Setting and Reviewing Standards to Control SO2 Pollution

EPA Pesticide Factsheets

EPA sets National Ambient Air Quality Standards (NAAQS) for SO2 to protect public health (primary standard) and to protect public welfare (secondary standard). The Clean Air Act also requires EPA to periodically review and revise them if appropriate.

Setting and Reviewing Standards to Control NO2 Pollution

EPA Pesticide Factsheets

EPA sets National Ambient Air Quality Standards (NAAQS) for NO2 to protect public health (primary standard) and to protect public welfare (secondary standard). The Clean Air Act also requires EPA to periodically review and revise them if appropriate.

Using the Many-Faceted Rasch Model to Evaluate Standard Setting Judgments: An Illustration with the Advanced Placement Environmental Science Exam

ERIC Educational Resources Information Center

Kaliski, Pamela K.; Wind, Stefanie A.; Engelhard, George, Jr.; Morgan, Deanna L.; Plake, Barbara S.; Reshetar, Rosemary A.

2013-01-01

The many-faceted Rasch (MFR) model has been used to evaluate the quality of ratings on constructed response assessments; however, it can also be used to evaluate the quality of judgments from panel-based standard setting procedures. The current study illustrates the use of the MFR model for examining the quality of ratings obtained from a standard…

Quality Systems and ISO 9000 in Higher Education.

ERIC Educational Resources Information Center

Lundquist, Robert

1997-01-01

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

Using Learning Analytics to Enhance Student Learning in Online Courses Based on Quality Matters Standards

ERIC Educational Resources Information Center

Martin, Florence; Ndoye, Abdou; Wilkins, Patricia

2016-01-01

Quality Matters is recognized as a rigorous set of standards that guide the designer or instructor to design quality online courses. We explore how Quality Matters standards guide the identification and analysis of learning analytics data to monitor and improve online learning. Descriptive data were collected for frequency of use, time spent, and…

Quality specifications and standard-setting for stoma care patients.

PubMed

Primer, M A

1995-12-01

Quality specifications can be used as an information resource by purchasers of health care. The nature of service provision and nursing care can be positively influenced by the formalisation of standards and quality specifications. Auditing is essential in the ongoing evaluation of a quality system.

40 CFR 50.2 - Scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.2 Scope. (a) National primary and secondary ambient air quality standards under section 109 of the Act are set forth in this part. (b) National primary ambient air quality...

Implementing Model-Check for Employee and Management Satisfaction

NASA Technical Reports Server (NTRS)

Jones, Corey; LaPha, Steven

2013-01-01

This presentation will discuss methods to which ModelCheck can be implemented to not only improve model quality, but also satisfy both employees and management through different sets of quality checks. This approach allows a standard set of modeling practices to be upheld throughout a company, with minimal interaction required by the end user. The presenter will demonstrate how to create multiple ModelCheck standards, preventing users from evading the system, and how it can improve the quality of drawings and models.

Developing and Implementing a Quality Assurance Strategy for Electroconvulsive Therapy.

PubMed

Hollingsworth, Jessa; Baliko, Beverly; McKinney, Selina; Rosenquist, Peter

2018-04-17

The literature provides scant guidance in effective quality assurance strategies concerning the use of electroconvulsive therapy (ECT) for the treatment of psychiatric conditions. Numerous guidelines are published that provide guidance in the delivery of care; however, little has been done to determine how a program or facility might ensure compliance to best practice for safety, tolerability, and efficacy in performing ECT. The objective of this project was to create a quality assurance strategy specific to ECT. Determining standards for quality care and clarifying facility policy were key outcomes in establishing an effective quality assurance strategy. An audit tool was developed utilizing quality criteria derived from a systematic review of ECT practice guidelines, peer review, and facility policy. All ECT procedures occurring over a 2-month period of May to June 2017 were retrospectively audited and compared against target compliance rates set for the facility's ECT program. Facility policy was adapted to reflect quality standards, and audit findings were used to inform possible practice change initiatives, were used to create benchmarks for continuous quality monitoring, and were integrated into regular hospital quality meetings. Clarification on standards of care and the use of clinical auditing in ECT was an effective starting point in the development of a quality assurance strategy. Audit findings were successfully integrated into the hospital's overall quality program, and recognition of practice compliance informed areas for future quality development and policy revision in this small community-based hospital in the southeastern United States. This project sets the foundation for a quality assurance strategy that can be used to help monitor procedural safety and guide future improvement efforts in delivering ECT. Although it is just the first step in creating meaningful quality improvement, setting clear standards and identifying areas of greatest clinical need were crucial beginning for this hospital's growing program.

Methods for Environments and Contaminants: Criteria Air Pollutants

EPA Pesticide Factsheets

EPA’s Office of Air Quality Planning and Standards (OAQPS) has set primary (health-based) National Ambient Air Quality Standards (NAAQS) for six common air pollutants, often referred to as criteria air pollutants (or simply criteria pollutants).

Correlation pattern recognition: optimal parameters for quality standards control of chocolate marshmallow candy

NASA Astrophysics Data System (ADS)

Flores, Jorge L.; García-Torales, G.; Ponce Ávila, Cristina

2006-08-01

This paper describes an in situ image recognition system designed to inspect the quality standards of the chocolate pops during their production. The essence of the recognition system is the localization of the events (i.e., defects) in the input images that affect the quality standards of pops. To this end, processing modules, based on correlation filter, and segmentation of images are employed with the objective of measuring the quality standards. Therefore, we designed the correlation filter and defined a set of features from the correlation plane. The desired values for these parameters are obtained by exploiting information about objects to be rejected in order to find the optimal discrimination capability of the system. Regarding this set of features, the pop can be correctly classified. The efficacy of the system has been tested thoroughly under laboratory conditions using at least 50 images, containing 3 different types of possible defects.

Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?

PubMed

Chandra-Mouli, Venkatraman; Chatterjee, Subidita; Bose, Krishna

2016-02-06

Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.

Standards for Adult Education ESL Programs

ERIC Educational Resources Information Center

TESOL Press, 2013

2013-01-01

What are the components of a quality education ESL program? TESOL's "Standards for Adult Education ESL Programs" answers this question by defining quality components from a national perspective. Using program indicators in eight distinct areas, the standards can be used to review an existing program or as a guide in setting up a new…

New Ambient Air Quality Standards - Analytic Challenges and Process Changes: An FHWA Perspective of the Impacts on Small and Medium Sized Areas

DOT National Transportation Integrated Search

1999-01-01

Significant changes to standards and regulations that influence metropolitan transportation planning in many areas were made in 1997. Specifically, the U.S. EPA issued both a new set of National Ambient Air Quality Standards(NAAQS) and major revision...

US EPA Nonattainment Areas and Designations

EPA Pesticide Factsheets

This web service contains the following state level layers:Ozone 8-hr (1997 standard), Ozone 8-hr (2008 standard), Lead (2008 standard), SO2 1-hr (2010 standard), PM2.5 24hr (2006 standard), PM2.5 Annual (1997 standard), PM2.5 Annual (2012 standard), and PM10 (1987 standard). Full FGDC metadata records for each layer may be found by clicking the layer name at the web service endpoint (https://gispub.epa.gov/arcgis/rest/services/OAR_OAQPS/NonattainmentAreas/MapServer) and viewing the layer description. These layers identify areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for criteria air pollutants and have been designated nonattainment?? areas (NAA). The data are updated weekly from an OAQPS internal database. However, that does not necessarily mean the data have changed. The EPA Office of Air Quality Planning and Standards (OAQPS) has set National Ambient Air Quality Standards for six principal pollutants, which are called criteria pollutants. Under provisions of the Clean Air Act, which is intended to improve the quality of the air we breathe, EPA is required to set National Ambient Air Quality Standards for six common air pollutants. These commonly found air pollutants (also known as criteria pollutants) are found all over the United States. They are particle pollution (often referred to as particulate matter), ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. For each

Setting and Reviewing Standards to Control Carbon Monoxide (CO) Pollution in Outdoor Air

EPA Pesticide Factsheets

EPA sets National Ambient Air Quality Standards (NAAQS) for CO to protect public health and to protect public welfare. The Clean Air Act also requires EPA to periodically review and revise them if appropriate.

Development of a core set of outcome measures for OAB treatment.

PubMed

Foust-Wright, Caroline; Wissig, Stephanie; Stowell, Caleb; Olson, Elizabeth; Anderson, Anita; Anger, Jennifer; Cardozo, Linda; Cotterill, Nikki; Gormley, Elizabeth Ann; Toozs-Hobson, Philip; Heesakkers, John; Herbison, Peter; Moore, Kate; McKinney, Jessica; Morse, Abraham; Pulliam, Samantha; Szonyi, George; Wagg, Adrian; Milsom, Ian

2017-12-01

Standardized measures enable the comparison of outcomes across providers and treatments giving valuable information for improving care quality and efficacy. The aim of this project was to define a minimum standard set of outcome measures and case-mix factors for evaluating the care of patients with overactive bladder (OAB). The International Consortium for Health Outcomes Measurement (ICHOM) convened an international working group (WG) of leading clinicians and patients to engage in a structured method for developing a core outcome set. Consensus was determined by a modified Delphi process, and discussions were supported by both literature review and patient input. The standard set measures outcomes of care for adults seeking treatment for OAB, excluding residents of long-term care facilities. The WG focused on treatment outcomes identified as most important key outcome domains to patients: symptom burden and bother, physical functioning, emotional health, impact of symptoms and treatment on quality of life, and success of treatment. Demographic information and case-mix factors that may affect these outcomes were also included. The standardized outcome set for evaluating clinical care is appropriate for use by all health providers caring for patients with OAB, regardless of specialty or geographic location, and provides key data for quality improvement activities and research.

Federal Workforce Quality: Measurement and Improvement

DTIC Science & Technology

1992-08-01

explicit standards of production and service quality . Assessment Tools 4 OPM should institutionalize its data collection program of longitudinal research...include data about quirements, should set explicit standards of various aspects of the model. That is, the production and service quality . effort...are the immediate consumers service quality are possible. of the products and services delivered, and still others in the larger society who have no

75 FR 2938 - National Ambient Air Quality Standards for Ozone

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-19

...Based on its reconsideration of the primary and secondary national ambient air quality standards (NAAQS) for ozone (O3) set in March 2008, EPA proposes to set different primary and secondary standards than those set in 2008 to provide requisite protection of public health and welfare, respectively. With regard to the primary standard for O3, EPA proposes that the level of the 8-hour primary standard, which was set at 0.075 ppm in the 2008 final rule, should instead be set at a lower level within the range of 0.060 to 0.070 parts per million (ppm), to provide increased protection for children and other ``at risk'' populations against an array of O3-related adverse health effects that range from decreased lung function and increased respiratory symptoms to serious indicators of respiratory morbidity including emergency department visits and hospital admissions for respiratory causes, and possibly cardiovascular-related morbidity as well as total non-accidental and cardiopulmonary mortality. With regard to the secondary standard for O3, EPA proposes that the secondary O3 standard, which was set identical to the revised primary standard in the 2008 final rule, should instead be a new cumulative, seasonal standard expressed as an annual index of the sum of weighted hourly concentrations, cumulated over 12 hours per day (8 am to 8 pm) during the consecutive 3-month period within the O3 season with the maximum index value, set at a level within the range of 7 to 15 ppm- hours, to provide increased protection against O3-related adverse impacts on vegetation and forested ecosystems.

DEVELOPMENT OF A NATIONAL CONSENSUS STANDARD FOR QUALITY ASSURANCE FOR ENVIRONMENTAL PROGRAMS

EPA Science Inventory

Decisions on where and how to clean-up Federally-owned facilities contaminated by mixtures of hazardous chemical and radioactive wastes requires that quality environmental data be obtained. he Federal Government currently using several different standards or sets of requirements ...

[Study on the optimization of monitoring indicators of drinking water quality during health supervision].

PubMed

Ye, Bixiong; E, Xueli; Zhang, Lan

2015-01-01

To optimize non-regular drinking water quality indices (except Giardia and Cryptosporidium) of urban drinking water. Several methods including drinking water quality exceed the standard, the risk of exceeding standard, the frequency of detecting concentrations below the detection limit, water quality comprehensive index evaluation method, and attribute reduction algorithm of rough set theory were applied, redundancy factor of water quality indicators were eliminated, control factors that play a leading role in drinking water safety were found. Optimization results showed in 62 unconventional water quality monitoring indicators of urban drinking water, 42 water quality indicators could be optimized reduction by comprehensively evaluation combined with attribute reduction of rough set. Optimization of the water quality monitoring indicators and reduction of monitoring indicators and monitoring frequency could ensure the safety of drinking water quality while lowering monitoring costs and reducing monitoring pressure of the sanitation supervision departments.

Langley Wind Tunnel Data Quality Assurance-Check Standard Results

NASA Technical Reports Server (NTRS)

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

2000-01-01

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

Patient Safety: Moving the Bar in Prison Health Care Standards

PubMed Central

Greifinger, Robert B.; Mellow, Jeff

2010-01-01

Improvements in community health care quality through error reduction have been slow to transfer to correctional settings. We convened a panel of correctional experts, which recommended 60 patient safety standards focusing on such issues as creating safety cultures at organizational, supervisory, and staff levels through changes to policy and training and by ensuring staff competency, reducing medication errors, encouraging the seamless transfer of information between and within practice settings, and developing mechanisms to detect errors or near misses and to shift the emphasis from blaming staff to fixing systems. To our knowledge, this is the first published set of standards focusing on patient safety in prisons, adapted from the emerging literature on quality improvement in the community. PMID:20864714

Research on Standard and Automatic Judgment of Press-fit Curve of Locomotive Wheel-set Based on AAR Standard

NASA Astrophysics Data System (ADS)

Lu, Jun; Xiao, Jun; Gao, Dong Jun; Zong, Shu Yu; Li, Zhu

2018-03-01

In the production of the Association of American Railroads (AAR) locomotive wheel-set, the press-fit curve is the most important basis for the reliability of wheel-set assembly. In the past, Most of production enterprises mainly use artificial detection methods to determine the quality of assembly. There are cases of miscarriage of justice appear. For this reason, the research on the standard is carried out. And the automatic judgment of press-fit curve is analysed and designed, so as to provide guidance for the locomotive wheel-set production based on AAR standard.

E-Learning Quality Standards for Consumer Protection and Consumer Confidence: A Canadian Case Study in E-Learning Quality Assurance

ERIC Educational Resources Information Center

Barker, Kathryn Chang

2007-01-01

Emerging concerns about quality of e-learning products and services animated a project in Canada to create quality standards that derived primarily from the needs of consumer, that could be used to guide the development and choice of e-learning at all levels of education and training, and that could be implemented in a simple manner. A set of…

INCITS W1.1 development update: appearance-based image quality standards for printers

NASA Astrophysics Data System (ADS)

Zeise, Eric K.; Rasmussen, D. René; Ng, Yee S.; Dalal, Edul; McCarthy, Ann; Williams, Don

2008-01-01

In September 2000, INCITS W1 (the U.S. representative of ISO/IEC JTC1/SC28, the standardization committee for office equipment) was chartered to develop an appearance-based image quality standard. (1),(2) The resulting W1.1 project is based on a proposal (3) that perceived image quality can be described by a small set of broad-based attributes. There are currently six ad hoc teams, each working towards the development of standards for evaluation of perceptual image quality of color printers for one or more of these image quality attributes. This paper summarizes the work in progress of the teams addressing the attributes of Macro-Uniformity, Colour Rendition, Gloss & Gloss Uniformity, Text & Line Quality and Effective Resolution.

Information management for aged care provision in Australia: development of an aged care minimum dataset and strategies to improve quality and continuity of care.

PubMed

Davis, Jenny; Morgans, Amee; Burgess, Stephen

2016-04-01

Efficient information systems support the provision of multi-disciplinary aged care and a variety of organisational purposes, including quality, funding, communication and continuity of care. Agreed minimum data sets enable accurate communication across multiple care settings. However, in aged care multiple and poorly integrated data collection frameworks are commonly used for client assessment, government reporting and funding purposes. To determine key information needs in aged care settings to improve information quality, information transfer, safety, quality and continuity of care to meet the complex needs of aged care clients. Modified Delphi methods involving five stages were employed by one aged care provider in Victoria, Australia, to establish stakeholder consensus for a derived minimum data set and address barriers to data quality. Eleven different aged care programs were identified; with five related data dictionaries, three minimum data sets, five program standards or quality frameworks. The remaining data collection frameworks related to diseases classification, funding, service activity reporting, and statistical standards and classifications. A total of 170 different data items collected across seven internal information systems were consolidated to a derived set of 60 core data items and aligned with nationally consistent data collection frameworks. Barriers to data quality related to inconsistencies in data items, staff knowledge, workflow, system access and configuration. The development an internal aged care minimum data set highlighted the critical role of primary data quality in the upstream and downstream use of client information; and presents a platform to build national consistency across the sector.

PERFORMANCE AUDITING OF A HUMAN AIR POLLUTION EXPOSURE CHAMBER FOR PM2.5

EPA Science Inventory

Databases derived from human health effects research play a vital role in setting environmental standards. An underlying assumption in using these databases for standard setting purposes is that they are of adequate quality. The performance auditing program described provides n...

Time to harmonize national ambient air quality standards.

PubMed

Kutlar Joss, Meltem; Eeftens, Marloes; Gintowt, Emily; Kappeler, Ron; Künzli, Nino

2017-05-01

The World Health Organization has developed ambient air quality guidelines at levels considered to be safe or of acceptable risk for human health. These guidelines are meant to support governments in defining national standards. It is unclear how they are followed. We compiled an inventory of ambient air quality standards for 194 countries worldwide for six air pollutants: PM 2.5 , PM 10 , ozone, nitrogen dioxide, sulphur dioxide and carbon monoxide. We conducted literature and internet searches and asked country representatives about national ambient air quality standards. We found information on 170 countries including 57 countries that did not set any air quality standards. Levels varied greatly by country and by pollutant. Ambient air quality standards for PM 2.5 , PM 10 and SO 2 poorly complied with WHO guideline values. The agreement was higher for CO, SO 2 (10-min averaging time) and NO 2 . Regulatory differences mirror the differences in air quality and the related burden of disease around the globe. Governments worldwide should adopt science based air quality standards and clean air management plans to continuously improve air quality locally, nationally, and globally.

Solving the Problem: Genome Annotation Standards before the Data Deluge.

PubMed

Klimke, William; O'Donovan, Claire; White, Owen; Brister, J Rodney; Clark, Karen; Fedorov, Boris; Mizrachi, Ilene; Pruitt, Kim D; Tatusova, Tatiana

2011-10-15

The promise of genome sequencing was that the vast undiscovered country would be mapped out by comparison of the multitude of sequences available and would aid researchers in deciphering the role of each gene in every organism. Researchers recognize that there is a need for high quality data. However, different annotation procedures, numerous databases, and a diminishing percentage of experimentally determined gene functions have resulted in a spectrum of annotation quality. NCBI in collaboration with sequencing centers, archival databases, and researchers, has developed the first international annotation standards, a fundamental step in ensuring that high quality complete prokaryotic genomes are available as gold standard references. Highlights include the development of annotation assessment tools, community acceptance of protein naming standards, comparison of annotation resources to provide consistent annotation, and improved tracking of the evidence used to generate a particular annotation. The development of a set of minimal standards, including the requirement for annotated complete prokaryotic genomes to contain a full set of ribosomal RNAs, transfer RNAs, and proteins encoding core conserved functions, is an historic milestone. The use of these standards in existing genomes and future submissions will increase the quality of databases, enabling researchers to make accurate biological discoveries.

Solving the Problem: Genome Annotation Standards before the Data Deluge

PubMed Central

Klimke, William; O'Donovan, Claire; White, Owen; Brister, J. Rodney; Clark, Karen; Fedorov, Boris; Mizrachi, Ilene; Pruitt, Kim D.; Tatusova, Tatiana

2011-01-01

The promise of genome sequencing was that the vast undiscovered country would be mapped out by comparison of the multitude of sequences available and would aid researchers in deciphering the role of each gene in every organism. Researchers recognize that there is a need for high quality data. However, different annotation procedures, numerous databases, and a diminishing percentage of experimentally determined gene functions have resulted in a spectrum of annotation quality. NCBI in collaboration with sequencing centers, archival databases, and researchers, has developed the first international annotation standards, a fundamental step in ensuring that high quality complete prokaryotic genomes are available as gold standard references. Highlights include the development of annotation assessment tools, community acceptance of protein naming standards, comparison of annotation resources to provide consistent annotation, and improved tracking of the evidence used to generate a particular annotation. The development of a set of minimal standards, including the requirement for annotated complete prokaryotic genomes to contain a full set of ribosomal RNAs, transfer RNAs, and proteins encoding core conserved functions, is an historic milestone. The use of these standards in existing genomes and future submissions will increase the quality of databases, enabling researchers to make accurate biological discoveries. PMID:22180819

PREDICTING THE IMPACT OF TROPOSPHERIC OZONE ON ECOLOGICAL RESOURCES FOR SETTING NATIONAL AMBIENT AIR QUALITY STANDARDS

EPA Science Inventory

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

Results from a Community-Wide Pilot Program to Standardize COPD Education for Patients Across Healthcare Settings in Rhode Island.

PubMed

Pelland, Kimberly; Youssef, Rouba; Calandra, Kathleen; Cellar, Jennifer; Thiesen, Jennifer; Gardner, Rebekah

2017-07-05

Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity, decreased quality of life, and burdensome hospital admissions. Therefore, patients with COPD interact with clinicians in a number of healthcare settings. A coalition of healthcare practitioners in Rhode Island, in partnership with the local Quality Improvement Organization, designed and implemented a standardized, COPD education program for use across multiple healthcare settings. More than 60 organizations participated, producing 140 Master Trainers, who trained 634 staff members at their facilities from October 2015 through June 2016. Master Trainers were satisfied with the training, and we observed significant increases in knowledge scores post-training among all participants, which remained significant when stratified by setting. These results demonstrate that implementation of a community-based program to disseminate patient-centered, standardized COPD education in multiple healthcare settings is feasible. We hope this program will ultimately improve patient outcomes and serve as the foundation for expanding standardized education for other chronic conditions. [Full article available at http://rimed.org/rimedicaljournal-2017-07.asp].

PERFORMANCE AUDITING OF A HUMAN AIR POLLUTION EXPOSURE SYSTEM FOR PM2.5

EPA Science Inventory

Databases derived from human health effects research play a vital role in setting environmental standards. An underlying assumption in using these databases for standard setting purposes is that they are of adequate quality. The performance auditing program described in this ma...

Synthetic Spike-in Standards Improve Run-Specific Systematic Error Analysis for DNA and RNA Sequencing

PubMed Central

Zook, Justin M.; Samarov, Daniel; McDaniel, Jennifer; Sen, Shurjo K.; Salit, Marc

2012-01-01

While the importance of random sequencing errors decreases at higher DNA or RNA sequencing depths, systematic sequencing errors (SSEs) dominate at high sequencing depths and can be difficult to distinguish from biological variants. These SSEs can cause base quality scores to underestimate the probability of error at certain genomic positions, resulting in false positive variant calls, particularly in mixtures such as samples with RNA editing, tumors, circulating tumor cells, bacteria, mitochondrial heteroplasmy, or pooled DNA. Most algorithms proposed for correction of SSEs require a data set used to calculate association of SSEs with various features in the reads and sequence context. This data set is typically either from a part of the data set being “recalibrated” (Genome Analysis ToolKit, or GATK) or from a separate data set with special characteristics (SysCall). Here, we combine the advantages of these approaches by adding synthetic RNA spike-in standards to human RNA, and use GATK to recalibrate base quality scores with reads mapped to the spike-in standards. Compared to conventional GATK recalibration that uses reads mapped to the genome, spike-ins improve the accuracy of Illumina base quality scores by a mean of 5 Phred-scaled quality score units, and by as much as 13 units at CpG sites. In addition, since the spike-in data used for recalibration are independent of the genome being sequenced, our method allows run-specific recalibration even for the many species without a comprehensive and accurate SNP database. We also use GATK with the spike-in standards to demonstrate that the Illumina RNA sequencing runs overestimate quality scores for AC, CC, GC, GG, and TC dinucleotides, while SOLiD has less dinucleotide SSEs but more SSEs for certain cycles. We conclude that using these DNA and RNA spike-in standards with GATK improves base quality score recalibration. PMID:22859977

PREDICTING THE IMPACT OF TROPOSPHERIC OZONE ON PLANTS AND ECOSYSTEMS AS A BASIS FOR SETTING NATIONAL AIR QUALITY STANDARDS

EPA Science Inventory

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

Innovations in projecting emissions for air quality modeling

EPA Science Inventory

Air quality modeling is used in setting air quality standards and in evaluating their costs and benefits. Historically, modeling applications have projected emissions and the resulting air quality only 5 to 10 years into the future. Recognition that the choice of air quality mana...

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

NASA Astrophysics Data System (ADS)

Zhu, Hongwei; Wu, Harris

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

ISO9000 and the quality management system in the digital hospital.

PubMed

Liu, Yalan; Yao, Bin; Zhang, Zigang

2002-01-01

ISO9000 quality management system (ISO9000QMS) emphasize on the customer-oriented, managers' leadership and all staff's joining, adopt the process method and system management, spread the taking facts as a basis to make decision and improve consistently, and establish win-win relation with the suppliers. So, the digital hospital can adopt the ISO9000QMS. In order to establish the ISO9000QMS, the digital hospital should: (1) Design integrally, including analyzing the operation procedure, clarifying the job duties, setting up the spreading team and setting the quality policy and objectives: (2) Learning the ISO9000 quality standards; (3) Drawing up the documents, including the quality manual, program files and operation guiding files; (4) Training according the documents; (5) Executing the quality standard, including the service quality auditing, quality record auditing and quality system auditing; (6) Improving continually. With the establishment of ISO900QMS, the digital hospital can appraise more accurately, analyze quality matters statistically and avoid the interference of artificial factors.

Analytical quality goals derived from the total deviation from patients' homeostatic set points, with a margin for analytical errors.

PubMed

Bolann, B J; Asberg, A

2004-01-01

The deviation of test results from patients' homeostatic set points in steady-state conditions may complicate interpretation of the results and the comparison of results with clinical decision limits. In this study the total deviation from the homeostatic set point is defined as the maximum absolute deviation for 95% of measurements, and we present analytical quality requirements that prevent analytical error from increasing this deviation to more than about 12% above the value caused by biology alone. These quality requirements are: 1) The stable systematic error should be approximately 0, and 2) a systematic error that will be detected by the control program with 90% probability, should not be larger than half the value of the combined analytical and intra-individual standard deviation. As a result, when the most common control rules are used, the analytical standard deviation may be up to 0.15 times the intra-individual standard deviation. Analytical improvements beyond these requirements have little impact on the interpretability of measurement results.

Leveraging Standards to Promote Program Quality

ERIC Educational Resources Information Center

Young, Michelle D.; Mawhinney, Hanna; Reed, Cynthia J.

2016-01-01

Standards provide a foundation for thinking about leadership development and practice. This article explores three sets of standards that impact educational leadership preparation: (a) the recently revised Interstate School Leaders Licensure Consortium (ISLLC) standards, which are now known as the Practice Standards for Educational Leaders (PSEL);…

76 FR 54293 - Review of National Ambient Air Quality Standards for Carbon Monoxide

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-31

...This rule is being issued at this time as required by a court order governing the schedule for completion of this review of the air quality criteria and the national ambient air quality standards (NAAQS) for carbon monoxide (CO). Based on its review, the EPA concludes the current primary standards are requisite to protect public health with an adequate margin of safety, and is retaining those standards. After review of the air quality criteria, EPA further concludes that no secondary standard should be set for CO at this time. EPA is also making changes to the ambient air monitoring requirements for CO, including those related to network design, and is updating, without substantive change, aspects of the Federal reference method.

PERFORMANCE AUDITING OF A HUMAN AIR POLLUTION EXPOSURE SYSTEM FOR COARSE PARTICULATE MATTER (PM2.5-10)

EPA Science Inventory

Databases derived from human health effects research play a vital role in setting environmental standards. An underlying assumption in using these databases for standard setting purposes is that they are of adequate quality. The performance auditing program described in this ma...

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

PubMed

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

2015-10-01

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

Quality management and accreditation in a mixed research and clinical hair testing analytical laboratory setting-a review.

PubMed

Fulga, Netta

2013-06-01

Quality management and accreditation in the analytical laboratory setting are developing rapidly and becoming the standard worldwide. Quality management refers to all the activities used by organizations to ensure product or service consistency. Accreditation is a formal recognition by an authoritative regulatory body that a laboratory is competent to perform examinations and report results. The Motherisk Drug Testing Laboratory is licensed to operate at the Hospital for Sick Children in Toronto, Ontario. The laboratory performs toxicology tests of hair and meconium samples for research and clinical purposes. Most of the samples are involved in a chain of custody cases. Establishing a quality management system and achieving accreditation became mandatory by legislation for all Ontario clinical laboratories since 2003. The Ontario Laboratory Accreditation program is based on International Organization for Standardization 15189-Medical laboratories-Particular requirements for quality and competence, an international standard that has been adopted as a national standard in Canada. The implementation of a quality management system involves management commitment, planning and staff education, documentation of the system, validation of processes, and assessment against the requirements. The maintenance of a quality management system requires control and monitoring of the entire laboratory path of workflow. The process of transformation of a research/clinical laboratory into an accredited laboratory, and the benefits of maintaining an effective quality management system, are presented in this article.

Quality assurance tendering and awarding contracts

NASA Astrophysics Data System (ADS)

1994-12-01

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

Standardized development of computer software. Part 2: Standards

NASA Technical Reports Server (NTRS)

Tausworthe, R. C.

1978-01-01

This monograph contains standards for software development and engineering. The book sets forth rules for design, specification, coding, testing, documentation, and quality assurance audits of software; it also contains detailed outlines for the documentation to be produced.

Evaluation of thermal cameras in quality systems according to ISO 9000 or EN 45000 standards

NASA Astrophysics Data System (ADS)

Chrzanowski, Krzysztof

2001-03-01

According to the international standards ISO 9001-9004 and EN 45001-45003 the industrial plants and the accreditation laboratories that implemented the quality systems according to these standards are required to evaluate an uncertainty of measurements. Manufacturers of thermal cameras do not offer any data that could enable estimation of measurement uncertainty of these imagers. Difficulties in determining the measurement uncertainty is an important limitation of thermal cameras for applications in the industrial plants and the cooperating accreditation laboratories that have implemented these quality systems. A set of parameters for characterization of commercial thermal cameras, a measuring set, some results of testing of these cameras, a mathematical model of uncertainty, and a software that enables quick calculation of uncertainty of temperature measurements with thermal cameras are presented in this paper.

[Output standard in the mental health services of Reggio Emilia, Italy. Methodological issues].

PubMed

Grassi, G

2000-01-01

The project Output Standards of the Mental Health Department (MHD) of Reggio Emilia is set out to define outputs and quality standards and to guarantee transparency and to facilitate organizational improvement. The MHD started an interprofessional working group that defined the MHD outputs as long as process, quality peculiarities, indicators and standards for each output. The MHD Director validated the group results. The MHD defined 9 outputs and its indicators and standards and consequently modified its data registration system, the way to supply free and partially charged services and budget indicators. As a result, a new instrument for management and quality control has been provided. The A. maintains that to define outputs, indicators and standards will allow to compare several services of the Department, get them omogeneous and guarantee and improve quality.

18 CFR 12.40 - Quality control programs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Quality control... PROJECT WORKS Other Responsibilities of Applicant or Licensee § 12.40 Quality control programs. (a... meeting any requirements or standards set by the Regional Engineer. If a quality control program is...

18 CFR 12.40 - Quality control programs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Quality control... PROJECT WORKS Other Responsibilities of Applicant or Licensee § 12.40 Quality control programs. (a... meeting any requirements or standards set by the Regional Engineer. If a quality control program is...

Technology Leadership and Its Relationship with School-Malaysia Standard of Education Quality (School-MSEQ)

ERIC Educational Resources Information Center

Hamzah, Mohd Izham Mohd; Juraime, Faridah; Hamid, Aida Hanim A.; Nordin, Norazah; Attan, Noraini

2014-01-01

This study examined the level of technology leadership practice among administrators in High Performing Schools (HPS) and its relationship with School-Malaysia Standard of Education Quality (School-MSEQ). A set of questionnaires was administered to 96 administrators in 12 HPS of secondary schools category. The data were analysed and interpreted…

Emission Reduction Potential of the Congestion Mitigation and Air Quality Program

DOT National Transportation Integrated Search

1997-05-19

The Congestion Mitigation and Air Quality Improvement Program (CMAQ) provides : funds to states for projects designed to help attain and maintain the national : ambient air quality standards (NAAQS) set under the Clean Air Act (CAA). CMAQ : was creat...

The CIQG International Quality Principles: Toward a Shared Understanding of Quality. CIQG Publication Series

ERIC Educational Resources Information Center

Uvalic-Trumbic, Stamenka

2016-01-01

The idea of developing International Quality Principles emerged from a dialogue and debate among colleagues from many countries at the Council for Higher Education Accreditation (CHEA) International Quality Group (CIQG) 2014 Annual Meeting. The discussion focused on whether a single set of international standards for academic quality in higher…

The 'Severe Hypertensive Illness in Pregnancy' (SHIP) audit: promoting quality care using a high risk monitoring chart and eclampsia treatment pack.

PubMed

Baldwin, K Joanne; Leighton, Nicola A; Kilby, M D; Wyldes, M; Churchill, D; Jones, P W; Johanson, R B

2002-07-01

We set out to measure the standards of care in a regional cohort of women with severe hypertensive illness of pregnancy and to subsequently improve the quality of care using a series of interventions. This was a multi centre cyclical criterion audit involving 21 maternity units in the West Midlands Region. Prospective data collection involved named co-ordinators in each unit using customised proformas. Intervention comprised feedback of baseline results to each hospital, a monitoring chart and eclampsia treatment pack. The first audit period (n = 183) was for a 4-month period between 1/9/96 and 31/12/96 and the second audit period (n = 111) was during the same 4-month period 1 year later. Although compliance with the audit standards set increased in all but one standard, there is clearly a need to make further improvements in the quality of care administered.

Comparison of PV signal quality using a novel circular mapping and ablation catheter versus a standard circular mapping catheter.

PubMed

von Bary, Christian; Fredersdorf-Hahn, Sabine; Heinicke, Norbert; Jungbauer, Carsten; Schmid, Peter; Riegger, Günter A; Weber, Stefan

2011-08-01

Recently, new catheter technologies have been developed for atrial fibrillation (AF) ablation. We investigate the diagnostic accuracy of a circular mapping and pulmonary vein ablation catheter (PVAC) compared with a standard circular mapping catheter (Orbiter) and the influence of filter settings on signal quality. After reconstruction of the left atrium by three-dimensional atriography, baseline PV potentials (PVP) were recorded consecutively with PVAC and Orbiter in 20 patients with paroxysmal AF. PVPs were compared and attributed to predefined anatomical PV segments. Ablation was performed in 80 PVs using the PVAC. If isolation of the PVs was assumed, signal assessment of each PV was repeated with the Orbiter. If residual PV potentials could be uncovered, different filter settings were tested to improve mapping quality of the PVAC. Ablation was continued until complete PV isolation (PVI) was confirmed with the Orbiter. Baseline mapping demonstrated a good correlation between the Orbiter and PVAC. Mapping accuracy using the PVAC for mapping and ablation was 94% (74 of 79 PVs). Additional mapping with the Orbiter improved the PV isolation rate to 99%. Adjustment of filter settings failed to improve quality of the PV signals compared with standard filter settings. Using the PVAC as a stand-alone strategy for mapping and ablation, one should be aware that in some cases, different signal morphology mimics PVI isolation. Adjustment of filter settings failed to improve signal quality. The use of an additional mapping catheter is recommended to become familiar with the particular signal morphology during the first PVAC cases or whenever there is a doubt about successful isolation of the pulmonary veins.

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

ERIC Educational Resources Information Center

Stringer, Neil Simon

2012-01-01

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

77 FR 50966 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Attainment Demonstration...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... moderate 8-hour ozone nonattainment area? In 1997, EPA revised the health-based NAAQS for ozone, setting it... standard based on scientific evidence demonstrating that ozone causes adverse health effects at lower ozone... was set. EPA determined that the 1997 8-hour standard would be more protective of human health...

Recreational Water Quality Criteria Limits

EPA Pesticide Factsheets

This set of Frequently Asked Questions (FAQ) provides an overview of NPDES permitting applicable to continuous dischargers (such as POTWs) based on water quality standards for pathogens and pathogen indicators associated with fecal contamination.

Lessons Learned on Quality (of) Standards

NASA Astrophysics Data System (ADS)

Gerlich, Rainer; Gerlich, Ralf

2011-08-01

Standards are used to describe and ensure the quality of products, services and processes throughout almost all branches of industry, including the field of software engineering. Contractors and suppliers are obligated by their customers and certification authorities to follow a certain set of standards during development. For example, a customer can easier actively participate in and control the contractor's process when enforcing a standard process..However, as with any requirement, a standard may also impede the contractor or supplier in assuring actual quality of the product in the sense of fitness for the purpose intended by the customer.This is the case when a standard defines specific quality assurance activities requiring a considerable amount of effort while other more efficient but equivalent or even superior approaches are blocked. Then improvement of the ratio between cost and quality exceeding miniscule advances is heavily impeded.While in some parts being too specific in defining the mechanisms of the enforced process, standards are sometimes too weak in defining the principles or goals on control of product quality.Therefore this paper addresses the following issues: (1) Which conclusions can be drawn on the quality and efficiency of a standard? (2) If and how is it possible to improve or evolve a standard? (3) How well does a standard guide a user towards high quality of the end product?One conclusion is that the analyzed standards do interfere with technological innovation, though the standards leave a lot of freedom for concretization and are understood as technology-independent.Another conclusion is that standards are not only a matter of quality but also a matter of competitiveness of the industry depending on resulting costs and time-to- market. When the costs induced by a standard are not adequate to the achievable quality, industry encounters a significant disadvantage.

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

PubMed

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

2016-12-01

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

A novel Python program for implementation of quality control in the ELISA.

PubMed

Wetzel, Hanna N; Cohen, Cinder; Norman, Andrew B; Webster, Rose P

2017-09-01

The use of semi-quantitative assays such as the enzyme-linked immunosorbent assay (ELISA) requires stringent quality control of the data. However, such quality control is often lacking in academic settings due to unavailability of software and knowledge. Therefore, our aim was to develop methods to easily implement Levey-Jennings quality control methods. For this purpose, we created a program written in Python (a programming language with an open-source license) and tested it using a training set of ELISA standard curves quantifying the Fab fragment of an anti-cocaine monoclonal antibody in mouse blood. A colorimetric ELISA was developed using a goat anti-human anti-Fab capture method. Mouse blood samples spiked with the Fab fragment were tested against a standard curve of known concentrations of Fab fragment in buffer over a period of 133days stored at 4°C to assess stability of the Fab fragment and to generate a test dataset to assess the program. All standard curves were analyzed using our program to batch process the data and to generate Levey-Jennings control charts and statistics regarding the datasets. The program was able to identify values outside of two standard deviations, and this identification of outliers was consistent with the results of a two-way ANOVA. This program is freely available, which will help laboratories implement quality control methods, thus improving reproducibility within and between labs. We report here successful testing of the program with our training set and development of a method for quantification of the Fab fragment in mouse blood. Copyright © 2017 Elsevier B.V. All rights reserved.

ISO 9000 Quality Management System

NASA Astrophysics Data System (ADS)

Hadjicostas, Evsevios

The ISO 9000 series describes a quality management system applicable to any organization. In this chapter we present the requirements of the standard in a way that is as close as possible to the needs of analytical laboratories. The sequence of the requirements follows that in the ISO 9001:2008 standard. In addition, the guidelines for performance improvement set out in the ISO 9004 are reviewed. Both standards should be used as a reference as well as the basis for further elaboration.

Monitoring maternal and newborn health outcomes in Bauchi State, Nigeria: an evaluation of a standards-based quality improvement intervention.

PubMed

Kabo, Ibrahim; Otolorin, Emmanuel; Williams, Emma; Orobaton, Nosa; Abdullahi, Hannatu; Sadauki, Habib; Abdulkarim, Masduk; Abegunde, Dele

2016-10-01

This study assessed the correlation between compliance with set performance standards and maternal and neonatal deaths in health facilities. Baseline and three annual follow-up assessments were conducted, and each was followed by a quality improvement initiative using the Standards Based Management and Recognition (SBM-R) approach. Twenty-three secondary health facilities of Bauchi state, Nigeria. Health care workers and maternity unit patients. We examined trends in: (i) achievement of SBM-R set performance standards based on annual assessment data, (ii) the use of maternal and newborn health (MNH) service delivery practices based on data from health facility registers and supportive supervision and (iii) MNH outcomes based on routine service statistics. At the baseline assessment in 2010, the facilities achieved 4% of SBM-R standards for MNH, on average, and this increased to 86% in 2013. Over the same time period, the study measured an increase in the administration of uterotonic for active management of third stage of labor from 10% to 95% and a decline in the incidence of postpartum hemorrhage from 3.3% to 1.9%. Institutional neonatal mortality rate decreased from 9 to 2 deaths per 1000 live births, while the institutional maternal mortality ratio dropped from 4113 to 1317 deaths per 100 000 live births. Scaling up SBM-R for quality improvement has the potential to prevent maternal and neonatal deaths in Nigeria and similar settings. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care.

Action for Environmental Quality. Standards and Enforcement for Air and Water Pollution Control.

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC.

The U.S. Environmental Protection Agency (EPA) is responsible for setting and enforcing environmental quality standards for the nation. With the Clean Air Act of 1970 (P.L. 91-604) and the Water Pollution Control Act of 1972 (P.L. 92-500), the first truly nationwide control programs were established. This booklet is designed to inform the public…

Impact of sampling techniques on measured stormwater quality data for small streams

USDA-ARS?s Scientific Manuscript database

Science-based sampling methodologies are needed to enhance water quality characterization for developing Total Maximum Daily Loads (TMDLs), setting appropriate water quality standards, and managing nonpoint source pollution. Storm event sampling, which is vital for adequate assessment of water qual...

USL/DBMS NASA/PC R and D project system design standards

NASA Technical Reports Server (NTRS)

Dominick, Wayne D. (Editor); Moreau, Dennis R.

1984-01-01

A set of system design standards intended to assure the completeness and quality of designs developed for PC research and development projects is established. The standards presented address the areas of problem definition, initial design plan, design specification, and re-evaluation.

Managing Air Quality - Program Implementation

EPA Pesticide Factsheets

Describes elements for the set of activities to ensure that control strategies are put into effect and that air quality goals and standards are fulfilled, permitting programs, and additional resources related to implementation under the Clean Air Act.

Interobserver agreement between primary graders and an expert grader in the Bristol and Weston diabetic retinopathy screening programme: a quality assurance audit.

PubMed

Patra, S; Gomm, E M W; Macipe, M; Bailey, C

2009-08-01

To assess the quality and accuracy of primary grading in the Bristol and Weston diabetic retinopathy screening programme and to set standards for future interobserver agreement reports. A prospective audit of 213 image sets from six fully trained primary graders in the Bristol and Weston diabetic retinopathy screening programme was carried out over a 4-week period. All the images graded by the primary graders were regraded by an expert grader blinded to the primary grading results and the identity of the primary grader. The interobserver agreement between primary graders and the blinded expert grader and the corresponding Kappa coefficient was determined for overall grading, referable, non-referable and ungradable disease. The audit standard was set at 80% for interobserver agreement with a Kappa coefficient of 0.7. The interobserver agreement bettered the audit standard of 80% in all the categories. The Kappa coefficient was substantial (0.7) for the overall grading results and ranged from moderate to substantial (0.59-0.65) for referable, non-referable and ungradable disease categories. The main recommendation of the audit was to provide refresher training for the primary graders with focus on ungradable disease. The audit demonstrated an acceptable level of quality and accuracy of primary grading in the Bristol and Weston diabetic retinopathy screening programme and provided a standard against which future interobserver agreement can be measured for quality assurance within a screening programme. Diabet. Med. 26, 820-823 (2009).

Development of Indicators to Assess Quality of Care for Prostate Cancer.

PubMed

Nag, Nupur; Millar, Jeremy; Davis, Ian D; Costello, Shaun; Duthie, James B; Mark, Stephen; Delprado, Warick; Smith, David; Pryor, David; Galvin, David; Sullivan, Frank; Murphy, Áine C; Roder, David; Elsaleh, Hany; Currow, David; White, Craig; Skala, Marketa; Moretti, Kim L; Walker, Tony; De Ieso, Paolo; Brooks, Andrew; Heathcote, Peter; Frydenberg, Mark; Thavaseelan, Jeffery; Evans, Sue M

2016-02-20

The development, monitoring, and reporting of indicator measures that describe standard of care provide the gold standard for assessing quality of care and patient outcomes. Although indicator measures have been reported, little evidence of their use in measuring and benchmarking performance is available. A standard set, defining numerator, denominator, and risk adjustments, will enable global benchmarking of quality of care. To develop a set of indicators to enable assessment and reporting of quality of care for men with localised prostate cancer (PCa). Candidate indicators were identified from the literature. An international panel was invited to participate in a modified Delphi process. Teleconferences were held before and after each voting round to provide instruction and to review results. Panellists were asked to rate each proposed indicator on a Likert scale of 1-9 in a two-round iterative process. Calculations required to report on the endorsed indicators were evaluated and modified to reflect the data capture of the Prostate Cancer Outcomes Registry-Australia and New Zealand (PCOR-ANZ). A total of 97 candidate indicators were identified, of which 12 were endorsed. The set includes indicators covering pre-, intra-, and post-treatment of PCa care, within the limits of the data captured by PCOR-ANZ. The 12 endorsed quality measures enable international benchmarking on the quality of care of men with localised PCa. Reporting on these indicators enhances safety and efficacy of treatment, reduces variation in care, and can improve patient outcomes. PCa has the highest incidence of all cancers in men. Early diagnosis and relatively high survival rates mean issues of quality of care and best possible health outcomes for patients are important. This paper identifies 12 important measurable quality indicators in PCa care. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative

PubMed Central

Thomas-Gibson, Siwan; Bugajski, Marek; Bretthauer, Michael; Rees, Colin J; Dekker, Evelien; Hoff, Geir; Jover, Rodrigo; Suchanek, Stepan; Ferlitsch, Monika; Anderson, John; Roesch, Thomas; Hultcranz, Rolf; Racz, Istvan; Kuipers, Ernst J; Garborg, Kjetil; East, James E; Rupinski, Maciej; Seip, Birgitte; Bennett, Cathy; Senore, Carlo; Minozzi, Silvia; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Spada, Cristiano; Hassan, Cesare; Dinis-Ribeiro, Mario; Rutter, Matthew D

2017-01-01

The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for lower gastrointestinal endoscopy. We recommend that endoscopy services across Europe adopt the following seven key performance measures for lower gastrointestinal endoscopy for measurement and evaluation in daily practice at a center and endoscopist level: 1 rate of adequate bowel preparation (minimum standard 90%); 2 cecal intubation rate (minimum standard 90%); 3 adenoma detection rate (minimum standard 25%); 4 appropriate polypectomy technique (minimum standard 80%); 5 complication rate (minimum standard not set); 6 patient experience (minimum standard not set); 7 appropriate post-polypectomy surveillance recommendations (minimum standard not set). Other identified performance measures have been listed as less relevant based on an assessment of their importance, scientific acceptability, feasibility, usability, and comparison to competing measures. PMID:28507745

Escherichia coli and fecal-coliform bacteria as indicators of recreational water quality

USGS Publications Warehouse

Francy, D.S.; Myers, Donna N.; Metzker, K.D.

1993-01-01

In 1986, the U.S. Environmental Protection Agency (USEPA) recommended that Escherichia coli (E. coli) be used in place of fecal-coliform bacteria in State recreational water-quality standards as an indicator of fecal contamination. This announcement followed an epidemiological study in which E. coli concentration was shown to be a better predictor of swimming-associated gastrointestinal illness than fecal-coliform concentration. Water-resource managers from Ohio have decided to collect information specific to their waters and decide whether to use E. coli or fecal-coliform bacteria as the basis for State recreational water-quality standards. If one indicator is a better predictor of recreational water quality than the other and if the relation between the two indicators is variable, then the indicator providing the most accurate measure of recreational water quality should be used in water-quality standards. Water-quality studies of the variability of concentrations of E. coli to fecal-coliform bacteria have shown that (1) concentrations of the two indicators are positively correlated, (2) E. coli to fecal-coliform ratios differ considerably from site to site, and (3) the E. coli criteria recommended by USEPA may be more difficult to meet than current (1992) fecal-coliform standards. In this study, a statistical analysis was done on concentrations of E. coli and fecal-coliform bacteria in water samples collected by two government agencies in Ohio-- the U.S. Geological Survey (USGS) and the Ohio River Valley Water Sanitation Commission (ORSANCO). Data were organized initially into five data sets for statistical analysis: (1) Cuyahoga River, (2) Olentangy River, (3) Scioto River, (4) Ohio River at Anderson Ferry, and (5) Ohio River at Cincinnati Water Works and Tanners Creek. The USGS collected the data in sets 1, 2, and 3, whereas ORSANCO collected the data in sets 4 and 5. The relation of E. coli to fecal-coliform concentration was investigated by use of linear-regression analysis and analysis of covariance. Log-transformed E. coli and fecal-coliform concentrations were highly correlated in all data sets (r-values ranged from 0.929 to 0.984). Linear regression analysis on USGS and ORSANCO data sets showed that concentration of E. coli could be predicted from fecal-coliform concentration (coefficients of determination (R2) ranged from 0.863 to 0.970). Results of analysis of covariance (ANCOVA) indicated that the predictive equations among the three USGS data sets and two ORSANCO data sets were not significantly different and that the data could be pooled into two large data sets, one for USGS data and one for ORSANCO data. However, results of ANCOVA indicated that USGS and ORSANCO data could not be pooled into one large data set. Predictions of E. coli concentrations calculated for USGS And ORSANCO regression relations, based on fecal-coliform concentrations set to equal Ohio water-quality standards, further showed the differences in E. coli to fecal-coliform relations among data sets. For USGS data, a predicted geometric mean of 176 col/100 mL (number of colonies per 100 milliliters) was greater than the current geometric-mean E. coli standard for bathing water of 126 col/100mL. In contrast, for ORSANCO data, the predicted geometric mean of 101 col/100 mL was less than the current E. coli standard. The risk of illness associated with predicted E. coli concentrations for USGS and ORSANCO data was evaluated by use of the USEPA regression equation that predicts swimming-related gastroenteritis rates from E. coli concentrations.1 The predicted geometric-mean E. coli concentrations for bathing water of 176 col/100 mL for USGS data and 101 col/100 mL for ORSANCO data would allow 9.4 and 7.1 gastrointestinal illnesses per 1,000 swimmers, respectively. This prediction compares well with the illness rate of 8 individuals per 1,000 swimmers estimated by the USEPA for an E. coli concentration of 126 col/100 mL. Therefore, the

NAAQS IMPLEMENTATION

EPA Science Inventory

The Clean Air Act requires EPA to set National Ambient Air Quality Standards (NAAQS) for six criteria pollutants (lead, carbon monoxide, sulfur dioxide, nitrous oxides, ozone, and particulate matter). After setting NAAQS, there are several activities required to implement the st...

Reducing lead in air and preventing childhood exposure near lead smelters: learning from the U.S. experience.

PubMed

Sullivan, Marianne

2015-05-01

Childhood lead exposure and poisoning near primary lead smelters continues in developed and developing countries. In the United States, the problem of lead poisoning in children caused by smelter emissions was first documented in the early 1970s. In 1978, Environmental Protection Agency set National Ambient Air Quality Standards for lead. Attainment of this lead standard in areas near operating lead smelters took twenty to thirty years. Childhood lead exposure and poisoning continued to occur after the lead National Ambient Air Quality Standards were set and before compliance was achieved. This article analyzes and discusses the factors that led to the eventual achievement of the 1978 lead National Ambient Air Quality Standards near primary smelters and the reduction of children's blood lead levels in surrounding communities. Factors such as federal and state regulation, monitoring of emissions, public health activities such as blood lead surveillance and health education, relocation of children, environmental group and community advocacy, and litigation all played a role. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Novice teen driving : education and training administrative standards.

DOT National Transportation Integrated Search

2009-10-09

The Novice Teen Driver Education and Training Administrative Standards set forth in this document serve to guide all novice teen driver education and training programs in States striving to provide quality, consistent driver education and training. W...

Multimedia telehomecare system using standard TV set.

PubMed

Guillén, S; Arredondo, M T; Traver, V; García, J M; Fernández, C

2002-12-01

Nowadays, there are a very large number of patients that need specific health support at home. The deployment of broadband communication networks is making feasible the provision of home care services with a proper quality of service. This paper presents a telehomecare multimedia platform that runs over integrated services digital network and internet protocol using videoconferencing standards H.320 and H.323, and standard TV set for patient interaction. This platform allows online remote monitoring: ECG, heart sound, blood pressure. Usability, affordability, and interoperability were considered for the design and development of its hardware and software components. A first evaluation of technical and usability aspects were carried forward with 52 patients of a private clinic and 10 students in the University. Results show a high rate (mean = 4.33, standard deviation--SD = 1.63 in a five-points Likert scale) in the global perception of users on the quality of images, voice, and feeling of virtual presence.

77 FR 64737 - Partial Approval and Partial Disapproval of Air Quality State Implementation Plans; Nevada...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-23

... standard was set at 15 micrograms per cubic meter ([mu]g/m\\3\\), based on the 3-year average of annual... 2.5 standard was set at 65 [mu]g/m\\3\\, based on the 3- year average of the 98th percentile of 24... partially approve the submittal based on EPA's independent evaluation of Nevada's impact on receptor states...

42 CFR 410.143 - Requirements for approved accreditation organizations.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Notice of any proposed changes in its accreditation standards and requirements or evaluation process. If... enforcement of its standards to a set of quality standards (described in § 410.144) and processes when any of the following conditions exist: (i) CMS imposes new requirements or changes its process for approving...

Obtaining greater value from health care: the roles of the U.S. government.

PubMed

Schoenbaum, Stephen C; Audet, Anne-Marie J; Davis, Karen

2003-01-01

The problems of quality and cost in the U.S. health care system are unlikely to be solved without strong leadership from the federal government, which can mobilize action to set national priorities for quality; develop and promulgate standards for care; and stimulate implementation of performance measures and standards for providers. All of these functions would best be carried out by a new federal agency. Furthermore, the federal government should design payment policies based on the performance standards, invest in needed information technology, and invest in research related to improving care and in training professionals to support nationwide quality improvement.

Mental health measurement among women veterans receiving co-located, collaborative care services.

PubMed

Lilienthal, Kaitlin R; Buchholz, Laura J; King, Paul R; Vair, Christina L; Funderburk, Jennifer S; Beehler, Gregory P

2017-12-01

Routine use of measurement to identify patient concerns and track treatment progress is critical to high quality patient care. This is particularly relevant to the Primary Care Behavioral Health model, where rapid symptom assessment and effective referral management are critical to sustaining population-based care. However, research suggests that women who receive treatment in co-located collaborative care settings utilizing the PCBH model are less likely to be assessed with standard measures than men in these settings. The current study utilized regional retrospective data obtained from the Veterans Health Administration's electronic medical record system to: (1) explore rates of mental health measurement for women receiving co-located collaborative care services (N = 1008); and (2) to identify predictors of mental health measurement in women veterans in these settings. Overall, only 8% of women had documentation of standard mental health measures. Measurement was predicted by diagnosis, facility size, length of care episode and care setting. Specifically, women diagnosed with depression were less likely than those with anxiety disorders to have standard mental health measurement documented. Several suggestions are offered to increase the quality of mental health care for women through regular use of measurement in integrated care settings.

