective of this cohort study was to explore relationships among the home food environment (HFE), child/parent characteristics, diet quality, and measured weight status among 699 child-parent pairs from King County, WA, and San Diego County, CA. HFE variables included parenting style/feeding practices, food rules, frequency of eating out, home food availability, and parents' perceptions of food costs. Child dietary intake was measured by 3-day recall and diet quality indicators included fruits and vegetables, sweet/savory snacks, high-calorie beverages, and Dietary Approaches to Stop Hypertension (DASH) score. Individual linear regression models were run in which child BMI z score and child diet quality indicators were dependent variables and HFE variables and child/parent characteristics were independent variables of interest. Fruit and vegetable consumption was associated with parental encouragement/modeling (β=.68, P<0.001) and unhealthful food availability (-0.27, P<0.05); DASH score with food availability (healthful: 1.3, P<0.01; unhealthful: -2.25, P<0.001), food rules (0.45, P<0.01), and permissive feeding style (-1.04, P<0.05); high-calorie beverages with permissive feeding style (0.14, P<0.01) and unhealthful food availability (0.21, P<0.001); and sweet/savory snacks with healthful food availability (0.26, P<0.05; unexpectedly positive). Children's BMI z score was positively associated with parent's use of food restriction (0.21, P<0.001), permissive feeding style (0.16, P<0.05), and concern for healthy food costs (0.10, P<0.01), but negatively with verbal encouragement/modeling (-0.17, P<0.05), and pressure to eat (-0.34, P<0.001). Various HFE factors associated with parenting around eating and food availability are related to child diet quality and weight status. These factors should be considered when designing interventions for improving child health. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Do employed and nonemployed Korean mothers experience different levels of psychological well-being in relation to their gender role attitudes and role qualities?

PubMed

Kim, H

1998-06-01

This study explored the association of gender role attitudes (GRAs) and the quality of roles with the psychological well-being among employed and nonemployed mothers in Korea. Evidence supports the thesis that employed mothers with more liberal GRAs will report higher levels of psychological well-being. All role qualities were expected to be related to women's psychological well-being regardless of work status. Maternal role was expected to be more important in determining a working mothers well-being, but wife role was in fact the most important. Among nonemployed mothers, both the maternal and wife role affected well-being. Participants were recruits from a variety of institutional settings in Seoul, Korea, in 1995. The sample included 700 mothers, of whom 263 were working mothers; 295 were nonemployed mothers. Most were highly educated and affluent. The first model included only social structural variables, which were unrelated to the relationship between employment status and well-being. Gender of children was the only significant variable. Nonemployed mothers with a son had greater well-being than those without a son. The model excluding all social structural variables showed that GRA was unrelated to employed mothers' well-being. But, inclusion of the interaction between attitude and group suggests that well-being was related to agreement with whatever their role was. A model that included role qualities found that roles as wife, mother, and employee were positively related to well-being. The role of wife was significantly related to well-being among employed mothers. The wife and mother roles were significantly related to well-being among nonemployed mothers.

The late Holocene kauri chronology: assessing the potential of a 4500-year record for palaeoclimate reconstruction

NASA Astrophysics Data System (ADS)

Boswijk, G.; Fowler, A. M.; Palmer, J. G.; Fenwick, P.; Hogg, A.; Lorrey, A.; Wunder, J.

2014-04-01

Millennial and multi-millennial tree-ring chronologies can provide useful proxy records of past climate, giving insight into a more complete range of natural climate variability prior to the 20th century. Since the 1980s a multi-millennial tree-ring chronology has been developed from kauri (Agathis australis) from the upper North Island, New Zealand. Previous work has demonstrated the sensitivity of kauri to the El Niño-Southern Oscillation (ENSO). Here we present recent additions and extensions to the late Holocene kauri chronology (LHKC), and assess the potential of a composite master chronology, AGAUc13, for palaeoclimate reconstruction. The updated composite kauri chronology now spans 4491 years (2488 BCE-2002 CE) and includes data from 18 modern sites, 25 archaeological sites, and 18 sub-fossil (swamp) kauri sites. Consideration of the composition and statistical quality of AGAUc13 suggests the LHKC has utility for palaeoclimate reconstruction but there are caveats. These include: (a) differences in character between the three assemblages including growth rate and sensitivity; (b) low sample depth and low statistical quality in the 10th-13th century CE, when the record transitions from modern and archaeological material to the swamp kauri; (c) a potential difference in amplitude of the signal in the swamp kauri; (d) a westerly bias in site distribution prior to 911 CE; (e) variable statistical quality across the entire record associated with variable replication; and (f) complex changes in sample depth and tree age and size which may influence centennial scale trends in the data. Further tree ring data are required to improve statistical quality, particularly in the first half of the second millennium CE.

A Low Cost High Density Sensor Network for Air Quality at London Heathrow Airport

NASA Astrophysics Data System (ADS)

Bright, V.; Mead, M. I.; Popoola, O. A.; Baron, R. P.; Saffell, J.; Stewart, G.; Kaye, P.; Jones, R.

2012-12-01

Atmospheric composition within urban areas has a direct effect on the air quality of an environment in which a large majority of people live and work. Atmospheric pollutants including ozone (O3), nitrogen dioxide (NO2), volatile organic compounds (VOCs) and particulate matter (PM) can have a significant effect on human health. As such it is important to determine the potential exposure of individuals to these atmospheric constituents and investigate the processes that lead to the degradation of air quality within the urban environment. Whilst modelled pollutant levels on the local scale often suggest high degrees of spatial and temporal variability, the relatively sparse fixed site automated urban networks only provide low spatial resolution data that do not appear adequate in detecting such small scale variability. In this paper we demonstrate that measurements can now be made using networks of low-cost sensors that utilise a variety of techniques, including electrochemical and optical, to measure concentrations of atmospheric species. Once equipped with GPS and GPRS to determine position and transmit data respectively, these networks have the potential to provide valuable insights into pollutant variability inherent on the local or micro-scale. The methodology has been demonstrated successfully in field campaigns carried out in cities including London and Valencia, and is now being deployed as part of the Sensor Networks for Air Quality currently deployed at London Heathrow airport (SNAQ-Heathrow) which is outlined in the partner paper presented by Mead et al. (this conference). The SNAQ-Heathrow network of 50 sensor nodes will provide an unprecedented data set that includes measurements of O3, NO, NO2, CO, CO2, SO2, total VOCs, size-speciated PM as well as meteorological variables that include temperature, relative humidity, wind speed and direction. This network will provide high temporal (20 second intervals) and spatial (50 sites within the airport area) resolution data over a 12 month period with data transmitted back to a server every 2 hours. In this paper we present the data capture and storage, data accessibility, data mining and visualisation techniques applied to the measurements of the SNAQ Heathrow high density sensor network, the preliminary results of which provide an insight into the potential use of such networks in characterising air quality, emissions and validating dispersion models on local scales. We also present a web based interface developed for the sensor network that allows users to access archived data and assess meteorological conditions, atmospheric dispersion, pollutant levels and emission rates.

Quality of search strategies reported in systematic reviews published in stereotactic radiosurgery.

PubMed

Faggion, Clovis M; Wu, Yun-Chun; Tu, Yu-Kang; Wasiak, Jason

2016-06-01

Systematic reviews require comprehensive literature search strategies to avoid publication bias. This study aimed to assess and evaluate the reporting quality of search strategies within systematic reviews published in the field of stereotactic radiosurgery (SRS). Three electronic databases (Ovid MEDLINE(®), Ovid EMBASE(®) and the Cochrane Library) were searched to identify systematic reviews addressing SRS interventions, with the last search performed in October 2014. Manual searches of the reference lists of included systematic reviews were conducted. The search strategies of the included systematic reviews were assessed using a standardized nine-question form based on the Cochrane Collaboration guidelines and Assessment of Multiple Systematic Reviews checklist. Multiple linear regression analyses were performed to identify the important predictors of search quality. A total of 85 systematic reviews were included. The median quality score of search strategies was 2 (interquartile range = 2). Whilst 89% of systematic reviews reported the use of search terms, only 14% of systematic reviews reported searching the grey literature. Multiple linear regression analyses identified publication year (continuous variable), meta-analysis performance and journal impact factor (continuous variable) as predictors of higher mean quality scores. This study identified the urgent need to improve the quality of search strategies within systematic reviews published in the field of SRS. This study is the first to address how authors performed searches to select clinical studies for inclusion in their systematic reviews. Comprehensive and well-implemented search strategies are pivotal to reduce the chance of publication bias and consequently generate more reliable systematic review findings.

Enhancing uniformity and overall quality of red cell concentrate with anaerobic storage

PubMed Central

Yoshida, Tatsuro; Blair, Abbejane; D'Alessandro, Angelo; Nemkov, Travis; Dioguardi, Michael; Silliman, Christopher C.; Dunham, Andrew

2017-01-01

Background Recent research focused on understanding stored red blood cell (RBC) quality has demonstrated high variability in measures of RBC function and health across units. Studies have historically linked this high variability to variations in processing, storage method, and age. More recently, a large number of studies have focused on differences in donor demographics, donor iron sufficiency, and genetic predisposition of the donor to poor storage, particularly through mechanisms of accelerated oxidative damage. A study was undertaken to evaluate a potential additional source of unit to unit variation in stored RBC: the role of variable percent oxygen saturation (%SO2) levels on blood quality parameters during storage. Materials and methods %SO2 data from 492 LR-RBC/AS-3 units used for internal and external collaborative research was included in the analysis. Whole blood units were processed into red blood cells, AS-3 added, leucocyte reduced, in compliance with American Association of Blood Banks guidelines. LR-RBC/AS-3 products were subsequently analysed for %SO2 levels within 3–24 hours of phlebotomy using a co-oximeter. Separately, to evaluate the impact of pre-storage as well as increasing levels of %SO2 during storage, a pool-and-split study was performed. Four units of LR-RBC/AS-3 were split 6 ways; “as is” (control), hyperoxygenated to more than 90%, and four levels of pre-storage %SO2. The units were periodically sampled up to 42 days and analysed for %SO2, pCO2, methaemoglobin, ATP, 2,3-BPG as well as with the metabolomics workflow. Results The measured mean %SO2 in LR-RBC/AS-3 within 24 hours of collection was 45.9±17.5% with (32.7–61.0 IQR). %SO2 in all products increased to approximately 95–100% in three weeks. Measured blood quality parameters including ATP, % haemolysis, methaemoglobin, oxidised lipids, and GSH/GSSG indicated suppressed cellular metabolism and increased red cell degradation in response to higher %SO2 levels. Discussion The surprisingly high variability in starting %SO2 levels, coupled with negative impacts of high oxygen saturation on red blood cell quality indicates that oxygen levels may be an important and under-appreciated source of unit-to-unit variability in RBC quality. PMID:28263176

Enhancing uniformity and overall quality of red cell concentrate with anaerobic storage.

PubMed

Yoshida, Tatsuro; Blair, Abbejane; D'alessandro, Angelo; Nemkov, Travis; Dioguardi, Michael; Silliman, Christopher C; Dunham, Andrew

2017-03-01

Recent research focused on understanding stored red blood cell (RBC) quality has demonstrated high variability in measures of RBC function and health across units. Studies have historically linked this high variability to variations in processing, storage method, and age. More recently, a large number of studies have focused on differences in donor demographics, donor iron sufficiency, and genetic predisposition of the donor to poor storage, particularly through mechanisms of accelerated oxidative damage. A study was undertaken to evaluate a potential additional source of unit to unit variation in stored RBC: the role of variable percent oxygen saturation (%SO 2 ) levels on blood quality parameters during storage. %SO 2 data from 492 LR-RBC/AS-3 units used for internal and external collaborative research was included in the analysis. Whole blood units were processed into red blood cells, AS-3 added, leucocyte reduced, in compliance with American Association of Blood Banks guidelines. LR-RBC/AS-3 products were subsequently analysed for %SO 2 levels within 3-24 hours of phlebotomy using a co-oximeter. Separately, to evaluate the impact of pre-storage as well as increasing levels of %SO 2 during storage, a pool-and-split study was performed. Four units of LR-RBC/AS-3 were split 6 ways; "as is" (control), hyperoxygenated to more than 90%, and four levels of pre-storage %SO 2 . The units were periodically sampled up to 42 days and analysed for %SO 2 , pCO 2 , methaemoglobin, ATP, 2,3-BPG as well as with the metabolomics workflow. The measured mean %SO 2 in LR-RBC/AS-3 within 24 hours of collection was 45.9±17.5% with (32.7-61.0 IQR). %SO 2 in all products increased to approximately 95-100% in three weeks. Measured blood quality parameters including ATP, % haemolysis, methaemoglobin, oxidised lipids, and GSH/GSSG indicated suppressed cellular metabolism and increased red cell degradation in response to higher %SO 2 levels. The surprisingly high variability in starting %SO 2 levels, coupled with negative impacts of high oxygen saturation on red blood cell quality indicates that oxygen levels may be an important and under-appreciated source of unit-to-unit variability in RBC quality.

Sleep Quality Estimation based on Chaos Analysis for Heart Rate Variability

NASA Astrophysics Data System (ADS)

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

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

Game Location and Team Quality Effects on Performance Profiles in Professional Soccer

PubMed Central

Lago-Peñas, Carlos; Lago-Ballesteros, Joaquin

2011-01-01

Home advantage in team sports has an important role in determining the outcome of a game. The aim of the present study was to identify the soccer game- related statistics that best discriminate home and visiting teams according to the team quality. The sample included all 380 games of the Spanish professional men’s league. The independent variables were game location (home or away) and the team quality. Teams were classified into four groups according to their final ranking at the end of the league. The game-related statistics registered were divided into three groups: (i) variables related to goals scored; (ii) variables related to offense and (iii) variables related to defense. A univariate (t-test and Mann-Whitney U) and multivariate (discriminant analysis) analysis of data was done. Results showed that home teams have significantly higher means for goal scored, total shots, shots on goal, attacking moves, box moves, crosses, offsides committed, assists, passes made, successful passes, dribbles made, successful dribbles, ball possession, and gains of possession, while visiting teams presented higher means for losses of possession and yellow cards. In addition, the findings of the current study confirm that game location and team quality are important in determining technical and tactical performances in matches. Teams described as superior and those described as inferior did not experience the same home advantage. Future research should consider the influence of other confounding variables such as weather conditions, game status and team form. Key points Home teams have significantly higher figures for attack indicators probably due to facilities familiarity and crowd effects. The teams’ game-related statistics profile varied according to game location and team quality. Teams described as superior and those described as inferior did not experience the same home advantage. PMID:24150619

Combining fixed effects and instrumental variable approaches for estimating the effect of psychosocial job quality on mental health: evidence from 13 waves of a nationally representative cohort study.

PubMed

Milner, Allison; Aitken, Zoe; Kavanagh, Anne; LaMontagne, Anthony D; Pega, Frank; Petrie, Dennis

2017-06-23

Previous studies suggest that poor psychosocial job quality is a risk factor for mental health problems, but they use conventional regression analytic methods that cannot rule out reverse causation, unmeasured time-invariant confounding and reporting bias. This study combines two quasi-experimental approaches to improve causal inference by better accounting for these biases: (i) linear fixed effects regression analysis and (ii) linear instrumental variable analysis. We extract 13 annual waves of national cohort data including 13 260 working-age (18-64 years) employees. The exposure variable is self-reported level of psychosocial job quality. The instruments used are two common workplace entitlements. The outcome variable is the Mental Health Inventory (MHI-5). We adjust for measured time-varying confounders. In the fixed effects regression analysis adjusted for time-varying confounders, a 1-point increase in psychosocial job quality is associated with a 1.28-point improvement in mental health on the MHI-5 scale (95% CI: 1.17, 1.40; P < 0.001). When the fixed effects was combined with the instrumental variable analysis, a 1-point increase psychosocial job quality is related to 1.62-point improvement on the MHI-5 scale (95% CI: -0.24, 3.48; P = 0.088). Our quasi-experimental results provide evidence to confirm job stressors as risk factors for mental ill health using methods that improve causal inference. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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

PubMed

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

2017-03-01

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

Continuous water-quality monitoring and regression analysis to estimate constituent concentrations and loads in the Red River of the North, Fargo, North Dakota, 2003-05

USGS Publications Warehouse

Ryberg, Karen R.

2006-01-01

This report presents the results of a study by the U.S. Geological Survey, done in cooperation with the Bureau of Reclamation, U.S. Department of the Interior, to estimate water-quality constituent concentrations in the Red River of the North at Fargo, North Dakota. Regression analysis of water-quality data collected in 2003-05 was used to estimate concentrations and loads for alkalinity, dissolved solids, sulfate, chloride, total nitrite plus nitrate, total nitrogen, total phosphorus, and suspended sediment. The explanatory variables examined for regression relation were continuously monitored physical properties of water-streamflow, specific conductance, pH, water temperature, turbidity, and dissolved oxygen. For the conditions observed in 2003-05, streamflow was a significant explanatory variable for all estimated constituents except dissolved solids. pH, water temperature, and dissolved oxygen were not statistically significant explanatory variables for any of the constituents in this study. Specific conductance was a significant explanatory variable for alkalinity, dissolved solids, sulfate, and chloride. Turbidity was a significant explanatory variable for total phosphorus and suspended sediment. For the nutrients, total nitrite plus nitrate, total nitrogen, and total phosphorus, cosine and sine functions of time also were used to explain the seasonality in constituent concentrations. The regression equations were evaluated using common measures of variability, including R2, or the proportion of variability in the estimated constituent explained by the regression equation. R2 values ranged from 0.703 for total nitrogen concentration to 0.990 for dissolved-solids concentration. The regression equations also were evaluated by calculating the median relative percentage difference (RPD) between measured constituent concentration and the constituent concentration estimated by the regression equations. Median RPDs ranged from 1.1 for dissolved solids to 35.2 for total nitrite plus nitrate. Regression equations also were used to estimate daily constituent loads. Load estimates can be used by water-quality managers for comparison of current water-quality conditions to water-quality standards expressed as total maximum daily loads (TMDLs). TMDLs are a measure of the maximum amount of chemical constituents that a water body can receive and still meet established water-quality standards. The peak loads generally occurred in June and July when streamflow also peaked.

Comparison of variability in pork carcass composition and quality between barrows and gilts.

PubMed

Overholt, M F; Arkfeld, E K; Mohrhauser, D A; King, D A; Wheeler, T L; Dilger, A C; Shackelford, S D; Boler, D D

2016-10-01

Pigs ( = 8,042) raised in 8 different barns representing 2 seasons (cold and hot) and 2 production focuses (lean growth and meat quality) were used to characterize variability of carcass composition and quality traits between barrows and gilts. Data were collected on 7,684 pigs at the abattoir. Carcass characteristics, subjective loin quality, and fresh ham face color (muscles) were measured on a targeted 100% of carcasses. Fresh belly characteristics, boneless loin weight, instrumental loin color, and ultimate loin pH measurements were collected from 50% of the carcasses each slaughter day. Adipose tissue iodine value (IV), 30-min loin pH, LM slice shear force, and fresh ham muscle characteristic measurements were recorded on 10% of carcasses each slaughter day. Data were analyzed using the MIXED procedure of SAS as a 1-way ANOVA in a randomized complete block design with 2 levels (barrows and gilts). Barn (block), marketing group, production focus, and season were random variables. A 2-variance model was fit using the REPEATED statement of the MIXED procedure, grouped by sex for analysis of least squares means. Homogeneity of variance was tested on raw data using Levene's test of the GLM procedure. Hot carcass weight of pigs (94.6 kg) in this study was similar to U.S. industry average HCW (93.1 kg). Therefore, these data are representative of typical U.S. pork carcasses. There was no difference ( ≥ 0.09) in variability of HCW or loin depth between barrow and gilt carcasses. Back fat depth and estimated carcass lean were more variable ( ≤ 0.0001) and IV was less variable ( = 0.05) in carcasses from barrows than in carcasses from gilts. Fresh belly weight and thickness were more variable ( ≤ 0.01) for bellies of barrows than bellies of gilts, but there was no difference in variability for belly length, width, or flop distance ( ≥ 0.06). Fresh loin subjective color was less variable ( < 0.01) and subjective marbling was more variable ( < 0.0001) in loins from barrows than in those from gilts, but there were no differences ( ≥ 0.08) in variability for any other loin traits or fresh ham traits. Overall, traits associated with carcass fatness, including back fat depth, belly thickness, and marbling, but not IV, were more variable in carcasses from barrows than in carcasses from gilts, whereas minimal differences in variability existed between carcasses of barrows and carcasses of gilts for traits associated with carcass muscling and lean quality.

The Effect of State Regulatory Stringency on Nursing Home Quality

PubMed Central

Mukamel, Dana B; Weimer, David L; Harrington, Charlene; Spector, William D; Ladd, Heather; Li, Yue

2012-01-01

Objective To test the hypothesis that more stringent quality regulations contribute to better quality nursing home care and to assess their cost-effectiveness. Data Sources/Setting Primary and secondary data from all states and U.S. nursing homes between 2005 and 2006. Study Design We estimated seven models, regressing quality measures on the Harrington Regulation Stringency Index and control variables. To account for endogeneity between regulation and quality, we used instrumental variables techniques. Quality was measured by staffing hours by type per case-mix adjusted day, hotel expenditures, and risk-adjusted decline in activities of daily living, high-risk pressure sores, and urinary incontinence. Data Collection All states' licensing and certification offices were surveyed to obtain data about deficiencies. Secondary data included the Minimum Data Set, Medicare Cost Reports, and the Economic Freedom Index. Principal Findings Regulatory stringency was significantly associated with better quality for four of the seven measures studied. The cost-effectiveness for the activities-of-daily-living measure was estimated at about 72,000 in 2011/ Quality Adjusted Life Year. Conclusions Quality regulations lead to better quality in nursing homes along some dimensions, but not all. Our estimates of cost-effectiveness suggest that increased regulatory stringency is in the ballpark of other acceptable cost-effective practices. PMID:22946859

Influence of quality of life, self-perception, and self-esteem on orthodontic treatment need.

PubMed

Dos Santos, Patrícia R; Meneghim, Marcelo de C; Ambrosano, Glaucia M B; Filho, Mario Vedovello; Vedovello, Silvia A S

2017-01-01

In this study, we aimed to assess the relationship between normative and perceived orthodontic treatment need associated with quality of life, self-esteem, and self-perception. The sample included 248 schoolchildren aged 12 years. The normative aspect of orthodontic treatment was assessed by the Dental Health Component and the Aesthetic Component of the Index of Orthodontic Treatment Need. The subjects were further evaluated for their oral health-related quality of life, self-esteem, and self-perception of oral esthetics. The Aesthetic Component of the Index of Orthodontic Treatment Need was considered as the response variable, and generalized linear models estimated by the GENMOD procedure (release 9.3, 2010; SAS Institute, Cary, NC). Model 1 was estimated with only the intercept, providing the basis for evaluating the reduction in variance in the other models studied; then the variables were tested sequentially, considering P ≤0.05 as the criterion for remaining in the model. In the model, self-perception and self-esteem were statistically significant in relation to the perceived need for treatment. The normative need was significantly associated with the outcome variable and was not influenced by independent variables. The normative need for orthodontics treatment was not overestimated by the perceived need, and the perceived need was not influenced by sex and the impact on quality of life. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Sleep in adolescents of different socioeconomic status: a systematic review

PubMed Central

Felden, Érico Pereira Gomes; Leite, Carina Raffs; Rebelatto, Cleber Fernando; Andrade, Rubian Diego; Beltrame, Thais Silva

2015-01-01

Objective: To analyze the sleep characteristics in adolescents from different socioeconomic levels. Data source: Original studies found in the MEDLINE/PubMed and SciELO databases without language and period restrictions that analyzed associations between sleep variables and socioeconomic indicators. The initial search resulted in 99 articles. After reading the titles and abstracts and following inclusion and exclusion criteria, 12 articles with outcomes that included associations between sleep variables (disorders, duration, quality) and socioeconomic status (ethnicity, family income, and social status) were analyzed. Data synthesis: The studies associating sleep with socioeconomic variables are recent, published mainly after the year 2000. Half of the selected studies were performed with young Americans, and only one with Brazilian adolescents. Regarding ethnic differences, the studies do not have uniform conclusions. The main associations found were between sleep variables and family income or parental educational level, showing a trend among poor, low social status adolescents to manifest low duration, poor quality of sleeping patterns. Conclusions: The study found an association between socioeconomic indicators and quality of sleep in adolescents. Low socioeconomic status reflects a worse subjective perception of sleep quality, shorter duration, and greater daytime sleepiness. Considering the influence of sleep on physical and cognitive development and on the learning capacity of young individuals, the literature on the subject is scarce. There is a need for further research on sleep in different realities of the Brazilian population. PMID:26298657

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.

Development, application, and sensitivity analysis of a water quality index for drinking water management in small systems.

PubMed

Scheili, A; Rodriguez, Manuel J; Sadiq, R

2015-11-01

The aim of this study was to produce a drinking water assessment tool for operators of small distribution systems. A drinking water quality index (DWQI) was developed and applied to small systems based on the water quality index of the Canadian Council of Ministers of Environment. The drinking water quality index was adapted to specific needs by creating four drinking water quality scenarios. First, the temporal and spatial dimensions of drinking water quality variability were taken into account. The DWQI was designed to express global drinking water quality according to different monitoring frequencies. Daily, monthly, and seasonal assessment was also considered. With the data made available, it was possible to use the index as a spatial monitoring tool and express water quality in different points in the distribution system. Moreover, adjustments were made to prioritize the type of contaminant to monitor. For instance, monitoring contaminants with acute health effects led to a scenario based on daily measures, including easily accessible and affordable water quality parameters. On the other hand, contaminants with chronic effects, especially disinfection by-products, were considered in a seasonal monitoring scenario where disinfection by-product reference values were redefined according to their seasonal variability. A sensitivity analysis was also carried out to validate the index. Globally, the DWQI developed is adapted to the needs of small systems. In fact, expressing drinking water quality using the DWQI contributes to the identification of problematic periods and segments in the distribution system. Further work may include this index in the development of a customized decision-making tool for small-system operators and managers.

Quality of life profile and correlated factors in chronic leg ulcer patients in the mid-west of São Paulo State, Brazil*

PubMed Central

Wachholz, Patrick Alexander; Masuda, Paula Yoshiko; Nascimento, Dejair Caitano; Taira, Cecilia Midori Higashi; Cleto, Norma Gondim

2014-01-01

BACKGROUND Chronic leg ulcer may have an impact on patients' quality of life. OBJECTIVES This study aimed to identify the impact of leg ulcers on patient's quality of life using the Dermatology Life Quality Index and to define the main factors correlated with this perception. METHOD Cross-sectional, non-probabilistic sampling study. We included patients with chronic leg ulcers being treated for at least 3 months. A sociodemographic and clinical survey was conducted to assess the profile of the ulcers. We administered a screening for depressive symptoms and the Dermatology Life Quality Index. We performed a descriptive statistical analysis, chi-square test and Mann-Whitney test for categorical data, Pearson for numeric variables, and multiple regression for categorical data. RESULTS Forty-one patients were assessed. Their mean age was 61.78 years. Venous ulcers (48.8%) were the most prevalent. Seventy-three percent of the sample perceived no impact/low impact on quality of life in the past week, and 26.8% perceived moderate/high impact. A multiple regression analysis identified the causes of lesion, pain related to the ulcers, time of onset, and severity of the depressive symptoms as the variables that had an influence on quality of life. CONCLUSIONS The majority of the sample perceived low or no impact of the condition on the quality of the life. The variables etiology of the lesion (p<0.001), pain related to the ulcers (p=0.001), time of onset (p=0.006), and severity of the depressive symptoms (p<0.001) had an influence on the quality of life, suggesting the need for further studies with more robust designs to confirm the causal relationship between these characteristics and quality of life. PMID:24626651

METEOROLOGICAL AND TRANSPORT MODELING

EPA Science Inventory

Advanced air quality simulation models, such as CMAQ, as well as other transport and dispersion models, require accurate and detailed meteorology fields. These meteorology fields include primary 3-dimensional dynamical and thermodynamical variables (e.g., winds, temperature, mo...

Formulation characteristics and in vitro release testing of cyclosporine ophthalmic ointments.

PubMed

Dong, Yixuan; Qu, Haiou; Pavurala, Naresh; Wang, Jiang; Sekar, Vasanthakumar; Martinez, Marilyn N; Fahmy, Raafat; Ashraf, Muhammad; Cruz, Celia N; Xu, Xiaoming

2018-06-10

The aim of the present study was to investigate the relationship between formulation/process variables versus the critical quality attributes (CQAs) of cyclosporine ophthalmic ointments and to explore the feasibility of using an in vitro approach to assess product sameness. A definitive screening design (DSD) was used to evaluate the impact of formulation and process variables. The formulation variables included drug percentage, percentage of corn oil and lanolin alcohol. The process variables studied were mixing temperature, mixing time and the method of mixing. The quality and performance attributes examined included drug assay, content uniformity, image analysis, rheology (storage modulus, shear viscosity) and in vitro drug release. Of the formulation variables evaluated, the percentage of the drug substance and the percentage of corn oil in the matrix were the most influential factors with respect to in vitro drug release. Conversely, the process parameters tested were observed to have minimal impact. An evaluation of the release mechanism of cyclosporine from the ointment revealed an interplay between formulation (e.g. physicochemical properties of the drug and ointment matrix type) and the release medium. These data provide a scientific basis to guide method development for in vitro drug release testing of ointment dosage forms. These results demonstrate that the in vitro methods used in this investigation were fit-for-purpose for detecting formulation and process changes and therefore amenable to assessment of product sameness. Published by Elsevier B.V.

A Comparison of Levels of Quality of Life, Depression and Loneliness among Athletes with Different Levels of Training

ERIC Educational Resources Information Center

Unver, Saban; Atan, Tulin; Cavusoglu, Gul; Erim, Vedat; Yamak, Bade

2015-01-01

The purpose of this study is to compare the levels of life quality, depression and loneliness among the students of the Faculty of Sports Sciences (FSS), national wrestlers and non national wrestlers in terms of some demographic variables. The participants of the study included 37 students from the Faculty of Sports Sciences of Ondokuz Mayis…

Health Related Quality of Life in Children with Autism Spectrum Disorders: The Clinical and Demographic Related Factors in Turkey

ERIC Educational Resources Information Center

Kose, Sezen; Erermis, Serpil; Ozturk, Onder; Ozbaran, Burcu; Demiral, Nagehan; Bildik, Tezan; Aydin, Cahide

2013-01-01

We aimed to investigate the Health Related Quality of Life and related clinical variables (HRQoL) of children with Autism Spectrum Disorders (ASD). We included 102 children with ASD (46 with autism, 38 with pervasive developmental disorder not otherwise specified (PDD-NOS) and 18 with Asperger's syndrome (AS)) and 39 typically developing children…

Climate-growth relationships for yellow-poplar across structural and site quality gradients in the southern Appalachian Mountains

Treesearch

Tara L. Keyser; Peter M. Brown

2014-01-01

Forecasted changes in climate across the southeastern US include an increase in temperature along with more variable precipitation patterns, including an increase in the severity and frequency of drought events. As such, the management of forests for increased resistance or resilience to the direct and indirect effects of climate change, including decreased tree- and...

China's Air Quality and Respiratory Disease Mortality Based on the Spatial Panel Model.

PubMed

Cao, Qilong; Liang, Ying; Niu, Xueting

2017-09-18

Background : Air pollution has become an important factor restricting China's economic development and has subsequently brought a series of social problems, including the impact of air pollution on the health of residents, which is a topical issue in China. Methods : Taking into account this spatial imbalance, the paper is based on the spatial panel data model PM 2.5 . Respiratory disease mortality in 31 Chinese provinces from 2004 to 2008 is taken as the main variable to study the spatial effect and impact of air quality and respiratory disease mortality on a large scale. Results : It was found that there is a spatial correlation between the mortality of respiratory diseases in Chinese provinces. The spatial correlation can be explained by the spatial effect of PM 2.5 pollutions in the control of other variables. Conclusions : Compared with the traditional non-spatial model, the spatial model is better for describing the spatial relationship between variables, ensuring the conclusions are scientific and can measure the spatial effect between variables.

77 FR 34117 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-08

... other high credit quality, short-term fixed-income or similar securities (including shares of money market funds, bank deposits, bank money market accounts, certain variable rate-demand notes, and...- income or similar securities (including shares of money market funds, bank deposits, bank money market...

Intradaily variability of water quality in a shallow tidal lagoon: Mechanisms and implications

USGS Publications Warehouse

Lucas, L.V.; Sereno, D.M.; Burau, J.R.; Schraga, T.S.; Lopez, C.B.; Stacey, M.T.; Parchevsky, K.V.; Parchevsky, V.P.

2006-01-01

Although surface water quality and its underlying processes vary over time scales ranging from seconds to decades, they have historically been studied at the lower (weekly to interannual) frequencies. The aim of this study was to investigate intradaily variability of three water quality parameters in a small freshwater tidal lagoon (Mildred Island, California). High frequency time series of specific conductivity, water temperature, and chlorophyll a at two locations within the habitat were analyzed in conjunction with supporting hydrodynamic, meteorological, biological, and spatial mapping data. All three constituents exhibited large amplitude intradaily (e.g., semidiurnal tidal and diurnal) oscillations, and periodicity varied across constituents, space, and time. Like other tidal embayments, this habitat is influenced by several processes with distinct periodicities including physical controls, such as tides, solar radiation, and wind, and biological controls, such as photosynthesis, growth, and grazing. A scaling approach was developed to estimate individual process contributions to the observed variability. Scaling results were generally consistent with observations and together with detailed examination of time series and time derivatives, revealed specific mechanisms underlying the observed periodicities, including interactions between the tidal variability, heating, wind, and biology. The implications for monitoring were illustrated through subsampling of the data set. This exercise demonstrated how quantities needed by scientists and managers (e.g., mean or extreme concentrations) may be misrepresented by low frequency data and how short-duration high frequency measurements can aid in the design and interpretation of temporally coarser sampling programs. The dispersive export of chlorophyll a from the habitat exhibited a fortnightly variability corresponding to the modulation of semidiurnal tidal currents with the diurnal cycle of phytoplankton variability, demonstrating how high frequency interactions can govern long-term trends. Process identification, as through the scaling analysis here, can help us anticipate changes in system behavior and adapt our own interactions with the system. ?? 2006 Estuarine Research Federation.

Variable methodological quality and use found in systematic reviews referenced in STEMI clinical practice guidelines.

PubMed

Scott, Jared; Howard, Benjamin; Sinnett, Philip; Schiesel, Michael; Baker, Jana; Henderson, Patrick; Vassar, Matt

2017-12-01

The objective of this study was to assess the methodological quality and clarity of reporting of the systematic reviews (SRs) supporting clinical practice guideline (CPG) recommendations in the management of ST-elevation myocardial infarction (STEMI) across international CPGs. We searched 13 guideline clearinghouses including the National Guideline Clearinghouse and Guidelines International Network (GIN). To meet inclusion criteria CPGs must be pertinent to the management of STEMI, endorsed by a governing body or national organization, and written in English. We retrieved SRs from the reference sections using a combination of keywords and hand searching. Two investigators scored eligible SRs using AMSTAR and PRISMA. We included four CPGs. We extracted 71 unique SRs. These SRs received AMSTAR scores ranging from 1 (low) to 9 (high) on an 11-point scale. All CPGs consistently underperformed in areas including disclosure of funding sources, risk of bias, and publication bias according to AMSTAR. PRISMA checklist completeness ranged from 44% to 96%. The PRISMA scores indicated that SRs did not provide a full search strategy, study protocol and registration, assessment of publication bias or report funding sources. Only one SR was referenced in all four CPGs. All CPGs omitted a large subset of available SRs cited by other guidelines. Our study demonstrates the variable quality of SRs used to establish recommendations within guidelines included in our sample. Although guideline developers have acknowledged this variability, it remains a significant finding that needs to be addressed further. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Copyright © 2017 Elsevier Inc. All rights reserved.

Measuring allostatic load in the workforce: a systematic review

PubMed Central

MAUSS, Daniel; LI, Jian; SCHMIDT, Burkhard; ANGERER, Peter; JARCZOK, Marc N.

2014-01-01

The Allostatic Load Index (ALI) has been used to establish associations between stress and health-related outcomes. This review summarizes the measurement and methodological challenges of allostatic load in occupational settings. Databases of Medline, PubPsych, and Cochrane were searched to systematically explore studies measuring ALI in working adults following the PRISMA statement. Study characteristics, biomarkers and methods were tabulated. Methodological quality was evaluated using a standardized checklist. Sixteen articles (2003–2013) met the inclusion criteria, with a total of 39 (range 6–17) different variables used to calculate ALI. Substantial heterogeneity was observed in the number and type of biomarkers used, the analytic techniques applied and study quality. Particularly, primary mediators were not regularly included in ALI calculation. Consensus on methods to measure ALI in working populations is limited. Research should include longitudinal studies using multi-systemic variables to measure employees at risk for biological wear and tear. PMID:25224337

Variation in Red Blood Cell Transfusion Practices During Cardiac Operations Among Centers in Maryland: Results From a State Quality-Improvement Collaborative.

PubMed

Magruder, J Trent; Blasco-Colmenares, Elena; Crawford, Todd; Alejo, Diane; Conte, John V; Salenger, Rawn; Fonner, Clifford E; Kwon, Christopher C; Bobbitt, Jennifer; Brown, James M; Nelson, Mark G; Horvath, Keith A; Whitman, Glenn R

2017-01-01

Variation in red blood cell (RBC) transfusion practices exists at cardiac surgery centers across the nation. We tested the hypothesis that significant variation in RBC transfusion practices between centers in our state's cardiac surgery quality collaborative remains even after risk adjustment. Using a multiinstitutional statewide database created by the Maryland Cardiac Surgery Quality Initiative (MCSQI), we included patient-level data from 8,141 patients undergoing isolated coronary artery bypass (CAB) or aortic valve replacement at 1 of 10 centers. Risk-adjusted multivariable logistic regression models were constructed to predict the need for any intraoperative RBC transfusion, as well as for any postoperative RBC transfusion, with anonymized center number included as a factor variable. Unadjusted intraoperative RBC transfusion probabilities at the 10 centers ranged from 13% to 60%; postoperative RBC transfusion probabilities ranged from 16% to 41%. After risk adjustment with demographic, comorbidity, and operative data, significant intercenter variability was documented (intraoperative probability range, 4% -59%; postoperative probability range, 13%-39%). When stratifying patients by preoperative hematocrit quartiles, significant variability in intraoperative transfusion probability was seen among all quartiles (lowest quartile: mean hematocrit value, 30.5% ± 4.1%, probability range, 17%-89%; highest quartile: mean hematocrit value, 44.8% ± 2.5%; probability range, 1%-35%). Significant variation in intercenter RBC transfusion practices exists for both intraoperative and postoperative transfusions, even after risk adjustment, among our state's centers. Variability in intraoperative RBC transfusion persisted across quartiles of preoperative hematocrit values. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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

USGS Publications Warehouse

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

1997-01-01

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

Scale effects on spatially varying relationships between urban landscape patterns and water quality.

PubMed

Sun, Yanwei; Guo, Qinghai; Liu, Jian; Wang, Run

2014-08-01

Scientific interpretation of the relationships between urban landscape patterns and water quality is important for sustainable urban planning and watershed environmental protection. This study applied the ordinary least squares regression model and the geographically weighted regression model to examine the spatially varying relationships between 12 explanatory variables (including three topographical factors, four land use parameters, and five landscape metrics) and 15 water quality indicators in watersheds of Yundang Lake, Maluan Bay, and Xinglin Bay with varying levels of urbanization in Xiamen City, China. A local and global investigation was carried out at the watershed-level, with 50 and 200 m riparian buffer scales. This study found that topographical features and landscape metrics are the dominant factors of water quality, while land uses are too weak to be considered as a strong influential factor on water quality. Such statistical results may be related with the characteristics of land use compositions in our study area. Water quality variations in the 50 m buffer were dominated by topographical variables. The impact of landscape metrics on water quality gradually strengthen with expanding buffer zones. The strongest relationships are obtained in entire watersheds, rather than in 50 and 200 m buffer zones. Spatially varying relationships and effective buffer zones were verified in this study. Spatially varying relationships between explanatory variables and water quality parameters are more diversified and complex in less urbanized areas than in highly urbanized areas. This study hypothesizes that all these varying relationships may be attributed to the heterogeneity of landscape patterns in different urban regions. Adjustment of landscape patterns in an entire watershed should be the key measure to successfully improving urban lake water quality.

Drivers of Water Quality Variability in Northern Coastal Ecuador

PubMed Central

Hubbard, Alan E.; Nelson, Kara L.; Eisenberg, Joseph N.S.

2012-01-01

The microbiological safety of water is commonly measured using indicator organisms, but the spatiotemporal variability of these indicators can make interpretation of data difficult. Here we systematically explore variability in E.coli concentrations in surface source and household drinking water in a rural Ecuadorian village over one year. We observed more variability in water quality on an hourly basis (up to 2.4-log difference) than on a daily (2.2-log difference) or weekly basis (up to 1.8-log difference). E.coli counts were higher in the wet season than in the dry season for both source (0.42-log difference; p<0.0001) and household (0.11-log difference; p=0.077) samples. In the wet season, a one-cm increase in weekly rainfall was associated with a 3% decrease (p=0.006) in E.coli counts in source samples and a 6% decrease (p=0.012) in household samples. Each additional person in the river when source samples were collected was associated with a 4% increase (p=0.026) in E.coli counts in the wet season. Factors affecting household water quality included rainfall, water source, and covering the container. The variability can be understood as a combination of environmental (e.g., seasonal and soil processes) and other drivers (e.g., human river use, water practices and sanitation), each working at different timescales. PMID:19368173

An evidence-based framework to measure quality of allied health care.

PubMed

Grimmer, Karen; Lizarondo, Lucylynn; Kumar, Saravana; Bell, Erica; Buist, Michael; Weinstein, Philip

2014-02-26

There is no standard way of describing the complexities of allied health (AH) care, or its quality. AH is an umbrella term which excludes medicine and nursing, and variably includes disciplines which provide therapy, diagnostic, or scientific services. This paper outlines a framework for a standard approach to evaluate the quality of AH therapy services. A realist synthesis framework describing what AH does, how it does it, and what is achieved, was developed. This was populated by the findings of a systematic review of literature published since 1980 reporting concepts of quality relevant to AH. Articles were included on quality measurement concepts, theories, debates, and/or hypothetical frameworks. Of 139 included articles, 21 reported on descriptions of quality potentially relevant to AH. From these, 24 measures of quality were identified, with 15 potentially relating to what AH does, 17 to how AH delivers care, 8 relating to short term functional outcomes, and 9 relating to longer term functional and health system outcomes. A novel evidence-based quality framework was proposed to address the complexity of AH therapies. This should assist in better evaluation of AH processes and outcomes, costs, and evidence-based engagement of AH providers in healthcare teams.

The effect of two different visual presentation modalities on the narratives of mainstream grade 3 children.

PubMed

Klop, D; Engelbrecht, L

2013-12-01

This study investigated whether a dynamic visual presentation method (a soundless animated video presentation) would elicit better narratives than a static visual presentation method (a wordless picture book). Twenty mainstream grade 3 children were randomly assigned to two groups and assessed with one of the visual presentation methods. Narrative performance was measured in terms of micro- and macrostructure variables. Microstructure variables included productivity (total number of words, total number of T-units), syntactic complexity (mean length of T-unit) and lexical diversity measures (number of different words). Macrostructure variables included episodic structure in terms of goal-attempt-outcome (GAO) sequences. Both visual presentation modalities elicited narratives of similar quantity and quality in terms of the micro- and macrostructure variables that were investigated. Animation of picture stimuli did not elicit better narratives than static picture stimuli.

[Intrinsic motivation: a new direction of understanding and treatment of schizophrenia?].

PubMed

Wertman, Maayan; Grunhaus, Leon; Israeli, David

2013-09-01

While diagnosing schizophrenia, clinicians focus on feeling the quality and nature of the internal motivation of patients. This motivational quality was theoretically conceptualized by Self Determination Theory (SDT). In this article we will review some of the basics of this theory, which focuses on motivational variables assessing behavior on an internal-external axis. Then, we will review prominent findings in the topic of using SDT concepts for the treatment of schizophrenia. The next stage will include a discussion as to the relationship between intrinsic and extrinsic motivators as well as possible neuroanatomy of these behavioral variables. Finally, directions for research will be offered in the field of schizophrenia diagnosis and treatment.

Risk factors for fatigue in patients with epilepsy.

PubMed

Yan, Song; Wu, Yuanbin; Deng, Yanchun; Liu, Yonghong; Zhao, Jingjing; Ma, Lei

2016-11-01

Fatigue is highly prevalent in patients with epilepsy and has a major impact on quality of life, but little data is available on its effects and management in epilepsy. To identify the incidence and risk factors of fatigue in patients with epilepsy, 105 epilepsy patients (45 women and 60 men) were enrolled in our study. Demographic and clinical data were collected and psychological variables including fatigue, sleep quality, excess daytime sleepiness, anxiety, and depression were measured by Fatigue Severity Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale, respectively. Of 105 patients, 29.5% exhibited fatigue (FSS score ⩾4). We found no correlation between the occurrence of fatigue and any of our demographic or clinical variables. Fatigue is correlated with low sleep quality, anxiety, and depression, but not with excess daytime sleepiness. Thus, we concluded that fatigue is highly prevalent in patients with epilepsy, and that low sleep quality, anxiety, and depression are significantly correlated with fatigue in epileptics, while excess daytime sleepiness not. Copyright © 2016. Published by Elsevier Ltd.

Regression model development and computational procedures to support estimation of real-time concentrations and loads of selected constituents in two tributaries to Lake Houston near Houston, Texas, 2005-9

USGS Publications Warehouse

Lee, Michael T.; Asquith, William H.; Oden, Timothy D.

2012-01-01

In December 2005, the U.S. Geological Survey (USGS), in cooperation with the City of Houston, Texas, began collecting discrete water-quality samples for nutrients, total organic carbon, bacteria (Escherichia coli and total coliform), atrazine, and suspended sediment at two USGS streamflow-gaging stations that represent watersheds contributing to Lake Houston (08068500 Spring Creek near Spring, Tex., and 08070200 East Fork San Jacinto River near New Caney, Tex.). Data from the discrete water-quality samples collected during 2005–9, in conjunction with continuously monitored real-time data that included streamflow and other physical water-quality properties (specific conductance, pH, water temperature, turbidity, and dissolved oxygen), were used to develop regression models for the estimation of concentrations of water-quality constituents of substantial source watersheds to Lake Houston. The potential explanatory variables included discharge (streamflow), specific conductance, pH, water temperature, turbidity, dissolved oxygen, and time (to account for seasonal variations inherent in some water-quality data). The response variables (the selected constituents) at each site were nitrite plus nitrate nitrogen, total phosphorus, total organic carbon, E. coli, atrazine, and suspended sediment. The explanatory variables provide easily measured quantities to serve as potential surrogate variables to estimate concentrations of the selected constituents through statistical regression. Statistical regression also facilitates accompanying estimates of uncertainty in the form of prediction intervals. Each regression model potentially can be used to estimate concentrations of a given constituent in real time. Among other regression diagnostics, the diagnostics used as indicators of general model reliability and reported herein include the adjusted R-squared, the residual standard error, residual plots, and p-values. Adjusted R-squared values for the Spring Creek models ranged from .582–.922 (dimensionless). The residual standard errors ranged from .073–.447 (base-10 logarithm). Adjusted R-squared values for the East Fork San Jacinto River models ranged from .253–.853 (dimensionless). The residual standard errors ranged from .076–.388 (base-10 logarithm). In conjunction with estimated concentrations, constituent loads can be estimated by multiplying the estimated concentration by the corresponding streamflow and by applying the appropriate conversion factor. The regression models presented in this report are site specific, that is, they are specific to the Spring Creek and East Fork San Jacinto River streamflow-gaging stations; however, the general methods that were developed and documented could be applied to most perennial streams for the purpose of estimating real-time water quality data.

Quality by design approach: application of artificial intelligence techniques of tablets manufactured by direct compression.

PubMed

Aksu, Buket; Paradkar, Anant; de Matas, Marcel; Ozer, Ozgen; Güneri, Tamer; York, Peter

2012-12-01

The publication of the International Conference of Harmonization (ICH) Q8, Q9, and Q10 guidelines paved the way for the standardization of quality after the Food and Drug Administration issued current Good Manufacturing Practices guidelines in 2003. "Quality by Design", mentioned in the ICH Q8 guideline, offers a better scientific understanding of critical process and product qualities using knowledge obtained during the life cycle of a product. In this scope, the "knowledge space" is a summary of all process knowledge obtained during product development, and the "design space" is the area in which a product can be manufactured within acceptable limits. To create the spaces, artificial neural networks (ANNs) can be used to emphasize the multidimensional interactions of input variables and to closely bind these variables to a design space. This helps guide the experimental design process to include interactions among the input variables, along with modeling and optimization of pharmaceutical formulations. The objective of this study was to develop an integrated multivariate approach to obtain a quality product based on an understanding of the cause-effect relationships between formulation ingredients and product properties with ANNs and genetic programming on the ramipril tablets prepared by the direct compression method. In this study, the data are generated through the systematic application of the design of experiments (DoE) principles and optimization studies using artificial neural networks and neurofuzzy logic programs.

A global assessment of climate-water quality relationships in large rivers: an elasticity perspective.

PubMed

Jiang, Jiping; Sharma, Ashish; Sivakumar, Bellie; Wang, Peng

2014-01-15

To uncover climate-water quality relationships in large rivers on a global scale, the present study investigates the climate elasticity of river water quality (CEWQ) using long-term monthly records observed at 14 large rivers. Temperature and precipitation elasticities of 12 water quality parameters, highlighted by N- and P-nutrients, are assessed. General observations on elasticity values show the usefulness of this approach to describe the magnitude of stream water quality responses to climate change, which improves that of simple statistical correlation. Sensitivity type, intensity and variability rank of CEWQ are reported and specific characteristics and mechanism of elasticity of nutrient parameters are also revealed. Among them, the performance of ammonia, total phosphorus-air temperature models, and nitrite, orthophosphorus-precipitation models are the best. Spatial and temporal assessment shows that precipitation elasticity is more variable in space than temperature elasticity and that seasonal variation is more evident for precipitation elasticity than for temperature elasticity. Moreover, both anthropogenic activities and environmental factors are found to impact CEWQ for select variables. The major relationships that can be inferred include: (1) human population has a strong linear correlation with temperature elasticity of turbidity and total phosphorus; and (2) latitude has a strong linear correlation with precipitation elasticity of turbidity and N nutrients. As this work improves our understanding of the relation between climate factors and surface water quality, it is potentially helpful for investigating the effect of climate change on water quality in large rivers, such as on the long-term change of nutrient concentrations. © 2013.

Riparian buffer design guidelines for water quality and wildlife habitat functions on agricultural landscapes in the Intermountain West: Case Study

Treesearch

Craig W. Johnson; Susan Buffler

2008-01-01

This hypothetical case study illustrates how the riparian buffer planning protocol described in the RB handbook is used to plan a buffer for both water quality and wildlife conservation on a specific project site. The case study site includes riparian buffer characteristics typical of the study area-variable topography and soils, flood plain wetlands, seeps, springs,...

Analysis And Control System For Automated Welding

NASA Technical Reports Server (NTRS)

Powell, Bradley W.; Burroughs, Ivan A.; Kennedy, Larry Z.; Rodgers, Michael H.; Goode, K. Wayne

1994-01-01

Automated variable-polarity plasma arc (VPPA) welding apparatus operates under electronic supervision by welding analysis and control system. System performs all major monitoring and controlling functions. It acquires, analyzes, and displays weld-quality data in real time and adjusts process parameters accordingly. Also records pertinent data for use in post-weld analysis and documentation of quality. System includes optoelectronic sensors and data processors that provide feedback control of welding process.

[Is the stomach a main landmark on the abdominal circumference? Audit of 3 operators].

PubMed

Laurent, A-C; Blanc, J; Grangé, G

2016-05-01

The fetal weight estimation depends largely on the accuracy of abdominal circumference. The quality criteria are standardized to minimize variability and include visualization of the stomach. The objective of this study is to investigate the presence or absence of the stomach on the abdominal circumference for 3 different operators. We conducted re-reading of 204 ultrasound images in the second and third trimester of pregnancy, performed by three operators, at the maternity Port Royal in Paris in 2013. On these images, the presence of the stomach was sought and other quality criteria were verified. Among the 204 images, 166 included the stomach (81%). When studying for each of the three operators, there were 79%, 72% and 98% of the stomach into the abdominal circumference, a significant difference between operators (P=0.0029). Regarding the secondary criteria, the quality criteria found most often were the calipers and well placed ellipse (89%). According to the previous studies, the stomach seems to be a reference to search. Our study shows variability depending on the different operators. If a hierarchy of quality criteria is to be considered, the stomach does not seem to be the first criterion to search. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Approach for environmental baseline water sampling

USGS Publications Warehouse

Smith, K.S.

2011-01-01

Samples collected during the exploration phase of mining represent baseline conditions at the site. As such, they can be very important in forecasting potential environmental impacts should mining proceed, and can become measurements against which future changes are compared. Constituents in stream water draining mined and mineralized areas tend to be geochemically, spatially, and temporally variable, which presents challenges in collecting both exploration and baseline water-quality samples. Because short-term (daily) variations can complicate long-term trends, it is important to consider recent findings concerning geochemical variability of stream-water constituents at short-term timescales in designing sampling plans. Also, adequate water-quality information is key to forecasting potential ecological impacts from mining. Therefore, it is useful to collect baseline water samples adequate tor geochemical and toxicological modeling. This requires complete chemical analyses of dissolved constituents that include major and minor chemical elements as well as physicochemical properties (including pH, specific conductance, dissolved oxygen) and dissolved organic carbon. Applying chemical-equilibrium and appropriate toxicological models to water-quality information leads to an understanding of the speciation, transport, sequestration, bioavailability, and aquatic toxicity of potential contaminants. Insights gained from geochemical and toxicological modeling of water-quality data can be used to design appropriate mitigation and for economic planning for future mining activities.

Reporting of research quality characteristics of studies published in 6 major clinical dental specialty journals.

PubMed

Pandis, Nikolaos; Polychronopoulou, Argy; Madianos, Phoebus; Makou, Margarita; Eliades, Theodore

2011-06-01

The objective of this article was to record reporting characteristics related to study quality of research published in major specialty dental journals with the highest impact factor (Journal of Endodontics, Journal of Oral and Maxillofacial Surgery, American Journal of Orthodontics and Dentofacial Orthopedics; Pediatric Dentistry, Journal of Clinical Periodontology, and International Journal of Prosthetic Dentistry). The included articles were classified into the following 3 broad subject categories: (1) cross-sectional (snap-shot), (2) observational, and (3) interventional. Multinomial logistic regression was conducted for effect estimation using the journal as the response and randomization, sample calculation, confounding discussed, multivariate analysis, effect measurement, and confidence intervals as the explanatory variables. The results showed that cross-sectional studies were the dominant design (55%), whereas observational investigations accounted for 13%, and interventions/clinical trials for 32%. Reporting on quality characteristics was low for all variables: random allocation (15%), sample size calculation (7%), confounding issues/possible confounders (38%), effect measurements (16%), and multivariate analysis (21%). Eighty-four percent of the published articles reported a statistically significant main finding and only 13% presented confidence intervals. The Journal of Clinical Periodontology showed the highest probability of including quality characteristics in reporting results among all dental journals. Copyright © 2011 Elsevier Inc. All rights reserved.

Housing Satisfaction of Older (55+) Single-Person Householders in U.S. Rural Communities.

PubMed

Ahn, Mira; Lee, Sung-Jin

2016-08-01

This study aims to understand the housing satisfaction of older (55+) single-person householders in U.S. rural communities using the available variables from a secondary data set, the 2011 American Housing Survey (AHS). In this study, housing satisfaction was considered to be an indicator of quality of life. Based on previous studies, we developed a model to test a hypothesized relationship between older (55+) single-person householders' (N = 1,017) housing satisfaction and their personal, physical, financial, and environmental characteristics. Multiple regression results showed that the model was supported, indicating that significant variables in housing satisfaction include age, gender, health status, age of house, structure type, and unit location. Among the significant variables, health status was revealed to be the strongest factor in housing satisfaction. Housing satisfaction was discussed as potential indicators of quality of life. © The Author(s) 2015.

Environmental and Water Quality Operational Studies: Proceedings of the DeGray Lake Symposium Held in Arkadelphia, Arkansas.

DTIC Science & Technology

1987-03-01

statistics for storm water quality variables and fractions of phosphorus, solids, and carbon are presented in Tables 7 and 8, respectively. The correlation...matrix and factor analysis (same method as used for baseflow) of storm water quality variables suggested three groups: Group I - TMG, TCA, TNA, TSI...models to predict storm water quality . The 11 static and 3 dynamic storm variables were used as potential dependent variables. All independent and

Quality of Life in Cutaneous Lupus Erythematosus

PubMed Central

Klein, Rachel; Moghadam-Kia, Siamak; Taylor, Lynne; Coley, Christopher; Okawa, Joyce; LoMonico, Jonathan; Chren, Mary-Margaret; Werth, Victoria P.

2010-01-01

Background Little is known about quality of life in patients with cutaneous lupus erythematosus. Objective We sought to determine how cutaneous lupus affects quality of life and which independent variables are associated with poor quality of life. Methods 157 patients with cutaneous lupus completed surveys related to quality of life, including the Skindex-29 and the SF-36. Results Quality of life in cutaneous lupus is severely impaired, particularly with respect to emotional well-being. Patients with cutaneous lupus have worse quality of life than those with other common dermatologic conditions, such as acne, non-melanoma skin cancer, and alopecia. With respect to mental health status, patients with cutaneous lupus have similar or worse scores than patients with hypertension, type 2 diabetes mellitus, recent myocardial infarction, and congestive heart failure. Factors related to poor quality of life include female gender, generalized disease, severe disease, distribution of lesions, and younger age. Limitations The study was done at a single referral-only center. Conclusion Patients with cutaneous lupus have very impaired quality of life, particularly from an emotional perspective. PMID:21397983

Exploring household income as a predictor of psychological well-being among long-term colorectal cancer survivors.

PubMed

Lundy, J Jason; Coons, Stephen Joel; Wendel, Christopher; Hornbrook, Mark C; Herrinton, Lisa; Grant, Marcia; Krouse, Robert S

2009-03-01

The purpose of this analysis was to determine the unique contribution of household income to the variance explained in psychological well-being (PWB) among a sample of colorectal cancer (CRC) survivors. This study is a secondary analysis of data collected as part of the Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors Study, which included CRC survivors with (cases) and without (controls) ostomies. The dataset included socio-demographic, health status, and health-related quality of life (HRQOL) information. HRQOL was assessed with the modified City of Hope Quality of Life (mCOH-QOL)-Ostomy questionnaire and SF-36v2. To assess the relationship between income and PWB, a hierarchical linear regression model was constructed combining data from both cases and controls. After accounting for the proportion of variance in PWB explained by the other independent variables in the model, the additional variance explained by income was significant (R (2) increased from 0.228 to 0.250; P = 0.006). Although the study design does not allow causal inference, these results demonstrate a significant relationship between income and PWB in CRC survivors. The findings suggest that for non-randomized group comparisons of HRQOL, income should, at the very least, be included as a control variable in the analysis.

The impact of high progesterone levels on the day of HCG administration in assisted human reproduction treatments.

PubMed

Tanada, Michelli S; Yoshida, Ivan H; Santos, Monise; Berton, Caroline Z; Souto, Elen; Carvalho, Waldemar P de; Cordts, Emerson B; Barbosa, Caio P

2018-06-01

Progesterone is a steroid hormone that acts on the endometrium. It is known for producing physical and mood-related side effects. Few studies have looked into how progesterone levels affect embryo development and quality. This study aimed to find a cutoff level for serum progesterone on the day of HCG administration from which embryo quality is impaired. The study included 145 cycles, from which 885 oocytes and 613 embryos were obtained. All patients had their serum progesterone levels measured on the day of HCG administration. Data sets were collected from patient medical records. The chi-square test was used to assess qualitative variables and the Mann-Whitney test to evaluate quantitative variables. Statistical analysis revealed that serum progesterone levels and reproductive variables were not significantly associated. In regards to oocyte maturity, however, when progesterone levels were greater than 1.3 ng/mL the probability of oocytes being immature increased by 12.7%. The fragmentation rate of embryos categorized as "top quality" in D3 increased proportionately to increases in progesterone levels (12.23%). High progesterone levels appeared to be correlated with increased embryo fragmentation rates, but high serum levels of the hormone on the day of HCG administration had no impact on reproductive variables and were not associated with impaired embryo development.

[Sleep in adolescents of different socioeconomic status: a systematic review].

