Comparing two survey methods of measuring health-related indicators: Lot Quality Assurance Sampling and Demographic Health Surveys.

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Anoke, Sarah C; Mwai, Paul; Jeffery, Caroline; Valadez, Joseph J; Pagano, Marcello

2015-12-01

Two common methods used to measure indicators for health programme monitoring and evaluation are the demographic and health surveys (DHS) and lot quality assurance sampling (LQAS); each one has different strengths. We report on both methods when utilised in comparable situations. We compared 24 indicators in south-west Uganda, where data for prevalence estimations were collected independently for the two methods in 2011 (LQAS: n = 8876; DHS: n = 1200). Data were stratified (e.g. gender and age) resulting in 37 comparisons. We used a two-sample two-sided Z-test of proportions to compare both methods. The average difference between LQAS and DHS for 37 estimates was 0.062 (SD = 0.093; median = 0.039). The average difference among the 21 failures to reject equality of proportions was 0.010 (SD = 0.041; median = 0.009); among the 16 rejections, it was 0.130 (SD = 0.010, median = 0.118). Seven of the 16 rejections exhibited absolute differences of 0.10 and 0.20 (mean = 0.261, SD = 0.083). There is 75.7% agreement across the two surveys. Both methods yield regional results, but only LQAS provides information at less granular levels (e.g. the district level) where managerial action is taken. The cost advantage and localisation make LQAS feasible to conduct more frequently, and provides the possibility for real-time health outcomes monitoring. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Quality Indicators for Learning Analytics

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Scheffel, Maren; Drachsler, Hendrik; Stoyanov, Slavi; Specht, Marcus

2014-01-01

This article proposes a framework of quality indicators for learning analytics that aims to standardise the evaluation of learning analytics tools and to provide a mean to capture evidence for the impact of learning analytics on educational practices in a standardised manner. The criteria of the framework and its quality indicators are based on…

Characterization of groundwater quality using water evaluation indices, multivariate statistics and geostatistics in central Bangladesh

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Md. Bodrud-Doza

2016-04-01

Full Text Available This study investigates the groundwater quality in the Faridpur district of central Bangladesh based on preselected 60 sample points. Water evaluation indices and a number of statistical approaches such as multivariate statistics and geostatistics are applied to characterize water quality, which is a major factor for controlling the groundwater quality in term of drinking purposes. The study reveal that EC, TDS, Ca2+, total As and Fe values of groundwater samples exceeded Bangladesh and international standards. Ground water quality index (GWQI exhibited that about 47% of the samples were belonging to good quality water for drinking purposes. The heavy metal pollution index (HPI, degree of contamination (Cd, heavy metal evaluation index (HEI reveal that most of the samples belong to low level of pollution. However, Cd provide better alternative than other indices. Principle component analysis (PCA suggests that groundwater quality is mainly related to geogenic (rock–water interaction and anthropogenic source (agrogenic and domestic sewage in the study area. Subsequently, the findings of cluster analysis (CA and correlation matrix (CM are also consistent with the PCA results. The spatial distributions of groundwater quality parameters are determined by geostatistical modeling. The exponential semivariagram model is validated as the best fitted models for most of the indices values. It is expected that outcomes of the study will provide insights for decision makers taking proper measures for groundwater quality management in central Bangladesh.

Measuring quality of care: considering conceptual approaches to quality indicator development and evaluation.

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Stelfox, Henry T; Straus, Sharon E

2013-12-01

In this article, we describe one approach for developing and evaluating quality indicators. We focus on describing different conceptual approaches to quality indicator development, review one approach for developing quality indicators, outline how to evaluate quality indicators once developed, and discuss quality indicator maintenance. The key steps for developing quality indicators include specifying a clear goal for the indicators; using methodologies to incorporate evidence, expertise, and patient perspectives; and considering contextual factors and logistics of implementation. The Strategic Framework Board and the National Quality Measure Clearinghouse have developed criteria for evaluating quality indicators that complement traditional psychometric evaluations. Optimal strategies for quality indicator maintenance and dissemination have not been determined, but experiences with clinical guideline maintenance may be informative. For quality indicators to effectively guide quality improvement efforts, they must be developed, evaluated, maintained, and implemented using rigorous evidence-informed practices. Copyright © 2013 Elsevier Inc. All rights reserved.

Canadian environmental sustainability indicators : air quality indicator : data sources methods 2005

International Nuclear Information System (INIS)

2006-01-01

National indicators of freshwater quality, air quality and greenhouse gas emissions were established in 2004 by the Canadian government in recognition that public health and economic well-being are linked to the quality of the environment. These indicators build on a base of an established national monitoring network and are communicated to the public by Environment Canada, Statistics Canada and Health Canada in an effort to provide reliable information on the state of the environment. Each indicator reported in a given year has an associated data sources and methods report to provide technical detail and background information that will help interpret the indicator. This particular report focused on the basic methods and data for the air quality indicator as it was reported in 2005. It approximated public exposure to ground-level ozone, a key component of smog and a harmful pollutant. Since ozone levels are influenced by weather and transboundary flows of pollutants, this report analyzed observed concentrations in relation to where people live. The indicator measures the seasonal average of the highest 8-hour average ground-level ozone concentration for each day. The indicator reflects possible health impacts related to ozone over the entire season. It is population-weighted and assumes that ozone concentrations are constant within a radius of 40 km around each monitoring station. It was noted that future improvements for the air quality indicator will include measures of fine particulate matter and improvements in monitoring methods. 9 refs., 2 tabs., 6 figs

Monitoring bacterial indicators of water quality in a tidally influenced delta: A Sisyphean pursuit.

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Partyka, Melissa L; Bond, Ronald F; Chase, Jennifer A; Atwill, Edward R

2017-02-01

The Sacramento-San Joaquin Delta Estuary (Delta) is the confluence of two major watersheds draining the Western Sierra Nevada mountains into the Central Valley of California, ultimately terminating into San Francisco Bay. We sampled 88 sites once a month for two years (2006-2008) over 87 separate sampling events for a total of 1740 samples. Water samples were analyzed for fecal indicator bacteria (Escherichia coli, enterococci and fecal coliforms), and 53 other physiochemical, land use, and environmental characteristics. The purpose of the study was to create a baseline of microbial water quality in the Delta and to identify various factors (climatic, land use, tidal, etc.) that were associated with elevated concentrations of indicator bacteria. Fecal indicator bacteria generally had weak to modest relationships to environmental conditions; the strength and direction of which varied for each microbial indicator, drainage region, and across seasons. Measured and unmeasured, site-specific effects accounted for large portions of variance in model predictions (ρ=0.086 to 0.255), indicating that spatial autocorrelation was a major component of water quality outcomes. The effects of tidal cycling and lack of connectivity between waterways and surrounding landscapes likely contributed to the lack of association between local land uses and microbial outcomes, though weak associations may also be indicative of mismatched spatiotemporal scales. The complex nature of this system necessitates continued monitoring and regular updates to statistical models designed to predict microbial water quality. Copyright © 2016 Elsevier B.V. All rights reserved.

Evaluation of the EIA system performance in Greece, using quality indicators

International Nuclear Information System (INIS)

Androulidakis, Ioannis; Karakassis, Ioannis

2006-01-01

Greece was among the last countries in the European Union to adopt the EU Directives on Environmental Impact Assessment, upgrading the previously existing legislative framework. The aim of the present paper was to appraise the quality of a randomly selected sample of EISs using non-obligatory but quality-related indicators and to evaluate the overall quality of these studies produced in Greece during the last decade (1993-2003). It was found that the majority of these EISs performed rather poorly in respect of most indicators used and there was little evidence of improvement with time. It is concluded that the authorities in charge still have little experience in coping with the increasing bulk of project submissions and are primarily interested in conformity with formal requirements rather than in reliable predictions and in overall quality of the EIA procedure

Soil Quality Indicator: a new concept

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Barão, Lúcia; Basch, Gottlieb

2017-04-01

During the last century, cultivated soils have been intensively exploited for food and feed production. This exploitation has compromised the soils' natural functions and many of the soil-mediated ecosystems services, including its production potential for agriculture. Also, soils became increasingly vulnerable and less resilient to a wide range of threats. To overcome this situation, new and better management practices are needed to prevent soil from degradation. However, to adopt the best management practices in a specific location, it is necessary to evaluate the soil quality status first. Different soil quality indicators have been suggested over the last decades in order to evaluate the soil status, and those are often based on the performance of soil chemical, physical and biological properties. However, the direct link between these properties and the associated soil functions or soil vulnerability to threats appears more difficult to be established. This present work is part of the iSQAPER project- Interactive Soil Quality Assessment in Europe and China for Agricultural Productivity and Environmental Resilience, where new soil quality concepts are explored to provide better information regarding the effects of the most promising agricultural management practices on soil quality. We have developed a new conceptual soil quality indicator which determines the soil quality status, regarding its vulnerability towards different threats. First, different indicators were specifically developed for each of the eight threats considered - Erosion, SOM decline, Poor Structure, Poor water holding capacity, Compaction, N-Leaching, Soil-borne pests and diseases and Salinization. As an example for the case of Erosion, the RUSLE equation for the estimate of the soil annual loss was used. Secondly, a reference classification was established for each indicator to integrate all possible results into a Good, Intermediate or Bad classification. Finally, all indicators were

Health indicators associated with poor sleep quality among university students

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Márcio Flávio Moura de Araújo

Full Text Available Objective To associate the sleep quality of Brazilian undergraduate students with health indicators. Method A cross-sectional study was developed with a random sample of 662 undergraduate students from Fortaleza, Brazil. The demographic data, Pittsburgh Sleep Quality Index and health data indicators (smoking, alcoholism, sedentary lifestyle, nutritional condition and serum cholesterol were collected through a self-administered questionnaire. Blood was collected at a clinical laboratory. In order to estimate the size of the associations, a Poisson Regression was used. Results For students who are daily smokers, the occurrence of poor sleep was higher than in non-smokers (p<0.001. Prevalence rate values were nevertheless close to 1. Conclusion The likelihood of poor sleep is almost the same in smokers and in alcoholics.

Development of a Novel Quality Improvement Indicator Based on the Hemolysis Index.

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Lee, Eun Jin; Kim, Miyoung; Kim, Han Sung; Park, Min Jeong; Lee, Young Kyung; Kang, Hee Jung

2016-11-01

Hemolysis frequently causes preanalytical errors in laboratory measurements. We aimed to develop a quality improvement indicator for evaluating the extent of inappropriate procedures causing hemolysis in clinical samples collected in medical care units. We defined the threshold value of the hemolysis index (H index) causing significant interference with analyte measurement and analyzed the H index values of clinical samples in relation to the threshold. The H index threshold value causing a 10% bias in the measurement of lactate dehydrogenase was found to be 25. The monthly mean H index and monthly frequency of samples with an H index >25 were significantly different among the types of ward (P=0.001, respectively), and significantly decreased after replacement of a laboratory centrifuge lacking temperature control (20.6±0.58 vs 23.30±1.08, P=0.01; 23.4±1.69% vs 32.6±1.78%, P=0.01). The monthly mean H index and the monthly frequency of samples with an H index above a threshold value may be useful quality improvement indicators for detection of inappropriate procedures in the acquisition and handling of blood samples in medical care units.

Dimensionality reduction of quality of life indicators

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Andrea Jindrová

2012-01-01

Full Text Available Selecting indicators for assessing the quality of life at the regional level is not unambigous. Currently, there are no precisely defined indicators that would give comprehensive information about the quality of life on a local level. In this paper we focus on the determination (selection of groups of indicators that can be interpreted, on the basis of studied literature, as factors characterizing the quality of life. Furthermore, on the application of methods to reduce the dimensionality of these indicators, from the source of the database CULS KROK, which provides statistics on the regional and districts level. To reduce the number of indicators and the subsequent creation of derived variables that capture the relationships between selected indicators multivariate statistical analysis methods, especially method of principal components and factor analysis were used. This paper also indicates the methodology grant project “Methodological Approaches to assess Subjective Aspects of the life quality in regions of the Czech Republic”.

Quality indicators for hip fracture care, a systematic review.

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Voeten, S C; Krijnen, P; Voeten, D M; Hegeman, J H; Wouters, M W J M; Schipper, I B

2018-05-17

Quality indicators are used to measure quality of care and enable benchmarking. An overview of all existing hip fracture quality indicators is lacking. The primary aim was to identify quality indicators for hip fracture care reported in literature, hip fracture audits, and guidelines. The secondary aim was to compose a set of methodologically sound quality indicators for the evaluation of hip fracture care in clinical practice. A literature search according to the PRISMA guidelines and an internet search were performed to identify hip fracture quality indicators. The indicators were subdivided into process, structure, and outcome indicators. The methodological quality of the indicators was judged using the Appraisal of Indicators through Research and Evaluation (AIRE) instrument. For structure and process indicators, the construct validity was assessed. Sixteen publications, nine audits and five guidelines were included. In total, 97 unique quality indicators were found: 9 structure, 63 process, and 25 outcome indicators. Since detailed methodological information about the indicators was lacking, the AIRE instrument could not be applied. Seven indicators correlated with an outcome measure. A set of nine quality indicators was extracted from the literature, audits, and guidelines. Many quality indicators are described and used. Not all of them correlate with outcomes of care and have been assessed methodologically. As methodological evidence is lacking, we recommend the extracted set of nine indicators to be used as the starting point for further clinical research. Future research should focus on assessing the clinimetric properties of the existing quality indicators.

Quality Indicators in Radiation Oncology

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Albert, Jeffrey M. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Das, Prajnan, E-mail: prajdas@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

2013-03-15

Oncologic specialty societies and multidisciplinary collaborative groups have dedicated considerable effort to developing evidence-based quality indicators (QIs) to facilitate quality improvement, accreditation, benchmarking, reimbursement, maintenance of certification, and regulatory reporting. In particular, the field of radiation oncology has a long history of organized quality assessment efforts and continues to work toward developing consensus quality standards in the face of continually evolving technologies and standards of care. This report provides a comprehensive review of the current state of quality assessment in radiation oncology. Specifically, this report highlights implications of the healthcare quality movement for radiation oncology and reviews existing efforts to define and measure quality in the field, with focus on dimensions of quality specific to radiation oncology within the “big picture” of oncologic quality assessment efforts.

Quality Indicators in Radiation Oncology

International Nuclear Information System (INIS)

Albert, Jeffrey M.; Das, Prajnan

2013-01-01

Oncologic specialty societies and multidisciplinary collaborative groups have dedicated considerable effort to developing evidence-based quality indicators (QIs) to facilitate quality improvement, accreditation, benchmarking, reimbursement, maintenance of certification, and regulatory reporting. In particular, the field of radiation oncology has a long history of organized quality assessment efforts and continues to work toward developing consensus quality standards in the face of continually evolving technologies and standards of care. This report provides a comprehensive review of the current state of quality assessment in radiation oncology. Specifically, this report highlights implications of the healthcare quality movement for radiation oncology and reviews existing efforts to define and measure quality in the field, with focus on dimensions of quality specific to radiation oncology within the “big picture” of oncologic quality assessment efforts

An Assessment of the AGA and CCFA Quality Indicators in a Sample of Patients Diagnosed with Inflammatory Bowel Disease.

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Tkacz, Joseph; Brady, Brenna L; Meyer, Roxanne; Lofland, Jennifer H; Ruetsch, Charles; Coelho-Prabhu, Nayantara

2015-11-01

Inflammatory bowel disease (IBD) is a chronic relapsing disease characterized by activation of the mucosal immune system and inflammation of the gastrointestinal tract. Management of IBD places a significant burden on the health care system because of the complexity of treatment, variability in patient outcomes, and chronic nature of the disease.  To investigate the American Gastroenterological Association (AGA) and Crohn's and Colitis Foundation of America's (CCFA) quality measurement sets in a sample of IBD patients. Fourteen quality measures were restated for application to a claims database and calculated using Optum Clinformatics DataMart database. Selected measures were calculated over calendar year 2011. Performance measures ranged from 0.4% for AGA measure 9, prophylaxis for venous thromboembolism, to 66.9% for AGA measure 8, testing for Clostridium difficile. CCFA outcome measures ranged from 0.6% qualifying for CCFA O10, report of fecal incontinence, to 32.9% for CCFA O1, prednisone usage. In addition to Clostridium difficile testing, the use of appropriate corticosteroid-sparing therapy (51.1%) and testing for latent tuberculosis before initiating anti-tumor necrosis factor therapy (45.0%) were the highest achieved measures. This is the first examination of IBD quality measures using administrative claims. Rates of achievement across measures were variable and likely affected by the ability to calculate certain measures with claims data. Future studies should further examine measurement of IBD quality indicators in claims data to assess the validity of claims-based analyses and to ascertain whether measure attainment translates into better overall health or IBD-related outcomes.

Measures and Indicators of Vgi Quality: AN Overview

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Antoniou, V.; Skopeliti, A.

2015-08-01

The evaluation of VGI quality has been a very interesting and popular issue amongst academics and researchers. Various metrics and indicators have been proposed for evaluating VGI quality elements. Various efforts have focused on the use of well-established methodologies for the evaluation of VGI quality elements against authoritative data. In this paper, a number of research papers have been reviewed and summarized in a detailed report on measures for each spatial data quality element. Emphasis is given on the methodology followed and the data used in order to assess and evaluate the quality of the VGI datasets. However, as the use of authoritative data is not always possible many researchers have turned their focus on the analysis of new quality indicators that can function as proxies for the understanding of VGI quality. In this paper, the difficulties in using authoritative datasets are briefly presented and new proposed quality indicators are discussed, as recorded through the literature review. We classify theses new indicators in four main categories that relate with: i) data, ii) demographics, iii) socio-economic situation and iv) contributors. This paper presents a dense, yet comprehensive overview of the research on this field and provides the basis for the ongoing academic effort to create a practical quality evaluation method through the use of appropriate quality indicators.

MEASURES AND INDICATORS OF VGI QUALITY: AN OVERVIEW

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V. Antoniou

2015-08-01

Full Text Available The evaluation of VGI quality has been a very interesting and popular issue amongst academics and researchers. Various metrics and indicators have been proposed for evaluating VGI quality elements. Various efforts have focused on the use of well-established methodologies for the evaluation of VGI quality elements against authoritative data. In this paper, a number of research papers have been reviewed and summarized in a detailed report on measures for each spatial data quality element. Emphasis is given on the methodology followed and the data used in order to assess and evaluate the quality of the VGI datasets. However, as the use of authoritative data is not always possible many researchers have turned their focus on the analysis of new quality indicators that can function as proxies for the understanding of VGI quality. In this paper, the difficulties in using authoritative datasets are briefly presented and new proposed quality indicators are discussed, as recorded through the literature review. We classify theses new indicators in four main categories that relate with: i data, ii demographics, iii socio-economic situation and iv contributors. This paper presents a dense, yet comprehensive overview of the research on this field and provides the basis for the ongoing academic effort to create a practical quality evaluation method through the use of appropriate quality indicators.

Application of Water Quality and Ecology Indices of Benthic Macroinvertebrate to Evaluate Water Quality of Tertiary Irrigation in Malang District

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Desi Kartikasari

2013-12-01

Full Text Available This research aims to determine the water quality of tertiary irrigation in several subdistricts in Malang, namely Kepanjen, Karangploso, and Tumpang. The water quality depends on the water quality indices (National Sanitation Foundation’s-NSF Indices and O’Connor’s Indices based on variables TSS, TDS, pH, DO, and Nitrate concentrate and ecological indices of benthic macroinvertebrate (Diversity Indices Shannon-Wiener, Hilsenhof Biotic Indices-HBI, Average Score per Taxon-ASPT which is calculated by Biological Monitoring Working Party-BMWP, Ephemeroptera Indices, Plecoptera, Trichoptera-EPT. Observation of the physico-chemical water quality and benthic macroinvertebrate on May 2012 to April 2013. The sampling in each subdistrict was done at two selected stations in tertiary irrigation channel with three plot at each station. The data of physico-chemical quality of water were used to calculate the water quality indices, while the benthic macroinvertebrate data were used to calculate the ecological indices. The research findings showed that 27 taxa of benthic macroinvertebrates belong 10 classes were found in the three subdistrict. The pH, DO, Nitrate, TSS and TDS in six tertiary irrigation channels in Malang still met the water quality standards based on Government Regulation No. 82 of 2001 on Management of Water Quality and Water Pollution Control Class III. Based on NSF-WQI indices and O'Connor's Indices, water qualities in these irrigation channels were categorized into medium or moderate (yellow to good (green category. However, based on benthic macroinvertebrate communities which was used to determine the HBI, the water quality in the irrigation channels were categorized into the fair category (fairly significant organic pollution to fairly poor (significant organic pollution, while based on the value of ASPT, the water were categorized into probable moderate pollution to probable severe pollution. The irrigation water which was

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

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

2018-04-10

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

SOCIO-CULTURAL AND MEDICAL INDICATORS OF THE SCHOOLCHILDREN'S QUALITY OF LIFE

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Slobodanka Bašić

2003-01-01

Full Text Available An estimate of life quality is based upon medical, psychological and social indicators. It increasingly engages the attention of doctors of medicine, sociologists and psychologists.The aim of this research is to headlight some more relevant socio-cultural parametres in order to determine the quality of life of schoolchildren, that is, to determine whether the crisis in which our society has found itself has produced such socio-cultural conditions that could have induced changes in the children's quality of life and, if they have, to what extent the crisis has been reflected upon their health. The research has comprised 398 schoolchildren and their parents, three elementary schools from Nish and one in Sokobanja.The research of the socio-cultural and medical indicators of their quality of life has shown that the parent's education and ther material position have had an important influence upon the children's life quality.Since there has been no significant presence of any disease recorded in the observed children's sample, it can be concluded that the socio-cultural features have affected the children's life but they have not any significant impact upon their health.

An environmental scan of quality indicators in critical care.

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Valiani, Sabira; Rigal, Romain; Stelfox, Henry T; Muscedere, John; Martin, Claudio M; Dodek, Peter; Lamontagne, François; Fowler, Robert; Gheshmy, Afshan; Cook, Deborah J; Forster, Alan J; Hébert, Paul C

2017-06-21

We performed a directed environmental scan to identify and categorize quality indicators unique to critical care that are reported by key stakeholder organizations. We convened a panel of experts ( n = 9) to identify key organizations that are focused on quality improvement or critical care, and reviewed their online publications and website content for quality indicators. We identified quality indicators specific to the care of critically ill adult patients and then categorized them according to the Donabedian and the Institute of Medicine frameworks. We also noted the organizations' rationale for selecting these indicators and their reported evidence base. From 28 targeted organizations, we identified 222 quality indicators, 127 of which were unique. Of the 127 indicators, 63 (32.5%) were safety indicators and 61 (31.4%) were effectiveness indicators. The rationale for selecting quality indicators was supported by consensus for 58 (26.1%) of the 222 indicators and by published research evidence for 45 (20.3%); for 119 indicators (53.6%), the rationale was not reported or the reader was referred to other organizations' reports. Of the 127 unique quality indicators, 27 (21.2%) were accompanied by a formal grading of evidence, whereas for 52 (40.9%), no reference to evidence was provided. There are many quality indicators related to critical care that are available in the public domain. However, owing to a paucity of rationale for selection, supporting evidence and results of implementation, it is not clear which indicators should be adopted for use. Copyright 2017, Joule Inc. or its licensors.

Quality in the provision of headache care. 2: defining quality and its indicators.

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Peters, Michele; Jenkinson, Crispin; Perera, Suraj; Loder, Elizabeth; Jensen, Rigmor; Katsarava, Zaza; Gil Gouveia, Raquel; Broner, Susan; Steiner, Timothy

2012-08-01

The objective of this study was to define "quality" of headache care, and develop indicators that are applicable in different settings and cultures and to all types of headache. No definition of quality of headache care has been formulated. Two sets of quality indicators, proposed in the US and UK, are limited to their localities and/or specific to migraine and their development received no input from people with headache. We first undertook a literature review. Then we conducted a series of focus-group consultations with key stakeholders (doctors, nurses and patients) in headache care. From the findings we proposed a large number of putative quality indicators, and refined these and reduced their number in consultations with larger international groups of stakeholder representatives. We formulated a definition of quality from the quality indicators. Five main themes were identified: (1) headache services; (2) health professionals; (3) patients; (4) financial resources; (5) political agenda and legislation. An initial list of 160 putative quality indicators in 14 domains was reduced to 30 indicators in 9 domains. These gave rise to the following multidimensional definition of quality of headache care: "Good-quality headache care achieves accurate diagnosis and individualized management, has appropriate referral pathways, educates patients about their headaches and their management, is convenient and comfortable, satisfies patients, is efficient and equitable, assesses outcomes and is safe." Quality in headache care is multidimensional and resides in nine essential domains that are of equal importance. The indicators are currently being tested for feasibility of use in clinical settings.

Quality-of-care indicators for non-small cell lung cancer.

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Tanvetyanon, Tawee

2009-10-01

Quality-of-care indicators are measurable elements of practice performance that can be used to assess the quality or change in quality of the care provided. To date, the literature on quality-of-care indicators for non-small cell lung cancer (NSCLC) has not been reviewed. A search was performed to identify articles reporting on quality-of-care indicators specific for NSCLC published from January 2003 to May 2009 (using MEDLINE and American Society of Clinical Oncology abstract databases). Web sites of major quality care organizations were also searched. The identified indicators were then classified by their aspect of care provision (structure-of-care, process-of-care, or outcome-of-care indicator). For structure-of-care quality indicators, the most cited indicators were related to the quality of lung surgery. These included being National Cancer Institute-designated cancer centers or high-volume hospitals. For process-of-care quality indicators, the most common indicators were the receipt of surgery for early-stage NSCLC and the administration of chemotherapy for advanced-stage NSCLC. For outcome-of-care quality indicators, the most cited indicators were related to postoperative morbidity or mortality after lung surgery. Several quality-of-care indicators for NSCLC are available. Process-of-care indicators are the most studied. The use of these indicators to measure practice performance holds the promise of improving outcomes of patients with NSCLC.

Selecting clinical quality indicators for laboratory medicine.

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Barth, Julian H

2012-05-01

Quality in laboratory medicine is often described as doing the right test at the right time for the right person. Laboratory processes currently operate under the oversight of an accreditation body which gives confidence that the process is good. However, there are aspects of quality that are not measured by these processes. These are largely focused on ensuring that the most clinically appropriate test is performed and interpreted correctly. Clinical quality indicators were selected through a two-phase process. Firstly, a series of focus groups of clinical scientists were held with the aim of developing a list of quality indicators. These were subsequently ranked in order by an expert panel of primary and secondary care physicians. The 10 top indicators included the communication of critical results, comprehensive education to all users and adequate quality assurance for point-of-care testing. Laboratories should ensure their tests are used to national standards, that they have clinical utility, are calibrated to national standards and have long-term stability for chronic disease management. Laboratories should have error logs and demonstrate evidence of measures introduced to reduce chances of similar future errors. Laboratories should make a formal scientific evaluation of analytical quality. This paper describes the process of selection of quality indicators for laboratory medicine that have been validated sequentially by deliverers and users of the service. They now need to be converted into measureable variables related to outcome and validated in practice.

Evaluation of diet quality indicators in adults

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Katarína Fatrcová-Šramková

2013-11-01

Recommended Dietary Allowance levels, i.e. ³RDA. Blood samples from peripheral blood were taken after all-night starvation and then analyzed by using Reflotron (Roche Diagnostics GmbH, Mannheim, Germany. The data from nutritional intake and biochemical parameters were analyzed using t-test and chi-quadrat-test. The normal cholesterolaemia occured in 47% (thr first group Without risk, and 53% of the examined participants (the second group Risk were classified with risky cholesterol values (5 mmol.l-1 and more. Among the subjects with hypercholesterolaemia they had 27% higher values of triglycerides (1.9 mmol.l-1 and more, while in the rest of set there were only 14% characterized with hypertriacylglycerolaemia. The probands with the negative high cholesterol level in blood had significantly higher triacylglycerolaemia (P In case of Healthy Eating Index the most participants met the criterion only for one recommendation (41%, and fifth of volunteers fulfilled two recommendation altogether. Taking into account all parameters the probands met cholesterol in diet (56% best, less saturated fat (35%, total fat (24%, and at least sodium intake (9%. Within Healthy Diet Indicator there were recorded fulfillments: for cholesterol in 56%, for saturated fatty acids in 35%, for protein in 32%, for fiber in 22%, and for polyunsaturated fatty acids in 17%. From five criteria there was met only one recommendation of 36% of subjects, 17% achieved two fulfillments, and other 17% three ones. Evaluation of Diet Quality Index recorded that the following order of recommendation fulfillment was obtained: cholesterol (56 % > calcium (44 % > saturated fat (35 % > total fat (24 % > natrium (9 %. Only one fulfillment reached 37 %, two recommendations met 27 %, and three 14 %. From all three considered indicators the recommendation for cholesterol intake was met most (by 56% probands, worst for total fat (24%, fiber (22%, polyunsaturated fat (17%, and  natrium (9%. In conclusion, this study

Adjustment of nursing home quality indicators

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Hirdes John P

2010-04-01

Full Text Available Abstract Background This manuscript describes a method for adjustment of nursing home quality indicators (QIs defined using the Center for Medicaid & Medicare Services (CMS nursing home resident assessment system, the Minimum Data Set (MDS. QIs are intended to characterize quality of care delivered in a facility. Threats to the validity of the measurement of presumed quality of care include baseline resident health and functional status, pattern of comorbidities, and facility case mix. The goal of obtaining a valid facility-level estimate of true quality of care should include adjustment for resident- and facility-level sources of variability. Methods We present a practical and efficient method to achieve risk adjustment using restriction and indirect and direct standardization. We present information on validity by comparing QIs estimated with the new algorithm to one currently used by CMS. Results More than half of the new QIs achieved a "Moderate" validation level. Conclusions Given the comprehensive approach and the positive findings to date, research using the new quality indicators is warranted to provide further evidence of their validity and utility and to encourage their use in quality improvement activities.

Urbanization, housing and environmental quality indicators ...

African Journals Online (AJOL)

Urbanization, housing and environmental quality indicators. ... Journal of Agriculture, Forestry and the Social Sciences ... Urbanization ideally should also imply an enhancement of housing quality and other components of human settlements such as power supply, portable water, good roads, proper refuse and sewage ...

Comparing Effects of Forestland conversion to Tea Farming on Soil Quality Indices

Science.gov (United States)

Gholoubi, A.; Emami, H.; Alizadeh, A.; Jones, S. B.

2017-12-01

The effect of land use type on soil function within an ecosystem can be assessed and monitored using soil quality indices. The research examined effects of land use change from natural forest to tea farming (with the same physiography and parent materials) on soil properties in different regions of the Guilan province, northern Iran. Two universally-accepted methods of soil quality evaluation were used to understand soil conditions in these two land uses. Thirty-six soil samples (0 -30 cm) were randomly collected from six sites with 3 replications. The soil quality of forestland and tea farms was determined using the cumulative rating (CR) index and the Cornell Comprehensive Assessment of Soil Health (CASH) scoring functions. Effects of Land use change on soil quality or health were significant (P tea farm soils. forestland use affected most soil properties and thus their scores in both evaluation methods. Soil organic carbon and pH were the most important indicators reduced by land use change at all locations. There were significant correlations between these indicators and other soil chemical, physical and biological factors affected by changing forestland use.

Evaluating quality indicators for patients with community-acquired pneumonia.

Science.gov (United States)

Rhew, D C; Goetz, M B; Shekelle, P G

2001-11-01

Several organizations have published evidence-based quality indicators for community-acquired pneumonia (CAP). However, there is variability in the types of indicators presented between organizations and the level of supporting evidence for each of the indicators. A systematic review of the literature and relevant Internet Web sites was performed to identify quality indicators for CAP that have been proposed or recommended by organizations, and each of the indicators was then critically appraised, using a well-defined set of criteria. The MEDLINE, EMBASE, Best Evidence, and Cochrane Systematic Review databases and Internet Web sites were searched for articles and guidelines published between January 1980 and May 2001 to identify quality indicators for CAP and relevant evidence. Experts in the area of health services research were contacted to identify additional sources. A well-defined set of criteria was applied to evaluate each of the quality indicators. The systematic review of the literature and Internet Web sites yielded 44 CAP-specific quality indicators. The critical appraisal of these indicators yielded 16 indicators that were supported by a study that identified an association between quality of care and the process of care or outcome measure, were applied to enough patients to be able to detect clinically meaningful differences, were clinically and/or economically relevant, were measurable in a clinical practice setting, and were precise in their specifications. Many organizations recommend indicators for CAP. Indicators may serve as measures of clinical performance for clinicians and hospitals, may help in benchmarking, and may ultimately facilitate improvements in quality of care and cost reductions. However, CAP indicators often vary in their meaningfulness, scientific soundness, and interpretability of results. A set of five critical appraisal questions may assist in the evaluation of which quality indicators are most valid.

Biological indices for classification of water quality around Mae Moh power plant, Thailand

Directory of Open Access Journals (Sweden)

Pongsarun Junshum and Siripen Traichaiyaporn

2007-12-01

Full Text Available The algal communities and water quality were monitored at eight sampling sites around Mae Moh power plant during January-December 2003. Three biological indices, viz. algal genus pollution index, saprobic index, and Shannon-Weaver index, were adopted to classify the water quality around the power plant in comparison with the measured physico-chemical water quality. The result shows that the Shannon-Weaver diversity index appears to be much more applicable and interpretable for the classification of water quality around the Mae Moh power plant than the algal genus pollution index and the saprobic index.

Extending cluster lot quality assurance sampling designs for surveillance programs.

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Hund, Lauren; Pagano, Marcello

2014-07-20

Lot quality assurance sampling (LQAS) has a long history of applications in industrial quality control. LQAS is frequently used for rapid surveillance in global health settings, with areas classified as poor or acceptable performance on the basis of the binary classification of an indicator. Historically, LQAS surveys have relied on simple random samples from the population; however, implementing two-stage cluster designs for surveillance sampling is often more cost-effective than simple random sampling. By applying survey sampling results to the binary classification procedure, we develop a simple and flexible nonparametric procedure to incorporate clustering effects into the LQAS sample design to appropriately inflate the sample size, accommodating finite numbers of clusters in the population when relevant. We use this framework to then discuss principled selection of survey design parameters in longitudinal surveillance programs. We apply this framework to design surveys to detect rises in malnutrition prevalence in nutrition surveillance programs in Kenya and South Sudan, accounting for clustering within villages. By combining historical information with data from previous surveys, we design surveys to detect spikes in the childhood malnutrition rate. Copyright © 2014 John Wiley & Sons, Ltd.

A cluster-randomised quality improvement study to improve two inpatient stroke quality indicators.

Science.gov (United States)

Williams, Linda; Daggett, Virginia; Slaven, James E; Yu, Zhangsheng; Sager, Danielle; Myers, Jennifer; Plue, Laurie; Woodward-Hagg, Heather; Damush, Teresa M

2016-04-01

Quality indicator collection and feedback improves stroke care. We sought to determine whether quality improvement training plus indicator feedback was more effective than indicator feedback alone in improving inpatient stroke indicators. We conducted a cluster-randomised quality improvement trial, randomising hospitals to quality improvement training plus indicator feedback versus indicator feedback alone to improve deep vein thrombosis (DVT) prophylaxis and dysphagia screening. Intervention sites received collaborative-based quality improvement training, external facilitation and indicator feedback. Control sites received only indicator feedback. We compared indicators pre-implementation (pre-I) to active implementation (active-I) and post-implementation (post-I) periods. We constructed mixed-effect logistic models of the two indicators with a random intercept for hospital effect, adjusting for patient, time, intervention and hospital variables. Patients at intervention sites (1147 admissions), had similar race, gender and National Institutes of Health Stroke Scale scores to control sites (1017 admissions). DVT prophylaxis improved more in intervention sites during active-I period (ratio of ORs 4.90, pimproved similarly in both groups during active-I, but control sites improved more in post-I period (ratio of ORs 0.67, p=0.04). In logistic models, the intervention was independently positively associated with DVT performance during active-I period, and negatively associated with dysphagia performance post-I period. Quality improvement training was associated with early DVT improvement, but the effect was not sustained over time and was not seen with dysphagia screening. External quality improvement programmes may quickly boost performance but their effect may vary by indicator and may not sustain over time. 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/

Hanford Sampling Quality Management Plan (HSQMP)

International Nuclear Information System (INIS)

Hyatt, J.E.

1995-06-01

HSQMP establishes quality requirements in response to DOE Order 5700. 6C and to 10 Code of Federal Regulations 830.120. HSQMP is designed to meet the needs of Richland Operations Office for controlling the quality of services provided by sampling operations. It is issued through the Analytical Services Program of the Waste Programs Division. This document describes the Environmental Sampling and Analysis Program activities considered to represent the best management activities necessary to achieve a sampling program with adequate control

interRAI home care quality indicators

NARCIS (Netherlands)

Morris, J.N.; Fries, B.E.; Frijters, D.H.M.; Hirdes, J.P.; Steel, R.K.

2013-01-01

Background: This paper describe the development of interRAI's second-generation home care quality indicators (HC-QIs). They are derived from two of interRAI's widely used community assessments: the Community Health Assessment and the Home Care Assessment. In this work the form in which the quality

Evaluation of headache service quality indicators

DEFF Research Database (Denmark)

Katsarava, Zaza; Gouveia, Raquel Gil; Jensen, Rigmor

2015-01-01

that deficiencies in headache care worldwide might be recognized and rectified. These indicators themselves require evaluation and proof of fitness for purpose. This pilot study begins this process. METHODS: We tested the quality indicators in the tertiary headache centres of the University of Duisburg...... of ensuring equal access to the services); and over protocols for reporting serious adverse events. CONCLUSION: This pilot study to assess feasibility of the methods and acceptability of the instruments of headache service quality evaluation was successful. The project is ready to be taken into its next...

Water quality of hydrologic bench marks; an indicator of water quality in the natural environment

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Biesecker, James E.; Leifeste, Donald K.

1974-01-01

Water-quality data, collected at 57 hydrologic bench-mark stations in 37 States, allow the definition of water quality in the 'natural' environment and the comparison of 'natural' water quality with water quality of major streams draining similar water-resources regions. Results indicate that water quality in the 'natural' environment is generally very good. Streams draining hydrologic bench-mark basins generally contain low concentrations of dissolved constituents. Water collected at the hydrologic bench-mark stations was analyzed for the following minor metals: arsenic, barium, cadmium, hexavalent chromium, cobalt, copper, lead, mercury, selenium, silver, and zinc. Of 642 analyses, about 65 percent of the observed concentrations were zero. Only three samples contained metals in excess of U.S. Public Health Service recommended drinking-water standards--two selenium concentrations and one cadmium concentration. A total of 213 samples were analyzed for 11 pesticidal compounds. Widespread but very low-level occurrence of pesticide residues in the 'natural' environment was found--about 30 percent of all samples contained low-level concentrations of pesticidal compounds. The DDT family of pesticides occurred most commonly, accounting for 75 percent of the detected occurrences. The highest observed concentration of DDT was 0.06 microgram per litre, well below the recommended maximum permissible in drinking water. Nitrate concentrations in the 'natural' environment generally varied from 0.2 to 0.5 milligram per litre. The average concentration of nitrate in many major streams is as much as 10 times greater. The relationship between dissolved-solids concentration and discharge per unit area in the 'natural' environment for the various physical divisions in the United States has been shown to be an applicable tool for approximating 'natural' water quality. The relationship between dissolved-solids concentration and discharge per unit area is applicable in all the physical

Effects of sparse sampling schemes on image quality in low-dose CT

International Nuclear Information System (INIS)

Abbas, Sajid; Lee, Taewon; Cho, Seungryong; Shin, Sukyoung; Lee, Rena

2013-01-01

Purpose: Various scanning methods and image reconstruction algorithms are actively investigated for low-dose computed tomography (CT) that can potentially reduce a health-risk related to radiation dose. Particularly, compressive-sensing (CS) based algorithms have been successfully developed for reconstructing images from sparsely sampled data. Although these algorithms have shown promises in low-dose CT, it has not been studied how sparse sampling schemes affect image quality in CS-based image reconstruction. In this work, the authors present several sparse-sampling schemes for low-dose CT, quantitatively analyze their data property, and compare effects of the sampling schemes on the image quality.Methods: Data properties of several sampling schemes are analyzed with respect to the CS-based image reconstruction using two measures: sampling density and data incoherence. The authors present five different sparse sampling schemes, and simulated those schemes to achieve a targeted dose reduction. Dose reduction factors of about 75% and 87.5%, compared to a conventional scan, were tested. A fully sampled circular cone-beam CT data set was used as a reference, and sparse sampling has been realized numerically based on the CBCT data.Results: It is found that both sampling density and data incoherence affect the image quality in the CS-based reconstruction. Among the sampling schemes the authors investigated, the sparse-view, many-view undersampling (MVUS)-fine, and MVUS-moving cases have shown promising results. These sampling schemes produced images with similar image quality compared to the reference image and their structure similarity index values were higher than 0.92 in the mouse head scan with 75% dose reduction.Conclusions: The authors found that in CS-based image reconstructions both sampling density and data incoherence affect the image quality, and suggest that a sampling scheme should be devised and optimized by use of these indicators. With this strategic

Statistical analysis of the influence of wheat black point kernels on selected indicators of wheat flour quality

Directory of Open Access Journals (Sweden)

Petrov Verica D.

2011-01-01

Full Text Available The influence of wheat black point kernels on selected indicators of wheat flour quality - farinograph and extensograph indicators, amylolytic activity, wet gluten and flour ash content, were examined in this study. The examinations were conducted on samples of wheat harvested in the years 2007 and 2008 from the area of Central Banat in four treatments-control (without black point flour and with 2, 4 and 10% of black point flour which was added as a replacement for a part of the control sample. Statistically significant differences between treatments were observed on the dough stability, falling number and extensibility. The samples with 10% of black point flour had the lowest dough stability and the highest amylolytic activity and extensibility. There was a trend of the increasing 15 min drop and water absorption with the increased share of black point flour. Extensograph area, resistance and ratio resistance to extensibility decreased with the addition of black point flour, but not properly. Mahalanobis distance indicates that the addition of 10% black point flour had the greatest influence on the observed quality indicators, thus proving that black point contributes to the technological quality of wheat, i.e .flour.

Macroinvetebrate Assemblages as Indicators of Water Quality of the West Seti River, Bajhang, Nepal

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Mohana Matangulu

2017-08-01

Full Text Available Water quality of the West Seti River, a tributary of the Karnali in West Nepal was assessed using macroinvertebrates as bioindicators. The main objective of the study was to assess the ecological water quality of the West Seti River and to generate a baseline data on macroinvertebrate assemblages. The sampling was conducted during December 2015 and a total of 11 sampling sites were selected from the West Seti River and its tributaries. Qualitative samples of macroinvertebrates were collected from different habitats. Selected physico-chemical parameters such as pH and temperature were estimated on-site. Dissolved oxygen (DO was estimated by Winkler’s method. The macroinvertebrate samples were enumerated and identified up to Family level following standard literature. Chi-square test was performed to see whether macroinvertebrate taxa varied significantly along the altitudinal gradient and between the West Seti River and its tributaries. An ecological assessment tool Nepalese Biotic Score/ Average Score Per Taxon (NEPBIOS/ASPT was applied to assess the water quality of the sampling sites. The pH value ranged from 7.9 to 8.7 indicating the alkaline nature of the river. A total of 1666 individuals belonging to 34 Families and 7 Orders of macro-invertebrates were observed. The highest diversity of the macroinvertebrate taxa was observed at site T5 with nineteen Families whereas the lowest taxa diversity was observed at R3 with only five Families. The variation in macroinvertebrate assemblages between the sub-tropical and temperate zones; and the West Seti River and its tributaries were not significant. NEPBIOS/ASPT revealed a score of Water Quality Class of III-IV at Site R3 indicating that the site was polluted. This site was characterized by the abundance of red Chironomids which are considered as the indicators of organic pollution.International Journal of EnvironmentVolume-6, Issue-3, Jun-Aug 2017, page: 25-45

Quality improvement of interdisciplinary rounds by leadership training based on essential quality indicators of the Interdisciplinary Rounds Assessment Scale.

Science.gov (United States)

Ten Have, Elsbeth C M; Nap, Raoul E; Tulleken, Jaap E

2013-10-01

The implementation of interdisciplinary teams in the intensive care unit (ICU) has focused attention on leadership behavior. Daily interdisciplinary rounds (IDRs) in ICUs integrate leadership behavior and interdisciplinary teamwork. The purpose of this intervention study was to measure the effect of leadership training on the quality of IDRs in the ICU. A nonrandomized intervention study was conducted in four ICUs for adults. The intervention was a 1-day training session in a simulation environment and workplace-based feedback sessions. Measurement included 28 videotaped IDRs (total, 297 patient presentations) that were assessed with 10 essential quality indicators of the validated IDR Assessment Scale. Participants were 19 intensivists who previously had no formal training in leading IDRs. They were subdivided by cluster sampling into a control group (ten experienced intensivists) and intervention group (nine intensive care fellows). Mann-Whitney U test was used to compare results between control and intervention groups. Baseline measurements of control and intervention groups revealed two indicators that differed significantly. The frequency of yes ratings for the intervention group significantly increased for seven of the ten indicators from before to after intervention. The frequency of yes ratings after training was significantly greater in the intervention than control groups for eight of the ten essential quality indicators. The leadership training improved the quality of the IDRs performed in the ICUs. This may improve quality and safety of patient care.

Hanford Sampling Quality Management Plan (HSQMP)

International Nuclear Information System (INIS)

Hyatt, J.E.

1995-01-01

This document provides a management tool for evaluating and designing the appropriate elements of a field sampling program. This document provides discussion of the elements of a program and is to be used as a guidance document during the preparation of project and/or function specific documentation. This document does not specify how a sampling program shall be organized. The HSQMP is to be used as a companion document to the Hanford Analytical Services Quality Assurance Plan (HASQAP) DOE/RL-94-55. The generation of this document was enhanced by conducting baseline evaluations of current sampling organizations. Valuable input was received from members of field and Quality Assurance organizations. The HSQMP is expected to be a living document. Revisions will be made as regulations and or Hanford Site conditions warrant changes in the best management practices. Appendices included are: summary of the sampling and analysis work flow process, a user's guide to the Data Quality Objective process, and a self-assessment checklist

Classifying indicators of quality: a collaboration between Dutch and English regulators.