US EPA Nonattainment Areas and Designations-PM10 (1987 NAAQS)

EPA Pesticide Factsheets

This web service contains the following layer: PM10 Nonattainment Areas (1987 NAAQS). Full FGDC metadata records for each layer may be found by clicking the layer name at the web service endpoint (https://gispub.epa.gov/arcgis/rest/services/OAR_OAQPS/NAA1987PM10/MapServer) and viewing the layer description. These layers identify areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for criteria air pollutants and have been designated nonattainment?? areas (NAA). The data are updated weekly from an OAQPS internal database. However, that does not necessarily mean the data have changed. The EPA Office of Air Quality Planning and Standards (OAQPS) has set National Ambient Air Quality Standards for six principal pollutants, which are called criteria pollutants. Under provisions of the Clean Air Act, which is intended to improve the quality of the air we breathe, EPA is required to set National Ambient Air Quality Standards for six common air pollutants. These commonly found air pollutants (also known as criteria pollutants) are found all over the United States. They are particle pollution (often referred to as particulate matter), ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. For each criteria pollutant, there are specific procedures used for measuring ambient concentrations and for calculating long-term (quarterly or annual) and/or short-term (24-hour) exposure levels. The metho

US EPA Nonattainment Areas and Designations-Lead (2008 NAAQS)

EPA Pesticide Factsheets

This web service contains the following layers: Lead NAA 2008 NAAQS and Lead NAA Centroids 2008 NAAQS. Full FGDC metadata records for each layer may be found by clicking the layer name at the web service endpoint (https://gispub.epa.gov/arcgis/rest/services/OAR_OAQPS/NAA2008Lead/MapServer) and viewing the layer description. These layers identify areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for criteria air pollutants and have been designated nonattainment?? areas (NAA). The data are updated weekly from an OAQPS internal database. However, that does not necessarily mean the data have changed. The EPA Office of Air Quality Planning and Standards (OAQPS) has set National Ambient Air Quality Standards for six principal pollutants, which are called criteria pollutants. Under provisions of the Clean Air Act, which is intended to improve the quality of the air we breathe, EPA is required to set National Ambient Air Quality Standards for six common air pollutants. These commonly found air pollutants (also known as criteria pollutants) are found all over the United States. They are particle pollution (often referred to as particulate matter), ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. For each criteria pollutant, there are specific procedures used for measuring ambient concentrations and for calculating long-term (quarterly or annual) and/or short-term (24-hour) exposure l

US EPA Nonattainment Areas and Designations-8 Hour Ozone (2008 NAAQS)

EPA Pesticide Factsheets

This web service contains the following layers: Ozone 2008 NAAQS NAA State Level and Ozone 2008 NAAQS NAA National Level. Full FGDC metadata records for each layer may be found by clicking the layer name at the web service endpoint (https://gispub.epa.gov/arcgis/rest/services/OAR_OAQPS/NAA2008Ozone8hour/MapServer) and viewing the layer description. These layers identify areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for criteria air pollutants and have been designated nonattainment?? areas (NAA). The data are updated weekly from an OAQPS internal database. However, that does not necessarily mean the data have changed. The EPA Office of Air Quality Planning and Standards (OAQPS) has set National Ambient Air Quality Standards for six principal pollutants, which are called criteria pollutants. Under provisions of the Clean Air Act, which is intended to improve the quality of the air we breathe, EPA is required to set National Ambient Air Quality Standards for six common air pollutants. These commonly found air pollutants (also known as criteria pollutants) are found all over the United States. They are particle pollution (often referred to as particulate matter), ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. For each criteria pollutant, there are specific procedures used for measuring ambient concentrations and for calculating long-term (quarterly or annual) and/or short-

US EPA Nonattainment Areas and Designations-8 Hour Ozone (1997 NAAQS)

EPA Pesticide Factsheets

This web service contains the following layers: Ozone 1997 NAAQS NAA State Level and Ozone 1997 NAAQS NAA National Level. Full FGDC metadata records for each layer may be found by clicking the layer name at the web service endpoint (https://gispub.epa.gov/arcgis/rest/services/OAR_OAQPS/NAA1997Ozone8hour/MapServer) and viewing the layer description. These layers identify areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for criteria air pollutants and have been designated nonattainment?? areas (NAA). The data are updated weekly from an OAQPS internal database. However, that does not necessarily mean the data have changed. The EPA Office of Air Quality Planning and Standards (OAQPS) has set National Ambient Air Quality Standards for six principal pollutants, which are called criteria pollutants. Under provisions of the Clean Air Act, which is intended to improve the quality of the air we breathe, EPA is required to set National Ambient Air Quality Standards for six common air pollutants. These commonly found air pollutants (also known as criteria pollutants) are found all over the United States. They are particle pollution (often referred to as particulate matter), ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. For each criteria pollutant, there are specific procedures used for measuring ambient concentrations and for calculating long-term (quarterly or annual) and/or short

Quality control and improvement of cancer care: what is needed? 4th European Roundtable Meeting (ERTM) May 5th, 2017, Berlin, Germany.

PubMed

Ortmann, Olaf; Helbig, Ulrike; Torode, Julie; Schreck, Stefan; Karjalainen, Sakari; Bettio, Manola; Ringborg, Ulrik; Klinkhammer-Schalke, Monika; Bray, Freddy

2018-06-01

National Cancer Control Plans (NCCPs) often describe structural requirements for high quality cancer care. During the fourth European Roundtable Meeting (ERTM) participants shared learnings from their own national setting to formulate best practice in optimizing communication strategies between parties involved in clinical cancer registries, cancer centers and guideline groups. A decentralized model of data collection close to the patient and caregiver enhances timely completion and the quality of the data captured. Nevertheless, central coordination is necessary to define datasets, indicators, standard settings, education, training and quality control to maintain standards across the network. In particular, interaction of parties in cancer care network has to be established and maintained on a regular basis. After establishing the structural requirements of cancer care networks, communication between the different components and parties is required to analyze outcome data, provide regular reporting to all and develop strategies for continuous improvement of quality across the network.

Evidence-based quality indicators for stroke rehabilitation.

PubMed

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

2012-01-01

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

Quality of haemophilia care in The Netherlands: new standards for optimal care.

PubMed

Leebeek, Frank W G; Fischer, Kathelijn

2014-04-01

In the Netherlands, the first formal haemophilia comprehensive care centre was established in 1964, and Dutch haemophilia doctors have been organised since 1972. Although several steps were taken to centralise haemophilia care and maintain quality of care, treatment was still delivered in many hospitals, and formal criteria for haemophilia treatment centres as well as a national haemophilia registry were lacking. In collaboration with patients and other stakeholders, Dutch haemophilia doctors have undertaken a formal process to draft new quality standards for the haemophilia treatment centres. First a project group including doctors, nurses, patients and the institute for harmonisation of quality standards undertook a literature study on quality standards and performed explorative visits to several haemophilia treatment centres in the Netherlands. Afterwards concept standards were defined and validated in two treatment centres. Next, the concept standards were evaluated by haemophilia doctors, patients, health insurance representatives and regulators. Finally, the final version of the standards of care was approved by Central body of Experts on quality standards in clinical care and the Dutch Ministry of Health. A team of expert auditors have been trained and, together with an independent auditor, will perform audits in haemophilia centres applying for formal certification. Concomitantly, a national registry for haemophilia and allied disorders is being set up. It is expected that these processes will lead to further concentration and improved quality of haemophilia care in the Netherlands.

Development of the private practice management standards for psychology.

PubMed

Mathews, Rebecca; Stokes, David; Littlefield, Lyn; Collins, Leah

2011-01-01

This paper describes the process of developing a set of private practice management standards to support Australian psychologists and promote high quality services to the public. A review of the literature was conducted to identify management standards relevant to psychology, which were further developed in consultation with a panel of experts in psychology or in the development of standards. Forty-three psychologists in independent private practice took part in either a survey (n=22) to provide feedback on the relevance of, and their compliance with, the identified standards, or a 6-month pilot study (n=21) in which a web-based self-assessment instrument evaluating the final set of standards and performance indicators was implemented in their practice to investigate self-reported change in management procedures. The pilot study demonstrated good outcomes for practitioners when evaluation of compliance to the standards was operationalized in a self-assessment format. Study results are based on a small sample size. Nevertheless, relevance and utility of the standards was found providing an initial version of management standards that have relevance to the practice of psychology in Australia, along with a system for evaluating psychological service provision to ensure best practice in service delivery. © 2010 National Association for Healthcare Quality.

Standards of care provided by early pregnancy assessment units (EPAU): a UK-wide survey.

PubMed

Poddar, A; Tyagi, J; Hawkins, E; Opemuyi, I

2011-10-01

Standards of services provided by the EPAUs across the UK vary from one unit to another. The aim of this purposive sampling self-administered survey was to assess these standards against a benchmark set by the Royal College of Obstetricians and Gynaecologists (RCOG). These standards were set out in a report by a RCOG working party (2008). Out of 181 units contacted in this survey, 140 units responded. We looked at the setup of the EPAU, services offered, accessibility and protocols for management of miscarriage and ectopic pregnancy. The survey shows that there is a considerable variation in the management protocols and the quality of services offered by the EPAUs in the UK. Many units do not meet the standards set by the RCOG.

Table of Historical Carbon Monoxide (CO) National Ambient Air Quality Standards (NAAQS)

EPA Pesticide Factsheets

See the history of limits to the level of carbon monoxide (CO) in ambient air, set through the NAAQS review and rulemaking process under the Clean Air Act. This includes both primary and secondary standards.

Table of Historical Nitrogen Dioxide National Ambient Air Quality Standards (NAAQS)

EPA Pesticide Factsheets

See the history of limits to the level of nitrogen dioxide (NO2) in ambient air, set through the NAAQS review and rulemaking process under the Clean Air Act. This includes both primary and secondary standards.

Table of Historical Sulfur Dioxide National Ambient Air Quality Standards (NAAQS)

EPA Pesticide Factsheets

See the history of limits to the level of sulfur dioxide (SO2) in ambient air, set through the NAAQS review and rulemaking process under the Clean Air Act. This includes both primary and secondary standards.

A Rising Tide of Primary School Standards--The Role of Data Systems in Improving Equitable Access for All to Quality Education in Vietnam

ERIC Educational Resources Information Center

Attfield, Ian; Vu, Binh Thanh

2013-01-01

The approach taken over the past decade to introduce minimum primary school standards in Vietnam is reviewed, with annual school audits that measured both input (quality) and output indicators. It describes a successful, context specific approach in which flexible data systems were used to support the evolution and adoption of a new set of…

Proposed DoD (Department of Defense) Internet Protocol Standard.

DTIC Science & Technology

1982-07-06

parameters fall into two categories: service quality parameters and service options. Service quality parameters influence the transmission service provided...Corporation 6 July 1982 -7- TM-7172/481/OO o Service Quality Parameters - Precedence : attempts preferential treatment for high importance datagrams...select the transmission quality. IP passes the type of service (TOS) command set for service quality to the SNP where it is mapped into subnetwork

Standards of care and quality indicators for multidisciplinary care models for psoriatic arthritis in Spain.

PubMed

Gratacós, Jordi; Luelmo, Jesús; Rodríguez, Jesús; Notario, Jaume; Marco, Teresa Navío; de la Cueva, Pablo; Busquets, Manel Pujol; Font, Mercè García; Joven, Beatriz; Rivera, Raquel; Vega, Jose Luis Alvarez; Álvarez, Antonio Javier Chaves; Parera, Ricardo Sánchez; Carrascosa, Jose Carlos Ruiz; Martínez, Fernando José Rodríguez; Sánchez, José Pardo; Olmos, Carlos Feced; Pujol, Conrad; Galindez, Eva; Barrio, Silvia Pérez; Arana, Ana Urruticoechea; Hergueta, Mercedes; Coto, Pablo; Queiro, Rubén

2018-06-01

To define and give priority to standards of care and quality indicators of multidisciplinary care for patients with psoriatic arthritis (PsA). A systematic literature review on PsA standards of care and quality indicators was performed. An expert panel of rheumatologists and dermatologists who provide multidisciplinary care was established. In a consensus meeting group, the experts discussed and developed the standards of care and quality indicators and graded their priority, agreement and also the feasibility (only for quality indicators) following qualitative methodology and a Delphi process. Afterwards, these results were discussed with 2 focus groups, 1 with patients, another with health managers. A descriptive analysis is presented. We obtained 25 standards of care (9 of structure, 9 of process, 7 of results) and 24 quality indicators (2 of structure, 5 of process, 17 of results). Standards of care include relevant aspects in the multidisciplinary care of PsA patients like an appropriate physical infrastructure and technical equipment, the access to nursing care, labs and imaging techniques, other health professionals and treatments, or the development of care plans. Regarding quality indicators, the definition of multidisciplinary care model objectives and referral criteria, the establishment of responsibilities and coordination among professionals and the active evaluation of patients and data collection were given a high priority. Patients considered all of them as important. This set of standards of care and quality indicators for the multidisciplinary care of patients with PsA should help improve quality of care in these patients.

Water quality assessment of bioenergy production

Treesearch

Rocio Diaz-Chavez; Goran Berndes; Dan Neary; Andre Elia Neto; Mamadou Fall

2011-01-01

Water quality is a measurement of the biological, chemical, and physical characteristics of water against certain standards set to ensure ecological and/or human health. Biomass production and conversion to fuels and electricity can impact water quality in lakes, rivers, and aquifers with consequences for aquatic ecosystem health and also human water uses. Depending on...

Standards of Multimedia Graphic Design in Education

ERIC Educational Resources Information Center

Aldalalah, Osamah Ahmad; Ababneh, Ziad Waleed Mohamed

2015-01-01

This study aims to determine Standards of Multimedia Graphic Design in Education through the analysis of the theoretical basis and previous studies related to this subject. This study has identified the list of standards of Multimedia, Graphic Design, each of which has a set indicator through which the quality of Multimedia can be evaluated in…

Redefining What It Means to Be a Teacher through Professional Standards: Implications for Continuing Teacher Education

ERIC Educational Resources Information Center

Torrance, Deirdre; Forde, Christine

2017-01-01

This article connects with an international debate around the place of professional standards in educational policy targeted at enhancing teacher quality, with associated implications for continuing teacher education. Scotland provides a fertile context for discussion, having developed sets of professional standards in response to a recent…

Adaptation and implementation of standardized order sets in a network of multi-hospital corporations in rural Ontario.

PubMed

Meleskie, Jessica; Eby, Don

2009-01-01

Standardized, preprinted or computer-generated physician orders are an attractive project for organizations that wish to improve the quality of patient care. The successful development and maintenance of order sets is a major undertaking. This article recounts the collaborative experience of the Grey Bruce Health Network in adapting and implementing an existing set of physician orders for use in its three hospital corporations. An Order Set Committee composed of primarily front-line staff was given authority over the order set development, approval and implementation processes. This arrangement bypassed the traditional approval process and facilitated the rapid implementation of a large number of order sets in a short time period.

Importance of implementing an analytical quality control system in a core laboratory.

PubMed

Marques-Garcia, F; Garcia-Codesal, M F; Caro-Narros, M R; Contreras-SanFeliciano, T

2015-01-01

The aim of the clinical laboratory is to provide useful information for screening, diagnosis and monitoring of disease. The laboratory should ensure the quality of extra-analytical and analytical process, based on set criteria. To do this, it develops and implements a system of internal quality control, designed to detect errors, and compare its data with other laboratories, through external quality control. In this way it has a tool to detect the fulfillment of the objectives set, and in case of errors, allowing corrective actions to be made, and ensure the reliability of the results. This article sets out to describe the design and implementation of an internal quality control protocol, as well as its periodical assessment intervals (6 months) to determine compliance with pre-determined specifications (Stockholm Consensus(1)). A total of 40 biochemical and 15 immunochemical methods were evaluated using three different control materials. Next, a standard operation procedure was planned to develop a system of internal quality control that included calculating the error of the analytical process, setting quality specifications, and verifying compliance. The quality control data were then statistically depicted as means, standard deviations, and coefficients of variation, as well as systematic, random, and total errors. The quality specifications were then fixed and the operational rules to apply in the analytical process were calculated. Finally, our data were compared with those of other laboratories through an external quality assurance program. The development of an analytical quality control system is a highly structured process. This should be designed to detect errors that compromise the stability of the analytical process. The laboratory should review its quality indicators, systematic, random and total error at regular intervals, in order to ensure that they are meeting pre-determined specifications, and if not, apply the appropriate corrective actions. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

Combined comfort model of thermal comfort and air quality on buses in Hong Kong.

PubMed

Shek, Ka Wing; Chan, Wai Tin

2008-01-25

Air-conditioning settings are important factors in controlling the comfort of passengers on buses. The local bus operators control in-bus air quality and thermal environment by conforming to the prescribed levels stated in published standards. As a result, the settings are merely adjusted to fulfill the standards, rather than to satisfy the passengers' thermal comfort and air quality. Such "standard-oriented" practices are not appropriate; the passengers' preferences and satisfaction should be emphasized instead. Thus a "comfort-oriented" philosophy should be implemented to achieve a comfortable in-bus commuting environment. In this study, the achievement of a comfortable in-bus environment was examined with emphasis on thermal comfort and air quality. Both the measurement of physical parameters and subjective questionnaire surveys were conducted to collect practical in-bus thermal and air parameters data, as well as subjective satisfaction and sensation votes from the passengers. By analyzing the correlation between the objective and subjective data, a combined comfort models were developed. The models helped in evaluating the percentage of dissatisfaction under various combinations of passengers' sensation votes towards thermal comfort and air quality. An effective approach integrated the combined comfort model, hardware and software systems and the bus air-conditioning system could effectively control the transient in-bus environment. By processing and analyzing the data from the continuous monitoring system with the combined comfort model, air-conditioning setting adjustment commands could be determined and delivered to the hardware. This system adjusted air-conditioning settings depending on real-time commands along the bus journey. Therefore, a comfortable in-bus air quality and thermal environment could be achieved and efficiently maintained along the bus journey despite dynamic outdoor influences. Moreover, this model can help optimize air-conditioning control by striking a beneficial balance between energy conservation and passengers' satisfaction level.

Glocal clinical registries: pacemaker registry design and implementation for global and local integration--methodology and case study.

PubMed

da Silva, Kátia Regina; Costa, Roberto; Crevelari, Elizabeth Sartori; Lacerda, Marianna Sobral; de Moraes Albertini, Caio Marcos; Filho, Martino Martinelli; Santana, José Eduardo; Vissoci, João Ricardo Nickenig; Pietrobon, Ricardo; Barros, Jacson V

2013-01-01

The ability to apply standard and interoperable solutions for implementing and managing medical registries as well as aggregate, reproduce, and access data sets from legacy formats and platforms to advanced standard formats and operating systems are crucial for both clinical healthcare and biomedical research settings. Our study describes a reproducible, highly scalable, standard framework for a device registry implementation addressing both local data quality components and global linking problems. We developed a device registry framework involving the following steps: (1) Data standards definition and representation of the research workflow, (2) Development of electronic case report forms using REDCap (Research Electronic Data Capture), (3) Data collection according to the clinical research workflow and, (4) Data augmentation by enriching the registry database with local electronic health records, governmental database and linked open data collections, (5) Data quality control and (6) Data dissemination through the registry Web site. Our registry adopted all applicable standardized data elements proposed by American College Cardiology / American Heart Association Clinical Data Standards, as well as variables derived from cardiac devices randomized trials and Clinical Data Interchange Standards Consortium. Local interoperability was performed between REDCap and data derived from Electronic Health Record system. The original data set was also augmented by incorporating the reimbursed values paid by the Brazilian government during a hospitalization for pacemaker implantation. By linking our registry to the open data collection repository Linked Clinical Trials (LinkedCT) we found 130 clinical trials which are potentially correlated with our pacemaker registry. This study demonstrates how standard and reproducible solutions can be applied in the implementation of medical registries to constitute a re-usable framework. Such approach has the potential to facilitate data integration between healthcare and research settings, also being a useful framework to be used in other biomedical registries.

Nutriendo la Promesa: Materiales Para la Aplicacion de las Normas de Ejecucion del Programa Head Start. Guia Para la Utilizacion de los Materiales [y] Transparencias (Nurturing the Promise: Set of Training Materials on the Head Start Program Performance Standards. User's Guide [and] Set of Transparencies).

ERIC Educational Resources Information Center

Educational Services, Inc., Washington, DC.

Since 1975, the Head Start Program Performance Standards have defined the services that local programs are required to provide to enrolled children and families. With revisions effective in 1998, the Program Performance Standards translate the Head Start vision into quality practices implemented at the local level. This document is comprised of a…

The quality of care in occupational therapy: an assessment of selected Michigan hospitals.

PubMed

Kirchman, M M

1979-07-01

In this study, a methodology was developed and tested for assessing the quality of care in occupational therapy between educational and noneducational clinical settings, as measured by process and outcome. An instrument was constructed for an external audit of the hospital record. Standards drafted by the investigator were established as normative by a panel of experts for use in judging the programs. Hospital records of 84 patients with residual hemiparesis or hemiplegia in three noneducational settings and of 100 patients with similar diagnoses in two educational clinical settings from selected Michigan facilities were chosen by proportionate stratified random sampling. The process study showed that occupational therapy was of significantly higher quality in the educational settings. The outcome study did not show significant differences between types of settings. Implications for education and practice are discussed.

User-generated quality standards for youth mental health in primary care: a participatory research design using mixed methods

PubMed Central

Graham, Tanya; Rose, Diana; Murray, Joanna; Ashworth, Mark; Tylee, André

2014-01-01

Objectives To develop user-generated quality standards for young people with mental health problems in primary care using a participatory research model. Methods 50 young people aged 16–25 from community settings and primary care participated in focus groups and interviews about their views and experiences of seeking help for mental health problems in primary care, cofacilitated by young service users and repeated to ensure respondent validation. A second group of young people also aged 16–25 who had sought help for any mental health problem from primary care or secondary care within the last 5 years were trained as focus groups cofacilitators (n=12) developed the quality standards from the qualitative data and participated in four nominal groups (n=28). Results 46 quality standards were developed and ranked by young service users. Agreement was defined as 100% of scores within a two-point region. Group consensus existed for 16 quality standards representing the following aspects of primary care: better advertising and information (three); improved competence through mental health training and skill mix within the practice (two); alternatives to medication (three); improved referral protocol (three); and specific questions and reassurances (five). Alternatives to medication and specific questions and reassurances are aspects of quality which have not been previously reported. Conclusions We have demonstrated the feasibility of using participatory research methods in order to develop user-generated quality standards. The development of patient-generated quality standards may offer a more formal method of incorporating the views of service users into quality improvement initiatives. This method can be adapted for generating quality standards applicable to other patient groups. PMID:24920648

A set of care quality indicators for stroke management.

PubMed

Navarro Soler, I M; Ignacio García, E; Masjuan Vallejo, J; Gállego Culleré, J; Mira Solves, J J

2017-06-22

This study proposes a set of quality indicators for care outcomes in patients with acute cerebral infarction. These indicators are understandable and relevant from a clinical viewpoint, as well as being acceptable and feasible in terms of time required, ease of data capture, and interpretability. The method consisted of reaching consensus among doctors after having reviewed the literature on quality indicators in stroke. We then designed and conducted a field study to assess the understandability and feasibility of the set of indicators. Consensus yielded 8 structural indicators, 5 process indicators, and 12 result indicators. Additionally, standards of reference were established for each indicator. This set of indicators can be used to monitor the quality care for stroke patients, identify strengths, and potentially to identify areas needing improvement. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

US EPA Nonattainment Areas and Designations-SO2 (2010 NAAQS)

EPA Pesticide Factsheets

This web service contains the following layer: SO2 2010 NAAQS State Level. Full FGDC metadata records for each layer may be found by clicking the layer name at the web service endpoint (https://gispub.epa.gov/arcgis/rest/services/OAR_OAQPS/NAA2010SO21hour/MapServer) and viewing the layer description. These layers identify areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for criteria air pollutants and have been designated nonattainment?? areas (NAA). The data are updated weekly from an OAQPS internal database. However, that does not necessarily mean the data have changed. The EPA Office of Air Quality Planning and Standards (OAQPS) has set National Ambient Air Quality Standards for six principal pollutants, which are called criteria pollutants. Under provisions of the Clean Air Act, which is intended to improve the quality of the air we breathe, EPA is required to set National Ambient Air Quality Standards for six common air pollutants. These commonly found air pollutants (also known as criteria pollutants) are found all over the United States. They are particle pollution (often referred to as particulate matter), ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. For each criteria pollutant, there are specific procedures used for measuring ambient concentrations and for calculating long-term (quarterly or annual) and/or short-term (24-hour) exposure levels. The methods and a

US EPA Nonattainment Areas and Designations-24 Hour PM2.5 (2006 NAAQS)

EPA Pesticide Factsheets

This web service contains the following layers: PM2.5 24hr 2006 NAAQS State Level and PM2.5 24hr 2006 NAAQS National. Full FGDC metadata records for each layer may be found by clicking the layer name at the web service endpoint (https://gispub.epa.gov/arcgis/rest/services/OAR_OAQPS/NAA2006PM2524hour/MapServer) and viewing the layer description. These layers identify areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for criteria air pollutants and have been designated nonattainment?? areas (NAA). The data are updated weekly from an OAQPS internal database. However, that does not necessarily mean the data have changed. The EPA Office of Air Quality Planning and Standards (OAQPS) has set National Ambient Air Quality Standards for six principal pollutants, which are called criteria pollutants. Under provisions of the Clean Air Act, which is intended to improve the quality of the air we breathe, EPA is required to set National Ambient Air Quality Standards for six common air pollutants. These commonly found air pollutants (also known as criteria pollutants) are found all over the United States. They are particle pollution (often referred to as particulate matter), ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. For each criteria pollutant, there are specific procedures used for measuring ambient concentrations and for calculating long-term (quarterly or annual) and/or short-ter

US EPA Nonattainment Areas and Designations-Annual PM2.5 (1997 NAAQS)

EPA Pesticide Factsheets

This web service contains the following layers: PM2.5 Annual 1997 NAAQS State Level and PM2.5 Annual 1997 NAAQS National . It also contains the following tables: maps99.FRED_MAP_VIEWER.%fred_area_map_data and maps99.FRED_MAP_VIEWER.%fred_area_map_view. Full FGDC metadata records for each layer may be found by clicking the layer name at the web service endpoint (https://gispub.epa.gov/arcgis/rest/services/OAR_OAQPS/NAA1997PM25Annual/MapServer) and viewing the layer description.These layers identify areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for criteria air pollutants and have been designated nonattainment?? areas (NAA). The data are updated weekly from an OAQPS internal database. However, that does not necessarily mean the data have changed. The EPA Office of Air Quality Planning and Standards (OAQPS) has set National Ambient Air Quality Standards for six principal pollutants, which are called criteria pollutants. Under provisions of the Clean Air Act, which is intended to improve the quality of the air we breathe, EPA is required to set National Ambient Air Quality Standards for six common air pollutants. These commonly found air pollutants (also known as criteria pollutants) are found all over the United States. They are particle pollution (often referred to as particulate matter), ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. For each criteria pollutant, there

US EPA Nonattainment Areas and Designations-Annual PM2.5 (2012 NAAQS)

EPA Pesticide Factsheets

This web service contains the following layer: PM2.5 Annual 2012 NAAQS State Level. Full FGDC metadata records for each layer may be found by clicking the layer name at the web service endpoint (https://gispub.epa.gov/arcgis/rest/services/OAR_OAQPS/NAA2012PM25Annual/MapServer) and viewing the layer description. These layers identify areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for criteria air pollutants and have been designated nonattainment?? areas (NAA). The data are updated weekly from an OAQPS internal database. However, that does not necessarily mean the data have changed. The EPA Office of Air Quality Planning and Standards (OAQPS) has set National Ambient Air Quality Standards for six principal pollutants, which are called criteria pollutants. Under provisions of the Clean Air Act, which is intended to improve the quality of the air we breathe, EPA is required to set National Ambient Air Quality Standards for six common air pollutants. These commonly found air pollutants (also known as criteria pollutants) are found all over the United States. They are particle pollution (often referred to as particulate matter), ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. For each criteria pollutant, there are specific procedures used for measuring ambient concentrations and for calculating long-term (quarterly or annual) and/or short-term (24-hour) exposure levels. The me

24 CFR 200.954 - Supplementary specific requirements under the HUD building product standard and certification...

Code of Federal Regulations, 2012 CFR

2012-04-01

... shall also include the manufacturer's name, plant location, and shelf life. (c) Periodic tests and quality assurance. Under the procedures set forth in § 200.935(d)(8) concerning periodic tests and quality... administrator. (2) The administrator shall also review the quality assurance procedures twice a year to assure...

24 CFR 200.954 - Supplementary specific requirements under the HUD building product standard and certification...

Code of Federal Regulations, 2011 CFR

2011-04-01

... shall also include the manufacturer's name, plant location, and shelf life. (c) Periodic tests and quality assurance. Under the procedures set forth in § 200.935(d)(8) concerning periodic tests and quality... administrator. (2) The administrator shall also review the quality assurance procedures twice a year to assure...

Oral Proficiency Standards and Foreign Language Teacher Candidates: Current Findings and Future Research Directions

ERIC Educational Resources Information Center

Glisan, Eileen W.; Swender, Elvira; Surface, Eric A.

2013-01-01

The renewed national focus on teacher quality and effectiveness has resulted in more rigorous standards that describe the knowledge and skills required of teacher candidates across all disciplines. In the area of foreign languages, three sets of professional standards address the oral proficiency of teachers in the target languages they teach…

The Problem of Correspondence of Educational and Professional Standards (Results of Empirical Research)

ERIC Educational Resources Information Center

Piskunova, Elena; Sokolova, Irina; Kalimullin, Aydar

2016-01-01

In the article, the problem of correspondence of educational standards of higher pedagogical education and teacher professional standards in Russia is actualized. Modern understanding of the quality of vocational education suggests that in the process of education the student develops a set of competencies that will enable him or her to carry out…

Voluntary Online-Teaching Standards Come Amid Concerns over Quality

ERIC Educational Resources Information Center

Trotter, Andrew

2008-01-01

As learning over the Internet grows in both popularity and controversy, experts are hoping that a new set of national standards for online teaching may help bring clarity and credibility to an industry that some analysts say sorely needs both. The voluntary standards, released February 21 by the North American Council for Online Learning, or…

Educational Freedom for a Democratic Society: A Critique of National Standards, Goals, and Curriculum.

ERIC Educational Resources Information Center

Miller, Ron, Ed.

This book of essay provides an analysis of how Goals 2000 and other standards-setting initiatives will affect local school districts and private schools. The essayists reflect diverse perspectives on the issue and argue that mandated standards will have devastating effects on children's learning and on the quality of democratic community life.…

The governance of quality management in dutch health care: new developments and strategic challenges.

PubMed

Maarse, J A M; Ruwaard, D; Spreeuwenberg, C

2013-01-01

This article gives a brief sketch of quality management in Dutch health care. Our focus is upon the governance of guideline development and quality measurement. Governance is conceptualized as the structure and process of steering of quality management. The governance structure of guideline development in the Netherlands can be conceptualized as a network without central coordination. Much depends upon the self-initiative of stakeholders. A similar picture can be found in quality measurement. Special attention is given to the development of care standards for chronic disease. Care standards have a broader scope than guidelines and take an explicit patient perspective. They not only contain evidence-based and up-to-date guidelines for the care pathway but also contain standards for self-management. Furthermore, they comprise a set of indicators for measuring the quality of care of the entire pathway covered by the standard. The final part of the article discusses the mission, tasks and strategic challenges of the newly established National Health Care Institute (Zorginstituut Nederland), which is scheduled to be operative in 2013.

Minimum reporting standards for clinical research on groin pain in athletes

PubMed Central

Delahunt, Eamonn; Thorborg, Kristian; Khan, Karim M; Robinson, Philip; Hölmich, Per; Weir, Adam

2015-01-01

Groin pain in athletes is a priority area for sports physiotherapy and sports medicine research. Heterogeneous studies with low methodological quality dominate research related to groin pain in athletes. Low-quality studies undermine the external validity of research findings and limit the ability to generalise findings to the target patient population. Minimum reporting standards for research on groin pain in athletes are overdue. We propose a set of minimum reporting standards based on best available evidence to be utilised in future research on groin pain in athletes. Minimum reporting standards are provided in relation to: (1) study methodology, (2) study participants and injury history, (3) clinical examination, (4) clinical assessment and (5) radiology. Adherence to these minimum reporting standards will strengthen the quality and transparency of research conducted on groin pain in athletes. This will allow an easier comparison of outcomes across studies in the future. PMID:26031644

Estimating the Pollution Risk of Cadmium in Soil Using a Composite Soil Environmental Quality Standard

PubMed Central

Huang, Biao; Zhao, Yongcun

2014-01-01

Estimating standard-exceeding probabilities of toxic metals in soil is crucial for environmental evaluation. Because soil pH and land use types have strong effects on the bioavailability of trace metals in soil, they were taken into account by some environmental protection agencies in making composite soil environmental quality standards (SEQSs) that contain multiple metal thresholds under different pH and land use conditions. This study proposed a method for estimating the standard-exceeding probability map of soil cadmium using a composite SEQS. The spatial variability and uncertainty of soil pH and site-specific land use type were incorporated through simulated realizations by sequential Gaussian simulation. A case study was conducted using a sample data set from a 150 km2 area in Wuhan City and the composite SEQS for cadmium, recently set by the State Environmental Protection Administration of China. The method may be useful for evaluating the pollution risks of trace metals in soil with composite SEQSs. PMID:24672364

Evaluation of Government Quality Assurance Oversight for DoD Acquisition Programs

DTIC Science & Technology

2014-11-03

W. Edwards Deming , Joseph M. Juran,” July 1992, the Aerospace Standard (AS) 9100, and an industrially recognized quality management handbook... Deming , Joseph M. Juran,” July 1992, and Juran’s Quality Handbook (5th Edition). The Navy TQLO publication summarizes the best practices developed by...world renowned quality management experts who have set quality management best practices for more than 50 years ; Philip B. Crosby, W. Edwards Deming , and

The robust design for improving crude palm oil quality in Indonesian Mill

NASA Astrophysics Data System (ADS)

Maretia Benu, Siti; Sinulingga, Sukaria; Matondang, Nazaruddin; Budiman, Irwan

2018-04-01

This research was conducted in palm oil mill in Sumatra Utara Province, Indonesia. Currently, the main product of this mill is Crude Palm Oil (CPO) and hasn’t met the expected standard quality. CPO is the raw material for many fat derivative products. The generally stipulated quality criteria are dirt count, free fatty acid, and moisture of CPO. The aim of this study is to obtain the optimal setting for factor’s affect the quality of CPO. The optimal setting will result in an improvement of product’s quality. In this research, Experimental Design with Taguchi Method is used. Steps of this method are identified influence factors, select the orthogonal array, processed data using ANOVA test and signal to noise ratio, and confirmed the research using Quality Loss Function. The result of this study using Taguchi Method is to suggest to set fruit maturity at 75.4-86.9%, digester temperature at 95°C and press at 21 Ampere to reduce quality deviation until 42.42%.

Advancing Resident Assessment in Graduate Medical Education

PubMed Central

Swing, Susan R.; Clyman, Stephen G.; Holmboe, Eric S.; Williams, Reed G.

2009-01-01

Background The Outcome Project requires high-quality assessment approaches to provide reliable and valid judgments of the attainment of competencies deemed important for physician practice. Intervention The Accreditation Council for Graduate Medical Education (ACGME) convened the Advisory Committee on Educational Outcome Assessment in 2007–2008 to identify high-quality assessment methods. The assessments selected by this body would form a core set that could be used by all programs in a specialty to assess resident performance and enable initial steps toward establishing national specialty databases of program performance. The committee identified a small set of methods for provisional use and further evaluation. It also developed frameworks and processes to support the ongoing evaluation of methods and the longer-term enhancement of assessment in graduate medical education. Outcome The committee constructed a set of standards, a methodology for applying the standards, and grading rules for their review of assessment method quality. It developed a simple report card for displaying grades on each standard and an overall grade for each method reviewed. It also described an assessment system of factors that influence assessment quality. The committee proposed a coordinated, national-level infrastructure to support enhancements to assessment, including method development and assessor training. It recommended the establishment of a new assessment review group to continue its work of evaluating assessment methods. The committee delivered a report summarizing its activities and 5 related recommendations for implementation to the ACGME Board in September 2008. PMID:21975993

Establishing the pharmaceutical quality of Chinese herbal medicine: a provisional BCS classification.

PubMed

Fong, Sophia Y K; Liu, Mary; Wei, Hai; Löbenberg, Raimar; Kanfer, Isadore; Lee, Vincent H L; Amidon, Gordon L; Zuo, Zhong

2013-05-06

The Biopharmaceutical Classification System (BCS), which is a scientific approach to categorize active drug ingredient based on its solubility and intestinal permeability into one of the four classes, has been used to set the pharmaceutical quality standards for drug products in western society. However, it has received little attention in the area of Chinese herbal medicine (CHM). This is likely, in part, due to the presence of multiple active components as well as lack of standardization of CHM. In this report, we apply BCS classification to CHMs provisionally as a basis for establishing improved in vitro quality standards. Based on a top-200 drugs selling list in China, a total of 31 CHM products comprising 50 official active marker compounds (AMCs) were provisionally classified according to BCS. Information on AMC content and doses of these CHM products were retrieved from the Chinese Pharmacopoeia. BCS parameters including solubility and permeability of the AMCs were predicted in silico (ACD/Laboratories). A BCS classification of CHMs according to biopharmaceutical properties of their AMCs is demonstrated to be feasible in the current study and can be used to provide a minimum set of quality standards. Our provisional results showed that 44% of the included AMCs were classified as Class III (high solubility, low permeability), followed by Class II (26%), Class I (18%), and Class IV (12%). A similar trend was observed when CHMs were classified in accordance with the BCS class of AMCs. Most (45%) of the included CHMs were classified as Class III, followed by Class II (16%), Class I (10%), and Class IV (6%); whereas 23% of the CHMs were of mixed class due to the presence of multiple individual AMCs with different BCS classifications. Moreover, about 60% of the AMCs were classified as high-solubility compounds (Class I and Class III), suggesting an important role for an in vitro dissolution test in setting quality control standards ensuring consistent biopharmaceutical quality for the commercially available CHM products. That is, provisionally, more than half of the AMCs of the top-selling CHMs included in this study would be candidates for a bioequivalence (BE) biowaiver, based on WHO recommendations and EMEA guidelines. Thus a dissolution requirement on these AMCs would represent a significant advance in the pharmaceutical quality of CHM today.

[Study on quality standards of decoction pieces of salt Alpinia].

PubMed

Li, Wenbing; Hu, Changjiang; Long, Lanyan; Huang, Qinwan; Xie, Xiuqiong

2010-12-01

To establish the quality criteria for decoction pieces of salt Alpinia. Decoction pieces of salt Alpinia were measured with moisture, total ash, acid-insoluble ash, water-extract and volatile oils according to the procedures recorded in the Chinese Pharmacopoeia 2010. The content of Nootkatone was determined by HPLC, and NaCl, by chloridion electrode method. We obtained results of total ash, acid-insoluble ash, water-extract and volatile oils of 10 batches of decoction pieces of salt Alpinia moisture; Meanwhile we set the HPLC and chloridion electrode method. This research established a fine quality standard for decoction pieces of salt Alpinia.

UK key performance indicators and quality assurance standards for colonoscopy.

PubMed

Rees, Colin J; Thomas Gibson, Siwan; Rutter, Matt D; Baragwanath, Phil; Pullan, Rupert; Feeney, Mark; Haslam, Neil

2016-12-01

Colonoscopy should be delivered by endoscopists performing high quality procedures. The British Society of Gastroenterology, the UK Joint Advisory Group on GI Endoscopy, and the Association of Coloproctology of Great Britain and Ireland have developed quality assurance measures and key performance indicators for the delivery of colonoscopy within the UK. This document sets minimal standards for delivery of procedures along with aspirational targets that all endoscopists should aim for. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Greater vertical spot spacing to improve femtosecond laser capsulotomy quality.

PubMed

Schultz, Tim; Joachim, Stephanie C; Noristani, Rozina; Scott, Wendell; Dick, H Burkhard

2017-03-01

To evaluate the effect of adapted capsulotomy laser settings on the cutting quality in femtosecond laser-assisted cataract surgery. Ruhr-University Eye Clinic, Bochum, Germany. Prospective randomized case series. Eyes were treated with 1 of 2 laser settings. In Group 1, the regular standard settings were used (incisional depth 600 μm, pulse energy 4 μJ, horizontal spot spacing 5 μm, vertical spot spacing 10 μm, treatment time 1.2 seconds). In Group 2, vertical spot spacing was increased to 15 μm and the treatment time was 1.0 seconds. Light microscopy was used to evaluate the cut quality of the capsule edge. The size and number of tags (misplaced laser spots, which form a second cut of the capsule with high tear risk) were evaluated in a blinded manner. Groups were compared using the Mann-Whitney U test. The study comprised 100 eyes (50 eyes in each group). Cataract surgery was successfully completed in all eyes, and no anterior capsule tear occurred during the treatment. Histologically, significant fewer tags were observed with the new capsulotomy laser setting. The mean score for the number and size of free tags was significantly lower in this group than with the standard settings (P < .001). The new laser settings improved cut quality and reduced the number of tags. The modification has the potential to reduce the risk for radial capsule tears in femtosecond laser-assisted cataract surgery. With the new settings, no tags and no capsule tears were observed under the operating microscope in any eye. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

AMT's Position on Physician's Office Laboratories.

ERIC Educational Resources Information Center

AMT Events, 1986

1986-01-01

The following standards are affirmed by the American Medical Technologists organization: (1) regardless of the size of the laboratory setting, the patient deserves the highest quality of laboratory service available; (2) certified personnel should be employed by physicians in office laboratories; (3) quality control should be mandatory and…

Characterizing the Exposure of Regional-Scale Air Quality in the Northeastern United States

EPA Science Inventory

The Clean Air Act (CAA) requires that the United States (U.S.) Environmental Protection Agency (EPA) set National Ambient Air Quality Standards (NAAQS) for pollutants considered harmful to human health and the environment. Previous research has shown that high ambient ozone leve...

Air Quality Criteria for Lead (Final Report, 2006)

EPA Science Inventory

National Ambient Air Quality Standards (NAAQS) are promulgated by the United States Environmental Protection Agency (EPA) to meet requirements set forth in Sections 108 and 109 of the U.S. Clean Air Act. Those two Clean Air Act sections require the EPA Administrator (1) to list w...

The Role of Early Head Start Programs in Addressing the Child Care Needs of Low-Income Families with Infants and Toddlers: Influences on Child Care Use and Quality.

ERIC Educational Resources Information Center

Love, John M.; Constantine, Jill; Paulsell, Diane; Boller, Kimberly; Ross, Christine; Raikes, Helen; Brady-Smith, Christy; Brooks-Gunn, Jeanne

2004-01-01

In 1994, the Secretary's Advisory Committee on Services for Families with Infants and Toddlers set forth a vision for Early Head Start programs in declaring that all child care settings used by Early Head Start families, whether or not the program provides the care directly, must meet the high standards of quality embodied in the Head Start…

Standards for Reporting Mathematics Professional Development in Research Studies

ERIC Educational Resources Information Center

Sztajn, Paola

2011-01-01

This Research Commentary addresses the need for standards for describing mathematics professional development in mathematics education research reports. Considering that mathematics professional development is an emerging research field, it is timely to set expectations for what constitutes high-quality reporting in this field. (Contains 2 tables.)

Generation of silver standard concept annotations from biomedical texts with special relevance to phenotypes.

PubMed

Oellrich, Anika; Collier, Nigel; Smedley, Damian; Groza, Tudor

2015-01-01

Electronic health records and scientific articles possess differing linguistic characteristics that may impact the performance of natural language processing tools developed for one or the other. In this paper, we investigate the performance of four extant concept recognition tools: the clinical Text Analysis and Knowledge Extraction System (cTAKES), the National Center for Biomedical Ontology (NCBO) Annotator, the Biomedical Concept Annotation System (BeCAS) and MetaMap. Each of the four concept recognition systems is applied to four different corpora: the i2b2 corpus of clinical documents, a PubMed corpus of Medline abstracts, a clinical trails corpus and the ShARe/CLEF corpus. In addition, we assess the individual system performances with respect to one gold standard annotation set, available for the ShARe/CLEF corpus. Furthermore, we built a silver standard annotation set from the individual systems' output and assess the quality as well as the contribution of individual systems to the quality of the silver standard. Our results demonstrate that mainly the NCBO annotator and cTAKES contribute to the silver standard corpora (F1-measures in the range of 21% to 74%) and their quality (best F1-measure of 33%), independent from the type of text investigated. While BeCAS and MetaMap can contribute to the precision of silver standard annotations (precision of up to 42%), the F1-measure drops when combined with NCBO Annotator and cTAKES due to a low recall. In conclusion, the performances of individual systems need to be improved independently from the text types, and the leveraging strategies to best take advantage of individual systems' annotations need to be revised. The textual content of the PubMed corpus, accession numbers for the clinical trials corpus, and assigned annotations of the four concept recognition systems as well as the generated silver standard annotation sets are available from http://purl.org/phenotype/resources. The textual content of the ShARe/CLEF (https://sites.google.com/site/shareclefehealth/data) and i2b2 (https://i2b2.org/NLP/DataSets/) corpora needs to be requested with the individual corpus providers.

Recent progress in the development of ISO 19751

NASA Astrophysics Data System (ADS)

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

2006-01-01

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

Peer pressure and public reporting within healthcare setting: improving accountability and health care quality in hospitals.

PubMed

Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Capizzi, Silvio; Ricciardi, Walter

2012-01-01

In the last few years, the need of public reporting of health outcomes has acquired a great importance. The public release of performance results could be a tool for improving health care quality and many attempts have been made in order to introduce public reporting programs within the health care context at different levels. It would be necessary to promote the introduction of a standardized set of outcome and performance measures in order to improve quality of health care services and to make health care providers aware of the importance of transparency and accountability.

Quality-assurance plan for water-quality activities in the North Florida Program Office, Florida District

USGS Publications Warehouse

Berndt, Marian P.; Katz, Brian G.

2000-01-01

In accordance with guidelines set forth by the Office of Water Quality in the Water Resources Division of the U.S. Geological Survey, a quality-assurance plan was created for use by the Florida District's North Florida Program Office in conducting water-quality activities. This plan documents the standards, policies, and procedures used by the North Florida Program Office for activities related to the collection, processing, storage, analysis, and publication of water-quality data.

Teaching Affective Qualities in Physical Education

ERIC Educational Resources Information Center

Heidorn, Brent; Welch, Mindy M.

2010-01-01

Physical educators at all levels have observed learners in a school-based physical education setting as well as physical activity or sport settings outside of organized school curricula demonstrating behaviors deemed inappropriate or inconsistent with professional standards. Because sport is such a public, social, and international phenomenon,…

Core Outcome Set-STAndards for Development: The COS-STAD recommendations.

PubMed

Kirkham, Jamie J; Davis, Katherine; Altman, Douglas G; Blazeby, Jane M; Clarke, Mike; Tunis, Sean; Williamson, Paula R

2017-11-01

The use of core outcome sets (COS) ensures that researchers measure and report those outcomes that are most likely to be relevant to users of their research. Several hundred COS projects have been systematically identified to date, but there has been no formal quality assessment of these studies. The Core Outcome Set-STAndards for Development (COS-STAD) project aimed to identify minimum standards for the design of a COS study agreed upon by an international group, while other specific guidance exists for the final reporting of COS development studies (Core Outcome Set-STAndards for Reporting [COS-STAR]). An international group of experienced COS developers, methodologists, journal editors, potential users of COS (clinical trialists, systematic reviewers, and clinical guideline developers), and patient representatives produced the COS-STAD recommendations to help improve the quality of COS development and support the assessment of whether a COS had been developed using a reasonable approach. An open survey of experts generated an initial list of items, which was refined by a 2-round Delphi survey involving nearly 250 participants representing key stakeholder groups. Participants assigned importance ratings for each item using a 1-9 scale. Consensus that an item should be included in the set of minimum standards was defined as at least 70% of the voting participants from each stakeholder group providing a score between 7 and 9. The Delphi survey was followed by a consensus discussion with the study management group representing multiple stakeholder groups. COS-STAD contains 11 minimum standards that are the minimum design recommendations for all COS development projects. The recommendations focus on 3 key domains: the scope, the stakeholders, and the consensus process. The COS-STAD project has established 11 minimum standards to be followed by COS developers when planning their projects and by users when deciding whether a COS has been developed using reasonable methods.

Optimization of Collision Detection in Surgical Simulations

NASA Astrophysics Data System (ADS)

Custură-Crăciun, Dan; Cochior, Daniel; Neagu, Corneliu

2014-11-01

Just like flight and spaceship simulators already represent a standard, we expect that soon enough, surgical simulators should become a standard in medical applications. A simulations quality is strongly related to the image quality as well as the degree of realism of the simulation. Increased quality requires increased resolution, increased representation speed but more important, a larger amount of mathematical equations. To make it possible, not only that we need more efficient computers, but especially more calculation process optimizations. A simulator executes one of the most complex sets of calculations each time it detects a contact between the virtual objects, therefore optimization of collision detection is fatal for the work-speed of a simulator and hence in its quality

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

EPA Science Inventory

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

Quality Assurance at a Distance: International Accreditation in Taiwan Higher Education

ERIC Educational Resources Information Center

Hou, Angela Yung-Chi

2011-01-01

In response to the global competitiveness in higher education, the government, in recent years, has encouraged Taiwan colleges and universities to seek international accreditation, which raises several questions, such as jurisdiction over national accreditation, a single set of standards for local and global quality assurance, demand for the…

Statistical Process Control: Going to the Limit for Quality.

ERIC Educational Resources Information Center

Training, 1987

1987-01-01

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

45 CFR 205.190 - Standard-setting authority for institutions.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

DESIGN AND EVALUATION OF AN INLET CONDITIONER TO DRY PARTICLES FOR AN AERODYNAMIC PARTICLE SIZER

EPA Science Inventory

Atmospheric particulate matter is one of six pollutants for which the Environmental Protection Agency (EPA) has set National Ambient Air Quality Standards. Particulate matter standards are specified by particle size as PM _2.5 defined as the mass concentration of ′fine...

Baseline Assessment of 25-Hydroxyvitamin D Reference Material and Proficiency Testing/External Quality Assurance Material Commutability: A Vitamin D Standardization Program Study.

PubMed

Phinney, Karen W; Sempos, Christopher T; Tai, Susan S-C; Camara, Johanna E; Wise, Stephen A; Eckfeldt, John H; Hoofnagle, Andrew N; Carter, Graham D; Jones, Julia; Myers, Gary L; Durazo-Arvizu, Ramon; Miller, W Greg; Bachmann, Lorin M; Young, Ian S; Pettit, Juanita; Caldwell, Grahame; Liu, Andrew; Brooks, Stephen P J; Sarafin, Kurtis; Thamm, Michael; Mensink, Gert B M; Busch, Markus; Rabenberg, Martina; Cashman, Kevin D; Kiely, Mairead; Galvin, Karen; Zhang, Joy Y; Kinsella, Michael; Oh, Kyungwon; Lee, Sun-Wha; Jung, Chae L; Cox, Lorna; Goldberg, Gail; Guberg, Kate; Meadows, Sarah; Prentice, Ann; Tian, Lu; Brannon, Patsy M; Lucas, Robyn M; Crump, Peter M; Cavalier, Etienne; Merkel, Joyce; Betz, Joseph M

2017-09-01

The Vitamin D Standardization Program (VDSP) coordinated a study in 2012 to assess the commutability of reference materials and proficiency testing/external quality assurance materials for total 25-hydroxyvitamin D [25(OH)D] in human serum, the primary indicator of vitamin D status. A set of 50 single-donor serum samples as well as 17 reference and proficiency testing/external quality assessment materials were analyzed by participating laboratories that used either immunoassay or LC-MS methods for total 25(OH)D. The commutability test materials included National Institute of Standards and Technology Standard Reference Material 972a Vitamin D Metabolites in Human Serum as well as materials from the College of American Pathologists and the Vitamin D External Quality Assessment Scheme. Study protocols and data analysis procedures were in accordance with Clinical and Laboratory Standards Institute guidelines. The majority of the test materials were found to be commutable with the methods used in this commutability study. These results provide guidance for laboratories needing to choose appropriate reference materials and select proficiency or external quality assessment programs and will serve as a foundation for additional VDSP studies.

Learning in Australian Early Childhood Education and Care Settings: Changing Professional Practice

ERIC Educational Resources Information Center

Tayler, Collette

2012-01-01

For the first time across Australia, early education and care services are subject to a single, national set of regulations and standards governing the quality of provision. Concurrently, a set of outcomes for all children aged from birth to 5 years and a ranking system to make transparent the performance of programmes have been developed. This…

Quality Assurance of RNA Expression Profiling in Clinical Laboratories

PubMed Central

Tang, Weihua; Hu, Zhiyuan; Muallem, Hind; Gulley, Margaret L.

2012-01-01

RNA expression profiles are increasingly used to diagnose and classify disease, based on expression patterns of as many as several thousand RNAs. To ensure quality of expression profiling services in clinical settings, a standard operating procedure incorporates multiple quality indicators and controls, beginning with preanalytic specimen preparation and proceeding thorough analysis, interpretation, and reporting. Before testing, histopathological examination of each cellular specimen, along with optional cell enrichment procedures, ensures adequacy of the input tissue. Other tactics include endogenous controls to evaluate adequacy of RNA and exogenous or spiked controls to evaluate run- and patient-specific performance of the test system, respectively. Unique aspects of quality assurance for array-based tests include controls for the pertinent outcome signatures that often supersede controls for each individual analyte, built-in redundancy for critical analytes or biochemical pathways, and software-supported scrutiny of abundant data by a laboratory physician who interprets the findings in a manner facilitating appropriate medical intervention. Access to high-quality reagents, instruments, and software from commercial sources promotes standardization and adoption in clinical settings, once an assay is vetted in validation studies as being analytically sound and clinically useful. Careful attention to the well-honed principles of laboratory medicine, along with guidance from government and professional groups on strategies to preserve RNA and manage large data sets, promotes clinical-grade assay performance. PMID:22020152

Setting Standards for Medically-Based Running Analysis

PubMed Central

Vincent, Heather K.; Herman, Daniel C.; Lear-Barnes, Leslie; Barnes, Robert; Chen, Cong; Greenberg, Scott; Vincent, Kevin R.

2015-01-01

Setting standards for medically based running analyses is necessary to ensure that runners receive a high-quality service from practitioners. Medical and training history, physical and functional tests, and motion analysis of running at self-selected and faster speeds are key features of a comprehensive analysis. Self-reported history and movement symmetry are critical factors that require follow-up therapy or long-term management. Pain or injury is typically the result of a functional deficit above or below the site along the kinematic chain. PMID:25014394

[Quality of care indicators for the care of human immunodeficiency virus-infected individuals, adapted to the pediatric age].