PubMed

Felden, Érico Pereira Gomes; Leite, Carina Raffs; Rebelatto, Cleber Fernando; Andrade, Rubian Diego; Beltrame, Thais Silva

2015-12-01

To analyze the sleep characteristics in adolescents from different socioeconomic levels. Original studies found in the Medline/PubMed and SciELO databases without language and period restrictions that analyzed associations between sleep variables and socioeconomic indicators. The initial search resulted in 99 articles. After reading the titles and abstracts and following inclusion and exclusion criteria, 12 articles with outcomes that included associations between sleep variables (disorders, duration, quality) and socioeconomic status (ethnicity, family income, and social status) were analyzed. The studies associating sleep with socioeconomic variables are recent, published mainly after the year 2000. Half of the selected studies were performed with young Americans, and only one with Brazilian adolescents. Regarding ethnic differences, the studies do not have uniform conclusions. The main associations found were between sleep variables and family income or parental educational level, showing a trend among poor, low social status adolescents to manifest low duration, poor quality of sleeping patterns. The study found an association between socioeconomic indicators and quality of sleep in adolescents. Low socioeconomic status reflects a worse subjective perception of sleep quality, shorter duration, and greater daytime sleepiness. Considering the influence of sleep on physical and cognitive development and on the learning capacity of young individuals, the literature on the subject is scarce. There is a need for further research on sleep in different realities of the Brazilian population. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Snacking Behaviors, Diet Quality, and BMI in a Community Sample of Working Adults

PubMed Central

Barnes, Timothy L.; French, Simone A.; Harnack, Lisa J.; Mitchell, Nathan R.; Wolfson, Julian

2015-01-01

Background Snacking behaviors have been linked with higher energy intake and excess weight. However results have been inconsistent. Moreover, few data are available on the extent to which snacking affects diet quality. Objective This study describes snacking behaviors, including total snacking energy, frequency, time of day, and percentage of snacking energy intake by food groups, and their associations with diet quality and BMI. Design Snacking behaviors and dietary intake were examined cross-sectionally among 233 adults participating in a community-based worksite nutrition intervention from September 2010–February 2013. Three telephone-administered 24-hour dietary recalls were collected (two weekday; one weekend day). Diet quality was characterized by the Healthy Eating Index (HEI)-2010 and BMI was computed using measured height and weight. Setting The setting was a large metropolitan medical complex in Minneapolis, Minnesota. Main outcome measures Outcome measures included diet quality and BMI. Statistical analyses General linear regression models were used to examine associations between each of the snacking behaviors as independent variables, and diet quality and BMI as dependent variables. Results Percent of snacking energy from fruit & juice (β=0.13, P=0.001) and nuts (β=0.16, P=0.008) were significantly positively associated with diet quality. Percent of snacking energy from desserts and sweets (β=−0.16, P<0.001) and sugar-sweetened beverages (β=−0.22, P=0.024) were significantly inversely associated. Percent of snacking energy from vegetables (β=−0.18, P=0.044) was significantly associated with lower BMI. Percent snacking energy from desserts and sweets was significantly associated with a higher BMI (β=0.04, P=0.017). Conclusions Snack food choices, but not total energy from snacks, frequency or time of day, were significantly associated with diet quality and BMI. PMID:25769747

Reporting quality of statistical methods in surgical observational studies: protocol for systematic review.

PubMed

Wu, Robert; Glen, Peter; Ramsay, Tim; Martel, Guillaume

2014-06-28

Observational studies dominate the surgical literature. Statistical adjustment is an important strategy to account for confounders in observational studies. Research has shown that published articles are often poor in statistical quality, which may jeopardize their conclusions. The Statistical Analyses and Methods in the Published Literature (SAMPL) guidelines have been published to help establish standards for statistical reporting.This study will seek to determine whether the quality of statistical adjustment and the reporting of these methods are adequate in surgical observational studies. We hypothesize that incomplete reporting will be found in all surgical observational studies, and that the quality and reporting of these methods will be of lower quality in surgical journals when compared with medical journals. Finally, this work will seek to identify predictors of high-quality reporting. This work will examine the top five general surgical and medical journals, based on a 5-year impact factor (2007-2012). All observational studies investigating an intervention related to an essential component area of general surgery (defined by the American Board of Surgery), with an exposure, outcome, and comparator, will be included in this systematic review. Essential elements related to statistical reporting and quality were extracted from the SAMPL guidelines and include domains such as intent of analysis, primary analysis, multiple comparisons, numbers and descriptive statistics, association and correlation analyses, linear regression, logistic regression, Cox proportional hazard analysis, analysis of variance, survival analysis, propensity analysis, and independent and correlated analyses. Each article will be scored as a proportion based on fulfilling criteria in relevant analyses used in the study. A logistic regression model will be built to identify variables associated with high-quality reporting. A comparison will be made between the scores of surgical observational studies published in medical versus surgical journals. Secondary outcomes will pertain to individual domains of analysis. Sensitivity analyses will be conducted. This study will explore the reporting and quality of statistical analyses in surgical observational studies published in the most referenced surgical and medical journals in 2013 and examine whether variables (including the type of journal) can predict high-quality reporting.

Quality assessment of osteoporosis clinical practice guidelines for physical activity and safe movement: an AGREE II appraisal.

PubMed

Armstrong, James Jacob; Rodrigues, Isabel Braganca; Wasiuta, Tom; MacDermid, Joy C

2016-01-01

Many osteoporosis clinical practice guidelines are published, and the extent to which physical activity and safe movement is addressed varies. To better inform clinical decision-making, a quality assessment and structured analysis of recommendations was undertaken. Guideline quality varied substantially, and improvement is necessary in physical activity and safe movement recommendations. The purpose of the present study is to survey available osteoporosis clinical practice guidelines (CPGs) containing physical activity and safe movement recommendations in order to assess the methodological quality with which they were developed. An analysis of the various physical activity and safe movement recommendations was conducted to determine variability between CPGs. An online literature search revealed 19 CPGs meeting our inclusion criteria. Three independent scorers evaluated CPG quality using the Appraisal of Guidelines for Research and Evaluation version II (AGREE II) instrument. Two separate individuals used a standard table to extract relevant recommendations. Intra-reviewer AGREE II score agreement ranged from fair to good (intra-class correlation coefficient (ICC) = 0.34 to 0.65). The quality of the 19 included CPGs was variable (AGREE sub-scores: 14 to 100%). CPGs scored higher in the "scope and purpose" and "clarity of presentation" domains. They scored the lowest in "applicability" and "editorial independence." Four CPGs were classified as high quality, ten average quality, and five low quality. Most CPGs recommended weight-bearing, muscle-strengthening, and resistance exercises. Information on exercise dosage, progression, and contraindications was often absent. Immobility and movements involving spinal flexion and/or torsion were discouraged. There were several high-quality CPGs; however, variability in quality and lack of specific parameters for implementation necessitates caution and critical examination by readers. CPG development groups should pay special attention to the clinical applicability of their CPGs as well as fully disclosing conflicts of interest. CPGs were in general an agreement regarding safe physical activity and safe movement recommendations. However, recommendations were often vague and the more specific recommendations were inconsistent between CPGs.

Does human resource management improve family planning service quality? Analysis from the Kenya Service Provision Assessment 2010.

PubMed

Thatte, Nandita; Choi, Yoonjoung

2015-04-01

Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be explored to better understand the relationship between HR management and FP service quality. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

A comparative analysis of health-related quality of life for residents of U.S. counties with and without coal mining.

PubMed

Zullig, Keith J; Hendryx, Michael

2010-01-01

We compared health-related quality of life (HRQOL) in mining and non-mining counties in and out of Appalachia using the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. Dependent variables included self-rated health, the number of poor physical and mental health days, the number of activity limitation days (in the last 30 days), and the Centers for Disease Control and Prevention Healthy Days Index. Independent variables included the presence of coal mining, Appalachian region residence, metropolitan status, primary care physician supply, and BRFSS behavioral (e.g., smoking, body mass index, and alcohol consumption) and demographic (e.g., age, gender, race, and income) variables. We compared dependent variables across a four-category variable: Appalachia (yes/ no) and coal mining (yes/no). We used SUDAAN Multilog and multiple linear regression models with post-hoc least-squares means to test for Appalachian coal-mining effects after adjusting for covariates. Residents of coal-mining counties inside and outside of Appalachia reported significantly fewer healthy days for both physical and mental health, and poorer self-rated health (p < 0.0005) when compared with referent U.S. non-coal-mining counties, but disparities were greatest for people residing in Appalachian coal-mining areas. Furthermore, results remained consistent in separate analyses by gender and age. Coal-mining areas are characterized by greater socioeconomic disadvantage, riskier health behaviors, and environmental degradation that are associated with reduced HRQOL.

Multihole Arc-Welding Orifice

NASA Technical Reports Server (NTRS)

Swaim, Benji D.

1989-01-01

Modified orifice for variable-polarity plasma-arc welding directs welding plume so it creates clean, even welds on both Inconel(R) and aluminum alloys. Includes eight holes to relieve back pressure in plasma. Quality of welds on ferrous and nonferrous alloys improved as result.

EPA ’s ECOLOGICAL MODELS FOR INTEGRATED WATERSHED MANAGEMENT

EPA Science Inventory

Aquatic ecological populations and communities are affected by the nature and quality of the water in which they live. Specific factors that affect instream biota include chemical variables, biotic interactions, energy source, flow regime, and habitat structure. As watershed mana...

Sensitivities of Internal Combustion Automotive Engines to Variations in Fuel Properties

DOT National Transportation Integrated Search

1982-02-01

An assessment of the sensitivity of the automotive gasoline and diesel engines to variations in fuel properties has been made. The variables studied include H/C ratio, distillation range, aromatic content, ignition quality as determined by the octane...

Implementation of Departmental Quality Strategies Is Positively Associated with Clinical Practice: Results of a Multicenter Study in 73 Hospitals in 7 European Countries

PubMed Central

2015-01-01

Background Given the amount of time and resources invested in implementing quality programs in hospitals, few studies have investigated their clinical impact and what strategies could be recommended to enhance its effectiveness. Objective To assess variations in clinical practice and explore associations with hospital- and department-level quality management systems. Design Multicenter, multilevel cross-sectional study. Setting and Participants Seventy-three acute care hospitals with 276 departments managing acute myocardial infarction, deliveries, hip fracture, and stroke in seven countries. Intervention None. Measures Predictor variables included 3 hospital- and 4 department-level quality measures. Six measures were collected through direct observation by an external surveyor and one was assessed through a questionnaire completed by hospital quality managers. Dependent variables included 24 clinical practice indicators based on case note reviews covering the 4 conditions (acute myocardial infarction, deliveries, hip fracture and stroke). A directed acyclic graph was used to encode relationships between predictors, outcomes, and covariates and to guide the choice of covariates to control for confounding. Results and Limitations Data were provided on 9021 clinical records by 276 departments in 73 hospitals. There were substantial variations in compliance with the 24 clinical practice indicators. Weak associations were observed between hospital quality systems and 4 of the 24 indicators, but on analyzing department-level quality systems, strong associations were observed for 8 of the 11 indicators for acute myocardial infarction and stroke. Clinical indicators supported by higher levels of evidence were more frequently associated with quality systems and activities. Conclusions There are significant gaps between recommended standards of care and clinical practice in a large sample of hospitals. Implementation of department-level quality strategies was significantly associated with good clinical practice. Further research should aim to develop clinically relevant quality standards for hospital departments, which appear to be more effective than generic hospital-wide quality systems. PMID:26588842

Implementation of Departmental Quality Strategies Is Positively Associated with Clinical Practice: Results of a Multicenter Study in 73 Hospitals in 7 European Countries.

PubMed

Sunol, Rosa; Wagner, Cordula; Arah, Onyebuchi A; Kristensen, Solvejg; Pfaff, Holger; Klazinga, Niek; Thompson, Caroline A; Wang, Aolin; DerSarkissian, Maral; Bartels, Paul; Michel, Philippe; Groene, Oliver

2015-01-01

Given the amount of time and resources invested in implementing quality programs in hospitals, few studies have investigated their clinical impact and what strategies could be recommended to enhance its effectiveness. To assess variations in clinical practice and explore associations with hospital- and department-level quality management systems. Multicenter, multilevel cross-sectional study. Seventy-three acute care hospitals with 276 departments managing acute myocardial infarction, deliveries, hip fracture, and stroke in seven countries. None. Predictor variables included 3 hospital- and 4 department-level quality measures. Six measures were collected through direct observation by an external surveyor and one was assessed through a questionnaire completed by hospital quality managers. Dependent variables included 24 clinical practice indicators based on case note reviews covering the 4 conditions (acute myocardial infarction, deliveries, hip fracture and stroke). A directed acyclic graph was used to encode relationships between predictors, outcomes, and covariates and to guide the choice of covariates to control for confounding. Data were provided on 9021 clinical records by 276 departments in 73 hospitals. There were substantial variations in compliance with the 24 clinical practice indicators. Weak associations were observed between hospital quality systems and 4 of the 24 indicators, but on analyzing department-level quality systems, strong associations were observed for 8 of the 11 indicators for acute myocardial infarction and stroke. Clinical indicators supported by higher levels of evidence were more frequently associated with quality systems and activities. There are significant gaps between recommended standards of care and clinical practice in a large sample of hospitals. Implementation of department-level quality strategies was significantly associated with good clinical practice. Further research should aim to develop clinically relevant quality standards for hospital departments, which appear to be more effective than generic hospital-wide quality systems.

Relating landscape characteristics to non-point source pollution in mine waste-located watersheds using geospatial techniques.

PubMed

Xiao, Huaguo; Ji, Wei

2007-01-01

Landscape characteristics of a watershed are important variables that influence surface water quality. Understanding the relationship between these variables and surface water quality is critical in predicting pollution potential and developing watershed management practices to eliminate or reduce pollution risk. To understand the impacts of landscape characteristics on water quality in mine waste-located watersheds, we conducted a case study in the Tri-State Mining District which is located in the conjunction of three states (Missouri, Kansas and Oklahoma). Severe heavy metal pollution exists in that area resulting from historical mining activities. We characterized land use/land cover over the last three decades by classifying historical multi-temporal Landsat imagery. Landscape metrics such as proportion, edge density and contagion were calculated based on the classified imagery. In-stream water quality data over three decades were collected, including lead, zinc, iron, cadmium, aluminum and conductivity which were used as key water quality indicators. Statistical analyses were performed to quantify the relationship between landscape metrics and surface water quality. Results showed that landscape characteristics in mine waste-located watersheds could account for as much as 77% of the variation of water quality indicators. A single landscape metric alone, such as proportion of mine waste area, could be used to predict surface water quality; but its predicting power is limited, usually accounting for less than 60% of the variance of water quality indicators.

Analysis of Student Satisfaction Toward Quality of Service Facility

NASA Astrophysics Data System (ADS)

Napitupulu, D.; Rahim, R.; Abdullah, D.; Setiawan, MI; Abdillah, LA; Ahmar, AS; Simarmata, J.; Hidayat, R.; Nurdiyanto, H.; Pranolo, A.

2018-01-01

The development of higher education is very rapid rise to the tight competition both public universities and private colleges. XYZ University realized to win the competition, required continuous quality improvement, including the quality of existing service facilities. Amenities quality services is believed to support the success of the learning activities and improve user satisfaction. This study aims to determine the extent to which the quality of the services effect on user satisfaction. The research method used is survey-based questionnaire that measure perception and expectation. The results showed a gap between perception and expectations of the respondents have a negative value for each item. This means XYZ service facility at the university is not currently meet the expectations of society members. Three service facility that has the lowest index is based on the perception of respondents is a laboratory (2.56), computer and multimedia (2.63) as well as wifi network (2.99). The magnitude of the correlation between satisfaction with the quality of service facilities is 0.725 which means a strong and positive relationship. The influence of the quality of service facilities to the satisfaction of the students is 0.525 meaning that the variable quality of the services facility can explain 52.5% of the variable satisfaction. The study provided recommendations for improvements to enhance the quality of services facility at the XYZ university facilities.

Applying probabilistic temporal and multisite data quality control methods to a public health mortality registry in Spain: a systematic approach to quality control of repositories.

PubMed

Sáez, Carlos; Zurriaga, Oscar; Pérez-Panadés, Jordi; Melchor, Inma; Robles, Montserrat; García-Gómez, Juan M

2016-11-01

To assess the variability in data distributions among data sources and over time through a case study of a large multisite repository as a systematic approach to data quality (DQ). Novel probabilistic DQ control methods based on information theory and geometry are applied to the Public Health Mortality Registry of the Region of Valencia, Spain, with 512 143 entries from 2000 to 2012, disaggregated into 24 health departments. The methods provide DQ metrics and exploratory visualizations for (1) assessing the variability among multiple sources and (2) monitoring and exploring changes with time. The methods are suited to big data and multitype, multivariate, and multimodal data. The repository was partitioned into 2 probabilistically separated temporal subgroups following a change in the Spanish National Death Certificate in 2009. Punctual temporal anomalies were noticed due to a punctual increment in the missing data, along with outlying and clustered health departments due to differences in populations or in practices. Changes in protocols, differences in populations, biased practices, or other systematic DQ problems affected data variability. Even if semantic and integration aspects are addressed in data sharing infrastructures, probabilistic variability may still be present. Solutions include fixing or excluding data and analyzing different sites or time periods separately. A systematic approach to assessing temporal and multisite variability is proposed. Multisite and temporal variability in data distributions affects DQ, hindering data reuse, and an assessment of such variability should be a part of systematic DQ procedures. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Stress, anger and Mediterranean diet as predictors of metabolic syndrome.

PubMed

Garcia-Silva, Jaqueline; Navarrete Navarrete, Nuria; Ruano Rodríguez, Ana; Peralta-Ramírez, María Isabel; Mediavilla García, Juan Diego; Caballo, Vicente E

2017-10-30

Metabolic syndrome (MetS) is a cluster of metabolic conditions that include abdominal obesity, reduction in cholesterol concentrations linked to high density lipoproteins (HLDc), elevated triglycerides, increased blood pressure and hyperglycaemia. Given that this is a multicausal disease, the aim of this study is to identify the psychological, emotional and lifestyle variables that can have an influence on the different MetS components. A cross-sectional study with 103 patients with diagnostic criteria for MetS (47 male and 56 female). Anthropometric, clinical and analytical measurements were collected to assess the variables associated with MetS. The main psychological and emotional variables were also assessed. Different multiple linear regression tests were performed to identify which variables were predictive of MetS. The dependent variables were body mass index (BMI), abdominal circumference, HDLc, and quality of life, and the predictive variables were psychological stress, anger and adherence to a Mediterranean diet. The results showed that psychological stress was a predictor of quality of life (β=-0.55, P≤0). Similarly, anger was a predictor of BMI (β=0.23, P=.047) and abdominal circumference (β=0.27, P=.021). As expected, adherence to a Mediterranean diet was a predictor of HDLc (β=0.2, P=.045) and of quality of life (β=-0.18, P=.031). The results confirm a link between adherence to certain dietary habits and lifestyle, however they go one step further and show the importance of psychological and emotional factors like psychological stress and anger in some MetS components. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Evaluation of variability and quality control procedures for a receptor-binding assay for paralytic shellfish poisoning toxins.

PubMed

Ruberu, S R; Langlois, G W; Masuda, M; Perera, S Kusum

2012-01-01

The receptor-binding assay (RBA) method for determining saxatoxin (STX) and its numerous analogues, which cause paralytic shellfish poisoning (PSP) in humans, was evaluated in a single laboratory study. Each step of the assay preparation procedure including the performance of the multi-detector TopCount® instrument was evaluated for its contribution to method variability. The overall inherent RBA variability was determined to be 17%. Variability within the 12 detectors was observed; however, there was no reproducible pattern in detector performance. This observed variability among detectors could be attributed to other factors, such as pipetting errors. In an attempt to reduce the number of plates rejected due to excessive variability in the method's quality control parameters, a statistical approach was evaluated using either Grubbs' test or the Student's t-test for rejecting outliers in the measurement of triplicate wells. This approach improved the ratio of accepted versus rejected plates, saving cost and time for rerunning the assay. However, the potential reduction in accuracy and the lack of improvement in precision suggests caution when using this approach. The current study has recommended an alternate quality control procedure for accepting or rejecting plates in place of the criteria currently used in the published assay, or the alternative of outlier testing. The recommended procedure involves the development of control charts to monitor the critical parameters identified in the published method (QC sample, EC₅₀, slope of calibration curve), with the addition of a fourth critical parameter which is the top value (100% binding) of the calibration curve.

Trends in selected water-quality characteristics, Flathead River at Flathead, British Columbia, and at Columbia Falls, Montana, water years, 1975-86

USGS Publications Warehouse

Cary, L.E.

1989-01-01

Data for selected water quality variables were evaluated for trends at two sampling stations--Flathead River at Flathead, British Columbia (Flathead station) and Flathead River at Columbia Falls, Montana (Columbia Falls station). The results were compared between stations. The analyses included data from water years 1975-86 at the Flathead station and water years 1979-86 at the Columbia Falls station. The seasonal Kendall test was applied to adjusted concentrations for variables related to discharge and to unadjusted concentrations for the remaining variables. Slope estimates were made for variables with significant trends unless data were reported as less than the detection limit. At the Flathead station, concentrations of dissolved solids, calcium, magnesium, sodium, dissolved nitrite plus nitrate nitrogen, ammonia nitrogen (total and dissolved), total organic nitrogen, and total phosphorus increased during the study period. Concentrations of total nitrite plus nitrate nitrogen and dissolved iron decreased during the same period. At the Columbia Falls station, concentrations increased for calcium and magnesium and decreased for sulfate and dissolved phosphorus. No trends were detected for 10 other variables tested at each station. Data for the Flathead station were reanalyzed for water years 1979-86. Trends in the data increased for magnesium and dissolved nitrite plus nitrate nitrogen and decreased for dissolved iron. Magnesium was the only variable that displayed a trend (increasing) at both stations. The increasing trends that were detected probably will not adversely affect the water quality of the Flathead River in the near future. (USGS)

Determination of the optimal training principle and input variables in artificial neural network model for the biweekly chlorophyll-a prediction: a case study of the Yuqiao Reservoir, China.

PubMed

Liu, Yu; Xi, Du-Gang; Li, Zhao-Liang

2015-01-01

Predicting the levels of chlorophyll-a (Chl-a) is a vital component of water quality management, which ensures that urban drinking water is safe from harmful algal blooms. This study developed a model to predict Chl-a levels in the Yuqiao Reservoir (Tianjin, China) biweekly using water quality and meteorological data from 1999-2012. First, six artificial neural networks (ANNs) and two non-ANN methods (principal component analysis and the support vector regression model) were compared to determine the appropriate training principle. Subsequently, three predictors with different input variables were developed to examine the feasibility of incorporating meteorological factors into Chl-a prediction, which usually only uses water quality data. Finally, a sensitivity analysis was performed to examine how the Chl-a predictor reacts to changes in input variables. The results were as follows: first, ANN is a powerful predictive alternative to the traditional modeling techniques used for Chl-a prediction. The back program (BP) model yields slightly better results than all other ANNs, with the normalized mean square error (NMSE), the correlation coefficient (Corr), and the Nash-Sutcliffe coefficient of efficiency (NSE) at 0.003 mg/l, 0.880 and 0.754, respectively, in the testing period. Second, the incorporation of meteorological data greatly improved Chl-a prediction compared to models solely using water quality factors or meteorological data; the correlation coefficient increased from 0.574-0.686 to 0.880 when meteorological data were included. Finally, the Chl-a predictor is more sensitive to air pressure and pH compared to other water quality and meteorological variables.

Impact of ozone observations on the structure of a tropical cyclone using coupled atmosphere-chemistry data assimilation

NASA Astrophysics Data System (ADS)

Lim, S.; Park, S. K.; Zupanski, M.

2015-04-01

Since the air quality forecast is related to both chemistry and meteorology, the coupled atmosphere-chemistry data assimilation (DA) system is essential to air quality forecasting. Ozone (O3) plays an important role in chemical reactions and is usually assimilated in chemical DA. In tropical cyclones (TCs), O3 usually shows a lower concentration inside the eyewall and an elevated concentration around the eye, impacting atmospheric as well as chemical variables. To identify the impact of O3 observations on TC structure, including atmospheric and chemical information, we employed the Weather Research and Forecasting model coupled with Chemistry (WRF-Chem) with an ensemble-based DA algorithm - the maximum likelihood ensemble filter (MLEF). For a TC case that occurred over the East Asia, our results indicate that the ensemble forecast is reasonable, accompanied with larger background state uncertainty over the TC, and also over eastern China. Similarly, the assimilation of O3 observations impacts atmospheric and chemical variables near the TC and over eastern China. The strongest impact on air quality in the lower troposphere was over China, likely due to the pollution advection. In the vicinity of the TC, however, the strongest impact on chemical variables adjustment was at higher levels. The impact on atmospheric variables was similar in both over China and near the TC. The analysis results are validated using several measures that include the cost function, root-mean-squared error with respect to observations, and degrees of freedom for signal (DFS). All measures indicate a positive impact of DA on the analysis - the cost function and root mean square error have decreased by 16.9 and 8.87%, respectively. In particular, the DFS indicates a strong positive impact of observations in the TC area, with a weaker maximum over northeast China.

Methodological requirements for valid tissue-based biomarker studies that can be used in clinical practice.

PubMed

True, Lawrence D

2014-03-01

Paralleling the growth of ever more cost efficient methods to sequence the whole genome in minute fragments of tissue has been the identification of increasingly numerous molecular abnormalities in cancers--mutations, amplifications, insertions and deletions of genes, and patterns of differential gene expression, i.e., overexpression of growth factors and underexpression of tumor suppressor genes. These abnormalities can be translated into assays to be used in clinical decision making. In general terms, the result of such an assay is subject to a large number of variables regarding the characteristics of the available sample, particularities of the used assay, and the interpretation of the results. This review discusses the effects of these variables on assays of tissue-based biomarkers, classified by macromolecule--DNA, RNA (including micro RNA, messenger RNA, long noncoding RNA, protein, and phosphoprotein). Since the majority of clinically applicable biomarkers are immunohistochemically detectable proteins this review focuses on protein biomarkers. However, the principles outlined are mostly applicable to any other analyte. A variety of preanalytical variables impacts on the results obtained, including analyte stability (which is different for different analytes, i.e., DNA, RNA, or protein), period of warm and of cold ischemia, fixation time, tissue processing, sample storage time, and storage conditions. In addition, assay variables play an important role, including reagent specificity (notably but not uniquely an issue concerning antibodies used in immunohistochemistry), technical components of the assay, quantitation, and assay interpretation. Finally, appropriateness of an assay for clinical application is an important issue. Reference is made to publicly available guidelines to improve on biomarker development in general and requirements for clinical use in particular. Strategic goals are formulated in order to improve on the quality of biomarker reporting, including issues of analyte quality, experimental detail, assay efficiency and precision, and assay appropriateness.

Analysis of Within-Test Variability of Non-Destructive Test Methods to Evaluate Compressive Strength of Normal Vibrated and Self-Compacting Concretes

NASA Astrophysics Data System (ADS)

Nepomuceno, Miguel C. S.; Lopes, Sérgio M. R.

2017-10-01

Non-destructive tests (NDT) have been used in the last decades for the assessment of in-situ quality and integrity of concrete elements. An important step in the application of NDT methods concerns to the interpretation and validation of the test results. In general, interpretation of NDT results should involve three distinct phases leading to the development of conclusions: processing of collected data, analysis of within-test variability and quantitative evaluation of property under investigation. The analysis of within-test variability can provide valuable information, since this can be compared with that of within-test variability associated with the NDT method in use, either to provide a measure of the quality control or to detect the presence of abnormal circumstances during the in-situ application. This paper reports the analysis of the experimental results of within-test variability of NDT obtained for normal vibrated concrete and self-compacting concrete. The NDT reported includes the surface hardness test, ultrasonic pulse velocity test, penetration resistance test, pull-off test, pull-out test and maturity test. The obtained results are discussed and conclusions are presented.

Assessment of reservoir system variable forecasts

NASA Astrophysics Data System (ADS)

Kistenmacher, Martin; Georgakakos, Aris P.

2015-05-01

Forecast ensembles are a convenient means to model water resources uncertainties and to inform planning and management processes. For multipurpose reservoir systems, forecast types include (i) forecasts of upcoming inflows and (ii) forecasts of system variables and outputs such as reservoir levels, releases, flood damage risks, hydropower production, water supply withdrawals, water quality conditions, navigation opportunities, and environmental flows, among others. Forecasts of system variables and outputs are conditional on forecasted inflows as well as on specific management policies and can provide useful information for decision-making processes. Unlike inflow forecasts (in ensemble or other forms), which have been the subject of many previous studies, reservoir system variable and output forecasts are not formally assessed in water resources management theory or practice. This article addresses this gap and develops methods to rectify potential reservoir system forecast inconsistencies and improve the quality of management-relevant information provided to stakeholders and managers. The overarching conclusion is that system variable and output forecast consistency is critical for robust reservoir management and needs to be routinely assessed for any management model used to inform planning and management processes. The above are demonstrated through an application from the Sacramento-American-San Joaquin reservoir system in northern California.

An open-source software package for multivariate modeling and clustering: applications to air quality management.

PubMed

Wang, Xiuquan; Huang, Guohe; Zhao, Shan; Guo, Junhong

2015-09-01

This paper presents an open-source software package, rSCA, which is developed based upon a stepwise cluster analysis method and serves as a statistical tool for modeling the relationships between multiple dependent and independent variables. The rSCA package is efficient in dealing with both continuous and discrete variables, as well as nonlinear relationships between the variables. It divides the sample sets of dependent variables into different subsets (or subclusters) through a series of cutting and merging operations based upon the theory of multivariate analysis of variance (MANOVA). The modeling results are given by a cluster tree, which includes both intermediate and leaf subclusters as well as the flow paths from the root of the tree to each leaf subcluster specified by a series of cutting and merging actions. The rSCA package is a handy and easy-to-use tool and is freely available at http://cran.r-project.org/package=rSCA . By applying the developed package to air quality management in an urban environment, we demonstrate its effectiveness in dealing with the complicated relationships among multiple variables in real-world problems.

Effect of aquifer storage and recovery (ASR) on recovered stormwater quality variability.

PubMed

Page, D W; Peeters, L; Vanderzalm, J; Barry, K; Gonzalez, D

2017-06-15

Aquifer Storage and Recovery (ASR) is increasingly being considered as a means of reusing urban stormwater to supplement available urban water resources. Storage of stormwater in an aquifer has been shown to affect water quality but it has also been claimed that storage will also decrease the stormwater quality variability making for improved predictability and management. This study is the first to document the changes in stormwater quality variability as a result of subsurface storage at four full scale ASR sites using advanced statistical techniques. New methods to examine water quality are required as data is often highly left censored and so traditional measures of variability such as the coefficient of variation are inappropriate. It was observed that for some water quality parameters (most notably E. coli) there was a marked improvement of water quality and a significant decrease in variability at all sites. This means that aquifer storage prior to engineered treatment systems may be advantageous in terms of system design to avoid over engineering. For other parameters such as metal(loids)s and nutrients the trend was less clear due to the numerous processes occurring during storage leading to an increase in variability, especially for geogenic metals and metalloids such as iron and arsenic. Depending upon the specific water quality parameters and end use, use of ASR may not have a dampening effect on stormwater quality variability. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Developing Evidence & Gathering Data about Teacher Education Program Quality

ERIC Educational Resources Information Center

American Association of State Colleges and Universities, 2007

2007-01-01

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

Evaluating the quality of Internet information for femoroacetabular impingement.

PubMed

Lee, Simon; Shin, Jason J; Haro, Marc S; Song, Sang H; Nho, Shane J

2014-10-01

The Internet has become a ubiquitous source of medical information for both the patient and the physician. However, the quality of this information is highly variable. We evaluated the quality of Internet information available for femoroacetabular impingement (FAI). Four popular search engines were used to collect 100 Web sites containing information on FAI. Web sites were evaluated based on authorship, various content criteria, and the presence of Health On the Net Code of Conduct (HONcode) certification. By use of a novel evaluation system for quality, Web sites were also classified as excellent, high, moderate, poor, or inadequate and were subsequently analyzed. Web sites were evaluated as a group, followed by authorship type, by HONcode certification, and by quality level. Of the Web sites, 73 offered the ability to contact the author, 91 offered a considerable explanation of FAI, 54 provided surgical treatment options, 58 offered nonsurgical treatment options, 27 discussed possible complications, 11 discussed eligibility criteria, 31 discussed rehabilitation, 67 discussed a differential diagnosis, and 48 included peer-reviewed citations. We categorized 40 Web sites as academic, 33 as private, 9 as industry, 9 as public education, and 9 as blogs. Our novel quality evaluation system classified 16 Web sites as excellent, 18 as high, 17 as moderate, 18 as poor, and 31 as inadequate. Only 8% of all evaluated Web sites contained HONcode certification. We found that the quality of information available on the Internet about FAI was dramatically variable. A significantly large proportion of Web sites were from academic sources, but this did not necessarily indicate higher quality. Sites with HONcode certification showed as much variability in quality as noncertified sites. This study increases clinician competence in the available Internet information about FAI and helps them to confidently guide patients to formulate appropriate medical decisions based on high-quality information. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Development of an electronic database for Acute Pain Service outcomes

PubMed Central

Love, Brandy L; Jensen, Louise A; Schopflocher, Donald; Tsui, Ban CH

2012-01-01

BACKGROUND: Quality assurance is increasingly important in the current health care climate. An electronic database can be used for tracking patient information and as a research tool to provide quality assurance for patient care. OBJECTIVE: An electronic database was developed for the Acute Pain Service, University of Alberta Hospital (Edmonton, Alberta) to record patient characteristics, identify at-risk populations, compare treatment efficacies and guide practice decisions. METHOD: Steps in the database development involved identifying the goals for use, relevant variables to include, and a plan for data collection, entry and analysis. Protocols were also created for data cleaning quality control. The database was evaluated with a pilot test using existing data to assess data collection burden, accuracy and functionality of the database. RESULTS: A literature review resulted in an evidence-based list of demographic, clinical and pain management outcome variables to include. Time to assess patients and collect the data was 20 min to 30 min per patient. Limitations were primarily software related, although initial data collection completion was only 65% and accuracy of data entry was 96%. CONCLUSIONS: The electronic database was found to be relevant and functional for the identified goals of data storage and research. PMID:22518364

Use of NEXRAD radar-based observations for quality control of in-situ rain gauge measurements

NASA Astrophysics Data System (ADS)

Nelson, B. R.; Prat, O.; Leeper, R.

2017-12-01

Rain gauge quality control is an often over looked important step in the archive of historical precipitation estimates. We investigate the possibilities that exist for using ground based radar networks for quality control of rain gauge measurements. This process includes the point to pixel comparisons of the rain gauge measurements with NEXRAD observations. There are two NEXRAD based data sets used for reference; the NCEP stage IV and the NWS MRMS gridded data sets. The NCEP stage IV data set is available at 4km hourly for the period 2002-present and includes the radar-gauge bias adjusted precipitation estimate. The NWS MRMS data set includes several different variables such as reflectivity, radar-only estimates, precipitation flag, and radar-gauge bias adjusted precipitation estimates. The latter product provides for much more information to apply quality control such as identification of precipitation type, identification of storm type and Z-R relation. In addition, some of the variables are available at 5-minute scale. The rain gauge networks that are investigated are the Climate Reference Network (CRN), the Fischer-Porter Hourly Precipitation Database (HPD), and the Hydrometeorological Automated Data System (HADS). The CRN network is available at the 5-minute scale, the HPD network is available at the 15-minute and hourly scale, and HADS is available at the hourly scale. The varying scales present challenges for comparisons. However given the higher resolution radar-based products we identify an optimal combination of rain gauge observations that can be compared to the radar-based information. The quality control process focuses on identifying faulty gauges in direct comparison while a deeper investigation focuses on event-based differences from light rain to extreme storms.

A church-based diet and physical activity intervention for rural, lower Mississippi Delta African American adults: Delta Body and Soul effectiveness study, 2010-2011.

PubMed

Tussing-Humphreys, Lisa; Thomson, Jessica L; Mayo, Tanyatta; Edmond, Emanuel

2013-06-06

Obesity, diabetes, and hypertension have reached epidemic levels in the largely rural Lower Mississippi Delta (LMD) region. We assessed the effectiveness of a 6-month, church-based diet and physical activity intervention, conducted during 2010 through 2011, for improving diet quality (measured by the Healthy Eating Index-2005) and increasing physical activity of African American adults in the LMD region. We used a quasi-experimental design in which 8 self-selected eligible churches were assigned to intervention or control. Assessments included dietary, physical activity, anthropometric, and clinical measures. Statistical tests for group comparisons included χ(2), Fisher's exact, and McNemar's tests for categorical variables, and mixed-model regression analysis for continuous variables and modeling intervention effects. Retention rates were 85% (176 of 208) for control and 84% (163 of 195) for intervention churches. Diet quality components, including total fruit, total vegetables, and total quality improved significantly in both control (mean [standard deviation], 0.3 [1.8], 0.2 [1.1], and 3.4 [9.6], respectively) and intervention (0.6 [1.7], 0.3 [1.2], and 3.2 [9.7], respectively) groups, while significant increases in aerobic (22%) and strength/flexibility (24%) physical activity indicators were apparent in the intervention group only. Regression analysis indicated that intervention participation level and vehicle ownership were significant positive predictors of change for several diet quality components. This church-based diet and physical activity intervention may be effective in improving diet quality and increasing physical activity of LMD African American adults. Components key to the success of such programs are participant engagement in educational sessions and vehicle access.

What is the effectiveness of obesity related interventions at retail grocery stores and supermarkets? -a systematic review.

PubMed

Adam, Abdulfatah; Jensen, Jørgen D

2016-12-28

The Prevalence of obesity and overweight has been increasing in many countries. Many factors have been identified as contributing to obesity including the food environment, especially the access, availability and affordability of healthy foods in grocery stores and supermarkets. Several interventions have been carried out in retail grocery/supermarket settings as part of an effort to understand and influence consumption of healthful foods. The review's key outcome variable is sale/purchase of healthy foods as a result of the interventions. This systematic review sheds light on the effectiveness of food store interventions intended to promote the consumption of healthy foods and the methodological quality of studies reporting them. Systematic literature search spanning from 2003 to 2015 (inclusive both years), and confined to papers in the English language was conducted. Studies fulfilling search criteria were identified and critically appraised. Studies included in this review report health interventions at physical food stores including supermarkets and corner stores, and with outcome variable of adopting healthier food purchasing/consumption behavior. The methodological quality of all included articles has been determined using a validated 16-item quality assessment tool (QATSDD). The literature search identified 1580 publications, of which 42 met the inclusion criteria. Most interventions used a combination of information (e.g. awareness raising through food labeling, promotions, campaigns, etc.) and increasing availability of healthy foods such as fruits and vegetables. Few used price interventions. The average quality score for all papers is 65.0%, or an overall medium methodological quality. Apart from few studies, most studies reported that store interventions were effective in promoting purchase of healthy foods. Given the diverse study settings and despite the challenges of methodological quality for some papers, we find efficacy of in-store healthy food interventions in terms of increased purchase of healthy foods. Researchers need to take risk of bias and methodological quality into account when designing future studies that should guide policy makers. Interventions which combine price, information and easy access to and availability of healthy foods with interactive and engaging nutrition information, if carefully designed can help customers of food stores to buy and consume more healthy foods.

[Probabilistic models of mortality for patients hospitalized in conventional units].

PubMed

Rué, M; Roqué, M; Solà, J; Macià, M

2001-09-29

We have developed a tool to measure disease severity of patients hospitalized in conventional units in order to evaluate and compare the effectiveness and quality of health care in our setting. A total of 2,274 adult patients admitted consecutively to inpatient units from the Medicine, Surgery and Orthopaedic Surgery, and Trauma Departments of the Corporació Sanitària Parc Taulí of Sabadell, Spain, between November 1, 1997 and September 30, 1998 were included. The following variables were collected: demographic data, previous health state, substance abuse, comorbidity prior to admission, characteristics of the admission, clinical parameters within the first 24 hours of admission, laboratory results and data from the Basic Minimum Data Set of hospital discharges. Multiple logistic regression analysis was used to develop mortality probability models during the hospital stay. The mortality probability model at admission (MPMHOS-0) contained 7 variables associated with mortality during hospital stay: age, urgent admission, chronic cardiac insufficiency, chronic respiratory insufficiency, chronic liver disease, neoplasm, and dementia syndrome. The mortality probability model at 24-48 hours from admission (MPMHOS-24) contained 9 variables: those included in the MPMHOS-0 plus two statistically significant laboratory variables: hemoglobin and creatinine. Severity measures, in particular those presented in this study, can be helpful for the interpretation of hospital mortality rates and can guide mortality or quality committees at the time of investigating health care-related problems.

[Development and application of a multi-species water quality model for water distribution systems with EPANET-MSX].

PubMed

Sun, Fu; Chen, Ji-ning; Zeng, Si-yu

2008-12-01

A conceptual multi-species water quality model for water distribution systems was developed on the basis of the toolkit of the EPANET-MSX software. The model divided the pipe segment into four compartments including pipe wall, biofilm, boundary layer and bulk liquid. The involved processes were substrate utilization and microbial growth, decay and inactivation of microorganisms, mass transfer of soluble components through the boundary layer, adsorption and desorption of particular components between bulk liquid and biofilm, oxidation and halogenation of organic matter by residual chlorine, and chlorine consumption by pipe wall. The fifteen simulated variables included the seven common variables both in the biofilm and in the bulk liquid, i.e. soluble organic matter, particular organic matter, ammonia nitrogen, residual chlorine, heterotrophic bacteria, autotrophic bacteria and inert solids, as well as biofilm thickness on the pipe wall. The model was validated against the data from a series of pilot experiments, and the simulation accuracy for residual chlorine and turbidity were 0.1 mg/L and 0.3 NTU respectively. A case study showed that the model could reasonably reflect the dynamic variation of residual chlorine and turbidity in the studied water distribution system, while Monte Carlo simulation, taking into account both the variability of finished water from the waterworks and the uncertainties of model parameters, could be performed to assess the violation risk of water quality in the water distribution system.

China’s Air Quality and Respiratory Disease Mortality Based on the Spatial Panel Model

PubMed Central

Cao, Qilong; Liang, Ying; Niu, Xueting

2017-01-01

Background: Air pollution has become an important factor restricting China’s economic development and has subsequently brought a series of social problems, including the impact of air pollution on the health of residents, which is a topical issue in China. Methods: Taking into account this spatial imbalance, the paper is based on the spatial panel data model PM2.5. Respiratory disease mortality in 31 Chinese provinces from 2004 to 2008 is taken as the main variable to study the spatial effect and impact of air quality and respiratory disease mortality on a large scale. Results: It was found that there is a spatial correlation between the mortality of respiratory diseases in Chinese provinces. The spatial correlation can be explained by the spatial effect of PM2.5 pollutions in the control of other variables. Conclusions: Compared with the traditional non-spatial model, the spatial model is better for describing the spatial relationship between variables, ensuring the conclusions are scientific and can measure the spatial effect between variables. PMID:28927016

A quantitative study of factors influencing quality of life in rural Mexican women diagnosed with HIV.

PubMed

Holtz, Carol; Sowell, Richard; VanBrackle, Lewis; Velasquez, Gabriela; Hernandez-Alonso, Virginia

2014-01-01

This quantitative study explored the level of Quality of Life (QoL) in indigenous Mexican women and identified psychosocial factors that significantly influenced their QoL, using face-to-face interviews with 101 women accessing care in an HIV clinic in Oaxaca, Mexico. Variables included demographic characteristics, levels of depression, coping style, family functioning, HIV-related beliefs, and QoL. Descriptive statistics were used to analyze participant characteristics, and women's scores on data collection instruments. Pearson's R correlational statistics were used to determine the level of significance between study variables. Multiple regression analysis examined all variables that were significantly related to QoL. Pearson's correlational analysis of relationships between Spirituality, Educating Self about HIV, Family Functioning, Emotional Support, Physical Care, and Staying Positive demonstrated positive correlation to QoL. Stigma, depression, and avoidance coping were significantly and negatively associated with QoL. The final regression model indicated that depression and avoidance coping were the best predictor variables for QoL. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Shoulder Pain, Functional Status, and Health-Related Quality of Life after Head and Neck Cancer Surgery

PubMed Central

Wang, Hsiao-Lan; Keck, Juanita F.; Weaver, Michael T.; Mikesky, Alan; Bunnell, Karen; Buelow, Janice M.; Rawl, Susan M.

2013-01-01

Head and neck cancer (HNC) patients experience treatment-related complications that may interfere with health-related quality of life (HRQOL). The purpose of this study was to describe the symptom experience (shoulder pain) and functional status factors that are related to global and domain-specific HRQOL at one month after HNC surgery. In this exploratory study, we examined 29 patients. The outcome variables included global HRQOL as well as physical, functional, emotional, and social well-being. Symptom experience and functional status factors were the independent variables. In the symptom experience variables, shoulder pain distress was negatively associated with physical well-being (R 2 = 0.24). Among the functional status variables, eating impairment was negatively related to global HRQOL (R 2 = 0.18) and physical well-being (R 2 = 0.21). Speaking impairment and impaired body image explained a large amount of the variance in functional well-being (R 2 = 0.45). This study provided initial results regarding symptom experience and functional status factors related to poor HRQOL in the early postoperative period for HNC patients. PMID:24455274

Occupational Electromagnetic Field Exposures Associated with Sleep Quality: A Cross-Sectional Study

PubMed Central

Liu, Hui; Chen, Guangdi; Pan, Yifeng; Chen, Zexin; Jin, Wen; Sun, Chuan; Chen, Chunjing; Dong, Xuanjun; Chen, Kun; Xu, Zhengping; Zhang, Shanchun; Yu, Yunxian

2014-01-01

Background Exposure to electromagnetic field (EMF) emitted by mobile phone and other machineries concerns half the world’s population and raises the problem of their impact on human health. The present study aims to explore the effects of electromagnetic field exposures on sleep quality and sleep duration among workers from electric power plant. Methods A cross-sectional study was conducted in an electric power plant of Zhejiang Province, China. A total of 854 participants were included in the final analysis. The detailed information of participants was obtained by trained investigators using a structured questionnaire, which including socio-demographic characteristics, lifestyle variables, sleep variables and electromagnetic exposures. Physical examination and venous blood collection were also carried out for every study subject. Results After grouping daily occupational electromagnetic exposure into three categories, subjects with long daily exposure time had a significantly higher risk of poor sleep quality in comparison to those with short daily exposure time. The adjusted odds ratios were 1.68 (95%CI: 1.18, 2.39) and 1.57 (95%CI: 1.10, 2.24) across tertiles. Additionally, among the subjects with long-term occupational exposure, the longer daily occupational exposure time apparently increased the risk of poor sleep quality (OR (95%CI): 2.12 (1.23∼3.66) in the second tertile; 1.83 (1.07∼3.15) in the third tertile). There was no significant association of long-term occupational exposure duration, monthly electric fee or years of mobile-phone use with sleep quality or sleep duration. Conclusions The findings showed that daily occupational EMF exposure was positively associated with poor sleep quality. It implies EMF exposure may damage human sleep quality rather than sleep duration. PMID:25340654

Explaining variation in tropical plant community composition: influence of environmental and spatial data quality.

PubMed

Jones, Mirkka M; Tuomisto, Hanna; Borcard, Daniel; Legendre, Pierre; Clark, David B; Olivas, Paulo C

2008-03-01

The degree to which variation in plant community composition (beta-diversity) is predictable from environmental variation, relative to other spatial processes, is of considerable current interest. We addressed this question in Costa Rican rain forest pteridophytes (1,045 plots, 127 species). We also tested the effect of data quality on the results, which has largely been overlooked in earlier studies. To do so, we compared two alternative spatial models [polynomial vs. principal coordinates of neighbour matrices (PCNM)] and ten alternative environmental models (all available environmental variables vs. four subsets, and including their polynomials vs. not). Of the environmental data types, soil chemistry contributed most to explaining pteridophyte community variation, followed in decreasing order of contribution by topography, soil type and forest structure. Environmentally explained variation increased moderately when polynomials of the environmental variables were included. Spatially explained variation increased substantially when the multi-scale PCNM spatial model was used instead of the traditional, broad-scale polynomial spatial model. The best model combination (PCNM spatial model and full environmental model including polynomials) explained 32% of pteridophyte community variation, after correcting for the number of sampling sites and explanatory variables. Overall evidence for environmental control of beta-diversity was strong, and the main floristic gradients detected were correlated with environmental variation at all scales encompassed by the study (c. 100-2,000 m). Depending on model choice, however, total explained variation differed more than fourfold, and the apparent relative importance of space and environment could be reversed. Therefore, we advocate a broader recognition of the impacts that data quality has on analysis results. A general understanding of the relative contributions of spatial and environmental processes to species distributions and beta-diversity requires that methodological artefacts are separated from real ecological differences.

Overview of Systematic Reviews: Yoga as a Therapeutic Intervention for Adults with Acute and Chronic Health Conditions

PubMed Central

McCall, Marcy C.; Ward, Alison; Roberts, Nia W.; Heneghan, Carl

2013-01-01

Objectives. Overview the quality, direction, and characteristics of yoga interventions for treatment of acute and chronic health conditions in adult populations. Methods. We searched for systematic reviews in 10 online databases, bibliographic references, and hand-searches in yoga-related journals. Included reviews satisfy Oxman criteria and specify yoga as a primary intervention in one or more randomized controlled trials for treatment in adults. The AMSTAR tool and GRADE approach evaluated the methodological quality of reviews and quality of evidence. Results. We identified 2202 titles, of which 41 full-text articles were assessed for eligibility and 26 systematic reviews satisfied inclusion criteria. Thirteen systematic reviews include quantitative data and six papers include meta-analysis. The quality of evidence is generally low. Sixteen different types of health conditions are included. Eleven reviews show tendency towards positive effects of yoga intervention, 15 reviews report unclear results, and no, reviews report adverse effects of yoga. Yoga appears most effective for reducing symptoms in anxiety, depression, and pain. Conclusion. Although the quality of systematic reviews is high, the quality of supporting evidence is low. Significant heterogeneity and variability in reporting interventions by type of yoga, settings, and population characteristics limit the generalizability of results. PMID:23762174

Patient Experience Shows Little Relationship with Hospital Quality Management Strategies

PubMed Central

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

2015-01-01

Objectives Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. Materials and Methods We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. Results Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute myocardial infarction n = 1,379, hip fracture n = 1,503, deliveries n = 2,088, stroke n = 1,566). Patients admitted for hip fracture and stroke had the lowest scores across the four patient-reported experience measures throughout. Patients admitted after acute myocardial infarction reported highest scores on patient experience and hospital recommendation; women after delivery reported highest scores for patient involvement and health care transition. We found no substantial associations between hospital-wide quality management strategies, patient involvement in quality management, or patient-centered care strategies with any of the patient-reported experience measures. Conclusion This is the largest study so far to assess the complex relationship between quality management strategies and patient experience with care. Our findings suggest absence of and wide variations in the institutionalization of strategies to engage patients in quality management, or implement strategies to improve patient-centeredness of care. Seemingly counterintuitive inverse associations could be capturing a scenario where hospitals with poorer quality management were beginning to improve their patient experience. The former suggests that patient-centered care is not yet sufficiently integrated in quality management, while the latter warrants a nuanced assessment of the motivation and impact of involving patients in the design and assessment of services. PMID:26151864

Patient Experience Shows Little Relationship with Hospital Quality Management Strategies.

PubMed

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

2015-01-01

Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute myocardial infarction n = 1,379, hip fracture n = 1,503, deliveries n = 2,088, stroke n = 1,566). Patients admitted for hip fracture and stroke had the lowest scores across the four patient-reported experience measures throughout. Patients admitted after acute myocardial infarction reported highest scores on patient experience and hospital recommendation; women after delivery reported highest scores for patient involvement and health care transition. We found no substantial associations between hospital-wide quality management strategies, patient involvement in quality management, or patient-centered care strategies with any of the patient-reported experience measures. This is the largest study so far to assess the complex relationship between quality management strategies and patient experience with care. Our findings suggest absence of and wide variations in the institutionalization of strategies to engage patients in quality management, or implement strategies to improve patient-centeredness of care. Seemingly counterintuitive inverse associations could be capturing a scenario where hospitals with poorer quality management were beginning to improve their patient experience. The former suggests that patient-centered care is not yet sufficiently integrated in quality management, while the latter warrants a nuanced assessment of the motivation and impact of involving patients in the design and assessment of services.

Systematic review of tonsil surgery quality registers and introduction of the Nordic Tonsil Surgery Register Collaboration.

PubMed

Ruohoalho, Johanna; Østvoll, Eirik; Bratt, Mette; Bugten, Vegard; Bäck, Leif; Mäkitie, Antti; Ovesen, Therese; Stalfors, Joacim

2018-06-01

Surgical quality registers provide tools to measure and improve the outcome of surgery. International register collaboration creates an opportunity to assess and critically evaluate national practices, and increases the size of available datasets. Even though millions of yearly tonsillectomies and tonsillotomies are performed worldwide, clinical practices are variable and inconsistency of evidence regarding the best clinical practice exists. The need for quality improvement actions is evident. We aimed to systematically investigate the existing tonsil surgery quality registers found in the literature, and to provide a thorough presentation of the planned Nordic Tonsil Surgery Register Collaboration. A systematic literature search of MEDLINE and EMBASE databases (from January 1990 to December 2016) was conducted to identify registers, databases, quality improvement programs or comprehensive audit programs addressing tonsil surgery. We identified two active registers and three completed audit programs focusing on tonsil surgery quality registration. Recorded variables were fairly similar, but considerable variation in coverage, number of operations included and length of time period for inclusion was discovered. Considering tonsillectomies and tonsillotomies being among the most commonly performed surgical procedures in otorhinolaryngology, it is surprising that only two active registers could be identified. We present a Nordic Tonsil Surgery Register Collaboration-an international tonsil surgery quality register project aiming to provide accurate benchmarks and enhance the quality of tonsil surgery in Denmark, Finland, Norway and Sweden.

Quality of Web-based information on cocaine addiction.

PubMed

Khazaal, Yasser; Chatton, Anne; Cochand, Sophie; Zullino, Daniele

2008-08-01

To evaluate the quality of web-based information on cocaine use and addiction and to investigate potential content quality indicators. Three keywords: cocaine, cocaine addiction and cocaine dependence were entered into two popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality. "Health on the Net" (HON) quality label, and DISCERN scale scores aiding people without content expertise to assess quality of written health publication were used to verify their efficiency as quality indicators. Of the 120 websites identified, 61 were included. Most were commercial sites. The results of the study indicate low scores on each of the measures including content quality. A global score (the sum of accountability, interactivity, content quality and aesthetic criteria) appeared as a good content quality indicator. While cocaine education websites for patients are widespread, their global quality is poor. There is a need for better evidence-based information about cocaine use and addiction on the web. The poor and variable quality of web-based information and its possible impact on physician-patient relationship argue for a serious provider for patient talk about the health information found on Internet. Internet sites could improve their content using the global score as a quality indicator.

Quality control in public participation assessments of water quality: the OPAL Water Survey.

PubMed

Rose, N L; Turner, S D; Goldsmith, B; Gosling, L; Davidson, T A

2016-07-22

Public participation in scientific data collection is a rapidly expanding field. In water quality surveys, the involvement of the public, usually as trained volunteers, generally includes the identification of aquatic invertebrates to a broad taxonomic level. However, quality assurance is often not addressed and remains a key concern for the acceptance of publicly-generated water quality data. The Open Air Laboratories (OPAL) Water Survey, launched in May 2010, aimed to encourage interest and participation in water science by developing a 'low-barrier-to-entry' water quality survey. During 2010, over 3000 participant-selected lakes and ponds were surveyed making this the largest public participation lake and pond survey undertaken to date in the UK. But the OPAL approach of using untrained volunteers and largely anonymous data submission exacerbates quality control concerns. A number of approaches were used in order to address data quality issues including: sensitivity analysis to determine differences due to operator, sampling effort and duration; direct comparisons of identification between participants and experienced scientists; the use of a self-assessment identification quiz; the use of multiple participant surveys to assess data variability at single sites over short periods of time; comparison of survey techniques with other measurement variables and with other metrics generally considered more accurate. These quality control approaches were then used to screen the OPAL Water Survey data to generate a more robust dataset. The OPAL Water Survey results provide a regional and national assessment of water quality as well as a first national picture of water clarity (as suspended solids concentrations). Less than 10 % of lakes and ponds surveyed were 'poor' quality while 26.8 % were in the highest water quality band. It is likely that there will always be a question mark over untrained volunteer generated data simply because quality assurance is uncertain, regardless of any post hoc data analyses. Quality control at all stages, from survey design, identification tests, data submission and interpretation can all increase confidence such that useful data can be generated by public participants.

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

PubMed

Ilic, Dragan; Risbridger, Gail; Green, Sally

2004-07-01

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

Quality by design: optimization of a liquid filled pH-responsive macroparticles using Draper-Lin composite design.

PubMed

Rafati, Hasan; Talebpour, Zahra; Adlnasab, Laleh; Ebrahimi, Samad Nejad

2009-07-01

In this study, pH responsive macroparticles incorporating peppermint oil (PO) were prepared using a simple emulsification/polymer precipitation technique. The formulations were examined for their properties and the desired quality was then achieved using a quality by design (QBD) approach. For this purpose, a Draper-Lin small composite design study was employed in order to investigate the effect of four independent variables, including the PO to water ratio, the concentration of pH sensitive polymer (hydroxypropyl methylcellulose phthalate), acid and plasticizer concentrations, on the encapsulation efficiency and PO loading. The analysis of variance showed that the polymer concentration was the most important variable on encapsulation efficiency (p < 0.05). The multiple regression analysis of the results led to equations that adequately described the influence of the independent variables on the selected responses. Furthermore, the desirability function was employed as an effective tool for transforming each response separately and encompassing all of these responses in an overall desirability function for global optimization of the encapsulation process. The optimized macroparticles were predicted to yield 93.4% encapsulation efficiency and 72.8% PO loading, which were remarkably close to the experimental values of 89.2% and 69.5%, consequently.

Modeling relationships between catchment attributes and river water quality in southern catchments of the Caspian Sea.

PubMed

Hasani Sangani, Mohammad; Jabbarian Amiri, Bahman; Alizadeh Shabani, Afshin; Sakieh, Yousef; Ashrafi, Sohrab

2015-04-01

Increasing land utilization through diverse forms of human activities, such as agriculture, forestry, urban growth, and industrial development, has led to negative impacts on the water quality of rivers. To find out how catchment attributes, such as land use, hydrologic soil groups, and lithology, can affect water quality variables (Ca(2+), Mg(2+), Na(+), Cl(-), HCO 3 (-) , pH, TDS, EC, SAR), a spatio-statistical approach was applied to 23 catchments in southern basins of the Caspian Sea. All input data layers (digital maps of land use, soil, and lithology) were prepared using geographic information system (GIS) and spatial analysis. Relationships between water quality variables and catchment attributes were then examined by Spearman rank correlation tests and multiple linear regression. Stepwise approach-based multiple linear regressions were developed to examine the relationship between catchment attributes and water quality variables. The areas (%) of marl, tuff, or diorite, as well as those of good-quality rangeland and bare land had negative effects on all water quality variables, while those of basalt, forest land cover were found to contribute to improved river water quality. Moreover, lithological variables showed the greatest most potential for predicting the mean concentration values of water quality variables, and noting that measure of EC and TDS have inversely associated with area (%) of urban land use.

Predictive capacity of sperm quality parameters and sperm subpopulations on field fertility after artificial insemination in sheep.

PubMed

Santolaria, P; Vicente-Fiel, S; Palacín, I; Fantova, E; Blasco, M E; Silvestre, M A; Yániz, J L

2015-12-01

This study was designed to evaluate the relevance of several sperm quality parameters and sperm population structure on the reproductive performance after cervical artificial insemination (AI) in sheep. One hundred and thirty-nine ejaculates from 56 adult rams were collected using an artificial vagina, processed for sperm quality assessment and used to perform 1319 AI. Analyses of sperm motility by computer-assisted sperm analysis (CASA), sperm nuclear morphometry by computer-assisted sperm morphometry analysis (CASMA), membrane integrity by acridine orange-propidium iodide combination and sperm DNA fragmentation using the sperm chromatin dispersion test (SCD) were performed. Clustering procedures using the sperm kinematic and morphometric data resulted in the classification of spermatozoa into three kinematic and three morphometric sperm subpopulations. Logistic regression procedures were used, including fertility at AI as the dependent variable (measured by lambing, 0 or 1) and farm, year, month of AI, female parity, female lambing-treatment interval, ram, AI technician and sperm quality parameters (including sperm subpopulations) as independent factors. Sperm quality variables remaining in the logistic regression model were viability and VCL. Fertility increased for each one-unit increase in viability (by a factor of 1.01) and in VCL (by a factor of 1.02). Multiple linear regression analyses were also performed to analyze the factors possibly influencing ejaculate fertility (N=139). The analysis yielded a significant (P<0.05) relationship between sperm viability and ejaculate fertility. The discriminant ability of the different semen variables to predict field fertility was analyzed using receiver operating characteristic (ROC) curve analysis. Sperm viability and VCL showed significant, albeit limited, predictive capacity on field fertility (0.57 and 0.54 Area Under Curve, respectively). The distribution of spermatozoa in the different subpopulations was not related to fertility. Copyright © 2015 Elsevier B.V. All rights reserved.

Nurse practice environment, workload, burnout, job outcomes, and quality of care in psychiatric hospitals: a structural equation model approach.

PubMed

Van Bogaert, Peter; Clarke, Sean; Willems, Riet; Mondelaers, Mieke

2013-07-01

To study the relationships between nurse practice environment, workload, burnout, job outcomes and nurse-reported quality of care in psychiatric hospital staff. Nurses' practice environments in general hospitals have been extensively investigated. Potential variations across practice settings, for instance in psychiatric hospitals, have been much less studied. A cross-sectional design with a survey. A structural equation model previously tested in acute hospitals was evaluated using survey data from a sample of 357 registered nurses, licensed practical nurses, and non-registered caregivers from two psychiatric hospitals in Belgium between December 2010-April 2011. The model included paths between practice environment dimensions and outcome variables, with burnout in a mediating position. A workload measure was also tested as a potential mediator between the practice environment and outcome variables. An improved model, slightly modified from the one validated earlier in samples of acute care nurses, was confirmed. This model explained 50% and 38% of the variance in job outcomes and nurse-reported quality of care respectively. In addition, workload was found to play a mediating role in accounting for job outcomes and significantly improved a model that ultimately explained 60% of the variance in these variables. In psychiatric hospitals as in general hospitals, nurse-physician relationship and other organizational dimensions such as nursing and hospital management were closely associated with perceptions of workload and with burnout and job satisfaction, turnover intentions, and nurse-reported quality of care. Mechanisms linking key variables and differences across settings in these relationships merit attention by managers and researchers. © 2012 Blackwell Publishing Ltd.