Science.gov (United States)

Mears, Alex; Vesseur, Jan; Hamblin, Richard; Long, Paul; Den Ouden, Lya

2011-12-01

Many approaches to measuring quality in healthcare exist, generally employing indicators or metrics. While there are important differences, most of these approaches share three key areas of measurement: safety, effectiveness and patient experience. The European Partnership for Supervisory Organisations in Health Services and Social Care (EPSO) exists as a working group and discussion forum for European regulators. This group undertook to identify a common framework within which European approaches to indicators could be compared. A framework was developed to classify indicators, using four sets of criteria: conceptualization of quality, Donabedian definition (structure, process, outcome), data type (derivable, collectable from routine sources, special collections, samples) and data use (judgement (singular or part of framework) benchmarking, risk assessment). Indicators from English and Dutch hospital measurement programmes were put into the framework, showing areas of agreement and levels of comparability. In the first instance, results are only illustrative. The EPSO has been a powerful driver for undertaking cross-European research, and this project is the first of many to take advantage of the access to international expertize. It has shown that through development of a framework that deconstructs national indicators, commonalities can be identified. Future work will attempt to incorporate other nations' indicators, and attempt cross-national comparison.

Key Performance Indicators of Public Universities Based on Quality Assessment Criteria in Thailand

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Sukboonyasatit, Kritsana; Thanapaisarn, Chaiwit; Manmar, Lampang

2011-01-01

The research objective was to develop public universities' key performance indicators. Qualitative research and interviews were employed with each public university's senior executive and quality assessors. The sample group was selected by the office of the public sector development commission and Thailand's public universities can be separated…

Key interventions and quality indicators for quality improvement of STEMI care: a RAND Delphi survey.

Science.gov (United States)

Aeyels, Daan; Sinnaeve, Peter R; Claeys, Marc J; Gevaert, Sofie; Schoors, Danny; Sermeus, Walter; Panella, Massimiliano; Coeckelberghs, Ellen; Bruyneel, Luk; Vanhaecht, Kris

2017-12-13

Identification, selection and validation of key interventions and quality indicators for improvement of in hospital quality of care for ST-elevated myocardial infarction (STEMI) patients. A structured literature review was followed by a RAND Delphi Survey. A purposively selected multidisciplinary expert panel of cardiologists, nurse managers and quality managers selected and validated key interventions and quality indicators prior for quality improvement for STEMI. First, 34 experts (76% response rate) individually assessed the appropriateness of items to quality improvement on a nine point Likert scale. Twenty-seven key interventions, 16 quality indicators at patient level and 27 quality indicators at STEMI care programme level were selected. Eighteen additional items were suggested. Experts received personal feedback, benchmarking their score with group results (response rate, mean, median and content validity index). Consequently, 32 experts (71% response rate) openly discussed items with an item-content validity index above 75%. By consensus, the expert panel validated a final set of 25 key interventions, 13 quality indicators at patient level and 20 quality indicators at care programme level prior for improvement of in hospital care for STEMI. A structured literature review and multidisciplinary expertise was combined to validate a set of key interventions and quality indicators prior for improvement of care for STEMI. The results allow researchers and hospital staff to evaluate and support quality improvement interventions in a large cohort within the context of a health care system.

Study on a pattern classification method of soil quality based on simplified learning sample dataset

Science.gov (United States)

Zhang, Jiahua; Liu, S.; Hu, Y.; Tian, Y.

2011-01-01

Based on the massive soil information in current soil quality grade evaluation, this paper constructed an intelligent classification approach of soil quality grade depending on classical sampling techniques and disordered multiclassification Logistic regression model. As a case study to determine the learning sample capacity under certain confidence level and estimation accuracy, and use c-means algorithm to automatically extract the simplified learning sample dataset from the cultivated soil quality grade evaluation database for the study area, Long chuan county in Guangdong province, a disordered Logistic classifier model was then built and the calculation analysis steps of soil quality grade intelligent classification were given. The result indicated that the soil quality grade can be effectively learned and predicted by the extracted simplified dataset through this method, which changed the traditional method for soil quality grade evaluation. ?? 2011 IEEE.

Air quality as respiratory health indicator: a critical review.

Science.gov (United States)

Moshammer, Hanns; Wallner, Peter

2011-09-01

As part of the European Public Health project IMCA II validity and practicability of "air pollution" as a respiratory health indicator were analyzed. The definitions of air quality as an indicator proposed by the WHO project ECOEHIS and by IMCA I were compared. The public availability of the necessary data was checked through access to web-based data-bases. Practicability and interpretation of the indicator were discussed with project partners and external experts. Air quality serves as a kind of benchmark for the good health-related environmental policy. In this sense, it is a relevant health indicator. Although air quality is not directly in the responsibility of health policy, its vital importance for the population's health should not be neglected. In principle, data is available to calculate this IMCA indicator for any chosen area in Europe. The indicator is relevant and informative, but calculation and interpretation need input from local expert knowledge. The European health policy is well advised to take air quality into account. To that end, an interdisciplinary approach is warranted. The proposed definition of air quality as a (respiratory) health indicator is workable, but correct interpretation depends on expert and local knowledge.

Evaluating how variants of floristic quality assessment indicate wetland condition.

Science.gov (United States)

Kutcher, Thomas E; Forrester, Graham E

2018-03-28

Biological indicators are useful tools for the assessment of ecosystem condition. Multi-metric and multi-taxa indicators may respond to a broader range of disturbances than simpler indicators, but their complexity can make them difficult to interpret, which is critical to indicator utility for ecosystem management. Floristic Quality Assessment (FQA) is an example of a biological assessment approach that has been widely tested for indicating freshwater wetland condition, but less attention has been given to clarifying the factors controlling its response. FQA quantifies the aggregate of vascular plant species tolerance to habitat degradation (conservatism), and model variants have incorporated species richness, abundance, and indigenity (native or non-native). To assess bias, we tested FQA variants in open-canopy freshwater wetlands against three independent reference measures, using practical vegetation sampling methods. FQA variants incorporating species richness did not correlate with our reference measures and were influenced by wetland size and hydrogeomorphic class. In contrast, FQA variants lacking measures of species richness responded linearly to reference measures quantifying individual and aggregate stresses, suggesting a broad response to cumulative degradation. FQA variants incorporating non-native species, and a variant additionally incorporating relative species abundance, improved performance over using only native species. We relate our empirical findings to ecological theory to clarify the functional properties and implications of the FQA variants. Our analysis indicates that (1) aggregate conservatism reliably declines with increased disturbance; (2) species richness has varying relationships with disturbance and increases with site area, confounding FQA response; and (3) non-native species signal human disturbance. We propose that incorporating species abundance can improve FQA site-level relevance with little extra sampling effort. Using our

The effect of clustering on lot quality assurance sampling: a probabilistic model to calculate sample sizes for quality assessments.

Science.gov (United States)

Hedt-Gauthier, Bethany L; Mitsunaga, Tisha; Hund, Lauren; Olives, Casey; Pagano, Marcello

2013-10-26

Traditional Lot Quality Assurance Sampling (LQAS) designs assume observations are collected using simple random sampling. Alternatively, randomly sampling clusters of observations and then individuals within clusters reduces costs but decreases the precision of the classifications. In this paper, we develop a general framework for designing the cluster(C)-LQAS system and illustrate the method with the design of data quality assessments for the community health worker program in Rwanda. To determine sample size and decision rules for C-LQAS, we use the beta-binomial distribution to account for inflated risk of errors introduced by sampling clusters at the first stage. We present general theory and code for sample size calculations.The C-LQAS sample sizes provided in this paper constrain misclassification risks below user-specified limits. Multiple C-LQAS systems meet the specified risk requirements, but numerous considerations, including per-cluster versus per-individual sampling costs, help identify optimal systems for distinct applications. We show the utility of C-LQAS for data quality assessments, but the method generalizes to numerous applications. This paper provides the necessary technical detail and supplemental code to support the design of C-LQAS for specific programs.

Measurement of Health Care Quality in Atopic Dermatitis - Development and Application of a Set of Quality Indicators.

Science.gov (United States)

Steinke, S; Beikert, F C; Langenbruch, A; Fölster-Holst, R; Ring, J; Schmitt, J; Werfel, T; Hintzen, S; Franzke, N; Augustin, M

2018-05-15

Quality indicators are essential tools for the assessment of health care, in particular for guideline-based procedures. 1) Development of a set of indicators for the evaluation of process and outcomes quality in atopic dermatitis (AD) care. 2) Application of the indicators to a cross-sectional study and creation of a global process quality index. An expert committee consisting of 10 members of the German guideline group on atopic dermatitis condensed potential quality indicators to a final set of 5 outcomes quality and 12 process quality indicators using a Delphi panel. The outcomes quality and 7 resp. 8 process quality indicators were retrospectively applied to a nationwide study on 1,678 patients with atopic dermatitis (AtopicHealth). Each individual process quality indicator score was then summed up to a global index (ranges from 0 (no quality achieved) to 100 (full quality achieved)) displaying the quality of health care. In total, the global process quality index revealed a median value of 62.5 and did not or only slightly correlate to outcome indicators as the median SCORAD (SCORing Atopic Dermatitis; rp =0.08), Dermatology Life Quality Index (DLQI; rp = 0.256), and Patient Benefit Index (PBI; rp = -0.151). Process quality of AD care is moderate to good. The health care process quality index does not substantially correlate to the health status of AD patients measured by 5 different outcomes quality indicators. Further research should include the investigation of reliability, responsiveness, and feasibility of the proposed quality indicators for AD. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Effects of Grazing and Fire Frequency on Floristic Quality and its Relationship to Indicators of Soil Quality in Tallgrass Prairie.

Science.gov (United States)

Manning, George C; Baer, Sara G; Blair, John M

2017-12-01

Fire and grazing are widely used to manage grasslands for conservation purposes, but few studies have evaluated the effects of these drivers on the conservation value of plant communities measured by the floristic quality index (FQI). Further, the influence of fire and grazing on soil properties and functions are difficult for land managers and restoration practitioners to assess. The objectives of this study were to: (1) quantify the independent and interactive effects of grazing and fire frequency on floristic quality in native tallgrass prairie to provide potential benchmarks for community assessment, and (2) to explore whether floristic quality can serve as an indicator of soil structure and function for more holistic ecosystem assessments. A factorial combination of fire frequencies (1-2, 4, and 20 years return intervals) and grazing (by bison or ungrazed) treatments were sampled for plant species composition, and for several indicators of soil quality in lowland tallgrass prairie. Floristic quality, diversity, and richness were higher in grazed than ungrazed prairie over all fire frequencies (P soil bulk density were also higher in grazed prairie soil over all fire frequencies (P soil N were positively correlated with FQI (P soil N pools are more strongly influenced by grazing than fire and that floristic quality can be an indicator of total soil C and N stocks in never cultivated lowland prairie.

A set of care quality indicators for stroke management.

Science.gov (United States)

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.

Formalising medical quality indicators to improve guidelines

NARCIS (Netherlands)

Van Gendt, Marjolein; Ten Teije, Annette; Serban, Radu; Van Harmelen, Frank

2005-01-01

Medical guidelines can significantly improve quality of medical care and reduce costs. But how do we get sound and well-structured guidelines? This paper investigates the use of quality indicators that are formulated by medical institutions to evaluate medical care. The main research questions are

A first-approximation urban-air-quality indicator

Science.gov (United States)

David M. Paproski; Julian R. Walker

1977-01-01

Development of the first-approximation-urban-air-quality indicator was reported by the Economic Council of Canada. The indicator takes account of ambient concentrations of five pollutants: sulfur dioxide, particulate matter, oxides of nitrogen, carbon monoxide, and total oxidants. Epidemiological evidence indicating the potential impact of these pollutants on human...

Assessing soil quality indicator under different land use and soil erosion using multivariate statistical techniques.

Science.gov (United States)

Nosrati, Kazem

2013-04-01

Soil degradation associated with soil erosion and land use is a critical problem in Iran and there is little or insufficient scientific information in assessing soil quality indicator. In this study, factor analysis (FA) and discriminant analysis (DA) were used to identify the most sensitive indicators of soil quality for evaluating land use and soil erosion within the Hiv catchment in Iran and subsequently compare soil quality assessment using expert opinion based on soil surface factors (SSF) form of Bureau of Land Management (BLM) method. Therefore, 19 soil physical, chemical, and biochemical properties were measured from 56 different sampling sites covering three land use/soil erosion categories (rangeland/surface erosion, orchard/surface erosion, and rangeland/stream bank erosion). FA identified four factors that explained for 82 % of the variation in soil properties. Three factors showed significant differences among the three land use/soil erosion categories. The results indicated that based upon backward-mode DA, dehydrogenase, silt, and manganese allowed more than 80 % of the samples to be correctly assigned to their land use and erosional status. Canonical scores of discriminant functions were significantly correlated to the six soil surface indices derived of BLM method. Stepwise linear regression revealed that soil surface indices: soil movement, surface litter, pedestalling, and sum of SSF were also positively related to the dehydrogenase and silt. This suggests that dehydrogenase and silt are most sensitive to land use and soil erosion.

Indicators for Research Performance in the Humanities? The Scholars’ View on Research Quality and Indicators

Energy Technology Data Exchange (ETDEWEB)

Ochsner, M.; Hug, S.E.

2016-07-01

In this paper, we present indicators for research quality in the humanities collected in our previous work (Ochsner, Hug, & Daniel, 2012). We focus on how these indicators are accepted by humanities scholars. We also investigate differences between different subgroups of the humanities scholars we surveyed with regard to their preferences for such indicators. We address the theme of the conference (‘peripheries frontiers and beyond’) regarding two notions of (scientometric) periphery: First, we investigate indicators for research quality in the humanities, a field where there is a lack on knowledge on how to assess or even measure research quality, in fact, there is a quite broad consensus that (evaluative) bibliometrics cannot be readily applied in the humanities (Hicks, 2004; Nederhof, 2006). Second, we fully cover three humanities disciplines at Swiss universities and member universities of the League of European Research Universities (LERU). Scholars are a neglected stakeholder when it comes to the design of research assessment procedures or the selection of research indicators. However, they are directly affected, they know best what research quality in their field is and what impact the use of certain indicators could have on their research practices. The paper is structured as follows: first, we present the background for selecting indicators for research quality. This is followed by a description of our analysis methods and the presentation of the results. We finally discuss the results with regard to their use in research evaluation. (Author)

Effects of Grazing and Fire Frequency on Floristic Quality and its Relationship to Indicators of Soil Quality in Tallgrass Prairie

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Manning, George C.; Baer, Sara G.; Blair, John M.

2017-12-01

Fire and grazing are widely used to manage grasslands for conservation purposes, but few studies have evaluated the effects of these drivers on the conservation value of plant communities measured by the floristic quality index (FQI). Further, the influence of fire and grazing on soil properties and functions are difficult for land managers and restoration practitioners to assess. The objectives of this study were to: (1) quantify the independent and interactive effects of grazing and fire frequency on floristic quality in native tallgrass prairie to provide potential benchmarks for community assessment, and (2) to explore whether floristic quality can serve as an indicator of soil structure and function for more holistic ecosystem assessments. A factorial combination of fire frequencies (1-2, 4, and 20 years return intervals) and grazing (by bison or ungrazed) treatments were sampled for plant species composition, and for several indicators of soil quality in lowland tallgrass prairie. Floristic quality, diversity, and richness were higher in grazed than ungrazed prairie over all fire frequencies ( P total N, and soil bulk density were also higher in grazed prairie soil over all fire frequencies ( P total organic C, and total soil N were positively correlated with FQI ( P quality and soil N pools are more strongly influenced by grazing than fire and that floristic quality can be an indicator of total soil C and N stocks in never cultivated lowland prairie.

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

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

2017-03-01

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

Evaluation of drinking water quality indices (case study: Bushehr province, Iran

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Nematollah Jafarzadeh

2017-05-01

Full Text Available Background: Internal corrosion and the formation of scale in water distribution pipes are the most important problems for an urban water distribution system. Physical, chemical, or biological factors can lead to these two processes. Internal corrosion and scale formation can impact health, economy, and aesthetics. This study assessed the physicochemical quality parameters and evaluated the potential for corrosion and scale formation in drinking water at the distribution systems of 5 selected cities in Bushehr province (Kangan, Dashtestan, Dashti, Bushehr, and Ganaveh from 2009-2012. Methods: This study was carried out based on laboratory data collected from monthly samplings of tap water in the Water and Wastewater Company of Bushehr province during the years 2009-2012. Internal corrosion and scale formation rates were calculated using the Ryznar, Langelier, Aggressive, and Puckorius indices. Results: The results of the Ryznar, Puckorius, Aggressive and Langelier indices indicated that the drinking water in the 5 selected cities of Bushehr province was corrosive. Moreover, the majority of parameters used to determine water quality exceeded Iran’s national standards. Conclusion: It is concluded that there is problem of water corrosion and scaling in drinking water of distribution systems in selected cities.

Perceived Residential Environment Quality Indicators and neighborhood attachment: A confirmation study on a Chinese sample in Chongqing.

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Mao, Yanhui; Fornara, Ferdinando; Manca, Sara; Bonnes, Mirilia; Bonaiuto, Marino

2015-09-01

This paper concerns people's assessment of their neighborhood of residence in a Chinese urban context. The aim of the study was to verify the factorial structure and the reliability of two instruments originally developed and validated in Italy (the full versions of the Perceived Residential Environment Quality Indicators [PREQIs] and of the Neighborhood Attachment Scale [NAS]) in a different cultural and linguistic context. The instruments consist of 11 scales measuring the PREQIs and one scale measuring neighborhood attachment (NA). The PREQIs scales include items covering four macroevaluative domains of residential environment quality: architectural and urban planning aspects (three scales: Architectural and Town-planning Space, Organization of Accessibility and Roads, Green Areas), sociorelational aspects (one scale: People and Social Relations), functional aspects (four scales: Welfare Services, Recreational Services, Commercial Services, and Transport Services), and contextual aspects (three scales: Pace of Life, Environmental Health, Upkeep and Care). The PREQIs and NAS were included in a self-report questionnaire, which had been translated and back-translated from English to Chinese, and was then administered to 340 residents in six districts (differing along various features) of a highly urbanized context in China, the city of Chongqing. Results confirmed the factorial structure of the scales and demonstrated good internal consistency of the indicators, thus reaffirming the results of previous studies carried out in Western urban contexts. The indicators tapping the neighborhood's contextual aspects (i.e., pace of life, environmental health, and upkeep) emerged as most correlated to NA. © 2015 The Institute of Psychology, Chinese Academy of Sciences and Wiley Publishing Asia Pty Ltd.

[Quality Indicators of Primary Health Care Facilities in Austria].

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Semlitsch, Thomas; Abuzahra, Muna; Stigler, Florian; Jeitler, Klaus; Posch, Nicole; Siebenhofer, Andrea

2017-07-11

Background The strengthening of primary health care is one major goal of the current national health reform in Austria. In this context, a new interdisciplinary concept was developed in 2014 that defines structures and requirements for future primary health care facilities. Objective The aim of this project was the development of quality indicators for the evaluation of the scheduled primary health care facilities in Austria, which are in accordance with the new Austrian concept. Methods We used the RAND/NPCRDC method for the development and selection of the quality indicators. We conducted systematic literature searches for existing measures in international databases for quality indicators as well as in bibliographic databases. All retrieved measures were evaluated and rated by an expert panel in a 2-step process regarding relevance and feasibility. Results Overall, the literature searches yielded 281 potentially relevant quality indicators, which were summarized to 65 different quality measures for primary health care. Out of these, the panel rated and accepted 30 measures as relevant and feasible for use in Austria. Five of these indicators were structure measures, 14 were process measures and the remaining 11 were outcome measures. Based on the Austrian primary health care concept, the final set of quality indicators was grouped in the 5 following domains: Access to primary health care (5), quality of care (15), continuity of care (5), coordination of care (4), and safety (1). Conclusion This set of quality measures largely covers the four defined functions of primary health care. It enables standardized evaluation of primary health care facilities in Austria regarding the implementation of the Austrian primary health care concept as well as improvement in healthcare of the population. © Georg Thieme Verlag KG Stuttgart · New York.

Stakeholders' perspectives on quality indicators for diabetes care: a qualitative study.

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Markhorst, Joekie; Martirosyan, Liana; Calsbeek, Hiske; Braspenning, Jozé

2012-01-01

Transparency in diabetes care requires quality indicators that are of interest to stakeholders in order to optimise their usage. Indicator development is often focused on consensus, and little is known about stakeholders' preferences for information on quality. To explore the preferences of consumers, providers, purchasers and policy makers for different quality domains and indicators in relation to the intended use of quality indicators. Between June and December 2009, 14 semi-structured interviews were held with stakeholders who have a decisive vote in the selection of the national indicator set for diabetes care in the Netherlands. The following subjects were explored: (1) the aims of using information on quality; (2) the interpretation of and preferences for the quality domains of safety, timeliness, effectiveness and patient-centredness in relation to the user aims; and (3) the preferences for structure, process or outcome indicators. Content analysis was used to analyse qualitative data. Stakeholders had similar and different aims according to their roles. The interpretations of quality domains varied greatly between the stakeholders. Besides differences in interpretation, their preferences were similar. Most stakeholders prioritised patient-centredness above the other domains of quality, ranked in order of priority as safety, effectiveness and timeliness, whereas purchasers also prioritised efficiency. All stakeholders preferred to use process indicators or a mix of process and outcome indicators. The preferences of the stakeholders for quality indicators seem to be neither well-refined nor congruent. The implementation of an indicator set can probably be improved if the stakeholders' definitions and preferences for quality domains become more explicit during the selection process for indicators.

Environmental quality integrated indicator applied to the management of the Jiquiriçá river watershed, BA, Brazil

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Raquel Maria de Oliveira

2010-04-01

Full Text Available In this work social, economic and environmental aspects were studied using the concept of programming by commitment, with the objective of structuring an integrated indicator capable of estimating the degree of the environmental quality of the Jiquiriça river basin, BA, composed by the indicator of environmental salubrity, water quality and soil’s protection. For the determination of the environmental salubrity indicator, data of the following variables were collected: existence of treated water supply, disposition and treatment of solid residues, diseases vectors control, the existence of the Agenda 21, socioeconomics data and indices of human development for each municipal district located in the area of the watershed. The indicator of the water quality was structured based on the analysis of water samples collected in eight sampling points along Jiquiriçá river and determined by seven parameters. The indicator of soil’s protection was based on the analysis of maps obtained according to the weight of each steepness and land use class. Results indicate that the watershed is in a poor equilibrium condition and suggest the need for structural investments as well as changes in public polices. The methodology used was efficient for this watershed management and could be used as tool for the environmental planning of the region, once it can be adapted to several situations depending on the data availability.

Evaluating the Effect of Software Quality Characteristics on Health Care Quality Indicators

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Sakineh Aghazadeh

2015-07-01

Full Text Available Introduction: Various types of software are used in health care organizations to manage information and care processes. The quality of software has been an important concern for both health authorities and designers of Health Information Technology. Thus, assessing the effect of software quality on the performance quality of healthcare institutions is essential. Method: The most important health care quality indicators in relation to software quality characteristics are provided via an already performed literature review. ISO 9126 standard model is used for definition and integration of various characteristics of software quality. The effects of software quality characteristics and sub-characteristics on the healthcare indicators are evaluated through expert opinion analyses. A questionnaire comprising of 126 questions of 10-point Likert scale was used to gather opinions of experts in the field of Medical/Health Informatics. The data was analyzed using Structural Equation Modeling. Results: Our findings showed that software Maintainability was rated as the most effective factor on user satisfaction (R2 =0.89 and Functionality as the most important and independent variable affecting patient care quality (R2 =0.98. Efficiency was considered as the most effective factor on workflow (R2 =0.97, and Maintainability as the most important factor that affects healthcare communication (R2 =0.95. Usability and Efficiency were rated as the most effectual factor affecting patient satisfaction (R2 =0.80, 0.81. Reliability, Maintainability, and Efficiency were considered as the main factors affecting care costs (R2 =0.87, 0.74, 0.87. Conclusion: We presented a new model based on ISO standards. The model demonstrates and weighs the relations between software quality characteristics and healthcare quality indicators. The clear relationships between variables and the type of the metrics and measurement methods used in the model make it a reliable method to assess

Water quality in Atlantic rainforest mountain rivers (South America): quality indices assessment, nutrients distribution, and consumption effect.

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Avigliano, Esteban; Schenone, Nahuel

2016-08-01

The South American Atlantic rainforest is a one-of-a-kind ecosystem considered as a biodiversity hotspot; however, in the last decades, it was intensively reduced to 7 % of its original surface. Water resources and water quality are one of the main goods and services this system provides to people. For monitoring and management recommendations, the present study is focused on (1) determining the nutrient content (nitrate, nitrite, ammonium, and phosphate) and physiochemical parameters (temperature, pH, electrical conductivity, turbidity, dissolved oxygen, and total dissolved solids) in surface water from 24 rainforest mountain rivers in Argentina, (2) analyzing the human health risk, (3) assessing the environmental distribution of the determined pollutants, and (4) analyzing water quality indices (WQIobj and WQImin). In addition, for total coliform bacteria, a dataset was used from literature. Turbidity, total dissolved solids, and nitrite (NO2 (-)) exceeded the guideline value recommended by national or international guidelines in several sampling stations. The spatial distribution pattern was analyzed by Principal Component Analysis and Factor Analysis (PCA/FA) showing well-defined groups of rivers. Both WQI showed good adjustment (R (2) = 0.89) and rated water quality as good or excellent in all sampling sites (WQI > 71). Therefore, this study suggests the use of the WQImin for monitoring water quality in the region and also the water treatment of coliform, total dissolved solids, and turbidity.

Quality Indicators for In-Hospital Pharmaceutical Care of Dutch Elderly Patients Development and Validation of an ACOVE-Based Quality Indicator Set

NARCIS (Netherlands)

Wierenga, Peter C.; Klopotowska, Joanna E.; Smorenburg, Susanne M.; van Kan, Hendrikus J.; Bijleveld, Yuma A.; Dijkgraaf, Marcel G.; de Rooij, Sophia E.

2011-01-01

Background: In 2001, the ACOVE (Assessing Care Of Vulnerable Elders) quality indicators (QIs) were developed in the US to measure the quality of care of vulnerable elderly patients. However, the ACOVE QI set was developed mainly to assess the overall quality of care of community-dwelling vulnerable

Internet quality indicators for health professional agencies and associations.

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Courtney, Karen L; Alexander, Gregory L; Pack, Beth; Bax, Heather; Adams-Leander, Shelia; Holcomb, Melissa

2005-01-01

Building on work within public administration research, five categories of quality indicators are proposed for evaluating World Wide Web (web) sites belonging to state health professional agencies and associations. The five measures include: transparency, transactions, connectivity, personalization and usability. This project describes the construction of each quality indicator index and a calculation of quality scores. This project applies these methods to state Boards of Nursing and nursing association websites.

Quality indicators and shelf life of red octopus (Octopus maya in chilling storage

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Mariel GULLIAN-KLANIAN

2016-01-01

Full Text Available Abstract There are no precedents concerning the quality of Octopus maya during chilled storage. This study evaluated the shelf life of the red octopus in chilling storage (4oC and the correlation of the sensory quality index with microbiological counting and the biochemical indicators (hypoxanthine, histamine and volatile amines. A total of 112 whole raw octopi (average weight of 896 g were randomly selected from seven batches and exposed to 4°C for 18, 24, 48, 72, 84, 96, and 100 h. The histamine concentration (91.7%, followed by the counts of psychrotrophic bacteria (5.5% and hypoxanthine (2.2%, were the predictors from the redundancy analysis that better explained the changes taking place during the chilling hours. After 72 h of chilling, the microbial count was determined to be log 4.7 CFU/g, and the octopus samples were classified as B quality (minor sensory quality defects based on the sensory quality scale. Although the samples were not classified as unacceptable at 100 h of refrigeration by the sensory index, the level of histamine reached the defect action level (5 mg/100 g as ruled by the International Food Safety Authorities. The shelf life of the red octopus in chilling storage was predicted to be 119 h.

[Construction and implementation of two quality indicators in nursing services].

Science.gov (United States)

de Moura, Gisela Maria Schebela Souto; Juchem, Beatriz Cavalcanti; Falk, Maria Lucia Rodrigues; de Magalhães, Ana Maria Muller; Suzuki, Lyliam Midori

2009-03-01

Indicators monitor the quality of services and improve the attention offered to the patients. Hospital de Clinicas de Porto Alegre, Rio Grande do Sul, Brazil, has been developing strategies to assess its services according to its institutional management policy of quality The present study aims to report the experience at this university hospital with the construction and implementation of quality indicators in its nursing services. In 2006, four indicators were established: incidence of pressure ulcer, with a goal of quality of nursing services, for this is a large hospital.

Guidelines for the processing and quality assurance of benthic invertebrate samples collected as part of the National Water-Quality Assessment Program

Science.gov (United States)

Cuffney, T.F.; Gurtz, M.E.; Meador, M.R.

1993-01-01

Benthic invertebrate samples are collected as part of the U.S. Geological Survey's National Water-Quality Assessment Program. This is a perennial, multidisciplinary program that integrates biological, physical, and chemical indicators of water quality to evaluate status and trends and to develop an understanding of the factors controlling observed water quality. The Program examines water quality in 60 study units (coupled ground- and surface-water systems) that encompass most of the conterminous United States and parts of Alaska and Hawaii. Study-unit teams collect and process qualitative and semi-quantitative invertebrate samples according to standardized procedures. These samples are processed (elutriated and subsampled) in the field to produce as many as four sample components: large-rare, main-body, elutriate, and split. Each sample component is preserved in 10-percent formalin, and two components, large-rare and main-body, are sent to contract laboratories for further processing. The large-rare component is composed of large invertebrates that are removed from the sample matrix during field processing and placed in one or more containers. The main-body sample component consists of the remaining sample materials (sediment, detritus, and invertebrates) and is subsampled in the field to achieve a volume of 750 milliliters or less. The remaining two sample components, elutriate and split, are used for quality-assurance and quality-control purposes. Contract laboratories are used to identify and quantify invertebrates from the large-rare and main-body sample components according to the procedures and guidelines specified within this document. These guidelines allow the use of subsampling techniques to reduce the volume of sample material processed and to facilitate identifications. These processing procedures and techniques may be modified if the modifications provide equal or greater levels of accuracy and precision. The intent of sample processing is to

Radiation hazard indices of soil and water samples in Northern Malaysian Peninsula.

Science.gov (United States)

Almayahi, B A; Tajuddin, A A; Jaafar, M S

2012-11-01

The radioactivity quantity and quality were determined in soil and water samples in Northern Malaysian Peninsula (NMP) using HPGe spectroscopy and GR-135 spectrometer. The (226)Ra, (232)Th and (40)K concentrations in soil samples are 57±2, 68±4 and 427±17 Bq kg(-1), respectively, whereas in water samples were found to be 2.86±0.79, 3.78±1.73 and 152±12 Bq l(-1), respectively. These concentrations are within those reported from literature in other countries in the world. The radiological hazard indices of the samples were also calculated. The mean values obtained from soil samples are 186 Bq kg(-1), 88 nGy h(-1), 108 μSv y(-1), 0.50 and 0.65 for Radium Equivalent Activity (Ra(eq)), Absorbed Dose Rates (D(R)), Annual Effective Dose Rates (ED), External Hazard Index (H(ex)) and Internal Hazard Index (H(in)) respectively, whereas, for water samples were found to be 20, 10, 13, 0.05 and 0.06, respectively. All the health hazard indices are well below their recommended limits, except in two soil sampling sites which were found to be (*)025 (1.1 H(ex)) and (*)026 (1.1 H(ex), 1.6 H(in)). The calculated and the measured gamma dose rates had a good correlation coefficient, R=0.88. Moreover, the average value radon is 20 (in the range of 7-64) Bq m(-3), a positive correlation (R=0.81) was observed between the (222)Rn and (226)Ra concentrations in samples measured by the SNC continuous radon monitor (model 1029, Sun Nuclear Corporation) and HPGe detector, respectively. Some soils in this study with H(in) and H(ex)samples, therefore, water after processing and filtration is safe and suitable for use in household and industrial purposes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Sterols indicate water quality and wastewater treatment efficiency.

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Reichwaldt, Elke S; Ho, Wei Y; Zhou, Wenxu; Ghadouani, Anas

2017-01-01

As the world's population continues to grow, water pollution is presenting one of the biggest challenges worldwide. More wastewater is being generated and the demand for clean water is increasing. To ensure the safety and health of humans and the environment, highly efficient wastewater treatment systems, and a reliable assessment of water quality and pollutants are required. The advance of holistic approaches to water quality management and the increasing use of ecological water treatment technologies, such as constructed wetlands and waste stabilisation ponds (WSPs), challenge the appropriateness of commonly used water quality indicators. Instead, additional indicators, which are direct measures of the processes involved in the stabilisation of human waste, have to be established to provide an in-depth understanding of system performance. In this study we identified the sterol composition of wastewater treated in WSPs and assessed the suitability of human sterol levels as a bioindicator of treatment efficiency of wastewater in WSPs. As treatment progressed in WSPs, the relative abundance of human faecal sterols, such as coprostanol, epicoprostanol, 24-ethylcoprostanol, and sitostanol decreased significantly and the sterol composition in wastewater changed significantly. Furthermore, sterol levels were found to be correlated with commonly used wastewater quality indicators, such as BOD, TSS and E. coli. Three of the seven sterol ratios that have previously been used to track sewage pollution in the environment, detected a faecal signal in the effluent of WSPs, however, the others were influenced by high prevalence of sterols originating from algal and fungal activities. This finding poses a concern for environmental assessment studies, because environmental pollution from waste stabilisation ponds can go unnoticed. In conclusion, faecal sterols and their ratios can be used as reliable indicators of treatment efficiency and water quality during wastewater

Study the Soil Quality Changes Indicators Using Nemoro and Integrated Quality Index Models in Some Khuzestan’s Soils

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F. Ramezani

2016-09-01

Full Text Available Introduction: Aspects of the physical, chemical and biological are considered. Land degradation for soil quality, or improve soil quality assessment is important.This study was conducted to evaluate soil quality indicators using quantitative models in some lands of Khuzestan province (Iran.Such studies, which are carried out to create a balance between the biological production and the maintenance and improvement of land resource quality, provide a framework for land degradation control and also for identification of sustainable management. Such studies, which are carried out to create a balance between the biological production and the maintenance and improvement of land resource quality, provide a framework for land degradation control and also for identification of sustainable management. Materials and Methods: In order to evaluate the effect of crop management and cultivation on soil quality, Select several Khuzestan region and Samples were taken from the surrounding cultivated land. Physiochemical characteristics of soil samples from a depth of0-30 cm such as soil texture, bulk density (Db, mean weight diameter of wet aggregates (MWD, relative field capacity (RFC, air capacity (FA,plant available water capacity (AWC, saturated hydraulic conductivity (Ks, organic carbon (OC,electrical conductivity (EC, pH, soluble cations (Mg, Ca, Na,sodium absorption ratio (SAR, exchange sodium percent (ESP and cation exchange capacity were determined (CEC. The soil quality was evaluated by integrated quality index (IQI and Nemero quality index (NQI in two data sets of soil properties including MDS and TDS. In these models, a set of characteristics that affect the quality of the soil in the form of a mathematical model incorporating and to propose a numerical quantity this number serve as general indicator of soil quality, Reflect the characteristics of the target. Results and Discussion: The results showed that there was significant correlation between

Quality of care in European home care programs using the second generation interRAI Home Care Quality Indicators (HCQIs).

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Foebel, Andrea D; van Hout, Hein P; van der Roest, Henriëtte G; Topinkova, Eva; Garms-Homolova, Vjenka; Frijters, Dinnus; Finne-Soveri, Harriet; Jónsson, Pálmi V; Hirdes, John P; Bernabei, Roberto; Onder, Graziano

2015-11-14

Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI's second-generation home care quality indicators (HCQIs) were developed in 2013. This study assesses the quality of home care services in six European countries using these HCQIs as well as the two derived summary scales. Data for this study were derived from the Aged in Home Care (AdHOC) study - a cohort study that examined different models of community care in European countries. The current study selected a sub-sample of the AdHOC cohort from six countries whose follow-up data were complete (Czech Republic, Denmark, Finland, Germany, Italy and the Netherlands). Data were collected from the interRAI Home Care instrument (RAI-HC) between 2000 and 2002. The 23 HCQIs of interest were determined according to previously established methodology, including risk adjustment. Two summary measures, the Clinical Balance Scale and Independence Quality Scale were also determined using established methodology. A total of 1,354 individuals from the AdHOC study were included in these analyses. Of the 23 HCQIs that were measured, the highest proportion of individuals experienced declines in Instrumental Activities of Daily Living (IADLs) (48.4 %). Of the clinical quality indicators, mood decline was the most prevalent (30.0 %), while no flu vaccination and being alone and distressed were the most prevalent procedural and social quality indicators, respectively (33.4 and 12.8 %). Scores on the two summary scales varied by country, but were concentrated around the median mark. The interRAI HCQIs can be used to determine the quality of home care services in Europe and identify areas for improvement. Our results suggest functional declines may prove the most beneficial targets for interventions.

[Application of laboratory information system in the management of the key indicators of quality inspection].

Science.gov (United States)

Guo, Ye; Chen, Qian; Wu, Wei; Cui, Wei

2015-03-31

To establish a system of monitoring the key indicator of quality for inspection (KIQI) on a laboratory information system (LIS), and to have a better management of KIQI. Clinical sample made in PUMCH were collected during the whole of 2014. Next, interactive input program were designed to accomplish data collecting of the disqualification rate of samples, the mistake rate of samples and the occasions of losing samples, etc. Then, a series moment of sample collection, laboratory sample arrived, sample test, sample check, response to critical value, namely, trajectory information left on LIS were recorded and the qualification rate of TAT, the notification rate of endangering result were calculated. Finally, the information about quality control were collected to build an internal quality control database and the KIQI, such as the out-of-control rate of quality control and the total error of test items were monitored. The inspection of the sample management shows the disqualification rates in 2014 were all below the target, but the rates in January and February were a little high and the rates of four wards were above 2%. The mistake rates of samples was 0.47 cases/10 000 cases, attaining the target (laboratory reports shows the qualification rates of TAT was within the acceptable range (> 95%), however the rates of blood routine in November (94.75%) was out of range. We have solved the problem by optimizing the processes. The notification rate of endangering result attained the target (≥ 98%), while the rate of timely notification is needed to improve. Quality inspection shows the CV of APTT in August (5.02%) was rising significantly, beyond the accepted CV (5.0%). We have solved the problem by changing the reagent. The CV of TT in 2014 were all below the allowable CV, thus the allowable CV of the next year lower to 10%. It is an objective and effective method to manage KIQI with the powerful management mode of database and information process capability on LIS.

Development of indicators of the quality of radiotherapy for localized prostate cancer

International Nuclear Information System (INIS)

Danielson, Brita; Brundage, Michael; Pearcey, Robert; Bass, Brenda; Pickles, Tom; Bahary, Jean-Paul; Foley, Kimberley; Mackillop, William

2011-01-01

Purpose: To develop a set of indicators of the quality of radiotherapy (RT) for localized prostate cancer. Methods and materials: Following a comprehensive review of the literature to identify candidate quality indicators, we utilized a modified Delphi technique to develop a set of indicators of the quality of RT for localized prostate cancer. The first Delphi round consisted of an online survey in which radiation oncologists were asked to rate the importance of the candidate quality indicators. The second round was a face-to-face meeting of a smaller group of radiation oncologists to discuss, rate, and rank a final set of quality indicators. Results: The literature review identified 57 candidate quality indicators. After the two rounds of the Delphi process, a final set of 25 indicators was agreed upon. The set includes quality indicators covering all aspects of prostate cancer radical RT management: pre-treatment assessment, external beam RT, brachytherapy, androgen deprivation therapy, and follow-up. Conclusions: This new set of quality indicators is more comprehensive than others described in the literature, and can be applied to patterns of care studies that assess the quality of RT for prostate cancer. The process used to develop this set of indicators can be readily adapted for use in other contexts.

ISOTROPIC LUMINOSITY INDICATORS IN A COMPLETE AGN SAMPLE

International Nuclear Information System (INIS)

Diamond-Stanic, Aleksandar M.; Rieke, George H.; Rigby, Jane R.

2009-01-01

The [O IV] λ25.89 μm line has been shown to be an accurate indicator of active galactic nucleus (AGN) intrinsic luminosity in that it correlates well with hard (10-200 keV) X-ray emission. We present measurements of [O IV] for 89 Seyfert galaxies from the unbiased revised Shapley-Ames (RSA) sample. The [O IV] luminosity distributions of obscured and unobscured Seyferts are indistinguishable, indicating that their intrinsic AGN luminosities are quite similar and that the RSA sample is well suited for tests of the unified model. In addition, we analyze several commonly used proxies for AGN luminosity, including [O III] λ5007 A, 6 cm radio, and 2-10 keV X-ray emission. We find that the radio luminosity distributions of obscured and unobscured AGNs show no significant difference, indicating that radio luminosity is a useful isotropic luminosity indicator. However, the observed [O III] and 2-10 keV luminosities are systematically smaller for obscured Seyferts, indicating that they are not emitted isotropically.

Assessment of emergency general surgery care based on formally developed quality indicators.

Science.gov (United States)

Ingraham, Angela; Nathens, Avery; Peitzman, Andrew; Bode, Allison; Dorlac, Gina; Dorlac, Warren; Miller, Preston; Sadeghi, Mahsa; Wasserman, Deena D; Bilimoria, Karl

2017-08-01

Emergency general surgery outcomes vary widely across the United States. The utilization of quality indicators can reduce variation and assist providers in administering care aligned with established recommendations. Previous quality indicators have not focused on emergency general surgery patients. We identified indicators of high-quality emergency general surgery care and assessed patient- and hospital-level compliance with these indicators. We utilized a modified Delphi technique (RAND Appropriateness Methodology) to develop quality indicators. Through 2 rankings, an expert panel ranked potential quality indicators for validity. We then examined historic compliance with select quality indicators after 4 nonelective procedures (cholecystectomy, appendectomy, colectomy, small bowel resection) at 4 academic centers. Of 25 indicators rated as valid, 13 addressed patient-level quality and 12 addressed hospital-level quality. Adherence with 18 indicators was assessed. Compliance with performing a cholecystectomy for acute cholecystitis within 72 hours of symptom onset ranged from 45% to 76%. Compliance with surgery start times within 3 hours from the decision to operate for uncontained perforated viscus ranged from 20% to 100%. Compliance with exploration of patients with small bowel obstructions with ischemia/impending perforation within 3 hours of the decision to operate was 0% to 88%. For 3 quality indicators (auditing 30-day unplanned readmissions/operations for patients previously managed nonoperatively, monitoring time to source control for intra-abdominal infections, and having protocols for bypass/transfer), none of the hospitals were compliant. Developing indicators for providers to assess their performance provides a foundation for specific initiatives. Adherence to quality indicators may improve the quality of emergency general surgery care provided for which current outcomes are potentially modifiable. Copyright © 2017 Elsevier Inc. All rights reserved.

A Comprehensive Real-Time Indoor Air-Quality Level Indicator

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Jungho Kang

2016-09-01

Full Text Available The growing concern about Indoor Air-Quality has accelerated the development of small, low-cost air-quality monitoring systems. These systems are capable of monitoring various indoor air pollutants in real time, notifying users about the current air-quality status and gathering the information to the central server. However, most Internet of Things (IoT-based air-quality monitoring systems numerically present the sensed value per pollutant, making it difficult for general users to identify how polluted the air is. Therefore, in this paper, we first introduce a tiny air-quality monitoring system that we developed and, based on the system, we also test the applicability of the comprehensive Air-Quality Index (AQI, which is widely used all over the world, in terms of its capacity for a comprehensive indoor air-quality indication. We also develop design considerations for an IoT-based air-quality monitoring system and propose a real-time comprehensive indoor air-quality level indication method, which effectively copes with dynamic changes and is efficient in terms of processing and memory overhead.

Evaluating laboratory key performance using quality indicators in Alexandria University Hospital Clinical Chemistry Laboratories.

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Rizk, Mostafa M; Zaki, Adel; Hossam, Nermine; Aboul-Ela, Yasmin

2014-12-01

The performance of clinical laboratories plays a fundamental role in the quality and effectiveness of healthcare. To evaluate the laboratory performance in Alexandria University Hospital Clinical Laboratories using key quality indicators and to compare the performance before and after an improvement plan based on ISO 15189 standards. The study was carried out on inpatient samples for a period of 7 months that was divided into three phases: phase I included data collection for evaluation of the existing process before improvement (March-May 2012); an intermediate phase, which included corrective, preventive action, quality initiative and steps for improvement (June 2012); and phase II, which included data collection for evaluation of the process after improvement (July 2012-September 2012). In terms of the preanalytical indicators, incomplete request forms in phase I showed that the total number of received requests were 31 944, with a percentage of defected request of 33.66%; whereas in phase II, there was a significant reduction in all defected request items (Plaboratories.