PubMed

Soler-Palacín, Pere; Provens, Ana Clara; Martín-Nalda, Andrea; Espiau, María; Fernández-Polo, Aurora; Figueras, Concepció

2014-03-01

Since infection with human immunodeficiency virus (HIV) was first described, there have been many advances in its diagnosis, monitoring and treatment. However, few contributions are related to the area of health care quality. In this sense, the Spanish Study Group on AIDS (GESIDA) has developed a set of quality care indicators for adult patients living with HIV infection that includes a total of 66 indicators, 22 of which are considered to be relevant. Standards were calculated for each of them in order to reflect the level of the quality of care offered to these patients. Similar documents for pediatric patients are currently lacking. Preparation of a set of quality care indicators applicable to pediatric patients based on the GESIDA document and the Spanish Guidelines for monitoring of pediatric patients infected with HIV. Each indicator was analysed with respect to the required standards in all patients under 18 years of age followed-up in our Unit, with the aim of evaluating the quality of care provided. A total of 61 indicators were collected (51 from the GESIDA document and 10 from currently available pediatric guidelines), 30 of which were considered to be relevant. An overall compliance of 81%-83% was obtained when assessing the relevant indicators. The availability of health care quality standards is essential for the care of pediatric HIV-infected patients. The assessment of these indicators in our Unit yielded satisfactory results. Copyright © 2012 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Prison Health Care Governance: Guaranteeing Clinical Independence

PubMed Central

Pont, Jörg; Enggist, Stefan; Stöver, Heino; Williams, Brie; Greifinger, Robert

2018-01-01

Clinical independence is an essential component of good health care and health care professionalism, particularly in correctional settings (jails, prisons, and other places of detention), where the relationship between patients and caregivers is not based on free choice and where the punitive correctional setting can challenge optimal medical care. Independence for the delivery of health care services is defined by international standards as a critical element for quality health care in correctional settings, yet many correctional facilities do not meet these standards because of a lack of awareness, persisting legal regulations, contradictory terms of employment for health professionals, or current health care governance structures. We present recommendations for the implementation of independent health care in correctional settings. PMID:29470125

Quality evaluation of value sets from cancer study common data elements using the UMLS semantic groups

PubMed Central

Solbrig, Harold R; Chute, Christopher G

2012-01-01

Objective The objective of this study is to develop an approach to evaluate the quality of terminological annotations on the value set (ie, enumerated value domain) components of the common data elements (CDEs) in the context of clinical research using both unified medical language system (UMLS) semantic types and groups. Materials and methods The CDEs of the National Cancer Institute (NCI) Cancer Data Standards Repository, the NCI Thesaurus (NCIt) concepts and the UMLS semantic network were integrated using a semantic web-based framework for a SPARQL-enabled evaluation. First, the set of CDE-permissible values with corresponding meanings in external controlled terminologies were isolated. The corresponding value meanings were then evaluated against their NCI- or UMLS-generated semantic network mapping to determine whether all of the meanings fell within the same semantic group. Results Of the enumerated CDEs in the Cancer Data Standards Repository, 3093 (26.2%) had elements drawn from more than one UMLS semantic group. A random sample (n=100) of this set of elements indicated that 17% of them were likely to have been misclassified. Discussion The use of existing semantic web tools can support a high-throughput mechanism for evaluating the quality of large CDE collections. This study demonstrates that the involvement of multiple semantic groups in an enumerated value domain of a CDE is an effective anchor to trigger an auditing point for quality evaluation activities. Conclusion This approach produces a useful quality assurance mechanism for a clinical study CDE repository. PMID:22511016

Quality standards for bone conduction implants.

PubMed

Gavilan, Javier; Adunka, Oliver; Agrawal, Sumit; Atlas, Marcus; Baumgartner, Wolf-Dieter; Brill, Stefan; Bruce, Iain; Buchman, Craig; Caversaccio, Marco; De Bodt, Marc T; Dillon, Meg; Godey, Benoit; Green, Kevin; Gstoettner, Wolfgang; Hagen, Rudolf; Hagr, Abdulrahman; Han, Demin; Kameswaran, Mohan; Karltorp, Eva; Kompis, Martin; Kuzovkov, Vlad; Lassaletta, Luis; Li, Yongxin; Lorens, Artur; Martin, Jane; Manoj, Manikoth; Mertens, Griet; Mlynski, Robert; Mueller, Joachim; O'Driscoll, Martin; Parnes, Lorne; Pulibalathingal, Sasidharan; Radeloff, Andreas; Raine, Christopher H; Rajan, Gunesh; Rajeswaran, Ranjith; Schmutzhard, Joachim; Skarzynski, Henryk; Skarzynski, Piotr; Sprinzl, Georg; Staecker, Hinrich; Stephan, Kurt; Sugarova, Serafima; Tavora, Dayse; Usami, Shin-Ichi; Yanov, Yuri; Zernotti, Mario; Zorowka, Patrick; de Heyning, Paul Van

2015-01-01

Bone conduction implants are useful in patients with conductive and mixed hearing loss for whom conventional surgery or hearing aids are no longer an option. They may also be used in patients affected by single-sided deafness. To establish a consensus on the quality standards required for centers willing to create a bone conduction implant program. To ensure a consistently high level of service and to provide patients with the best possible solution the members of the HEARRING network have established a set of quality standards for bone conduction implants. These standards constitute a realistic minimum attainable by all implant clinics and should be employed alongside current best practice guidelines. Fifteen items are thoroughly analyzed. They include team structure, accommodation and clinical facilities, selection criteria, evaluation process, complete preoperative and surgical information, postoperative fitting and assessment, follow-up, device failure, clinical management, transfer of care and patient complaints.

The administrator's quest for quality.

PubMed

Ross, A

1988-01-01

Times are tough and will become even tougher. Retrenchment issues will be foremost in many operational settings. Failure to understand baseline quality standards will make it extremely difficult to know where to cut and how to regroup without adversely affecting patient attitudes and service. Practice patterns are changing rapidly and the astute administrator needs to be prepared to participate freely in decisions affecting quality, service and costs.

Using collective expert judgements to evaluate quality measures of mass spectrometry images.

PubMed

Palmer, Andrew; Ovchinnikova, Ekaterina; Thuné, Mikael; Lavigne, Régis; Guével, Blandine; Dyatlov, Andrey; Vitek, Olga; Pineau, Charles; Borén, Mats; Alexandrov, Theodore

2015-06-15

Imaging mass spectrometry (IMS) is a maturating technique of molecular imaging. Confidence in the reproducible quality of IMS data is essential for its integration into routine use. However, the predominant method for assessing quality is visual examination, a time consuming, unstandardized and non-scalable approach. So far, the problem of assessing the quality has only been marginally addressed and existing measures do not account for the spatial information of IMS data. Importantly, no approach exists for unbiased evaluation of potential quality measures. We propose a novel approach for evaluating potential measures by creating a gold-standard set using collective expert judgements upon which we evaluated image-based measures. To produce a gold standard, we engaged 80 IMS experts, each to rate the relative quality between 52 pairs of ion images from MALDI-TOF IMS datasets of rat brain coronal sections. Experts' optional feedback on their expertise, the task and the survey showed that (i) they had diverse backgrounds and sufficient expertise, (ii) the task was properly understood, and (iii) the survey was comprehensible. A moderate inter-rater agreement was achieved with Krippendorff's alpha of 0.5. A gold-standard set of 634 pairs of images with accompanying ratings was constructed and showed a high agreement of 0.85. Eight families of potential measures with a range of parameters and statistical descriptors, giving 143 in total, were evaluated. Both signal-to-noise and spatial chaos-based measures performed highly with a correlation of 0.7 to 0.9 with the gold standard ratings. Moreover, we showed that a composite measure with the linear coefficients (trained on the gold standard with regularized least squares optimization and lasso) showed a strong linear correlation of 0.94 and an accuracy of 0.98 in predicting which image in a pair was of higher quality. The anonymized data collected from the survey and the Matlab source code for data processing can be found at: https://github.com/alexandrovteam/IMS_quality. © The Author 2015. Published by Oxford University Press.

Using collective expert judgements to evaluate quality measures of mass spectrometry images

PubMed Central

Palmer, Andrew; Ovchinnikova, Ekaterina; Thuné, Mikael; Lavigne, Régis; Guével, Blandine; Dyatlov, Andrey; Vitek, Olga; Pineau, Charles; Borén, Mats; Alexandrov, Theodore

2015-01-01

Motivation: Imaging mass spectrometry (IMS) is a maturating technique of molecular imaging. Confidence in the reproducible quality of IMS data is essential for its integration into routine use. However, the predominant method for assessing quality is visual examination, a time consuming, unstandardized and non-scalable approach. So far, the problem of assessing the quality has only been marginally addressed and existing measures do not account for the spatial information of IMS data. Importantly, no approach exists for unbiased evaluation of potential quality measures. Results: We propose a novel approach for evaluating potential measures by creating a gold-standard set using collective expert judgements upon which we evaluated image-based measures. To produce a gold standard, we engaged 80 IMS experts, each to rate the relative quality between 52 pairs of ion images from MALDI-TOF IMS datasets of rat brain coronal sections. Experts’ optional feedback on their expertise, the task and the survey showed that (i) they had diverse backgrounds and sufficient expertise, (ii) the task was properly understood, and (iii) the survey was comprehensible. A moderate inter-rater agreement was achieved with Krippendorff’s alpha of 0.5. A gold-standard set of 634 pairs of images with accompanying ratings was constructed and showed a high agreement of 0.85. Eight families of potential measures with a range of parameters and statistical descriptors, giving 143 in total, were evaluated. Both signal-to-noise and spatial chaos-based measures performed highly with a correlation of 0.7 to 0.9 with the gold standard ratings. Moreover, we showed that a composite measure with the linear coefficients (trained on the gold standard with regularized least squares optimization and lasso) showed a strong linear correlation of 0.94 and an accuracy of 0.98 in predicting which image in a pair was of higher quality. Availability and implementation: The anonymized data collected from the survey and the Matlab source code for data processing can be found at: https://github.com/alexandrovteam/IMS_quality. Contact: theodore.alexandrov@embl.de PMID:26072506

Standardization of Analysis Sets for Reporting Results from ADNI MRI Data

PubMed Central

Wyman, Bradley T.; Harvey, Danielle J.; Crawford, Karen; Bernstein, Matt A.; Carmichael, Owen; Cole, Patricia E.; Crane, Paul; DeCarli, Charles; Fox, Nick C.; Gunter, Jeffrey L.; Hill, Derek; Killiany, Ronald J.; Pachai, Chahin; Schwarz, Adam J.; Schuff, Norbert; Senjem, Matthew L.; Suhy, Joyce; Thompson, Paul M.; Weiner, Michael; Jack, Clifford R.

2013-01-01

The ADNI 3D T1-weighted MRI acquisitions provide a rich dataset for developing and testing analysis techniques for extracting structural endpoints. To promote greater rigor in analysis and meaningful comparison of different algorithms, the ADNI MRI Core has created standardized analysis sets of data comprising scans that met minimum quality control requirements. We encourage researchers to test and report their techniques against these data. Standard analysis sets of volumetric scans from ADNI-1 have been created, comprising: screening visits, 1 year completers (subjects who all have screening, 6 and 12 month scans), two year annual completers (screening, 1, and 2 year scans), two year completers (screening, 6 months, 1 year, 18 months (MCI only) and 2 years) and complete visits (screening, 6 months, 1 year, 18 months (MCI only), 2, and 3 year (normal and MCI only) scans). As the ADNI-GO/ADNI-2 data becomes available, updated standard analysis sets will be posted regularly. PMID:23110865

Methods to characterize environmental settings of stream and groundwater sampling sites for National Water-Quality Assessment

USGS Publications Warehouse

Nakagaki, Naomi; Hitt, Kerie J.; Price, Curtis V.; Falcone, James A.

2012-01-01

Characterization of natural and anthropogenic features that define the environmental settings of sampling sites for streams and groundwater, including drainage basins and groundwater study areas, is an essential component of water-quality and ecological investigations being conducted as part of the U.S. Geological Survey's National Water-Quality Assessment program. Quantitative characterization of environmental settings, combined with physical, chemical, and biological data collected at sampling sites, contributes to understanding the status of, and influences on, water-quality and ecological conditions. To support studies for the National Water-Quality Assessment program, a geographic information system (GIS) was used to develop a standard set of methods to consistently characterize the sites, drainage basins, and groundwater study areas across the nation. This report describes three methods used for characterization-simple overlay, area-weighted areal interpolation, and land-cover-weighted areal interpolation-and their appropriate applications to geographic analyses that have different objectives and data constraints. In addition, this document records the GIS thematic datasets that are used for the Program's national design and data analyses.

Designing image segmentation studies: Statistical power, sample size and reference standard quality.

PubMed

Gibson, Eli; Hu, Yipeng; Huisman, Henkjan J; Barratt, Dean C

2017-12-01

Segmentation algorithms are typically evaluated by comparison to an accepted reference standard. The cost of generating accurate reference standards for medical image segmentation can be substantial. Since the study cost and the likelihood of detecting a clinically meaningful difference in accuracy both depend on the size and on the quality of the study reference standard, balancing these trade-offs supports the efficient use of research resources. In this work, we derive a statistical power calculation that enables researchers to estimate the appropriate sample size to detect clinically meaningful differences in segmentation accuracy (i.e. the proportion of voxels matching the reference standard) between two algorithms. Furthermore, we derive a formula to relate reference standard errors to their effect on the sample sizes of studies using lower-quality (but potentially more affordable and practically available) reference standards. The accuracy of the derived sample size formula was estimated through Monte Carlo simulation, demonstrating, with 95% confidence, a predicted statistical power within 4% of simulated values across a range of model parameters. This corresponds to sample size errors of less than 4 subjects and errors in the detectable accuracy difference less than 0.6%. The applicability of the formula to real-world data was assessed using bootstrap resampling simulations for pairs of algorithms from the PROMISE12 prostate MR segmentation challenge data set. The model predicted the simulated power for the majority of algorithm pairs within 4% for simulated experiments using a high-quality reference standard and within 6% for simulated experiments using a low-quality reference standard. A case study, also based on the PROMISE12 data, illustrates using the formulae to evaluate whether to use a lower-quality reference standard in a prostate segmentation study. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Glocal Clinical Registries: Pacemaker Registry Design and Implementation for Global and Local Integration – Methodology and Case Study

PubMed Central

da Silva, Kátia Regina; Costa, Roberto; Crevelari, Elizabeth Sartori; Lacerda, Marianna Sobral; de Moraes Albertini, Caio Marcos; Filho, Martino Martinelli; Santana, José Eduardo; Vissoci, João Ricardo Nickenig; Pietrobon, Ricardo; Barros, Jacson V.

2013-01-01

Background The ability to apply standard and interoperable solutions for implementing and managing medical registries as well as aggregate, reproduce, and access data sets from legacy formats and platforms to advanced standard formats and operating systems are crucial for both clinical healthcare and biomedical research settings. Purpose Our study describes a reproducible, highly scalable, standard framework for a device registry implementation addressing both local data quality components and global linking problems. Methods and Results We developed a device registry framework involving the following steps: (1) Data standards definition and representation of the research workflow, (2) Development of electronic case report forms using REDCap (Research Electronic Data Capture), (3) Data collection according to the clinical research workflow and, (4) Data augmentation by enriching the registry database with local electronic health records, governmental database and linked open data collections, (5) Data quality control and (6) Data dissemination through the registry Web site. Our registry adopted all applicable standardized data elements proposed by American College Cardiology / American Heart Association Clinical Data Standards, as well as variables derived from cardiac devices randomized trials and Clinical Data Interchange Standards Consortium. Local interoperability was performed between REDCap and data derived from Electronic Health Record system. The original data set was also augmented by incorporating the reimbursed values paid by the Brazilian government during a hospitalization for pacemaker implantation. By linking our registry to the open data collection repository Linked Clinical Trials (LinkedCT) we found 130 clinical trials which are potentially correlated with our pacemaker registry. Conclusion This study demonstrates how standard and reproducible solutions can be applied in the implementation of medical registries to constitute a re-usable framework. Such approach has the potential to facilitate data integration between healthcare and research settings, also being a useful framework to be used in other biomedical registries. PMID:23936257

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

PubMed

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

2012-02-01

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

42 CFR 494.110 - Condition: Quality assessment and performance improvement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... time. (c) Standard: Prioritizing improvement activities. The dialysis facility must set priorities for performance improvement, considering prevalence and severity of identified problems and giving priority to...

Factors Affecting Success of Training Companies

ERIC Educational Resources Information Center

Rogala, Piotr; Batko, Roman; Wawak, Slawomir

2017-01-01

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

Air Quality Impacts of Increased Use of Ethanol under the United States' Energy Independence and Security Act

EPA Science Inventory

Increased use of ethanol in the United States fuel supply will impact emissions and ambient concentrations of greenhouse gases, “criteria” pollutants for which the U. S. EPA sets ambient air quality standards, and a variety of air toxic compounds. This paper focuses on impacts of...

Poor nutrition on the menu: children's meals at America's top chain restaurants.

PubMed

Batada, Ameena; Bruening, Meg; Marchlewicz, Elizabeth H; Story, Mary; Wootan, Margo G

2012-06-01

We evaluated the nutritional quality of children's meals at chain restaurants, because children obtain about a third of their daily calories from away-from-home foods and studies show that restaurant foods are often higher in calories and lower in nutritional value than foods prepared at home. We assessed the nutritional quality of children's meals at the 50 largest U.S. restaurant chains by visiting each chain's web site or calling the company. Eighteen of the chains did not have children's meals and 10 did not provide adequate nutrition information to be included in the study. The nutritional quality of each meal combination was evaluated against a set of nutrition standards based on key nutrition recommendations in the Dietary Guidelines for Americans. Of the 22 restaurants that had children's menus and available nutrition information, 99% of 1662 children's meal combinations were of poor nutritional quality. Restaurants should support healthier choices for children by reformulating existing menu items and adding new healthier items, posting calories on menus, and setting nutrition standards for marketing to children.

Technology in the Trenches: Using Standards To Improve the Quality of Instruction.

ERIC Educational Resources Information Center

Soine, Robin

New approaches to teaching and learning are common, but nothing will change unless these ideas are brought to the frontlines of the classroom. Facing the challenge to incorporate varied innovative teaching and learning strategies, set statewide and schoolwide goals, and implement standards, schools need a systematic, consistent framework and high…

40 CFR 428.66 - Pretreatment standards for new sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... treatment works must comply with 40 CFR part 403, in addition to the limitations set forth in paragraphs (a) and (b) of this section. (a) The following pretreatment standard establishes the quantity or quality... publicly owned treatment works by a new point source subject to the provisions of this subpart: Pollutant...

40 CFR 428.66 - Pretreatment standards for new sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... treatment works must comply with 40 CFR part 403, in addition to the limitations set forth in paragraphs (a) and (b) of this section. (a) The following pretreatment standard establishes the quantity or quality... publicly owned treatment works by a new point source subject to the provisions of this subpart: Pollutant...

40 CFR 428.76 - Pretreatment standards for new sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

... treatment works must comply with 40 CFR part 403, in addition to the limitations set forth in paragraphs (a) and (b) of this section. (a) The following pretreatment standard establishes the quantity or quality... publicly owned treatment works by a new point source subject to the provisions of this subpart: Pollutant...

40 CFR 428.106 - Pretreatment standards for new sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

... works must comply with 40 CFR part 403, in addition to the limitations set forth in paragraphs (a) and (b) of this section. (a) The following pretreatment standard establishes the quantity or quality of... treatment works by a new point source subject to the provisions of this subpart: Pollutant or pollutant...

40 CFR 428.56 - Pretreatment standards for new sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

... treatment works must comply with 40 CFR part 403, in addition to the limitations set forth in paragraphs (a) and (b) of this section. (a) The following pretreatment standard establishes the quantity or quality... publicly owned treatment works by a new point source subject to the provisions of this subpart: Pollutant...

40 CFR 428.66 - Pretreatment standards for new sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

... treatment works must comply with 40 CFR part 403, in addition to the limitations set forth in paragraphs (a) and (b) of this section. (a) The following pretreatment standard establishes the quantity or quality... publicly owned treatment works by a new point source subject to the provisions of this subpart: Pollutant...

Report to NATEF Board of Trustees on Certification and Update Training.

ERIC Educational Resources Information Center

Shoemaker, Byrl R.

The automotive industry continues to be the only industry that has set national standards for vocational-technical education and certification programs that meet those standards. The certification program for automotive technician training has proved that it improves the quality of training in programs at secondary and postsecondary levels.…

Practical considerations for obtaining high quality quantitative computed tomography data of the skeletal system.

PubMed

Troy, Karen L; Edwards, W Brent

2018-05-01

Quantitative CT (QCT) analysis involves the calculation of specific parameters such as bone volume and density from CT image data, and can be a powerful tool for understanding bone quality and quantity. However, without careful attention to detail during all steps of the acquisition and analysis process, data can be of poor- to unusable-quality. Good quality QCT for research requires meticulous attention to detail and standardization of all aspects of data collection and analysis to a degree that is uncommon in a clinical setting. Here, we review the literature to summarize practical and technical considerations for obtaining high quality QCT data, and provide examples of how each recommendation affects calculated variables. We also provide an overview of the QCT analysis technique to illustrate additional opportunities to improve data reproducibility and reliability. Key recommendations include: standardizing the scanner and data acquisition settings, minimizing image artifacts, selecting an appropriate reconstruction algorithm, and maximizing repeatability and objectivity during QCT analysis. The goal of the recommendations is to reduce potential sources of error throughout the analysis, from scan acquisition to the interpretation of results. Copyright © 2018 Elsevier Inc. All rights reserved.

Measuring housing quality in the absence of a monetized real estate market.

PubMed

Rindfuss, Ronald R; Piotrowski, Martin; Thongthai, Varachai; Prasartkul, Pramote

2007-03-01

Measuring housing quality or value or both has been a weak component of demographic and development research in less developed countries that lack an active real estate (housing) market. We describe a new method based on a standardized subjective rating process. It is designed to be used in settings that do not have an active, monetized housing market. The method is applied in an ongoing longitudinal study in north-east Thailand and could be straightforwardly used in many other settings. We develop a conceptual model of the process whereby households come to reside in high-quality or low-quality housing units. We use this theoretical model in conjunction with longitudinal data to show that the new method of measuring housing quality behaves as theoretically expected, thus providing evidence of face validity.

[Quality control and assessment of qualitative interview in health care research].

PubMed

Xie, Yan-ming; Liao, Xing

2008-07-01

It is not finally concluded how to standardize the use of qualitative research in the world. Qualitative researchers disagree with each other about this issue. As we know, there have been a large number of articles written in different ways about qualitative research due to the "flexibility", one of its features. Qualitative research is quite different from quantitative research which is easy to control its quality and quality assessment. A series of criteria has been set up for quantitative research. However qualitative research needs to be improved in these aspects, in which qualitative interviews are mostly used at home and abroad at present. Hence, it becomes an important and urgent issue for qualitative researchers to standardly control and assess the quality of qualitative interview.

Ten tips for incorporating scientific quality improvement into everyday work.

PubMed

Goldmann, Don

2011-04-01

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

Ten tips for incorporating scientific quality improvement into everyday work

PubMed Central

2011-01-01

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

[Standard operating procedures in ethic committees].

PubMed

Czarkowski, Marek

2006-02-01

Polish ethic committees should have to work together in order to maintain and develop high quality standards in the protection of human subjects. Exchanging knowledge, know-how and information polish ethic committees should have to implement standard operating procedures. Procedures should improve quality and proficiency of all types of ethic committee's activities. Standard operating procedures should cover as important problems as conflict of interest, trial's insurance or elections of ethic committees. The opinions of experts who have been reviewing medical research projects for several years may prove to be especially valuable in this setting. Governmental initiatives and creation of forum for polish ethic committees are essential in the effective standardisation, coordination and implementation of procedures in regional ethic committees. These projects need support via public funding from our authorities.

The Victorian Lung Cancer Registry pilot: improving the quality of lung cancer care through the use of a disease quality registry.

PubMed

Stirling, Rob G; Evans, S M; McLaughlin, P; Senthuren, M; Millar, J; Gooi, J; Irving, L; Mitchell, P; Haydon, A; Ruben, J; Conron, M; Leong, T; Watkins, N; McNeil, J J

2014-10-01

Lung cancer remains a major disease burden in Victoria (Australia) and requires a complex and multidisciplinary approach to ensure optimal care and outcomes. To date, no uniform mechanism is available to capture standardized population-based outcomes and thereby provide benchmarking. The establishment of such a data platform is, therefore, a primary requisite to enable description of process and outcome in lung cancer care and to drive improvement in the quality of care provided to individuals with lung cancer. A disease quality registry pilot has been established to capture prospective data on all adult patients with clinical or tissue diagnoses of small cell and non-small cell lung cancer. Steering and management committees provide clinical governance and supervise quality indicator selection. Quality indicators were selected following extensive literature review and evaluation of established clinical practice guidelines. A minimum dataset has been established and training and data capture by data collectors is facilitated using a web-based portal. Case ascertainment is established by regular institutional reporting of ICD-10 discharge coding. Recruitment is optimized by provision of opt-out consent. The collection of a standardized minimum data set optimizes capacity for harmonized population-based data capture. Data collection has commenced in a variety of settings reflecting metropolitan and rural, and public, and private health care institutions. The data set provides scope for the construction of a risk-adjusted model for outcomes. A data access policy and a mechanism for escalation policy for outcome outliers has been established. The Victorian Lung Cancer Registry provides a unique capacity to provide and confirm quality assessment in lung cancer and to drive improvement in quality of care across multidisciplinary stakeholders.

Design and Establishment of Quality Model of Fundamental Geographic Information Database

NASA Astrophysics Data System (ADS)

Ma, W.; Zhang, J.; Zhao, Y.; Zhang, P.; Dang, Y.; Zhao, T.

2018-04-01

In order to make the quality evaluation for the Fundamental Geographic Information Databases(FGIDB) more comprehensive, objective and accurate, this paper studies and establishes a quality model of FGIDB, which formed by the standardization of database construction and quality control, the conformity of data set quality and the functionality of database management system, and also designs the overall principles, contents and methods of the quality evaluation for FGIDB, providing the basis and reference for carry out quality control and quality evaluation for FGIDB. This paper designs the quality elements, evaluation items and properties of the Fundamental Geographic Information Database gradually based on the quality model framework. Connected organically, these quality elements and evaluation items constitute the quality model of the Fundamental Geographic Information Database. This model is the foundation for the quality demand stipulation and quality evaluation of the Fundamental Geographic Information Database, and is of great significance on the quality assurance in the design and development stage, the demand formulation in the testing evaluation stage, and the standard system construction for quality evaluation technology of the Fundamental Geographic Information Database.

El Camino Hospital: using health information technology to promote patient safety.

PubMed

Bukunt, Susan; Hunter, Christine; Perkins, Sharon; Russell, Diana; Domanico, Lee

2005-10-01

El Camino Hospital is a leader in the use of health information technology to promote patient safety, including bar coding, computerized order entry, electronic medical records, and wireless communications. Each year, El Camino Hospital's board of directors sets performance expectations for the chief executive officer, which are tied to achievement of local, regional, and national safety and quality standards, including the six Institute of Medicine quality dimensions. He then determines a set of explicit quality goals and measurable actions, which serve as guidelines for the overall hospital. The goals and progress reports are widely shared with employees, medical staff, patients and families, and the public. For safety, for example, the medication error reduction team tracks and reviews medication error rates. The hospital has virtually eliminated transcription errors through its 100% use of computerized physician order entry. Clinical pathways and standard order sets have reduced practice variation, providing a safer environment. Many projects focused on timeliness, such as emergency department wait time, lab turnaround time, and pneumonia time to initial antibiotic. Results have been mixed, with projects most successful when a link was established with patient outcomes, such as in reducing time to percutaneous transluminal coronary angioplasty for patients with acute myocardial infarction.

Quality audit--a review of the literature concerning delivery of continence care.

PubMed

Swaffield, J

1995-09-01

This paper outlines the role of quality audit within the framework of quality assurance, presenting the concurrent and retrospective approaches available. The literature survey provides a review of the limited audit tools available and their application to continence services and care delivery, as well as attempts to produce tools from national and local standard setting. Audit is part of a process; it can involve staff, patients and their relatives and the team of professionals providing care, as well as focusing on organizational and management levels. In an era of market delivery of services there is a need to justify why audit is important to continence advisors and managers. Effectiveness, efficiency and economics may drive the National Health Service, but quality assurance, which includes standards and audit tools, offers the means to ensure the quality of continence services and care to patients and auditing is also required in the purchaser/provider contracts for patient services. An overview and progress to date of published and other a projects in auditing continence care and service is presented. By outlining and highlighting the audit of continence service delivery and care as a basis on which to build quality assurance programmes, it is hoped that this knowledge will be shared through the setting up of a central auditing clearing project.

Variation in passing standards for graduation-level knowledge items at UK medical schools.

PubMed

Taylor, Celia A; Gurnell, Mark; Melville, Colin R; Kluth, David C; Johnson, Neil; Wass, Val

2017-06-01

Given the absence of a common passing standard for students at UK medical schools, this paper compares independently set standards for common 'one from five' single-best-answer (multiple-choice) items used in graduation-level applied knowledge examinations and explores potential reasons for any differences. A repeated cross-sectional study was conducted. Participating schools were sent a common set of graduation-level items (55 in 2013-2014; 60 in 2014-2015). Items were selected against a blueprint and subjected to a quality review process. Each school employed its own standard-setting process for the common items. The primary outcome was the passing standard for the common items by each medical school set using the Angoff or Ebel methods. Of 31 invited medical schools, 22 participated in 2013-2014 (71%) and 30 (97%) in 2014-2015. Schools used a mean of 49 and 53 common items in 2013-2014 and 2014-2015, respectively, representing around one-third of the items in the examinations in which they were embedded. Data from 19 (61%) and 26 (84%) schools, respectively, met the inclusion criteria for comparison of standards. There were statistically significant differences in the passing standards set by schools in both years (effect sizes (f 2 ): 0.041 in 2013-2014 and 0.218 in 2014-2015; both p < 0.001). The interquartile range of standards was 5.7 percentage points in 2013-2014 and 6.5 percentage points in 2014-2015. There was a positive correlation between the relative standards set by schools in the 2 years (Pearson's r = 0.57, n = 18, p = 0.014). Time allowed per item, method of standard setting and timing of examination in the curriculum did not have a statistically significant impact on standards. Independently set standards for common single-best-answer items used in graduation-level examinations vary across UK medical schools. Further work to examine standard-setting processes in more detail is needed to help explain this variability and develop methods to reduce it. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Quality assurance plan for discharge measurements using broadband acoustic Doppler current profilers

USGS Publications Warehouse

Lipscomb, S.W.

1995-01-01

The recent introduction of the Acoustic Doppler Current Profiler (ADCP) as an instrument for measuring velocities and discharge in the riverine and estuarine environment promises to revolutionize the way these data are collected by the U.S. Geological Survey. The ADCP and associated software, however, compose a complex system and should be used only by qualifies personnel. Standard procedures should be rigorously followed to ensure that the quality of data collected is commensurate with the standards set by the Water Resources Division for all its varied activities in hydrologic investigations.

Comparison of data used for setting occupational exposure limits.

PubMed

Schenk, Linda

2010-01-01

It has previously been shown that occupational exposure limits (OELs) for the same substance can vary significantly between different standard-setters. The work presented in this paper identifies the steps in the process towards establishing an OEL and how variations in those processes could account for these differences. This study selects for further scrutiny substances for which the level of OELs vary by a factor of 100, focussing on 45 documents concerning 14 substances from eight standard-setters. Several of the OELs studied were more than 20 years old and based on outdated knowledge. Furthermore, different standard-setters sometimes based their OELs on different sets of data, and data availability alone could not explain all differences in the selection of data sets used by standard-setters. While the interpretation of key studies did not differ significantly in standard-setters' documentations, the evaluations of the key studies' quality did. Also, differences concerning the critical effect coincided with differences in the level of OELs for half of the substances.

Standards and guidelines for observational studies: quality is in the eye of the beholder.

PubMed

Morton, Sally C; Costlow, Monica R; Graff, Jennifer S; Dubois, Robert W

2016-03-01

Patient care decisions demand high-quality research. To assist those decisions, numerous observational studies are being performed. Are the standards and guidelines to assess observational studies consistent and actionable? What policy considerations should be considered to ensure decision makers can determine if an observational study is of high-quality and valid to inform treatment decisions? Based on a literature review and input from six experts, we compared and contrasted nine standards/guidelines using 23 methodological elements involved in observational studies (e.g., study protocol, data analysis, and so forth). Fourteen elements (61%) were addressed by at least seven standards/guidelines; 12 of these elements disagreed in the approach. Nine elements (39%) were addressed by six or fewer standards/guidelines. Ten elements (43%) were not actionable in at least one standard/guideline that addressed the element. The lack of observational study standard/guideline agreement may contribute to variation in study conduct; disparities in what is considered credible research; and ultimately, what evidence is adopted. A common set of agreed on standards/guidelines for conducting observational studies will benefit funders, researchers, journal editors, and decision makers. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Standardized network order sets in rural Ontario: a follow-up report on successes and sustainability.

PubMed

Rawn, Andrea; Wilson, Katrina

2011-01-01

Unifying, implementing and sustaining a large order set project requires strategic placement of key organizational professionals to provide ongoing user education, communication and support. This article will outline the successful strategies implemented by the Grey Bruce Health Network, Evidence-Based Care Program to reduce length of stay, increase patient satisfaction and increase the use of best practices resulting in quality outcomes, safer practice and better allocation of resources by using standardized Order Sets within a network of 11 hospital sites. Audits conducted in 2007 and again in 2008 revealed a reduced length of stay of 0.96 in-patient days when order sets were used on admission and readmission for the same or a related diagnosis within one month decreased from 5.5% without order sets to 3.5% with order sets.

Best Practices for Making Scientific Data Discoverable and Accessible through Integrated, Standards-Based Data Portals

NASA Astrophysics Data System (ADS)

Lucido, J. M.

2013-12-01

Scientists in the fields of hydrology, geophysics, and climatology are increasingly using the vast quantity of publicly-available data to address broadly-scoped scientific questions. For example, researchers studying contamination of nearshore waters could use a combination of radar indicated precipitation, modeled water currents, and various sources of in-situ monitoring data to predict water quality near a beach. In discovering, gathering, visualizing and analyzing potentially useful data sets, data portals have become invaluable tools. The most effective data portals often aggregate distributed data sets seamlessly and allow multiple avenues for accessing the underlying data, facilitated by the use of open standards. Additionally, adequate metadata are necessary for attribution, documentation of provenance and relating data sets to one another. Metadata also enable thematic, geospatial and temporal indexing of data sets and entities. Furthermore, effective portals make use of common vocabularies for scientific methods, units of measure, geologic features, chemical, and biological constituents as they allow investigators to correctly interpret and utilize data from external sources. One application that employs these principles is the National Ground Water Monitoring Network (NGWMN) Data Portal (http://cida.usgs.gov/ngwmn), which makes groundwater data from distributed data providers available through a single, publicly accessible web application by mediating and aggregating native data exposed via web services on-the-fly into Open Geospatial Consortium (OGC) compliant service output. That output may be accessed either through the map-based user interface or through the aforementioned OGC web services. Furthermore, the Geo Data Portal (http://cida.usgs.gov/climate/gdp/), which is a system that provides users with data access, subsetting and geospatial processing of large and complex climate and land use data, exemplifies the application of International Standards Organization (ISO) metadata records to enhance data discovery for both human and machine interpretation. Lastly, the Water Quality Portal (http://www.waterqualitydata.us/) achieves interoperable dissemination of water quality data by referencing a vocabulary service for mapping constituents and methods between the USGS and USEPA. The NGWMN Data Portal, Geo Data Portal and Water Quality Portal are three examples of best practices when implementing data portals that provide distributed scientific data in an integrated, standards-based approach.

[Assessing the balance of quality indicator sets of external quality assurance according to SGB V section 136].

PubMed

Doebler, Klaus; Geraedts, Max

2017-12-20

The value and usefulness of the results of indicator-based performance measurement in healthcare for different purposes do not only depend on the methodological quality of the individual indicators but also on the composition of the indicator sets. So far, the balance of the currently used indicator sets of the German mandatory national performance measurement system for hospitals has not been systematically analyzed. Due to the lack of a methodological gold standard for the assessment of balance and orientation of indicator sets we adapted the OECD concept of quality dimensions and defined four categories: 1) "Achieving primary goals of treatment", 2) "Avoiding adverse events", 3) "Indication" and 4) "Patient-centeredness". We defined rules for the assignment to the categories and analyzed the distribution of the 239 indicators from 29 medical areas in relation to these categories. 63 indicators (26.4 %) were assigned to the category "Achieving primary goals of treatment", 153 (64.0 %) to the category "Avoiding adverse events", 18 (7.5 %) to the category "Indication", one indicator (0.4 %) to the category "Patient-centeredness". Four indicators (1.7 %) addressed documentation quality. 12 of the 29 indicator sets only covered one OECD quality dimension by at least one indicator. The current indicator sets seem to be unbalanced with a strong focus on the category "Avoiding adverse events". As regards the goal of monitoring the compliance with minimal safety standards and performing improvement interventions, the direction of the indicator sets seems to be appropriate. With respect to other goals, such as for example the identification of "excellence", further development efforts are required. One relevant reason for the dominant focus on the category "Avoiding adverse events" seems to be that data sources for a follow-up and for the inclusion of the patient perspective have not been available until recently. There is a strong demand for the consequent use of these data sources to optimize the interpretability and value of the current performance measurement. The methodological approach presented may offer useful information to assess the value of indicator sets for different purposes although further development and research is necessary. Copyright © 2017. Published by Elsevier GmbH.

Making Quality Health Websites a National Public Health Priority: Toward Quality Standards.

PubMed

Devine, Theresa; Broderick, Jordan; Harris, Linda M; Wu, Huijuan; Hilfiker, Sandra Williams

2016-08-02

Most US adults have limited health literacy skills. They struggle to understand complex health information and services and to make informed health decisions. The Internet has quickly become one of the most popular places for people to search for information about their health, thereby making access to quality information on the Web a priority. However, there are no standardized criteria for evaluating Web-based health information. Every 10 years, the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) develops a set of measurable objectives for improving the health of the nation over the coming decade, known as Healthy People. There are two objectives in Healthy People 2020 related to website quality. The first is objective Health Communication and Health Information Technology (HC/HIT) 8.1: increase the proportion of health-related websites that meet 3 or more evaluation criteria for disclosing information that can be used to assess information reliability. The second is objective HC/HIT-8.2: increase the proportion of health-related websites that follow established usability principles. The ODPHP conducted a nationwide assessment of the quality of Web-based health information using the Healthy People 2020 objectives. The ODPHP aimed to establish (1) a standardized approach to defining and measuring the quality of health websites; (2) benchmarks for measurement; (3) baseline data points to capture the current status of website quality; and (4) targets to drive improvement. The ODPHP developed the National Quality Health Website Survey instrument to assess the quality of health-related websites. The ODPHP used this survey to review 100 top-ranked health-related websites in order to set baseline data points for these two objectives. The ODPHP then set targets to drive improvement by 2020. This study reviewed 100 health-related websites. For objective HC/HIT-8.1, a total of 58 out of 100 (58.0%) websites met 3 or more out of 6 reliability criteria. For objective HC/HIT-8.2, a total of 42 out of 100 (42.0%) websites followed 10 or more out of 19 established usability principles. On the basis of these baseline data points, ODPHP set targets for the year 2020 that meet the minimal statistical significance-increasing objective HC/HIT-8.1 data point to 70.5% and objective HC/HIT-8.2 data point to 55.7%. This research is a critical first step in evaluating the quality of Web-based health information. The criteria proposed by ODPHP provide methods to assess website quality for professionals designing, developing, and managing health-related websites. The criteria, baseline data, and targets are valuable tools for driving quality improvement.

Making Quality Health Websites a National Public Health Priority: Toward Quality Standards

PubMed Central

2016-01-01

Background Most US adults have limited health literacy skills. They struggle to understand complex health information and services and to make informed health decisions. The Internet has quickly become one of the most popular places for people to search for information about their health, thereby making access to quality information on the Web a priority. However, there are no standardized criteria for evaluating Web-based health information. Every 10 years, the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) develops a set of measurable objectives for improving the health of the nation over the coming decade, known as Healthy People. There are two objectives in Healthy People 2020 related to website quality. The first is objective Health Communication and Health Information Technology (HC/HIT) 8.1: increase the proportion of health-related websites that meet 3 or more evaluation criteria for disclosing information that can be used to assess information reliability. The second is objective HC/HIT-8.2: increase the proportion of health-related websites that follow established usability principles. Objective The ODPHP conducted a nationwide assessment of the quality of Web-based health information using the Healthy People 2020 objectives. The ODPHP aimed to establish (1) a standardized approach to defining and measuring the quality of health websites; (2) benchmarks for measurement; (3) baseline data points to capture the current status of website quality; and (4) targets to drive improvement. Methods The ODPHP developed the National Quality Health Website Survey instrument to assess the quality of health-related websites. The ODPHP used this survey to review 100 top-ranked health-related websites in order to set baseline data points for these two objectives. The ODPHP then set targets to drive improvement by 2020. Results This study reviewed 100 health-related websites. For objective HC/HIT-8.1, a total of 58 out of 100 (58.0%) websites met 3 or more out of 6 reliability criteria. For objective HC/HIT-8.2, a total of 42 out of 100 (42.0%) websites followed 10 or more out of 19 established usability principles. On the basis of these baseline data points, ODPHP set targets for the year 2020 that meet the minimal statistical significance—increasing objective HC/HIT-8.1 data point to 70.5% and objective HC/HIT-8.2 data point to 55.7%. Conclusions This research is a critical first step in evaluating the quality of Web-based health information. The criteria proposed by ODPHP provide methods to assess website quality for professionals designing, developing, and managing health-related websites. The criteria, baseline data, and targets are valuable tools for driving quality improvement. PMID:27485512

Air Quality Criteria for Ozone and Related Photochemical ...

EPA Pesticide Factsheets

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

Project officer's perspective: quality assurance as a management tool.

PubMed

Heiby, J

1993-06-01

Advances in the management of health programs in less developed countries (LDC) have not kept pace with the progress of the technology used. The US Agency for International Development mandated the Quality Assurance Project (QAP) to provide quality improvement technical assistance to primary health care systems in LDCs while developing appropriate quality assurance (QA) strategies. The quality of health care in recent years in the US and Europe focused on the introduction of management techniques developed for industry into health systems. The experience of the QAP and its predecessor, the PRICOR Project, shows that quality improvement techniques facilitate measurement of quality of care. A recently developed WHO model for the management of the sick child provides scientifically based standards for actual care. Since 1988, outside investigators measuring how LDC clinicians perform have revealed serious deficiencies in quality compared with the program's own standards. This prompted developed of new QA management initiatives: 1) communicating standards clearly to the program staff; 2) actively monitoring actual performance corresponds to these standards; and 3) taking action to improve performance. QA means that managers are expected to monitor service delivery, undertake problem solving, and set specific targets for quality improvement. Quality improvement methods strengthen supervision as supervisors can objectively assess health worker performance. QA strengthens the management functions that support service delivery, e.g., training, records management, finance, logistics, and supervision. Attention to quality can contribute to improved health worker motivation and effective incentive programs by recognition for a job well done and opportunities for learning new skills. These standards can also address patient satisfaction. QA challenges managers to aim for the optimal level of care attainable.

Lead and tap water

MedlinePlus

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

Water quality program elements for Space Station Freedom

NASA Technical Reports Server (NTRS)

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

1991-01-01

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

Reflections on Assessment in Open Distance Learning (ODL): The Case of the University of South Africa (UNISA)

ERIC Educational Resources Information Center

Letseka, Moeketsi; Pitsoe, Victor

2013-01-01

The article explores the challenges of assessment in open distance learning (ODL). The authors argue that ultimately assessment should be about improving the quality of teaching and effective learning. It should be based on making expectations explicit and public, setting appropriate criteria and high standards for learning quality, systematically…

A System Evaluation Theory Analyzing Value and Results Chain for Institutional Accreditation in Oman

ERIC Educational Resources Information Center

Paquibut, Rene Ymbong

2017-01-01

Purpose: This paper aims to apply the system evaluation theory (SET) to analyze the institutional quality standards of Oman Academic Accreditation Authority using the results chain and value chain tools. Design/methodology/approach: In systems thinking, the institutional standards are connected as input, process, output and feedback and leads to…

From Data Entry to Evidence-Based Decision-Making: How Data and Analysis Can Drive Improvements in Admissions Policies

ERIC Educational Resources Information Center

Hourigan, Clare

2011-01-01

Academic standards and performance outcomes are a major focus of the current Cycle 2 Australian Universities Quality Agency (AUQA) audits. AUQA has clearly stated that universities will need to provide "evidence of setting, maintaining, and reviewing institutional academic standards and outcomes" (2010, p. 27). To do this, universities…

The Art and Science of Photography in Hand Surgery

PubMed Central

Wang, Keming; Kowalski, Evan J.; Chung, Kevin C.

2013-01-01

High-quality medical photography plays an important role in teaching and demonstrating the functional capacity of the hands, as well as in medicolegal documentation. Obtaining standardized, high-quality photographs is now an essential component of many surgery practices. The importance of standardized photography in facial and cosmetic surgery has been well documented in previous studies, but no studies have thoroughly addressed the details of photography for hand surgery. In this paper, we will provide a set of guidelines and basic camera concepts for different scenarios to help hand surgeons obtain appropriate and informative high quality photographs. A camera used for medical photography should come equipped with a large sensor size and an optical zoom lens with a focal length ranging anywhere from 14-75mm. In a clinic or office setting, we recommend six standardized views of the hand and four views for the wrist, and additional views should be taken for tendon ruptures, nerve injuries, or other deformities of the hand. For intra-operative pictures, the camera operator should understand the procedure and pertinent anatomy in order to properly obtain high-quality photographs. When digital radiographs are not available, and radiographic film must be photographed, it is recommended to reduce the exposure and change the color mode to black and white to obtain the best possible pictures. The goal of medical photography is to present the subject in an accurate and precise fashion. PMID:23755927

Development of spatial data guidelines and standards: spatial data set documentation to support hydrologic analysis in the U.S. Geological Survey

USGS Publications Warehouse

Fulton, James L.

1992-01-01

Spatial data analysis has become an integral component in many surface and sub-surface hydrologic investigations within the U.S. Geological Survey (USGS). Currently, one of the largest costs in applying spatial data analysis is the cost of developing the needed spatial data. Therefore, guidelines and standards are required for the development of spatial data in order to allow for data sharing and reuse; this eliminates costly redevelopment. In order to attain this goal, the USGS is expanding efforts to identify guidelines and standards for the development of spatial data for hydrologic analysis. Because of the variety of project and database needs, the USGS has concentrated on developing standards for documenting spatial sets to aid in the assessment of data set quality and compatibility of different data sets. An interim data set documentation standard (1990) has been developed that provides a mechanism for associating a wide variety of information with a data set, including data about source material, data automation and editing procedures used, projection parameters, data statistics, descriptions of features and feature attributes, information on organizational contacts lists of operations performed on the data, and free-form comments and notes about the data, made at various times in the evolution of the data set. The interim data set documentation standard has been automated using a commercial geographic information system (GIS) and data set documentation software developed by the USGS. Where possible, USGS developed software is used to enter data into the data set documentation file automatically. The GIS software closely associates a data set with its data set documentation file; the documentation file is retained with the data set whenever it is modified, copied, or transferred to another computer system. The Water Resources Division of the USGS is continuing to develop spatial data and data processing standards, with emphasis on standards needed to support hydrologic analysis, hydrologic data processing, and publication of hydrologic thermatic maps. There is a need for the GIS vendor community to develop data set documentation tools similar to those developed by the USGS, or to incorporate USGS developed tools in their software.

U.S. Geological Survey quality-assurance plan for continuous water-quality monitoring in Kansas, 2014

USGS Publications Warehouse

Bennett, Trudy J.; Graham, Jennifer L.; Foster, Guy M.; Stone, Mandy L.; Juracek, Kyle E.; Rasmussen, Teresa J.; Putnam, James E.

2014-01-01

A quality-assurance plan for use in conducting continuous water-quality monitoring activities has been developed for the Kansas Water Science Center in accordance with guidelines set forth by the U.S. Geological Survey. This quality-assurance plan documents the standards, policies, and procedures used by the U.S. Geological Survey in Kansas for activities related to the collection, processing, storage, analysis, and release of continuous water-quality monitoring data. The policies and procedures that are documented in this quality-assurance plan for continuous water-quality monitoring activities complement quality-assurance plans for surface-water and groundwater activities in Kansas.

Quality-assurance plan for water-quality activities in the U.S. Geological Survey Washington Water Science Center

USGS Publications Warehouse

Conn, Kathleen E.; Huffman, Raegan L.; Barton, Cynthia

2017-05-08

In accordance with guidelines set forth by the Office of Water Quality in the Water Mission Area of the U.S. Geological Survey, a quality-assurance plan has been created for use by the Washington Water Science Center (WAWSC) in conducting water-quality activities. This qualityassurance plan documents the standards, policies, and procedures used by the WAWSC for activities related to the collection, processing, storage, analysis, and publication of water-quality data. The policies and procedures documented in this quality-assurance plan for water-quality activities complement the quality-assurance plans for surface-water and groundwater activities at the WAWSC.

The relationship between social capital and quality management systems in European hospitals: a quantitative study.

PubMed

Hammer, Antje; Arah, Onyebuchi A; Dersarkissian, Maral; Thompson, Caroline A; Mannion, Russell; Wagner, Cordula; Ommen, Oliver; Sunol, Rosa; Pfaff, Holger

2013-01-01

Strategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. We assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals. We used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. The average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4) and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27). Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029). The results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of previous research, could have important implications for the work of hospital managers and the design and evaluation of hospital quality management systems.

The Relationship between Social Capital and Quality Management Systems in European Hospitals: A Quantitative Study

PubMed Central

Hammer, Antje; Arah, Onyebuchi A.; DerSarkissian, Maral; Thompson, Caroline A.; Mannion, Russell; Wagner, Cordula; Ommen, Oliver; Sunol, Rosa; Pfaff, Holger

2013-01-01

Background Strategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. Objectives We assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals. Methods We used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. Results The average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4) and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27). Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029). Conclusion The results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of previous research, could have important implications for the work of hospital managers and the design and evaluation of hospital quality management systems. PMID:24392027

An International Standard Set of Patient-Centered Outcome Measures After Stroke.

PubMed

Salinas, Joel; Sprinkhuizen, Sara M; Ackerson, Teri; Bernhardt, Julie; Davie, Charlie; George, Mary G; Gething, Stephanie; Kelly, Adam G; Lindsay, Patrice; Liu, Liping; Martins, Sheila C O; Morgan, Louise; Norrving, Bo; Ribbers, Gerard M; Silver, Frank L; Smith, Eric E; Williams, Linda S; Schwamm, Lee H

2016-01-01

Value-based health care aims to bring together patients and health systems to maximize the ratio of quality over cost. To enable assessment of healthcare value in stroke management, an international standard set of patient-centered stroke outcome measures was defined for use in a variety of healthcare settings. A modified Delphi process was implemented with an international expert panel representing patients, advocates, and clinical specialists in stroke outcomes, stroke registers, global health, epidemiology, and rehabilitation to reach consensus on the preferred outcome measures, included populations, and baseline risk adjustment variables. Patients presenting to a hospital with ischemic stroke or intracerebral hemorrhage were selected as the target population for these recommendations, with the inclusion of transient ischemic attacks optional. Outcome categories recommended for assessment were survival and disease control, acute complications, and patient-reported outcomes. Patient-reported outcomes proposed for assessment at 90 days were pain, mood, feeding, selfcare, mobility, communication, cognitive functioning, social participation, ability to return to usual activities, and health-related quality of life, with mobility, feeding, selfcare, and communication also collected at discharge. One instrument was able to collect most patient-reported subdomains (9/16, 56%). Minimum data collection for risk adjustment included patient demographics, premorbid functioning, stroke type and severity, vascular and systemic risk factors, and specific treatment/care-related factors. A consensus stroke measure Standard Set was developed as a simple, pragmatic method to increase the value of stroke care. The set should be validated in practice when used for monitoring and comparisons across different care settings. © 2015 The Authors.

Using Academy Standards of Excellence in Nutrition and Dietetics for organization self-assessment and quality improvement.

PubMed

Price, Joyce A; Kent, Sue; Cox, Sharon A; McCauley, Sharon M; Parekh, Janki; Klein, Catherine J

2014-08-01

Standards of Excellence in Nutrition and Dietetics for an Organization is a self-assessment tool to measure and evaluate an organization's program, services, and initiatives that identify and distinguish the Registered Dietitian Nutritionist (RDN) brand as the professional expert in food and nutrition. The Standards of Excellence will serve as a road map to recognize RDNs as leaders and collaborators. Standards of Excellence criteria apply to all practice segments of nutrition and dietetics: health care, education and research, business and industry, and community nutrition and public health. Given the membership's call to action to be recognized for their professional expertise, the Academy of Nutrition and Dietetics Quality Management Committee developed four Standards of Excellence in Nutrition and Dietetics for Organizations: Quality of Leadership, Quality of Organization, Quality of Practice, and Quality of Outcomes. Within each standard, specific indicators provide strategies for an organization to demonstrate excellence. The Academy will develop a self-evaluation scoring tool to assist the organization in applying and implementing one or more of the strategies in the Standards of Excellence indicators. The organization can use the self-assessment tool to establish itself as a Center of Excellence in Nutrition and Dietetics. The role examples illustrate initiatives RDNs and organizations can take to identify themselves as a Center of Excellence in Nutrition and Dietetics. Achieving the Excellence level is an important collaborative initiative between nutrition and dietetics organizations and the Academy to provide increased autonomy, supportive management, respect within peers and community, opportunities for professional development, support for further education, and compensation for the RDN. For purposes of the Standards, "organization" means workplace or practice setting. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

An update on dental imaging.

PubMed

Whaites, E; Brown, J

1998-08-22

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

The Oregon Quality Education Model Applied to Schools Characterized by Low Student Enrollment, Sparse Distribution of Students, and Remote Settings with Findings Relating to Equity of Services. White Paper.

ERIC Educational Resources Information Center

Hill, Jonathan

The Oregon Quality Education Model (QEM) was developed by the state to identify the fundamental requirements and costs for a quality education that meets Oregon's academic standards. It will determine the funding of Oregon schools. Among the assumptions upon which the QEM is built were that elementary school enrollment is 340 students, middle…

A standard for measuring metadata quality in spectral libraries

NASA Astrophysics Data System (ADS)

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

2013-12-01

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

Interpreting the ASTM 'content standard for digital geospatial metadata'

USGS Publications Warehouse

Nebert, Douglas D.

1996-01-01

ASTM and the Federal Geographic Data Committee have developed a content standard for spatial metadata to facilitate documentation, discovery, and retrieval of digital spatial data using vendor-independent terminology. Spatial metadata elements are identifiable quality and content characteristics of a data set that can be tied to a geographic location or area. Several Office of Management and Budget Circulars and initiatives have been issued that specify improved cataloguing of and accessibility to federal data holdings. An Executive Order further requires the use of the metadata content standard to document digital spatial data sets. Collection and reporting of spatial metadata for field investigations performed for the federal government is an anticipated requirement. This paper provides an overview of the draft spatial metadata content standard and a description of how the standard could be applied to investigations collecting spatially-referenced field data.

Increasing patient safety and efficiency in transfusion therapy using formal process definitions.

PubMed

Henneman, Elizabeth A; Avrunin, George S; Clarke, Lori A; Osterweil, Leon J; Andrzejewski, Chester; Merrigan, Karen; Cobleigh, Rachel; Frederick, Kimberly; Katz-Bassett, Ethan; Henneman, Philip L

2007-01-01

The administration of blood products is a common, resource-intensive, and potentially problem-prone area that may place patients at elevated risk in the clinical setting. Much of the emphasis in transfusion safety has been targeted toward quality control measures in laboratory settings where blood products are prepared for administration as well as in automation of certain laboratory processes. In contrast, the process of transfusing blood in the clinical setting (ie, at the point of care) has essentially remained unchanged over the past several decades. Many of the currently available methods for improving the quality and safety of blood transfusions in the clinical setting rely on informal process descriptions, such as flow charts and medical algorithms, to describe medical processes. These informal descriptions, although useful in presenting an overview of standard processes, can be ambiguous or incomplete. For example, they often describe only the standard process and leave out how to handle possible failures or exceptions. One alternative to these informal descriptions is to use formal process definitions, which can serve as the basis for a variety of analyses because these formal definitions offer precision in the representation of all possible ways that a process can be carried out in both standard and exceptional situations. Formal process definitions have not previously been used to describe and improve medical processes. The use of such formal definitions to prospectively identify potential error and improve the transfusion process has not previously been reported. The purpose of this article is to introduce the concept of formally defining processes and to describe how formal definitions of blood transfusion processes can be used to detect and correct transfusion process errors in ways not currently possible using existing quality improvement methods.