Cross-Generational Valuing among Peer Academic Librarians

ERIC Educational Resources Information Center

Munde, Gail; Coonin, Bryna

2015-01-01

This study investigated the skills, knowledge, abilities or dispositions that are most valued and respected by academic librarians, and determined how these qualities might, or might not, be associated with generational membership. Other variables included institutional classification, career length, years since first professional degree, and…

Multi-scale monitoring for improved nutrient management

USDA-ARS?s Scientific Manuscript database

In many watersheds, monitoring at the outlet of small watersheds has not been able to demonstrate that conservation efforts have had any impact on stream water quality. Reasons are multiple including legacy issues, time for the conservation practices to have any benefit, temporal variability of weat...

Effects of heat stress and insulin sensitizers on pig adipose tissue

USDA-ARS?s Scientific Manuscript database

Heat stress (HS) negatively impacts several swine production variables, including carcass fat quality. Pigs reared in HS have more adipose tissue than energetically predicted, explainable by HS-induced hyperinsulinemia. Study objectives were to evaluate insulin’s role in altering fat characteristics...

Value-based purchasing and hospital acquired conditions: are we seeing improvement?

PubMed

Spaulding, Aaron; Zhao, Mei; Haley, D Rob

2014-12-01

To determine if the Value-Based Purchasing Performance Scoring system correlates with hospital acquired condition quality indicators. This study utilizes the following secondary data sources: the American Hospital Association (AHA) annual survey and the Centers for Medicare and Medicaid (CMS) Value-Based Purchasing and Hospital Acquired Conditions databases. Zero-inflated negative binomial regression was used to examine the effect of CMS total performance score on counts of hospital acquired conditions. Hospital structure variables including size, ownership, teaching status, payer mix, case mix, and location were utilized as control variables. The secondary data sources were merged into a single database using Stata 10. Total performance scores, which are used to determine if hospitals should receive incentive money, do not correlate well with quality outcome in the form of hospital acquired conditions. Value-based purchasing does not appear to correlate with improved quality and patient safety as indicated by Hospital Acquired Condition (HAC) scores. This leads us to believe that either the total performance score does not measure what it should, or the quality outcome measurements do not reflect the quality of the total performance scores measure. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Real-time assessments of water quality: expanding nowcasting throughout the Great Lakes

USGS Publications Warehouse

,

2013-01-01

Nowcasts are systems that inform the public of current bacterial water-quality conditions at beaches on the basis of predictive models. During 2010–12, the U.S. Geological Survey (USGS) worked with 23 local and State agencies to improve existing operational beach nowcast systems at 4 beaches and expand the use of predictive models in nowcasts at an additional 45 beaches throughout the Great Lakes. The predictive models were specific to each beach, and the best model for each beach was based on a unique combination of environmental and water-quality explanatory variables. The variables used most often in models to predict Escherichia coli (E. coli) concentrations or the probability of exceeding a State recreational water-quality standard included turbidity, day of the year, wave height, wind direction and speed, antecedent rainfall for various time periods, and change in lake level over 24 hours. During validation of 42 beach models during 2012, the models performed better than the current method to assess recreational water quality (previous day's E. coli concentration). The USGS will continue to work with local agencies to improve nowcast predictions, enable technology transfer of predictive model development procedures, and implement more operational systems during 2013 and beyond.

Remote-sensing based approach to forecast habitat quality under climate change scenarios.

PubMed

Requena-Mullor, Juan M; López, Enrique; Castro, Antonio J; Alcaraz-Segura, Domingo; Castro, Hermelindo; Reyes, Andrés; Cabello, Javier

2017-01-01

As climate change is expected to have a significant impact on species distributions, there is an urgent challenge to provide reliable information to guide conservation biodiversity policies. In addressing this challenge, we propose a remote sensing-based approach to forecast the future habitat quality for European badger, a species not abundant and at risk of local extinction in the arid environments of southeastern Spain, by incorporating environmental variables related with the ecosystem functioning and correlated with climate and land use. Using ensemble prediction methods, we designed global spatial distribution models for the distribution range of badger using presence-only data and climate variables. Then, we constructed regional models for an arid region in the southeast Spain using EVI (Enhanced Vegetation Index) derived variables and weighting the pseudo-absences with the global model projections applied to this region. Finally, we forecast the badger potential spatial distribution in the time period 2071-2099 based on IPCC scenarios incorporating the uncertainty derived from the predicted values of EVI-derived variables. By including remotely sensed descriptors of the temporal dynamics and spatial patterns of ecosystem functioning into spatial distribution models, results suggest that future forecast is less favorable for European badgers than not including them. In addition, change in spatial pattern of habitat suitability may become higher than when forecasts are based just on climate variables. Since the validity of future forecast only based on climate variables is currently questioned, conservation policies supported by such information could have a biased vision and overestimate or underestimate the potential changes in species distribution derived from climate change. The incorporation of ecosystem functional attributes derived from remote sensing in the modeling of future forecast may contribute to the improvement of the detection of ecological responses under climate change scenarios.

Remote-sensing based approach to forecast habitat quality under climate change scenarios

PubMed Central

Requena-Mullor, Juan M.; López, Enrique; Castro, Antonio J.; Alcaraz-Segura, Domingo; Castro, Hermelindo; Reyes, Andrés; Cabello, Javier

2017-01-01

As climate change is expected to have a significant impact on species distributions, there is an urgent challenge to provide reliable information to guide conservation biodiversity policies. In addressing this challenge, we propose a remote sensing-based approach to forecast the future habitat quality for European badger, a species not abundant and at risk of local extinction in the arid environments of southeastern Spain, by incorporating environmental variables related with the ecosystem functioning and correlated with climate and land use. Using ensemble prediction methods, we designed global spatial distribution models for the distribution range of badger using presence-only data and climate variables. Then, we constructed regional models for an arid region in the southeast Spain using EVI (Enhanced Vegetation Index) derived variables and weighting the pseudo-absences with the global model projections applied to this region. Finally, we forecast the badger potential spatial distribution in the time period 2071–2099 based on IPCC scenarios incorporating the uncertainty derived from the predicted values of EVI-derived variables. By including remotely sensed descriptors of the temporal dynamics and spatial patterns of ecosystem functioning into spatial distribution models, results suggest that future forecast is less favorable for European badgers than not including them. In addition, change in spatial pattern of habitat suitability may become higher than when forecasts are based just on climate variables. Since the validity of future forecast only based on climate variables is currently questioned, conservation policies supported by such information could have a biased vision and overestimate or underestimate the potential changes in species distribution derived from climate change. The incorporation of ecosystem functional attributes derived from remote sensing in the modeling of future forecast may contribute to the improvement of the detection of ecological responses under climate change scenarios. PMID:28257501

Water Quality Characteristics of Sembrong Dam Reservoir, Johor, Malaysia

NASA Astrophysics Data System (ADS)

Mohd-Asharuddin, S.; Zayadi, N.; Rasit, W.; Othman, N.

2016-07-01

A study of water quality and heavy metal content in Sembrong Dam water was conducted from April - August 2015. A total of 12 water quality parameters and 6 heavy metals were measured and classified based on the Interim National Water Quality Standard of Malaysia (INWQS). The measured and analyzed parameter variables were divided into three main categories which include physical, chemical and heavy metal contents. Physical and chemical parameter variables were temperature, dissolved oxygen (DO), biochemical oxygen demand (BOD), chemical oxygen demand (COD), total suspended solid (TSS), turbidity, pH, nitrate, phosphate, ammonium, conductivity and salinity. The heavy metals measured were copper (Cu), lead (Pb), aluminium (Al), chromium (Cr), ferum (Fe) and zinc (Zn). According to INWQS, the water salinity, conductivity, BOD, TSS and nitrate level fall under Class I, while the Ph, DO and turbidity lie under Class IIA. Furthermore, values of COD and ammonium were classified under Class III. The result also indicates that the Sembrong Dam water are not polluted with heavy metals since all heavy metal readings recorded were falls far below Class I.

A new independent authority is needed to issue National Health Care guidelines.

PubMed

Keyhani, Salomeh; Kim, Azalea; Mann, Micah; Korenstein, Deborah

2011-02-01

Health experts emphasize that getting doctors to follow clinical guidelines can save both lives and money. Less attention has been paid to how the guidelines are developed and the variability in the recommendations they include. We examined the quality and content of screening guidelines as a proxy for guidelines in general and found that the source of the guidelines affects their quality. Guidelines with inconsistent recommendations are unlikely to serve patients or physicians well. The creation of an independent organization that would work with multiple stakeholders to develop guidelines holds the potential to improve their quality.

Aircraft model prototypes which have specified handling-quality time histories

NASA Technical Reports Server (NTRS)

Johnson, S. H.

1978-01-01

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

A review of recent analyses of the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS)

PubMed Central

Potter, D.; Nasserie, T.; Tonmyr, L.

2015-01-01

Abstract Introduction: The objective of this analysis is to identify, assess the quality and summarize the findings of peer-reviewed articles that used data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS) published since November 2011 and data from provincial oversamples of the CIS as well as to illustrate evolving uses of these datasets. Methods: Articles were identified from the Public Health Agency of Canada’s data request records tracking access to CIS data and publications produced from that data. At least two raters independently reviewed and appraised the quality of each article. Results: A total of 32 articles were included. Common strengths of articles included clearly stated research aims, appropriate control variables and analyses, sufficient sample sizes, appropriate conclusions and relevance to practice or policy. Common problem areas of articles included unclear definitions for variables and inclusion criteria of cases. Articles frequently measured the associations between maltreatment, child, caregiver, household and agency/referral characteristics and investigative outcomes such as opening cases for ongoing services and placement. Conclusion: Articles using CIS data were rated positively on most quality indicators. Researchers have recently focussed on inadequately studied categories of maltreatment (exposure to intimate partner violence [IPV]), neglect and emotional maltreatment) and examined factors specific to First Nations children. Data from the CIS oversamples have been underutilized. The use of multivariate analysis techniques has increased. PMID:26605559

Exploring household income as a predictor of psychological well-being among long-term colorectal cancer survivors

PubMed Central

Coons, Stephen Joel; Wendel, Christopher; Hornbrook, Mark C; Herrinton, Lisa; Grant, Marcia; Krouse, Robert S

2009-01-01

Purpose The purpose of this analysis was to determine the unique contribution of household income to the variance explained in psychological well-being (PWB) among a sample of colorectal cancer (CRC) survivors. Methods This study is a secondary analysis of data collected as part of the Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors Study, which included CRC survivors with (cases) and without (controls) ostomies. The dataset included socio-demographic, health status, and health-related quality of life (HRQOL) information. HRQOL was assessed with the modified City of Hope Quality of Life (mCOH-QOL)-Ostomy questionnaire and SF-36v2. To assess the relationship between income and PWB, a hierarchical linear regression model was constructed combining data from both cases and controls. Results After accounting for the proportion of variance in PWB explained by the other independent variables in the model, the additional variance explained by income was significant (R2 increased from 0.228 to 0.250; p = 0.006). Conclusions Although the study design does not allow causal inference, these results demonstrate a significant relationship between income and PWB in CRC survivors. The findings suggest that for non-randomized group comparisons of HRQOL, income should, at the very least, be included as a control variable in the analysis. PMID:19132550

Mobility and cognition are associated with wellbeing and health related quality of life among older adults: a cross-sectional analysis of the Vancouver Falls Prevention Cohort.

PubMed

Davis, Jennifer C; Bryan, Stirling; Li, Linda C; Best, John R; Hsu, Chun Liang; Gomez, Caitlin; Vertes, Kelly A; Liu-Ambrose, Teresa

2015-07-05

Ascertaining individuals' quality of life and wellbeing is essential in public health and clinical research. The impact of these two pressing geriatric syndromes--impaired mobility and cognitive function--on wellbeing and quality of life is not well examined. Hence, our objective was to identify key clinically relevant outcome measures of mobility and cognitive function that explain variation in wellbeing and health related quality of life (HRQoL) among community dwelling older adults. We conducted a cross-sectional analysis of 229 participants presenting to the Vancouver Falls Prevention Clinic from June 2010 through October 2013. The linear regression models included two dependent variables: the ICECAP-O assessing wellbeing and the EQ-5D-3L assessing HRQoL. Key independent variables included the Short Performance Physical Battery (SPPB) and the Montreal Cognitive Assessment (MoCA). Covariates included Functional Comorbidity Index (FCI), sex and age. In the two multiple linear regression models, age was statistically controlled. Other covariates (i.e., sex and FCI) were included based on statistical significance (i.e., p < 0.05). The SPPB was significantly associated with HRQoL and with wellbeing after adjusting for known covariates (p < 0.05, Unstandardized ß (Standard Error) 0.023 (0.006) for HRQoL and 0.016 (0.003) for wellbeing). The MoCA was significantly associated with wellbeing after adjusting for known covariates (p = 0.006), Unstandardized ß (Standard Error) 0.005 (0.002) but not with health related quality of life (p > 0.05). We found that a measure of mobility and balance was associated with HRQoL and wellbeing. However, cognitive function was associated with wellbeing only. This study highlights the potential importance of considering wellbeing as an outcome measure if interventions are intended to have a broader impact than health alone.

Seeing the forests and the trees—innovative approaches to exploring heterogeneity in systematic reviews of complex interventions to enhance health system decision-making: a protocol

PubMed Central

2014-01-01

Background To improve quality of care and patient outcomes, health system decision-makers need to identify and implement effective interventions. An increasing number of systematic reviews document the effects of quality improvement programs to assist decision-makers in developing new initiatives. However, limitations in the reporting of primary studies and current meta-analysis methods (including approaches for exploring heterogeneity) reduce the utility of existing syntheses for health system decision-makers. This study will explore the role of innovative meta-analysis approaches and the added value of enriched and updated data for increasing the utility of systematic reviews of complex interventions. Methods/Design We will use the dataset from our recent systematic review of 142 randomized trials of diabetes quality improvement programs to evaluate novel approaches for exploring heterogeneity. These will include exploratory methods, such as multivariate meta-regression analyses and all-subsets combinatorial meta-analysis. We will then update our systematic review to include new trials and enrich the dataset by surveying authors of all included trials. In doing so, we will explore the impact of variables not, reported in previous publications, such as details of study context, on the effectiveness of the intervention. We will use innovative analytical methods on the enriched and updated dataset to identify key success factors in the implementation of quality improvement interventions for diabetes. Decision-makers will be involved throughout to help identify and prioritize variables to be explored and to aid in the interpretation and dissemination of results. Discussion This study will inform future systematic reviews of complex interventions and describe the value of enriching and updating data for exploring heterogeneity in meta-analysis. It will also result in an updated comprehensive systematic review of diabetes quality improvement interventions that will be useful to health system decision-makers in developing interventions to improve outcomes for people with diabetes. Systematic review registration PROSPERO registration no. CRD42013005165 PMID:25115289

Canopy management in rainfed vineyards (cv. Tempranillo) for optimising water use and enhancing wine quality.

PubMed

Pascual, Miquel; Romero, María-Paz; Rufat, Josep; Villar, Josep M

2015-12-01

Rainfed viticulture, mainly in semi-arid environments, is limited by environmental variability, particularly precipitation and its seasonal distribution, and soil water availability, thus ultimately determining the final quality of grape and wine. Studies on the feasibility of practices such as canopy management to adapt plant growth and yield to soil water availability open up possibilities to preserve wine quality and reinforce the characteristics of the terroir. Principal components analysis was used to identify the relationships between a large set of variables, including soil, plant, canopy management, and wine characteristics. Canopy management was found to have a predominant influence on plant response to soil water by modifying plant water status, changing the amino acid profile in berries and, concomitantly, altering the sensorial attributes of the wine obtained. Grapevine canopy management strategies, such as reiterate shoot trimming to restrict growth during early phases, are effective in adapting plant response to soil water availability. Such strategies affect berry and wine quality, mainly the amino acid profile and sensorial attributes of the wine, without changing yield or grape harvest quality control parameters. Also, in such conditions, nitrogen does not make a significant contribution to grapevine growth or yield or to grape quality. © 2015 Society of Chemical Industry.

Post-processing method for wind speed ensemble forecast using wind speed and direction

NASA Astrophysics Data System (ADS)

Sofie Eide, Siri; Bjørnar Bremnes, John; Steinsland, Ingelin

2017-04-01

Statistical methods are widely applied to enhance the quality of both deterministic and ensemble NWP forecasts. In many situations, like wind speed forecasting, most of the predictive information is contained in one variable in the NWP models. However, in statistical calibration of deterministic forecasts it is often seen that including more variables can further improve forecast skill. For ensembles this is rarely taken advantage of, mainly due to that it is generally not straightforward how to include multiple variables. In this study, it is demonstrated how multiple variables can be included in Bayesian model averaging (BMA) by using a flexible regression method for estimating the conditional means. The method is applied to wind speed forecasting at 204 Norwegian stations based on wind speed and direction forecasts from the ECMWF ensemble system. At about 85 % of the sites the ensemble forecasts were improved in terms of CRPS by adding wind direction as predictor compared to only using wind speed. On average the improvements were about 5 %, but mainly for moderate to strong wind situations. For weak wind speeds adding wind direction had more or less neutral impact.

“Skill of Generalized Additive Model to Detect PM2.5 Health ...

EPA Pesticide Factsheets

Summary. Measures of health outcomes are collinear with meteorology and air quality, making analysis of connections between human health and air quality difficult. The purpose of this analysis was to determine time scales and periods shared by the variables of interest (and by implication scales and periods that are not shared). Hospital admissions, meteorology (temperature and relative humidity), and air quality (PM2.5 and daily maximum ozone) for New York City during the period 2000-2006 were decomposed into temporal scales ranging from 2 days to greater than two years using a complex wavelet transform. Health effects were modeled as functions of the wavelet components of meteorology and air quality using the generalized additive model (GAM) framework. This simulation study showed that GAM is extremely successful at extracting and estimating a health effect embedded in a dataset. It also shows that, if the objective in mind is to estimate the health signal but not to fully explain this signal, a simple GAM model with a single confounder (calendar time) whose smooth representation includes a sufficient number of constraints is as good as a more complex model.Introduction. In the context of wavelet regression, confounding occurs when two or more independent variables interact with the dependent variable at the same frequency. Confounding also acts on a variety of time scales, changing the PM2.5 coefficient (magnitude and sign) and its significance ac

Quality indicators in inflammatory bowel disease.

PubMed

Berry, Sameer K; Melmed, Gil Y

2018-01-01

Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is a chronic, debilitating, and expensive condition affecting millions of people globally. There is significant variation in the quality of care for patients with IBD across North America, Europe, and Asia; this variation suggests poor quality of care due to overuse, underuse, or misuse of health services and disparity of outcomes. Several initiatives have been developed to reduce variation in care delivery and improve processes of care, patient outcomes, and reduced healthcare costs. These initiatives include the development of quality indicator sets to standardize care across organizations, and learning health systems to enable data sharing between doctors and patients, and sharing of best practices among providers. These programs have been variably successful in improving patient outcomes and reducing healthcare utilization. Further studies are needed to demonstrate the long-term impact and applicability of these efforts in different geographic areas around the world, as regional variations in patient populations, societal preferences, and costs should inform local quality improvement efforts.

Identification and Assessment of Potential Water Quality Impact Factors for Drinking-Water Reservoirs

PubMed Central

Gu, Qing; Deng, Jinsong; Wang, Ke; Lin, Yi; Li, Jun; Gan, Muye; Ma, Ligang; Hong, Yang

2014-01-01

Various reservoirs have been serving as the most important drinking water sources in Zhejiang Province, China, due to the uneven distribution of precipitation and severe river pollution. Unfortunately, rapid urbanization and industrialization have been continuously challenging the water quality of the drinking-water reservoirs. The identification and assessment of potential impacts is indispensable in water resource management and protection. This study investigates the drinking water reservoirs in Zhejiang Province to better understand the potential impact on water quality. Altogether seventy-three typical drinking reservoirs in Zhejiang Province encompassing various water storage levels were selected and evaluated. Using fifty-two reservoirs as training samples, the classification and regression tree (CART) method and sixteen comprehensive variables, including six sub-sets (land use, population, socio-economy, geographical features, inherent characteristics, and climate), were adopted to establish a decision-making model for identifying and assessing their potential impacts on drinking-water quality. The water quality class of the remaining twenty-one reservoirs was then predicted and tested based on the decision-making model, resulting in a water quality class attribution accuracy of 81.0%. Based on the decision rules and quantitative importance of the independent variables, industrial emissions was identified as the most important factor influencing the water quality of reservoirs; land use and human habitation also had a substantial impact on water quality. The results of this study provide insights into the factors impacting the water quality of reservoirs as well as basic information for protecting reservoir water resources. PMID:24919129

Identification and assessment of potential water quality impact factors for drinking-water reservoirs.

PubMed

Gu, Qing; Deng, Jinsong; Wang, Ke; Lin, Yi; Li, Jun; Gan, Muye; Ma, Ligang; Hong, Yang

2014-06-10

Various reservoirs have been serving as the most important drinking water sources in Zhejiang Province, China, due to the uneven distribution of precipitation and severe river pollution. Unfortunately, rapid urbanization and industrialization have been continuously challenging the water quality of the drinking-water reservoirs. The identification and assessment of potential impacts is indispensable in water resource management and protection. This study investigates the drinking water reservoirs in Zhejiang Province to better understand the potential impact on water quality. Altogether seventy-three typical drinking reservoirs in Zhejiang Province encompassing various water storage levels were selected and evaluated. Using fifty-two reservoirs as training samples, the classification and regression tree (CART) method and sixteen comprehensive variables, including six sub-sets (land use, population, socio-economy, geographical features, inherent characteristics, and climate), were adopted to establish a decision-making model for identifying and assessing their potential impacts on drinking-water quality. The water quality class of the remaining twenty-one reservoirs was then predicted and tested based on the decision-making model, resulting in a water quality class attribution accuracy of 81.0%. Based on the decision rules and quantitative importance of the independent variables, industrial emissions was identified as the most important factor influencing the water quality of reservoirs; land use and human habitation also had a substantial impact on water quality. The results of this study provide insights into the factors impacting the water quality of reservoirs as well as basic information for protecting reservoir water resources.

Parental Characteristics, Family Ecology, and the Caregiving Environment of Adolescents with Disabilities.

ERIC Educational Resources Information Center

Bradley, Robert H.; And Others

This study examined relationships between the caregiving environment, severity of disability, and several aspects of family ecology for 102 adolescents with disabilities. Family ecology variables included poverty status, parental intelligence, social support, and marital quality. The disability categories were mental retardation; orthopedic…

A smart use for mobiles.

PubMed

Amani, Sarah; Trueland, Jennifer

A library of NHS-approved mobile phone apps has been launched in response to concerns about the variable quality of health apps. This article describes the latest apps to be included in the library and reveals how nurse Sarah Amani helped to develop an app for mental health service users.

Dimensions of Parenting in Families Having Children with Disabilities.

ERIC Educational Resources Information Center

Bradley, Robert H.; And Others

1991-01-01

This study examined relationships between parenting, severity of disability, and 5 aspects of family ecology for 83 preschool and 69 elementary school children with disabilities. Family ecology variables included socioeconomic status, coping styles, social support, stressful life events, and marital quality. Results showed positive correlations…

Gender differences in the quality of life of patients with liver cirrhosis related to hepatitis C after liver transplantation.

PubMed

Bianco, Tonino; Cillo, Umberto; Amodio, Piero; Zanus, Giacomo; Salari, Annalisa; Neri, Daniele; Bombonato, Giancarlo; Schiff, Sami; Baggio, Giovannella; Ronco, Claudio; Brocca, Alessandra; Soni, Sachin; Minazzato, Lina

2013-01-01

Hepatitis C virus (HCV) infection frequently leads to chronic liver disease, which adversely affects the quality of life (QoL) of the patient. The gender of the patient may be an important variable in the way severity of the disease is perceived. The aim of our study is to evaluate the effect of the gender variable on QoL in HCV-positive patients. This study included a total of 52 patients (26 men and 26 women) who completed a 1-year follow-up after liver transplantation. QoL was assessed using the SF-36 questionnaire. Male subjects have significantly higher scores on physical role functioning, bodily pain and physical activity compared with females. Females have a better QoL compared to males with regard to the emotional state and mental health. These results show a significant effect of the gender variable on QoL in HCV patients. © 2013 S. Karger AG, Basel.

Strategies to predict and improve eating quality of cooked beef using carcass and meat composition traits in Angus cattle.

PubMed

Mateescu, R G; Oltenacu, P A; Garmyn, A J; Mafi, G G; VanOverbeke, D L

2016-05-01

Product quality is a high priority for the beef industry because of its importance as a major driver of consumer demand for beef and the ability of the industry to improve it. A 2-prong approach based on implementation of a genetic program to improve eating quality and a system to communicate eating quality and increase the probability that consumers' eating quality expectations are met is outlined. The objectives of this study were 1) to identify the best carcass and meat composition traits to be used in a selection program to improve eating quality and 2) to develop a relatively small number of classes that reflect real and perceptible differences in eating quality that can be communicated to consumers and identify a subset of carcass and meat composition traits with the highest predictive accuracy across all eating quality classes. Carcass traits, meat composition, including Warner-Bratzler shear force (WBSF), intramuscular fat content (IMFC), trained sensory panel scores, and mineral composition traits of 1,666 Angus cattle were used in this study. Three eating quality indexes, EATQ1, EATQ2, and EATQ3, were generated by using different weights for the sensory traits (emphasis on tenderness, flavor, and juiciness, respectively). The best model for predicting eating quality explained 37%, 9%, and 19% of the variability of EATQ1, EATQ2, and EATQ3, and 2 traits, WBSF and IMFC, accounted for most of the variability explained by the best models. EATQ1 combines tenderness, juiciness, and flavor assessed by trained panels with 0.60, 0.15, and 0.25 weights, best describes North American consumers, and has a moderate heritability (0.18 ± 0.06). A selection index (I= -0.5[WBSF] + 0.3[IMFC]) based on phenotypic and genetic variances and covariances can be used to improve eating quality as a correlated trait. The 3 indexes (EATQ1, EATQ2, and EATQ3) were used to generate 3 equal (33.3%) low, medium, and high eating quality classes, and linear combinations of traits that best predict class membership were estimated using a predictive discriminant analysis. The best predictive model to classify new observations into low, medium, and high eating quality classes defined by the EATQ1 index included WBSF, IMFC, HCW, and marbling score and resulted in a total error rate of 47.06%, much lower than the 60.74% error rate when the prediction of class membership was based on the USDA grading system. The 2 best predictors were WBSF and IMFC, and they accounted for 97.2% of the variability explained by the best model.

Impact of image quality on reliability of the measurements of left ventricular systolic function and global longitudinal strain in 2D echocardiography

PubMed Central

Nagata, Yasufumi; Kado, Yuichiro; Onoue, Takeshi; Otani, Kyoko; Nakazono, Akemi; Otsuji, Yutaka; Takeuchi, Masaaki

2018-01-01

Background Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) play important roles in diagnosis and management of cardiac diseases. However, the issue of the accuracy and reliability of LVEF and GLS remains to be solved. Image quality is one of the most important factors affecting measurement variability. The aim of this study was to investigate whether improved image quality could reduce observer variability. Methods Two sets of three apical images were acquired using relatively old- and new-generation ultrasound imaging systems (Vivid 7 and Vivid E95) in 308 subjects. Image quality was assessed by endocardial border delineation index (EBDI) using a 3-point scoring system. Three observers measured the LVEF and GLS, and these values and inter-observer variability were investigated. Results Image quality was significantly better with Vivid E95 (EBDI: 26.8 ± 5.9) than that with Vivid 7 (22.8 ± 6.3, P < 0.0001). Regarding the inter-observer variability of LVEF, the r-value, bias, 95% limit of agreement and intra-class correlation coefficient for Vivid 7 were comparable to those for Vivid E95. The % variabilities were significantly lower for Vivid E95 (5.3–6.5%) than those for Vivid 7 (6.5–7.5%). Regarding GLS, all observer variability parameters were better for Vivid E95 than for Vivid 7. Improvements in image quality yielded benefits to both LVEF and GLS measurement reliability. Multivariate analysis showed that image quality was indeed an important factor of observer variability in the measurement of LVEF and GLS. Conclusions The new-generation ultrasound imaging system offers improved image quality and reduces inter-observer variability in the measurement of LVEF and GLS. PMID:29432198

Impact of image quality on reliability of the measurements of left ventricular systolic function and global longitudinal strain in 2D echocardiography.

PubMed

Nagata, Yasufumi; Kado, Yuichiro; Onoue, Takeshi; Otani, Kyoko; Nakazono, Akemi; Otsuji, Yutaka; Takeuchi, Masaaki

2018-03-01

Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) play important roles in diagnosis and management of cardiac diseases. However, the issue of the accuracy and reliability of LVEF and GLS remains to be solved. Image quality is one of the most important factors affecting measurement variability. The aim of this study was to investigate whether improved image quality could reduce observer variability. Two sets of three apical images were acquired using relatively old- and new-generation ultrasound imaging systems (Vivid 7 and Vivid E95) in 308 subjects. Image quality was assessed by endocardial border delineation index (EBDI) using a 3-point scoring system. Three observers measured the LVEF and GLS, and these values and inter-observer variability were investigated. Image quality was significantly better with Vivid E95 (EBDI: 26.8 ± 5.9) than that with Vivid 7 (22.8 ± 6.3, P  < 0.0001). Regarding the inter-observer variability of LVEF, the r -value, bias, 95% limit of agreement and intra-class correlation coefficient for Vivid 7 were comparable to those for Vivid E95. The % variabilities were significantly lower for Vivid E95 (5.3-6.5%) than those for Vivid 7 (6.5-7.5%). Regarding GLS, all observer variability parameters were better for Vivid E95 than for Vivid 7. Improvements in image quality yielded benefits to both LVEF and GLS measurement reliability. Multivariate analysis showed that image quality was indeed an important factor of observer variability in the measurement of LVEF and GLS. The new-generation ultrasound imaging system offers improved image quality and reduces inter-observer variability in the measurement of LVEF and GLS. © 2018 The authors.

Developing a Dynamic SPARROW Water Quality Decision Support System Using NASA Remotely-Sensed Products

NASA Astrophysics Data System (ADS)

Al-Hamdan, M. Z.; Smith, R. A.; Hoos, A.; Schwarz, G. E.; Alexander, R. B.; Crosson, W. L.; Srikishen, J.; Estes, M., Jr.; Cruise, J.; Al-Hamdan, A.; Ellenburg, W. L., II; Flores, A.; Sanford, W. E.; Zell, W.; Reitz, M.; Miller, M. P.; Journey, C. A.; Befus, K. M.; Swann, R.; Herder, T.; Sherwood, E.; Leverone, J.; Shelton, M.; Smith, E. T.; Anastasiou, C. J.; Seachrist, J.; Hughes, A.; Graves, D.

2017-12-01

The USGS Spatially Referenced Regression on Watershed Attributes (SPARROW) surface water quality modeling system has been widely used for long term, steady state water quality analysis. However, users have increasingly requested a dynamic version of SPARROW that can provide seasonal estimates of nutrients and suspended sediment to receiving waters. The goal of this NASA-funded project is to develop a dynamic decision support system to enhance the southeast SPARROW water quality model and finer-scale dynamic models for selected coastal watersheds through the use of remotely-sensed data and other NASA Land Information System (LIS) products. The spatial and temporal scale of satellite remote sensing products and LIS modeling data make these sources ideal for the purposes of development and operation of the dynamic SPARROW model. Remote sensing products including MODIS vegetation indices, SMAP surface soil moisture, and OMI atmospheric chemistry along with LIS-derived evapotranspiration (ET) and soil temperature and moisture products will be included in model development and operation. MODIS data will also be used to map annual land cover/land use in the study areas and in conjunction with Landsat and Sentinel to identify disturbed areas that might be sources of sediment and increased phosphorus loading through exposure of the bare soil. These data and others constitute the independent variables in a regression analysis whose dependent variables are the water quality constituents total nitrogen, total phosphorus, and suspended sediment. Remotely-sensed variables such as vegetation indices and ET can be proxies for nutrient uptake by vegetation; MODIS Leaf Area Index can indicate sources of phosphorus from vegetation; soil moisture and temperature are known to control rates of denitrification; and bare soil areas serve as sources of enhanced nutrient and sediment production. The enhanced SPARROW dynamic models will provide improved tools for end users to manage water quality in near real time and for the formulation of future scenarios to inform strategic planning. Time-varying SPARROW outputs will aid water managers in decision making regarding allocation of resources in protecting aquatic habitats, planning for harmful algal blooms, and restoration of degraded habitats, stream segments, or lakes.

Variability in Lotic Communities in Three Contrasting Stream Environments in the Santa Ana River Basin, California, 1999-2001

USGS Publications Warehouse

Burton, Carmen A.

2008-01-01

Biotic communities and environmental conditions can be highly variable between natural ecosystems. The variability of natural assemblages should be considered in the interpretation of any ecological study when samples are either spatially or temporally distributed. Little is known about biotic variability in the Santa Ana River Basin. In this report, the lotic community and habitat assessment data from ecological studies done as part of the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) program are used for a preliminary assessment of variability in the Santa Ana Basin. Habitat was assessed, and benthic algae, benthic macroinvertebrate, and fish samples were collected at four sites during 1999-2001. Three of these sites were sampled all three years. One of these sites is located in the San Bernardino Mountains, and the other two sites are located in the alluvial basin. Analysis of variance determined that the three sites with multiyear data were significantly different for 41 benthic algae metrics and 65 macroinvertebrate metrics and fish communities. Coefficients of variation (CVs) were calculated for the habitat measurements, metrics of benthic algae, and macroinvertebrate data as measures of variability. Annual variability of habitat data was generally greater at the mountain site than at the basin sites. The mountain site had higher CVs for water temperature, depth, velocity, canopy angle, streambed substrate, and most water-quality variables. In general, CVs of most benthic algae metrics calculated from the richest-targeted habitat (RTH) samples were greater at the mountain site. In contrast, CVs of most benthic algae metrics calculated from depositional-targeted habitat (DTH) samples were lower at the mountain site. In general, CVs of macroinvertebrate metrics calculated from qualitative multihabitat (QMH) samples were lower at the mountain site. In contrast, CVs of many metrics calculated from RTH samples were greater at the mountain site than at one of the basin sites. Fish communities were more variable at the basin sites because more species were present at these sites. Annual variability of benthic algae metrics was related to annual variability in habitat variables. The CVs of benthic algae metrics related to the most CVs of habitat variables included QMH taxon richness, the RTH percentage richness, RTH abundance of tolerant taxa, RTH percentage richness of halophilic diatoms, RTH percentage abundance of sestonic diatoms, DTH percentage richness of nitrogen heterotrophic diatoms, and DTH pollution tolerance index. The CVs of macroinvertebrate metrics related to the most CVs of habitat variables included the RTH trichoptera, RTH EPT, RTH scraper richness, RTH nonchironomid dipteran abundance (in percent), and RTH EPA (U.S. Environmental Protection Agency) tolerance, which is based on abundance. Many of the CVs of habitat variables related to CVs of macroinvertebrate metrics were the same habitat variables that were related to the CVs of benthic algae metrics. On the basis of these results, annual variability may have a role in the relationship of benthic algae and macroinvertebrates assemblages with habitat and water quality in the Santa Ana Basin. This report provides valuable baseline data on the variability of biological communities in the Santa Ana Basin.

[Quality of sleep and selective attention in university students: descriptive cross-sectional study].

PubMed

Fontana, Silvia Alicia; Raimondi, Waldina; Rizzo, María Laura

2014-09-05

Sleep quality not only refers to sleeping well at night, but also includes appropriate daytime functioning. Poor quality of sleep can affect a variety of attention processes. The aim of this investigation was to evaluate the relationship between the perceived quality of sleep and selective focus in a group of college students. A descriptive cross-sectional study was carried out in a group of 52 Argentinian college students of the Universidad Adventista del Plata. The Pittsburgh Sleep Quality Index, the Continuous Performance Test and the Trail Making Test were applied. The main results indicate that students sleep an average of 6.48 hours. Generally half of the population tested had a good quality of sleep. However, the dispersion seen in some components demonstrates the heterogeneity of the sample in these variables. It was observed that the evaluated attention processes yielded different levels of alteration in the total sample: major variability in the process of process and in the divided-attention processes were detected. A lower percentage of alteration was observed in the process of attention support. Poor quality of sleep has more impact in the sub processes with greater participation of corticocortical circuits (selective and divided attention) and greater involvement of the prefrontal cortex. Fewer difficulties were found in the attention-support processes that rely on subcortical regions and have less frontal involvement.

Implementation of "Quality by Design (QbD)" Approach for the Development of 5-Fluorouracil Loaded Thermosensitive Hydrogel.

PubMed

Dalwadi, Chintan; Patel, Gayatri

2016-01-01

The purpose of this study was to investigate Quality by Design (QbD) principle for the preparation of hydrogel products to prove both practicability and utility of executing QbD concept to hydrogel based controlled release systems. Product and process understanding will help in decreasing the variability of critical material and process parameters, which give quality product output and reduce the risk. This study includes the identification of the Quality Target Product Profiles (QTPPs) and Critical Quality Attributes (CQAs) from literature or preliminary studies. To identify and control the variability in process and material attributes, two tools of QbD was utilized, Quality Risk Management (QRM) and Experimental Design. Further, it helps to identify the effect of these attributes on CQAs. Potential risk factors were identified from fishbone diagram and screened by risk assessment and optimized by 3-level 2- factor experimental design with center points in triplicate, to analyze the precision of the target process. This optimized formulation was further characterized by gelling time, gelling temperature, rheological parameters, in-vitro biodegradation and in-vitro drug release. Design space was created using experimental design tool that gives the control space and working within this controlled space reduces all the failure modes below the risk level. In conclusion, QbD approach with QRM tool provides potent and effectual pyramid to enhance the quality into the hydrogel.

Transitions of male partners of women with breast cancer: hope, guilt, and quality of life.

PubMed

Duggleby, Wendy; Thomas, Jasmine; Montford, Kelly; Thomas, Roanne; Nekolaichuk, Cheryl; Ghosh, Sunita; Cumming, Ceiwen; Tonkin, Katia

2015-03-01

To (a) describe the types of transitions experienced by male spousal caregivers of women with breast cancer and the strategies used by male spouses to deal with these transitions and (b) examine factors related to their quality of life, including demographic variables, self-efficacy, caregiver guilt, hope, the quality of life of their partner with breast cancer, and transitions. Cross-sectional, transformational, mixed-methods approach. Participants' homes. 105 dyads of male spouses and their female partners diagnosed with stages I-III breast cancer. 600 surveys were mailed to women with breast cancer and their male partners. Significant variables were entered into a multivariate model. Male caregiver quality of life. The quality of life of male spouse participants was positively influenced by hope (p < 0.01). It was negatively influenced by caregiver guilt scores (p < 0.01) and the method of dealing with their transitions by "doing what needs to be done" (p = 0.04). The male caregivers with higher quality-of-life scores reported higher hope and lower caregiver guilt scores. They reported lower quality-of-life scores if they dealt with transitions by "doing what needs to be done."
 Strategies to support male spouses of women with breast cancer should involve ways to foster hope, reduce feelings of guilt, and encourage male caregivers to engage more in supporting their spouses.

The Effect of Aromatherapy on Sleep Quality of Elderly People Residing in a Nursing Home.

PubMed

Faydalı, Saide; Çetinkaya, Funda

Sleep is important for health and quality of life in the elderly, and sleep disturbances are reported to be associated with many of the adverse medical conditions. This research was carried out to evaluate the effect of inhalation of lavender oil on sleep quality of nursing home residents. A questionnaire was used to evaluate sociodemographic characteristics and sleeping properties of the 30 volunteers, enrolled. Pittsburgh Sleep Quality Index was applied as a pre- and posttest to measure sleep quality of individuals who inhaled lavender oil drops on the pillows every evening for a week before sleeping. Before and after aromatherapy, the mean Pittsburgh Sleep Quality Index score of the nursing home residents was (Equation is included in full-text article.)= 6.0 ± 5.1 and (Equation is included in full-text article.)= 2.6 ± 3.4, respectively, whereas statistically significant difference was not observed for independent variables. Cronbach α reliability coefficient of the Pittsburgh Sleep Quality Index scale was found to be 0.816. The results indicated an improvement of sleep quality of nursing home residents after the application of aromatherapy with lavender oil.

[A meta-analysis of the variables related to depression in Korean patients with a stroke].

PubMed

Park, Eun Young; Shin, In Soo; Kim, Jung Hee

2012-08-01

The purpose of this study was to use meta-analysis to evaluate the variables related to depression in patients who have had a stroke. The materials of this study were based on 16 variables obtained from 26 recent studies over a span of 10 years which were selected from doctoral dissertations, master's thesis and published articles. Related variables were categorized into sixteen variables and six variable groups which included general characteristics of the patients, disease characteristics, psychological state, physical function, basic needs, and social variables. Also, the classification of six defensive and three risk variables group was based on the negative or positive effect of depression. The quality of life (ES=-.79) and acceptance of disability (ES=-.64) were highly correlated with depression in terms of defensive variables. For risk variables, anxiety (ES=.66), stress (ES=.53) showed high correlation effect size among the risk variables. These findings showed that defensive and risk variables were related to depression among stroke patients. Psychological interventions and improvement in physical functions should be effective in decreasing depression among stroke patients.

Stream water temperature limits occupancy of salamanders in mid-Atlantic protected areas

USGS Publications Warehouse

Grant, Evan H. Campbell; Wiewel, Amber N. M.; Rice, Karen C.

2014-01-01

Stream ecosystems are particularly sensitive to urbanization, and tolerance of water-quality parameters is likely important to population persistence of stream salamanders. Forecasted climate and landscape changes may lead to significant changes in stream flow, chemical composition, and temperatures in coming decades. Protected areas where landscape alterations are minimized will therefore become increasingly important for salamander populations. We surveyed 29 streams at three national parks in the highly urbanized greater metropolitan area of Washington, DC. We investigated relationships among water-quality variables and occupancy of three species of stream salamanders (Desmognathus fuscus, Eurycea bislineata, and Pseudotriton ruber). With the use of a set of site-occupancy models, and accounting for imperfect detection, we found that stream-water temperature limits salamander occupancy. There was substantial uncertainty about the effects of the other water-quality variables, although both specific conductance (SC) and pH were included in competitive models. Our estimates of occupancy suggest that temperature, SC, and pH have some importance in structuring stream salamander distribution.

Exercise to improve sleep in insomnia: exploration of the bidirectional effects.

PubMed

Baron, Kelly Glazer; Reid, Kathryn J; Zee, Phyllis C

2013-08-15

Exercise improves sleep quality, mood, and quality of life among older adults with insomnia. The purpose of the study was to evaluate the daily bidirectional relationships between exercise and sleep in a sample of women with insomnia. Participants included 11 women (age M = 61.27, SD 4.15) with insomnia who engaged in 30 min of aerobic exercise 3 times per week. Self-reported sleep quality was assessed at baseline and at 16 weeks. Sleep and exercise logs and wrist activity were collected continuously. Sleep variables included subjective sleep quality and objective measures recorded via wrist actigraphy (sleep onset latency [SOL], total sleep time [TST], sleep efficiency [SE], wake after sleep onset [WASO], and fragmentation index [FI]). Age, subjective sleep quality, TST, SOL, and physical fitness at baseline were tested as moderators of the daily effects. TST, SE, and self-reported global sleep quality improved from baseline to 16 weeks (p values < 0.05). Baseline ratings of sleepiness were negatively correlated with exercise session duration (p < 0.05). Daily exercise was not associated with subjective or objective sleep variables during the corresponding night. However, participants had shorter exercise duration following nights with longer SOL (p < 0.05). TST at baseline moderated the daily relationship between TST and next day exercise duration (p < 0.05). The relationship between shorter TST and shorter next day exercise was stronger in participants who had shorter TST at baseline. Results suggest that sleep influences next day exercise rather than exercise influencing sleep. The relationship between TST and next day exercise was stronger for those with shorter TST at baseline. These results suggest that improving sleep may encourage exercise participation.

The Utility of the OMI HCHO and NO2 Data Products in Air Quality Decision- Making Activities

NASA Technical Reports Server (NTRS)

Duncan, Bryan N.

2010-01-01

We will present three related air quality applications of the OMI HCHO (formaldehyde) and NO2 (nitrogen dioxide) data products, which we us to support mission planning of an OMI-like instrument for the proposed GEO-CAPE satellite that has as one of its objectives to study air quality from space. First, we will discuss a novel and practical application of the data products to the "weight of evidence" in the air quality decision-making process (e.g., State Implementation Plan (SIP)) for a city, region, or state to demonstrate that it is making progress toward attainment of the National Ambient Air Quality Standard (NAAQS) for ozone. Any trend, or lack thereof, in the observed OMI HCHO/NO2, which we use as an air quality indicator, may support that an emission control strategy implemented to reduce ozone is or is not occurring for a metropolitan area. Second, we will discuss how we use variations in the OMI HCHO product as a proxy for variability in the biogenic hydrocarbon, isoprene, which is an important player for the formation of high levels of ozone and the dominant source of HCHO in the eastern U.S. Third, we will discuss the variability of NO2 in the U.S. as indicated by the OMI NO2 product. In addition, we will show the impact of the 2005 hurricanes on pollutant emissions, including those associated with the intensive oil extraction and refining activities, in the Gulf of Mexico region using the OMI NO2 product. The variability of HCHO and NO2 as indicated by OMI helps us to understand changes in the OMI HCHO/NO2 and the implications for ozone formation.

Temporal and spatial variations in fly ash quality

USGS Publications Warehouse

Hower, J.C.; Trimble, A.S.; Eble, C.F.

2001-01-01

Fly ash quality, both as the amount of petrographically distinguishable carbons and in chemistry, varies in both time and space. Temporal variations are a function of a number of variables. Variables can include variations in the coal blend organic petrography, mineralogy, and chemistry; variations in the pulverization of the coal, both as a function of the coal's Hardgrove grindability index and as a function of the maintenance and settings of the pulverizers; and variations in the operating conditions of the boiler, including changes in the pollution control system. Spatial variation, as an instantaneous measure of fly ash characteristics, should not involve changes in the first two sets of variables listed above. Spatial variations are a function of the gas flow within the boiler and ducts, certain flow conditions leading to a tendency for segregation of the less-dense carbons in one portion of the gas stream. Caution must be applied in sampling fly ash. Samples from a single bin, or series of bins, m ay not be representative of the whole fly ash, providing a biased view of the nature of the material. Further, it is generally not possible to be certain about variation until the analysis of the ash is complete. ?? 2001 Elsevier Science B.V. All rights reserved.

The Ph.D. Production Function: The Case at Berkeley.

ERIC Educational Resources Information Center

Breneman, David W.

This report analyzes departmental variations in time to degree and attrition in Ph.D. programs at Berkeley. An alternative hypothesis, the Ph.D. production function, is examined by cross-section econometric analysis of 28 departments. The inputs included in the production function were student variables--quality and percent males; faculty…

School Quality and Learning Gains in Rural Guatemala

ERIC Educational Resources Information Center

Marshall, Jeffery H.

2009-01-01

I use unusually detailed data on schools, teachers and classrooms to explain student achievement growth in rural Guatemala. Several variables that have received little attention in previous studies--including the number of school days, teacher content knowledge and pedagogical methods--are robust predictors of achievement. A series of…

PARTIAL LEAST SQUARE ANALYSES FOR ASSOCIATION OF LANDSCAPE METRICS WITH WATER BIOLOGICAL AND CHEMICAL PROPERTIES IN THE SAVANNAH RIVER BASIN

EPA Science Inventory

Surface water quality is related to conditions in the surrounding geophysical environment, including soils, landcover, and anthropogenic activities. A number of statistical methods may be used to analyze and explore relationships among variables. Single-, multiple- and multivaria...

EVALUATING THE ROLE OF HABITAT QUALITY ON ESTABLISHMENT OF GM AGROSTIS STOLONIFERA PLANTS IN NON-AGRONOMIC SETTINGS

EPA Science Inventory

We compared soil chemistry and plant community data at non-agronomic mesic locations that either did or did not contain genetically modified (GM) Agrostis stolonifera. The best two-variable logistic regression model included soil Mn content and A. stolonifera cover and explained...

Hospitalizations for ambulatory care sensitive conditions and quality of primary care: their relation with socioeconomic and health care variables in the Madrid regional health service (Spain).

PubMed

Magán, Purificación; Alberquilla, Angel; Otero, Angel; Ribera, José Manuel

2011-01-01

Hospitalizations for ambulatory care sensitive conditions (ACSH) have been proposed as an indirect indicator of the effectiveness and quality of care provided by primary health care. To investigate the association of ACSH rates with population socioeconomic factors and with characteristics of primary health care. Cross-sectional, ecologic study. Using hospital discharge data, ACSH were selected from the list of conditions validated for Spain. All 34 health districts in the Region of Madrid, Spain. Individuals aged 65 years or older residing in the region of Madrid between 2001 and 2003, inclusive. Age- and gender-adjusted ACSH rates in each health district. The adjusted ACSH rate per 1000 population was 35.37 in men and 20.45 in women. In the Poisson regression analysis, an inverse relation was seen between ACSH rates and the socioeconomic variables. Physician workload was the only health care variable with a statistically significant relation (rate ratio of 1.066 [95% CI; 1.041-1.091]). These results were similar in the analyses disaggregated by gender. In the multivariate analyses that included health care variables, none of the health care variables were statistically significant. ACSH may be more closely related with socioeconomic variables than with characteristics of primary care activity. Therefore, other factors outside the health system must be considered to improve health outcomes in the population.

The relationship between nurse practice environment, nurse work characteristics, burnout and job outcome and quality of nursing care: a cross-sectional survey.

PubMed

Van Bogaert, Peter; Kowalski, Christoph; Weeks, Susan Mace; Van Heusden, Danny; Clarke, Sean P

2013-12-01

To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment. Acute care hospitals face daily challenges to their efforts to achieve nurse workforce stability, safety, and quality of care. A body of knowledge shows a favourably rated nurse practice environment as an important condition for better nurse and patient outcome variables; however, further research initiatives are imperative for a clear understanding to support and guide the practice community. Cross-sectional survey. Grounded on previous empirical findings, a structural equation model designed with valid measurement instruments was tested. The study population was registered acute care nurses (N=1201) in two independent hospitals and one hospital group with six hospitals in Belgium. Nurse practice environment dimensions predicted job outcome variables and nurse ratings of quality of care. Analyses were consistent with features of nurses' work characteristics including perceived workload, decision latitude, and social capital, as well as three dimension of burnout playing mediating roles between nurse practice environment and outcomes. A revised model adjusted using various fit measures explained 52% and 47% of job outcomes and nurse-assessed quality of care, respectively. The study refines understanding of the relationship between aspects of nursing practice in order to achieve favourable nursing outcomes and offers important concepts for managers to track in their daily work. The findings of this study indicate that it is important for clinicians and leaders to consider how nurses are involved in decision-making about care processes and tracking outcomes of care and whether they are able to work with physicians, superiors, peers, and subordinates in a trusting environment based on shared values. The involvement of nurse managers at the unit level is especially critical because of associations with nurse work characteristics such as decision latitude and social capital and outcome variables. Further practice and research initiatives to support nurses' involvement in decision-making process and interdisciplinary teamwork are recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

TRAINING ERRORS AND RUNNING RELATED INJURIES: A SYSTEMATIC REVIEW

PubMed Central

Buist, Ida; Sørensen, Henrik; Lind, Martin; Rasmussen, Sten

2012-01-01

Purpose: The purpose of this systematic review was to examine the link between training characteristics (volume, duration, frequency, and intensity) and running related injuries. Methods: A systematic search was performed in PubMed, Web of Science, Embase, and SportDiscus. Studies were included if they examined novice, recreational, or elite runners between the ages of 18 and 65. Exposure variables were training characteristics defined as volume, distance or mileage, time or duration, frequency, intensity, speed or pace, or similar terms. The outcome of interest was Running Related Injuries (RRI) in general or specific RRI in the lower extremity or lower back. Methodological quality was evaluated using quality assessment tools of 11 to 16 items. Results: After examining 4561 titles and abstracts, 63 articles were identified as potentially relevant. Finally, nine retrospective cohort studies, 13 prospective cohort studies, six case-control studies, and three randomized controlled trials were included. The mean quality score was 44.1%. Conflicting results were reported on the relationships between volume, duration, intensity, and frequency and RRI. Conclusion: It was not possible to identify which training errors were related to running related injuries. Still, well supported data on which training errors relate to or cause running related injuries is highly important for determining proper prevention strategies. If methodological limitations in measuring training variables can be resolved, more work can be conducted to define training and the interactions between different training variables, create several hypotheses, test the hypotheses in a large scale prospective study, and explore cause and effect relationships in randomized controlled trials. Level of evidence: 2a PMID:22389869

Perspective: Improving Nutritional Guidelines for Sustainable Health Policies: Current Status and Perspectives.

PubMed

Magni, Paolo; Bier, Dennis M; Pecorelli, Sergio; Agostoni, Carlo; Astrup, Arne; Brighenti, Furio; Cook, Robert; Folco, Emanuela; Fontana, Luigi; Gibson, Robert A; Guerra, Ranieri; Guyatt, Gordon H; Ioannidis, John Pa; Jackson, Ann S; Klurfeld, David M; Makrides, Maria; Mathioudakis, Basil; Monaco, Alessandro; Patel, Chirag J; Racagni, Giorgio; Schünemann, Holger J; Shamir, Raanan; Zmora, Niv; Peracino, Andrea

2017-07-01

A large body of evidence supports the notion that incorrect or insufficient nutrition contributes to disease development. A pivotal goal is thus to understand what exactly is appropriate and what is inappropriate in food ingestion and the consequent nutritional status and health. The effective application of these concepts requires the translation of scientific information into practical approaches that have a tangible and measurable impact at both individual and population levels. The agenda for the future is expected to support available methodology in nutrition research to personalize guideline recommendations, properly grading the quality of the available evidence, promoting adherence to the well-established evidence hierarchy in nutrition, and enhancing strategies for appropriate vetting and transparent reporting that will solidify the recommendations for health promotion. The final goal is to build a constructive coalition among scientists, policy makers, and communication professionals for sustainable health and nutritional policies. Currently, a strong rationale and available data support a personalized dietary approach according to personal variables, including sex and age, circulating metabolic biomarkers, food quality and intake frequency, lifestyle variables such as physical activity, and environmental variables including one's microbiome profile. There is a strong and urgent need to develop a successful commitment among all the stakeholders to define novel and sustainable approaches toward the management of the health value of nutrition at individual and population levels. Moving forward requires adherence to well-established principles of evidence evaluation as well as identification of effective tools to obtain better quality evidence. Much remains to be done in the near future. © 2017 American Society for Nutrition.

Fatigue as a Driver of Overall Quality of Life in Cancer Patients.

PubMed

McCabe, Ryan M; Grutsch, James F; Braun, Donald P; Nutakki, Swetha B

2015-01-01

This manuscript describes an approach for analyzing large amounts of disparate clinical data to elucidate the most impactful factor(s) that relate to a meaningful clinical outcome, in this case, the quality of life of cancer patients. The relationships between clinical and quality of life variables were evaluated using the EORTC QLQ-C30 global health domain--a validated surrogate variable for overall cancer patient well-being. A cross-sectional study design was used to evaluate the determinants of global health in cancer patients who initiated treatment at two regional medical centers between January 2001 and December 2009. Variables analyzed included 15 EORTC QLQ-C30 scales, age at diagnosis, gender, newly diagnosed/ recurrent disease status, and stage. The decision tree algorithm, perhaps unfamiliar to practicing clinicians, evaluates the relative contribution of individual parameters in classifying a clinically meaningful functional endpoint, such as the global health of a patient. Multiple patient characteristics were identified as important contributors. Fatigue, in particular, emerged as the most prevalent indicator of cancer patients' quality of life in 16/23 clinically relevant subsets. This analysis allowed results to be stated in a clinically-intuitive, rule set format using the language and quantities of the Quality of Life (QoL) tool itself. By applying the classification algorithms to a large data set, identification of fatigue as a root factor in driving global health and overall QoL was revealed. The ability to practice mining of clinical data sets to uncover critical clinical insights that are immediately applicable to patient care practices is illustrated.

Fatigue as a Driver of Overall Quality of Life in Cancer Patients

PubMed Central

McCabe, Ryan M.; Grutsch, James F.; Braun, Donald P.; Nutakki, Swetha B.

2015-01-01

Background This manuscript describes an approach for analyzing large amounts of disparate clinical data to elucidate the most impactful factor(s) that relate to a meaningful clinical outcome, in this case, the quality of life of cancer patients. The relationships between clinical and quality of life variables were evaluated using the EORTC QLQ-C30 global health domain—a validated surrogate variable for overall cancer patient well-being. Methods A cross-sectional study design was used to evaluate the determinants of global health in cancer patients who initiated treatment at two regional medical centers between January 2001 and December 2009. Variables analyzed included 15 EORTC QLQ-C30 scales, age at diagnosis, gender, newly diagnosed/ recurrent disease status, and stage. The decision tree algorithm, perhaps unfamiliar to practicing clinicians, evaluates the relative contribution of individual parameters in classifying a clinically meaningful functional endpoint, such as the global health of a patient. Findings Multiple patient characteristics were identified as important contributors. Fatigue, in particular, emerged as the most prevalent indicator of cancer patients’ quality of life in 16/23 clinically relevant subsets. This analysis allowed results to be stated in a clinically-intuitive, rule set format using the language and quantities of the Quality of Life (QoL) tool itself. Interpretation By applying the classification algorithms to a large data set, identification of fatigue as a root factor in driving global health and overall QoL was revealed. The ability to practice mining of clinical data sets to uncover critical clinical insights that are immediately applicable to patient care practices is illustrated. PMID:26070133

Assessing Impacts on Unplanned Hospitalisations of Care Quality and Access Using a Structural Equation Method: With a Case Study of Diabetes

PubMed Central

Congdon, Peter

2016-01-01

Background: Enhanced quality of care and improved access are central to effective primary care management of long term conditions. However, research evidence is inconclusive in establishing a link between quality of primary care, or access, and adverse outcomes, such as unplanned hospitalisation. Methods: This paper proposes a structural equation model for quality and access as latent variables affecting adverse outcomes, such as unplanned hospitalisations. In a case study application, quality of care (QOC) is defined in relation to diabetes, and the aim is to assess impacts of care quality and access on unplanned hospital admissions for diabetes, while allowing also for socio-economic deprivation, diabetes morbidity, and supply effects. The study involves 90 general practitioner (GP) practices in two London Clinical Commissioning Groups, using clinical quality of care indicators, and patient survey data on perceived access. Results: As a single predictor, quality of care has a significant negative impact on emergency admissions, and this significant effect remains when socio-economic deprivation and morbidity are allowed. In a full structural equation model including access, the probability that QOC negatively impacts on unplanned admissions exceeds 0.9. Furthermore, poor access is linked to deprivation, diminished QOC, and larger list sizes. Conclusions: Using a Bayesian inference methodology, the evidence from the analysis is weighted towards negative impacts of higher primary care quality and improved access on unplanned admissions. The methodology of the paper is potentially applicable to other long term conditions, and relevant when care quality and access cannot be measured directly and are better regarded as latent variables. PMID:27598184

Assessing Impacts on Unplanned Hospitalisations of Care Quality and Access Using a Structural Equation Method: With a Case Study of Diabetes.

PubMed

Congdon, Peter

2016-09-01

Enhanced quality of care and improved access are central to effective primary care management of long term conditions. However, research evidence is inconclusive in establishing a link between quality of primary care, or access, and adverse outcomes, such as unplanned hospitalisation. This paper proposes a structural equation model for quality and access as latent variables affecting adverse outcomes, such as unplanned hospitalisations. In a case study application, quality of care (QOC) is defined in relation to diabetes, and the aim is to assess impacts of care quality and access on unplanned hospital admissions for diabetes, while allowing also for socio-economic deprivation, diabetes morbidity, and supply effects. The study involves 90 general practitioner (GP) practices in two London Clinical Commissioning Groups, using clinical quality of care indicators, and patient survey data on perceived access. As a single predictor, quality of care has a significant negative impact on emergency admissions, and this significant effect remains when socio-economic deprivation and morbidity are allowed. In a full structural equation model including access, the probability that QOC negatively impacts on unplanned admissions exceeds 0.9. Furthermore, poor access is linked to deprivation, diminished QOC, and larger list sizes. Using a Bayesian inference methodology, the evidence from the analysis is weighted towards negative impacts of higher primary care quality and improved access on unplanned admissions. The methodology of the paper is potentially applicable to other long term conditions, and relevant when care quality and access cannot be measured directly and are better regarded as latent variables.

Modeling Aircraft Emissions for Regional-scale Air Quality: Adapting a New Global Aircraft Emissions Database for the U.S

NASA Astrophysics Data System (ADS)

Arunachalam, S.; Baek, B. H.; Vennam, P. L.; Woody, M. C.; Omary, M.; Binkowski, F.; Fleming, G.

2012-12-01

Commercial aircraft emit substantial amounts of pollutants during their complete activity cycle that ranges from landing-and-takeoff (LTO) at airports to cruising in upper elevations of the atmosphere, and affect both air quality and climate. Since these emissions are not uniformly emitted over the earth, and have substantial temporal and spatial variability, it is vital to accurately evaluate and quantify the relative impacts of aviation emissions on ambient air quality. Regional-scale air quality modeling applications do not routinely include these aircraft emissions from all cycles. Federal Aviation Administration (FAA) has developed the Aviation Environmental Design Tool (AEDT), a software system that dynamically models aircraft performance in space and time to calculate fuel burn and emissions from gate-to-gate for all commercial aviation activity from all airports globally. To process in-flight aircraft emissions and to provide a realistic representation of these for treatment in grid-based air quality models, we have developed an interface processor called AEDTproc that accurately distributes full-flight chorded emissions in time and space to create gridded, hourly model-ready emissions input data. Unlike the traditional emissions modeling approach of treating aviation emissions as ground-level sources or processing emissions only from the LTO cycles in regional-scale air quality studies, AEDTproc distributes chorded inventories of aircraft emissions during LTO cycles and cruise activities into a time-variant 3-D gridded structure. We will present results of processed 2006 global emissions from AEDT over a continental U.S. modeling domain to support a national-scale air quality assessment of the incremental impacts of aircraft emissions on surface air quality. This includes about 13.6 million flights within the U.S. out of 31.2 million flights globally. We will focus on assessing spatio-temporal variability of these commercial aircraft emissions, and comparing upper tropospheric budgets of NOx from aircraft and lightning sources in the modeling domain.

