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Sample records for beam quality indicator

  1. Quality indicators

    DEFF Research Database (Denmark)

    Hjorth-Andersen, Christian

    1991-01-01

    In recent literature it has been suggested that consumers need have no knowledge of product quality as a number of quality indicators (or signals) may be used as substitutes. Very little attention has been paid to the empirical verification of these studies. The present paper is devoted...... to the issue of how well these indicators perform, using market data provided by consumer magazines from 3 countries. The results strongly indicate that price is a poor quality indicator. The paper also presents some evidence which suggests that seller reputation and easily observable characteristics are also...

  2. Quality indicators in radiotherapy

    International Nuclear Information System (INIS)

    Cionini, Luca; Gardani, Gianstefano; Gabriele, Pietro; Magri, Secondo; Morosini, Pier Luigi; Rosi, Antonella; Viti, Vincenza

    2007-01-01

    Background and purpose: There is a widespread and increasing tendency to develop hospital performance indicators in the field of accreditation/certification systems and quality benchmarking. A study has been undertaken to develop a set of performance indicators for a typical radiotherapy Centre and to evaluate their ability to provide a continuous quality improvement. Materials and methods: A working group consisting of radiation oncologists, medical physicists and radiation technologists under the coordination of experts in health technology assessment has elaborated a set of general indicators able to monitor performances and the quality level of a typical radiotherapy Centre. The work has been carried out through four steps: a preliminary set of indicators was selected; data on these indicators were collected in a number of Italian radiotherapy Centres and medical physics Services; problems in collection and analysis of data were discussed; a final set of indicators was developed. Results: A final set of 13 indicators is here presented. They concern general structural and/or operational features, health physics activities and accuracy and technical complexity of the treatment. Conclusions: The indicators tested in a few Italian Centres of radiotherapy and medical physics Services are now ready to be utilized by a larger community

  3. Air quality indicators

    International Nuclear Information System (INIS)

    Clench-Aas, Jocelyn; Guerreiro, Cristina; Bartonova, Alena

    1999-06-01

    This report proposes and describes in detail several air quality indicators that may be used to describe population exposure. The suggested indicators account for temporal and spatial patterns of pollution and movements of individuals between different micro-environments. The Air Quality Indicator /AQI) should represent both the spatial and temporal aspects of pollution exposure that may have important effects on health. Two indicators are needed, the Population Air Quality Indicator and the Individual Air Quality Indicator. Mean concentrations, 98th percentile and maximum values are the traditional indicators for estimating exposure. the temporal variability of PM-10 and NO 2 , however, is here described by means of: 1) The rate of change of pollution as the difference between two consecutive hourly values and of 2) episodes, described in terms of number, duration and winter episode period, maximum concentration in the episode and integrated episode exposure (episode AOT50/100). The spatial variation of AQIs can be described in several ways, e.g.: 1) Concentrations in neighbouring grid squares can be compared as an indication of spatial variation and 2) point estimates can be compared to grid values for a description of variation within a grid. Both methods are presented here. A test of the representativity of static point estimates for pollution exposure is to compare them to an estimate of air pollution exposure accounting for movements between different locations, obtained using diaries. The ultimate aim of AQIs is to describe the population exposure to ambient pollution. This is done by estimating the number of people exposed using different characteristics of AQIs. The data used to describe these indicators originates from dispersion modelling of short-term air pollution concentrations in Oslo. Two series of data are used. One represents hour-for hour concentrations in the 1 km 2 grid system covering the city of Oslo, winter 1994/95, calculated by the grid

  4. On beam quality and flatness of radiotherapy megavoltage photon beams

    International Nuclear Information System (INIS)

    Hossain, Murshed; Rhoades, Jeffrey

    2016-01-01

    Ratio of percentage depth dose (PDD) at two depths, PDD at a depth of 10 cm (PDD 10 ), and beam flatness are monitored regularly for radiotherapy beams for quality assurance. The purpose of this study is to understand the effects of changes in one of these parameters on the other. Is it possible to monitor only the beam flatness and not PDD? The investigation has two components. Naturally occurring i.e., unintended changes in PDD ratio and in-plane flatness for 6 and 10 MV photon beams for one particular Siemens Artiste Linac are monitored for a period of about 4 years. Secondly, deliberate changes in the beam parameters are induced by changing the bending magnet current (BMI). Relationships between various beam parameters for unintended changes as well as deliberate changes are characterized. Long term unintentional changes of PDD ratio are found to have no systematic trend. The flatness in the in plane direction for 6 and 10 MV beams show slow increase of 0.43 and 0.75 % respectively in about 4 years while the changes in the PDD ratio show no such trend. Over 10 % changes in BMI are required to induce changes in the beam quality indices at 2 % level. PDD ratio for the 10 MV beam is found to be less sensitive, while the depth of maximum dose, d max , is more sensitive to the changes in BMI compared to the 6 MV beam. Tolerances are more stringent for PDD 10 than PDD ratio for the 10 MV beam. PDD ratio, PDD 10 , and flatness must be monitored independently. Furthermore, off axis ratio alone cannot be used to monitor flatness. The effect of beam quality change in the absolute dose is clinically insignificant.

  5. A better beam quality

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    Progress has been made on two fronts, providing physics data and preparing for higher intensities. Over the Whitsun weekend of May 22 to 24, 5 fills for physics provided almost 30 hours of stable colliding beams, all with bunch intensities around 2x1010 protons and at a β* of 2m. The first three of these fills were with 6 bunches per beam, giving 3 pairs of collisions in all experiments. For the other two fills, the number of bunches per beam was increased to 13, giving 8 pairs of colliding bunches, and for the first time luminosities were pushed above 1029 cm-2s-1, 2 orders of magnitude higher than first collisions in March. In between and after these physics fills, nominal bunches of 1011 protons were successfully ramped and brought into collision in ATLAS and CMS for the first time (not in stable beam conditions and without squeeze). Event rates seen by the experiments were in the expected range for these conditions. In the middle of this work, a short fill with beams of 7 nominal bunches was ...

  6. Quality Indicators for Learning Analytics

    Science.gov (United States)

    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…

  7. Quality Indicators in Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. 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

  9. Quality indicators for eye bank.

    Science.gov (United States)

    Acharya, Manisha; Biswas, Saurabh; Das, Animesh; Mathur, Umang; Dave, Abhishek; Singh, Ashok; Dubey, Suneeta

    2018-03-01

    The aim of this study is to identify quality indicators of the eye bank and validate their effectivity. Adverse reaction rate, discard rate, protocol deviation rate, and compliance rate were defined as Quality Indicators of the eye bank. These were identified based on definition of quality that captures two dimensions - "result quality" and "process quality." The indicators were measured and tracked as part of quality assurance (QA) program of the eye bank. Regular audits were performed to validate alignment of standard operating procedures (SOP) with regulatory and surgeon acceptance standards and alignment of activities performed in the eye bank with the SOP. Prospective study of the indicators was performed by comparing their observed values over the period 2011-2016. Adverse reaction rate decreased more than 8-fold (from 0.61% to 0.07%), discard rate decreased and stabilized at 30%, protocol deviation rate decreased from 1.05% to 0.08%, and compliance rate reported by annual quality audits improved from 59% to 96% at the same time. In effect, adverse reaction rate, discard rate, and protocol deviation rate were leading indicators, and compliance rate was the trailing indicator. These indicators fulfill an important gap in available literature on QA in eye banking. There are two ways in which these findings can be meaningful. First, eye banks which are new to quality measurement can adopt these indicators. Second, eye banks which are already deeply engaged in quality improvement can test these indicators in their eye bank, thereby incorporating them widely and improving them over time.

  10. Quality indicators for eye bank

    Directory of Open Access Journals (Sweden)

    Manisha Acharya

    2018-01-01

    Full Text Available Purpose: The aim of this study is to identify quality indicators of the eye bank and validate their effectivity. Methods: Adverse reaction rate, discard rate, protocol deviation rate, and compliance rate were defined as Quality Indicators of the eye bank. These were identified based on definition of quality that captures two dimensions – “result quality” and “process quality.” The indicators were measured and tracked as part of quality assurance (QA program of the eye bank. Regular audits were performed to validate alignment of standard operating procedures (SOP with regulatory and surgeon acceptance standards and alignment of activities performed in the eye bank with the SOP. Prospective study of the indicators was performed by comparing their observed values over the period 2011–2016. Results: Adverse reaction rate decreased more than 8-fold (from 0.61% to 0.07%, discard rate decreased and stabilized at 30%, protocol deviation rate decreased from 1.05% to 0.08%, and compliance rate reported by annual quality audits improved from 59% to 96% at the same time. In effect, adverse reaction rate, discard rate, and protocol deviation rate were leading indicators, and compliance rate was the trailing indicator. Conclusion: These indicators fulfill an important gap in available literature on QA in eye banking. There are two ways in which these findings can be meaningful. First, eye banks which are new to quality measurement can adopt these indicators. Second, eye banks which are already deeply engaged in quality improvement can test these indicators in their eye bank, thereby incorporating them widely and improving them over time.

  11. Website quality indicators for consumers.

    Science.gov (United States)

    Griffiths, Kathleen M; Christensen, Helen

    2005-11-15

    The rating tool DISCERN was designed for use by consumers without content expertise to evaluate the quality of health information. There is some evidence that DISCERN may be a valid indicator of evidence-based website quality when applied by health professionals. However, it is not known if the tool is a valid measure of evidence-based quality when used by consumers. Since it is a lengthy instrument requiring training in its use, DISCERN may prove impractical for use by the typical consumer. It is therefore important to explore the validity of other simpler potential indicators of site quality such as Google PageRank. This study aimed to determine (1) whether the instrument DISCERN is a valid indicator of evidence-based Web content quality for consumers without specific mental health training, and (2) whether Google PageRank is an indicator of website content quality as measured by an evidence-based gold standard. This was a cross-sectional survey of depression websites using consumer and health professional raters. The main outcome measures were (1) site characteristics, (2) evidence-based quality of content as measured by evidence-based depression guidelines, (3) DISCERN scores, (4) Google PageRank, and (5) user satisfaction. There was a significant association between evidence-based quality ratings and average DISCERN ratings both for consumers (r = 0.62, P = .001) and health professionals (r = 0.80, P PageRank (r = 0.59, P = .002). However, the correlation between DISCERN scores and user satisfaction was higher than the correlation between Google PageRank and user satisfaction. DISCERN has potential as an indicator of content quality when used either by experts or by consumers. Google PageRank shows some promise as an automatic indicator of quality.

  12. A Beam Quality Monitor for LHC Beams in the SPS

    CERN Document Server

    Papotti, G

    2008-01-01

    The SPS Beam Quality Monitor (BQM) system monitors the longitudinal parameters of the beam before extraction to the LHC to prevent losses and degradation of the LHC luminosity by the injection of low quality beams. It is implemented in two priority levels. At the highest level the SPS-LHC synchronization and global beam structure are verified. If the specifications are not met, the beam should be dumped in the SPS before extraction. On the second level, individual bunch position, length and stability are checked for beam quality assessment. Tolerances are adapted to the mode of operation and extraction to the LHC can also be inhibited. Beam parameters are accessed by acquiring bunch profiles with a longitudinal pick up and fast digital oscilloscope. The beam is monitored for instabilities during the acceleration cycle and thoroughly checked a few ms before extraction for a final decision on extraction interlock. Dedicated hardware and software components implementing fast algorithms are required. In this pape...

  13. Verificação do fator de calibração e indicador da qualidade do feixe de aceleradores lineares Verification of dose output and beam quality indicator in linear accelerators

    Directory of Open Access Journals (Sweden)

    Maria da Penha Silva

    2001-10-01

    Full Text Available Um programa de garantia da qualidade é um pré-requisito obrigatório para a exatidão necessária em radioterapia. Este trabalho relata parte dos testes de rotina mensal do controle da qualidade dos aceleradores lineares do Instituto Nacional do Câncer, relativos à calibração dos feixes de fótons e elétrons, no período de dois anos. Os resultados foram comparados com as recomendações do protocolo AAPM TG-40. Na análise do fator de calibração para o feixe de fótons foi encontrado um desvio máximo de 12%; para o feixe de elétrons o maior desvio encontrado foi 10%. A flutuação observada no indicador da qualidade do feixe para os feixes de elétrons foi maior que para os feixes de fótons. Os resultados confirmam a importância de um programa de garantia da qualidade em um serviço de radioterapia, permitindo correções rápidas da dose administrada ao paciente.A quality assurance program is a mandatory prerequisite for obtaining the high level of accuracy required for radiotherapy. This paper reports the results of part of the routine quality control tests for linear accelerators at the National Cancer Institute, Brazil, performed monthly over a period of two years. These tests included dose output and beam quality indicator. The results were compared with the guidelines of the AAPM TG-40 protocol. The results for the photon beams have shown dose output variations of up to 12%; for electron beams, the largest deviation found was 10%. The fluctuations observed in the beam quality indicator for the electron beams were greater than for the photon beams. These results strongly emphasize the importance of a quality assurance program in radiotherapy services in order to allow prompt corrections of the dose delivered to the patient.

  14. Generalized beam quality factor of aberrated truncated Gaussian laser beams

    CSIR Research Space (South Africa)

    Mafusire, C

    2011-07-01

    Full Text Available with a quadratic refractive index profile, a change in the beam quality factor can be used to infer the pre- sence of aberrations and thereby study the media of interest. For these reasons, among others, research into the beam qual- ity factor... very much like a normal lens (without the rotational symmetry associated with defocus) since the beam quality factor is calculated in the principal axes. With y-astigmatism, the lenslike behavior does not take place in the principal axes where...

  15. 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...

  16. 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

  17. [Family physicians attitude towards quality indicator program].

    Science.gov (United States)

    Shani, Michal; Nakar, Sasson; Azuri, Yossi

    2012-10-01

    Quality indicator programs for primary care are implanted throughout the world improving quality in health care. In this study, we have assessed family physicians attitudes towards the quality indicators program in Israel. Questionnaires were distributed to family physicians in various continuing educational programs. The questionnaire addressed demographics, whether the physician dealt with quality indicators, time devoted by the physician to quality indicators, pressure placed on the physician related to quality indicators, and the working environment. A total of 140 questionnaires were distributed and 91 (65%) were completed. The average physician age was 49 years (range 33-65 years]; the average working experience as a family physician was 17.8 years (range 0.5-42); 58 physicians were family medicine specialist (65.9%). Quality indicators were part of the routine work of 94% of the physicians; 72% of the physicians noted the importance of quality indicators; 84% of the physicians noted that quality indicators demand better team work; 76% of the physicians noted that quality indicators have reduced their professional independence. Pressure to deal with quality indicators was noted by 72% of the family physicians. Pressure to deal with quality indicators was related to reduced loyalty to their employer (P = 0.001), reducing their interest to practice family medicine (p programs, without creating a heavy burden on the work of family physicians.