Eliciting the Intension of Drug Value Sets – Principles and Quality Assurance Applications

PubMed Central

Bahr, Nathan J.; Nelson, Scott D.; Winnenburg, Rainer; Bodenreider, Olivier

2018-01-01

Value sets (VSs) used in electronic clinical quality measures are lists of codes from standard terminologies (“extensional” VSs), whose purpose (“intension”) is not always explicitly stated. We elicited the intension for the 09/01/2014 release of extensional medication value sets by comparison to drug classes from the October 2014 release of RxClass. Value sets matched drug classes if they shared common ingredients, as evidenced by Jaccard similarity score. We elicited the intension of 80 extensional value sets. The average Jaccard similarity was 0.65 for single classes and 0.80 for combination classes, with 34% (27/80) of the value sets having high similarity scores. Manual review by a pharmacist indicated 51% (41/80) of the drug classes selected as the best mapping for a value set matched the intension reflected in that value set name. This approach has the potential for facilitating the development and maintenance of medication value sets. PMID:29295218

[Research progress on standards of commodity classes of Chinese materia medica and discussion on several key problems].

PubMed

Yang, Guang; Zeng, Yan; Guo, Lan-Ping; Huang, Lu-Qi; Jin, Yan; Zheng, Yu-Guang; Wang, Yong-Yan

2014-05-01

Standards of commodity classes of Chinese materia medica is an important way to solve the "Lemons Problem" of traditional Chinese medicine market. Standards of commodity classes are also helpful to rebuild market mechanisms for "high price for good quality". The previous edition of commodity classes standards of Chinese materia medica was made 30 years ago. It is no longer adapted to the market demand. This article researched progress on standards of commodity classes of Chinese materia medica. It considered that biological activity is a better choice than chemical constituents for standards of commodity classes of Chinese materia medica. It is also considered that the key point to set standards of commodity classes is finding the influencing factors between "good quality" and "bad quality". The article also discussed the range of commodity classes of Chinese materia medica, and how to coordinate standards of pharmacopoeia and commodity classes. According to different demands, diversiform standards can be used in commodity classes of Chinese materia medica, but efficacy is considered the most important index of commodity standard. Decoction pieces can be included in standards of commodity classes of Chinese materia medica. The authors also formulated the standards of commodity classes of Notoginseng Radix as an example, and hope this study can make a positive and promotion effect on traditional Chinese medicine market related research.

Promoting Good Clinical Laboratory Practices and Laboratory Accreditation to Support Clinical Trials in Sub-Saharan Africa

PubMed Central

Shott, Joseph P.; Saye, Renion; Diakité, Moussa L.; Sanogo, Sintry; Dembele, Moussa B.; Keita, Sekouba; Nagel, Mary C.; Ellis, Ruth D.; Aebig, Joan A.; Diallo, Dapa A.; Doumbo, Ogobara K.

2012-01-01

Laboratory capacity in the developing world frequently lacks quality management systems (QMS) such as good clinical laboratory practices, proper safety precautions, and adequate facilities; impacting the ability to conduct biomedical research where it is needed most. As the regulatory climate changes globally, higher quality laboratory support is needed to protect study volunteers and to accurately assess biological parameters. The University of Bamako and its partners have undertaken a comprehensive QMS plan to improve quality and productivity using the Clinical and Laboratory Standards Institute standards and guidelines. The clinical laboratory passed the College of American Pathologists inspection in April 2010, and received full accreditation in June 2010. Our efforts to implement high-quality standards have been valuable for evaluating safety and immunogenicity of malaria vaccine candidates in Mali. Other disease-specific research groups in resource-limited settings may benefit by incorporating similar training initiatives, QMS methods, and continual improvement practices to ensure best practices. PMID:22492138

SU-F-BRD-10: Lung IMRT Planning Using Standardized Beam Bouquet Templates

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

Yuan, L; Wu, Q J.; Yin, F

2014-06-15

Purpose: We investigate the feasibility of choosing from a small set of standardized templates of beam bouquets (i.e., entire beam configuration settings) for lung IMRT planning to improve planning efficiency and quality consistency, and also to facilitate automated planning. Methods: A set of beam bouquet templates is determined by learning from the beam angle settings in 60 clinical lung IMRT plans. A k-medoids cluster analysis method is used to classify the beam angle configuration into clusters. The value of the average silhouette width is used to determine the ideal number of clusters. The beam arrangements in each medoid of themore » resulting clusters are taken as the standardized beam bouquet for the cluster, with the corresponding case taken as the reference case. The resulting set of beam bouquet templates was used to re-plan 20 cases randomly selected from the database and the dosimetric quality of the plans was evaluated against the corresponding clinical plans by a paired t-test. The template for each test case was manually selected by a planner based on the match between the test and reference cases. Results: The dosimetric parameters (mean±S.D. in percentage of prescription dose) of the plans using 6 beam bouquet templates and those of the clinical plans, respectively, and the p-values (in parenthesis) are: lung Dmean: 18.8±7.0, 19.2±7.0 (0.28), esophagus Dmean: 32.0±16.3, 34.4±17.9 (0.01), heart Dmean: 19.2±16.5, 19.4±16.6 (0.74), spinal cord D2%: 47.7±18.8, 52.0±20.3 (0.01), PTV dose homogeneity (D2%-D99%): 17.1±15.4, 20.7±12.2 (0.03).The esophagus Dmean, cord D02 and PTV dose homogeneity are statistically better in the plans using the standardized templates, but the improvements (<5%) may not be clinically significant. The other dosimetric parameters are not statistically different. Conclusion: It's feasible to use a small number of standardized beam bouquet templates (e.g. 6) to generate plans with quality comparable to that of clinical plans. Partially supported by NIH/NCI under grant #R21CA161389 and a master research grant by Varian Medical System.« less

Audit activity and quality of completed audit projects in primary care in Staffordshire.

PubMed Central

Chambers, R; Bowyer, S; Campbell, I

1995-01-01

OBJECTIVES--To survey audit activity in primary care and determine which practice factors are associated with completed audit; to survey the quality of completed audit projects. DESIGN--From April 1992 to June 1993 a team from the medical audit advisory group visited all general practices; a research assistant visited each practice to study the best audit project. Data were collected in structured interviews. SETTING--Staffordshire, United Kingdom. SUBJECTS--All 189 general practices. MAIN MEASURES--Audit activity using Oxford classification system. Quality of best audit project by assessing choice of topic; participation of practice staff; setting of standards; methods of data collection and presentation of results; whether a plan to make changes resulted from the audit; and whether changes led to the set standards being achieved. RESULTS--Audit information was available from 169 practices (89%). 44(26%) practices had carried out at least one full audit; 40(24%) had not started audit. Mean scores with the Oxford classification system were significantly higher with the presence of a practice manager (2.7(95% confidence interval 2.4 to 2.9) v 1.2(0.7 to 1.8), p < 0.0001) and with computerisation (2.8(2.5 to 3.1) v 1.4 (0.9 to 2.0), p < 0.0001), organised notes (2.6(2.1 to 3.0) v 1.7(7.2 to 2.2), p = 0.03), being a training practice (3.5(3.2 to 3.8) v 2.1(1.8 to 2.4), p < 0.0001), and being a partnership (2.8(2.6 to 3.0) v 1.5(1.1 to 2.0), p < 0.0001). Standards had been set in 62 of the 71 projects reviewed. Data were collected prospectively in 36 projects and retrospectively in 35. 16 projects entailed taking samples from a study population and 55 from the whole population. 50 projects had a written summary. Performance was less than the standards set or expected in 56 projects. 62 practices made changes as a result of the audit. 35 of the 53 that had reviewed the changes found that the original standards had been reached. CONCLUSIONS--Evaluation of audit in primary care should include evaluation of the methods used, whether deficiencies were identified, and whether changes were implemented to resolve any problems found. PMID:10153426

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

PubMed

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

2009-08-01

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

Chesapeake Bay TMDL

EPA Pesticide Factsheets

In 2010 EPA established the Chesapeake Bay TMDL, a comprehensive pollution diet with accountability measures to restore clean water in the bay and local waters. It set limits for nutrients and sediment to meet water quality standards across the watershed

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

PubMed

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

2016-07-08

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

[Procedure of seed quality testing and seed grading standard of Prunus humilis].

PubMed

Wen, Hao; Ren, Guang-Xi; Gao, Ya; Luo, Jun; Liu, Chun-Sheng; Li, Wei-Dong

2014-11-01

So far there exists no corresponding quality test procedures and grading standards for the seed of Prunus humilis, which is one of the important source of base of semen pruni. Therefor we set up test procedures that are adapt to characteristics of the P. humilis seed through the study of the test of sampling, seed purity, thousand-grain weight, seed moisture, seed viability and germination percentage. 50 cases of seed specimens of P. humilis tested. The related data were analyzed by cluster analysis. Through this research, the seed quality test procedure was developed, and the seed quality grading standard was formulated. The seed quality of each grade should meet the following requirements: for first grade seeds, germination percentage ≥ 68%, thousand-grain weight 383 g, purity ≥ 93%, seed moisture ≤ 5%; for second grade seeds, germination percentage ≥ 26%, thousand-grain weight ≥ 266 g, purity ≥ 73%, seed moisture ≤9%; for third grade seeds, germination percentage ≥ 10%, purity ≥ 50%, thousand-grain weight ≥ 08 g, seed moisture ≤ 13%.

Evaluating Software Assurance Knowledge and Competency of Acquisition Professionals

DTIC Science & Technology

2014-10-01

of ISO 12207 -2008, both internationally and in the United States [7]. That standard documents a comprehensive set of activities and supporting...grows, organizations must ensure that their procurement agents acquire high quality, secure software. ISO 12207 and the Software Assurance Competency...cyberattacks grows, organizations must ensure that their procurement agents acquire high quality, secure software. ISO 12207 and the Software Assurance

Quality standards for predialysis education: results from a consensus conference

PubMed Central

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

2015-01-01

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

Developing a Standard Set of Patient-Centred Outcomes for Inflammatory Bowel Disease-an International, Cross-disciplinary Consensus.

PubMed

Kim, Andrew H; Roberts, Charlotte; Feagan, Brian G; Banerjee, Rupa; Bemelman, Willem; Bodger, Keith; Derieppe, Marc; Dignass, Axel; Driscoll, Richard; Fitzpatrick, Ray; Gaarentstroom-Lunt, Janette; Higgins, Peter D; Kotze, Paulo Gustavo; Meissner, Jillian; O'Connor, Marian; Ran, Zhi-Hua; Siegel, Corey A; Terry, Helen; van Deen, Welmoed K; van der Woude, C Janneke; Weaver, Alandra; Yang, Suk-Kyun; Sands, Bruce E; Vermeire, Séverine; Travis, Simon Pl

2018-03-28

Success in delivering value-based healthcare involves measuring outcomes that matter most to patients. Our aim was to develop a minimum Standard Set of patient-centred outcome measures for inflammatory bowel disease [IBD], for use in different healthcare settings. An international working group [n = 25] representing patients, patient associations, gastroenterologists, surgeons, specialist nurses, IBD registries and patient-reported outcome measure [PROM] methodologists participated in a series of teleconferences incorporating a modified Delphi process. Systematic review of existing literature, registry data, patient focus groups and open review periods were used to reach consensus on a minimum set of standard outcome measures and risk adjustment variables. Similar methodology has been used in 21 other disease areas [www.ichom.org]. A minimum Standard Set of outcomes was developed for patients [aged ≥16] with IBD. Outcome domains included survival and disease control [survival, disease activity/remission, colorectal cancer, anaemia], disutility of care [treatment-related complications], healthcare utilization [IBD-related admissions, emergency room visits] and patient-reported outcomes [including quality of life, nutritional status and impact of fistulae] measured at baseline and at 6 or 12 month intervals. A single PROM [IBD-Control questionnaire] was recommended in the Standard Set and minimum risk adjustment data collected at baseline and annually were included: demographics, basic clinical information and treatment factors. A Standard Set of outcome measures for IBD has been developed based on evidence, patient input and specialist consensus. It provides an international template for meaningful, comparable and easy-to-interpret measures as a step towards achieving value-based healthcare in IBD.

Quality-Assurance Plan for Water-Quality Activities of the U.S. Geological Survey Montana Water Science Center

USGS Publications Warehouse

Lambing, John H.

2006-01-01

In accordance with guidelines set forth by the Office of Water Quality in the Water Resources Discipline of the U.S. Geological Survey (USGS), a quality-assurance plan has been created for use by the USGS Montana Water Science Center in conducting water-quality activities. This quality-assurance plan documents the standards, policies, and procedures used by the USGS Montana Water Science Center for activities related to the collection, processing, storage, analysis, and publication of water-quality data. The policies and procedures presented in this quality-assurance plan for water-quality activities complement the quality-assurance plans for surface-water and ground-water activities and suspended-sediment analysis.

Further Choice and Quality: The Charter for Further Education.

ERIC Educational Resources Information Center

Department for Education and Employment, London (England).

This charter explains what is being done to promote high standards of service for all who use technical colleges in the new further education (FE) sector in England--students, employers, and other members of the local community. It sets out the standards one has a right to expect from colleges in the FE sector and other organizations involved in…

A Study on Financial Reporting Standards and Accounting Quality- Evidence from China

NASA Astrophysics Data System (ADS)

Liou, Cheng-Hwai

2013-02-01

According to institutional theorists, the forms and business models of corporation are mainly shaped by factors such as politics, regulations, social norms and cultures. This paper examines how the International Financial Reporting Standards (IFRS) and institutional environment influence the accounting quality, in response to the threat of political extraction in China. We took mainland China as an example instead in our study, following the accounting quality definition of Barth et al. [2], we found that the developments of Chinese government performance audit are conspicuously different by region; to reflect such differences, we elaborated our research by dividing mainland China into 31 categories (provinces or cities). We set 2003-2010 as the time horizon for this study. After testing the Regression model, our empirical research achieved two conclusions: 1) IFRS adoption in China should significantly improve the accounting quality, and 2) IFRS and institutional environment should synthetically influence the quality of accounting as well.

Mapping Air Quality Index of Carbon Monoxide (CO) in Medan City

NASA Astrophysics Data System (ADS)

Suryati, I.; Khair, H.

2017-03-01

This study aims to map and analyze air quality index of carbon monoxide (CO) in Medan City. This research used 12 (twelve) sampling points around in Medan with an hour duration each point. CO concentration was analyzed using the NDIR CO Analyzer sampling tool. The concentration CO was obtained between 1 ppm - 23 ppm, with an average concentration was 9.5 ppm. This condition is still below the national ambient air quality standard set by Government Regulation of Indonesian Republic Number 41-1999 amounted to 29 ppm. The result of CO concentration measurements was converted into air pollutant standard index, obtained the index value of 58 - 204. Surfer 10 was used to create map of air pollutant standard index for CO. The map illustrates very unhealthy area where located in the Medan Belawan district. The main factors affecting the concentration of CO are from transportation and meteorological factors.

Capturing the imagination of nurse executives in tracking the quality of nursing care.

PubMed

Kurtzman, Ellen T; Jennings, Bonnie M

2008-01-01

Nurses represent the single largest healthcare profession in the United States. A growing evidence base demonstrates nursing's direct influence on inpatient safety and healthcare outcomes. Support for nursing's essential role in quality and patient safety and mounting interest in publicly reporting performance results have led to efforts to standardized nursing-sensitive performance measures. To this end, in 2004, the National Quality Forum endorsed a set of 15 nursing-sensitive consensus standards intended for use by the public in assessing inpatient nursing care. However, until recently, only anecdotal knowledge existed regarding the implementation of these consensus standards. As a step toward better understanding the interest in and adoption of nursing performance measures, The Robert Wood Johnson Foundation funded a study that concluded in March 2007. In this article, findings from the study are summarized as they apply to nursing leadership and implications for the future role of the nurse executive.

Environmental and nutrition impact of achieving new School Food Plan recommendations in the primary school meals sector in England

PubMed Central

Wickramasinghe, Kremlin; Rayner, Mike; Goldacre, Michael; Townsend, Nick; Scarborough, Peter

2017-01-01

Objectives The aim of this modelling study was to estimate the expected changes in the nutritional quality and greenhouse gas emissions (GHGEs) of primary school meals due to the adoption of new mandatory food-based standards for school meals. Setting Nationally representative random sample of 136 primary schools in England was selected for the Primary School Food Survey (PSFS) with 50% response rate. Participants A sample of 6690 primary students from PSFS who consumed school meals. Outcome measures Primary School Food Plan (SFP) nutritional impact was assessed using both macronutrient and micronutrient quality. The environmental impact was measured by GHGEs. Methods The scenario tested was one in which every meal served in schools met more than half of the food-based standards mentioned in the SFP (SFP scenario). We used findings from a systematic review to assign GHGE values for each food item in the data set. The GHGE value and nutritional quality of SFP scenario meals was compared with the average primary school meal in the total PSFS data set (pre-SFP scenario). Prior to introduction of the SFP (pre-SFP scenario), the primary school meals had mandatory nutrient-based guidelines. Results The percentage of meals that met the protein standard increased in the SFP scenario and the proportion of meals that met the standards for important micronutrients (eg, iron, calcium, vitamin A and C) also increased. However, the SFP scenario did not improve the salt, saturated fat and free sugar levels. The mean GHGE value of meals which met the SFP standards was 0.79 (95% CI 0.77 to 0.81) kgCO2e compared with a mean value of 0.72 (0.71 to 0.74) kgCO2e for all meals. Adopting the SFP would increase the total emissions associated with primary school meals by 22 000 000 kgCO2e per year. Conclusions The universal adoption of the new food-based standards, without reformulation would result in an increase in the GHGEs of school meals and improve some aspects of the nutritional quality, but it would not improve the average salt, sugar and saturated fat content levels. PMID:28381419

[Implementation results of emission standards of air pollutants for thermal power plants: a numerical simulation].

PubMed

Wang, Zhan-Shan; Pan, Li-Bo

2014-03-01

The emission inventory of air pollutants from the thermal power plants in the year of 2010 was set up. Based on the inventory, the air quality of the prediction scenarios by implementation of both 2003-version emission standard and the new emission standard were simulated using Models-3/CMAQ. The concentrations of NO2, SO2, and PM2.5, and the deposition of nitrogen and sulfur in the year of 2015 and 2020 were predicted to investigate the regional air quality improvement by the new emission standard. The results showed that the new emission standard could effectively improve the air quality in China. Compared with the implementation results of the 2003-version emission standard, by 2015 and 2020, the area with NO2 concentration higher than the emission standard would be reduced by 53.9% and 55.2%, the area with SO2 concentration higher than the emission standard would be reduced by 40.0%, the area with nitrogen deposition higher than 1.0 t x km(-2) would be reduced by 75.4% and 77.9%, and the area with sulfur deposition higher than 1.6 t x km(-2) would be reduced by 37.1% and 34.3%, respectively.

Software Development Standard Processes (SDSP)

NASA Technical Reports Server (NTRS)

Lavin, Milton L.; Wang, James J.; Morillo, Ronald; Mayer, John T.; Jamshidian, Barzia; Shimizu, Kenneth J.; Wilkinson, Belinda M.; Hihn, Jairus M.; Borgen, Rosana B.; Meyer, Kenneth N.;

Supporting Parental Involvement in Children's Early Learning: Lessons from Community Childcare Centres in Dublin's Docklands

ERIC Educational Resources Information Center

Share, Michelle; Kerrins, Liz

2013-01-01

Recently in Ireland attention has been placed on the importance of parental involvement in early childhood care and education settings as seen in the Síolta Quality Standards and Aistear Curriculum Framework. Yet there is little Irish empirical evidence on parental involvement in childcare settings; on the involvement models being used, or on the…

100 Years of inspiring quality at the ACS: how did we get here? Journal of Pediatric Surgery Lecture.

PubMed

Hoyt, David B; Schneidman, Diane S

2014-01-01

Throughout its 100-year history of working to ensure that surgical patients receive safe, high-quality, cost-effective care, the American College of Surgeons has adhered to four key principles: (1) Set the standards to identify and set the highest clinical standards based on the collection of outcomes data and other scientific evidence that can be customized to each patient's condition so that surgeons can offer the right care, at the right time, in the right setting. (2) Build the right infrastructure to provide the highest quality care with surgical facilities having in place appropriate and adequate staffing levels, a reasonable mix of specialists, and the right equipment. Checklists and health information technology, such as the electronic health record, are components of this infrastructure. (3) Collect robust data so that surgical decisions are based on clinical data drawn from medical charts that track patients after discharge from the hospital. Data should be risk-adjusted and collected in nationally benchmarked registries to allow institutions to compare their care with other providers. (4) Verify processes and infrastructure by having an external authority periodically affirm that the right systems are in place at health care institutions, that outcomes are being measured and benchmarked, and that hospitals and providers are proactively responding to these findings. © 2014.

24 CFR 574.340 - Additional standards for community residences.

Code of Federal Regulations, 2014 CFR

2014-04-01

... residential setting with appropriate services to enhance the quality of life for those who are unable to live independently; and to enable such persons to participate as fully as possible in community life. (b) If grant...

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... and changes in its patient care. (c) Standard: Program activities. (1) The ASC must set priorities for... by the ASC. (2) Addresses the ASC's priorities and that all improvements are evaluated for...

Hydrogeochemical characterization and Natural Background Levels in urbanized areas: Milan Metropolitan area (Northern Italy)

NASA Astrophysics Data System (ADS)

De Caro, Mattia; Crosta, Giovanni B.; Frattini, Paolo

2017-04-01

Although aquifers in densely populated and industrialized areas are extremely valuable and sensitive to contamination, an estimate of the groundwater quality status relative to baseline conditions is lacking for many of them. This paper provides a hydrogeochemical characterization of the groundwater in the Milan metropolitan area, one of the most densely populated areas in Europe. First, a conceptual model of the study area based on the analysis of the spatial distribution of natural chemical species and indicator contaminants is presented. The hydrochemical facies of the study area depend on the lithology of catchments drained by the main contributing rivers and on the aquifer settings. The anthropogenic influence on the groundwater quality of superficial aquifers is studied by means of probability plots, concentration versus depth plots and spatial-temporal plots for nitrate, sulfate and chloride. These allow differentiation of contaminated superficial aquifers from deep confined aquifers with baseline water quality. Natural Background Levels (NBL) of selected species (Cl, Na, NH4, SO4, NO3, As, Fe, Mn and Zn) are estimated by means of the pre-selection (PS) and the component separation (CS) statistical approaches. The NBLs depend on hydrogeological settings of the study area; sodium, chloride, sulfate and zinc NBL values never exceed the environmental water quality standards. NBL values of ammonium, iron, arsenic and manganese exceed the environmental water quality standards in the anaerobic portion of the aquifers. On the basis of observations, a set of criteria and precautions are suggested for adoption with both PS and CS methods in the aquifer characterization of highly urbanized areas.

Specification and tolerancing of bulk glass material imperfections with ISO standards

NASA Astrophysics Data System (ADS)

Krisiloff, Allen J.

2017-08-01

Standards for the specification of tolerances for glass material imperfections have been evolving over the past 40 years. Today, several individual ISO Standards for drawings and drawing notation - ISO 10110-2, ISO-10110-3, and ISO- 10110-4, which were last revised in 1996 and 1997 - are being merged and re-written to incorporate technical improvements and enhance the clarity of presentation. The new standard, tentatively numbered ISO 10110-18, is on schedule for release in 2018. It will also provide notation to directly utilize concepts and quality classes defined in ISO 12123, the newly revised standard for raw glass material. New ways to specify striae and a way to specify raw material specifications on a finished part drawing are two additional highlights of the revised versions of this set of ISO standards. This paper will discuss the old shortcomings, their corrections, and the new features incorporated into the set of standards currently under final development and whose publication is expected next year.

Optimizing nursing care delivery systems in the Army: back to basics with care teams and peer feedback.

PubMed

Prue-Owens, Kathy; Watkins, Miko; Wolgast, Kelly A

2011-01-01

The Patient CaringTouch System emerged from a comprehensive assessment and gap analysis of clinical nursing capabilities in the Army. The Patient CaringTouch System now provides the framework and set of standards by which we drive excellence in quality nursing care for our patients and excellence in quality of life for our nurses in Army Medicine. As part of this enterprise transformation, we placed particular emphasis on the delivery of nursing care at the bedside as well as the integration of a formal professional peer feedback process in support of individual nurse practice enhancement. The Warrior Care Imperative Action Team was chartered to define and establish the standards for care teams in the clinical settings and the process by which we established formal peer feedback for our professional nurses. This back-to-basics approach is a cornerstone of the Patient CaringTouch System implementation and sustainment.

A new CT collimator for producing two simultaneous overlapping slices from one scan. [for biomedical applications

NASA Technical Reports Server (NTRS)

Kwoh, Y. S.; Glenn, W. V., Jr.; Reed, I. S.; Truong, T. K.

1981-01-01

A new CT collimator is developed which is capable of producing two simultaneous successive overlapping images from a single scan. The collimator represents a modification of the standard EMI 5005 collimator achieved by alternately masking one end or portions of both ends of the X-ray detectors at a 13-mm beamwidth so that a set of 540 filtered projections is obtained for each scan which can be separated into two sets of interleaved projections corresponding to views 3 mm apart. Tests have demonstrated that the quality of the images produced from these two projections almost equals the quality of those produced by the standard collimator from two separate scans. The new collimator may thus be used to achieve a speed improvement in the generation of overlapping sections as well as a reduction in X-ray dosage.

The best choice of equipment to obtain high quality standardised results in intra-oral photography - a comparison between the common practice in the UK and the gold standard set by the literature.

PubMed

Marcato, Laura; Sandler, Jonathan

2018-04-01

Since digital technology made dental photography widely available, photographers have been trying to establish the 'gold standard' when obtaining intra-oral photographs. A basic knowledge of photographic principles, familiarity with particular dental techniques and a correct choice and use of equipment contribute significantly both to the standardisation and quality of photographs. A recent survey between members of the Institute of Medical Illustrators shed a light on the current practice in the UK. Medical photographers do not always have access to the full range of suitable equipment. A better selection of retractors and occlusal mirrors would undoubtedly contribute to higher quality images.

Supervised exercise therapy versus home-based exercise therapy versus walking advice for intermittent claudication.

PubMed

Hageman, David; Fokkenrood, Hugo Jp; Gommans, Lindy Nm; van den Houten, Marijn Ml; Teijink, Joep Aw

2018-04-06

Although supervised exercise therapy (SET) provides significant symptomatic benefit for patients with intermittent claudication (IC), it remains an underutilized tool. Widespread implementation of SET is restricted by lack of facilities and funding. Structured home-based exercise therapy (HBET) with an observation component (e.g., exercise logbooks, pedometers) and just walking advice (WA) are alternatives to SET. This is the second update of a review first published in 2006. The primary objective was to provide an accurate overview of studies evaluating effects of SET programs, HBET programs, and WA on maximal treadmill walking distance or time (MWD/T) for patients with IC. Secondary objectives were to evaluate effects of SET, HBET, and WA on pain-free treadmill walking distance or time (PFWD/T), quality of life, and self-reported functional impairment. The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register (December 16, 2016) and the Cochrane Central Register of Controlled Trials (2016, Issue 11). We searched the reference lists of relevant studies identified through searches for other potential trials. We applied no restriction on language of publication. We included parallel-group randomized controlled trials comparing SET programs with HBET programs and WA in participants with IC. We excluded studies in which control groups did not receive exercise or walking advice (maintained normal physical activity). We also excluded studies comparing exercise with percutaneous transluminal angioplasty, bypass surgery, or drug therapy. Three review authors (DH, HF, and LG) independently selected trials, extracted data, and assessed trials for risk of bias. Two other review authors (MvdH and JT) confirmed the suitability and methodological quality of trials. For all continuous outcomes, we extracted the number of participants, mean outcome, and standard deviation for each treatment group through the follow-up period, if available. We extracted Medical Outcomes Study Short Form 36 outcomes to assess quality of life, and Walking Impairment Questionnaire outcomes to assess self-reported functional impairment. As investigators used different scales to present results of walking distance and time, we standardized reported data to effect sizes to enable calculation of an overall standardized mean difference (SMD). We obtained summary estimates for all outcome measures using a random-effects model. We assessed the quality of evidence using the GRADE approach. For this update, we included seven additional studies, making a total of 21 included studies, which involved a total of 1400 participants: 635 received SET, 320 received HBET, and 445 received WA. In general, SET and HBET programs consisted of three exercise sessions per week. Follow-up ranged from six weeks to two years. Most trials used a treadmill walking test to investigate effects of exercise therapy on walking capacity. However, two trials assessed only quality of life, functional impairment, and/or walking behavior (i.e., daily steps measured by pedometer). The overall methodological quality of included trials was moderate to good. However, some trials were small with respect to numbers of participants, ranging from 20 to 304.SET groups showed clear improvement in MWD/T compared with HBET and WA groups, with overall SMDs at three months of 0.37 (95% confidence interval [CI] 0.12 to 0.62; P = 0.004; moderate-quality evidence) and 0.80 (95% CI 0.53 to 1.07; P < 0.00001; high-quality evidence), respectively. This translates to differences in increased MWD of approximately 120 and 210 meters in favor of SET groups. Data show improvements for up to six and 12 months, respectively. The HBET group did not show improvement in MWD/T compared with the WA group (SMD 0.30, 95% CI -0.45 to 1.05; P = 0.43; moderate-quality evidence).Compared with HBET, SET was more beneficial for PFWD/T but had no effect on quality of life parameters nor on self-reported functional impairment. Compared with WA, SET was more beneficial for PFWD/T and self-reported functional impairment, as well as for some quality of life parameters (e.g., physical functioning, pain, and physical component summary after 12 months), and HBET had no effect.Data show no obvious effects on mortality rates. Thirteen of the 1400 participants died, but no deaths were related to exercise therapy. Overall, adherence to SET was approximately 80%, which was similar to that reported with HBET. Only limited adherence data were available for WA groups. Evidence of moderate and high quality shows that SET provides an important benefit for treadmill-measured walking distance (MWD and PFWD) compared with HBET and WA, respectively. Although its clinical relevance has not been definitively demonstrated, this benefit translates to increased MWD of 120 and 210 meters after three months in SET groups. These increased walking distances are likely to have a positive impact on the lives of patients with IC. Data provide no clear evidence of a difference between HBET and WA. Trials show no clear differences in quality of life parameters nor in self-reported functional impairment between SET and HBET. However, evidence is of low and very low quality, respectively. Investigators detected some improvements in quality of life favoring SET over WA, but analyses were limited by small numbers of studies and participants. Future studies should focus on disease-specific quality of life and other functional outcomes, such as walking behavior and physical activity, as well as on long-term follow-up.

Developing policy, standard orders, and quality-assurance monitoring for palliative sedation therapy.

PubMed

Ghafoor, Virginia L; Silus, Lauren S

2011-03-15

The development of a policy, evidence-based standard orders, and monitoring for palliative sedation therapy (PST) is described. Concerns regarding PST at the University of Minnesota Medical Center (UMMC) arose and needed to be addressed in a formal process. A multidisciplinary group consisting of palliative care physicians, nurse practitioners, clinical nurse specialists, and clinical pharmacy specialists reached consensus on the practice model and medications to be used for PST. Major elements of the plan included the development and implementation of an institutional policy for palliative sedation; standard orders for patient care, sedation, and monitoring; education for staff, patients, and patients' family members; and quality-assurance monitoring. A literature review was performed to identify research and guidelines defining the practice of PST. Policy content includes the use of a standard order set linking patient care, medication administration, the monitoring of sedation, and symptom management. Approval of the policy involved several UMMC committees. An evaluation matrix was used to determine critical areas for PST monitoring and to guide development of a form to monitor quality. A retrospective chart audit using the quality-assurance monitoring form assessed baseline sedation medication and patient outcomes. Assessment of compliance began in the fall of 2008, after the policy and standard orders were approved by the UMMC medical executive committee. In 2008, two cases of PST were monitored using the standardized form. PST cases will be continually monitored and analyzed. Development of policy, standard orders, and quality-assurance monitoring for PST required a formal multidisciplinary process. A process-improvement process is critical to defining institutional policy, educational goals, and outcome metrics for PST.

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

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

Not Available

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

Experimenting Design and Implementation of an Educational Services Management System Based on ISO/IEC 20000 Standard

NASA Astrophysics Data System (ADS)

Lezcano, Jean-Marc; Adachihara, Hatsuo; Prunier, Marc

European higher education organizations are encouraged to implement quality management practices. Existing quality standards and frameworks do not capitalize an important set of best practices addressing educational services delivery. The ISO/IEC 20000 standard, elaborated from IT service management issues, is widening its field of application and may represent an interesting alternative. A specific approach is needed to apprehend the particular nature of educational services, consider the systemic cooperating roles of educational system and learning system, and define ISO/IEC 20000 vocabulary and concepts adapted to the domain. ISO/IEC 20000 may provide an answer to European Standard Guideline compliance and improve educational services management. The current experimentation is expected to cast light on the complexity, practicality and effectiveness of the use of ISO/IEC 20000 in a first field of "non IT" services.

Ambient assisted living healthcare frameworks, platforms, standards, and quality attributes.

PubMed

Memon, Mukhtiar; Wagner, Stefan Rahr; Pedersen, Christian Fischer; Beevi, Femina Hassan Aysha; Hansen, Finn Overgaard

2014-03-04

Ambient Assisted Living (AAL) is an emerging multi-disciplinary field aiming at exploiting information and communication technologies in personal healthcare and telehealth systems for countering the effects of growing elderly population. AAL systems are developed for personalized, adaptive, and anticipatory requirements, necessitating high quality-of-service to achieve interoperability, usability, security, and accuracy. The aim of this paper is to provide a comprehensive review of the AAL field with a focus on healthcare frameworks, platforms, standards, and quality attributes. To achieve this, we conducted a literature survey of state-of-the-art AAL frameworks, systems and platforms to identify the essential aspects of AAL systems and investigate the critical issues from the design, technology, quality-of-service, and user experience perspectives. In addition, we conducted an email-based survey for collecting usage data and current status of contemporary AAL systems. We found that most AAL systems are confined to a limited set of features ignoring many of the essential AAL system aspects. Standards and technologies are used in a limited and isolated manner, while quality attributes are often addressed insufficiently. In conclusion, we found that more inter-organizational collaboration, user-centered studies, increased standardization efforts, and a focus on open systems is needed to achieve more interoperable and synergetic AAL solutions.

Dietary supplements quality analysis tools from the United States Pharmacopeia.

PubMed

Sarma, Nandakumara; Giancaspro, Gabriel; Venema, Jaap

2016-01-01

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

Ambient Assisted Living Healthcare Frameworks, Platforms, Standards, and Quality Attributes

PubMed Central

Memon, Mukhtiar; Wagner, Stefan Rahr; Pedersen, Christian Fischer; Beevi, Femina Hassan Aysha; Hansen, Finn Overgaard

2014-01-01

Ambient Assisted Living (AAL) is an emerging multi-disciplinary field aiming at exploiting information and communication technologies in personal healthcare and telehealth systems for countering the effects of growing elderly population. AAL systems are developed for personalized, adaptive, and anticipatory requirements, necessitating high quality-of-service to achieve interoperability, usability, security, and accuracy. The aim of this paper is to provide a comprehensive review of the AAL field with a focus on healthcare frameworks, platforms, standards, and quality attributes. To achieve this, we conducted a literature survey of state-of-the-art AAL frameworks, systems and platforms to identify the essential aspects of AAL systems and investigate the critical issues from the design, technology, quality-of-service, and user experience perspectives. In addition, we conducted an email-based survey for collecting usage data and current status of contemporary AAL systems. We found that most AAL systems are confined to a limited set of features ignoring many of the essential AAL system aspects. Standards and technologies are used in a limited and isolated manner, while quality attributes are often addressed insufficiently. In conclusion, we found that more inter-organizational collaboration, user-centered studies, increased standardization efforts, and a focus on open systems is needed to achieve more interoperable and synergetic AAL solutions. PMID:24599192

Hard x-ray micro-tomography of a human head post-mortem as a gold standard to compare x-ray modalities

NASA Astrophysics Data System (ADS)

Dalstra, M.; Schulz, G.; Dagassan-Berndt, D.; Verna, C.; Müller-Gerbl, M.; Müller, B.

2016-10-01

An entire human head obtained at autopsy was micro-CT scanned in a nano/micro-CT scanner in a 6-hour long session. Despite the size of the head, it could still be scanned with a pixel size of 70 μm. The aim of this study was to obtain an optimal quality 3D data-set to be used as baseline control in a larger study comparing the image quality of various cone beam CT systems currently used in dentistry. The image quality of the micro-CT scans was indeed better than the ones of the clinical imaging modalities, both with regard to noise and streak artifacts due to metal dental implants. Bony features in the jaws, like the trabecular architecture and the thin wall of the alveolar bone were clearly visible. Therefore, the 3D micro-CT data-set can be used as the gold standard for linear, angular, and volumetric measurements of anatomical features in and around the oral cavity when comparing clinical imaging modalities.

Analysing data from patient-reported outcome and quality of life endpoints for cancer clinical trials: a start in setting international standards.

PubMed

Bottomley, Andrew; Pe, Madeline; Sloan, Jeff; Basch, Ethan; Bonnetain, Franck; Calvert, Melanie; Campbell, Alicyn; Cleeland, Charles; Cocks, Kim; Collette, Laurence; Dueck, Amylou C; Devlin, Nancy; Flechtner, Hans-Henning; Gotay, Carolyn; Greimel, Eva; Griebsch, Ingolf; Groenvold, Mogens; Hamel, Jean-Francois; King, Madeleine; Kluetz, Paul G; Koller, Michael; Malone, Daniel C; Martinelli, Francesca; Mitchell, Sandra A; Moinpour, Carol M; Musoro, Jammbe; O'Connor, Daniel; Oliver, Kathy; Piault-Louis, Elisabeth; Piccart, Martine; Pimentel, Francisco L; Quinten, Chantal; Reijneveld, Jaap C; Schürmann, Christoph; Smith, Ashley Wilder; Soltys, Katherine M; Taphoorn, Martin J B; Velikova, Galina; Coens, Corneel

2016-11-01

Measures of health-related quality of life (HRQOL) and other patient-reported outcomes generate important data in cancer randomised trials to assist in assessing the risks and benefits of cancer therapies and fostering patient-centred cancer care. However, the various ways these measures are analysed and interpreted make it difficult to compare results across trials, and hinders the application of research findings to inform publications, product labelling, clinical guidelines, and health policy. To address these problems, the Setting International Standards in Analyzing Patient-Reported Outcomes and Quality of Life Endpoints Data (SISAQOL) initiative has been established. This consortium, directed by the European Organisation for Research and Treatment of Cancer (EORTC), was convened to provide recommendations on how to standardise the analysis of HRQOL and other patient-reported outcomes data in cancer randomised trials. This Personal View discusses the reasons why this project was initiated, the rationale for the planned work, and the expected benefits to cancer research, patient and provider decision making, care delivery, and policy making. Copyright © 2016 Elsevier Ltd. All rights reserved.

Automated extraction of ejection fraction for quality measurement using regular expressions in Unstructured Information Management Architecture (UIMA) for heart failure.

PubMed

Garvin, Jennifer H; DuVall, Scott L; South, Brett R; Bray, Bruce E; Bolton, Daniel; Heavirland, Julia; Pickard, Steve; Heidenreich, Paul; Shen, Shuying; Weir, Charlene; Samore, Matthew; Goldstein, Mary K

2012-01-01

Left ventricular ejection fraction (EF) is a key component of heart failure quality measures used within the Department of Veteran Affairs (VA). Our goals were to build a natural language processing system to extract the EF from free-text echocardiogram reports to automate measurement reporting and to validate the accuracy of the system using a comparison reference standard developed through human review. This project was a Translational Use Case Project within the VA Consortium for Healthcare Informatics. We created a set of regular expressions and rules to capture the EF using a random sample of 765 echocardiograms from seven VA medical centers. The documents were randomly assigned to two sets: a set of 275 used for training and a second set of 490 used for testing and validation. To establish the reference standard, two independent reviewers annotated all documents in both sets; a third reviewer adjudicated disagreements. System test results for document-level classification of EF of <40% had a sensitivity (recall) of 98.41%, a specificity of 100%, a positive predictive value (precision) of 100%, and an F measure of 99.2%. System test results at the concept level had a sensitivity of 88.9% (95% CI 87.7% to 90.0%), a positive predictive value of 95% (95% CI 94.2% to 95.9%), and an F measure of 91.9% (95% CI 91.2% to 92.7%). An EF value of <40% can be accurately identified in VA echocardiogram reports. An automated information extraction system can be used to accurately extract EF for quality measurement.

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

PubMed

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

2015-01-01

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

Method of calculation overall equipment effectiveness in fertilizer factory

NASA Astrophysics Data System (ADS)

Siregar, I.; Muchtar, M. A.; Rahmat, R. F.; Andayani, U.; Nasution, T. H.; Sari, R. M.

2018-02-01

This research was conducted at a fertilizer company in Sumatra, where companies that produce fertilizers in large quantities to meet the needs of consumers. This company cannot be separated from issues related to the performance/effectiveness of the machinery and equipment. It can be seen from the engine that runs every day without a break resulted in not all of the quality of products in accordance with the quality standards set by the company. Therefore, to measure and improve the performance of the machine in the unit Plant Urea-1 as a whole then used method of Overall Equipment Effectiveness (OEE), which is one important element in the Total Productive Maintenance (TPM) to measure the effectiveness of the machine so that it can take measures to maintain that level. In July, August and September OEE values above the standard set at 85%. Meanwhile, in October, November and December have not reached the standard OEE values. The low value of OEE due to lack of time availability of machines for the production shut down due to the occurrence of the engine long enough so that the availability of reduced production time.

The art and science of photography in hand surgery.

PubMed

Wang, Keming; Kowalski, Evan J; Chung, Kevin C

2014-03-01

High-quality medical photography plays an important role in teaching and demonstrating the functional capacity of the hands as well as in medicolegal documentation. Obtaining standardized, high-quality photographs is now an essential component of many surgery practices. The importance of standardized photography in facial and cosmetic surgery has been well documented in previous studies, but no studies have thoroughly addressed the details of photography for hand surgery. In this paper, we provide a set of guidelines and basic camera concepts for different scenarios to help hand surgeons obtain appropriate and informative high-quality photographs. A camera used for medical photography should come equipped with a large sensor size and an optical zoom lens with a focal length ranging anywhere from 14 to 75 mm. In a clinic or office setting, we recommend 6 standardized views of the hand and 4 views for the wrist; additional views should be taken for tendon ruptures, nerve injuries, or other deformities of the hand. For intraoperative pictures, the camera operator should understand the procedure and pertinent anatomy in order to properly obtain high-quality photographs. When digital radiographs are not available and radiographic film must be photographed, it is recommended to reduce the exposure and change the color mode to black and white to obtain the best possible pictures. The goal of medical photography is to present the subject in an accurate and precise fashion. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Quality-Assurance Plan for Water-Quality Activities in the USGS Ohio Water Science Center

USGS Publications Warehouse

Francy, Donna S.; Shaffer, Kimberly H.

2008-01-01

In accordance with guidelines set forth by the Office of Water Quality in the Water Resources Discipline of the U.S. Geological Survey, a quality-assurance plan has been written for use by the Ohio Water Science Center in conducting water-quality activities. This quality-assurance plan documents the standards, policies, and procedures used by the Ohio Water Science Center for activities related to the collection, processing, storage, analysis, and publication of water-quality data. The policies and procedures documented in this quality-assurance plan for water-quality activities are meant to complement the Ohio Water Science Center quality-assurance plans for water-quality monitors, the microbiology laboratory, and surface-water and ground-water activities.

Economic evaluations of clinical pharmacist interventions on hospital inpatients: a systematic review of recent literature.

PubMed

Gallagher, James; McCarthy, Suzanne; Byrne, Stephen

2014-12-01

Clinical and cost-effectiveness evidence are needed to justify the existence or extension of routine clinical pharmacy services in hospital settings. Previous reviews have indicated that clinical pharmacist interventions are likely to have a positive economic impact on hospital budgets but highlighted issues relating to the quality of studies. The primary aim of this review was to feature economic evaluations of clinical pharmacy services which targeted hospital inpatients. The review focused on the current cost-effectiveness status of different services, in addition to evaluating the quality of individual studies. Results of this systematic review were compared with cost-effectiveness and quality related findings of reviews which considered earlier time frames and alternative settings. A systematic review of the literature included a review of the following databases: Academic Search Complete, Cochrane Library, EconLit, Embase Elsevier, NHS Economic Evaluation Database and PubMed. Only studies with an economic assessment of a clinical pharmacy service provided in a hospital setting were included. Data relating to the cost-effectiveness was extracted from eligible studies. Methodologies employed and overall quality of the studies was also reviewed. A grading system was applied to determine the quality of studies. Consolidated Health Economic Evaluation Reporting Standards statement was employed to determine which aspects of a high quality health economic study were employed. Twenty studies were deemed eligible for inclusion. Overall, pharmacist interventions had a positive impact on hospital budgets. Only three studies (15 %) were deemed to be "good-quality" studies. No 'novel'clinical pharmacist intervention was identified during the course of this review. Clinical pharmacy interventions continue to provide cost savings. However, the standard of studies published has stagnated or even deteriorated in comparison with those included in previous reviews. Utilisation of published guidelines at initial stages of future studies may help improve the overall quality of studies.

Sports Injury Surveillance Systems: A Review of Methods and Data Quality.

PubMed

Ekegren, Christina L; Gabbe, Belinda J; Finch, Caroline F

2016-01-01

Data from sports injury surveillance systems are a prerequisite to the development and evaluation of injury prevention strategies. This review aimed to identify ongoing sports injury surveillance systems and determine whether there are gaps in our understanding of injuries in certain sport settings. A secondary aim was to determine which of the included surveillance systems have evaluated the quality of their data, a key factor in determining their usefulness. A systematic search was carried out to identify (1) publications presenting methodological details of sports injury surveillance systems within clubs and organisations; and (2) publications describing quality evaluations and the quality of data from these systems. Data extracted included methodological details of the surveillance systems, methods used to evaluate data quality, and results of these evaluations. Following literature search and review, a total of 15 sports injury surveillance systems were identified. Data relevant to each aim were summarised descriptively. Most systems were found to exist within professional and elite sports. Publications concerning data quality were identified for seven (47%) systems. Validation of system data through comparison with alternate sources has been undertaken for only four systems (27%). This review identified a shortage of ongoing injury surveillance data from amateur and community sport settings and limited information about the quality of data in professional and elite settings. More surveillance systems are needed across a range of sport settings, as are standards for data quality reporting. These efforts will enable better monitoring of sports injury trends and the development of sports safety strategies.

Water-quality assessment and wastewater-management alternatives for Dardenne Creek in St Charles County, Missouri

USGS Publications Warehouse

Berkas, W.R.; Lodderhose, J.R.

1985-01-01

The quality of water in the 15 mile downstream reach of Dardenne Creek in St. Charles County, Missouri, was assessed to determine if it met the Missouri water quality standards. Concentrations of dissolved oxygen and total ammonia failed to meet water quality standards downstream from the Harvester-Dardenne and St. Peters Wastewater-Treatment Plants. The QUAL-II SEMCOG water quality model was calibrated and verified using two independent data sets from Dardenne Creek. Management alternatives using current, design capacity, and future expansion wastewater discharges from the St. Peters Wastewater-Treatment Plant were evaluated. Results of the computer simulation indicate that a nitrification-type advanced-treatment facility installed at the plant would produce a 5-day carbonaceous biochemical oxygen demand of 10 mg/L. An effluent limit of 5.0 mg/L of 5-day carbonaceous biochemical oxygen demand would further improve the water quality of Dardenne Creek; however, an additional treatment process, such as sand filtration, would be needed to meet this criterion. (USGS)

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

ERIC Educational Resources Information Center

McGee, Steven; Nutakki, Nivedita

2017-01-01

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

The Impact of the Evaluation of the Standards of Undergraduate Teaching Work on Teaching at Higher Education Institutions: An Investigative Study

ERIC Educational Resources Information Center

Yaoming, Gao; Ping, Zhang; Hui, Chen; Lili, Lan; Guanghui, Zhang

2009-01-01

A questionnaire investigation of academic staff and teaching administrators at Shanghai Normal University and Shanghai Fisheries University shows that the evaluation of the standards of undergraduate teaching work has had positive effects on teaching work and that setting up an evaluation system is an effective measure for assuring the quality of…

SU-E-T-223: High-Energy Photon Standard Dosimetry Data: A Quality Assurance Tool.

PubMed

Lowenstein, J; Kry, S; Molineu, A; Alvarez, P; Aguirre, J; Summers, P; Followill, D

2012-06-01

Describe the Radiological Physics Center's (RPC) extensive standard dosimetry data set determined from on-site audits measurements. Measurements were made during on-site audits to institutions participating in NCI funded cooperative clinical trials for 44 years using a 0.6cc cylindrical ionization chamber placed within the RPC's water tank. Measurements were made on Varian, Siemens, and Elekta/Philips accelerators for 11 different energies from 68 models of accelerators. We have measured percent depth dose, output factors, and off-axis factors for 123 different accelerator model/energy combinations for which we have 5 or more sets of measurements. The RPC analyzed these data and determined the 'standard data' for each model/energy combination. The RPC defines 'standard data' as the mean value of 5 or more sets of dosimetry data or agreement with published depth dose data (within 2%). The analysis of these standard data indicates that for modern accelerator models, the dosimetry data for a particular model/energy are within ï,±2%. The RPC has always found accelerators of the same make/model/energy combination have the same dosimetric properties in terms of depth dose, field size dependence and off-axis factors. Because of this consistency, the RPC can assign standard data for percent depth dose, average output factors and off-axis factors for a given combination of energy and accelerator make and model. The RPC standard data can be used as a redundant quality assurance tool to assist Medical Physicists to have confidence in their clinical data to within 2%. The next step is for the RPC to provide a way for institutions to submit data to the RPC to determine if their data agrees with the standard data as a redundant check. This work was supported by PHS grants CA10953 awarded by NCI, DHHS. © 2012 American Association of Physicists in Medicine.

Audit of memory clinic practice against CCG guidelines: West Suffolk Hospital.

PubMed

Mahmoud, Afef; Vandana, Balakrishna Menon; Chipperfield, Ruth; Ferrera, Silvia; Rubinsztein, Judy

2015-09-01

The memory service based in the West Suffolk has received increased funding to deliver a high quality service against standards set by the Clinical Commissioning Group (CCG). This audit aims to examine if we are achieving the standards set by the local CCG and to identify areas to improve the quality of the service.We also aimed to assess information as to how many patients referred had dementia. If they had a dementia suitable for possible anti-dementia medication (such as dementia of Alzheimer's type, Alzheimer's mixed type or atypical or Lewy body/ Parkinson's dementia) to ascertain if they were being offered anti-dementia medication. Retrospective analysis of 60 patients from the memory service were analysed. The first 10 patients referred in alternative months were selected for inclusion. Standards were based on targets set by the CCG in terms of time needed to assess, diagnose, communicate diagnosis to the GP and give post diagnostic advice. Patients in this memory service were being seen 37 days (on average) after referral. Most patients received a diagnosis at their initial assessment but some needed further investigation to establish the diagnosis or the specific type of diagnosis. The time for letters to be typed did not meet standards and letters were sent out on average 23 days after patients were being seen. Post diagnostic advice was delivered to most who received a diagnosis. Our service is offering timely diagnosis to those referred to the memory service in line with national guidelines.

Standards for testing and clinical validation of seizure detection devices.

PubMed

Beniczky, Sándor; Ryvlin, Philippe

2018-06-01

To increase the quality of studies on seizure detection devices, we propose standards for testing and clinical validation of such devices. We identified 4 key features that are important for studies on seizure detection devices: subjects, recordings, data analysis and alarms, and reference standard. For each of these features, we list the specific aspects that need to be addressed in the studies, and depending on these, studies are classified into 5 phases (0-4). We propose a set of outcome measures that need to be reported, and we propose standards for reporting the results. These standards will help in designing and reporting studies on seizure detection devices, they will give readers clear information on the level of evidence provided by the studies, and they will help regulatory bodies in assessing the quality of the validation studies. These standards are flexible, allowing classification of the studies into one of the 5 phases. We propose actions that can facilitate development of novel methods and devices. Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.

[Quality control in herbal supplements].

PubMed

Oelker, Luisa

2005-01-01

Quality and safety of food and herbal supplements are the result of a whole of different elements as good manufacturing practice and process control. The process control must be active and able to individuate and correct all possible hazards. The main and most utilized instrument is the hazard analysis critical control point (HACCP) system the correct application of which can guarantee the safety of the product. Herbal supplements need, in addition to standard quality control, a set of checks to assure the harmlessness and safety of the plants used.

Effects of stick design features on perceptions of characteristics of cigarettes.

PubMed

Borland, Ron; Savvas, Steven

2013-09-01

To examine the extent (if any) that cigarette stick dimension, tipping paper design and other decorative design/branding have on Australian smokers' perceptions of those cigarettes. An internet survey of 160 young Australian adult ever-smokers who were shown computer images of three sets of cigarette sticks--five sticks of different lengths and diameters (set A), five sticks with different tipping paper design (set B) and four sticks of different decorative design (set C). Branding was a between-subjects randomised condition for set C. For each set, respondents ranked sticks on most and least attractive, highest and lowest quality and strongest and weakest taste. Cigarette sticks were perceived as different on attractiveness, quality and strength of taste. Standard stick length/diameter was perceived as the most attractive and highest quality stick, with men more inclined to rate a slim stick as less attractive. A stick with a cork-patterned tipping paper and a gold band was seen as most attractive, of highest quality and strongest in taste compared to other tipping designs. Branded sticks were seen as more attractive, higher in quality and stronger tasting than non-branded designs, regardless of brand, although the effects were stronger for a prestige compared with a budget brand. Characteristics of the cigarette stick affect smokers' perceptions of the attributes of those cigarettes and thus are a potential means by which product differentiation can occur. A comprehensive policy to eliminate promotional aspects of cigarette design and packaging needs to include rules about stick design.

The quality of raw water for drinking water unit in Jakarta-Indonesia

NASA Astrophysics Data System (ADS)

Sidabutar, Noni Valeria; Hartono, Djoko M.; Soesilo, Tri Edhi Budhi; Hutapea, Reynold C.

2017-03-01

Water problems, i.e quality, quantity, continuity of clean water faced by the mostly urban area. Jakarta also faces similar issues, because the needs of society higher than the number of water fulfilled by the government. Moreover, Jakarta's water quality does not meet the standard set by the Government and heavily polluted by anthropogenic activities along its rivers. This research employs a quantitative research approach with the mix-method. It examines the raw water quality status for drinking water in West Tarum Canalin 2011-2015. The research results show water quality with this research, using water quality of with the water categorized as heavily-polluted category based on the Ministry of Environment's Decree No 115/2003 regarding the Guidelines for Determination of Water Quality Status. This present research also shown the water quality (parameters pH, temperature, Dissolved Oxygen (DO), Chemical Oxygen Demand (COD), and Biochemical Oxygen Demand (BOD)) from Jatiluhur Dam to the intake drinking water unit. In thirteen points of sampling also, the results obtained the parameters DO, COD, and BOD are fluctuating and exceed the standard.