Adherence and health literacy as related to outcome of patients treated for rheumatoid arthritis : Analyses of a large-scale observational study.

PubMed

Kuipers, J G; Koller, M; Zeman, F; Müller, K; Rüffer, J U

2018-04-24

Disabilities in daily living and quality of life are key endpoints for evaluating the treatment outcome for rheumatoid arthritis (RA). Factors possibly contributing to good outcome are adherence and health literacy. The survey included a representative nationwide sample of German rheumatologists and their patients with RA. The physician questionnaire included the disease activity score (DAS28) and medical prescriptions. The patient questionnaire included fatigue (EORTC QLQ-FA13), health assessment questionnaire (HAQ), quality of life (SF-12), health literacy (HELP), and patients' listings of their medications. Adherence was operationalized as follows: patient-reported (CQR5), behavioral (concordance between physicians' and patients' listings of medications), physician-assessed, and a combined measure of physician rating (1 = very adherent, 0 = less adherent) and the match between physicians' prescriptions and patients' accounts of their medications (1 = perfect match, 0 = no perfect match) that yielded three categories of adherence: high, medium, and low. Simple and multiple linear regressions (controlling for age, sex, smoking, drinking alcohol, and sport) were calculated using adherence and health literacy as predictor variables, and disease activity and patient-reported outcomes as dependent variables. 708 pairs of patient and physician questionnaires were analyzed. The mean patient age (73% women) was 60 years (SD = 12). Multiple regression analyses showed that high adherence was significantly associated with 5/7 outcome variables and health literacy with 7/7 outcome variables. Adherence and health literacy had weak but consistent effects on most outcomes. Thus, enhancing adherence and understanding of medical information could improve outcome, which should be investigated in future interventional studies.

Physical and mental quality of life in adult patients with haemophilia in Belgium: the impact of financial issues.

PubMed

Carvalhosa, A M; Henrard, S; Lambert, C; Hermans, C

2014-07-01

In Belgium, where haemophilia affects approximately 1:7000 people (2011), data on patients' quality of life (QoL) is scarce. This project aims to assess physical and mental QoL (P-QoL and M-QoL) simultaneously, and to analyse the influence of different variables on these two aspects of QoL. After Ethics Committee approval, we contacted 84 adult haemophilia A (HA) and haemophilia B (HB) patients, without current inhibitors, on replacement therapy (on-demand or secondary prophylaxis), regularly followed up at our comprehensive treatment centre. Seventy-one (n = 59 HA, n = 12 HB) replied to our questionnaire, which included the SF36v2 QoL assessment forms. We analysed two groups of variables: one including variables previously associated with decreased QoL, and another including variables with unclear impact on QoL (e.g., patients' understanding of haemophilia-related issues, economical concerns). In our population (mean ± SD age: 45.2 ± 14.7 years old), P-QoL appeared more reduced than M-QoL. P-QoL was strongly influenced by the number of arthropathies while M-QoL was primarily affected by patients' concern of personal costs due to haemophilia. Among this latter group, having knowledge of insurance coverage had a positive impact on M-QoL. Scores did not depend on haemophilia type. QoL was impaired in our haemophilia patients. A simultaneous assessment of P-QoL and M-QoL confirmed the benefit of primary prophylaxis in P-QoL, while originally pointing out the major burden of patients' concerns and poor understanding of haemophilia-related economical issues on their M-QoL. This might become a particularly challenging issue in times of financial crisis. © 2013 John Wiley & Sons Ltd.

Integrating mindfulness in supportive cancer care: a cohort study on a mindfulness-based day care clinic for cancer survivors.

PubMed

Dobos, Gustav; Overhamm, Tatiana; Büssing, Arndt; Ostermann, Thomas; Langhorst, Jost; Kümmel, Sherko; Paul, Anna; Cramer, Holger

2015-10-01

The aim of this study was to investigate the effects of a mindfulness-based day care clinic group program for cancer survivors on health-related quality of life and mental health; and to investigate which psychological variables are associated with changes in health variables. One hundred seventeen cancer survivors (91.0 % female; mean age 53.9 ± 10.7 years; 65.0 % breast cancer; mean time since diagnosis 27.2 ± 46.5 months) participated in an 11-week mindfulness-based day care clinic group program, 6 h per week. The intervention incorporated mindfulness-based meditation, yoga, cognitive-behavioral techniques, and lifestyle modification. Outcome measures including health-related quality of life (EORTC QLQ-C30), depression and anxiety (HADS); and psychological variables including life satisfaction (BMLSS), mindfulness (FMI), adaptive coping styles (AKU), spiritual/religious attitudes in dealing with illness (SpREUK), and interpretation of illness (IIQ) were assessed before, after, and 3 months after the intervention. Using mixed linear models, significant improvements in global health status, physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning were found. Cancer-related symptoms, including fatigue, pain, insomnia, constipation, anxiety, and depression, also improved significantly. Mindfulness, life satisfaction, health satisfaction, all coping styles, all spiritual/religious attitudes, and interpretation of illness as something of value increased; interpretation of illness as punishment decreased significantly (all p < 0.05). Improved outcomes were associated with increases in psychological variables, mainly life satisfaction, health satisfaction, and trust in medical help (R (2) = 7.3-43.6 %). Supportive mindfulness-based interventions can be considered as an effective means to improve cancer survivors' physical and mental health. Functional improvements are associated with improved satisfaction and coping styles.

QUALITY CONTROL - VARIABILITY IN PROTOCOLS

EPA Science Inventory

The EPA Risk Reduction Engineering Laboratory’s Quality Assurance Office, which published the popular pocket guide Preparing Perfect Project Plans, is now introducing another quality assurance reference aid. The document Variability in Protocols (VIP) was initially designed as a ...

Is there a disparity in the hospital care received under a universal health insurance program in Taiwan?

PubMed

Hsiao, Yu-Yu; Cheng, Shou-Hsia

2013-07-01

To analyze the disparity in hospital care among people of various socio-economic status (SES) under a universal health insurance scheme. A survey questionnaire was mailed to discharged patients in October 2010. This study included 183 large-scale hospitals in Taiwan. A total of 3015 patients/caregivers completed the questionnaires, which yielded a response rate of 58%. Three variables were included. The two access-to-care variables were admission route and accreditation level of the hospital in which the patient stayed. A structured questionnaire, the patient-reported hospital quality (PRHQ), was included to characterize patient's experience of hospital stay. Patients with lower education were less likely to be admitted to a hospital according to a planned schedule, or to choose an Medical Center Hospital. However, SES was not associated with the PRHQ scores. Furthermore, patients with unplanned admission were associated with lower PRHQ scores than those with planned admission to the hospital. Under the universal health insurance system in Taiwan, lower education is associated with unplanned admission to a hospital, which might result in poorer perceived quality of care. Reducing unplanned admission is a challenge for health authorities in the future.

Physical-property, water-quality, plankton, and bottom-material data for Devils Lake and East Devils Lake, North Dakota, September 1988 through October 1990

USGS Publications Warehouse

Sando, Steven K.; Sether, Bradley A.

1993-01-01

Physical-properties were measured and water-quality, plankton, and bottom-material samples were collected at 10 sites in Devils Lake and East Devils Lake during September 1988 through October 1990 to study water-quality variability and water-quality and plankton relations in Devils Lake and East Devils Lake. Physical properties measured include specific conductance, pH, water temperature, dissolved-oxygen concentration, water transparency, and light transmission. Water-quality samples were analyzed for concentrations of major ions, selected nutrients, and selected trace elements. Plankton samples were examined for identification and enumeration of phytoplankton and zooplankton species, and bottom-material samples were analyzed for concentrations of selected nutrients. Data-collection procedures are discussed and the data are presented in tabular form.

Chemometric optimization of the robustness of the near infrared spectroscopic method in wheat quality control.

PubMed

Pojić, Milica; Rakić, Dušan; Lazić, Zivorad

2015-01-01

A chemometric approach was applied for the optimization of the robustness of the NIRS method for wheat quality control. Due to the high number of experimental (n=6) and response variables to be studied (n=7) the optimization experiment was divided into two stages: screening stage in order to evaluate which of the considered variables were significant, and optimization stage to optimize the identified factors in the previously selected experimental domain. The significant variables were identified by using fractional factorial experimental design, whilst Box-Wilson rotatable central composite design (CCRD) was run to obtain the optimal values for the significant variables. The measured responses included: moisture, protein and wet gluten content, Zeleny sedimentation value and deformation energy. In order to achieve the minimal variation in responses, the optimal factor settings were found by minimizing the propagation of error (POE). The simultaneous optimization of factors was conducted by desirability function. The highest desirability of 87.63% was accomplished by setting up experimental conditions as follows: 19.9°C for sample temperature, 19.3°C for ambient temperature and 240V for instrument voltage. Copyright © 2014 Elsevier B.V. All rights reserved.

A respiratory alert model for the Shenandoah Valley, Virginia, USA

NASA Astrophysics Data System (ADS)

Hondula, David M.; Davis, Robert E.; Knight, David B.; Sitka, Luke J.; Enfield, Kyle; Gawtry, Stephen B.; Stenger, Phillip J.; Deaton, Michael L.; Normile, Caroline P.; Lee, Temple R.

2013-01-01

Respiratory morbidity (particularly COPD and asthma) can be influenced by short-term weather fluctuations that affect air quality and lung function. We developed a model to evaluate meteorological conditions associated with respiratory hospital admissions in the Shenandoah Valley of Virginia, USA. We generated ensembles of classification trees based on six years of respiratory-related hospital admissions (64,620 cases) and a suite of 83 potential environmental predictor variables. As our goal was to identify short-term weather linkages to high admission periods, the dependent variable was formulated as a binary classification of five-day moving average respiratory admission departures from the seasonal mean value. Accounting for seasonality removed the long-term apparent inverse relationship between temperature and admissions. We generated eight total models specific to the northern and southern portions of the valley for each season. All eight models demonstrate predictive skill (mean odds ratio = 3.635) when evaluated using a randomization procedure. The predictor variables selected by the ensembling algorithm vary across models, and both meteorological and air quality variables are included. In general, the models indicate complex linkages between respiratory health and environmental conditions that may be difficult to identify using more traditional approaches.

A methodology model for quality management in a general hospital.

PubMed

Stern, Z; Naveh, E

1997-01-01

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

Continuous water-quality monitoring and regression analysis to estimate constituent concentrations and loads in the Sheyenne River, North Dakota, 1980-2006

USGS Publications Warehouse

Ryberg, Karen R.

2007-01-01

This report presents the results of a study by the U.S. Geological Survey, done in cooperation with the North Dakota State Water Commission, to estimate water-quality constituent concentrations at seven sites on the Sheyenne River, N. Dak. Regression analysis of water-quality data collected in 1980-2006 was used to estimate concentrations for hardness, dissolved solids, calcium, magnesium, sodium, and sulfate. The explanatory variables examined for the regression relations were continuously monitored streamflow, specific conductance, and water temperature. For the conditions observed in 1980-2006, streamflow was a significant explanatory variable for some constituents. Specific conductance was a significant explanatory variable for all of the constituents, and water temperature was not a statistically significant explanatory variable for any of the constituents in this study. The regression relations were evaluated using common measures of variability, including R2, the proportion of variability in the estimated constituent concentration explained by the explanatory variables and regression equation. R2 values ranged from 0.784 for calcium to 0.997 for dissolved solids. The regression relations also were evaluated by calculating the median relative percentage difference (RPD) between measured constituent concentration and the constituent concentration estimated by the regression equations. Median RPDs ranged from 1.7 for dissolved solids to 11.5 for sulfate. The regression relations also may be used to estimate daily constituent loads. The relations should be monitored for change over time, especially at sites 2 and 3 which have a short period of record. In addition, caution should be used when the Sheyenne River is affected by ice or when upstream sites are affected by isolated storm runoff. Almost all of the outliers and highly influential samples removed from the analysis were made during periods when the Sheyenne River might be affected by ice.

Factors affecting Escherichia coli concentrations at Lake Erie public bathing beaches

USGS Publications Warehouse

Francy, Donna S.; Darner, Robert A.

1998-01-01

The environmental and water-quality factors that affect concentrations of Escherichia coli (E. coli) in water and sediment were investigated at three public bathing beachesEdgewater Park, Villa Angela, and Sims Parkin the Cleveland, Ohio metropolitan area. This study was done to aid in the determination of safe recreational use and to help water- resource managers assess more quickly and accurately the degradation of recreational water quality. Water and lake-bottom sediments were collected and ancillary environmental data were compiled for 41 days from May through September 1997. Water samples were analyzed for E. coli concentrations, suspended sediment concentrations, and turbidity. Lake- bottom sediment samples from the beach area were analyzed for E. coli concentrations and percent dry weight. Concentrations of E. coli were higher and more variable at Sims Park than at Villa Angela or Edgewater Park; concentrations were lowest at Edgewater Park. Time-series plots showed that short-term storage (less than one week) of E. coli in lake-bottom sediments may have occurred, although no evidence for long-term storage was found during the sampling period. E. coli concentrations in water were found to increase with increasing wave height, but the resuspension of E. coli from lake-bottom sediments by wave action could not be adequately assessed; higherwave heights were often associated with the discharge of sewage containing E. coli during or after a rainfall and wastewater-treatment plant overflow. Multiple linear regression (MLR) was used to develop models to predict recreational water quality at the in water. The related variables included turbidity, antecedent rainfall, antecedent weighted rainfall, volumes of wastewater-treatment plant overflows and metered outfalls (composed of storm-water runoff and combined-sewer overflows), a resuspension index, and wave heights. For the beaches in this study, wind speed, wind direction, water temperature, and the prswimmers were not included in the model because they were shown to be statistically unrelated to E. coli concentrations. From the several models developed, one model was chosen that accounted for 58 percent of the variability in E. coli concentrations. The chosen MLR model contained weighted categorical rainfall, beach-specific turbidity, wave height, and terms to correct for the different magnitudes of E. coli concentrations among the three beaches. For 1997, the MLR model predicted the recreational water quality as well as, and in some cases better than, antecedent E. coli concentrations (the current method). The MLR model improved the sensitivity of the prediction and the percentage of correct predictions over the current method; however, the MLR model predictions still erred to a similar degree as the current method with regard to false negatives. A false negative would allow swimming when, in fact, the bathing water standard was exceeded. More work needs to be done to validate the MLR model with data collected during other recreational seasons, especially during a season with a greater frequency and intensity of summer rains. Studies could focus on adding to the MLR model other environmental and water-quality variables that improve the predictive ability of the model. These variables might include concentrations of E. coli in deeper sediments outside the bathing area, the direction of lake currents, site-specific-rainfall amounts, time-of-day information on overflows and metered outfalls, concentrations of E. coli in treated wastewater-treatment plant effluents, and occurrences of sewage-line breaks. Rapid biological or chemical methods for determination of recreational water quality could also be used as variables in model refinements. Possible methods include the use of experimental rapid assay methods for determination of E. coli concentrations or other fecal indicators and the use of chemical tracers for fecal contamination, such as coprostanol (a degradation

The impact of posttraumatic stress disorder on quality of life and health service utilization among veterans who have schizophrenia.

PubMed

Calhoun, Patrick S; Bosworth, Hayden B; Stechuchak, Karen A; Strauss, Jennifer; Butterfield, Marian I

2006-06-01

The present study examined the impact of comorbid posttraumatic stress disorder (PTSD) on health-related quality of life and objective measures of health service utilization in 165 male veterans who have primary schizophrenia. Comorbid PTSD was assessed with the PTSD Checklist. Comorbid PTSD was significantly associated with decreased quality of life and increased medical service utilization, including increased psychiatric hospitalization and increased outpatient physical health visits, even after controlling for other clinical and demographic variables among this sample of patients who had primary schizophrenia. Veterans who have schizophrenia should be screened carefully for exposure to trauma and posttraumatic stress disorder.

The Early Development and Evolution of the QARTOD for In-Situ Wave Measurements

NASA Astrophysics Data System (ADS)

Bouchard, R. H.; Thomas, J.; Teng, C. C.; Burnett, W.; Castel, D.

2017-12-01

In 2013 the US Integrated Ocean Observing System (IOOS) Program Office issued manual was for the Real-Time Quality Control of In-Situ Surface Wave Data. This was one of the first Quality Assurance/Quality Control of Real-Time Oceanographic Data (QARTOD) manuals that now cover 11 different in situ measurements. This landmark document was the product of an effort initiated at a 2002 OCEANS.US workshop. The workshop identified and prioritized ocean variables with directional waves ranked as one of the highest key variables for inclusion into a national backbone of observations. The workshop was the impetus that led to the first QARTOD meeting in 2003 that involved over 80 participants and developed minimum standards for real-time observations. Over three more QARTOD meetings, two ad hoc meetings, and many hours of coordination and review involving dozens of wave measurement users and providers, consensus was reached on a list of essential "must Do's" for quality control tests that eventually formed the basis of the manual. The IOOS QARTOD manual established a standard format, provided greater detail, included codeable examples of the algorithms and established a framework for periodic reviews and updates. While the bulk of the quality control procedures originated with those being used by the Coastal Data Information Program (CDIP) and by NOAA's National Data Buoy Center (NDBC), QARTOD also enlisted the expertise of federal, academic, and industry partners. CDIP and NDBC each operated more than 100 wave measuring buoys and had long histories of wave buoy measurements. In addition to buoy measurements, users and providers of fixed and bottom-mounted wave systems were also included. This paper examines the individual contributions, early developments, and the evolution of the QARTOD wave measurement efforts that culminated in the US IOOS manual. These efforts serve as an example of how individuals with a common interest and dedication can achieve results for the common good. Quality control algorithms of value, but not included in the essential list and further quality control advancements outside of the QARTOD will also be reviewed.

Profiles of the evaluators: impact of psychographic variables on the consumer-oriented quality assessment of mobile television

NASA Astrophysics Data System (ADS)

Jumisko-Pyykkö, Satu; Häkkinen, Jukka

2008-02-01

In the product development of services it is important to adjust mobile video quality according to the quality requirements of potential users. Therefore, a careful participant selection is very important. However, in the literature the details of participant selection are often handled without great detail. This is also reflected in the handling of experimental results, where the impact of psychographic factors on quality is rarely reported. As the user attributes potentially have a large effect to the results, we investigated the role of various psychographical variables on the subjective evaluation of audiovisual video quality in two different experiments. The studied variables were age, gender, education, professionalism, television consumption, experiences of different digital video qualities, and attitude towards technology. The results showed that quality evaluations were affected by almost all background factors. The most significant variables were age, professionalism, knowledge of digital quality features and attitude towards technology. The knowledge of these factors can be exploited in careful participant selection, which will in turn increase the validity of results as the subjective evaluations reflect better the requirements of potential users.

Calculating the risk of a pancreatic fistula after a pancreaticoduodenectomy: a systematic review

PubMed Central

Vallance, Abigail E; Young, Alastair L; Macutkiewicz, Christian; Roberts, Keith J; Smith, Andrew M

2015-01-01

Background A post-operative pancreatic fistula (POPF) is a major cause of morbidity and mortality after a pancreaticoduodenectomy (PD). This systematic review aimed to identify all scoring systems to predict POPF after a PD, consider their clinical applicability and assess the study quality. Method An electronic search was performed of Medline (1946–2014) and EMBASE (1996–2014) databases. Results were screened according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and quality assessed according to the QUIPS (quality in prognostic studies) tool. Results Six eligible scoring systems were identified. Five studies used the International Study Group on Pancreatic Fistula (ISGPF) definition. The proposed scores feature between two and five variables and of the 16 total variables, the majority (12) featured in only one score. Three scores could be fully completed pre-operatively whereas 1 score included intra-operative and two studies post-operative variables. Four scores were internally validated and of these, two scores have been subject to subsequent multicentre review. The median QUIPS score was 38 out of 50 (range 16–50). Conclusion These scores show potential in calculating the individualized patient risk of POPF. There is, however, much variation in current scoring systems and further validation in large multicentre cohorts is now needed. PMID:26456948

[Cognitive complaints in people with human immunodeficiency virus in Spain: prevalence and related variables].

PubMed

Muñoz-Moreno, José A; Fuster-Ruiz de Apodaca, Maria J; Fumaz, Carmina R; Ferrer, Maria J; Molero, Fernando; Jaen, Àngels; Clotet, Bonaventura; Dalmau, David

2014-05-20

Cognitive complaints have been scarcely studied in people with HIV in Spain. The aim of this research was to know the prevalence of cognitive complaints in HIV-infected people, as well as its potential relationships with demographic, clinical and psychological variables, in the era of combination antiretroviral therapies. Observational multicenter study developed in 4 hospitals and 10 NGOs, in which 791 people with HIV in Spain participated. A self-reported questionnaire was used to evaluate demographic and clinical variables, and an assessment of cognitive complaints, emotional status and quality of life variables was also included. Descriptive and inferential tests were used for statistical analyses. Almost half of the sample (49.8%) referred cognitive complaints, in 72.1% of them an association with interference on daily living activities was found. Memory and attention were the areas most prevalently perceived as affected. The existence of cognitive complaints correlated with a longer HIV infection, lower CD4+ cell count, undetectable viral load and worse quality of life. A discriminant analysis determined that depression, anxiety, older age, living with no partner and low education level allowed to classify optimally HIV-infected people with cognitive complaints. Self-reported cognitive complaints are frequent in people infected with HIV in the current era of combination antiretroviral therapies. This fact is related to emotional disturbances and poor quality of life, but also to impaired immunological and virological status. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Quantifying the residence time and flushing characteristics of a shallow, back-barrier estuary: Application of hydrodynamic and particle tracking models

USGS Publications Warehouse

Defne, Zafer; Ganju, Neil K.

2015-01-01

Estuarine residence time is a major driver of eutrophication and water quality. Barnegat Bay-Little Egg Harbor (BB-LEH), New Jersey, is a lagoonal back-barrier estuary that is subject to anthropogenic pressures including nutrient loading, eutrophication, and subsequent declines in water quality. A combination of hydrodynamic and particle tracking modeling was used to identify the mechanisms controlling flushing, residence time, and spatial variability of particle retention. The models demonstrated a pronounced northward subtidal flow from Little Egg Inlet in the south to Pt. Pleasant Canal in the north due to frictional effects in the inlets, leading to better flushing of the southern half of the estuary and particle retention in the northern estuary. Mean residence time for BB-LEH was 13 days but spatial variability was between ∼0 and 30 days depending on the initial particle location. Mean residence time with tidal forcing alone was 24 days (spatial variability between ∼0 and 50 days); the tides were relatively inefficient in flushing the northern end of the Bay. Scenarios with successive exclusion of physical processes from the models revealed that meteorological and remote offshore forcing were stronger drivers of exchange than riverine inflow. Investigations of water quality and eutrophication should take into account spatial variability in hydrodynamics and residence time in order to better quantify the roles of nutrient loading, production, and flushing.

Temporal and spatial variation in allocating annual traffic activity across an urban region and implications for air quality assessments

PubMed Central

Batterman, Stuart

2015-01-01

Patterns of traffic activity, including changes in the volume and speed of vehicles, vary over time and across urban areas and can substantially affect vehicle emissions of air pollutants. Time-resolved activity at the street scale typically is derived using temporal allocation factors (TAFs) that allow the development of emissions inventories needed to predict concentrations of traffic-related air pollutants. This study examines the spatial and temporal variation of TAFs, and characterizes prediction errors resulting from their use. Methods are presented to estimate TAFs and their spatial and temporal variability and used to analyze total, commercial and non-commercial traffic in the Detroit, Michigan, U.S. metropolitan area. The variability of total volume estimates, quantified by the coefficient of variation (COV) representing the percentage departure from expected hourly volume, was 21, 33, 24 and 33% for weekdays, Saturdays, Sundays and holidays, respectively. Prediction errors mostly resulted from hour-to-hour variability on weekdays and Saturdays, and from day-to-day variability on Sundays and holidays. Spatial variability was limited across the study roads, most of which were large freeways. Commercial traffic had different temporal patterns and greater variability than noncommercial vehicle traffic, e.g., the weekday variability of hourly commercial volume was 28%. The results indicate that TAFs for a metropolitan region can provide reasonably accurate estimates of hourly vehicle volume on major roads. While vehicle volume is only one of many factors that govern on-road emission rates, air quality analyses would be strengthened by incorporating information regarding the uncertainty and variability of traffic activity. PMID:26688671

[Quality analysis of observational studies on pelvic organ prolapse in China].

PubMed

Wang, Y T; Tao, L Y; He, H J; Han, J S

2017-06-25

Objective: To evaluate the quality of observational studies on pelvic organ prolapse in China. Methods: The checklist of strengthening the reporting of observational studies in epidemiology (STROBE) statement was applied to evaluate the observational studies. The articles were searched in the SinoMed database using the terms: prolapse, uterine prolapse, cystocele, rectal prolapse and pelvic floor; limited to Chinese core journals in obstetrics and gynecology from January 1996 to December 2015. With two 10-year groups (1996-2005 and 2006-2015), the χ(2) test was used to evaluate inter-group differences. Results: (1) A total of 386 observational studies were selected, including 15.5%(60/386) of case-control studies, 80.6%(311/386) of cohort studies and 3.9% (15/386) of cross-sectional studies. (2) There were totally 22 items including 34 sub-items in the checklist. There were 17 sub-items (50.0%, 17/34) had a reporting ratio less than 50% in all of aticles, including: 1a (study's design) 3.9% (15/386), 6a (participants) 24.6% (95/386), 6b (matched studies) 0 (0/386), 9 (bias) 8.3% (32/386), 10 (study size) 3.9%, 11 (quantitative variables) 41.2% (159/386), 12b-12e (statistical methods in detail) 0-2.6% (10/386), 13a (numbers of individuals at each stage of study) 18.9% (73/386), 13b (reasons for non-participation at each stage) 18.9%, 13c (flow diagram) 0, 16b and 16c (results of category boundaries and relative risk) 9.6% (37/386) and 0, 19 (limitations) 31.6% (122/386), 22 (funding) 20.5% (79/386). (3) The quality of articles published in the two decades (1996-2005 and 2006-2015) were compared, and 38.2%(13/34) of sub-items had been significantly improved in the second 10-year (all P< 0.05). The improved items were as follows: 1b (integrity of abstract), 2 (background/rationale), 6a (participants), 7 (variables), 8 (data sources/measurement), 9 (bias), 11 (quantitative variables), 12a (statistical methods), 17 (other analyses), 18 (key results), 19 (limitations), 21 (generalisability), 22 (funding). Conclusions: The quality of observational studies on POP in China is suboptimal in half of evaluation items. However, the quality of articles published in the second 10-year have significantly improved.

Types of social supports predicting health-related quality of life among adult patients with CHD in the Institut Jantung Negara (National Heart Institute), Malaysia.

PubMed

Tye, Sue K; Kandavello, Geetha; Gan, Kah L

2017-01-01

The objectives of this study were to examine which types of social supports - emotional/informational support, tangible support, affectionate support, and positive interactions - are the predictors of health-related quality of life (HRQoL) in adult patients with CHD and to assess the influence of demographic variables and clinical factors on these variables. In total, 205 adult patients with CHD from the National Heart Institute, Malaysia, were recruited. Patients were first screened by cardiology consultants to ensure they fit the inclusion criteria before filling in questionnaires, which were medical outcome studies - social support survey and AQoL-8D. Results/conclusions All social supports and their subscales were found to have mild-to-moderate significant relationships with physical dimension, psychological dimension, and overall HRQoL; however, only positive interaction, marital status, and types of diagnosis were reported as predictors of HRQoL. Surprisingly, with regard to the physical dimension of quality of life, social supports were not significant predictors, but educational level, marital status, and types of diagnosis were significant predictors. Positive interaction, affectionate support, marital status, and types of diagnosis were again found to be predictors in the aspects of the psychological dimension of quality of life. In conclusion, positive interaction and affectionate support, which include elements of fun, relaxation, love, and care, should be included in the care of adult patients with CHD.

Essential elements of professional nursing environments in Primary Care and their influence on the quality of care.

PubMed

Gea-Caballero, Vicente; Castro-Sánchez, Enrique; Júarez-Vela, Raúl; Díaz-Herrera, Miguel Ángel; de Miguel-Montoya, Isabel; Martínez-Riera, José Ramón

Nursing work environments are key determinants of care quality. Our study aimed to evaluate the characteristics of nursing environments in primary care settings in the Canary Islands, and identify crucial components of such environments to improve quality. We conducted a cross-sectional study in primary care organisations using the Practice Environment Scale - Nursing Work Index tool. We collected sociodemographic variables, scores, and selected the essential items conducive to optimal care. Appropriate parametric and non-parametric statistical tests were used to analyse relations between variables (CI = 95%, error = 5%). One hundred and forty-four nurses participated. The mean total score was 81.6. The results for the five dimensions included in the Practice Environment Scale - Nursing Work Index ranged from 2.25 - 2.92 (Mean). Twelve key items for quality of care were selected; six were positive in the Canary Islands, two were mixed, and four negative. 7/12 items were included in Dimension 2 (fundamentals of nursing). Being a manager was statistically associated with higher scores (p<.000). Years of experience was inversely associated with scores in the 12 items (p<.021). Nursing work environments in primary care settings in the Canary Islands are comparable to others previously studied in Spain. Areas to improve were human resources and participation of nurses in management decisions. Nurse managers must be knowledgeable about their working environments so they can focus on improvements in key dimensions. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Square2 - A Web Application for Data Monitoring in Epidemiological and Clinical Studies

PubMed

Schmidt, Carsten Oliver; Krabbe, Christine; Schössow, Janka; Albers, Martin; Radke, Dörte; Henke, Jörg

2017-01-01

Valid scientific inferences from epidemiological and clinical studies require high data quality. Data generating departments therefore aim to detect data irregularities as early as possible in order to guide quality management processes. In addition, after the completion of data collections the obtained data quality must be evaluated. This can be challenging in complex studies due to a wide scope of examinations, numerous study variables, multiple examiners, devices, and examination centers. This paper describes a Java EE web application used to monitor and evaluate data quality in institutions with complex and multiple studies, named Square 2 . It uses the Java libraries Apache MyFaces 2, extended by BootsFaces for layout and style. RServe and REngine manage calls to R server processes. All study data and metadata are stored in PostgreSQL. R is the statistics backend and LaTeX is used for the generation of print ready PDF reports. A GUI manages the entire workflow. Square 2 covers all steps in the data monitoring workflow, including the setup of studies and their structure, the handling of metadata for data monitoring purposes, selection of variables, upload of data, statistical analyses, and the generation as well as inspection of quality reports. To take into account data protection issues, Square 2 comprises an extensive user rights and roles concept.

Use of care management practices in small- and medium-sized physician groups: do public reporting of physician quality and financial incentives matter?

PubMed

Alexander, Jeffrey A; Maeng, Daniel; Casalino, Lawrence P; Rittenhouse, Diane

2013-04-01

To examine the effect of public reporting (PR) and financial incentives tied to quality performance on the use of care management practices (CMPs) among small- and medium-sized physician groups. Survey data from The National Study of Small and Medium-sized Physician Practices were used. Primary data collection was also conducted to assess community-level PR activities. The final sample included 643 practices engaged in quality reporting; about half of these practices were subject to PR. We used a treatment effects model. The instrumental variables were the community-level variables that capture the level of PR activity in each community in which the practices operate. (1) PR is associated with increased use of CMPs, but the estimate is not statistically significant; (2) financial incentives are associated with greater use of CMPs; (3) practices' awareness/sensitivity to quality reports is positively related to their use of CMPs; and (4) combined PR and financial incentives jointly affect CMP use to a greater degree than either of these factors alone. Small- to medium-sized practices appear to respond to PR and financial incentives by greater use of CMPs. Future research needs to investigate the appropriate mix and type of incentive arrangements and quality reporting. © Health Research and Educational Trust.

Process audits versus product quality monitoring of bulk milk.

PubMed

Velthuis, A G J; van Asseldonk, M A P M

2011-01-01

Assessment of milk quality is based on bulk milk testing and farm certification on process quality audits. It is unknown to what extent dairy farm audits improve milk quality. A statistical analysis was conducted to quantify possible associations between bulk milk testing and dairy farm audits. The analysis comprised 64.373 audit outcomes on 26,953 dairy farms, which were merged with all conducted laboratory tests of bulk milk samples 12 mo before the audit. Each farm audit record included 271 binary checklist items and 52 attention point variables (given to farmers if serious deviations were observed), both indicating possible deviations from the desired farm situation. Test results included somatic cell count (SCC), total bacterial count (TBC), antimicrobial drug residues (ADR), level of butyric acid spores (BAB), freezing point depression (FPD), level of free fatty acid (FFA), and milk sediment (SED). Results show that numerous audit variables were related to bulk milk test results, although the goodness of fit of the models was generally low. Cow hygiene, clean cubicles, hygiene of milking parlor, and utility room were positively correlated with superior product quality, mainly with respect to SCC, TBC, BAB, FPD, FFA, and SED. Animal health or veterinary drugs management (i.e., drug treatment recording, marking of treated animals, and storage of veterinary drugs) related to SCC, FPD, FFA, and SED. The availability of drinking water was related to TBC, BAB, FFA, and SED, whereas maintenance of the milking equipment was related mainly to SCC, FPD, and FFA. In summary, bulk milk quality and farm audit outcomes are, to some degree, associated: if dairy farms are assessed negatively on specific audit aspects, the bulk milk quality is more likely to be inferior. However, the proportion of the total variance in milk test results explained by audits ranged between 4 and 13% (depending on the specific bulk milk test), showing that auditing dairy farms provides additional information but has a limited association with the outcome of a product quality control program. This study suggests that farm audits could be streamlined to include only relevant checklist items and that bulk milk quality monitoring could be used as a basis of selecting farms for more or less frequent audits. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Climatological Modeling of Monthly Air Temperature and Precipitation in Egypt through GIS Techniques

NASA Astrophysics Data System (ADS)

El Kenawy, A.

2009-09-01

This paper describes a method for modeling and mapping four climatic variables (maximum temperature, minimum temperature, mean temperature and total precipitation) in Egypt using a multiple regression approach implemented in a GIS environment. In this model, a set of variables including latitude, longitude, elevation within a distance of 5, 10 and 15 km, slope, aspect, distance to the Mediterranean Sea, distance to the Red Sea, distance to the Nile, ratio between land and water masses within a radius of 5, 10, 15 km, the Normalized Difference Vegetation Index (NDVI), the Normalized Difference Water Index (NDWI), the Normalized Difference Temperature Index (NDTI) and reflectance are included as independent variables. These variables were integrated as raster layers in MiraMon software at a spatial resolution of 1 km. Climatic variables were considered as dependent variables and averaged from quality controlled and homogenized 39 series distributing across the entire country during the period of (1957-2006). For each climatic variable, digital and objective maps were finally obtained using the multiple regression coefficients at monthly, seasonal and annual timescale. The accuracy of these maps were assessed through cross-validation between predicted and observed values using a set of statistics including coefficient of determination (R2), root mean square error (RMSE), mean absolute error (MAE), mean bias Error (MBE) and D Willmott statistic. These maps are valuable in the sense of spatial resolution as well as the number of observatories involved in the current analysis.

Appending Limited Clinical Data to an Administrative Database for Acute Myocardial Infarction Patients: The Impact on the Assessment of Hospital Quality.

PubMed

Hannan, Edward L; Samadashvili, Zaza; Cozzens, Kimberly; Jacobs, Alice K; Venditti, Ferdinand J; Holmes, David R; Berger, Peter B; Stamato, Nicholas J; Hughes, Suzanne; Walford, Gary

2016-05-01

Hospitals' risk-standardized mortality rates and outlier status (significantly higher/lower rates) are reported by the Centers for Medicare and Medicaid Services (CMS) for acute myocardial infarction (AMI) patients using Medicare claims data. New York now has AMI claims data with blood pressure and heart rate added. The objective of this study was to see whether the appended database yields different hospital assessments than standard claims data. New York State clinically appended claims data for AMI were used to create 2 different risk models based on CMS methods: 1 with and 1 without the added clinical data. Model discrimination was compared, and differences between the models in hospital outlier status and tertile status were examined. Mean arterial pressure and heart rate were both significant predictors of mortality in the clinically appended model. The C statistic for the model with the clinical variables added was significantly higher (0.803 vs. 0.773, P<0.001). The model without clinical variables identified 10 low outliers and all of them were percutaneous coronary intervention hospitals. When clinical variables were included in the model, only 6 of those 10 hospitals were low outliers, but there were 2 new low outliers. The model without clinical variables had only 3 high outliers, and the model with clinical variables included identified 2 new high outliers. Appending even a small number of clinical data elements to administrative data resulted in a difference in the assessment of hospital mortality outliers for AMI. The strategy of adding limited but important clinical data elements to administrative datasets should be considered when evaluating hospital quality for procedures and other medical conditions.

Variation of organic matter quantity and quality in streams at Critical Zone Observatory watersheds

USGS Publications Warehouse

Miller, Matthew P.; Boyer, Elizabeth W.; McKnight, Diane M.; Brown, Michael G.; Gabor, Rachel S.; Hunsaker, Carolyn T.; Iavorivska , Lidiia; Inamdar, Shreeram; Kaplan, Louis A.; Johnson, Dale W.; Lin, Henry; McDowell, William H.; Perdrial, Julia N.

2016-01-01

The quantity and chemical composition of dissolved organic matter (DOM) in surface waters influence ecosystem processes and anthropogenic use of freshwater. However, despite the importance of understanding spatial and temporal patterns in DOM, measures of DOM quality are not routinely included as part of large-scale ecosystem monitoring programs and variations in analytical procedures can introduce artifacts. In this study, we used consistent sampling and analytical methods to meet the objective of defining variability in DOM quantity and quality and other measures of water quality in streamflow issuing from small forested watersheds located within five Critical Zone Observatory sites representing contrasting environmental conditions. Results show distinct separations among sites as a function of water quality constituents. Relationships among rates of atmospheric deposition, water quality conditions, and stream DOM quantity and quality are consistent with the notion that areas with relatively high rates of atmospheric nitrogen and sulfur deposition and high concentrations of divalent cations result in selective transport of DOM derived from microbial sources, including in-stream microbial phototrophs. We suggest that the critical zone as a whole strongly influences the origin, composition, and fate of DOM in streams. This study highlights the value of consistent DOM characterization methods included as part of long-term monitoring programs for improving our understanding of interactions among ecosystem processes as controls on DOM biogeochemistry.

Qualitative Video Analysis of Track-Cycling Team Pursuit in World-Class Athletes.

PubMed

Sigrist, Samuel; Maier, Thomas; Faiss, Raphael

2017-11-01

Track-cycling team pursuit (TP) is a highly technical effort involving 4 athletes completing 4 km from a standing start, often in less than 240 s. Transitions between athletes leading the team are obviously of utmost importance. To perform qualitative video analyses of transitions of world-class athletes in TP competitions. Videos captured at 100 Hz were recorded for 77 races (including 96 different athletes) in 5 international track-cycling competitions (eg, UCI World Cups and World Championships) and analyzed for the 12 best teams in the UCI Track Cycling TP Olympic ranking. During TP, 1013 transitions were evaluated individually to extract quantitative (eg, average lead time, transition number, length, duration, height in the curve) and qualitative (quality of transition start, quality of return at the back of the team, distance between third and returning rider score) variables. Determination of correlation coefficients between extracted variables and end time allowed assessment of relationships between variables and relevance of the video analyses. Overall quality of transitions and end time were significantly correlated (r = .35, P = .002). Similarly, transition distance (r = .26, P = .02) and duration (r = .35, P = .002) were positively correlated with end time. Conversely, no relationship was observed between transition number, average lead time, or height reached in the curve and end time. Video analysis of TP races highlights the importance of quality transitions between riders, with preferably swift and short relays rather than longer lead times for faster race times.

Organizational culture affecting quality of care: guideline adherence in perioperative antibiotic use.

PubMed

Ukawa, Naoto; Tanaka, Masayuki; Morishima, Toshitaka; Imanaka, Yuichi

2015-02-01

The objective of this work was to elucidate aspects of organizational culture associated with hospital performance in perioperative antibiotic prophylaxis using quantitative data in a multicenter and multidimensional study. Cross-sectional retrospective study using a survey data and administrative data. Eighty-three acute hospitals in Japan. A total of 4856 respondents in the organizational culture study, and 23 172 patients for the quality indicator analysis. Multilevel models of various cultural dimensions were used to analyze the association between hospital organizational culture and guideline adherence. The dependent variable was adherence or non-adherence to Japanese and CDC guidelines at the patient level and main independent variable was hospital groups categorized according to organizational culture score. Other control variables included hospital characteristics such as ownership, bed capacity, region and urbanization level of location. The multilevel analysis showed that hospitals with a high score in organizational culture were more likely to adhere to the Japanese and CDC guidelines when compared with lower scoring hospitals. In particular, the hospital group with high scores in the 'collaboration' and 'professional growth' dimensions had three times the odds for Japanese guideline adherence in comparison with low-scoring hospitals. Our study revealed that various aspects of organizational culture were associated with adherence to guidelines for perioperative antibiotic use. Hospital managers aiming to improve quality of care may benefit from improving hospital organizational culture. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Assessment of the methodological and ethical quality of clinical trials published in family medicine journals

PubMed

Castaño-García, Alberto; Guillén-Grima, Francisco; León-Sanz, Pilar

2018-01-01

To evaluate some methodological and ethical quality variables of clinical trials (CTs) published in 10 family medicine journals. Quality descriptive study of 10 family medicine journals including CTs in humans published since 2010 to 2013. We obtained 141 CT and 2447 were excluded. CTs parallels controlled in 92.9% (95% confidence interval [95% CI]: 92.0-93.9). Masked randomization in 72.3% (95% CI: 71.7-73.1), decentralized in 51.8% (95% CI: 51.4-52.4) and using as control an active treatment in 82.2% (95% CI: 81.5-83.1). Wrote informed consent in 48.9% (95% CI: 48.5-49.5) and it was not withdrawn in 56.0% of cases (95% CI: 55.5-56.7). Approval by clinical research ethics committee (CREC) in 134, and there was no conflict of interest in 117 CTs. Average κ was 0.96 (95% CI: 0.93-0.99). We observe an increase in some quality variables like masked randomization (19.6%) and approval by CREC (75%) post CONSORT, in CTs published in 10 family medicine journals (2010-2013). Copyright: © 2018 SecretarÍa de Salud

Job strain and health-related quality of life in a national sample.

PubMed

Lerner, D J; Levine, S; Malspeis, S; D'Agostino, R B

1994-10-01

Studies of the health effects of job strain have focused on morbidity and mortality as outcomes. This is the first study to examine the relationship of job strain to more comprehensive health status measures that encompass health-related quality of life. In a national cross-sectional survey, 1319 working men and women, aged 18 through 64 years, completed a modified version of the Job Content Questionnaire that classified workers' jobs into four categories: high strain, passive, low strain, and active. Subjects also completed the Medical Outcomes Study Short-Form Health Survey and a health distress scale. Logistic regression analyses were employed that controlled for age, race/ethnicity, gender, and education. Both work and nonwork variables were included. Job strain was significantly associated with five of nine components of health-related quality of life: physical functioning, role functioning related to physical health, vitality, social functioning, and mental health. Job strain made a modest yet statistically significant contribution beyond the effects of chronic illness and psychosocial variables. The results provide justification for further investigating the role of job strain as an independent risk factor for health-related quality of life.

Concordance of Child and Parent Reports of Health-Related Quality of Life in Children With Mild Traumatic Brain or Non-Brain Injuries and in Uninjured Children: Longitudinal Evaluation.

PubMed

Pieper, Pam; Garvan, Cynthia

2015-01-01

This study aimed to determine (a) concordance between parents' and children's perceptions of health-related quality of life (HRQoL) for children who sustained a mild traumatic brain injury or a mild non-brain injury or who were uninjured at baseline and at 1, 3, 6, and 12 months postinjury; (b) test-retest reliability of the Pediatric Quality of Life Inventory Generic Core and Cognitive Functioning Scales in the uninjured group; and (c) which, if any, variables predicted parity in child/parent dyad responses. This longitudinal study included 103 child/parent dyads in three groups. Each child and parent completed Pediatric Quality of Life Inventory questionnaires within 24 hours of injury and at months 1, 3, 6, and 12 postinjury. Child/parent HRQoL concordance was generally poor. The variables for age, gender, and study group were not found to be response-parity predictors. Inclusion of child and parent perceptions provides a more comprehensive picture of the child's HRQoL, increasing provider awareness of related health care needs. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Determinants of Quality of Family Planning Counseling among Private Health Facilities in Lagos.

PubMed

Johnson, Doug; Ugaz, Jorge

2016-09-01

We use a unique dataset that includes an objective measure of the quality of family planning counseling from 927 private health facilities in Lagos State, Nigeria, to determine which variables at the facility and provider levels are most closely correlated with the quality of family planning counseling. Our data on quality come from mystery client surveys in which the clients posed as women seeking family planning counseling. We find that quality is strongly associated with the cadre of provider, with doctors delivering substantially higher-quality counselling than nurses. Doctors not only outperform nurses overall, but also perform better on each category of quality and spend nearly three minutes longer on average counseling the mystery client. Location, fees charged for the service, and facility type are also strongly correlated with quality. The degree to which a facility specializes in family planning and facility size are only weakly predictive of quality. © 2016 The Population Council, Inc.

Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review.

PubMed

Munce, Sarah E P; Perrier, Laure; Shin, Saeha; Adhihetty, Chamila; Pitzul, Kristen; Nelson, Michelle L A; Bayley, Mark T

2017-09-07

While many outcomes post-stroke (e.g., depression) have been previously investigated, there is no complete data on the impact of a variety of quality improvement strategies on the quality of life and physical and psychological well-being of individuals post-stroke. The current paper outlines a systematic review protocol on the impact of quality improvement strategies on quality of life as well as physical and psychological well-being of individuals with stroke. MEDLINE, CINAHL, EMBASE, and PsycINFO databases will be searched. Two independent reviewers will conduct all levels of screening, data abstraction, and quality appraisal. Only randomized controlled trials that report on the impact of quality improvement strategies on quality of life outcomes in people with stroke will be included. The secondary outcomes will be physical and psychological well-being. Quality improvement strategies include audit and feedback, case management, team changes, electronic patient registries, clinician education, clinical reminders, facilitated relay of clinical information to clinicians, patient education, (promotion of) self-management, patient reminder systems, and continuous quality improvement. Studies published since 2000 will be included to increase the relevancy of findings. Results will be grouped according to the target group of the varying quality improvement strategies (i.e., health system, health care professionals, or patients) and/or by any other noteworthy grouping variables, such as etiology of stroke or by sex. This systematic review will identify those quality improvement strategies aimed at the health system, health care professionals, and patients that impact the quality of life of individuals with stroke. Improving awareness and utilization of such strategies may enhance uptake of stroke best practices and reduce inappropriate health care utilization costs. PROSPERO, CRD42017064141.

Boundary-Spanning Actors in Urban 4-H: An Action Research Case Study

ERIC Educational Resources Information Center

David, Victoria Dotson

2014-01-01

Today's Cooperative Extension organization continues to face challenges of providing relevant, quality programming in urban communities. Challenges include the ability to build capacity in Extension's urban youth educators to assess and interpret the unique, variable needs of urban clients and to communicate effectively the identified…

Multi-Variable and Multi-Site Calibration and Validation of SWAT for Water Quality in the Kaskaskia River Watershed

EPA Science Inventory

The Future Midwest Landscape (FML) project is part of the U.S. Environmental Protection Agency’s new Ecosystem Services Research Program, undertaken to examine the variety of ways in which landscapes that include crop lands, conservation areas, wetlands, lakes and streams affect ...

The Role of Communication and Cohesion in Reducing Social Loafing in Group Projects

ERIC Educational Resources Information Center

Lam, Chris

2015-01-01

This study examines previously untested variables that influence social loafing in professional and technical communication group projects by determining the influence of communication quality and task cohesion on social loafing. A set-up factors model, which included group size, peer review, project scope, and method of team formation, was also…

Soil property changes during loblolly pine production

Treesearch

R. Wayne Skaggs; Devendra M. Amatya; G.M. Chescheir; Christine D. Blanton

2006-01-01

Three watersheds, each approximately 25 ha, were instrumented to measure and record drainage rate, water table depth, rainfall and meteorological data. Data continuously collected on the site since 1988 include response of hydrologic and water quality variables for nearly all growth stages of a Loblolly pine plantation. Data for drainage outflow rates and water table...

State-of-the-Art pH Electrode Quality Control for Measurements of Acidic, Low Ionic Strength Waters.

ERIC Educational Resources Information Center

Stapanian, Martin A.; Metcalf, Richard C.

1990-01-01

Described is the derivation of the relationship between the pH measurement error and the resulting percentage error in hydrogen ion concentration including the use of variable activity coefficients. The relative influence of the ionic strength of the solution on the percentage error is shown. (CW)

Clinical dysphagia risk predictors after prolonged orotracheal intubation

PubMed Central

de Medeiros, Gisele Chagas; Sassi, Fernanda Chiarion; Mangilli, Laura Davison; Zilberstein, Bruno; de Andrade, Claudia Regina Furquim

2014-01-01

OBJECTIVES: To elucidate independent risk factors for dysphagia after prolonged orotracheal intubation. METHODS: The participants were 148 consecutive patients who underwent clinical bedside swallowing assessments from September 2009 to September 2011. All patients had received prolonged orotracheal intubations and were admitted to one of several intensive care units of a large Brazilian school hospital. The correlations between the conducted water swallow test results and dysphagia risk levels were analyzed for statistical significance. RESULTS: Of the 148 patients included in the study, 91 were male and 57 were female (mean age, 53.64 years). The univariate analysis results indicated that specific variables, including extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking, and other signs, were possible significant high-risk indicators of dysphagia onset. The multivariate analysis results indicated that cervical auscultation and coughing were independent predictive variables for high dysphagia risk. CONCLUSIONS: Patients displaying extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking and other signs should benefit from early swallowing evaluations. Additionally, early post-extubation dysfunction recognition is paramount in reducing the morbidity rate in this high-risk population. PMID:24473554

Clinical dysphagia risk predictors after prolonged orotracheal intubation.

PubMed

Medeiros, Gisele Chagas de; Sassi, Fernanda Chiarion; Mangilli, Laura Davison; Zilberstein, Bruno; Andrade, Claudia Regina Furquim de

2014-01-01

To elucidate independent risk factors for dysphagia after prolonged orotracheal intubation. The participants were 148 consecutive patients who underwent clinical bedside swallowing assessments from September 2009 to September 2011. All patients had received prolonged orotracheal intubations and were admitted to one of several intensive care units of a large Brazilian school hospital. The correlations between the conducted water swallow test results and dysphagia risk levels were analyzed for statistical significance. Of the 148 patients included in the study, 91 were male and 57 were female (mean age, 53.64 years). The univariate analysis results indicated that specific variables, including extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking, and other signs, were possible significant high-risk indicators of dysphagia onset. The multivariate analysis results indicated that cervical auscultation and coughing were independent predictive variables for high dysphagia risk. Patients displaying extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking and other signs should benefit from early swallowing evaluations. Additionally, early post-extubation dysfunction recognition is paramount in reducing the morbidity rate in this high-risk population.

Changes in biological communities of the Fountain Creek Basin, Colorado, 2003–2016, in relation to antecedent streamflow, water quality, and habitat

USGS Publications Warehouse

Roberts, James J.; Bruce, James F.; Zuellig, Robert E.

2018-01-08

The analysis described in this report is part of a longterm project monitoring the biological communities, habitat, and water quality of the Fountain Creek Basin. Biology, habitat, and water-quality data have been collected at 10 sites since 2003. These data include annual samples of aquatic invertebrate communities, fish communities, water quality, and quantitative riverine habitat. This report examines trends in biological communities from 2003 to 2016 and explores relationships between biological communities and abiotic variables (antecedent streamflow, physical habitat, and water quality). Six biological metrics (three invertebrate and three fish) and four individual fish species were used to examine trends in these data and how streamflow, habitat, and (or) water quality may explain these trends. The analysis of 79 trends shows that the majority of significant trends decreased over the trend period. Overall, 19 trends before adjustments for streamflow in the fish (12) and invertebrate (7) metrics were all decreasing except for the metric Invertebrate Species Richness at the most upstream site in Monument Creek. Seven of these trends were explained by streamflow and four trends were revealed that were originally masked by variability in antecedent streamflow. Only two sites (Jimmy Camp Creek at Fountain, CO and Fountain Creek near Pinon, CO) had no trends in the fish or invertebrate metrics. Ten of the streamflow-adjusted trends were explained by habitat, one was explained by water quality, and five were not explained by any of the variables that were tested. Overall, from 2003 to 2016, all the fish metric trends were decreasing with an average decline of 40 percent, and invertebrate metrics decreased on average by 9.5 percent. A potential peak streamflow threshold was identified above which there is severely limited production of age-0 flathead chub (Platygobio gracilis).

Quality of life domains among non-Hodgkin lymphoma survivors: an integrative literature review

PubMed Central

LEAK, ASHLEY; MAYER, DEBORAH K.; SMITH, SOPHIA

2011-01-01

Survival rates of individuals with non-Hodgkin lymphoma (NHL) have increased in the past several years, as has the prevalence of older adults who are managing late and long-term effects of the disease and its treatment. In this integrative review, the state of the science for determining the quality of life (QOL) among NHL survivors is outlined. An online search of Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and the Cochrane Library databases was conducted using the following Keywords: non-Hodgkin lymphoma, health-related quality of life, quality of life, and impact of cancer. Eighteen studies published between 2000 and 2010 are reviewed. Of these, 17 were descriptive, cross-sectional designs, and one was a systematic review. The studies included participants of varying ages and years post-diagnosis as reported in several countries. Importantly, many used one or more QOL measures as outcome variables. Future research is needed on older and minority cancer populations and should include longitudinal and interventional studies. PMID:21534866

A statistical summary of data from the U.S. Geological Survey's national water quality networks

USGS Publications Warehouse

Smith, R.A.; Alexander, R.B.

1983-01-01

The U.S. Geological Survey Operates two nationwide networks to monitor water quality, the National Hydrologic Bench-Mark Network and the National Stream Quality Accounting Network (NASQAN). The Bench-Mark network is composed of 51 stations in small drainage basins which are as close as possible to their natural state, with no human influence and little likelihood of future development. Stations in the NASQAN program are located to monitor flow from accounting units (subregional drainage basins) which collectively encompass the entire land surface of the nation. Data collected at both networks include streamflow, concentrations of major inorganic constituents, nutrients, and trace metals. The goals of the two water quality sampling programs include the determination of mean constituent concentrations and transport rates as well as the analysis of long-term trends in those variables. This report presents a station-by-station statistical summary of data from the two networks for the period 1974 through 1981. (Author 's abstract)

Gender, Emotion Work, and Relationship Quality: A Daily Diary Study

PubMed Central

Curran, Melissa A.; McDaniel, Brandon T.; Pollitt, Amanda M.; Totenhagen, Casey J.

2015-01-01

We use the gender relations perspective from feminist theorizing to investigate how gender and daily emotion work predict daily relationship quality in 74 couples (148 individuals in dating, cohabiting, or married relationships) primarily from the southwest U.S. Emotion work is characterized by activities that enhance others’ emotional well-being. We examined emotion work two ways: trait (individuals’ average levels) and state (individuals’ daily fluctuations). We examined actor and partner effects of emotion work and tested for gender differences. As outcome variables, we included six types of daily relationship quality: love, commitment, satisfaction, closeness, ambivalence, and conflict. This approach allowed us to predict three aspects of relationship quality: average levels, daily fluctuations, and volatility (overall daily variability across a week). Three patterns emerged. First, emotion work predicted relationship quality in this diverse set of couples. Second, gender differences were minimal for fixed effects: Trait and state emotion work predicted higher average scores on, and positive daily increases in, individuals’ own positive relationship quality and lower average ambivalence. Third, gender differences were more robust for volatility: For partner effects, having a partner who reported higher average emotion work predicted lower volatility in love, satisfaction, and closeness for women versus greater volatility in love and commitment for men. Neither gender nor emotion work predicted average levels, daily fluctuations, or volatility in conflict. We discuss implications and future directions pertaining to the unique role of gender in understanding the associations between daily emotion work and volatility in daily relationship quality for relational partners. PMID:26508808

Marital Status, Marital Quality, and Heart Rate Variability in the MIDUS Cohort

PubMed Central

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

2015-01-01

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

Gender, Emotion Work, and Relationship Quality: A Daily Diary Study.

PubMed

Curran, Melissa A; McDaniel, Brandon T; Pollitt, Amanda M; Totenhagen, Casey J

2015-08-01

We use the gender relations perspective from feminist theorizing to investigate how gender and daily emotion work predict daily relationship quality in 74 couples (148 individuals in dating, cohabiting, or married relationships) primarily from the southwest U.S. Emotion work is characterized by activities that enhance others' emotional well-being. We examined emotion work two ways: trait (individuals' average levels) and state (individuals' daily fluctuations). We examined actor and partner effects of emotion work and tested for gender differences. As outcome variables, we included six types of daily relationship quality: love, commitment, satisfaction, closeness, ambivalence, and conflict. This approach allowed us to predict three aspects of relationship quality: average levels, daily fluctuations, and volatility (overall daily variability across a week). Three patterns emerged. First, emotion work predicted relationship quality in this diverse set of couples. Second, gender differences were minimal for fixed effects: Trait and state emotion work predicted higher average scores on, and positive daily increases in, individuals' own positive relationship quality and lower average ambivalence. Third, gender differences were more robust for volatility: For partner effects, having a partner who reported higher average emotion work predicted lower volatility in love, satisfaction, and closeness for women versus greater volatility in love and commitment for men. Neither gender nor emotion work predicted average levels, daily fluctuations, or volatility in conflict. We discuss implications and future directions pertaining to the unique role of gender in understanding the associations between daily emotion work and volatility in daily relationship quality for relational partners.

A Partial Least-Squares Analysis of Health-Related Quality-of-Life Outcomes After Aneurysmal Subarachnoid Hemorrhage.

PubMed

Young, Julia M; Morgan, Benjamin R; Mišić, Bratislav; Schweizer, Tom A; Ibrahim, George M; Macdonald, R Loch

2015-12-01

Individuals who have aneurysmal subarachnoid hemorrhages (SAHs) experience decreased health-related qualities of life (HRQoLs) that persist after the primary insult. To identify clinical variables that concurrently associate with HRQoL outcomes by using a partial least-squares approach, which has the distinct advantage of explaining multidimensional variance where predictor variables may be highly collinear. Data collected from the CONSCIOUS-1 trial was used to extract 29 clinical variables including SAH presentation, hospital procedures, and demographic information in addition to 5 HRQoL outcome variables for 256 individuals. A partial least-squares analysis was performed by calculating a heterogeneous correlation matrix and applying singular value decomposition to determine components that best represent the correlations between the 2 sets of variables. Bootstrapping was used to estimate statistical significance. The first 2 components accounting for 81.6% and 7.8% of the total variance revealed significant associations between clinical predictors and HRQoL outcomes. The first component identified associations between disability in self-care with longer durations of critical care stay, invasive intracranial monitoring, ventricular drain time, poorer clinical grade on presentation, greater amounts of cerebral spinal fluid drainage, and a history of hypertension. The second component identified associations between disability due to pain and discomfort as well as anxiety and depression with greater body mass index, abnormal heart rate, longer durations of deep sedation and critical care, and higher World Federation of Neurosurgical Societies and Hijdra scores. By applying a data-driven, multivariate approach, we identified robust associations between SAH clinical presentations and HRQoL outcomes. EQ-VAS, EuroQoL visual analog scaleHRQoL, health-related quality of lifeICU, intensive care unitIVH, intraventricular hemorrhagePLS, partial least squaresSAH, subarachnoid hemorrhageSVD, singular value decompositionWFNS, World Federation of Neurosurgical Societies.

A joint modelling exercise designed to assess the respective impact of emission changes and meteorological variability on the observed air quality trends in major urban hotspots.

NASA Astrophysics Data System (ADS)

Colette, Augustin; Bessagnet, Bertrand; Dangiola, Ariela; D'Isidoro, Massimo; Gauss, Michael; Granier, Claire; Hodnebrog, Øivind; Jakobs, Hermann; Kanakidou, Maria; Khokhar, Fahim; Law, Kathy; Maurizi, Alberto; Meleux, Frederik; Memmesheimer, Michael; Nyiri, Agnes; Rouil, Laurence; Stordal, Frode; Tampieri, Francesco

2010-05-01

With the growth of urban agglomerations, assessing the drivers of variability of air quality in and around the main anthropogenic emission hotspots has become a major societal concern as well as a scientific challenge. These drivers include emission changes and meteorological variability; both of them can be investigated by means of numerical modelling of trends over the past few years. A collaborative effort has been developed in the framework of the CityZen European project to address this question. Several chemistry and transport models (CTMs) are deployed in this activity: four regional models (BOLCHEM, CHIMERE, EMEP and EURAD) and three global models (CTM2, MOZART, and TM4). The period from 1998 to 2007 has been selected for the historic reconstruction. The focus for the present preliminary presentation is Europe. A consistent set of emissions is used by all partners (EMEP for the European domain and IPCC-AR5 beyond) while a variety of meteorological forcing is used to gain robustness in the ensemble spread amongst models. The results of this experiment will be investigated to address the following questions: - Is the envelope of models able to reproduce the observed trends of the key chemical constituents? - How the variability amongst models changes in time and space and what does it tell us about the processes driving the observed trends? - Did chemical regimes and aerosol formation processes changed in selected hotspots? Answering the above questions will contribute to fulfil the ultimate goal of the present study: distinguishing the respective contribution of meteorological variability and emissions changes on air quality trends in major anthropogenic emissions hotspots.