Assessment of quality indicators in spanish higher military education

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Olmos Gómez Maria del Carmen

2016-01-01

Full Text Available The quality assessment is subject to multiple interpretations of its content and purpose, and also regarding to methods and techniques used to develop it. Although purposes of assessment are varied, usually pursuit three goals: Improvement, accountability and information. Currently, the concept of quality evaluation has been replaced by the management of educational quality, as Matthew [6] point “the new culture of evaluation is no longer oriented to penalty, ranking or selection of people, as provide a reasoned and reasonable information to guide the management of educational improvement”. Military Training Centres are externally evaluated by an experts External Evaluation Unit to identify strengths and weaknesses on their self-evaluation system and focus on important aspects related to the organization of the Centre, development of work plans, teacher’s style and students learning strategies, system of evaluation and qualification and accurate recommendations to improve all that. This research focuses on the evaluation of quality indicators for the external evaluation of higher education at Military Education Centres in Spain and it is funded by a joint project between University of Granada and MADOC. The technique used for collecting and analysing information was a content description of several documents provided by these military educational authorities, arising the identification and extraction of relevant indicators on the evaluation of higher education. This analysis was primarily based on standards and indicators systems by ANECA (National Agency for Quality Assessment and Accreditation adapted to the Military Higher Education, but also it was consider other standards by international agencies and evaluative institutions, such as University of Chile, University of Paraguay, Canarias Agency for Quality Assessment and Accreditation and Agency for Quality Education System University of Castilla y León. The analysis realize a usual

Assessment of quality indicators in Spanish higher military education

Directory of Open Access Journals (Sweden)

Olmos Gómez Maria del Carmen

2016-01-01

Full Text Available The quality assessment is subject to multiple interpretations of its content and purpose, and also regarding to methods and techniques used to develop it. Although purposes of assessment are varied, usually pursuit three goals: Improvement, accountability and information. Currently, the concept of quality evaluation has been replaced by the management of educational quality, as Matthew [6] point “the new culture of evaluation is no longer oriented to penalty, ranking or selection of people, as provide a reasoned and reasonable information to guide the management of educational improvement”. Military Training Centres are externally evaluated by an experts External Evaluation Unit to identify strengths and weaknesses on their self-evaluation system and focus on important aspects related to the organization of the Centre, development of work plans, teacher’s style and students learning strategies, system of evaluation and qualification and accurate recommendations to improve all that. This research focuses on the evaluation of quality indicators for the external evaluation of higher education at Military Education Centres in Spain and it is funded by a joint project between University of Granada and MADOC. The technique used for collecting and analysing information was a content description of several documents provided by these military educational authorities, arising the identification and extraction of relevant indicators on the evaluation of higher education. This analysis was primarily based on standards and indicators systems by ANECA (National Agency for Quality Assessment and Accreditation adapted to the Military Higher Education, but also it was consider other standards by international agencies and evaluative institutions, such as University of Chile, University of Paraguay, Canarias Agency for Quality Assessment and Accreditation and Agency for Quality Education System University of Castilla y León. The analysis realize a usual

Quality indicators in intensive care medicine for Germany – third edition 2017

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Kumpf, Oliver

2017-08-01

Full Text Available Quality improvement in medicine is depending on measurement of relevant quality indicators. The quality indicators for intensive care medicine of the German Interdisciplinary Society of Intensive Care Medicine (DIVI from the year 2013 underwent a scheduled evaluation after three years. There were major changes in several indicators but also some indicators were changed only minimally. The focus on treatment processes like , , and , as well as the number of 10 indicators were not changed. Most topics remained except for which was introduced instead of . was added as an outcome indicator. These quality indicators are used in the peer review in intensive care, a method endorsed by the DIVI. A validity period of three years is planned for the quality indicators.

Developing quality indicators for community services: the case of district nursing.

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Davies, Philippa; Wye, Lesley; Horrocks, Sue; Salisbury, Chris; Sharp, Debbie

2011-01-01

Quality indicators exist for the acute and primary care sectors in the National Health Service (NHS), but until recently little attention has been given to measuring the quality of community services. The innovative project described in this paper attempted to address that gap. To produce a framework for developing quality indicators for Bristol Community Health services. To develop a set of initial indicators for Bristol Community Health services using the proposed framework. After familiarising ourselves with community services and NHS policy, gathering the views of stakeholders and consulting the literature on quality indicators, we designed a framework for indicator development, using the 'test' case of the district nursing service. The long list of possible indicators came from best practice guidelines for wound, diabetes and end of life care, the three conditions most commonly treated by district nurses. To narrow down this list we surveyed and held workshops with district nurses, interviewed service users by telephone and met with commissioners and senior community health managers. The final set of quality indicators for district nurses included 23 organisational and clinical process and outcome indicators and eight patient experience indicators. These indicators are now being piloted, together with two potential tools identified to capture patient reported outcomes. Developing quality indicators for community services is time consuming and resource intensive. A range of skills are needed including clinical expertise, project management and skills in evidence-based medicine. The commitment and involvement of front-line professionals is crucial.

Chapter 5: Quality assurance/quality control in stormwater sampling

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Sampling the quality of stormwater presents unique challenges because stormwater flow is relatively short-lived with drastic variability. Furthermore, storm events often occur with little advance warning, outside conventional work hours, and under adverse weather conditions. Therefore, most stormwat...

Validation of two complementary oral-health related quality of life indicators (OIDP and OSS 0-10 in two qualitatively distinct samples of the Spanish population

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Albaladejo A

2008-11-01

Full Text Available Abstract Background Oral health-related quality of life can be assessed positively, by measuring satisfaction with mouth, or negatively, by measuring oral impact on the performance of daily activities. The study objective was to validate two complementary indicators, i.e., the OIDP (Oral Impacts on Daily Performances and Oral Satisfaction 0–10 Scale (OSS, in two qualitatively different socio-demographic samples of the Spanish adult population, and to analyse the factors affecting both perspectives of well-being. Methods A cross-sectional study was performed, recruiting a Validation Sample from randomly selected Health Centres in Granada (Spain, representing the general population (n = 253, and a Working Sample (n = 561 randomly selected from active Regional Government staff, i.e., representing the more privileged end of the socio-demographic spectrum of this reference population. All participants were examined according to WHO methodology and completed an in-person interview on their oral impacts and oral satisfaction using the OIDP and OSS 0–10 respectively. The reliability and validity of the two indicators were assessed. An alternative method of describing the causes of oral impacts is presented. Results The reliability coefficient (Cronbach's alpha of the OIDP was above the recommended 0.7 threshold in both Validation and Occupational samples (0.79 and 0.71 respectively. Test-retest analysis confirmed the external reliability of the OSS (Intraclass Correlation Coefficient, 0.89; p Conclusion OIDP and OSS are valid and reliable subjective measures of oral impacts and oral satisfaction, respectively, in an adult Spanish population. Exploring simultaneously these issues may provide useful insights into how satisfaction and impact on well-being are constructed.

European Society of Gynaecologic Oncology Quality Indicators for Advanced Ovarian Cancer Surgery.

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Querleu, Denis; Planchamp, François; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Cristiana; van der Zee, Ate; Vergote, Ignace; du Bois, Andreas

2016-09-01

The surgical management of advanced ovarian cancer involves complex surgery. Implementation of a quality management program has a major impact on survival. The goal of this work was to develop a list of quality indicators (QIs) for advanced ovarian cancer surgery that can be used to audit and improve the clinical practice. This task has been carried out under the auspices of the European Society of Gynaecologic Oncology (ESGO). Quality indicators were based on scientific evidence and/or expert consensus. A 4-step evaluation process included a systematic literature search for the identification of potential QIs and the documentation of scientific evidence, physical meetings of an ad hoc multidisciplinarity International Development Group, an internal validation of the targets and scoring system, and an external review process involving physicians and patients. Ten structural, process, or outcome indicators were selected. Quality indicators 1 to 3 are related to achievement of complete cytoreduction, caseload in the center, training, and experience of the surgeon. Quality indicators 4 to 6 are related to the overall management, including active participation to clinical research, decision-making process within a structured multidisciplinary team, and preoperative workup. Quality indicator 7 addresses the high value of adequate perioperative management. Quality indicators 8 to 10 highlight the need of recording pertinent information relevant to improvement of quality. An ESGO-approved template for the operative report has been designed. Quality indicators were described using a structured format specifying what the indicator is measuring, measurability specifications, and targets. Each QI was associated with a score, and an assessment form was built. The ESGO quality criteria can be used for self-assessment, for institutional or governmental quality assurance programs, and for the certification of centers. Quality indicators and corresponding targets give

Quality Indicators for Global Benchmarking of Localized Prostate Cancer Management.

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Sampurno, Fanny; Zheng, Jia; Di Stefano, Lydia; Millar, Jeremy L; Foster, Claire; Fuedea, Ferran; Higano, Celestia; Hulan, Hartwig; Mark, Stephen; Moore, Caroline; Richardson, Alison; Sullivan, Frank; Wenger, Neil S; Wittmann, Daniela; Evans, Sue

2018-03-01

We sought to develop a core set of clinical indicators to enable international benchmarking of localized prostate cancer management using data available in the TrueNTH (True North) Global Registry. An international expert panel completed an online survey and participated in a face to face meeting. Participants included 3 urologists, 3 radiation oncologists, 2 psychologists, 1 medical oncologist, 1 nurse and 1 epidemiologist with prostate cancer expertise from a total of 7 countries. Current guidelines on prostate cancer treatment and potential quality indicators were identified from a literature review. These potential indicators were refined and developed through a modified Delphi process during which each panelist independently and repeatedly rated each indicator based on importance (satisfying the indicator demonstrated a provision of high quality care) and feasibility (the likelihood that data used to construct the indicator could be collected at a population level). The main outcome measure was items with panel agreement indicted by a disagreement index less 1, median importance 8.5 or greater and median feasibility 9 or greater. The expert panel endorsed 33 indicators. Seven of these 33 prostate cancer quality indicators assessed care relating to diagnosis, 7 assessed primary treatment, 1 assessed salvage treatment and 18 assessed health outcomes. We developed a set of quality indicators to measure prostate cancer care using numerous international evidence-based clinical guidelines. These indicators will be pilot tested in the TrueNTH Global Registry. Reports comparing indicator performance will subsequently be distributed to groups at participating sites with the purpose of improving the consistency and quality of prostate cancer management on a global basis. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Quality indicators for all dimensions of infertility care quality: consensus between professionals and patients

NARCIS (Netherlands)

Dancet, E.A.; D'Hooghe, T.M.; Spiessens, C.; Sermeus, W.; Neubourg, D. De; Karel, N.; Kremer, J.A.M.; Nelen, W.L.D.M.

2013-01-01

STUDY QUESTION: What is the relative importance of the six dimensions of quality of care according to different stakeholders and can a quality indicator set address all six quality dimensions and incorporate the views from professionals working in different disciplines and from patients? SUMMARY

First Dutch Consensus of Pain Quality Indicators for Pain Treatment Facilities.

Science.gov (United States)

de Meij, Nelleke; van Grotel, Marloes; Patijn, Jacob; van der Weijden, Trudy; van Kleef, Maarten

2016-01-01

There is a general consensus about the need to define and improve the quality of pain treatment facilities. Although guidelines and recommendations to improve the quality of pain practice management have been launched, provision of appropriate pain treatment is inconsistent and the quality of facilities varies widely. The aim of the study was to develop an expert-agreed list of quality indicators applicable to pain treatment facilities. The list was also intended to be used as the basis for a set of criteria for registered status of pain treatment facilities. The University Pain Center Maastricht at the Department of Anesthesiology and Pain Management of the Maastricht University Medical Center conducted a 3-round Delphi study in collaboration with the Board of the Pain Section of the Dutch Society of Anesthesiologists (NVA). Twenty-five quality indicators were selected as relevant to 2 types of pain treatment facilities, pain clinics and pain centers. The final expert-agreed list consisted of 22 quality indicators covering 7 quality domains: supervision, availability of care, staffing level and patient load, quality policy, multidisciplinarity, regionalization, and research and education. This set of quality indicators may facilitate organizational evaluation and improve insight into service quality from the perspectives of patients, pain specialists, and other healthcare professionals. Recommendations for improvements to the current set of quality indicators are made. In 2014 the process of registering pain treatment facilities in the Netherlands started; facilities can register as a pain clinic or pain center. © 2015 World Institute of Pain.

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

Science.gov (United States)

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.

Effects of physical and chemical heterogeneity on water-quality samples obtained from wells

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Reilly, Thomas E.; Gibs, Jacob

1993-01-01

Factors that affect the mass of chemical constituents entering a well include the distributions of flow rate and chemical concentrations along and near the screened or open section of the well. Assuming a layered porous medium (with each layer being characterized by a uniform hydraulic conductivity and chemical concentration), a knowledge of the flow from each layer along the screened zone and of the chemical concentrations in each layer enables the total mass entering the well to be determined. Analyses of hypothetical systems and a site at Galloway, NJ, provide insight into the temporal variation of water-quality data observed when withdrawing water from screened wells in heterogeneous ground-water systems.The analyses of hypothetical systems quantitatively indicate the cause-and-effect relations that cause temporal variability in water samples obtained from wells. Chemical constituents that have relatively uniform concentrations with depth may not show variations in concentrations in the water discharged from a well after the well is purged (evacuation of standing water in the well casing). However, chemical constituents that do not have uniform concentrations near the screened interval of the well may show variations in concentrations in the well discharge water after purging because of the physics of ground-water flow in the vicinity of the screen.Water-quality samples were obtained through time over a 30 minute period from a site at Galloway, NJ. The water samples were analyzed for aromatic hydrocarbons, and the data for benzene, toluene, and meta+para xylene were evaluated for temporal variations. Samples were taken from seven discrete zones, and the flow-weighted concentrations of benzene, toluene, and meta+para xylene all indicate an increase in concentration over time during pumping. These observed trends in time were reproduced numerically based on the estimated concentration distribution in the aquifer and the flow rates from each zone.The results of

European Educational Research Quality Indicators (EERQI): A first prototype framework of intrinsic and extrinsic indicators

NARCIS (Netherlands)

Mooij, Ton

2011-01-01

Mooij, T. (2011, 15-16 March). European Educational Research Quality Indicators (EERQI): A first prototype framework of intrinsic and extrinsic indicators. Paper presented at the final EERQI conference, Brussels, University Foundation.

Quality evaluation of commercially sold table water samples in Michael Okpara University of Agriculture, Umudike, Nigeria and surrounding environments

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D.O. Okorie

2015-01-01

Full Text Available In Michael Okpara University of Agriculture, Umudike, Nigeria (MOUAU and surrounding environments, table water of different brands is commercially hawked by vendors. To the best of our knowledge, there is no scientific documentation on the quality of these water samples. Hence this study which evaluated the quality of different brands of water samples commercially sold in MOUAU and surrounding environments. The physicochemical properties (pH, total dissolved solids (TDS, biochemical oxygen demand (BOD, total hardness, dissolved oxygen, Cl, NO3, ammonium nitrogen (NH3N, turbidity, total suspended solids (TSS, Ca, Mg, Na and K of the water samples as indices of their quality were carried out using standard techniques. Results obtained from this study indicated that most of the chemical constituents of these table water samples commercially sold in Umudike environment conformed to the standards given by the Nigerian Industrial Standard (NIS, World Health Organization (WHO and American Public Health Association (APHA, respectively, while values obtained for ammonium nitrogen in these water samples calls for serious checks on methods of their production and delivery to the end users.

Combining Archetypes, Ontologies and Formalization Enables Automated Computation of Quality Indicators.

Science.gov (United States)

Legaz-García, María Del Carmen; Dentler, Kathrin; Fernández-Breis, Jesualdo Tomás; Cornet, Ronald

2017-01-01

ArchMS is a framework that represents clinical information and knowledge using ontologies in OWL, which facilitates semantic interoperability and thereby the exploitation and secondary use of clinical data. However, it does not yet support the automated assessment of quality of care. CLIF is a stepwise method to formalize quality indicators. The method has been implemented in the CLIF tool which supports its users in generating computable queries based on a patient data model which can be based on archetypes. To enable the automated computation of quality indicators using ontologies and archetypes, we tested whether ArchMS and the CLIF tool can be integrated. We successfully automated the process of generating SPARQL queries from quality indicators that have been formalized with CLIF and integrated them into ArchMS. Hence, ontologies and archetypes can be combined for the execution of formalized quality indicators.

Estimation of air quality by air pollution indices

International Nuclear Information System (INIS)

Liblik, Valdo; Kundel, Helmut

1999-01-01

A novel system for estimating the quality of atmospheric air in the over-ground air layer with the help of air pollution indices was developed. The method is based on a comparison of measured or calculated maximum short-term concentrations and average annual concentrations of pollutants with maximum permissible concentrations (with regard to human beings and vegetation). Special air quality estimation scales for residential areas and natural systems are presented. On the basis of the concentration of the substance under study zones of very high, high, rather high, moderate, low and very low air pollution were distinguished in the over-ground layer of the atmosphere. These are projected to land surface for landscape zonation. The application of the system of indices is demonstrated in the analysis of air quality for the towns of Kohtla-Jarve, Johvi and Kivioli (in 1997-1998). A comparative analysis of the air pollution zones distinguished on the basis of emissions and data from bio monitoring yielded satisfactory results. The system of air pollution indices developed enables to process the results of air monitoring in case of pollution fields of complicated composition so that the result for estimating the quality of ambient air in a residential area is easily understood by inhabitants and interpretable with the help of a special scale; analyse temporal changes in the quality of the air in towns, villages and other residential areas and use the results as basis for developing measures for reducing the pollution of ambient air; carry out zonation of large territories on the basis of air pollution levels (spatial air pollution zones are projected on the ground surface) and estimate air quality in places where air monitoring is lacking to forecast the possible effect of air pollution on natural systems (author)

Quality Control Samples for the Radiological Determination of Tritium in Urine Samples

International Nuclear Information System (INIS)

Ost'pezuk, P.; Froning, M.; Laumen, S.; Richert, I.; Hill, P.

2004-01-01

The radioactive decay product of tritium is a low energy beta that cannot penetrate the outer dead layer of human skin. Therefore , the main hazard associated with tritium is internal exposure. In addition, due to the relatively long half life and short biological half life, tritium must be ingested in large amounts to pose a significant health risk. On the other hand, the internal exposure should be kept as low as practical. For incorporation monitoring of professional radiation workers the quality control is of utmost importance. In the Research Centre Juelich GmbH (FZJ) a considerable fraction of monitoring by excretion analysis relates to the isotope Tritium. Usually an aliquot of an urine sample is mixed with a liquid scintillator and measured in a liquid scintillation counter. Quality control samples in the form of three kind of internal reference samples (blank, reference samples with low activity and reference sample with elevated activity) were prepared from a mixed, Tritium (free) urine samples. 1 ml of these samples were pipetted into a liquid scintillation vial. In the part of theses vials a known amounts of Tritium were added. All these samples were stored at 20 degrees. Based on long term use of all these reference samples it was possible to construct appropriate control charts with the upper and lower alarm limits. Daily use of these reference samples decrease significantly the risk for false results in original urine with no significant increase of the determination time. (Author) 2 refs

Robowell: An automated process for monitoring ground water quality using established sampling protocols

Science.gov (United States)

Granato, G.E.; Smith, K.P.

1999-01-01

Robowell is an automated process for monitoring selected ground water quality properties and constituents by pumping a well or multilevel sampler. Robowell was developed and tested to provide a cost-effective monitoring system that meets protocols expected for manual sampling. The process uses commercially available electronics, instrumentation, and hardware, so it can be configured to monitor ground water quality using the equipment, purge protocol, and monitoring well design most appropriate for the monitoring site and the contaminants of interest. A Robowell prototype was installed on a sewage treatment plant infiltration bed that overlies a well-studied unconfined sand and gravel aquifer at the Massachusetts Military Reservation, Cape Cod, Massachusetts, during a time when two distinct plumes of constituents were released. The prototype was operated from May 10 to November 13, 1996, and quality-assurance/quality-control measurements demonstrated that the data obtained by the automated method was equivalent to data obtained by manual sampling methods using the same sampling protocols. Water level, specific conductance, pH, water temperature, dissolved oxygen, and dissolved ammonium were monitored by the prototype as the wells were purged according to U.S Geological Survey (USGS) ground water sampling protocols. Remote access to the data record, via phone modem communications, indicated the arrival of each plume over a few days and the subsequent geochemical reactions over the following weeks. Real-time availability of the monitoring record provided the information needed to initiate manual sampling efforts in response to changes in measured ground water quality, which proved the method and characterized the screened portion of the plume in detail through time. The methods and the case study described are presented to document the process for future use.

Quality Management and Key Performance Indicators in Oncologic Esophageal Surgery.

Science.gov (United States)

Gockel, Ines; Ahlbrand, Constantin Johannes; Arras, Michael; Schreiber, Elke Maria; Lang, Hauke

2015-12-01

Ranking systems and comparisons of quality and performance indicators will be of increasing relevance for complex "high-risk" procedures such as esophageal cancer surgery. The identification of evidence-based standards relevant for key performance indicators in esophageal surgery is essential for establishing monitoring systems and furthermore a requirement to enhance treatment quality. In the course of this review, we analyze the key performance indicators case volume, radicality of resection, and postoperative morbidity and mortality, leading to continuous quality improvement. Ranking systems established on this basis will gain increased relevance in highly complex procedures within the national and international comparison and furthermore improve the treatment of patients with esophageal carcinoma.

Can examination of WWW usage statistics and other indirect quality indicators distinguish the relative quality of medical web sites?

Science.gov (United States)

Hernández-Borges, A A; Macías-Cervi, P; Gaspar-Guardado, M A; Torres-Alvarez de Arcaya, M L; Ruiz-Rabaza, A; Jiménez-Sosa, A

1999-01-01

The Internet offers a great amount of health related websites, but concern has been raised about their reliability. Several subjective evaluation criteria and websites rating systems have been proposed as a help for the Internet users to distinguish among web resources with different quality, but their efficacy has not been proven. To evaluate the agreement of a subset of Internet rating systems editorial boards regarding their evaluations of a sample of pediatric websites. To evaluate certain websites characteristics as possible quality indicators for pediatric websites. Comparative survey of the Results of systematic evaluations of the contents and formal aspects of a sample of pediatric websites, with the number of daily visits to those websites, the time since their last update, the impact factor of their authors or editors, and the number of websites linked to them. 363 websites were compiled from eight rating systems. Only 25 were indexed and evaluated by at least two rating systems. This subset included more updated and more linked websites. There was no correlation among the Results of the evaluation of these 25 websites by the rating systems. The number of inbound links to the websites significantly correlated with their updating frequency (pquality indicators. On the other hand, the citation analysis on the Web by the quantification of inbound links to medical websites could be an objective and feasible tool in rating great amounts of websites.

Occurrence, molecular characterization and antibiogram of water quality indicator bacteria in river water serving a water treatment plant

Energy Technology Data Exchange (ETDEWEB)

Okeke, Benedict C., E-mail: bokeke@aum.edu [Department of Biology, Auburn University at Montgomery, P.O. Box 244023, Montgomery, AL 36124 (United States); Thomson, M. Sue [Department of Biology, Auburn University at Montgomery, P.O. Box 244023, Montgomery, AL 36124 (United States); Moss, Elica M. [Department of Natural Resources and Environmental Science, Alabama A and M University, AL 35762 (United States)

2011-11-01

Water pollution by microorganisms of fecal origin is a current world-wide public health concern. Total coliforms, fecal coliforms (Escherichia coli) and enterococci are indicators commonly used to assess the microbiological safety of water resources. In this study, influent water samples and treated water were collected seasonally from a water treatment plant and two major water wells in a Black Belt county of Alabama and evaluated for water quality indicator bacteria. Influent river water samples serving the treatment plant were positive for total coliforms, fecal coliforms (E. coli), and enterococci. The highest number of total coliform most probable number (MPN) was observed in the winter (847.5 MPN/100 mL) and the lowest number in the summer (385.6 MPN/100 mL). Similarly E. coli MPN was substantially higher in the winter (62.25 MPN/100 mL). Seasonal variation of E. coli MPN in influent river water samples was strongly correlated with color (R{sup 2} = 0.998) and turbidity (R{sup 2} = 0.992). Neither E. coli nor other coliform type bacteria were detected in effluent potable water from the treatment plant. The MPN of enterococci was the highest in the fall and the lowest in the winter. Approximately 99.7 and 51.5 enterococci MPN/100 mL were recorded in fall and winter seasons respectively. One-way ANOVA tests revealed significant differences in seasonal variation of total coliforms (P < 0.05), fecal coliforms (P < 0.01) and enterococci (P < 0.01). Treated effluent river water samples and well water samples revealed no enterococci contamination. Representative coliform bacteria selected by differential screening on Coliscan Easygel were identified by 16S ribosomal RNA gene sequence analysis. E. coli isolates were sensitive to gentamicin, trimethoprim/sulfamethazole, ciprofloxacin, vancomycin, tetracycline, ampicillin, cefixime, and nitrofurantoin. Nonetheless, isolate BO-54 displayed decreased sensitivity compared to other E. coli isolates. Antibiotic sensitivity

Occurrence, molecular characterization and antibiogram of water quality indicator bacteria in river water serving a water treatment plant

International Nuclear Information System (INIS)

Okeke, Benedict C.; Thomson, M. Sue; Moss, Elica M.

2011-01-01

Water pollution by microorganisms of fecal origin is a current world-wide public health concern. Total coliforms, fecal coliforms (Escherichia coli) and enterococci are indicators commonly used to assess the microbiological safety of water resources. In this study, influent water samples and treated water were collected seasonally from a water treatment plant and two major water wells in a Black Belt county of Alabama and evaluated for water quality indicator bacteria. Influent river water samples serving the treatment plant were positive for total coliforms, fecal coliforms (E. coli), and enterococci. The highest number of total coliform most probable number (MPN) was observed in the winter (847.5 MPN/100 mL) and the lowest number in the summer (385.6 MPN/100 mL). Similarly E. coli MPN was substantially higher in the winter (62.25 MPN/100 mL). Seasonal variation of E. coli MPN in influent river water samples was strongly correlated with color (R 2 = 0.998) and turbidity (R 2 = 0.992). Neither E. coli nor other coliform type bacteria were detected in effluent potable water from the treatment plant. The MPN of enterococci was the highest in the fall and the lowest in the winter. Approximately 99.7 and 51.5 enterococci MPN/100 mL were recorded in fall and winter seasons respectively. One-way ANOVA tests revealed significant differences in seasonal variation of total coliforms (P < 0.05), fecal coliforms (P < 0.01) and enterococci (P < 0.01). Treated effluent river water samples and well water samples revealed no enterococci contamination. Representative coliform bacteria selected by differential screening on Coliscan Easygel were identified by 16S ribosomal RNA gene sequence analysis. E. coli isolates were sensitive to gentamicin, trimethoprim/sulfamethazole, ciprofloxacin, vancomycin, tetracycline, ampicillin, cefixime, and nitrofurantoin. Nonetheless, isolate BO-54 displayed decreased sensitivity compared to other E. coli isolates. Antibiotic sensitivity pattern

Image quality indicators for radiography and recommendations for their use - 1966

Energy Technology Data Exchange (ETDEWEB)

1976-01-01

This Standard covers dimensional requirements, materials, construction and marking of wire type and step/hole type image quality indicators for assessing quality of radiographs on materials from 3 mm to 250 mm thick. Standard models of each type; use of image quality indicators (with obtainable sensitivity values) and charts for calculations. (Metric)

Spatial Variability of Indicators of Jiaokou Reservoir Under Different Sampling Scales

Directory of Open Access Journals (Sweden)

WEI Wen-juan

2016-12-01

Full Text Available This research determined total nitrogen, total phosphorus, ammonia nitrogen and potassium permanganate contents in different scales of Jiaokou reservoir with the purpose of exploring the applicability of spatial variability and its characteristic in different sampling scales. The results showed that, compared the sampling scales of 100 m with 200 m, there were some differences among four indicators in the spatial variation, interpolation simulation and spatial distribution. About the testing model fit, the fitting model for the total nitrogen, permanganate index was Gaussian model, the fitting model for total phosphorus, ammonia nitrogen was the spherical model; Combining evaluation of parameters of models and comprehensive evaluation of spatial interpolation, total nitrogen, total phosphorus showed stronger spatial correlation and better interpolation simulation quality on the sampling scales of 200 m, while total phosphorus and permanganate index showed certain advantages on the 100 m scale; On the aspect of spatial distributions, the contents of ammonia nitrogen and potassium permanganate were mainly affected by human factors, the total phosphorus was affected by internal factors of the reservoir, while total nitrogen was closely related to farming activities around reservoir. The above results showed that total nitrogen, ammonia nitrogen were more available for the 200 m scales and total phosphorus, potassium permanganate were more available for the 100 m scales.

Irrigation water quality as indicator of sustainable rural development

Directory of Open Access Journals (Sweden)

Trajković Slaviša

2004-01-01

Full Text Available The sustainable rural development more and more depends on the efficient usage of water resources. Most often, at least in one part of the year, the rain is not sufficient for plant growth and rain plant production significantly depends on the yearly precipitation variation. The increase and stability of the agricultural production is possible in the irrigation conditions. The most part (around 70% of the global water resources is used for food production. Irrigation water quality indicator is used to show if the available water resources have the required quality for application in agriculture. Irrigation is characterised by the complex water-plant-soil relationship, and in that eco-system the man as the end user of the irrigated fields occupies a very important place. That explains the difficulties in producing one universal classification of irrigation water quality. The paper analyses numerous water quality classifications from the aspect of the applicability on the quantifying of this indicator. The adopted classification should possess understandable, qualified and internationally comparable indicator. Thus, local classifications (Neigebauer, Miljkovic cannot be used for this indicator. United Nation Food and Agricultural Organization (FAO and US Salinity Laboratory (USSL classifications are used for the evaluation of the irrigation water quality throughout the world. FAO classification gives the complex picture of the usability of the irrigation water from the point of its influence on the soil and the plants. However, the scope of the analyses is not often suited to the needs of that classification, which makes it difficult to apply. The conclusion is that the USSL (US Salinity Laboratory classification is best suited to this range of chemical water analyses. The evaluation of the irrigation water quality indicator in the Juzna Morava river basin, upstream from the Toplica river estuary is given in this paper. Based on the obtained

Quality indicators for woodwind reed material

International Nuclear Information System (INIS)

Glave, Stefan; Pallon, Jan; Bornman, Chris; Bjoern, Lars Olof; Wallen, Rita; Raastam, Jacob; Kristiansson, Per; Elfman, Mikael; Malmqvist, Klas

1999-01-01

For the generation of sound, some woodwind musical instruments, e.g. oboe, bassoon, clarinet and saxophone, are provided with mouthpieces made from reeds. These reeds are the culms of Arundo donax, a tall, cane-like perennial grass. A general problem is that the material is of varying quality, yet externally differences cannot be observed. Hence, large proportions of the prepared reeds are unusable. One hypothesis is that the changes in quality are correlated with differences in the chemical and anatomical structure of the tissue. Therefore, a comparison of superior and inferior mouthpieces, used by professional musicians, was undertaken to determinate potential indicators of quality. Nuclear microprobe analysis of reeds was carried out and complemented by scanning electron and light microscopy. The elemental levels of Si, P, S, Cl, K and Ca were compared between good and poor mouthpieces using appropriate statistical tests. No statistically significant differences could be identified. Microscopical observations showed that partial occlusion of vessels by tylose formation was associated with material deemed unusable

Headache service quality: evaluation of quality indicators in 14 specialist-care centres.

Science.gov (United States)

Schramm, Sara; Uluduz, Derya; Gouveia, Raquel Gil; Jensen, Rigmor; Siva, Aksel; Uygunoglu, Ugur; Gvantsa, Giorgadze; Mania, Maka; Braschinsky, Mark; Filatova, Elena; Latysheva, Nina; Osipova, Vera; Skorobogatykh, Kirill; Azimova, Julia; Straube, Andreas; Eren, Ozan Emre; Martelletti, Paolo; De Angelis, Valerio; Negro, Andrea; Linde, Mattias; Hagen, Knut; Radojicic, Aleksandra; Zidverc-Trajkovic, Jasna; Podgorac, Ana; Paemeleire, Koen; De Pue, Annelien; Lampl, Christian; Steiner, Timothy J; Katsarava, Zaza

2016-12-01

The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). Employing previously-developed instruments in 14 such centres, we made enquiries, in each, of health-care providers (doctors, nurses, psychologists, physiotherapists) and 50 patients, and analysed the medical records of 50 other patients. Enquiries were in 9 domains: diagnostic accuracy, individualized management, referral pathways, patient's education and reassurance, convenience and comfort, patient's satisfaction, equity and efficiency of the headache care, outcome assessment and safety. Our study showed that highly experienced headache centres treated their patients in general very well. The centres were content with their work and their patients were content with their treatment. Including disability and quality-of-life evaluations in clinical assessments, and protocols regarding safety, proved problematic: better standards for these are needed. Some centres had problems with follow-up: many specialised centres operated in one-touch systems, without possibility of controlling long-term management or the success of treatments dependent on this. This first Europe-wide quality study showed that the quality indicators were workable in specialist care. They demonstrated common trends, producing evidence of what is majority practice. They also uncovered deficits that might be remedied in order to improve quality. They offer the means of setting benchmarks against which service quality may be judged. The next step is to take the evaluation process into non-specialist care (EHF/LTB levels 1 and 2).

An approach based on HPLC-fingerprint and chemometrics to quality consistency evaluation of Matricaria chamomilla L. commercial samples

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Agnieszka Viapiana

2016-10-01

Full Text Available Chamomile has been used as an herbal medication since ancient times and is still popular because it contains various bioactive phytochemicals that could provide therapeutic effects. In this study, a simple and reliable HPLC method was developed to evaluate the quality consistency of nineteen chamomile samples through establishing a chromatographic fingerprint, quantification of phenolic compounds and determination of antioxidant activity. For fingerprint analysis, 12 peaks were selected as the common peaks to evaluate the similarities of commercial samples of chamomile obtained from different manufacturers. A similarity analysis was performed to assess the similarity/dissimilarity of chamomile samples where values varied from 0.868 to 0.990 what indicating that samples from different manufacturers were consistent. Additionally, simultaneous quantification of five phenolic acids (gallic, caffeic, syringic, p-coumaric, ferulic and four flavonoids (rutin, myricetin, quercetin and keampferol was performed to interpret the quality consistency. In quantitative analysis, the nine individual phenolic compounds showed good regression (r > 0.9975. Inter- and intra-day precisions for all analysed compounds expressed as relative standard deviation (CV ranged from 0.05% to 3.12%. Since flavonoids and other polyphenols are commonly recognised as natural antioxidants, the antioxidant activity of chamomile samples was evaluated using 1,1-diphenyl-2-picrylhydrazyl (DPPH radical scavenging activity and ferric reducing/antioxidant power (FRAP assay. Correlation analysis was used to assess the relationship between antioxidant activity and phenolic composition, and multivariate analysis (PCA and HCA were applied to distinguish chamomile samples. Results shown in the study indicate high similarity of chamomile samples among them, widely spread in the market and commonly used by people as infusions or teas, as well as that there were no statistically significant

An Approach Based on HPLC-Fingerprint and Chemometrics to Quality Consistency Evaluation of Matricaria chamomilla L. Commercial Samples

Science.gov (United States)

Viapiana, Agnieszka; Struck-Lewicka, Wiktoria; Konieczynski, Pawel; Wesolowski, Marek; Kaliszan, Roman

2016-01-01

Chamomile has been used as an herbal medication since ancient times and is still popular because it contains various bioactive phytochemicals that could provide therapeutic effects. In this study, a simple and reliable HPLC method was developed to evaluate the quality consistency of nineteen chamomile samples through establishing a chromatographic fingerprint, quantification of phenolic compounds and determination of antioxidant activity. For fingerprint analysis, 12 peaks were selected as the common peaks to evaluate the similarities of commercial samples of chamomile obtained from different manufacturers. A similarity analysis was performed to assess the similarity/dissimilarity of chamomile samples where values varied from 0.868 to 0.990 what indicating that samples from different manufacturers were consistent. Additionally, simultaneous quantification of five phenolic acids (gallic, caffeic, syringic, p-coumaric, ferulic) and four flavonoids (rutin, myricetin, quercetin and keampferol) was performed to interpret the quality consistency. In quantitative analysis, the nine individual phenolic compounds showed good regression (r > 0.9975). Inter- and intra-day precisions for all analyzed compounds expressed as relative standard deviation (CV) ranged from 0.05% to 3.12%. Since flavonoids and other polyphenols are commonly recognized as natural antioxidants, the antioxidant activity of chamomile samples was evaluated using 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity and ferric reducing/antioxidant power (FRAP) assay. Correlation analysis was used to assess the relationship between antioxidant activity and phenolic composition, and multivariate analysis (PCA and HCA) were applied to distinguish chamomile samples. Results shown in the study indicate high similarity of chamomile samples among them, widely spread in the market and commonly used by people as infusions or teas, as well as that there were no statistically significant differences among

Quality Indicators for Quality of Care During Hospitalization for Vulnerable Elder Persons

National Research Council Canada - National Science Library

Kleerup, Eric

2004-01-01

.... While many of the above conditions, such as congestive heart failure, pressure ulcers, and ischemic heart disease, contain indicators for the quality of hospital care associated with that condition...

Biological and biochemical soil quality indicators for agricultural management

Science.gov (United States)

Bongiorno, Giulia

2017-04-01

Soil quality is defined as the capacity of a soil to perform multiple functions. Agricultural soils can, in principle, sustain a wide range of functions. However, negative pressure exerted by natural and anthropogenic soil threats such as soil erosion, soil organic matter losses and soil compaction have the potential to permanently damage soil quality. Soil chemical, physical and biological parameters can be used as indicators of soil quality. The specific objective of this study is to assess the suitability of novel soil parameters as soil quality indicators. We focus on biological/biochemical parameters, due to the unique role of soil biota in soil functions and to their high sensitivity to disturbances. The novel indicators are assessed in ten European long-term field experiments (LTEs) with different agricultural land use (arable and permanent crops), management regimes and pedo-climatic characteristics. The contrasts in agricultural management are represented by conventional/reduced tillage, organic/mineral fertilization and organic matter addition/no organic matter addition. We measured two different pools of labile organic carbon (dissolved organic carbon (DOC), and permanganate oxidizable carbon (POXC)), and determined DOC quality through its fractionation in hydrophobic and hydrophilic compounds. In addition, total nematode abundance has been assessed with qPCR. These parameters will be related to soil functions which have been measured with a minimum data set of indicators for soil quality (including TOC, macronutrients, and soil respiration). As a preliminary analysis, the Sensitivity Index (SI) for a given LTE was calculated for DOC and POXC according to Bolinder et al., 1999 as the ratio of the soil attribute under modified practices (e.g. reduced tillage) compared to the conventional practices (e.g. conventional tillage). The overall effect of the sustainable management on the indicators has been derived by calculating an average SI for those LTEs

Monitoring of performance management using Quality Assurance Indicators and ISO requirement

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Dargahi H

2007-06-01

Full Text Available Background: Quality assurance is a prevention-oriented system that can be used to improve the quality of care, increase productivity and monitor the performance management in clinical laboratories. ISO 9001: 2000 requirements are a collection of management and technical systems designed to implement quality assurance and monitor performance management in organizations. Methods: A checklist was prepared to monitor the preanalytical, analytical and postanalytical stages of laboratory performance management in 16 areas and all laboratory activities in 14 of the clinical laboratories of the Tehran University of Medical Sciences (TUMS hospitals. Collected data were stored and statistically analyzed using SPSS software. Results: The best performance, in which 77.73% of quality assurance indicators were observed, was found in Sina Hospital. However, only 57.56% of these indicators were fulfilled at Farabi Hospital, with the lowest-level performance among the clinical laboratories of TUMS hospitals. The highest level of compliance with quality assurance indicators was in the hematology departments and for facility demands in management areas. Overall, quality assurance indicators were appropriately followed in only 7% of the clinical laboratories. Conclusion: The average quality assurance observation rate in the clinical laboratories studied was 67.22%, which is insufficient and must be remedied with stricter enforcement of the ISO 9001: 2000 regulations.

Physical soil quality indicators for monitoring British soils

Science.gov (United States)

Corstanje, Ron; Mercer, Theresa G.; Rickson, Jane R.; Deeks, Lynda K.; Newell-Price, Paul; Holman, Ian; Kechavarsi, Cedric; Waine, Toby W.

2017-09-01

Soil condition or quality determines its ability to deliver a range of functions that support ecosystem services, human health and wellbeing. The increasing policy imperative to implement successful soil monitoring programmes has resulted in the demand for reliable soil quality indicators (SQIs) for physical, biological and chemical soil properties. The selection of these indicators needs to ensure that they are sensitive and responsive to pressure and change, e.g. they change across space and time in relation to natural perturbations and land management practices. Using a logical sieve approach based on key policy-related soil functions, this research assessed whether physical soil properties can be used to indicate the quality of British soils in terms of their capacity to deliver ecosystem goods and services. The resultant prioritised list of physical SQIs was tested for robustness, spatial and temporal variability, and expected rate of change using statistical analysis and modelling. Seven SQIs were prioritised: soil packing density, soil water retention characteristics, aggregate stability, rate of soil erosion, depth of soil, soil structure (assessed by visual soil evaluation) and soil sealing. These all have direct relevance to current and likely future soil and environmental policy and are appropriate for implementation in soil monitoring programmes.

Physical soil quality indicators for monitoring British soils

Directory of Open Access Journals (Sweden)

R. Corstanje

2017-09-01

Full Text Available Soil condition or quality determines its ability to deliver a range of functions that support ecosystem services, human health and wellbeing. The increasing policy imperative to implement successful soil monitoring programmes has resulted in the demand for reliable soil quality indicators (SQIs for physical, biological and chemical soil properties. The selection of these indicators needs to ensure that they are sensitive and responsive to pressure and change, e.g. they change across space and time in relation to natural perturbations and land management practices. Using a logical sieve approach based on key policy-related soil functions, this research assessed whether physical soil properties can be used to indicate the quality of British soils in terms of their capacity to deliver ecosystem goods and services. The resultant prioritised list of physical SQIs was tested for robustness, spatial and temporal variability, and expected rate of change using statistical analysis and modelling. Seven SQIs were prioritised: soil packing density, soil water retention characteristics, aggregate stability, rate of soil erosion, depth of soil, soil structure (assessed by visual soil evaluation and soil sealing. These all have direct relevance to current and likely future soil and environmental policy and are appropriate for implementation in soil monitoring programmes.

Procedures for sampling and sample-reduction within quality assurance systems for solid biofuels

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-04-15

The bias introduced when sampling solid biofuels from stockpiles or containers instead of from moving streams is assessed as well as the number and size of samples required to represent accurately the bulk sample, variations introduced when reducing bulk samples into samples for testing, and the usefulness of sample reduction methods. Details are given of the experimental work carried out in Sweden and Denmark using sawdust, wood chips, wood pellets, forestry residues and straw. The production of a model European Standard for quality assurance of solid biofuels is examined.

Inter-rater reliability of nursing home quality indicators in the U.S

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Roy Jason

2003-11-01

Full Text Available Abstract Background In the US, Quality Indicators (QI's profiling and comparing the performance of hospitals, health plans, nursing homes and physicians are routinely published for consumer review. We report the results of the largest study of inter-rater reliability done on nursing home assessments which generate the data used to derive publicly reported nursing home quality indicators. Methods We sampled nursing homes in 6 states, selecting up to 30 residents per facility who were observed and assessed by research nurses on 100 clinical assessment elements contained in the Minimum Data Set (MDS and compared these with the most recent assessment in the record done by facility nurses. Kappa statistics were generated for all data items and derived for 22 QI's over the entire sample and for each facility. Finally, facilities with many QI's with poor Kappa levels were compared to those with many QI's with excellent Kappa levels on selected characteristics. Results A total of 462 facilities in 6 states were approached and 219 agreed to participate, yielding a response rate of 47.4%. A total of 5758 residents were included in the inter-rater reliability analyses, around 27.5 per facility. Patients resembled the traditional nursing home resident, only 43.9% were continent of urine and only 25.2% were rated as likely to be discharged within the next 30 days. Results of resident level comparative analyses reveal high inter-rater reliability levels (most items >.75. Using the research nurses as the "gold standard", we compared composite quality indicators based on their ratings with those based on facility nurses. All but two QI's have adequate Kappa levels and 4 QI's have average Kappa values in excess of .80. We found that 16% of participating facilities performed poorly (Kappa .75 on 12 or more QI's. No facility characteristics were related to reliability of the data on which Qis are based. Conclusion While a few QI's being used for public reporting

Assessing and monitoring soil quality at agricultural waste disposal areas-Soil Indicators

Science.gov (United States)

Doula, Maria; Kavvadias, Victor; Sarris, Apostolos; Lolos, Polykarpos; Liakopoulou, Nektaria; Hliaoutakis, Aggelos; Kydonakis, Aris

2014-05-01

The necessity of elaborating indicators is one of the priorities identified by the United Nations Convention to Combat Desertification (UNCCD). The establishment of an indicator monitoring system for environmental purposes is dependent on the geographical scale. Some indicators such as rain seasonality or drainage density are useful over large areas, but others such as soil depth, vegetation cover type, and land ownership are only applicable locally. In order to practically enhance the sustainability of land management, research on using indicators for assessing land degradation risk must initially focus at local level because management decisions by individual land users are taken at this level. Soils that accept wastes disposal, apart from progressive degradation, may cause serious problems to the surrounding environment (humans, animals, plants, water systems, etc.), and thus, soil quality should be necessarily monitored. Therefore, quality indicators, representative of the specific waste type, should be established and monitored periodically. Since waste composition is dependent on their origin, specific indicators for each waste type should be established. Considering agricultural wastes, such a specification, however, could be difficult, since almost all agricultural wastes are characterized by increased concentrations of the same elements, namely, phosphorous, nitrogen, potassium, sulfur, etc.; contain large amounts of organic matter; and have very high values of chemical oxygen demand (COD), biochemical oxygen demand (BOD), and electrical conductivity. Two LIFE projects, namely AgroStrat and PROSODOL are focused on the identification of soil indicators for the assessment of soil quality at areas where pistachio wastes and olive mill wastes are disposed, respectively. Many soil samples were collected periodically for 2 years during PROSODOL and one year during AgroStrat (this project is in progress) from waste disposal areas and analyzed for 23 parameters

Choosing a Cluster Sampling Design for Lot Quality Assurance Sampling Surveys

OpenAIRE

Hund, Lauren; Bedrick, Edward J.; Pagano, Marcello

2015-01-01

Lot quality assurance sampling (LQAS) surveys are commonly used for monitoring and evaluation in resource-limited settings. Recently several methods have been proposed to combine LQAS with cluster sampling for more timely and cost-effective data collection. For some of these methods, the standard binomial model can be used for constructing decision rules as the clustering can be ignored. For other designs, considered here, clustering is accommodated in the design phase. In this paper, we comp...

The importance of using quality indicators in nursing care

Directory of Open Access Journals (Sweden)

Thaizy Valânia Lopes Silveira

Full Text Available OBJECTIVE: To investigate the opinion of hospital nurses on the use of quality indicators for nursing care. METHOD: Research based on the qualitative approach, conducted with 41 nurses from two charity hospitals in Minas Gerais, from September to October 2013. Interviews with a semi-structured script were used to collect data. The empirical data were organized by means of content analysis. RESULTS: Indicators are important for assessing the provided care, for improving the quality of care, and for defining strategies to achieve goals. CONCLUSIONS: The difficulties encountered when using these indicators revealed the following constituent elements: lack of time, inadequate number of professionals and lack of knowledge on the subject. It was concluded that nurses understand that indicators are instruments that enable evaluations and improvements, but their understanding of how to use these instruments is incomplete and fragmented.