Soprano and source: A laryngographic analysis

NASA Astrophysics Data System (ADS)

Bateman, Laura Anne

2005-04-01

Popular music in the 21st century uses a particular singing quality for female voice that is quite different from the trained classical singing quality. Classical quality has been the subject of a vast body of research, whereas research that deals with non-classical qualities is limited. In order to learn more about these issues, the author chose to do research on singing qualities using a variety of standard voice quality tests. This paper looks at voice qualities found in various different styles of singing: Classical, Belt, Legit, R&B, Jazz, Country, and Pop. The data was elicited from a professional soprano and the voice qualities reflect industry standards. The data set for this paper is limited to samples using the vowel [i]. Laryngographic (LGG) data was generated simultaneously with the audio samples. This paper will focus on the results of the LGG analysis; however, an audio analysis was also performed using Spectrogram, LPC, and FFT. Data from the LGG is used to calculate the contact quotient, speed quotient, and ascending slope. The LGG waveform is also visually assessed. The LGG analysis gives insights into the source vibration for the different singing styles.

Investigation of priorities in water quality management based on correlations and variations.

PubMed

Boyacıoğlu, Hülya; Gündogdu, Vildan; Boyacıoğlu, Hayal

2013-04-15

The development of water quality assessment strategies investigating spatial and temporal changes caused by natural and anthropogenic phenomena is an important tool in management practices. This paper used cluster analysis, water quality index method, sensitivity analysis and canonical correlation analysis to investigate priorities in pollution control activities. Data sets representing 22 surface water quality parameters were subject to analysis. Results revealed that organic pollution was serious threat for overall water quality in the region. Besides, oil and grease, lead and mercury were the critical variables violating the standard. In contrast to inorganic variables, organic and physical-inorganic chemical parameters were influenced by variations in physical conditions (discharge, temperature). This study showed that information produced based on the variations and correlations in water quality data sets can be helpful to investigate priorities in water management activities. Moreover statistical techniques and index methods are useful tools in data - information transformation process. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

PubMed

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

2017-09-07

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

Clinical evaluation of reducing acquisition time on single-photon emission computed tomography image quality using proprietary resolution recovery software.

PubMed

Aldridge, Matthew D; Waddington, Wendy W; Dickson, John C; Prakash, Vineet; Ell, Peter J; Bomanji, Jamshed B

2013-11-01

A three-dimensional model-based resolution recovery (RR) reconstruction algorithm that compensates for collimator-detector response, resulting in an improvement in reconstructed spatial resolution and signal-to-noise ratio of single-photon emission computed tomography (SPECT) images, was tested. The software is said to retain image quality even with reduced acquisition time. Clinically, any improvement in patient throughput without loss of quality is to be welcomed. Furthermore, future restrictions in radiotracer supplies may add value to this type of data analysis. The aims of this study were to assess improvement in image quality using the software and to evaluate the potential of performing reduced time acquisitions for bone and parathyroid SPECT applications. Data acquisition was performed using the local standard SPECT/CT protocols for 99mTc-hydroxymethylene diphosphonate bone and 99mTc-methoxyisobutylisonitrile parathyroid SPECT imaging. The principal modification applied was the acquisition of an eight-frame gated data set acquired using an ECG simulator with a fixed signal as the trigger. This had the effect of partitioning the data such that the effect of reduced time acquisitions could be assessed without conferring additional scanning time on the patient. The set of summed data sets was then independently reconstructed using the RR software to permit a blinded assessment of the effect of acquired counts upon reconstructed image quality as adjudged by three experienced observers. Data sets reconstructed with the RR software were compared with the local standard processing protocols; filtered back-projection and ordered-subset expectation-maximization. Thirty SPECT studies were assessed (20 bone and 10 parathyroid). The images reconstructed with the RR algorithm showed improved image quality for both full-time and half-time acquisitions over local current processing protocols (P<0.05). The RR algorithm improved image quality compared with local processing protocols and has been introduced into routine clinical use. SPECT acquisitions are now acquired at half of the time previously required. The method of binning the data can be applied to any other camera system to evaluate the reduction in acquisition time for similar processes. The potential for dose reduction is also inherent with this approach.

Laryngoscope illuminance in a tertiary children's hospital: implications for quality laryngoscopy.

PubMed

Volsky, Peter G; Murphy, Michael K; Darrow, David H

2014-07-01

Laryngoscopes are used by otolaryngologists in a variety of hospital emergency and critical care settings. However, only rarely have quality-related aspects of laryngoscope function and application been studied. To compare the illuminance of laryngoscopes commonly used in a hospital setting to established standards and to assess the potential effects of maintenance practices on laryngoscope illuminance. Observational study of laryngoscope light output and cross-sectional survey of individuals charged with laryngoscope maintenance in a tertiary care children's hospital. Illuminance was chosen as the unit of measurement (lux). Laryngoscopes in the operating room, emergency department, and pediatric intensive care unit were tested according to a standard technique. Illuminance standards for laryngoscopes, published by the International Organization for Standardization (ISO) (500 lux) and in the medical literature (867 lux) were used as benchmarks. Mean laryngoscope illuminance by type of laryngoscope and light source and percentage of laryngoscopes with illuminance below established standards as well as nonfunctioning units. Maintenance practices were evaluated as a secondary outcome. A total of 319 laryngoscopes were tested; 283 were incandescent bulb units used by anesthesiologists, emergency physicians, and intensivists and 36 were xenon light units used by otolaryngologists. Mean (SD) illuminance was 1330 (1160) lux in the incandescent group and 16,600 (13,000) lux in the xenon group (P < .001). Substandard illuminance was observed only in the incandescent group, in 29% to 43% of laryngoscopes; 5% of the incandescent group did not turn on at all. Maintenance of laryngoscopes was performed on a reactive rather than a preventive basis. At our facility, approximately one-third of incandescent laryngoscopes exhibited substandard light output. On the basis of these findings, our hospital has converted all of its incandescent laryngoscopes to light-emitting diode (LED) devices. Such changes, as well as the institution of a quality-control program including scheduled laryngoscope inspection and battery and bulb replacement for incandescent laryngoscopes, may reduce adverse events associated with poor-quality direct laryngoscopy.

Paths to partnership: Veterans Health Administration's Journey in pilot testing breast cancer care quality measures.

PubMed

Hogg, Lori Hoffman

2014-01-01

Prioritizing personalized, proactive, patient-driven health care is among the Veterans Health Administration's (VHA's) transformational initiatives. As one of the largest integrated healthcare systems, the VHA sets standards for performance measures and outcomes achieved in quality of care. Evidence-based practice (EBP) is a hallmark in oncology nursing care. EBP can be linked to positive outcomes and improving quality that can be influenced directly by nursing interventions. VHA oncology nurses had the opportunity to partner with the Oncology Nursing Society (ONS), ONS Foundation, and the Joint Commission in the multiyear development of a comprehensive approach to quality cancer care. Building on a platform of existing measures and refining measurement sets culminated in testing evidence-based, nursing-sensitive quality measures for reliability through the ONS Foundation-supported Breast Cancer Care (BCC) Quality Measures Set. The BCC Measures afforded the VHA to have its many sites collectively assess documentation of the symptoms of patients with breast cancer, the use of colony-stimulating factors, and education about neutropenia precautions provided. Parallel paths of the groups, seeking evidence-based measures, led to the perfect partnership in the VHA's journey in pilot testing the BCC Measures in veterans with breast cancer. This generated further quality assessments and continuous improvement projects for spread and sustainability throughout the VHA.

British Association for the Study of Community Dentistry (BASCD) guidance on sampling for surveys of child dental health. A BASCD coordinated dental epidemiology programme quality standard.

PubMed

Pine, C M; Pitts, N B; Nugent, Z J

1997-03-01

The British Association for the Study of Community Dentistry (BASCD) is responsible for the coordination of locally based surveys of child dental health which permit local and national comparisons between health authorities and regions. These surveys began in 1985/86 in England and Wales, 1987/88 in Scotland and 1993/94 in Northern Ireland. BASCD has taken an increasing lead in setting quality standards in discussion with the NHS Epidemiology Coordinators of the Dental Epidemiology Programme. This paper comprises guidance on the sampling for these surveys.

IMI's teaching design, feedback system and its localization

NASA Astrophysics Data System (ADS)

Wen, Tingting; Zhang, Xuexin

2017-08-01

In Britain, the Institute of the Motor Industry (IMI) sets the National Occupational Standards for all sectors of the automotive industry. The IMI certificate and associated training programs are well recognized for its high quality both in the United Kingdom (UK) and internationally. Using China's first groups studying IMI Level 3 certificate for teachers and Level 2 certificate for students as a sample, we analyzed the seven central aspects in IMI teaching, namely, assessment standard, environment, method, content, procedure, quality control and feedback. We then proposed strategies and guidelines for its localization in China, which would be particularly important for the establishment and expansion of IMI centers.

Comparison of Aerodynamic Resistance Parameterizations and Implications for Dry Deposition Modeling

EPA Science Inventory

Nitrogen deposition data used to support the secondary National Ambient Air Quality Standards and critical loads research derives from both measurements and modeling. Data sets with spatial coverage sufficient for regional scale deposition assessments are currently generated fro...

Data: The Common Thread & Tie That Binds Exposure Science

EPA Science Inventory

While a number of ongoing efforts exist aimed at empirically measuring or modeling exposure data, problems persist regarding availability and access to this data. Innovations in managing proprietary data, establishing data quality, standardization of data sets, and sharing of exi...

The birds did it!

EPA Science Inventory

The US EPA and WHO have set recreational water quality standards based on epidemiologic studies to protect human health at beaches. These studies have largely been limited to sewage-impacted sites, and resources are unlikely to be available to assess the myriad of other impacted...

Cost Effectiveness Of Selected Roadway Dust Control Methods For Eagle River, Alaska

DOT National Transportation Integrated Search

1988-01-01

The U.S. Environmental Protection Agency has set air quality standards for airborne particulates with diameters equal to or less than ten microns (PM10 particulates). These particulates have been correlated with respiratory illnesses. The primary sta...

EPA Approved New Jersey Source-Specific Requirements

EPA Pesticide Factsheets

This section sets forth the applicable State Implementation Plan (SIP) for New Jersey under section 110 of the Clean Air Act, as amended, 42 U.S.C. 7401 et seq., and 40 CFR part 51 to meet National Ambient Air Quality Standards.

Recovery Potential Screening for Prioritizing Restoration in Maryland Watersheds

EPA Science Inventory

States’ responsibilities under the Clean Water Act include identifying impaired waters (those not achieving Water Quality Standards) and ultimately restoring them. The high numbers of impaired waters in most states calls for yearly priority-setting decisions on restoration fundin...

Practical semen analysis: from A to Z

PubMed Central

Brazil, Charlene

2010-01-01

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

Should Title 24 Ventilation Requirements Be Amended to include an Indoor Air Quality Procedure?

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

Dutton, Spencer M.; Mendell, Mark J.; Chan, Wanyu R.

Minimum outdoor air ventilation rates (VRs) for buildings are specified in standards, including California?s Title 24 standards. The ASHRAE ventilation standard includes two options for mechanically-ventilated buildings ? a prescriptive ventilation rate procedure (VRP) that specifies minimum VRs that vary among occupancy classes, and a performance-based indoor air quality procedure (IAQP) that may result in lower VRs than the VRP, with associated energy savings, if IAQ meeting specified criteria can be demonstrated. The California Energy Commission has been considering the addition of an IAQP to the Title 24 standards. This paper, based on a review of prior data and newmore » analyses of the IAQP, evaluates four future options for Title 24: no IAQP; adding an alternate VRP, adding an equivalent indoor air quality procedure (EIAQP), and adding an improved ASHRAE-like IAQP. Criteria were established for selecting among options, and feedback was obtained in a workshop of stakeholders. Based on this review, the addition of an alternate VRP is recommended. This procedure would allow lower minimum VRs if a specified set of actions were taken to maintain acceptable IAQ. An alternate VRP could also be a valuable supplement to ASHRAE?s ventilation standard.« less

Pharmaceutical Equivalence of Distributed Generic Antiretroviral (ARV) in Asian Settings: The Cross-Sectional Surveillance Study - PEDA Study.

PubMed

Sapsirisavat, Vorapot; Vongsutilers, Vorasit; Thammajaruk, Narukjaporn; Pussadee, Kanitta; Riyaten, Prakit; Kerr, Stephen; Avihingsanon, Anchalee; Phanuphak, Praphan; Ruxrungtham, Kiat

2016-01-01

Ensuring that medicines meet quality standards is mandatory for ensuring safety and efficacy. There have been occasional reports of substandard generic medicines, especially in resource-limiting settings where policies to control quality may be less rigorous. As HIV treatment in Thailand depends mostly on affordable generic antiretrovirals (ARV), we performed quality assurance testing of several generic ARV available from different sources in Thailand and a source from Vietnam. We sampled Tenofovir 300mg, Efavirenz 600mg and Lopinavir/ritonavir 200/50mg from 10 primary hospitals randomly selected from those participating in the National AIDS Program, 2 non-government organization ARV clinics, and 3 private drug stores. Quality of ARV was analyzed by blinded investigators at the Faculty of Pharmaceutical Science, Chulalongkorn University. The analysis included an identification test for drug molecules, a chemical composition assay to quantitate the active ingredients, a uniformity of mass test and a dissolution test to assess in-vitro drug release. Comparisons were made against the standards described in the WHO international pharmacopeia. A total of 42 batches of ARV from 15 sources were sampled from January-March 2015. Among those generics, 23, 17, 1, and 1 were Thai-made, Indian-made, Vietnamese-made and Chinese-made, respectively. All sampled products, regardless of manufacturers or sources, met the International Pharmacopeia standards for composition assay, mass uniformity and dissolution. Although local regulations restrict ARV supply to hospitals and clinics, samples of ARV could be bought from private drug stores even without formal prescription. Sampled generic ARVs distributed within Thailand and 1 Vietnamese pharmacy showed consistent quality. However some products were illegally supplied without prescription, highlighting the importance of dispensing ARV for treatment or prevention in facilities where continuity along the HIV treatment and care cascade is available.

Assessing the conceptual clarity and evidence base of quality criteria/standards developed for evaluating decision aids

PubMed Central

McDonald, Heather; Charles, Cathy; Gafni, Amiram

2011-01-01

Abstract Context  Promoting patient participation in treatment decision making is of increasing interest to researchers, clinicians and policy makers. Decision aids (DAs) are advocated as one way to help achieve this goal. Despite their proliferation, there has been little agreement on criteria or standards for evaluating these tools. To fill this gap, an international collaboration of researchers and others interested in the development, content and quality of DAs have worked over the past several years to develop a checklist and, based on this checklist, an instrument for determining whether any given DA meets a defined set of quality criteria. Objective/Methods  In this paper, we offer a framework for assessing the conceptual clarity and evidence base used to support the development of quality criteria/standards for evaluating DAs. We then apply this framework to assess the conceptual clarity and evidence base underlying the International Patient Decision Aids Standards (IPDAS) checklist criteria for one of the checklist domains: how best to present in DAs probability information to patients on treatment benefits and risks. Conclusion  We found that some of the central concepts underlying the presenting probabilities domain were not defined. We also found gaps in the empirical evidence and theoretical support for this domain and criteria within this domain. Finally, we offer suggestions for steps that should be undertaken for further development and refinement of quality standards for DAs in the future. PMID:22050440

SU-F-J-16: Planar KV Imaging Dose Reduction Study

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

Gershkevitsh, E; Zolotuhhin, D

Purpose: IGRT has become an indispensable tool in modern radiotherapy with kV imaging used in many departments due to superior image quality and lower dose when compared to MV imaging. Many departments use manufacturer supplied protocols for imaging which are not always optimised between image quality and radiation dose (ALARA). Methods: Whole body phantom PBU-50 (Kyoto Kagaku ltd., Japan) for imaging in radiology has been imaged on Varian iX accelerator (Varian Medical Systems, USA) with OBI 1.5 system. Manufacturer’s default protocols were adapted by modifying kV and mAs values when imaging different anatomical regions of the phantom (head, thorax, abdomen,more » pelvis, extremities). Images with different settings were independently reviewed by two persons and their suitability for IGRT set-up correction protocols were evaluated. The suitable images with the lowest mAs were then selected. The entrance surface dose (ESD) for manufacturer’s default protocols and modified protocols were measured with RTI Black Piranha (RTI Group, Sweden) and compared. Image quality was also measured with kVQC phantom (Standard Imaging, USA) for different protocols. The modified protocols have been applied for clinical work. Results: For most cases optimized protocols reduced the ESD on average by a factor of 3(range 0.9–8.5). Further reduction in ESD has been observed by applying bow-tie filter designed for CBCT. The largest reduction in dose (12.2 times) was observed for Thorax lateral protocol. The dose was slightly increased (by 10%) for large pelvis AP protocol. Conclusion: Manufacturer’s default IGRT protocols could be optimised to reduce the ESD to the patient without losing the necessary image quality for patient set-up correction. For patient set-up with planar kV imaging the bony anatomy is mostly used and optimization should focus on this aspect. Therefore, the current approach with anthropomorphic phantom is more advantageous in optimization over standard kV quality control phantoms and SNR metrics.« less

The American College of Surgeons: an enduring commitment to quality and patient care.

PubMed

Hoyt, David B; Schneidman, Diane S

2015-03-01

This paper describes the American College of Surgeons' 100-plus-year commitment to improving quality and patient care. It summarizes programs that the College established a century ago to improve patient care, including the Hospital Standardization Program, and new initiatives, such as the ACS National Surgical Quality Improvement Program. The College's longstanding experience with quality improvement programs is enabling the organization to play a critical and influential role in helping to ensure that health care reforms, including those in the Affordable Care Act, are implemented in a way that best serves that interests of the surgical patient. Through a combination of these data analysis systems and the application of a finely tuned set of values, the College has become a respected voice in quality and patient safety. The ultimate goal is to create an environment where high value and high reliability take precedence over high volume and where all health care professionals play an active leadership role in delivering optimal, coordinated care. This article further describes how the surgical culture can be reshaped to meet these evolving needs and demands. The American College of Surgeons (ACS) has a longstanding commitment to improving the quality of surgical care through outcome measurement, standards setting, accreditation, and educational activities. This legacy has enabled the ACS to play an influential role in recent developments related to implementation of the Affordable Care Act (ACA) and Medicare physician payment reform. Copyright © 2015 Elsevier Inc. All rights reserved.

Softcopy quality ruler method: implementation and validation

NASA Astrophysics Data System (ADS)

Jin, Elaine W.; Keelan, Brian W.; Chen, Junqing; Phillips, Jonathan B.; Chen, Ying

2009-01-01

A softcopy quality ruler method was implemented for the International Imaging Industry Association (I3A) Camera Phone Image Quality (CPIQ) Initiative. This work extends ISO 20462 Part 3 by virtue of creating reference digital images of known subjective image quality, complimenting the hardcopy Standard Reference Stimuli (SRS). The softcopy ruler method was developed using images from a Canon EOS 1Ds Mark II D-SLR digital still camera (DSC) and a Kodak P880 point-and-shoot DSC. Images were viewed on an Apple 30in Cinema Display at a viewing distance of 34 inches. Ruler images were made for 16 scenes. Thirty ruler images were generated for each scene, representing ISO 20462 Standard Quality Scale (SQS) values of approximately 2 to 31 at an increment of one just noticeable difference (JND) by adjusting the system modulation transfer function (MTF). A Matlab GUI was developed to display the ruler and test images side-by-side with a user-adjustable ruler level controlled by a slider. A validation study was performed at Kodak, Vista Point Technology, and Aptina Imaging in which all three companies set up a similar viewing lab to run the softcopy ruler method. The results show that the three sets of data are in reasonable agreement with each other, with the differences within the range expected from observer variability. Compared to previous implementations of the quality ruler, the slider-based user interface allows approximately 2x faster assessments with 21.6% better precision.

ASVCP guidelines: quality assurance for point-of-care testing in veterinary medicine.

PubMed

Flatland, Bente; Freeman, Kathleen P; Vap, Linda M; Harr, Kendal E

2013-12-01

Point-of-care testing (POCT) refers to any laboratory testing performed outside the conventional reference laboratory and implies close proximity to patients. Instrumental POCT systems consist of small, handheld or benchtop analyzers. These have potential utility in many veterinary settings, including private clinics, academic veterinary medical centers, the community (eg, remote area veterinary medical teams), and for research applications in academia, government, and industry. Concern about the quality of veterinary in-clinic testing has been expressed in published veterinary literature; however, little guidance focusing on POCT is available. Recognizing this void, the ASVCP formed a subcommittee in 2009 charged with developing quality assurance (QA) guidelines for veterinary POCT. Guidelines were developed through literature review and a consensus process. Major recommendations include (1) taking a formalized approach to POCT within the facility, (2) use of written policies, standard operating procedures, forms, and logs, (3) operator training, including periodic assessment of skills, (4) assessment of instrument analytical performance and use of both statistical quality control and external quality assessment programs, (5) use of properly established or validated reference intervals, (6) and ensuring accurate patient results reporting. Where possible, given instrument analytical performance, use of a validated 13s control rule for interpretation of control data is recommended. These guidelines are aimed at veterinarians and veterinary technicians seeking to improve management of POCT in their clinical or research setting, and address QA of small chemistry and hematology instruments. These guidelines are not intended to be all-inclusive; rather, they provide a minimum standard for maintenance of POCT instruments in the veterinary setting. © 2013 American Society for Veterinary Clinical Pathology and European Society for Veterinary Clinical Pathology.

Instrument Quality Control.

PubMed

Jayakody, Chatura; Hull-Ryde, Emily A

2016-01-01

Well-defined quality control (QC) processes are used to determine whether a certain procedure or action conforms to a widely accepted standard and/or set of guidelines, and are important components of any laboratory quality assurance program (Popa-Burke et al., J Biomol Screen 14: 1017-1030, 2009). In this chapter, we describe QC procedures useful for monitoring the accuracy and precision of laboratory instrumentation, most notably automated liquid dispensers. Two techniques, gravimetric QC and photometric QC, are highlighted in this chapter. When used together, these simple techniques provide a robust process for evaluating liquid handler accuracy and precision, and critically underpin high-quality research programs.

DCTune Perceptual Optimization of Compressed Dental X-Rays

NASA Technical Reports Server (NTRS)

Watson, Andrew B.; Null, Cynthia H. (Technical Monitor)

1997-01-01

In current dental practice, x-rays of completed dental work are often sent to the insurer for verification. It is faster and cheaper to transmit instead digital scans of the x-rays. Further economies result if the images are sent in compressed form. DCtune is a technology for optimizing DCT quantization matrices to yield maximum perceptual quality for a given bit-rate, or minimum bit-rate for a given perceptual quality. In addition, the technology provides a means of setting the perceptual quality of compressed imagery in a systematic way. The purpose of this research was, with respect to dental x-rays: (1) to verify the advantage of DCTune over standard JPEG; (2) to verify the quality control feature of DCTune; and (3) to discover regularities in the optimized matrices of a set of images. Additional information is contained in the original extended abstract.

Urban rainwater runoff quantity and quality - A potential endogenous resource in cities?

PubMed

Angrill, Sara; Petit-Boix, Anna; Morales-Pinzón, Tito; Josa, Alejandro; Rieradevall, Joan; Gabarrell, Xavier

2017-03-15

Rainwater harvesting might help to achieve self-sufficiency, but it must comply with health standards. We studied the runoff quantity and quality harvested from seven urban surfaces in a university campus in Barcelona according to their use (pedestrian or motorized mobility) and materials (concrete, asphalt and slabs). An experimental rainwater harvesting system was used to collect the runoff resulting from a set of rainfall events. We estimated the runoff coefficient and initial abstraction of each surface and analyzed the physicochemical and microbiological properties, and hydrocarbon and metal content of the samples. Rainfall intensity, surface material and state of conservation were essential parameters. Because of low rainfall intensity and surface degradation, the runoff coefficient was variable, with a minimum of 0.41. Concrete had the best quality, whereas weathering and particulate matter deposition led to worse quality in asphalt areas. Physicochemical runoff quality was outstanding when compared to superficial and underground water. Microorganisms were identified in the samples (>1 CFU/100 mL) and treatment is required to meet human consumption standards. Motorized traffic mostly affects the presence of metals such as zinc (31.7 μg/L). In the future, sustainable mobility patterns might result in improved rainwater quality standards. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reduction and standardization of surgical instruments in pediatric inguinal hernia repair.

PubMed

Koyle, Martin A; AlQarni, Naif; Odeh, Rakan; Butt, Hissan; Alkahtani, Mohammed M; Konstant, Louis; Pendergast, Lisa; Koyle, Leah C C; Baker, G Ross

2018-02-01

To standardize and reduce surgical instrumentation by >25% within a 9-month period for pediatric inguinal hernia repair (PIHR), using "improvement science" methodology. We prospectively evaluated instruments used for PIHR in 56 consecutive cases by individual surgeons across two separate subspecialties, pediatric surgery (S) and pediatric urology (U), to measure actual number of instruments used compared with existing practice based on preference cards. Based on this evaluation, a single preference card was developed using only instruments that had been used in >50% of all cases. A subsequent series of 52 cases was analyzed to assess whether the new tray contained the ideal instrumentation. Cycle time (CT), to sterilize and package the instruments, and weights of the trays were measured before and after the intervention. A survey of operating room (OR) nurses and U and S surgeons was conducted before and after the introduction of the standardized tray to assess the impact and perception of standardization. Prior to creating the standardized tray, a U PIHR tray contained 96 instruments with a weight of 13.5 lbs, while the S set contained 51, weighing 11.2 lbs. The final standardized set comprised 28 instruments and weighed 7.8 lbs. Of 52 PIHRs performed after standardization, in three (6%) instances additional instruments were requested. CT was reduced from 11 to 8 min (U and S respectively) to <5 min for the single tray. Nurses and surgeons reported that quality, safety, and efficiency were improved, and that efforts should continue to standardize instrumentation for other common surgeries. Standardization of surgical equipment can be employed across disciplines with the potential to reduce costs and positively impact quality, safety, and efficiencies. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Setting the standard, implementation and auditing within haemodialysis.

PubMed

Jones, J

1997-01-01

With an ever increasing awareness of the need to deliver a quality of care that is measurable in Nursing, the concept of Standards provides an ideal tool (1). Standards operate outside the boundaries of policies and procedures to provide an audit tool of authenticity and flexibility. Within our five Renal Units, while we felt confident that we were delivering an excellent standard of care to our patients and continually trying to improve upon it, what we really needed was a method of measuring this current level of care and highlighting key areas where we could offer improvement.

Standardized Reporting of the Eczema Area and Severity Index (EASI) and the Patient-Oriented Eczema Measure (POEM): A Recommendation by the Harmonising Outcome Measures for Eczema (HOME) Initiative.

PubMed

Grinich, E; Schmitt, J; Küster, D; Spuls, P I; Williams, H C; Chalmers, J R; Thomas, K S; Apfelbacher, C; Prinsen, C A C; Furue, M; Stuart, B; Carter, B; Simpson, E

2018-05-10

Several organizations from multiple fields of medicine are setting standards for clinical research including protocol development, 1 harmonization of outcome reporting, 2 statistical analysis, 3 quality assessment 4 and reporting of findings. 1 Clinical research standardization facilitates the interpretation and synthesis of data, increases the usability of trial results for guideline groups and shared decision-making, and reduces selective outcome reporting bias. The mission of the Harmonising Outcome Measures for Eczema (HOME) initiative is to establish an agreed-upon core set of outcomes to be measured and reported in all clinical trials of atopic dermatitis (AD). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Static Analysis Alert Audits: Lexicon and Rules

DTIC Science & Technology

2016-11-04

collaborators • Includes a standard set of well-defined determinations for static analysis alerts • Includes a set of auditing rules to help auditors make...consistent decisions in commonly-encountered situations Different auditors should make the same determination for a given alert! Improve the quality and...scenarios • Establish assumptions auditors can make • Overall: help make audit determinations more consistent We developed 12 rules • Drew on our own

Laboratory challenges conducting international clinical research in resource-limited settings.

PubMed

Fitzgibbon, Joseph E; Wallis, Carole L

2014-01-01

There are many challenges to performing clinical research in resource-limited settings. Here, we discuss several of the most common laboratory issues that must be addressed. These include issues relating to organization and personnel, laboratory facilities and equipment, standard operating procedures, external quality assurance, shipping, laboratory capacity, and data management. Although much progress has been made, innovative ways of addressing some of these issues are still very much needed.

Automated extraction of ejection fraction for quality measurement using regular expressions in Unstructured Information Management Architecture (UIMA) for heart failure

PubMed Central

DuVall, Scott L; South, Brett R; Bray, Bruce E; Bolton, Daniel; Heavirland, Julia; Pickard, Steve; Heidenreich, Paul; Shen, Shuying; Weir, Charlene; Samore, Matthew; Goldstein, Mary K

2012-01-01

Objectives Left ventricular ejection fraction (EF) is a key component of heart failure quality measures used within the Department of Veteran Affairs (VA). Our goals were to build a natural language processing system to extract the EF from free-text echocardiogram reports to automate measurement reporting and to validate the accuracy of the system using a comparison reference standard developed through human review. This project was a Translational Use Case Project within the VA Consortium for Healthcare Informatics. Materials and methods We created a set of regular expressions and rules to capture the EF using a random sample of 765 echocardiograms from seven VA medical centers. The documents were randomly assigned to two sets: a set of 275 used for training and a second set of 490 used for testing and validation. To establish the reference standard, two independent reviewers annotated all documents in both sets; a third reviewer adjudicated disagreements. Results System test results for document-level classification of EF of <40% had a sensitivity (recall) of 98.41%, a specificity of 100%, a positive predictive value (precision) of 100%, and an F measure of 99.2%. System test results at the concept level had a sensitivity of 88.9% (95% CI 87.7% to 90.0%), a positive predictive value of 95% (95% CI 94.2% to 95.9%), and an F measure of 91.9% (95% CI 91.2% to 92.7%). Discussion An EF value of <40% can be accurately identified in VA echocardiogram reports. Conclusions An automated information extraction system can be used to accurately extract EF for quality measurement. PMID:22437073

Low-Quality Housing Is Associated With Increased Risk of Malaria Infection: A National Population-Based Study From the Low Transmission Setting of Swaziland

PubMed Central

Dlamini, Nomcebo; Ntshalintshali, Nyasatu; Pindolia, Deepa; Allen, Regan; Nhlabathi, Nomcebo; Novotny, Joseph; Kang Dufour, Mi-Suk; Midekisa, Alemayehu; Gosling, Roly; LeMenach, Arnaud; Cohen, Justin; Dorsey, Grant; Greenhouse, Bryan; Kunene, Simon

2017-01-01

Abstract Background. Low-quality housing may confer risk of malaria infection, but evidence in low transmission settings is limited. Methods. To examine the relationship between individual level housing quality and locally acquired infection in children and adults, a population-based cross-sectional analysis was performed using existing surveillance data from the low transmission setting of Swaziland. From 2012 to 2015, cases were identified through standard diagnostics in health facilities and by loop-mediated isothermal amplification in active surveillance, with uninfected subjects being household members and neighbors. Housing was visually assessed in a home visit and then classified as low, high, or medium quality, based on housing components being traditional, modern, or both, respectively. Results. Overall, 11426 individuals were included in the study: 10960 uninfected and 466 infected (301 symptomatic and 165 asymptomatic). Six percent resided in low-quality houses, 26% in medium-quality houses, and 68% in high-quality houses. In adjusted models, low- and medium-quality construction was associated with increased risk of malaria compared with high-quality construction (adjusted odds ratio [AOR], 2.11 and 95% confidence interval [CI], 1.26–3.53 for low vs high; AOR, 1.56 and 95% CI, 1.15–2.11 for medium vs high). The relationship was independent of vector control, which also conferred a protective effect (AOR, 0.67; 95% CI, .50–.90) for sleeping under an insecticide-treated bed net or a sprayed structure compared with neither. Conclusions. Our study adds to the limited literature on housing quality and malaria risk from low transmission settings. Housing improvements may offer an attractive and sustainable additional strategy to support countries in malaria elimination. PMID:28580365

Low-Quality Housing Is Associated With Increased Risk of Malaria Infection: A National Population-Based Study From the Low Transmission Setting of Swaziland.

PubMed

Dlamini, Nomcebo; Hsiang, Michelle S; Ntshalintshali, Nyasatu; Pindolia, Deepa; Allen, Regan; Nhlabathi, Nomcebo; Novotny, Joseph; Kang Dufour, Mi-Suk; Midekisa, Alemayehu; Gosling, Roly; LeMenach, Arnaud; Cohen, Justin; Dorsey, Grant; Greenhouse, Bryan; Kunene, Simon

2017-01-01

Low-quality housing may confer risk of malaria infection, but evidence in low transmission settings is limited. To examine the relationship between individual level housing quality and locally acquired infection in children and adults, a population-based cross-sectional analysis was performed using existing surveillance data from the low transmission setting of Swaziland. From 2012 to 2015, cases were identified through standard diagnostics in health facilities and by loop-mediated isothermal amplification in active surveillance, with uninfected subjects being household members and neighbors. Housing was visually assessed in a home visit and then classified as low, high, or medium quality, based on housing components being traditional, modern, or both, respectively. Overall, 11426 individuals were included in the study: 10960 uninfected and 466 infected (301 symptomatic and 165 asymptomatic). Six percent resided in low-quality houses, 26% in medium-quality houses, and 68% in high-quality houses. In adjusted models, low- and medium-quality construction was associated with increased risk of malaria compared with high-quality construction (adjusted odds ratio [AOR], 2.11 and 95% confidence interval [CI], 1.26-3.53 for low vs high; AOR, 1.56 and 95% CI, 1.15-2.11 for medium vs high). The relationship was independent of vector control, which also conferred a protective effect (AOR, 0.67; 95% CI, .50-.90) for sleeping under an insecticide-treated bed net or a sprayed structure compared with neither. Our study adds to the limited literature on housing quality and malaria risk from low transmission settings. Housing improvements may offer an attractive and sustainable additional strategy to support countries in malaria elimination. © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

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

PubMed

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

2016-07-01

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

Comparison of four methods of establishing control limits for monitoring quality controls in infectious disease serology testing.

PubMed

Dimech, Wayne; Karakaltsas, Marina; Vincini, Giuseppe A

2018-05-25

A general trend towards conducting infectious disease serology testing in centralized laboratories means that quality control (QC) principles used for clinical chemistry testing are applied to infectious disease testing. However, no systematic assessment of methods used to establish QC limits has been applied to infectious disease serology testing. A total of 103 QC data sets, obtained from six different infectious disease serology analytes, were parsed through standard methods for establishing statistical control limits, including guidelines from Public Health England, USA Clinical and Laboratory Standards Institute (CLSI), German Richtlinien der Bundesärztekammer (RiliBÄK) and Australian QConnect. The percentage of QC results failing each method was compared. The percentage of data sets having more than 20% of QC results failing Westgard rules when the first 20 results were used to calculate the mean±2 standard deviation (SD) ranged from 3 (2.9%) for R4S to 66 (64.1%) for 10X rule, whereas the percentage ranged from 0 (0%) for R4S to 32 (40.5%) for 10X when the first 100 results were used to calculate the mean±2 SD. By contrast, the percentage of data sets with >20% failing the RiliBÄK control limits was 25 (24.3%). Only two data sets (1.9%) had more than 20% of results outside the QConnect Limits. The rate of failure of QCs using QConnect Limits was more applicable for monitoring infectious disease serology testing compared with UK Public Health, CLSI and RiliBÄK, as the alternatives to QConnect Limits reported an unacceptably high percentage of failures across the 103 data sets.

KSC Center Director Bridges accepts an ISO 9001 certificate from DNV

NASA Technical Reports Server (NTRS)

1998-01-01

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

KSC-98pc907

NASA Image and Video Library

1998-08-11

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

KSC-98pc908

NASA Image and Video Library

1998-08-11

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

Optimization of window settings for standard and advanced virtual monoenergetic imaging in abdominal dual-energy CT angiography.

PubMed

Caruso, Damiano; Parinella, Ashley H; Schoepf, U Joseph; Stroebel, Maxwell H; Mangold, Stefanie; Wichmann, Julian L; Varga-Szemes, Akos; Ball, B Devon; De Santis, Domenico; Laghi, Andrea; De Cecco, Carlo N

2017-03-01

To determine the optimal window setting for displaying virtual monoenergetic reconstructions of third generation dual-source, dual-energy CT (DECT) angiography of the abdomen. Forty-five patients were evaluated with DECT angiography (90/150 kV, 180/90 ref. mAs). Three datasets were reconstructed: standard linear blending (M_0.6), 70 keV traditional virtual monoenergetic (M70), and 40 keV advanced noise-optimized virtual monoenergetic (M40+). The best window setting (width and level, W/L) was assessed by two blinded observers and was correlated with aortic attenuation to obtain the Optimized W/L setting (O-W/L). Subjective image quality was assessed, and vessel diameters were measured to determine any possible influences between different W/L settings. Repeated measures of variance were used to evaluate comparison of W/L values, image quality, and vessel sizing between M_0.6, M70, and M40+. The Best W/L (B-W/L) for M70 and M40+ was 880/280 and 1410/450, respectively. Results from regression analysis inferred an O-W/L of 850/270 for M70 and 1350/430 for M40+. Significant differences for W and L were found between the Best and the Optimized W/L for M40+, and between M70 and M40+ for both the Best and Optimized W/L. No significant differences for vessel measurements were found using the O-W/L for M40+ compared to the standard M_0.6 (p ≥ 0.16), and significant differences were observed when using the B-W/L with M40+ compared to M_0.6 (p ≤ 0.04). In order to optimize virtual monoenergetic imaging with both traditional M70 and advanced M40+, adjusting the W/L settings is necessary. Our results suggest a W/L setting of 850/270 for M70 and 1350/430 for M40+.

Comparison of Power Versus Manual Injection in Bolus Shape and Image Quality on Contrast-Enhanced Magnetic Resonance Angiography: An Experimental Study in a Swine Model.

PubMed

Tsuboyama, Takahiro; Jost, Gregor; Pietsch, Hubertus; Tomiyama, Noriyuki

2017-09-01

The aim of this study was to compare power versus manual injection in bolus shape and image quality on contrast-enhanced magnetic resonance angiography (CE-MRA). Three types of CE-MRA (head-neck 3-dimensional [3D] MRA with a test-bolus technique, thoracic-abdominal 3D MRA with a bolus-tracking technique, and thoracic-abdominal time-resolved 4-dimensional [4D] MRA) were performed after power and manual injection of gadobutrol (0.1 mmol/kg) at 2 mL/s in 12 pigs (6 sets of power and manual injections for each type of CE-MRA). For the quantitative analysis, the signal-to-noise ratio was measured on ascending aorta, descending aorta, brachiocephalic trunk, common carotid artery, and external carotid artery on the 6 sets of head-neck 3D MRA, and on ascending aorta, descending aorta, brachiocephalic trunk, abdominal aorta, celiac trunk, and renal artery on the 6 sets of thoracic-abdominal 3D MRA. Bolus shapes were evaluated on the 6 sets each of test-bolus scans and 4D MRA. For the qualitative analysis, arterial enhancement, superimposition of nontargeted enhancement, and overall image quality were evaluated on 3D MRA. Visibility of bolus transition was assessed on 4D MRA. Intraindividual comparison between power and manual injection was made by paired t test, Wilcoxon rank sum test, and analysis of variance by ranks. Signal-to-noise ratio on 3D MRA was statistically higher with power injection than with manual injection (P < 0.001). Bolus shapes (test-bolus, 4D MRA) were represented by a characteristic standard bolus curve (sharp first-pass peak followed by a gentle recirculation peak) in all the 12 scans with power injection, but only in 1 of the 12 scans with manual injection. Standard deviations of time-to-peak enhancement were smaller in power injection than in manual injection. Qualitatively, although both injection methods achieved diagnostic quality on 3D MRA, power injection exhibited significantly higher image quality than manual injection (P = 0.001) due to significantly higher arterial enhancement (P = 0.031) and less superimposition of nontargeted enhancement (P = 0.001). Visibility of bolus transition on 4D MRA was significantly better with power injection than with manual injection (P = 0.031). Compared with manual injection, power injection provides more standardized bolus shapes and higher image quality due to higher arterial enhancement and less superimposition of nontargeted vessels.

Nonlinear Multiobjective MPC-Based Optimal Operation of a High Consistency Refining System in Papermaking

DOE PAGES

Li, Mingjie; Zhou, Ping; Wang, Hong; ...

2017-09-19

As one of the most important unit in the papermaking industry, the high consistency (HC) refining system is confronted with challenges such as improving pulp quality, energy saving, and emissions reduction in its operation processes. Here in this correspondence, an optimal operation of HC refining system is presented using nonlinear multiobjective model predictive control strategies that aim at set-point tracking objective of pulp quality, economic objective, and specific energy (SE) consumption objective, respectively. First, a set of input and output data at different times are employed to construct the subprocess model of the state process model for the HC refiningmore » system, and then the Wiener-type model can be obtained through combining the mechanism model of Canadian Standard Freeness and the state process model that determines their structures based on Akaike information criterion. Second, the multiobjective optimization strategy that optimizes both the set-point tracking objective of pulp quality and SE consumption is proposed simultaneously, which uses NSGA-II approach to obtain the Pareto optimal set. Furthermore, targeting at the set-point tracking objective of pulp quality, economic objective, and SE consumption objective, the sequential quadratic programming method is utilized to produce the optimal predictive controllers. In conclusion, the simulation results demonstrate that the proposed methods can make the HC refining system provide a better performance of set-point tracking of pulp quality when these predictive controllers are employed. In addition, while the optimal predictive controllers orienting with comprehensive economic objective and SE consumption objective, it has been shown that they have significantly reduced the energy consumption.« less

Nonlinear Multiobjective MPC-Based Optimal Operation of a High Consistency Refining System in Papermaking

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

Li, Mingjie; Zhou, Ping; Wang, Hong

As one of the most important unit in the papermaking industry, the high consistency (HC) refining system is confronted with challenges such as improving pulp quality, energy saving, and emissions reduction in its operation processes. Here in this correspondence, an optimal operation of HC refining system is presented using nonlinear multiobjective model predictive control strategies that aim at set-point tracking objective of pulp quality, economic objective, and specific energy (SE) consumption objective, respectively. First, a set of input and output data at different times are employed to construct the subprocess model of the state process model for the HC refiningmore » system, and then the Wiener-type model can be obtained through combining the mechanism model of Canadian Standard Freeness and the state process model that determines their structures based on Akaike information criterion. Second, the multiobjective optimization strategy that optimizes both the set-point tracking objective of pulp quality and SE consumption is proposed simultaneously, which uses NSGA-II approach to obtain the Pareto optimal set. Furthermore, targeting at the set-point tracking objective of pulp quality, economic objective, and SE consumption objective, the sequential quadratic programming method is utilized to produce the optimal predictive controllers. In conclusion, the simulation results demonstrate that the proposed methods can make the HC refining system provide a better performance of set-point tracking of pulp quality when these predictive controllers are employed. In addition, while the optimal predictive controllers orienting with comprehensive economic objective and SE consumption objective, it has been shown that they have significantly reduced the energy consumption.« less

Setting standards at the forefront of delivery system reform: aligning care coordination quality measures for multiple chronic conditions.

PubMed

DuGoff, Eva H; Dy, Sydney; Giovannetti, Erin R; Leff, Bruce; Boyd, Cynthia M

2013-01-01

The primary study objective is to assess how three major health reform care coordination initiatives (Accountable Care Organizations, Independence at Home, and Community-Based Care Transitions) measure concepts critical to care coordination for people with multiple chronic conditions. We find that there are major differences in quality measurement across these three large and politically important programs. Quality measures currently used or proposed for these new health reform-related programs addressing care coordination primarily capture continuity of care. Other key areas of care coordination, such as care transitions, patient-centeredness, and cross-cutting care across multiple conditions are infrequently addressed. The lack of a comprehensive and consistent measure set for care coordination will pose challenges for healthcare providers and policy makers who seek, respectively, to provide and reward well-coordinated care. In addition, this heterogeneity in measuring care coordination quality will generate new information, but will inhibit comparisons between these care coordination programs. © 2013 National Association for Healthcare Quality.

[Quality assurance in interventional cardiology].

PubMed

Gülker, H

2009-10-01

Quality assurance in clinical studies aiming at approval of pharmaceutical products is submitted to strict rules, controls and auditing regulations. Comparative instruments to ensure quality in diagnostic and therapeutic procedures are not available in interventional cardiology, likewise in other fields of cardiovascular medicine. Quality assurance simply consists of "quality registers" with basic data not externally controlled. Based on the experiences of clinical studies and their long history of standardization it is assumed that these data may be severely flawed thus being inappropriate to set standards for diagnostic and therapeutic strategies. The precondition for quality assurance are quality data. In invasive coronary angiography and intervention medical indications, the decision making process interventional versus surgical revascularization, technical performance and after - care are essential aspects affecting quality of diagnostics and therapy. Quality data are externally controlled data. To collect quality data an appropriate infrastructure is a necessary precondition which is not existent. For an appropriate infrastructure investments have to be done both to build up as well as to sustain the necessary preconditions. As long as there are no infrastructure and no investments there will be no "quality data". There exist simply registers of data which are not proved to be a basis for significant assurance and enhancement in quality in interventional coronary cardiology. Georg Thieme Verlag KG Stuttgart, New York.

Economic Assessment and Budgetary Impact of a Telemedicine Procedure and Spirometry Quality Control in the Primary Care Setting.

PubMed

Marina, Nuria; Bayón, Juan Carlos; López de Santa María, Elena; Gutiérrez, Asunción; Inchausti, Marta; Bustamante, Victor; Gáldiz, Juan B

2016-01-01

To evaluate the economic impact of a telemedicine procedure designed to improve the quality of lung function testing (LFT) in primary care in a public healthcare system, compared with the standard method. The economic impact of 9,039 LFTs performed in 51 health centers (2010-2013) using telespirometry (TS) compared to standard spirometry (SS) was studied. TS costs more per unit than SS (€47.80 vs. €39.70) (2013), but the quality of the TS procedure is superior (84% good quality, compared to 61% using the standard procedure). Total cost of TS was €431,974 (compared with €358,306€ for SS), generating an economic impact of €73,668 (2013). The increase in cost for good quality LFT performed using TS was €34,030 (2010) and €144,295 (2013), while the costs of poor quality tests fell by €15,525 (2010) and 70,627€ (2013). The cost-effectiveness analysis concludes that TS is 23% more expensive and 46% more effective. Healthcare costs consequently fall as the number of LFTs performed by TS rises. Avoiding poor quality, invalid LFTs generates savings that compensate for the increased costs of performing LFTs with TS, making it a cost-effective method. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

Data management in clinical research: An overview

PubMed Central

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

2012-01-01

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

Partners in Quality: Tools for Practitioners in Child Care Settings. Standards of Practice, Code of Ethics, Guide to Self-Reflection = Partenaires pour la qualite: Outils pour les intervenantes des divers milieux de garde d'enfants. Normes de pratique, Code de deontologie, Guide d'introspection.

ERIC Educational Resources Information Center

Doherty, Gillian

Partners in Quality is a research and development project sponsored by the Canadian Child Care Federation and its affiliates to explore how child care providers, parents, and other partners can work together to support and improve quality in child care. This booklet, in both English and French, supplements a series to support child care providers…

Quality assessment program for EuroFlow protocols: summary results of four-year (2010-2013) quality assurance rounds.

PubMed

Kalina, Tomas; Flores-Montero, Juan; Lecrevisse, Quentin; Pedreira, Carlos E; van der Velden, Vincent H J; Novakova, Michaela; Mejstrikova, Ester; Hrusak, Ondrej; Böttcher, Sebastian; Karsch, Dennis; Sędek, Łukasz; Trinquand, Amelie; Boeckx, Nancy; Caetano, Joana; Asnafi, Vahid; Lucio, Paulo; Lima, Margarida; Helena Santos, Ana; Bonaccorso, Paola; van der Sluijs-Gelling, Alita J; Langerak, Anton W; Martin-Ayuso, Marta; Szczepański, Tomasz; van Dongen, Jacques J M; Orfao, Alberto

2015-02-01

Flow cytometric immunophenotyping has become essential for accurate diagnosis, classification, and disease monitoring in hemato-oncology. The EuroFlow Consortium has established a fully standardized "all-in-one" pipeline consisting of standardized instrument settings, reagent panels, and sample preparation protocols and software for data analysis and disease classification. For its reproducible implementation, parallel development of a quality assurance (QA) program was required. Here, we report on the results of four consecutive annual rounds of the novel external QA EuroFlow program. The novel QA scheme aimed at monitoring the whole flow cytometric analysis process (cytometer setting, sample preparation, acquisition and analysis) by reading the median fluorescence intensities (MedFI) of defined lymphocytes' subsets. Each QA participant applied the predefined reagents' panel on blood cells of local healthy donors. A uniform gating strategy was applied to define lymphocyte subsets and to read MedFI values per marker. The MedFI values were compared with reference data and deviations from reference values were quantified using performance score metrics. In four annual QA rounds, we analyzed 123 blood samples from local healthy donors on 14 different instruments in 11 laboratories from nine European countries. The immunophenotype of defined cellular subsets appeared sufficiently standardized to permit unified (software) data analysis. The coefficient of variation of MedFI for 7 of 11 markers performed repeatedly below 30%, average MedFI in each QA round ranged from 86 to 125% from overall median. Calculation of performance scores was instrumental to pinpoint standardization failures and their causes. Overall, the new EuroFlow QA system for the first time allowed to quantify the technical variation that is introduced in the measurement of fluorescence intensities in a multicentric setting over an extended period of time. EuroFlow QA is a proficiency test specific for laboratories that use standardized EuroFlow protocols. It may be used to complement, but not replace, established proficiency tests. © 2014 International Society for Advancement of Cytometry. © 2014 International Society for Advancement of Cytometry.

What Does it Mean to Publish Data in Earth System Science Data Journal?

NASA Astrophysics Data System (ADS)

Carlson, D.; Pfeiffenberger, H.

2015-12-01

The availability of more than 120 data sets in ESSD represents an unprecedented effort by providers, data centers and ESSD. ESSD data sets and their accompanying data descriptions undergo rigorous review. The data sets reside at any of more than 20 cooperating data centers. The ESSD publication process depends on but challenges the concepts of digital object identification and exacerbates the varied interpretations of the phrase 'data publication'. ESSD adopts the digital object identifier (doi). Key questions apply to doi's and other identifiers. How will persistent identifiers point accurately to distributed or replicated data? How should data centers and data publishers use identifier technologies to ensure authenticity and integrity? Should metadata associated with identifiers distinguish among raw, quality controlled and derived data processing levels, or indicate license or copyright status?Data centers publish data sets according to internal metadata standards but without indicators of quality control. Publication in this sense indicates availability. National data portals compile, serve and publish data products as a service to national researchers and, often, to meet national requirements. Publication in this second case indicates availability in a national context; the data themselves may still reside at separate data centers. Data journals such as ESSD or Scientific Data publish peer-reviewed, quality controlled data sets. These data sets almost always reside at a separate data center - the journal and the center maintain explicit identifier linkages. Data journals add quality to the feature of availability. A single data set processed through these layers will generate three independent doi's but the doi's will provide little information about availability or quality. Could the data world learn from the URL world to consider additions? Suffixes? Could we use our experience with processing levels or data maturity to propose and agree such extensions?

[Bacteriological quality of air in a ward for sterile pharmaceutical preparations].

PubMed

Caorsi P, Beatriz; Sakurada Z, Andrea; Ulloa F, M Teresa; Pezzani V, Marcela; Latorre O, Paz

2011-02-01

An extremely clean area is required for preparation of sterile pharmaceutical compounds, in compliance with international standards, to minimize the probability of microbial contamination. To evaluate the bacteriological quality of the air in the Sterile Pharmaceutical Preparation Unit of the University of Chile's Clinical Hospital and to set up alerts and action levels of bacterial growth. We studied eight representative sites of our Unit on a daily basis from January to February 2005 and twice a week from June 2005 to February 2006. We collected 839 samples of air by impact in the Petri dish. 474 (56.5%) samples were positive; 17 (3.5%) of them had an inappropriate bacterial growth (2% of total samples). The samples from sites 1 and 2 (big and small biosafety cabinets) were negative. The countertop and transfer area occasionally exceeded the bacterial growth limits. The most frequently isolated bacteria were coagulase-negative staphylococci, Micrococcus spp and Corynebacterium spp, from skin microbiota, and Bacillus spp, an environmental bacteria. From a microbiological perspective, the air quality in our sterile preparation unit complied with international standards. Setting institutional alerts and action levels and appropriately identifying bacteria in sensitive areas permits quantification of the microbial load and application of preventive measures.

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

PubMed

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

2015-07-01

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

German MedicalTeachingNetwork (MDN) implementing national standards for teacher training.

PubMed

Lammerding-Koeppel, M; Ebert, T; Goerlitz, A; Karsten, G; Nounla, C; Schmidt, S; Stosch, C; Dieter, P

2016-01-01

An increasing demand for proof of professionalism in higher education strives for quality assurance (QA) and improvement in medical education. A wide range of teacher trainings is available to medical staff in Germany. Cross-institutional approval of individual certificates is usually a difficult and time consuming task for institutions. In case of non-acceptance it may hinder medical teachers in their professional mobility. The faculties of medicine aimed to develop a comprehensive national framework, to promote standards for formal faculty development programmes across institutions and to foster professionalization of medical teaching. Addressing the above challenges in a joint approach, the faculties set up the national MedicalTeacherNetwork (MDN). Great importance is attributed to work out nationally concerted standards for faculty development and an agreed-upon quality control process across Germany. Medical teachers benefit from these advantages due to portability of faculty development credentials from one faculty of medicine to another within the MDN system. The report outlines the process of setting up the MDN and the national faculty development programme in Germany. Success factors, strengths and limitations are discussed from an institutional, individual and general perspective. Faculties engaged in similar developments might be encouraged to transfer the MDN concept to their countries.

CHALLENGES IN SETTING UP QUALITY CONTROL IN DIAGNOSTIC RADIOLOGY FACILITIES IN NIGERIA.

PubMed

Inyang, S O; Egbe, N O; Ekpo, E

2015-01-01

The Nigerian Nuclear Regulatory Authority (NNRA) was established to regulate and control the use of radioactive and radiation emitting sources in Nigeria. Quality control (QC) on diagnostic radiology equipment form part of the fundamental requirements for the authorization of diagnostic radiology facilities in the Country. Some quality control tests (output, exposure linearity and reproducibility) were measured on the x-ray machines in the facilities that took part in the study. Questionnaire was developed to evaluate the frequencies at which QC tests were conducted in the facilities and the challenges in setting up QC. Results show great variation in the values of the QC parameters measured. Inadequate cooperation by facilities management, lack of QC equipment and insufficient staff form the major challenges in setting up QC in the facilities under study. The responses on the frequencies at which QC tests should be conducted did not correspond to the recommended standards; indicating that personnel were not familiar with QC implementation and may require further training on QC.

Clinical audit, a valuable tool to improve quality of care: General methodology and applications in nephrology.

PubMed

Esposito, Pasquale; Dal Canton, Antonio

2014-11-06

Evaluation and improvement of quality of care provided to the patients are of crucial importance in the daily clinical practice and in the health policy planning and financing. Different tools have been developed, including incident analysis, health technology assessment and clinical audit. The clinical audit consist of measuring a clinical outcome or a process, against well-defined standards set on the principles of evidence-based medicine in order to identify the changes needed to improve the quality of care. In particular, patients suffering from chronic renal diseases, present many problems that have been set as topics for clinical audit projects, such as hypertension, anaemia and mineral metabolism management. Although the results of these studies have been encouraging, demonstrating the effectiveness of audit, overall the present evidence is not clearly in favour of clinical audit. These findings call attention to the need to further studies to validate this methodology in different operating scenarios. This review examines the principle of clinical audit, focusing on experiences performed in nephrology settings.