Including quality attributes in efficiency measures consistent with net benefit: creating incentives for evidence based medicine in practice.

PubMed

Eckermann, Simon; Coelli, Tim

2013-01-01

Evidence based medicine supports net benefit maximising therapies and strategies in processes of health technology assessment (HTA) for reimbursement and subsidy decisions internationally. However, translation of evidence based medicine to practice is impeded by efficiency measures such as cost per case-mix adjusted separation in hospitals, which ignore health effects of care. In this paper we identify a correspondence method that allows quality variables under control of providers to be incorporated in efficiency measures consistent with maximising net benefit. Including effects framed from a disutility bearing (utility reducing) perspective (e.g. mortality, morbidity or reduction in life years) as inputs and minimising quality inclusive costs on the cost-disutility plane is shown to enable efficiency measures consistent with maximising net benefit under a one to one correspondence. The method combines advantages of radial properties with an appropriate objective of maximising net benefit to overcome problems of inappropriate objectives implicit with alternative methods, whether specifying quality variables with utility bearing output (e.g. survival, reduction in morbidity or life years), hyperbolic or exogenous variables. This correspondence approach is illustrated in undertaking efficiency comparison at a clinical activity level for 45 Australian hospitals allowing for their costs and mortality rates per admission. Explicit coverage and comparability conditions of the underlying correspondence method are also shown to provide a robust framework for preventing cost-shifting and cream-skimming incentives, with appropriate qualification of analysis and support for data linkage and risk adjustment where these conditions are not satisfied. Comparison on the cost-disutility plane has previously been shown to have distinct advantages in comparing multiple strategies in HTA, which this paper naturally extends to a robust method and framework for comparing efficiency of health care providers in practice. Consequently, the proposed approach provides a missing link between HTA and practice, to allow active incentives for evidence based net benefit maximisation in practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

A quality improvement plan for hypertension control: the INCOTECA Project (INterventions for COntrol of hyperTEnsion in CAtalonia)

PubMed Central

Vallès-Fernandez, Roser; Rosell-Murphy, Magdalena; Correcher-Aventin, Olga; Mengual-Martínez, Lucas; Aznar-Martínez, Núria; Prieto-De Lamo, Gemma; Franzi-Sisó, Alícia; Puig-Manresa, Jordi; Ma Bonet-Simó, Josep

2009-01-01

Background Different studies have shown insufficient blood pressure (BP) control in hypertensive patients. Multiple factors influence hypertension management, and the quality of primary care is one of them. We decided therefore to evaluate the effectiveness of a quality improvement plan directed at professionals of Primary Health Care Teams (PHCT) with the aim to achieve a better control of hypertension. The hypothesis of the study is that the implementation of a quality improvement plan will improve the control of hypertension. The primary aim of this study will be to evaluate the effectiveness of this plan. Methods and design Design: multicentric study quasi-experimental before – after with control group. The non-randomised allocation of the intervention will be done at PHCT level. Setting: 18 PHCT in the Barcelona province (Spain). Sample: all patients with a diagnosis of hypertension (population based study). Exclusion criteria: patients with a diagnosis of hypertension made later than 01/01/2006 and patients younger than 18 years. Intervention: a quality improvement plan, which targets primary health care professionals and includes educational sessions, feedback to health professionals, audit and implementation of recommended clinical practice guidelines for the management of hypertensive patients. Measurements: age, sex, associated co-morbidity (diabetes mellitus type I and II, heart failure and renal failure). The following variables will be recorded: BP measurement, cardiovascular risk and antihypertensive drugs used. Results will be measured before the start of the intervention and twelve months after the start of the study. Dependent variable: prevalence of hypertensive patients with poor BP control. Analysis: Chi-square test and Student's t-test will be used to measure the association between independent qualitative and quantitative variables, respectively. Non-parametric tests will be used for the analysis of non-normally distributed variables. Significance level (α) will be set at < 0.05. Outcomes will be analysed on an intention-to-treat basis. Discussion The implementation of a quality improvement plan might benefit the coordination of different professionals of PHCTs and may also improve blood pressure control. Trial Registration This protocol has been registered at clinicaltrials.gov with the ID number MS: 1998275938244441. PMID:19321009

Socioeconomic and Cultural Correlates of Diet Quality in the Canadian Arctic: Results from the 2007-2008 Inuit Health Survey.

PubMed

Galloway, Tracey; Johnson-Down, Louise; Egeland, Grace M

2015-09-01

We examined the impact of socioeconomic and cultural factors on dietary quality in adult Inuit living in the Canadian Arctic. Interviews and a 24-h dietary recall were administered to 805 men and 1292 women from Inuit regions in the Canadian Arctic. We examined the effect of age, sex, education, income, employment, and cultural variables on respondents' energy, macronutrient intake, sodium/potassium ratio, and healthy eating index. Logistic regression was used to assess the impact of socioeconomic status (SES) on diet quality indicators. Age was positively associated with traditional food (TF) consumption and greater energy from protein but negatively associated with total energy and fibre intake. Associations between SES and diet quality differed considerably between men and women and there was considerable regional variability in diet quality measures. Age and cultural variables were significant predictors of diet quality in logistic regression. Increased age and use of the Inuit language in the home were the most significant predictors of TF consumption. Our findings are consistent with studies reporting a nutrition transition in circumpolar Inuit. We found considerable variability in diet quality and complex interaction between SES and cultural variables producing mixed effects that differ by age and gender.

Effect of hot carcass weight on loin, ham, and belly quality from pigs sourced from a commercial processing facility,.

PubMed

Harsh, B N; Arkfeld, E K; Mohrhauser, D A; King, D A; Wheeler, T L; Dilger, A C; Shackelford, S D; Boler, D D

2017-11-01

The objective was to determine the predictive abilities of HCW for loin, ham, and belly quality of 7,684 pigs with carcass weights ranging from 53.2 to 129.6 kg. Carcass composition, subjective loin quality, and ham face color were targeted on all carcasses, whereas in-plant instrumental loin color and belly quality were assessed on 52.0 and 47.5% of carcasses, respectively. Loin chop slice shear force (SSF), cured ham quality, and adipose iodine value (IV) were evaluated on at least 10% of the population. The slope of regression lines and coefficients of determination between HCW and quality traits were computed using PROC REG of SAS and considered significant at ≤ 0.05. As HCW increased, boneless loins became darker and redder, evidenced by lower L* (β = -0.0243, < 0.001) and greater a* values (β = 0.0106, < 0.001); however, HCW accounted for only ≤0.80% of the variability in loin L* and a* values. Similarly, subjective loin color score (β = 0.0024, < 0.001) increased with increasing carcass weight, but subjective marbling score was not affected by HCW (β = -0.0022, = 0.06). After 20 d of aging, HCW explained only 0.98% of the variability in loin L* values (β = -0.0287, < 0.01). Heavier carcasses had lower SSF values (β = -0.1269, < 0.001) of LM chops, although HCW explained only 4.46% of the variability in SSF. Although heavier carcasses produced loins that exhibited lower ultimate pH values (β = -0.0018, < 0.001), HCW explained only 1.23% of the variability in ultimate loin pH. Interestingly, cook loss decreased (β = -0.0521, < 0.001) as HCW increased, with HCW accounting for 5.60% of the variability in cook loss. Heavier carcasses resulted in darker, redder ham face color ( < 0.001), but HCW accounted for only ≤2.87% of the variability in ham face L* values and 0.47% of the variability in a* values. Heavier carcasses produced thicker and firmer bellies, with HCW accounting for 37.81% of the variability in belly thickness (β = 0.0272, < 0.001), 20.35% of the variability in subjective flop score (β = 0.0406, < 0.001), and 10.35% of the variability in IV (β = -0.1263, < 0.001). Overall, the proportion of variability in loin and ham quality explained by HCW was poor (≤5.60%), suggesting that HCW is a poor predictor of the primal quality of pigs within this weight range. Nonetheless, HCW was a moderate predictor of belly quality traits. The findings of this study suggest that increasing HCW did not compromise loin, ham, or belly quality attributes.

Water quality assessment with hierarchical cluster analysis based on Mahalanobis distance.

PubMed

Du, Xiangjun; Shao, Fengjing; Wu, Shunyao; Zhang, Hanlin; Xu, Si

2017-07-01

Water quality assessment is crucial for assessment of marine eutrophication, prediction of harmful algal blooms, and environment protection. Previous studies have developed many numeric modeling methods and data driven approaches for water quality assessment. The cluster analysis, an approach widely used for grouping data, has also been employed. However, there are complex correlations between water quality variables, which play important roles in water quality assessment but have always been overlooked. In this paper, we analyze correlations between water quality variables and propose an alternative method for water quality assessment with hierarchical cluster analysis based on Mahalanobis distance. Further, we cluster water quality data collected form coastal water of Bohai Sea and North Yellow Sea of China, and apply clustering results to evaluate its water quality. To evaluate the validity, we also cluster the water quality data with cluster analysis based on Euclidean distance, which are widely adopted by previous studies. The results show that our method is more suitable for water quality assessment with many correlated water quality variables. To our knowledge, it is the first attempt to apply Mahalanobis distance for coastal water quality assessment.

Writing Quality in Chinese Children: Speed and Fluency Matter

PubMed Central

Yan, Cathy Ming Wai; McBride-Chang, Catherine; Wagner, Richard K.; Zhang, Juan; Wong, Anita M. Y.; Shu, Hua

2015-01-01

There were two goals of the present study. The first was to create a scoring scheme by which 9-year-old Chinese children’s writing compositions could be rated to form a total score for writing quality. The second was to examine cognitive correlates of writing quality at age 9 from measures administered at ages 6–9. Age 9 writing compositions were scored using a 7-element rubric; following confirmatory factor analyses, 5 of these elements were retained to represent overall writing quality for subsequent analyses. Measures of vocabulary knowledge, Chinese word dictation, phonological awareness, speed of processing, speeded naming, and handwriting fluency at ages 6–9 were all significantly associated with the obtained overall writing quality measure even when the statistical effect of age was removed. With vocabulary knowledge, dictation skill, age, gender, and phonological awareness included in a regression equation, 35% of the variance in age 9 writing quality was explained. With the variables of speed of processing, speeded naming, and handwriting fluency additionally included as a block, 12% additional variance in the equation was explained. In addition to gender, overall unique correlates of writing quality were dictation, speed of processing, and handwriting fluency, underscoring the importance of both general automaticity and specific writing fluency for writing quality development in children. PMID:25750486

Systematic reviews addressing microsurgical head and neck reconstruction.

PubMed

Momeni, Arash; Jacobson, Joshua Y; Lee, Gordon K

2015-01-01

Systematic reviews frequently form the basis for clinical decision making and guideline development. Yet, the quality of systematic reviews has been variable, thus raising concerns about the validity of their conclusions. In the current study, a quality analysis of systematic reviews was performed, addressing microsurgical head and neck reconstruction. A PubMed search was performed to identify all systematic reviews published up to and including December 2012 in 12 surgical journals. Two authors independently reviewed the literature and extracted data from the included reviews. Discrepancies were resolved by consensus. Quality assessment was performed using AMSTAR. The initial search retrieved 1020 articles. After screening titles and abstracts, 987 articles were excluded. Full-text review of the remaining 33 articles resulted in further exclusion of 18 articles, leaving 15 systematic reviews for final analysis. A marked increase in the number of published systematic reviews over time was noted (P = 0.07). The median AMSTAR score was 5, thus reflecting a "fair" quality. No evidence for improvement in methodological quality over time was noted. The trend to publish more systematic reviews in microsurgical head and neck reconstruction is encouraging. However, efforts are indicated to improve the methodological quality of systematic reviews. Familiarity with criteria of methodological quality is critical to ensure future improvements in the quality of systematic reviews conducted in microsurgery.

Early warning of changing drinking water quality by trend analysis.

PubMed

Tomperi, Jani; Juuso, Esko; Leiviskä, Kauko

2016-06-01

Monitoring and control of water treatment plants play an essential role in ensuring high quality drinking water and avoiding health-related problems or economic losses. The most common quality variables, which can be used also for assessing the efficiency of the water treatment process, are turbidity and residual levels of coagulation and disinfection chemicals. In the present study, the trend indices are developed from scaled measurements to detect warning signs of changes in the quality variables of drinking water and some operating condition variables that strongly affect water quality. The scaling is based on monotonically increasing nonlinear functions, which are generated with generalized norms and moments. Triangular episodes are classified with the trend index and its derivative. Deviation indices are used to assess the severity of situations. The study shows the potential of the described trend analysis as a predictive monitoring tool, as it provides an advantage over the traditional manual inspection of variables by detecting changes in water quality and giving early warnings.

[Care quality in intensive care evaluated by the patients using a service quality scale (SERVQUAL)].

PubMed

Regaira Martínez, E; Sola Iriarte, M; Goñi Viguria, R; Del Barrio Linares, M; Margall Coscojuela, M A; Asiain Erro, M C

2010-01-01

The evaluation made by the patients on the quality of service received is important to introduce improvement strategies in the care quality. 1. To evaluate the care quality through the analysis of the differences obtained between expectations and perceptions, that the patients have of the service received in the ICU. 2. To analyze if there is any relationship between care quality evaluated by the patients and the sociodemographic variables. A total of 86 patients who were conscious and oriented during their stay in the ICU were studied prospectively. At 24h of the discharge from the ICU, the SERVQUAL (Service Quality) scale, adapted for the hospital setting by Babakus and Mangold (1992), was applied. This scale measures the care quality based on the difference in scores obtained between expectations and perceptions of the patients. The positive scores indicate that the perceptions of the patients exceed their expectations. The scale has 5 dimensions: Tangibility, Reliability, Responsiveness, Assurances and Empathy. It includes 15 items for perceptions and the same for expectations, with 5 grades of response (1 totally disagree - 5 totally agree). The mean score of perceptions 66.92) exceeded that of the expectations (62.30). The mean score of the difference between perceptions and expectations for the total of the SERVQUAL scale was 4.62. It was also positive for each one of the dimensions: Tangibility=1.44, Reliability=0.53, Responsiveness=0.95, Assurances=0.99, Empathy=0.71. No statistically significant associations were found between care quality evaluated by the patients and the sociodemographic variables. The care quality perceived by the patients in the ICU exceeds their expectations, and had no relationship with the sociodemographic characteristics. Copyright 2009 Elsevier España, S.L. y SEEIUC. All rights reserved.

Benthic invertebrates of fixed sites in the western Lake Michigan drainages, Wisconsin and Michigan, 1993-95

USGS Publications Warehouse

Lenz, Bernard N.; Rheaume, S.J.

2000-01-01

This report describes the variability in family-level benthic-invertebrate population data and the reliability of the data as a water-quality indicator for 11 fixed surface-water sites in the Western Lake Michigan Drainages study area of the National Water-Quality Assessment Program. Benthic-invertebrate-community measures were computed for the following: number of individuals, Hilsenhoff’s Family-Level Biotic Index, number and percent EPT (Ephemeroptera, Plecoptera, and Tricoptera), Margalef’s Diversity Index, and mean tolerance value. Relations between these measures and environmental setting, habitat, and of chemical water quality are examined. Benthic-invertebrate communities varied greatly among fixed sites and within individual streams among multiple-reach and multiple-year sampling. The variations between multiple reaches and years were sometimes larger than those found between different fixed sites. Factors affecting benthic invertebrates included both habitat and chemical quality. Generally, fixed-site streams with the highest diversity, greatest number of benthic invertebrates, and those at which community measures indicated the best water quality also had the best habitat and chemical quality. Variations among reaches are most likely related to differences in habitat. Variations among years are most likely related to climatic changes, which create variations in flow and/or chemical quality. The variability in the data analyzed in this study shows how benthic invertebrates are affected by differences in both habitat and water quality, making them useful indicators of stream health; however, a single benthic-invertebrate sample alone cannot be relied upon to accurately describe water quality of the streams in this study. Benthic-invertebrate data contributed valuable information on the biological health of the 11 fixed sites when used as one of several data sources for assessing water quality.

Overall quality of life and difficulty paying for ostomy supplies in the Veterans Affairs ostomy health-related quality of life study: an exploratory analysis.

PubMed

Coons, Stephen Joel; Chongpison, Yuda; Wendel, Christopher S; Grant, Marcia; Krouse, Robert S

2007-09-01

To explore whether there was a significant relationship between difficulty paying for ostomy supplies and overall quality of life among a sample of ostomates receiving care from the Veterans Health Administration (VHA). The data were collected as part of the Veterans Affairs (VA) Ostomy Health-Related Quality of Life Study, in which 511 respondents (239 cases, 272 controls) completed a survey instrument that included the modified City of Hope Quality of Life (mCOH-QOL) Ostomy questionnaire, SF-36V, and sociodemographic items. Responses from the 239 cases (ie, patients with intestinal stomas) were used in this analysis. The modified City of Hope Quality of Life Ostomy questionnaire item, "How good is your overall quality of life?," was the dependent variable for this analysis. The primary independent variable was the response (yes/no) to the item, "If you pay for any of the (ostomy) costs, is it difficult for you?" A hierarchical regression model was used to examine whether difficulty paying was significantly related to overall quality of life after adjusting for age, income, race/ethnicity, and physical health. After accounting for the proportion of variance explained by age, income, race/ethnicity, and physical health, the additional proportion of variance explained by difficulty paying was statistically significant. Individuals reporting difficulty paying had a roughly 1 point lower (ie, beta-coefficient = -1.052; SE = 0.481) overall quality of life score on the 11-point scale. We found a significant association between difficulty paying for ostomy supplies and overall quality of life. Although the cross-sectional study design does not allow causal inference, the results suggest a relationship that merits further examination.

The relationship between foot posture and plantar pressure during walking in adults: A systematic review.

PubMed

Buldt, Andrew K; Allan, Jamie J; Landorf, Karl B; Menz, Hylton B

2018-02-23

Foot posture is a risk factor for some lower limb injuries, however the underlying mechanism is not well understood. Plantar pressure analysis is one technique to investigate the interaction between foot posture and biomechanical function of the lower limb. The aim of this review was to investigate the relationship between foot posture and plantar pressure during walking. A systematic database search was conducted using MEDLINE, CINAHL, SPORTDiscus and Embase to identify studies that have assessed the relationship between foot posture and plantar pressure during walking. Included studies were assessed for methodological quality. Meta-analysis was not conducted due to heterogeneity between studies. Inconsistencies included foot posture classification techniques, gait analysis protocols, selection of plantar pressure parameters and statistical analysis approaches. Of the 4213 citations identified for title and abstract review, sixteen studies were included and underwent quality assessment; all were of moderate methodological quality. There was some evidence that planus feet display higher peak pressure, pressure-time integral, maximum force, force-time integral and contact area predominantly in the medial arch, central forefoot and hallux, while these variables are lower in the lateral and medial forefoot. In contrast, cavus feet display higher peak pressure and pressure-time integral in the heel and lateral forefoot, while pressure-time integral, maximum force, force-time integral and contact area are lower for the midfoot and hallux. Centre of pressure was more laterally deviated in cavus feet and more medially deviated in planus feet. Overall, effect sizes were moderate, but regression models could only explain a small amount of variance in plantar pressure variables. Despite these significant findings, future research would benefit from greater methodological rigour, particularly in relation to the use of valid foot posture measurement techniques, gait analysis protocols, and standardised approaches for analysis and reporting of plantar pressure variables. Copyright © 2018 Elsevier B.V. All rights reserved.

Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors

PubMed Central

Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik

2014-01-01

Aim: To explore the mechanisms through which nurse practice environment dimensions, such as nurse–physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Background: Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Design: Cross-sectional survey. Method: Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Results: Nurse practice environment dimensions predicted nurses’ ratings of job outcome variables as well as quality of care. Features of nurses’ work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. Conclusion: The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses’ perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services. PMID:25431563

Change of sleep quality from pre- to 3 years post-solid organ transplantation: The Swiss Transplant Cohort Study

PubMed Central

Denhaerynck, Kris; Huynh-Do, Uyen; Binet, Isabelle; Hadaya, Karine; De Geest, Sabina

2017-01-01

Background Poor sleep quality (SQ) is common after solid organ transplantation; however, very little is known about its natural history. We assessed the changes in SQ from pre- to 3 years post-transplant in adult heart, kidney, liver and lung recipients included in the prospective nation-wide Swiss Transplant Cohort Study. We explored associations with selected variables in patients suffering persistent poor SQ compared to those with good or variable SQ. Methods Adult single organ transplant recipients enrolled in the Swiss Transplant Cohort Study with pre-transplant and at least 3 post-transplant SQ assessment data were included. SQ was self-reported pre-transplant (at listing), then at 6, 12, 24 and 36 months post-transplant. A single SQ item was used to identify poor (0–5) and good sleepers (6–10). Between organ groups, SQ was compared via logistic regression analysis with generalized estimating equations. Within the group reporting persistently poor SQ, we used logistic regression or Kaplan-Meier analysis as appropriate to check for differences in global quality of life and survival. Results In a sample of 1173 transplant patients (age: 52.1±13.2 years; 65% males; 66% kidney, 17% liver, 10% lung, 7% heart) transplanted between 2008 and 2012, pre- transplant poor SQ was highest in liver (50%) and heart (49%) recipients. Overall, poor SQ decreased significantly from pre-transplant (38%) to 24 months post-transplant (26%) and remained stable at 3 years (29%). Patients reporting persistently poor SQ had significantly more depressive symptomatology and lower global quality of life. Conclusion Because self-reported poor SQ is related to poorer global quality of life, these results emphasize the need for further studies to find suitable treatment options for poor SQ in transplant recipients. PMID:29020112

Risk for depression during interferon-alpha treatment is affected by the serotonin transporter polymorphism.

PubMed

Lotrich, Francis E; Ferrell, Robert E; Rabinovitz, Mordechai; Pollock, Bruce G

2009-02-15

Major depressive disorder (MDD) occurs in a subset of patients receiving interferon-alpha treatment, although many are resilient to this side effect. Genetic differences in the serotonin reuptake transporter promoter (5-HTTLPR) may interact with the inflammatory system and influence depression risk. A cohort of 71 nondepressed hepatitis C patients about to receive interferon-alpha was prospectively followed, employing a diagnostic structured clinical interview (Structured Clinical Interview for DSM-IV Axis I Disorders [SCID-I]) and self-report questionnaires. Patients were genotyped for the 5-HTTLPR (L(G), L(A), and S) and the variable number of tandem repeats (VNTR) polymorphism in the second intron. Kaplan-Meier analyses were used to compare major depression incidence. Genotype effects on sleep quality (Pittsburgh Sleep Quality Index) and Beck Depression Inventory (BDI) were assessed using mixed-effect repeated-measure analyses. The L(A) allele was associated with a decreased rate of developing MDD (Mantel-Cox log rank test p < .05) with the L(A)/L(A) genotype being the most resilient. This genotype was also associated with better sleep quality [F(61.2,2) = 3.3, p < .05]. The ability of baseline sleep quality to predict depression incidence disappeared when also including genotype in the model. Conversely, the relationship of neuroticism with depression incidence (B = .07, SE = .02, p < .005) was not mitigated when including genotype. Using a prospective design, 5-HTTLPR is associated with MDD incidence during interferon-alpha treatment. Preliminary evidence that this effect could be mediated by effects on sleep quality was observed. These findings provide support for a possible interaction between inflammatory cytokine (interferon-alpha) exposure and 5-HTTLPR variability in MDD.

Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors.

PubMed

Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik

2014-01-01

To explore the mechanisms through which nurse practice environment dimensions, such as nurse-physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Cross-sectional survey. Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Nurse practice environment dimensions predicted nurses' ratings of job outcome variables as well as quality of care. Features of nurses' work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses' perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services.

Green innovation and sustainable industrial systems within sustainability and company improvement perspective

NASA Astrophysics Data System (ADS)

Edi Nugroho Soebandrija, Khristian

2017-12-01

This paper comprises discussion of Green Innovation and Sustainable Industrial Systems within Sustainability and Company Improvement Perspective of beverage manufacturing company (BMC). The stakeholder theory is the grand theory for the company improvement perspective in this paper. The data processing in this paper is conducted through software which are SEM-PLS with SmartPLS 2.0 and SPSS 19. The specified objective of this paper has focus on sustainability as one of 6 variables, in lieu of those 6 variables as the big picture. The reason behind this focus on sustainability is the fact that there are assorted challenges in sustainability that is ranging from economic, environment and company perspectives. Those challenges in sustainability include the sustainable service supply chain management and its involvement of society. The overall objective is to analyze relationship hypothesis of 6 variables, 4 of them (leadership, organizational learning, innovation, and performance) are based on Malcolm Baldrige’s performance excellence concept to achieve sustainability and competitive advantage through company-competitor and customer questionnaire, and its relation to Total Quality Management (TQM) and Quality Management System (QMS). In conclusion, the spearheaded of company improvement in this paper is in term of consumer satisfaction through 99.997% quality standards. These can be achieved by ambidexterity through exploitation and exploration innovation. Furthermore, in this paper, TQM enables to obtain popularity brand index achievement that is greater than 45.9%. Subsequently, ISO22000 of food security standard encompasses quality standard of ISO9000 and HACCP. Through the ambidexterity of exploitation and exploration (Non Standard Product Inspection) NOSPI machine, the company improvement generates the achievement of 75% automation, 99.997% quality control standard and 80% of waste reduction.

Evaluation of Environmental Quality Productive Ecosystem Guayas (Ecuador).

NASA Astrophysics Data System (ADS)

Pozo, Wilson; Pardo, Francisco; Sanfeliu, Teófilo; Carrera, Gloria; Jordan, Manuel; Bech, Jaume; Roca, Núria

2015-04-01

Natural resources are deteriorating very rapidly in the Gulf of Guayaquil and the area of influence in the Guayas Basin due to human activity. Specific problems are generated by the mismanagement of the aquaculture industry affecting the traditional agricultural sectors: rice, banana, sugarcane, cocoa, coffee, and soya also studied, and by human and industrial settlements. The development of industrial activities such as aquaculture (shrimp building for shrimp farming in ponds) and agriculture, have increasingly contributed to the generation of waste, degrading and potentially toxic elements in high concentrations, which can have adverse effects on organisms in the ecosystems, in the health of the population and damage the ecological and environmental balance. The productive Guayas ecosystem, consists of three interrelated ecosystems, the Gulf of Guayaquil, the Guayas River estuary and the Guayas Basin buffer. The objective of this study was to evaluate the environmental quality of the productive Guayas ecosystem (Ecuador), through operational and specific objectives: 1) Draw up the transition coastal zone in the Gulf of Guayaquil, 2) Set temporal spatial variability of soil salinity in wetlands rice, Lower Guayas Basin, 3) evaluate the heavy metals in wetland rice in the Lower Basin of Guayas. The physical and chemical parameters of the soils have been studied. These are indicators of environmental quality. The multivariate statistical method showed the relations of similarities and dissimilarities between variables and parameter studies as stable. Moreover, the boundaries of coastal transition areas, temporal spatial variability of soil salinity and heavy metals in rice cultivation in the Lower Basin of Guayas were researched. The sequential studies included and discussed represent a broad framework of fundamental issues that has been valued as a basic component of the productive Guayas ecosystem. They are determinants of the environmental quality of the Guayas productive ecosystem. Keyword: Evaluation, Environmental Quality, Productive Ecosystem

Relationship among family environment, self-control, friendship quality, and adolescents’ smartphone addiction in South Korea: Findings from nationwide data

PubMed Central

Kim, Hye-Jin; Min, Jin-Young; Lee, Tae-Jin; Yoo, Seunghyun

2018-01-01

Background Many studies have examined the negative impact on smartphone addiction in adolescents. Recent concerns have focused on predictors of smartphone addiction. This study aimed to investigate the association of adolescents’ smartphone addiction with family environment (specifically, domestic violence and parental addiction). We further investigated whether self-control and friendship quality, as predictors of smartphone addiction, may reduce the observed risk. Methods We used the 2013 national survey on internet usage and utilization data from the National Information Agency of Korea. Information on exposure and covariates included self-reported experience of domestic violence and parental addiction, sociodemographic variables, and other variables potentially related to smartphone addiction. Smartphone addiction was estimated using a smartphone addiction proneness scale, a standardized measure developed by national institutions in Korea. Results Adolescents who had experienced domestic violence (OR = 1.74; 95% CI: 1.23–2.45) and parental addiction (OR = 2.01; 95% CI: 1.24–3.27) were found to be at an increased risk for smartphone addiction after controlling for all potential variables. Furthermore, on classifying adolescents according to their level of self-control and friendship quality the association between domestic violence and parental addiction, and smartphone addiction was found to be significant in the group with adolescents with lower levels of self-control (OR = 2.87; 95% CI: 1.68–4.90 and OR = 1.95; 95% CI: 1.34–2.83) and friendship quality (OR = 2.33; 95% CI: 1.41–3.85 and OR = 1.83; 95% CI: 1.26–2.64). Conclusion Our findings suggest that family dysfunction was significantly associated with smartphone addiction. We also observed that self-control and friendship quality act as protective factors against adolescents’ smartphone addiction. PMID:29401496

Relationship among family environment, self-control, friendship quality, and adolescents' smartphone addiction in South Korea: Findings from nationwide data.

PubMed

Kim, Hye-Jin; Min, Jin-Young; Min, Kyoung-Bok; Lee, Tae-Jin; Yoo, Seunghyun

2018-01-01

Many studies have examined the negative impact on smartphone addiction in adolescents. Recent concerns have focused on predictors of smartphone addiction. This study aimed to investigate the association of adolescents' smartphone addiction with family environment (specifically, domestic violence and parental addiction). We further investigated whether self-control and friendship quality, as predictors of smartphone addiction, may reduce the observed risk. We used the 2013 national survey on internet usage and utilization data from the National Information Agency of Korea. Information on exposure and covariates included self-reported experience of domestic violence and parental addiction, sociodemographic variables, and other variables potentially related to smartphone addiction. Smartphone addiction was estimated using a smartphone addiction proneness scale, a standardized measure developed by national institutions in Korea. Adolescents who had experienced domestic violence (OR = 1.74; 95% CI: 1.23-2.45) and parental addiction (OR = 2.01; 95% CI: 1.24-3.27) were found to be at an increased risk for smartphone addiction after controlling for all potential variables. Furthermore, on classifying adolescents according to their level of self-control and friendship quality the association between domestic violence and parental addiction, and smartphone addiction was found to be significant in the group with adolescents with lower levels of self-control (OR = 2.87; 95% CI: 1.68-4.90 and OR = 1.95; 95% CI: 1.34-2.83) and friendship quality (OR = 2.33; 95% CI: 1.41-3.85 and OR = 1.83; 95% CI: 1.26-2.64). Our findings suggest that family dysfunction was significantly associated with smartphone addiction. We also observed that self-control and friendship quality act as protective factors against adolescents' smartphone addiction.

Critical and systematic evaluation of data for estimating human exposures to 2,4-dichlorophenoxyacetic acid (2,4-D) - quality and generalizability.

PubMed

LaKind, Judy S; Burns, Carol J; Naiman, Daniel Q; O'Mahony, Cian; Vilone, Giulia; Burns, Annette J; Naiman, Joshua S

2017-01-01

The herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) has been commercially available since the 1940's. Despite decades of data on 2,4-D in food, air, soil, and water, as well as in humans, the quality the quality of these data has not been comprehensively evaluated. Using selected elements of the Biomonitoring, Environmental Epidemiology, and Short-lived Chemicals (BEES-C) instrument (temporal variability, avoidance of sample contamination, analyte stability, and urinary methods of matrix adjustment), the quality of 156 publications of environmental- and biomonitoring-based 2,4-D data was examined. Few publications documented steps were taken to avoid sample contamination. Similarly, most studies did not demonstrate the stability of the analyte from sample collection to analysis. Less than half of the biomonitoring publications reported both creatinine-adjusted and unadjusted urine concentrations. The scope and detail of data needed to assess temporal variability and sources of 2,4-D varied widely across the reviewed studies. Exposures to short-lived chemicals such as 2,4-D are impacted by numerous and changing external factors including application practices and formulations. At a minimum, greater transparency in reporting of quality control measures is needed. Perhaps the greatest challenge for the exposure community is the ability to reach consensus on how to address problems specific to short-lived chemical exposures in observational epidemiology investigations. More extensive conversations are needed to advance our understanding of human exposures and enable interpretation of these data to catch up to analytical capabilities. The problems defined in this review remain exquisitely difficult to address for chemicals like 2,4-D, with short and variable environmental and physiological half-lives and with exposures impacted by numerous and changing external factors.

The Effect of Ambient Water Quality on Lakefront Property Values: Evidence from Coeur d'Alene, Idaho

NASA Astrophysics Data System (ADS)

Liao, H.

2015-12-01

Climate warming is causing water temperatures to increase and subsequent changes in water quality. To develop innovative approaches for mitigating the possible negative social consequences of such changes, more research efforts are needed to investigate how people perceive and respond to ambient water quality. This research examines the amenity value of water quality in the areas centered on Lake Coeur d'Alene of Northern Idaho. Through a hedonic analysis, we find that two important water-quality variables have had significant effects on lakefront property values, including Secchi disc reading, a technical measure of water clarity, and the presence of Eurasian watermilfoil, an aquatic invasive species. We further explore the spatial heterogeneity of water-quality benefits along the urban-rural gradient and find that access to urban amenities has strengthened the water-quality benefits in the lakefront housing market. Our findings could be used to incentivize private property owners and stakeholders to commit time and funding to cope with the potential degradation of water quality under climate change.

Quality of Education Predicts Performance on the Wide Range Achievement Test-4th Edition Word Reading Subtest

PubMed Central

Sayegh, Philip; Arentoft, Alyssa; Thaler, Nicholas S.; Dean, Andy C.; Thames, April D.

2014-01-01

The current study examined whether self-rated education quality predicts Wide Range Achievement Test-4th Edition (WRAT-4) Word Reading subtest and neurocognitive performance, and aimed to establish this subtest's construct validity as an educational quality measure. In a community-based adult sample (N = 106), we tested whether education quality both increased the prediction of Word Reading scores beyond demographic variables and predicted global neurocognitive functioning after adjusting for WRAT-4. As expected, race/ethnicity and education predicted WRAT-4 reading performance. Hierarchical regression revealed that when including education quality, the amount of WRAT-4's explained variance increased significantly, with race/ethnicity and both education quality and years as significant predictors. Finally, WRAT-4 scores, but not education quality, predicted neurocognitive performance. Results support WRAT-4 Word Reading as a valid proxy measure for education quality and a key predictor of neurocognitive performance. Future research should examine these findings in larger, more diverse samples to determine their robust nature. PMID:25404004

Effects of marketing group and production focus on quality and variability of adipose tissue and bellies sourced from a commercial processing facility

USDA-ARS?s Scientific Manuscript database

Objectives were to determine the effects of marketing group on quality and variability of belly and adipose tissue quality traits of pigs sourced from differing production focuses (lean vs. quality). Pigs (N = 8,042) raised in 8 barns representing 2 seasons (cold and hot) were used. Three groups wer...

Work-related stress and quality of life among Iranian blue-collar workers with self-reported low back pain.

PubMed

Kabir-Mokamelkhah, Elaheh; Bahrami-Ahmadi, Amir; Aghili, Negar

2016-01-01

Background: Impairment in quality of life and mental health had been reported in the previous studies as the results of musculoskeletal disorders among workers. Mental health has a wide concept and contains different disorders including anxiety, depression or even decreased quality of life, all of which having challengeable impacts on work- related characters such as work productivity and absensism. The present study aimed at evaluating work- related stress and quality of life among Iranian blue-collar workers of Fars ABFA Company with selfreported low back pain. Methods: In the present study, we focused on the low back pain among 451 blue-collar workers and assessed their work- related stress and quality of life status using DASS-21 and short form questionnaire (SF-36), respectively. Independent sample t-test was used to compare the qualitative variables, and chi-square test was utilized for statistical analysis of the qualitative variables. Results: Mean of the total score of quality of life among workers with low back pain was significantly lower than in those workers without low back pain. The mean of work- related stress score was significantly higher in workers with low back pain than in workers without low back pain. The mean quality of life subdomains in patients with low back pain was significantly lower than in workers without low back pain. Conclusion: Findings of the present study revealed that workers with low back pain had lower quality of life score and higher work- related stress score. These findings should be considered in designing preventive programs rather than controlling the pain.

Noise Removal on Ocean Scalars by Means of Singularity-Based Fusion

NASA Astrophysics Data System (ADS)

Umbert, M.; Turiel, A.; Hoareau, N.; Ballabrera, J.; Martinez, J.; guimbard, S.; Font, J.

2013-12-01

Thanks to new remote sensing platforms as SMOS and Aquarius we have now access to synoptic maps of Sea Surface Salinity (SSS) at global scale. Both missions require a non-negligible amount of development in order to meet pre-launch requirements on the quality of the retrieved variables. Development efforts have been so far mainly concentrated in improving the accuracy of the acquired signals from the radiometric point of view, which is a point-wise characteristic, that is, the qualities of each point in the snapshot or swath are considered separately. However, some spatial redundancy (i.e., spatial correlation) is implicit in geophysical signals, and particularly in SSS. This redundancy is known since the beginning of the remote sensing age: eddies and fronts are visually evident in images of different variables, including Sea Surface Temperature (SST), Sea Surface Height (SSH), Ocean Color (OC), Synthetic Aperture Radars (SAR) and Brightness Temperatures (BT) at different bands. An assessment on the quality of SSS products accounting for this kind of spatial redundancy would be very interesting. So far, the structure of those correlations have been evidenced using correlation functions, but correlation functions vary from one variable to other; additionally, they are not characteristic to the points of the image but to a given large enough area. The introduction of singularity analysis for remote sensing maps of the ocean has shown that the correspondence among different scalars can be rigorously stated in terms of the correspondence of the values of their associated singularity exponents. The singularity exponents of a scalar at a given point is a unitless measure of the degree of regularity or irregularity of this function at that given point. Hence, singularity exponents can be directly compared disregarding the physical meaning of the variable from which they were derived. Using singularity analysis we can assess the quality of any scalar, as singularity exponents align in fronts following the streamlines of the flow, while noise breaks up the coherence of singularity fronts. The analysis of the output of numerical models show that up to the numerical accuracy singularity exponents of different scalars take the same values at every point. Taking the correspondence of the singularity exponents into account, it can be proved that two scalars having the same singularity exponents have a relation of functional dependence (a matricial identity involving their gradients). That functional relation can be approximated by a local linear regression under some hypothesis, which simplifies and speeds up the calculations and leads to a simple algorithm to reduce noise on a given ocean scalar using another higher- quality variable as template. This simple algorithm has been applied to SMOS data with a considerable quality gain. As a template, high-level SST maps from different sources have been used, while SMOS L2 and L3 SSS maps, and even brightness temperature maps play the role of the noisy data to be corrected. In all instances the noise level is divided by a factor of two at least. This quality gain opens the use of SMOS data for new applications, including the instant identification of ocean fronts, rain lenses, hurricane tracks, etc.

Combining Water Quality and Cost-Benefit Analysis to Examine the Implications of Agricultural Best Management Practices

NASA Astrophysics Data System (ADS)

Rao, N. S.; Easton, Z. M.; Lee, D. R.; Steenhuis, T. S.

2007-12-01

Nutrient runoff from agricultural fields threatens water quality and can impair habitats in many watersheds. Agencies consider these potential risks as they determine acceptable levels of nutrient loading. For example, in the New York City (NYC) watershed, the Environmental Protection Agency's Total Maximum Daily Load (TMDL) for phosphorus (P) has been set at 15μg P L-1 to protect against eutrophication and bacterial outbreaks. In the NYC watersheds agricultural Best Management Practices (BMPs) are the primary means to control nonpoint source P loading. BMPs include riparian buffers, filter strips, manure storage facilities, crop rotation, stripcropping, tree planting and nutrient management plans (NMPs). Water quality research on BMPs to date has included studies on site-specificity of different BMPs, short and long term BMP efficacy, and placement of BMPs with respect to critical source areas. A necessary complement to studies addressing water quality aspects of different BMPs are studies examining the cost-benefit aspects of BMPs. In general, there are installment, maintenance and opportunity costs associated with each BMP, and there are benefits, including cost share agreements between farmers and farm agencies, and increased efficiency of farm production and maintenance. Combining water quality studies and related cost-benefit analyses would help planners and watershed managers determine how best improve water quality. Our research examines the costs-benefit structure associated with BMP scenarios on a one-farm headwater watershed in the Catskill Mountains of NY. The different scenarios include "with and without" BMPs, combinations of BMPs, and different BMP placements across agricultural fields. The costs associated with each BMP scenarios are determined using information from farm agencies and watershed planning agencies. With these data we perform a cost-benefit analysis for the different BMP scenarios and couple the water quality modeling using the Variable Source Loading Function (VSLF) model (Schneiderman et al., 2007) with the cost-benefit analysis to look at the specific water quality and economic consequences of different watershed management scenarios. The results of our study will be useful for planners and watershed managers in determining how best to reduce nonpoint source pollution in a cost-effective manner. References Schneiderman, E.M., T.S. Steenhuis, D.J. Thongs, Z.M. Easton, M.S. Zion, G.F. Mendoza, M.T. Walter, and A.C. Neal. 2007. Incorporating variable source area hydrology into curve number based watershed loading functions. Hydrol. Proc. (In Press).

Spiritual or religious struggle in hematopoietic cell transplant survivors.

PubMed

King, Stephen Duane; Fitchett, George; Murphy, Patricia E; Pargament, Kenneth I; Martin, Paul J; Johnson, Rebecca H; Harrison, David A; Loggers, Elizabeth Trice

2017-02-01

This study describes the prevalence of religious or spiritual (R/S) struggle in long-term survivors after hematopoietic cell transplantation (HCT), demographic and medical correlates of R/S struggle, and its associations with depression and quality of life. Data were collected in conjunction with an annual survey of adult (age ≥18 years) survivors of HCT. Study measures included R/S struggle (negative religious coping, NRC, from Brief RCOPE), measures of quality of life (subscales from 36-item Short Form Health Survey and McGill), and the Patient Health Questionnaire 8. R/S struggle was defined as any non-zero response on the NRC. Factors associated with R/S struggle were identified using multi-variable logistic regression models. The study analyzed data from 1449 respondents who ranged from 6 months to 40 years after HCT. Twenty-seven percent had some R/S struggle. In a multi-variable logistic regression model, R/S struggle was associated with greater depression and poorer quality of life. R/S struggle was also associated with younger age, non-White race, and self-identification as either religious but not spiritual or spiritual but not religious. R/S struggle was not associated with any medical variables, including time since transplant. Religious or spiritual struggle is common among HCT survivors, even many years after HCT. Survivors should be screened and, as indicated, referred to a professional with expertise in R/S struggle. Further study is needed to determine causal relationships, longitudinal trajectory, impact of struggle intensity, and effects of R/S struggle on health, mood, and social roles for HCT survivors. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

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

Understanding diagnostic variability in breast pathology: lessons learned from an expert consensus review panel

PubMed Central

Allison, Kimberly H; Reisch, Lisa M; Carney, Patricia A; Weaver, Donald L; Schnitt, Stuart J; O’Malley, Frances P; Geller, Berta M; Elmore, Joann G

2015-01-01

Aims To gain a better understanding of the reasons for diagnostic variability, with the aim of reducing the phenomenon. Methods and results In preparation for a study on the interpretation of breast specimens (B-PATH), a panel of three experienced breast pathologists reviewed 336 cases to develop consensus reference diagnoses. After independent assessment, cases coded as diagnostically discordant were discussed at consensus meetings. By the use of qualitative data analysis techniques, transcripts of 16 h of consensus meetings for a subset of 201 cases were analysed. Diagnostic variability could be attributed to three overall root causes: (i) pathologist-related; (ii) diagnostic coding/study methodology-related; and (iii) specimen-related. Most pathologist-related root causes were attributable to professional differences in pathologists’ opinions about whether the diagnostic criteria for a specific diagnosis were met, most frequently in cases of atypia. Diagnostic coding/study methodology-related root causes were primarily miscategorizations of descriptive text diagnoses, which led to the development of a standardized electronic diagnostic form (BPATH-Dx). Specimen-related root causes included artefacts, limited diagnostic material, and poor slide quality. After re-review and discussion, a consensus diagnosis could be assigned in all cases. Conclusions Diagnostic variability is related to multiple factors, but consensus conferences, standardized electronic reporting formats and comments on suboptimal specimen quality can be used to reduce diagnostic variability. PMID:24511905

Modeled summer background concentration nutrients and ...

EPA Pesticide Factsheets

We used regression models to predict background concentration of four water quality indictors: total nitrogen (N), total phosphorus (P), chloride, and total suspended solids (TSS), in the mid-continent (USA) great rivers, the Upper Mississippi, the Lower Missouri, and the Ohio. From best-model linear regressions of water quality indicators with land use and other stressor variables, we determined the concentration of the indicators when the land use and stressor variables were all set to zero the y-intercept. Except for total P on the Upper Mississippi River and chloride on the Ohio River, we were able to predict background concentration from significant regression models. In every model with more than one predictor variable, the model included at least one variable representing agricultural land use and one variable representing development. Predicted background concentration of total N was the same on the Upper Mississippi and Lower Missouri rivers (350 ug l-1), which was much lower than a published eutrophication threshold and percentile-based thresholds (25th percentile of concentration at all sites in the population) but was similar to a threshold derived from the response of sestonic chlorophyll a to great river total N concentration. Background concentration of total P on the Lower Missouri (53 ug l-1) was also lower than published and percentile-based thresholds. Background TSS concentration was higher on the Lower Missouri (30 mg l-1) than the other ri

Framework for Evaluating Water Quality of the New England Crystalline Rock Aquifers

USGS Publications Warehouse

Harte, Philip T.; Robinson, Gilpin R.; Ayotte, Joseph D.; Flanagan, Sarah M.

2008-01-01

Little information exists on regional ground-water-quality patterns for the New England crystalline rock aquifers (NECRA). A systematic approach to facilitate regional evaluation is needed for several reasons. First, the NECRA are vulnerable to anthropogenic and natural contaminants such as methyl tert-butyl ether (MTBE), arsenic, and radon gas. Second, the physical characteristics of the aquifers, termed 'intrinsic susceptibility', can lead to variable and degraded water quality. A framework approach for characterizing the aquifer region into areas of similar hydrogeology is described in this report and is based on hypothesized relevant physical features and chemical conditions (collectively termed 'variables') that affect regional patterns of ground-water quality. A framework for comparison of water quality across the NECRA consists of a group of spatial variables related to aquifer properties, hydrologic conditions, and contaminant sources. These spatial variables are grouped under four general categories (features) that can be mapped across the aquifers: (1) geologic, (2) hydrophysiographic, (3) land-use land-cover, and (4) geochemical. On a regional scale, these variables represent indicators of natural and anthropogenic sources of contaminants, as well as generalized physical and chemical characteristics of the aquifer system that influence ground-water chemistry and flow. These variables can be used in varying combinations (depending on the contaminant) to categorize the aquifer into areas of similar hydrogeologic characteristics to evaluate variation in regional water quality through statistical testing.

Pilot non dialysis chronic renal insufficiency study (P-ND-CRIS): a pilot study of an open prospective hospital-based French cohort.

PubMed

Massol, Jacques; Janin, Gérard; Bachot, Camille; Gousset, Christophe; Deville, Geoffroy Sainte-Claire; Chalopin, Jean-Marc

2017-02-01

Before establishing a prospective cohort, an initial pilot study is recommended. However, there are no precise guidelines on this subject. This paper reports the findings of a French regional pilot study carried out in three nephrology departments, before realizing a major prospective Non Dialysis Chronic Renal Insufficiency study (ND-CRIS). We carried out an internal pilot study. The objectives of this pilot study were to validate the feasibility (regulatory approval, providing patients with information, availability of variables, refusal rate of eligible patients) and quality criteria (missing data, rate of patients lost to follow-up, characteristics of the patients included and non-included eligible patients, quality control of the data gathered) and estimate the human resources necessary (number of clinical research associates required). The authorizations obtained (CCTIRS - CNIL) and the contracts signed with hospitals have fulfilled the regulatory requirements. After validating the information on the study provided to patients, 1849 of them were included in three centres (university hospital, intercommunal hospital, town hospital) between April 2012 and September 2015. The low refusal rate (51 patients) and the characteristics of non-included patients have confirmed the benefit for patients of participating in the study and provide evidence of the feasibility and representativeness of the population studied. The lack of missing data on the variables studied, the quality of the data analyzed and the low number of patients lost to follow-up are evidence of the quality of the study. By taking into account the time spent by CRAs to enter data and to travel, as well as the annual patient numbers in each hospital, we estimate that five CRAs will be required in total. With no specific guidelines on how to realize a pilot study before implementing a major prospective cohort, we considered it pertinent to report our experience of P-ND-CRIS. This experience confirms that i) feasibility, ii) quality of data and iii) evaluating the resources required must be validated before carrying out a large prospective cohort study such as ND-CRIS.

Improving spatial prediction of Schistosoma haematobium prevalence in southern Ghana through new remote sensors and local water access profiles.

PubMed

Kulinkina, Alexandra V; Walz, Yvonne; Koch, Magaly; Biritwum, Nana-Kwadwo; Utzinger, Jürg; Naumova, Elena N

2018-06-04

Schistosomiasis is a water-related neglected tropical disease. In many endemic low- and middle-income countries, insufficient surveillance and reporting lead to poor characterization of the demographic and geographic distribution of schistosomiasis cases. Hence, modeling is relied upon to predict areas of high transmission and to inform control strategies. We hypothesized that utilizing remotely sensed (RS) environmental data in combination with water, sanitation, and hygiene (WASH) variables could improve on the current predictive modeling approaches. Schistosoma haematobium prevalence data, collected from 73 rural Ghanaian schools, were used in a random forest model to investigate the predictive capacity of 15 environmental variables derived from RS data (Landsat 8, Sentinel-2, and Global Digital Elevation Model) with fine spatial resolution (10-30 m). Five methods of variable extraction were tested to determine the spatial linkage between school-based prevalence and the environmental conditions of potential transmission sites, including applying the models to known human water contact locations. Lastly, measures of local water access and groundwater quality were incorporated into RS-based models to assess the relative importance of environmental and WASH variables. Predictive models based on environmental characterization of specific locations where people contact surface water bodies offered some improvement as compared to the traditional approach based on environmental characterization of locations where prevalence is measured. A water index (MNDWI) and topographic variables (elevation and slope) were important environmental risk factors, while overall, groundwater iron concentration predominated in the combined model that included WASH variables. The study helps to understand localized drivers of schistosomiasis transmission. Specifically, unsatisfactory water quality in boreholes perpetuates reliance of surface water bodies, indirectly increasing schistosomiasis risk and resulting in rapid reinfection (up to 40% prevalence six months following preventive chemotherapy). Considering WASH-related risk factors in schistosomiasis prediction can help shift the focus of control strategies from treating symptoms to reducing exposure.

The determinants of self-reported health-related quality of life in a culturally and socially diverse South African community.

PubMed Central

Jelsma, Jennifer; Ferguson, Gillian

2004-01-01

OBJECTIVE: To determine factors predictive of the score on the visual analogue scale (VAS) of the EQ-5D questionnaire. METHODS: The responses of 1159 residents of a socially and ethnically diverse suburb of Cape Town, South Africa, to the EQ-5D questionnaire were analysed using forward stepwise multiple regression. The variables entered included ethnic group, religious affiliation (Christian or Muslim), income level, unemployment, recent illness or disability and each level of the five EQ-5D domains. FINDINGS: The model developed accounted for an adjusted r(2) of 0.234 and included 11 variables. In addition to the EQ-5D domains, the presence of a disability, an income of less than 420 US dollars per month, unemployment and age in years were significant predictors of VAS score. CONCLUSION: The substantial contribution of health state to the VAS indicates that it is a valid measure of health-related quality of life (HRQoL) across population groups. However, the subjects with lower social status reported a worse HRQoL than their health state alone warranted and this variable might need to be taken into account if the VAS is to be used to compare health states across populations. This paper provides empirical evidence of how HRQoL is perceived by different socioeconomic, cultural, ethnic and religious communities within a developing country. PMID:15112009

Linking North American Summer Ozone Pollution Episodes to Subseasonal Atmospheric Variability

NASA Astrophysics Data System (ADS)

White, E. C.; Watt-Meyer, O.; Kushner, P. J.; Jones, D. B. A.

2017-12-01

Ozone concentrations in the planetary boundary layer (PBL) are positively correlated with surface air temperature due to shared influences including incident solar radiation and PBL stagnancy, as well as the temperature-sensitive emission of ozone precursor compounds. While previous studies have linked heat waves in North America to modes of subseasonal atmospheric variability, such analyses have not been applied to summertime ozone pollution episodes. This study investigates a possible link between subseasonal atmospheric variability in reanalysis data and summertime ozone pollution episodes identified in almost thirty years of in-situ measurements from the Air Quality System (AQS) network in the United States. AQS stations are grouped into regions likely to experience simultaneous extreme ozone concentrations using statistical clustering methods. Composite meteorological patterns are calculated for ozone episodes in each of these regions. The same analysis is applied to heat waves identified in AQS temperature records for comparison. Local meteorological features during typical ozone episodes include extreme temperatures and reduced cloud cover related to anomalous synoptic-scale anticyclonic circulation aloft. These anticyclonic anomalies are typically embedded in wave trains extending from the North Pacific to North Atlantic. Spectral analysis of these wave trains reveals that low-frequency standing waves play a prominent role. These long-lived circulation patterns may provide a means to increase air quality prediction lead-times and to estimate the frequency of ozone pollution episodes under climate change.

A systematic approach to evaluate parameter consistency in the inlet stream of source separated biowaste composting facilities: A case study in Colombia.

PubMed

Oviedo-Ocaña, E R; Torres-Lozada, P; Marmolejo-Rebellon, L F; Torres-López, W A; Dominguez, I; Komilis, D; Sánchez, A

2017-04-01

Biowaste is commonly the largest fraction of municipal solid waste (MSW) in developing countries. Although composting is an effective method to treat source separated biowaste (SSB), there are certain limitations in terms of operation, partly due to insufficient control to the variability of SSB quality, which affects process kinetics and product quality. This study assesses the variability of the SSB physicochemical quality in a composting facility located in a small town of Colombia, in which SSB collection was performed twice a week. Likewise, the influence of the SSB physicochemical variability on the variability of compost parameters was assessed. Parametric and non-parametric tests (i.e. Student's t-test and the Mann-Whitney test) showed no significant differences in the quality parameters of SSB among collection days, and therefore, it was unnecessary to establish specific operation and maintenance regulations for each collection day. Significant variability was found in eight of the twelve quality parameters analyzed in the inlet stream, with corresponding coefficients of variation (CV) higher than 23%. The CVs for the eight parameters analyzed in the final compost (i.e. pH, moisture, total organic carbon, total nitrogen, C/N ratio, total phosphorus, total potassium and ash) ranged from 9.6% to 49.4%, with significant variations in five of those parameters (CV>20%). The above indicate that variability in the inlet stream can affect the variability of the end-product. Results suggest the need to consider variability of the inlet stream in the performance of composting facilities to achieve a compost of consistent quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluating the quality of websites relating to diet and eating disorders.

PubMed

Guardiola-Wanden-Berghe, Rocío; Gil-Pérez, Josefa D; Sanz-Valero, Javier; Wanden-Berghe, Carmina

2011-12-01

To verify whether the Credibility Indicator is able to evaluate the quality of websites. This is a descriptive cross-sectional study of websites on diet and anorexia/bulimia, using searches on Google to access the study population. Quality was studied using 22 variables selected by consolidating international proposals. In addition, eight variables belonging to the Credibility Indicator were also studied. Three hundred and fifty four homepages relating to diet and 366 homepages relating to anorexia/bulimia were evaluated. None of the websites met all of the quality criteria; neither did any website satisfy all of the Credibility Indicators. A positive correlation was observed between fulfilment of the Quality items and the Credibility Indicator (R = 0.72; P < 0.001). Significant differences were found in the fulfilment of the Total Quality variables between the websites that had these variables and those that did not (t-test = -9.91, P < 0.001). The quality of websites covering issues of diet and anorexia/bulimia is still poor. The Credibility Indicator is a useful aid when determining the quality of a website. It is evident that identifying authorship and affiliation is an important factor in predicting the quality of the information. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

Assessing the Association Between Asthma and Air Quality in the Presence of Wildfires

NASA Technical Reports Server (NTRS)

Young, L. J.; Lopiano, K. K.; Xu, X.; Holt, N. M.; Leary, E.; Al-Hamdan, M. Z.; Crosson, W. L.; Estes, M. G.; Luvall, J. C.; Estes, S. M.;

Variability of water quality across headwater catchments with distinct soils and hydrologic systems in central Missouri

USDA-ARS?s Scientific Manuscript database

Surface water and groundwater contamination by herbicides and fertilizers continues to be a major water quality problem in central Missouri. The purpose of this study was to examine spatial variability of water quality among three different headwater catchments – Goodwater Creek Experimental Watersh...

Accounting for Unobserved Time-Varying Quality in Recreation Demand: An Application to a Sonoran Desert Wilderness

EPA Science Inventory

Environmental variables can be important factors in recreation demand. Analysts wishing to quantify environmental quality impacts face the difficult issue of isolating them from unobserved variables. Quality changes may occur in space, varying between sites, or in time, varying b...

Nursing home director of nursing leadership style and director of nursing-sensitive survey deficiencies.

PubMed

McKinney, Selina H; Corazzini, Kirsten; Anderson, Ruth A; Sloane, Richard; Castle, Nicholas G

2016-01-01

Nursing homes are becoming increasingly complex clinical environments because of rising resident acuity and expansion of postacute services within a context of historically poor quality performance. Discrete quality markers have been linked to director of nursing (DON) leadership behaviors. However, the impact of DON leadership across all measured areas of DON jurisdiction has not been tested using comprehensive domains of quality deficiencies. The aim of this study was to examine the effects of DON leadership style including behaviors that facilitate the exchange of information between diverse people on care quality domains through the lens of complexity science. Three thousand six hundred nine DONs completed leadership and intent-to-quit surveys. Quality markers that were deemed DON sensitive included all facility survey deficiencies in the domains of resident behaviors/facility practices, quality of life, nursing services, and quality of care. Logistic regression procedures estimated associations between variables. The odds of deficiencies for all DON sensitive survey domains were lower in facilities where DONs practiced complexity leadership including more staff input and shared decisional authority. DON quit intentions were aligned with higher odds of facility deficiencies across all domains. Results supported the hypotheses that DONs using complexity leadership approaches by interacting more freely with staff, discussing resident issues, and sharing decision making produced better care outcomes from every DON sensitive metric assessed by Centers for Medicare and Medicaid Services. The mechanism linking poor quality with high DON quit intentions is an area for future research. Encouraging DON use of complexity leadership approaches has the potential to improve a broad swath of quality outcomes.

Development and implementation of an automated quantitative film digitizer quality control program

NASA Astrophysics Data System (ADS)

Fetterly, Kenneth A.; Avula, Ramesh T. V.; Hangiandreou, Nicholas J.

1999-05-01

A semi-automated, quantitative film digitizer quality control program that is based on the computer analysis of the image data from a single digitized test film was developed. This program includes measurements of the geometric accuracy, optical density performance, signal to noise ratio, and presampled modulation transfer function. The variability of the measurements was less than plus or minus 5%. Measurements were made on a group of two clinical and two laboratory laser film digitizers during a trial period of approximately four months. Quality control limits were established based on clinical necessity, vendor specifications and digitizer performance. During the trial period, one of the digitizers failed the performance requirements and was corrected by calibration.

Selected papers in the hydrologic sciences, 1986

USGS Publications Warehouse

Subitzky, Seymour

1987-01-01

Water-quality data from long-term (24 years), fixed- station monitoring at the Cape Fear River at Lock 1 near Kelly, N.C., and various measures of basin development are correlated. Subbasin population, number of acres of cropland in the subbasin, number of people employed in manufacturing, and tons of fertilizer applied in the basin are considered as measures of basinwide development activity. Linear correlations show statistically significant posi- tive relations between both population and manufacturing activity and most of the dissolved constituents considered. Negative correlations were found between the acres of harvested cropland and most of the water-quality measures. The amount of fertilizer sold in the subbasin was not statistically related to the water-quality measures considered in this report. The statistical analysis was limited to several commonly used measures of water quality including specific conductance, pH, dissolved solids, several major dissolved ions, and a few nutrients. The major dissolved ions included in the analysis were calcium, sodium, potassium, magnesium, chloride, sulfate, silica, bicarbonate, and fluoride. The nutrients included were dissolved nitrite plus nitrate nitrogen, dissolved ammonia nitrogen, total nitrogen, dissolved phosphates, and total phosphorus. For the chemicals evaluated, manufacturing and population sources are more closely associated with water quality in the Cape Fear River at Lock 1 than are agricultural variables.

Association of biomarkers with health-related quality of life and history of stressors in myalgic encephalomyelitis/chronic fatigue syndrome patients.