Soil enzymes: health and quality indicators

Directory of Open Access Journals (Sweden)

Laura E. Cerón Rincón

2005-01-01

define sustainability, in other words, the maintenance of their functions inside the limits of an ecosystem. The health and quality indicators are a set of measurements (physical, chemical and biological properties that pretend to establish quality standards for this resource; the enzymatic activity is placed inside this set because of its close relationship with the other properties and because of its sensibleness to the changes due to handling and use. The present review pretends to illustrate how the tracking of the biological catalysis of the soil through uses and alterations that an ecosystem may suffer, may supply information for the understanding of how the processes responsible for the maintenance of functions such as biomass production, pollutant remediation and cycling of nutrients, suffer changes and if these are positive, negative or iterative.

From Computer-interpretable Guidelines to Computer-interpretable Quality Indicators: A Case for an Ontology.

Science.gov (United States)

White, Pam; Roudsari, Abdul

2014-01-01

In the United Kingdom's National Health Service, quality indicators are generally measured electronically by using queries and data extraction, resulting in overlap and duplication of query components. Electronic measurement of health care quality indicators could be improved through an ontology intended to reduce duplication of effort during healthcare quality monitoring. While much research has been published on ontologies for computer-interpretable guidelines, quality indicators have lagged behind. We aimed to determine progress on the use of ontologies to facilitate computer-interpretable healthcare quality indicators. We assessed potential for improvements to computer-interpretable healthcare quality indicators in England. We concluded that an ontology for a large, diverse set of healthcare quality indicators could benefit the NHS and reduce workload, with potential lessons for other countries.

FIELD TEST OF THE FLAME QUALITY INDICATOR

Energy Technology Data Exchange (ETDEWEB)

Rudin, Andrew M; Butcher, Thomas; Troost, Henry

2003-02-04

The flame quality indicator concept was developed at BNL specifically to monitor the brightness of the flame in a small oil burner and to provide a ''call for service'' notification when the brightness has changed from its setpoint, either high or low. In prior development work BNL has explored the response of this system to operational upsets such as excess air changes, fouled atomizer nozzles, poor fuel quality, etc. Insight Technologies, Inc. and Honeywell, Inc. have licensed this technology from the U.S. Department of Energy and have been cooperating to develop product offerings which meet industry needs with an optimal combination of function and price. Honeywell has recently completed the development of the Flame Quality Monitor (FQM or Honeywell QS7100F). This is a small module which connects via a serial cable to the burners primary operating control. Primary advantages of this approach are simplicity, cost, and ease of installation. Call-for-service conditions are output in the form of front panel indicator lights and contact closure which can trigger a range of external communication options. Under this project a field test was conducted of the FQM in cooperation with service organizations in Virginia, Pennsylvania, New Jersey, New York, and Connecticut. At total of 83 field sites were included. At each site the FQM was installed in parallel with another embodiment of this concept--the Insight AFQI. The AFQI incorporates a modem and provides the ability to provide detailed information on the trends in the flame quality over the course of the two year test period. The test site population was comprised of 79.5% boilers, 13.7% warm air furnaces, and 6.8% water heaters. Nearly all were of residential size--with firing rates ranging from 0.6 gallons of oil per hour to 1.25. During the course of the test program the monitoring equipment successfully identified problems including: plugged fuel lines, fouled nozzles, collapsed combustion

Are patent medicine vendors effective agents in malaria control? Using lot quality assurance sampling to assess quality of practice in Jigawa, Nigeria.

Directory of Open Access Journals (Sweden)

Sima Berendes

Full Text Available BACKGROUND: Patent medicine vendors (PMV provide antimalarial treatment and care throughout Sub-Saharan Africa, and can play an important role in the fight against malaria. Their close-to-client infrastructure could enable lifesaving artemisinin-based combination therapy (ACT to reach patients in time. However, systematic assessments of drug sellers' performance quality are crucial if their role is to be managed within the health system. Lot quality assurance sampling (LQAS could be an efficient method to monitor and evaluate PMV practice, but has so far never been used for this purpose. METHODS: In support of the Nigeria Malaria Booster Program we assessed PMV practices in three Senatorial Districts (SDs of Jigawa, Nigeria. A two-stage LQAS assessed whether at least 80% of PMV stores in SDs used national treatment guidelines. Acceptable sampling errors were set in consultation with government officials (alpha and beta <0.10. The hypergeometric formula determined sample sizes and cut-off values for SDs. A structured assessment tool identified high and low performing SDs for quality of care indicators. FINDINGS: Drug vendors performed poorly in all SDs of Jigawa for all indicators. For example, all SDs failed for stocking and selling first-line antimalarials. PMV sold no longer recommended antimalarials, such as Chloroquine, Sulfadoxine-Pyrimethamine and oral Artesunate monotherapy. Most PMV were ignorant of and lacked training about new treatment guidelines that had endorsed ACTs as first-line treatment for uncomplicated malaria. CONCLUSION: There is urgent need to regularly monitor and improve the availability and quality of malaria treatment provided by medicine sellers in Nigeria; the irrational use of antimalarials in the ACT era revealed in this study bears a high risk of economic loss, death and development of drug resistance. LQAS has been shown to be a suitable method for monitoring malaria-related indicators among PMV, and should be

Proxy Graph: Visual Quality Metrics of Big Graph Sampling.

Science.gov (United States)

Nguyen, Quan Hoang; Hong, Seok-Hee; Eades, Peter; Meidiana, Amyra

2017-06-01

Data sampling has been extensively studied for large scale graph mining. Many analyses and tasks become more efficient when performed on graph samples of much smaller size. The use of proxy objects is common in software engineering for analysis and interaction with heavy objects or systems. In this paper, we coin the term 'proxy graph' and empirically investigate how well a proxy graph visualization can represent a big graph. Our investigation focuses on proxy graphs obtained by sampling; this is one of the most common proxy approaches. Despite the plethora of data sampling studies, this is the first evaluation of sampling in the context of graph visualization. For an objective evaluation, we propose a new family of quality metrics for visual quality of proxy graphs. Our experiments cover popular sampling techniques. Our experimental results lead to guidelines for using sampling-based proxy graphs in visualization.

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

Science.gov (United States)

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

2012-03-01

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

Health assessment using aqua-quality indicators of alpine streams (Khunjerab National Park), Gilgit, Pakistan.

Science.gov (United States)

Ali, Salar; Gao, Junfeng; Begum, Farida; Rasool, Atta; Ismail, Muhammad; Cai, Yongjiu; Ali, Shaukat; Ali, Shujaat

2017-02-01

This preliminary research was conducted to evaluate the alpine stream health by using water quality as an indicator in Khunjerab National park of the Karakoram ranges located in Pak-China boarder Pakistan having altitude of 3660 m. This study investigated the stream health in the context of the presence or absence of sensitive species, their diversity, and their taxa richness. The water and macroinvertebrate samples were collected from 17 different locations from upstream and downstream of the river by using random sampling method. Macroinvertebrate samples were obtained using kick net (500-μm mesh size) and hand-picking method (NYSDEC). A total of 710 counts including 41 families of macroinvertebrates were recorded comprising of 7 orders including: Ephemeroptera (46%) being the most dominant group, Plecoptera (33%), Trichoptera (5%), Chironomidae (Diptera) (14%), Heteroptera (1%), and Coleoptera (1%). Ephemeroptera, Trichoptera, and Plecoptera (EPT) were found in abundance at the main source, Qarchanai, Dhee, and Tourqeen Nullah, as compared to the other locations of the stream. The most dominant macroinvertebrate was Ephemeroptera whose relative abundance is Pi = 0.49 by using the Shannon index. However, different statistical tools, including principal component analysis (PCA), cluster analysis (CA), ANOVA, and linear regression model, show a strong correlation between water quality and macroinvertebrates. The overall results of the biological indicators showed better ecological health at downstream compared to upstream. This study will provide basic information and understanding about the macroinvertebrates for future researchers, and the data will be helpful for upcoming research programs on alpine streams for the discovery and occurrences of macroinvertebrates and associated fauna.

Do treatment quality indicators predict cardiovascular outcomes in patients with diabetes?

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Grigory Sidorenkov

Full Text Available BACKGROUND: Landmark clinical trials have led to optimal treatment recommendations for patients with diabetes. Whether optimal treatment is actually delivered in practice is even more important than the efficacy of the drugs tested in trials. To this end, treatment quality indicators have been developed and tested against intermediate outcomes. No studies have tested whether these treatment quality indicators also predict hard patient outcomes. METHODS: A cohort study was conducted using data collected from >10.000 diabetes patients in the Groningen Initiative to Analyze Type 2 Treatment (GIANTT database and Dutch Hospital Data register. Included quality indicators measured glucose-, lipid-, blood pressure- and albuminuria-lowering treatment status and treatment intensification. Hard patient outcome was the composite of cardiovascular events and all-cause death. Associations were tested using Cox regression adjusting for confounding, reporting hazard ratios (HR with 95% confidence intervals. RESULTS: Lipid and albuminuria treatment status, but not blood pressure lowering treatment status, were associated with the composite outcome (HR = 0.77, 0.67-0.88; HR = 0.75, 0.59-0.94. Glucose lowering treatment status was associated with the composite outcome only in patients with an elevated HbA1c level (HR = 0.72, 0.56-0.93. Treatment intensification with glucose-lowering but not with lipid-, blood pressure- and albuminuria-lowering drugs was associated with the outcome (HR = 0.73, 0.60-0.89. CONCLUSION: Treatment quality indicators measuring lipid- and albuminuria-lowering treatment status are valid quality measures, since they predict a lower risk of cardiovascular events and mortality in patients with diabetes. The quality indicators for glucose-lowering treatment should only be used for restricted populations with elevated HbA1c levels. Intriguingly, the tested indicators for blood pressure-lowering treatment did not predict patient

Data Quality Indicators Composition and Calculus: Engineering and Information Systems Approaches

Directory of Open Access Journals (Sweden)

Leon REZNIK

2015-02-01

Full Text Available Big Data phenomenon is a result of novel technological developments in sensor, computer and communication technologies. Nowadays more and more data are produced by nanoscale photonic, optoelectronic and electronic devices. However, their quality characteristics could be very low. The paper proposes new methods of the data management with huge data amounts that is based on associating of data quality indicators with each data entity. To achieve this goal, one needs to define the composition of the data quality indicators and to develop their integration calculus. As data quality evaluation involves multi-disciplinary research, various metrics have been investigated. The paper describes two major approaches in assigning the data quality indicators and developing their integration calculus. The information systems approach employs traditional high-level metrics like data accuracy, consistency and completeness. The engineering approach utilizes signal characteristics processed with the probability based calculus. The data quality metrics composition and calculus are discussed. The tools developed to automate the metrics selection and calculus procedures are presented. The user- friendly interface examples are provided.

Relationship between the properties of raw and cooked spaghetti - new indices for pasta quality evaluation

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Biernacka, Beata; Dziki, Dariusz; Różyło, Renata; Wójcik, Monika; Miś, Antoni; Romankiewicz, Daria; Krzysiak, Zbigniew

2018-04-01

The quality of pasta can be evaluated by measuring the characteristics which encompass the most important quality parameters, such as colour, cooking properties and texture. The aim of the study was to suggest new indices which can be used to evaluate the quality of pasta. For the tests, 15 samples of spaghetti (produced from either semolina or common wheat flour) were used. The bending test was performed for the determination of the strength properties of raw pasta, while the pasta colour parameters were evaluated via the Commission Internationale de l'Eclairage system. The pasta cooking test included the evaluation of optimum cooking time, weight increase index and cooking loss. The samples of cooked spaghetti were cut, and the parameters describing pasta texture were determined. Statistical analysis showed significant correlations (α = 0.05) between colour parameters (lightness and redness) and pasta ash content (R = -0.90 and 0.84, respectively). The mechanical properties of raw pasta correlated positively with pasta density. The strongest correlation was found between pasta density and flexural strength. The destruction force for raw spaghetti during the bending test correlated significantly and positively with the cutting force of the cooked pasta. The obtained correlations can be helpful in pasta quality evaluation.

[Confirming Indicators of Qualitative Results by Chromatography-mass Spectrometry in Biological Samples].

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Liu, S D; Zhang, D M; Zhang, W; Zhang, W F

2017-04-01

Because of the exist of complex matrix, the confirming indicators of qualitative results for toxic substances in biological samples by chromatography-mass spectrometry are different from that in non-biological samples. Even in biological samples, the confirming indicators are different in various application areas. This paper reviews the similarities and differences of confirming indicators for the analyte in biological samples by chromatography-mass spectrometry in the field of forensic toxicological analysis and other application areas. These confirming indicators include retention time （RT）, relative retention time （RRT）, signal to noise （S/N）, characteristic ions, relative abundance of characteristic ions, parent ion-daughter ion pair and abundance ratio of ion pair, etc. Copyright© by the Editorial Department of Journal of Forensic Medicine.

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

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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.

Evaluation of polar organic micropollutants as indicators for wastewater-related coastal water quality impairment

International Nuclear Information System (INIS)

Nödler, Karsten; Tsakiri, Maria; Aloupi, Maria; Gatidou, Georgia; Stasinakis, Athanasios S.; Licha, Tobias

2016-01-01

Results from coastal water pollution monitoring (Lesvos Island, Greece) are presented. In total, 53 samples were analyzed for 58 polar organic micropollutants such as selected herbicides, biocides, corrosion inhibitors, stimulants, artificial sweeteners, and pharmaceuticals. Main focus is the application of a proposed wastewater indicator quartet (acesulfame, caffeine, valsartan, and valsartan acid) to detect point sources and contamination hot-spots with untreated and treated wastewater. The derived conclusions are compared with the state of knowledge regarding local land use and infrastructure. The artificial sweetener acesulfame and the stimulant caffeine were used as indicators for treated and untreated wastewater, respectively. In case of a contamination with untreated wastewater the concentration ratio of the antihypertensive valsartan and its transformation product valsartan acid was used to further refine the estimation of the residence time of the contamination. The median/maximum concentrations of acesulfame and caffeine were 5.3/178 ng L"−"1 and 6.1/522 ng L"−"1, respectively. Their detection frequency was 100%. Highest concentrations were detected within the urban area of the capital of the island (Mytilene). The indicator quartet in the gulfs of Gera and Kalloni (two semi-enclosed embayments on the island) demonstrated different concentration patterns. A comparatively higher proportion of untreated wastewater was detected in the gulf of Gera, which is in agreement with data on the wastewater infrastructure. The indicator quality of the micropollutants to detect wastewater was compared with electrical conductivity (EC) data. Due to their anthropogenic nature and low detection limits, the micropollutants are superior to EC regarding both sensitivity and selectivity. The concentrations of atrazine, diuron, and isoproturon did not exceed the annual average of their environmental quality standards (EQS) defined by the European Commission. At two

Quality of life and physical activity in a sample of Brazilian older adults.

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Guedes, Dartagnan P; Hatmann, Angélica C; Martini, Fábio Antônio N; Borges, Marcelo B; Bernardelli, Rinaldo

2012-03-01

To investigate the association between physical activity and quality of life in a sample of Brazilian older adults. The Portuguese version of the World Health Organization Quality of Life Instrument-Older Adults Module and International Physical Activity Questionnaire was administered to 1,204 subjects (645 women and 559 men) aged ≥ 60 years. Older adults of both genders who reported to be more physically active attributed higher scores to the sensory ability, autonomy, and intimacy domains, in addition to presenting significantly higher overall quality of life, irrespectively of age, marital status, educational level, and socioeconomic status. Specifically in women, the scores obtained for the social participation domain were significantly higher in the strata of active and very active subjects when compared to sedentary subjects. The results indicate that increases in the levels of physical activity can contribute to improvements in quality of life of older adults.

Quality Indicators and Outcomes of Emergency Caesarean ...

African Journals Online (AJOL)

AJRH Managing Editor

The objective of this research study is to identify quality indicators of cesarean deliveries and determine their relationship to neonatal ..... (N=39). P value. Mean. Age. 24.8 + 5.8. 25.6 + 5.9. 0.74. Duration of labor. (hours) ... chains must be improved on a national and local ... emergency obstetric care: A handbook, Geneva,.

Dashboard report on performance on select quality indicators to cancer care providers.

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Stattin, Pär; Sandin, Fredrik; Sandbäck, Torsten; Damber, Jan-Erik; Franck Lissbrant, Ingela; Robinson, David; Bratt, Ola; Lambe, Mats

2016-01-01

Cancer quality registers are attracting increasing attention as important, but still underutilized sources of clinical data. To optimize the use of registers in quality assurance and improvement, data have to be rapidly collected, collated and presented as actionable, at-a-glance information to the reporting departments. This article presents a dashboard performance report on select quality indicators to cancer care providers. Ten quality indicators registered on an individual patient level in the National Prostate Cancer Register of Sweden and recommended by the National Prostate Cancer Guidelines were selected. Data reported to the National Prostate Cancer Register are uploaded within 24 h to the Information Network for Cancer Care platform. Launched in 2014, "What''s Going On, Prostate Cancer" provides rapid, at-a-glance performance feedback to care providers. The indicators include time to report to the National Prostate Cancer Register, waiting times, designated clinical nurse specialist, multidisciplinary conference, adherence to guidelines for diagnostic work-up and treatment, and documentation and outcome of treatment. For each indicator, three performance levels were defined. What's Going On, a dashboard performance report on 10 selected quality indicators to cancer care providers, provides an example of how data in cancer quality registers can be transformed into condensed, at-a-glance information to be used as actionable metrics for quality assurance and improvement.

Kaolin Quality Prediction from Samples: A Bayesian Network Approach

International Nuclear Information System (INIS)

Rivas, T.; Taboada, J.; Ordonez, C.; Matias, J. M.

2009-01-01

We describe the results of an expert system applied to the evaluation of samples of kaolin for industrial use in paper or ceramic manufacture. Different machine learning techniques - classification trees, support vector machines and Bayesian networks - were applied with the aim of evaluating and comparing their interpretability and prediction capacities. The predictive capacity of these models for the samples analyzed was highly satisfactory, both for ceramic quality and paper quality. However, Bayesian networks generally proved to be the most useful technique for our study, as this approach combines good predictive capacity with excellent interpretability of the kaolin quality structure, as it graphically represents relationships between variables and facilitates what-if analyses.

Quality of omeprazole purchased via the Internet and personally imported into Japan: comparison with products sampled in other Asian countries.

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Rahman, Mohammad Sofiqur; Yoshida, Naoko; Sugiura, Sakura; Tsuboi, Hirohito; Keila, Tep; Kiet, Heng Bun; Zin, Theingi; Tanimoto, Tsuyoshi; Kimura, Kazuko

2018-03-01

To evaluate the quality of omeprazole personally imported into Japan via the Internet and to compare the quality of these samples with previously collected samples from two other Asian countries. The samples were evaluated by observation, authenticity investigation and pharmacopoeial quality analysis. Quality comparison of some selected samples was carried out by dissolution profiling, Raman spectroscopy and principle component analysis (PCA). Observation of the Internet sites and samples revealed some discrepancies including the delivery of a wrong sample and the selling of omeprazole without a prescription, although it is a prescription medicine. Among the 28 samples analysed, all passed the identification test, 26 (93%) passed the quantity and content uniformity tests and all passed the dissolution test. Dissolution profiling confirmed that all the personally imported omeprazole samples remained intact in the acid medium. On the other hand, six samples from two of the same manufacturers, previously collected during surveys in Cambodia and Myanmar, frequently showed premature omeprazole release in acid. Raman spectroscopy and PCA showed significant variation between omeprazole formulations in personally imported samples and the samples from Cambodia and Myanmar. Our results indicate that the pharmaceutical quality of omeprazole purchased through the Internet was sufficient, as determined by pharmacopeial tests. However, omeprazole formulations distributed in different market segments by the same manufacturers were of diverse quality. Measures are needed to ensure consistent quality of products and to prevent entry of substandard products into the legitimate supply chain. © 2018 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Quality of Life Indicators for Individuals with Intellectual Disabilities: Extending Current Practice

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Brown, Ivan; Hatton, Chris; Emerson, Eric

2013-01-01

Quality of life is a social construct that is measured by what are considered to be its most appropriate indicators. Quality of life measurement in intellectual disability reflects a variety of indicators, often grouped under life domains. Subjective and objective methods of measuring indicators each have strengths and drawbacks, but it is…

[Quality of DNA from archival pathological samples of gallbladder cancer].

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Roa, Iván; de Toro, Gonzalo; Sánchez, Tamara; Slater, Jeannie; Ziegler, Anne Marie; Game, Anakaren; Arellano, Leonardo; Schalper, Kurt; de Aretxabala, Xabier

2013-12-01

The quality of the archival samples stored at pathology services could be a limiting factor for molecular biology studies. To determine the quality of DNA extracted from gallbladder cancer samples at different institutions. One hundred ninety four samples coming from five medical centers in Chile, were analyzed. DNA extraction was quantified determining genomic DNA concentration. The integrity of DNA was determined by polymerase chain reaction amplification of different length fragments of a constitutive gene (β-globin products of 110, 268 and 501 base pairs). The mean DNA concentration obtained in 194 gallbladder cancer samples was 48 ± 43.1 ng/µl. In 22% of samples, no amplification was achieved despite obtaining a mean DNA concentration of 58.3 ng/ul. In 81, 67 and 22% of samples, a DNA amplification of at least 110, 268 or 501 base pairs was obtained, respectively. No differences in DNA concentration according to the source of the samples were demonstrated. However, there were marked differences in DNA integrity among participating centers. Samples from public hospitals were of lower quality than those from private clinics. Despite some limitations, in 80% of cases, the integrity of DNA in archival samples from pathology services in our country would allow the use of molecular biology techniques.

Quality Improvement in Critical Care: Selection and Development of Quality Indicators

Science.gov (United States)

Martin, Claudio M.; Project, The Quality Improvement in Critical Care

2016-01-01

Background. Caring for critically ill patients is complex and resource intensive. An approach to monitor and compare the function of different intensive care units (ICUs) is needed to optimize outcomes for patients and the health system as a whole. Objective. To develop and implement quality indicators for comparing ICU characteristics and performance within and between ICUs and regions over time. Methods. Canadian jurisdictions with established ICU clinical databases were invited to participate in an iterative series of face-to-face meetings, teleconferences, and web conferences. Eighteen adult intensive care units across 14 hospitals and 5 provinces participated in the process. Results. Six domains of ICU function were identified: safe, timely, efficient, effective, patient/family satisfaction, and staff work life. Detailed operational definitions were developed for 22 quality indicators. The feasibility was demonstrated with the collection of 3.5 years of data. Statistical process control charts and graphs of composite measures were used for data display and comparisons. Medical and nursing leaders as well as administrators found the system to be an improvement over prior methods. Conclusions. Our process resulted in the selection and development of 22 indicators representing 6 domains of ICU function. We have demonstrated the feasibility of such a reporting system. This type of reporting system will demonstrate variation between units and jurisdictions to help identify and prioritize improvement efforts. PMID:27493476

Instrument Psychometrics: Parental Satisfaction and Quality Indicators of Perinatal Palliative Care.

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Wool, Charlotte

2015-10-01

Despite a life-limiting fetal diagnosis, prenatal attachment often occurs in varying degrees resulting in role identification by an individual as a parent. Parents recognize quality care and report their satisfaction when interfacing with health care providers. The aim was to test an instrument measuring parental satisfaction and quality indicators with parents electing to continue a pregnancy after learning of a life-limiting fetal diagnosis. A cross sectional survey design gathered data using a computer-mediated platform. Subjects were parents (n=405) who opted to continue a pregnancy affected by a life-limiting diagnosis. Factor analysis using principal component analysis with Varimax rotation was used to validate the instrument, evaluate components, and summarize the explained variance achieved among quality indicator items. The Prenatal Scale was reduced to 37 items with a three-component solution explaining 66.19% of the variance and internal consistency reliability of 0.98. The Intrapartum Scale included 37 items with a four-component solution explaining 66.93% of the variance and a Cronbach α of 0.977. The Postnatal Scale was reduced to 44 items with a six-component solution explaining 67.48% of the variance. Internal consistency reliability was 0.975. The Parental Satisfaction and Quality Indicators of Perinatal Palliative Care Instrument is a valid and reliable measure for parent-reported quality care and satisfaction. Use of this instrument will enable clinicians and researchers to measure quality indicators and parental satisfaction. The instrument is useful for assessing, analyzing, and reporting data on quality for care delivered during the prenatal, intrapartum, and postnatal periods.

Water-quality assessment of south-central Texas : comparison of water quality in surface-water samples collected manually and by automated samplers

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Ging, Patricia B.

1999-01-01

Surface-water sampling protocols of the U.S. Geological Survey National Water-Quality Assessment (NAWQA) Program specify samples for most properties and constituents to be collected manually in equal-width increments across a stream channel and composited for analysis. Single-point sampling with an automated sampler (autosampler) during storms was proposed in the upper part of the South-Central Texas NAWQA study unit, raising the question of whether property and constituent concentrations from automatically collected samples differ significantly from those in samples collected manually. Statistical (Wilcoxon signed-rank test) analyses of 3 to 16 paired concentrations for each of 26 properties and constituents from water samples collected using both methods at eight sites in the upper part of the study unit indicated that there were no significant differences in concentrations for dissolved constituents, other than calcium and organic carbon.

Biological indices of soil quality: an ecosystem case study of their use

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Jennifer D. Knoepp; David C. Coleman; D.A. Crossley; James S. Clark

2000-01-01

Soil quality indices can help ensure that site productivity and soil function are maintained. Biological indices yield evidence of how a soil functions and interacts with the plants, animals, and climate that comprise an ecosystem. Soil scientists can identify and quantify both chemical and biological soil-quality indicators for ecosystems with a single main function,...

Identification of Colored Dyes that are Resistant to Fading on Exposure to Ethylene Oxide; Use with Indicating FTA™ Sample Collection Cards

Directory of Open Access Journals (Sweden)

Nina Moran

2016-01-01

Full Text Available Regulatory Standards and Forensic Communities are expressing an expectation for HID products to be certified as “DNA-free.” Recently, “DNA-free” status was described for HID-related products using ethylene oxide (EtO; this gas reduces the presence of amplifiable DNA and causes minimal interference to downstream HID-analytical methods. During sample collection, indicating cards, for example, Indicating FTA™ (GE Healthcare Life Sciences, UK, are used to collect and store buccal cell DNA. These cards contain a dye which changes color on application of a colorless sample. Generating “DNA-free” indicating cards using EtO should not impact the dyes' ability to indicate sample location or the efficacy of the card in downstream HID-analytical methods. This study was initiated to identify alternative dyes to those currently used with sample indicating collection cards. The most promising, dyes when applied to cellulose papers exhibited a uniform color distribution and excellent sample indicating properties even when mixed with chemicals associated with FTA™. When dyed cellulose papers were exposed to EtO, ultraviolet radiation, elevated temperature, and humidity, negligible fading or discoloration was observed. The presence of these dyes on cellulose papers did not interfere with direct short tandem repeat (STR profiling. Allelic concordance, first pass success rate, and mean peak heights were comparable to samples applied to Indicating FTA. Biological samples applied to EtO-treated dyed cellulose papers and stored >1 month produced full STR profiles of sufficient quality to allow submission to DNA databases, confirming negligible interference from EtO treatment. These alternative sample indicating dyes resist EtO-mediated fading while fulfilling the Forensic Community's expectation for “DNA-free” with negligible impact on collection card performance.

[Development of quality of care indicators to support chronic disease management].

Science.gov (United States)

Beaulieu, Marie-dominique; Pomey, Marie-pascale; Del Grande, Claudio; Côté, Brigitte; Tremblay, Éric; Ghorbel, Monia; Hua, Phuong

2015-01-01

This article presents the results of a project conducted by the Institut national d'excellence en santé et en services sociaux of Québec to develop quality of care indicators for the management of six chronic illnesses. Indicators were identified through literature searches and analysis of clinical practice guidelines (CPGs). Interdisciplinary expert panels assessed their validity and the strength of the evidence on which they were based. Representatives of patients (N = 19) and professionals (N = 29) were consulted on their relevance and acceptability. Indicators were categorized according to the Chronic Care Model (CCM). A total of 164 indicators were developed, 126 specific to the illnesses under study and 38 on processes and outcomes generic to the CCM. There was convergence between patients and professionals on the relevance of a majority of indicators. Professionals expressed concerns on the indicators measured by means of patient surveys that they considered to be too subjective. The importance given to CPGs as the main source of indicators resulted in a great number of indicators of the technical quality ofcare. Using the CCM contributed to a broader perspective of quality. The consultation process identified some of the concerns of professionals about indicator measurement, thusguidingfuture implementation initiatives.

Extra-analytical quality indicators and laboratory performances.

Science.gov (United States)

Sciacovelli, Laura; Aita, Ada; Plebani, Mario

2017-07-01

In the last few years much progress has been made in raising the awareness of laboratory medicine professionals about the effectiveness of quality indicators (QIs) in monitoring, and improving upon, performances in the extra-analytical phases of the Total Testing Process (TTP). An effective system for management of QIs includes the implementation of an internal assessment system and participation in inter-laboratory comparison. A well-designed internal assessment system allows the identification of critical activities and their systematic monitoring. Active participation in inter-laboratory comparison provides information on the performance level of one laboratory with respect to that of other participating laboratories. In order to guarantee the use of appropriate QIs and facilitate their implementation, many laboratories have adopted the Model of Quality Indicators (MQI) proposed by Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) of IFCC, since 2008, which is the result of international consensus and continuous experimentation, and updating to meet new, constantly emerging needs. Data from participating laboratories are collected monthly and reports describing the statistical results and evaluating laboratory data, utilizing the Six Sigma metric, issued regularly. Although the results demonstrate that the processes need to be improved upon, overall the comparison with data collected in 2014 shows a general stability of quality levels and that an improvement has been achieved over time for some activities. The continuous monitoring of QI data allows identification all possible improvements, thus highlighting the value of participation in the inter-laboratory program proposed by WG-LEPS. The active participation of numerous laboratories will guarantee an ever more significant State-of-the-Art, promote the reduction of errors and improve quality of the TTP, thus guaranteeing patient safety. Copyright © 2017. Published by Elsevier Inc.

Effects of Backpacker Use, Pack Stock Trail Use, and Pack Stock Grazing on Water-Quality Indicators, Including Nutrients, E. coli, Hormones, and Pharmaceuticals, in Yosemite National Park, USA

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Forrester, Harrison; Clow, David; Roche, James; Heyvaert, Alan; Battaglin, William

2017-09-01

We investigated how visitor-use affects water quality in wilderness in Yosemite National Park. During the summers of 2012-2014, we collected and analyzed surface-water samples for water-quality indicators, including fecal indicator bacteria Escherichia coli, nutrients (nitrogen, phosphorus, carbon), suspended sediment concentration, pharmaceuticals, and hormones. Samples were collected upstream and downstream from different types of visitor use at weekly to biweekly intervals and during summer storms. We conducted a park-wide synoptic sampling campaign during summer 2014, and sampled upstream and downstream from meadows to evaluate the mitigating effect of meadows on water quality. At pack stock stream crossings, Escherichia coli concentrations were greater downstream from crossings than upstream (median downstream increase in Escherichia coli of three colony forming units 100 mL-1), with the greatest increases occurring during storms (median downstream increase in Escherichia coli of 32 CFU 100 mL-1). At backpacker use sites, hormones, and pharmaceuticals (e.g., insect repellent) were detected at downstream sites, and Escherichia coli concentrations were greater at downstream sites (median downstream increase in Escherichia coli of 1 CFU 100 mL-1). Differences in water quality downstream vs. upstream from meadows grazed by pack stock were not detectable for most water-quality indicators, however, Escherichia coli concentrations decreased downstream, suggesting entrapment and die-off of fecal indicator bacteria in meadows. Our results indicate that under current-use levels pack stock trail use and backpacker use are associated with detectable, but relatively minor, effects on water quality, which are most pronounced during storms.

Indices for the assessment of nutritional quality of meals: a systematic review.

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Gorgulho, B M; Pot, G K; Sarti, F M; Marchioni, D M

2016-06-01

This systematic review aimed to synthesise information on indices developed to evaluate nutritional quality of meals. A strategy for systematic search of the literature was developed using keywords related to assessment of meal quality. Databases searched included ScienceDirect, PubMed, Lilacs, SciELO, Scopus, Cochrane, Embase and Google Scholar. The literature search resulted in seven different meal quality indices. Each article was analysed in order to identify the following items: authors, country, year, study design, population characteristics, type of meal evaluated, dietary assessment method, characteristics evaluated (nutrients or food items), score range, index components, nutritional references, correlations performed, validation and relationship with an outcome (if existing). Two studies developed instruments to assess the quality of breakfast, three analysed lunch, one evaluated dinner and one was applied to all types of meals and snacks. All meal quality indices reviewed were based on the evaluation of presence or absence of food groups and relative contributions of nutrients, according to food-based guidelines or nutrient references, adapting the daily dietary recommendations to one specific meal. Most of the indices included three items as components for meal quality assessment: (I) total fat or some specific type of fat, (II) fruits and vegetables and (III) cereals or whole grains. This systematic review indicates aspects that need further research, particularly the numerous approaches to assessing meals considering different foods and nutrients, and the need for validation studies of meal indices.

The sampling characteristics of electivity indices.

Science.gov (United States)

Lechowicz, Martin J

1982-01-01

Electivity indices measure the utilization of food types (r) in relation to their abundance or availability in the environment (p). Foods that constitute a larger proportion of the diet than of the available foods are considered preferred; conversely those proportionately underrepresented in the diet are avoided. A food is eaten at random if its proportion in the diet equals its proportion in the environment. A family of electivity indices stemming from Ivlev's (1961) classic monograph exist and differ only in the particular algorithm used to calculate electivity from r and p.For each available index I graphed the values of electivity as contours for all combinations of r and p. These graphs are compared to illustrate the strengths and weaknesses of each index on the basis of the following criteria: 1) the value of the index when r=p for a food, 2) the symmetry of the electivity value as feeding deviates from random, 3) the possible range of index values, 4) the linearity of changes in electivity over the full range of r and p, 5) the sensitivity of the index to sampling errors, 6) the statistical testability of the electivity, and 7) the stability of the electivity value for a food type that changes relative abundance or occurs in combination with different food types. No one index ideally satisfies all the criteria.The host preferences of gypsy moth, Lymantria dispar, feeding on tree foliage in an undisturbed deciduous forest in southwestern Quebec, Canada were used to compare the available indices: Ivlev's electivity, E; Ivlev's forage ratio, E'; Jacob's modified electivity, D; Jacob's modified forage ratio, log Q; Chesson's alpha; Strauss' linear index, L; and Vanderploeg and Scavia's relativized electivity, E * . The electivity values calculated by each index differ one from another; host trees shown as preferred by one index will frequently appear avoided according to an alternative index. The rank order electivities for the 19 available host trees, however

Effects of logging activities on ecological water quality indicators in the Berasau River, Johor, Malaysia.

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Nor Zaiha, A; Mohd Ismid, M S; Salmiati; Shahrul Azri, M S

2015-08-01

Influence of deforestation on biodiversity of aquatic organisms was investigated in a stream in the Ulu Sedili Forest Reserve. The stream was monitored five (5) times from December 2011 until December 2012 with 2-month intervals. Sampling of benthic communities was carried out using rectangular dip net while water quality study using a YSI ProPlus meter and the rest were done in the laboratory. Physicochemical parameters and water quality index (WQI) calculation showed no significant difference among the investigated events. WQI classified the Berasau River between Class II (good) to III (moderate) of river water quality. In total, 603 individuals representing 25 taxa that were recorded with Decapods from genus Macrobrabchium were widely distributed. Several intolerant taxa, especially Ephemeroptera and Odonata, were also observed in this river. According to Pearson's correlation analysis, the richness and diversity indices were generally influenced by water quality parameters represented by WQI (P < 0.01). In conclusion, logging activities have strong attributes for variation in benthic macroinvertebrate assemblage.

Using the Delphi method to develop nursing-sensitive quality indicators for the NICU.

Science.gov (United States)

Chen, Lin; Huang, Li-Hua; Xing, Mei-Yuan; Feng, Zhi-Xian; Shao, Le-Wen; Zhang, Mei-Yun; Shao, Rong-Ya

2017-02-01

To develop nursing-sensitive quality indicators consistent with current medical practices in Chinese neonatal intensive care units. The development of nursing-sensitive quality indicators has become a top priority in nursing management. To the best of our knowledge, there has been no objective, scientific and sensitive evaluation of the quality of neonatal intensive care unit nursing in China. A modified Delphi technique was used to seek opinions from experts about what should be used and prioritised as indicators of quality care in neonatal intensive care unit nursing. Based on a literature review, we identified 21 indicators of nursing-sensitive quality in the neonatal intensive care unit. Our group of 11 consultants chose 13 indicators to be discussed using the Delphi method. In October and November 2014, 39 neonatal intensive care unit experts in 18 tertiary hospitals spread across six provinces participated in two rounds of Delphi panels. Of the 13 indicators discussed, 11 were identified as indicators of nursing-sensitive quality in the neonatal intensive care unit: rate of nosocomial infections, rate of accidental endotracheal extubation, rate of errors in medication administration, rate of treatment for pain, rate of peripheral venous extravasation, rate of compliance with handwashing techniques, incidence of pressure ulcers, incidence of noise, the bed-to-care ratio, the proportion of nurses with greater than five years neonatal intensive care unit experience and incidence of retinopathy. The 11 neonatal intensive care unit nursing-sensitive indicators identified by the Delphi method integrated with basic Chinese practices provide a basis for nursing management and the monitoring of nursing quality. This study identified nursing-sensitive quality indicators for neonatal intensive care unit care that are suitable for current clinical practice in China. © 2016 John Wiley & Sons Ltd.

Indicator value of lotic water mites (Acari: Hydrachnidia and their use in macroinvertebrate-based indices for water quality assessment purposes

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Miccoli F. P.

2013-10-01

Full Text Available The Water Framework Directive (WFD of the European Union includes benthic macroinvertebrates for the ecological assessment of running waters. The invertebrate-based Star-ICMi index, adopted in 2010, does not include Hydrachnidia (water mites in its complex formulation. However, Hydrachnidia are associated with many environmental variables and may be useful for stream ecological characterization. We have therefore assessed the bioindicator value of Hydrachnidia in streams of central Italy, and the ability of two mite-containing (the PTH and the newly formulated PTHfam indices and four mite-excluding biotic indices (Star-ICMi, BMWP, ASPT, and IBE to characterize 216 sites ranging from semipristine to impacted. Mite bioindicator value was high at family level. Index reliability was consistently low for the PTH and ASPT indices. Distribution of mite families across quality classes (QCs was fully separated only for the PTHfam index. QC assignment remained reliable at high index values (i.e., at high ecological status for the PTHfam and BMWP indices, while logarithmic correlations between the PTHfam and the other indices suggest that the latter may misrepresent sites in high, good, and moderate ecological status sensu WFD. Further studies on the PTHfam index are warranted in light of its simplicity, high reliability, and low sampling and taxonomic identification effort.

Indicators for the automated analysis of drug prescribing quality.

Science.gov (United States)

Coste, J; Séné, B; Milstein, C; Bouée, S; Venot, A

1998-01-01

Irrational and inconsistent drug prescription has considerable impact on morbidity, mortality, health service utilization, and community burden. However, few studies have addressed the methodology of processing the information contained in these drug orders used to study the quality of drug prescriptions and prescriber behavior. We present a comprehensive set of quantitative indicators for the quality of drug prescriptions which can be derived from a drug order. These indicators were constructed using explicit a priori criteria which were previously validated on the basis of scientific data. Automatic computation is straightforward, using a relational database system, such that large sets of prescriptions can be processed with minimal human effort. We illustrate the feasibility and value of this approach by using a large set of 23,000 prescriptions for several diseases, selected from a nationally representative prescriptions database. Our study may result in direct and wide applications in the epidemiology of medical practice and in quality control procedures.

Sampling quality assurance guidance in support of EM environmental sampling and analysis activities

International Nuclear Information System (INIS)

1994-05-01

This document introduces quality assurance guidance pertaining to the design and implementation of sampling procedures and processes for collecting environmental data for DOE's Office of EM (Environmental Restoration and Waste Management)

SYNTHETIC ANALYSIS OF INDICATORS USED IN THE ANALYSIS OF PRODUCT QUALITY DIFFERENTIATED AND NON-DIFFERENTIATED ON QUALITY CLASSES

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ECOBICI MIHAELA LOREDANA

2016-12-01

Full Text Available Product quality has been and will remain one of the most important indicators of increasing economic and financial performance of a company. Quality is that which ensures the greatest part of the competitiveness of a product or service, this being the result of some important aspects such as: products and services of quality to meet consumers requirements, low costs without affecting the quality level, the performance of contractual obligations, customer satisfaction and last but not least obtaining profit. Research and results concerning this issue will result in the prerequisites in the process for quality assurance that can develop both internally and externally. The purpose of this article lies in the approach and illustration of the aspects of products differentiated and non-differentiated in quality classes. In launching this research I will try to highlight some aspects that most efficiently the indicators mentioned above, indicators that read to what extent a certain product meets the characteristics specified to its destination.

Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology

DEFF Research Database (Denmark)

Dumonceau, Jean-Marc; Deprez, Pierre H; Jenssen, Christian

2017-01-01

For pancreatic solid lesions, ESGE recommends performing endoscopic ultrasound (EUS)-guided sampling as first-line procedure when a pathological diagnosis is required. Alternatively, percutaneous sampling may be considered in metastatic disease.Strong recommendation, moderate quality evidence.In ...

The quality of sample surveys in a developing nation

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Paul A Bourne

2010-08-01

Full Text Available Paul A Bourne1, Christopher AD Charles2,3, Neva South-Bourne4, Chloe Morris1, Denise Eldemire-Shearer1, Maureen D Kerr-Campbell51Department of Community Health and Psychiatry, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica; 2King Graduate School, Monroe College, Bronx, New York, USA; 3Center for Victim Support, Harlem Hospital Center, New York, USA; 4Research assistant for Paul A Bourne; 5Systems Development Unit, Main Library, Faculty of Humanities and Education, University of the West Indies, Mona, Kingston, JamaicaBackground: In Jamaica, population census began in 1844, and many intercensal ratios obtained from the census data showed that there is a general high degree of accuracy of the data. However, statistics from the Jamaican Ministry of Health showed that there are inaccuracies in health data collected from males using sample surveys.Objectives: The objectives of the present research are to 1 investigate the accuracy of a national sample survey, 2 explore the feasibility and quality of using a subnational sample survey to represent a national survey, 3 aid other scholars in understanding the probability of using national sample surveys and subnational sample surveys, 4 assess older men’s ­evaluation of their health status, and 5 determine whether dichotomization changes self-evaluated health status.Methods: For the current study, the data used in the analysis were originally collected from 2 different sources: 1 the Jamaica Survey of Living Conditions (JSLC and 2 Survey of Older Men (SOM. Cross validation of self-evaluated data of men in Jamaica was done with comparable samples of the complete JSLC data and the SOM data, where men older than 55 years were selected from each sample.Results: In study 1, 50.2% of respondents indicated at least good self-evaluated health status compared with 74.0% in study 2. Statistical associations were found between health status and survey sample (Χ2 [df = 5

Quality indicators in the mobile industry rankings based on indicators of customer satisfaction with the hybrid approach DEMATEL and ANP appropriate strategy based on gray system

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Ashouri Fatemeh

2016-01-01

Full Text Available The quality of services as a vital element in the strategic competitiveness and commercial success are various methods have been developed to evaluate it. Prioritizing qualitative indicators based on the quality of mobile phone services enables the company gives top priority due to the higher percentage of satisfied customers provide. This study tries to customer satisfaction according to criteria to prioritize mobile operators pay qualitative characteristics. A sample consisted of 450 individuals (46% women, 54% men from IRANCELL operator (Iran in 2015 which selected randomly. Results shows between four considered strategies maximum priorities belong to S1 which is denote to more services beyond customer expectations.

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

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

2015-01-01

The process of obtaining and analyzing water samples from the environment includes a number of steps that can affect the reported result. The equipment used to collect and filter samples, the bottles used for specific subsamples, any added preservatives, sample storage in the field, and shipment to the laboratory have the potential to affect how accurately samples represent the environment from which they were collected. During the early 1990s, the U.S. Geological Survey implemented policies to include the routine collection of quality-control samples in order to evaluate these effects and to ensure that water-quality data were adequately representing environmental conditions. Since that time, the U.S. Geological Survey Office of Water Quality has provided training in how to design effective field quality-control sampling programs and how to evaluate the resultant quality-control data. This report documents that training material and provides a reference for methods used to analyze quality-control data.

Developing a framework of, and quality indicators for, general practice management in Europe.

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Engels, Yvonne; Campbell, Stephen; Dautzenberg, Maaike; van den Hombergh, Pieter; Brinkmann, Henrik; Szécsényi, Joachim; Falcoff, Hector; Seuntjens, Luc; Kuenzi, Beat; Grol, Richard

2005-04-01

To develop a framework for general practice management made up of quality indicators shared by six European countries. Two-round postal Delphi questionnaire in the setting of general practice in Belgium, France, Germany, The Netherlands, Switzerland and the United Kingdom. Six national expert panels, each consisting of 10 members, primarily primary care practitioners and experts in the field of quality in primary care participated in the study. The main outcome measures were: (a) a European framework with indicators for the organization of primary care; and (b) ratings of the face validity of the usefulness of the indicators by expert panels in six countries. Agreement was reached about a definition of practice management across five domains (infrastructure, staff, information, finance, and quality and safety), and a common set of indicators for the organization of general practice. The panellist response rate was 95%. Sixty-two indicators (37%) were rated face valid by all six panels. Examples include out of hours service, accessibility, the content of doctors' bags and staff involvement in quality improvement. No indicators were rated invalid by all six panels. It proved to be possible to develop a European set of indicators for assessing the quality of practice management, despite the differences in health care systems and cultures in the six different countries. These indicators will now be used in a quality assessment procedure of practice management in nine European countries. While organizational indicators are part of the new GMS contract in the UK, this research shows that many practice management issues within primary care are also of relevance in other European countries.

Canadian Association of Gastroenterology consensus guidelines on safety and quality indicators in endoscopy.