Design Of Measurements For Evaluating Readiness Of Technoware Components To Meet The Required Standard Of Products

NASA Astrophysics Data System (ADS)

Fauzi, Ilham; Muharram Hasby, Fariz; Irianto, Dradjad

2018-03-01

Although government is able to make mandatory standards that must be obeyed by the industry, the respective industries themselves often have difficulties to fulfil the requirements described in those standards. This is especially true in many small and medium sized enterprises that lack the required capital to invest in standard-compliant equipment and machineries. This study aims to develop a set of measurement tools for evaluating the level of readiness of production technology with respect to the requirements of a product standard based on the quality function deployment (QFD) method. By combining the QFD methodology, UNESCAP Technometric model [9] and Analytic Hierarchy Process (AHP), this model is used to measure a firm’s capability to fulfill government standard in the toy making industry. Expert opinions from both the governmental officers responsible for setting and implementing standards and the industry practitioners responsible for managing manufacturing processes are collected and processed to find out the technological capabilities that should be improved by the firm to fulfill the existing standard. This study showed that the proposed model can be used successfully to measure the gap between the requirements of the standard and the readiness of technoware technological component in a particular firm.

45 CFR 153.500 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE AFFORDABLE CARE ACT Health Insurance... for the QHP for activities that improve health care quality as set forth in § 158.150 of this...

The Technical Communicator and ISO 9000.

ERIC Educational Resources Information Center

Weiss, Edmond H.

1993-01-01

Describes the complexities of ISO 9000, a set of generic quality standards to which any commercial firm wishing to do business with a member firm of the European Economic Community will have to comply. Describes opportunities for professional technical communicators in providing the required product documentation. (SR)

A Population of Assessment Tasks

ERIC Educational Resources Information Center

Daro, Phil; Burkhardt, Hugh

2012-01-01

We propose the development of a "population" of high-quality assessment tasks that cover the performance goals set out in the "Common Core State Standards for Mathematics." The population will be published. Tests are drawn from this population as a structured random sample guided by a "balancing algorithm."

Pocket-sized versus standard ultrasound machines in abdominal imaging.

PubMed

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

2014-06-01

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

Prenatal nutrition services: a cost analysis.

PubMed

Splett, P L; Caldwell, H M; Holey, E S; Alton, I R

1987-02-01

The scarcity of information about program costs in relation to quality care prompted a cost analysis of prenatal nutrition services in two urban settings. This study examined prenatal nutrition services in terms of total costs, per client costs, per visit costs, and cost per successful outcome. Standard cost-accounting principles were used. Outcome measures, based on written quality assurance criteria, were audited using standard procedures. In the studied programs, nutrition services were delivered for a per client cost of $72 in a health department setting and $121 in a hospital-based prenatal care program. Further analysis illustrates that total and per client costs can be misleading and that costs related to successful outcomes are much higher. The three levels of cost analysis reported provide baseline data for quantifying the costs of providing prenatal nutrition services to healthy pregnant women. Cost information from these cost analysis procedures can be used to guide adjustments in service delivery to assure successful outcomes of nutrition care. Accurate cost and outcome data are necessary prerequisites to cost-effectiveness and cost-benefit studies.

A risk analysis for production processes with disposable bioreactors.

PubMed

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

2014-01-01

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

NASA's Global Change Master Directory: Discover and Access Earth Science Data Sets, Related Data Services, and Climate Diagnostics

NASA Astrophysics Data System (ADS)

Aleman, A.; Olsen, L. M.; Ritz, S.; Stevens, T.; Morahan, M.; Grebas, S. K.

2011-12-01

NASA's Global Change Master Directory provides the scientific community with the ability to discover, access, and use Earth science data, data-related services, and climate diagnostics worldwide.The GCMD offers descriptions of Earth science data sets using the Directory Interchange Format (DIF) metadata standard; Earth science related data services are described using the Service Entry Resource Format (SERF); and climate visualizations are described using the Climate Diagnostic (CD) standard. The DIF, SERF and CD standards each capture data attributes used to determine whether a data set, service, or climate visualization is relevant to a user's needs.Metadata fields include: title, summary, science keywords, service keywords, data center, data set citation, personnel, instrument, platform, quality, related URL, temporal and spatial coverage, data resolution and distribution information.In addition, nine valuable sets of controlled vocabularies have been developed to assist users in normalizing the search for data descriptions. An update to the GCMD's search functionality is planned to further capitalize on the controlled vocabularies during database queries.By implementing a dynamic keyword "tree", users will have the ability to search for data sets by combining keywords in new ways.This will allow users to conduct more relevant and efficient database searches to support the free exchange and re-use of Earth science data.

Ambient Air Quality Data Inventory

EPA Pesticide Factsheets

The Office of Air and Radiation's (OAR) Ambient Air Quality Data (Current) contains ambient air pollution data collected by EPA, other federal agencies, as well as state, local, and tribal air pollution control agencies. Its component data sets have been collected over the years from approximately 10,000 monitoring sites, of which approximately 5,000 are currently active. OAR's Office of Air Quality Planning and Standards (OAQPS) and other internal and external users, rely on this data to assess air quality, assist in Attainment/Non-Attainment designations, evaluate State Implementation Plans for Non-Attainment Areas, perform modeling for permit review analysis, and other air quality management functions. Air quality information is also used to prepare reports for Congress as mandated by the Clean Air Act. This data covers air quality data collected after 1980, when the Clean Air Act requirements for monitoring were significantly modified. Air quality data from the Agency's early years (1970s) remains available (see OAR PRIMARY DATA ASSET: Ambient Air Quality Data -- Historical), but because of technical and definitional differences the two data assets are not directly comparable. The Clean Air Act of 1970 provided initial authority for monitoring air quality for Conventional Air Pollutants (CAPs) for which EPA has promulgated National Ambient Air Quality Standards (NAAQS). Requirements for monitoring visibility-related parameters were added in 1977. Requiremen

Automated estimation of image quality for coronary computed tomographic angiography using machine learning.

PubMed

Nakanishi, Rine; Sankaran, Sethuraman; Grady, Leo; Malpeso, Jenifer; Yousfi, Razik; Osawa, Kazuhiro; Ceponiene, Indre; Nazarat, Negin; Rahmani, Sina; Kissel, Kendall; Jayawardena, Eranthi; Dailing, Christopher; Zarins, Christopher; Koo, Bon-Kwon; Min, James K; Taylor, Charles A; Budoff, Matthew J

2018-03-23

Our goal was to evaluate the efficacy of a fully automated method for assessing the image quality (IQ) of coronary computed tomography angiography (CCTA). The machine learning method was trained using 75 CCTA studies by mapping features (noise, contrast, misregistration scores, and un-interpretability index) to an IQ score based on manual ground truth data. The automated method was validated on a set of 50 CCTA studies and subsequently tested on a new set of 172 CCTA studies against visual IQ scores on a 5-point Likert scale. The area under the curve in the validation set was 0.96. In the 172 CCTA studies, our method yielded a Cohen's kappa statistic for the agreement between automated and visual IQ assessment of 0.67 (p < 0.01). In the group where good to excellent (n = 163), fair (n = 6), and poor visual IQ scores (n = 3) were graded, 155, 5, and 2 of the patients received an automated IQ score > 50 %, respectively. Fully automated assessment of the IQ of CCTA data sets by machine learning was reproducible and provided similar results compared with visual analysis within the limits of inter-operator variability. • The proposed method enables automated and reproducible image quality assessment. • Machine learning and visual assessments yielded comparable estimates of image quality. • Automated assessment potentially allows for more standardised image quality. • Image quality assessment enables standardization of clinical trial results across different datasets.

Reporting Qualitative Research: Standards, Challenges, and Implications for Health Design.

PubMed

Peditto, Kathryn

2018-04-01

This Methods column describes the existing reporting standards for qualitative research, their application to health design research, and the challenges to implementation. Intended for both researchers and practitioners, this article provides multiple perspectives on both reporting and evaluating high-quality qualitative research. Two popular reporting standards exist for reporting qualitative research-the Consolidated Criteria for Reporting Qualitative Research (COREQ) and the Standards for Reporting Qualitative Research (SRQR). Though compiled using similar procedures, they differ in their criteria and the methods to which they apply. Creating and applying reporting criteria is inherently difficult due to the undefined and fluctuating nature of qualitative research when compared to quantitative studies. Qualitative research is expansive and occasionally controversial, spanning many different methods of inquiry and epistemological approaches. A "one-size-fits-all" standard for reporting qualitative research can be restrictive, but COREQ and SRQR both serve as valuable tools for developing responsible qualitative research proposals, effectively communicating research decisions, and evaluating submissions. Ultimately, tailoring a set of standards specific to health design research and its frequently used methods would ensure quality research and aid reviewers in their evaluations.

A Cross-Sectional Comparison of Perceived Quality of Primary Care by Hypertensive Patients in Shanghai and Shenzhen, China

PubMed Central

Li, Haitao; Wei, Xiaolin; Wong, Martin Chi-Sang; Wong, Samuel Yeung-Shan; Yang, Nan; Griffiths, Sian M.

2015-01-01

Abstract Hypertension should be best managed under primary care settings. This study aimed to compare, between Shanghai and Shenzhen, the perceived quality of primary care in terms of accessibility, continuity, co-ordination, and comprehensiveness among hypertensive patients. A cross-sectional study was conducted in Shanghai and Shenzhen, China. Multistage random sampling method was used to select 8 community health centers. Data from primary care users were collected through on-site face-to-face interviews using the primary care assessment tool. Good quality standard was set as a value of 3 for each attribute and a value of 18 for total score. We included 568 patients in Shanghai and 128 patients in Shenzhen. Compared with those in Shenzhen, hypertensive patients in Shanghai reported a higher score in co-ordination of information (3.37 vs 3.66; P < 0.001), but lower scores in continuity of care (3.36 vs 3.27; P < 0.001), and comprehensiveness-service provision (3.26 vs 2.79; P < 0.001). There was no statistically significant difference in total scores between the 2 cities (18.19 vs 18.15). Over 3-quarters of hypertensive patients in both cities reported accessibility (97.2% vs 91.4%) and co-ordination of services (76.1% vs 80.5%) under good quality standard, while <1-quarter of them rated continuity of care (23.6% vs 22.7%), co-ordination of information (4.8% vs 21.1%), and comprehensiveness-service availability (15.1% vs 25.0%) under that standard. Compared with Shenzhen, the perceived quality of primary care for hypertensive patients in Shanghai was better in terms of co-ordination of information, but poorer on continuity of care and comprehensiveness-service provision. Our study suggests that there is room for quality improvement in both cities. PMID:26313780

Evaluating the U.S. Food Safety Modernization Act Produce Safety Rule Standard for Microbial Quality of Agricultural Water for Growing Produce.

PubMed

Havelaar, Arie H; Vazquez, Kathleen M; Topalcengiz, Zeynal; Muñoz-Carpena, Rafael; Danyluk, Michelle D

2017-10-09

The U.S. Food and Drug Administration (FDA) has defined standards for the microbial quality of agricultural surface water used for irrigation. According to the FDA produce safety rule (PSR), a microbial water quality profile requires analysis of a minimum of 20 samples for Escherichia coli over 2 to 4 years. The geometric mean (GM) level of E. coli should not exceed 126 CFU/100 mL, and the statistical threshold value (STV) should not exceed 410 CFU/100 mL. The water quality profile should be updated by analysis of a minimum of five samples per year. We used an extensive set of data on levels of E. coli and other fecal indicator organisms, the presence or absence of Salmonella, and physicochemical parameters in six agricultural irrigation ponds in West Central Florida to evaluate the empirical and theoretical basis of this PSR. We found highly variable log-transformed E. coli levels, with standard deviations exceeding those assumed in the PSR by up to threefold. Lognormal distributions provided an acceptable fit to the data in most cases but may underestimate extreme levels. Replacing censored data with the detection limit of the microbial tests underestimated the true variability, leading to biased estimates of GM and STV. Maximum likelihood estimation using truncated lognormal distributions is recommended. Twenty samples are not sufficient to characterize the bacteriological quality of irrigation ponds, and a rolling data set of five samples per year used to update GM and STV values results in highly uncertain results and delays in detecting a shift in water quality. In these ponds, E. coli was an adequate predictor of the presence of Salmonella in 150-mL samples, and turbidity was a second significant variable. The variability in levels of E. coli in agricultural water was higher than that anticipated when the PSR was finalized, and more detailed information based on mechanistic modeling is necessary to develop targeted risk management strategies.

British Association for the Study of Community Dentistry (BASCD) guidance on the statistical aspects of training and calibration of examiners for surveys of child dental health. A BASCD coordinated dental epidemiology programme quality standard.

PubMed

Pine, C M; Pitts, N B; Nugent, Z J

1997-03-01

The British Association for the Study of Community Dentistry (BASCD) is responsible for the coordination of locally based surveys of child dental health which permit local and national comparisons between health authorities and regions. These surveys began in 1985/86 in England and Wales, 1987/88 in Scotland and 1993/94 in Northern Ireland. BASCD has taken an increasing lead in setting quality standards in discussion with the NHS Epidemiology Coordinators of the Dental Epidemiology Programme. This paper comprises guidance on the statistical aspects of training and calibration of examiners for these surveys.

Scientific and Legal Perspectives on Science Generated for Regulatory Activities

PubMed Central

Henry, Carol J.; Conrad, James W.

2008-01-01

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

Scientific and legal perspectives on science generated for regulatory activities.

PubMed

Henry, Carol J; Conrad, James W

2008-01-01

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

[Assessment of quality indicators in pediatric poisoning in an emergency service].

PubMed

Giménez Roca, C; Martínez Sánchez, L; Calzada Baños, Y; Trenchs Sainz de la Maza, V; Quintilla Martínez, J M; Luaces Cubells, C

2014-01-01

Assessment of quality indicators allows clinicians to evaluate clinical assistance with a standard, to detect deficiencies and to improve medical assistance. Patients who came to emergency services of a tertiary level hospital for suspicion of poisoning from January 2011 to June 2012 were assessed using 20 quality indicators of pediatric poisoning. Data collection was performed by retrospective review of clinical reports. A total of 393 patients were admitted for suspicion of poisoning (0.3% of all admissions).The standard was reached in 11 indicators and not reached in 6: administration of activated charcoal within 2hours of poison ingestion (standard=90%, result=83.5%); attention within the first 15minutes of arriving in the emergency service (standard=90%, result=60.4%); start of gastrointestinal decontamination within 20minutes of arrival in emergency services (standard=90%, result=29.7%); performing of electrocardiogram on the patients poisoned with cardiotoxic substances (standard=95%, result=87%); judicial communication of cases of poisoning that could conceal a crime (standard=95%, result=31.3%), and collection of the minimal set of information of poisoned patients (standard=90%, result=1.9%). Three indicators could not be evaluated as a consequence of the limited number of cases where they could be applied (<5). The main deficiencies are related to delay in assistance, collection of information and completion of judicial reports. Giving these patients priority, designing a checklist to collect the main points of their management, and creating obligatory fields for data in computerized medical records, are the main actions available to achieve pediatric poisoning quality indicators in this emergency service. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Quality Control and Peer Review of Data Sets: Mapping Data Archiving Processes to Data Publication Requirements

NASA Astrophysics Data System (ADS)

Mayernik, M. S.; Daniels, M.; Eaker, C.; Strand, G.; Williams, S. F.; Worley, S. J.

2012-12-01

Data sets exist within scientific research and knowledge networks as both technical and non-technical entities. Establishing the quality of data sets is a multi-faceted task that encompasses many automated and manual processes. Data sets have always been essential for science research, but now need to be more visible as first-class scholarly objects at national, international, and local levels. Many initiatives are establishing procedures to publish and curate data sets, as well as to promote professional rewards for researchers that collect, create, manage, and preserve data sets. Traditionally, research quality has been assessed by peer review of textual publications, e.g. journal articles, conference proceedings, and books. Citation indices then provide standard measures of productivity used to reward individuals for their peer-reviewed work. Whether a similar peer review process is appropriate for assessing and ensuring the quality of data sets remains as an open question. How does the traditional process of peer review apply to data sets? This presentation will describe current work being done at the National Center for Atmospheric Research (NCAR) in the context of the Peer REview for Publication & Accreditation of Research Data in the Earth sciences (PREPARDE) project. PREPARDE is assessing practices and processes for data peer review, with the goal of developing recommendations. NCAR data management teams perform various kinds of quality assessment and review of data sets prior to making them publicly available. The poster will investigate how notions of peer review relate to the types of data review already in place at NCAR. We highlight the data set characteristics and management/archiving processes that challenge the traditional peer review processes by using a number of questions as probes, including: Who is qualified to review data sets? What formal and informal documentation is necessary to allow someone outside of a research team to review a data set? What data set review can be done pre-publication, and what must be done post-publication? What components of the data sets review processes can be automated, and what components will always require human expertise and evaluation?

Measuring Data Quality Through a Source Data Verification Audit in a Clinical Research Setting.

PubMed

Houston, Lauren; Probst, Yasmine; Humphries, Allison

2015-01-01

Health data has long been scrutinised in relation to data quality and integrity problems. Currently, no internationally accepted or "gold standard" method exists measuring data quality and error rates within datasets. We conducted a source data verification (SDV) audit on a prospective clinical trial dataset. An audit plan was applied to conduct 100% manual verification checks on a 10% random sample of participant files. A quality assurance rule was developed, whereby if >5% of data variables were incorrect a second 10% random sample would be extracted from the trial data set. Error was coded: correct, incorrect (valid or invalid), not recorded or not entered. Audit-1 had a total error of 33% and audit-2 36%. The physiological section was the only audit section to have <5% error. Data not recorded to case report forms had the greatest impact on error calculations. A significant association (p=0.00) was found between audit-1 and audit-2 and whether or not data was deemed correct or incorrect. Our study developed a straightforward method to perform a SDV audit. An audit rule was identified and error coding was implemented. Findings demonstrate that monitoring data quality by a SDV audit can identify data quality and integrity issues within clinical research settings allowing quality improvement to be made. The authors suggest this approach be implemented for future research.

A new approach to the identification of Landscape Quality Objectives (LQOs) as a set of indicators.

PubMed

Sowińska-Świerkosz, Barbara Natalia; Chmielewski, Tadeusz J

2016-12-15

The objective of the paper is threefold: (1) to introduce Landscape Quality Objectives (LQOs) as a set of indicators; (2) to present a method of linking social and expert opinion in the process of the formulation of landscape indicators; and (3) to present a methodological framework for the identification of LQOs. The implementation of these goals adopted a six-stage procedure based on the use of landscape units: (1) GIS analysis; (2) classification; (3) social survey; (4) expert value judgement; (5) quality assessment; and (6) guidelines formulation. The essence of the research was the presentation of features that determine landscape quality according to public opinion as a set of indicators. The results showed that 80 such indicators were identified, of both a qualitative (49) and a quantitative character (31). Among the analysed units, 60% (18 objects) featured socially expected (and confirmed by experts) levels of landscape quality, and 20% (6 objects) required overall quality improvement in terms of both public and expert opinion. The adopted procedure provides a new tool for integrating social responsibility into environmental management. The advantage of the presented method is the possibility of its application in the territories of various European countries. It is flexible enough to be based on cartographic studies, landscape research methods, and environmental quality standards existing in a given country. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

Mehrazmay, Alireza; Karambakhsh, Alireza; Salesi, Mahmood

2015-07-01

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

Using standard treatment protocols to manage costs and quality of hospital services.

PubMed

Meyer, J W; Feingold, M G

1993-06-01

The current health care environment has made it critically important that hospital costs and quality be managed in an integrated fashion. Promised health care reforms are expected to make cost reduction and quality enhancement only more important. Traditional methods of hospital cost and quality control have largely been replaced by such approaches as practice parameters, outcomes measurement, clinical indicators, clinical paths, benchmarking, patient-centered care, and a focus on patient selection criteria. This Special Report describes an integrated process for strategically managing costs and quality simultaneously, incorporating key elements of many important new quality and cost control tools. By using a multidisciplinary group process to develop standard treatment protocols, hospitals and their medical staffs address the most important services provided within major product lines. Using both clinical and financial data, groups of physicians, nurses, department managers, financial analysts, and administrators redesign key patterns of care within their hospital, incorporating the best practices of their own and other institutions. The outcome of this process is a new, standardized set of clinical guidelines that reduce unnecessary variation in care, eliminate redundant interventions, establish clear lines of communication for all caregivers, and reduce the cost of each stay. The hospital, medical staff, and patients benefit from the improved opportunities for managed care contracting, more efficient hospital systems, consensus-based quality measures, and reductions in the cost of care. STPs offer a workable and worthwhile approach to positioning the hospital of the 1990s for operational efficiency and cost and quality competitiveness.

Probiotic use in at-risk populations.

PubMed

Sanders, Mary Ellen; Merenstein, Daniel J; Ouwehand, Arthur C; Reid, Gregor; Salminen, Seppo; Cabana, Michael D; Paraskevakos, George; Leyer, Gregory

To inform health care providers about quality standards for manufacture of probiotic products being recommended for at-risk patient populations. Probiotics are used in a variety of clinical settings, sometimes in at-risk populations for therapeutic endpoints. Although probiotics might not be approved as drugs, they are sometimes used for the prevention or treatment of disease. In the United States, and many regions of the world, probiotic products are marketed as dietary supplements (not drugs) and are therefore subject to different manufacturing and quality control standards than approved drugs are. Health care providers need to be assured that probiotic products used in at-risk populations are safe for this use. Pharmacists should require certificates of analysis, which document quality standards, from manufacturers of products stocked in hospital formularies or other pharmacies dispensing to at-risk people. Although responsible manufacturers use stringent quality standards on their processes and finished products, using a third party to verify compliance with manufacturing and accuracy of product labeling adds assurance to end users that the product is of high quality. It is in patients' best interest to use probiotics in the prevention and treatment of conditions when the evidence is convincing. To protect high-risk patients, probiotic products should meet stringent microbiological standards. Product testing results should be available for review before recommending probiotic products to at-risk individuals. For products used in at-risk populations, manufacturers should provide this information or participate in a third-party verification program that certifies compliance. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Correction factors for the NMi free-air ionization chamber for medium-energy x-rays calculated with the Monte Carlo method.

PubMed

Grimbergen, T W; van Dijk, E; de Vries, W

1998-11-01

A new method is described for the determination of x-ray quality dependent correction factors for free-air ionization chambers. The method is based on weighting correction factors for mono-energetic photons, which are calculated using the Monte Carlo method, with measured air kerma spectra. With this method, correction factors for electron loss, scatter inside the chamber and transmission through the diaphragm and front wall have been calculated for the NMi free-air chamber for medium-energy x-rays for a wide range of x-ray qualities in use at NMi. The newly obtained correction factors were compared with the values in use at present, which are based on interpolation of experimental data for a specific set of x-ray qualities. For x-ray qualities which are similar to this specific set, the agreement between the correction factors determined with the new method and those based on the experimental data is better than 0.1%, except for heavily filtered x-rays generated at 250 kV. For x-ray qualities dissimilar to the specific set, differences up to 0.4% exist, which can be explained by uncertainties in the interpolation procedure of the experimental data. Since the new method does not depend on experimental data for a specific set of x-ray qualities, the new method allows for a more flexible use of the free-air chamber as a primary standard for air kerma for any x-ray quality in the medium-energy x-ray range.

Assessing image quality of low-cost laparoscopic box trainers: options for residents training at home.

PubMed

Kiely, Daniel J; Stephanson, Kirk; Ross, Sue

2011-10-01

Low-cost laparoscopic box trainers built using home computers and webcams may provide residents with a useful tool for practice at home. This study set out to evaluate the image quality of low-cost laparoscopic box trainers compared with a commercially available model. Five low-cost laparoscopic box trainers including the components listed were compared in random order to one commercially available box trainer: A (high-definition USB 2.0 webcam, PC laptop), B (Firewire webcam, Mac laptop), C (high-definition USB 2.0 webcam, Mac laptop), D (standard USB webcam, PC desktop), E (Firewire webcam, PC desktop), and F (the TRLCD03 3-DMEd Standard Minimally Invasive Training System). Participants observed still image quality and performed a peg transfer task using each box trainer. Participants rated still image quality, image quality with motion, and whether the box trainer had sufficient image quality to be useful for training. Sixteen residents in obstetrics and gynecology took part in the study. The box trainers showing no statistically significant difference from the commercially available model were A, B, C, D, and E for still image quality; A for image quality with motion; and A and B for usefulness of the simulator based on image quality. The cost of the box trainers A-E is approximately $100 to $160 each, not including a computer or laparoscopic instruments. Laparoscopic box trainers built from a high-definition USB 2.0 webcam with a PC (box trainer A) or from a Firewire webcam with a Mac (box trainer B) provide image quality comparable with a commercial standard.

Nurse-led hypnotherapy: an innovative approach to Irritable Bowel Syndrome.

PubMed

Bremner, Helen

2013-08-01

Irritable Bowel Syndrome (IBS) is a common, chronic functional illness, which can greatly reduce patients' quality of life, and consumes healthcare resources. Standard treatments include dietary changes and medication, though these are often ineffective. Clinical studies of hypnotherapy demonstrate improvement in symptoms and quality of life in over 80% of subjects with intractable IBS. Our experience of a nurse-led hypnotherapy service for IBS in a community setting provides evidence of comparable efficacy for symptom control, improved quality of life, reduced dependence on medication and improved general health measures. We address the challenges of setting up and maintaining the service in a changing healthcare environment. This model of care could act as a template for providers of gastroenterology and functional disease services wishing to provide IBS care. Copyright © 2013 Elsevier Ltd. All rights reserved.

High Sensitivity and Specificity of Clinical Microscopy in Rural Health Facilities in Western Kenya Under an External Quality Assurance Program

PubMed Central

Wafula, Rebeccah; Sang, Edna; Cheruiyot, Olympia; Aboto, Angeline; Menya, Diana; O'Meara, Wendy Prudhomme

2014-01-01

Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible. PMID:24935953

Feasibility of establishing a biosafety level 3 tuberculosis culture laboratory of acceptable quality standards in a resource-limited setting: an experience from Uganda.

PubMed

Ssengooba, Willy; Gelderbloem, Sebastian J; Mboowa, Gerald; Wajja, Anne; Namaganda, Carolyn; Musoke, Philippa; Mayanja-Kizza, Harriet; Joloba, Moses Lutaakome

2015-01-15

Despite the recent innovations in tuberculosis (TB) and multi-drug resistant TB (MDR-TB) diagnosis, culture remains vital for difficult-to-diagnose patients, baseline and end-point determination for novel vaccines and drug trials. Herein, we share our experience of establishing a BSL-3 culture facility in Uganda as well as 3-years performance indicators and post-TB vaccine trials (pioneer) and funding experience of sustaining such a facility. Between September 2008 and April 2009, the laboratory was set-up with financial support from external partners. After an initial procedure validation phase in parallel with the National TB Reference Laboratory (NTRL) and legal approvals, the laboratory registered for external quality assessment (EQA) from the NTRL, WHO, National Health Laboratories Services (NHLS), and the College of American Pathologists (CAP). The laboratory also instituted a functional quality management system (QMS). Pioneer funding ended in 2012 and the laboratory remained in self-sustainability mode. The laboratory achieved internationally acceptable standards in both structural and biosafety requirements. Of the 14 patient samples analyzed in the procedural validation phase, agreement for all tests with NTRL was 90% (P <0.01). It started full operations in October 2009 performing smear microscopy, culture, identification, and drug susceptibility testing (DST). The annual culture workload was 7,636, 10,242, and 2,712 inoculations for the years 2010, 2011, and 2012, respectively. Other performance indicators of TB culture laboratories were also monitored. Scores from EQA panels included smear microscopy >80% in all years from NTRL, CAP, and NHLS, and culture was 100% for CAP panels and above regional average scores for all years with NHLS. Quarterly DST scores from WHO-EQA ranged from 78% to 100% in 2010, 80% to 100% in 2011, and 90 to 100% in 2012. From our experience, it is feasible to set-up a BSL-3 TB culture laboratory with acceptable quality performance standards in resource-limited countries. With the demonstrated quality of work, the laboratory attracted more research groups and post-pioneer funding, which helped to ensure sustainability. The high skilled experts in this research laboratory also continue to provide an excellent resource for the needed national discussion of the laboratory and quality management systems.

45 CFR 153.500 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... health care quality as set forth in § 158.150 of this subchapter; expenditures by the QHP issuer for the... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE AFFORDABLE CARE ACT Health Insurance...

77 FR 60506 - Agency Information Collection Activities: Request for Comments for a New Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-03

... through Friday, except Federal holidays. SUPPLEMENTARY INFORMATION: Title: Customer Satisfaction Surveys. Background: Executive Order 12862, ``Setting Customer Service Standards'' requires that federal agencies provide the highest quality service to our customers by identifying them and determining what they think...

CHARACTERIZING SURFACE WATERS THAT MAY NOT REQUIRE FILTRATION

EPA Science Inventory

Field data from various utilities were studied with the object of identifying a set of characteristics of a surface water that might allow it to be successfully treated by disinfection alone, thus avoiding the need to filter. It was found possible to define water quality standard...

EPA Approved Nonregulatory Provisions and Quasi-Regulatory Measures in the New Jersey SIP

EPA Pesticide Factsheets

This section sets forth the applicable State Implementation Plan (SIP) for New Jersey under section 110 of the Clean Air Act, as amended, 42 U.S.C. 7401 et seq., and 40 CFR part 51 to meet National Ambient Air Quality Standards.

Following the Rules Set by Accreditation Agencies and Governing Bodies to Maintain In-Compliance Status: Applying Critical Thinking Skills When Evaluating the Need for Change in the Clinical Laboratory.

PubMed

Byrne, Karen M; Levy, Kimberly Y; Reese, Erika M

2016-05-01

Maintaining an in-compliance clinical laboratory takes continuous awareness and review of standards, regulations, and best practices. A strong quality assurance program and well informed leaders who maintain professional networks can aid in this necessary task. This article will discuss a process that laboratories can follow to interpret, understand, and comply with the rules and standards set by laboratory accreditation bodies. Published by Oxford University Press on behalf American Society for Clinical Pathology, 2016. This work is written by US Government employees and is in the public domain in the United States.

DCTune Perceptual Optimization of Compressed Dental X-Rays

NASA Technical Reports Server (NTRS)

Watson, Andrew B.; Null, Cynthia H. (Technical Monitor)

1996-01-01

In current dental practice, x-rays of completed dental work are often sent to the insurer for verification. It is faster and cheaper to transmit instead digital scans of the x-rays. Further economies result if the images are sent in compressed form. DCTune is a technology for optimizing DCT (digital communication technology) quantization matrices to yield maximum perceptual quality for a given bit-rate, or minimum bit-rate for a given perceptual quality. Perceptual optimization of DCT color quantization matrices. In addition, the technology provides a means of setting the perceptual quality of compressed imagery in a systematic way. The purpose of this research was, with respect to dental x-rays, 1) to verify the advantage of DCTune over standard JPEG (Joint Photographic Experts Group), 2) to verify the quality control feature of DCTune, and 3) to discover regularities in the optimized matrices of a set of images. We optimized matrices for a total of 20 images at two resolutions (150 and 300 dpi) and four bit-rates (0.25, 0.5, 0.75, 1.0 bits/pixel), and examined structural regularities in the resulting matrices. We also conducted psychophysical studies (1) to discover the DCTune quality level at which the images became 'visually lossless,' and (2) to rate the relative quality of DCTune and standard JPEG images at various bitrates. Results include: (1) At both resolutions, DCTune quality is a linear function of bit-rate. (2) DCTune quantization matrices for all images at all bitrates and resolutions are modeled well by an inverse Gaussian, with parameters of amplitude and width. (3) As bit-rate is varied, optimal values of both amplitude and width covary in an approximately linear fashion. (4) Both amplitude and width vary in systematic and orderly fashion with either bit-rate or DCTune quality; simple mathematical functions serve to describe these relationships. (5) In going from 150 to 300 dpi, amplitude parameters are substantially lower and widths larger at corresponding bit-rates or qualities. (6) Visually lossless compression occurs at a DCTune quality value of about 1. (7) At 0.25 bits/pixel, comparative ratings give DCTune a substantial advantage over standard JPEG. As visually lossless bit-rates are approached, this advantage of necessity diminishes. We have concluded that DCTune optimized quantization matrices provide better visual quality than standard JPEG. Meaningful quality levels may be specified by means of the DCTune metric. Optimized matrices are very similar across the class of dental x-rays, suggesting the possibility of a 'class-optimal' matrix. DCTune technology appears to provide some value in the context of compressed dental x-rays.

Clinical and economic outcomes of nurse-led services in the ambulatory care setting: A systematic review.

PubMed

Chan, Raymond J; Marx, Wolfgang; Bradford, Natalie; Gordon, Louisa; Bonner, Ann; Douglas, Clint; Schmalkuche, Diana; Yates, Patsy

2018-05-01

With the increasing burden of chronic and age-related diseases, and the rapidly increasing number of patients receiving ambulatory or outpatient-based care, nurse-led services have been suggested as one solution to manage increasing demand on the health system as they aim to reduce waiting times, resources, and costs while maintaining patient safety and enhancing satisfaction. The aims of this review were to assess the clinical effectiveness, economic outcomes and key implementation characteristics of nurse-led services in the ambulatory care setting. A systematic review was conducted using the standard Cochrane Collaboration methodology and was prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library, MEDLINE EBSCO, CINAHL EBSCO, and PsycINFO Ovid (from inception to April 2016). Data were extracted and appraisal undertaken. We included randomised controlled trials; quasi-randomised controlled trials; controlled and non-controlled before-and-after studies that compared the effects of nurse-led services in the ambulatory or community care setting with an alternative model of care or standard care. Twenty-five studies of 180,308 participants were included in this review. Of the 16 studies that measured and reported on health-related quality of life outcomes, the majority of studies (n = 13) reported equivocal outcomes; with three studies demonstrating superior outcomes and one demonstrating inferior outcomes in comparison with physician-led and standard care. Nurse-led care demonstrated either equivalent or better outcomes for a number of outcomes including symptom burden, self-management and behavioural outcomes, disease-specific indicators, satisfaction and perception of quality of life, and health service use. Benefits of nurse-led services remain inconclusive in terms of economic outcomes. Nurse-led care is a safe and feasible model of care for consideration across a number of ambulatory care settings. With appropriate training and support provided, nurse-led care is able to produce at least equivocal outcomes or at times better outcomes in terms of health-related quality of life compared to physician-led care or standard care for managing chronic conditions. There is a lack of high quality economic evaluations for nurse-led services, which is essential for guiding the decision making of health policy makers. Key factors such as education and qualification of the nurse; self-management support; resources available for the nurse; prescribing capabilities; and evaluation using appropriate outcome should be carefully considered for future planning of nurse-led services. Copyright © 2018 Elsevier Ltd. All rights reserved.

European union standards for tuberculosis care.

PubMed

Migliori, G B; Zellweger, J P; Abubakar, I; Ibraim, E; Caminero, J A; De Vries, G; D'Ambrosio, L; Centis, R; Sotgiu, G; Menegale, O; Kliiman, K; Aksamit, T; Cirillo, D M; Danilovits, M; Dara, M; Dheda, K; Dinh-Xuan, A T; Kluge, H; Lange, C; Leimane, V; Loddenkemper, R; Nicod, L P; Raviglione, M C; Spanevello, A; Thomsen, V Ø; Villar, M; Wanlin, M; Wedzicha, J A; Zumla, A; Blasi, F; Huitric, E; Sandgren, A; Manissero, D

2012-04-01

The European Centre for Disease Prevention and Control (ECDC) and the European Respiratory Society (ERS) jointly developed European Union Standards for Tuberculosis Care (ESTC) aimed at providing European Union (EU)-tailored standards for the diagnosis, treatment and prevention of tuberculosis (TB). The International Standards for TB Care (ISTC) were developed in the global context and are not always adapted to the EU setting and practices. The majority of EU countries have the resources and capacity to implement higher standards to further secure quality TB diagnosis, treatment and prevention. On this basis, the ESTC were developed as standards specifically tailored to the EU setting. A panel of 30 international experts, led by a writing group and the ERS and ECDC, identified and developed the 21 ESTC in the areas of diagnosis, treatment, HIV and comorbid conditions, and public health and prevention. The ISTCs formed the basis for the 21 standards, upon which additional EU adaptations and supplements were developed. These patient-centred standards are targeted to clinicians and public health workers, providing an easy-to-use resource, guiding through all required activities to ensure optimal diagnosis, treatment and prevention of TB. These will support EU health programmes to identify and develop optimal procedures for TB care, control and elimination.

[The OPTIMISE study (Optimal Type 2 Diabetes Management Including Benchmarking and Standard Treatment]. Results for Luxembourg].

PubMed

Michel, G

2012-01-01

The OPTIMISE study (NCT00681850) has been run in six European countries, including Luxembourg, to prospectively assess the effect of benchmarking on the quality of primary care in patients with type 2 diabetes, using major modifiable vascular risk factors as critical quality indicators. Primary care centers treating type 2 diabetic patients were randomized to give standard care (control group) or standard care with feedback benchmarked against other centers in each country (benchmarking group). Primary endpoint was percentage of patients in the benchmarking group achieving pre-set targets of the critical quality indicators: glycated hemoglobin (HbAlc), systolic blood pressure (SBP) and low-density lipoprotein (LDL) cholesterol after 12 months follow-up. In Luxembourg, in the benchmarking group, more patients achieved target for SBP (40.2% vs. 20%) and for LDL-cholesterol (50.4% vs. 44.2%). 12.9% of patients in the benchmarking group met all three targets compared with patients in the control group (8.3%). In this randomized, controlled study, benchmarking was shown to be an effective tool for improving critical quality indicator targets, which are the principal modifiable vascular risk factors in diabetes type 2.

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.

[Analyses of cosmetic sanitary quality in Hunan Province in 2010].

PubMed

Liu, Yanhong; Sun, Zhenqiu; Shi, Jingcheng; Shen, Minxue; Hu, Jingxuan; Lei, Shiyue; Hu, Ming

2012-05-01

To establish a scientific foundation for cosmetic supervision and administration based on the analysis of the sanitary quality of cosmetics in Hunan Province during 2010. According to Cosmetic Sanitary Standards (set by the Ministry of Health, People's Republic of China), 150 random samples of cosmetics in Hunan were assayed both for microbial items (including total plate count, fungus and yeast, fecal coliform, staphylococcus aureus, pseudomonas aeruginosa) and chemical items (including 17 kinds of prohibited substances and 14 kinds of restricted substances). The total rate of cosmetics failing to meet the standards was 22.0% of the 150 samples; specific rates for failing perfumes, skin care products (eye cream) and deodorant products were, relatively, 70.6%, 60.00%, and 44.4%. Four kinds of prohibited substances, including diethyl phthalate, acrylamide, asbestos and neodymium, as well as 2 kinds of restricted substances, including triclosan and formaldehyde, were found to exceed standards. None of microbial items exceeded standard levels. The sanitary quality control of cosmetics is lax. Administrative departments should not only reinforce their post-production supervision with respect to cosmetics, but also consolidate their control over the process of cosmetic production in order to solve the problem of toxic residues or illegal and intentional adulterations.

Air Quality uFIND: User-oriented Tool Set for Air Quality Data Discovery and Access

NASA Astrophysics Data System (ADS)

Hoijarvi, K.; Robinson, E. M.; Husar, R. B.; Falke, S. R.; Schultz, M. G.; Keating, T. J.

2012-12-01

Historically, there have been major impediments to seamless and effective data usage encountered by both data providers and users. Over the last five years, the international Air Quality (AQ) Community has worked through forums such as the Group on Earth Observations AQ Community of Practice, the ESIP AQ Working Group, and the Task Force on Hemispheric Transport of Air Pollution to converge on data format standards (e.g., netCDF), data access standards (e.g., Open Geospatial Consortium Web Coverage Services), metadata standards (e.g., ISO 19115), as well as other conventions (e.g., CF Naming Convention) in order to build an Air Quality Data Network. The centerpiece of the AQ Data Network is the web service-based tool set: user-oriented Filtering and Identification of Networked Data. The purpose of uFIND is to provide rich and powerful facilities for the user to: a) discover and choose a desired dataset by navigation through the multi-dimensional metadata space using faceted search, b) seamlessly access and browse datasets, and c) use uFINDs facilities as a web service for mashups with other AQ applications and portals. In a user-centric information system such as uFIND, the user experience is improved by metadata that includes the general fields for discovery as well as community-specific metadata to narrow the search beyond space, time and generic keyword searches. However, even with the community-specific additions, the ISO 19115 records were formed in compliance with the standard, so that other standards-based search interface could leverage this additional information. To identify the fields necessary for metadata discovery we started with the ISO 19115 Core Metadata fields and fields that were needed for a Catalog Service for the Web (CSW) Record. This fulfilled two goals - one to create valid ISO 19115 records and the other to be able to retrieve the records through a Catalog Service for the Web query. Beyond the required set of fields, the AQ Community added additional fields using a combination of keywords and ISO 19115 fields. These extensions allow discovery by measurement platform or observed phenomena. Beyond discovery metadata, the AQ records include service identification objects that allow standards-based clients, such as some brokers, to access the data found via OGC WCS or WMS data access protocols. uFIND, is one such smart client, this combination of discovery and access metadata allows the user to preview each registered dataset through spatial and temporal views; observe the data access and usage pattern and also find links to dataset-specific metadata directly in uFIND. The AQ data providers also benefit from this architecture since their data products are easier to find and re-use, enhancing the relevance and importance of their products. Finally, the earth science community at large benefits from the Service Oriented Architecture of uFIND, since it is a service itself and allows service-based interfacing with providers and users of the metadata, allowing uFIND facets to be further refined for a particular AQ application or completely repurposed for other Earth Science domains that use the same set of data access and metadata standards.

Disaster Victim Identification: quality management from an odontology perspective.

PubMed

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

2012-06-01

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

The Quality of Reporting of Abstracts in Physical Therapy Literature is Suboptimal: Cross-Sectional, Bibliographic Analysis.

PubMed

Richter, Randy R; Sebelski, Chris A; Austin, Tricia M

2016-09-01

The quality of abstract reporting in physical therapy literature is unknown. The purpose of this study was to provide baseline data for judging the future impact of the 2010 Consolidated Standards of Reporting Trials statement specifically referencing the 2008 Consolidated Standards of Reporting Trials statement for reporting of abstracts of randomized controlled trials across and between a broad sample and a core sample of physical therapy literature. A cross-sectional, bibliographic analysis was conducted. Abstracts of randomized controlled trials from 2009 were retrieved from PubMed, PEDro, and CENTRAL. Eligibility was determined using PEDro criteria. For outcomes measures, items from the Consolidated Standards of Reporting Trials statement for abstract reporting were used for assessment. Raters were not blinded to citation details. Using a computer-generated set of random numbers, 150 abstracts from 112 journals comprised the broad sample. A total of 53 abstracts comprised the core sample. Fourteen of 20 Consolidated Standards of Reporting Trials items for both samples were reported in less than 50% of the abstracts. Significantly more abstracts in the core sample reported (% difference core - broad; 95% confidence interval) title (28.4%; 12.9%-41.2%), blinding (15.2%; 1.6%-29.8%), setting (47.6%; 32.4%-59.4%), and confidence intervals (13.1%; 5.0%-25.1%). These findings provide baseline data for determining if continuing efforts to improve abstract reporting are heeded.

Communicating data quality through Web Map Services

NASA Astrophysics Data System (ADS)

Blower, Jon; Roberts, Charles; Griffiths, Guy; Lewis, Jane; Yang, Kevin

2013-04-01

The sharing and visualization of environmental data through spatial data infrastructures is becoming increasingly common. However, information about the quality of data is frequently unavailable or presented in an inconsistent fashion. ("Data quality" is a phrase with many possible meanings but here we define it as "fitness for purpose" - therefore different users have different notions of what constitutes a "high quality" dataset.) The GeoViQua project (www.geoviqua.org) is developing means for eliciting, formatting, discovering and visualizing quality information using ISO and Open Geospatial Consortium (OGC) standards. Here we describe one aspect of the innovations of the GeoViQua project. In this presentation, we shall demonstrate new developments in using Web Map Services to communicate data quality at the level of datasets, variables and individual samples. We shall outline a new draft set of conventions (known as "WMS-Q"), which describe a set of rules for using WMS to convey quality information (OGC draft Engineering Report 12-160). We shall demonstrate these conventions through new prototype software, based upon the widely-used ncWMS software, that applies these rules to enable the visualization of uncertainties in raster data such as satellite products and the results of numerical simulations. Many conceptual and practical issues have arisen from these experiments. How can source data be formatted so that a WMS implementation can detect the semantic links between variables (e.g. the links between a mean field and its variance)? The visualization of uncertainty can be a complex task - how can we provide users with the power and flexibility to choose an optimal strategy? How can we maintain compatibility (as far as possible) with existing WMS clients? We explore these questions with reference to existing standards and approaches, including UncertML, NetCDF-U and Styled Layer Descriptors.

Setting standards and monitoring quality in the NHS 1999-2013: a classic case of goal conflict.

PubMed

Littlejohns, Peter; Knight, Alec; Littlejohns, Anna; Poole, Tara-Lynn; Kieslich, Katharina

2017-04-01

2013 saw the National Health Service (NHS) in England severely criticized for providing poor quality despite successive governments in the previous 15 years, establishing a range of new institutions to improve NHS quality. This study seeks to understand the contributions of political and organizational influences in enabling the NHS to deliver high-quality care through exploring the experiences of two of the major new organizations established to set standards and monitor NHS quality. We used a mixed method approach: first a cross-sectional, in-depth qualitative interview study and then the application of principal agent modeling (Waterman and Meier broader framework). Ten themes were identified as influencing the functioning of the NHS regulatory institutions: socio-political environment; governance and accountability; external relationships; clarity of purpose; organizational reputation; leadership and management; organizational stability; resources; organizational methods; and organizational performance. The organizations could be easily mapped onto the framework, and their transience between the different states could be monitored. We concluded that differing policy objectives for NHS quality monitoring resulted in central involvement and organizational change. This had a disruptive effect on the ability of the NHS to monitor quality. Constant professional leadership, both clinical and managerial, and basing decisions on best evidence, both technical and organizational, helped one institution to deliver on its remit, even within a changing political/policy environment. Application of the Waterman-Meier framework enabled an understanding and description of the dynamic relationship between central government and organizations in the NHS and may predict when tensions will arise in the future. © 2016 The Authors. The International Journal of Health Planning and Management Published by John Wiley & Sons Ltd. © 2016 The Authors. The International Journal of Health Planning and Management Published by John Wiley & Sons Ltd.

Setting standards and monitoring quality in the NHS 1999–2013: a classic case of goal conflict

PubMed Central

Knight, Alec; Littlejohns, Anna; Poole, Tara‐Lynn; Kieslich, Katharina

2016-01-01

Abstract 2013 saw the National Health Service (NHS) in England severely criticized for providing poor quality despite successive governments in the previous 15 years, establishing a range of new institutions to improve NHS quality. This study seeks to understand the contributions of political and organizational influences in enabling the NHS to deliver high‐quality care through exploring the experiences of two of the major new organizations established to set standards and monitor NHS quality. We used a mixed method approach: first a cross‐sectional, in‐depth qualitative interview study and then the application of principal agent modeling (Waterman and Meier broader framework). Ten themes were identified as influencing the functioning of the NHS regulatory institutions: socio‐political environment; governance and accountability; external relationships; clarity of purpose; organizational reputation; leadership and management; organizational stability; resources; organizational methods; and organizational performance. The organizations could be easily mapped onto the framework, and their transience between the different states could be monitored. We concluded that differing policy objectives for NHS quality monitoring resulted in central involvement and organizational change. This had a disruptive effect on the ability of the NHS to monitor quality. Constant professional leadership, both clinical and managerial, and basing decisions on best evidence, both technical and organizational, helped one institution to deliver on its remit, even within a changing political/policy environment. Application of the Waterman–Meier framework enabled an understanding and description of the dynamic relationship between central government and organizations in the NHS and may predict when tensions will arise in the future. © 2016 The Authors. The International Journal of Health Planning and Management Published by John Wiley & Sons Ltd. PMID:27435020

Set-free Markov state model building

NASA Astrophysics Data System (ADS)

Weber, Marcus; Fackeldey, Konstantin; Schütte, Christof

2017-03-01

Molecular dynamics (MD) simulations face challenging problems since the time scales of interest often are much longer than what is possible to simulate; and even if sufficiently long simulations are possible the complex nature of the resulting simulation data makes interpretation difficult. Markov State Models (MSMs) help to overcome these problems by making experimentally relevant time scales accessible via coarse grained representations that also allow for convenient interpretation. However, standard set-based MSMs exhibit some caveats limiting their approximation quality and statistical significance. One of the main caveats results from the fact that typical MD trajectories repeatedly re-cross the boundary between the sets used to build the MSM which causes statistical bias in estimating the transition probabilities between these sets. In this article, we present a set-free approach to MSM building utilizing smooth overlapping ansatz functions instead of sets and an adaptive refinement approach. This kind of meshless discretization helps to overcome the recrossing problem and yields an adaptive refinement procedure that allows us to improve the quality of the model while exploring state space and inserting new ansatz functions into the MSM.

The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and how to select an outcome measurement instrument.

PubMed

Mokkink, Lidwine B; Prinsen, Cecilia A C; Bouter, Lex M; Vet, Henrica C W de; Terwee, Caroline B

2016-01-19

COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) is an initiative of an international multidisciplinary team of researchers who aim to improve the selection of outcome measurement instruments both in research and in clinical practice by developing tools for selecting the most appropriate available instrument. In this paper these tools are described, i.e. the COSMIN taxonomy and definition of measurement properties; the COSMIN checklist to evaluate the methodological quality of studies on measurement properties; a search filter for finding studies on measurement properties; a protocol for systematic reviews of outcome measurement instruments; a database of systematic reviews of outcome measurement instruments; and a guideline for selecting outcome measurement instruments for Core Outcome Sets in clinical trials. Currently, we are updating the COSMIN checklist, particularly the standards for content validity studies. Also new standards for studies using Item Response Theory methods will be developed. Additionally, in the future we want to develop standards for studies on the quality of non-patient reported outcome measures, such as clinician-reported outcomes and performance-based outcomes. In summary, we plea for more standardization in the use of outcome measurement instruments, for conducting high quality systematic reviews on measurement instruments in which the best available outcome measurement instrument is recommended, and for stopping the use of poor outcome measurement instruments.

The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and how to select an outcome measurement instrument

PubMed Central

Mokkink, Lidwine B.; Prinsen, Cecilia A. C.; Bouter, Lex M.; de Vet, Henrica C. W.; Terwee, Caroline B.

2016-01-01

Background: COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) is an initiative of an international multidisciplinary team of researchers who aim to improve the selection of outcome measurement instruments both in research and in clinical practice by developing tools for selecting the most appropriate available instrument. Method: In this paper these tools are described, i.e. the COSMIN taxonomy and definition of measurement properties; the COSMIN checklist to evaluate the methodological quality of studies on measurement properties; a search filter for finding studies on measurement properties; a protocol for systematic reviews of outcome measurement instruments; a database of systematic reviews of outcome measurement instruments; and a guideline for selecting outcome measurement instruments for Core Outcome Sets in clinical trials. Currently, we are updating the COSMIN checklist, particularly the standards for content validity studies. Also new standards for studies using Item Response Theory methods will be developed. Additionally, in the future we want to develop standards for studies on the quality of non-patient reported outcome measures, such as clinician-reported outcomes and performance-based outcomes. Conclusions: In summary, we plea for more standardization in the use of outcome measurement instruments, for conducting high quality systematic reviews on measurement instruments in which the best available outcome measurement instrument is recommended, and for stopping the use of poor outcome measurement instruments. PMID:26786084

Quality assurance and the need to evaluate interventions and audit programme outcomes.

PubMed

Zhao, Min; Vaartjes, Ilonca; Klipstein-Grobusch, Kerstin; Kotseva, Kornelia; Jennings, Catriona; Grobbee, Diederick E; Graham, Ian

2017-06-01

Evidence-based clinical guidelines provide standards for the provision of healthcare. However, these guidelines have been poorly implemented in daily practice. Clinical audit is a quality improvement tool to promote quality of care in daily practice and to improve outcomes through the systematic review of care delivery and implementation of changes. A major priority in the management of subjects with cardiovascular disease (CVD) management is secondary prevention by controlling cardiovascular risk factors and providing appropriate medical treatment. Clinical audits can be applied to monitor modifiable risk factors and evaluate quality improvements of CVD management in daily practice. Existing clinical audits have provided an overview of the burden of risk factors in subjects with CVD and reflect real-world risk factor recording and management. However, consistent and representative data from clinic audits are still insufficient to fully monitor quality improvement of CVD management. Data are lacking in particular from low- and middle-income countries, limiting the evaluation of CVD management quality by clinical audit projects in many settings. To support the development of clinical standards, monitor daily practice performance, and improve quality of care in CVD management at national and international levels, more widespread clinical audits are warranted.

Support and performance improvement for primary health care workers in low- and middle-income countries: a scoping review of intervention design and methods

PubMed Central

Mabey, David C.; Chaudhri, Simran; Brown Epstein, Helen-Ann; Lawn, Stephen D.

2017-01-01

Abstract Primary health care workers (HCWs) in low- and middle-income settings (LMIC) often work in challenging conditions in remote, rural areas, in isolation from the rest of the health system and particularly specialist care. Much attention has been given to implementation of interventions to support quality and performance improvement for workers in such settings. However, little is known about the design of such initiatives and which approaches predominate, let alone those that are most effective. We aimed for a broad understanding of what distinguishes different approaches to primary HCW support and performance improvement and to clarify the existing evidence as well as gaps in evidence in order to inform decision-making and design of programs intended to support and improve the performance of health workers in these settings. We systematically searched the literature for articles addressing this topic, and undertook a comparative review to document the principal approaches to performance and quality improvement for primary HCWs in LMIC settings. We identified 40 eligible papers reporting on interventions that we categorized into five different approaches: (1) supervision and supportive supervision; (2) mentoring; (3) tools and aids; (4) quality improvement methods, and (5) coaching. The variety of study designs and quality/performance indicators precluded a formal quantitative data synthesis. The most extensive literature was on supervision, but there was little clarity on what defines the most effective approach to the supervision activities themselves, let alone the design and implementation of supervision programs. The mentoring literature was limited, and largely focused on clinical skills building and educational strategies. Further research on how best to incorporate mentorship into pre-service clinical training, while maintaining its function within the routine health system, is needed. There is insufficient evidence to draw conclusions about coaching in this setting, however a review of the corporate and the business school literature is warranted to identify transferrable approaches. A substantial literature exists on tools, but significant variation in approaches makes comparison challenging. We found examples of effective individual projects and designs in specific settings, but there was a lack of comparative research on tools across approaches or across settings, and no systematic analysis within specific approaches to provide evidence with clear generalizability. Future research should prioritize comparative intervention trials to establish clear global standards for performance and quality improvement initiatives. Such standards will be critical to creating and sustaining a well-functioning health workforce and for global initiatives such as universal health coverage. PMID:27993961

Calibration of medium-resolution monochrome cathode ray tube displays for the purpose of board examinations.

PubMed

Evanoff, M G; Roehrig, H; Giffords, R S; Capp, M P; Rovinelli, R J; Hartmann, W H; Merritt, C

2001-06-01

This report discusses calibration and set-up procedures for medium-resolution monochrome cathode ray tubes (CRTs) taken in preparation of the oral portion of the board examination of the American Board of Radiology (ABR). The board examinations took place in more than 100 rooms of a hotel. There was one display-station (a computer and the associated CRT display) in each of the hotel rooms used for the examinations. The examinations covered the radiologic specialties cardiopulmonary, musculoskeletal, gastrointestinal, vascular, pediatric, and genitourinary. The software used for set-up and calibration was the VeriLUM 4.0 package from Image Smiths in Germantown, MD. The set-up included setting minimum luminance and maximum luminance, as well as positioning of the CRT in each examination room with respect to reflections of roomlights. The calibration for the grey scale rendition was done meeting the Digital Imaging and communication in Medicine (DICOM) 14 Standard Display Function. We describe these procedures, and present the calibration data in. tables and graphs, listing initial values of minimum luminance, maximum luminance, and grey scale rendition (DICOM 14 standard display function). Changes of these parameters over the duration of the examination were observed and recorded on 11 monitors in a particular room. These changes strongly suggest that all calibrated CRTs be monitored over the duration of the examination. In addition, other CRT performance data affecting image quality such as spatial resolution should be included in set-up and image quality-control procedures.