PubMed

Fenouillet, Emmanuel; Vigouroux, Aude; Steinberg, Jean Guillaume; Chagvardieff, Alexandre; Retornaz, Frédérique; Guieu, Regis; Jammes, Yves

2016-08-31

Myalgic encephalomyelitis chronic fatigue syndrome (ME/CFS) is a common debilitating disorder associated with an intense fatigue, a reduced physical activity, and an impaired quality of life. There are no established biological markerof the syndrome. The etiology is unknown and its pathogenesis appears to be multifactorial. Various stressors, including intense physical activity, severe infection, and emotional stress are reported in the medical history of ME/CFS patients which raises the question whether any physiological and biological abnormalities usually found in these patients could be indicative of the etiology and/or the quality-of-life impairment. Thirty-six patients and 11 age-matched healthy controls were recruited. The following variables that appear to address common symptoms of ME/CFS were studied here: (1) muscle fatigue during exercise has been investigated by monitoring the compound muscle action potential (M-wave); (2) the excessive oxidative stress response to exercise was measured via two plasma markers (thiobarbituric acid reactive substances: TBARS; reduced ascorbic-acid: RAA); (3) a potential inflammatory component was addressed via expression of CD26 on peripheral blood mononuclear cells; (4) quality-of-life impairment was assessed using the London Handicap Scale (LHS) and the Medical Outcome Study Short Form-36 (SF-36). The medical history of each patient, including the presence of stressors such as intense sports practice, severe acute infection and/or severe emotional stress was documented. We observed that: (1) there were striking differences between cases and controls with regard to three biological variables: post-exercise M-wave, TBARS variations and CD26-expression at rest; (2) each of these three variables correlated with the other two; (3) abnormalities in the biomarkers associated with health-related quality of life: the LHS score was negatively correlated with the exercise-induced TBARS increase and positively correlated with CD26-expression while the pain component of SF-36 was negatively correlated with CD26-expression; (4) the TBARS increase and the M-wave decrease were the highest, and the CD26-expression level the lowest in patients who had been submitted to infectious stressors. In ME/CFS patients, severe alterations of the muscle excitability, the redox status, as well as the CD26-expression level are correlated with a marked impairment of the quality-of-life. They are particularly significant when infectious stressors are reported in the medical history.

Quality measurement in physician-staffed emergency medical services: a systematic literature review.

PubMed

Haugland, Helge; Uleberg, Oddvar; Klepstad, Pål; Krüger, Andreas; Rehn, Marius

2018-05-15

Quality measurement of physician-staffed emergency medical services (P-EMS) is necessary to improve service quality. Knowledge and consensus on this topic are scarce, making quality measurement of P-EMS a high-priority research area. The aim of this review was to identify, describe and evaluate studies of quality measurement in P-EMS. The databases of MEDLINE and Embase were searched initially, followed by a search for included article citations in Scopus. The study eligibility criteria were: (1) articles describing the use of one quality indicator (QI) or more in P-EMS, (2) original manuscripts, (3) articles published from 1 January 1968 until 5 October 2016. The literature search identified 4699 records. 4543 were excluded after reviewing title and abstract. An additional 129 were excluded based on a full-text review. The remaining 27 papers were included in the analysis. Methodological quality was assessed using an adapted critical appraisal tool. The description of used QIs and methods of quality measurement was extracted. Variables describing the involved P-EMSs were extracted as well. In the included papers, a common understanding of which QIs to use in P-EMS did not exist. Fifteen papers used only a single QI. The most widely used QIs were 'Adherence to medical protocols', 'Provision of advanced interventions', 'Response time' and 'Adverse events'. The review demonstrated a lack of shared understanding of which QIs to use in P-EMS. Moreover, papers using only one QI dominated the literature, thus increasing the risk of a narrow perspective in quality measurement. Future quality measurement in P-EMS should rely on a set of consensus-based QIs, ensuring a comprehensive approach to quality measurement.

A new method for defining and managing process alarms and for correcting process operation when an alarm occurs.

PubMed

Brooks, Robin; Thorpe, Richard; Wilson, John

2004-11-11

A new mathematical treatment of alarms that considers them as multi-variable interactions between process variables has provided the first-ever method to calculate values for alarm limits. This has resulted in substantial reductions in false alarms and hence in alarm annunciation rates in field trials. It has also unified alarm management, process control and product quality control into a single mathematical framework so that operations improvement and hence economic benefits are obtained at the same time as increased process safety. Additionally, an algorithm has been developed that advises what changes should be made to Manipulable process variables to clear an alarm. The multi-variable Best Operating Zone at the heart of the method is derived from existing historical data using equation-free methods. It does not require a first-principles process model or an expensive series of process identification experiments. Integral with the method is a new format Process Operator Display that uses only existing variables to fully describe the multi-variable operating space. This combination of features makes it an affordable and maintainable solution for small plants and single items of equipment as well as for the largest plants. In many cases, it also provides the justification for the investments about to be made or already made in process historian systems. Field Trials have been and are being conducted at IneosChlor and Mallinckrodt Chemicals, both in the UK, of the new geometric process control (GPC) method for improving the quality of both process operations and product by providing Process Alarms and Alerts of much high quality than ever before. The paper describes the methods used, including a simple visual method for Alarm Rationalisation that quickly delivers large sets of Consistent Alarm Limits, and the extension to full Alert Management with highlights from the Field Trials to indicate the overall effectiveness of the method in practice.

The influence of drought on flow‐ecology relationships in Ozark Highland streams

USGS Publications Warehouse

Lynch, Dustin T.; Leasure, D. R.; Magoulick, Daniel D.

2018-01-01

Drought and summer drying can have strong effects on abiotic and biotic components of stream ecosystems. Environmental flow‐ecology relationships may be affected by drought and drying, adding further uncertainty to the already complex interaction of flow with other environmental variables, including geomorphology and water quality.Environment–ecology relationships in stream communities in Ozark Highland streams, USA, were examined over two years with contrasting environmental conditions, a drought year (2012) and a flood year (2013). We analysed fish, crayfish and benthic macroinvertebrate assemblages using two different approaches: (1) a multiple regression analysis incorporating predictor variables related to habitat, water quality, geomorphology and hydrology and (2) a canonical ordination procedure using only hydrologic variables in which forward selection was used to select predictors that were most related to our response variables.Reach‐scale habitat quality and geomorphology were found to be the most important influences on community structure, but hydrology was also important, particularly during the flood year. We also found substantial between‐year variation in environment–ecology relationships. Some ecological responses differed significantly between drought and flood years, while others remained consistent. We found that magnitude was the most important flow component overall, but that there was a shift in relative importance from low flow metrics during the drought year to average flow metrics during the flood year, and the specific metrics of importance varied markedly between assemblages and years.Findings suggest that understanding temporal variation in flow‐ecology relationships may be crucial for resource planning. While some relationships show temporal variation, others are consistent between years. Additionally, different kinds of hydrologic variables can differ greatly in terms of which assemblages they affect and how they affect them. Managers can address this complexity by focusing on relationships that are temporally stable and flow metrics that are consistently important across groups, such as flood frequency and flow variability.

Systematic evaluation of clinical practice guidelines for pharmacogenomics.

PubMed

Beckett, Robert D; Kisor, David F; Smith, Thomas; Vonada, Brooke

2018-06-01

To systematically assess methodological quality of pharmacogenomics clinical practice guidelines. Guidelines published through 2017 were reviewed by at least three independent reviewers using the AGREE II instrument, which consists of 23 items grouped into 6 domains and 2 items representing an overall assessment. Items were assessed on a seven-point rating scale, and aggregate quality scores were calculated. 31 articles were included. All guidelines were published as peer-reviewed articles and 90% (n = 28) were endorsed by professional organizations. Mean AGREE II domain scores (maximum score 100%) ranged from 46.6 ± 11.5% ('applicability') to 78.9 ± 11.4% ('clarity of presentation'). Median overall quality score was 72.2% (IQR: 61.1-77.8%). Quality of pharmacogenomics guidelines was generally high, but variable, for most AGREE II domains.

Association between screen viewing duration and sleep duration, sleep quality, and excessive daytime sleepiness among adolescents in Hong Kong.

PubMed

Mak, Yim Wah; Wu, Cynthia Sau Ting; Hui, Donna Wing Shun; Lam, Siu Ping; Tse, Hei Yin; Yu, Wing Yan; Wong, Ho Ting

2014-10-28

Screen viewing is considered to have adverse impacts on the sleep of adolescents. Although there has been a considerable amount of research on the association between screen viewing and sleep, most studies have focused on specific types of screen viewing devices such as televisions and computers. The present study investigated the duration with which currently prevalent screen viewing devices (including televisions, personal computers, mobile phones, and portable video devices) are viewed in relation to sleep duration, sleep quality, and daytime sleepiness among Hong Kong adolescents (N = 762). Television and computer viewing remain prevalent, but were not correlated with sleep variables. Mobile phone viewing was correlated with all sleep variables, while portable video device viewing was shown to be correlated only with daytime sleepiness. The results demonstrated a trend of increase in the prevalence and types of screen viewing and their effects on the sleep patterns of adolescents.

Acculturation and health-related quality of life among Vietnamese immigrant women in transnational marriages in Taiwan.

PubMed

Yang, Yung-Mei; Wang, Hsiu-Hung

2011-10-01

To examine associations between demographic variables, acculturation, and health-related quality of life among Vietnamese immigrant women in transnational marriages in Taiwan. A cross-sectional survey of 203 participants in southern Taiwan. Instruments included a demographic inventory, the Suinn-Lew Asian Self-Identity Acculturation Scale, and the Short Form Health Survey-Version 2. Most participants had low acculturation levels. Length of residency, number of children, marital status, level of education, religion of spouse, and employment status of spouse significantly correlated with level of acculturation, as did mental health, bodily pain, vitality, and social functioning. Programs are needed to encourage social assimilation for Vietnamese immigrant women in Taiwan. Culturally sensitive medical evaluations will ensure early treatment of mental and physical health problems caused by the stress of acculturation. An increased understanding of variables affecting Southeast Asian immigrant women's acculturation process will improve health status.

Benchmarking heart rate variability toolboxes.

PubMed

Vest, Adriana N; Li, Qiao; Liu, Chengyu; Nemati, Shamim; Shah, Amit; Clifford, Gari D

Heart rate variability (HRV) metrics hold promise as potential indicators for autonomic function, prediction of adverse cardiovascular outcomes, psychophysiological status, and general wellness. Although the investigation of HRV has been prevalent for several decades, the methods used for preprocessing, windowing, and choosing appropriate parameters lack consensus among academic and clinical investigators. A comprehensive and open-source modular program is presented for calculating HRV implemented in Matlab with evidence-based algorithms and output formats. We compare our software with another widely used HRV toolbox written in C and available through PhysioNet.org. Our findings show substantially similar results when using high quality electrocardiograms (ECG) free from arrhythmias. Our software shows equivalent performance alongside an established predecessor and includes validated tools for performing preprocessing, signal quality, and arrhythmia detection to help provide standardization and repeatability in the field, leading to fewer errors in the presence of noise or arrhythmias. Copyright © 2017 Elsevier Inc. All rights reserved.

Quality of life for women after a myocardial infarction.

PubMed

Wingate, S

1995-01-01

To assess the level of quality of life and to determine the relationship of selected variables to quality of life in a sample of women after a myocardial infarction (MI). Ex post facto, one-group, correlational survey. Offices of cardiologists in private practice. Consecutive sample of 96 women who had a diagnosis of MI, and who had not undergone cardiac surgery. The mean quality of life score was 21.6. Significant variables in the regression equation were employment status (p < 0.01), social support (p < 0.01), and self-esteem (p = 0.04), and these three variables accounted for 45% of the variance in quality of life. The quality of life scores in this sample were higher than expected and similar to those of healthy populations. Those women in the sample who returned to their former employment status and had higher levels of social support and self-esteem had higher levels of quality of life.

Impact of sampling techniques on measured stormwater quality data for small streams

USGS Publications Warehouse

Harmel, R.D.; Slade, R.M.; Haney, R.L.

2010-01-01

Science-based sampling methodologies are needed to enhance water quality characterization for setting appropriate water quality standards, developing Total Maximum Daily Loads, and managing nonpoint source pollution. Storm event sampling, which is vital for adequate assessment of water quality in small (wadeable) streams, is typically conducted by manual grab or integrated sampling or with an automated sampler. Although it is typically assumed that samples from a single point adequately represent mean cross-sectional concentrations, especially for dissolved constituents, this assumption of well-mixed conditions has received limited evaluation. Similarly, the impact of temporal (within-storm) concentration variability is rarely considered. Therefore, this study evaluated differences in stormwater quality measured in small streams with several common sampling techniques, which in essence evaluated within-channel and within-storm concentration variability. Constituent concentrations from manual grab samples and from integrated samples were compared for 31 events, then concentrations were also compared for seven events with automated sample collection. Comparison of sampling techniques indicated varying degrees of concentration variability within channel cross sections for both dissolved and particulate constituents, which is contrary to common assumptions of substantial variability in particulate concentrations and of minimal variability in dissolved concentrations. Results also indicated the potential for substantial within-storm (temporal) concentration variability for both dissolved and particulate constituents. Thus, failing to account for potential cross-sectional and temporal concentration variability in stormwater monitoring projects can introduce additional uncertainty in measured water quality data. Copyright ?? 2010 by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America. All rights reserved.

Survivors of Child Maltreatment and Postpartum Depression: An Integrative Review.

PubMed

Hutchens, Bridget F; Kearney, Joan; Kennedy, Holly Powell

2017-11-01

An integrative review was performed to explore the relationship between a maternal history of child maltreatment and subsequent postpartum depression (PPD) symptoms. Six electronic databases were used to explore the literature, including PubMed, CINAHL, MEDLINE, PsycINFO, Embase, and Scopus. Studies were included that used victims of child maltreatment as one of the independent variables and PPD symptoms as one of the dependent variables. Studies were excluded if they focused only on women with adult intimate partner violence or women with PPD who were perpetrators of child abuse rather than survivors. The studies were required to be original research, and there was no limit to years or language. The search yielded 589 studies, 16 of which were included in the final sample. These studies were assessed for quality, and a data display matrix was developed to extract the sample, design, methods, operational definitions for independent and dependent variables of interest, major findings with effect sizes, and limitations. Using the data display matrix, the studies' methods and findings were synthesized for divergent and convergent patterns. Studies were varied in their designs, samples, and operational definitions of child maltreatment and PPD, and were low to moderate in quality. Results were inconsistent, but a majority suggest a positive association between a maternal history of child maltreatment and subsequent symptoms of PPD. Child maltreatment and PPD are complex issues that require careful screening by women's health care providers and clearly defined operational definitions in future research. Implications for clinical practice and research are discussed. © 2017 by the American College of Nurse-Midwives.

Quality and Variability of Online Available Physical Therapy Protocols From Academic Orthopaedic Surgery Programs for Anterior Cruciate Ligament Reconstruction.

PubMed

Makhni, Eric C; Crump, Erica K; Steinhaus, Michael E; Verma, Nikhil N; Ahmad, Christopher S; Cole, Brian J; Bach, Bernard R

2016-08-01

To assess the quality and variability found across anterior cruciate ligament (ACL) rehabilitation protocols published online by academic orthopaedic programs. Web-based ACL physical therapy protocols from United States academic orthopaedic programs available online were included for review. Main exclusion criteria included concomitant meniscus repair, protocols aimed at pediatric patients, and failure to provide time points for the commencement or recommended completion of any protocol components. A comprehensive, custom scoring rubric was created that was used to assess each protocol for the presence or absence of various rehabilitation components, as well as when those activities were allowed to be initiated in each protocol. Forty-two protocols were included for review from 155 U.S. academic orthopaedic programs. Only 13 protocols (31%) recommended a prehabilitation program. Five protocols (12%) recommended continuous passive motion postoperatively. Eleven protocols (26%) recommended routine partial or non-weight bearing immediately postoperatively. Ten protocols (24%) mentioned utilization of a secondary/functional brace. There was considerable variation in range of desired full-weight-bearing initiation (9 weeks), as well as in the types of strength and proprioception exercises specifically recommended. Only 8 different protocols (19%) recommended return to sport after achieving certain strength and activity criteria. Many ACL rehabilitation protocols recommend treatment modalities not supported by current reports. Moreover, high variability in the composition and time ranges of rehabilitation components may lead to confusion among patients and therapists. Level II. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Integrative medicine for chronic pain

PubMed Central

Saha, Felix J.; Brüning, Alexander; Barcelona, Cyrus; Büssing, Arndt; Langhorst, Jost; Dobos, Gustav; Lauche, Romy; Cramer, Holger

2016-01-01

Abstract Introduction: Integrative medicine inpatient treatment has been shown to improve physical and mental health in patients with internal medicine conditions. The aim of this study was to investigate the effectiveness of a 2-week integrative medicine inpatient treatment in patients with chronic pain syndromes and the association of treatment success with patient-related process variables. Methods: Inpatients with chronic pain syndromes participating in a 2-week integrative medicine inpatient program were included. Patients’ pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were measured on admission, discharge, and 6 months after discharge. Likewise process variables including ability and will to change, emotional/rational disease acceptance, mindfulness, life and health satisfaction, and easiness of life were assessed. Results: A total of 310 inpatients (91% female, mean age 50.7 ± 12.4 year, 26.5% low back pain, and 22.9% fibromyalgia) were included. Using mixed linear models, significant improvements in pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were found (all P < 0.05). Ability to change and implementation, disease acceptance, mindfulness, life and health satisfaction, and light heartedness/easiness likewise improved (all P < 0.05). Improved outcomes were associated with increases in process variables, mainly ability to change and implementation, disease acceptance, life and health satisfaction, and light heartedness/easiness (R2 = 0.03–0.40). Conclusions: Results of this study suggest that a 2-week integrative medicine inpatient treatment can benefit patients with chronic pain conditions. Functional improvements are associated with improved ability to change and implementation, disease acceptance, and satisfaction. PMID:27399133

A Comparison of Student Views on Web-Based and Face-to-Face Higher Education

ERIC Educational Resources Information Center

Sad, Suleyman Nihat; Goktas, Ozlem; Bayrak, Ilhami

2014-01-01

The study aimed to describe and compare the perceptions of web-based distance education students and campus-based face-to-face students about the quality of education provided in their programs with regard to variables including gender, marital status, and employment status. A baseline descriptive survey design and complementary "ex post…

Manchester Clinical Placement Index (MCPI). Conditions for Medical Students' Learning in Hospital and Community Placements

ERIC Educational Resources Information Center

Dornan, Tim; Muijtjens, Arno; Graham, Jennifer; Scherpbier, Albert; Boshuizen, Henny

2012-01-01

The drive to quality-manage medical education has created a need for valid measurement instruments. Validity evidence includes the theoretical and contextual origin of items, choice of response processes, internal structure, and interrelationship of a measure's variables. This research set out to explore the validity and potential utility of an…

Long-term continuous measurement of near-road air pollution in Las Vegas: Seasonal variability in traffic emissions impact on local air quality

EPA Science Inventory

Excess air pollution along roadways is an issue of public health concern and motivated a long-term measurement effort established by the U.S. Environmental Protection Agency in Las Vegas, Nevada. Measurements of air pollutants – including black carbon (BC), carbon monoxide (CO),...

Survival and Growth of Bottomland Hardwood Seedlings and Natural Woody Invaders Near Forest Edges

Treesearch

John W. McCoy; Bobby D. Keeland; Kristi Wharton

2004-01-01

Several oak species are frequently planted for reforestation projects in the Lower Mississippi Alluvial Valley (LMAV), but the success of these plantings has been variable. The survival and growth of planted seed or seedlings are affected by a variety of factors, including competition, herbivory, site preparation, precipitation, planting stock quality, and planting...

Bond quality of phenol-based adhesives containing liquefied creosote-treated wood

Treesearch

Chung-Yun Hse; Feng Fu; Hui Pan

2009-01-01

Liquefaction of spent creosote-treated wood was studied to determine the technological practicability of its application in converting treated wood waste into resin adhesives. A total of 144 plywood panels were fabricated with experimental variables included 2 phenol to wood (P/W) ratios in liquefaction, 6 resin formulations (3 formaldehyde/liquefied wood (F/...

Application of quality by design concept to develop a dual gradient elution stability-indicating method for cloxacillin forced degradation studies using combined mixture-process variable models.

PubMed

Zhang, Xia; Hu, Changqin

2017-09-08

Penicillins are typical of complex ionic samples which likely contain large number of degradation-related impurities (DRIs) with different polarities and charge properties. It is often a challenge to develop selective and robust high performance liquid chromatography (HPLC) methods for the efficient separation of all DRIs. In this study, an analytical quality by design (AQbD) approach was proposed for stability-indicating method development of cloxacillin. The structures, retention and UV characteristics rules of penicillins and their impurities were summarized and served as useful prior knowledge. Through quality risk assessment and screen design, 3 critical process parameters (CPPs) were defined, including 2 mixture variables (MVs) and 1 process variable (PV). A combined mixture-process variable (MPV) design was conducted to evaluate the 3 CPPs simultaneously and a response surface methodology (RSM) was used to achieve the optimal experiment parameters. A dual gradient elution was performed to change buffer pH, mobile-phase type and strength simultaneously. The design spaces (DSs) was evaluated using Monte Carlo simulation to give their possibility of meeting the specifications of CQAs. A Plackett-Burman design was performed to test the robustness around the working points and to decide the normal operating ranges (NORs). Finally, validation was performed following International Conference on Harmonisation (ICH) guidelines. To our knowledge, this is the first study of using MPV design and dual gradient elution to develop HPLC methods and improve separations for complex ionic samples. Copyright © 2017 Elsevier B.V. All rights reserved.

The effect of an industrial effluent on an urban stream benthic community: water quality vs habitat quality.

PubMed

Nedeau, Ethan J; Merritt, Richard W; Kaufman, Michael G

2003-01-01

We studied the effect of an industrial effluent on the water quality, habitat quality, and benthic macroinvertebrates of an urban stream in southwestern Michigan (USA). The effluent affected water quality by raising in-stream temperatures 13-18 degree C during colder months and carrying high amounts of iron (> 20 x higher than ambient) that covered the streambed. The effluent also affected habitat conditions by increasing total stream discharge by 50-150%, causing a significant change in substrate and flow conditions. We used three methods to collect benthic macroinvertebrates in depositional and erosional habitats and to understand the relative importance of habitat quality and water quality alterations. Macroinvertebrate response variables included taxonomic richness, abundance, and proportional abundance of sensitive taxonomic groups. Results indicated that the effluent had a positive effect on macroinvertebrate communities by increasing the quantity of riffle habitat, but a negative effect on macroinvertebrate communities by reducing water quality. Results illustrated the need for careful consideration of habitat quality and water quality in restoration or remediation programs.

Psychological Risk Factors and Outcomes of Dance Injury: A Systematic Review.

PubMed

Mainwaring, Lynda M; Finney, Caitlin

2017-09-15

Historically, dance medicine and science has focused on the physical aspects rather than the psychological aspects of dance injury. Psychological variables, however, have been shown to influence the occurrence of injury and post-injury outcomes. The purpose of this review was to examine the dance psychology literature and determine the specific psychological factors reported to be associated with the incidence, frequency, and outcome of dance injuries. A systematic literature search was conducted using SPORTDiscus, MEDLINE, CINAHL, and PsycINFO. All retrieved articles were screened based on criteria developed a priori, and selected articles were subsequently assessed for quality. Thirteen studies met the inclusion and quality assessment criteria. Psychological factors associated with both risk and outcome of dance injury included the following: stress, psychological distress, disordered eating, and coping. Factors associated only with risk of injury were sleep, personality, and social support. The results suggest that psychological variables can affect both the incidence and outcome of dance injury among dancers. Therefore, it is critical to gain a well-rounded, thorough understanding of all the factors, including psychological, that have a negative impact on dancers with respect to dance injury. The findings are discussed in terms of the utility of including psychological assessment and intervention, such as cognitive behavioral therapy, when implementing preventative and treatment measures in dance schools and companies.

Study of bituminous surface treatments in Virginia : analysis of factors that significantly influence the quality of bituminous surface treatments.

DOT National Transportation Integrated Search

1970-01-01

It is obvious that many variables may influence the quality of a surface treatment, but the relative importance of the many variables involved is a matter of conjecture. The purpose of this study was to define those variables which do significantly i...

Intergenerational Relationship Quality Across Three Generations

PubMed Central

Tighe, Lauren A.; Fingerman, Karen L.; Zarit, Steven H.

2012-01-01

Objectives. Studies of intergenerational relationship quality often include one or two generations. This study examined within-family differences and similarities or transmission of positive and negative relationship quality across three generations. Method. Participants included 633 middle-aged individuals (G2; 52% women, ages 40–60 years), 592 of their offspring (G3; 53% daughters; ages 18–41 years), and 337 of their parents (i.e., grandparents; G1; 69% women; ages 59–96 years). Results. Multilevel models revealed differences and similarities in relationship quality across generations. The oldest generation (G1) reported greater positive and less negative quality relationships than the middle (G2) and the younger (G3) generations. There was limited evidence of transmission. Middle-aged respondents who reported more positive and less negative ties with their parents (G1) reported more positive and less negative ties with their own children (G3). Grandmother (G1) reports of more positive relationship quality were associated with G3 reports of more positive relationship quality with G2. Discussion. Findings are consistent with the intergenerational stake hypothesis and only partially consistent with the theory of intergenerational transmission. Overall, this study suggests that there is greater within-family variability than similarities in how family members feel about one another. PMID:22628478

[Effectiveness of virtual immersion programmes in patients with Parkinson's disease. A systematic review].

PubMed

Morales-Gomez, S; Elizagaray-Garcia, I; Yepes-Rojas, O; de la Puente-Ranea, L; Gil-Martinez, A

2018-02-01

Parkinson disease (PD) is the second most common neurodegenerative disease. Virtual reality (VR) is being used in rehabilitation of neurological patients. To analyze the VR systems' therapeutically effectiveness through PD diagnosed subjects with variables of motor, quality of life and cognition. Electronics database were used to look for articles: Medline, EMBASE, PEDro, CINAHL and Cochrane. The inclusion criteria were: randomized control trial (RCT) performed in PD with at least one VR variable included in the therapeutically treatment and diagnosed PD subjects. Four RCT were chosen showing all good methodology quality. Concordance between evaluators was moderate-high. VR was the main treatment in all of them. VR was more effective in balance improvement in PD subjects than conventional physiotherapy in two RCT. VR was not more effective in balance improvement in PD subjects than conventional physiotherapy in two RCT. Contradictory evidences where showed between the effectiveness of the VR programs versus conventional programs in the effectiveness of balance treatment with PD subjects. Non-motor variables improvement was not greater in subjects with VR treatments versus the ones with conventional physiotherapy in the four RCT. The treatments with VR cannot be assumed as more effectives than conventional physiotherapy through PD subjects in motor and psychosocial variables.

Surface quality and topographic inspection of variable compliance part after precise turning

NASA Astrophysics Data System (ADS)

Nieslony, P.; Krolczyk, G. M.; Wojciechowski, S.; Chudy, R.; Zak, K.; Maruda, R. W.

2018-03-01

The paper presents the problem of precise turning of the mould parts with variable compliance and demonstrates a topographic inspection of the machined surface quality. The study was conducted for the cutting tools made of cemented carbide with coatings, in a range of variable cutting parameters. The long shaft with special axial hole, made of hardened 55NiCrMoV6 steel was selected as a workpiece. The carried out study included the stiffness measurement of the machining system, as well as the investigation of cutting force components. In this context, the surface topography parameters were evaluated using the stylus profile meter and analysed. The research revealed that the surface topography, alongside the 3D functional parameters, and PSD influences the performance of the machined surface. The lowest surface roughness parameters values, equalled to Sa = 1 μm and Sz = 4.3 μm have been obtained during turning with cutting speed vc = 90 m/min. The stable turning of variable compliance part affects the surface texture formation with a unidirectional perpendicular, anisotropic structure. Nevertheless, in case of unstable turning, the characteristic chatter marks are observed, and process dynamics has greater contribution in formation of surface finish than turning kinematics and elastic plastic deformation of workpiece.

Impact of Pharmacotherapy on Quality of Life in Patients with Parkinson's Disease.

PubMed

Martinez-Martin, Pablo; Rodriguez-Blazquez, Carmen; Forjaz, Maria João; Kurtis, Monica M

2015-05-01

Quality of life (QoL) is a patient-reported outcome frequently included in Parkinson's disease (PD) clinical trials as a secondary or tertiary endpoint. However, QoL is an important variable that reflects the impact of disease and treatment from the patients' perspective. In a chronic, neurodegenerative disease such as PD, with a wide range of complex symptoms, QoL provides valuable and comprehensive information on the patients' health status. This narrative review aims to evaluate the effect of specific PD treatments currently in use on patients' QoL measured with the Parkinson's Disease Questionnaire, 39-item (PDQ-39) or 8-item (PDQ-8) version. A quantification of this effect is provided by calculation of the relative change and effect size. These two parameters allow an intuitive standardized approach to the importance of change based on its magnitude. Some high-quality studies (Level I) were found for levodopa (immediate- or extended-release formulations), levodopa with added-on catechol-O-methyltransferase (COMT) inhibitors, levodopa/carbidopa gel for intestinal infusion, some dopamine agonists (ropinirole, cabergoline, pergolide), and the monoamine oxidase B (MAO-B) inhibitor safinamide. As a whole, these studies found a beneficial effect of variable magnitude, weak to moderate, on patients' QoL. Studies with a lower level of evidence or not providing enough data to estimate relative change and effect size, including those for the apomorphine subcutaneous pump, also reported improvement of QoL, but the evidence was insufficient to confirm the effect. More high-quality studies focused on QoL are needed to determine the real impact of PD drug treatments for this important outcome.

[Cancer pain management: Systematic review and critical appraisal of clinical practice guidelines].

PubMed

Martínez-Nicolás, I; Ángel-García, D; Saturno, P J; López-Soriano, F

2016-01-01

Although several clinical practice guidelines have been developed in the last decades, cancer pain management is still deficient. The purpose of this work was to carry out a comprehensive and systematic literature review of current clinical practice guidelines on cancer pain management, and critically appraise their methodology and content in order to evaluate their quality and validity to cope with this public health issue. A systematic review was performed in the main databases, using English, French and Spanish as languages, from 2008 to 2013. Reporting and methodological quality was rated with the Appraisal of Guidelines, Research and Evaluation II (AGREE-II) tool, including an inter-rater reliability analysis. Guideline recommendations were extracted and classified into several categories and levels of evidence, aiming to analyse guidelines variability and evidence-based content comprehensiveness. Six guidelines were included. A wide variability was found in both reporting and methodological quality of guidelines, as well as in the content and the level of evidence of their recommendations. The Scottish Intercollegiate Guidelines Network guideline was the best rated using AGREE-II, while the Sociedad Española de Oncología Médica guideline was the worst rated. The Ministry of Health Malaysia guideline was the most comprehensive, and the Scottish Intercollegiate Guidelines Network guideline was the second one. The current guidelines on cancer pain management have limited quality and content. We recommend Ministry of Health Malaysia and Scottish Intercollegiate Guidelines Network guidelines, whilst Sociedad Española de Oncología Médica guideline still needs to improve. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

A Randomized Trial to Assess the Contribution of a Novel Thorax Support Vest (Corset) in Preventing Mechanical Complications of Median Sternotomy.

PubMed

Caimmi, Philippe P; Sabbatini, Maurizio; Kapetanakis, Emmanouil I; Cantone, Silvia; Ferraz, Marcus V; Cannas, Mario; Tesler, Ugo F

2017-06-01

Mechanical complications of median sternotomy may cause significant morbidity and mortality in cardiac surgical patients. This study was aimed at assessing the role of Posthorax support vest (Epple, Inc., Vienna, Austria) in the prevention of sternal complications and the improvement of anatomical healing in patients at high risk for mechanical sternal dehiscence after cardiac surgery by mean of median sternotomy. A prospective, randomized, study was performed and 310 patients with predisposing factors for sternal dehiscence after sternotomy for cardiac surgery were included. The patients were divided into two groups: patients who received the Posthorax support vest after surgery, and patients who did not. Primary variables assessed included the incidence of mechanical sternal complications, the quality of sternal healing, the rate of re-operation, the duration of hospitalization, rate and duration of hospital, re-admission for sternal complications. Secondary variables assessed were the post-operative pain, the number of requests for supplemental analgesia and the quality of life measured by means of the EQ-5D format. Patients using vest demonstrated a lower incidence of mechanical sternal complications, a better anatomical sternum healing, lower hospital stay, no re-operations for sternal dehiscence before discharge and lower re-admissions for mechanical sternal complication. In addition, patients using a vest reported a better quality of life with better freedom from limitations in mobility, self-care, and pain. Our findings demonstrate that the use of the Posthorax vest reduces post-sternotomy mechanical complications and improves the healing of the sternotomy, the clinical course, and the post-operative quality of life.

How reliable are national surveillance data? Findings from an audit of Canadian methicillin-resistant Staphylococcus aureus surveillance data.

PubMed

Forrester, Leslie; Collet, Jun Chen; Mitchell, Robyn; Pelude, Linda; Henderson, Elizabeth; Vayalumkal, Joseph; Leduc, Stephanie; Ghahreman, Saeed; Weir, Christine; Gravel, Denise

2012-03-01

The Canadian Nosocomial Infection Surveillance Program (CNISP) has conducted surveillance for incident cases of methicillin-resistant Staphylococcus aureus (MRSA) in sentinel hospitals since 1995. In 2007, a reliability audit of the 2005 data was conducted. In 2005, 5,652 cases were submitted to the CNISP from 43 hospitals. A proportional sample of submitted forms (up to 25) from each site were randomly selected. Stratified random sampling was used to obtain the comparison data. The original data were compared with the reabstracted data for congruence on 7 preselected variables. Reabstracted data were received from 30 out of 43 hospitals (70%), providing 443 of the 598 case forms requested (74%). Of these, 397 (90%) had matching case identification numbers. Overall, the percentage of discordant responses was 7.0%, ranging from 3.5% for sex and up to 23.7% for less well-defined variables (eg, where MRSA was acquired). Our findings suggest that, in general, the 2005 MRSA data are reliable. However to improve reliability a data quality framework with quality assurance practices, including ongoing auditing should be integrated into the CNISP's surveillance programs. Providing training to data collectors and standard definitions with practical examples may help to improve data quality, especially for those variables that require clinical judgment. Crown Copyright © 2012. Published by Mosby, Inc. All rights reserved.

Craniodentofacial characteristics, dental esthetics-related quality of life, and self-esteem.

PubMed

Gavric, Anja; Mirceta, Dubravka; Jakobovic, Mario; Pavlic, Andrej; Zrinski, Magda Trinajstic; Spalj, Stjepan

2015-06-01

Self-esteem is a psychological trait that may develop in interaction with craniodentofacial esthetics. The aim of this study was to explore the relationship among craniodentofacial characteristics, dental esthetics-related quality of life, and self-esteem in adolescents and young adults. The study was cross-sectional; the sample included 200 pupils and university students (58% female) aged 13 to 33 years. The Rosenberg Self-Esteem Scale and the Psychosocial Impact of Dental Aesthetics Questionnaire were used. Craniodentofacial features were estimated by the method of Martin and Saller, the Index of Orthodontic Treatment Need, and the Index of Complexity, Outcome and Need. When malocclusion severity increases, dental esthetics-related quality of life decreases. The multiple linear regression showed that with the control of all other predictors in the model, the social impact of dental esthetics, borderline dental self-confidence, and facial type contribute the most to explain the variability of self-esteem, accounting for 3.2%, 1.3%, and 1.4%, respectively, of the variability values. The whole model accounts for 24.2% of the variability of self-esteem. In adolescents and young adults, self-esteem appears to be more influenced by the self-perceived psychosocial impacts of dental esthetics than the normative level of malocclusion, craniofacial typology, sex, or age. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Markov blanket-based approach for learning multi-dimensional Bayesian network classifiers: an application to predict the European Quality of Life-5 Dimensions (EQ-5D) from the 39-item Parkinson's Disease Questionnaire (PDQ-39).

PubMed

Borchani, Hanen; Bielza, Concha; Martı Nez-Martı N, Pablo; Larrañaga, Pedro

2012-12-01

Multi-dimensional Bayesian network classifiers (MBCs) are probabilistic graphical models recently proposed to deal with multi-dimensional classification problems, where each instance in the data set has to be assigned to more than one class variable. In this paper, we propose a Markov blanket-based approach for learning MBCs from data. Basically, it consists of determining the Markov blanket around each class variable using the HITON algorithm, then specifying the directionality over the MBC subgraphs. Our approach is applied to the prediction problem of the European Quality of Life-5 Dimensions (EQ-5D) from the 39-item Parkinson's Disease Questionnaire (PDQ-39) in order to estimate the health-related quality of life of Parkinson's patients. Fivefold cross-validation experiments were carried out on randomly generated synthetic data sets, Yeast data set, as well as on a real-world Parkinson's disease data set containing 488 patients. The experimental study, including comparison with additional Bayesian network-based approaches, back propagation for multi-label learning, multi-label k-nearest neighbor, multinomial logistic regression, ordinary least squares, and censored least absolute deviations, shows encouraging results in terms of predictive accuracy as well as the identification of dependence relationships among class and feature variables. Copyright © 2012 Elsevier Inc. All rights reserved.

The Association of Workplace Exposures on Quality of Life in Small and Medium Enterprises Workers: A Cross-Sectional Study in Four ASEAN Countries.

PubMed

Isahak, Marzuki; Loh, May Young; Susilowati, Indri Hapsari; Kaewboonchoo, Orawan; Harncharoen, Kitiphong; Mohd Amin, Nursuhaili; Toai, Nguyen Phuong; Low, Wah-Yun; Ratanasiripong, Paul

2017-05-01

Quality of life is associated with several factors, including personal living styles and working conditions. This article aims to investigate the factors associated with quality of life among small and medium enterprises (SME) workers in 4 countries of the Association of Southeast Asian Nations (ASEAN), namely Malaysia, Indonesia, Thailand, and Vietnam. A total of 2014 workers from food and textile industries were asked to answer a questionnaire about their sociodemographic characteristics, working environment and conditions, and quality of life. Results from showed that lifestyle (ie, alcohol intake and exercising), working characteristics (ie, shift work, working hours, and working days) and workplace conditions were associated with SME workers' quality of life (ie, physical, psychological, social, and environmental domain). Among the 16 types of workplace conditions, "sitting on the chair" and "slippery floor" most affect their quality of life . It is important for these variables to be taken into account in promoting workers' well-being and quality of life.

Long-term trend analysis of reservoir water quality and quantity at the landscape scale in two major river basins of Texas, USA.

USGS Publications Warehouse

Patino, Reynaldo; Asquith, William H.; VanLandeghem, Matthew M.; Dawson, D.

2016-01-01

Trends in water quality and quantity were assessed for 11 major reservoirs of the Brazos and Colorado river basins in the southern Great Plains (maximum period of record, 1965–2010). Water quality, major contributing-stream inflow, storage, local precipitation, and basin-wide total water withdrawals were analyzed. Inflow and storage decreased and total phosphorus increased in most reservoirs. The overall, warmest-, or coldest-monthly temperatures increased in 7 reservoirs, decreased in 1 reservoir, and did not significantly change in 3 reservoirs. The most common monotonic trend in salinity-related variables (specific conductance, chloride, sulfate) was one of no change, and when significant change occurred, it was inconsistent among reservoirs. No significant change was detected in monthly sums of local precipitation. Annual water withdrawals increased in both basins, but the increase was significant (P < 0.05) only in the Colorado River and marginally significant (P < 0.1) in the Brazos River. Salinity-related variables dominated spatial variability in water quality data due to the presence of high- and low-salinity reservoirs in both basins. These observations present a landscape in the Brazos and Colorado river basins where, in the last ∼40 years, reservoir inflow and storage generally decreased, eutrophication generally increased, and water temperature generally increased in at least 1 of 3 temperature indicators evaluated. Because local precipitation remained generally stable, observed reductions in reservoir inflow and storage during the study period may be attributable to other proximate factors, including increased water withdrawals (at least in the Colorado River basin) or decreased runoff from contributing watersheds.

The association between social network relationships and depressive symptoms among older Americans: what matters most?

PubMed

Litwin, Howard

2011-08-01

Although social network relationships are linked to mental health in late life, it is still unclear whether it is the structure of social networks or their perceived quality that matters. The current study regressed a dichotomous 8-item version of the Center for Epidemiological Studies Depression Scale (CESD-8) score on measures of social network relationships among Americans, aged 65-85 years, from the first wave of the National Social Life, Health and Aging Project. The network indicators included a structural variable - social network type - and a series of relationship quality indicators: perceived positive and negative ties with family, friends and spouse/ partner. Multivariate logistic regression analyses controlled for age, gender, education, income, race/ethnicity, religious affiliation, functional health and physical health. The perceived social network quality variables were unrelated to the presence of a high level of depressive symptoms, but social network type maintained an association with this mental health outcome even after controlling for confounders. Respondents embedded in resourceful social network types in terms of social capital--"diverse," "friend" and "congregant" networks--reported less presence of depressive symptoms, to varying degrees. The results show that the structure of the network seems to matter more than the perceived quality of the ties as an indicator of depressive symptoms. Moreover, the composite network type variable stands out in capturing the differences in mental state. The construct of network type should be incorporated in mental health screening among older people who reside in the community. One's social network type can be an important initial indicator that one is at risk.

Allergen manufacturing and quality aspects for allergen immunotherapy in Europe and the United States: An analysis from the EAACI AIT Guidelines Project.

PubMed

Bonertz, A; Roberts, G; Slater, J E; Bridgewater, J; Rabin, R L; Hoefnagel, M; Timon, M; Pini, C; Pfaar, O; Sheikh, A; Ryan, D; Akdis, C; Goldstein, J; Poulsen, L K; van Ree, R; Rhyner, C; Barber, D; Palomares, O; Pawankar, R; Hamerlijnk, D; Klimek, L; Agache, I; Angier, E; Casale, T; Fernandez-Rivas, M; Halken, S; Jutel, M; Lau, S; Pajno, G; Sturm, G; Varga, E M; Gerth van Wijk, R; Bonini, S; Muraro, A; Vieths, S

2018-04-01

Adequate quality is essential for any medicinal product to be eligible for marketing. Quality includes verification of the identity, content and purity of a medicinal product in combination with a specified production process and its control. Allergen products derived from natural sources require particular considerations to ensure adequate quality. Here, we describe key aspects of the documentation on manufacturing and quality aspects for allergen immunotherapy products in the European Union and the United States. In some key parts, requirements in these areas are harmonized while other fields are regulated separately between both regions. Essential differences are found in the use of Reference Preparations, or the requirement to apply standardized assays for potency determination. As the types of products available are different in specific regions, regulatory guidance for such products may also be available in one specific region only, such as for allergoids in the European Union. Region-specific issues and priorities are a result of this. As allergen products derived from natural sources are inherently variable in their qualitative and quantitative composition, these products present special challenges to balance the variability and ensuring batch-to-batch consistency. Advancements in scientific knowledge on specific allergens and their role in allergic disease will consequentially find representation in future regulatory guidelines. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Food Insecurity and Perceived Diet Quality Among Low-Income Older Americans with Functional Limitations.

PubMed

Chang, Yunhee; Hickman, Haley

2018-05-01

To evaluate how functional limitations are associated with food insecurity and perceived diet quality in low-income older Americans. Nationwide repeated cross-sectional surveys regarding health and nutritional status. The National Health and Nutrition Examination Surveys, 2007-2008, 2009-2010, and 2011-2012. Individuals aged ≥65 years with household incomes ≤130% of the federal poverty level (n = 1,323). Dependent variables included dichotomous indicators of food insecurity and poor-quality diet, measured with the household food security survey module and respondents' own ratings, respectively. Independent variable was presence of limitations in physical functioning. Weighted logistic regressions with nested controls and interaction terms. Functional limitations in low-income older adults were associated with 1.69 times higher odds of food insecurity (P < .01) and 1.65 times higher odds of poor-quality diet (P < .01) after accounting for individuals' health care needs and socioeconomic conditions. These associations were greatest among those living alone (odds ratio = 3.38 for food insecurity; 3.07 for poor-quality diet; P < .05) and smallest among those living with a partner. Low-income older adults who live alone with functional limitations are exposed to significant nutritional risk. Resources should be directed to facilitating their physical access to healthful foods. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Variability in individual assessment behaviour and its implications for collective decision-making.

PubMed

O'Shea-Wheller, Thomas A; Masuda, Naoki; Sendova-Franks, Ana B; Franks, Nigel R

2017-02-08

Self-organized systems of collective behaviour have been demonstrated in a number of group-living organisms. There is, however, less research relating to how variation in individual assessments may facilitate group decision-making. Here, we investigate this using the decentralized system of collective nest choice behaviour employed by the ant Temnothorax albipennis, combining experimental results with computational modelling. In experiments, isolated workers of this species were allowed to investigate new nest sites of differing quality, and it was found that for any given nest quality, there was wide variation among individuals in the durations that they spent within each nest site. Additionally, individual workers were consistent in spending more time in nest sites of higher quality, and less time in those of lower quality. Hence, the time spent in a new nest site must have included an assessment of nest quality. As nest site visit durations (henceforth termed assessment durations) are linked to recruitment, it is possible that the variability we observed may influence the collective decision-making process of colonies. Thus, we explored this further using a computational model of nest site selection, and found that heterogeneous nest assessments conferred a number of potential benefits. Furthermore, our experiments showed that nest quality assessments were flexible, being influenced by experience of prior options. Our findings help to elucidate the potential mechanisms underlying group behaviour, and highlight the importance of heterogeneity among individuals, rather than precise calibration, in shaping collective decision-making. © 2017 The Author(s).

Establishing the common patterns of future tropospheric ozone under diverse climate change scenarios

NASA Astrophysics Data System (ADS)

Jimenez-Guerrero, Pedro; Gómez-Navarro, Juan J.; Jerez, Sonia; Lorente-Plazas, Raquel; Baro, Rocio; Montávez, Juan P.

2013-04-01

The impacts of climate change on air quality may affect long-term air quality planning. However, the policies aimed at improving air quality in the EU directives have not accounted for the variations in the climate. Climate change alone influences future air quality through modifications of gas-phase chemistry, transport, removal, and natural emissions. As such, the aim of this work is to check whether the projected changes in gas-phase air pollution over Europe depends on the scenario driving the regional simulation. For this purpose, two full-transient regional climate change-air quality projections for the first half of the XXI century (1991-2050) have been carried out with MM5+CHIMERE system, including A2 and B2 SRES scenarios. Experiments span the periods 1971-2000, as a reference, and 2071-2100, as future enhanced greenhouse gas and aerosol scenarios (SRES A2 and B2). The atmospheric simulations have a horizontal resolution of 25 km and 23 vertical layers up to 100 mb, and were driven by ECHO-G global climate model outputs. The analysis focuses on the connection between meteorological and air quality variables. Our simulations suggest that the modes of variability for tropospheric ozone and their main precursors hardly change under different SRES scenarios. The effect of changing scenarios has to be sought in the intensity of the changing signal, rather than in the spatial structure of the variation patterns, since the correlation between the spatial patterns of variability in A2 and B2 simulation is r > 0.75 for all gas-phase pollutants included in this study. In both cases, full-transient simulations indicate an enhanced enhanced chemical activity under future scenarios. The causes for tropospheric ozone variations have to be sought in a multiplicity of climate factors, such as increased temperature, different distribution of precipitation patterns across Europe, increased photolysis of primary and secondary pollutants due to lower cloudiness, etc. Nonetheless, according to the results of this work future ozone is conditioned by the dependence of biogenic emissions on the climatological patterns of variability. In this sense, ozone over Europe is mainly driven by the warming-induced increase in biogenic emitting activity (vegetation is kept invariable in the simulations, but estimations of these emissions strongly depends on shortwave radiation and temperature, which are substantially modified in climatic simulations). Moreover, one of the most important drivers for ozone increase is the decrease of cloudiness (related to stronger solar radiation) mostly over southern Europe at the first half of the XXI century. However, given the large uncertainty isoprene sensitivity to climate change and the large uncertainties associated to the cloudiness projections, these results should be carefully considered.

Disease Severity, Quality of Life, and Psychiatric Morbidity in Patients With Psoriasis With Reference to Sociodemographic, Lifestyle, and Clinical Variables: A Prospective, Cross-Sectional Study From Lahore, Pakistan

PubMed Central

Khawaja, Abdul Rahman; Bokhari, Syed Muhammad Azam; Rasheed, Tariq; Shahzad, Atif; Hanif, Muhammad; Qadeer, Faisal

2015-01-01

Background: Psoriasis is an immune-mediated, chronic disease with a genetic background that involves skin, nails, and joints. The incidence of psoriasis varies from 2.0% to 4.0% depending on the geographical location, ethnic background, and environmental conditions. Recent research has proved that psoriasis is a systemic inflammatory disease with extensive systemic implications. Objectives of the study were to explore the severity of psoriasis, dermatology-related quality of life, and psychiatric health of the patients with reference to sociodemographic, lifestyle, and clinical characteristics. Method: Consecutive patients with psoriasis (ICD-10 criteria) from skin outpatient clinics of 3 tertiary care hospitals in Lahore, Pakistan, between November 1, 2012, and December 31, 2012, were assessed in this prospective cross-sectional study. The final sample includes 87 patients who were evaluated for severity of psoriasis (Psoriasis Area Severity Index [PASI]), dermatology-related quality of life (Dermatology Life Quality Index [DLQI]), and psychiatric morbidity (12-item General Health Questionnaire [GHQ-12]) and were assessed on 23 sociodemographic, lifestyle, and clinical variables. Results: Of the 23 variables, the PASI was significantly associated with education and habit of drinking alcohol (P < .05), the DLQI was significantly associated with disturbed eating (P < .05), and the GHQ-12 score was significantly associated with hair disease (P < .05), current income (P < .05), and disturbed eating and sleeping (P < .01). The PASI, DLQI, and GHQ-12 were not usually affected by sociodemographic, lifestyle, and clinical factors, except for some variables such as education of the patient, alcohol intake, eating and sleeping disturbance, and income status. A statistically significant correlation (P < .01) was found between all 3 scores (ie, PASI, DLQI, and GHQ-12). The correlation coefficients of the PASI with the DLQI and GHQ-12 are 0.345 and 0.460, respectively, and that of the DLQI with the GHQ-12 is 0.635. A moderating effect of the DLQI score was found on the relationship between the PASI and GHQ-12 scores. Conclusions: Psoriasis has an immense impact on the life of patients and common comorbidities in psoriasis including coronary heart disease, depression, cerebrovascular disease, and metabolic syndrome. Screening for these comorbidities in psoriasis patients is essential. Impaired quality of life negatively affects the psyche of patients and initiates coping mechanisms, which may lead to depression and anxiety, social dysfunction, and loss of confidence, and the psychosocial burden of the disease may become more than the physical burden. The dermatologist usually manages physical disease and fails to address the social, emotional, and psychological aspects. Quality of life improves if these psychological aspects are also properly dealt with. PMID:26644955

Variability in cotton fiber yield, fiber quality, and soil properties in a southeastern coastal plain

USDA-ARS?s Scientific Manuscript database

To maximize profitability, cotton (GossypiumhirsutumL.) producers must attempt to control the quality of the crop while maximizing yield. The objective of this research was to measure the intrinsic variability present in cotton fiber yield and quality. The 0.5-ha experimental site was located in a...

Water Quality in the Production of Containerized Longleaf Pine Seedlings

Treesearch

David J. Moorhead; John M. Ruter

2002-01-01

The consistent production of quality container grown seedlings requires that key production variables be identified and controlled; otherwise, quality and the percentage of marketable plants will be erratic (Garber and Ruter 1993a). Additionally, production times and costs may increase unless production variables are monitored and managed throughout the production...

Comparison of variability in pork carcass composition and quality between barrows and gilts

USDA-ARS?s Scientific Manuscript database

Pigs (N = 8,042) raised in 8 different barns representing 2 seasons (cold and hot)and 2 production focuses (lean growth and meat quality) were used to characterize variability of carcass composition and quality traits between barrows and gilts. Data were collected on 7,684 pigs at the abattoir. Carc...

Women, Physical Activity, and Quality of Life: Self-concept as a Mediator.

PubMed

Gonzalo Silvestre, Tamara; Ubillos Landa, Silvia

2016-02-22

The objectives of this research are: (a) analyze the incremental validity of physical activity's (PA) influence on perceived quality of life (PQL); (b) determine if PA's predictive power is mediated by self-concept; and (c) study if results vary according to a unidimensional or multidimensional approach to self-concept measurement. The sample comprised 160 women from Burgos, Spain aged 18 to 45 years old. Non-probability sampling was used. Two three-step hierarchical regression analyses were applied to forecast PQL. The hedonic quality-of-life indicators, self-concept, self-esteem, and PA were included as independent variables. The first regression analysis included global self-concept as predictor variable, while the second included its five dimensions. Two mediation analyses were conducted to see if PA's ability to predict PQL was mediated by global and physical self-concept. Results from the first regression shows that self-concept, satisfaction with life, and PA were significant predictors. PA slightly but significantly increased explained variance in PQL (2.1%). In the second regression, substituting global self-concept with its five constituent factors, only the physical dimension and satisfaction with life predicted PQL, while PA ceased to be a significant predictor. Mediation analysis revealed that only physical self-concept mediates the relationship between PA and PQL (z = 1.97, p < .050), and not global self-concept. Physical self-concept was the strongest predictor and approximately 32.45 % of PA's effect on PQL was mediated by it. This study's findings support a multidimensional view of self-concept, and represent a more accurate image of the relationship between PQL, PA, and self-concept.

Work, work environments and other factors influencing nurse faculty intention to remain employed: a cross-sectional study.

PubMed

Tourangeau, Ann; Saari, Margaret; Patterson, Erin; Ferron, Era Mae; Thomson, Heather; Widger, Kimberley; MacMillan, Kathleen

2014-06-01

Given the role nurse faculty have in educating nurses, little is known about what influences their intention to remain employed (ITR) in academic settings. Findings from a nurse faculty survey administered to test a conceptual model of factors hypothesized as influencing nurse faculty ITR are reported. A cross-sectional survey design was employed. We included colleges and universities in Ontario, Canada. The population of Ontario nurse faculty who reported being employed as nurse faculty with the College of Nurses of Ontario (Canada) was included. Of the 1328 nurse faculty who were surveyed, 650 participated. Participants completed a questionnaire with measures of work, work environment, job satisfaction, burnout and ITR. Regression analyses were conducted to test the model. Ten of 26 independent variables explained 25.4% of variance in nurse faculty ITR for five years. These variables included: proximity to retirement, quality of relationships with colleagues, being employed full time, having dependents, satisfaction with work-life balance, quality of education, satisfaction with job status, access to financial support for education from organization, access to required human resources and being unionized. Although not all influencing factors are modifiable, academic leadership should develop strategies that encourage nurse faculty ITR. Strategies that support collegial relationships among faculty, increase the number of full time positions, promote work-life balance, engage faculty in assessing and strengthening education quality, support faculty choice between full-time and part-time work, and ensure adequate human resources required to teach effectively will lead to heightened nurse faculty ITR. © 2013.

Taste phenotype associates with cardiovascular disease risk factors via diet quality in multivariate modeling.

PubMed

Sharafi, Mastaneh; Rawal, Shristi; Fernandez, Maria Luz; Huedo-Medina, Tania B; Duffy, Valerie B

2018-05-08

Sensations from foods and beverages drive dietary choices, which in turn, affect risk of diet-related diseases. Perception of these sensation varies with environmental and genetic influences. This observational study aimed to examine associations between chemosensory phenotype, diet and cardiovascular disease (CVD) risk. Reportedly healthy women (n = 110, average age 45 ± 9 years) participated in laboratory-based measures of chemosensory phenotype (taste and smell function, propylthiouracil (PROP) bitterness) and CVD risk factors (waist circumference, blood pressure, serum lipids). Diet variables included preference and intake of sweet/high-fat foods, dietary restraint, and diet quality based on reported preference (Healthy Eating Preference Index-HEPI) and intake (Healthy Eating Index-HEI). We found that females who reported high preference yet low consumption of sweet/high-fat foods had the highest dietary restraint and depressed quinine taste function. PROP nontasters were more likely to report lower diet quality; PROP supertasters more likely to consume but not like a healthy diet. Multivariate structural models were fitted to identify predictors of CVD risk factors. Reliable latent taste (quinine taste function, PROP tasting) and smell (odor intensity) variables were identified, with taste explaining more variance in the CVD risk factors. Lower bitter taste perception was associated with elevated risk. In multivariate models, the HEPI completely mediated the taste-adiposity and taste-HDL associations and partially mediated the taste-triglyceride or taste-systolic blood pressure associations. The taste-LDL pathway was significant and direct. The HEI could not replace HEPI in adequate models. However, using a latent diet quality variable with HEPI and HEI, increased the strength of association between diet quality and adiposity or CVD risk factors. In conclusion, bitter taste phenotype was associated with CVD risk factors via diet quality, particularly when assessed by level of food liking/disliking. Copyright © 2018 Elsevier Inc. All rights reserved.

Third molar removal and its impact on quality of life: systematic review and meta-analysis.

PubMed

Duarte-Rodrigues, Lucas; Miranda, Ednele Fabyene Primo; Souza, Taiane Oliveira; de Paiva, Haroldo Neves; Falci, Saulo Gabriel Moreira; Galvão, Endi Lanza

2018-05-24

The purpose of this systematic review was to assess the impact of third molar removal on patient's quality of life. To address the study purpose, investigators designed and implemented a systematic review. The primary outcome variable was the quality of life after third molar extraction. An electronic search was conducted through March, 2017, on the PUBMED, Virtual Health Library (VHL), Web of Science, and OVID, to identify relevant literatures. Research studies (randomized or non-randomized clinical trials) were included that evaluated the quality of life in individuals before and after third molar extraction, using validated measures of oral health-related quality of life with quantitative approach, besides procedures performed under local anesthesia. The R software was used to measure the mean difference on the quality of life between the preoperative period and follow-up days. A total of 1141 studies were identified. Of this total, 13 articles were selected in the present systematic review, of which six studies were included in the meta-analysis. All of these 13 articles used the OHIP-14, and 4 of this 13 used OHQoLUK-16 to evaluate the quality of life. Regarding quality assessment, four of the 13 included studies in this review received a maximum score of 9 points, according to the Newcastle-Ottawa (NOS). The OHIP-14 mean score on the first postoperative day was 17.57 (95% CI 11.84-23.30, I 2  = 96%) higher than the preoperative period. On the seventh postoperative day, the quality of life assessed by OHIP-14 got worse again. This systematic review revealed that the highest negative impact on quality of life of individuals submitted to third molar surgery was observed on the first postoperative day, decreasing over the follow-up period.

Research of interaction between technological and material parameters during densification of sunflower hulls

NASA Astrophysics Data System (ADS)

Križan, Peter; Matúš, Miloš; Beniak, Juraj; Šooš, Ľubomír

2018-01-01

During the biomass densification can be recognized various technological variables and also material parameters which significantly influences the final solid biofuels (pellets) quality. In this paper, we will present the research findings concerning relationships between technological and material variables during densification of sunflower hulls. Sunflower hulls as an unused source is a typical product of agricultural industry in Slovakia and belongs to the group of herbaceous biomass. The main goal of presented experimental research is to determine the impact of compression pressure, compression temperature and material particle size distribution on final biofuels quality. Experimental research described in this paper was realized by single-axis densification, which was represented by experimental pressing stand. The impact of mentioned investigated variables on the final briquettes density and briquettes dilatation was determined. Mutual interactions of these variables on final briquettes quality are showing the importance of mentioned variables during the densification process. Impact of raw material particle size distribution on final biofuels quality was also proven by experimental research on semi-production pelleting plant.

[Influence of childbirth experience and postpartum depression on quality of life in women after birth].

PubMed

Yeo, Jung Hee; Chun, Nami

2013-02-01

The purpose of this study was to identify influence of childbirth experience and postpartum depression on quality of life in women after birth. Two hundred and eleven postpartum women were asked to complete the questionnaires on their childbirth experience during their admission and on their postpartum depression and quality of life between one to three weeks after birth. Initial data were collected from February 1 to May 30, 2011 at two obstetric hospitals in Busan, Korea. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and hierarchical multiple regression. The women's childbirth experience and postpartum depression were identified as factors influencing quality of life after birth. The model explained 50% of the variables. Results suggest that childbirth educators should include strategies to increase a positive childbirth experience and to decrease postpartum depression in their education programs in order to improve women's quality of life.

Variation in marital quality in a national sample of divorced women.

PubMed

James, Spencer L

2015-06-01

Previous work has compared marital quality between stably married and divorced individuals. Less work has examined the possibility of variation among divorcés in trajectories of marital quality as divorce approaches. This study addressed that hole by first examining whether distinct trajectories of marital quality can be discerned among women whose marriages ended in divorce and, second, the profile of women who experienced each trajectory. Latent class growth analyses with longitudinal data from a nationally representative sample were used to "look backward" from the time of divorce. Although demographic and socioeconomic variables from this national sample did not predict the trajectories well, nearly 66% of divorced women reported relatively high levels of both happiness and communication and either low or moderate levels of conflict. Future research including personality or interactional patterns may lead to theoretical insights about patterns of marital quality in the years leading to divorce. (c) 2015 APA, all rights reserved).

Energy density and variability in abundance of pigeon guillemot prey: Support for the quality-variability trade-off hypothesis

USGS Publications Warehouse

Litzow, Michael A.; Piatt, John F.; Abookire, Alisa A.; Robards, Martin D.

2004-01-01

1. The quality-variability trade-off hypothesis predicts that (i) energy density (kJ g-1) and spatial-temporal variability in abundance are positively correlated in nearshore marine fishes; and (ii) prey selection by a nearshore piscivore, the pigeon guillemot (Cepphus columba Pallas), is negatively affected by variability in abundance. 2. We tested these predictions with data from a 4-year study that measured fish abundance with beach seines and pigeon guillemot prey utilization with visual identification of chick meals. 3. The first prediction was supported. Pearson's correlation showed that fishes with higher energy density were more variable on seasonal (r = 0.71) and annual (r = 0.66) time scales. Higher energy density fishes were also more abundant overall (r = 0.85) and more patchy at a scale of 10s of km (r = 0.77). 4. Prey utilization by pigeon guillemots was strongly non-random. Relative preference, defined as the difference between log-ratio transformed proportions of individual prey taxa in chick diets and beach seine catches, was significantly different from zero for seven of the eight main prey categories. 5. The second prediction was also supported. We used principal component analysis (PCA) to summarize variability in correlated prey characteristics (energy density, availability and variability in abundance). Two PCA scores explained 32% of observed variability in pigeon guillemot prey utilization. Seasonal variability in abundance was negatively weighted by these PCA scores, providing evidence of risk-averse selection. Prey availability, energy density and km-scale variability in abundance were positively weighted. 6. Trophic interactions are known to create variability in resource distribution in other systems. We propose that links between resource quality and the strength of trophic interactions may produce resource quality-variability trade-offs.