  18. Quality indicators for breast cancer

    DEFF Research Database (Denmark)

    Poortmans, Philip; Aznar, Marianne; Bartelink, Harry

    2012-01-01

    Radiation therapy for breast cancer has considerably changed over the years, from simple simulator-based 2-dimensional techniques to sophisticated image-guided individualized treatments, with maximally protected normal structures. This has led to a substantial improvement in the outcome of breast...... cancer patients in terms of disease control, survival, and quality of life. This progress is based on clinical research and paralleled by progress in delivering sophisticated radiation treatment. Clinical trials resulted in identifying patients groups who will benefit from radiation treatment. They also...

  19. In situ measurement of laser beam quality

    Science.gov (United States)

    Hashemi, Somayeh Sadat; Ghavami Sabouri, Saeed; Khorsandi, Alireza

    2017-09-01

    An innovative optical method is introduced for the beam quality measurement of any arbitrary transverse mode based on the reconstruction of the mode from a few-frame image of the beam cross-section. This is performed by the decomposition of a mode to its basic Hermite-Gaussian modal coefficients. The performance of the proposed method is examined through M 2-factor measurement of the beam of a Nd:YAG laser which was forced to oscillate in a certain mode using a crossed rectangular intracavity aperture. Obtained results have shown that this method can be alternatively replaced for the hologram- and ISO-based techniques recently exploiting for beam quality measurement regardless of the mode type and the position of utilized CCD camera along the beam direction.

  20. Biological indicators of radiation quality

    International Nuclear Information System (INIS)

    Bender, M.A.; Wong, R.M.A.

    1982-01-01

    The induction of many biological effects by high linear energy transfer (LET) radiation is strikingly different in one or two respects from the induction by acute low-LET radiation. If the acute low-LET dose-effect curve is of the usual quadratic form, it becomes linear as LET increases. In any case the linear slope increases as LET increases; that is, the relative biological effectiveness (RBE) increases. Both changes might be exploited as biological indicators of whether or not the recent recalculations of dose and of neutron contribution to dose at Hiroshima and Nagasaki seem consistent with the epidemiological observations. The biological end points that have been extensively studied in survivors include acute effects, growth and development after in utero or childhood exposure, genetic and cytogenetic effects in offspring, somatic chromosomal aberrations in survivors, and, of course, cancers, including leukemia. No significant indication among offspring of genetic or cytogenetic effects attributable to parental exposure has been found. Among the remaining end points, only the data on somatic chromosomal aberrations and on cancers appear robust enough to allow one to draw definite inferences by comparing experiences at the two cities

  1. Bench calibration of INDUS-2 beam position indicators

    International Nuclear Information System (INIS)

    Tyagi, Y.; Banerji, Anil; Kotaiah, S.

    2005-01-01

    A third generation synchrotron radiation source of energy 2.5 GeV named INDUS-2 at Centre for Advanced Technology (C.A.T), Indore (M.P) is in the advanced stage of construction. Accurate determination and correction of beam closed orbit in INDUS-2 machine within 100 of microns is a very desirable goal. Bench based calibration of Beam Position Indicators (BPI) play a very important and useful role during initial commissioning of electron machines. To precisely measure transverse position of electron beam in the Indus-2 storage ring, 56 Beam Position Indicators (BPI) will be installed in INDUS-2 machine. Out of 56 Beam Position Indicators 40 are of individual type whereas 16 are integrated with dipole vacuum chamber. The Beam Position Indicators are required to be calibrated before they can be installed. The calibration is done to determine electrical offset with respect to defined mechanical centre, to determine displacement sensitivities as well as non linearity's of BPI. Ideally when beam passes through the geometrical center of BPI's, all electrodes should have same signal strength. However due to different capacitance of electrodes and offset and drift in electronics, the electrical centre (mechanical x, y where all electrodes shows same signal strength) differs from mechanical centre of BPI. A fully automatic calibration system has been developed to carry out the calibration of Beam Position Indicators. A calibration software has been developed which has necessary utilities to process and display calibration data and results. This paper describes the calibration results of Indus-2 BPM. (author)

  2. Dimensionality reduction of quality of life indicators

    Directory of Open Access Journals (Sweden)

    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”.

  3. Quality factor of aberrated gaussian laser beams

    CSIR Research Space (South Africa)

    Mafusire, C

    2010-09-01

    Full Text Available 15 20 25 30 35 M 4 © CSIR 2010 www.csir.co.za Conclusion • Laser beam quality depends on - y-Astigmatism - y-Coma - x-Coma - y-Triangular astigmatism - x-Triangular astigmatism - Spherical aberration...

  4. Longitudinal Beam measurements at the LHC: The LHC Beam Quality Monitor

    CERN Document Server

    Papotti, G; Follin, F; Wehrle, U

    2011-01-01

    The LHC Beam Quality Monitor is a system that measures individual bunch lengths and positions, similarly to the twin system SPS Beam Quality Monitor, from which it was derived. The pattern verification that the system provides is vital during the injection process to verify the correctness of the injected pattern, while the bunch length measurement is fed back to control the longitudinal emittance blow up performed during the energy ramp and provides a general indication of the health of the RF system. The algorithms used, the hardware implementation and the system integration in the LHC control infrastructure are presented in this paper, along with possible improvements.

  5. 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

  6. 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

  7. 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 ...

  8. Selecting clinical quality indicators for laboratory medicine.

    Science.gov (United States)

    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.

  9. High quality electron beams from a laser wakefield accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Wiggins, S M; Issac, R C; Welsh, G H; Brunetti, E; Shanks, R P; Anania, M P; Cipiccia, S; Manahan, G G; Aniculaesei, C; Ersfeld, B; Islam, M R; Burgess, R T L; Vieux, G; Jaroszynski, D A [SUPA, Department of Physics, University of Strathclyde, Glasgow (United Kingdom); Gillespie, W A [SUPA, Division of Electronic Engineering and Physics, University of Dundee, Dundee (United Kingdom); MacLeod, A M [School of Computing and Creative Technologies, University of Abertay Dundee, Dundee (United Kingdom); Van der Geer, S B; De Loos, M J, E-mail: m.wiggins@phys.strath.ac.u [Pulsar Physics, Burghstraat 47, 5614 BC Eindhoven (Netherlands)

    2010-12-15

    High quality electron beams have been produced in a laser-plasma accelerator driven by femtosecond laser pulses with a peak power of 26 TW. Electrons are produced with an energy up to 150 MeV from the 2 mm gas jet accelerator and the measured rms relative energy spread is less than 1%. Shot-to-shot stability in the central energy is 3%. Pepper-pot measurements have shown that the normalized transverse emittance is {approx}1{pi} mm mrad while the beam charge is in the range 2-10 pC. The generation of high quality electron beams is understood from simulations accounting for beam loading of the wakefield accelerating structure. Experiments and self-consistent simulations indicate that the beam peak current is several kiloamperes. Efficient transportation of the beam through an undulator is simulated and progress is being made towards the realization of a compact, high peak brilliance free-electron laser operating in the vacuum ultraviolet and soft x-ray wavelength ranges.

  10. Soil Quality Indicator: a new concept

    Science.gov (United States)

    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

  11. 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...

  12. Adjustment of nursing home quality indicators

    Directory of Open Access Journals (Sweden)

    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.

  13. 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,.

  14. Average spreading and beam quality evolution of Gaussian array beams propagating through oceanic turbulence

    International Nuclear Information System (INIS)

    Zhi, Dong; Chen, Yizhu; Tao, Rumao; Ma, Yanxing; Zhou, Pu; Si, Lei

    2015-01-01

    The propagation properties of a radial Gaussian beam array through oceanic turbulence are studied analytically. The analytical expressions for the average intensity and the beam quality (power-in-the-bucket (PIB) and M 2 -factor) of a radial beam array in a turbulent ocean are derived based on an account of statistical optics methods, the extended Huygens-Fresnel principle, and the second order moments of the Wigner distribution function. The influences of w, ε, and χ T on the average intensity are investigated. The array divergence increases and the laser beam spreads as the salinity-induced dominant, ε decreased, and χ T increased. Further, the analytical expression of PIB and the M 2 -factor in the target plane is obtained. The changes of PIB and the M 2 -factor with three oceanic turbulence parameters indicate that the stronger turbulence with a larger w, smaller ε, and larger χ T results in the value of PIB decreasing, the value of the M 2 -factor increasing, and the beam quality degrading. (letter)

  15. A laser beam quality definition based on induced temperature rise.

    Science.gov (United States)

    Miller, Harold C

    2012-12-17

    Laser beam quality metrics like M(2) can be used to describe the spot sizes and propagation behavior of a wide variety of non-ideal laser beams. However, for beams that have been diffracted by limiting apertures in the near-field, or those with unusual near-field profiles, the conventional metrics can lead to an inconsistent or incomplete description of far-field performance. This paper motivates an alternative laser beam quality definition that can be used with any beam. The approach uses a consideration of the intrinsic ability of a laser beam profile to heat a material. Comparisons are made with conventional beam quality metrics. An analysis on an asymmetric Gaussian beam is used to establish a connection with the invariant beam propagation ratio.

  16. 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.

  17. [Indication for mitral valve interventions: Development of a quality indicator for external hospital quality assurance].

    Science.gov (United States)

    Köster, Christina; Schorbach, Lena; Wrede, Stephanie; Meyer, Sven; Kazmaier, Tonia; Szecsenyi, Joachim

    2017-11-01

    The indication for a mitral valve intervention is an important patient-relevant parameter for the assessment of process quality and the comparison of healthcare providers. In this article, we describe the development of a corresponding quality indicator for an external hospital quality assurance (QA) procedure in Germany. An expert panel was set up by the aQua Institute to assist with the development of a QA procedure for mitral valve interventions and the associated quality indicators. In a comprehensive, systematic literature and evidence research, the American and European guidelines were identified as the best evidence available. Especially the more current American guideline formed the basis on which a quality indicator dealing with the correct indication for a mitral valve intervention was developed. The developed quality indicator assesses the proportion of patients for whom an indication for a mitral valve intervention was determined in compliance with guideline recommendations. The indicator differentiates between surgical and catheter-based procedures. To determine whether or not the indication was correct, different medical parameters are included, such as, for example, type of mitral valve defect, etiology of the disease, severity of symptoms, valve morphology (e. g., mitral valve area), valve hemodynamics and comorbidity, which healthcare providers have to document. The documentation for the developed quality indicator is considerable. Nonetheless, its relevance is undeniable because it allows the user to determine whether a surgical or catheter-based mitral valve intervention was necessary and performed according to guideline recommendations. In the first year of its implementation, this indicator should be evaluated for further improvement and simplification of assessment. Copyright © 2017. Published by Elsevier GmbH.

  18. Using Target Ablation for Ion Beam Quality Improvement

    International Nuclear Information System (INIS)

    Zhao Shuan; Chen Jia-Er; Lin Chen; Ma Wen-Jun; Yan Xue-Qing; Wang Jun-Jie

    2016-01-01

    During the laser foil interaction, the output ion beam quality including the energy spread and beam divergence can be improved by the target ablation, due to the direct laser acceleration (DLA) electrons generated in the ablation plasma. The acceleration field established at the target rear by these electrons, which is highly directional and triangle-envelope, is helpful for the beam quality. With the help of the target ablation, both the beam divergence and energy spread will be reduced. If the ablation is more sufficient, the impact of DLA-electron-caused field will be strengthened, and the beam quality will be better, confirmed by the particle-in-cell simulation. (paper)

  19. 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

  20. Minimal requirements for quality controls in radiotherapy with external beams

    International Nuclear Information System (INIS)

    1999-01-01

    Physical dosimetric guidelines have been developed by the Italian National Institute of Health study group on quality assurance in radiotherapy to define protocols for quality controls in external beam radiotherapy. While the document does not determine strict rules or firm recommendations, it suggests minimal requirements for quality controls necessary to guarantee an adequate degree of accuracy in external beam radiotherapy [it

  1. 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

  2. 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.

  3. Evaluation of diet quality indicators in adults

    Directory of Open Access Journals (Sweden)

    Katarína Fatrcová-Šramková

    2013-11-01

    Full Text Available 96 800x600 Normal 0 false false false CS JA X-NONE Several indices evaluate the quality of diet. The indices are based on nutrient requirements and dietary guidelines for the prevention of chronic diseases (to reduce the risk of chronic diseases. The Healthy Eating Index, Healthy Diet Indicator, and Diet Quality Index consist of components, which represent different aspects of a healthy diet. The indicators of diet quality are based on dietary intake data from 24-hour dietary recalls.  The aim of the research was to evaluate the nutrition of adults according to the selected criteria of three diet quality indicators: Healthy Eating Index, Healthy Diet Indicator, Diet Quality Index. 234 nutrition daily records were evaluated (from 78 probands per 3 days. Nutritional intake and blood biochemical parameters were defined in 56 females and 22 men (72% and 28% respectively aged from 24 to 62 years. The nutritional software Alimenta 4.3e (Food Research Institute, Bratislava, Slovakia, 2004 was used to calculate the nutrient intake. The evaluation of nutrition intake was focused on four parameters/recommendations of the Healthy Eating Index (to reduce total fat intake to 30% or less of energy, to reduce saturated fatty acid intake to less than 10% of energy, to reduce cholesterol intake to less than 300 mg daily, to limit total daily intake of sodium to 2400 mg or less, on five parameters/recommendations of the Healthy Diet Indicator (saturated fatty acids 0-10% of energy intake, polyunsaturated fatty acids 3-7% of energy intake, protein 10-15% of energy intake, dietary fiber 27-40 g, cholesterol 0-300 mg, on five parameters/recommendations of the Diet Quality Index (to reduce total fat intake to 30% or less of energy, to reduce saturated fatty acid intake to less than 10% of energy, to reduce cholesterol intake to less than 300 mg daily, to limit total daily intake of sodium to 2400 mg or less, to maintain adequate calcium intake – approximately

  4. Performance Indicators of Indoor Environmental Quality (IEQ ...

    African Journals Online (AJOL)

    Sultan

    environmental framework for the promotion of a healthy and comfortable ... (n.d.) consists of six metrics namely: Indoor air quality (IAQ) ..... Quality. Thermal quality measurement in the hospital ...... article/pii/S036013231300142X. Jensen, K.

  5. 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.

  6. Summary Of Session 4: How Do We Monitor Beam Quality?

    Energy Technology Data Exchange (ETDEWEB)

    Karantzoulis, E

    2001-07-01

    Up to the end of the 80's beam quality was mainly believed to be connected only to the intensity i.e. beam quantity. However, with the new colliders already functioning or programmed, new and more (also in safety) demanding production machines (e.g. isotope) and the many new 3rd generation synchrotron radiation sources that accommodate many experimental lines, the beam quality (BQ) issue has to be re-examined, re-evaluated and re-defined. (author)

  7. Summary Of Session 4: How Do We Monitor Beam Quality?

    Energy Technology Data Exchange (ETDEWEB)

    Karantzoulis, E

    2001-07-01

    Up to the end of the 80's beam quality was mainly believed to be connected only to the intensity i.e. beam quantity. However, with the new colliders already functioning or programmed, new and more (also in safety) demanding production machines (e.g. isotope) and the many new 3rd generation synchrotron radiation sources that accommodate many experimental lines, the beam quality (BQ) issue has to be re-examined, re-evaluated and re-defined. (author)

  8. Summary Of Session 4: How Do We Monitor Beam Quality?

    International Nuclear Information System (INIS)

    Karantzoulis, E.