Science.gov (United States)

Armstrong, David; Barkun, Alan; Bridges, Ron; Carter, Rose; de Gara, Chris; Dube, Catherine; Enns, Robert; Hollingworth, Roger; Macintosh, Donald; Borgaonkar, Mark; Forget, Sylviane; Leontiadis, Grigorios; Meddings, Jonathan; Cotton, Peter; Kuipers, Ernst J

2012-01-01

Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality, highlight the need for clearly defined, evidence-based processes to support quality improvement in endoscopy. To identify processes and indicators of quality and safety relevant to high-quality endoscopy service delivery. A multidisciplinary group of 35 voting participants developed recommendation statements and performance indicators. Systematic literature searches generated 50 initial statements that were revised iteratively following a modified Delphi approach using a web-based evaluation and voting tool. Statement development and evidence evaluation followed the AGREE (Appraisal of Guidelines, REsearch and Evaluation) and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) guidelines. At the consensus conference, participants voted anonymously on all statements using a 6-point scale. Subsequent web-based voting evaluated recommendations for specific, individual quality indicators, safety indicators and mandatory endoscopy reporting fields. Consensus was defined a priori as agreement by 80% of participants. Consensus was reached on 23 recommendation statements addressing the following: ethics (statement 1: agreement 100%), facility standards and policies (statements 2 to 9: 90% to 100%), quality assurance (statements 10 to 13: 94% to 100%), training, education, competency and privileges (statements 14 to 19: 97% to 100%), endoscopy reporting standards (statements 20 and 21: 97% to 100%) and patient perceptions (statements 22 and 23: 100%). Additionally, 18 quality indicators (agreement 83% to 100%), 20 safety indicators (agreement 77% to 100%) and 23 recommended endoscopy-reporting elements (agreement 91% to 100%) were identified. The consensus process identified a clear need for high-quality clinical and outcomes research to support quality improvement in the delivery of endoscopy services. The

STUDY ON WATER QUALITY INDICATORS AT TAIA TREATMENT PLANT HUNDEDOARA COUNTY

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Ramona Violeta CAZALBAŞU

2017-05-01

Full Text Available Water is consumed in its natural form or in a processed one. It is a well-known fact that enterprises, institutions, energy and agriculture consume it as processed water whereas the population consumes it as drinking water or wastewater. This paper presents the study of water quality indicators from the treatment plant Taia in Hunedoara County. The following quality indicators were determined: turbidity, hardness, alkalinity, chlorine oxide and organic substances. The determined quality indicators revealed that they fall within the limits set by legislation, with some exceptions. In each step of purification of organic substances there has been a continual reduction, this being carried out both biologically because of the biomass deposited on sand grains in the filter bed as well as especially during the oxidation step with active chlorine

Quality assessment of pollution indicators in marine water at critical locations of the Gulf of Mannar Biosphere Reserve, Tuticorin.

Science.gov (United States)

Rajendran, Viji; Nirmaladevi D, Shrinithivihahshini; Srinivasan, Balakrishnan; Rengaraj, Chithradevi; Mariyaselvam, Sheelamary

2018-01-01

The present study focused on the shoreline environment of urban and industrial areas, and the aim of this study was to assess the coastal water quality in the Gulf of Mannar Biosphere Reserve. Water samples were collected from five different coastal sites during the premonsoon and monsoon seasons. The samples were analyzed following the standard methods. The results showed that the levels of microbiological indicators in the samples highly exceeded the regional and national standard seawater permissible limits, and environmental parameters such as the total suspended solid and dissolved oxygen were affected significantly (p<0.05). To identify frequent pollution indicators, their levels should be estimated to determine possible pollution in coastal ecosystems due to human interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of backpacker use, pack stock trail use, and pack stock grazing on water-quality indicators, including nutrients, E. coli, hormones, and pharmaceuticals, in Yosemite National Park, USA

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Forrester, Harrison; Clow, David W.; Roche, James W.; Heyvaert, Alan C.; Battaglin, William A.

2017-01-01

We investigated how visitor-use affects water quality in wilderness in Yosemite National Park. During the summers of 2012–2014, we collected and analyzed surface-water samples for water-quality indicators, including fecal indicator bacteria Escherichia coli, nutrients (nitrogen, phosphorus, carbon), suspended sediment concentration, pharmaceuticals, and hormones. Samples were collected upstream and downstream from different types of visitor use at weekly to biweekly intervals and during summer storms. We conducted a park-wide synoptic sampling campaign during summer 2014, and sampled upstream and downstream from meadows to evaluate the mitigating effect of meadows on water quality. At pack stock stream crossings, Escherichia coli concentrations were greater downstream from crossings than upstream (median downstream increase in Escherichia coli of three colony forming units 100 mL−1), with the greatest increases occurring during storms (median downstream increase in Escherichia coli of 32 CFU 100 mL−1). At backpacker use sites, hormones, and pharmaceuticals (e.g., insect repellent) were detected at downstream sites, and Escherichia coli concentrations were greater at downstream sites (median downstream increase in Escherichia coli of 1 CFU 100 mL−1). Differences in water quality downstream vs. upstream from meadows grazed by pack stock were not detectable for most water-quality indicators, however, Escherichia coli concentrations decreased downstream, suggesting entrapment and die-off of fecal indicator bacteria in meadows. Our results indicate that under current-use levels pack stock trail use and backpacker use are associated with detectable, but relatively minor, effects on water quality, which are most pronounced during storms.

Ecological attributes of the benthic community and indices of water quality in urban, rural and preserved environments

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Claudia Eiko Yoshida

Full Text Available INTRODUCTION: Reference streams are pristine streams, untouched or unaltered by man, it being possible to use their environmental characteristics as quality threshold values. Besides the organic impacts measured via water quality biological monitoring programs, it has become necessary to evaluate the relationship between alterations in the landscape of streams and surrounding areas and changes in the structure of the macroinvertebrate community; AIM: The objective of the present study was to correlate the changes in the landscape with the ecological attributes of the community and indices of water quality, and to recommend reference condition values for the integrity of streams in the region of Jundiai (SP; METHODS: The benthic fauna were sampled in three urban streams, three rural streams and three preserved streams during July 2010, using a Surber-type sampler. The characteristics of the landscape were evaluated by means of Diversity of Habitat; the community, analyzed for several biodiversity indices, and; the water quality assessed using the indices River-BCI, BMWP-CETEC (CETEC - Science and Technology Center, ASPT and SOMI (SOMI - Serra dos Órgãos Multimetric Index (Serra dos Órgãos is a mountain range national park in the state of Rio de Janeiro; RESULTS: The structure and the composition of the communities varied according to the stream and this was reflected in the values of the biological and environmental quality indices. The best conditions were found in preserved streams, intermediate streams and rural streams while the worst conditions were found in the urban streams. The significant Pearson correlations (r > 0.73 and P < 0.05 between the diversity of habitat index and the ecological and water quality index attributes in the streams of Jundiai demonstrated that diversity of habitat may be a good predictor of the environmental characteristics evaluated.

Preliminary probe of quality indicators and quality specification in total testing process in 5753 laboratories in China.

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Fei, Yang; Kang, Fengfeng; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Wang, Zhiguo; Chen, Wenxiang

2016-08-01

The aim of the study was to promote the establishment and implementation of quality indicators (QIs) in clinical laboratories, catch up with the state of art, and provide preliminary quality specifications for established QIs. Clinical laboratories from different provinces in China were included in this QIs survey in 2015. All participants were asked to collect data related to QIs and complete QIs questionnaires. Defect percentages and sigma values were calculated for each QI. The 25th percentile, median, and the 75th percentile of defect percentages and TATs were calculated as optimum, desirable and minimum quality specifications. While 25th, median, and 75th of sigma values were calculated as minimum, desirable and optimum quality specifications, respectively. Five thousand seven hundred and fifty-three clinical laboratories from 28 provinces in China participated in this survey. Median defect percentages of pre-examination QIs varied largely from 0.01% (incorrect sample container) to 0.57% (blood culture contamination) with sigma values varied from 4.0σ to 5.1σ. Median defect percentages of examination phase QIs were all really high. The most common problem in examination phase was test uncovered by inter-laboratory comparison (86.67%). Defect percentages of critical values notification and timely critical values notification were all 0.00% (6.0σ). While the median of defect percentages of incorrect laboratory reports was only 0.01% (5.4σ). Improvements are needed in all phases of total testing process (TTP) in laboratories in China, especially in examination phase. More attention should be paid when microbiology specimens are collected and results are reported. Quality specifications can provide directions for laboratories to make effort for.

A 2-1-1 research collaboration: participant accrual and service quality indicators.

Science.gov (United States)

Eddens, Katherine S; Alcaraz, Kassandra I; Kreuter, Matthew W; Rath, Suchitra; Greer, Regina

2012-12-01

In times of crises, 2-1-1 serves as a lifeline in many ways. These crises often cause a spike in call volume that can challenge 2-1-1's ability to meet its service quality standards. For researchers gathering data through 2-1-1s, a sudden increase in call volume might reduce accrual as 2-1-1 has less time to administer study protocols. Research activities imbedded in 2-1-1 systems may affect directly 2-1-1 service quality indicators. Using data from a 2-1-1 research collaboration, this paper examines the impact of crises on call volume to 2-1-1, how call volume affects research participant accrual through 2-1-1, and how research recruitment efforts affect 2-1-1 service quality indicators. t-tests were used to examine the effect of call volume on research participant accrual. Linear and logistic regressions were used to examine the effect of research participant accrual on 2-1-1 service quality indicators. Data were collected June 2010-December 2011; data were analyzed in 2012. Findings from this collaboration suggest that crises causing spikes in call volume adversely affect 2-1-1 service quality indicators as well as accrual of research participants. Administering a brief (2-3 minute) health risk assessment did not affect service quality negatively, but administering a longer (15-18 minute) survey had a modest adverse effect on these indicators. In 2-1-1 research collaborations, both partners need to understand the dynamic relationship among call volume, research accrual, and service quality and adjust expectations accordingly. If research goals include administering a longer survey, increased staffing of 2-1-1 call centers may be needed to avoid compromising service quality. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Using Aquatic Insects as Indicators of Water Quality

Science.gov (United States)

Dyche, Steven E.

1977-01-01

Described is a science field activity that studies the presence of certain aquatic insects, like stoneflies, as indicators of water quality. Equipment, materials, and methods are listed in detail, including suggestions for building certain supplies. Results of previous studies on the Yellowstone River are included. (MA)

Continuous quality control of the blood sampling procedure using a structured observation scheme

DEFF Research Database (Denmark)

Seemann, T. L.; Nybo, M.

2015-01-01

Background: An important preanalytical factor is the blood sampling procedure and its adherence to the guidelines, i.e. CLSI and ISO 15189, in order to ensure a consistent quality of the blood collection. Therefore, it is critically important to introduce quality control on this part of the process....... As suggested by the EFLM working group on the preanalytical phase we introduced continuous quality control of the blood sampling procedure using a structured observation scheme to monitor the quality of blood sampling performed on an everyday basis. Materials and methods: Based on our own routines the EFLM....... Conclusion: It is possible to establish a continuous quality control on blood sampling. It has been well accepted by the staff and we have already been able to identify critical areas in the sampling process. We find that continuous auditing increase focus on the quality of blood collection which ensures...

Quality indicators in laboratory medicine: a fundamental tool for quality and patient safety.

Science.gov (United States)

Plebani, Mario; Sciacovelli, Laura; Marinova, Mariela; Marcuccitti, Jessica; Chiozza, Maria Laura

2013-09-01

The identification of reliable quality indicators (QIs) is a crucial step in enabling users to quantify the quality of laboratory services. The current lack of attention to extra-laboratory factors is in stark contrast with the body of evidence pointing to the multitude of errors that continue to occur in the pre- and post-analytical phases. Different QIs and terminologies are currently used and, therefore, there is the need to harmonize proposed QIs. A model of quality indicators (MQI) has been consensually developed by a group of clinical laboratories according to a project launched by a working group of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). The model includes 57 QIs related to key processes (35 pre-, 7 intra- and 15 post-analytical phases) and 3 to support processes. The developed MQI and the data collected provide evidence of the feasibility of the project to harmonize currently available QIs, but further efforts should be done to involve more clinical laboratories and to collect a more consistent amount of data. Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Groundwater-quality data in 12 GAMA study units: Results from the 2006–10 initial sampling period and the 2008–13 trend sampling period, California GAMA Priority Basin Project

Science.gov (United States)

Mathany, Timothy M.

2017-03-09

constituents (volatile organic compounds, pesticides, and pesticide degradates), constituents of special interest (perchlorate and 1,2,3-trichloropropane), and natural inorganic constituents (nutrients, major and minor ions, and trace elements). Isotopic tracers (tritium, carbon-14, and stable isotopes of hydrogen and oxygen in water) also were measured to help identify processes affecting groundwater quality and the sources and ages of the sampled groundwater. More than 200 constituents and water-quality indicators were measured during the trend sampling period.Quality-control samples (blanks, replicates, matrix-spikes, and surrogate compounds) were collected at about one-third of the trend sites, and the results for these samples were used to evaluate the quality of the data for the groundwater samples. On the basis of detections in laboratory and field blank samples collected by GAMA-PBP study units, including the 12 study units presented here, reporting levels for some groundwater results were adjusted in this report. Differences between replicate samples were mostly within acceptable ranges, indicating low variability in analytical results. Matrix-spike recoveries were largely within the acceptable range (70 to 130 percent).This study did not attempt to evaluate the quality of water delivered to consumers. After withdrawal, groundwater used for drinking water typically is treated, disinfected, and blended with other waters to achieve acceptable water quality. The comparison benchmarks used in this report apply to treated water that is served to the consumer, not to untreated groundwater. To provide some context for the results, however, concentrations of constituents measured in these groundwater samples were compared with benchmarks established by the U.S. Environmental Protection Agency and the State of California. Comparisons between data collected for this study and benchmarks for drinking water are for illustrative purposes only and are not indicative of compliance

Selection indices for yield and quality traits in sweet corn

International Nuclear Information System (INIS)

Asghar, M.J.; Mehdi, S.S.

2010-01-01

The efficiency of three selection indices, viz., Smith-Hazel index (SHI), Desired gain index (DGI) and Base Index (BI) was compared for the improvement of an open pollinated sweet corn (Zea mays L. Saccharata) population. The data of genetic studies on various yield and quality traits among S1 families were used to construct these selection indices. Smith-Hazel index was found to be the most efficient in improving the aggregate genotype of yield traits for most of the selection strategies. Base index proved to be more efficient as compared to Smith-Hazel index in the improvement of aggregate genotype for five out of six selection strategies of quality traits. Both smith-hazel and Base indices were found useful for the improvement of sweetness and sweet flavour for all the selection strategies. When selection was confined to eight yield and four quality traits simultaneously, Base index proved to be more efficient as compared to Smith-Hazel index and desired gain index in improving the aggregate genotype for almost all the selection strategies. (author)

Comparing wastewater chemicals, indicator bacteria concentrations, and bacterial pathogen genes as fecal pollution indicators

Science.gov (United States)

Haack, S.K.; Duris, J.W.; Fogarty, L.R.; Kolpin, D.W.; Focazio, M.J.; Furlong, E.T.; Meyer, M.T.

2009-01-01

The objective of this study was to compare fecal indicator bacteria (FIB) (fecal coliforms, Escherichia coli [EC], and enterococci [ENT]) concentrations with a wide array of typical organic wastewater chemicals and selected bacterial genes as indicators of fecal pollution in water samples collected at or near 18 surface water drinking water intakes. Genes tested included esp (indicating human-pathogenic ENT) and nine genes associated with various animal sources of shiga-toxin-producing EC (STEC). Fecal pollution was indicated by genes and/or chemicals for 14 of the 18 tested samples, with little relation to FIB standards. Of 13 samples with animal sources of STEC) were detected in eight. Only the EC eaeA gene was positively correlated with FIB concentrations. Human-source fecal pollution was indicated by the esp gene and the human pharmaceutical carbamazepine in one of the nine samples that met all FIB recreational water quality standards. Escherichia coli rfbO157 and stx2c genes, which are typically associated with cattle sources and are of potential human health significance, were detected in one sample in the absence of tested chemicals. Chemical and gene-based indicators of fecal contamination may be present even when FIB standards are met, and some may, unlike FIB, indicate potential sources. Application of multiple water quality indicators with variable environmental persistence and fate may yield greater confidence in fecal pollution assessment and may inform remediation decisions. Copyright ?? 2009 by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America. All rights reserved.

[Indicators of healthcare quality in day surgery (2010-2012)].

Science.gov (United States)

Martínez Rodenas, F; Codina Grifell, J; Deulofeu Quintana, P; Garrido Corchón, J; Blasco Casares, F; Gibanel Garanto, X; Cuixart Vilamajó, L; de Haro Licer, J; Vazquez Dorrego, X

2014-01-01

Monitoring quality indicators in Ambulatory Surgery centers is fundamental in order to identify problems, correct them and prevent them. Given their large number, it is essential to select the most valid ones. The objectives of the study are the continuous improvement in the quality of healthcare of day-case surgery in our center, by monitoring selective quality parameters, having periodic information on the results and taking corrective measures, as well as achieving a percentage of unplanned transfer and cancellations within quality standards. Prospective, observational and descriptive study of the day-case surgery carried out from January 2010 to December 2012. Unplanned hospital admissions and cancellations on the same day of the operation were selected and monitored, along with their reasons. Hospital admissions were classified as: inappropriate selection, medical-surgical complications, and others. The results were evaluated each year and statistically analysed using χ(2) tests. A total of 8,300 patients underwent day surgery during the 3 years studied. The day-case surgery and outpatient index increased by 5.4 and 6.4%, respectively (P<.01). Unexpected hospital admissions gradually decreased due to the lower number of complications (P<.01). Hospital admissions, due to an extended period of time in locoregional anaesthesia recovery, also decreased (P<.01). There was improved prevention of nausea and vomiting, and of poorly controlled pain. The proportion of afternoon admissions was significantly reduced (P<.01). The cancellations increased in 2011 (P<.01). The monitoring of quality parameters in day-case surgery has been a useful tool in our clinical and quality management. Globally, the unplanned transfer and cancellations have been within the quality standards and many of the indicators analysed have improved. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Evaluation of sensory attributes and some-quality indices of irradiated spices

International Nuclear Information System (INIS)

Subbulakshmi, G.; Udipi, Shobha; Raheja, Reshma; Sharma, Arun; Padwal Desai, S.R.; Nair, P.M.

1991-01-01

Ground pepper, chilli, coriander, cumin, turmeric and a spice mix (sambar powder) exposed to an absorbed dose of 10 kGy of gamma irradiation were studied for microbial and sensory quality changes, if any, on storage for 3 months. No significant differences between the irradiated and non-irradiated samples could be observed in their sensory qualities. While no increase in microbial load in sealed irradiated samples could be observed, those that were irradiated but opened repeatedly for daily use did show a marginal increase in microbial load. (author). 8 refs., 1 tab

Developing quality indicators for older adults: transfer from the USA to the UK is feasible.

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Steel, N; Melzer, D; Shekelle, P G; Wenger, N S; Forsyth, D; McWilliams, B C

2004-08-01

Measurement of the quality of health care is essential for quality improvement, and patients are an underused source of data about quality of care. We describe the adaptation of a set of USA quality indicators for use in patient interview surveys in England, to measure the extent to which older patients receive a broad range of effective health care interventions in both primary and secondary care. One hundred and nineteen quality indicators covering 16 clinical areas, based on a set of indicators for the care of vulnerable elderly patients in the USA, were reviewed by a panel of 10 clinical experts in England. A modified version of the RAND/UCLA appropriateness method was used and panel members were supplied with literature reviews summarising the evidence base for each quality indicator. The indicators were sent for comment before the panel meeting to UK charitable organisations for older people. The panel rated 102 of the 119 indicators (86%) as valid for use in England; 17 (14%) were rejected as invalid. All 58 indicators about treatment or continuity and follow up were rated as valid compared with just over half (13 of 24) of the indicators about screening. These 102 indicators are suitable for use in patient interview surveys, including the English Longitudinal Study of Ageing (ELSA). The systematic measurement of quality of care at the population level and identification of gaps in quality is essential for quality improvement. There is potential for transfer of quality indicators between countries, at least for the health care of older people.

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

Science.gov (United States)

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

2014-08-01

Good quality indicators should have face validity, relevance to patients, and be able to be measured reliably. Beyond these general requirements, good quality indicators should also have certain statistical properties, including sufficient variability to identify poor performers, relative insensitivity to severity adjustment, and the ability to capture what providers do rather than patients' characteristics. We assessed the performance of candidate indicators of ICU quality on these criteria. Indicators included ICU readmission, mortality, several length of stay outcomes, and the processes of venous-thromboembolism and stress ulcer prophylaxis provision. Retrospective cohort study. One hundred thirty-eight U.S. ICUs from 2001-2008 in the Project IMPACT database. Two hundred sixty-eight thousand eight hundred twenty-four patients discharged from U.S. ICUs. None. We assessed indicators' (1) variability across ICU-years; (2) degree of influence by patient vs. ICU and hospital characteristics using the Omega statistic; (3) sensitivity to severity adjustment by comparing the area under the receiver operating characteristic curve (AUC) between models including vs. excluding patient variables, and (4) correlation between risk adjusted quality indicators using a Spearman correlation. Large ranges of among-ICU variability were noted for all quality indicators, particularly for prolonged length of stay (4.7-71.3%) and the proportion of patients discharged home (30.6-82.0%), and ICU and hospital characteristics outweighed patient characteristics for stress ulcer prophylaxis (ω, 0.43; 95% CI, 0.34-0.54), venous thromboembolism prophylaxis (ω, 0.57; 95% CI, 0.53-0.61), and ICU readmissions (ω, 0.69; 95% CI, 0.52-0.90). Mortality measures were the most sensitive to severity adjustment (area under the receiver operating characteristic curve % difference, 29.6%); process measures were the least sensitive (area under the receiver operating characteristic curve % differences

Indicators of image quality and doses in mammography

International Nuclear Information System (INIS)

Gaona, E.; Franco E, J.G.; Azorin N, J.; Diaz G, J.A.I.; Arreola, M.

2007-01-01

Full text: The purpose of the study was to determine the values of the image quality indicators and their relationship with the dose in mammography of screen-film that they allowed the detection of a bigger number of objects in the images obtained with the mannequin (phantom) authorized of the ACR/FDA. The study was carried out in four mammography services in a period of 12 months. The indicators of the image quality are the half optic density (DOM), contrast (differences of densities), the number of observed objects in the images and the dose for image. The minimum acceptable values by the ACR/FDA are a half optical density of 1.4, contrast of 0.4 and the one numbers minimum of objects observed in the image of the mannequin of mammography of 10 (4 fibers, 3 groups of calcifications and 3 masses), with a maximum dose by image of 3 mGy. The found results are half optical density of 1.9, contrast of 0.56 and the average number of objects observed in the images of 12, with a dose in the interval of 1.6 mGy to 2.4 mGy. The doses were measured by thermoluminescent dosimetry and ionization chamber. Once carried out the analysis of the tendencies of the indicators of image quality and their distributions is found that for a p < 0.05, the bigger number of objects observed in the images is in the interval from 1.8 to 1.9 of DOM. When comparing both mammography system, the system screen-film has a lower variability in the distribution of objects associated to a DOM. (Author)

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

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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

Spiked natural matrix materials as quality assessment samples

International Nuclear Information System (INIS)

Feiner, M.S.; Sanderson, C.G.

1988-01-01

The Environmental Measurements Laboratory has conducted the Quality Assessment Program since 1976 to evaluate the quality of the environmental radioactivity data, which is reported to the Department of Energy by as many as 42 commercial contractors involved in nuclear work. In this program, matrix materials of known radionuclide concentrations are distributed routinely to the contractors and the reported results are compared. The five matrices used are: soil, vegetation, animal tissue, water and filter paper. Environmental soil, vegetation and animal tissue are used, but the water and filter paper samples are prepared by spiking with known amounts of standard solutions traceable to the National Bureau of Standards. A summary of results is given to illustrate the successful operation of the program. Because of the difficulty and high cost of collecting large samples of natural matrix material and to increase the versatility of the program, an attempt was recently made to prepare the soil, vegetation and animal tissue samples with spiked solutions. A description of the preparation of these reference samples and the results of analyses are presented along with a discussion of the pitfalls and advantages of this approach. 19 refs.; 6 tabs

[Quality management in a clinical research facility: Evaluation of changes in quality in-house figures and the appraisal of in-house quality indicators].

Science.gov (United States)

Aden, Bile; Allekotte, Silke; Mösges, Ralph

2016-12-01

For long-term maintenance and improvement of quality within a clinical research institute, the implementation and certification of a quality management system is suitable. Due to the implemented quality management system according to the still valid DIN EN ISO 9001:2008 desired quality objectives are achieved effectively. The evaluation of quality scores and the appraisal of in-house quality indicators make an important contribution in this regard. In order to achieve this and draw quality assurance conclusions, quality indicators as sensible and sensitive as possible are developed. For this, own key objectives, the retrospective evaluation of quality scores, a prospective follow-up and also discussions establish the basis. In the in-house clinical research institute the measures introduced by the quality management led to higher efficiency in work processes, improved staff skills, higher customer satisfaction and overall to more successful outcomes in relation to the self-defined key objectives. Copyright © 2016. Published by Elsevier GmbH.

Screening for quality indicators and phenolic compounds of biotechnological interest in honey samples from six species of stingless bees (Hymenoptera: Apidae

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Rosane Gomes de OLIVEIRA

Full Text Available Abstract Honey from stingless bees of the genus Melipona is a well sought product. Nevertheless lack of legal frameworks for quality assessment complicates the evaluation of food safety and marketing of these products. Seeking to assess the quality of honey from the bees of this genus, physical and chemical analyses, identification of phenolic compounds, and microbiological evaluation from six species of stingless bees was performed. The honey samples showed high reducing sugars, low protein levels and a balanced microbiota. High total phenols and flavonoids and higher antioxidant activity were also recorded. Different phenolic compounds of great biotechnological potential were identified and of these apigenin, kaempferol and luteolin were identified for the first time in honey. To the best of our knowledge, this is one of the few works describing a detail characterization of melipona honey together with identification of the phenolic compounds of significant therapeutic value.

X-ray Computed Tomography Image Quality Indicator (IQI) Development

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National Aeronautics and Space Administration — Phase one of the program is to identify suitable x-ray Computed Tomography (CT) Image Quality Indicator (IQI) design(s) that can be used to adequately capture CT...

Environmental quality indicators and financial development in Malaysia: unity in diversity.

Science.gov (United States)

Alam, Arif; Azam, Muhammad; Abdullah, Alias Bin; Malik, Ihtisham Abdul; Khan, Anwar; Hamzah, Tengku Adeline Adura Tengku; Faridullah; Khan, Muhammad Mushtaq; Zahoor, Hina; Zaman, Khalid

2015-06-01

Environmental quality indicators are crucial for responsive and cost-effective policies. The objective of the study is to examine the relationship between environmental quality indicators and financial development in Malaysia. For this purpose, the number of environmental quality indicators has been used, i.e., air pollution measured by carbon dioxide emissions, population density per square kilometer of land area, agricultural production measured by cereal production and livestock production, and energy resources considered by energy use and fossil fuel energy consumption, which placed an impact on the financial development of the country. The study used four main financial indicators, i.e., broad money supply (M2), domestic credit provided by the financial sector (DCFS), domestic credit to the private sector (DCPC), and inflation (CPI), which each financial indicator separately estimated with the environmental quality indicators, over a period of 1975-2013. The study used the generalized method of moments (GMM) technique to minimize the simultaneity from the model. The results show that carbon dioxide emissions exert the positive correlation with the M2, DCFC, and DCPC, while there is a negative correlation with the CPI. However, these results have been evaporated from the GMM estimates, where carbon emissions have no significant relationship with any of the four financial indicators in Malaysia. The GMM results show that population density has a negative relationship with the all four financial indicators; however, in case of M2, this relationship is insignificant to explain their result. Cereal production has a positive relationship with the DCPC, while there is a negative relationship with the CPI. Livestock production exerts the positive relationship with the all four financial indicators; however, this relationship with the CPI has a more elastic relationship, while the remaining relationship is less elastic with the three financial indicators in a country

SAQC: SNP Array Quality Control

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Li Ling-Hui

2011-04-01

Full Text Available Abstract Background Genome-wide single-nucleotide polymorphism (SNP arrays containing hundreds of thousands of SNPs from the human genome have proven useful for studying important human genome questions. Data quality of SNP arrays plays a key role in the accuracy and precision of downstream data analyses. However, good indices for assessing data quality of SNP arrays have not yet been developed. Results We developed new quality indices to measure the quality of SNP arrays and/or DNA samples and investigated their statistical properties. The indices quantify a departure of estimated individual-level allele frequencies (AFs from expected frequencies via standardized distances. The proposed quality indices followed lognormal distributions in several large genomic studies that we empirically evaluated. AF reference data and quality index reference data for different SNP array platforms were established based on samples from various reference populations. Furthermore, a confidence interval method based on the underlying empirical distributions of quality indices was developed to identify poor-quality SNP arrays and/or DNA samples. Analyses of authentic biological data and simulated data show that this new method is sensitive and specific for the detection of poor-quality SNP arrays and/or DNA samples. Conclusions This study introduces new quality indices, establishes references for AFs and quality indices, and develops a detection method for poor-quality SNP arrays and/or DNA samples. We have developed a new computer program that utilizes these methods called SNP Array Quality Control (SAQC. SAQC software is written in R and R-GUI and was developed as a user-friendly tool for the visualization and evaluation of data quality of genome-wide SNP arrays. The program is available online (http://www.stat.sinica.edu.tw/hsinchou/genetics/quality/SAQC.htm.

Statistical issues in reporting quality data: small samples and casemix variation.

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Zaslavsky, A M

2001-12-01

To present two key statistical issues that arise in analysis and reporting of quality data. Casemix variation is relevant to quality reporting when the units being measured have differing distributions of patient characteristics that also affect the quality outcome. When this is the case, adjustment using stratification or regression may be appropriate. Such adjustments may be controversial when the patient characteristic does not have an obvious relationship to the outcome. Stratified reporting poses problems for sample size and reporting format, but may be useful when casemix effects vary across units. Although there are no absolute standards of reliability, high reliabilities (interunit F > or = 10 or reliability > or = 0.9) are desirable for distinguishing above- and below-average units. When small or unequal sample sizes complicate reporting, precision may be improved using indirect estimation techniques that incorporate auxiliary information, and 'shrinkage' estimation can help to summarize the strength of evidence about units with small samples. With broader understanding of casemix adjustment and methods for analyzing small samples, quality data can be analysed and reported more accurately.

Human Capital Questionnaire: Assessment of European nurses' perceptions as indicators of human capital quality.

Science.gov (United States)

Yepes-Baldó, Montserrat; Romeo, Marina; Berger, Rita

2013-06-01

Healthcare accreditation models generally include indicators related to healthcare employees' perceptions (e.g. satisfaction, career development, and health safety). During the accreditation process, organizations are asked to demonstrate the methods with which assessments are made. However, none of the models provide standardized systems for the assessment of employees. In this study, we analyzed the psychometric properties of an instrument for the assessment of nurses' perceptions as indicators of human capital quality in healthcare organizations. The Human Capital Questionnaire was applied to a sample of 902 nurses in four European countries (Spain, Portugal, Poland, and the UK). Exploratory factor analysis identified six factors: satisfaction with leadership, identification and commitment, satisfaction with participation, staff well-being, career development opportunities, and motivation. The results showed the validity and reliability of the questionnaire, which when applied to healthcare organizations, provide a better understanding of nurses' perceptions, and is a parsimonious instrument for assessment and organizational accreditation. From a practical point of view, improving the quality of human capital, by analyzing nurses and other healthcare employees' perceptions, is related to workforce empowerment. © 2012 Wiley Publishing Asia Pty Ltd.

Home Care Quality Indicators (HCQIS) Based on the MDS-HC

Science.gov (United States)

Hirdes, John P.; Fries, Brant E.; Morris, John N.; Ikegami, Naoki; Zimmerman, David; Dalby, Dawn M.; Aliaga, Pablo; Hammer, Suzanne; Jones, Richard

2004-01-01

Purpose: This study aimed to develop home care quality indicators (HCQIs) to be used by a variety of audiences including consumers, agencies, regulators, and policy makers to support evidence-based decision making related to the quality of home care services. Design and Methods: Data from 3,041 Canadian and 11,252 U.S. home care clients assessed…

Faculty Perceptions of Online Teaching Effectiveness and Indicators of Quality

Directory of Open Access Journals (Sweden)

Christine Frazer

2017-01-01

Full Text Available Online education programs in nursing are increasing rapidly. Faculty need to be competent in their role and possess the skills necessary to positively impact student outcomes. Existing research offers effective teaching strategies for online education; however, there may be some disconnect in the application of these strategies and faculty perceptions of associated outcomes. Focus groups were formed to uncover how nursing faculty in an online program define and describe teaching effectiveness and quality indicators in an asynchronous online environment. A semistructured interview format guided group discussion. Participants (n=11 included nurse educators from an online university with an average of 15 years of experience teaching in nursing academia and 6 years in an online environment. Teaching effectiveness, indicators of quality, and student success were three categories that emerged from the analysis of data. What materialized from the analysis was an overarching concept of a “dance” that occurs in the online environment. Effective online teachers facilitate, connect, lead, and work in synchrony with students to obtain indicators of quality such as student success, student improvement over time, and student application of knowledge to the professional role.

The Global Streamflow Indices and Metadata Archive (GSIM) - Part 2: Quality control, time-series indices and homogeneity assessment

Science.gov (United States)

Gudmundsson, Lukas; Do, Hong Xuan; Leonard, Michael; Westra, Seth

2018-04-01

This is Part 2 of a two-paper series presenting the Global Streamflow Indices and Metadata Archive (GSIM), which is a collection of daily streamflow observations at more than 30 000 stations around the world. While Part 1 (Do et al., 2018a) describes the data collection process as well as the generation of auxiliary catchment data (e.g. catchment boundary, land cover, mean climate), Part 2 introduces a set of quality controlled time-series indices representing (i) the water balance, (ii) the seasonal cycle, (iii) low flows and (iv) floods. To this end we first consider the quality of individual daily records using a combination of quality flags from data providers and automated screening methods. Subsequently, streamflow time-series indices are computed for yearly, seasonal and monthly resolution. The paper provides a generalized assessment of the homogeneity of all generated streamflow time-series indices, which can be used to select time series that are suitable for a specific task. The newly generated global set of streamflow time-series indices is made freely available with an digital object identifier at https://doi.pangaea.de/10.1594/PANGAEA.887470" target="_blank">https://doi.pangaea.de/10.1594/PANGAEA.887470 and is expected to foster global freshwater research, by acting as a ground truth for model validation or as a basis for assessing the role of human impacts on the terrestrial water cycle. It is hoped that a renewed interest in streamflow data at the global scale will foster efforts in the systematic assessment of data quality and provide momentum to overcome administrative barriers that lead to inconsistencies in global collections of relevant hydrological observations.

Utility of pollution indices in assessment of soil quality around ...

African Journals Online (AJOL)

The quality of soil in the vicinity of Madaka mining sites were investigated in this study using Environmental Pollution Indices. Geological mapping of the study area indicated that the area was dominated by schist and granite. The static water level measurement revealed a westward groundwater flow direction which also ...

A systematic review of diet quality indices in relation to obesity.

Science.gov (United States)

Asghari, Golaleh; Mirmiran, Parvin; Yuzbashian, Emad; Azizi, Fereidoun

2017-04-01

Tools, called 'diet/dietary quality indices', evaluate the level of adherence to a specified pattern or a set of recommendations in populations. Yet, there are no review studies providing unanimous comprehensive results of dietary indices on obesity. We reviewed observational studies, focusing on the association of diet quality indices with general obesity or abdominal obesity in adults. We systematically conducted a search in all English language publications available on MEDLINE, ISI Web of Science and Embase between January 1990 and January 2016. Among the wide variety of indices and weight-derived variables, studies with dietary-guideline-based indices and mean changes for weight gain or OR for general obesity and abdominal obesity were selected. From a total of 479 articles, thirty-four studies were selected for the current review, ten of which had prospective designs and twenty-six had cross-sectional designs. Associations of weight status with the original Healthy Eating Index (HEI) and other versions of the HEI including alternative HEI, HEI-2005 and HEI-05 were examined in thirteen studies, with ten studies revealing significant associations. The HEI was a better general obesity predictor in men than in women. Diet scores lacked efficacy in assessing overall diet quality and demonstrated no significant findings in developing countries, in comparison with US populations. In addition, indices based on dietary diversity scores were directly associated with weight gain. Despite the insufficient evidence to draw definitive conclusions about the relation between dietary indices and obesity, HEI was found to be inversely associated with obesity and diversity-based indices were positively associated with obesity.

Centrifugation protocols: tests to determine optimal lithium heparin and citrate plasma sample quality.

Science.gov (United States)

Dimeski, Goce; Solano, Connie; Petroff, Mark K; Hynd, Matthew

2011-05-01

Currently, no clear guidelines exist for the most appropriate tests to determine sample quality from centrifugation protocols for plasma sample types with both lithium heparin in gel barrier tubes for biochemistry testing and citrate tubes for coagulation testing. Blood was collected from 14 participants in four lithium heparin and one serum tube with gel barrier. The plasma tubes were centrifuged at four different centrifuge settings and analysed for potassium (K(+)), lactate dehydrogenase (LD), glucose and phosphorus (Pi) at zero time, poststorage at six hours at 21 °C and six days at 2-8°C. At the same time, three citrate tubes were collected and centrifuged at three different centrifuge settings and analysed immediately for prothrombin time/international normalized ratio, activated partial thromboplastin time, derived fibrinogen and surface-activated clotting time (SACT). The biochemistry analytes indicate plasma is less stable than serum. Plasma sample quality is higher with longer centrifugation time, and much higher g force. Blood cells present in the plasma lyse with time or are damaged when transferred in the reaction vessels, causing an increase in the K(+), LD and Pi above outlined limits. The cells remain active and consume glucose even in cold storage. The SACT is the only coagulation parameter that was affected by platelets >10 × 10(9)/L in the citrate plasma. In addition to the platelet count, a limited but sensitive number of assays (K(+), LD, glucose and Pi for biochemistry, and SACT for coagulation) can be used to determine appropriate centrifuge settings to consistently obtain the highest quality lithium heparin and citrate plasma samples. The findings will aid laboratories to balance the need to provide the most accurate results in the best turnaround time.

Is the Readmission Rate a Valid Quality Indicator? A Review of the Evidence

Science.gov (United States)

Fischer, Claudia; Lingsma, Hester F.; Marang-van de Mheen, Perla J.; Kringos, Dionne S.; Klazinga, Niek S.; Steyerberg, Ewout W.

2014-01-01

Introduction Hospital readmission rates are increasingly used for both quality improvement and cost control. However, the validity of readmission rates as a measure of quality of hospital care is not evident. We aimed to give an overview of the different methodological aspects in the definition and measurement of readmission rates that need to be considered when interpreting readmission rates as a reflection of quality of care. Methods We conducted a systematic literature review, using the bibliographic databases Embase, Medline OvidSP, Web-of-Science, Cochrane central and PubMed for the period of January 2001 to May 2013. Results The search resulted in 102 included papers. We found that definition of the context in which readmissions are used as a quality indicator is crucial. This context includes the patient group and the specific aspects of care of which the quality is aimed to be assessed. Methodological flaws like unreliable data and insufficient case-mix correction may confound the comparison of readmission rates between hospitals. Another problem occurs when the basic distinction between planned and unplanned readmissions cannot be made. Finally, the multi-faceted nature of quality of care and the correlation between readmissions and other outcomes limit the indicator's validity. Conclusions Although readmission rates are a promising quality indicator, several methodological concerns identified in this study need to be addressed, especially when the indicator is intended for accountability or pay for performance. We recommend investing resources in accurate data registration, improved indicator description, and bundling outcome measures to provide a more complete picture of hospital care. PMID:25379675

Is the readmission rate a valid quality indicator? A review of the evidence.

Directory of Open Access Journals (Sweden)

Claudia Fischer

Full Text Available Hospital readmission rates are increasingly used for both quality improvement and cost control. However, the validity of readmission rates as a measure of quality of hospital care is not evident. We aimed to give an overview of the different methodological aspects in the definition and measurement of readmission rates that need to be considered when interpreting readmission rates as a reflection of quality of care.We conducted a systematic literature review, using the bibliographic databases Embase, Medline OvidSP, Web-of-Science, Cochrane central and PubMed for the period of January 2001 to May 2013.The search resulted in 102 included papers. We found that definition of the context in which readmissions are used as a quality indicator is crucial. This context includes the patient group and the specific aspects of care of which the quality is aimed to be assessed. Methodological flaws like unreliable data and insufficient case-mix correction may confound the comparison of readmission rates between hospitals. Another problem occurs when the basic distinction between planned and unplanned readmissions cannot be made. Finally, the multi-faceted nature of quality of care and the correlation between readmissions and other outcomes limit the indicator's validity.Although readmission rates are a promising quality indicator, several methodological concerns identified in this study need to be addressed, especially when the indicator is intended for accountability or pay for performance. We recommend investing resources in accurate data registration, improved indicator description, and bundling outcome measures to provide a more complete picture of hospital care.

Quality indicators for the analysis of communication in an online course

Directory of Open Access Journals (Sweden)

Antonella Pezzotti

2012-08-01

Full Text Available This study describes the development and validation of quality indicators for analyzing forums interactions in an online course in biology teaching. The aim is to evaluate the quality of communication so as to strengthen the tutor’s role and help students learn fundamental biology concepts while enhancing their collaboration competencies. The indicators are used to analyze cognitive, metacognitive and relational aspects, drawing on a content analysis methodology. The model appears to have a wide range of possible applications in other online courses.

Quality indicators for safe medication preparation and administration: a systematic review

NARCIS (Netherlands)

Smeulers, Marian; Verweij, Lotte; Maaskant, Jolanda M.; de Boer, Monica; Krediet, C. T. Paul; Nieveen van Dijkum, Els J. M.; Vermeulen, Hester

2015-01-01

One-third of all medication errors causing harm to hospitalized patients occur in the medication preparation and administration phase, which is predominantly a nursing activity. To monitor, evaluate and improve the quality and safety of this process, evidence-based quality indicators can be used.

Methods for collecting algal samples as part of the National Water-Quality Assessment Program

Science.gov (United States)

Porter, Stephen D.; Cuffney, Thomas F.; Gurtz, Martin E.; Meador, Michael R.

1993-01-01

Benthic algae (periphyton) and phytoplankton communities are characterized in the U.S. Geological Survey's National Water-Quality Assessment Program as part of an integrated physical, chemical, and biological assessment of the Nation's water quality. This multidisciplinary approach provides multiple lines of evidence for evaluating water-quality status and trends, and for refining an understanding of the factors that affect water-quality conditions locally, regionally, and nationally. Water quality can be characterized by evaluating the results of qualitative and quantitative measurements of the algal community. Qualitative periphyton samples are collected to develop of list of taxa present in the sampling reach. Quantitative periphyton samples are collected to measure algal community structure within selected habitats. These samples of benthic algal communities are collected from natural substrates, using the sampling methods that are most appropriate for the habitat conditions. Phytoplankton samples may be collected in large nonwadeable streams and rivers to meet specific program objectives. Estimates of algal biomass (chlorophyll content and ash-free dry mass) also are optional measures that may be useful for interpreting water-quality conditions. A nationally consistent approach provides guidance on site, reach, and habitat selection, as well as information on methods and equipment for qualitative and quantitative sampling. Appropriate quality-assurance and quality-control guidelines are used to maximize the ability to analyze data locally, regionally, and nationally.

Assessment of the quality of fall detection and management in primary care in the Netherlands based on the ACOVE quality indicators

NARCIS (Netherlands)

Askari, M; Eslami, S; van Rijn, M; Medlock, S; Moll van Charante, E P; van der Velde, N; de Rooij, S E; Abu-Hanna, A

UNLABELLED: We determined adherence to nine fall-related ACOVE quality indicators to investigate the quality of management of falls in the elderly population by general practitioners in the Netherlands. Our findings demonstrate overall low adherence to these indicators, possibly indicating

Are performance indicators used for hospital quality management: a qualitative interview study amongst health professionals and quality managers in The Netherlands

NARCIS (Netherlands)

Botje, Daan; ten Asbroek, Guus; Plochg, Thomas; Anema, Helen; Kringos, Dionne S.; Fischer, Claudia; Wagner, Cordula; Klazinga, Niek S.

2016-01-01

Hospitals are under increasing pressure to share indicator-based performance information. These indicators can also serve as a means to promote quality improvement and boost hospital performance. Our aim was to explore hospitals' use of performance indicators for internal quality management

Evaluating the scientific basis of quality indicators in colorectal cancer care: A systematic review

NARCIS (Netherlands)

Keikes, Lotte; Koopman, Miriam; Tanis, Pieter J.; Lemmens, Valery E. P. P.; Punt, Cornelis J. A.; van Oijen, Martijn G. H.

2017-01-01

In colorectal cancer care, many indicators for assessment and improvement of quality of care are being used. These quality indicators serve as national and international benchmarks to compare health care on hospital and patient level. However, the scientific basis of these indicators is often

Evaluating the scientific basis of quality indicators in colorectal cancer care : A systematic review

NARCIS (Netherlands)

Keikes, Lotte; Koopman, Miriam; Tanis, Pieter J.; Lemmens, Valery E.P.P.; Punt, Cornelis J.A.; van Oijen, Martijn G.H.

2017-01-01

Aim In colorectal cancer care, many indicators for assessment and improvement of quality of care are being used. These quality indicators serve as national and international benchmarks to compare health care on hospital and patient level. However, the scientific basis of these indicators is often

Serengeti real estate: density vs. fitness-based indicators of lion habitat quality.

Science.gov (United States)

Mosser, Anna; Fryxell, John M; Eberly, Lynn; Packer, Craig

2009-10-01

Habitat quality is typically inferred by assuming a direct relationship between consumer density and resource abundance, although it has been suggested that consumer fitness may be a more accurate measure of habitat quality. We examined density vs. fitness-based measures of habitat quality for lions in the Serengeti National Park, Tanzania. A 40-year average of female reproductive success (yearling cubs per female) was best explained by proximity to river confluences, whereas patterns of productivity (yearling cubs per km(2)) and adult female density (individuals per km(2)) were associated with more general measures of habitat quality and areas of shelter in poor habitat. This suggests that density may not accurately distinguish between high-quality 'source' areas and low-quality sites that merely provide refuges for effectively non-reproductive individuals. Our results indicate that density may be a misleading indicator of real estate value, particularly for populations that do not conform to an ideal free distribution.

Are performance indicators used for hospital quality management: a qualitative interview study amongst health professionals and quality managers in The Netherlands.