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

PubMed

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

2004-07-19

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

Counting quality because quality counts: differing standards in master's in medical education programmes.

PubMed

Pugsley, Lesley; Brigley, Stephen; Allery, Lynne; Macdonald, Janet

2008-02-01

In the United Kingdom the medical teacher role is being formalized. One result is that Masters level programmes in medical education are proliferating; however little or no attempt has been made to capture any differences in quality offered by them. A small scale project (Allery et al. 2006) set out to rectify this omission. Drawing on data from that study, this paper considers the variation in standards across programmes. Specifically research methods training provided in MMEd courses and levels of support for researchers is investigated. A secondary analysis of the data generated by the evaluative study and gathered via review of programme web sites, semi structured interviews with MSc course directors and case studies in two sites, identified from purposive sampling. Variations in both taught and research elements were identified. The quality of the research experience was compromised for some students many of whom were poorly prepared to undertake educational research and the question of standards raised in respect of those institutions where the examination process lacked real academic rigour. The variance in research methods training and support raises a number of issues in relation to quality standards. The medical education community needs to engage in open and critical dialogue around the whole constellation of paradigms, methods and activities that pertain in educational research. Unless or until we address these deeper concerns, research into medical education will suffer through a lack of design flair, implementation and rigour.

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

PubMed

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

2007-04-01

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

Validation of the AOP network “Thyroperoxidase and/or deiodinase inhibition leading to impaired swim bladder inflation”

EPA Science Inventory

Industrial chemicals released in the aquatic environment can pose risks for both environmental and human health. Fish are widely used sentinels for evaluating aquatic toxicity to vertebrates in order to set environmental quality standards, However, chronic toxicity testing with f...

Analysis of Indoor Air Pollution of Decoration and Control Measures

NASA Astrophysics Data System (ADS)

Yan, Li

2017-05-01

Nowadays, the human health is closely related to quality of indoor air. This article analyzes the main types of pollution to indoor air and their harms to human health, and on this basis, it sets forth the prevention measures comprehensively and proposes advices to normalize industry standards.

Idaho's Blueprint for Early Learning: "The Essential Elements."

ERIC Educational Resources Information Center

Wheeler, Myrl, Ed.

Designed to provide information related to quality early care and education services for providers, policy makers, and clients in Idaho, This "blueprint" outlines the nine essential elements for best practices in early care and education settings. The document is presented in three parts. Part 1 delineates standards and indicators in…

Development of a Standard Set of Software Indicators for Aeronautical Systems Center.

DTIC Science & Technology

1992-09-01

29:12). The composite models listed include COCOMO and the Software Productivity, Quality, and Reliability Model ( SPQR ) (29:12). The SPQR model was...determine the values of the 68 input parameters. Source provides no specifics. Indicator Name SPQR (SW Productivity, Qual, Reliability) Indicator Class

National Assessment Technical Quality.

ERIC Educational Resources Information Center

Chelimsky, Eleanor

In 1991 the National Assessment Governing Board (NAGB) released a report interpreting the achievement of U.S. students in mathematics on the 1990 National Assessment of Educational Progress in terms of a set of performance standards. The NAGB had been designing and implementing an approach to defining basic, proficient, and advanced levels of…

Evaluation of Methods for Analysis of Lead in Air Particulates: An Intra-Laboratory and Inter-Laboratory Comparison

EPA Science Inventory

In 2008, the United States Environmental Protection Agency (USEPA) set a new National Ambient Air Quality Standard (NAAQS) for lead (Pb) in total suspended particulate matter (Pb-TSP) which called for significant decreases in the allowable limits. The Federal Reference Method (FR...

The grain-size lineup: A test of a novel eyewitness identification procedure.

PubMed

Horry, Ruth; Brewer, Neil; Weber, Nathan

2016-04-01

When making a memorial judgment, respondents can regulate their accuracy by adjusting the precision, or grain size, of their responses. In many circumstances, coarse-grained responses are less informative, but more likely to be accurate, than fine-grained responses. This study describes a novel eyewitness identification procedure, the grain-size lineup, in which participants eliminated any number of individuals from the lineup, creating a choice set of variable size. A decision was considered to be fine-grained if no more than 1 individual was left in the choice set or coarse-grained if more than 1 individual was left in the choice set. Participants (N = 384) watched 2 high-quality or low-quality videotaped mock crimes and then completed 4 standard simultaneous lineups or 4 grain-size lineups (2 target-present and 2 target-absent). There was some evidence of strategic regulation of grain size, as the most difficult lineup was associated with a greater proportion of coarse-grained responses than the other lineups. However, the grain-size lineup did not outperform the standard simultaneous lineup. Fine-grained suspect identifications were no more diagnostic than suspect identifications from standard lineups, whereas coarse-grained suspect identifications carried little probative value. Participants were generally reluctant to provide coarse-grained responses, which may have hampered the utility of the procedure. For a grain-size approach to be useful, participants may need to be trained or instructed to use the coarse-grained option effectively. (c) 2016 APA, all rights reserved).

Abbott Preschool: 10 Years Later

ERIC Educational Resources Information Center

Donovan, Laura Fasbach

2009-01-01

When New Jersey set out to level the educational playing field between the state's poorest and wealthiest school districts a decade ago, one of the mission's most important components was ensuring teacher quality met the same high standards regardless of zip code. Research shows, a teacher's own education and training in early childhood education…

Industrial Sectors Integrated Solutions (ISIS) - An Engineering–Economic and Multi-Pollutant Modeling Framework for Comprehensive Regulatory Analyses

EPA Science Inventory

Based on the National Academy of Science’s 2004 report, “Air Quality Management in the United States”, the National Research Council (NRC) recommended to the US Environmental Protection Agency (EPA) that standard setting, planning, and control strategy development should be based...

A site-based approach to delivering rangeland ecosystem services

USDA-ARS?s Scientific Manuscript database

Rangeland ecosystems are capable of providing an array of ecosystem services important to the wellbeing of society. Some of these services (e.g. meat, fibre) are transported to markets and their quantity, quality and value are established via a set of widely accepted standards. Other services (e.g. ...

THE PASSIVE OZONE NETWORK IN DALLAS (POND CONCEPT) - A MODELING OPPORTUNITY WITH COMMUNITY INVOLVEMENT

EPA Science Inventory

Despite tremendous efforts towards regulating and controlling tropospheric ozone (O3) formation, over 70 million people currently live in U.S. counties which exceed the National Ambient Air Quality Standard (NAAQS) set for 03. These high 03 concentrations alone cost the U.S. ap...

Problem-Solving Therapy for Depression in Adults: A Systematic Review

ERIC Educational Resources Information Center

Gellis, Zvi D.; Kenaley, Bonnie

2008-01-01

Objectives: This article presents a systematic review of the evidence on problem-solving therapy (PST) for depressive disorders in noninstitutionalized adults. Method: Intervention studies using randomized controlled designs are included and methodological quality is assessed using a standard set of criteria from the Cochrane Collaborative Review…

42 CFR 438.207 - Assurances of adequate capacity and services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Access Standards § 438.207 Assurances of adequate capacity and services. (a) Basic rule. The State... with the State's requirements for availability of services, as set forth in § 438.206. (e) CMS' right...

QMRA as a compliment to epidemiologic studies estimating bather risk at recreational beaches

EPA Science Inventory

The US EPA and WHO have set recreational water quality standards based on epidemiologic studies to protect human health at beaches. These studies have largely been limited to sewage-impacted sites and resources are unlikely to be available to assess the myriad of other impacted ...

Utility of Inferential Norming with Smaller Sample Sizes

ERIC Educational Resources Information Center

Zhu, Jianjun; Chen, Hsin-Yi

2011-01-01

We examined the utility of inferential norming using small samples drawn from the larger "Wechsler Intelligence Scales for Children-Fourth Edition" (WISC-IV) standardization data set. The quality of the norms was estimated with multiple indexes such as polynomial curve fit, percentage of cases receiving the same score, average absolute…

Kansas: Early Head Start Initiative

ERIC Educational Resources Information Center

Center for Law and Social Policy, Inc. (CLASP), 2012

2012-01-01

Kansas Early Head Start (KEHS) provides comprehensive services following federal Head Start Program Performance Standards for pregnant women and eligible families with children from birth to age 4. KEHS was implemented in 1998 using Child Care and Development Block Grant (CCDBG) quality set-aside dollars augmented by a transfer of federal…

War Nurseries: Lessons in Quality.

ERIC Educational Resources Information Center

Hurwitz, Sally C.

1998-01-01

Describes development of the Kaiser Child Service Centers at the Kaiser Shipbuilding Company (Portland, Oregon) during World War II, child-care centers created through the Lanham Act. Describes staff recruitment and the services provided. Maintains that the Kaiser Center set a new standard for child care and helped to shape the field of early…

Medicines management: an interview study of nurses at a secure psychiatric hospital.

PubMed

Haw, Camilla; Stubbs, Jean; Dickens, Geoff

2015-02-01

To explore mental health nurses' knowledge, attitudes and clinical judgement concerning medicines management in an inpatient setting with a view to enhancing training. Medicines management is a key role of mental health nurses, but little research has been conducted into their training needs. An exploratory mixed-methods design was used involving individual interviews with participants to investigate their responses to hypothetical medicine administration scenarios. Interviews were held with a convenience sample of 50 Registered Nurses working in a specialist mental health hospital between November 2012-February 2013. Participants were presented with clinical vignettes describing eight scenarios they might encounter as part of their medicines management role and asked about how they would respond. Responses were assessed by two independent raters against ten quality standards underpinning the vignettes. The median number of responses that were judged to demonstrate adequate awareness of associated quality standards was 4 (range 1-7), indicating that many participants did not appear to be aware of, or compliant with, current UK medicines management guidance and local policy. Many would not report a 'near miss' or medicines administration error. There was a lack of awareness of guidance on verbal prescribing, consent to treatment rules and the administration of off-label/unlicensed drugs. Past year attendance on a medicines management course, time since registration and self-reported knowledge of national standards for medicines administration did not discriminate between total score on the 10 quality standards. The medicines management training needs of participants appeared not to be fully met by the existing learning sources. The use of vignettes to assess nurses' training needs requires evaluation in other settings. © 2014 John Wiley & Sons Ltd.

Particle mobility size spectrometers: harmonization of technical standards and data structure to facilitate high quality long-term observations of atmospheric particle number size distributions

NASA Astrophysics Data System (ADS)

Wiedensohler, A.; Birmili, W.; Nowak, A.; Sonntag, A.; Weinhold, K.; Merkel, M.; Wehner, B.; Tuch, T.; Pfeifer, S.; Fiebig, M.; Fjäraa, A. M.; Asmi, E.; Sellegri, K.; Depuy, R.; Venzac, H.; Villani, P.; Laj, P.; Aalto, P.; Ogren, J. A.; Swietlicki, E.; Roldin, P.; Williams, P.; Quincey, P.; Hüglin, C.; Fierz-Schmidhauser, R.; Gysel, M.; Weingartner, E.; Riccobono, F.; Santos, S.; Grüning, C.; Faloon, K.; Beddows, D.; Harrison, R. M.; Monahan, C.; Jennings, S. G.; O'Dowd, C. D.; Marinoni, A.; Horn, H.-G.; Keck, L.; Jiang, J.; Scheckman, J.; McMurry, P. H.; Deng, Z.; Zhao, C. S.; Moerman, M.; Henzing, B.; de Leeuw, G.

2010-12-01

Particle mobility size spectrometers often referred to as DMPS (Differential Mobility Particle Sizers) or SMPS (Scanning Mobility Particle Sizers) have found a wide application in atmospheric aerosol research. However, comparability of measurements conducted world-wide is hampered by lack of generally accepted technical standards with respect to the instrumental set-up, measurement mode, data evaluation as well as quality control. This article results from several instrument intercomparison workshops conducted within the European infrastructure project EUSAAR (European Supersites for Atmospheric Aerosol Research). Under controlled laboratory conditions, the number size distribution from 20 to 200 nm determined by mobility size spectrometers of different design are within an uncertainty range of ±10% after correcting internal particle losses, while below and above this size range the discrepancies increased. Instruments with identical design agreed within ±3% in the peak number concentration when all settings were done carefully. Technical standards were developed for a minimum requirement of mobility size spectrometry for atmospheric aerosol measurements. Technical recommendations are given for atmospheric measurements including continuous monitoring of flow rates, temperature, pressure, and relative humidity for the sheath and sample air in the differential mobility analyser. In cooperation with EMEP (European Monitoring and Evaluation Program), a new uniform data structure was introduced for saving and disseminating the data within EMEP. This structure contains three levels: raw data, processed data, and final particle size distributions. Importantly, we recommend reporting raw measurements including all relevant instrument parameters as well as a complete documentation on all data transformation and correction steps. These technical and data structure standards aim to enhance the quality of long-term size distribution measurements, their comparability between different networks and sites, and their transparency and traceability back to raw data.

How Many Bits Are Enough?

NASA Technical Reports Server (NTRS)

Larimer, James; Gille, Jennifer; Luszcz, Jeff; Hindson, William S. (Technical Monitor)

1997-01-01

Carlson and Cohen suggest that 'the perfect image is one that looks like a piece of the world viewed through a picture frame.' They propose that the metric for the perfect image be the discriminability of the reconstructed image from the ideal image the reconstruction is meant to represent. If these two images, the ideal and the reconstruction are noticeably different, then the reconstruction is less than perfect. If they cannot be discriminated then the reconstructed image is perfect. This definition has the advantage that it can be used to define 'good enough' image quality. An image that fully satisfies a task's image quality requirements for example text legibility, is selected to be the standard. Rendered images are then compared to the standard. Rendered images that are indiscriminable from the standard are good enough. Test patterns and test image sets serve as standards for many tasks and are commonplace to the image communications and display industries, so this is not a new nor novel idea.

Swedish snus and the GothiaTek® standard

PubMed Central

2011-01-01

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

Changes in perceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal.

PubMed

Agha, Sohail; Gage, Anastasia; Balal, Asma

2007-05-01

With declining levels of international donor funding for financing reproductive health programmes, developing country governments and international donors are looking towards private sector strategies to expand the supply of quality reproductive health services. One of the challenges of a health franchise is to improve the quality of services provided by independent private practitioners. Private providers are more likely to abide by the quality standards set by a franchiser if they see a financial benefit resulting from franchise participation. This study was conducted to measure whether (a) there were improvements in perceived quality of care and perceived access to health facilities once these facilities became part of a franchise and (b) improvements in perceived quality and perceived access were associated with increased client loyalty to franchised clinics. Franchisees were given basic reproductive health training for seven days and services marketing training for two days. Exit interviews were conducted with male and female clients at health facilities. A pre-test measurement was taken in April 2001, prior to the start of project activities. A post-test measurement was taken in February/March 2002, about 9 months after the pre-test. Multilevel regression analysis, which takes the hierarchical structure of the data into account, was used for the analysis. After taking provider-level variation into account and controlling for client characteristics, the analyses showed significant improvements in perceived quality of care and perceived access to services. Private provider participation in a franchise network helps improve client perceptions of quality of, and access to, services. Improvements in client perceptions of quality and access contribute to increased client loyalty to franchised clinics. Once increased client loyalty translates into higher client volumes, providers are likely to see the benefits of franchise participation. In turn, this should lead to increased provider willingness to remain part of the franchise and to abide by the standards of quality set by the franchiser.

Religiousness affects mental health, pain and quality of life in older people in an outpatient rehabilitation setting.

PubMed

Lucchetti, Giancarlo; Lucchetti, Alessandra Granero; Badan-Neto, Antonio M; Peres, Patricia T; Peres, Mario F P; Moreira-Almeida, Alexander; Gomes, Cláudio; Koenig, Harold G

2011-03-01

To evaluate the relationship between religiousness and mental health, hospitalization, pain, disability and quality of life in older adults from an outpatient rehabilitation setting in Sao Paulo, Brazil. Cross-sectional study. A total of 110 patients aged 60 years or older were interviewed during attendance at an outpatient rehabilitation service. Researchers administered a standardized questionnaire that assessed socio-demographic data, religiousness, self-reported quality of life, anxiety, physical activity limitation, depression, pain and cognition. Predictors were included in each model analysis, and a backward conditional method was used for variable selection using logistic regression (categorical outcomes) or linear regression (continuous outcomes). Thirty-one patients (28.2%) fulfilled criteria for significant depressive symptoms, 27 (24.5%) for anxiety, and 10 (9.6%) for cognitive impairment. Pain was present in 89 (80.7%) patients. Limited depressive symptoms (as assessed by the Geriatric Depression Scale), and greater self-reported quality of life were related to greater self-reported religiousness, as were scores on the Mini-Mental State Examination (less cognitive impairment), and lower ratings of pain. Religiousness is related to significantly less depressive symptoms, better quality of life, less cognitive impairment, and less perceived pain. Clinicians should consider taking a spiritual history and ensuring that spiritual needs are addressed among older patients in rehabilitation settings.

Orthopaedic surgery in natural disaster and conflict settings: how can quality care be ensured?

PubMed

Alvarado, Oscar; Trelles, Miguel; Tayler-Smith, Katie; Joseph, Holdine; Gesline, Rodné; Wilna, Thélusma Eli; Mohammad Omar, Mohammad Karim; Faiz Mohammad, Niaz Mohammad; Muhima Mastaki, John; Chingumwa Buhu, Richard; Caluwaerts, An; Dominguez, Lynette

2015-10-01

Médecins sans Frontières (MSF) is one of the main providers of orthopaedic surgery in natural disaster and conflict settings and strictly imposes a minimum set of context-specific standards before any surgery can be performed. Based on MSF's experience of performing orthopaedic surgery in a number of such settings, we describe: (a) whether it was possible to implement the minimum standards for one of the more rigorous orthopaedic procedures--internal fixation--and when possible, the time frame, (b) the volume and type of interventions performed and (c) the intra-operative mortality rates and postoperative infection rates. We conducted a retrospective review of routine programme data collected between 2007 and 2014 from three MSF emergency surgical interventions in Haiti (following the 2010 earthquake) and three ongoing MSF projects in Kunduz (Afghanistan), Masisi (Democratic Republic of the Congo) and Tabarre (Haiti). The minimum standards for internal fixation were achieved in one emergency intervention site in Haiti, and in Kunduz and Tabarre, taking up to 18 months to implement in Kunduz. All sites achieved the minimum standards to perform amputations, reductions and external fixations, with a total of 9,409 orthopaedic procedures performed during the study period. Intraoperative mortality rates ranged from 0.6 to 1.9 % and postoperative infection rates from 2.4 to 3.5 %. In settings affected by natural disaster or conflict, a high volume and wide repertoire of orthopaedic surgical procedures can be performed with good outcomes when minimum standards are in place. More demanding procedures like internal fixation may not always be feasible.

Electroencephalography leads placed by nontechnologists using a template system produce signals equal in quality to technologist-applied, collodion disk leads.

PubMed

Kolls, Brad J; Olson, Daiwai M; Gallentine, William B; Skeen, Mark B; Skidmore, Christopher T; Sinha, Saurabh R

2012-02-01

The purpose of this study was to compare the quality of the electroencephalographic (EEG) data obtained with a BraiNet template in a practical use setting, to that obtained with standard 10/20 spaced, technologist-applied, collodion-based disk leads. Pairs of 8-hour blocks of EEG data were prospectively collected from 32 patients with a Glasgow coma score of ≤9 and clinical concern for underlying nonconvulsive status epilepticus over a 6-month period in the Neurocritical Care Unit at the Duke University Medical Center. The studies were initiated with the BraiNet template system applied by critical care nurse practitioners or physicians, followed by standard, collodion leads applied by registered technologists using the 10/20 system of placement. Impedances were measured at the beginning and end of each block recorded and variance in impedance, mean impedance, and the largest differences in impedances found within a given lead set were compared. Physicians experienced in reading EEG performed a masked review of the EEG segments obtained to assess the subjective quality of the recordings obtained with the templates. We found no clinically significant differences in the impedance measures. There was a 3-hour reduction in the time required to initiate EEG recording using the templates (P < 0.001). There was no difference in the overall subjective quality distributions for template-applied versus technologist-applied EEG leads. The templates were also found to be well accepted by the primary users in the intensive care unit. The findings suggest that the EEG data obtained with this approach are comparable with that obtained by registered technologist-applied leads and represents a possible solution to the growing clinical need for continuous EEG recording availability in the critical care setting.

Addressing standards of care in resource-limited settings.

PubMed

Dawson, Liza; Klingman, Karin L; Marrazzo, Jeanne

2014-01-01

: The choice between "best-known" standards of care (SOC) or "best available" standards as the control arm in a clinical trial is a fundamental dilemma in clinical research in resource-limited settings (RLS). When the health system is delivering less than an optimal level of care, using highest standard of care in a clinical trial may produce results that cannot be implemented or sustained locally. On the other hand, using interventions that are more feasible in the local setting may involve suboptimal care, and clinical outcomes may be affected. The need for improved standards in health systems in RLS, and the difficulty in securing them, has led many researchers advocate for policy changes at the national or international level to improve clinical care more systemically. SOC decisions in a clinical trial affect the level of benefit provided to study participants and the policy implications of the trial findings. SOC choices should provide high-quality care to help advance the health care system in host countries participating in the trial, but balancing the scientific and ethical objectives of SOC choices is difficult, and there is no single formula for selecting the appropriate SOC. Despite the challenges, well-designed and conducted clinical trials can and should make significant contributions to health systems in RLS.

[Should disease management be feared? (1): hospital care].

PubMed

Gaspoz, J M; Rutschmann, O

2005-11-23

The goals of disease management are: (1) an integrated health care delivery system; (2) knowledge-based care; (3) elaborate information systems; (4) continuous quality improvement. In-hospital disease management and, more specifically, critical pathways, establish standardized care plans, set goals and time actions to reach these goals. They can reduce variations in practice patterns and resource utilization without compromising quality of care. Such strategies participate to quality improvement programs in hospitals when they involve and empower all actors of a given process of care, are not imposed from outside, and use sound and rigorous development and evaluation methods.

Hydrogeologic and water-quality reconnaissance of the artesian aquifer under the Shoalwater Bay Indian Reservation and Tokeland Peninsula, Pacific County, Washington, 1998-99

USGS Publications Warehouse

Lane, R.C.; Ebbert, J.C.

2002-01-01

The U.S. Geological Survey (USGS) collected and compiled hydrogeologic and water quality data from September 1998 through September 1999 to describe the hydrogeologic setting and to assess the quality of the water in the artesian aquifer under the Shoalwater Bay Indian Reservation and the adjacent Tokeland Peninsula area of Pacific County, Washington. Hydrogeologic data include descriptions of 38 wells, lithologic data for 27 wells, and water-level data for 17 wells and 1 tidal station. Water-quality data include field measurements for temperature, specific conductance, pH, alkalinity, bicarbonate, carbonate, dissolved oxygen, and laboratory analyses for major inorganic ions, metals, nutrients, methylene blue-active substances, and pesticides. None of the 93 field measurements or chemicals analyzed for exceeded the U.S. Environmental Protection Agency (USEPA) primary standards for drinking water and only 2 constituents (iron and manganese) exceeded the USEPA secondary standards. Sixty-six of the constituents (including all 53 pesticides) were at or below the reporting or detection levels established by the USGS National Water Quality Laboratory.

Combining natural background levels (NBLs) assessment with indicator kriging analysis to improve groundwater quality data interpretation and management.

PubMed

Ducci, Daniela; de Melo, M Teresa Condesso; Preziosi, Elisabetta; Sellerino, Mariangela; Parrone, Daniele; Ribeiro, Luis

2016-11-01

The natural background level (NBL) concept is revisited and combined with indicator kriging method to analyze the spatial distribution of groundwater quality within a groundwater body (GWB). The aim is to provide a methodology to easily identify areas with the same probability of exceeding a given threshold (which may be a groundwater quality criteria, standards, or recommended limits for selected properties and constituents). Three case studies with different hydrogeological settings and located in two countries (Portugal and Italy) are used to derive NBL using the preselection method and validate the proposed methodology illustrating its main advantages over conventional statistical water quality analysis. Indicator kriging analysis was used to create probability maps of the three potential groundwater contaminants. The results clearly indicate the areas within a groundwater body that are potentially contaminated because the concentrations exceed the drinking water standards or even the local NBL, and cannot be justified by geogenic origin. The combined methodology developed facilitates the management of groundwater quality because it allows for the spatial interpretation of NBL values. Copyright © 2016 Elsevier B.V. All rights reserved.

[Quality control at the Istituto di Anatomia e Istologia patologica at the Università di Bologna].

PubMed

Alampi, G; Baroni, R; Berti, E; Ceccarelli, C; Dina, R; Eusebi, V; Giangaspero, F; Grigioni, F W; Lecce, S; Losi, L

1994-04-01

The growing importance in medical practice of a standardized diagnosis in cyto- and histopathology and the recent recommendations for the adoption of standardized schemes for quality control in anatomic pathology by International Committees stimulated the medical staff of the Institute of Anatomic Pathology of the University of Bologna to adopt a pertinent method. The method used by the Department of Pathology of the Yale University (New Haven, Connecticut, USA) was chosen. A Committee for the quality control was appointed and two kinds of controls were set up: an External Quality Assessment (review of the difficult cases by external experts, slide seminars) and an Internal Quality Assessment performed by the members of the Committee on the diagnostic and laboratory routine of the Institute. Such a survey is periodically monitored during the monthly meetings of the Committee and described in the monthly reports. The present paper illustrates the method adopted and the preliminary results obtained in order to stimulate the discussion of such a critical theme in contemporary Anatomic Pathology at a national level.

Application of fuzzy set theory for integral assessment of agricultural products quality

NASA Astrophysics Data System (ADS)

Derkanosova, N. M.; Ponomareva, I. N.; Shurshikova, G. V.; Vasilenko, O. A.

2018-05-01

The methodology of integrated assessment of quality and safety of agricultural products, approbated by the example of indicators of wheat grain in relation to the provision of consumer properties of bakery products, was developed. Determination of the level of quality of the raw ingredients will allow direct using of agricultural raw materials for food production, taking into account ongoing technology, types of products, and, respectively, rational use of resource potential of the agricultural sector. The mathematical tool of the proposed method is a fuzzy set theory. The fuzzy classifier to evaluate the properties of the grain is formed. The set of six indicators normalized by the national standard is determined; values are ordered and represented by linguistic variables with a trapeziform membership function; the rules for calculation of membership functions are presented. Specific criteria values for individual indicators in shaping the quality of the finished products are considered. For one of the samples of wheat grain values of membership; functions of the linguistic variable "level" for all indicators and the linguistic variable "level of quality" were calculated. It is established that the studied sample of grain obtains the 2 (average) level of quality. Accordingly, it can be recommended for the production of bakery products with higher requirements for the structural-mechanical properties bakery and puff pastry products hearth bread and flour confectionery products of the group of hard dough cookies and crackers

Setting Standards at the Forefront of Delivery System Reform: Aligning Care Coordination Quality Measures for Multiple Chronic Conditions

PubMed Central

DuGoff, Eva H.; Dy, Sydney; Giovannetti, Erin R.; Leff, Bruce; Boyd, Cynthia M.

2015-01-01

The primary study objective is to assess how three major health reform care coordination initiatives (Accountable Care Organizations, Independence at Home, and Community-based Care Transitions) measure concepts critical to care coordination for people with multiple chronic conditions. We find that there are major differences in quality measurement across these three large and politically important programs. Quality measures currently used or proposed for these new health reform-related programs addressing care coordination primarily capture continuity of care. Other key areas of care coordination, such as care transitions, patient-centeredness, and cross-cutting care across multiple conditions are infrequently addressed. The lack of a comprehensive and consistent measure set for care coordination will pose challenges for health care providers and policymakers who seek, respectively, to provide and reward well-coordinated care. In addition, this heterogeneity in measuring care coordination quality will generate new information, but will inhibit comparisons between these care coordination programs. PMID:24004040

Quality of workplace social relationships and perceived health.

PubMed

Rydstedt, Leif W; Head, Jenny; Stansfeld, Stephen A; Woodley-Jones, Davina

2012-06-01

Associations between the quality of social relationships at work and mental and self-reported health were examined to assess whether these associations were independent of job strain. The study was based on cross-sectional survey data from 728 employees (response rate 58%) and included the Demand-Control-(Support) (DC-S) model, six items on the quality of social relationships at the workplace, the General Health Questionnaire (30), and an item on self-reported physical health. Logistic regression analyses were used. A first set of models were run with adjustment for age, sex, and socioeconomic group. A second set of models were run adjusted for the dimensions of the DC-S model. Positive associations were found between the quality of social relationships and mental health as well as self-rated physical health, and these associations remained significant even after adjustment for the dimensions. The findings add support to the Health and Safety Executive stress management standards on social relationships at the workplace.

Cost-effectiveness of molecular testing for thyroid nodules with atypia of undetermined significance cytology.

PubMed

Lee, Lawrence; How, Jacques; Tabah, Roger J; Mitmaker, Elliot J

2014-08-01

Novel molecular diagnostics, such as the gene expression classifier (GEC) and gene mutation panel (GMP) testing, may improve the management for thyroid nodules with atypia of undetermined significance (AUS) cytology. The cost-effectiveness of an approach combining both tests in different practice settings in North America is unknown. The aim of the study was to determine the cost-effectiveness of two diagnostic molecular tests, singly or in combination, for AUS thyroid nodules. We constructed a microsimulation model to investigate cost-effectiveness from US (Medicare) and Canadian healthcare system perspectives. Low-risk patients with AUS thyroid nodules were simulated. We examined five management strategies: 1) routine GEC; 2) routine GEC + selective GMP; 3) routine GMP; 4) routine GMP + selective GEC; and 5) standard management. Lifetime costs and quality-adjusted life-years were measured. From the US perspective, the routine GEC + selective GMP strategy was the dominant strategy. From the Canadian perspective, routine GEC + selective GMP cost and additional CAN$24 030 per quality-adjusted life-year gained over standard management, and was dominant over the other strategies. Sensitivity analyses reported that the decisions from both perspectives were sensitive to variations in the probability of malignancy in the nodule and the costs of the GEC and GMP. The probability of cost-effectiveness for routine GEC + selective GMP was low. In the US setting, the most cost-effective strategy was routine GEC + selective GMP. In the Canadian setting, standard management was most likely to be cost effective. The cost of these molecular diagnostics will need to be reduced to increase their cost-effectiveness for practice settings outside the United States.

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

NASA Astrophysics Data System (ADS)

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

2002-01-01

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

Implementing a Data Quality Strategy to Simplify Access to Data

NASA Astrophysics Data System (ADS)

Druken, K. A.; Trenham, C. E.; Evans, B. J. K.; Richards, C. J.; Wang, J.; Wyborn, L. A.

2016-12-01

To ensure seamless programmatic access for data analysis (including machine learning), standardization of both data and services is vital. At the Australian National Computational Infrastructure (NCI) we have developed a Data Quality Strategy (DQS) that currently provides processes for: (1) the consistency of data structures in the underlying High Performance Data (HPD) platform; (2) quality control through compliance with recognized community standards; and (3) data quality assurance through demonstrated functionality across common platforms, tools and services. NCI hosts one of Australia's largest repositories (10+ PBytes) of research data collections spanning datasets from climate, coasts, oceans and geophysics through to astronomy, bioinformatics and the social sciences. A key challenge is the application of community-agreed data standards to the broad set of Earth systems and environmental data that are being used. Within these disciplines, data span a wide range of gridded, ungridded (i.e., line surveys, point clouds), and raster image types, as well as diverse coordinate reference projections and resolutions. By implementing our DQS we have seen progressive improvement in the quality of the datasets across the different subject domains, and through this, the ease by which the users can programmatically access the data, either in situ or via web services. As part of its quality control procedures, NCI has developed a compliance checker based upon existing domain standards. The DQS also includes extensive Functionality Testing which include readability by commonly used libraries (e.g., netCDF, HDF, GDAL, etc.); accessibility by data servers (e.g., THREDDS, Hyrax, GeoServer), validation against scientific analysis and programming platforms (e.g., Python, Matlab, QGIS); and visualization tools (e.g., ParaView, NASA Web World Wind). These tests ensure smooth interoperability between products and services as well as exposing unforeseen requirements and dependencies. The results provide an important component of quality control within the DQS as well as clarifying the requirement for any extensions to the relevant standards that help support the uptake of data by broader international communities.

Will the circle be unbroken: a history of the U.S. National Ambient Air Quality Standards.

PubMed

Bachmann, John

2007-06-01

In celebration of the 100th anniversary of the Air & Waste Management Association, this review examines the history of air quality management (AQM) in the United States over the last century, with an emphasis on the ambient standards programs established by the landmark 1970 Clean Air Act (CAA) Amendments. The current CAA system is a hybrid of several distinct air pollution control philosophies, including the recursive or circular system driven by ambient standards. Although this evolving system has resulted in tremendous improvements in air quality, it has been far from perfect in terms of timeliness and effectiveness. The paper looks at several periods in the history of the U.S. program, including: (1) 1900-1970, spanning the early smoke abatement and smog control programs, the first federal involvement, and the development of a hybrid AQM approach in the 1970 CAA; (2) 1971-1976, when the first National Ambient Air Quality Standards (NAAQS) were set and implemented; (3) 1977-1993, a period of the first revisions to the standards, new CAA Amendments, delays in implementation and decision-making, and key science/policy/legislative developments that would alter both the focus and scale of air pollution programs and how they are implemented; and (4) 1993-2006, the second and third wave of NAAQS revisions and their implementation in the context of the 1990 CAA. This discussion examines where NAAQS have helped drive implementation programs and how improvements in both effects and air quality/control sciences influenced policy and legislation to enhance the effectiveness of the system over time. The review concludes with a look toward the future of AQM, emphasizing challenges and ways to meet them. The most significant of these is the need to make more efficient progress toward air quality goals, while adjusting the system to address the growing intersections between air quality management and climate change.

Failure of Standard Training Sets in the Analysis of Fast-Scan Cyclic Voltammetry Data.

PubMed

Johnson, Justin A; Rodeberg, Nathan T; Wightman, R Mark

2016-03-16

The use of principal component regression, a multivariate calibration method, in the analysis of in vivo fast-scan cyclic voltammetry data allows for separation of overlapping signal contributions, permitting evaluation of the temporal dynamics of multiple neurotransmitters simultaneously. To accomplish this, the technique relies on information about current-concentration relationships across the scan-potential window gained from analysis of training sets. The ability of the constructed models to resolve analytes depends critically on the quality of these data. Recently, the use of standard training sets obtained under conditions other than those of the experimental data collection (e.g., with different electrodes, animals, or equipment) has been reported. This study evaluates the analyte resolution capabilities of models constructed using this approach from both a theoretical and experimental viewpoint. A detailed discussion of the theory of principal component regression is provided to inform this discussion. The findings demonstrate that the use of standard training sets leads to misassignment of the current-concentration relationships across the scan-potential window. This directly results in poor analyte resolution and, consequently, inaccurate quantitation, which may lead to erroneous conclusions being drawn from experimental data. Thus, it is strongly advocated that training sets be obtained under the experimental conditions to allow for accurate data analysis.

KSC Center Director Bridges accepts an ISO 9001 certification plaque from DNV

NASA Technical Reports Server (NTRS)

1998-01-01

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

[Quality standards for duplex ultrasonographic assessment (duplex us) of abdominal aortic stent grafts].

PubMed

Diard, A; Becker, F; Pichot, O

2017-05-01

The quality standards of the French Society of Vascular Medicine for the ultrasound assessment of lower limb arteries in vascular medicine practice are based on the principle that these examinations have to meet two requirements: technical know-how (knowledge of devices and methodologies); medical know-how (level of examination matching the indication and purpose of the examination, interpretation and critical analysis of results). To describe an optimal level of examination adjusted to the indication or clinical hypothesis; to establish harmonious practices, methodologies, terminologies, results description and report; to provide good practice reference points and to promote a high quality process. The three levels of examination, indications and objectives for each level; the reference standard examination (level 2) and its variants according to indications; the minimal content of the exam report, the medical conclusion letter to the corresponding physician (synthesis, conclusion and management suggestions); commented glossary (anatomy, hemodynamics, signs and symptoms); technical basis; device settings. Here, we discuss duplex ultrasound for the supervision of the aortic stent grafts. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

KSC-98pc909

NASA Image and Video Library

1998-08-11

Center Director Roy Bridges speaks to KSC employees at the ISO certification ceremony held at the Training Auditorium. Bridges was presented an ISO 9001 certificate and plaque awarded to KSC by Det Norske Veritas (DNV), Inc., an international ISO certification organization. ISO 9001 comprises the most detailed, comprehensive set of standard requirements for quality programs established by the International Standards Organization. The presentation followed a successful independent audit by DNV of the KSC Management System in May of this year. The third-party auditors examined about 20 elements of KSC's system, including management responsibility, design control, documentation, test and inspection, and corrective action procedures. DNV found that KSC met or exceeded the stringent quality standards in all areas. KSC will use this certification as a tool to improve an already worldclass team. All NASA centers are required by NASA Administrator Daniel S. Goldin to be ISO 9001 registered by September 1999. NASA is the first federal agency to seek the quality certification. Next to Bridges is Heidi Hollingsworth, with the Center for Independent Living, who uses American Sign Language for any hearing-impaired employees in the audience

Sustainable reduction of antibiotic-induced antimicrobial resistance (ARena) in German ambulatory care: study protocol of a cluster randomised trial.

PubMed

Kamradt, Martina; Kaufmann-Kolle, Petra; Andres, Edith; Brand, Tonia; Klingenberg, Anja; Glassen, Katharina; Poß-Doering, Regina; Uhlmann, Lorenz; Hees, Katharina; Weber, Dorothea; Gutscher, Andreas; Wambach, Veit; Szecsenyi, Joachim; Wensing, Michel

2018-02-05

Despite many initiatives to enhance the rational use of antibiotics, there remains substantial room for improvement. The overall aim of this study is to optimise the appropriate use of antibiotics in German ambulatory care in patients with acute non-complicated infections (respiratory tract infections, such as bronchitis, sinusitis, tonsillitis and otitis media), community-acquired pneumonia and non-complicated cystitis, in order to counter the advancing antimicrobial resistance development. A three-armed cluster randomised trial will be conducted in 14 practice networks in two German federal states (Bavaria and North Rhine-Westphalia) and an added cohort that reflects standard care. The trial is accompanied by a process evaluation. Each arm will receive a different set of implementation strategies. Arm A receives a standard set, comprising of e-learning on communication with patients and quality circles with data-based feedback for physicians, information campaigns for the public, patient information material and performance-based additional reimbursement. Arm B receives this standard set plus e-learning on communication with patients and quality circles with data-based feedback tailored for non-physician health professionals of the practice team and information material for tablet computers (culture sensitive). Arm C receives the standard set as well as a computerised decision support system and quality circles in local multidisciplinary groups. The study aims to recruit 193 practices which will provide data on 23,934 patients each year (47,867 patients in total). The outcome evaluation is based on claims data and refers to established indicators of the European Surveillance of Antimicrobial Consumption Network (ESAC-Net). Primary and secondary outcomes relate to prescribing of antibiotics, which will be analysed in multivariate regression models. The process evaluation is based on interviews with surveys among physicians, non-physician health professionals of the practice team and stakeholders. A patient survey is conducted in one of the study arms. Interview data will be qualitatively analysed using thematic framework analysis. Survey data of physicians, non-physician health professionals of the practice team and patients will use descriptive and exploratory statistics for analysis. The ARena trial will examine the effectiveness of large scale implementation strategies and explore their delivery in routine practice. ISRCTN, ISRCTN58150046 . Registered 24 August 2017.

Electronic Information Standards to Support Obesity Prevention and Bridge Services Across Systems, 2010-2015.

PubMed

Wiltz, Jennifer L; Blanck, Heidi M; Lee, Brian; Kocot, S Lawrence; Seeff, Laura; McGuire, Lisa C; Collins, Janet

2017-10-26

Electronic information technology standards facilitate high-quality, uniform collection of data for improved delivery and measurement of health care services. Electronic information standards also aid information exchange between secure systems that link health care and public health for better coordination of patient care and better-informed population health improvement activities. We developed international data standards for healthy weight that provide common definitions for electronic information technology. The standards capture healthy weight data on the "ABCDs" of a visit to a health care provider that addresses initial obesity prevention and care: assessment, behaviors, continuity, identify resources, and set goals. The process of creating healthy weight standards consisted of identifying needs and priorities, developing and harmonizing standards, testing the exchange of data messages, and demonstrating use-cases. Healthy weight products include 2 message standards, 5 use-cases, 31 LOINC (Logical Observation Identifiers Names and Codes) question codes, 7 healthy weight value sets, 15 public-private engagements with health information technology implementers, and 2 technical guides. A logic model and action steps outline activities toward better data capture, interoperable systems, and information use. Sharing experiences and leveraging this work in the context of broader priorities can inform the development of electronic information standards for similar core conditions and guide strategic activities in electronic systems.

Electronic Information Standards to Support Obesity Prevention and Bridge Services Across Systems, 2010–2015

PubMed Central

Blanck, Heidi M.; Lee, Brian; Kocot, S. Lawrence; Seeff, Laura; McGuire, Lisa C.; Collins, Janet

2017-01-01

Electronic information technology standards facilitate high-quality, uniform collection of data for improved delivery and measurement of health care services. Electronic information standards also aid information exchange between secure systems that link health care and public health for better coordination of patient care and better-informed population health improvement activities. We developed international data standards for healthy weight that provide common definitions for electronic information technology. The standards capture healthy weight data on the “ABCDs” of a visit to a health care provider that addresses initial obesity prevention and care: assessment, behaviors, continuity, identify resources, and set goals. The process of creating healthy weight standards consisted of identifying needs and priorities, developing and harmonizing standards, testing the exchange of data messages, and demonstrating use-cases. Healthy weight products include 2 message standards, 5 use-cases, 31 LOINC (Logical Observation Identifiers Names and Codes) question codes, 7 healthy weight value sets, 15 public–private engagements with health information technology implementers, and 2 technical guides. A logic model and action steps outline activities toward better data capture, interoperable systems, and information use. Sharing experiences and leveraging this work in the context of broader priorities can inform the development of electronic information standards for similar core conditions and guide strategic activities in electronic systems. PMID:29072985

Final Environmental Assessment for the Establishment of an Air-to-Surface Helicopter Gunnery Training Target Set at White Sands Missile Range, New Mexico

DTIC Science & Technology

2007-12-01

AQCR Air Quality Control Region AR Army Regulation ARC Acoustic Research Complex BLM Bureau of Land Management BMP best management practice CAA...night average A-weighted sound level mg/m3 milligrams per cubic meter MSL mean sea level NAAQS National Ambient Air Quality Standards NASA ...unique characteristics required by the U.S. Army, U.S. Navy, USAF, National Aeronautics and Space Administration ( NASA ), and other Federal and

Benchmarking for Excellence and the Nursing Process

NASA Technical Reports Server (NTRS)

Sleboda, Claire

1999-01-01

Nursing is a service profession. The services provided are essential to life and welfare. Therefore, setting the benchmark for high quality care is fundamental. Exploring the definition of a benchmark value will help to determine a best practice approach. A benchmark is the descriptive statement of a desired level of performance against which quality can be judged. It must be sufficiently well understood by managers and personnel in order that it may serve as a standard against which to measure value.

High sensitivity and specificity of clinical microscopy in rural health facilities in western Kenya under an external quality assurance program.

PubMed

Wafula, Rebeccah; Sang, Edna; Cheruiyot, Olympia; Aboto, Angeline; Menya, Diana; O'Meara, Wendy Prudhomme

2014-09-01

Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible. © The American Society of Tropical Medicine and Hygiene.

Rationale and development of an on-line quality assurance programme for colposcopy in a population-based cervical screening setting in Italy.

PubMed

Bucchi, Lauro; Cristiani, Paolo; Costa, Silvano; Schincaglia, Patrizia; Garutti, Paola; Sassoli de Bianchi, Priscilla; Naldoni, Carlo; Olea, Oswaldo; Sideri, Mario

2013-06-28

Colposcopy, the key step in the management of women with abnormal Pap smear results, is a visual technique prone to observer variation, which implies the need for prolonged apprenticeship, continuous training, and quality assurance (QA) measures. Colposcopy QA programmes vary in level of responsibility of organizing subjects, geographic coverage, scope, model, and type of actions. The programmes addressing the clinical standards of colposcopy (quality of examination and appropriateness of clinical decisions) are more limited in space and less sustainable over time than those focused on the provision of the service (resources, accessibility, etc.). This article reports on the protocol of a QA programme targeting the clinical quality of colposcopy in a population-based cervical screening service in an administrative region of northern Italy. After a situation analysis of local colposcopy audit practices and previous QA initiatives, a permanent web-based QA programme was developed. The design places more emphasis on providing education and feedback to participants than on testing them. The technical core is a log-in web application accessible on the website of the regional Administration. The primary objectives are to provide (1) a practical opportunity for retraining of screening colposcopists, and (2) a platform for them to interact with colposcopists from other settings and regions through exchange and discussion of digital colposcopic images. The retraining function is based on repeated QA sessions in which the registered colposcopists log-in, classify a posted set of colpophotographs, and receive on line a set of personal feedback data. Each session ends with a plenary seminar featuring the presentation of overall results and an interactive review of the test set of colpophotographs. This is meant to be a forum for an open exchange of views that may lead to more knowledge and more diagnostic homogeneity. The protocol includes the criteria for selection of colpophotographs and the rationale for colposcopic gold standards. This programme is an ongoing initiative open to further developments, in particular in the area of basic training. It uses the infrastructure of the internet to give a novel solution to technical problems affecting colposcopy QA in population-based screening services.

The accurate assessment of small-angle X-ray scattering data

DOE PAGES

Grant, Thomas D.; Luft, Joseph R.; Carter, Lester G.; ...

2015-01-23

Small-angle X-ray scattering (SAXS) has grown in popularity in recent times with the advent of bright synchrotron X-ray sources, powerful computational resources and algorithms enabling the calculation of increasingly complex models. However, the lack of standardized data-quality metrics presents difficulties for the growing user community in accurately assessing the quality of experimental SAXS data. Here, a series of metrics to quantitatively describe SAXS data in an objective manner using statistical evaluations are defined. These metrics are applied to identify the effects of radiation damage, concentration dependence and interparticle interactions on SAXS data from a set of 27 previously described targetsmore » for which high-resolution structures have been determined via X-ray crystallography or nuclear magnetic resonance (NMR) spectroscopy. Studies show that these metrics are sufficient to characterize SAXS data quality on a small sample set with statistical rigor and sensitivity similar to or better than manual analysis. The development of data-quality analysis strategies such as these initial efforts is needed to enable the accurate and unbiased assessment of SAXS data quality.« less

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

NASA Technical Reports Server (NTRS)

Perkins, Sharon; Arend, Mark B.

1990-01-01

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

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

NASA Technical Reports Server (NTRS)

Perkins, Sharon; Arend, Mark B.

1990-01-01

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

Quality indicators to compare accredited independent pharmacies and accredited chain pharmacies in Thailand.

PubMed

Arkaravichien, Wiwat; Wongpratat, Apichaya; Lertsinudom, Sunee

2016-08-01

Background Quality indicators determine the quality of actual practice in reference to standard criteria. The Community Pharmacy Association (Thailand), with technical support from the International Pharmaceutical Federation, developed a tool for quality assessment and quality improvement at community pharmacies. This tool has passed validity and reliability tests, but has not yet had feasibility testing. Objective (1) To test whether this quality tool could be used in routine settings. (2) To compare quality scores between accredited independent and accredited chain pharmacies. Setting Accredited independent pharmacies and accredited chain pharmacies in the north eastern region of Thailand. Methods A cross sectional study was conducted in 34 accredited independent pharmacies and accredited chain pharmacies. Quality scores were assessed by observation and by interviewing the responsible pharmacists. Data were collected and analyzed by independent t-test and Mann-Whitney U test as appropriate. Results were plotted by histogram and spider chart. Main outcome measure Domain's assessable scores, possible maximum scores, mean and median of measured scores. Results Domain's assessable scores were close to domain's possible maximum scores. This meant that most indicators could be assessed in most pharmacies. The spider chart revealed that measured scores in the personnel, drug inventory and stocking, and patient satisfaction and health promotion domains of chain pharmacies were significantly higher than those of independent pharmacies (p < 0.05). There was no statistical difference between independent pharmacies and chain pharmacies in the premise and facility or dispensing and patient care domains. Conclusion Quality indicators developed by the Community Pharmacy Association (Thailand) could be used to assess quality of practice in pharmacies in routine settings. It is revealed that the quality scores of chain pharmacies were higher than those of independent pharmacies.

NASA's Global Change Master Directory: Discover and Access Earth Science Data Sets, Related Data Services, and Climate Diagnostics

NASA Technical Reports Server (NTRS)

Aleman, Alicia; Olsen, Lola; Ritz, Scott; Morahan, Michael; Cepero, Laurel; Stevens, Tyler

2011-01-01

NASA's Global Change Master Directory provides the scientific community with the ability to discover, access, and use Earth science data, data-related services, and climate diagnostics worldwide. The GCMD offers descriptions of Earth science data sets using the Directory Interchange Format (DIF) metadata standard; Earth science related data services are described using the Service Entry Resource Format (SERF); and climate visualizations are described using the Climate Diagnostic (CD) standard. The DIF, SERF and CD standards each capture data attributes used to determine whether a data set, service, or climate visualization is relevant to a user's needs. Metadata fields include: title, summary, science keywords, service keywords, data center, data set citation, personnel, instrument, platform, quality, related URL, temporal and spatial coverage, data resolution and distribution information. In addition, nine valuable sets of controlled vocabularies have been developed to assist users in normalizing the search for data descriptions. An update to the GCMD's search functionality is planned to further capitalize on the controlled vocabularies during database queries. By implementing a dynamic keyword "tree", users will have the ability to search for data sets by combining keywords in new ways. This will allow users to conduct more relevant and efficient database searches to support the free exchange and re-use of Earth science data. http://gcmd.nasa.gov/

Comparison of Multidetector Computed Tomography and Flat-Panel Computed Tomography Regarding Visualization of Cortical Fractures, Cortical Defects, and Orthopedic Screws: A Phantom Study.

PubMed

Neubauer, Jakob; Benndorf, Matthias; Lang, Hannah; Lampert, Florian; Kemna, Lars; Konstantinidis, Lukas; Neubauer, Claudia; Reising, Kilian; Zajonc, Horst; Kotter, Elmar; Langer, Mathias; Goerke, Sebastian M

2015-08-01

To compare the visualization of cortical fractures, cortical defects, and orthopedic screws in a dedicated extremity flat-panel computed tomography (FPCT) scanner and a multidetector computed tomography (MDCT) scanner.We used feet of European roe deer as phantoms for cortical fractures, cortical defects, and implanted orthopedic screws. FPCT and MDCT scans were performed with equivalent dose settings. Six observers rated the scans according to number of fragments, size of defects, size of defects opposite orthopedic screws, and the length of different screws. The image quality regarding depiction of the cortical bone was assessed. The gold standard (real number of fragments) was evaluated by autopsy.The correlation of reader assessment of fragments, cortical defects, and screws with the gold standard was similar for FPCT and MDCT. Three readers rated the subjective image quality of the MDCT to be higher, whereas the others showed no preferences.Although the image quality was rated higher in the MDCT than in the FPCT by 3 out of 6 observers, both modalities proved to be comparable regarding the visualization of cortical fractures, cortical defects, and orthopedic screws and of use to musculoskeletal radiology regarding fracture detection and postsurgical evaluation in our experimental setting.

Systematic reviews identify important methodological flaws in stroke rehabilitation therapy primary studies: review of reviews.

PubMed

Santaguida, Pasqualina; Oremus, Mark; Walker, Kathryn; Wishart, Laurie R; Siegel, Karen Lohmann; Raina, Parminder

2012-04-01

A "review of reviews" was undertaken to assess methodological issues in studies evaluating nondrug rehabilitation interventions in stroke patients. MEDLINE, CINAHL, PsycINFO, and the Cochrane Database of Systematic Reviews were searched from January 2000 to January 2008 within the stroke rehabilitation setting. Electronic searches were supplemented by reviews of reference lists and citations identified by experts. Eligible studies were systematic reviews; excluded citations were narrative reviews or reviews of reviews. Review characteristics and criteria for assessing methodological quality of primary studies within them were extracted. The search yielded 949 English-language citations. We included a final set of 38 systematic reviews. Cochrane reviews, which have a standardized methodology, were generally of higher methodological quality than non-Cochrane reviews. Most systematic reviews used standardized quality assessment criteria for primary studies, but not all were comprehensive. Reviews showed that primary studies had problems with randomization, allocation concealment, and blinding. Baseline comparability, adverse events, and co-intervention or contamination were not consistently assessed. Blinding of patients and providers was often not feasible and was not evaluated as a source of bias. The eligible systematic reviews identified important methodological flaws in the evaluated primary studies, suggesting the need for improvement of research methods and reporting. Copyright © 2012 Elsevier Inc. All rights reserved.

Standardized development of computer software. Part 1: Methods

NASA Technical Reports Server (NTRS)

Tausworthe, R. C.

1976-01-01

This work is a two-volume set on standards for modern software engineering methodology. This volume presents a tutorial and practical guide to the efficient development of reliable computer software, a unified and coordinated discipline for design, coding, testing, documentation, and project organization and management. The aim of the monograph is to provide formal disciplines for increasing the probability of securing software that is characterized by high degrees of initial correctness, readability, and maintainability, and to promote practices which aid in the consistent and orderly development of a total software system within schedule and budgetary constraints. These disciplines are set forth as a set of rules to be applied during software development to drastically reduce the time traditionally spent in debugging, to increase documentation quality, to foster understandability among those who must come in contact with it, and to facilitate operations and alterations of the program as requirements on the program environment change.

College quality and hourly wages: evidence from the self-revelation model, sibling models and instrumental variables.

PubMed

Borgen, Nicolai T

2014-11-01

This paper addresses the recent discussion on confounding in the returns to college quality literature using the Norwegian case. The main advantage of studying Norway is the quality of the data. Norwegian administrative data provide information on college applications, family relations and a rich set of control variables for all Norwegian citizens applying to college between 1997 and 2004 (N = 141,319) and their succeeding wages between 2003 and 2010 (676,079 person-year observations). With these data, this paper uses a subset of the models that have rendered mixed findings in the literature in order to investigate to what extent confounding biases the returns to college quality. I compare estimates obtained using standard regression models to estimates obtained using the self-revelation model of Dale and Krueger (2002), a sibling fixed effects model and the instrumental variable model used by Long (2008). Using these methods, I consistently find increasing returns to college quality over the course of students' work careers, with positive returns only later in students' work careers. I conclude that the standard regression estimate provides a reasonable estimate of the returns to college quality. Copyright © 2014 Elsevier Inc. All rights reserved.

Effects of modifying the World Health Organization standard operating procedures for malaria microscopy to improve surveillance in resource poor settings.