    2001-01-01

    Up to the end of the 80's beam quality was mainly believed to be connected only to the intensity i.e. beam quantity. However, with the new colliders already functioning or programmed, new and more (also in safety) demanding production machines (e.g. isotope) and the many new 3rd generation synchrotron radiation sources that accommodate many experimental lines, the beam quality (BQ) issue has to be re-examined, re-evaluated and re-defined. (author)

  9. Measuring Beam Quality of Hollow Core Photonic Crystal Fibers

    DEFF Research Database (Denmark)

    Shephard, J.D.; Roberts, John; Jones, J.D.C.

    2006-01-01

    In this paper, the authors measure the quality of the delivered beam from hollow core photonic crystal fibers (HC-PCFs). The$M^2$parameter is determined, and the near- to far-field transition is examined. The influence on these properties due to the presence of a core surround mode is evaluated.......17 for the same output beam. This highlights the need for careful consideration when measuring and describing the beam quality delivered by these novel photonic fibers....

  10. Saturne II: characteristics of the proton beam, field qualities and corrections, acceleration of the polarized protons

    International Nuclear Information System (INIS)

    Laclare, J.-L.

    1978-01-01

    Indicated specifications of Saturne II are summed up: performance of the injection system, quality of the guidance field (magnetic measurements and multipolar corrections), transverse and longitudinal instabilities, characteristics of the beam stored in the machine and of the extracted beam. The problem of depolarization along the acceleration cycle is briefly discussed (1 or 2% between injection and 3 GeV) [fr

  11. Analytical quality, performance indices and laboratory service

    DEFF Research Database (Denmark)

    Hilden, Jørgen; Magid, Erik

    1999-01-01

    analytical error, bias, cost effectiveness, decision-making, laboratory techniques and procedures, mass screening, models, statistical, quality control......analytical error, bias, cost effectiveness, decision-making, laboratory techniques and procedures, mass screening, models, statistical, quality control...

  12. Numerical determination of injector design for high beam quality

    International Nuclear Information System (INIS)

    Boyd, J.K.

    1985-01-01

    The performance of a free electron laser strongly depends on the electron beam quality or brightness. The electron beam is transported into the free electron laser after it has been accelerated to the desired energy. Typically the maximum beam brightness produced by an accelerator is constrained by the beam brightness deliverd by the accelerator injector. Thus it is important to design the accelerator injector to yield the required electron beam brightness. The DPC (Darwin Particle Code) computer code has been written to numerically model accelerator injectors. DPC solves for the transport of a beam from emission through acceleration up to the full energy of the injector. The relativistic force equation is solved to determine particle orbits. Field equations are solved for self consistent electric and magnetic fields in the Darwin approximation. DPC has been used to investigate the beam quality consequences of A-K gap, accelerating stress, electrode configuration and axial magnetic field profile

  13. Indications for quality assurance in conformal radiotherapy in Italy

    International Nuclear Information System (INIS)

    Banci Buonamici, F.; DE Angelis, C.; Rosi, A.; Tabocchini, M.A.; Iotti, C.; Olmi, P.

    2008-01-01

    Intensity-Modulated Radiation Therapy (IMRT) is an advanced and promising technique of external beam irradiation. IMRT is able to conform the dose distribution to the 3D tumour shape also for complex geometries, preserving surrounding normal tissues and reducing the probability of side effects. IMRT is a time consuming and complex technique and its use demands high level quality assurance. It is, therefore, very important to define conditions for its utilization. Professionals of Radiotherapy Centres, with experience in the IMRT use, have constituted a multidisciplinary working group with the aim of developing indications in this field. Purpose of the present document is to highlight relevant aspects of the technique, but also to underline the high complexity of the technique, whose implementation requires extreme attention of the staff of Radiotherapy Centres involved [it

  14. Measuring educational quality by means of indicators

    NARCIS (Netherlands)

    Scheerens, Jaap; Scheerens, J; Luyten, H.; van Ravens, J.

    2011-01-01

    In this chapter the input-process-outcomes-context framework, introduced in Chapter 1 is used for categorising and describing input indicators, process indicators, outcome indicators and context indicators. The chapter starts out with a review and further illustration of this framework and follows

  15. Quality Indicators and Outcomes of Emergency Caesarean ...

    African Journals Online (AJOL)

    Uterine rupture and cesarean hysterectomy were associated with an outcome of neonatal death (p<0.001). Infrastructure and personnel limitations are major barriers to the improvement of quality of cesarean deliveries. Future endeavors towards quality improvement must address these deficiencies. (Afr J Reprod Health ...

  16. Quality indicators for hip fracture care, a systematic review.

    Science.gov (United States)

    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.

  17. Influence of mode competition on beam quality of fiber amplifier

    International Nuclear Information System (INIS)

    Xiao Qi-Rong; Yan Ping; Sun Jun-Yi; Chen Xiao; Ren Hai-Cui; Gong Ma-Li

    2014-01-01

    Theoretical and experimental studies of the influence of the mode competition on the output beam quality of fiber amplifiers are presented. Rate equations and modal decomposition method are used in the theoretical model. In the experiment, the output beam-quality factor of a fiber amplifier, which is based on a Yb-doped double-clad large mode area fiber as a function of the seed beam quality and the pump power of the amplifier, is measured. The experimental results are consistent with the theoretical analysis. (electromagnetism, optics, acoustics, heat transfer, classical mechanics, and fluid dynamics)

  18. Quality Indicators and Outcomes of Emergency Caesarean ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    personnel limitations are major barriers to the improvement of quality of cesarean deliveries. Future endeavors towards ..... order to address this problem, medication supply chains must be improved on a national and local level and improved ...

  19. Using time series for the statistical monitoring of spectral quality index of electron beams for clinical use; Uso de series temporales para el control estadistico del indice de calidad espectral de haces de electrones para uso clinico

    Energy Technology Data Exchange (ETDEWEB)

    Martinez-Luna, R. J.; Vega, J. M. de la; Vilches, M.; Guirado, D.; Zamora, L. I.; Lallena, A. M.

    2011-07-01

    Using the techniques of statistical process control (SPC) keeps track of the variable that controls the stability of the spectrum of electron beam accelerators in clinical use. In this process, applied since 1995, we obtained a high number of false alarms. Our work shows that this unexpected behavior appears to treat the variable of interest as a normal random variable, independent and identically distributed (iid), when in fact the observations of this variable are positively correlated with each other. (Author)

  20. Cone Beam CT vs. Fan Beam CT: A Comparison of Image Quality and Dose Delivered Between Two Differing CT Imaging Modalities.

    Science.gov (United States)

    Lechuga, Lawrence; Weidlich, Georg A

    2016-09-12

    A comparison of image quality and dose delivered between two differing computed tomography (CT) imaging modalities-fan beam and cone beam-was performed. A literature review of quantitative analyses for various image quality aspects such as uniformity, signal-to-noise ratio, artifact presence, spatial resolution, modulation transfer function (MTF), and low contrast resolution was generated. With these aspects quantified, cone beam computed tomography (CBCT) shows a superior spatial resolution to that of fan beam, while fan beam shows a greater ability to produce clear and anatomically correct images with better soft tissue differentiation. The results indicate that fan beam CT produces superior images to that of on-board imaging (OBI) cone beam CT systems, while providing a considerably less dose to the patient.

  1. 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.

  2. On beam quality and stopping power ratios for high-energy x-rays

    International Nuclear Information System (INIS)

    Johnsson, S.A.; Ceberg, C.P.; Knoeoes, T.; Nilsson, P.

    2000-01-01

    The aim of this work is to quantitatively compare two commonly used beam quality indices, TPR(20/10) and %dd(10) x , with respect to their ability to predict stopping power ratios (water to air), s w,air , for high-energy x-rays. In particular, effects due to a varied amount of filtration of the photon beam will be studied. A new method for characterizing beam quality is also presented, where the information we strive to obtain is the moments of the spectral distribution. We will show how the moments enter into a general description of the transmission curve and that it is possible to correlate the moments to s w,air with a unique and simple relationship. Comparisons with TPR(20/10) and %dd(10) x show that the moments are well suited for beam quality specification in terms of choosing the correct s w,air . (author)

  3. Quality correction factors of composite IMRT beam deliveries: Theoretical considerations

    International Nuclear Information System (INIS)

    Bouchard, Hugo

    2012-01-01

    Purpose: In the scope of intensity modulated radiation therapy (IMRT) dosimetry using ionization chambers, quality correction factors of plan-class-specific reference (PCSR) fields are theoretically investigated. The symmetry of the problem is studied to provide recommendable criteria for composite beam deliveries where correction factors are minimal and also to establish a theoretical limit for PCSR delivery k Q factors. Methods: The concept of virtual symmetric collapsed (VSC) beam, being associated to a given modulated composite delivery, is defined in the scope of this investigation. Under symmetrical measurement conditions, any composite delivery has the property of having a k Q factor identical to its associated VSC beam. Using this concept of VSC, a fundamental property of IMRT k Q factors is demonstrated in the form of a theorem. The sensitivity to the conditions required by the theorem is thoroughly examined. Results: The theorem states that if a composite modulated beam delivery produces a uniform dose distribution in a volume V cyl which is symmetric with the cylindrical delivery and all beams fulfills two conditions in V cyl : (1) the dose modulation function is unchanged along the beam axis, and (2) the dose gradient in the beam direction is constant for a given lateral position; then its associated VSC beam produces no lateral dose gradient in V cyl , no matter what beam modulation or gantry angles are being used. The examination of the conditions required by the theorem lead to the following results. The effect of the depth-dose gradient not being perfectly constant with depth on the VSC beam lateral dose gradient is found negligible. The effect of the dose modulation function being degraded with depth on the VSC beam lateral dose gradient is found to be only related to scatter and beam hardening, as the theorem holds also for diverging beams. Conclusions: The use of the symmetry of the problem in the present paper leads to a valuable theorem showing

  4. The SPS Beam quality monitor, from design to operation

    CERN Document Server

    Papotti, G; Follin, F; Shaposhnikova, E

    2011-01-01

    The SPS Beam Quality Monitor is a system that monitors longitudinal beam parameters on a cycle-by-cycle basis and prevents extraction to the LHC in case the specifications are not met. This avoids losses, unnecessary stress of machine protection components and luminosity degradation, additionally helping efficiency during the filling process. The system has been operational since the 2009 LHC run, checking the beam pattern, its correct position with respect to the LHC references, individual bunch lengths and stability. In this paper the algorithms used, the hardware implementation and the operational aspects are presented.

  5. Measurement system with high accuracy for laser beam quality.

    Science.gov (United States)

    Ke, Yi; Zeng, Ciling; Xie, Peiyuan; Jiang, Qingshan; Liang, Ke; Yang, Zhenyu; Zhao, Ming

    2015-05-20

    Presently, most of the laser beam quality measurement system collimates the optical path manually with low efficiency and low repeatability. To solve these problems, this paper proposed a new collimated method to improve the reliability and accuracy of the measurement results. The system accuracy controlled the position of the mirror to change laser beam propagation direction, which can realize the beam perpendicularly incident to the photosurface of camera. The experiment results show that the proposed system has good repeatability and the measuring deviation of M2 factor is less than 0.6%.

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

    Science.gov (United States)

    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.

  7. LHC Injection Beam Quality During LHC Run I

    CERN Document Server

    AUTHOR|(CDS)2079186; Kain, Verena; Stapnes, Steinar

    The LHC at CERN was designed to accelerate proton beams from 450 GeV to 7 TeV and collide them in four large experiments. The 450 GeV beam is extracted from the last pre-accelerator, the SPS, and injected into the LHC via two 3 km long transfer lines, TI 2 and TI 8. The injection process is critical in terms of preservation of beam quality and machine protection. During LHC Run I (2009-2013) the LHC was filled with twelve high intensity injections per ring, in batches of up to 144 bunches of 1.7*10^11 protons per bunch. The stored beam energy of such a batch is already an order of magnitude above the damage level of accelerator equipment. Strict quality and machine protection requirements at injection have a significant impact on operational efficiency. During the first years of LHC operation, the injection phase was identified as one of the limiting factors for fast LHC turnaround time. The LHC Injection Quality Check (IQC) software framework was developed as a part of this thesis to monitor the beam quality...

  8. Radiation quality of beams of negative pions

    International Nuclear Information System (INIS)

    Dicello, J.F.; Brenner, D.J.

    1981-01-01

    As a negative pion stops in tissue, it attaches itself to an adjacent atom to form a mesonic atom. Subsequently, the wave function of the pion interacts with that of the nucleus and the pion is absorbed. Because the energy associated with the rest mass of the pion is greater than the separation energy of the nuclear particles, the nucleus disintegrates (pion star). In tissue, approximately 40 MeV goes into overcoming the binding energies; 20 MeV goes into kinetic energy of charged particles; 80 MeV goes into kinetic energy of neutrons. In cases where biological studies are performed with beams of negative pions, as much as 20% of the total absorbed dose in the treatment volume and about 50% of the high-LET dose (> 100 keV/μm) can result from neutrons. The degree of biological response and the variation of that response throughout the treatment volume can be altered by the neutron dose

  9. 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.

  10. Comparison between TG-51 and TRS-398: electron contamination effect on photon beam-quality specification

    International Nuclear Information System (INIS)

    Medina, Antonio Lopez; Teijeiro, Antonio; Salvador, Francisco; Medal, Daniela; Vazquez, Julio; Salgado, Manuel; Carrion, MarIa C

    2004-01-01

    Two dosimetry protocols based on absorbed dose to water have recently been implemented: TG-51 and TRS-398. These protocols use different beam-quality indices. The effect of electron contamination in measurements of %dd(10) x has been proposed as a disadvantage of the TG-51. For actual measurements of %dd(10) x in five clinical beams ) a purging magnet was employed to remove the electron contamination. Also, %dd(10) x was measured in the different ways described in TG-51 for high-energy beams: with a lead foil at 50 cm from the phantom surface, at 30 cm, and for open beam. Moreover, TPR 20,10 was determined. Also, periodic quality-control measurements were used for comparing both quality indices and variation over time, but D 20,10 was used instead of TPR 20,10 and measurements in open beam for the %dd(10) x determination. Considering both protocols, S w,air and k Q were calculated in order to compare the results with the experimental data. Significant differences (0.3% for k Q ) were only found for the two high-energy beams, but when the electron contamination is underestimated by TG-51, the difference in k Q is lower. Differences in the other cases and variations over time were less than 0.1%

  11. Calculation of beam quality correction factor using Monte Carlo simulation

    International Nuclear Information System (INIS)

    Kawachi, T.; Saitoh, H.; Myojoyama, A.; Katayose, T.; Kojima, T.; Fukuda, K.; Inoue, M.