Quality by design approach for understanding the critical quality attributes of cyclosporine ophthalmic emulsion.

PubMed

Rahman, Ziyaur; Xu, Xiaoming; Katragadda, Usha; Krishnaiah, Yellela S R; Yu, Lawrence; Khan, Mansoor A

2014-03-03

Restasis is an ophthalmic cyclosporine emulsion used for the treatment of dry eye syndrome. There are no generic products for this product, probably because of the limitations on establishing in vivo bioequivalence methods and lack of alternative in vitro bioequivalence testing methods. The present investigation was carried out to understand and identify the appropriate in vitro methods that can discriminate the effect of formulation and process variables on critical quality attributes (CQA) of cyclosporine microemulsion formulations having the same qualitative (Q1) and quantitative (Q2) composition as that of Restasis. Quality by design (QbD) approach was used to understand the effect of formulation and process variables on critical quality attributes (CQA) of cyclosporine microemulsion. The formulation variables chosen were mixing order method, phase volume ratio, and pH adjustment method, while the process variables were temperature of primary and raw emulsion formation, microfluidizer pressure, and number of pressure cycles. The responses selected were particle size, turbidity, zeta potential, viscosity, osmolality, surface tension, contact angle, pH, and drug diffusion. The selected independent variables showed statistically significant (p < 0.05) effect on droplet size, zeta potential, viscosity, turbidity, and osmolality. However, the surface tension, contact angle, pH, and drug diffusion were not significantly affected by independent variables. In summary, in vitro methods can detect formulation and manufacturing changes and would thus be important for quality control or sameness of cyclosporine ophthalmic products.

A systematic review of the quality of conduct and reporting of systematic reviews and meta-analyses in paediatric surgery

PubMed Central

Gudlaugsdottir, Katrin; Andrews, James

2017-01-01

Objective Our objective was to evaluate quality of conduct and reporting of published systematic reviews and meta-analyses in paediatric surgery. We also aimed to identify characteristics predictive of review quality. Background Systematic reviews summarise evidence by combining sources, but are potentially prone to bias. To counter this, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was published to aid in reporting. Similarly, the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) measurement tool was designed to appraise methodology. The paediatric surgical literature has seen an increasing number of reviews over the past decade, but quality has not been evaluated. Methods Adhering to PRISMA guidelines, we performed a systematic review with a priori design to identify systematic reviews and meta-analyses of interventions in paediatric surgery. From 01/2010 to 06/2016, we searched: MEDLINE, EMBASE, Cochrane, Centre for Reviews and Dissemination, Web of Science, Google Scholar, reference lists and journals. Two reviewers independently selected studies and extracted data. We assessed conduct and reporting using AMSTAR and PRISMA. Scores were calculated as the sum of reported items. We also extracted author, journal and article characteristics, and used them in exploratory analysis to determine which variables predict quality. Results 112 articles fulfilled eligibility criteria (53 systematic reviews; 59 meta-analyses). Overall, 68% AMSTAR and 56.8% PRISMA items were reported adequately. Poorest scores were identified with regards a priori design, inclusion of structured summaries, including the grey literature, citing excluded articles and evaluating bias. 13 reviews were pre-registered and 6 in PRISMA-endorsing journals. The following predicted quality in univariate analysis:, word count, Cochrane review, journal h-index, impact factor, journal endorses PRISMA, PRISMA adherence suggested in author guidance, article mentions PRISMA, review includes comparison of interventions and review registration. The latter three variables were significant in multivariate regression. Conclusions There are gaps in the conduct and reporting of systematic reviews in paediatric surgery. More endorsement by journals of the PRISMA guideline may improve review quality, and the dissemination of reliable evidence to paediatric clinicians. PMID:28384296

Cardiac surgery report cards: comprehensive review and statistical critique.

PubMed

Shahian, D M; Normand, S L; Torchiana, D F; Lewis, S M; Pastore, J O; Kuntz, R E; Dreyer, P I

2001-12-01

Public report cards and confidential, collaborative peer education represent distinctly different approaches to cardiac surgery quality assessment and improvement. This review discusses the controversies regarding their methodology and relative effectiveness. Report cards have been the more commonly used approach, typically as a result of state legislation. They are based on the presumption that publication of outcomes effectively motivates providers, and that market forces will reward higher quality. Numerous studies have challenged the validity of these hypotheses. Furthermore, although states with report cards have reported significant decreases in risk-adjusted mortality, it is unclear whether this improvement resulted from public disclosure or, rather, from the development of internal quality programs by hospitals. An additional confounding factor is the nationwide decline in heart surgery mortality, including states without quality monitoring. Finally, report cards may engender negative behaviors such as high-risk case avoidance and "gaming" of the reporting system, especially if individual surgeon results are published. The alternative approach, continuous quality improvement, may provide an opportunity to enhance performance and reduce interprovider variability while avoiding the unintended negative consequences of report cards. This collaborative method, which uses exchange visits between programs and determination of best practice, has been highly effective in northern New England and in the Veterans Affairs Administration. However, despite their potential advantages, quality programs based solely on confidential continuous quality improvement do not address the issue of public accountability. For this reason, some states may continue to mandate report cards. In such instances, it is imperative that appropriate statistical techniques and report formats are used, and that professional organizations simultaneously implement continuous quality improvement programs. The statistical methodology underlying current report cards is flawed, and does not justify the degree of accuracy presented to the public. All existing risk-adjustment methods have substantial inherent imprecision, and this is compounded when the results of such patient-level models are aggregated and used inappropriately to assess provider performance. Specific problems include sample size differences, clustering of observations, multiple comparisons, and failure to account for the random component of interprovider variability. We advocate the use of hierarchical or multilevel statistical models to address these concerns, as well as report formats that emphasize the statistical uncertainty of the results.

[Study of quality of life in adults with common variable immunodeficiency by using the Questionnaire SF-36].

PubMed

López-Pérez, Patricia; Miranda-Novales, Guadalupe; Segura-Méndez, Nora Hilda; Del Rivero-Hernández, Leonel; Cambray-Gutiérrez, Cesar; Chávez-García, Aurora

2014-01-01

Quality of life is a multidimensional concept that includes physical, emotional and social components associated with the disease. The use of tools to assess the Quality of Life Health Related (HRQOL) has increased in recent decades. Common variable immunodeficiency (CVID) is the most commonly diagnosed primary immunodeficiency. To evaluate the quality of life in patients with CVID using the questionnaire SF -36. A descriptive cross-sectional survey included 23 patients diagnosed with CVID, belonging to the Immunodeficiency Clinic Service of Allergology and Clinical Immunology in CMN Siglo XXI, IMSS. The questionnaire SF- 36 validated in Spanish was applied. descriptive statistics with simple frequencies and percentages, inferential statistics: Fisher exact test and ANOVA to compare means. The study involved 23 patients, 14 women (60%) and 9 men (40%), mean age 38.6 ± 14.7 years. The highest score was obtained in 83% emotional role. Dimensions with further deterioration in both genders were: 54% general health, vitality 59% and physical performance 72%. No differences were found regarding gender. The only issue in which statistically significant differences were found in patients with more than 3 comorbidities was change in health status in the past year (p=0.007). Patients with severe comorbidities, such as haematologicaloncological (leukemias, lymphomas, neoplasms), and pulmonary (severe bronchiectasis) showed further deterioration in the aspects of physical performance 73% and 64% emotional role. 65% of patients reported an improvement in health status in 74% in the last year. Adult patients with CVID show deterioration in different dimensions, particularly in the areas of general health, vitality and physical performance. Patients with severe comorbidities such as leukemia, lymphomas, malignancies and severe bronchiectasis show further deterioration in some aspects of quality of life, especially in physical performance and emotional role. A higher number of comorbidities was significantly associated with a lower score in changing health. The questionnaire SF-36 is useful for evaluating the quality of life of our patients with CVID.

Optimising UAV topographic surveys processed with structure-from-motion: Ground control quality, quantity and bundle adjustment

NASA Astrophysics Data System (ADS)

James, M. R.; Robson, S.; d'Oleire-Oltmanns, S.; Niethammer, U.

2017-03-01

Structure-from-motion (SfM) algorithms greatly facilitate the production of detailed topographic models from photographs collected using unmanned aerial vehicles (UAVs). However, the survey quality achieved in published geomorphological studies is highly variable, and sufficient processing details are never provided to understand fully the causes of variability. To address this, we show how survey quality and consistency can be improved through a deeper consideration of the underlying photogrammetric methods. We demonstrate the sensitivity of digital elevation models (DEMs) to processing settings that have not been discussed in the geomorphological literature, yet are a critical part of survey georeferencing, and are responsible for balancing the contributions of tie and control points. We provide a Monte Carlo approach to enable geomorphologists to (1) carefully consider sources of survey error and hence increase the accuracy of SfM-based DEMs and (2) minimise the associated field effort by robust determination of suitable lower-density deployments of ground control. By identifying appropriate processing settings and highlighting photogrammetric issues such as over-parameterisation during camera self-calibration, processing artefacts are reduced and the spatial variability of error minimised. We demonstrate such DEM improvements with a commonly-used SfM-based software (PhotoScan), which we augment with semi-automated and automated identification of ground control points (GCPs) in images, and apply to two contrasting case studies - an erosion gully survey (Taroudant, Morocco) and an active landslide survey (Super-Sauze, France). In the gully survey, refined processing settings eliminated step-like artefacts of up to 50 mm in amplitude, and overall DEM variability with GCP selection improved from 37 to 16 mm. In the much more challenging landslide case study, our processing halved planimetric error to 0.1 m, effectively doubling the frequency at which changes in landslide velocity could be detected. In both case studies, the Monte Carlo approach provided a robust demonstration that field effort could by substantially reduced by only deploying approximately half the number of GCPs, with minimal effect on the survey quality. To reduce processing artefacts and promote confidence in SfM-based geomorphological surveys, published results should include processing details which include the image residuals for both tie points and GCPs, and ensure that these are considered appropriately within the workflow.

The impact of Circulation Weather Types in Urban Air Quality in Portugal

NASA Astrophysics Data System (ADS)

Russo, Ana; Trigo, Ricardo

2013-04-01

It is now clear that emissions of the main air pollutants in Europe have declined significantly in recent decades (EEA, 2011). Nevertheless, many European countries (including Portugal) do not expect to comply with one (or more) pollutant emission ceilings and to air quality limit values, especially for particulate matter (PM), ground level ozone (O3) and nitrogen dioxide (NO2) (EEA, 2011). Consequently, and considering that air pollution (AP) plays a role as a major cause of human mortality and morbidity, exposure to pollutants remains a key environment-related health concern (EEA 2010). Thus, and to comply with the new limits, new strategies must be applied for air quality management. The main objective of this work is to present an objective classification of pre-defined and widely used CWTs affecting Portugal and, based on the most relevant patterns, provide a framework that is useful to characterise the occurrence of pollution episodes, namely its inter-annual and intra-annual variability, as well as the occurrence of extreme events. CWTs were determined using the simple Geostrophic approximation according to the methodology proposed by Trigo and DaCamara (2000). The interannual variability of the resulting CWTs was determined for the period with AP data (2002-2010) and the number of days for each CWT and season for the same period was accounted for. During this period, the most frequent CWTs were found to be the anticyclonic (A), the north (N) and the northeast (NE) types, accounting respectively for 34.7%, 10.9% and 14% of the days. However, higher-than average episodes tend to occur associated predominantly with situations characterized by a few less frequent CWTs, namely easterly (E), northeasterly (NE) and southeasterly (SE) types (that together contributed to less than one fourth of all observed days), are the ones which are associated to higher median and maximum concentrations of the three pollutants. Results obtained highlight the existence of strong links between the interannual variability of daily air quality and interannual variability of CWTs. Additionally, three specific extreme episodes were assessed in more detail including a comparison with results obtained with the HYSPLIT system model. In general, all the pollutants' extreme events occur associated predominantly with situations characterized by an Eastern component and advection of dry air masses.

SLEEP QUALITY AND ITS ASSOCIATION WITH PSYCHOLOGICAL SYMPTOMS IN ADOLESCENT ATHLETES

PubMed Central

Gomes, Gabriel Cordeiro; dos Passos, Muana Hiandra Pereira; Silva, Hítalo Andrade; de Oliveira, Valéria Mayaly Alves; Novaes, Wbinayara Alves; Pitangui, Ana Carolina Rodarti; de Araújo, Rodrigo Cappato

2017-01-01

ABSTRACT Objective: To verify the prevalence of poor sleep quality and its association with personal characteristics and symptoms of depression, anxiety and stress in amateur adolescent athletes. Methods: 309 adolescent athletes aged between 10 and 19 years were enrolled. Data collection included: a structured questionnaire, with personal information; the Pittsburgh Sleep Quality Index (PSQI); and the Depression, Anxiety and Stress Scale (DASS-21). Results are described in mean and standard deviation (numeric variables) and absolute and relative frequencies (categorical variables). For the inferential analysis, Student’s t-test and chi-square test were performed, in addition to Poisson regression. Prevalence ratios (PR) were calculated in a 95% confidence interval (95%CI). Results: The mean age of participants was 14.1±2.1, being 13.8±2.0 and 15.0±2.1, respectively, for those with good and poor sleep quality. Poor sleep quality was recorded in 28.2% (n=87), depression in 26.9% (n=83) and anxiety/stress in 40.1% (n=124). Poor sleep quality was associated with ages between 15 and 19 years (PR 1.24; 95%CI 1.14-1.37), overweight (PR 1.12; 95%CI 1.01-1.24) and psychological symptoms of depression (PR 1.23; 95%CI 1.08-1.40) and anxiety/stress (PR 1.16; 95%CI 1.04-1.28). Conclusions: The presence of overweight and psychological symptoms and the age over 15 years were risk factors for increasing the likelihood of poor sleep quality in adolescent athletes. PMID:28977294

Influence of fatigue, depression, and demographic, socioeconomic, and clinical variables on quality of life of patients with epilepsy.

PubMed

Senol, Vesile; Soyuer, Ferhan; Arman, Fehim; Oztürk, Ahmet

2007-02-01

The purpose of this study was to define the influence of fatigue, depression, and clinical, demographic, and socioeconomic factors on the quality of life of patients with epilepsy. The study was performed on 103 adult patients who visited Erciyes University Epilepsy Outpatient Clinic between 2004 and 2005. Patients were evaluated with the Form of Negotiation, Quality of Life in Epilepsy Inventory (QOLIE-89), Beck Depression Inventory, and Fatigue Severity Scale. Mean age of the patients was 34.3+/-12.6, and mean duration of disease was 12.6+/-9.3 years. Among these patients, 52.4% were men, 49.5% were married, 15.5% had a university education, 53.4% had low incomes, 45.6% had generalized seizures, and 35.0% had experienced one or more seizures per month during the preceding year. The most significant variables in the domain of Overall quality of life were seizure frequency (P<0.001), depression (P<0.001), and fatigue (P<0.001); the variables in the domain of Mental Health were seizure frequency (P<0.001) and fatigue (P<0.001); the variable in the Cognitive domain was fatigue (P<0.001); the variables in the domain of Physical Health were social insurance coverage (P<0.01), fatigue (P<0.01), and age (P<0.01); the variables in the Epilepsy Targeted domain were depression (P<0.001), seizure frequency (P<0.001), and fatigue (P<0.01). Although quality of life has multiple determinants, seizure frequency, fatigue, and depression are the most important factors affecting quality of life in patients with epilepsy. One or more seizures per month, severe fatigue, and depression are associated with lower quality of life in some but not all domains. Partial correlations demonstrated that fatigue was a significant independent predictor of quality of life. The present study confirms that fatigue can be a powerful predictor of quality of life.

The effect of consumers’ perception to the satisfaction of use of traditional medicines in Medan

NASA Astrophysics Data System (ADS)

Siregar, R. S.; Supriana, T.; Haryanti, S.

2018-02-01

Consumption of chemical medicines fluctuated in 2009-2014, whereas the consumption of solid traditional medicine increased in 2009-2014. The purpose of this study is to analyse the influence of consumers’s perception on the consumption of traditional medicinal plants. The data was analysed by using a binomial logit regression analysis. It is found that the consumers’s perceptions affect customer satisfaction simultaneously are the health benefits variable, quality of traditional medicine variable, price of traditional medicine and available product; the health benefits variable and quality of traditional medicine variable partially have significant effects to customers’s satisfaction simultaneously satisfaction partially; the health benefit variable and quality of traditional medicine is found to have a marginal effect of 7% and 4%, respectively.

Quantity and Quality of Caregivers' Linguistic Input to 18-Month and 3-Year-Old Children Who Are Hard of Hearing.

PubMed

Ambrose, Sophie E; Walker, Elizabeth A; Unflat-Berry, Lauren M; Oleson, Jacob J; Moeller, Mary Pat

2015-01-01

The primary objective of this study was to examine the quantity and quality of caregiver talk directed to children who are hard of hearing (CHH) compared with children with normal hearing (CNH). For the CHH only, the study explored how caregiver input changed as a function of child age (18 months versus 3 years), which child and family factors contributed to variance in caregiver linguistic input at 18 months and 3 years, and how caregiver talk at 18 months related to child language outcomes at 3 years. Participants were 59 CNH and 156 children with bilateral, mild-to-severe hearing loss. When children were approximately 18 months and/or 3 years of age, caregivers and children participated in a 5-min semistructured, conversational interaction. Interactions were transcribed and coded for two features of caregiver input representing quantity (number of total utterances and number of total words) and four features representing quality (number of different words, mean length of utterance in morphemes, proportion of utterances that were high level, and proportion of utterances that were directing). In addition, at the 18-month visit, parents completed a standardized questionnaire regarding their child's communication development. At the 3-year visit, a clinician administered a standardized language measure. At the 18-month visit, the CHH were exposed to a greater proportion of directing utterances than the CNH. At the 3-year visit, there were significant differences between the CNH and CHH for number of total words and all four of the quality variables, with the CHH being exposed to fewer words and lower quality input. Caregivers generally provided higher quality input to CHH at the 3-year visit compared with the 18-month visit. At the 18-month visit, quantity variables, but not quality variables, were related to several child and family factors. At the 3-year visit, the variable most strongly related to caregiver input was child language. Longitudinal analyses indicated that quality, but not quantity, of caregiver linguistic input at 18 months was related to child language abilities at 3 years, with directing utterances accounting for significant unique variance in child language outcomes. Although caregivers of CHH increased their use of quality features of linguistic input over time, the differences when compared with CNH suggest that some caregivers may need additional support to provide their children with optimal language learning environments. This is particularly important given the relationships that were identified between quality features of caregivers' linguistic input and children's language abilities. Family supports should include a focus on developing a style that is conversational eliciting as opposed to directive.

Language, literacy, attentional behaviors, and instructional quality predictors of written composition for first graders

PubMed Central

Kim, Young-Suk; Otaiba, Stephanie Al; Sidler, Jessica Folsom; Gruelich, Luana

2013-01-01

We had two primary purposes in the present study: (1) to examine unique child-level predictors of written composition which included language skills, literacy skills (e.g., reading and spelling), and attentiveness and (2) to examine whether instructional quality (quality in responsiveness and individualization, and quality in spelling and writing instruction) is uniquely related to written composition for first-grade children (N = 527). Children’s written composition was evaluated on substantive quality (ideas, organization, word choice, and sentence flow) and writing conventions (spelling, mechanics, and handwriting). Results revealed that for the substantive quality of writing, children’s grammatical knowledge, reading comprehension, letter writing automaticity, and attentiveness were uniquely related. Teachers’ responsiveness was also uniquely related to the substantive quality of written composition after accounting for child predictors and other instructional quality variables. For the writing conventions outcome, children’s spelling and attentiveness were uniquely related, but instructional quality was not. These results suggest the importance of paying attention to multiple component skills such as language, literacy, and behavioral factors as well as teachers’ responsiveness for writing development. PMID:24062600

Simple and rapid quality control of sulfated glycans by a fluorescence sensor assay--exemplarily developed for the sulfated polysaccharides from red algae Delesseria sanguinea.

PubMed

Lühn, Susanne; Grimm, Juliane C; Alban, Susanne

2014-04-10

Sulfated polysaccharides (SP) from algae are of great interest due to their manifold biological activities. Obstacles to commercial (especially medical) application include considerable variability and complex chemical composition making the analysis and the quality control challenging. The aim of this study was to evaluate a simple microplate assay for screening the quality of SP. It is based on the fluorescence intensity (FI) increase of the sensor molecule Polymer-H by SP and was originally developed for direct quantification of SP. Exemplarily, 65 SP batches isolated from the red alga Delesseria sanguinea (D.s.-SP) and several other algae polysaccharides were investigated. Their FI increase in the Polymer-H assay was compared with other analytical parameters. By testing just one concentration of a D.s.-SP sample, quality deviations from the reference D.s.-SP and thus both batch-to-batch variability and stability can be detected. Further, structurally distinct SP showed to differ in their concentration-dependent FI profiles. By using corresponding reference compounds, the Polymer-H assay is therefore applicable as identification assay with high negative predictability. In conclusion, the Polymer-H assay showed to represent not only a simple method for quantification, but also for characterization identification and differentiation of SP of marine origin.

Long-term improvements in oral communication skills and quality of peer relations in children with cochlear implants: parental testimony.

PubMed

Bat-Chava, Y; Martin, D; Imperatore, L

2014-11-01

Few research studies have examined longitudinal improvements in oral communication skills and quality of peer relationships of children with implants. Moreover, although the emerging literature suggests that improvement in social functioning follows improvement in oral communication, it is still unknown what factors enhance or impede the relations between these constructs. Based on parent interviews, the current study examined the long-term improvements in speech and oral language skills and relationships with hearing peers in 19 implanted children. Results demonstrate that on average, children continue to improve in oral communication skills and quality of peer relationships even years after implantation, especially those with initial poorer skills. While oral communication ability and quality of peer relationships are strongly associated at each time point, gains in these two variables are associated only for some of the children. Other factors, including self-confidence and peer acceptance, seem to moderate this relationship. Qualitative data are presented to illustrate these relations among variables and to assist in theory building. The results highlight the need for more specific examination of various developmental periods in combination with the progress of oral communication and peer relationships among children with implants. © 2013 John Wiley & Sons Ltd.

The sensitivity of derived estimates to the measurment quality objectives for independent variables

Treesearch

Francis A. Roesch

2002-01-01

The effect of varying the allowed measurement error for individual tree variables upon county estimates of gross cubic-foot volume was examined. Measurement Quality Ob~ectives (MQOs) for three forest tree variables (biological identity, diameter, and height) used in individual tree gross cubic-foot volume equations were varied from the current USDA Forest Service...

The Sensitivity of Derived Estimates to the Measurement Quality Objectives for Independent Variables

Treesearch

Francis A. Roesch

2005-01-01

The effect of varying the allowed measurement error for individual tree variables upon county estimates of gross cubic-foot volume was examined. Measurement Quality Objectives (MQOs) for three forest tree variables (biological identity, diameter, and height) used in individual tree gross cubic-foot volume equations were varied from the current USDA Forest Service...

Mental health issues decrease diabetes-specific quality of life independent of glycaemic control and complications: findings from Australia’s living with diabetes cohort study

PubMed Central

2013-01-01

Background While factors associated with health-related quality of life for people with chronic diseases including diabetes are well researched, far fewer studies have investigated measures of disease-specific quality of life. The purpose of this study is to assess the impact of complications and comorbidities on diabetes-specific quality of life in a large population-based cohort of type 2 diabetic patients. Methods The Living with Diabetes Study recruited participants from the National Diabetes Services Scheme in Australia. Data were collected via a mailed self-report questionnaire. Diabetes-specific quality of life was measured using the Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaire. The analyses are for 3609 patients with type 2 diabetes. Regression models with adjustment for control variables investigated the association of complications and comorbidities with diabetes-specific quality of life. Next, the most parsimonious model for diabetes-specific quality of life after controlling for important covariates was examined. Results The expected associations with better diabetes-specific quality of life were evident, such as increased income, not on insulin, better glycaemic control and older age. However, being single and having been diagnosed with cancer were also associated with better ADDQoL. Additionally, poorer diabetes-specific quality of life was strongly sensitive to the presence of diabetes complications and mental health conditions such as depression, anxiety and schizophrenia. These relationships persisted after adjustment for gender, age, duration of diabetes, treatment regimen, sampling region and other treatment and socio-demographic variables. Conclusions A greater appreciation of the complexities of diabetes-specific quality of life can help tailor disease management and self-care messages given to patients. Attention to mental health issues may be as important as focusing on glycaemic control and complications. Therefore clinicians’ ability to identify and mange mental health issues and/or refer patients is critical to improving patients’ diabetes-specific quality of life. PMID:24131673

Social capital and trust in providers.

PubMed

Ahern, Melissa M; Hendryx, Michael S

2003-10-01

Trust in providers has been in decline in recent decades. This study attempts to identify sources of trust in characteristics of health care systems and the wider community. The design is cross-sectional. Data are from (1) the 1996 Household Survey of the Community Tracking Study, drawn from 24 Metropolitan Statistical Areas; (2) a 1996 multi-city broadcast media marketing database including key social capital indicators; (3) Interstudy; (4) the American Hospital Association; and (5) the American Medical Association. Independent variables include individual socio-demographic variables, HMO enrollment, community-level health sector variables, and social capital. The dependent variable is self-reported trust in physicians. Data are merged from the various sources and analyzed using SUDAAN. Subjects include adults in the Household Survey who responded to the items on trust in physicians (N=17,653). Trust in physicians is independently predicted by community social capital (p<0.001). Trust is also negatively related to HMO enrollment and to many individual characteristics. The effect of HMOs is not uniform across all communities. Social capital plays a role in how health care is perceived by citizens, and how health care is delivered by providers. Efforts to build trust and collaboration in a community may improve trust in physicians, health care quality, access, and preserve local health care control.

Cost effectiveness of fecal DNA screening for colorectal cancer: a systematic review and quality appraisal of the literature.

PubMed

Skally, Mairead; Hanly, Paul; Sharp, Linda

2013-06-01

Fecal DNA (fDNA) testing is a noninvasive potential alternative to current colorectal cancer screening tests. We conducted a systematic review and quality assessment of studies of cost-effectiveness of fDNA as a colorectal cancer screening tool (compared with no screening and other screening modalities), and identified key variables that impinged on cost-effectiveness. We searched MEDLINE, Embase, and the Centre for Reviews and Dissemination for cost-effectiveness studies of fDNA-based screening, published in English by September 2011. Studies that undertook an economic evaluation of fDNA, using either a cost-effectiveness or cost-utility analysis, compared with other relevant screening modalities and/or no screening were included. Additional inclusion criteria related to the presentation of data pertaining to model variables including time horizon, costs, fDNA performance characteristics, screening uptake, and comparators. A total of 369 articles were initially identified for review. After removing duplicates and applying inclusion and exclusion criteria, seven articles were included in the final review. Data was abstracted on key descriptor variables including screening scenarios, time horizon, costs, test performance characteristics, screening uptake, comparators, and incremental cost-effectiveness ratios. Quality assessment was undertaken using a standard checklist for economic evaluations. Studies cited by cost-effectiveness articles as the source of data on fDNA test performance characteristics were also reviewed. Seven cost-effectiveness studies were included, from the USA (4), Canada (1), Israel (1), and Taiwan (1). Markov models (5), a partially observable Markov decision process model (1) and MISCAN and SimCRC (1) microsimulation models were used. All studies took a third-party payer perspective and one included, in addition, a societal perspective. Comparator screening tests, screening intervals, and specific fDNA tests varied between studies. fDNA sensitivity and specificity parameters were derived from 12 research studies and one meta-analysis. Outcomes assessed were life-years gained and quality-adjusted life-years gained. fDNA was cost-effective when compared with no screening in six studies. Compared with other screening modalities, fDNA was not considered cost-effective in any of the base-case analyses: in five studies it was dominated by all alternatives considered. Sensitivity analyses identified cost, compliance, and test parameters as key influential parameters. In general, poor presentation of "study design" and "data collection" details lowered the quality of included articles. Although the literature searches were designed for high sensitivity, the possibility cannot be excluded that some eligible studies may have been missed. Reports (such as Health Technology Assessments produced by government agencies) and other forms of grey literature were excluded because they are difficult to identify systematically and/or may not report methods and results in sufficient detail for assessment. On the basis of the available (albeit limited) evidence, while fDNA is cost-effective when compared with no screening, it is currently dominated by most of the other available screening options. Cost and test performance appear to be the main influences on cost-effectiveness.

Construction of an environmental quality index for public health research

PubMed Central

2014-01-01

Background A more comprehensive estimate of environmental quality would improve our understanding of the relationship between environmental conditions and human health. An environmental quality index (EQI) for all counties in the U.S. was developed. Methods The EQI was developed in four parts: domain identification; data source acquisition; variable construction; and data reduction. Five environmental domains (air, water, land, built and sociodemographic) were recognized. Within each domain, data sources were identified; each was temporally (years 2000–2005) and geographically (county) restricted. Variables were constructed for each domain and assessed for missingness, collinearity, and normality. Domain-specific data reduction was accomplished using principal components analysis (PCA), resulting in domain-specific indices. Domain-specific indices were then combined into an overall EQI using PCA. In each PCA procedure, the first principal component was retained. Both domain-specific indices and overall EQI were stratified by four rural–urban continuum codes (RUCC). Higher values for each index were set to correspond to areas with poorer environmental quality. Results Concentrations of included variables differed across rural–urban strata, as did within-domain variable loadings, and domain index loadings for the EQI. In general, higher values of the air and sociodemographic indices were found in the more metropolitan areas and the most thinly populated areas have the lowest values of each of the domain indices. The less-urbanized counties (RUCC 3) demonstrated the greatest heterogeneity and range of EQI scores (−4.76, 3.57) while the thinly populated strata (RUCC 4) contained counties with the most positive scores (EQI score ranges from −5.86, 2.52). Conclusion The EQI holds promise for improving our characterization of the overall environment for public health. The EQI describes the non-residential ambient county-level conditions to which residents are exposed and domain-specific EQI loadings indicate which of the environmental domains account for the largest portion of the variability in the EQI environment. The EQI was constructed for all counties in the United States, incorporating a variety of data to provide a broad picture of environmental conditions. We undertook a reproducible approach that primarily utilized publically-available data sources. PMID:24886426

High-efficiency cell concepts on low-cost silicon sheets

NASA Technical Reports Server (NTRS)

Bell, R. O.; Ravi, K. V.

1985-01-01

The limitations on sheet growth material in terms of the defect structure and minority carrier lifetime are discussed. The effect of various defects on performance are estimated. Given these limitations designs for a sheet growth cell that will make the best of the material characteristics are proposed. Achievement of optimum synergy between base material quality and device processing variables is proposed. A strong coupling exists between material quality and the variables during crystal growth, and device processing variables. Two objectives are outlined: (1) optimization of the coupling for maximum performance at minimal cost; and (2) decoupling of materials from processing by improvement in base material quality to make it less sensitive to processing variables.

The experience factory: Can it make you a 5? or what is its relationship to other quality and improvement concepts?

NASA Technical Reports Server (NTRS)

Basili, Victor R.

1992-01-01

The concepts of quality improvements have permeated many businesses. It is clear that the nineties will be the quality era for software and there is a growing need to develop or adapt quality improvement approaches to the software business. Thus we must understand software as an artifact and software as a business. Since the business we are dealing with is software, we must understand the nature of software and software development. The software discipline is evolutionary and experimental; it is a laboratory science. Software is development not production. The technologies of the discipline are human based. There is a lack of models that allow us to reason about the process and the product. All software is not the same; process is a variable, goals are variable, etc. Packaged, reusable, experiences require additional resources in the form of organization, processes, people, etc. There have been a variety of organizational frameworks proposed to improve quality for various businesses. The ones discussed in this presentation include: Plan-Do-Check-Act, a quality improvement process based upon a feedback cycle for optimizing a single process model/production line; the Experience Factory/Quality Improvement Paradigm, continuous improvements through the experimentation, packaging, and reuse of experiences based upon a business's needs; Total Quality Management, a management approach to long term success through customer satisfaction based on the participation of all members of an organization; the SEI capability maturity model, a staged process improvement based upon assessment with regard to a set of key process areas until you reach a level 5 which represents a continuous process improvement; and Lean (software) Development, a principle supporting the concentration of the production on 'value added' activities and the elimination of reduction of 'not value added' activities.

Impact of an Information Technology-Enabled Initiative on the Quality of Prostate Multiparametric MRI Reports

PubMed Central

Silveira, Patricia C.; Dunne, Ruth; Sainani, Nisha I.; Lacson, Ronilda; Silverman, Stuart G.; Tempany, Clare M.; Khorasani, Ramin

2015-01-01

Rationale and Objectives Assess the impact of implementing a structured report template and a computer-aided diagnosis (CAD) tool on the quality of prostate multiparametric MRI (mp-MRI) reports. Materials and Methods Institutional Review Board approval was obtained for this HIPAA-compliant study performed at an academic medical center. The study cohort included all prostate mp-MRI reports (n=385) finalized 6 months before and after implementation of a structured report template and a CAD tool (collectively the IT tools) integrated into the PACS workstation. Primary outcome measure was quality of prostate mp-MRI reports. An expert panel of our institution’s subspecialty trained abdominal radiologists defined prostate mp-MRI report quality as optimal, satisfactory or unsatisfactory based on documentation of 9 variables. Reports were reviewed to extract the predefined quality variables and determine whether the IT tools were used to create each report. Chi-square and Student’s t-tests were used to compare report quality before and after implementation of IT tools. Results The overall proportion of optimal or satisfactory reports increased from 29.8% (47/158) to 53.3% (121/227) (p<0.001) after implementing the IT tools. While the proportion of optimal or satisfactory reports increased among reports generated using at least one of the IT tools (47/158=[29.8%] vs. 105/161=[65.2%]; p<0.001), there was no change in quality among reports generated without use of the IT tools (47/158=[29.8%] vs. 16/66=[24.2%]; p=0.404). Conclusion The use of a structured template and CAD tool improved the quality of prostate mp-MRI reports compared to free-text report format and subjective measurement of contrast enhancement kinetic curve. PMID:25863794

Influence of physician factors on the effectiveness of a continuing medical education intervention.

PubMed

Flores, Sergio; Reyes, Hortensia; Perez-Cuevas, Ricardo

2006-01-01

Continuing medical education (CME) is essential for improving the quality of care in primary health care settings. This study's objective was to determine how the characteristics of family physicians influenced the effectiveness of a multifaceted CME intervention to improve the management of acute respiratory infection (ARI) or type 2 diabetes (DM2). A secondary analysis was conducted based on data from 121 family physicians, who participated in the educational intervention study. The outcome variable was positive change in physician's performance for treatment of ARI or DM2. The exposure variable was multifaceted CME intervention. Independent variables were professional physicians and organizational characteristics. Analysis included log binomial regression modeling. Factors influencing positive change included, for ARI, participation in the CME intervention and medical director interested in that condition and for DM2, participation in the CME intervention, medical director interested in DM2, and being a teacher. Physicians' characteristics and organizational environment influence the effectiveness of educational intervention and are therefore relevant to the implementation of CME strategies.

Regional Climate Simulation and Data Assimilation with Variable-Resolution GCMs

NASA Technical Reports Server (NTRS)

Fox-Rabinovitz, Michael S.

2002-01-01

Variable resolution GCMs using a global stretched grid (SG) with enhanced regional resolution over one or multiple areas of interest represents a viable new approach to regional climateklimate change and data assimilation studies and applications. The multiple areas of interest, at least one within each global quadrant, include the major global mountains and major global monsoonal circulations over North America, South America, India-China, and Australia. They also can include the polar domains, and the European and African regions. The SG-approach provides an efficient regional downscaling to mesoscales, and it is an ideal tool for representing consistent interactions of globaYlarge- and regionallmeso- scales while preserving the high quality of global circulation. Basically, the SG-GCM simulations are no different from those of the traditional uniform-grid GCM simulations besides using a variable-resolution grid. Several existing SG-GCMs developed by major centers and groups are briefly described. The major discussion is based on the GEOS (Goddard Earth Observing System) SG-GCM regional climate simulations.

The EPOS-CC Score: An Integration of Independent, Tumor- and Patient-Associated Risk Factors to Predict 5-years Overall Survival Following Colorectal Cancer Surgery.

PubMed

Haga, Yoshio; Ikejiri, Koji; Wada, Yasuo; Ikenaga, Masakazu; Koike, Shoichiro; Nakamura, Seiji; Koseki, Masato

2015-06-01

Surgical audit is an essential task for the estimation of postoperative outcome and comparison of quality of care. Previous studies on surgical audits focused on short-term outcomes, such as postoperative mortality. We propose a surgical audit evaluating long-term outcome following colorectal cancer surgery. The predictive model for this audit is designated as 'Estimation of Postoperative Overall Survival for Colorectal Cancer (EPOS-CC)'. Thirty-one tumor-related and physiological variables were prospectively collected in 889 patients undergoing elective resection for colorectal cancer between April 2005 and April 2007 in 16 Japanese hospitals. Postoperative overall survival was assessed over a 5-years period. The EPOS-CC score was established by selecting significant variables in a uni- and multivariate analysis and allocating a risk-adjusted multiplication factor to each variable using Cox regression analysis. For validation, the EPOS-CC score was compared to the predictive power of UICC stage. Inter-hospital variability of the observed-to-estimated 5-years survival was assessed to estimate quality of care. Among the 889 patients, 804 (90%) completed the 5-years follow-up. Univariate analysis displayed a significant correlation with 5-years survival for 14 physiological and nine tumor-related variables (p < 0.005). Highly significant p-values below 0.0001 were found for age, ASA score, severe pulmonary disease, respiratory history, performance status, hypoalbuminemia, alteration of hemoglobin, serum sodium level, and for all histological variables except tumor location. Age, TNM stage, lymphatic invasion, performance status, and serum sodium level were independent variables in the multivariate analysis and were entered the EPOS-CC model for the prediction of survival. Risk-adjusted multiplication factors between 1.5 (distant metastasis) and 0.16 (serum sodium level) were accorded to the different variables. The predictive power of EPOS-CC was superior to the one of UICC stage; area under the curve 0.87, 95% CI 0.85-0.90 for EPOS-CC, and 0.80, 0.76-0.83 for UICC stage, p < 0.001. Quality of care did not differ between hospitals. The EPOS-CC score including the independent variables age, performance status, serum sodium level, TNM stage, and lymphatic invasion is superior to the UICC stage in the prediction of 5-years overall survival. This higher accuracy might be explained by the inclusion of physiological factors, thus also taking non-tumor-associated deaths into account. Furthermore, EPOS-CC score may compare quality of care among different institutions. Future studies are necessary to further evaluate this score and help improving the prediction of long-term survival following colorectal cancer surgery.

Divergent pathways to influence: Cognition and behavior differentially mediate the effects of optimism on physical and mental quality of life in Chinese university students.

PubMed

Ramsay, Jonathan E; Yang, Fang; Pang, Joyce S; Lai, Ching-Man; Ho, Roger Cm; Mak, Kwok-Kei

2015-07-01

Previous research has indicated that both cognitive and behavioral variables mediate the positive effect of optimism on quality of life; yet few attempts have been made to accommodate these constructs into a single explanatory framework. Adopting Fredrickson's broaden-and-build perspective, we examined the relationships between optimism, self-rated health, resilience, exercise, and quality of life in 365 Chinese university students using path analysis. For physical quality of life, a two-stage model, in which the effects of optimism were sequentially mediated by cognitive and behavioral variables, provided the best fit. A one-stage model, with full mediation by cognitive variables, provided the best fit for mental quality of life. This suggests that optimism influences physical and mental quality of life via different pathways. © The Author(s) 2013.

Outcomes Definitions and Statistical Tests in Oncology Studies: A Systematic Review of the Reporting Consistency.

PubMed

Rivoirard, Romain; Duplay, Vianney; Oriol, Mathieu; Tinquaut, Fabien; Chauvin, Franck; Magne, Nicolas; Bourmaud, Aurelie

2016-01-01

Quality of reporting for Randomized Clinical Trials (RCTs) in oncology was analyzed in several systematic reviews, but, in this setting, there is paucity of data for the outcomes definitions and consistency of reporting for statistical tests in RCTs and Observational Studies (OBS). The objective of this review was to describe those two reporting aspects, for OBS and RCTs in oncology. From a list of 19 medical journals, three were retained for analysis, after a random selection: British Medical Journal (BMJ), Annals of Oncology (AoO) and British Journal of Cancer (BJC). All original articles published between March 2009 and March 2014 were screened. Only studies whose main outcome was accompanied by a corresponding statistical test were included in the analysis. Studies based on censored data were excluded. Primary outcome was to assess quality of reporting for description of primary outcome measure in RCTs and of variables of interest in OBS. A logistic regression was performed to identify covariates of studies potentially associated with concordance of tests between Methods and Results parts. 826 studies were included in the review, and 698 were OBS. Variables were described in Methods section for all OBS studies and primary endpoint was clearly detailed in Methods section for 109 RCTs (85.2%). 295 OBS (42.2%) and 43 RCTs (33.6%) had perfect agreement for reported statistical test between Methods and Results parts. In multivariable analysis, variable "number of included patients in study" was associated with test consistency: aOR (adjusted Odds Ratio) for third group compared to first group was equal to: aOR Grp3 = 0.52 [0.31-0.89] (P value = 0.009). Variables in OBS and primary endpoint in RCTs are reported and described with a high frequency. However, statistical tests consistency between methods and Results sections of OBS is not always noted. Therefore, we encourage authors and peer reviewers to verify consistency of statistical tests in oncology studies.

Outcomes Definitions and Statistical Tests in Oncology Studies: A Systematic Review of the Reporting Consistency

PubMed Central

Rivoirard, Romain; Duplay, Vianney; Oriol, Mathieu; Tinquaut, Fabien; Chauvin, Franck; Magne, Nicolas; Bourmaud, Aurelie

2016-01-01

Background Quality of reporting for Randomized Clinical Trials (RCTs) in oncology was analyzed in several systematic reviews, but, in this setting, there is paucity of data for the outcomes definitions and consistency of reporting for statistical tests in RCTs and Observational Studies (OBS). The objective of this review was to describe those two reporting aspects, for OBS and RCTs in oncology. Methods From a list of 19 medical journals, three were retained for analysis, after a random selection: British Medical Journal (BMJ), Annals of Oncology (AoO) and British Journal of Cancer (BJC). All original articles published between March 2009 and March 2014 were screened. Only studies whose main outcome was accompanied by a corresponding statistical test were included in the analysis. Studies based on censored data were excluded. Primary outcome was to assess quality of reporting for description of primary outcome measure in RCTs and of variables of interest in OBS. A logistic regression was performed to identify covariates of studies potentially associated with concordance of tests between Methods and Results parts. Results 826 studies were included in the review, and 698 were OBS. Variables were described in Methods section for all OBS studies and primary endpoint was clearly detailed in Methods section for 109 RCTs (85.2%). 295 OBS (42.2%) and 43 RCTs (33.6%) had perfect agreement for reported statistical test between Methods and Results parts. In multivariable analysis, variable "number of included patients in study" was associated with test consistency: aOR (adjusted Odds Ratio) for third group compared to first group was equal to: aOR Grp3 = 0.52 [0.31–0.89] (P value = 0.009). Conclusion Variables in OBS and primary endpoint in RCTs are reported and described with a high frequency. However, statistical tests consistency between methods and Results sections of OBS is not always noted. Therefore, we encourage authors and peer reviewers to verify consistency of statistical tests in oncology studies. PMID:27716793

Depth as an organizer of fish assemblages in floodplain lakes

USGS Publications Warehouse

Miranda, L.E.

2011-01-01

Depth reduction is a natural process in floodplain lakes, but in many basins has been accelerated by anthropogenic disturbances. A diverse set of 42 floodplain lakes in the Yazoo River Basin (Mississippi, USA) was examined to test the hypothesis of whether depth reduction was a key determinant of water quality and fish assemblage structure. Single and multiple variable analyses were applied to 10 commonly monitored water variables and 54 fish species. Results showed strong associations between depth and water characteristics, and between depth and fish assemblages. Deep lakes provided less variable environments, clearer water, and a wider range of microhabitats than shallow lakes. The greater environmental stability was reflected by the dominant species in the assemblages, which included a broader representation of large-body species, species less tolerant of extreme water quality, and more predators. Stability in deep lakes was further reflected by reduced among-lake variability in taxa representation. Fish assemblages in shallow lakes were more variable than deep lakes, and commonly dominated by opportunistic species that have early maturity, extended breeding seasons, small adult size, and short lifespan. Depth is a causal factor that drives many physical and chemical variables that contribute to organizing fish assemblages in floodplain lakes. Thus, correlations between fish and water transparency, temperature, oxygen, trophic state, habitat structure, and other environmental descriptors may ultimately be totally or partly regulated by depth. In basins undergoing rapid anthropogenic modifications, local changes forced by depth reductions may be expected to eliminate species available from the regional pool and could have considerable ecological implications. ?? 2010 Springer Basel AG (outside the USA).

Assessment of the reliability of data collected for the Department of Veterans Affairs national surgical quality improvement program.

PubMed

Davis, Chester L; Pierce, John R; Henderson, William; Spencer, C David; Tyler, Christine; Langberg, Robert; Swafford, Jennan; Felan, Gladys S; Kearns, Martha A; Booker, Brigitte

2007-04-01

The Office of the Medical Inspector of the Department of Veterans Affairs (VA) studied the reliability of data collected by the VA's National Surgical Quality Improvement Program (NSQIP). The study focused on case selection bias, accuracy of reports on patients who died, and interrater reliability measurements of patient risk variables and outcomes. Surgical data from a sample of 15 VA medical centers were analyzed. For case selection bias, reviewers applied NSQIP criteria to include or exclude 2,460 patients from the database, comparing their results with those of NSQIP staff. For accurate reporting of patients who died, reviewers compared Social Security numbers of 10,444 NSQIP records with those found in the VA Beneficiary Identification and Records Locator Subsystem, VA Patient Treatment Files, and Social Security Administration death files. For measurement of interrater reliability, reviewers reabstracted 59 variables in each of 550 patient medical records that also were recorded in the NSQIP database. On case selection bias, the reviewers agreed with NSQIP decisions on 2,418 (98%) of the 2,460 cases. Computer record matching identified 4 more deaths than the NSQIP total of 198, a difference of about 2%. For 52 of the categorical variables, agreement, uncorrected for chance, was 96%. For 48 of 52 categorical variables, kappas ranged from 0.61 to 1.0 (substantial to almost perfect agreement); none of the variables had kappas of less than 0.20 (slight to poor agreement). This sample of medical centers shows adherence to criteria in selecting cases for the NSQIP database, for reporting deaths, and for collecting patient risk variables.

Analytical and simulator study of advanced transport

NASA Technical Reports Server (NTRS)

Levison, W. H.; Rickard, W. W.

1982-01-01

An analytic methodology, based on the optimal-control pilot model, was demonstrated for assessing longitidunal-axis handling qualities of transport aircraft in final approach. Calibration of the methodology is largely in terms of closed-loop performance requirements, rather than specific vehicle response characteristics, and is based on a combination of published criteria, pilot preferences, physical limitations, and engineering judgment. Six longitudinal-axis approach configurations were studied covering a range of handling qualities problems, including the presence of flexible aircraft modes. The analytical procedure was used to obtain predictions of Cooper-Harper ratings, a solar quadratic performance index, and rms excursions of important system variables.

Inter-rater reliability of data elements from a prototype of the Paul Coverdell National Acute Stroke Registry

PubMed Central

Reeves, Mathew J; Mullard, Andrew J; Wehner, Susan

2008-01-01

Background The Paul Coverdell National Acute Stroke Registry (PCNASR) is a U.S. based national registry designed to monitor and improve the quality of acute stroke care delivered by hospitals. The registry monitors care through specific performance measures, the accuracy of which depends in part on the reliability of the individual data elements used to construct them. This study describes the inter-rater reliability of data elements collected in Michigan's state-based prototype of the PCNASR. Methods Over a 6-month period, 15 hospitals participating in the Michigan PCNASR prototype submitted data on 2566 acute stroke admissions. Trained hospital staff prospectively identified acute stroke admissions, abstracted chart information, and submitted data to the registry. At each hospital 8 randomly selected cases were re-abstracted by an experienced research nurse. Inter-rater reliability was estimated by the kappa statistic for nominal variables, and intraclass correlation coefficient (ICC) for ordinal and continuous variables. Factors that can negatively impact the kappa statistic (i.e., trait prevalence and rater bias) were also evaluated. Results A total of 104 charts were available for re-abstraction. Excellent reliability (kappa or ICC > 0.75) was observed for many registry variables including age, gender, black race, hemorrhagic stroke, discharge medications, and modified Rankin Score. Agreement was at least moderate (i.e., 0.75 > kappa ≥; 0.40) for ischemic stroke, TIA, white race, non-ambulance arrival, hospital transfer and direct admit. However, several variables had poor reliability (kappa < 0.40) including stroke onset time, stroke team consultation, time of initial brain imaging, and discharge destination. There were marked systematic differences between hospital abstractors and the audit abstractor (i.e., rater bias) for many of the data elements recorded in the emergency department. Conclusion The excellent reliability of many of the data elements supports the use of the PCNASR to monitor and improve care. However, the poor reliability for several variables, particularly time-related events in the emergency department, indicates the need for concerted efforts to improve the quality of data collection. Specific recommendations include improvements to data definitions, abstractor training, and the development of ED-based real-time data collection systems. PMID:18547421

Application of Quality by Design (QbD) Principles to Extractables/Leachables Assessment. Establishing a Design Space for Terminally Sterilized Aqueous Drug Products Stored in a Plastic Packaging System.

PubMed

Jenke, Dennis

2010-01-01

The concept of quality by design (QbD) reflects the current global regulatory thinking related to pharmaceutical products. A cornerstone of the QbD paradigm is the concept of a design space, where the design space is a multidimensional combination of input variables and process parameters that have been demonstrated to provide the assurance of product quality. If a design space can be established for a pharmaceutical process or product, then operation within the design space confirms that the product or process output possesses the required quality attributes. This concept of design space can be applied to the safety (leachables) assessment of drug products manufactured and stored in packaging systems. Critical variables in such a design space would include those variables that affect the interaction of the drug product and its packaging, including (a) composition of the drug product, (b) composition of the packaging system, (c) configuration of the packaging system, and (d) the conditions of contact. This paper proposes and justifies such a leachables design space for aqueous drug products packaged in a specific plastic packaging system. Such a design space has the following boundaries:Aqueous drug products with a pH in the range of 2 to 8 and that contain no polarity-impacting agents such as organic solubilizers and stabilizers (addressing variable a). Packaging systems manufactured from materials that meet the system's existing material specifications (addressing variable b). Nominal fill volumes from 50 to 1000 mL (addressing variable c). Products subjected to terminal sterilization and then stored at room temperature for a period of up to 24 months (addressing variable d). The ramification of such a design space is that any drug product that falls within these boundaries is deemed to be compatible with the packaging system, from the perspective of safety, without the requirement of supporting drug product testing. When drug products are packaged in plastic container systems, substances may leach from the container and accumulate in the product. It is necessary that the drug product's vendor demonstrate that any such leaching does not occur to the extent that the leached substances adversely affect the product's safety and/or efficacy. One method for accomplishing this objective is via analysis of the drug product to identify and quantify the leached substances. When a particular packaging system is utilized for multiple drug products, one reaches the point, after testing numerous drug products, where the leaching properties of the packaging system are well known and readily predictable. In such a case, testing of additional products in the same packaging system produces no new information and thus becomes redundant and unnecessary. The quality by design (QbD) principle can be simply stated as follows: once a system has been tested to the extent that the test results are predictable, further testing can be replaced by establishing that the system was operating within a defined design space. The purpose of this paper is to demonstrate the application of QbD principles to a packaging system that has been utilized with over 12 parenteral drug products. The paper concludes that the leachables profile of all drug products that fit a certain description (the design space) is known and predicable.

Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis.

PubMed

Palmeira, António L; Markland, David A; Silva, Marlene N; Branco, Teresa L; Martins, Sandra C; Minderico, Cláudia S; Vieira, Paulo N; Barata, José T; Serpa, Sidónio O; Sardinha, Luis B; Teixeira, Pedro J

2009-02-09

Changes in body image and subjective well-being variables (e.g. self-esteem) are often reported as outcomes of obesity treatment. However, they may, in turn, also influence behavioral adherence and success in weight loss. The present study examined associations among obesity treatment-related variables, i.e., change in weight, quality of life, body image, and subjective well-being, exploring their role as both mediators and outcomes, during a behavioral obesity treatment. Participants (BMI = 31.1 +/- 4.1 kg/m2; age = 38.4 +/- 6.7 y) were 144 women who attended a 12-month obesity treatment program and a comparison group (n = 49), who received a general health education program. The intervention included regular group meetings promoting lasting behavior changes in physical activity and dietary intake. Body image, quality of life, subjective well-being, and body weight were measured at baseline and treatment's end. Mediation was tested by multiple regression and a resampling approach to measure indirect effects. Treatment group assignment was the independent variable while changes in weight and in psychosocial variables were analyzed alternatively as mediators and as dependent variables. At 12 months, the intervention group had greater weight loss (-5.6 +/- 6.8% vs. -1.2 +/- 4.6%, p < .001) and larger decreases in body size dissatisfaction (effect size of 1.08 vs. .41, p < .001) than the comparison group. Significant improvements were observed in both groups for all other psychosocial variables (effect sizes ranging from .31-.75, p < .05). Mediation analysis showed that changes in body image and body weight were concurrently mediators and outcomes of treatment, suggesting reciprocal influences. Weight loss partially mediated the effect of treatment on quality of life and on self-esteem but the reciprocal effect was not observed. Changes in weight and body image may reciprocally affect each other during the course of behavioral obesity treatment. No evidence of reciprocal relationships was found for the other models under analysis; however, weight changes partially explained the effects of treatment on quality of life and self-esteem. Weight and psychosocial changes co-occur during treatment and will probably influence each other dynamically, in ways not yet adequately understood. Results from this study support the inclusion of intervention contents aimed at improving body image in weight management programs.

Do We See Eye to Eye? Moderators of Correspondence between Student and Faculty Evaluations of Day-to-Day Teaching

ERIC Educational Resources Information Center

Cain, Kathleen M.; Wilkowski, Benjamin M.; Barlett, Christopher P.; Boyle, Colleen D.; Meier, Brian P.

2018-01-01

Students and instructors show moderate levels of agreement about the quality of day-to-day teaching. In the present study, we replicated and extended this finding by asking how correspondence between student and instructor ratings is moderated by time of semester and student demographic variables. Participants included 137 students and 5…

A Comparison of Student Attitudes Towards School, Teachers and Peers in Swedish Comprehensive Schools Now and 35 Years Ago

ERIC Educational Resources Information Center

Holfve-Sabel, Mary-Anne

2006-01-01

Background: This investigation focuses on student attitudes and looks at school quality from the perspective of affective variables rather than students' knowledge or abilities. The concept of attitude includes ways of feeling, thinking and behaving and maintaining an expression of one's identity within the environment. The analysis focuses on…

A wildland fire emission inventory for the western United States - uncertainty across spatial and temporal scales

Treesearch

Shawn Urbanski; WeiMin Hao

2010-01-01

Emissions of trace gases and aerosols by biomass burning (BB) have a significant influence on the chemical composition of the atmosphere, air quality, and climate. BB emissions depend on a range of variables including burned area, fuels, meteorology, combustion completeness, and emission factors (EF). Emission algorithms provide BB emission inventories (EI) which serve...

Assessing soil compaction on Forest Inventory & Analysis phase 3 field plots using a pocket penetrometer

Treesearch

Michael C. Amacher; Katherine P. O' Neill

2004-01-01

Soil compaction is an important indicator of soil quality, yet few practical methods are available to quantitatively measure this variable. Although an assessment of the areal extent of soil compaction is included as part of the soil indicator portion of the Forest Inventory & Analysis (FIA) program, no quantitative measurement of the degree of soil compaction...

Shedding Further Light on the Effects of Various Types and Quality of Early Child Care on Infant-Mother Attachment Relationship: The Haifa Study of Early Child Care.

ERIC Educational Resources Information Center

Sagi, Abraham; Koren-Karie, Nina; Gini, Motti; Ziv, Yair; Joels, Tirtsa

2002-01-01

The Haifa Study of Early Child Care examined the unique contribution of various child-care-related correlates to infant-mother attachment. Findings indicated that, after controlling for other potential contributing variables (including mother characteristics, mother-child interaction, and mother- father relationship), center care adversely…

Glaucoma and quality of life: fall and driving risk.

PubMed

Montana, Cynthia L; Bhorade, Anjali M

2018-03-01

Numerous population-based studies suggest that glaucoma is an independent risk factor for falling and motor vehicle collisions, particularly for older adults. These adverse events lead to increased healthcare expenditures and decreased quality of life. Current research priorities, therefore, include identifying factors that predispose glaucoma patients to falling and unsafe driving, and developing screening strategies and targeted rehabilitation. The purpose of this article is to review recent studies that address these priorities. Studies continue to support that glaucoma patients, particularly those with advanced disease, have an increased risk of falling or unsafe driving. Risk factors, however, remain variable and include severity and location of visual field defects, contrast sensitivity, and performance on divided attention tasks. Such variability is likely because of the multifactorial nature of ambulating and driving and compensatory strategies used by patients. Falls and unsafe driving remain a serious public health issue for older adults with glaucoma. Ambulation and driving are complex tasks and there is no consensus yet, regarding the best methods for risk stratification and targeted interventions to increase safety. Therefore, comprehensive and individualized assessments are recommended to most effectively evaluate a patient's risk for falling or unsafe driving.

Statistics for stochastic modeling of volume reduction, hydrograph extension, and water-quality treatment by structural stormwater runoff best management practices (BMPs)

USGS Publications Warehouse

Granato, Gregory E.

2014-01-01

The U.S. Geological Survey (USGS) developed the Stochastic Empirical Loading and Dilution Model (SELDM) in cooperation with the Federal Highway Administration (FHWA) to indicate the risk for stormwater concentrations, flows, and loads to be above user-selected water-quality goals and the potential effectiveness of mitigation measures to reduce such risks. SELDM models the potential effect of mitigation measures by using Monte Carlo methods with statistics that approximate the net effects of structural and nonstructural best management practices (BMPs). In this report, structural BMPs are defined as the components of the drainage pathway between the source of runoff and a stormwater discharge location that affect the volume, timing, or quality of runoff. SELDM uses a simple stochastic statistical model of BMP performance to develop planning-level estimates of runoff-event characteristics. This statistical approach can be used to represent a single BMP or an assemblage of BMPs. The SELDM BMP-treatment module has provisions for stochastic modeling of three stormwater treatments: volume reduction, hydrograph extension, and water-quality treatment. In SELDM, these three treatment variables are modeled by using the trapezoidal distribution and the rank correlation with the associated highway-runoff variables. This report describes methods for calculating the trapezoidal-distribution statistics and rank correlation coefficients for stochastic modeling of volume reduction, hydrograph extension, and water-quality treatment by structural stormwater BMPs and provides the calculated values for these variables. This report also provides robust methods for estimating the minimum irreducible concentration (MIC), which is the lowest expected effluent concentration from a particular BMP site or a class of BMPs. These statistics are different from the statistics commonly used to characterize or compare BMPs. They are designed to provide a stochastic transfer function to approximate the quantity, duration, and quality of BMP effluent given the associated inflow values for a population of storm events. A database application and several spreadsheet tools are included in the digital media accompanying this report for further documentation of methods and for future use. In this study, analyses were done with data extracted from a modified copy of the January 2012 version of International Stormwater Best Management Practices Database, designated herein as the January 2012a version. Statistics for volume reduction, hydrograph extension, and water-quality treatment were developed with selected data. Sufficient data were available to estimate statistics for 5 to 10 BMP categories by using data from 40 to more than 165 monitoring sites. Water-quality treatment statistics were developed for 13 runoff-quality constituents commonly measured in highway and urban runoff studies including turbidity, sediment and solids; nutrients; total metals; organic carbon; and fecal coliforms. The medians of the best-fit statistics for each category were selected to construct generalized cumulative distribution functions for the three treatment variables. For volume reduction and hydrograph extension, interpretation of available data indicates that selection of a Spearman’s rho value that is the average of the median and maximum values for the BMP category may help generate realistic simulation results in SELDM. The median rho value may be selected to help generate realistic simulation results for water-quality treatment variables. MIC statistics were developed for 12 runoff-quality constituents commonly measured in highway and urban runoff studies by using data from 11 BMP categories and more than 167 monitoring sites. Four statistical techniques were applied for estimating MIC values with monitoring data from each site. These techniques produce a range of lower-bound estimates for each site. Four MIC estimators are proposed as alternatives for selecting a value from among the estimates from multiple sites. Correlation analysis indicates that the MIC estimates from multiple sites were weakly correlated with the geometric mean of inflow values, which indicates that there may be a qualitative or semiquantitative link between the inflow quality and the MIC. Correlations probably are weak because the MIC is influenced by the inflow water quality and the capability of each individual BMP site to reduce inflow concentrations.

A new definition of pharmaceutical quality: assembly of a risk simulation platform to investigate the impact of manufacturing/product variability on clinical performance.