PubMed

Fernando, Sumadhya D; Ihalamulla, Ratnasiri L; Wickremasinghe, Renu; de Silva, Nipun L; Thilakarathne, Janani H; Wijeyaratne, Pandu; Premaratne, Risintha G

2014-03-15

Individuals with fever are screened for malaria in specially-established malaria diagnostic laboratories set up in rural hospitals in the Northern and Eastern Provinces of Sri Lanka. Large numbers of blood smears negative for malaria parasites are being screened daily. Good quality smears are essential to maintain a high diagnostic competency among the technical staff. The modifications made to the World Health Organization (WHO) standard operating procedures to improve the quality of smears have been studied. A blinded, controlled, interventional study was conducted in 22 intervention and 21 control malaria diagnostic laboratories. Changes were made to the WHO standard operating procedure protocols to prepare, stain and examine blood smears for malaria parasite detection which were implemented in intervention laboratories. These included wipe-cleaning slides, preparing both thick and thin smears on the same slide, reversing the order of collecting blood for thick and thin smears, dry fixing thick smear for 20-25 minutes under table lamp, polishing the edge of spreader slide with sand paper and fixing the thin smear with methanol if not stained within four hours. Parameters with respect to quality of the smear as per WHO criteria were studied using randomly selected slides, and time taken for the report to be issued was recorded in both groups before and after the intervention. There were no significant differences observed in the parameters studied at baseline between the two groups or pre and post intervention in the control group. In the intervention group streak formation in thin smears was reduced from 29.4% to 5.0%. The average fixing time of thick smears was reduced from 2.4 hours to 20 minutes. Inappropriate thickness of thick smears reduced from 18.3% to 1.5%. Overall quality of thick smears and thin smears increased from 76.1% to 98.0% and 81.7% to 87.0%, respectively. The quality of slides bearing both thick and thin smears increased from 60.0% to 87.0%. New protocols with amendments to the WHO standard technical procedures ensure that good quality blood smears are prepared rapidly to diagnose malaria and the time required to issue the reports was reduced.

Environmental and nutrition impact of achieving new School Food Plan recommendations in the primary school meals sector in England.

PubMed

Wickramasinghe, Kremlin; Rayner, Mike; Goldacre, Michael; Townsend, Nick; Scarborough, Peter

2017-04-05

The aim of this modelling study was to estimate the expected changes in the nutritional quality and greenhouse gas emissions (GHGEs) of primary school meals due to the adoption of new mandatory food-based standards for school meals. Nationally representative random sample of 136 primary schools in England was selected for the Primary School Food Survey (PSFS) with 50% response rate. A sample of 6690 primary students from PSFS who consumed school meals. Primary School Food Plan (SFP) nutritional impact was assessed using both macronutrient and micronutrient quality. The environmental impact was measured by GHGEs. The scenario tested was one in which every meal served in schools met more than half of the food-based standards mentioned in the SFP (SFP scenario). We used findings from a systematic review to assign GHGE values for each food item in the data set. The GHGE value and nutritional quality of SFP scenario meals was compared with the average primary school meal in the total PSFS data set (pre-SFP scenario). Prior to introduction of the SFP (pre-SFP scenario), the primary school meals had mandatory nutrient-based guidelines. The percentage of meals that met the protein standard increased in the SFP scenario and the proportion of meals that met the standards for important micronutrients (eg, iron, calcium, vitamin A and C) also increased. However, the SFP scenario did not improve the salt, saturated fat and free sugar levels. The mean GHGE value of meals which met the SFP standards was 0.79 (95% CI 0.77 to 0.81) kgCO 2 e compared with a mean value of 0.72 (0.71 to 0.74) kgCO 2 e for all meals. Adopting the SFP would increase the total emissions associated with primary school meals by 22 000 000 kgCO 2 e per year. The universal adoption of the new food-based standards, without reformulation would result in an increase in the GHGEs of school meals and improve some aspects of the nutritional quality, but it would not improve the average salt, sugar and saturated fat content levels. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Clinical audit, a valuable tool to improve quality of care: General methodology and applications in nephrology

PubMed Central

Esposito, Pasquale; Dal Canton, Antonio

2014-01-01

Evaluation and improvement of quality of care provided to the patients are of crucial importance in the daily clinical practice and in the health policy planning and financing. Different tools have been developed, including incident analysis, health technology assessment and clinical audit. The clinical audit consist of measuring a clinical outcome or a process, against well-defined standards set on the principles of evidence-based medicine in order to identify the changes needed to improve the quality of care. In particular, patients suffering from chronic renal diseases, present many problems that have been set as topics for clinical audit projects, such as hypertension, anaemia and mineral metabolism management. Although the results of these studies have been encouraging, demonstrating the effectiveness of audit, overall the present evidence is not clearly in favour of clinical audit. These findings call attention to the need to further studies to validate this methodology in different operating scenarios. This review examines the principle of clinical audit, focusing on experiences performed in nephrology settings. PMID:25374819

Mapping the route to medication therapy management documentation and billing standardization and interoperabilility within the health care system: meeting proceedings.

PubMed

Millonig, Marsha K

2009-01-01

To convene a diverse group of stakeholders to discuss medication therapy management (MTM) documentation and billing standardization and its interoperability within the health care system. More than 70 stakeholders from pharmacy, health information systems, insurers/payers, quality, and standard-setting organizations met on October 7-8, 2008, in Bethesda, MD. The American Pharmacists Association (APhA) organized the invitational conference to facilitate discussion on strategic directions for meeting current market need for MTM documentation and billing interoperability and future market needs for MTM integration into electronic health records (EHRs). APhA recently adopted policy that specifically addresses technology barriers and encourages the use and development of standardized systems for the documentation and billing of MTM services. Day 1 of the conference featured six foundational presentations on health information technology (HIT) trends, perspectives on MTM from the profession and the Centers for Medicare & Medicaid Services, health care quality and medication-related outcome measures, integrating MTM workflow in EHRs, and the current state of MTM operalization in practice. After hearing presentations on day 1 and having the opportunity to pose questions to each speaker, conference participants were divided into three breakout groups on day 2. Each group met three times for 60 minutes each and discussed five questions from the perspective of a patient, provider, or payer. Three facilitators met with each of the groups and led discussion from one perspective (i.e., patient, provider, payer). Participants then reconvened as a complete group to participate in a discussion on next steps. HIT is expected to assist in delivering safe, effective, efficient, coordinated care as health professionals strive to improve the quality of care and outcomes for individual patients. The pharmacy profession is actively contributing to quality patient care through MTM services focused on identifying and preventing medication-related problems, improving medication use, and optimizing individual therapeutic outcomes. As MTM programs continue to expand within the health care system, one important limiting factor is the lack of standardization for documentation and billing of MTM services. This lack of interoperability between technology systems, software, and system platforms is presenting as a barrier to MTM service delivery for patients. APhA convened this invitational conference to identify strategic directions to address MTM documentation and billing standardization and interoperability. Participants viewed the meeting as highly successful in bringing together a unique, wide-ranging set of stakeholders, including the government, regulators, standards organizations, other health professions, technology firms, professional organizations, and practitioners, to share perspectives. They strongly encouraged the Association to continue this unique stakeholder dialogue. Participants provided a number of next-step suggestions for APhA to consider because of the event. Participants noted the pharmacy profession's success in building information technology systems for product transactions with systematic, organized, methodical thinking and the need to apply this success to patient services. A unique opportunity exists for the profession to influence and lead the HIT community in creating a workable health technology solution for MTM services. Reaching consensus on minimum data sets for each functional area--clinical, billing, quality improvement--would be a very important short-term gain. Further, participants said it was imperative for pharmacists and the pharmacy community at large to become actively engaged in HIT standards development efforts.

Cost effectiveness of novel oral anticoagulants for stroke prevention in atrial fibrillation depending on the quality of warfarin anticoagulation control.

PubMed

Janzic, Andrej; Kos, Mitja

2015-04-01

Vitamin K antagonists, such as warfarin, are standard treatments for stroke prophylaxis in patients with atrial fibrillation. Patient outcomes depend on quality of warfarin management, which includes regular monitoring and dose adjustments. Recently, novel oral anticoagulants (NOACs) that do not require regular monitoring offer an alternative to warfarin. The aim of this study was to evaluate whether cost effectiveness of NOACs for stroke prevention in atrial fibrillation depends on the quality of warfarin control. We developed a Markov decision model to simulate warfarin treatment outcomes in relation to the quality of anticoagulation control, expressed as percentage of time in the therapeutic range (TTR). Standard treatment with adjusted-dose warfarin and improved anticoagulation control by genotype-guided dosing were compared with dabigatran, rivaroxaban, apixaban and edoxaban. The analysis was performed from the Slovenian healthcare payer perspective using 2014 costs. In the base case, the incremental cost-effectiveness ratio for apixaban, dabigatran and edoxaban was below the threshold of €25,000 per quality-adjusted life-years compared with adjusted-dose warfarin with a TTR of 60%. The probability that warfarin was a cost-effective option was around 1%. This percentage rises as the quality of anticoagulation control improves. At a TTR of 70%, warfarin was the preferred treatment in half the iterations. The cost effectiveness of NOACs for stroke prevention in patients with nonvalvular atrial fibrillation who are at increased risk for stroke is highly sensitive to warfarin anticoagulation control. NOACs are more likely to be cost-effective options in settings with poor warfarin management than in settings with better anticoagulation control, where they may not represent good value for money.

Interlaboratory Study Characterizing a Yeast Performance Standard for Benchmarking LC-MS Platform Performance*

PubMed Central

Paulovich, Amanda G.; Billheimer, Dean; Ham, Amy-Joan L.; Vega-Montoto, Lorenzo; Rudnick, Paul A.; Tabb, David L.; Wang, Pei; Blackman, Ronald K.; Bunk, David M.; Cardasis, Helene L.; Clauser, Karl R.; Kinsinger, Christopher R.; Schilling, Birgit; Tegeler, Tony J.; Variyath, Asokan Mulayath; Wang, Mu; Whiteaker, Jeffrey R.; Zimmerman, Lisa J.; Fenyo, David; Carr, Steven A.; Fisher, Susan J.; Gibson, Bradford W.; Mesri, Mehdi; Neubert, Thomas A.; Regnier, Fred E.; Rodriguez, Henry; Spiegelman, Cliff; Stein, Stephen E.; Tempst, Paul; Liebler, Daniel C.

2010-01-01

Optimal performance of LC-MS/MS platforms is critical to generating high quality proteomics data. Although individual laboratories have developed quality control samples, there is no widely available performance standard of biological complexity (and associated reference data sets) for benchmarking of platform performance for analysis of complex biological proteomes across different laboratories in the community. Individual preparations of the yeast Saccharomyces cerevisiae proteome have been used extensively by laboratories in the proteomics community to characterize LC-MS platform performance. The yeast proteome is uniquely attractive as a performance standard because it is the most extensively characterized complex biological proteome and the only one associated with several large scale studies estimating the abundance of all detectable proteins. In this study, we describe a standard operating protocol for large scale production of the yeast performance standard and offer aliquots to the community through the National Institute of Standards and Technology where the yeast proteome is under development as a certified reference material to meet the long term needs of the community. Using a series of metrics that characterize LC-MS performance, we provide a reference data set demonstrating typical performance of commonly used ion trap instrument platforms in expert laboratories; the results provide a basis for laboratories to benchmark their own performance, to improve upon current methods, and to evaluate new technologies. Additionally, we demonstrate how the yeast reference, spiked with human proteins, can be used to benchmark the power of proteomics platforms for detection of differentially expressed proteins at different levels of concentration in a complex matrix, thereby providing a metric to evaluate and minimize preanalytical and analytical variation in comparative proteomics experiments. PMID:19858499

Restructuring an undergraduate dental curriculum to global standards--a case study in an Indian dental school.

PubMed

Kadagad, P; Tekian, A; Pinto, P X; Jirge, V L

2012-05-01

Globalisation has affected all aspects of life and dentistry is no exception. In the context of today's dentist being a global citizen, undergraduate training in dentistry is set to ensure converging standards so that international recognition of dental qualifications can move forward. The decision of the Dental Council of India to expand the undergraduate dental program to five years provides an opportunity to be part of the endeavor of the Global Dental Congress to achieve converging standards which was initially for the European Union, and now spreading out globally. Economic emergence in Indian subcontinent has resulted in growing oral health care needs both in quality and quantity. To address this issue, the graduating dentist needs to be trained following a competency based curricular model. Access to Internet facilitated the goal of achieving converging standards of dental schools to be feasible because of the instant communication and capacity to share information about training strategies via technology across the globe. Upgrading the undergraduate training to global standards by dental schools in India could be a wise and strategic move both for attracting students to study in India, as well as retaining the graduates after their training. The following is a case study of an Indian dental school set to restructure the undergraduate curriculum to global standards using the 8 steps of Kotter's transformational change. Change in curriculum and the subsequent accreditation of the school in global platform not only attracts prospective students but also results in producing competent dentists. Dental education provided by the institution can result in quality assurance, benchmarking the assessment system to achieve international recognition. This paper highlights the need and importance of facilitation of international convergence with long term aspirations for mutual recognition of international degrees. © 2011 John Wiley & Sons A/S.

Quantitative Microbial Risk Assessment (QMRA) as a Compliment to epidemiologic Studies Estimating Bather Risk at Recreational Beaches

EPA Science Inventory

The US EPA and WHO have set recreational water quality standards based on epidemiologic studies to protect human health at beaches. These studies have largely been limited to sewage-impacted sites and resources are unlikely to be available to assess the myriad of other impacted s...

South Africa?s Increased Matriculation Passes: What Skunks behind the Rose?

ERIC Educational Resources Information Center

Monyooe, Lebusa; Tjatji, Martin; Mosese, Eulenda

2014-01-01

This article argues that the exponential increases in the Grade 12 (Matriculation) passes post 1994 do not necessarily translate to quality because of the low performance norms and standards set for passing Grade 12. It further calls for a serious reflection and interrogation of existing policies on performance, benchmarks, teacher education…

Teacher Licensing Examinations--True Progress or an Illusion?

ERIC Educational Resources Information Center

Libman, Zipora

2009-01-01

Over the past 10 years, public criticism of student achievement has been accompanied by a multitude of educational reforms, most of which emphasized the importance of setting national standards for student achievement and for the level and quality of teaching. The demand for frameworks to assess the extent to which students and teachers met the…

[Principles in the organization of voluntary certifying system for studies and services in pathologic anatomy].

PubMed

Pal'tsev, M A; Kakturskiĭ, L V

2006-01-01

The aim of voluntary certification is to improve the quality of pathology service and to implement it under the Russian Federation's laws and existing standards. The noncommercial organization "Voluntary Certifying System for Postmortem Studies" has been set up, which includes expert groups comprising highly skilled specialists.

7 CFR 1778.3 - Objective.

Code of Federal Regulations, 2011 CFR

2011-01-01

... quantity or quality of water, or in which such a decline is considered imminent, to obtain or maintain adequate quantities of water that meets the standards set by the Safe Drinking Water Act (42 U.S.C. 300f et... (CONTINUED) EMERGENCY AND IMMINENT COMMUNITY WATER ASSISTANCE GRANTS § 1778.3 Objective. The objective of the...

78 FR 17902 - Approval and Promulgation of Implementation Plans and Designation of Areas for Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-25

... health (``primary'' NAAQS) and welfare (``secondary'' NAAQS). In 1978, EPA designated the San Diego Air... on scientific evidence demonstrating that ozone causes adverse health effects at lower ozone... was set. EPA determined that the 1997 ozone standard would be more protective of human health...

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

EPA Science Inventory

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

Economic Crisis and Inequality of Educational Opportunity in Latin America

ERIC Educational Resources Information Center

Torche, Florencia

2010-01-01

Research in the industrialized world shows that the influence of family background on educational attainment has remained stable or declined over time. In contrast, very little is known about the developing world. Using high-quality data sets and a standard protocol, this article offers a comparative analysis of trends in educational…

The Strengths and Weaknesses of ISO 9000 in Vocational Education

ERIC Educational Resources Information Center

Bevans-Gonzales, Theresa L.; Nair, Ajay T.

2004-01-01

ISO 9000 is a set of quality standards that assists an organization to identify, correct and prevent errors, and to promote continual improvement. Educational institutions worldwide are implementing ISO 9000 as they face increasing external pressure to maintain accountability for funding. Similar to other countries, in the United States vocational…

An Examination of the Implementation of Mathematics Lessons in a Chinese Kindergarten Classroom in the Setting of Standards Reform

ERIC Educational Resources Information Center

Hu, Bi Ying; Quebec Fuentes, Sarah; Ma, Jingjing; Ye, Feiwei; Roberts, Sherron Killingsworth

2017-01-01

In China, the "2001 Kindergarten Education Guidelines (Trial)", or "New Outline", delineates what constitutes high-quality, developmentally appropriate practices in all early childhood education curriculum domains, including mathematics. The "New Outline" is known for advocating a child-centered, play-based approach…

The (Im)possibility of Gay Teachers for Young Children

ERIC Educational Resources Information Center

King, James R.

2004-01-01

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

Understanding the Chinese Superintendency in the Context of Quality-Oriented Education

ERIC Educational Resources Information Center

Cravens, Xiu Chen; Liu, Yarong; Grogan, Margaret

2012-01-01

The implementation of national educational reform in China calls for newer and stronger school administration. Recognizing the need to establish a knowledge base for leadership development, we employ a set of existing US professional standards for educational leaders as a frame of reference to unpack the complex role of Chinese superintendents.…

Feasibility of Mapping Riparian Habitats Under Natural Conditions in California

Treesearch

David R. Dawdy

1989-01-01

The California State Water Resources Control Board is conducting hearings to set quantity and quality standards for river flows into San Francisco Bay. Comparisons of present conditions with "natural conditions" prior to European settlement were introduced into the hearings. Consumptive use relations were developed for various riparian and water-related...

OUTCROP-BASED LITHOFACIES AND DEPOSITIONAL SETTING OF ARSENIC-BEARING PERMIAN RED BEDS IN THE CENTRAL OKLAHOMA AQUIFER (COA), CLEVELAND COUNTY, OKLAHOMA

EPA Science Inventory

In January 2001, the Environmental Protection Agency established safe drinking water standards for arsenic at a maximum concentration of 10 mg/L. Results from the National Water-Quality Assessment Program (USGS), however, document the occurrence of arsenic concentrations in drin...

CEMENT. "A Concrete Experience." A Curriculum Developed for the Cement Industry.

ERIC Educational Resources Information Center

Taylor, Mary Lou

This instructor's guide contains 11 lesson plans for inplant classes on workplace skills for employees in a cement plant. The 11 units cover the following topics: goals; interpreting memoranda; applying a standard set of work procedures; qualities of a safe worker; accident prevention; insurance forms; vocabulary development; inventory control…

European Union Standards for Tuberculosis Care

PubMed Central

Migliori, G.B.; Zellweger, J.P.; Abubakar, I.; Ibraim, E.; Caminero, J.A.; De Vries, G.; D'Ambrosio, L.; Centis, R.; Sotgiu, G.; Menegale, O.; Kliiman, K.; Aksamit, T.; Cirillo, D.M.; Danilovits, M.; Dara, M.; Dheda, K.; Dinh-Xuan, A.T.; Kluge, H.; Lange, C.; Leimane, V.; Loddenkemper, R.; Nicod, L.P.; Raviglione, M.C.; Spanevello, A.; Thomsen, V.Ø.; Villar, M.; Wanlin, M.; Wedzicha, J.A.; Zumla, A.; Blasi, F.; Huitric, E.; Sandgren, A.; Manissero, D.

2012-01-01

The European Centre for Disease Prevention and Control (ECDC) and the European Respiratory Society (ERS) jointly developed European Union Standards for Tuberculosis Care (ESTC) aimed at providing European Union (EU)-tailored standards for the diagnosis, treatment and prevention of tuberculosis (TB). The International Standards for TB Care (ISTC) were developed in the global context and are not always adapted to the EU setting and practices. The majority of EU countries have the resources and capacity to implement higher standards to further secure quality TB diagnosis, treatment and prevention. On this basis, the ESTC were developed as standards specifically tailored to the EU setting. A panel of 30 international experts, led by a writing group and the ERS and ECDC, identified and developed the 21 ESTC in the areas of diagnosis, treatment, HIV and comorbid conditions, and public health and prevention. The ISTCs formed the basis for the 21 standards, upon which additional EU adaptations and supplements were developed. These patient-centred standards are targeted to clinicians and public health workers, providing an easy-to-use resource, guiding through all required activities to ensure optimal diagnosis, treatment and prevention of TB. These will support EU health programmes to identify and develop optimal procedures for TB care, control and elimination. PMID:22467723

Air quality and ocular discomfort aboard commercial aircraft.

PubMed

Backman, H; Haghighat, F

2000-10-01

Aircraft cabin air quality has been a subject of recent public health interest. Aircraft environments are designed according to standards to ensure the comfort and well-being of the occupants. The upper and lower limits of humidity set by ASHRAE standards are based on the maintenance of acceptable thermal conditions established solely on comfort considerations, including thermal sensation, skin wetness, skin dryness, dry eyes and ocular discomfort. The purpose of this study is to investigate the influence of air (carbon dioxide level, relative humidity, and temperature) aboard commercial aircraft on ocular discomfort and dry eye of aircraft personnel and passengers. Measurements of indoor air quality were performed in 15 different aircraft at different times and altitudes. Forty-two measurements of carbon dioxide, temperature, and humidity were performed with portable air samplers every 5 minutes. Passenger loads did not exceed 137 passengers. Thermal comfort rarely met ASHRAE standards. Low humidity levels and high carbon dioxide levels were found on the Airbus 320. The DC-9 had the highest humidity level and the Boeing-767 had the lowest carbon dioxide level. Air quality was poorest on the Airbus 320 aircraft. This poor level of air quality may cause intolerance to contact lenses, dry eyes, and may be a health hazard to both passengers and crew members. Improved ventilation and aircraft cabin micro-environments need to be made for the health and comfort of the occupants.

Measuring patient experience in dialysis: a new paradigm of quality assessment.

PubMed

Rhee, Connie M; Brunelli, Steven M; Subramanian, Lalita; Tentori, Francesca

2018-04-01

Patients' experience of care (PEC) is as an important dimension in quality of care. As a distinct entity from patient satisfaction and patient health-related quality of life, PEC is defined as patients' perceptions of the range of interactions they have with the health care system, including care from providers, facilities, and health plans. While traditionally PEC may be ascertained via informal assessments, in recent years, especially in the United States, there has been a shift towards standardized surveillance of PEC amongst dialysis patients in order to: (1) set a normative expectation regarding the importance of PEC; (2) standardize the components of patients' experience that are assessed to minimize potential "blind spots"; (3) provide a direct "voice" to the patient in communicating perceptions of their care; (4) facilitate comparisons of quality across facilities; and (5) broaden accountability for PEC to the entire multidisciplinary dialysis care team. In this review, we will discuss the significance of PEC as a quality of care metric in dialysis patients; the history of PEC assessment across other health care arenas; the development of the In-Center Hemodialysis Consumer Assessment of Healthcare Provider and Systems survey as a means to standardize PEC assessment among US dialysis patients; experiences in PEC assessment across international dialysis populations; and future areas of research needed to refine the ascertainment of PEC and its impact upon patient outcomes.

Evaluation of an iterative model-based reconstruction of pediatric abdominal CT with regard to image quality and radiation dose.

PubMed

Aurumskjöld, Marie-Louise; Söderberg, Marcus; Stålhammar, Fredrik; von Steyern, Kristina Vult; Tingberg, Anders; Ydström, Kristina

2018-06-01

Background In pediatric patients, computed tomography (CT) is important in the medical chain of diagnosing and monitoring various diseases. Because children are more radiosensitive than adults, they require minimal radiation exposure. One way to achieve this goal is to implement new technical solutions, like iterative reconstruction. Purpose To evaluate the potential of a new, iterative, model-based method for reconstructing (IMR) pediatric abdominal CT at a low radiation dose and determine whether it maintains or improves image quality, compared to the current reconstruction method. Material and Methods Forty pediatric patients underwent abdominal CT. Twenty patients were examined with the standard dose settings and 20 patients were examined with a 32% lower radiation dose. Images from the standard examination were reconstructed with a hybrid iterative reconstruction method (iDose 4 ), and images from the low-dose examinations were reconstructed with both iDose 4 and IMR. Image quality was evaluated subjectively by three observers, according to modified EU image quality criteria, and evaluated objectively based on the noise observed in liver images. Results Visual grading characteristics analyses showed no difference in image quality between the standard dose examination reconstructed with iDose 4 and the low dose examination reconstructed with IMR. IMR showed lower image noise in the liver compared to iDose 4 images. Inter- and intra-observer variance was low: the intraclass coefficient was 0.66 (95% confidence interval = 0.60-0.71) for the three observers. Conclusion IMR provided image quality equivalent or superior to the standard iDose 4 method for evaluating pediatric abdominal CT, even with a 32% dose reduction.

Is Your Biobank Up to Standards? A Review of the National Canadian Tissue Repository Network Required Operational Practice Standards and the Controlled Documents of a Certified Biobank.

PubMed

Hartman, Victoria; Castillo-Pelayo, Tania; Babinszky, Sindy; Dee, Simon; Leblanc, Jodi; Matzke, Lise; O'Donoghue, Sheila; Carpenter, Jane; Carter, Candace; Rush, Amanda; Byrne, Jennifer; Barnes, Rebecca; Mes-Messons, Anne-Marie; Watson, Peter

2018-02-01

Ongoing quality management is an essential part of biobank operations and the creation of high quality biospecimen resources. Adhering to the standards of a national biobanking network is a way to reduce variability between individual biobank processes, resulting in cross biobank compatibility and more consistent support for health researchers. The Canadian Tissue Repository Network (CTRNet) implemented a set of required operational practices (ROPs) in 2011 and these serve as the standards and basis for the CTRNet biobank certification program. A review of these 13 ROPs covering 314 directives was conducted after 5 years to identify areas for revision and update, leading to changes to 7/314 directives (2.3%). A review of all internal controlled documents (including policies, standard operating procedures and guides, and forms for actions and processes) used by the BC Cancer Agency's Tumor Tissue Repository (BCCA-TTR) to conform to these ROPs was then conducted. Changes were made to 20/106 (19%) of BCCA-TTR documents. We conclude that a substantial fraction of internal controlled documents require updates at regular intervals to accommodate changes in best practices. Reviewing documentation is an essential aspect of keeping up to date with best practices and ensuring the quality of biospecimens and data managed by biobanks.

Nutrition Standards for Away-from-home Foods in the United States

PubMed Central

Cohen, Deborah A.; Bhatia, Rajiv

2012-01-01

Away-from-home foods are regulated with respect to the prevention of food-borne diseases and potential contaminants, but not for their contribution to dietary-related chronic diseases. Away-from-home foods have more calories, salt, sugar, and fat and provide fewer fruits and vegetables than recommended by national nutrition guidelines; thus, frequent consumption of away-from-home foods contributes to obesity, hypertension, diabetes, heart disease, and cancer. In light of this, many localities are already adopting regulations or sponsoring programs to improve the quality of away-from-home foods. We review the rationale for developing nutritional performance standards for away-from-home foods in light of limited human capacity to regulate intake or physiologically compensate for a poor diet. We offer a set of model performance standards to be considered as a new area of environmental regulation. Models for voluntary implementation of consumer standards exist in the environmental domain and may be useful templates for implementation. Implementing such standards, whether voluntarily or via regulations, will require addressing a number of practical and ideological challenges. Politically, regulatory standards contradict the belief that adults should be able to navigate dietary risks in away-from-home settings unaided. PMID:22329431

An approach for quantitative image quality analysis for CT

NASA Astrophysics Data System (ADS)

Rahimi, Amir; Cochran, Joe; Mooney, Doug; Regensburger, Joe

2016-03-01

An objective and standardized approach to assess image quality of Compute Tomography (CT) systems is required in a wide variety of imaging processes to identify CT systems appropriate for a given application. We present an overview of the framework we have developed to help standardize and to objectively assess CT image quality for different models of CT scanners used for security applications. Within this framework, we have developed methods to quantitatively measure metrics that should correlate with feature identification, detection accuracy and precision, and image registration capabilities of CT machines and to identify strengths and weaknesses in different CT imaging technologies in transportation security. To that end we have designed, developed and constructed phantoms that allow for systematic and repeatable measurements of roughly 88 image quality metrics, representing modulation transfer function, noise equivalent quanta, noise power spectra, slice sensitivity profiles, streak artifacts, CT number uniformity, CT number consistency, object length accuracy, CT number path length consistency, and object registration. Furthermore, we have developed a sophisticated MATLAB based image analysis tool kit to analyze CT generated images of phantoms and report these metrics in a format that is standardized across the considered models of CT scanners, allowing for comparative image quality analysis within a CT model or between different CT models. In addition, we have developed a modified sparse principal component analysis (SPCA) method to generate a modified set of PCA components as compared to the standard principal component analysis (PCA) with sparse loadings in conjunction with Hotelling T2 statistical analysis method to compare, qualify, and detect faults in the tested systems.

A strategic approach for managing conflict in hospitals: responding to the Joint Commission leadership standard, Part 1.

PubMed

Scott, Charity; Gerardi, Debra

2011-02-01

The Joint Commission's leadership standard for conflict management in hospitals, LD.02.04.01, states, "The hospital manages conflict between leadership groups to protect the quality and safety of care." This standard is one of numerous standards and alerts issued by The Joint Commission that address conflict and communication. They underscore the significant impact of relational dynamics on patient safety and quality of care and the critical need for a strategic approach to conflict in health care organizations. Whether leadership conflicts openly threaten a major disruption of hospital operations or whether unresolved conflicts lurk beneath the surface of daily interactions, unaddressed conflict can undermine a hospital's efforts to ensure safe, high-quality patient care. How leaders manage organizational conflict has a significant impact on achieving strategic objectives. Aligning conflict management approaches with quality and safety goals is the first step in adopting a strategic approach to conflict management. A strategic approach goes beyond reducing costs of litigation or improving grievance processes--it integrates a collaborative mind-set and individual conflict competency with nonadversarial processes. Conflict assessment should determine how conflicts are handled among the leaders at the hospital, the degree of conflict competence already present among the leaders, where the most significant conflicts occur, and how leaders think a conflict management system might work for them. Strategically aligning a conflict management approach that addresses conflict among leadership groups as a means of protecting the quality and safety of patient care is at the heart of LD.02.04.01.

EPA Office of Water (OW): Impaired Waters with TMDLs NHDPlus Indexed Dataset

EPA Pesticide Factsheets

The Total Maximum Daily Load (TMDL) Tracking System contains information on waters that are Not Supporting their designated uses. These waters are listed by the state as impaired under Section 303(d) of the Clean Water Act. The status of TMDLs are also tracked. TMDLs are pollution control measures that reduce the discharge of pollutants into impaired waters. A TMDL or Total Maximum Daily Load is a calculation of the maximum amount of a pollutant that a waterbody can receive and still meet water quality standards, and an allocation of that amount to the pollutant's sources. What is a total maximum daily load (TMDL)? Water quality standards are set by States, Territories, and Tribes. They identify the uses for each waterbody, for example, drinking water supply, contact recreation (swimming), and aquatic life support (fishing), and the scientific criteria to support that use. A TMDL is the sum of the allowable loads of a single pollutant from all contributing point and nonpoint sources. The calculation must include a margin of safety to ensure that the waterbody can be used for the purposes the state has designated. The calculation must also account for seasonal variation in water quality. The Clean Water Act, section 303, establishes the water quality standards and TMDL programs.

Standard operating procedures (SOPs): reason for, types of, adequacy, approval, and deviations from and revisions to.

PubMed

Isaman, V; Thelin, R

1995-09-01

Standard Operating Procedures (SOPs) are required in order to comply with the Good Laboratory Practice Standards (GLPS) as promulgated in the Federal Insecticide, Fungicide and Rodenticide Act (FIFRA) 40 CFR Part 160. Paragraph 160.81 (a) states: "A testing facility shall have standard operating procedures in writing setting forth study methods that management is satisfied are adequate to insure the quality and integrity of the data generated in the course of a study." Types of SOPs include administrative and personnel, analyses, substances, quality assurance and records, test system, equipment, and field related. All SOPs must be adequate in scope to describe the function in sufficient detail such that the study data are reproducible. All SOPs must be approved by a management level as described in a corporate organization chart. Signatures for SOP responsibility, authorship, and Quality Assurance review adds strength and accountability to the SOP. In the event a procedure or method is performed differently from what is stated in the SOP, an SOP deviation is necessary. As methods and procedures are improved, SOP revisions are necessary to maintain SOP adequacy and applicability. The replaced SOP is put into a historical SOP file and all copies of the replaced SOPs are destroyed.

Analysis of chemistry textbook content and national science education standards in terms of air quality-related learning goals

NASA Astrophysics Data System (ADS)

Naughton, Wendy

In this study's Phase One, representatives of nine municipal agencies involved in air quality education were interviewed and interview transcripts were analyzed for themes related to what citizens need to know or be able to do regarding air quality concerns. Based on these themes, eight air quality Learning Goal Sets were generated and validated via peer and member checks. In Phase Two, six college-level, liberal-arts chemistry textbooks and the National Science Education Standards (NSES) were analyzed for congruence with Phase One learning goals. Major categories of desired citizen understandings highlighted in agency interviews concerned air pollution sources, impact, detection, and transport. Identified cognitive skills focused on information-gathering and -evaluating skills, enabling informed decision-making. A content match was found between textbooks and air quality learning goals, but most textbooks fail to address learning goals that remediate citizen misconceptions and inabilities---particularly those with a "personal experience" focus. A partial match between NSES and air quality learning goals was attributed to differing foci: Researcher-derived learning goals deal specifically with air quality, while NSES focus is on "fundamental science concepts," not "many science topics." Analysis of findings within a situated cognition framework suggests implications for instruction and NSES revision.

A simulation-based approach for estimating premining water quality: Red Mountain Creek, Colorado

USGS Publications Warehouse

Runkel, Robert L.; Kimball, Briant A; Walton-Day, Katherine; Verplanck, Philip L.

2007-01-01

Regulatory agencies are often charged with the task of setting site-specific numeric water quality standards for impaired streams. This task is particularly difficult for streams draining highly mineralized watersheds with past mining activity. Baseline water quality data obtained prior to mining are often non-existent and application of generic water quality standards developed for unmineralized watersheds is suspect given the geology of most watersheds affected by mining. Various approaches have been used to estimate premining conditions, but none of the existing approaches rigorously consider the physical and geochemical processes that ultimately determine instream water quality. An approach based on simulation modeling is therefore proposed herein. The approach utilizes synoptic data that provide spatially-detailed profiles of concentration, streamflow, and constituent load along the study reach. This field data set is used to calibrate a reactive stream transport model that considers the suite of physical and geochemical processes that affect constituent concentrations during instream transport. A key input to the model is the quality and quantity of waters entering the study reach. This input is based on chemical analyses available from synoptic sampling and observed increases in streamflow along the study reach. Given the calibrated model, additional simulations are conducted to estimate premining conditions. In these simulations, the chemistry of mining-affected sources is replaced with the chemistry of waters that are thought to be unaffected by mining (proximal, premining analogues). The resultant simulations provide estimates of premining water quality that reflect both the reduced loads that were present prior to mining and the processes that affect these loads as they are transported downstream. This simulation-based approach is demonstrated using data from Red Mountain Creek, Colorado, a small stream draining a heavily-mined watershed. Model application to the premining problem for Red Mountain Creek is based on limited field reconnaissance and chemical analyses; additional field work and analyses may be needed to develop definitive, quantitative estimates of premining water quality.

Accounting for both local aquatic community composition and bioavailability in setting site-specific quality standards for zinc.

PubMed

Peters, Adam; Simpson, Peter; Moccia, Alessandra

2014-01-01

Recent years have seen considerable improvement in water quality standards (QS) for metals by taking account of the effect of local water chemistry conditions on their bioavailability. We describe preliminary efforts to further refine water quality standards, by taking account of the composition of the local ecological community (the ultimate protection objective) in addition to bioavailability. Relevance of QS to the local ecological community is critical as it is important to minimise instances where quality classification using QS does not reconcile with a quality classification based on an assessment of the composition of the local ecology (e.g. using benthic macroinvertebrate quality assessment metrics such as River InVertebrate Prediction and Classification System (RIVPACS)), particularly where ecology is assessed to be at good or better status, whilst chemical quality is determined to be failing relevant standards. The alternative approach outlined here describes a method to derive a site-specific species sensitivity distribution (SSD) based on the ecological community which is expected to be present at the site in the absence of anthropogenic pressures (reference conditions). The method combines a conventional laboratory ecotoxicity dataset normalised for bioavailability with field measurements of the response of benthic macroinvertebrate abundance to chemical exposure. Site-specific QSref are then derived from the 5%ile of this SSD. Using this method, site QSref have been derived for zinc in an area impacted by historic mining activities. Application of QSref can result in greater agreement between chemical and ecological metrics of environmental quality compared with the use of either conventional (QScon) or bioavailability-based QS (QSbio). In addition to zinc, the approach is likely to be applicable to other metals and possibly other types of chemical stressors (e.g. pesticides). However, the methodology for deriving site-specific targets requires additional development and validation before they can be robustly applied during surface water classification.

Using the NEMA NU 4 PET image quality phantom in multipinhole small-animal SPECT.

PubMed

Harteveld, Anita A; Meeuwis, Antoi P W; Disselhorst, Jonathan A; Slump, Cornelis H; Oyen, Wim J G; Boerman, Otto C; Visser, Eric P

2011-10-01

Several commercial small-animal SPECT scanners using multipinhole collimation are presently available. However, generally accepted standards to characterize the performance of these scanners do not exist. Whereas for small-animal PET, the National Electrical Manufacturers Association (NEMA) NU 4 standards have been defined in 2008, such standards are still lacking for small-animal SPECT. In this study, the image quality parameters associated with the NEMA NU 4 image quality phantom were determined for a small-animal multipinhole SPECT scanner. Multiple whole-body scans of the NEMA NU 4 image quality phantom of 1-h duration were performed in a U-SPECT-II scanner using (99m)Tc with activities ranging between 8.4 and 78.2 MBq. The collimator contained 75 pinholes of 1.0-mm diameter and had a bore diameter of 98 mm. Image quality parameters were determined as a function of average phantom activity, number of iterations, postreconstruction spatial filter, and scatter correction. In addition, a mouse was injected with (99m)Tc-hydroxymethylene diphosphonate and was euthanized 6.5 h after injection. Multiple whole-body scans of this mouse of 1-h duration were acquired for activities ranging between 3.29 and 52.7 MBq. An increase in the number of iterations was accompanied by an increase in the recovery coefficients for the small rods (RC(rod)), an increase in the noise in the uniform phantom region, and a decrease in spillover ratios for the cold-air- and water-filled scatter compartments (SOR(air) and SOR(wat)). Application of spatial filtering reduced image noise but lowered RC(rod). Filtering did not influence SOR(air) and SOR(wat). Scatter correction reduced SOR(air) and SOR(wat). The effect of total phantom activity was primarily seen in a reduction of image noise with increasing activity. RC(rod), SOR(air), and SOR(wat) were more or less constant as a function of phantom activity. The relation between acquisition and reconstruction settings and image quality was confirmed in the (99m)Tc-hydroxymethylene diphosphonate mouse scans. Although developed for small-animal PET, the NEMA NU 4 image quality phantom was found to be useful for small-animal SPECT as well, allowing for objective determination of image quality parameters and showing the trade-offs between several of these parameters on variation of acquisition and reconstruction settings.

Variability in the chemistry of private drinking water supplies and the impact of domestic treatment systems on water quality.

PubMed

Ander, E L; Watts, M J; Smedley, P L; Hamilton, E M; Close, R; Crabbe, H; Fletcher, T; Rimell, A; Studden, M; Leonardi, G

2016-12-01

Tap water from 497 properties using private water supplies, in an area of metalliferous and arsenic mineralisation (Cornwall, UK), was measured to assess the extent of compliance with chemical drinking water quality standards, and how this is influenced by householder water treatment decisions. The proportion of analyses exceeding water quality standards were high, with 65 % of tap water samples exceeding one or more chemical standards. The highest exceedances for health-based standards were nitrate (11 %) and arsenic (5 %). Arsenic had a maximum observed concentration of 440 µg/L. Exceedances were also high for pH (47 %), manganese (12 %) and aluminium (7 %), for which standards are set primarily on aesthetic grounds. However, the highest observed concentrations of manganese and aluminium also exceeded relevant health-based guidelines. Significant reductions in concentrations of aluminium, cadmium, copper, lead and/or nickel were found in tap waters where households were successfully treating low-pH groundwaters, and similar adventitious results were found for arsenic and nickel where treatment was installed for iron and/or manganese removal, and successful treatment specifically to decrease tap water arsenic concentrations was observed at two properties where it was installed. However, 31 % of samples where pH treatment was reported had pH < 6.5 (the minimum value in the drinking water regulations), suggesting widespread problems with system maintenance. Other examples of ineffectual treatment are seen in failed responses post-treatment, including for nitrate. This demonstrates that even where the tap waters are considered to be treated, they may still fail one or more drinking water quality standards. We find that the degree of drinking water standard exceedances warrant further work to understand environmental controls and the location of high concentrations. We also found that residents were more willing to accept drinking water with high metal (iron and manganese) concentrations than international guidelines assume. These findings point to the need for regulators to reinforce the guidance on drinking water quality standards to private water supply users, and the benefits to long-term health of complying with these, even in areas where treated mains water is widely available.

Meat standards and grading: a world view.

PubMed

Polkinghorne, R J; Thompson, J M

2010-09-01

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

Acute sensory responses of nonsmokers at very low environmental tobacco smoke concentrations in controlled laboratory settings.

PubMed

Junker, M H; Danuser, B; Monn, C; Koller, T

2001-10-01

The objective of this study was to provide a basis for effectively protecting nonsmokers from acute sensory impacts and for preventing deterioration of indoor air quality caused by environmental tobacco smoke (ETS) emissions. With an olfactory experiment we determined odor detection thresholds (OT) of sidestream ETS (sETS), and with a full-body exposure experiment we investigated sensory symptoms at very low sETS exposure concentrations. OT concentrations for sETS are three and more orders of magnitude lower than ETS concentrations measured in field settings and correspond to a fresh air dilution volume of > 19,000 m(3) per cigarette, over 100 times more than had previously been suggested for acceptable indoor air conditions. Eye and nasal irritations were observed at one order of magnitude lower sETS concentrations than previously reported, corresponding to a fresh air dilution volume of > 3,000 m(3) per cigarette. These findings have great practical implications for defining indoor air quality standards in indoor compartments where ETS emissions occur. Our study strongly supports the implementation and control of smoking policies such as segregating smoking areas from areas where smoking is not permitted or instituting smoking bans in public buildings.

An Evaluation Framework for Lossy Compression of Genome Sequencing Quality Values.

PubMed

Alberti, Claudio; Daniels, Noah; Hernaez, Mikel; Voges, Jan; Goldfeder, Rachel L; Hernandez-Lopez, Ana A; Mattavelli, Marco; Berger, Bonnie

2016-01-01

This paper provides the specification and an initial validation of an evaluation framework for the comparison of lossy compressors of genome sequencing quality values. The goal is to define reference data, test sets, tools and metrics that shall be used to evaluate the impact of lossy compression of quality values on human genome variant calling. The functionality of the framework is validated referring to two state-of-the-art genomic compressors. This work has been spurred by the current activity within the ISO/IEC SC29/WG11 technical committee (a.k.a. MPEG), which is investigating the possibility of starting a standardization activity for genomic information representation.

Development of ICF Core Sets to standardize assessment of functioning and impairment in ADHD: the path ahead.

PubMed

Bölte, Sven; de Schipper, Elles; Holtmann, Martin; Karande, Sunil; de Vries, Petrus J; Selb, Melissa; Tannock, Rosemary

2014-12-01

In the study of health and quality of life in attention deficit/hyperactivity disorder (ADHD), it is of paramount importance to include assessment of functioning. The International Classification of Functioning, Disability and Health (ICF) provides a comprehensive, universally accepted framework for the description of functioning in relation to health conditions. In this paper, the authors outline the process to develop ICF Core Sets for ADHD. ICF Core Sets are subgroups of ICF categories selected to capture the aspects of functioning that are most likely to be affected in specific disorders. The ICF categories that will be included in the ICF Core Sets for ADHD will be determined at an ICF Core Set Consensus Conference, wherein evidence from four preliminary studies (a systematic review, an expert survey, a patient and caregiver qualitative study, and a clinical cross-sectional study) will be integrated. Comprehensive and Brief ICF Core Sets for ADHD will be developed with the goal of providing useful standards for research and clinical practice, and to generate a common language for the description of functioning in ADHD in different areas of life and across the lifespan.

Ambient-temperature incubation for the field detection of Escherichia coli in drinking water.

PubMed

Brown, J; Stauber, C; Murphy, J L; Khan, A; Mu, T; Elliott, M; Sobsey, M D

2011-04-01

 Escherichia coli is the pre-eminent microbiological indicator used to assess safety of drinking water globally. The cost and equipment requirements for processing samples by standard methods may limit the scale of water quality testing in technologically less developed countries and other resource-limited settings, however. We evaluate here the use of ambient-temperature incubation in detection of E. coli in drinking water samples as a potential cost-saving and convenience measure with applications in regions with high (>25°C) mean ambient temperatures.   This study includes data from three separate water quality assessments: two in Cambodia and one in the Dominican Republic. Field samples of household drinking water were processed in duplicate by membrane filtration (Cambodia), Petrifilm™ (Cambodia) or Colilert® (Dominican Republic) on selective media at both standard incubation temperature (35–37°C) and ambient temperature, using up to three dilutions and three replicates at each dilution. Matched sample sets were well correlated with 80% of samples (n = 1037) within risk-based microbial count strata (E. coli CFU 100 ml−1 counts of <1, 1–10, 11–100, 101–1000, >1000), and a pooled coefficient of variation of 17% (95% CI 15–20%) for paired sample sets across all methods.   These results suggest that ambient-temperature incubation of E. coli in at least some settings may yield sufficiently robust data for water safety monitoring where laboratory or incubator access is limited.

Optical tests for using smartphones inside medical devices

NASA Astrophysics Data System (ADS)

Bernat, Amir S.; Acobas, Jennifer K.; Phang, Ye Shang; Hassan, David; Bolton, Frank J.; Levitz, David

2018-02-01

Smartphones are currently used in many medical applications and are more frequently being integrated into medical imaging devices. The regulatory requirements in existence today however, particularly the standardization of smartphone imaging through validation and verification testing, only partially cover imaging characteristics with a smartphone. Specifically, it has been shown that smartphone camera specifications are of sufficient quality for medical imaging, and there are devices which comply with the FDA's regulatory requirements for a medical device such as a device's field of view, direction of viewing and optical resolution and optical distortion. However, these regulatory requirements do not call specifically for color testing. Images of the same object using automatic settings or different light sources can show different color composition. Experimental results showing such differences are presented. Under some circumstances, such differences in color composition could potentially lead to incorrect diagnoses. It is therefore critical to control the smartphone camera and illumination parameters properly. This paper examines different smartphone camera settings that affect image quality and color composition. To test and select the correct settings, a test methodology is proposed. It aims at evaluating and testing image color correctness and white balance settings for mobile phones and LED light sources. Emphasis is placed on color consistency and deviation from gray values, specifically by evaluating the ΔC values based on the CIEL*a*b* color space. Results show that such standardization minimizes differences in color composition and thus could reduce the risk of a wrong diagnosis.

Twelve tips for assessment psychometrics.

PubMed

Coombes, Lee; Roberts, Martin; Zahra, Daniel; Burr, Steven

2016-01-01

It is incumbent on medical schools to show, both to regulatory bodies and to the public at large, that their graduating students are "fit for purpose" as tomorrow's doctors. Since students graduate by virtue of passing assessments, it is vital that schools quality assure their assessment procedures, standards, and outcomes. An important part of this quality assurance process is the appropriate use of psychometric analyses. This begins with development of an empowering, evidence-based culture in which assessment validity can be demonstrated. Preparation prior to an assessment requires the establishment of appropriate rules, test blueprinting and standard setting. When an assessment has been completed, the reporting of test results should consider reliability, assessor, demographic, and long-term analyses across multiple levels, in an integrated way to ensure the information conveyed to all stakeholders is meaningful.

Comparing image quality of print-on-demand books and photobooks from web-based vendors

NASA Astrophysics Data System (ADS)

Phillips, Jonathan; Bajorski, Peter; Burns, Peter; Fredericks, Erin; Rosen, Mitchell

2010-01-01

Because of the emergence of e-commerce and developments in print engines designed for economical output of very short runs, there are increased business opportunities and consumer options for print-on-demand books and photobooks. The current state of these printing modes allows for direct uploading of book files via the web, printing on nonoffset printers, and distributing by standard parcel or mail delivery services. The goal of this research is to assess the image quality of print-on-demand books and photobooks produced by various Web-based vendors and to identify correlations between psychophysical results and objective metrics. Six vendors were identified for one-off (single-copy) print-on-demand books, and seven vendors were identified for photobooks. Participants rank ordered overall quality of a subset of individual pages from each book, where the pages included text, photographs, or a combination of the two. Observers also reported overall quality ratings and price estimates for the bound books. Objective metrics of color gamut, color accuracy, accuracy of International Color Consortium profile usage, eye-weighted root mean square L*, and cascaded modulation transfer acutance were obtained and compared to the observer responses. We introduce some new methods for normalizing data as well as for strengthening the statistical significance of the results. Our approach includes the use of latent mixed-effect models. We found statistically significant correlation with overall image quality and some of the spatial metrics, but correlations between psychophysical results and other objective metrics were weak or nonexistent. Strong correlation was found between psychophysical results of overall quality assessment and estimated price associated with quality. The photobook set of vendors reached higher image-quality ratings than the set of print-on-demand vendors. However, the photobook set had higher image-quality variability.

Characterizations of a Quality Certified Athletic Trainer

PubMed Central

Raab, Scot; Wolfe, Brent D.; Gould, Trenton E.; Piland, Scott G.

2011-01-01

Context: Didactic proficiency does not ensure clinical aptitude. Quality athletic health care requires clinical knowledge and affective traits. Objective: To develop a grounded theory explaining the constructs of a quality certified athletic trainer (AT). Design: Delphi study. Setting: Interviews in conference rooms or business offices and by telephone. Patients or Other Participants: Thirteen ATs (men = 8, women = 5) stratified across the largest employment settings (high school, college, clinical) in the 4 largest districts of the National Athletic Trainers' Association (2, 3, 4, 9). Data Collection and Analysis: Open-ended interview questions were audio recorded, transcribed, and reviewed before condensing. Two member checks ensured trustworthiness. Open coding reduced text to descriptive adjectives. Results: We grouped adjectives into 5 constructs (care, communication, commitment, integrity, knowledge) and grouped these constructs into 2 higher-order constructs (affective traits, effective traits). Conclusions: According to participants, ATs who demonstrate the ability to care, show commitment and integrity, value professional knowledge, and communicate effectively with others can be identified as quality ATs. These abilities facilitate the creation of positive relationships. These relationships allow the quality AT to interact with patients and other health care professionals on a knowledgeable basis that ultimately improves health care delivery. Our resulting theory supported the examination of characteristics not traditionally assessed in an athletic training education program. If researchers can show that these characteristics develop ATs into quality ATs (eg, those who work better with others, relate meaningfully with patients, and improve the standard of health care), they must be cultivated in the educational setting. PMID:22488194

Feasibility of evaluating quality cancer care using registry data and electronic health records: a population-based study.

PubMed

Caldarella, Adele; Amunni, Gianni; Angiolini, Catia; Crocetti, Emanuele; Di Costanzo, Francesco; Di Leo, Angelo; Giusti, Francesco; Pegna, Andrea Lopes; Mantellini, Paola; Luzzatto, Lucio; Paci, Eugenio

2012-08-01

To evaluate the quality of patients care, a set of indicators of the standards of cancer care were defined. We developed a set of indicators to assess the implementation in daily practice of recommendation produced by a regional network (Istituto Toscano Tumori). This set was tested in a retrospective study in the resident population of the Tuscany Region; the regional health system is organized on 12 local health authorities which refer to three macro areas (Area Vasta). The study included incident colorectal, lung and breast cancer cases listed in 2004 for the Tuscan Cancer Registry, a population-based registry which collected tumor cases diagnosed in all residents in Tuscany. Electronic data from registry database were used to determine the compliance with each indicator for patients in 2004. To validate the results, an ad hoc clinical survey including the same geographical area for the year 2006 was performed. None. The proportion of patients who fulfilled each of the indicators. Our study showed the feasibility of the evaluation of the quality of cancer care using cancer registry population-based data and major computerized information systems. The estimation of the selected indicators confirmed a good homogeneity among areas, and globally revealed a good intraregional performance. Further work is needed to develop specific quality measures, particularly about structural data and to continually revise indicators of quality of care. Data from a cancer registry, however, can be useful to evaluate quality of cancer care.

Orienting health care information systems toward quality: how Group Health Cooperative of Puget Sound did it.

PubMed

Goverman, I L

1994-11-01

Group Health Cooperative of Puget Sound (GHC), a large staff-model health maintenance organization based in Seattle, is redesigning its information systems to provide the systems and information needed to support its quality agenda. Long-range planning for GHC's information resources was done in three phases. In assessment, interviews, surveys, and a benchmarking effort identified strengths and weaknesses of the existing information systems. We concluded that we needed to improve clinical care and patient management systems and enhance health plan applications. In direction setting, we developed six objectives (for example, approach information systems in a way that is consistent with quality improvement principles). Detailed planning was used to define projects, timing, and resource allocations. Some of the most important efforts in the resulting five-year plan include the development of (1) a computerized patient record; (2) a provider-based clinical workstation for access to patient information, order entry, results reporting, guidelines, and reminders; (3) a comprehensive set of patient management and service quality systems; (4) reengineered structures, policies, and processes within the health plan, supported by a complete set of integrated information systems; (5) a standardized, high-capacity communications network to provide linkages both within GHC and among its business partners; and (6) a revised oversight structure for information services, which forms partnerships with users. A quality focus ensured that each project not only produced its own benefits but also supported the larger organizational goals associated with "total" quality.

Water as consumed and its impact on the consumer--do we understand the variables?

PubMed

Bates, A J

2000-01-01

Water is the most important natural resource in the world, without it life cannot exist. In 1854 a cholera outbreak in London caused 10, 000 deaths and positively linked enteric disease with bacterial contamination of drinking water by sewage pollution. Since then, adequate water hygiene standards and sewage purification have played the most significant role in disease eradication and public health improvements everywhere. Standards for drinking water have become an extensive range of microbiological and chemical parametric values. Which has not increased consumer, if the media is to be believed. Customers rightly expect that the water they drink is safe and wholesome. Standard setting is perceived as a precise science and meaningful to health. Is this justified and do scientists and regulators who derive and set the standards understand the uncertainties in the system? Water is the universal solvent, therefore it will never be pure; it will contain impurities prior to and after treatment. Knowledge of its potential to become contaminated is necessary to understand the epidemiology associated with waterborne contaminants and their effects. Water use patterns vary considerably and affect assumptions based on toxicology derived from laboratory studies under tightly controlled conditions. Consideration must be given to the model systems used to assess toxicity and translate results from the laboratory to the real world, if sensible scientifically-based water quality standards are to be set and achieved cost effectively.

A taxonomy of multinational ethical and methodological standards for clinical trials of therapeutic interventions

PubMed Central

Ashton, Carol M; Wray, Nelda P; Jarman, Anna F; Kolman, Jacob M; Wenner, Danielle M; Brody, Baruch A

2013-01-01

Background If trials of therapeutic interventions are to serve society’s interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical-trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world’s nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample (N=55) of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial’s stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. PMID:21429960

A taxonomy of multinational ethical and methodological standards for clinical trials of therapeutic interventions.

PubMed

Ashton, Carol M; Wray, Nelda P; Jarman, Anna F; Kolman, Jacob M; Wenner, Danielle M; Brody, Baruch A

2011-06-01

If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical-trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as 'core', 39 addressing trials of invasive procedures and a 5% sample (N=55) of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research.