Science.gov (United States)

Botje, Daan; Ten Asbroek, Guus; Plochg, Thomas; Anema, Helen; Kringos, Dionne S; Fischer, Claudia; Wagner, Cordula; Klazinga, Niek S

2016-10-13

Hospitals are under increasing pressure to share indicator-based performance information. These indicators can also serve as a means to promote quality improvement and boost hospital performance. Our aim was to explore hospitals' use of performance indicators for internal quality management activities. We conducted a qualitative interview study among 72 health professionals and quality managers in 14 acute care hospitals in The Netherlands. Concentrating on orthopaedic and oncology departments, our goal was to gain insight into data collection and use of performance indicators for two conditions: knee and hip replacement surgery and breast cancer surgery. The semi-structured interviews were recorded and summarised. Based on the data, themes were synthesised and the analyses were executed systematically by two analysts independently. The findings were validated through comparison. The hospitals we investigated collect data for performance indicators in different ways. Similarly, these hospitals have different ways of using such data to support their quality management, while some do not seem to use the data for this purpose at all. Factors like 'linking pin champions', pro-active quality managers and engaged medical specialists seem to make a difference. In addition, a comprehensive hospital data infrastructure with electronic patient records and robust data collection software appears to be a prerequisite to produce reliable external performance indicators for internal quality improvement. Hospitals often fail to use performance indicators as a means to support internal quality management. Such data, then, are not used to its full potential. Hospitals are recommended to focus their human resource policy on 'linking pin champions', the engagement of professionals and a pro-active quality manager, and to invest in a comprehensive data infrastructure. Furthermore, the differences in data collection processes between Dutch hospitals make it difficult to draw

Computer graphics for quality control in the INAA of geological samples

International Nuclear Information System (INIS)

Grossman, J.N.; Baedecker, P.A.

1987-01-01

A data reduction system for the routine instrumental activation analysis of samples is described, with particular emphasis on interactive graphics capabilities for evaluating analytical quality. Graphics procedures were developed to interactively control the analysis of selected photopeaks during spectral analysis, and to evaluate detector performance during a given counting cycle. Graphics algorithms are also used to compare the data on reference samples with accepted values, to prepare quality control charts to evaluate long term precision and to search for systematic variations in data on reference samples as a function of time. (author)

Assessment of the quality of fall detection and management in primary care in the Netherlands based on the ACOVE quality indicators

NARCIS (Netherlands)

Askari, M.; Eslami, S.; van Rijn, M.; Medlock, S.; Moll van Charante, E. P.; van der Velde, N.; de Rooij, S. E.; Abu-Hanna, A.

2016-01-01

We determined adherence to nine fall-related ACOVE quality indicators to investigate the quality of management of falls in the elderly population by general practitioners in the Netherlands. Our findings demonstrate overall low adherence to these indicators, possibly indicating insufficiency in the

Measuring the quality of renal care: things to keep in mind when selecting and using quality indicators

NARCIS (Netherlands)

van der Veer, Sabine N.; van Biesen, Wim; Couchoud, Cécile; Tomson, Charles R. V.; Jager, Kitty J.

2014-01-01

This educational paper discusses a variety of indicators that can be used to measure the quality of care in renal medicine. Based on what aspect of care they reflect, indicators can be grouped into four main categories: structure, process, surrogate outcome and outcome indicators. Each category has

Estimates of Inequality Indices Based on Simple Random, Ranked Set, and Systematic Sampling

OpenAIRE

Bansal, Pooja; Arora, Sangeeta; Mahajan, Kalpana K.

2013-01-01

Gini index, Bonferroni index, and Absolute Lorenz index are some popular indices of inequality showing different features of inequality measurement. In general simple random sampling procedure is commonly used to estimate the inequality indices and their related inference. The key condition that the samples must be drawn via simple random sampling procedure though makes calculations much simpler but this assumption is often violated in practice as the data does not always yield simple random ...

Malnutrition in Dutch health care: prevalence, prevention, treatment, and quality indicators.

Science.gov (United States)

Meijers, Judith M M; Halfens, Ruud J G; van Bokhorst-de van der Schueren, Marian A E; Dassen, Theo; Schols, Jos M G A

2009-05-01

In most health care organizations there is still insufficient awareness for recognizing and treating malnourished patients. To gain more insight into nutritional care policies in Dutch health care organizations, this study investigated screening, treatment, and other quality indicators of nutritional care. In 2007 a cross-sectional multicenter study was performed that included 20 255 patients (hospitals, n = 6021; nursing homes, n = 11 902; home care, n = 2332). A standardized questionnaire was used to study nutritional screening and treatment at the patient level and quality indicators at institutional and ward levels (e.g., malnutrition guidelines/protocols, nutritional education, and weighing policy). Nutritional screening was performed more often in nursing homes (60.2%) than in hospitals (40.3%) and home care (13.9%, P hospitals, and home care. At ward level nursing homes focused more on the quality of nutritional care than did hospitals and home care, especially with respect to controlling the use of nutritional guidelines (54.6%, P malnutrition is still a considerable problem in one of every five patients in all participating health care settings. It furthermore demonstrates that recognizing and treating malnutrition continues to be problematic. To target the problem of malnutrition adequately, more awareness is needed of the importance of nutritional screening, appropriate treatment, and other nutritional quality indicators.

Assessing quality in European educational research indicators and approaches

CERN Document Server

Åström, Fredrik; Hansen, Antje

2014-01-01

Competition-based models for research policy and management have an increasing influence throughout the research process, from attracting funding to publishing results. The introduction of quality control methods utilizing various forms of performance indicators is part of this development. The authors presented in this volume deal with the following questions: What counts as ‘quality’ and how can this be assessed? What are the possible side effects of current quality control systems on research conducted in the European Research Area, especially in the social sciences and the humanities?

Quality indicators on the use of antimicrobials in critically ill patients.

Science.gov (United States)

Vera, P; Palomar, M; Álvarez-Lerma, F

2014-12-01

Quality indicators have been applied to many areas of health care in recent years, including intensive care. However, they have not been specifically developed and validated for antimicrobial use in critically ill patients. Antimicrobials play a key role in intensive care units not only in the prognosis of each individual patient, but also in the development of resistance and changes in the flora in this setting. Evaluating the use of these agents is complex in the intensive care unit, however, because the indications vary greatly and antimicrobial treatment is often changed during admission. We designed and developed specific quality indicators regarding the use of antimicrobials in critically ill patients admitted to the intensive care unit. These indicators are proposed as a tool for application in intensive care units to detect problems in the use of antimicrobials. Future trials are needed, however, to validate these indicators in a large population over time. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review.

Science.gov (United States)

Boulkedid, Rym; Abdoul, Hendy; Loustau, Marine; Sibony, Olivier; Alberti, Corinne

2011-01-01

Delphi technique is a structured process commonly used to developed healthcare quality indicators, but there is a little recommendation for researchers who wish to use it. This study aimed 1) to describe reporting of the Delphi method to develop quality indicators, 2) to discuss specific methodological skills for quality indicators selection 3) to give guidance about this practice. Three electronic data bases were searched over a 30 years period (1978-2009). All articles that used the Delphi method to select quality indicators were identified. A standardized data extraction form was developed. Four domains (questionnaire preparation, expert panel, progress of the survey and Delphi results) were assessed. Of 80 included studies, quality of reporting varied significantly between items (9% for year's number of experience of the experts to 98% for the type of Delphi used). Reporting of methodological aspects needed to evaluate the reliability of the survey was insufficient: only 39% (31/80) of studies reported response rates for all rounds, 60% (48/80) that feedback was given between rounds, 77% (62/80) the method used to achieve consensus and 57% (48/80) listed quality indicators selected at the end of the survey. A modified Delphi procedure was used in 49/78 (63%) with a physical meeting of the panel members, usually between Delphi rounds. Median number of panel members was 17(Q1:11; Q3:31). In 40/70 (57%) studies, the panel included multiple stakeholders, who were healthcare professionals in 95% (38/40) of cases. Among 75 studies describing criteria to select quality indicators, 28 (37%) used validity and 17(23%) feasibility. The use and reporting of the Delphi method for quality indicators selection need to be improved. We provide some guidance to the investigators to improve the using and reporting of the method in future surveys.

Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review.

Directory of Open Access Journals (Sweden)

Rym Boulkedid

Full Text Available OBJECTIVE: Delphi technique is a structured process commonly used to developed healthcare quality indicators, but there is a little recommendation for researchers who wish to use it. This study aimed 1 to describe reporting of the Delphi method to develop quality indicators, 2 to discuss specific methodological skills for quality indicators selection 3 to give guidance about this practice. METHODOLOGY AND MAIN FINDING: Three electronic data bases were searched over a 30 years period (1978-2009. All articles that used the Delphi method to select quality indicators were identified. A standardized data extraction form was developed. Four domains (questionnaire preparation, expert panel, progress of the survey and Delphi results were assessed. Of 80 included studies, quality of reporting varied significantly between items (9% for year's number of experience of the experts to 98% for the type of Delphi used. Reporting of methodological aspects needed to evaluate the reliability of the survey was insufficient: only 39% (31/80 of studies reported response rates for all rounds, 60% (48/80 that feedback was given between rounds, 77% (62/80 the method used to achieve consensus and 57% (48/80 listed quality indicators selected at the end of the survey. A modified Delphi procedure was used in 49/78 (63% with a physical meeting of the panel members, usually between Delphi rounds. Median number of panel members was 17(Q1:11; Q3:31. In 40/70 (57% studies, the panel included multiple stakeholders, who were healthcare professionals in 95% (38/40 of cases. Among 75 studies describing criteria to select quality indicators, 28 (37% used validity and 17(23% feasibility. CONCLUSION: The use and reporting of the Delphi method for quality indicators selection need to be improved. We provide some guidance to the investigators to improve the using and reporting of the method in future surveys.

Using soil organic matter fractions as indicators of soil physical quality

DEFF Research Database (Denmark)

Pulido Moncada, Mansonia A.; Lozano, Z; Delgado, M

2018-01-01

The objective of this study was to evaluate the use of chemical and physical fractions of soil organic matter (SOM), rather than SOM per se, as indicators of soil physical quality (SPQ) based on their effect on aggregate stability (AS). Chemically extracted humic and fulvic acids (HA and FA) were...... used as chemical fractions, and heavy and light fractions (HF and LF) obtained by density separation as physical fractions. The analyses were conducted on medium-textured soils from tropical and temperate regions under cropland and pasture. Results show that soil organic carbon (SOC), SOM fractions...... and AS appear to be affected by land use regardless of the origin of the soils. A general separation of structurally stable and unstable soils between samples of large and small SOC content, respectively, was observed. SOM fractions did not show a better relationship with AS than SOC per se. In both...

Influence of sample quality on phenylalanine and 17-hydroxyprogesterone levels in neonatal screening

OpenAIRE

del Río Fabre, Lesley; González, Ernesto C; Frómeta, Amarilys; Castells, Elisa M; Tejeda, Yileidis

2010-01-01

Quality of the sample and phenylalanine and 17-hydroxyprogesterone levels in neonatal screening. In the programs for neonatal screening many different analytes are quantified from dried blood on filter paper cards. Several factors affect the quality of the samples invalidating their employment in the laboratory: inadequate collection procedures, quality of the filter paper, the drying, storage and transportation under extreme environmental conditions. This article aims to show how the quality...

Performance indicators used to assess the quality of primary dental care

NARCIS (Netherlands)

González, Grisel Zacca; Klazinga, Niek; ten Asbroek, Guus; Delnoij, Diana M.

2006-01-01

An appropriate quality of medical care including dental care should be an objective of every government that aims to improve the oral health of its population. OBJECTIVES: To determine performance indicators that could be used to assess the quality of primary dental care at different levels of a

Canadian Association of Gastroenterology Consensus Guidelines on Safety and Quality Indicators in Endoscopy

Directory of Open Access Journals (Sweden)

David Armstrong

2012-01-01

Full Text Available Several organizations worldwide have developed procedure-based guidelines and/or position statements regarding various aspects of quality and safety indicators, and credentialing for endoscopy. Although important, they do not specifically address patient needs or provide a framework for their adoption in the context of endoscopy services. The consensus guidelines reported in this article, however, aimed to identify processes and indicators relevant to the provision of high-quality endoscopy services that will support ongoing quality improvement across many jurisdictions, specifically in the areas of ethics, facility standards and policies, quality assurance, training and education, reporting standards and patient perceptions.

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

Science.gov (United States)

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.

Trail Creek I: Assessing the Water Quality of Streams using Fecal Indicator Bacteria and Microbial Source Tracking

Science.gov (United States)

Saintil, T.; Radcliffe, D. E.; Rasmussen, T. C.; Kannan, A.

2017-12-01

Fecal coliforms are indicators for disease-causing pathogens. The United States Environmental Protection Agency (US. EPA) recommends the use of E. coli and Enterococci because they are highly correlated with pathogenic organisms in recreational waters. This standard method helps to determine the overall water quality and the potential health risks. Studies have shown that it is difficult to estimate the exact sources of fecal contamination because both human and certain animal species contain E. coli and Enterococci in their waste. Certain strains of E. coli and Enterococci are also able to survive outside of their hosts, which should not be the case for an appropriate fecal indicator. As a result, microbial source tracking (MST) studies use gene specific markers to identify the possible contributors to water pollution whether human or animal. Trail Creek is a second-order stream located in Athens-Clarke County, GA. The 33-km2 watershed is approximately 64% forests, 18% pastures and 16% residential communities. Trail Creek is on the TMDL list and an extended study on the relationships between the different factors causing elevated fecal bacteria is needed. Synoptic sampling events were conducted during baseflow conditions at six locations. Storm sampling events (> 8 mm) were captured using automated samplers at two locations. These samplers were equipped with pressure transducers which record stage at 30-minute intervals. The samples were analyzed for fecal coliform, E. Coli and Enterococci. Water quality parameters including temperature, specific conductance, dissolved oxygen, pH, and turbidity were also recorded. Relationships between the parameters and fecal indicator bacteria show inconsistent patterns and high variability. Using quantitative PCR and MST techniques, the human specific marker (HF183) and ruminant marker (Rum2Bac) were used to identify the fecal sources in both baseflow and storm samples. The presence and abundance of the different markers at

Performance indicators: A tool for continuous quality improvement

Directory of Open Access Journals (Sweden)

Nidhi M Bhatnagar

2016-01-01

Full Text Available Background: Performance monitoring is an important tool which can be used for setting priorities for process improvement. At our centre, we have been monitoring every step in the processes, right from inventory of consumables (both critical and routine to number of donors reactive for TTI. We conducted a study to measure the impact of monitoring Performance Indicators and how it could be used as a tool for Continuous Quality Improvement (CQI. Materials and Methods: The present study was a retrospective study where the performance indicator (PI data of blood bank was analyzed for over four years. For certain parameters, benchmarks or thresholds were set that represented warning limits or action limits. The yearly data were collated from monthly data. "Shifts" or "Trends", if any, were identified and Corrective and Preventive Action (CAPA taken accordingly. At the end, outcomes of the analysis were charted. Results: After the yearly data evaluation, outcomes obtained were used to plan, correct and amend processes and systems in the blood center. It was observed that the workload of the center showed an upward trend. This helped us to plan for the purchase of consumables and management of manpower. The monitoring of usage and discard of blood helped in the efficient management of blood stocks. The need for any new equipment could also be judged by the trends in workload. Conclusion: Performance indicators are indispensible tools which various stakeholders in the Blood Transfusion centres should implement to improve on quality performance.

Performance indicators: A tool for continuous quality improvement.

Science.gov (United States)

Bhatnagar, Nidhi M; Soni, Shital; Gajjar, Maitrey; Shah, Mamta; Shah, Sangita; Patel, Vaidehi

2016-01-01

Performance monitoring is an important tool which can be used for setting priorities for process improvement. At our centre, we have been monitoring every step in the processes, right from inventory of consumables (both critical and routine) to number of donors reactive for TTI. We conducted a study to measure the impact of monitoring Performance Indicators and how it could be used as a tool for Continuous Quality Improvement (CQI). The present study was a retrospective study where the performance indicator (PI) data of blood bank was analyzed for over four years. For certain parameters, benchmarks or thresholds were set that represented warning limits or action limits. The yearly data were collated from monthly data. Shifts or Trends, if any, were identified and Corrective and Preventive Action (CAPA) taken accordingly. At the end, outcomes of the analysis were charted. After the yearly data evaluation, outcomes obtained were used to plan, correct and amend processes and systems in the blood center. It was observed that the workload of the center showed an upward trend. This helped us to plan for the purchase of consumables and management of manpower. The monitoring of usage and discard of blood helped in the efficient management of blood stocks. The need for any new equipment could also be judged by the trends in workload. Performance indicators are indispensible tools which various stakeholders in the Blood Transfusion centres should implement to improve on quality performance.

Heavy metals in soils of Hechuan County in the upper Yangtze (SW China): Comparative pollution assessment using multiple indices with high-spatial-resolution sampling.

Science.gov (United States)

Ni, Maofei; Mao, Rong; Jia, Zhongmin; Dong, Ruozhu; Li, Siyue

2018-02-01

In order to assess heavy metals (HMs) in soils of the upper Yangtze Basin, a very high-spatial-resolution sampling (582 soil samples) was conducted from Hechuan County, an important agricultural practice area in the Southwest China. Multiple indices including geoaccumulation index (I geo ), enrichment factor (EF), sediment pollution index (SPI) and risk index (RI), as well as multivariate statistics were employed for pollution assessment and source identification of HMs in soils. Our results demonstrated that the averages of eight HMs decreased in the following order: Zn (82.8 ± 15.9) > Cr (71.6 ± 12.2) > Ni (32.1 ± 9.89) > Pb (27.6 ± 13.8) > Cu (25.9 ± 11.8) > As (5.48 ± 3.42) > Cd (0.30 ± 0.077) > Hg (0.082 ± 0.092). Averages of HMs except Cd were lower than threshold value of Environmental Quality Standard for Soils, while 43% of total samples had Cd concentration exceeding the national standard, 1% of samples for Hg and 5% samples for Ni, moreover, Cd and Hg averages were much higher than their background levels. I geo and EF indicated that their levels decreased as follows: Cd > Hg > Zn > Pb > Ni > Cu > Cr > As, with moderate enrichments of Cd and Hg. RI indicated that 61.7% of all samples showed moderate risk, while 6.5% of samples with greater than considerable risk due to human activities should be paid more attention. Multivariate analysis showed lithogenic source of Cu, Cr, Ni and Zn, while Cd and Hg were largely contributed by anthropogenic activities such as agricultural practices. Our study would be helpful for improving soil environmental quality in SW, China, as well as supplying modern approaches for other areas with soil HM pollution. Copyright © 2017 Elsevier Inc. All rights reserved.

Quality control for measurement of soil samples containing 237Np and 241Am as radiotracer

International Nuclear Information System (INIS)

Sha Lianmao; Zhang Caihong; Song Hailong; Ren Xiaona; Han Yuhu; Zhang Aiming; Chu Taiwei

2003-01-01

This paper reports quality control (QC) for the measurement of soil samples containing 237 Np and 241 Am as radiotracers in migration test of transuranic nuclides. All of the QC were done independently by the QA members of analytical work. It mainly included checking 5%-10% of the total analyzed samples; preparing blank samples, blind replicate sample and spiked samples used as quality control samples to check the quality of analytical work

Quality indicators for diagnosis and treatment of respiratory tract infections in general practice: a modified Delphi study

DEFF Research Database (Denmark)

Hansen, Malene Plejdrup; Bjerrum, Lars; Gahrn-Hansen, Bente

2010-01-01

was achieved in both Delphi rounds. A total of 41 of the proposed 59 quality indicators attained consensus. None of the quality indicators focusing on the diagnostic process achieved consensus. Consensus was attained for 14 quality indicators focusing on the decision regarding antibiotic treatment and for 27...... quality indicators focusing on the choice of antibiotics. CONCLUSION: This study resulted in a final set of 41 quality indicators concerning respiratory tract infections in general practice. These quality indicators may be used to strengthen general practitioners' focus on their management of patients......OBJECTIVE: To develop a set of quality indicators focusing on the diagnosis and treatment of respiratory tract infections in general practice. DESIGN: A modified 2-round Delphi study. SETTING: General practice. SUBJECTS: A panel of 27 experts (13 countries) comprising mainly general practitioners...

Sample-size dependence of diversity indices and the determination of sufficient sample size in a high-diversity deep-sea environment

OpenAIRE

Soetaert, K.; Heip, C.H.R.

1990-01-01

Diversity indices, although designed for comparative purposes, often cannot be used as such, due to their sample-size dependence. It is argued here that this dependence is more pronounced in high diversity than in low diversity assemblages and that indices more sensitive to rarer species require larger sample sizes to estimate diversity with reasonable precision than indices which put more weight on commoner species. This was tested for Hill's diversity number N sub(0) to N sub( proportional ...

Computer graphics for quality control in the INAA of geological samples

Science.gov (United States)

Grossman, J.N.; Baedecker, P.A.

1987-01-01

A data reduction system for the routine instrumental activation analysis of samples is described, with particular emphasis on interactive graphics capabilities for evaluating analytical quality. Graphics procedures have been developed to interactively control the analysis of selected photopeaks during spectral analysis, and to evaluate detector performance during a given counting cycle. Graphics algorithms are also used to compare the data on reference samples with accepted values, to prepare quality control charts to evaluate long term precision and to search for systematic variations in data on reference samples as a function of time. ?? 1987 Akade??miai Kiado??.

The Global Streamflow Indices and Metadata Archive (GSIM – Part 2: Quality control, time-series indices and homogeneity assessment

Directory of Open Access Journals (Sweden)

L. Gudmundsson

2018-04-01

Full Text Available This is Part 2 of a two-paper series presenting the Global Streamflow Indices and Metadata Archive (GSIM, which is a collection of daily streamflow observations at more than 30 000 stations around the world. While Part 1 (Do et al., 2018a describes the data collection process as well as the generation of auxiliary catchment data (e.g. catchment boundary, land cover, mean climate, Part 2 introduces a set of quality controlled time-series indices representing (i the water balance, (ii the seasonal cycle, (iii low flows and (iv floods. To this end we first consider the quality of individual daily records using a combination of quality flags from data providers and automated screening methods. Subsequently, streamflow time-series indices are computed for yearly, seasonal and monthly resolution. The paper provides a generalized assessment of the homogeneity of all generated streamflow time-series indices, which can be used to select time series that are suitable for a specific task. The newly generated global set of streamflow time-series indices is made freely available with an digital object identifier at https://doi.pangaea.de/10.1594/PANGAEA.887470 and is expected to foster global freshwater research, by acting as a ground truth for model validation or as a basis for assessing the role of human impacts on the terrestrial water cycle. It is hoped that a renewed interest in streamflow data at the global scale will foster efforts in the systematic assessment of data quality and provide momentum to overcome administrative barriers that lead to inconsistencies in global collections of relevant hydrological observations.

Blood venous sample collection: Recommendations overview and a checklist to improve quality.

Science.gov (United States)

Giavarina, Davide; Lippi, Giuseppe

2017-07-01

The extra-analytical phases of the total testing process have substantial impact on managed care, as well as an inherent high risk of vulnerability to errors which is often greater than that of the analytical phase. The collection of biological samples is a crucial preanalytical activity. Problems or errors occurring shortly before, or soon after, this preanalytical step may impair sample quality and characteristics, or else modify the final results of testing. The standardization of fasting requirements, rest, patient position and psychological state of the patient are therefore crucial for mitigating the impact of preanalytical variability. Moreover, the quality of materials used for collecting specimens, along with their compatibility, can guarantee sample quality and persistence of chemical and physical characteristics of the analytes over time, so safeguarding the reliability of testing. Appropriate techniques and sampling procedures are effective to prevent problems such as hemolysis, undue clotting in the blood tube, draw of insufficient sample volume and modification of analyte concentration. An accurate identification of both patient and blood samples is a key priority as for other healthcare activities. Good laboratory practice and appropriate training of operators, by specifically targeting collection of biological samples, blood in particular, may greatly improve this issue, thus lowering the risk of errors and their adverse clinical consequences. The implementation of a simple and rapid check-list, including verification of blood collection devices, patient preparation and sampling techniques, was found to be effective for enhancing sample quality and reducing some preanalytical errors associated with these procedures. The use of this tool, along with implementation of objective and standardized systems for detecting non-conformities related to unsuitable samples, can be helpful for standardizing preanalytical activities and improving the quality of

Quality evaluation of processed clay soil samples.

Science.gov (United States)

Steiner-Asiedu, Matilda; Harrison, Obed Akwaa; Vuvor, Frederick; Tano-Debrah, Kwaku

2016-01-01

This study assessed the microbial quality of clay samples sold on two of the major Ghanaian markets. The study was a cross-sectional assessing the evaluation of processed clay and effects it has on the nutrition of the consumers in the political capital town of Ghana. The items for the examination was processed clay soil samples. Staphylococcus spp and fecal coliforms including Klebsiella, Escherichia, and Shigella and Enterobacterspp were isolated from the clay samples. Samples from the Kaneshie market in Accra recorded the highest total viable counts 6.5 Log cfu/g and Staphylococcal count 5.8 Log cfu/g. For fecal coliforms, Madina market samples had the highest count 6.5 Log cfu/g and also recorded the highest levels of yeast and mould. For Koforidua, total viable count was highest in the samples from the Zongo market 6.3 Log cfu/g. Central market samples had the highest count of fecal coliforms 4.6 Log cfu/g and yeasts and moulds 6.5 Log cfu/g. "Small" market recorded the highest staphylococcal count 6.2 Log cfu/g. The water activity of the clay samples were low, and ranged between 0.65±0.01 and 0.66±0.00 for samples collected from Koforidua and Accra respectively. The clay samples were found to contain Klebsiella spp. Escherichia, Enterobacter, Shigella spp. staphylococcus spp., yeast and mould. These have health implications when consumed.

Indicators to support the dynamic evaluation of air quality models

Science.gov (United States)

Thunis, P.; Clappier, A.

2014-12-01

Air quality models are useful tools for the assessment and forecast of pollutant concentrations in the atmosphere. Most of the evaluation process relies on the “operational phase” or in other words the comparison of model results with available measurements which provides insight on the model capability to reproduce measured concentrations for a given application. But one of the key advantages of air quality models lies in their ability to assess the impact of precursor emission reductions on air quality levels. Models are then used in a dynamic mode (i.e. response to a change in a given model input data) for which evaluation of the model performances becomes a challenge. The objective of this work is to propose common indicators and diagrams to facilitate the understanding of model responses to emission changes when models are to be used for policy support. These indicators are shown to be useful to retrieve information on the magnitude of the locally produced impacts of emission reductions on concentrations with respect to the “external to the domain” contribution but also to identify, distinguish and quantify impacts arising from different factors (different precursors). In addition information about the robustness of the model results is provided. As such these indicators might reveal useful as first screening methodology to identify the feasibility of a given action as well as to prioritize the factors on which to act for an increased efficiency. Finally all indicators are made dimensionless to facilitate the comparison of results obtained with different models, different resolutions, or on different geographical areas.

Elements and indicators for identification of quality of primary education

Directory of Open Access Journals (Sweden)

Sučević Vlasta M.

2015-01-01

Full Text Available Education is one of the main pillars of the quality of knowledge, and, in turn, social progress in general. There are numerous positions concerning quality of education, some more, and some less detailed. In order to determine the quality of a primary school, for example as 'poor', 'mediocre' or 'excellent', we use, more or less precisely, a certain idea about the value, and thus identify, again with a certain extent of accuracy, the position of the school in question in relation to other schools. In terms of the quality of education, it is necessary to analyze all segments of educational process. This includes the analysis of objectives of educational process, products of quality education as well as adequate and accessible technical-instrumental, that is, operational-procedural level of quality of educational process. Most authors connect the quality of primary education to results, that is, outcomes of education. In order to achieve quality of education, we need to achieve quality of particular components or elements of the whole of education. This paper deals with theoretical review of elements and indicators of quality of basic education, and provides a review of pedagogical strategies and their effect on certain components of quality with the aim to improve the effects on pedagogical and didactical resources of the quality of education.

Valuation of Biochemical and Microbiological Indicators in Soil Quality Assessment

OpenAIRE

Peruzzi, Elisabetta

2017-01-01

This thesis research aimed at valuating the suitability of biochemical and microbiological indicators in soil quality and soil health assessment, applying an interdisciplinary approach by means of different methodologies. As the concept of soil quality encompasses both functionality and biological diversity, two cases of study are proposed and each of them aimed at the description of this two aspects. The first case study examined the degree of interference of high soil copper contamination w...

The Alaska Commercial Fisheries Water Quality Sampling Methods and Procedures Manual

Energy Technology Data Exchange (ETDEWEB)

Folley, G.; Pearson, L.; Crosby, C. [Alaska Dept. of Environmental Conservation, Soldotna, AK (United States); DeCola, E.; Robertson, T. [Nuka Research and Planning Group, Seldovia, AK (United States)

2006-07-01

A comprehensive water quality sampling program was conducted in response to the oil spill that occurred when the M/V Selendang Ayu ship ran aground near a major fishing port at Unalaska Island, Alaska in December 2004. In particular, the sampling program focused on the threat of spilled oil to the local commercial fisheries resources. Spill scientists were unable to confidently model the movement of oil away from the wreck because of limited oceanographic data. In order to determine which fish species were at risk of oil contamination, a real-time assessment of how and where the oil was moving was needed, because the wreck became a continual source of oil release for several weeks after the initial grounding. The newly developed methods and procedures used to detect whole oil during the sampling program will be presented in the Alaska Commercial Fisheries Water Quality Sampling Methods and Procedures Manual which is currently under development. The purpose of the manual is to provide instructions to spill managers while they try to determine where spilled oil has or has not been encountered. The manual will include a meaningful data set that can be analyzed in real time to assess oil movement and concentration. Sections on oil properties and processes will be included along with scientific water quality sampling methods for whole and dissolved phase oil to assess potential contamination of commercial fishery resources and gear in Alaska waters during an oil spill. The manual will present a general discussion of factors that should be considered when designing a sampling program after a spill. In order to implement Alaska's improved seafood safety measures, the spatial scope of spilled oil must be known. A water quality sampling program can provide state and federal fishery managers and food safety inspectors with important information as they identify at-risk fisheries. 11 refs., 7 figs.

Quality indicators for treatment of respiratory tract infections? An assessment by Danish general practitioners

DEFF Research Database (Denmark)

Hansen, Malene Plejdrup; Bjerrum, Lars; Gahrn-Hansen, Bente

2013-01-01

Background: In 2008, a set of 41 quality indicators for antibiotic treatment of respiratory tract infections (RTIs) in general practice were developed in an international setting as part of the European project HAPPY AUDIT. Objectives: To investigate Danish general practitioners' (GPs') assessment...... of a set of internationally developed quality indicators and to explore if there is an association between the GPs' assessment of the indicators and their practice characteristics as well as their antibiotic prescription pattern. Methods: A total of 102 Danish GPs were invited to assess the 41 quality...

[Validation and adhesion to GESIDA quality indicators in patients with HIV infection].

Science.gov (United States)

Riera, Melchor; Esteban, Herminia; Suarez, Ignacio; Palacios, Rosario; Lozano, Fernando; Blanco, Jose R; Valencia, Eulalia; Ocampo, Antonio; Amador, Concha; Frontera, Guillem; vonWichmann-de Miguel, Miguel Angel

2016-01-01

The objective of the study is to validate the relevant GESIDA quality indicators for HIV infection, assessing the reliability, feasibility and adherence to them. The reliability was evaluated using the reproducibility of 6 indicators in peer review, with the second observer being an outsider. The feasibility and measurement of the level of adherence to the 22 indicators was conducted with annual fragmented retrospective collection of information from specific databases or the clinical charts of the nine participating hospitals. Reliability was very high, with interobserver agreement levels higher than 95% in 5 of the 6 indicators. The median time to achieve the indicators ranged between 5 and 600minutes, but could be achieved progressively from specific databases, enabling obtaining them automatically. As regards adherence to the indicators related with the initial evaluation of the patients, instructions and suitability of the guidelines for ART, adherence to ART, follow-up in clinics, and achieve an undetectable HIV by PCR at week 48 of the ART. Indicators of quality related to the prevention of opportunistic infections and control of comorbidities, the standards set were not achieved, and significant heterogeneity was observed between hospitals. The GESIDA quality indicators of HIV infection enabled the relevant indicators to be feasibly and reliably measured, and should be collected in all the units that care for patients with HIV infection. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Characterizing sampling and quality screening biases in infrared and microwave limb sounding

Science.gov (United States)

Millán, Luis F.; Livesey, Nathaniel J.; Santee, Michelle L.; von Clarmann, Thomas

2018-03-01

This study investigates orbital sampling biases and evaluates the additional impact caused by data quality screening for the Michelson Interferometer for Passive Atmospheric Sounding (MIPAS) and the Aura Microwave Limb Sounder (MLS). MIPAS acts as a proxy for typical infrared limb emission sounders, while MLS acts as a proxy for microwave limb sounders. These biases were calculated for temperature and several trace gases by interpolating model fields to real sampling patterns and, additionally, screening those locations as directed by their corresponding quality criteria. Both instruments have dense uniform sampling patterns typical of limb emission sounders, producing almost identical sampling biases. However, there is a substantial difference between the number of locations discarded. MIPAS, as a mid-infrared instrument, is very sensitive to clouds, and measurements affected by them are thus rejected from the analysis. For example, in the tropics, the MIPAS yield is strongly affected by clouds, while MLS is mostly unaffected. The results show that upper-tropospheric sampling biases in zonally averaged data, for both instruments, can be up to 10 to 30 %, depending on the species, and up to 3 K for temperature. For MIPAS, the sampling reduction due to quality screening worsens the biases, leading to values as large as 30 to 100 % for the trace gases and expanding the 3 K bias region for temperature. This type of sampling bias is largely induced by the geophysical origins of the screening (e.g. clouds). Further, analysis of long-term time series reveals that these additional quality screening biases may affect the ability to accurately detect upper-tropospheric long-term changes using such data. In contrast, MLS data quality screening removes sufficiently few points that no additional bias is introduced, although its penetration is limited to the upper troposphere, while MIPAS may cover well into the mid-troposphere in cloud-free scenarios. We emphasize that the

Effect of different cooking methods on minerals, vitamins and nutritional quality indices of kutum roach (Rutilus frisii kutum).

Science.gov (United States)

Hosseini, Hedayat; Mahmoudzadeh, Maryam; Rezaei, Masoud; Mahmoudzadeh, Leila; Khaksar, Ramin; Khosroshahi, Nader Karimian; Babakhani, Aria

2014-04-01

In this study, the influence of four cooking methods (baking, boiling, microwaving and frying) was evaluated on the nutritional value of kutum roach. Proximate, fatty acid composition, vitamin and mineral contents and also nutritional quality indices (NQI) of kutum roach were investigated before and after cooking treatment. All treated samples showed increase in protein, ash and lipid contents and decrease in the content of total omega-3 fatty acids (n-3) in comparison to raw fish fillets (control group). Cooking methods had no significant effect on omega-6 fatty acids (n-6) except for frying that increased it. Nonetheless, all of the cooking methods reduced vitamin B1, A and D contents. Boiling significantly decreased mineral contents including Na, K, P and Zn. Considering the overall nutritional quality indices, vitamin and mineral contents, baking is the best cooking method among other applied methods. Copyright © 2013 Elsevier Ltd. All rights reserved.

Air quality indices : a review

International Nuclear Information System (INIS)

Hewings, J.

2001-10-01

Pollution Probe presents some background information that will help in the development of a national Air Quality Index (AQI) in Canada. This report examines the issues that should be addressed in revising the national Index of the Quality of Air (IQUA) or creating a new national Air Quality Index. The IQUA was devised in 1976 and provides Canadians with real-time information on the state of community air quality by including major pollutants and their synergies. It is currently being used for air quality management plans and air quality alert systems. At the same time that the IQUA was devised, the United States Environmental Protection Agency (US EPA) produced a parallel air quality index known as the Pollution Standard Index (PSI) which incorporated 5 criteria pollutants (particulate matter, sulphur dioxide, carbon monoxide, nitrogen oxide and ground level ozone) for which national health-based standards were devised. In 1999, the US EPA renamed their index the Air Quality Index (AQI) and made revisions to the primary health-based national ambient air quality standards for ground-level ozone and particulate matter. Separate values for PM2.5 and PM10 were incorporated and mandatory reporting was required for metropolitan areas with populations of 350,000 or more. Similarly, the IQUA has undergone major developments that affect the validity of the index, including: rejection by the Working Group on Air Quality Objectives and Guidelines of the previous maximum desirable and maximum acceptable air quality criteria, recognition that standards for many of the contaminants are outdated, developing more sensitive instrumentation for real-time monitoring of contaminants. This report also describes the use of the national short term Air Quality Index by provincial, territorial and local authorities in Canada. Pollution Probe recommends setting up a mechanism to review and revise IQUA on a regular basis that would incorporate governments, the medical profession, special

Sampling in Qualitative Research: Improving the Quality of ...

African Journals Online (AJOL)

Sampling consideration in qualitative research is very important, yet in practice this appears not to be given the prominence and the rigour it deserves among Higher Education researchers. Accordingly, the quality of research outcomes in Higher Education has suffered from low utilisation. This has motivated the production ...

Finding even more anthropogenic indicators in mildly prepared sediment samples

DEFF Research Database (Denmark)

Enevold, Renée; Odgaard, Bent Vad

2016-01-01

be worth the effort to prepare the NPP samples with as mild a preparation method as possible. We have mildly prepared NPP samples from a small forest hollow, Tårup Lund, Denmark. From the recovered NPP assemblages we attempt identifying anthropogenic indicators by comparing to the environmental information......NPPs in anthropogenic soils and archaeological samples are often numerous in types as well as in abundance. Preparing these soil samples with methods based on acid digestion holds the potential of severe bias leaving the NPP assemblages devoid of acid vulnerable NPPs. In many cases it might...... derived from sediment, pollen and macrofossil analyses. The sediment from the forest hollow encompasses environmental information from the last 6000 years, including a period of locally intense pastoral and/or agricultural activity during the Iron Age. Keywords: NPP diversity, forest hollow, anthropogenic...

EPHT air quality (county PM2.5 and Ozone) indicators, 2001-2006

Data.gov (United States)

California Environmental Health Tracking Program — The EPHT air quality indicator files are from a SAS program which calculates the air indicators as developed by CDC's Environmental Public Health Tracking (EPHT) Air...

Evaluating Quality of Aged Archival Formalin-Fixed Paraffin-Embedded Samples for RNA-Sequencing

Science.gov (United States)

Archival formalin-fixed paraffin-embedded (FFPE) samples offer a vast, untapped source of genomic data for biomarker discovery. However, the quality of FFPE samples is often highly variable, and conventional methods to assess RNA quality for RNA-sequencing (RNA-seq) are not infor...

Formalization and Computation of Diabetes Quality Indicators with Patient Data from a Chinese Hospital

NARCIS (Netherlands)

Liu, Haitong; ten Teije, Annette; Dentler, Kathrin; Ma, Jingdong; Zhang, Shijing; Riaño, David; Lenz, Richard; Reichert, Manfred

2017-01-01

Clinical quality indicators are tools to measure the quality of healthcare and can be classified into structure-related, process-related and outcome-related indicators. The objective of this study is to investigate whether Electronic Medical Record (EMR) data from a Chinese diabetes specialty

Indices of water quality and metal pollution of Nile River, Egypt

Directory of Open Access Journals (Sweden)

Amaal M. Abdel-Satar

2017-03-01

Full Text Available Nile River is the valued natural and exclusive source of fresh water in Egypt, where the drinking water supply is limited to the river. The water quality of 24 sites between Aswan and Cairo along the Nile was investigated. To evaluate the suitability of water for aquatic life and drinking purposes, the indices of water quality (WQI, heavy metal pollution (HPI and contamination (Cd were computed. The water quality variations were mainly related to inorganic nutrients and heavy metals, where, the sites affected by intensive load of urban, agricultural and industrial wastewater showed serious deterioration of water quality compared with other sites. The anthropogenic impact sites showed high HPI and Cd values and associated with high risks, where, most of the studied metals often exceeded the drinking water and aquatic life limits. The aquatic WQI indicated that the Nile water quality deteriorated and extended from poor to marginal, while drinking WQI varied from marginal to good. Accordingly, the river becoming unfit for aquatic life and the situation is getting worse by decreases in the water budget from the Nile in Egypt by building of the Grand Ethiopian Renaissance Dam, where the dilution strength of the Nile system will reduce.

Evaluating Urban Quality: Indicators and Assessment Tools for Smart Sustainable Cities

Directory of Open Access Journals (Sweden)

Chiara Garau

2018-02-01

Full Text Available The analysis of urban sustainability is key to urban planning, and its usefulness extends to smart cities. Analyses of urban quality typically focus on applying methodologies that evaluate quality objectives at environmental, urban, and building levels. Research has shown that a system of indicators can be useful for developing qualitative and quantitative descriptors of urban environments. The first step in this study was to formulate a methodology to measure the quality of urban life based on investigative checklists and objective and subjective indicators, aggregated to develop an index to evaluate a city’s level of smart urban quality. The second step was to apply this methodology to evaluate the city of Cagliari (Italy at the neighbourhood scale, which is considered by literature the most suitable as a self-sufficient spatial unit for showing redevelopment results. In addition to sharing its research findings, this study aims to verify whether the methodology can be applied to similar urban contexts. The main outcomes of this research pertain to opportunities to numerically measure both objective and subjective aspects that affect urban quality. In this way, the most critical areas to be requalified have been highlighted in order to prepare policies congruent with the local context.

Are patent medicine vendors effective agents in malaria control? Using lot quality assurance sampling to assess quality of practice in Jigawa, Nigeria.

Science.gov (United States)

Berendes, Sima; Adeyemi, Olusegun; Oladele, Edward Adekola; Oresanya, Olusola Bukola; Okoh, Festus; Valadez, Joseph J

2012-01-01

Patent medicine vendors (PMV) provide antimalarial treatment and care throughout Sub-Saharan Africa, and can play an important role in the fight against malaria. Their close-to-client infrastructure could enable lifesaving artemisinin-based combination therapy (ACT) to reach patients in time. However, systematic assessments of drug sellers' performance quality are crucial if their role is to be managed within the health system. Lot quality assurance sampling (LQAS) could be an efficient method to monitor and evaluate PMV practice, but has so far never been used for this purpose. In support of the Nigeria Malaria Booster Program we assessed PMV practices in three Senatorial Districts (SDs) of Jigawa, Nigeria. A two-stage LQAS assessed whether at least 80% of PMV stores in SDs used national treatment guidelines. Acceptable sampling errors were set in consultation with government officials (alpha and beta LQAS has been shown to be a suitable method for monitoring malaria-related indicators among PMV, and should be applied in Nigeria and elsewhere to improve service delivery.

Readmission of ICU patients: A quality indicator?

Science.gov (United States)

Woldhek, Annemarie L; Rijkenberg, Saskia; Bosman, Rob J; van der Voort, Peter H J

2017-04-01

Readmission rate is frequently proposed as a quality indicator because it is related to both patient outcome and organizational efficiency. Currently available studies are not clear about modifiable factors as tools to reduce readmission rate. In a 14year retrospective cohort study of 19,750 ICU admissions we identified 1378 readmissions (7%). A multivariate logistic regression analysis for determinants of readmission within 24h, 48h, 72h and any time during hospital admission was performed with adjustment for patients' characteristics and initial admission severity scores. In all models with different time points, patients with older age, a medical and emergency surgery initial admission and patients with higher SOFA score have a higher risk of readmission. Immunodeficiency was a predictor only in the at any time model. Confirmed infection was predicted in all models except the 24h model. Last day noradrenaline treatment was predicted in the 24 and 48h model. Mechanical ventilation on admission independently protected for readmission, which can be explained by the large number of cardiac surgery patients. All multivariate models had a moderate performance with the highest AUC of 0.70. Readmission can be predicted with moderate precision and independent variables associated with readmission are age, severity of disease, type of admission, infection, immunodeficiency and last day noradrenaline use. The latter factor is the only one that can be modified and therefore readmission rate does not meet the criteria to be used as a useful quality indicator. Copyright © 2016 Elsevier Inc. All rights reserved.

Quality indicators to compare accredited independent pharmacies and accredited chain pharmacies in Thailand.

Science.gov (United States)

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 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.

Indices for the assessment of nutritional quality of meals: a systematic review

NARCIS (Netherlands)

Gorgulho, B.M.; Pot, G.K.; Sarti, F.M.; Marchioni, D.M.

2016-01-01

This systematic review aimed to synthesise information on indices developed to evaluate nutritional quality of meals. A strategy for systematic search of the literature was developed using keywords related to assessment of meal quality. Databases searched included ScienceDirect, PubMed, Lilacs,

Pre-analytical sample quality: metabolite ratios as an intrinsic marker for prolonged room temperature exposure of serum samples.

Directory of Open Access Journals (Sweden)

Gabriele Anton

Full Text Available Advances in the "omics" field bring about the need for a high number of good quality samples. Many omics studies take advantage of biobanked samples to meet this need. Most of the laboratory errors occur in the pre-analytical phase. Therefore evidence-based standard operating procedures for the pre-analytical phase as well as markers to distinguish between 'good' and 'bad' quality samples taking into account the desired downstream analysis are urgently needed. We studied concentration changes of metabolites in serum samples due to pre-storage handling conditions as well as due to repeated freeze-thaw cycles. We collected fasting serum samples and subjected aliquots to up to four freeze-thaw cycles and to pre-storage handling delays of 12, 24 and 36 hours at room temperature (RT and on wet and dry ice. For each treated aliquot, we quantified 127 metabolites through a targeted metabolomics approach. We found a clear signature of degradation in samples kept at RT. Storage on wet ice led to less pronounced concentration changes. 24 metabolites showed significant concentration changes at RT. In 22 of these, changes were already visible after only 12 hours of storage delay. Especially pronounced were increases in lysophosphatidylcholines and decreases in phosphatidylcholines. We showed that the ratio between the concentrations of these molecule classes could serve as a measure to distinguish between 'good' and 'bad' quality samples in our study. In contrast, we found quite stable metabolite concentrations during up to four freeze-thaw cycles. We concluded that pre-analytical RT handling of serum samples should be strictly avoided and serum samples should always be handled on wet ice or in cooling devices after centrifugation. Moreover, serum samples should be frozen at or below -80°C as soon as possible after centrifugation.

[Sampling in quality control of medicinal materials-A case of Epimedium].