PubMed

Short, Steven M; Cogdill, Robert P; D'Amico, Frank; Drennen, James K; Anderson, Carl A

2010-12-01

The absence of a unanimous, industry-specific definition of quality is, to a certain degree, impeding the progress of ongoing efforts to "modernize" the pharmaceutical industry. This work was predicated on requests by Dr. Woodcock (FDA) to re-define pharmaceutical quality in terms of risk by linking production characteristics to clinical attributes. A risk simulation platform that integrates population statistics, drug delivery system characteristics, dosing guidelines, patient compliance estimates, production metrics, and pharmacokinetic, pharmacodynamic, and in vitro-in vivo correlation models to investigate the impact of manufacturing variability on clinical performance of a model extended-release theophylline solid oral dosage system was developed. Manufacturing was characterized by inter- and intra-batch content uniformity and dissolution variability metrics, while clinical performance was described by a probabilistic pharmacodynamic model that expressed the probability of inefficacy and toxicity as a function of plasma concentrations. Least-squares regression revealed that both patient compliance variables, percent of doses taken and dosing time variability, significantly impacted efficacy and toxicity. Additionally, intra-batch content uniformity variability elicited a significant change in risk scores for the two adverse events and, therefore, was identified as a critical quality attribute. The proposed methodology demonstrates that pharmaceutical quality can be recast to explicitly reflect clinical performance. © 2010 Wiley-Liss, Inc. and the American Pharmacists Association

Etching Behavior of Aluminum Alloy Extrusions

NASA Astrophysics Data System (ADS)

Zhu, Hanliang

2014-11-01

The etching treatment is an important process step in influencing the surface quality of anodized aluminum alloy extrusions. The aim of etching is to produce a homogeneously matte surface. However, in the etching process, further surface imperfections can be generated on the extrusion surface due to uneven materials loss from different microstructural components. These surface imperfections formed prior to anodizing can significantly influence the surface quality of the final anodized extrusion products. In this article, various factors that influence the materials loss during alkaline etching of aluminum alloy extrusions are investigated. The influencing variables considered include etching process parameters, Fe-rich particles, Mg-Si precipitates, and extrusion profiles. This study provides a basis for improving the surface quality in industrial extrusion products by optimizing various process parameters.

Creating a Framework for Holistic Assessment of Aesthetics: A Response to Nilsson and Axelsson (2015) on Attributes of Aesthetic Quality of Textile Quality1.

PubMed

Carbon, Claus-Christian

2016-02-01

Nilsson and Axelsson (2015) made an important contribution by linking recent scientific approaches from the field of empirical aesthetics with everyday demands of museum conservators of deciding which items to be preserved or not. The authors made an important effort in identifying the valuable candidates of variables - but focused on visual properties only and on quite high-expertise aspects of aesthetic quality based on very sophisticated evaluations. The present article responds to the target paper by developing the outline of a more holistic approach for future research as a kind of framework that should assist a multi-modal approach, mainly including tactile sense. © The Author(s) 2016.

Seemingly unrelated intervention time series models for effectiveness evaluation of large scale environmental remediation.

PubMed

Ip, Ryan H L; Li, W K; Leung, Kenneth M Y

2013-09-15

Large scale environmental remediation projects applied to sea water always involve large amount of capital investments. Rigorous effectiveness evaluations of such projects are, therefore, necessary and essential for policy review and future planning. This study aims at investigating effectiveness of environmental remediation using three different Seemingly Unrelated Regression (SUR) time series models with intervention effects, including Model (1) assuming no correlation within and across variables, Model (2) assuming no correlation across variable but allowing correlations within variable across different sites, and Model (3) allowing all possible correlations among variables (i.e., an unrestricted model). The results suggested that the unrestricted SUR model is the most reliable one, consistently having smallest variations of the estimated model parameters. We discussed our results with reference to marine water quality management in Hong Kong while bringing managerial issues into consideration. Copyright © 2013 Elsevier Ltd. All rights reserved.

Random vectors and spatial analysis by geostatistics for geotechnical applications

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

Young, D.S.

1987-08-01

Geostatistics is extended to the spatial analysis of vector variables by defining the estimation variance and vector variogram in terms of the magnitude of difference vectors. Many random variables in geotechnology are in vectorial terms rather than scalars, and its structural analysis requires those sample variable interpolations to construct and characterize structural models. A better local estimator will result in greater quality of input models; geostatistics can provide such estimators; kriging estimators. The efficiency of geostatistics for vector variables is demonstrated in a case study of rock joint orientations in geological formations. The positive cross-validation encourages application of geostatistics tomore » spatial analysis of random vectors in geoscience as well as various geotechnical fields including optimum site characterization, rock mechanics for mining and civil structures, cavability analysis of block cavings, petroleum engineering, and hydrologic and hydraulic modelings.« less

The land-use legacy effect: Towards a mechanistic understanding of time-lagged water quality responses to land use/cover.

PubMed

Martin, Sherry L; Hayes, Daniel B; Kendall, Anthony D; Hyndman, David W

2017-02-01

Numerous studies have linked land use/land cover (LULC) to aquatic ecosystem responses, however only a few have included the dynamics of changing LULC in their analysis. In this study, we explicitly recognize changing LULC by linking mechanistic groundwater flow and travel time models to a historical time series of LULC, creating a land-use legacy map. We then illustrate the utility of legacy maps to explore relationships between dynamic LULC and lake water chemistry. We tested two main concepts about mechanisms linking LULC and lake water chemistry: groundwater pathways are an important mechanism driving legacy effects; and, LULC over multiple spatial scales is more closely related to lake chemistry than LULC over a single spatial scale. We applied statistical models to twelve water chemistry variables, ranging from nutrients to relatively conservative ions, to better understand the roles of biogeochemical reactivity and solubility on connections between LULC and aquatic ecosystem response. Our study illustrates how different areas can have long groundwater pathways that represent different LULC than what can be seen on the landscape today. These groundwater pathways delay the arrival of nutrients and other water quality constituents, thus creating a legacy of historic land uses that eventually reaches surface water. We find that: 1) several water chemistry variables are best fit by legacy LULC while others have a stronger link to current LULC, and 2) single spatial scales of LULC analysis performed worse for most variables. Our novel combination of temporal and spatial scales was the best overall model fit for most variables, including SRP where this model explained 54% of the variation. We show that it is important to explicitly account for temporal and spatial context when linking LULC to ecosystem response. Copyright © 2016. Published by Elsevier B.V.

Spatial match-mismatch between juvenile fish and prey provides a mechanism for recruitment variability across contrasting climate conditions in the eastern Bering Sea.

PubMed

Siddon, Elizabeth Calvert; Kristiansen, Trond; Mueter, Franz J; Holsman, Kirstin K; Heintz, Ron A; Farley, Edward V

2013-01-01

Understanding mechanisms behind variability in early life survival of marine fishes through modeling efforts can improve predictive capabilities for recruitment success under changing climate conditions. Walleye pollock (Theragra chalcogramma) support the largest single-species commercial fishery in the United States and represent an ecologically important component of the Bering Sea ecosystem. Variability in walleye pollock growth and survival is structured in part by climate-driven bottom-up control of zooplankton composition. We used two modeling approaches, informed by observations, to understand the roles of prey quality, prey composition, and water temperature on juvenile walleye pollock growth: (1) a bioenergetics model that included local predator and prey energy densities, and (2) an individual-based model that included a mechanistic feeding component dependent on larval development and behavior, local prey densities and size, and physical oceanographic conditions. Prey composition in late-summer shifted from predominantly smaller copepod species in the warmer 2005 season to larger species in the cooler 2010 season, reflecting differences in zooplankton composition between years. In 2010, the main prey of juvenile walleye pollock were more abundant, had greater biomass, and higher mean energy density, resulting in better growth conditions. Moreover, spatial patterns in prey composition and water temperature lead to areas of enhanced growth, or growth 'hot spots', for juvenile walleye pollock and survival may be enhanced when fish overlap with these areas. This study provides evidence that a spatial mismatch between juvenile walleye pollock and growth 'hot spots' in 2005 contributed to poor recruitment while a higher degree of overlap in 2010 resulted in improved recruitment. Our results indicate that climate-driven changes in prey quality and composition can impact growth of juvenile walleye pollock, potentially severely affecting recruitment variability.

Health-Related Quality of Life in a Predictive Model for Mortality in Older Breast Cancer Survivors.

PubMed

DuMontier, Clark; Clough-Gorr, Kerri M; Silliman, Rebecca A; Stuck, Andreas E; Moser, André

2018-03-13

To develop a predictive model and risk score for 10-year mortality using health-related quality of life (HRQOL) in a cohort of older women with early-stage breast cancer. Prospective cohort. Community. U.S. women aged 65 and older diagnosed with Stage I to IIIA primary breast cancer (N=660). We used medical variables (age, comorbidity), HRQOL measures (10-item Physical Function Index and 5-item Mental Health Index from the Medical Outcomes Study (MOS) 36-item Short-Form Survey; 8-item Modified MOS Social Support Survey), and breast cancer variables (stage, surgery, chemotherapy, endocrine therapy) to develop a 10-year mortality risk score using penalized logistic regression models. We assessed model discriminative performance using the area under the receiver operating characteristic curve (AUC), calibration performance using the Hosmer-Lemeshow test, and overall model performance using Nagelkerke R 2 (NR). Compared to a model including only age, comorbidity, and cancer stage and treatment variables, adding HRQOL variables improved discrimination (AUC 0.742 from 0.715) and overall performance (NR 0.221 from 0.190) with good calibration (p=0.96 from HL test). In a cohort of older women with early-stage breast cancer, HRQOL measures predict 10-year mortality independently of traditional breast cancer prognostic variables. These findings suggest that interventions aimed at improving physical function, mental health, and social support might improve both HRQOL and survival. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Diurnal testosterone variability is differentially associated with parenting quality in mothers and fathers.

PubMed

Endendijk, Joyce J; Hallers-Haalboom, Elizabeth T; Groeneveld, Marleen G; van Berkel, Sheila R; van der Pol, Lotte D; Bakermans-Kranenburg, Marian J; Mesman, Judi

2016-04-01

Previous studies on the relation between testosterone (T) levels and parenting have found ample evidence for the challenge hypothesis, demonstrating that high T levels inhibit parental involvement and that becoming a parent is related to a decrease in T levels in both mothers and fathers. However, less is known about the relation between T levels and more qualitative aspects of parenting. In the current study we examined basal T levels and diurnal variability in T levels in relation to mothers' and fathers' parenting quality. Participants included 217 fathers and 124 mothers with two children (3 and 5years of age). Evening and morning salivary T samples were analyzed with radio-immunoassays to determine circulating T levels. Parental sensitivity (i.e., child-centered responsiveness) and respect for children's autonomy were observed during free play in the family home. The results showed that higher evening T levels in mothers were associated with more sensitivity to the oldest and youngest child. Diurnal T variability was more consistently associated with parenting behavior towards their children than basal T levels. For fathers, more diurnal variability in T was associated with more sensitivity and more respect for autonomy with their youngest children. For mothers, more diurnal variability in T was associated with less sensitivity to both children and less respect for the youngest child's autonomy. These findings suggest that the T system might act differently in relation to parenting behavior in males and females. Copyright © 2016 Elsevier Inc. All rights reserved.

Statistical quality control through overall vibration analysis

NASA Astrophysics Data System (ADS)

Carnero, M. ^a. Carmen; González-Palma, Rafael; Almorza, David; Mayorga, Pedro; López-Escobar, Carlos

2010-05-01

The present study introduces the concept of statistical quality control in automotive wheel bearings manufacturing processes. Defects on products under analysis can have a direct influence on passengers' safety and comfort. At present, the use of vibration analysis on machine tools for quality control purposes is not very extensive in manufacturing facilities. Noise and vibration are common quality problems in bearings. These failure modes likely occur under certain operating conditions and do not require high vibration amplitudes but relate to certain vibration frequencies. The vibration frequencies are affected by the type of surface problems (chattering) of ball races that are generated through grinding processes. The purpose of this paper is to identify grinding process variables that affect the quality of bearings by using statistical principles in the field of machine tools. In addition, an evaluation of the quality results of the finished parts under different combinations of process variables is assessed. This paper intends to establish the foundations to predict the quality of the products through the analysis of self-induced vibrations during the contact between the grinding wheel and the parts. To achieve this goal, the overall self-induced vibration readings under different combinations of process variables are analysed using statistical tools. The analysis of data and design of experiments follows a classical approach, considering all potential interactions between variables. The analysis of data is conducted through analysis of variance (ANOVA) for data sets that meet normality and homoscedasticity criteria. This paper utilizes different statistical tools to support the conclusions such as chi squared, Shapiro-Wilks, symmetry, Kurtosis, Cochran, Hartlett, and Hartley and Krushal-Wallis. The analysis presented is the starting point to extend the use of predictive techniques (vibration analysis) for quality control. This paper demonstrates the existence of predictive variables (high-frequency vibration displacements) that are sensible to the processes setup and the quality of the products obtained. Based on the result of this overall vibration analysis, a second paper will analyse self-induced vibration spectrums in order to define limit vibration bands, controllable every cycle or connected to permanent vibration-monitoring systems able to adjust sensible process variables identified by ANOVA, once the vibration readings exceed established quality limits.

Aircrew coordination and decisionmaking: Peer ratings of video tapes made during a full mission simulation

NASA Technical Reports Server (NTRS)

Murphy, M. R.; Awe, C. A.

1986-01-01

Six professionally active, retired captains rated the coordination and decisionmaking performances of sixteen aircrews while viewing videotapes of a simulated commercial air transport operation. The scenario featured a required diversion and a probable minimum fuel situation. Seven point Likert-type scales were used in rating variables on the basis of a model of crew coordination and decisionmaking. The variables were based on concepts of, for example, decision difficulty, efficiency, and outcome quality; and leader-subordin ate concepts such as person and task-oriented leader behavior, and competency motivation of subordinate crewmembers. Five-front-end variables of the model were in turn dependent variables for a hierarchical regression procedure. The variance in safety performance was explained 46%, by decision efficiency, command reversal, and decision quality. The variance of decision quality, an alternative substantive dependent variable to safety performance, was explained 60% by decision efficiency and the captain's quality of within-crew communications. The variance of decision efficiency, crew coordination, and command reversal were in turn explained 78%, 80%, and 60% by small numbers of preceding independent variables. A principle component, varimax factor analysis supported the model structure suggested by regression analyses.

Uncertainties in selected river water quality data

NASA Astrophysics Data System (ADS)

Rode, M.; Suhr, U.

2007-02-01

Monitoring of surface waters is primarily done to detect the status and trends in water quality and to identify whether observed trends arise from natural or anthropogenic causes. Empirical quality of river water quality data is rarely certain and knowledge of their uncertainties is essential to assess the reliability of water quality models and their predictions. The objective of this paper is to assess the uncertainties in selected river water quality data, i.e. suspended sediment, nitrogen fraction, phosphorus fraction, heavy metals and biological compounds. The methodology used to structure the uncertainty is based on the empirical quality of data and the sources of uncertainty in data (van Loon et al., 2005). A literature review was carried out including additional experimental data of the Elbe river. All data of compounds associated with suspended particulate matter have considerable higher sampling uncertainties than soluble concentrations. This is due to high variability within the cross section of a given river. This variability is positively correlated with total suspended particulate matter concentrations. Sampling location has also considerable effect on the representativeness of a water sample. These sampling uncertainties are highly site specific. The estimation of uncertainty in sampling can only be achieved by taking at least a proportion of samples in duplicates. Compared to sampling uncertainties, measurement and analytical uncertainties are much lower. Instrument quality can be stated well suited for field and laboratory situations for all considered constituents. Analytical errors can contribute considerably to the overall uncertainty of river water quality data. Temporal autocorrelation of river water quality data is present but literature on general behaviour of water quality compounds is rare. For meso scale river catchments (500-3000 km2) reasonable yearly dissolved load calculations can be achieved using biweekly sample frequencies. For suspended sediments none of the methods investigated produced very reliable load estimates when weekly concentrations data were used. Uncertainties associated with loads estimates based on infrequent samples will decrease with increasing size of rivers.

Uncertainties in selected surface water quality data

NASA Astrophysics Data System (ADS)

Rode, M.; Suhr, U.

2006-09-01

Monitoring of surface waters is primarily done to detect the status and trends in water quality and to identify whether observed trends arise form natural or anthropogenic causes. Empirical quality of surface water quality data is rarely certain and knowledge of their uncertainties is essential to assess the reliability of water quality models and their predictions. The objective of this paper is to assess the uncertainties in selected surface water quality data, i.e. suspended sediment, nitrogen fraction, phosphorus fraction, heavy metals and biological compounds. The methodology used to structure the uncertainty is based on the empirical quality of data and the sources of uncertainty in data (van Loon et al., 2006). A literature review was carried out including additional experimental data of the Elbe river. All data of compounds associated with suspended particulate matter have considerable higher sampling uncertainties than soluble concentrations. This is due to high variability's within the cross section of a given river. This variability is positively correlated with total suspended particulate matter concentrations. Sampling location has also considerable effect on the representativeness of a water sample. These sampling uncertainties are highly site specific. The estimation of uncertainty in sampling can only be achieved by taking at least a proportion of samples in duplicates. Compared to sampling uncertainties measurement and analytical uncertainties are much lower. Instrument quality can be stated well suited for field and laboratory situations for all considered constituents. Analytical errors can contribute considerable to the overall uncertainty of surface water quality data. Temporal autocorrelation of surface water quality data is present but literature on general behaviour of water quality compounds is rare. For meso scale river catchments reasonable yearly dissolved load calculations can be achieved using biweekly sample frequencies. For suspended sediments none of the methods investigated produced very reliable load estimates when weekly concentrations data were used. Uncertainties associated with loads estimates based on infrequent samples will decrease with increasing size of rivers.

Water quality of arctic rivers in Finnish Lapland.

PubMed

Niemi, Jorma

2010-02-01

The water quality monitoring data of eight rivers situated in the Finnish Lapland above the Arctic Circle were investigated. These rivers are icebound annually for about 200 days. They belong to the International River Basin District founded according to the European Union Water Framework Directive and shared with Norway. They are part of the European river monitoring network that includes some 3,400 river sites. The water quality monitoring datasets available varied between the rivers, the longest comprising the period 1975-2003 and the shortest 1989-2003. For each river, annual medians of eight water quality variables were calculated. In addition, medians and fifth and 95th percentiles were calculated for the whole observation periods. The medians indicated good river water quality in comparison to other national or foreign rivers. However, the river water quality oscillated widely. Some rivers were in practice in pristine state, whereas some showed slight human impacts, e.g., occasional high values of hygienic indicator bacteria.

Interaction of feel system and flight control system dynamics on lateral flying qualities

NASA Technical Reports Server (NTRS)

Bailey, R. E.; Knotts, L. H.

1990-01-01

An experimental investigation of the influence of lateral feel system characteristics on fighter aircraft roll flying qualities was conducted using the variable stability USAF NT-33. Forty-two evaluation flights were flown by three engineering test pilots. The investigation utilized the power approach, visual landing task and up-and-away tasks including formation, gun tracking, and computer-generated compensatory attitude tracking tasks displayed on the Head-Up Display. Experimental variations included the feel system frequency, force-deflection gradient, control system command type (force or position input command), aircraft roll mode time constant, control system prefilter frequency, and control system time delay. The primary data were task performance records and evaluation pilot comments and ratings using the Cooper-Harper scale. The data highlight the unique and powerful effect of the feel system of flying qualities. The data show that the feel system is not 'equivalent' in flying qualities influence to analogous control system elements. A lower limit of allowable feel system frequency appears warranted to ensure good lateral flying qualities. Flying qualities criteria should most properly treat the feel system dynamic influence separately from the control system, since the input and output of this dynamic element is apparent to the pilot and thus, does not produce a 'hidden' effect.

Filling quality of the reports of adverse drug reactions received at the Pharmacovigilance Centre of São Paulo (Brazil): missing information hinders the analysis of suspected associations.

PubMed

Ribeiro, Adalton; Lima, Silvana; Zampieri, Maria-Elisa; Peinado, Mirtes; Figueras, Albert

2017-12-01

The completeness and accuracy of the reports of suspected adverse drug reactions is important in pharmacovigilance. The aim of the present study was to analyze the quality of the information included in the reports sent to the Pharmacovigilance Centre of São Paulo (Brazil). A sample of 999 reports received from January 2013 to December 2014 was selected. The quality of the filled information was evaluated according to a 'sufficiency' criterion to apply the Karch-Lasagna causality algorithm. There were 820 reports from manufacturers and 179 from health centres. Only 4.4% (44) were fully filled, thus allowing the adequate analysis of the causal relationship between the suspected medication and the adverse event. In 30% of the reports from manufacturers, the information about the critical variables was lacking or incomplete, preventing the adequate evaluation of the report. It was also noted that the reports' poor filling quality was not related with less severity or with old and well-known medicines. The poor quality of the information included in the reports received by this centre, especially those sent by pharmaceutical manufacturers, hampers the identification of potential safety signals. Measures to improve the quality of the reports must be urgently adopted.

Effects of Rhinophototherapy on Quality of Life in Persistant Allergic Rhinitis

PubMed Central

Korkmaz, Hakan; Sürenoğlu, Ünzile Akpinar; Saylam, Güleser; Özdek, Ali

2013-01-01

Objectives To investigate the effect of rhinophototherapy with medical therapy on quality of life in persistent allergic rhinitis. Methods A prospective, randomized study was being performed between December 2009 and March 2010. The study included 65 patients with persistent allergic rhinitis. The diagnosis was confirmed with positive skin tests. All of the patients had house dust mite allergies. We divided the patients into two groups. First group (n=33) was given topical mometasone furoate 200 mcg/day and levocetirizine 5 mg/day for a month. Rhinophototherapy was applied with the same medical therapy to the second group (n=32), twice a week for three weeks continuously. Rhinophototherapy included visible light, ultraviolet A and ultraviolet B. We evaluated patients before the treatment, at the first month and at the third month after treatment with rhinoconjunctivitis quality of life questionnaire, nasal symptom scores and visual analogue scale (VAS) scores. Results Improvements of all variables of the quality of life questionnaire, nasal symptom scores and VAS were statistically significant in the second group both on the first and the third months when compared with the first group. Conclusion Allergic rhinitis is a social problem and impairs quality of life. Rhinophototherapy with medical therapy improves the quality of life in allergic rhinitis. PMID:23799163

The Asthma Mobile Health Study, a large-scale clinical observational study using ResearchKit.

PubMed

Chan, Yu-Feng Yvonne; Wang, Pei; Rogers, Linda; Tignor, Nicole; Zweig, Micol; Hershman, Steven G; Genes, Nicholas; Scott, Erick R; Krock, Eric; Badgeley, Marcus; Edgar, Ron; Violante, Samantha; Wright, Rosalind; Powell, Charles A; Dudley, Joel T; Schadt, Eric E

2017-04-01

The feasibility of using mobile health applications to conduct observational clinical studies requires rigorous validation. Here, we report initial findings from the Asthma Mobile Health Study, a research study, including recruitment, consent, and enrollment, conducted entirely remotely by smartphone. We achieved secure bidirectional data flow between investigators and 7,593 participants from across the United States, including many with severe asthma. Our platform enabled prospective collection of longitudinal, multidimensional data (e.g., surveys, devices, geolocation, and air quality) in a subset of users over the 6-month study period. Consistent trending and correlation of interrelated variables support the quality of data obtained via this method. We detected increased reporting of asthma symptoms in regions affected by heat, pollen, and wildfires. Potential challenges with this technology include selection bias, low retention rates, reporting bias, and data security. These issues require attention to realize the full potential of mobile platforms in research and patient care.

Quality of life as a cancer nursing outcome variable.

PubMed

Padilla, G V; Grant, M M

1985-10-01

A reliable and valid multidimensional instrument for measuring quality of life in cancer patients has been developed. Furthermore, a model has been offered that describes how quality of life works as an outcome variable. Using this model, predictions were made of how nursing interventions may directly or indirectly impact on quality of life. Initial testing of the model using data from 135 colostomy patients showed how satisfaction with nursing care and personal control act as cognitive mediators of self-worth, which then impacts on dimensions of quality of life.

The University of Texas Houston Stroke Registry (UTHSR): implementation of enhanced data quality assurance procedures improves data quality

PubMed Central

2013-01-01

Background Limited information has been published regarding standard quality assurance (QA) procedures for stroke registries. We share our experience regarding the establishment of enhanced QA procedures for the University of Texas Houston Stroke Registry (UTHSR) and evaluate whether these QA procedures have improved data quality in UTHSR. Methods All 5093 patient records that were abstracted and entered in UTHSR, between January 1, 2008 and December 31, 2011, were considered in this study. We conducted reliability and validity studies. For reliability and validity of data captured by abstractors, a random subset of 30 records was used for re-abstraction of select key variables by two abstractors. These 30 records were re-abstracted by a team of experts that included a vascular neurologist clinician as the “gold standard”. We assessed inter-rater reliability (IRR) between the two abstractors as well as validity of each abstractor with the “gold standard”. Depending on the scale of variables, IRR was assessed with Kappa or intra-class correlations (ICC) using a 2-way, random effects ANOVA. For assessment of validity of data in UTHSR we re-abstracted another set of 85 patient records for which all discrepant entries were adjudicated by a vascular neurology fellow clinician and added to the set of our “gold standard”. We assessed level of agreement between the registry data and the “gold standard” as well as sensitivity and specificity. We used logistic regression to compare error rates for different years to assess whether a significant improvement in data quality has been achieved during 2008–2011. Results The error rate dropped significantly, from 4.8% in 2008 to 2.2% in 2011 (P < 0.001). The two abstractors had an excellent IRR (Kappa or ICC ≥ 0.75) on almost all key variables checked. Agreement between data in UTHSR and the “gold standard” was excellent for almost all categorical and continuous variables. Conclusions Establishment of a rigorous data quality assurance for our UTHSR has helped to improve the validity of data. We observed an excellent IRR between the two abstractors. We recommend training of chart abstractors and systematic assessment of IRR between abstractors and validity of the abstracted data in stroke registries. PMID:23767957

Simulating ensembles of source water quality using a K-nearest neighbor resampling approach.

PubMed

Towler, Erin; Rajagopalan, Balaji; Seidel, Chad; Summers, R Scott

2009-03-01

Climatological, geological, and water management factors can cause significant variability in surface water quality. As drinking water quality standards become more stringent, the ability to quantify the variability of source water quality becomes more important for decision-making and planning in water treatment for regulatory compliance. However, paucity of long-term water quality data makes it challenging to apply traditional simulation techniques. To overcome this limitation, we have developed and applied a robust nonparametric K-nearest neighbor (K-nn) bootstrap approach utilizing the United States Environmental Protection Agency's Information Collection Rule (ICR) data. In this technique, first an appropriate "feature vector" is formed from the best available explanatory variables. The nearest neighbors to the feature vector are identified from the ICR data and are resampled using a weight function. Repetition of this results in water quality ensembles, and consequently the distribution and the quantification of the variability. The main strengths of the approach are its flexibility, simplicity, and the ability to use a large amount of spatial data with limited temporal extent to provide water quality ensembles for any given location. We demonstrate this approach by applying it to simulate monthly ensembles of total organic carbon for two utilities in the U.S. with very different watersheds and to alkalinity and bromide at two other U.S. utilities.

Operator- and software-related post-experimental variability and source of error in 2-DE analysis.

PubMed

Millioni, Renato; Puricelli, Lucia; Sbrignadello, Stefano; Iori, Elisabetta; Murphy, Ellen; Tessari, Paolo

2012-05-01

In the field of proteomics, several approaches have been developed for separating proteins and analyzing their differential relative abundance. One of the oldest, yet still widely used, is 2-DE. Despite the continuous advance of new methods, which are less demanding from a technical standpoint, 2-DE is still compelling and has a lot of potential for improvement. The overall variability which affects 2-DE includes biological, experimental, and post-experimental (software-related) variance. It is important to highlight how much of the total variability of this technique is due to post-experimental variability, which, so far, has been largely neglected. In this short review, we have focused on this topic and explained that post-experimental variability and source of error can be further divided into those which are software-dependent and those which are operator-dependent. We discuss these issues in detail, offering suggestions for reducing errors that may affect the quality of results, summarizing the advantages and drawbacks of each approach.

Development of a design space and predictive statistical model for capsule filling of low-fill-weight inhalation products.

PubMed

Faulhammer, E; Llusa, M; Wahl, P R; Paudel, A; Lawrence, S; Biserni, S; Calzolari, V; Khinast, J G

2016-01-01

The objectives of this study were to develop a predictive statistical model for low-fill-weight capsule filling of inhalation products with dosator nozzles via the quality by design (QbD) approach and based on that to create refined models that include quadratic terms for significant parameters. Various controllable process parameters and uncontrolled material attributes of 12 powders were initially screened using a linear model with partial least square (PLS) regression to determine their effect on the critical quality attributes (CQA; fill weight and weight variability). After identifying critical material attributes (CMAs) and critical process parameters (CPPs) that influenced the CQA, model refinement was performed to study if interactions or quadratic terms influence the model. Based on the assessment of the effects of the CPPs and CMAs on fill weight and weight variability for low-fill-weight inhalation products, we developed an excellent linear predictive model for fill weight (R(2 )= 0.96, Q(2 )= 0.96 for powders with good flow properties and R(2 )= 0.94, Q(2 )= 0.93 for cohesive powders) and a model that provides a good approximation of the fill weight variability for each powder group. We validated the model, established a design space for the performance of different types of inhalation grade lactose on low-fill weight capsule filling and successfully used the CMAs and CPPs to predict fill weight of powders that were not included in the development set.

State estimation and prediction using clustered particle filters.

PubMed

Lee, Yoonsang; Majda, Andrew J

2016-12-20

Particle filtering is an essential tool to improve uncertain model predictions by incorporating noisy observational data from complex systems including non-Gaussian features. A class of particle filters, clustered particle filters, is introduced for high-dimensional nonlinear systems, which uses relatively few particles compared with the standard particle filter. The clustered particle filter captures non-Gaussian features of the true signal, which are typical in complex nonlinear dynamical systems such as geophysical systems. The method is also robust in the difficult regime of high-quality sparse and infrequent observations. The key features of the clustered particle filtering are coarse-grained localization through the clustering of the state variables and particle adjustment to stabilize the method; each observation affects only neighbor state variables through clustering and particles are adjusted to prevent particle collapse due to high-quality observations. The clustered particle filter is tested for the 40-dimensional Lorenz 96 model with several dynamical regimes including strongly non-Gaussian statistics. The clustered particle filter shows robust skill in both achieving accurate filter results and capturing non-Gaussian statistics of the true signal. It is further extended to multiscale data assimilation, which provides the large-scale estimation by combining a cheap reduced-order forecast model and mixed observations of the large- and small-scale variables. This approach enables the use of a larger number of particles due to the computational savings in the forecast model. The multiscale clustered particle filter is tested for one-dimensional dispersive wave turbulence using a forecast model with model errors.

The impact of forced displacement in World War II on mental health disorders and health-related quality of life in late life - a German population-based study.

PubMed

Freitag, Simone; Braehler, Elmar; Schmidt, Silke; Glaesmer, Heide

2013-02-01

Long-term effects of World War II experiences affect psychological and physical health in aged adults. Forced displacement as a traumatic event is associated with increased psychological burden even after several decades. This study investigates the contribution of forced displacement as a predictor for mental health disorders and adds the aspect of health-related quality of life (QoL). A sample of 1,659 German older adults aged 60-85 years was drawn from a representative survey. Post-traumatic stress disorder (PTSD), somatoform symptoms, depressive syndromes, and health-related QoL were assessed as outcome variables. Chi-square and t-test statistics examined differences between displaced and non-displaced people. Logistic regression analyses were performed to examine the impact of forced displacement on mental health disorders and QoL. Displaced people reported higher levels of PTSD, depressive and somatoform symptoms, and lower levels of health-related QoL. Displacement significantly predicted PTSD and somatoform symptoms in late life, but not depressive disorders. Health-related QoL was predicted by forced displacement and socio-demographic variables. Forced displacement is associated with an elevated risk for PTSD and somatoform symptoms and lowered health-related QoL in aged adults. Its unique impact declines after including socio-demographic variables. Long-term consequences of forced displacement need further investigations and should include positive aspects in terms of resilience and protective coping strategies.

Effects of electrical stimulus composition on cardiac electrophysiology in a rodent model of electroconvulsive therapy.

PubMed

Singh, Nagendra Madan; Sathyaprabha, T N; Thirthalli, Jagadisha; Andrade, Chittaranjan

2018-01-01

No electroconvulsive therapy (ECT) study on humans or in animal models has so far examined whether differently composed electrical stimuli exert different cardiac electrophysiological effects at constant electrical dose. The subject is important because cardiac electrophysiological changes may provide indirect information about ECT seizure quality as modulated by stimulus composition. Adult female Wistar rats ( n = 20/group) received fixed, moderately suprathreshold (18 mC) electrical stimuli. This stimulus in each of eight groups was formed by varying pulse amplitude, pulse width, pulse frequency, and stimulus duration. The electrocardiogram was recorded, and time and frequency domain variables were examined in 30 s epochs in preictal (30 s before electroconvulsive shock [ECS]), early postictal (starting 15 s after stimulation), and late postictal (5 h after ECS) periods. Alpha for statistical significance was set at P < 0.01 to adjust for multiple hypothesis testing. Cardiac electrophysiological indices in the eight groups did not differ significantly at baseline. At both early and late postictal time points, almost no analysis yielded statistically significant differences between groups for four time domain variables, including heart rate and standard deviation of R-R intervals, and for six frequency domain variables, including low-frequency power, high-frequency power, and total power. Cardiac electrophysiological measures may not be helpful to identify differences in seizure quality that are driven by differences in the composition of electrical stimuli at constant, moderately suprathreshold electrical dose. The generalization of this conclusion to threshold electrical doses and to human contexts requires a study.

[Mental Health Determines the Quality of Life in Patients With Cancer-Related Neuropathic Pain in Quito, Ecuador].

PubMed

Gordillo Altamirano, Fernando; Fierro Torres, María José; Cevallos Salas, Nelson; Cervantes Vélez, María Cristina

To identify the main factors determining the health related quality of life (HRQL) in patients with cancer-related neuropathic pain in a tertiary care hospital. A cross-sectional analytical study was performed on a sample of 237 patients meeting criteria for cancer-related neuropathic pain. Clinical and demographic variables were recorded including, cancer type, stage, time since diagnosis, pain intensity, physical functionality with the Palliative Performance Scale (PPS), and anxiety and depression with the Hospital Anxiety and Depression Scale (HADS). Their respective correlation coefficients (r) with HRQL assessed with the SF-36v2 Questionnaire were then calculated. Linear regression equations were then constructed with the variables that showed an r≥.5 with the HRQL. The HRQL scores of the sample were 39.3±9.1 (Physical Component) and 45.5±13.8 (Mental Component). Anxiety and depression strongly correlated with the mental component (r=-.641 and r=-.741, respectively) while PPS score correlated with the physical component (r=.617). The linear regression model that better explained the variance of the mental component was designed combining the Anxiety and Depression variables (R=77.3%; P<.001). The strong influence of psychiatric comorbidity on the HRQL of patients with cancer-related neuropathic pain makes an integral management plan essential for these patients to include interventions for its timely diagnosis and treatment. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

State estimation and prediction using clustered particle filters

PubMed Central

Lee, Yoonsang; Majda, Andrew J.

2016-01-01

Particle filtering is an essential tool to improve uncertain model predictions by incorporating noisy observational data from complex systems including non-Gaussian features. A class of particle filters, clustered particle filters, is introduced for high-dimensional nonlinear systems, which uses relatively few particles compared with the standard particle filter. The clustered particle filter captures non-Gaussian features of the true signal, which are typical in complex nonlinear dynamical systems such as geophysical systems. The method is also robust in the difficult regime of high-quality sparse and infrequent observations. The key features of the clustered particle filtering are coarse-grained localization through the clustering of the state variables and particle adjustment to stabilize the method; each observation affects only neighbor state variables through clustering and particles are adjusted to prevent particle collapse due to high-quality observations. The clustered particle filter is tested for the 40-dimensional Lorenz 96 model with several dynamical regimes including strongly non-Gaussian statistics. The clustered particle filter shows robust skill in both achieving accurate filter results and capturing non-Gaussian statistics of the true signal. It is further extended to multiscale data assimilation, which provides the large-scale estimation by combining a cheap reduced-order forecast model and mixed observations of the large- and small-scale variables. This approach enables the use of a larger number of particles due to the computational savings in the forecast model. The multiscale clustered particle filter is tested for one-dimensional dispersive wave turbulence using a forecast model with model errors. PMID:27930332

[Randomised study of the relationship between the use of CPRmeter® device and the quality of chest compressions in a simulated cardiopulmonary resuscitation].

PubMed

Calvo-Buey, J A; Calvo-Marcos, D; Marcos-Camina, R M

2016-01-01

To determine whether the use of CPRmeter(®) during the resuscitation manoeuvres, is related to a higher quality of external cardiac massage, as recommended by the International Liaison Committee on Resuscitation (ILCOR). To compare the quality obtained without the use or this, and whether there are differences related to anthropometric, demographic, professional and/or occupational factors. Experimental, open trial performed with life support simulators in a stratified random sample of 88 health workers randomly distributed between groups A (without indications of the device) and B (with them). The homogeneity of their confounding variables was compared, as well as the compressions depth and compressions rate, the proportion of completed release, and distribution of the quality massage variable (according to criteria ILCOR) between the groups. The qualitative variables were analysed with the chi-square test, and quantitative variables with the Student t-test or Mann-Whitney U-test and the association between the variable quality massage variable, and use of the device with the odds ratio. Group A: mean depth 42.1mm (standard deviation 10.1), mean rate 121.3/min (21.6), percentage of complete release 71.2% (36.9). Group B: 51.2mm (5.9) 111.9/min (6.4), 92.9% (10.1) respectively. Odds ratio for quality massage regarding the use of the device was 5.170 (95% CI; 2.060-12.977). The use of CPRmeter(®) device in simulated resuscitations is related to a higher quality of cardiac massage, improving the approach to the ILCOR recommendations, regardless of the characteristics of the participants. They were 83.8% more likely to achieve a quality massage using the device than without it. Copyright © 2015 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

The variation in quality and content of patient-focused health information on the Internet for otitis media.

PubMed

Joury, A; Joraid, A; Alqahtani, F; Alghamdi, A; Batwa, A; Pines, J M

2018-03-01

When symptoms of otitis media appear, parents and patients often access the Internet for health information. We study the content and quality of health information in parent-patient-focused websites for otitis media. We searched the 3 search engines (Google, Yahoo, and Bing) using "otitis media" and "middle ear infection" then reviewed the top 30 hits for each search. We included sites that were focused on providing patient-patient information about otitis media. A variety of instruments were used to assess website content and quality. In 35 included websites, there was considerable variation in content, with the average site having 11 out of 15 informational items potentially useful to parents and patients on otitis media (range 4-15). Across included websites, the mean DISCERN score was 47 out of 80 (low to medium quality), 16 (46%) were HONcode certified, and 8 (23%) fulfilled all the JAMA benchmark criteria. The average website was written at a 9th/10th-grade reading level. The content and quality of health information for otitis media in parent-and-patient-focused websites is highly variable. Although easy-to-read, high-quality websites with complete content are available, the average website sites is difficult to read without a high school education and is difficult to use. Consideration should be given to adopting a standard approach for presenting disease-specific information to parents and patients. © 2017 John Wiley & Sons Ltd.

Spatio-Temporal Trends and Identification of Correlated Variables with Water Quality for Drinking-Water Reservoirs

PubMed Central

Gu, Qing; Wang, Ke; Li, Jiadan; Ma, Ligang; Deng, Jinsong; Zheng, Kefeng; Zhang, Xiaobin; Sheng, Li

2015-01-01

It is widely accepted that characterizing the spatio-temporal trends of water quality parameters and identifying correlated variables with water quality are indispensable for the management and protection of water resources. In this study, cluster analysis was used to classify 56 typical drinking water reservoirs in Zhejiang Province into three groups representing different water quality levels, using data of four water quality parameters for the period 2006–2010. Then, the spatio-temporal trends in water quality were analyzed, assisted by geographic information systems (GIS) technology and statistical analysis. The results indicated that the water quality showed a trend of degradation from southwest to northeast, and the overall water quality level was exacerbated during the study period. Correlation analysis was used to evaluate the relationships between water quality parameters and ten independent variables grouped into four categories (land use, socio-economic factors, geographical features, and reservoir attributes). According to the correlation coefficients, land use and socio-economic indicators were identified as the most significant factors related to reservoir water quality. The results offer insights into the spatio-temporal variations of water quality parameters and factors impacting the water quality of drinking water reservoirs in Zhejiang Province, and they could assist managers in making effective strategies to better protect water resources. PMID:26492263

Spatio-Temporal Trends and Identification of Correlated Variables with Water Quality for Drinking-Water Reservoirs.

PubMed

Gu, Qing; Wang, Ke; Li, Jiadan; Ma, Ligang; Deng, Jinsong; Zheng, Kefeng; Zhang, Xiaobin; Sheng, Li

2015-10-20

It is widely accepted that characterizing the spatio-temporal trends of water quality parameters and identifying correlated variables with water quality are indispensable for the management and protection of water resources. In this study, cluster analysis was used to classify 56 typical drinking water reservoirs in Zhejiang Province into three groups representing different water quality levels, using data of four water quality parameters for the period 2006-2010. Then, the spatio-temporal trends in water quality were analyzed, assisted by geographic information systems (GIS) technology and statistical analysis. The results indicated that the water quality showed a trend of degradation from southwest to northeast, and the overall water quality level was exacerbated during the study period. Correlation analysis was used to evaluate the relationships between water quality parameters and ten independent variables grouped into four categories (land use, socio-economic factors, geographical features, and reservoir attributes). According to the correlation coefficients, land use and socio-economic indicators were identified as the most significant factors related to reservoir water quality. The results offer insights into the spatio-temporal variations of water quality parameters and factors impacting the water quality of drinking water reservoirs in Zhejiang Province, and they could assist managers in making effective strategies to better protect water resources.

A comprehensive strategy in the development of a cyclodextrin-modified microemulsion electrokinetic chromatographic method for the assay of diclofenac and its impurities: Mixture-process variable experiments and quality by design.

PubMed

Orlandini, S; Pasquini, B; Caprini, C; Del Bubba, M; Squarcialupi, L; Colotta, V; Furlanetto, S

2016-09-30

A comprehensive strategy involving the use of mixture-process variable (MPV) approach and Quality by Design principles has been applied in the development of a capillary electrophoresis method for the simultaneous determination of the anti-inflammatory drug diclofenac and its five related substances. The selected operative mode consisted in microemulsion electrokinetic chromatography with the addition of methyl-β-cyclodextrin. The critical process parameters included both the mixture components (MCs) of the microemulsion and the process variables (PVs). The MPV approach allowed the simultaneous investigation of the effects of MCs and PVs on the critical resolution between diclofenac and its 2-deschloro-2-bromo analogue and on analysis time. MPV experiments were used both in the screening phase and in the Response Surface Methodology, making it possible to draw MCs and PVs contour plots and to find important interactions between MCs and PVs. Robustness testing was carried out by MPV experiments and validation was performed following International Conference on Harmonisation guidelines. The method was applied to a real sample of diclofenac gastro-resistant tablets. Copyright © 2016 Elsevier B.V. All rights reserved.

Water-quality observations of the San Antonio segment of the Edwards aquifer, Texas, with an emphasis on processes influencing nutrient and pesticide geochemistry and factors affecting aquifer vulnerability, 2010–16

USGS Publications Warehouse

Opsahl, Stephen P.; Musgrove, MaryLynn; Mahler, Barbara J.; Lambert, Rebecca B.

2018-06-07

As questions regarding the influence of increasing urbanization on water quality in the Edwards aquifer are raised, a better understanding of the sources, fate, and transport of compounds of concern in the aquifer—in particular, nutrients and pesticides—is needed to improve water management decision-making capabilities. The U.S. Geological Survey, in cooperation with the San Antonio Water System, performed a study from 2010 to 2016 to better understand how water quality changes under a range of hydrologic conditions and in contrasting land-cover settings (rural and urban) in the Edwards aquifer. The study design included continuous hydrologic monitoring, continuous water-quality monitoring, and discrete sample collection for a detailed characterization of water quality at a network of sites throughout the aquifer system. The sites were selected to encompass a “source-to-sink” (that is, from aquifer recharge to aquifer discharge) approach. Network sites were selected to characterize rainfall, recharging surface water, and groundwater; groundwater sites included wells in the unconfined part of the aquifer (unconfined wells) and in the confined part of the aquifer (confined wells) and a major discharging spring. Storm-related samples—including rainfall samples, stormwater-runoff (surface-water) samples, and groundwater samples—were collected to characterize the aquifer response to recharge.Elevated nitrate concentrations relative to national background values and the widespread detection of pesticides indicate that the Edwards aquifer is vulnerable to contamination and that vulnerability is affected by factors such as land cover, aquifer hydrogeology, and changes in hydrologic conditions. Greater vulnerability of groundwater in urban areas relative to rural areas was evident from results for urban groundwater sites, which generally had higher nitrate concentrations, elevated δ15N-nitrate values, a greater diversity of pesticides, and higher pesticide concentrations. The continuum of water quality from unconfined rural groundwater sites (least affected by anthropogenic contamination) to unconfined urban groundwater sites (most affected by anthropogenic contamination) demonstrates enhanced vulnerability of urban versus rural land cover. Differences in contaminant occurrences and concentration among unconfined urban wells indicate that the urban parts of the aquifer are not uniformly vulnerable, but rather are affected by spatial differences in the sources of nutrients and pesticides. In urban areas, the shallow, unconfined groundwater sites showed greater temporal variability in both nutrient and pesticide concentrations, as well as a greater degree of contamination, than did deeper, confined groundwater sites. In comparison to that of the shallow, unconfined groundwater sites, the water quality of the deeper, confined groundwater sites was relatively invariant during this multiyear study. Although aquifer hydrogeology is an important factor related to aquifer vulnerability, land cover likely has a greater influence on pesticide contamination of groundwater. Temporal variability in hydrologic conditions for the Edwards aquifer is apparent in data for surface water as a source of groundwater recharge, water-level altitude in wells, spring discharge, and groundwater quality. This temporal variability affects recharge sources, recharge amounts, groundwater traveltimes, flow routing, water-rock interaction processes, dilution, mixing, and, in turn, water quality. Relations of land cover, aquifer hydrogeology, and changing hydrologic conditions to water quality are complex but provide insight into the vulnerability of Edwards aquifer groundwater—a vital drinking-water resource.

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

NASA Astrophysics Data System (ADS)

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

2017-03-01

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

Gender Differences in Sleep Disruption and Fatigue on Quality of Life Among Persons with Ostomies

PubMed Central

Baldwin, Carol M.; Grant, Marcia; Wendel, Christopher; Hornbrook, Mark C.; Herrinton, Lisa J.; McMullen, Carmit; Krouse, Robert S.

2009-01-01

Study Objectives: The aim of this study is to examine differences in sleep disruption and fatigue of men and women colorectal cancer (CRC) survivors with intestinal ostomies and associated health-related quality of life (HR-QOL). Methods: Participants in this cross-sectional study of long-term (> 5 years) CRC survivors received care at Kaiser Permanente. Measures included the City of Hope QOL Ostomy questionnaire with narrative comments for ostomy-related “greatest challenges.” The Short Form-36 Version 2 (SF-36v2) health survey provided physical (PCS) and mental composite scale (MCS) scores to examine generic HR-QOL. The “sleep disruption” and “fatigue” items from the ostomy questionnaire (scale from 0 to 10 with higher scores indicating better HR-QOL) were dependent variables, while independent variables included age, ethnicity, education, partnered status, body mass index, and time since surgery. Data were analyzed using chi-square for nominal variables, Student t-tests for continuous variables, and logistic regression with significance set at p < 0.05. Results: On the ostomy-specific measure, women (n = 118) compared to men (n = 168) reported more sleep disruption (p < 0.01), adjusted for age, and greater levels of fatigue (p < 0.01), adjusted for time since surgery. Women's PCS and MCS scores indicated poorer HR-QOL compared to men, and differences were clinically meaningful. Qualitative narrative comments suggested that sleep disruption could stem from ostomy-associated fear of or actual leakage during sleep. Conclusion: Although women CRC survivors with ostomies report more sleep disruption and fatigue, which is reflected in their reduced physical and mental health scores on the SF-36v2 compared to men with ostomies, their stated reasons for disrupted sleep are similar to their male counterparts. These findings can provide a foundation for gender-relevant ostomy interventions to improve sleep and HR-QOL in this patient population. Citation: Baldwin CM; Grant M; Wendel C; Hornbrook MC; Herrinton LJ; McMullen C; Krouse RS. Gender Differences in Sleep Disruption and Fatigue on Quality of Life Among Persons with Ostomies. J Clin Sleep Med 2009;5(4):335-343. PMID:19968011

Measurement of the M² beam propagation factor using a focus-tunable liquid lens.

PubMed

Niederriter, Robert D; Gopinath, Juliet T; Siemens, Mark E

2013-03-10

We demonstrate motion-free beam quality M² measurements of stigmatic, simple astigmatic, and general astigmatic (twisted) beams using only a focus-tunable liquid lens and a CCD camera. We extend the variable-focus technique to the characterization of general astigmatic beams by measuring the 10 second-order moments of the power density distribution for the twisted beam produced by passage through multimode optical fiber. Our method measures the same M² values as the traditional variable-distance method for a wide range of laser beam sources, including nearly TEM(00) (M²≈1) and general astigmatic multimode beams (M²≈8). The method is simple and compact, with no moving parts or complex apparatus and measurement precision comparable to the standard variable-distance method.

Factors associated with the Journal Impact Factor (JIF) for Urology and Nephrology Journals

PubMed Central

Sewell, Joseph M.; Adejoro, Oluwakayode O.; Fleck, Joseph R.; Wolfson, Julian A.; Konety, Badrinath R.

2015-01-01

ABSTRACT Purpose: The Journal Impact Factor (JIF) is an index used to compare a journal's quality among academic journals and it is commonly used as a proxy for journal quality. We sought to examine the JIF in order to elucidate the main predictors of the index while generating awareness among scientific community regarding need to modify the index calculation in the attempt to turn it more accurate. Materials and Methods: Under the Urology and Nephrology category in the Journal Citations Report Website, the top 17 Journals by JIF in 2011 were chosen for the study. All manuscripts’ abstracts published from 2009-2010 were reviewed; each article was categorized based on its research design (Retrospective, Review, etc). T and correlation tests were performed for categorical and continuous variables respectively. The JIF was the dependent variable. All variables were then included in a multivariate model. Results: 23,012 articles from seventeen journals were evaluated with a median of 1,048 (range=78-6,342) articles per journal. Journals with a society affiliation were associated with a higher JIF (p=0.05). Self-citations (rho=0.57, p=0.02), citations for citable articles (rho=0.73, p=0.001), citations to non-citable articles (rho=0.65, p=0.0046), and retrospective studies (rho=-0.51, p=0.03) showed a strong correlation. Slight modifications to include the non-citable articles in the denominator yield drastic changes in the JIF and the ranking of the journals. Conclusion: The JIF appears to be closely associated with the number of citable articles published. A change in the formula for calculating JIF to include all types of published articles in the denominator would result in a more accurate representation. PMID:26742962

A pilot study of yoga for breast cancer survivors: physical and psychological benefits.

PubMed

Culos-Reed, S Nicole; Carlson, Linda E; Daroux, Lisa M; Hately-Aldous, Susi

2006-10-01

Physical activity provides a number of physical and psychological benefits to cancer survivors, including lessening the impact of detrimental cancer-related symptoms and treatment side-effects (e.g. fatigue, nausea), and improving overall well-being and quality of life. The purpose of the present pilot study was to examine the physical and psychological benefits afforded by a 7-week yoga program for cancer survivors. Eligible participants (per-screened with PAR-Q/PAR-MED-X) were randomly assigned to either the intervention (n=20) or control group (n=18). All participants completed pre- and post-testing assessments immediately before and after the yoga program, respectively. The yoga program participants (M age=51.18 (10.33); 92% female) included primarily breast cancer survivors, on average 55.95 (54.39) months post-diagnosis. Significant differences between the intervention and the control group at post-intervention were seen only in psychosocial (i.e. global quality of life, emotional function, and diarrhea) variables (all p's <0.05). There were also trends for group differences, in the hypothesized directions, for the psychosocial variables of emotional irritability, gastrointestinal symptoms, cognitive disorganization, mood disturbance, tension, depression, and confusion (all p's <0.10). Finally, there were also significant improvements in both the program participants and the controls from pre- to post-intervention on a number of physical fitness variables. These initial findings suggest that yoga has significant potential and should be further explored as a beneficial physical activity option for cancer survivors. Future research might attempt to include a broader range of participants (e.g. other types of cancer diagnoses, male subjects), a larger sample size, and a longer program duration in an RCT.

Integrative medicine for chronic pain: A cohort study using a process-outcome design in the context of a department for internal and integrative medicine.

PubMed

Saha, Felix J; Brüning, Alexander; Barcelona, Cyrus; Büssing, Arndt; Langhorst, Jost; Dobos, Gustav; Lauche, Romy; Cramer, Holger

2016-07-01

Integrative medicine inpatient treatment has been shown to improve physical and mental health in patients with internal medicine conditions. The aim of this study was to investigate the effectiveness of a 2-week integrative medicine inpatient treatment in patients with chronic pain syndromes and the association of treatment success with patient-related process variables. Inpatients with chronic pain syndromes participating in a 2-week integrative medicine inpatient program were included. Patients' pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were measured on admission, discharge, and 6 months after discharge. Likewise process variables including ability and will to change, emotional/rational disease acceptance, mindfulness, life and health satisfaction, and easiness of life were assessed. A total of 310 inpatients (91% female, mean age 50.7 ± 12.4 year, 26.5% low back pain, and 22.9% fibromyalgia) were included. Using mixed linear models, significant improvements in pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were found (all P < 0.05). Ability to change and implementation, disease acceptance, mindfulness, life and health satisfaction, and light heartedness/easiness likewise improved (all P < 0.05). Improved outcomes were associated with increases in process variables, mainly ability to change and implementation, disease acceptance, life and health satisfaction, and light heartedness/easiness (R = 0.03-0.40). Results of this study suggest that a 2-week integrative medicine inpatient treatment can benefit patients with chronic pain conditions. Functional improvements are associated with improved ability to change and implementation, disease acceptance, and satisfaction.

Quality of life in children with adverse drug reactions: a narrative and systematic review.

PubMed

Del Pozzo-Magaña, Blanca R; Rieder, Michael J; Lazo-Langner, Alejandro

2015-10-01

Adverse drug reactions are a common problem affecting adults and children. The economic impact of the adverse drug reactions has been widely evaluated; however, studies of the impact on the quality of life of children with adverse drug reactions are scarce. The aim was to evaluate studies assessing the health-related quality of life of children with adverse drug reactions. We conducted a systematic review that included the following electronic databases: MEDLINE, EMBASE and the Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Cochrane Controlled Trials Register and the Health Technology Assessment Databases). Nine studies were included. Four of the studies were conducted in children with epilepsy; the rest of them involved children with chronic viral hepatitis, Crohn's disease, paediatric cancer and multiple adverse drug reactions compared with healthy children. Based on their findings, authors of all studies concluded that adverse drug reactions had a negative impact on the quality of life of children. No meta-analysis was conducted given the heterogeneous nature of the studies. To date, there is no specific instrument that measures quality of life of children with adverse drug reactions, and the information available is poor and variable. In general, adverse drug reactions have a negative impact on the quality of life of affected children. For those interested in this area, more work needs to be done to improve tools that help to evaluate efficiently the health-related quality of life of children with adverse drug reactions and chronic diseases. © 2014 The British Pharmacological Society.

Quality of life in children with adverse drug reactions: a narrative and systematic review

PubMed Central

Del Pozzo-Magaña, Blanca R; Rieder, Michael J; Lazo-Langner, Alejandro

2015-01-01

Aims Adverse drug reactions are a common problem affecting adults and children. The economic impact of the adverse drug reactions has been widely evaluated; however, studies of the impact on the quality of life of children with adverse drug reactions are scarce. The aim was to evaluate studies assessing the health-related quality of life of children with adverse drug reactions. Methods We conducted a systematic review that included the following electronic databases: MEDLINE, EMBASE and the Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Cochrane Controlled Trials Register and the Health Technology Assessment Databases). Results Nine studies were included. Four of the studies were conducted in children with epilepsy; the rest of them involved children with chronic viral hepatitis, Crohn’s disease, paediatric cancer and multiple adverse drug reactions compared with healthy children. Based on their findings, authors of all studies concluded that adverse drug reactions had a negative impact on the quality of life of children. No meta-analysis was conducted given the heterogeneous nature of the studies. Conclusions To date, there is no specific instrument that measures quality of life of children with adverse drug reactions, and the information available is poor and variable. In general, adverse drug reactions have a negative impact on the quality of life of affected children. For those interested in this area, more work needs to be done to improve tools that help to evaluate efficiently the health-related quality of life of children with adverse drug reactions and chronic diseases. PMID:24833305

Relation of stream quality to streamflow, and estimated loads of selected water-quality constituents in the James and Rappahannock rivers near the fall line of Virginia, July 1988 through June 1990

USGS Publications Warehouse

Belval, D.L.; Campbell, J.P.; Woodside, M.D.

1994-01-01

This report presents the results of a study by the U.S. Geological Survey, in cooperation with the Virginia Department of Environmental Quality-- Division of Intergovernmental Coordination to monitor and estimate loads of selected nutrients and suspended solids discharged to Chesapeake Bay from two major tributaries in Virginia. From July 1988 through June 1990, monitoring consisted of collecting depth-integrated, cross-sectional samples from the James and Rappahannock Rivers during storm- flow conditions and at scheduled intervals. Water- quality constituents that were monitored included total suspended solids (residue, total at 105 degrees Celsius), dissolved nitrite plus nitrate, dissolved ammonia, total Kjeldahl nitrogen (ammonia plus organic), total nitrogen, total phosphorus, dissolved orthopohosphorus, total organic carbon, and dissolved silica. Daily mean load estimates of each constituent were computed by month, using a seven-parameter log-linear-regression model that uses variables of time, discharge, and seasonality. Water-quality data and constituent- load estimates are included in the report in tabular and graphic form. The data and load estimates provided in this report will be used to calibrate the computer modeling efforts of the Chesapeake Bay region, evaluate the water quality of the Bay and the major effects on the water quality, and assess the results of best-management practices in Virginia.

Quality differentials and reproductive health service utilisation determinants in India.

PubMed

Anand, Sandip; Sinha, R K

2010-01-01

This paper seeks to establish relationships between women's reproductive health service use, assessed longitudinally and by facility type, with service quality perceptions related to public or private health facilities. The study was mainly secondary and quantitative in nature. It included analysing data collected by the International Institute for Population Sciences (IIPS) and The Johns Hopkins University (JHU) as a follow-up study to the 1998-1999 National Family Health Survey (NFHS-2). The follow-up survey was carried out in Tamil Nadu, Maharashtra, Bihar and Jharkhand. In 2002-2003, these four states were selected to capture socio-economic and demographic variations. Analysis includes composite indices and logistic regression analysis. A scale was constructed to measure utilisation levels. Dimensions include: service proximity, doctor availability, waiting time, medicines, facility cleanliness, dignified treatment, privacy, service affordability and treatment effectiveness. Findings indicate that doctor availability, waiting time, cleanliness, privacy and affordability at private health facilities enhance the probability that a health facility will be used for any reproductive health purpose. At the combined states level, medicine availability and treatment effectiveness at public health facilities enhances service use. The major limitation is that the study includes only selected Indian states. The findings may enhance Indian service-quality policy. The paper's main contribution is that seemingly for the first time in India, healthcare service use has been measured longitudinally and then explained through service quality variables by comparing public and private health facilities.

Within-Day Variability in the Quality of Classroom Interactions during Third and Fifth Grade: Implications for Children's Experiences and Conducting Classroom Observations

ERIC Educational Resources Information Center

Curby, Timothy W.; Stuhlman, Megan; Grimm, Kevin; Mashburn, Andrew; Chomat-Mooney, Lia; Downer, Jason; Hamre, Bridget; Pianta, Robert C.

2011-01-01

The quality of classroom interactions has typically been studied using aggregates of ratings over time. However, within-day ratings may contain important variability. This study investigated within-day variability using the NICHD Study of Early Childcare and Youth Development's observational data during grades 3 and 5. The first question examined…

Qualifying variability: patterns in water quality and biota from a long-term, multi-stream dataset

Treesearch

Camille Flinders; Douglas McLaughlin

2016-01-01

Effective water resources assessment and management requires quantitative information on the variability of ambient and biological conditions in aquatic communities. Although it is understood that natural systems are variable, robust estimates of variation in water quality and biotic endpoints (e.g. community-based structure and function metrics) are rare in US waters...

The impact of child sexual abuse on the course of bipolar disorder: a systematic review.

PubMed

Maniglio, Roberto

2013-06-01

The aim of this review was to elucidate the impact of child sexual abuse on all clinical phenomena that occur after the onset of bipolar disorder, including associated clinical features that are not part of the diagnostic criteria for the disorder. Five databases were searched and supplemented with a hand search of reference lists from retrieved papers. Study quality was assessed using a validated quality assessment tool. Blind assessments of study eligibility and quality were conducted by two independent researchers to reduce bias, minimize errors, and enhance the reliability of findings. Disagreements were resolved by consensus. Eighteen studies that included a total of 2996 adults and youths with bipolar disorder and met the minimum quality criteria necessary to ensure objectivity and not invalidate results were analyzed. Across studies, child sexual abuse was strongly (and perhaps directly) associated with posttraumatic stress disorder; whereas it was less strongly (and perhaps indirectly) related to suicide attempts, alcohol and/or drug abuse or dependence, psychotic symptoms, and an early age of illness onset. In regard to the association between child sexual abuse and other clinical variables concerning the course of bipolar disorder, evidence was scant or conflicting. Child sexual abuse is associated (either directly or indirectly) with some clinical phenomena that represent a more severe form of bipolar disorder. Although such a traumatic experience may directly affect the development of posttraumatic stress disorder, the effects of early sexual abuse on later suicidal behavior, substance abuse, and psychotic symptoms may operate through the mediating influences of certain psychopathological or neurobiological variables. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.