    2005-01-01

    In recent years, a number of the CyberKnife systems (Accuray C., U.S.) have been increasing significantly. However, the CyberKnife has unique treatment head structure and beam collimating system. Therefore, the global standard protocols can not be adopted for absolute absorbed dose dosimetry in CyberKnife beam. In this work, the energy spectrum of photon and electron from CyberKnife treatment head at 80 cm SSD and several depths in water are simulated with conscientious geometry using by the EGS Monte Carlo method. Furthermore, for calculation of the beam quality correction factor k Q , the mean restricted mass stopping power and the mass energy absorption coefficient of air, water and several chamber wall and waterproofing sleeve materials are calculated. As a result, the factors k Q CyberKnife beam for several ionization chambers are determined. And the relationship between the beam quality index PDD(10) x in CyberKnife beam and k Q is described in this report. (author)

  12. [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.

  13. 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.

  14. An environmental scan of quality indicators in critical care.

    Science.gov (United States)

    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.

  15. 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.

  16. Internet quality indicators for health professional agencies and associations.

    Science.gov (United States)

    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.

  17. Measures and Indicators of Vgi Quality: AN Overview

    Science.gov (United States)

    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.

  18. MEASURES AND INDICATORS OF VGI QUALITY: AN OVERVIEW

    Directory of Open Access Journals (Sweden)

    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.

  19. Image quality of cone beam CT on respiratory motion

    International Nuclear Information System (INIS)

    Zhang Ke; Li Minghui; Dai Jianrong; Wang Shi

    2011-01-01

    In this study,the influence of respiratory motion on Cone Beam CT (CBCT) image quality was investigated by a motion simulating platform, an image quality phantom, and a kV X-ray CBCT. A total of 21 motion states in the superior-inferior direction and the anterior-posterior direction, separately or together, was simulated by considering different respiration amplitudes, periods and hysteresis. The influence of motion on CBCT image quality was evaluated with the quality indexes of low contrast visibility, geometric accuracy, spatial resolution and uniformity of CT values. The results showed that the quality indexes were affected by the motion more prominently in AP direction than in SI direction, and the image quality was affected by the respiration amplitude more prominently than the respiration period and the hysteresis. The CBCT image quality and its characteristics influenced by the respiration motion, and may be exploited in finding solutions. (authors)

  20. 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...

  1. 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.

  2. Present status of high quality beam facility at Waseda University

    International Nuclear Information System (INIS)

    Washio, M.; Kawai, H.; Hama, Y.; Kudo, N.; Kobayashi, M.; Kuribayasi, T.; Kawaguchi, M.; Kuroda, R.; Maeda, K.; Nagasawa, F.; Ueyama, D.; Hizume, K.; Wang, X.J.; Hayano, H.; Urakawa, J.; Kashiwagi, S.

    2004-01-01

    A research project named High-Tech Research Center Project has been conducted at Waseda University. In this project, an RF gun system has been used for production of low emittance and short bunched electron beam. The experiments for the electron beam quality measurement have been carried out by slit scan techniques, etc. Short pulsed x-ray with the energy range of so-called water window has been generation by the inverse compton scattering. Further, the pulse radiolysis system has been constructed, and the stroboscopic pulse radiolysis has been applied for the detection of hydrated electron in picosecond time region. (author)

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

    Data.gov (United States)

    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...

  4. 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

  5. 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.

  6. 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)

  7. 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.

  8. Quality Indicators for Global Benchmarking of Localized Prostate Cancer Management.

    Science.gov (United States)

    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.

  9. 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 ...

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

    Science.gov (United States)

    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.

  11. Postharvest quality of cut roses following electron-beam irradiation

    International Nuclear Information System (INIS)

    Chang, A.Y.; Gladon, R.J.; Gleason, M.L.; Parker, S.K.; Agnew, N.H.; Olson, D.G.

    1997-01-01

    Cut Rosa x hybrida L. 'Royalty' flowers were used to determine the efficacy of electron-beam irradiation for increasing postharvest quality and decreasing petal infection by Botrytis cinerea Pers. In an experiment for determining the injury threshold, roses received electron-beam irradiation of 0, 0.5, 1, 2, and 4 kGy. Irradiation dosages greater than or equal to 4 kGy caused necrosis on petal tissue and decreased postharvest life at 20 degrees C. In a second experiment to evaluate postharvest quality, roses were irradiated at 0, 0.25, 0.5, 0.75, and 1 kGy. Dosages of 0.25 and 0.5 kGy slowed the rate of flower bud opening for 2 days but did not decrease postharvest quality when compared with nonirradiated roses. Roses that received irradiation dosages of 0.75 and 1 kGy showed unacceptable quality. In a third experiment, roses that had or had not been inoculated with B. cinerea were irradiated at 0, 0.25, 0.5, and 0.75 kGy. Irradiation did not control B. cinerea populations, and rose quality decreased as dosage increased. In a fourth experiment to determine the effect of irradiation on B. cinerea, conidia on water-agar plates exposed to dosages less than or equal to 1, 2, and 4 kGy germinated at rates of approximately 90%, 33%, and 2%, respectively, within 24 h

  12. Comparison of photon beam qualities for treatment of deep seated tumours

    International Nuclear Information System (INIS)

    Ssengabi, J.

    1977-06-01

    Physical parameters that influence the quality of photon beams have been examined. The interaction of photon beams of different qualities from cobolt-60 gamma rays to 42 MV X-rays, with a patient-target region system has been investigated with a view to compare the photon beam qualities under specified irradiation conditions. The concept of integral dose and its use in photon beam intercomparison has been investigated. The results of the study have shown the inadequacy of a single beam parameter, such as the central axis depth dose data, in the intercomparison of photon beam qualities for the treatment of deep seated tumours. (author)

  13. X-ray beam qualities for dental radiology purposes

    International Nuclear Information System (INIS)

    Santos, Marcus Aurelio P. dos; Fragoso, Maria da Conceicao de F.; Lima, Ricardo de A.; Hazim, Clovis A.

    2009-01-01

    In order to establish characteristics or properties of equipment for diagnostic radiology, e.g. ion chambers and semiconductor detectors, calibration laboratories offer a set of well-defined radiation conditions, called X-ray qualities, which can be used for many Physics studies and medical purposes. The standardization of radiation qualities has been carried out in several fields of study, but little attention has been given to the area of dental radiology, mainly for medical and physical applications using single-phase units with half-wave rectification. For this reason, a single-phase dental unit with adjustable peak voltage and tube current, called 'variable potential X-ray equipment', was developed aiming to define X-ray beam qualities for test and calibrations purposes. X-ray spectra at 50, 60 and 70 kVp were determined by using a CdTe detector and compared with those obtained for ten commercial X-ray dental units. As a result of this study, a set of X-ray qualities for the variable potential X-ray equipment was determined. The X-ray qualities spectra were utilized as reference for determination of a new set of X-ray qualities characterized for a constant potential X-ray equipment. Thus, sets of X-ray qualities were standardized and implemented in two X-ray laboratories: one with the variable potential X-ray equipment and other with constant potential X-ray equipment. These reference X-ray beam qualities should be used for test and calibration purposes involving scientific studies and services. (author)

  14. 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...

  15. Framework and indicator testing protocol for developing and piloting quality indicators for the UK quality and outcomes framework

    Directory of Open Access Journals (Sweden)

    Burke Martyn

    2011-08-01

    Full Text Available Abstract Background Quality measures should be subjected to a testing protocol before being used in practice using key attributes such as acceptability, feasibility and reliability, as well as identifying issues derived from actual implementation and unintended consequences. We describe the methodologies and results of an indicator testing protocol (ITP using data from proposed quality indicators for the United Kingdom Quality and Outcomes Framework (QOF. Methods The indicator testing protocol involved a multi-step and methodological process: 1 The RAND/UCLA Appropriateness Method, to test clarity and necessity, 2 data extraction from patients' medical records, to test technical feasibility and reliability, 3 diaries, to test workload, 4 cost-effectiveness modelling, and 5 semi-structured interviews, to test acceptability, implementation issues and unintended consequences. Testing was conducted in a sample of representative family practices in England. These methods were combined into an overall recommendation for each tested indicator. Results Using an indicator testing protocol as part of piloting was seen as a valuable way of testing potential indicators in 'real world' settings. Pilot 1 (October 2009-March 2010 involved thirteen indicators across six clinical domains and twelve indicators passed the indicator testing protocol. However, the indicator testing protocol identified a number of implementation issues and unintended consequences that can be rectified or removed prior to national roll out. A palliative care indicator is used as an exemplar of the value of piloting using a multiple attribute indicator testing protocol - while technically feasible and reliable, it was unacceptable to practice staff and raised concerns about potentially causing actual patient harm. Conclusions This indicator testing protocol is one example of a protocol that may be useful in assessing potential quality indicators when adapted to specific country health

  16. Measuring mode indices of a partially coherent vortex beam with Hanbury Brown and Twiss type experiment

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Ruifeng; Wang, Feiran; Chen, Dongxu; Wang, Yunlong; Zhou, Yu; Gao, Hong; Zhang, Pei, E-mail: zhangpei@mail.ustc.edu.cn; Li, Fuli [Key Laboratory of Quantum Information and Quantum Optoelectronic Devices, Shaanxi Province, Xi' an Jiaotong University, Xi' an 710049 (China)

    2016-02-01

    It is known that the cross-correlation function (CCF) of a partially coherent vortex (PCV) beam shows a robust link with the radial and azimuthal mode indices. However, the previous proposals are difficult to measure the CCF in practical systems, especially in the case of astronomical objects. In this letter, we demonstrate experimentally that the Hanbury Brown and Twiss effect can be used to measure the mode indices of the original vortex beam and investigate the relationship between the spatial coherent width and the characterization of CCF of the PCV beam. The technique we exploit is quite efficient and robust, and it may be useful in the field of free space communication and astronomy which are related to the photon's orbital angular momentum.

  17. Measuring mode indices of a partially coherent vortex beam with Hanbury Brown and Twiss type experiment

    International Nuclear Information System (INIS)

    Liu, Ruifeng; Wang, Feiran; Chen, Dongxu; Wang, Yunlong; Zhou, Yu; Gao, Hong; Zhang, Pei; Li, Fuli

    2016-01-01

    It is known that the cross-correlation function (CCF) of a partially coherent vortex (PCV) beam shows a robust link with the radial and azimuthal mode indices. However, the previous proposals are difficult to measure the CCF in practical systems, especially in the case of astronomical objects. In this letter, we demonstrate experimentally that the Hanbury Brown and Twiss effect can be used to measure the mode indices of the original vortex beam and investigate the relationship between the spatial coherent width and the characterization of CCF of the PCV beam. The technique we exploit is quite efficient and robust, and it may be useful in the field of free space communication and astronomy which are related to the photon's orbital angular momentum

  18. Water quality index and eutrophication indices of Caiabi River, MT

    Directory of Open Access Journals (Sweden)

    Grasiane Andrietti

    2016-03-01

    Full Text Available The objective of this study was to evaluate the water quality of the Caiabi River based upon the water quality index (WQI and the trophic state index (TSI, considering seasonal and spatial variations, with the aim of determining the most appropriate monitoring design for this study site. Sampling for water quality monitoring was conducted at five points on the Caiabi River from July 2012 to June 2013. Quality parameters quantified were as follows: pH, temperature, conductivity, dissolved oxygen, total and thermotolerant coliforms, turbidity, Kjeldahl nitrogen, nitrite, nitrate, total phosphorus, biochemical oxygen demand, series of solids, and chlorophyll a. Sampling procedures and analysis followed the methods recommended by the Standard Methods for the Examination of Water and Wastewater. The WQI results showed that the quality of the Caiabi River water is good. TSI results demonstrated the low risk of eutrophication in the Caiabi River, indicating an ultra-oligotrophic lotic environment. Analysis of variance showed that 10 of the 16 monitored quality parameters presented differences of means between the dry and rainy seasons or among the monitored points or in the interaction between seasons and points. These results indicate that two annual sampling collections at two points may be sufficient to describe the water quality behavior in the basin, as long as the conditions of land use are stable.

  19. Experimental determination of beam quality conversion factors kQ in clinical photon beams using ferrous sulphate (Fricke) dosimetry

    International Nuclear Information System (INIS)

    Palm, A.; Mattsson, Olof

    2002-01-01

    The implementation of protocols based on absorbed dose to water standards requires beam quality conversion factors, k Q . Calculated values of k Q are available for ionization chambers used for reference dosimetry. Ideally, k Q should be experimentally determined at the same beam qualities as that of the user. In this work we measure k Q factors in clinical photon beams and compare them with calculated and measured values. Beam quality conversion factors are determined for clinical photon beams of nominal energies 4 MV, 6 MV, 15 MV, and 25 MV, for commonly used cylindrical ionization chambers. Twelve chambers of eight different types are used. For three of them, no experimental data have previously been available. The experimental procedure is based on measurements with ionization chambers and Fricke dosimetry in the reference beam ( 60 Co γ radiation) and in clinical linear accelerator beams. The k Q values determined in this work generally agree within 0.5% with previously reported experimental values both when %dd(10) x and TPR 20,10 are used for beam quality specification. The agreement with calculated data is generally within 0.5%, except for the 15 MV beam. For this beam the measured values are usually between 0.5% and 1% lower than the data taken from the TG-51 protocol or the TRS-398 code of practice. For three NE2571 chambers and three NE2581 chambers, the maximum observed deviation of individual k Q values is 0.2% and 0.4%, respectively

  20. 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.

  1. 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.

  2. 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

  3. ISTC projects devoted to improving laser beam quality

    Science.gov (United States)

    Malakhov, Yu. I.

    2007-05-01

    Short overview is done about the activity of ISTC in a direction concerned with improving powerful laser beam quality by means of nonlinear and linear adaptive optics methods. Completed projects #0591 and #1929 resulted in the development of a stimulated Brillouin scattering (SBS) phase conjugation mirror of superhigh fidelity employing the kinoform optical elements (rasters of small lenses) of new generation designed for pulsed or pulse-periodic lasers with nanosecond scale pulse duration. Project #2631 is devoted to development of an adaptive optical system for phase registration and correction of laser beams with wave front vortices. The principles of operation of conventional adaptive systems are based on the assumption that the phase is a smooth continuous function in space. Therefore the solution of the Project tasks will assume a new step in adaptive optics.

  4. 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

  5. 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

  6. 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)

  7. 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)

  8. 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

  9. 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....

  10. 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.

  11. Using a tandem ionization chamber for quality control of X-ray beams

    International Nuclear Information System (INIS)

    Yoshizumi, Maira T.; Caldas, Linda V.E.