Science.gov (United States)

Wang, Chuanyi; Cao, Jinyi; Liang, Yun; Huang, Wenhua; Guo, Baolin

2009-04-01

To investigate the effect of the different individual number of sampling on the assay results of the medicinal materials. Epimedium pubescens and E. brevicornu were used as samples. The 6 sampling levels were formulated as 1 individual, 5, 10, 20, 30, 50 individuals mix, each level with 3 parallels and 1 individual level5 parallels. The contents of epimedin C and icariin, and the peak areas of epimedin A, epimedin B, rhamnosyl icarisid II and icarisid II in all samples were analyzed by HPLC. The variation degree varied with species and chemical constituents, but the RSD and the deviation from the true value decreased with the increase of individual number on the same chemical constituent. The sampling number should be more than 10 individuals in quality control of Epimedium, and 50 or more individuals would be better for representing the quality of medicinal materials.

Pursuing Quality Evidence: Applying Single-Subject Quality Indicators to Non-Experimental Qualitative Educational Research

Science.gov (United States)

Stodden, Robert A.; Yamamoto, Kathryn K.; Folk, Eric; Kong, Eran; Otsuji, Derek N.

2013-01-01

The need for quality evidence in support of strategies used while working with persons with autism and intellectual disability (ID) has been long been recognized by researchers and practitioners. The authors reviewed and applied a number of evidence-based indicators, developed through the "What Works Clearinghouse" (WWC), to the conduct…

[Prevalence of malnutrition, interventions and quality indicators in German nursing homes - first results of a nationwide pilot study].

Science.gov (United States)

Bartholomeyczik, S; Reuther, S; Luft, L; van Nie, N; Meijers, J; Schols, J; Halfens, R

2010-12-01

The aims of this study were to test the transfer and feasibility of a Dutch annual survey on malnutrition into German nursing homes and to gather first data about the prevalence of malnutrition, treatment and quality indicators in German resident homes. A cross-sectional multicentre study, using a standardised multilevel instrument (observation, questionnaire) developed in the University of Maastricht was applied. Variables are indicators for malnutrition and its risks, quality indicators, care dependency and treatment initiatives. The sample consisted of 32 nursing homes with 2,444 participating residents. 26% of the residents show indicators of malnutrition, a risk of malnutrition can be found in another 28%. Only one quarter of the nursing homes use a standardised nutritional screening instrument. Significantly more people with dementia have indicators of malnutrition. Most facilities provide a protocol or a guideline for the prevention and treatment of malnutrition. Also most are training their staff regularly in questions of malnutrition, half the institutions employ dieticians or nutritionists. Special treatment was initiated in half of all residents having indicators of malnutrition or showing a risk. The Dutch instrument is applicable in German nursing homes. Its utilisation shows that malnutrition is still a problem in German nursing homes. The standardised assessment of nutritional status is the exception; the interventions carried out should be improved.

Concordance between nurse-reported quality of care and quality of care as publicly reported by nurse-sensitive indicators

NARCIS (Netherlands)

D. Stalpers (Dewi); R.A.M.M. Kieft (Renate A. M. M.); D. van der Linden (Dimitri); M.J. Kaljouw (Marian J.); M.J. Schuurmans (Marieke )

2016-01-01

textabstractBackground: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between

Security of attachment and quality of mother-toddler social interaction in a high-risk sample.

Science.gov (United States)

Haltigan, John D; Lambert, Brittany L; Seifer, Ronald; Ekas, Naomi V; Bauer, Charles R; Messinger, Daniel S

2012-02-01

The quality of children's social interactions and their attachment security with a primary caregiver are two widely studied indices of socioemotional functioning in early childhood. Although both Bowlby and Ainsworth suggested that the parent-child interactions underlying the development of attachment security could be distinguished from other aspects of parent-child interaction (e.g., play), relatively little empirical research has examined this proposition. The aim of the current study was to explore this issue by examining concurrent relations between toddler's attachment security in the Strange Situation Procedure and quality of mother-child social interaction in a high-risk sample of toddlers characterized by prenatal cocaine exposure and low levels of maternal education. Analyses of variance suggested limited relations between attachment security and quality of social interaction. Further research examining the interrelations among various components of the parent-child relationship is needed. Copyright © 2011 Elsevier Inc. All rights reserved.

Evidence-based practice: a quality indicator analysis of peer-tutoring in adapted physical education.

Science.gov (United States)

Kalef, Laura; Reid, Greg; Macdonald, Cathy

2013-09-01

The purpose of the research was to conduct a quality indicator analysis of studies investigating peer-tutoring for students with a disability in adapted physical education. An electronic search was conducted among English journals published from 1960 to November 2012. Databases included ERIC, PsycINFO, and SPORTDiscus. Fifteen research studies employing group-experimental (Gersten et al., 2005) or single-subject designs (Horner et al., 2005) met inclusion criteria. Each study was assessed for the presence and clarity of quality indicators. Group designs met an average of 62.5% essential and 69% desirable indicators. An average of 80% of indicators was present for single-subject designs. Results suggest claims of peer-tutoring being an evidence-based practice are premature. Recommendations for clarifying and applying the quality indicators are offered. Copyright © 2013 Elsevier Ltd. All rights reserved.

Suitability of three indicators measuring the quality of coordination within hospitals

Directory of Open Access Journals (Sweden)

Loirat Philippe

2010-04-01

Full Text Available Abstract Background Coordination within hospitals is a major attribute of medical care and influences quality of care. This study tested the validity of 3 indicators covering two key aspects of coordination: the transfer of written information between professionals (medical record content, radiology exam order and the holding of multidisciplinary team meetings during treatment planning. Methods The study was supervised by the French health authorities (COMPAQH project. Data for the three indicators were collected in a panel of 30 to 60 volunteer hospitals by 6 Clinical Research Assistants. The metrological qualities of the indicators were assessed: (i Feasibility was assessed using a grid of 19 potential problems, (ii Inter-observer reliability was given by the kappa coefficient ( and internal consistency by Cronbach's alpha test, (iii Discriminatory power was given by an analysis of inter-hospital variability using the Gini coefficient as a measure of dispersion. Results Overall, 19281 data items were collected and analyzed. All three indicators presented acceptable feasibility and reliability (, 0.59 to 0.97 and showed wide differences among hospitals (Gini, 0.08 to 0.11, indicating that they are suitable for making comparisons among hospitals. Conclusion This set of 3 indicators provides a proxy measurement of coordination. Further research on the indicators is needed to find out how they can generate a learning process. The medical record indicator has been included in the French national accreditation procedure for healthcare organisations. The two other indicators are currently being assessed for inclusion.

Evaluation of Soil Quality Using Labile Organic Carbon and Carbon Management Indices in Agricultural Lands of Neyriz, Fars Province

Directory of Open Access Journals (Sweden)

Anahid Salmanpour

2017-02-01

Full Text Available Introduction: Soil organic matter is considered as an indicator of soil quality, because of its role on the stability of soil structure, water holding capacity, microbial activity, storage and release of nutrients. Although changes and trends of organic matter are assessed on the basis of organic carbon, it responds slowly to changes of soil management. Therefore, identifying sensitive components of organic carbon such as carbon labile lead to better understanding of the effect of land use change and soil management on soil quality. The main components of sustainable agriculture in arid and semi-arid regions are the amount of water; and soil and water salinity. Water deficit and irrigation with saline water are important limiting factors for cropping and result in adverse effects on soil properties and soil quality. Soil carbon changes is a function of addition of plant debris and removal of it from soil by its decomposition. If the amount of organic carbon significantly reduced due to the degradation of the soil physical and chemical properties and soil quality, agricultural production will face serious problems. To this end, this study was done to evaluate soil quality using soil labile carbon and soil carbon management indices in some agricultural lands of Neyriz area, Fars province, Iran. Materials and Methods: Five fields were selected in two regions, Dehfazel and Tal-e-mahtabi, consisted of irrigated wheat and barley with different amount of irrigation water and water salinity levels. Three farms were located in Dehfazel and two farms in Tal-e-Mahtabi region. In each farm, three points were randomly selected and soil samples were collected from 0-40 cm of the surface layer. Plant samples were taken from a 1x1 square meter and grain crop yield was calculated per hectare. Water samples were obtained in each region from the wells at the last irrigation. Physical and chemical characteristics of the soil and water samples were determined. Soil

Concordance between nurse-reported quality of care and quality of care as publicly reported by nurse-sensitive indicators

NARCIS (Netherlands)

Stalpers, Dewi; Kieft, Renate A M M; Van Der Linden, Dimitri; Kaljouw, Marian J.; Schuurmans, Marieke J.

2016-01-01

Background: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive

Bio indication of soil samples from contaminated military sites in Georgia

International Nuclear Information System (INIS)

Zakariadze, N.; Gagelidze, N.; Amiranashvili, L.; Nabakhtiani, G.; Tsigroshvili, Z.

2005-01-01

State of environment in Georgia is influenced significantly by political and economic situation of the last several years.The consequences of these conditions are pollution of water, air, and soil with health-hazardous emissions, dissemination of uncontrolled waste, highly toxic substances and unfit military and industrial materials in civil, agricultural, and military sites and respective facilities. In Georgia the specific problems of soil contamination are: spot type distribution of contaminants; simultaneous (synergetic) impacts of various pollutants; chronic and enduring impacts; pollution of moderate or low intensity. Pollutants, at low doses, may not cause immediate changes; however in some time they can create danger and become the risk factors for acquired lethal diseases developed in living organisms and accumulated in environment. Several cases of contamination with radionuclide substances distribution have been detected on in a number of regions in Georgia, which became the range for investigation of specific, spot type of pollution. The soil samples contaminated with following nuclides were studied: Single sources 226 Ra, Dust 226 Ra, Single sources 90 Sr, Single sources 137 Cs. The main goal of the team is complex study of contaminated territories. In parallel with polluted spots' indication, the investigation of ecological systems' reactions to diverse impacts is carried out. Bioassays application significantly increases quality and reliability of: assessment of contaminated territories; selection of optimal and available technologies for sanation and remediation; recommendations on urgent measures. As bio-indicators the main groups of microorganisms were studied: Bacteria, Actinomycetes and Microphyte fungi. The primary results showed that behaviour of observed microorganisms colonies could be satisfactorily described with the following parameters: CCU; Meeting factor; Diameter of colonies; Morphological similarity and difference. Simultaneous study

The impact of removing financial incentives from clinical quality indicators: longitudinal analysis of four Kaiser Permanente indicators.

NARCIS (Netherlands)

Lester, H.; Schmittdiel, J.; Selby, J.; Fireman, B.; Campbell, S.M.; Lee, J.; Whippy, A.; Madvig, P.

2010-01-01

OBJECTIVE: To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN: Longitudinal analysis. SETTING: 35 medical facilities of Kaiser Permanente Northern California,

Improving data quality and supervision of antiretroviral therapy sites in Malawi: an application of Lot Quality Assurance Sampling

Directory of Open Access Journals (Sweden)

Hedt-Gauthier Bethany L

2012-07-01

Full Text Available Abstract Background High quality program data is critical for managing, monitoring, and evaluating national HIV treatment programs. By 2009, the Malawi Ministry of Health had initiated more than 270,000 patients on HIV treatment at 377 sites. Quarterly supervision of these antiretroviral therapy (ART sites ensures high quality care, but the time currently dedicated to exhaustive record review and data cleaning detracts from other critical components. The exhaustive record review is unlikely to be sustainable long term because of the resources required and increasing number of patients on ART. This study quantifies the current levels of data quality and evaluates Lot Quality Assurance Sampling (LQAS as a tool to prioritize sites with low data quality, thus lowering costs while maintaining sufficient quality for program monitoring and patient care. Methods In January 2010, a study team joined supervision teams at 19 sites purposely selected to reflect the variety of ART sites. During the exhaustive data review, the time allocated to data cleaning and data discrepancies were documented. The team then randomly sampled 76 records from each site, recording secondary outcomes and the time required for sampling. Results At the 19 sites, only 1.2% of records had discrepancies in patient outcomes and 0.4% in treatment regimen. However, data cleaning took 28.5 hours in total, suggesting that data cleaning for all 377 ART sites would require over 350 supervision-hours quarterly. The LQAS tool accurately identified the sites with the low data quality, reduced the time for data cleaning by 70%, and allowed for reporting on secondary outcomes. Conclusions Most sites maintained high quality records. In spite of this, data cleaning required significant amounts of time with little effect on program estimates of patient outcomes. LQAS conserves resources while maintaining sufficient data quality for program assessment and management to allow for quality patient

Improving data quality and supervision of antiretroviral therapy sites in Malawi: an application of Lot Quality Assurance Sampling.

Science.gov (United States)

Hedt-Gauthier, Bethany L; Tenthani, Lyson; Mitchell, Shira; Chimbwandira, Frank M; Makombe, Simon; Chirwa, Zengani; Schouten, Erik J; Pagano, Marcello; Jahn, Andreas

2012-07-09

High quality program data is critical for managing, monitoring, and evaluating national HIV treatment programs. By 2009, the Malawi Ministry of Health had initiated more than 270,000 patients on HIV treatment at 377 sites. Quarterly supervision of these antiretroviral therapy (ART) sites ensures high quality care, but the time currently dedicated to exhaustive record review and data cleaning detracts from other critical components. The exhaustive record review is unlikely to be sustainable long term because of the resources required and increasing number of patients on ART. This study quantifies the current levels of data quality and evaluates Lot Quality Assurance Sampling (LQAS) as a tool to prioritize sites with low data quality, thus lowering costs while maintaining sufficient quality for program monitoring and patient care. In January 2010, a study team joined supervision teams at 19 sites purposely selected to reflect the variety of ART sites. During the exhaustive data review, the time allocated to data cleaning and data discrepancies were documented. The team then randomly sampled 76 records from each site, recording secondary outcomes and the time required for sampling. At the 19 sites, only 1.2% of records had discrepancies in patient outcomes and 0.4% in treatment regimen. However, data cleaning took 28.5 hours in total, suggesting that data cleaning for all 377 ART sites would require over 350 supervision-hours quarterly. The LQAS tool accurately identified the sites with the low data quality, reduced the time for data cleaning by 70%, and allowed for reporting on secondary outcomes. Most sites maintained high quality records. In spite of this, data cleaning required significant amounts of time with little effect on program estimates of patient outcomes. LQAS conserves resources while maintaining sufficient data quality for program assessment and management to allow for quality patient care.

The effects of storage temperature and duration of blood samples on DNA and RNA qualities.

Science.gov (United States)

Huang, Lien-Hung; Lin, Pei-Hsien; Tsai, Kuo-Wang; Wang, Liang-Jen; Huang, Ying-Hsien; Kuo, Ho-Chang; Li, Sung-Chou

2017-01-01

DNA and RNA samples from blood are the common examination target for non-invasive physical tests and/or biomedical studies. Since high-quality DNA and RNA samples guarantee the correctness of these tests and/or studies, we investigated the effects of storage temperature and storage duration of whole blood on DNA and RNA qualities. Subjects were enrolled to donate blood samples which were stored for different durations and at different temperatures, followed by the examinations on RNA quality, qPCR, DNA quality and DNA methylation. For RNA, we observed obvious quality decline with storage duration longer than 24 hours. Storage at low temperature does not keep RNA samples from degradation. And, storing whole blood samples in freezer dramatically damage RNA. For DNA, quality decline was not observed even with storage duration for 15 days. However, DNA methylation significantly altered with storage duration longer than three days. Storage duration within 24 hours is critical for collecting high-quality RNA samples for next-generation sequencing (NGS) assays (RIN≧8). If microarray assays are expected (RIN≧7), storage duration within 32 hours is acceptable. Although DNA is resistant within 15 days when kept in whole blood, DNA quantity dramatically decreases owing to WBC lysis. In addition, duration for more than three days significantly alter DNA methylation status, globally and locally. Our result provides a reference for dealing with blood samples.

Developing an Evaluation Framework of Quality Indicators for Learning Analytics

NARCIS (Netherlands)

Scheffel, Maren; Drachsler, Hendrik; Specht, Marcus

2017-01-01

This paper presents results from the continuous process of developing an evaluation framework of quality indicators for learning analytics (LA). Building on a previous study, a group concept mapping approach that uses multidimensional scaling and hierarchical clustering, the study presented here

Novel indicators of recreational water quality and swimming-associated illness

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In the United States and elsewhere, recreational water quality is monitored for fecal indicator bacteria to help prevent swimming-associated illnesses. Standard methods to measure these bacteria take at least 24 hours to obtain results. Molecular approaches such as quantitative p...

River Quality Investigations, Part 1: Some Diversity and Biotic Indices.

Science.gov (United States)

Hewitt, G.

1991-01-01

The following indices for assessing river water quality are described: Shannon-Weiner Diversity Index, Sorenson Quotient of Similarity, Czekanowski's Index of Similarity, Trent Biotic Index, Chandler Score, and Biological Monitoring Working Party Score. Their advantages and disadvantages are outlined. (Author)

Cortical reaction as an egg quality indicator in artificial reproduction of pikeperch, Sander lucioperca.

Science.gov (United States)

Zarski, Daniel; Krejszeff, Sławomir; Palińska, Katarzyna; Targońska, Katarzyna; Kupren, Krzysztof; Fontaine, Pascal; Kestemont, Patrick; Kucharczyk, Dariusz

2012-01-01

The aim of this study was to investigate the process of the cortical reaction in eggs of pikeperch, Sander lucioperca (L.), as well as the application of microscopic assessment of this process in egg quality evaluation. The analysis was carried out with eggs obtained from 10 females by artificial reproduction, in which hormonal stimulation with hCG was applied. Subsequently, each sample of eggs (separately from each female fish) was analysed. The analysis included observation of the cortical reaction and the process of egg swelling, and determination of the effect of temperature (12, 14 and 16°C) and the presence of spermatozoa on the cortical reaction. The results indicate that the cortical reaction in pikeperch eggs is quite violent, resulting in visible deformation of eggs between 3 and 5 min after activation. No effect of temperature or the presence of spermatozoa on the cortical reaction was observed. A strong correlation was recorded for the percentage of egg deformations observed and embryo survival rate. The described method of determination of pikeperch egg quality (based on egg deformation rate between 3 and 5 min after activation) may be highly useful, both in scientific research (where high-quality eggs are required) and in hatchery practice.

Linking clinical quality indicators to research evidence - a case study in asthma management for children.

Science.gov (United States)

Choong, Miew Keen; Tsafnat, Guy; Hibbert, Peter; Runciman, William B; Coiera, Enrico

2017-07-21

Clinical quality indicators are used to monitor the performance of healthcare services and should wherever possible be based on research evidence. Little is known however about the extent to which indicators in common use are based on research. The objective of this study is to measure the extent to which clinical quality indicators used in asthma management in children with outcome measurements can be linked to results in randomised controlled clinical trial (RCT) reports. This work is part of a broader research program to trial methods that improve the efficiency and accuracy of indicator development. National-level indicators for asthma management in children were extracted from the National Quality Measures Clearinghouse database and the National Institute for Health and Care Excellence quality standards by two independent appraisers. Outcome measures were extracted from all published English language RCT reports for asthma management in children below the age of 12 published between 2005 and 2014. The two sets were then linked by manually mapping both to a common set of Unified Medical Language System (UMLS) concepts. The analysis identified 39 indicators and 562 full text RCTs dealing with asthma management in children. About 95% (37/39) of the indicators could be linked to RCT outcome measures. It is possible to identify relevant RCT reports for the majority of indicators used to assess the quality of asthma management in childhood. The methods reported here could be automated to more generally support assessment of candidate indicators against the research evidence.

Signal quality indices and data fusion for determining clinical acceptability of electrocardiograms

International Nuclear Information System (INIS)

Clifford, G D; Behar, J; Li, Q; Rezek, I

2012-01-01

A completely automated algorithm to detect poor-quality electrocardiograms (ECGs) is described. The algorithm is based on both novel and previously published signal quality metrics, originally designed for intensive care monitoring. The algorithms have been adapted for use on short (5–10 s) single- and multi-lead ECGs. The metrics quantify spectral energy distribution, higher order moments and inter-channel and inter-algorithm agreement. Seven metrics were calculated for each channel (84 features in all) and presented to either a multi-layer perceptron artificial neural network or a support vector machine (SVM) for training on a multiple-annotator labelled and adjudicated training dataset. A single-lead version of the algorithm was also developed in a similar manner. Data were drawn from the PhysioNet Challenge 2011 dataset where binary labels were available, on 1500 12-lead ECGs indicating whether the entire recording was acceptable or unacceptable for clinical interpretation. We re-annotated all the leads in both the training set (1000 labelled ECGs) and test dataset (500 12-lead ECGs where labels were not publicly available) using two independent annotators, and a third for adjudication of differences. We found that low-quality data accounted for only 16% of the ECG leads. To balance the classes (between high and low quality), we created extra noisy data samples by adding noise from PhysioNet’s noise stress test database to some of the clean 12-lead ECGs. No data were shared between training and test sets. A classification accuracy of 98% on the training data and 97% on the test data were achieved. Upon inspection, incorrectly classified data were found to be borderline cases which could be classified either way. If these cases were more consistently labelled, we expect our approach to achieve an accuracy closer to 100%. (paper)

How teams use indicators for quality improvement - a multiple-case study on the use of multiple indicators in multidisciplinary breast cancer teams.

Science.gov (United States)

Gort, Marjan; Broekhuis, Manda; Regts, Gerdien

2013-11-01

A crucial issue in healthcare is how multidisciplinary teams can use indicators for quality improvement. Such teams have increasingly become the core component in both care delivery and in many quality improvement methods. This study aims to investigate the relationships between (1) team factors and the way multidisciplinary teams use indicators for quality improvement, and (2) both team and process factors and the intended results. An in-depth, multiple-case study was conducted in the Netherlands in 2008 involving four breast cancer teams using six structure, process and outcome indicators. The results indicated that the process of using indicators involves several stages and activities. Two teams applied a more intensive, active and interactive approach as they passed through these stages. These teams were perceived to have achieved good results through indicator use compared to the other two teams who applied a simple control approach. All teams experienced some difficulty in integrating the new formal control structure, i.e. measuring and managing performance, in their operational task, and in using their 'new' managerial task to decide as a team what and how to improve. Our findings indicate the presence of a network of relationships between team factors, the controllability and actionability of indicators, the indicator-use process, and the intended results. Copyright © 2013. Published by Elsevier Ltd.

Use of Quality Models and Indicators for Evaluating Test Quality in an ESP Course

Directory of Open Access Journals (Sweden)

IEVA RUDZINSKA

2013-12-01

Full Text Available Qualitative methods of assessment play a decisive role in education in general and in language learning in particular. The necessity to perform a qualitative assessment comes from both increased student competition in higher education institutions (HEIs, and hence higher demands for fair assessment, and a growing public awareness on higher education issues, and therefore the need to account for a wider circle of stakeholders, including society as a whole. The aim of the present paper is to study the regulations and laws pertaining to the issue of assessment in Latvian HEIs, as well as to carry out literature sources analysis about assessment in language testing, seeking to select criteria characterizing the quality of English for Specific Purposes (ESP tests and to apply the model of evaluating the quality of a language test on an example of a test in sport English, developed in a Latvian higher education institution. An analysis of the regulations and laws about assessment in higher education and literature sources about tests in language courses has enabled the development of a test quality model, consisting of seven intrinsic quality criteria: clarity, adequacy, deep approach, attractiveness, originality/similarity, orientation towards student learning result/process, test scoring objectivity/subjectivity. Quality criteria comprise eleven indicators. The reliability of the given model is evaluated by means of the whole model, its criteria and indicator Cronbach’s alphas and point-biserial (item-total correlations or discrimination indexes DI. The test was taken by 63 participants, all of them 2nd year full time students attending a Latvian higher education institution. A statistical data analysis was performed with SPSS 17.0. The results show that, although test adequacy and clarity is sufficiently high, attractiveness and deep approach should be improved. Also the reliability of one version of the test is higher than that of the other one

Usability Evaluation and Implementation of a Health Information Technology Dashboard of Evidence-Based Quality Indicators.

Science.gov (United States)

Schall, Mark Christopher; Cullen, Laura; Pennathur, Priyadarshini; Chen, Howard; Burrell, Keith; Matthews, Grace

2017-06-01

Health information technology dashboards that integrate evidence-based quality indicators can efficiently and accurately display patient risk information to promote early intervention and improve overall quality of patient care. We describe the process of developing, evaluating, and implementing a dashboard designed to promote quality care through display of evidence-based quality indicators within an electronic health record. Clinician feedback was sought throughout the process. Usability evaluations were provided by three nurse pairs and one physician from medical-surgical areas. Task completion times, error rates, and ratings of system usability were collected to compare the use of quality indicators displayed on the dashboard to the indicators displayed in a conventional electronic health record across eight experimental scenarios. Participants rated the dashboard as "highly usable" following System Usability Scale (mean, 87.5 [SD, 9.6]) and Poststudy System Usability Questionnaire (mean, 1.7 [SD, 0.5]) criteria. Use of the dashboard led to reduced task completion times and error rates in comparison to the conventional electronic health record for quality indicator-related tasks. Clinician responses to the dashboard display capabilities were positive, and a multifaceted implementation plan has been used. Results suggest application of the dashboard in the care environment may lead to improved patient care.

European Society of Gynaecologic Oncology Quality Indicators for Advanced Ovarian Cancer Surgery

NARCIS (Netherlands)

Querleu, Denis; Planchamp, Francois; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Cristiana; van der Zee, Ate; Vergote, Ignace; du Bois, Andreas

Objectives The surgical management of advanced ovarian cancer involves complex surgery. Implementation of a quality management program has a major impact on survival. The goal of this work was to develop a list of quality indicators (QIs) for advanced ovarian cancer surgery that can be used to audit

A THEORETICAL FRAMEWORK FOR QUALITY INDICATORS IN ELEARNING

Directory of Open Access Journals (Sweden)

Ciprian CEOBANU

2009-10-01

Full Text Available Advances in information and communication technologies, especially in Multimedia, Networking and Software Engineering allow the appearance of a new generation of computer-based training systems. Despite its obvious advantages in terms of reduced costs, simplified training programs and flexibility, e-learning was not always the miracle solution. Conceived as a powerful educational tool, e-learning was destined to change the face of learning but unfortunately, this change wasn’t exactly the intended one. The constant interest in researching and testing the use of Information and Communication Technologies (ICT, eLearning and multimedia in the learning process led to educational imperatives about the indicators that can reveal the level of quality for teaching and management of the course. Modern eLearning solutions now recognize the importance of learning as a social process and offer possibilities for collaboration with other learners, for interaction with the learning content and for guidance from teachers, trainers and tutors. Our aim is to analyze the importance of using ICT in a “learning society”. The present paper focuses on the strong potential that ICT provides, in order to develop the learning possibilities among students. The great challenge is to draw up a quality indicators framework which can represent an instrument for teachers on how to organize their online course – including ways of developing the teaching methods.

Efficient sampling to determine distribution of fruit quality and yield in a commercial apple orchard

DEFF Research Database (Denmark)

Martinez Vega, Mabel Virginia; Wulfsohn, D.; Zamora, I.

2012-01-01

In situ assessment of fruit quality and yield can provide critical data for marketing and for logistical planning of the harvest, as well as for site-specific management. Our objective was to develop and validate efficient field sampling procedures for this purpose. We used the previously reported...... ‘fractionator’ tree sampling procedure and supporting handheld software (Gardi et al., 2007; Wulfsohn et al., 2012) to obtain representative samples of fruit from a 7.6-ha apple orchard (Malus ×domestica ‘Fuji Raku Raku’) in central Chile. The resulting sample consisted of 70 fruit on 56 branch segments...... of yield. Estimated marketable yield was 295.8±50.2 t. Field and packinghouse records indicated that of 348.2 t sent to packing (52.4 t or 15% higher than our estimate), 263.0 t was packed for export (32.8 t less or -12% error compared to our estimate). The estimated distribution of caliber compared very...

Development and initial validation of prescribing quality indicators for patients with chronic kidney disease

NARCIS (Netherlands)

Smits, Kirsten P J; Sidorenkov, Grigory; Bilo, Henk J G; Bouma, Margriet; van Ittersum, Frans J; Voorham, Jaco; Navis, Gerjan; Denig, Petra

2016-01-01

BACKGROUND: Quality assessment is a key element for improving the quality of care. Currently, a comprehensive indicator set for measuring the quality of medication treatment in patients with chronic kidney disease (CKD) is lacking. Our aim was to develop and validate a set of prescribing quality

Developing Indicators of Service Quality Provided for Cardiovascular Patients Hospitalized in Cardiac Care Unit

Directory of Open Access Journals (Sweden)

Saber Azami-Aghdash

2013-03-01

Full Text Available Introduction: Cardiovascular diseases are among the most prevalent chronic diseases leading to high degrees of mortality and morbidity worldwide and in Iran. The aim of the current study was to determine and develop appropriate indicators for evaluating provided service quality for cardiovascular patients admitted to Cardiac Care Units (CCU in Iran. Methods: In order to determine the indicators for evaluating provided service quality, a four-stage process including reviewing systematic review articles in premier bibliographic databases, interview, performing two rounds of Delphi technique, and holding experts panel by attendance of experts in different fields was adopted. Finally, after recognizing relevant indicators in resources, these indicators were finalized during various stages using ideas of 27 experts in different fields. Results: Among 2800 found articles in the text reviewing phase, 21 articles, which had completely mentioned relevant indicators, were studied and 48 related indicators were extracted. After two interviews with a cardiologist and an epidemiologist, 32 items of the indicators were omitted and replaced by 27 indicators coping with the conditions of Iranian hospitals. Finally, 43 indicators were added into the Delphi phase and after 2 rounds of Delphi with 18 specialists, 7 cases were excluded due to their low scores of applicability. In the experts’ panel stage, 6 items were also omitted and 10 new indicators were developed to replace them. Eventually, 40 indicators were finalized. Conclusion: In this study, some proper indicators for evaluating provided service quality for CCU admissions in Iran were determined. Considering the informative richness of these indicators, they can be used by managers, policy makers, health service providers, and also insurance agencies in order to improve the quality of services, decisions, and policies.

Review article: what makes a good healthcare quality indicator? A systematic review and validation study.

Science.gov (United States)

Jones, Peter; Shepherd, Michael; Wells, Susan; Le Fevre, James; Ameratunga, Shanthi

2014-04-01

Indicators measuring aspects of performance to assess quality of care are often chosen arbitrarily. The present study aimed to determine what should be considered when selecting healthcare quality indicators, particularly focusing on the application to emergency medicine. Structured searches of electronic databases were supplemented by website searches of quality of care and benchmarking organisations, citation searches and discussions with experts. Candidate attributes of 'good' healthcare indicators were extracted independently by two authors. The validity of each attribute was independently assessed by 16 experts in quality of care and emergency medicine. Valid and reliable attributes were included in a critical appraisal tool for healthcare quality indicators, which was piloted by emergency medicine specialists. Twenty-three attributes were identified, and all were rated moderate to extremely important by an expert panel. The reliability was high: alpha = 0.98. Twelve existing tools explicitly stated a median (range) of 14 (8-17) attributes. A critical appraisal tool incorporating all the attributes was developed. This was piloted by four emergency medicine specialists who were asked to appraise and rank a set of six candidate indicators. Although using the tool took more time than implicit gestalt decision making: median (interquartile range) 190 (43-352) min versus 17.5 (3-34) min, their rankings changed after using the tool. To inform the appraisal of quality improvement indicators for emergency medicine, a comprehensive list of indicator attributes was identified, validated, developed into a tool and piloted. Although expert consensus is still required, this tool provides an explicit basis for discussions around indicator selection. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Variation in marital quality in a national sample of divorced women.

Science.gov (United States)

James, Spencer L

2015-06-01

Previous work has compared marital quality between stably married and divorced individuals. Less work has examined the possibility of variation among divorcés in trajectories of marital quality as divorce approaches. This study addressed that hole by first examining whether distinct trajectories of marital quality can be discerned among women whose marriages ended in divorce and, second, the profile of women who experienced each trajectory. Latent class growth analyses with longitudinal data from a nationally representative sample were used to "look backward" from the time of divorce. Although demographic and socioeconomic variables from this national sample did not predict the trajectories well, nearly 66% of divorced women reported relatively high levels of both happiness and communication and either low or moderate levels of conflict. Future research including personality or interactional patterns may lead to theoretical insights about patterns of marital quality in the years leading to divorce. (c) 2015 APA, all rights reserved).

Association between quality management and performance indicators in Dutch diabetes care groups: a cross-sectional study.

Science.gov (United States)

Campmans-Kuijpers, Marjo J E; Baan, Caroline A; Lemmens, Lidwien C; Klomp, Maarten L H; Romeijnders, Arnold C M; Rutten, Guy E H M

2015-05-11

To enhance the quality of diabetes care in the Netherlands, so-called care groups with three to 250 general practitioners emerged to organise and coordinate diabetes care. This introduced a new quality management level in addition to the quality management of separate general practices. We hypothesised that this new level of quality management might be associated with the aggregate performance indicators on the patient level. Therefore, we aimed to explore the association between quality management at the care group level and its aggregate performance indicators. A cross-sectional study. All Dutch care groups (n=97). 23 care groups provided aggregate register-based performance indicators of all their practices as well as data on quality management measured with a questionnaire filled out by 1 or 2 of their quality managers. The association between quality management, overall and in 6 domains ('organisation of care', 'multidisciplinary teamwork', 'patient centredness', 'performance management', 'quality improvement policy' and 'management strategies') on the one hand and 3 process indicators (the percentages of patients with at least 1 measurement of glycated haemoglobin, lipid profile and systolic blood pressure), and 3 intermediate outcome indicators (the percentages of patients with glycated haemoglobin below 53 mmol/mol (7%); low-density lipoprotein cholesterol below 2.5 mmol/L; and systolic blood pressure below 140 mm Hg) by weighted univariable linear regression. The domain 'management strategies' was significantly associated with the percentage of patients with a glycated haemoglobin quality management were not associated with aggregate process or outcome indicators. This first exploratory study on quality management showed weak or no associations between quality management of diabetes care groups and their performance. It remains uncertain whether this second layer on quality management adds to better quality of care. Published by the BMJ Publishing

The dissolved organic matter as a potential soil quality indicator in arable soils of Hungary.

Science.gov (United States)

Filep, Tibor; Draskovits, Eszter; Szabó, József; Koós, Sándor; László, Péter; Szalai, Zoltán

2015-07-01

Although several authors have suggested that the labile fraction of soils could be a potential soil quality indicator, the possibilities and limitations of using the dissolved organic matter (DOM) fraction for this purpose have not yet been investigated. The objective of this study was to evaluate the hypothesis that DOM is an adequate indicator of soil quality. To test this, the soil quality indices (SQI) of 190 arable soils from a Hungarian dataset were estimated, and these values were compared to DOM parameters (DOC and SUVA254). A clear difference in soil quality was found between the soil types, with low soil quality for arenosols (average SQI 0.5) and significantly higher values for gleysols, vertisols, regosols, solonetzes and chernozems. The SQI-DOC relationship could be described by non-linear regression, while a linear connection was observed between SQI and SUVA. The regression equations obtained for the dataset showed only one relatively weak significant correlation between the variables, for DOC (R (2) = 0.157(***); n = 190), while non-significant relationships were found for the DOC and SUVA254 values. However, an envelope curve operated with the datasets showed the robust potential of DOC to indicate soil quality changes, with a high R (2) value for the envelope curve regression equation. The limitations to using the DOM fraction of soils as a quality indicator are due to the contradictory processes which take place in soils in many cases.

Evaluation of groundwater quality and assessment of scaling potential and corrosiveness of water samples in Kadkan aquifer, Khorasan-e-Razavi Province, Iran.

Science.gov (United States)

Esmaeili-Vardanjani, Mostafa; Rasa, Iraj; Amiri, Vahab; Yazdi, Mohammad; Pazand, Kaveh

2015-02-01

The chemical analysis of 129 groundwater samples in the Kadkan area, Khorasan-e-Razavi Province, NE of Iran was evaluated to determine the hydrochemical processes, assessment of groundwater quality for irrigation purposes, corrosiveness, and scaling potential of the groundwater. Accordingly, the suitability of groundwater for irrigation was evaluated based on the sodium adsorption ratio, residual sodium carbonate, sodium percent, salinity hazard, and US Salinity Laboratory hazard diagram. Based on the electrical conductivity and sodium adsorption ratio, the dominant classes are C3-S1, C3-S2, C2-S1, and C4-S2. According to the Wilcox plot, about 50 % of the samples fall in the "Excellent to Good" and "Good to Permissible" classes. Besides, the Langelier saturation index, Ryznar stability index (RSI), Larson-Skold index, and Puckorius scaling index were evaluated for assessing the corrosiveness and scaling potential of the groundwater. Corrosiveness and scaling indices stated that the majority of samples are classified into "Aggressive" and "Very Aggressive" category. In addition, chloride and sulfate interfere in 90 % of the samples. Assessment of hydrochemical characteristics indicates Na-Mg-Cl as the predominant hydrochemical type. Spatial distribution of hydrochemical parameters indicates that hydrochemical processes are influenced by geology and hydrogeology of Kadkan aquifer. The Gibbs plots gave an indication that groundwater chemistry in this area may have acquired the chemistry mainly from evaporation and mineral precipitation. Grouping the samples based on Q-mode hierarchical cluster analysis helped to more separation of similar samples. The R-mode HCA grouped analyzed parameters into two groups based on similarity of hydrochemical characteristics. As a result, the samples collected in northern and southern parts of the study area show the best quality (i.e., lowest salinity) for some purposes such as irrigation and drinking.

Measuring Healthcare Providers' Performances Within Managed Competition Using Multidimensional Quality and Cost Indicators.

Science.gov (United States)

Portrait, France R M; van der Galiën, Onno; Van den Berg, Bernard

2016-04-01

The Dutch healthcare system is in transition towards managed competition. In theory, a system of managed competition involves incentives for quality and efficiency of provided care. This is mainly because health insurers contract on behalf of their clients with healthcare providers on, potentially, quality and costs. The paper develops a strategy to comprehensively analyse available multidimensional data on quality and costs to assess and report on the relative performance of healthcare providers within managed competition. We had access to individual information on 2409 clients of 19 Dutch diabetes care groups on a broad range of (outcome and process related) quality and cost indicators. We carried out a cost-consequences analysis and corrected for differences in case mix to reduce incentives for risk selection by healthcare providers. There is substantial heterogeneity between diabetes care groups' performances as measured using multidimensional indicators on quality and costs. Better quality diabetes care can be achieved with lower or higher costs. Routine monitoring using multidimensional data on quality and costs merged at the individual level would allow a systematic and comprehensive analysis of healthcare providers' performances within managed competition. Copyright © 2015 John Wiley & Sons, Ltd.

Sound quality indicators for urban places in Paris cross-validated by Milan data.

Science.gov (United States)

Ricciardi, Paola; Delaitre, Pauline; Lavandier, Catherine; Torchia, Francesca; Aumond, Pierre

2015-10-01

A specific smartphone application was developed to collect perceptive and acoustic data in Paris. About 3400 questionnaires were analyzed, regarding the global sound environment characterization, the perceived loudness of some emergent sources and the presence time ratio of sources that do not emerge from the background. Sound pressure level was recorded each second from the mobile phone's microphone during a 10-min period. The aim of this study is to propose indicators of urban sound quality based on linear regressions with perceptive variables. A cross validation of the quality models extracted from Paris data was carried out by conducting the same survey in Milan. The proposed sound quality general model is correlated with the real perceived sound quality (72%). Another model without visual amenity and familiarity is 58% correlated with perceived sound quality. In order to improve the sound quality indicator, a site classification was performed by Kohonen's Artificial Neural Network algorithm, and seven specific class models were developed. These specific models attribute more importance on source events and are slightly closer to the individual data than the global model. In general, the Parisian models underestimate the sound quality of Milan environments assessed by Italian people.

Field study of the composition of greywater and comparison of microbiological indicators of water quality in on-site systems.

Science.gov (United States)

Leonard, Margaret; Gilpin, Brent; Robson, Beth; Wall, Katrina

2016-08-01

Thirty on-site greywater systems were sampled to determine greywater characteristics and practices in the field. Kitchen greywater was present at eight sites and urine was included at seven sites. These non-traditional sources resulted in significantly higher concentrations of enterococci and 5-day biochemical oxygen demand (BOD5) in greywater. Even with the removal of these sources, the concentrations of microbial indicators indicated high levels of contamination could occur across all greywater sources, including "light" greywater. Using multiple microbial indicators showed that all samples had the potential for faecal contamination. Bacteroidales markers were confirmed in treated greywater and in each greywater source, highlighting the potential for human faecal contamination. Although Escherichia coli was absent in treated greywater recycled to the house, other microbial indicators were present; hence, caution is required in using E. coli concentrations as the sole indicator of microbiological water quality. High BOD5 or total suspended solid concentrations exceeded the levels recommended for effective disinfection. Subsurface irrigation, which is assumed to provide a five-log reduction in exposure, is a suitable reuse option for non-disinfected greywater. Only half the occupants had a good understanding of their greywater systems and 25 % of systems were poorly maintained. Elevated microbial indicator contamination of greywater sludge is a potential hazard during maintenance.

Evaluation of physical quality indices of a soil under a seasonal semideciduous forest

Directory of Open Access Journals (Sweden)

Thalita Campos Oliveira

2014-04-01

Full Text Available The concept of soil quality is currently the subject of great discussion due to the interaction of soil with the environment (soil-plant-atmosphere and practices of human intervention. However, concepts of soil quality relate quality to agricultural productivity, but assessment of soil quality in an agronomic context may be different from its assessment in natural areas. The aim of this study was to assess physical quality indices, the S index, soil aeration capacity (ACt/Pt, and water storage capacity (FC/Pt of the soil from a permanent plot in the Caetetus Ecological Reserve (Galia, São Paulo, Brazil under a seasonal semideciduous forest and compare them with the reference values for soil physical quality found in the literature. Water retention curves were used for that purpose. The S values found were higher than the proposed limit for soil physical quality (0.035. The A and E horizons showed the highest values because their sandy texture leads to a high slope of the water retention curve. The B horizons showed the lowest S values because their natural density leads to a lower slope of the water retention curve. The values found for ACt/Pt and FC/Pt were higher and lower than the idealized limits. The values obtained from these indices under natural vegetation can provide reference values for soils with similar properties that undergo changes due to anthropic activities. All the indices evaluated were effective in differentiating the effects of soil horizons in the natural hydro-physical functioning of the soils under study.

The macro-invertebrates and their value like indicators of the water quality

International Nuclear Information System (INIS)

Roldan Perez, Gabriel

1999-01-01

An analysis of the water pollution problems is presented and some of the more used methods for assessment of its damage degree through bio indicators are discussed. There are biological methods for assessment of water quality widely used in developed countries. Because the aquatic fauna existing there is different from the one here, those methods cannot be applied in the tropics before knowing what kinds of organisms live here and what ecological requirements they have. The adoption of a method for assessment of water quality in tropical mountains ecosystems is proposed, using macro invertebrates as bio indicators

Implementing quality indicators in intensive care units: exploring barriers to and facilitators of behaviour change

NARCIS (Netherlands)

de Vos, M.L.G.; van der Veer, S.N.; Graafmans, W.C.; de Keizer, N.F.; Jager, K.J.; Westert, G.P.; van der Voort, P.H.J.

2010-01-01

ABSTRACT: BACKGROUND: Quality indicators are increasingly used in healthcare but there are various barriers hindering their routine use. To promote the use of quality indicators, an exploration of the barriers to and facilitating factors for their implementation among healthcare professionals and

Benthic indicators to use in Ecological Quality classification of Mediterranean soft bottom marine ecosystems, including a new Biotic Index

Directory of Open Access Journals (Sweden)

N. SIMBOURA

2002-12-01

Full Text Available A general scheme for approaching the objective of Ecological Quality Status (EcoQ classification of zoobenthic marine ecosystems is presented. A system based on soft bottom benthic indicator species and related habitat types is suggested to be used for testing the typological definition of a given water body in the Mediterranean. Benthic indices including the Shannon-Wiener diversity index and the species richness are re-evaluated for use in classification. Ranges of values and of ecological quality categories are given for the diversity and species richness in different habitat types. A new biotic index (BENTIX is proposed based on the relative percentages of three ecological groups of species grouped according to their sensitivity or tolerance to disturbance factors and weighted proportionately to obtain a formula rendering a five step numerical scale of ecological quality classification. Its advantage against former biotic indices lies in the fact that it reduces the number of the ecological groups involved which makes it simpler and easier in its use. The Bentix index proposed is tested and validated with data from Greek and western Mediterranean ecosystems and examples are presented. Indicator species associated with specific habitat types and pollution indicator species, scored according to their degree of tolerance to pollution, are listed in a table. The Bentix index is compared and evaluated against the indices of diversity and species richness for use in classification. The advantages of the BENTIX index as a classification tool for ECoQ include independence from habitat type, sample size and taxonomic effort, high discriminative power and simplicity in its use which make it a robust, simple and effective tool for application in the Mediterranean Sea.