    2011-01-01

    X-ray beam qualities are defined by both the mean energies and by the half-value layers (HVL). Many international protocols use the half-value layer and the beam voltage to characterize the X-ray beam quality. A quality control program for X-ray equipment includes the constancy check of beam qualities, i.e., the periodical verification of the half-value layer, which can be a time consumable procedure. A tandem ionization chamber, developed at Instituto de Pesquisas Energeticas e Nucleares, was used to determine the HVL and its constancy for five radiotherapy standard beam qualities. This ionization chamber is composed by two sensitive volumes with inner electrodes made of different materials: aluminum and graphite. The beam quality constancy check test was performed during two months and the maximum variation obtained was 1.24% for the radiation beam quality T-10. This result is very satisfactory according to national recommendations. (author)

  12. Improvement of the beam quality of a diode laser with two active broad-area segments

    DEFF Research Database (Denmark)

    Chi, Mingjun; Thestrup, B.; Mortensen, J.L.

    2003-01-01

    The beam quality of a diode laser with two active segments was improved using an external cavity with collimating optics, a grating, and an output coupler. The beam quality of the output beam, which is the first-order diffractive beam from the grating, was improved by a factor of 2, and at least...... half of the freely running power of the laser was coupled out from the external cavity. The output power can be enhanced further by the feedback from the zeroth-order beam. The possibility of improving the beam quality further is discussed and a new double-external-cavity configuration is suggested....

  13. The quality of high-energy X-ray beams

    International Nuclear Information System (INIS)

    LaRiviere, P.D.

    1989-01-01

    Supplement 17 of the British Journal of Radiology is a survey of central-axis depth doses for radiotherapy machines, patterned largely on BJR Supplement 11 (1972). Inspection of high-energy X-ray depth doses for a 10 x 10 cm field at an SSD of 100 cm disclosed large differences between the two sets of data, especially for qualities above 8 MV, e.g. a depth dose of 80% at 10 cm is rated at about 19 MV according to BJR Supplement 11, and 23 MV according to BJR Supplement 17. It was found that Supplement 17 depth-dose data above 8 MV were erratic, but Supplement 11 data could be represented by an analytical expression, providing a unique means of assigning MV quality. It was also found that dose-weighted average energy of the filtered beam plotted smoothly against depth dose. For dosimetric purposes, it is suggested that this parameter be used as a true measure of beam quality, removing discrepancies introduced by the use of nominal MV for this purpose. (author)

  14. Sterols indicate water quality and wastewater treatment efficiency.

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

  16. A quality audit program for external beam radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Hanson, W.F.; Stovall, M. [Univ. of Texas, Houston, TX (United States)

    1993-12-31

    For more than 25 years, the University of Texas M. D. Anderson Cancer Center has had a quality audit program using mailed dosimeters to verify radiation therapy machine output. Two programs, one compulsory and one voluntary, presently monitor therapy beams at more than 1000 megavoltage-therapy facilities. A successful program requires two major components: a high-precision thermoluminescent dosimeter (TLD) system and dedicated staff that interact closely with the users to resolve discrepancies. The TLD system, the logistics used, and the human interaction of these programs are described. Examples show that the programs can identify major discrepancies, exceeding 5 %, as well as discrepancies as small as 3%.

  17. A new method for improving beam quality of LINAC

    International Nuclear Information System (INIS)

    Xie Jialin; Li Fengtian; Wang Yanshan; Wang Bosi

    1999-01-01

    The principle of the self-adaptive feed-forward (SAFF) control to improve the beam quality of linac is introduced. the analytical procedure for calculating the control signals, the structure of a practical control system, and applications of SAFF in klystron, RF gun, and linac are presented, especially the application in the thermionic gun whose response is non-linear, time-variant and of large time-delay. The described control system is operational and some primary experimental results have been obtained, including the control of amplitude and phase fluctuations of the klystron output, the microwave field in the gun cavity and linac

  18. A quality audit program for external beam radiotherapy

    International Nuclear Information System (INIS)

    Hanson, W.F.; Stovall, M.

    1993-01-01

    For more than 25 years, the University of Texas M. D. Anderson Cancer Center has had a quality audit program using mailed dosimeters to verify radiation therapy machine output. Two programs, one compulsory and one voluntary, presently monitor therapy beams at more than 1000 megavoltage-therapy facilities. A successful program requires two major components: a high-precision thermoluminescent dosimeter (TLD) system and dedicated staff that interact closely with the users to resolve discrepancies. The TLD system, the logistics used, and the human interaction of these programs are described. Examples show that the programs can identify major discrepancies, exceeding 5 %, as well as discrepancies as small as 3%

  19. 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)

  20. Electron beam water calorimetry measurements to obtain beam quality conversion factors.

    Science.gov (United States)

    Muir, Bryan R; Cojocaru, Claudiu D; McEwen, Malcolm R; Ross, Carl K

    2017-10-01

    To provide results of water calorimetry and ion chamber measurements in high-energy electron beams carried out at the National Research Council Canada (NRC). There are three main aspects to this work: (a) investigation of the behavior of ionization chambers in electron beams of different energies with focus on long-term stability, (b) water calorimetry measurements to determine absorbed dose to water in high-energy beams for direct calibration of ion chambers, and (c) using measurements of chamber response relative to reference ion chambers, determination of beam quality conversion factors, k Q , for several ion chamber types. Measurements are made in electron beams with energies between 8 MeV and 22 MeV from the NRC Elekta Precise clinical linear accelerator. Ion chamber measurements are made as a function of depth for cylindrical and plane-parallel ion chambers over a period of five years to investigate the stability of ion chamber response and for indirect calibration. Water calorimetry measurements are made in 18 MeV and 22 MeV beams. An insulated enclosure with fine temperature control is used to maintain a constant temperature (drifts less than 0.1 mK/min) of the calorimeter phantom at 4°C to minimize effects from convection. Two vessels of different designs are used with calibrated thermistor probes to measure radiation induced temperature rise. The vessels are filled with high-purity water and saturated with H 2 or N 2 gas to minimize the effect of radiochemical reactions on the measured temperature rise. A set of secondary standard ion chambers are calibrated directly against the calorimeter. Finally, several other ion chambers are calibrated in the NRC 60 Co reference field and then cross-calibrated against the secondary standard chambers in electron beams to realize k Q factors. The long-term stability of the cylindrical ion chambers in electron beams is better (always <0.15%) than plane-parallel chambers (0.2% to 0.4%). Calorimetry measurements

  1. [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.

  2. 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?

  3. 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/.

  4. 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

  5. Absorbed-dose beam quality conversion factors for cylindrical chambers in high energy photon beams.

    Science.gov (United States)

    Seuntjens, J P; Ross, C K; Shortt, K R; Rogers, D W

    2000-12-01

    Recent working groups of the AAPM [Almond et al., Med. Phys. 26, 1847 (1999)] and the IAEA (Andreo et al., Draft V.7 of "An International Code of Practice for Dosimetry based on Standards of Absorbed Dose to Water," IAEA, 2000) have described guidelines to base reference dosimetry of high energy photon beams on absorbed dose to water standards. In these protocols use is made of the absorbed-dose beam quality conversion factor, kQ which scales an absorbed-dose calibration factor at the reference quality 60Co to a quality Q, and which is calculated based on state-of-the-art ion chamber theory and data. In this paper we present the measurement and analysis of beam quality conversion factors kQ for cylindrical chambers in high-energy photon beams. At least three chambers of six different types were calibrated against the Canadian primary standard for absorbed dose based on a sealed water calorimeter at 60Co [TPR10(20)=0.572, %dd(10)x=58.4], 10 MV [TPR10(20)=0.682, %dd(10)x=69.6), 20 MV (TPR10(20)=0.758, %dd(10)x= 80.5] and 30 MV [TPR10(20) = 0.794, %dd(10)x= 88.4]. The uncertainty on the calorimetric determination of kQ for a single chamber is typically 0.36% and the overall 1sigma uncertainty on a set of chambers of the same type is typically 0.45%. The maximum deviation between a measured kQ and the TG-51 protocol value is 0.8%. The overall rms deviation between measurement and the TG-51 values, based on 20 chambers at the three energies, is 0.41%. When the effect of a 1 mm PMMA waterproofing sleeve is taken into account in the calculations, the maximum deviation is 1.1% and the overall rms deviation between measurement and calculation 0.48%. When the beam is specified using TPR10(20), and measurements are compared with kQ values calculated using the version of TG-21 with corrected formalism and data, differences are up to 1.6% when no sleeve corrections are taken into account. For the NE2571 and the NE2611A chamber types, for which the most literature data are

  6. 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

  7. Air Quality Monitoring with Routine Utilization of Ion Beam Analysis

    International Nuclear Information System (INIS)

    Wegrzynek, D.

    2013-01-01

    Full text: Information on source contributions to ambient air particulate concentrations is a vital tool for air quality management. Traditional gravimetric analysis of airborne particulate matter is unable to provide information on the sources contributing to air particulate concentrations. Ion beam analysis is used to identify the elemental composition of air particulates for source apportionment and determining the relative contribution of biogenic and anthropogenic sources to air particulate pollution. The elemental composition is obtained by proton induced X-ray emission technique (PIXE), which is an ion beam analysis (IBA) technique. The element concentrations are deduced from the X ray spectra produced when the particulate collected on a filter is bombarded with a high-energy proton beam. As part of the UNDP/IAEA/RCA Project RAS/8/082 ‘Better Management of the Environment, Natural Resources and Industrial Growth through Isotope and Radiation Technology,’ a collaborative alliance was formed between the Institute of Geological and Nuclear Sciences Limited and the Wellington Regional Council, New Zeland [1]. The purpose of the project was to examine the elemental composition of air particulate matter and determine the origins through source apportionment techniques. In New Zealand PM 10 and PM 2.5 fractions have been collected at the industrial area of Seaview, Wellington over two years using a GENT stacked filter unit sampler. Concentrations of elements with atomic mass above neon were determined using ion beam analysis and elemental carbon concentrations were determined using a reflectometer. Specific ambient source elemental 'fingerprints' were then determined by factor analysis and the relative contributions of various local and regional sources were assessed. The significant factors (sources) were determined to be sea salt, soil, industry, and combustion sources. Local industry was found to contribute to ambient lead concentrations. (author)

  8. An electron beam imaging system for quality assurance in IORT

    Science.gov (United States)

    Casali, F.; Rossi, M.; Morigi, M. P.; Brancaccio, R.; Paltrinieri, E.; Bettuzzi, M.; Romani, D.; Ciocca, M.; Tosi, G.; Ronsivalle, C.; Vignati, M.

    2004-01-01

    Intraoperative radiation therapy is a special radiotherapy technique, which enables a high dose of radiation to be given in a single fraction during oncological surgery. The major stumbling block to the large-scale application of the technique is the transfer of the patient, with an open wound, from the operating room to the radiation therapy bunker, with the consequent organisational problems and the increased risk of infection. To overcome these limitations, in the last few years a new kind of linear accelerator, the Novac 7, conceived for direct use in the surgical room, has become available. Novac 7 can deliver electron beams of different energies (3, 5, 7 and 9 MeV), with a high dose rate (up to 20 Gy/min). The aim of this work, funded by ENEA in the framework of a research contract, is the development of an innovative system for on-line measurements of 2D dose distributions and electron beam characterisation, before radiotherapy treatment with Novac 7. The system is made up of the following components: (a) an electron-light converter; (b) a 14 bit cooled CCD camera; (c) a personal computer with an ad hoc written software for image acquisition and processing. The performances of the prototype have been characterised experimentally with different electron-light converters. Several tests have concerned the assessment of the detector response as a function of impulse number and electron beam energy. Finally, the experimental results concerning beam profiles have been compared with data acquired with other dosimetric techniques. The achieved results make it possible to say that the developed system is suitable for fast quality assurance measurements and verification of 2D dose distributions.

  9. Survey of quality indicators in commercial dehydrated fruits.

    Science.gov (United States)

    Megías-Pérez, Roberto; Gamboa-Santos, Juliana; Soria, Ana Cristina; Villamiel, Mar; Montilla, Antonia

    2014-05-01

    Physical and chemical quality parameters (dry matter, aw, protein, carbohydrates, vitamin C, 2-furoylmethyl amino acids, rehydration ratio and leaching loss) have been determined in 30 commercial dehydrated fruits (strawberry, blueberry, raspberry, cranberry, cherry, apple, grapefruit, mango, kiwifruit, pineapple, melon, coconut, banana and papaya). For comparison purposes, strawberry samples processed in the laboratory by freeze-drying and by convective drying were used as control samples. Overall quality of dehydrated fruits seemed to be greatly dependent on processing conditions and, in a cluster analysis, samples which were presumably subjected to osmotic dehydration were separated from the rest of fruits. These samples presented the lowest concentration of vitamin C and the highest evolution of Maillard reaction, as evidenced by its high concentration of 2-furoylmethyl amino acids. This is the first study on the usefulness of this combination of chemical and physical indicators to assess the overall quality of commercial dehydrated fruits. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Health indicators associated with poor sleep quality among university students

    Directory of Open Access Journals (Sweden)

    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.

  11. Biomarker as an Indicator of River Water Quality Degradation

    Directory of Open Access Journals (Sweden)

    Dwina Roosmini

    2006-11-01

    Full Text Available Generally physical and chemical methods are use in river water quality monitoring; currently biomarker is developed as alternative biomonitoring method. The aim of this study is to look at the probability using aquatic species in monitoring river water pollutants exposure. This study was done by using Hyposarcus pardalis as biomarker to analyze river water quality in Upstream Citarum River. Hyposarcus pardalis were taken along the river at five sampling point and look at the Cu and Zn concentration. Results from this study show that there was an indication that river water quality has been degrading along the river from upstream to downstream. Zn concentration in Hyposarcus pardalis were increasing as well as Cu concentration. The increase of Zn concentration in Hyposarcus pardalis indicating that the river was polluted by Zn. Secondary data and observation at sampling location shown that textile was the dominant industry which may contribute the Zn concentration in river as they received the effluent. Cu is use in metal coating process, as well as textile industry metal industries were identified at Majalaya, Bantar Panjang, Dayeuh Kolot and Katapang in Bandung-Indonesia. As a receiving water from many activities along the river, upstream Citarum River water quality become degrading as the increasing of heavy metal Zn and Cu concentration in Hyposarcus pardalis.

  12. 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.

  13. 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.

  14. 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.

  15. 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)

  16. Effect of area x-ray beam equalization on image quality and dose in digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Jerry; Xu Tong; Husain, Adeel; Le, Huy; Molloi, Sabee [Department of Radiological Sciences, University of California, Irvine, CA 92697 (United States)

    2004-08-21

    In mammography, thick or dense breast regions persistently suffer from reduced contrast-to-noise ratio (CNR) because of degraded contrast from large scatter intensities and relatively high noise. Area x-ray beam equalization can improve image quality by increasing the x-ray exposure to under-penetrated regions without increasing the exposure to other breast regions. Optimal equalization parameters with respect to image quality and patient dose were determined through computer simulations and validated with experimental observations on a step phantom and an anthropomorphic breast phantom. Three parameters important in equalization digital mammography were considered: attenuator material (Z = 13-92), beam energy (22-34 kVp) and equalization level. A Mo/Mo digital mammography system was used for image acquisition. A prototype 16 x 16 piston driven equalization system was used for preparing patient-specific equalization masks. Simulation studies showed that a molybdenum attenuator and an equalization level of 20 were optimal for improving contrast, CNR and figure of merit (FOM = CNR{sup 2}/dose). Experimental measurements using these parameters showed significant improvements in contrast, CNR and FOM. Moreover, equalized images of a breast phantom showed improved image quality. These results indicate that area beam equalization can improve image quality in digital mammography.

  17. Improving the beam quality of the neutron radiography facility using the SLOWPOKE-2 at the Royal Military College of Canada

    International Nuclear Information System (INIS)

    Lewis, W.J.; Bennett, L.G.I.; Teshima, P.

    1996-01-01

    At the SLOWPOKE-2 Facility at the Royal Military College of Canada, a neutron radiography facility has been designed and installed, and the beam quality has been improved by performing a series of radiographs using American standard for testing and materials (ASTM) E 545 indicators. Other means of determining the progress such as bubble detectors and activation foils were used. Modifications to the nosepiece of the beam tube including shielding and linings for fast neutron and gamma radiation were made. (orig.)

  18. 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.

  19. Indications for cone beam computed tomography in children and young patients in a Turkish subpopulation.

    Science.gov (United States)

    İşman, Özlem; Yılmaz, Hasan Hüseyin; Aktan, Ali Murat; Yilmaz, Büşra

    2017-05-01

    Cone beam computed tomography (CBCT) imaging is widely used in children; however, it remains controversial because of the health effects of radiation. This retrospective study investigated the indications for CBCT and dentomaxillofacial pathologies in paediatric patients. CBCT images of 329 paediatric patients (i.e., aged anomalies (38.5%), followed by the localisation of impacted teeth (33.1%). There was no relationship between sex and indications. There were significant associations between age groups and malocclusion and dentomaxillofacial anomalies, localisation of impacted teeth, and trauma. The face was the most frequently imaged region, followed by the jaws (maxilla and mandible). The most common indication for CBCT was malocclusion and dentomaxillofacial anomalies in the primary and permanent dentition age groups, whereas the localisation of impacted teeth was the most common indication in the mixed dentition age group. Generally, CBCT was indicated in orthodontics and surgery. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. A criterion-based audit of the technical quality of external beam radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Brundage, Michael; Danielson, Brita; Pearcey, Robert; Bass, Brenda; Pickles, Tom; Bahary, Jean-Paul; Peng, Yingwei; Wallace, David; Mackillop, William

    2013-01-01

    Purpose: To evaluate the technical quality of external beam radiotherapy for prostate cancer in Canada. Methods: This was a multi-institution, retrospective study of a random sample of patients undergoing radiotherapy (RT) for prostate cancer in Canada. Patterns of care were determined by abstracting details of the patients’ management from original records. The quality of patient’s technical care was measured against a previously published, comprehensive suite of quality indicators. Results: 32 of the 37 RT centres participated. The total study population of 810 patients included 25% low-risk, 44% intermediate-risk, and 28% high-risk cases. 649 received external beam RT (EBRT) only, for whom compliance with 12 indicators of the quality of pre-treatment assessment ranged from 56% (sexual function documented) to 96% (staging bone scan obtained in high-risk patients). Compliance with treatment-related indicators ranged from 78% (dose to prostate ⩾74 Gy in intermediate risk patients not receiving hormone therapy) to 100% (3DCRT or IMRT plan). Compliance varied among centres; no centre demonstrated 100% compliance on all indicators and every centre was 100% compliant on at least some indicators. The number of assessment-related indicators (n = 13) with which a given centre was 100% compliant ranged from 4 to 11 (median 7) and the number of the treatment-specific indicators (n = 8) with which a given centre was 100% compliant ranged from 6 to 8 (median 8). ADT therapy was utilised in most high-risk cases (191, 92.3%). Conclusions: While patterns of prostate cancer care in Canada vary somewhat, compliance on the majority of quality indicators is very high. However, all centres showed room for improvement on several indicators and few individual patients received care that met target benchmarks on all quality measures. This variation is particularly important for indicators such as delivered dose where impact on disease outcome is known to exist, and suggests that

  1. 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.

  2. 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.

  3. 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.

  4. 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/

  5. SU-F-BRD-15: Quality Correction Factors in Scanned Or Broad Proton Therapy Beams Are Indistinguishable

    Energy Technology Data Exchange (ETDEWEB)

    Sorriaux, J; Lee, J [Molecular Imaging Radiotherapy & Oncology, Universite Catholique de Louvain, Brussels (Belgium); ICTEAM Institute, Universite catholique de Louvain, Louvain-la-Neuve (Belgium); Testa, M; Paganetti, H [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, Massachusetts (United States); Bertrand, D; Orban de Xivry, J [Ion Beam Applications, Louvain-la-neuve, Brabant Wallon (Belgium); Palmans, H [EBG MedAustron GmbH, Wiener Neustadt (Austria); National Physical Laboratory, Teddington (United Kingdom); Vynckier, S [Cliniques Universitaires Saint-Luc, Brussels (Belgium); Sterpin, E [Molecular Imaging Radiotherapy & Oncology, Universite Catholique de Louvain, Brussels (Belgium)

    2015-06-15

    Purpose: The IAEA TRS-398 code of practice details the reference conditions for reference dosimetry of proton beams using ionization chambers and the required beam quality correction factors (kQ). Pencil beam scanning (PBS) requires multiple spots to reproduce the reference conditions. The objective is to demonstrate, using Monte Carlo (MC) calculations, that kQ factors for broad beams can be used for scanned beams under the same reference conditions with no significant additional uncertainty. We consider hereafter the general Alfonso formalism (Alfonso et al, 2008) for non-standard beam. Methods: To approach the reference conditions and the associated dose distributions, PBS must combine many pencil beams with range modulation and shaping techniques different than those used in passive systems (broad beams). This might lead to a different energy spectrum at the measurement point. In order to evaluate the impact of these differences on kQ factors, ion chamber responses are computed with MC (Geant4 9.6) in a dedicated scanned pencil beam (Q-pcsr) producing a 10×10cm2 composite field with a flat dose distribution from 10 to 16 cm depth. Ion chamber responses are also computed by MC in a broad beam with quality Q-ds (double scattering). The dose distribution of Q -pcsr matches the dose distribution of Q-ds. k-(Q-pcsr,Q-ds) is computed for a 2×2×0.2cm{sup 3} idealized air cavity and a realistic plane-parallel ion chamber (IC). Results: Under reference conditions, quality correction factors for a scanned composite field versus a broad beam are the same for air cavity dose response, k-(Q-pcsr,Q-ds) =1.001±0.001 and for a Roos IC, k-(Q-pcsr,Q-ds) =0.999±0.005. Conclusion: Quality correction factors for ion chamber response in scanned and broad proton therapy beams are identical under reference conditions within the calculation uncertainties. The results indicate that quality correction factors published in IAEA TRS-398 can be used for scanned beams in the SOBP of a

  6. SU-F-BRD-15: Quality Correction Factors in Scanned Or Broad Proton Therapy Beams Are Indistinguishable

    International Nuclear Information System (INIS)

    Sorriaux, J; Lee, J; Testa, M; Paganetti, H; Bertrand, D; Orban de Xivry, J; Palmans, H; Vynckier, S; Sterpin, E

    2015-01-01

    Purpose: The IAEA TRS-398 code of practice details the reference conditions for reference dosimetry of proton beams using ionization chambers and the required beam quality correction factors (kQ). Pencil beam scanning (PBS) requires multiple spots to reproduce the reference conditions. The objective is to demonstrate, using Monte Carlo (MC) calculations, that kQ factors for broad beams can be used for scanned beams under the same reference conditions with no significant additional uncertainty. We consider hereafter the general Alfonso formalism (Alfonso et al, 2008) for non-standard beam. Methods: To approach the reference conditions and the associated dose distributions, PBS must combine many pencil beams with range modulation and shaping techniques different than those used in passive systems (broad beams). This might lead to a different energy spectrum at the measurement point. In order to evaluate the impact of these differences on kQ factors, ion chamber responses are computed with MC (Geant4 9.6) in a dedicated scanned pencil beam (Q-pcsr) producing a 10×10cm2 composite field with a flat dose distribution from 10 to 16 cm depth. Ion chamber responses are also computed by MC in a broad beam with quality Q-ds (double scattering). The dose distribution of Q -pcsr matches the dose distribution of Q-ds. k-(Q-pcsr,Q-ds) is computed for a 2×2×0.2cm 3 idealized air cavity and a realistic plane-parallel ion chamber (IC). Results: Under reference conditions, quality correction factors for a scanned composite field versus a broad beam are the same for air cavity dose response, k-(Q-pcsr,Q-ds) =1.001±0.001 and for a Roos IC, k-(Q-pcsr,Q-ds) =0.999±0.005. Conclusion: Quality correction factors for ion chamber response in scanned and broad proton therapy beams are identical under reference conditions within the calculation uncertainties. The results indicate that quality correction factors published in IAEA TRS-398 can be used for scanned beams in the SOBP of a high

  7. 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)

  8. Water quality evaluation of Al-Gharraf river by two water quality indices

    Science.gov (United States)

    Ewaid, Salam Hussein

    2017-11-01

    Water quality of Al-Gharraf river, the largest branch of Tigris River south of Iraq, was evaluated by the National Sanitation Foundation Water Quality Index (NFS WQI) and the Heavy Metal Pollution Index (HPI) depending on 13 physical, chemical, and biological parameters of water quality measured monthly at ten stations on the river during 2015. The NSF-WQI range obtained for the sampling sites was 61-70 indicating a medium water quality. The HPI value was 98.6 slightly below the critical value for drinking water of 100, and the water quality in the upstream stations is better than downstream due to decrease in water and the accumulation of contaminants along the river. This study explains the significance of applying the water quality indices that show the aggregate impact of ecological factors in charge of water pollution of surface water and which permits translation of the monitoring data to assist the decision makers.

  9. Monte Carlo calculations of electron beam quality conversion factors for several ion chamber types

    Energy Technology Data Exchange (ETDEWEB)

    Muir, B. R., E-mail: Bryan.Muir@nrc-cnrc.gc.ca [Measurement Science and Standards, National Research Council Canada, 1200 Montreal Road, Ottawa, Ontario K1A 0R6 (Canada); Rogers, D. W. O., E-mail: drogers@physics.carleton.ca [Carleton Laboratory for Radiotherapy Physics, Physics Department, Carleton University, 1125 ColonelBy Drive, Ottawa, Ontario K1S 5B6 (Canada)

    2014-11-01

    Purpose: To provide a comprehensive investigation of electron beam reference dosimetry using Monte Carlo simulations of the response of 10 plane-parallel and 18 cylindrical ion chamber types. Specific emphasis is placed on the determination of the optimal shift of the chambers’ effective point of measurement (EPOM) and beam quality conversion factors. Methods: The EGSnrc system is used for calculations of the absorbed dose to gas in ion chamber models and the absorbed dose to water as a function of depth in a water phantom on which cobalt-60 and several electron beam source models are incident. The optimal EPOM shifts of the ion chambers are determined by comparing calculations of R{sub 50} converted from I{sub 50} (calculated using ion chamber simulations in phantom) to R{sub 50} calculated using simulations of the absorbed dose to water vs depth in water. Beam quality conversion factors are determined as the calculated ratio of the absorbed dose to water to the absorbed dose to air in the ion chamber at the reference depth in a cobalt-60 beam to that in electron beams. Results: For most plane-parallel chambers, the optimal EPOM shift is inside of the active cavity but different from the shift determined with water-equivalent scaling of the front window of the chamber. These optimal shifts for plane-parallel chambers also reduce the scatter of beam quality conversion factors, k{sub Q}, as a function of R{sub 50}. The optimal shift of cylindrical chambers is found to be less than the 0.5 r{sub cav} recommended by current dosimetry protocols. In most cases, the values of the optimal shift are close to 0.3 r{sub cav}. Values of k{sub ecal} are calculated and compared to those from the TG-51 protocol and differences are explained using accurate individual correction factors for a subset of ion chambers investigated. High-precision fits to beam quality conversion factors normalized to unity in a beam with R{sub 50} = 7.5 cm (k{sub Q}{sup ′}) are provided. These

  10. 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...

  11. Annual report. (Air quality criteria and plants as biological indicators)

    Energy Technology Data Exchange (ETDEWEB)

    1969-01-01

    Studies have been carried out to derive air quality criteria as the basis for establishing emission limits. Experiments have also been carried out on the resistance of plant species which are important to the economy and public health. Among the specific avenues of investigation have been: the determination of phytotoxic hydrogen fluoride concentrations; studies on the resistance behavior of cultivated plants; fluorine enrichment in plant organs as a function of exposure height and wind speed; development and use of biological methods for detecting atmospheric impurities; detection of sulfur dioxide effects on plants; the use of transplanted lichens as air pollution indicators; grass cultures as indicators of fluorine pollution; biological accumulation of fluorine as a function of HF concentration in air; and the determination of lead and zinc levels in plants. 5 figures, 4 tables.

  12. [Patient satisfaction as a quality indicator in mental health].

    Science.gov (United States)

    Fernández-Martín, L C; Iglesias-de-Sena, H; Fombellida-Velasco, C; Vicente-Torres, I; Alonso-Sardón, M; Mirón Canelo, J A

    2016-01-01

    To improve the quality of care in a Mental Health Hospital and identify the level of patient satisfaction. A descriptive, longitudinal, and retrospective study was conducted on 666 patients who completed treatment in the Mental Health Day Hospital of Salamanca, during the period 1994-2012, using the Hospital Management Annual Reports. A questionnaire designed for this purpose was used as the measurement tool. Most of the patients satisfactorily valued aspects, such as the general impression of the treatment (90% said «good/fairly good») and perception of being helped (94% perceived «very/fairly helped»); with 83% believing that the hospital is accessible. As regards empathy-understanding, it was noted that 14% feel discontent. While 18% of patients expected to be completely cured, the 83% of patients that finished their treatment have said that, in their opinion, the symptoms have subsided «very or somewhat». As regards the knowledge that they have about their disease, 30% believe it has advanced «a lot.» Based on the perceptions reported by patients, it may be said that in general, the level of user satisfaction in the Mental Health Day Hospital is high. Assessing quality through the user opinions helps control the quality, considering that patient satisfaction is a good indicator of result of the care received during their hospitalisation. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. 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.