Enzyme activities by indicator of quality in organic soil

Science.gov (United States)

Raigon Jiménez, Mo; Fita, Ana Delores; Rodriguez Burruezo, Adrián

2016-04-01

The analytical determination of biochemical parameters, as soil enzyme activities and those related to the microbial biomass is growing importance by biological indicator in soil science studies. The metabolic activity in soil is responsible of important processes such as mineralization and humification of organic matter. These biological reactions will affect other key processes involved with elements like carbon, nitrogen and phosphorus , and all transformations related in soil microbial biomass. The determination of biochemical parameters is useful in studies carried out on organic soil where microbial processes that are key to their conservation can be analyzed through parameters of the metabolic activity of these soils. The main objective of this work is to apply analytical methodologies of enzyme activities in soil collections of different physicochemical characteristics. There have been selective sampling of natural soils, organic farming soils, conventional farming soils and urban soils. The soils have been properly identified conserved at 4 ° C until analysis. The enzyme activities determinations have been: catalase, urease, cellulase, dehydrogenase and alkaline phosphatase, which bring together a representative group of biological transformations that occur in the soil environment. The results indicate that for natural and agronomic soil collections, the values of the enzymatic activities are within the ranges established for forestry and agricultural soils. Organic soils are generally higher level of enzymatic, regardless activity of the enzyme involved. Soil near an urban area, levels of activities have been significantly reduced. The vegetation cover applied to organic soils, results in greater enzymatic activity. So the quality of these soils, defined as the ability to maintain their biological productivity is increased with the use of cover crops, whether or spontaneous species. The practice of cover based on legumes could be used as an ideal choice

Air quality indicators from the Environmental Performance Index: potential use and limitations in South Africa

Directory of Open Access Journals (Sweden)

Rebecca M. Garland

2017-06-01

Full Text Available In responding to deteriorating air quality, many countries, including South Africa, have implemented national programmes that aim to manage and regulate ambient air quality, and the emissions of air pollutants. One aspect within these management strategies is effective communication to stakeholders, including the general public, with regard to the state and trend of ambient air quality in South Africa. Currently, information on ambient air quality is communicated through ambient mass concentration values, as well as number of exceedances of South African National Ambient Standards. However, these do not directly communicate the potential impact on human health and the ecosystem. To this end, the use of air quality indicators is seen as a potential way to achieve communication to stakeholders in a simplified, yet scientifically defensible manner. Air quality indicators and their source data from the Environmental Performance Index (EPI were interrogated to understand their potential use in South Africa. An assessment of four air quality indicators, together with their source data, showed improvements in air quality over the time period studied, though the input data do have uncertainties. The source data for the PM indicators, which came from a global dataset, underestimated the annual PM2.5 concentrations in the Highveld Priority Area and Vaal Triangle Airshed Priority Area over the time period studied (2009-2014 by ~3.7 times. This highlights a key limitation of national-scale indicators and input data, that while the data used by the EPI are a well-thought out estimate of a country’s air quality profile, they remain a generalised estimate. The assumptions and uncertainty inherent in such an ambitious global-wide attempt make the estimates inaccurate for countries without proper emissions tracking and accounting and few monitoring stations, such as South Africa. Thus, the inputs and resultant indicators should be used with caution until such

A Critical Assessment of the Quality and Validity of Composite Indicators of Innovation

Energy Technology Data Exchange (ETDEWEB)

Vértesy, D.

2016-07-01

While it is generally accepted that monitoring innovation system performance requires a set of indicators, there is a constant debate on whether and how composite indices can be used to summarize them. This paper enters this discussion by assessing the validity and quality of the most commonly used composite indicators of innovation. In our framework, the validity of an index relates to the link between component indicators or aggregates and to the aspect(s) of national systems of innovation they seek to measure, while the quality of an indicator relates to its statistical properties. To better understand validity, we discuss how the evolution of the national system of innovation concept and its use in policy has shifted demand from an advocacy to more analytical functions of composite indicators of innovation.We next examine selected composite indicators of innovation (the WIPO-INSEAD’s Global Innovation Indicator, the Summary Innovation Index and Innovation Output Indicator of the European Commission and the Fraunhofer Innovation Index) in different contexts of external and internal validity and conduct global sensitivity analyses on them. Our policy-relevant findings highlight the need for analytically stronger composites of a more limited set of indicators.We also found significant quality differences across the indices, as some included components which explain little or none of the variance in composite scores, and were more sensitive to modeling choices. The indices studied differed in how validly they represented various innovation system functions and types of innovation, and showed information relevant for a broader or a more limited set of stakeholders. We argue that further development of innovation indicators should put more emphasis on identifying tradeoffs within innovation policy, and unintended consequences of innovative activities. (Author)

Microbial quality of some commercial yoghurt samples in Awka ...

African Journals Online (AJOL)

Microbiological quality of ten commercial samples representing ten different brands of yoghurt marketed in Awka metropolis, Anambra State was assessed using standard microbiological procedures. The analysis carried out was aimed at determining the presence and level of both bacterial and fungal contaminants in the ...

Spectral Slope as an Indicator of Pasture Quality

Directory of Open Access Journals (Sweden)

Rachel Lugassi

2014-12-01

Full Text Available In this study, we develop a spectral method for assessment of pasture quality based only on the spectral information obtained with a small number of wavelengths. First, differences in spectral behavior were identified across the near infrared–shortwave infrared spectral range that were indicative of changes in chemical properties. Then, slopes across different spectral ranges were calculated and correlated with the changes in crude protein (CP, neutral detergent fiber (NDF and metabolic energy concentration (MEC. Finally, partial least squares (PLS regression analysis was applied to identify the optimal spectral ranges for accurate assessment of CP, NDF and MEC. Six spectral domains and a set of slope criteria for real-time evaluation of pasture quality were suggested. The evaluation of three level categories (low, medium, high for these three parameters showed a success rate of: 73%–96% for CP, 72%–87% for NDF and 60%–85% for MEC. Moreover, only one spectral range, 1748–1764 nm, was needed to provide a good estimation of CP, NDF and MEC. Importantly, five of the six selected spectral regions were not affected by water absorbance. With some modifications, this rationale can be applied to further analyses of pasture quality from airborne sensors.

Evaluation of primary immunization coverage of infants under universal immunization programme in an urban area of bangalore city using cluster sampling and lot quality assurance sampling techniques.

Science.gov (United States)

K, Punith; K, Lalitha; G, Suman; Bs, Pradeep; Kumar K, Jayanth

2008-07-01

Is LQAS technique better than cluster sampling technique in terms of resources to evaluate the immunization coverage in an urban area? To assess and compare the lot quality assurance sampling against cluster sampling in the evaluation of primary immunization coverage. Population-based cross-sectional study. Areas under Mathikere Urban Health Center. Children aged 12 months to 23 months. 220 in cluster sampling, 76 in lot quality assurance sampling. Percentages and Proportions, Chi square Test. (1) Using cluster sampling, the percentage of completely immunized, partially immunized and unimmunized children were 84.09%, 14.09% and 1.82%, respectively. With lot quality assurance sampling, it was 92.11%, 6.58% and 1.31%, respectively. (2) Immunization coverage levels as evaluated by cluster sampling technique were not statistically different from the coverage value as obtained by lot quality assurance sampling techniques. Considering the time and resources required, it was found that lot quality assurance sampling is a better technique in evaluating the primary immunization coverage in urban area.

[Quality of care indicators for benign prostatic hyperplasia. A qualitative study].

Science.gov (United States)

Navarro-Pérez, Jorge; Peiró, Salvador; Brotons-Muntó, Francisco; López-Alcina, Emilio; Real-Romaguera, Arcadio

2014-05-01

To assess quality of care indicators for benign prostatic hyperplasia (BPH), and to evaluate their strengths and weaknesses for incorporation into health information systems. Structured expert meeting, using procedures adapted from the nominal group techniques and the Rand consensus method. Valencian School of Health Studies. Forty panellists (74% doctors, 70% from primary care settings) with experience in the management of BPH from 15 departments of the Valencia Health Agency. Three workshops were held simultaneously (examination and diagnosis, drug therapy, and appropriateness and results), and the 15 quality indicators selected by the coordination group were assessed. Eleven of the 15 indicators scored in the range of high relevance. The 5 best rated were: the use of alpha-blockers + 5-alpha reductase inhibitor from certain severity level, digital rectal examination in the initial assessment, follow-up with the International Prostate Symptoms Score (IPSS), the rate of urgent catheterization in Hospital Accident & Emergency Units, initial assessment with the IPSS and the use of alpha-blockers prior to catheter removal for acute retention of urine. Some of the assessed indicators can be useful for incorporation into health information systems. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Quality Indicators for Evaluating Prehospital Emergency Care: A Scoping Review.

Science.gov (United States)

Howard, Ian; Cameron, Peter; Wallis, Lee; Castren, Maaret; Lindstrom, Veronica

2018-02-01

Introduction Historically, the quality and performance of prehospital emergency care (PEC) has been assessed largely based on surrogate, non-clinical endpoints such as response time intervals or other crude measures of care (eg, stakeholder satisfaction). However, advances in Emergency Medical Services (EMS) systems and services world-wide have seen their scope and reach continue to expand. This has dictated that novel measures of performance be implemented to compliment this growth. Significant progress has been made in this area, largely in the form of the development of evidence-informed quality indicators (QIs) of PEC. Problem Quality indicators represent an increasingly popular component of health care quality and performance measurement. However, little is known about the development of QIs in the PEC environment. The purpose of this study was to assess the development and characteristics of PEC-specific QIs in the literature. A scoping review was conducted through a search of PubMed (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA); EMBase (Elsevier; Amsterdam, Netherlands); CINAHL (EBSCO Information Services; Ipswich, Massachusetts USA); Web of Science (Thomson Reuters; New York, New York USA); and the Cochrane Library (The Cochrane Collaboration; Oxford, United Kingdom). To increase the sensitivity of the literature, a search of the grey literature and review of select websites was additionally conducted. Articles were selected that proposed at least one PEC QI and whose aim was to discuss, analyze, or promote quality measurement in the PEC environment. The majority of research (n=25 articles) was published within the last decade (68.0%) and largely originated within the USA (68.0%). Delphi and observational methodologies were the most commonly employed for QI development (28.0%). A total of 331 QIs were identified via the article review, with an additional 15 QIs identified via the website review. Of

Study on Quality Indicator System of Rhythmic Gymnasts in Analytic Hierarchy Process

Science.gov (United States)

Luo, Lin

2017-08-01

The rhythmic gymnastics (RG) is a sport item with the direct aim of winning as well as a good ornamental value. The scientific selection by the rhythmic gymnasts is necessary for the success, and also the beginning for the scientific training of the gymnasts in their special training stage. According to RG characteristics and the physical characteristics of the gymnasts, also in combination with the investigations & interviews to the coaches who have years of training experience in RG, the experts & scholars on RG study & teaching in universities, and by referring to relevant documents, this paper established the quality indicator system in analytic hierarchy process (AHP). We summarized and selected several indicators obviously influencing the RG training and divided them into the three types of factors: physical factors, flexibility & strength factors, and speed & dexterity factors, according to which 12 specific indicators, their weights and comprehensive evaluation coefficients. Based on these indicators, we established the quality indicator system of the gymnasts, and developed corresponding software system, providing scientific theoretical basis & practical application basis for the selection & evaluation of the gymnasts.

[Potential for the survey of quality indicators based on a national emergency department registry : A systematic literature search].

Science.gov (United States)

Hörster, A C; Kulla, M; Brammen, D; Lefering, R

2018-06-01

Emergency department processes are often key for successful treatment. Therefore, collection of quality indicators is demanded. A basis for the collection is systematic, electronic documentation. The development of paper-based documentation into an electronic and interoperable national emergency registry is-besides the establishment of quality management for emergency departments-a target of the AKTIN project. The objective of this research is identification of internationally applied quality indicators. For the investigation of the current status of quality management in emergency departments based on quality indicators, a systematic literature search of the database PubMed, the Cochrane Library and the internet was performed. Of the 170 internationally applied quality indicators, 25 with at least two references are identified. A total of 10 quality indicators are ascertainable by the data set. An enlargement of the data set will enable the collection of seven further quality indicators. The implementation of data of care behind the emergency processes will provide eight additional quality indicators. This work was able to show that the potential of a national emergency registry for the establishment of quality indicators corresponds with the international systems taken into consideration and could provide a comparable collection of quality indicators.

Do structural quality indicators of nutritional care influence malnutrition prevalence in Dutch, German, and Austrian nursing homes?

Science.gov (United States)

van Nie, Noémi C; Meijers, Judith M M; Schols, Jos M G A; Lohrmann, Christa; Spreeuwenberg, Marieke; Halfens, Ruud J G

2014-01-01

The aim of this study was to explore whether structural quality indicators for nutritional care influence malnutrition prevalence in the Netherlands, Germany, and Austria. Furthermore, differences in malnutrition prevalence and structural quality indicators for nutritional care nursing homes in the three countries were examined. This was a cross-sectional, multicenter study using a standardized questionnaire at the patient, ward, and institutional levels. Malnutrition was assessed by low body mass index, undesired weight loss, and reduced intake. Structural quality indicators of nutritional care were measured at the ward and institutional levels. The prevalence of malnutrition differed significantly between the three countries (Netherlands 18%, Germany 20%, and Austria 22.7%). Structural quality indicators related to nutritional care as having a guideline of prevention and treatment of malnutrition were related to malnutrition and explained malnutrition prevalence variance between the Netherlands and Germany. Differences between the Netherlands and Austria in malnutrition prevalence still existed after controlling for these quality structural indicators. Structural quality indicators of nutritional care are important in explaining malnutrition variance between the Netherlands and Germany. However, they did not explain the difference in malnutrition prevalence between the Netherlands and Austria. Investigating the role of process indicators may provide insight in the role of structural quality indicators of nutritional care in explaining the malnutrition prevalence differences between the Netherlands and Austria. Copyright © 2014 Elsevier Inc. All rights reserved.

UK key performance indicators and quality assurance standards for colonoscopy.

Science.gov (United States)

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/.

Quality Indicators for the Total Testing Process.

Science.gov (United States)

Plebani, Mario; Sciacovelli, Laura; Aita, Ada

2017-03-01

ISO 15189:2012 requires the use of quality indicators (QIs) to monitor and evaluate all steps of the total testing process, but several difficulties dissuade laboratories from effective and continuous use of QIs in routine practice. An International Federation of Clinical Chemistry and Laboratory Medicine working group addressed this problem and implemented a project to develop a model of QIs to be used in clinical laboratories worldwide to monitor and evaluate all steps of the total testing process, and decrease error rates and improve patient services in laboratory testing. All laboratories are invited, at no cost, to enroll in the project and contribute to harmonized management at the international level. Copyright © 2016 Elsevier Inc. All rights reserved.

Soil quality indicator responses to row crop, grazed pasture, and agroforestry buffer management

Science.gov (United States)

Incorporation of trees and establishment of grass buffers within agroecosystems are management practices shown to enhance soil quality. Soil enzyme activities and water stable aggregates (WSA) have been identified as sensitive soil quality indicators to evaluate early responses to soil management. ...

Performance of biotic indices in comparison to chemical-based Water Quality Index (WQI) in evaluating the water quality of urban river.

Science.gov (United States)

Wan Abdul Ghani, Wan Mohd Hafezul; Abas Kutty, Ahmad; Mahazar, Mohd Akmal; Al-Shami, Salman Abdo; Ab Hamid, Suhaila

2018-04-19

In order to evaluate the water quality of one of the most polluted urban river in Malaysia, the Penchala River, performance of eight biotic indices, Biomonitoring Working Party (BMWP), BMWP Thai , BMWP Viet , Average Score Per Taxon (ASPT), ASPT Thai , BMWP Viet , Family Biotic Index (FBI), and Singapore Biotic Index (SingScore), was compared. The water quality categorization based on these biotic indices was then compared with the categorization of Malaysian Water Quality Index (WQI) derived from measurements of six water physicochemical parameters (pH, BOD, COD, NH 3 -N, DO, and TSS). The river was divided into four sections: upstream section (recreational area), middle stream 1 (residential area), middle stream 2 (commercial area), and downstream. Abundance and diversity of the macroinvertebrates were the highest in the upstream section (407 individual and H' = 1.56, respectively), followed by the middle stream 1 (356 individual and H' = 0.82). The least abundance was recorded in the downstream section (214 individual). Among all biotic indices, BMWP was the most reliable in evaluating the water quality of this urban river as their classifications were comparable to the WQI. BMWPs in this study have strong relationships with dissolved oxygen (DO) content. Our results demonstrated that the biotic indices were more sensitive towards organic pollution than the WQI. BMWP indices especially BMWP Viet were the most reliable and could be adopted along with the WQI for assessment of water quality in urban rivers.

Evaluation of primary immunization coverage of infants under universal immunization programme in an urban area of Bangalore city using cluster sampling and lot quality assurance sampling techniques

Directory of Open Access Journals (Sweden)

Punith K

2008-01-01

Full Text Available Research Question: Is LQAS technique better than cluster sampling technique in terms of resources to evaluate the immunization coverage in an urban area? Objective: To assess and compare the lot quality assurance sampling against cluster sampling in the evaluation of primary immunization coverage. Study Design: Population-based cross-sectional study. Study Setting: Areas under Mathikere Urban Health Center. Study Subjects: Children aged 12 months to 23 months. Sample Size: 220 in cluster sampling, 76 in lot quality assurance sampling. Statistical Analysis: Percentages and Proportions, Chi square Test. Results: (1 Using cluster sampling, the percentage of completely immunized, partially immunized and unimmunized children were 84.09%, 14.09% and 1.82%, respectively. With lot quality assurance sampling, it was 92.11%, 6.58% and 1.31%, respectively. (2 Immunization coverage levels as evaluated by cluster sampling technique were not statistically different from the coverage value as obtained by lot quality assurance sampling techniques. Considering the time and resources required, it was found that lot quality assurance sampling is a better technique in evaluating the primary immunization coverage in urban area.

[Evaluation method with radiographic image quality indicator for internal defects of dental casting metallic restoration].

Science.gov (United States)

Li, Y; Zheng, G; Lin, H

2014-12-18

To develop a new kind of dental radiographic image quality indicator (IQI) for internal quality of casting metallic restoration to influence on its usage life. Radiographic image quality indicator method was used to evaluate the depth of the defects region and internal quality of 127 casting metallic restoration and the accuracy was compared with that of conventional callipers method. In the 127 cases of casting metallic restoration, 9 were found the thickness less than 0.7 mm and the thinnest thickness only 0.2 mm in 26 casting metallic crowns or bridges' occlusal defects region. The data measured by image quality indicator were consistent with those measured by conventional gauging. Two metal inner crowns were found the thickness less than 0.3 mm in 56 porcelain crowns or bridges. The thickness of casting removable partial denture was more than 1.0 mm, but thinner regions were not found. It was found that in a titanium partial denture, the X-ray image of clasp was not uniform and there were internal porosity defects in the clasp. Special dental image quality indicator can solve the visual error problems caused by different observing backgrounds and estimate the depth of the defects region in the casting.

Quality in cytopathology: an analysis of the internal quality monitoring indicators of the Instituto Nacional de Câncer

Directory of Open Access Journals (Sweden)

Mario Lucio C. Araujo Jr

2015-04-01

Full Text Available Introduction: Quality control programs are required to ensure the effectiveness of Pap smear, which still remain a key strategy for control of cervical cancer worldwide. Objective: This study was based on the retrospective and quantitative analysis of the post-analytical phase indicators from the internal quality monitoring (IQM program for cytopathology laboratories, such as: positivity rate, atypical squamous cell (ASC/satisfactory exams ratio, ASC/abnormal test results ratio, ASC/squamous intraepithelial lesions (SIL ratio, percentage of tests compatible with high-grade squamous intraepithelial lesion (HSIL, and total of false negative. Materials and methods: The information was extracted from the computerized system of the Section for Integrated Technology in Cytopathology (Seção Integrada de Tecnologia em Citopatologia [SITEC], a reference institution for cancer cytopathology, from July 2013 to June 2014. From a total of 156,888 Pap smears, 157,454 were considered satisfactory for indicator analysis and 566 were excluded because they were considered unsatisfactory and/or rejected for analysis. The data was organized in tables using Microsoft Excel 2010 software, and categorized as indicators. Results: The averages for the indicators were: 7.2% for positivity rate, 56.9 for ASC/abnormal test ratio, 4.1 for ASC/satisfactory tests ratio, 1.4 for ASC/SIL ratio, 0.6% percentage for tests compatible with HSIL, and 2.1% for false-negative rate. Conclusion: The results show that an Internal Quality Monitoring Program is essencial to ensure quality for cytopathology laboratories, and a randomized review of at least 10% of the negative exams, as recommended by the Brazilian Ministry of Health/Instituto Nacional de Câncer (INCA, since is an effective method, especially for large laboratories.

Tracking of Power Quality Indicators during Wind Farm Islanding Experiment

DEFF Research Database (Denmark)

Terzija, V.; Crossley, P.A.; Stanojevic, V.

2007-01-01

The application of the two-stage Newton Type Algorithm for the tracking of the power quality indicators (in accordance with IEEE Standard 1459-2000) is presented in the paper. To estimate their spectra and fundamental frequency, the current and voltage signals are first processed and then the pow...... experiment in Denmark....

[A set of quality and safety indicators for hospitals of the "Agencia Valenciana de Salud"].

Science.gov (United States)

Nebot-Marzal, C M; Mira-Solves, J J; Guilabert-Mora, M; Pérez-Jover, V; Pablo-Comeche, D; Quirós-Morató, T; Cuesta Peredo, D

2014-01-01

To prepare a set of quality and safety indicators for Hospitals of the «Agencia Valenciana de Salud». The qualitative technique Metaplan® was applied in order to gather proposals on sustainability and nursing. The catalogue of the «Spanish Society of Quality in Healthcare» was adopted as a starting point for clinical indicators. Using the Delphi technique, 207 professionals were invited to participate in the selecting the most reliable and feasible indicators. Lastly, the resulting proposal was validated with the managers of 12 hospitals, taking into account the variability, objectivity, feasibility, reliability and sensitivity, of the indicators. Participation rates varied between 66.67% and 80.71%. Of the 159 initial indicators, 68 were prioritized and selected (21 economic or management indicators, 22 nursing indicators, and 25 clinical or hospital indicators). Three of them were common to all three categories and two did not match the specified criteria during the validation phase, thus obtaining a final catalogue of 63 indicators. A set of quality and safety indicators for Hospitals was prepared. They are currently being monitored using the hospital information systems. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Price as indicator for quality?

DEFF Research Database (Denmark)

Nielsen, Jørgen Ulff-Møller; Hansen, Jørgen Drud

This paper examines the relation between price differences and quality differences in an oligopoly model with intra-industry trade, where goods are horizontally as well as vertically differentiated. The analysis demonstrates that the ratio of prices is not linked to the ratio of qualities in any...

Lot quality assurance sampling to monitor supplemental immunization activity quality: an essential tool for improving performance in polio endemic countries.

Science.gov (United States)

Brown, Alexandra E; Okayasu, Hiromasa; Nzioki, Michael M; Wadood, Mufti Z; Chabot-Couture, Guillaume; Quddus, Arshad; Walker, George; Sutter, Roland W

2014-11-01

Monitoring the quality of supplementary immunization activities (SIAs) is a key tool for polio eradication. Regular monitoring data, however, are often unreliable, showing high coverage levels in virtually all areas, including those with ongoing virus circulation. To address this challenge, lot quality assurance sampling (LQAS) was introduced in 2009 as an additional tool to monitor SIA quality. Now used in 8 countries, LQAS provides a number of programmatic benefits: identifying areas of weak coverage quality with statistical reliability, differentiating areas of varying coverage with greater precision, and allowing for trend analysis of campaign quality. LQAS also accommodates changes to survey format, interpretation thresholds, evaluations of sample size, and data collection through mobile phones to improve timeliness of reporting and allow for visualization of campaign quality. LQAS becomes increasingly important to address remaining gaps in SIA quality and help focus resources on high-risk areas to prevent the continued transmission of wild poliovirus. © Crown copyright 2014.

Identifying individual changes in performance with composite quality indicators while accounting for regression to the mean.

Science.gov (United States)

Gajewski, Byron J; Dunton, Nancy

2013-04-01

Almost a decade ago Morton and Torgerson indicated that perceived medical benefits could be due to "regression to the mean." Despite this caution, the regression to the mean "effects on the identification of changes in institutional performance do not seem to have been considered previously in any depth" (Jones and Spiegelhalter). As a response, Jones and Spiegelhalter provide a methodology to adjust for regression to the mean when modeling recent changes in institutional performance for one-variable quality indicators. Therefore, in our view, Jones and Spiegelhalter provide a breakthrough methodology for performance measures. At the same time, in the interests of parsimony, it is useful to aggregate individual quality indicators into a composite score. Our question is, can we develop and demonstrate a methodology that extends the "regression to the mean" literature to allow for composite quality indicators? Using a latent variable modeling approach, we extend the methodology to the composite indicator case. We demonstrate the approach on 4 indicators collected by the National Database of Nursing Quality Indicators. A simulation study further demonstrates its "proof of concept."

Multidrug resistance among new tuberculosis cases: detecting local variation through lot quality-assurance sampling.

Science.gov (United States)

Hedt, Bethany Lynn; van Leth, Frank; Zignol, Matteo; Cobelens, Frank; van Gemert, Wayne; Nhung, Nguyen Viet; Lyepshina, Svitlana; Egwaga, Saidi; Cohen, Ted

2012-03-01

Current methodology for multidrug-resistant tuberculosis (MDR TB) surveys endorsed by the World Health Organization provides estimates of MDR TB prevalence among new cases at the national level. On the aggregate, local variation in the burden of MDR TB may be masked. This paper investigates the utility of applying lot quality-assurance sampling to identify geographic heterogeneity in the proportion of new cases with multidrug resistance. We simulated the performance of lot quality-assurance sampling by applying these classification-based approaches to data collected in the most recent TB drug-resistance surveys in Ukraine, Vietnam, and Tanzania. We explored 3 classification systems- two-way static, three-way static, and three-way truncated sequential sampling-at 2 sets of thresholds: low MDR TB = 2%, high MDR TB = 10%, and low MDR TB = 5%, high MDR TB = 20%. The lot quality-assurance sampling systems identified local variability in the prevalence of multidrug resistance in both high-resistance (Ukraine) and low-resistance settings (Vietnam). In Tanzania, prevalence was uniformly low, and the lot quality-assurance sampling approach did not reveal variability. The three-way classification systems provide additional information, but sample sizes may not be obtainable in some settings. New rapid drug-sensitivity testing methods may allow truncated sequential sampling designs and early stopping within static designs, producing even greater efficiency gains. Lot quality-assurance sampling study designs may offer an efficient approach for collecting critical information on local variability in the burden of multidrug-resistant TB. Before this methodology is adopted, programs must determine appropriate classification thresholds, the most useful classification system, and appropriate weighting if unbiased national estimates are also desired.

Processed meat intake is unfavorably and fish intake favorably associated with semen quality indicators among men attending a fertility clinic.

Science.gov (United States)

Afeiche, Myriam C; Gaskins, Audrey J; Williams, Paige L; Toth, Thomas L; Wright, Diane L; Tanrikut, Cigdem; Hauser, Russ; Chavarro, Jorge E

2014-07-01

Emerging literature suggests that men's diets may affect spermatogenesis as reflected in semen quality indicators, but literature on the relation between meat intake and semen quality is limited. Our objective was to prospectively examine the relation between meat intake and indicators of semen quality. Men in subfertile couples presenting for evaluation at the Massachusetts General Hospital Fertility Center were invited to participate in an ongoing study of environmental factors and fertility. A total of 155 men completed a validated food-frequency questionnaire and subsequently provided 338 semen samples over an 18-mo period from 2007-2012. We used linear mixed regression models to examine the relation between meat intake and semen quality indicators (total sperm count, sperm concentration, progressive motility, morphology, and semen volume) while adjusting for potential confounders and accounting for within-person variability across repeat semen samples. Among the 155 men (median age: 36.1 y; 83% white, non-Hispanic), processed meat intake was inversely related to sperm morphology. Men in the highest quartile of processed meat intake had, on average, 1.7 percentage units (95% CI: -3.3, -0.04) fewer morphologically normal sperm than men in the lowest quartile of intake (P-trend = 0.02). Fish intake was related to higher sperm count and percentage of morphologically normal sperm. The adjusted mean total sperm count increased from 102 million (95% CI: 80, 131) in the lowest quartile to 168 million (95% CI: 136, 207) sperm in the highest quartile of fish intake (P-trend = 0.005). Similarly, the adjusted mean percentages of morphologically normal sperm for men in increasing quartiles of fish intake were 5.9 (95% CI: 5.0, 6.8), 5.3 (95% CI: 4.4, 6.3), 6.3 (95% CI: 5.2, 7.4), and 7.5 (95% CI: 6.5, 8.5) (P-trend = 0.01). Consuming fish may have a positive impact on sperm counts and morphology, particularly when consumed instead of processed red meats. © 2014 American

An Evaluation of the Technical Adequacy of a Revised Measure of Quality Indicators of Transition

Science.gov (United States)

Morningstar, Mary E.; Lee, Hyunjoo; Lattin, Dana L.; Murray, Angela K.

2016-01-01

This study confirmed the reliability and validity of the Quality Indicators of Exemplary Transition Programs Needs Assessment-2 (QI-2). Quality transition program indicators were identified through a systematic synthesis of transition research, policies, and program evaluation measures. To verify reliability and validity of the QI-2, we…

Indices of quality surface water bodies in the planning of water resources

Directory of Open Access Journals (Sweden)

Rodríguez-Miranda, Juan Pablo

2016-12-01

Full Text Available This paper considers a review of the literature major and significant methods of quality indices of water applied in surface water bodies, used and proposed for assessing the significance of parameters of water quality in the assessment of surface water currents and they are usually used in making decisions for intervention and strategic prevention measures for those responsible for the conservation and preservation of watersheds where these water bodies belong. An exploratory methodology was applied to realize the conceptualization of each water quality index. As a result, it is observed that there are several important methods for determining the water quality index applied in surface water bodies.

Development of a Quality of Meals and Meal Service Set of Indicators for Residential Facilities for Elderly.

Science.gov (United States)

Van Damme, N; Buijck, B; Van Hecke, A; Verhaeghe, S; Goossens, E; Beeckman, D

2016-01-01

To develop a content validated set of indicators to evaluate the quality of meals and meal service in residential facilities for elderly. Inadequate food intake is an important risk factor for malnutrition in residential facilities for elderly. Through better meeting the needs and preferences of residents and optimization of meals and meal service, residents' food intake can improve. No indicators were available which could help to guide strategies to improve the quality of meals and meal service. The indicator set was developed according to the Indicator Development Manual of the Dutch Institute for Health Care Improvement (CBO). The working group consisted of three nurse researchers and one expert in gastrology and had expertise in elderly care, malnutrition, indicator development, and food quality. A preliminary list of potential indicators was compiled using the literature and the working group's expertise. Criteria necessary to measure the indicator in practice were developed for each potential indicator. In a double Delphi procedure, the list of potential indicators and respective criteria were analyzed for content validity, using a multidisciplinary expert panel of 11 experts in elderly meal care. A preliminary list of 20 quality indicators, including 45 criteria, was submitted to the expert panel in a double Delphi procedure. After the second Delphi round, 13 indicators and 25 criteria were accepted as having content validity. The content validity index (CVI) ranged from 0.83 to 1. The indicator set consisted of six structural, four result, and three outcome indicators covering the quality domains food, service and choice, as well as nutritional screening. The criteria measure diverse aspects of meal care which are part of the responsibility of kitchen staff and health care professionals. The 'quality of meals and meal service' set of indicators is a resource to map meal quality in residential facilities for elderly. As soon as feasibility tests in practice

Efficient sampling to determine the distribution of fruit quality and yield in a commercial apple orchard

DEFF Research Database (Denmark)

Martinez, M.; Wulfsohn, Dvora-Laio; Zamora, I.

2012-01-01

In situ assessment of fruit quality and yield can provide critical data for marketing and for logistical planning of the harvest, as well as for site-specific management. Our objective was to develop and validate efficient field sampling procedures for this purpose. We used the previously reported...... 'fractionator' tree sampling procedure and supporting handheld software (Gardi et al., 2007; Wulfsohn et al., 2012) to obtain representative samples of fruit from a 7.6-ha apple orchard (Malus ×domestica 'Fuji Raku Raku') in central Chile. The resulting sample consisted of 70 fruit on 56 branch segments...... of yield. Estimated marketable yield was 295.8±50.2 t. Field and packinghouse records indicated that of 348.2 t sent to packing (52.4 t or 15% higher than our estimate), 263.0 t was packed for export (32.8 t less or -12% error compared to our estimate). The estimated distribution of caliber compared very...

Applying Quality Indicators to Single-Case Research Designs Used in Special Education: A Systematic Review

Science.gov (United States)

Moeller, Jeremy D.; Dattilo, John; Rusch, Frank

2015-01-01

This study examined how specific guidelines and heuristics have been used to identify methodological rigor associated with single-case research designs based on quality indicators developed by Horner et al. Specifically, this article describes how literature reviews have applied Horner et al.'s quality indicators and evidence-based criteria.…

77 FR 32975 - AHRQ Workgroups on ICD-10-CM/PCS Conversion of Quality Indicators (QIs)

Science.gov (United States)

2012-06-04

... on ICD-10-CM/PCS Conversion of Quality Indicators (QIs) AGENCY: Agency for Healthcare Research and... workgroups, to be convened by AHRQ's contractor, on ICD-10-CM/PCS conversion of the AHRQ Quality Indicators..., please visit the AHRQ Web site at http://www.QUALITYindicators.AHRQ.gov . Specifically, each Workgroup on...

Certified quality management according to DIN ISO 9001 in a radiology department at a university hospital. Measurable changes in academic quality indicators?

International Nuclear Information System (INIS)

Lorenzen, Joern; Habermann, C.; Weber, C.; Adam, G.; Koops, A.; Utler, C.; Grzyska, U.

2009-01-01

Purpose: to evaluate the changes in academic quality indicators after implementation of a quality management system according to DIN ISO 9001:2000. Materials and methods: after implementation and certification of a quality management system, the actual state based on quality indicators from the fields of student teaching, research, continuing education and the satisfaction of referring physician was determined. After implementation of an action plan for the individual areas, the temporal changes in the ratios were documented in the follow-up. Results: the evaluation of teaching performance obtained by questionnaire among the students of the radiology course showed a steady increase in satisfaction (mean value 2003: 2.7; 2007: 3.9). In the field of research an increase in scientific output was achieved based on the number of an internal publication score (2002: 99 points; 2006: 509). Repeated opinion surveys among our referring physicians found improvements in indicators for the appointment of investigations, consulting service and waiting times for the investigation, while the waiting times for internal transport service did not improve. Exemplary measurements of the success of the advanced training of the staff demonstrated the need for continuing education for quality improvement. Conclusion: the evaluation of quality indicators showed over time a measurable positive impact on processes of a radiological Univ. Hospital after implementation of a QM system according to DIN ISO 9001:2000. (orig.)

[Certified quality management according to DIN ISO 9001 in a radiology department at a university hospital: measurable changes in academic quality indicators?].

Science.gov (United States)

Lorenzen, J; Habermann, C; Utler, C; Grzyska, U; Weber, C; Adam, G; Koops, A

2009-10-01

To evaluate the changes in academic quality indicators after implementation of a quality management system according to DIN ISO 9001:2000. After implementation and certification of a quality management system, the actual state based on quality indicators from the fields of student teaching, research, continuing education and the satisfaction of referring physician was determined. After implementation of an action plan for the individual areas, the temporal changes in the ratios were documented in the follow-up. The evaluation of teaching performance obtained by questionnaire among the students of the radiology course showed a steady increase in satisfaction (mean value 2003: 2.7; 2007: 3.9). In the field of research an increase in scientific output was achieved based on the number of an internal publication score (2002: 99 points; 2006: 509). Repeated opinion surveys among our referring physicians found improvements in indicators for the appointment of investigations, consulting service and waiting times for the investigation, while the waiting times for internal transport service did not improve. Exemplary measurements of the success of the advanced training of the staff demonstrated the need for continuing education for quality improvement. The evaluation of quality indicators showed over time a measurable positive impact on processes of a radiological University Hospital after implementation of a QM system according to DIN ISO 9001:2000. Georg Thieme Verlag KG Stuttgart-New York.

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

Science.gov (United States)

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 (de Pediatría. Published by Elsevier Espana. All rights reserved.

Comparison of Different Matrices as Potential Quality Control Samples for Neurochemical Dementia Diagnostics

NARCIS (Netherlands)

Lelental, Natalia; Brandner, Sebastian; Kofanova, Olga; Blennow, Kaj; Zetterberg, Henrik; Andreasson, Ulf; Engelborghs, Sebastiaan; Mroczko, Barbara; Gabryelewicz, Tomasz; Teunissen, Charlotte; Mollenhauer, Brit; Parnetti, Lucilla; Chiasserini, Davide; Molinuevo, Jose Luis; Perret-Liaudet, Armand; Verbeek, Marcel M.; Andreasen, Niels; Brosseron, Frederic; Bahl, Justyna M. C.; Herukka, Sanna-Kaisa; Hausner, Lucrezia; Froelich, Lutz; Labonte, Anne; Poirier, Judes; Miller, Anne-Marie; Zilka, Norbert; Kovacech, Branislav; Urbani, Andrea; Suardi, Silvia; Oliveira, Catarina; Baldeiras, Ines; Dubois, Bruno; Rot, Uros; Lehmann, Sylvain; Skinningsrud, Anders; Betsou, Fay; Wiltfang, Jens; Gkatzima, Olymbia; Winblad, Bengt; Buchfelder, Michael; Kornhuber, Johannes; Lewczuk, Piotr

2016-01-01

Background: Assay-vendor independent quality control (QC) samples for neurochemical dementia diagnostics (NDD) biomarkers are so far commercially unavailable. This requires that NDD laboratories prepare their own QC samples, for example by pooling leftover cerebrospinal fluid (CSF) samples.

Postpartum haemorrhage in midwifery care in the Netherlands: validation of quality indicators for midwifery guidelines.

Science.gov (United States)

Smit, Marrit; Chan, Kar-Li L; Middeldorp, Johanna M; van Roosmalen, Jos

2014-12-07

Postpartum haemorrhage (PPH) is still one of the major causes of severe maternal morbidity and mortality worldwide. Currently, no guideline for PPH occurring in primary midwifery care in the Netherlands is available. A set of 25 quality indicators for prevention and management of PPH in primary care has been developed by an expert panel consisting of midwives, obstetricians, ambulance personal and representatives of the Royal Dutch College of Midwives (KNOV) and the Dutch Society of Obstetrics and Gynecology (NVOG). This study aims to assess the performance of these quality indicators as an assessment tool for midwifery care and suitability for incorporation in a professional midwifery guideline. From April 2008 to April 2010, midwives reported cases of PPH. Cases were assessed using the 25 earlier developed quality indicators. Quality criteria on applicability, feasibility, adherence to the indicator, and the indicator's potential to monitor improvement were assessed. 98 cases of PPH were reported during the study period, of which 94 were analysed. Eleven indicators were found to be applicable and feasible. Five of these indicators showed improvement potential: routine administration of uterotonics, quantifying blood loss by weighing, timely referral to secondary care in homebirth and treatment of PPH using catherisation, uterine massage and oxytocin and the use of oxygen. Eleven out of 25 indicators were found to be suitable as an assessment tool for midwifery care of PPH and are therefore suitable for incorporation in a professional midwifery guideline. Larger studies are necessary to confirm these results.

PP095. Guideline-based development of quality indicators for hypertensive diseases in pregnancy

DEFF Research Database (Denmark)

Luitjes, S.H.E.; Wouters, M; Franx, A.

2012-01-01

for care improvement.RESULTS: A representative set of 14 quality indicators was selected from 48 initial guideline recommendations. Indicators concerned both professional performance and organisation of care for patients with hypertension in pregnancy.CONCLUSION: This study describes the systematic...

How Well Does Your IEP Measure Up?: Quality Indicators for Effective Service Delivery.

Science.gov (United States)

Twachtman-Cullen, Diane; Twachtman-Reilly, Jennifer

This book is intended to offer guidance in writing individualized education programs (IEPs) that deliver high-quality, need-based educational programming for students with autism spectrum disorders. Following an introductory historical overview of special education law, the remaining chapters in part 1 address the quality indicators for each of…

Assessment of water quality based on diatom indices in a small ...

African Journals Online (AJOL)

2016-04-02

Apr 2, 2016 ... single metric which is used to indicate the degree of impact. (Taylor et al. ... comparison of diatom-based water quality results, and are an additional reason for ...... establishing a framework for Community action in the field of.

Quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections in general practice

DEFF Research Database (Denmark)

Saust, Laura Trolle; Bjerrum, Lars; Arpi, Magnus

2017-01-01

Objective: To develop quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections, tailored to the Danish general practice setting. Design: A RAND/UCLA Appropriateness Method was used. Setting: General practice. Subjects: A panel of nine experts, mainly...... general practitioners, was asked to rate the relevance of 64 quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections based on guidelines. Subsequently, a face-to-face meeting was held to resolve misinterpretations and to achieve consensus. Main outcome measures...... indicators focusing on the diagnostic process and 19 indicators focusing on the decision about antibiotic treatment and choice of antibiotics, respectively. Conclusion: These newly developed quality indicators may be used to strengthen Danish general practitioners’ focus on their management of patients...

Psychosocial work environment and prediction of quality of care indicators in one Canadian health center.

Science.gov (United States)

Paquet, Maxime; Courcy, François; Lavoie-Tremblay, Mélanie; Gagnon, Serge; Maillet, Stéphanie

2013-05-01

Few studies link organizational variables and outcomes to quality indicators. This approach would expose operant mechanisms by which work environment characteristics and organizational outcomes affect clinical effectiveness, safety, and quality indicators. What are the predominant psychosocial variables in the explanation of organizational outcomes and quality indicators (in this case, medication errors and length of stay)? The primary objective of this study was to link the fields of evidence-based practice to the field of decision making, by providing an effective model of intervention to improve safety and quality. The study involved healthcare workers (n = 243) from 13 different care units of a university affiliated health center in Canada. Data regarding the psychosocial work environment (10 work climate scales, effort/reward imbalance, and social support) was linked to organizational outcomes (absenteeism, turnover, overtime), to the nurse/patient ratio and quality indicators (medication errors and length of stay) using path analyses. The models produced in this study revealed a contribution of some psychosocial factors to quality indicators, through an indirect effect of personnel- or human resources-related variables, more precisely: turnover, absenteeism, overtime, and nurse/patient ratio. Four perceptions of work environment appear to play an important part in the indirect effect on both medication errors and length of stay: apparent social support from supervisors, appreciation of the workload demands, pride in being part of one's work team, and effort/reward balance. This study reveals the importance of employee perceptions of the work environment as an indirect predictor of quality of care. Working to improve these perceptions is a good investment for loyalty and attendance. In general, better personnel conditions lead to fewer medication errors and shorter length of stay. © Sigma Theta Tau International.

Internal quality control indicators of cervical cytopathology exams performed in laboratories monitored by the External Quality Control Laboratory.

Science.gov (United States)

Ázara, Cinara Zago Silveira; Manrique, Edna Joana Cláudio; Tavares, Suelene Brito do Nascimento; de Souza, Nadja Lindany Alves; Amaral, Rita Goreti

2014-09-01

To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams. The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service. Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated. An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.

Keeping quality of imported dried fish

OpenAIRE

Goonewardene, I.S.R.; Etoh, S.

1980-01-01

All imported salted, dried fish samples tested had a salt content below 30% and above 12% and hence met requirements of the proposed standard. Also samples without quality cut tested had a greater salt content than that with quality cut. This indicates that salt contributes to protecting dried fish and hence may be endorsed by sensory evaluation to a certain extent. Samples with quality cut had more moisture than that without quality cut. But all samples with and without quality cut had a moi...

Pollution evaluation in the Shahrood River: Do physico-chemical and macroinvertebrate-based indices indicate same responses to anthropogenic activities?

Science.gov (United States)

Sharifinia, Moslem; Mahmoudifard, Abbas; Imanpour Namin, Javid; Ramezanpour, Zohreh; Yap, Chee Kong

2016-09-01

This study evaluates the impact of anthropogenic activities on the Shahrood River using water physico-chemical variables and macroinvertebrates data sets obtained over a period of 12 months between February 2012 and February 2013 at 8 sampling sites. Biotic indices i.e. FBI and BMWP based on macroinvertebrates and physico-chemical indices (MPI, HPI and NSF-WQI) were employed to evaluate the water quality status in connection with natural- and human-induced pressures. Based on physico-chemical indices, water quality was categorized as low polluted level and it is suitable for drinking purposes. The water quality based on biotic indices was related to the anthropic activities; a clear deterioration of the water quality was observed from upstream to downstream sites. The water quality along the river changed from very good (class I; reference sites) to good (class II; midstream sites) and turned into moderate (class III) and poor (class IV) quality (downstream sites). These findings indicate that biotic indices are more powerful indicators in assessing water quality than physico-chemical indices. Allocapnia, Glossosoma and Hesperoperla were exclusively related to least disturbed sites, and Naididae, Orthocladiinae and Ecdyonurus were found in sites showing notable degradation. Our results recommended that the use of macroinvertebrates could be employed as a cost-effective tool for biomonitoring and controlling of polluted riverine ecosystems in the Middle East. Finally, the results from this study may be useful not only for developing countries, but also for any organization struggling to use macroinvertebrate based indices with restricted financial resources and knowledge. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quality evaluation of processed clay soil samples | Steiner-Asiedu ...

African Journals Online (AJOL)

Introduction: This study assessed the microbial quality of clay samples sold on two of the major Ghanaian markets. Methods: The study was a cross-sectional assessing the evaluation of processed clay and effects it has on the nutrition of the consumers in the political capital town of Ghana. The items for the examination was ...

Effects of maternal absence due to employment on the quality of infant-mother attachment in a low-risk sample.

Science.gov (United States)

Barglow, P; Vaughn, B E; Molitor, N

1987-08-01

Recent reports have suggested that day-care experience initiated prior to 12 months of age is associated with increased proportions of infants whose attachment to mother is classified as "insecure-avoidant." However, reviewers have questioned the generality of these findings, noting that samples in which associations between early day-care experience and avoidant attachment patterns have been reported come from high-risk populations, and/or that the infants' day-care settings may not have been of high quality. In the present study, effects of maternal absences on infant-mother attachment quality were assessed in a low-risk, middle-class sample (N = 110). In all instances, substitute care had been initiated at least 4 months prior to the infant's first birthday and was provided in the infant's home by a person unrelated to the baby. Infants were assessed using the Ainsworth Strange Situation when they were 12-13 months of age. Analyses indicated that a significantly greater proportion of infants whose mothers worked outside the home (N = 54) were assigned to the category "insecure-avoidant" as compared to infants whose mothers remained in the home (N = 56) throughout the first year of life. Analyses of demographic and psychological data available for the sample indicated that this relation is dependent upon maternal parity (primi- vs. multiparous mother). The association between attachment quality and work status was significant only for firstborn children of full-time working mothers. The results are interpreted as evidence that the repeated daily separations experienced by infants whose mothers are working full-time constitute a "risk" factor for the development of "insecure-avoidant" infant-mother attachments.

Associations between sociodemographic, sampling and health factors and various salivary cortisol indicators in a large sample without psychopathology

NARCIS (Netherlands)

Vreeburg, Sophie A.; Kruijtzer, Boudewijn P.; van Pelt, Johannes; van Dyck, Richard; DeRijk, Roel H.; Hoogendijk, Witte J. G.; Smit, Johannes H.; Zitman, Frans G.; Penninx, Brenda

Background: Cortisol levels are increasingly often assessed in large-scale psychosomatic research. Although determinants of different salivary cortisol indicators have been described, they have not yet been systematically studied within the same study with a Large sample size. Sociodemographic,