  14. Impact of Spot Size and Beam-Shaping Devices on the Treatment Plan Quality for Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Moteabbed, Maryam, E-mail: mmoteabbed@partners.org; Yock, Torunn I.; Depauw, Nicolas; Madden, Thomas M.; Kooy, Hanne M.; Paganetti, Harald

    2016-05-01

    Purpose: This study aimed to assess the clinical impact of spot size and the addition of apertures and range compensators on the treatment quality of pencil beam scanning (PBS) proton therapy and to define when PBS could improve on passive scattering proton therapy (PSPT). Methods and Materials: The patient cohort included 14 pediatric patients treated with PSPT. Six PBS plans were created and optimized for each patient using 3 spot sizes (∼12-, 5.4-, and 2.5-mm median sigma at isocenter for 90- to 230-MeV range) and adding apertures and compensators to plans with the 2 larger spots. Conformity and homogeneity indices, dose-volume histogram parameters, equivalent uniform dose (EUD), normal tissue complication probability (NTCP), and integral dose were quantified and compared with the respective PSPT plans. Results: The results clearly indicated that PBS with the largest spots does not necessarily offer a dosimetric or clinical advantage over PSPT. With comparable target coverage, the mean dose (D{sub mean}) to healthy organs was on average 6.3% larger than PSPT when using this spot size. However, adding apertures to plans with large spots improved the treatment quality by decreasing the average D{sub mean} and EUD by up to 8.6% and 3.2% of the prescribed dose, respectively. Decreasing the spot size further improved all plans, lowering the average D{sub mean} and EUD by up to 11.6% and 10.9% compared with PSPT, respectively, and eliminated the need for beam-shaping devices. The NTCP decreased with spot size and addition of apertures, with maximum reduction of 5.4% relative to PSPT. Conclusions: The added benefit of using PBS strongly depends on the delivery configurations. Facilities limited to large spot sizes (>∼8 mm median sigma at isocenter) are recommended to use apertures to reduce treatment-related toxicities, at least for complex and/or small tumors.

  15. 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

  16. 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.

  17. 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

  18. Flattening filter free beams from TrueBeam and Versa HD units: Evaluation of the parameters for quality assurance

    Energy Technology Data Exchange (ETDEWEB)

    Fogliata, Antonella, E-mail: antonella.fogliata@humanitas.it; Reggiori, Giacomo; Stravato, Antonella; Scorsetti, Marta; Cozzi, Luca [Radiotherapy and Radiosurgery Department, Humanitas Research Hospital, Milan-Rozzano I-20098 (Italy); Fleckenstein, Jens; Schneider, Frank; Lohr, Frank [Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Mannheim D-68167 (Germany); Pachoud, Marc; Ghandour, Sarah [Radiation Oncology Department, Hôpital Riviera Chablais, Vevey CH-1800 (Switzerland); Krauss, Harald [Radio-Oncology Department, Kaiser Franz Josef Spital, Vienna A-1100 (Austria)

    2016-01-15

    Purpose: Flattening filter free (FFF) beams generated by medical linear accelerators are today clinically used for stereotactical and non-stereotactical radiotherapy treatments. Such beams differ from the standard flattened beams (FF) in the high dose rate and the profile shape peaked on the beam central axis. Definition of new parameters as unflatness and slope for FFF beams has been proposed based on a renormalization factor for FFF profiles. The present study aims to assess the dosimetric differences between FFF beams generated by linear accelerators from different vendors, and to provide renormalization and parameter data of the two kinds of units. Methods: Dosimetric data from two Varian TrueBeam and two Elekta Versa HD linear accelerators, all with 6 and 10 MV nominal accelerating potentials, FF and FFF modes have been collected. Renormalization factors and related fit parameters according to Fogliata et al. [“Definition of parameters for quality assurance of flattening filter free (FFF) photon beams in radiation therapy,” Med. Phys. 39, 6455–6464 (2012)] have been evaluated for FFF beams of both units and energies. Unflatness and slope parameters from profile curves were evaluated. Dosimetric differences in terms of beam penetration and near-the-surface dose were also assessed. Results: FFF profile parameters have been updated; renormalization factors and unflatness from the Varian units are consistent with the published data. Elekta FFF beam qualities, different from the Varian generated beams, tend to express similar behaviour as the FF beam of the corresponding nominal energy. TPR{sub 20,10} for 6 and 10 MV FF and FFF TrueBeam beams are 0.665, 0.629 (6 MV) and 0.738, 0.703 (10 MV). The same figures for Versa HD units are 0.684, 0.678 (6 MV) and 0.734, 0.721 (10 MV). Conclusions: Renormalization factor and unflatness parameters evaluated from Varian and Elekta FFF beams are provided, in particular renormalization factors table and fit parameters.

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

    Directory of Open Access Journals (Sweden)

    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

  20. The determination of beam quality correction factors: Monte Carlo simulations and measurements.

    Science.gov (United States)

    González-Castaño, D M; Hartmann, G H; Sánchez-Doblado, F; Gómez, F; Kapsch, R-P; Pena, J; Capote, R

    2009-08-07

    Modern dosimetry protocols are based on the use of ionization chambers provided with a calibration factor in terms of absorbed dose to water. The basic formula to determine the absorbed dose at a user's beam contains the well-known beam quality correction factor that is required whenever the quality of radiation used at calibration differs from that of the user's radiation. The dosimetry protocols describe the whole ionization chamber calibration procedure and include tabulated beam quality correction factors which refer to 60Co gamma radiation used as calibration quality. They have been calculated for a series of ionization chambers and radiation qualities based on formulae, which are also described in the protocols. In the case of high-energy photon beams, the relative standard uncertainty of the beam quality correction factor is estimated to amount to 1%. In the present work, two alternative methods to determine beam quality correction factors are prescribed-Monte Carlo simulation using the EGSnrc system and an experimental method based on a comparison with a reference chamber. Both Monte Carlo calculations and ratio measurements were carried out for nine chambers at several radiation beams. Four chamber types are not included in the current dosimetry protocols. Beam quality corrections for the reference chamber at two beam qualities were also measured using a calorimeter at a PTB Primary Standards Dosimetry Laboratory. Good agreement between the Monte Carlo calculated (1% uncertainty) and measured (0.5% uncertainty) beam quality correction factors was obtained. Based on these results we propose that beam quality correction factors can be generated both by measurements and by the Monte Carlo simulations with an uncertainty at least comparable to that given in current dosimetry protocols.

  1. Implementation to spanish protocol of quality control of accelerators to daily control of electron beams

    International Nuclear Information System (INIS)

    Adaimi Hernandez, P.; Ramirez Ros, J. C.; Casa de Julian, M. A. de la; Clemente Gutierrez, F.; Cabello Murillo, E.; Diaz Fuente, R.; Ferrando Sanchez, A.

    2011-01-01

    A revised procedure for daily control of the electron beams to make measurements more meaningful physically, having a better reproducibility and more in line with the recommendations of the Spanish Protocol for Quality Control in Electron Linear Accelerators Clinical Use. The daily quality control beams of high energy electrons that had been done so far was the finding that the record of a series of measures (symmetry, uniformity, stability, energy, beam central dose) were within tolerance values established. The amendment is to check the beam quality by directly measuring changes in absorption depth at which the dose is reduced to half its maximum value, R50.

  2. Analysis of ion beam teletherapy patient-specific quality assurance.

    Science.gov (United States)

    Liu, Xiaoli; Deng, Yu; Schlegel, Nicki; Huang, Zhijie; Moyers, Michael F

    2018-02-27

    The objective of this study was to evaluate the procedures for patient-specific quality assurance measurements using modulated scanned and energy stacked beams for proton and carbon ion teletherapy. Delivery records from 1734 portal measurements were analyzed using a 3-point pass criteria: more than 22 of 24 chambers in a water phantom (WP) had to have a measured dose difference from the planned portal doses less than or equal to 3%, or the distance from the measurement point location to a point location in the plan having the same dose had to be less than or equal to 3 mm (distance to agreement [DTA]), and the mean dose deviation of all chambers had to be less than 3%. Stratification of results showed some associations between measurement parameters and pass rates. For proton portals, pass rates were high at all measurement depths, but for carbon ion portals, pass rates decreased as a function of increasing measurement depth. Pass rates of both proton and carbon ion portals with 1 WP were slightly lower than those with a second WP. The total pass rates were 97.7% and 91.9% for proton and carbon ion patient portals, respectively. In general, the measured doses exhibited good agreement with the treatment planning system (TPS) calculated doses. When the chamber position was deeper than 150 mm in carbon ion beams, a lower pass rate was observed, which may have been caused by ion chamber array setup uncertainty (lateral and depth) in highly modulated portals or incorrect modeling of scatter by the TPS. These deviations need further investigation. Copyright © 2018 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  3. Feasibility of using a dose-area product ratio as beam quality specifier for photon beams with small field sizes.

    Science.gov (United States)

    Pimpinella, Maria; Caporali, Claudio; Guerra, Antonio Stefano; Silvi, Luca; De Coste, Vanessa; Petrucci, Assunta; Delaunay, Frank; Dufreneix, Stéphane; Gouriou, Jean; Ostrowsky, Aimé; Rapp, Benjamin; Bordy, Jean-Marc; Daures, Josiane; Le Roy, Maïwenn; Sommier, Line; Vermesse, Didier

    2018-01-01

    To investigate the feasibility of using the ratio of dose-area product at 20 cm and 10 cm water depths (DAPR 20,10 ) as a beam quality specifier for radiotherapy photon beams with field diameter below 2 cm. Dose-area product was determined as the integral of absorbed dose to water (D w ) over a surface larger than the beam size. 6 MV and 10 MV photon beams with field diameters from 0.75 cm to 2 cm were considered. Monte Carlo (MC) simulations were performed to calculate energy-dependent dosimetric parameters and to study the DAPR 20,10 properties. Aspects relevant to DAPR 20,10 measurement were explored using large-area plane-parallel ionization chambers with different diameters. DAPR 20,10 was nearly independent of field size in line with the small differences among the corresponding mean beam energies. Both MC and experimental results showed a dependence of DAPR 20,10 on the measurement setup and the surface over which D w is integrated. For a given setup, DAPR 20,10 values obtained using ionization chambers with different air-cavity diameters agreed with one another within 0.4%, after the application of MC correction factors accounting for effects due to the chamber size. DAPR 20,10 differences among the small field sizes were within 1% and sensitivity to the beam energy resulted similar to that of established beam quality specifiers based on the point measurement of D w . For a specific measurement setup and integration area, DAPR 20,10 proved suitable to specify the beam quality of small photon beams for the selection of energy-dependent dosimetric parameters. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  4. Associations between quality indicators of internal medicine residency training programs

    Science.gov (United States)

    2011-01-01

    Background Several residency program characteristics have been suggested as measures of program quality, but associations between these measures are unknown. We set out to determine associations between these potential measures of program quality. Methods Survey of internal medicine residency programs that shared an online ambulatory curriculum on hospital type, faculty size, number of trainees, proportion of international medical graduate (IMG) trainees, Internal Medicine In-Training Examination (IM-ITE) scores, three-year American Board of Internal Medicine Certifying Examination (ABIM-CE) first-try pass rates, Residency Review Committee-Internal Medicine (RRC-IM) certification length, program director clinical duties, and use of pharmaceutical funding to support education. Associations assessed using Chi-square, Spearman rank correlation, univariate and multivariable linear regression. Results Fifty one of 67 programs responded (response rate 76.1%), including 29 (56.9%) community teaching and 17 (33.3%) university hospitals, with a mean of 68 trainees and 101 faculty. Forty four percent of trainees were IMGs. The average post-graduate year (PGY)-2 IM-ITE raw score was 63.1, which was 66.8 for PGY3s. Average 3-year ABIM-CE pass rate was 95.8%; average RRC-IM certification was 4.3 years. ABIM-CE results, IM-ITE results, and length of RRC-IM certification were strongly associated with each other (p ITE scores were higher in programs with more IMGs and in programs that accepted pharmaceutical support (p < 0.05). RRC-IM certification was shorter in programs with higher numbers of IMGs. In multivariable analysis, a higher proportion of IMGs was associated with 1.17 years shorter RRC accreditation. Conclusions Associations between quality indicators are complex, but suggest that the presence of IMGs is associated with better performance on standardized tests but decreased duration of RRC-IM certification. PMID:21651768

  5. Definition of parameters for quality assurance of flattening filter free (FFF) photon beams in radiation therapy

    International Nuclear Information System (INIS)

    Fogliata, A.; Garcia, R.; Knöös, T.; Nicolini, G.; Clivio, A.; Vanetti, E.; Khamphan, C.; Cozzi, L.

    2012-01-01

    Purpose: Flattening filter free (FFF) beams generated by medical linear accelerators have recently started to be used in radiotherapy clinical practice. Such beams present fundamental differences with respect to the standard filter flattened (FF) beams, making the generally used dosimetric parameters and definitions not always viable. The present study will propose possible definitions and suggestions for some dosimetric parameters for use in quality assurance of FFF beams generated by medical linacs in radiotherapy. Methods: The main characteristics of the photon beams have been analyzed using specific data generated by a Varian TrueBeam linac having both FFF and FF beams of 6 and 10 MV energy, respectively. Results: Definitions for dose profile parameters are suggested starting from the renormalization of the FFF with respect to the corresponding FF beam. From this point the flatness concept has been translated into one of “unflatness” and other definitions have been proposed, maintaining a strict parallelism between FFF and FF parameter concepts. Conclusions: Ideas for quality controls used in establishing a quality assurance program when introducing FFF beams into the clinical environment are given here, keeping them similar to those used for standard FF beams. By following the suggestions in this report, the authors foresee that the introduction of FFF beams into a clinical radiotherapy environment will be as safe and well controlled as standard beam modalities using the existing guidelines.

  6. Quality indicators in a computerized technology information system

    International Nuclear Information System (INIS)

    Mancuso, C.A.; Hyde, R.A.

    1992-01-01

    An environmental technology information system was developed by EG ampersand G Idaho, Inc. at the Idaho National Engineering Laboratory (INEL) for the Department of Energy (DOE). The purpose of the system is to reduce costs and time associated with evaluating potential remedial alternatives for a waste site. The information system is organized to aid in the CERCLA process by describing the implementability, effectiveness, and cost of many remedial technologies. Technology categories included in the information system include: Institutional Controls, Retrieval, Separation, Characterization, Physical/Chemical Treatment, Biological Treatment, Thermal Treatment, Storage, Transportation, Disposal, Migration Control (containment), Support Systems, Waste Minimization, and Remote Operations. Two hundred and sixty processes are summarized in these technology areas. Information on these processes was collected from EPA publications, books, journal articles, conference proceedings, vendors, DOE publications, and technical experts. The purpose of this paper is to familiarize readers with issues associated with the development of information systems. A major issue is the system and software quality, which can be controlled by configuration management. Another major issue is the documentation of data quality indicators in references used to collect data for the system, which can not be controlled but must be planned for in the review process

  7. Photoinjector beam quality improvement by shaping the wavefront of a drive laser with oblique incidence

    International Nuclear Information System (INIS)

    He Zhigang; Wang Xiaohui; Jia Qika

    2012-01-01

    To increase the quantum efficiency (QE) of a copper photocathode and reduce the thermal emittance of an electron beam, a drive laser with oblique incidence was adopted in a BNL type photocathode rf gun. The disadvantageous effects on the beam quality caused by oblique incidence were analyzed qualitatively. A simple way to solve the problems through wavefront shaping was introduced and the beam quality was improved. (authors)

  8. Experimental determination of beam quality factors, kQ, for two types of Farmer chamber in a 10 MV photon and a 175 MeV proton beam.

    Science.gov (United States)

    Medin, Joakim; Ross, Carl K; Klassen, Norman V; Palmans, Hugo; Grusell, Erik; Grindborg, Jan-Erik

    2006-03-21

    Absorbed doses determined with a sealed water calorimeter operated at 4 degrees C are compared with the results obtained using ionization chambers and the IAEA TRS-398 code of practice in a 10 MV photon beam (TPR(20,10) = 0.734) and a 175 MeV proton beam (at a depth corresponding to the residual range, R(res) = 14.7 cm). Three NE 2571 and two FC65-G ionization chambers were calibrated in terms of absorbed-dose-to-water in (60)Co at the Swedish secondary standard dosimetry laboratory, directly traceable to the BIPM. In the photon beam quality, calorimetry was found to agree with ionometry within 0.3%, confirming the k(Q) values tabulated in TRS-398. In contrast, a 1.8% deviation was found in the proton beam at 6 g cm(-2) depth, suggesting that the TRS-398 tabulated k(Q) values for these two ionization chamber types are too high. Assuming no perturbation effect in the proton beam for the ionization chambers, a value for (w(air)/e)(Q) of 33.6 J C(-1) +/- 1.7% (k = 1) can be derived from these measurements. An analytical evaluation of the effect from non-elastic nuclear interactions in the ionization chamber wall indicates a perturbation effect of 0.6%. Including this estimated result in the proton beam would increase the determined (w(air)/e)(Q) value by the same amount.

  9. Recursive estimation of the parts production process quality indicator

    Directory of Open Access Journals (Sweden)

    Filipovich Oleg

    2017-01-01

    Full Text Available Consideration is given to a mathematical representation for manufacturing of batch parts on a metal-cutting machine tool. Linear dimensions of machined parts are assumed to be the major quality indicator, deviation from these dimensions is determined by size setting of machine tool and ensemble of random factors. It is allowed to have absolutely precise pre-setting of machine tool, effects from setup level offsetting due to deformation in process equipment on the specified indicator are disregarded. Consideration is given to factors which affect the tool wear, with two definitions of tool wear being provided. Reasons for development of random error in processing, dependence of measurement results on error as well as distribution laws and some parameters of random values are provided. To evaluate deviation of size setting value in each cycle, it is proposed to apply a recursive algorithm in description of investigated dynamic discrete process in the space state. Kalman filter equations are used in description of process model by means of first-order difference equations. The algorithm of recursive estimation is implemented in the mathematical software Maple. Simulation results which prove effectiveness of algorithm application to investigate the given dynamic system are provided. Variants of algorithm application and opportunities of further research are proposed.

  10. Dosimetric study of RapidArc plans with flattened beam (FB and flattening filter-free (FFF beam for localized prostate cancer based on physical indices

    Directory of Open Access Journals (Sweden)

    Birendra Kumar Rout

    2014-12-01

    Full Text Available Purpose: To identify the continual diversity between flattening photon beam (FB and Flattening Filter Free (FFF photon beams for localized prostate cancer; and to determine potential benefits and drawbacks of using unflattened beam for this type of treatment.Methods: Eight prostate cases including seminal vesicles selected for this study. The primary planning target volume (PTVP and boost planning target volume (PTVB were contoured. The total prescription dose was 78 Gy (56 Gy to PTVP and an additional 22 Gy to PTVB. For all cases, treatment plans using 6MV with FB and FFF beams with identical dose-volume constraints, arc angles and number of arcs were developed. The dose volume histograms for both techniques were compared for primary target volume and critical structures.Results: A low Sigma index (FFF: 1.65 + 0.361; FB: 1.725 + 0.39 indicating improved dose homogeneity in FFF beam. Conformity index (FFF: 0.994 + 0.01; FB: 0.993 + 0.01 is comparable for both techniques. Minimal difference of Organ at risk mean dose was observed. Normal tissue integral dose in FB plan resulted 1.5% lower than FFF plan. All the plans displayed significant increase (1.18 times for PTVP and 1.11 for PTBB in the average number of necessary MU with FFF beam.Conclusion: Diversity between FB and FFF beam plans were found. FFF beam accelerator has been utilized to develop clinically acceptable Rapid Arc treatment plans for prostate cancer with 6 MV.---------------------------------Cite this article as: Rout BK, Muralidhar KR, Ali M, Shekar MC, Kumar A. Dosimetric study of RapidArc plans with flattened beam (FB and flattening filter-free (FFF beam for localized prostate cancer based on physical indices. Int J Cancer Ther Oncol 2014; 2(4:02046.  DOI: 10.14319/ijcto.0204.6

  11. An assessment of Lot Quality Assurance Sampling to evaluate malaria outcome indicators: extending malaria indicator surveys.

    Science.gov (United States)

    Biedron, Caitlin; Pagano, Marcello; Hedt, Bethany L; Kilian, Albert; Ratcliffe, Amy; Mabunda, Samuel; Valadez, Joseph J

    2010-02-01

    Large investments and increased global prioritization of malaria prevention and treatment have resulted in greater emphasis on programme monitoring and evaluation (M&E) in many countries. Many countries currently use large multistage cluster sample surveys to monitor malaria outcome indicators on a regional and national level. However, these surveys often mask local-level variability important to programme management. Lot Quality Assurance Sampling (LQAS) has played a valuable role for local-level programme M&E. If incorporated into these larger surveys, it would provide a comprehensive M&E plan at little, if any, extra cost. The Mozambique Ministry of Health conducted a Malaria Indicator Survey (MIS) in June and July 2007. We applied LQAS classification rules to the 345 sampled enumeration areas to demonstrate identifying high- and low-performing areas with respect to two malaria program indicators-'household possession of any bednet' and 'household possession of any insecticide-treated bednet (ITN)'. As shown by the MIS, no province in Mozambique achieved the 70% coverage target for household possession of bednets or ITNs. By applying LQAS classification rules to the data, we identify 266 of the 345 enumeration areas as having bednet coverage severely below the 70% target. An additional 73 were identified with low ITN coverage. This article demonstrates the feasibility of integrating LQAS into multistage cluster sampling surveys and using these results to support a comprehensive national, regional and local programme M&E system. Furthermore, in the recommendations we outlined how to integrate the Large Country-LQAS design into macro-surveys while still obtaining results available through current sampling practices.

  12. 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

  13. [Job Satisfaction: a quality indicator in nursing human resource management].

    Science.gov (United States)

    Siqueira, Vera Thânia Alves; Kurcgant, Paulina

    2012-02-01

    This descriptive study addresses the job satisfaction of nurse managers and clinical nurses working at the Hematology and Hemotherapy Services of a public hospital in São Paulo. The study objectives were to identify the factors that caused job satisfaction among nurse managers and clinical nurses, and support the results in the development of indicators to evaluate the quality of nursing human resource management. The components of the study were: autonomy, interaction, professional status, job requirements, organizational norms and remuneration. Participants were 44 nurses. Data were collected using a Job Satisfaction Index (JSI) questionnaire. In conclusion, this study permitted the identification of the clinical nurse group, which was the most satisfied, with a JSI of 10.5; the managerial group scored 10.0. Regarding the satisfaction levels in regards to the current activity, 88.9% of the nurse managers reported feeling satisfied, as did 90.9% of clinical nurses. For both groups, autonomy was the component with the highest level of professional satisfaction.

  14. Impact of large x-ray beam collimation on image quality

    Science.gov (United States)

    Racine, Damien; Ba, Alexandre; Ott, Julien G.; Bochud, François O.; Verdun, Francis R.

    2016-03-01

    Large X-ray beam collimation in computed tomography (CT) opens the way to new image acquisition techniques and improves patient management for several clinical indications. The systems that offer large X-ray beam collimation enable, in particular, a whole region of interest to be investigated with an excellent temporal resolution. However, one of the potential drawbacks of this option might be a noticeable difference in image quality along the z-axis when compared with the standard helical acquisition mode using more restricted X-ray beam collimations. The aim of this project is to investigate the impact of the use of large X-ray beam collimation and new iterative reconstruction on noise properties, spatial resolution and low contrast detectability (LCD). An anthropomorphic phantom and a custom made phantom were scanned on a GE Revolution CT. The images were reconstructed respectively with ASIR-V at 0% and 50%. Noise power spectra, to evaluate the noise properties, and Target Transfer Functions, to evaluate the spatial resolution, were computed. Then, a Channelized Hotelling Observer with Gabor and Dense Difference of Gaussian channels was used to evaluate the LCD using the Percentage correct as a figure of merit. Noticeable differences of 3D noise power spectra and MTF have been recorded; however no significant difference appeared when dealing with the LCD criteria. As expected the use of iterative reconstruction, for a given CTDIvol level, allowed a significant gain in LCD in comparison to ASIR-V 0%. In addition, the outcomes of the NPS and TTF metrics led to results that would contradict the outcomes of CHO model observers if used for a NPWE model observer (Non- Prewhitening With Eye filter). The unit investigated provides major advantages for cardiac diagnosis without impairing the image quality level of standard chest or abdominal acquisitions.

  15. 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…

  16. Key Performance Indicators in the Evaluation of the Quality of Radiation Safety Programs.

    Science.gov (United States)

    Schultz, Cheryl Culver; Shaffer, Sheila; Fink-Bennett, Darlene; Winokur, Kay

    2016-08-01

    Beaumont is a multiple hospital health care system with a centralized radiation safety department. The health system operates under a broad scope Nuclear Regulatory Commission license but also maintains several other limited use NRC licenses in off-site facilities and clinics. The hospital-based program is expansive including diagnostic radiology and nuclear medicine (molecular imaging), interventional radiology, a comprehensive cardiovascular program, multiple forms of radiation therapy (low dose rate brachytherapy, high dose rate brachytherapy, external beam radiotherapy, and gamma knife), and the Research Institute (including basic bench top, human and animal). Each year, in the annual report, data is analyzed and then tracked and trended. While any summary report will, by nature, include items such as the number of pieces of equipment, inspections performed, staff monitored and educated and other similar parameters, not all include an objective review of the quality and effectiveness of the program. Through objective numerical data Beaumont adopted seven key performance indicators. The assertion made is that key performance indicators can be used to establish benchmarks for evaluation and comparison of the effectiveness and quality of radiation safety programs. Based on over a decade of data collection, and adoption of key performance indicators, this paper demonstrates one way to establish objective benchmarking for radiation safety programs in the health care environment.

  17. Beam-quality measurements using a spatial light modulator

    CSIR Research Space (South Africa)

    Schulze, C

    2012-11-01

    Full Text Available We present a fast and easy technique for measuring the beam propagation ratio, M2, of laser beams using a spatial light modulator. Our technique is based on digitally simulating the free-space propagation of light, thus eliminating the need...

  18. The ESTRO-EQUAL quality assurance network for photon and electron radiotherapy beams in Germany

    International Nuclear Information System (INIS)

    Ferreira, I.H.; Dutreix, A.; Richter, J.; Bridier, A.; Chavaudra, J.; Svensson, H.

    2001-01-01

    Background: In 1998 an ESTRO Quality Assurance Network for radiotherapy (EQUAL) has been set up for 25 European countries for photon and electron beams in reference and non-reference conditions. Material and Methods: Measurements are done using LiF powder (DTL937-Philitech, France) that is processed with the PCL3 automatic reader (Fimel-PTW). The participating centers irradiate the TLDs with an absorbed dose of 2 Gy according to the clinical routine. Results: Until September 2000 EQUAL has checked 135 photon beams (including the beams rechecked) from 51 radiotherapy centers in Germany out of 86 accepted centers. The results show that 2% of the beam outputs in reference conditions and 3% of the percentage depth doses are outside the tolerance level (deviation > ± 5%). 6% of the beam output variations and of the wedge transmission factors show deviations > ± 5%. The global analysis of results shows deviations > ± 5% in at least one parameter for 18 beams out of the 135 beams checked. Five rechecked beams present one ''real dosimetric'' problem in one or more parameters, corresponding to 4% of the 114 beams for which the deviations cannot be attributed to set-up errors. - The EQUAL network has checked 89 electron beams in Germany. The results show that all beam outputs checked are within the tolerance level. The standard deviation for the beam output in reference conditions is 2.0% and 2.2% for the beam output for the others field sizes. The percentage of deviations > 3% and ≤ 5% for the reference beam output is higher for electron beams than for photon beam checks. Therefore the electron beam calibration and the TPS algorithms should be improved to increase the accuracy of the patient dosimetry for radiotherapy. (orig.) [de

  19. Impact of Spot Size and Beam-Shaping Devices on the Treatment Plan Quality for Pencil Beam Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Moteabbed, Maryam; Yock, Torunn I.; Depauw, Nicolas; Madden, Thomas M.; Kooy, Hanne M.; Paganetti, Harald

    2016-01-01

    Purpose: This study aimed to assess the clinical impact of spot size and the addition of apertures and range compensators on the treatment quality of pencil beam scanning (PBS) proton therapy and to define when PBS could improve on passive scattering proton therapy (PSPT). Methods and Materials: The patient cohort included 14 pediatric patients treated with PSPT. Six PBS plans were created and optimized for each patient using 3 spot sizes (∼12-, 5.4-, and 2.5-mm median sigma at isocenter for 90- to 230-MeV range) and adding apertures and compensators to plans with the 2 larger spots. Conformity and homogeneity indices, dose-volume histogram parameters, equivalent uniform dose (EUD), normal tissue complication probability (NTCP), and integral dose were quantified and compared with the respective PSPT plans. Results: The results clearly indicated that PBS with the largest spots does not necessarily offer a dosimetric or clinical advantage over PSPT. With comparable target coverage, the mean dose (D_m_e_a_n) to healthy organs was on average 6.3% larger than PSPT when using this spot size. However, adding apertures to plans with large spots improved the treatment quality by decreasing the average D_m_e_a_n and EUD by up to 8.6% and 3.2% of the prescribed dose, respectively. Decreasing the spot size further improved all plans, lowering the average D_m_e_a_n and EUD by up to 11.6% and 10.9% compared with PSPT, respectively, and eliminated the need for beam-shaping devices. The NTCP decreased with spot size and addition of apertures, with maximum reduction of 5.4% relative to PSPT. Conclusions: The added benefit of using PBS strongly depends on the delivery configurations. Facilities limited to large spot sizes (>∼8 mm median sigma at isocenter) are recommended to use apertures to reduce treatment-related toxicities, at least for complex and/or small tumors.

  20. Evaluation of thermal effects on the beam quality of disk laser with unstable resonator

    Science.gov (United States)

    Shayganmanesh, Mahdi; Beirami, Reza

    2017-01-01

    In this paper thermal effects of the disk active medium and associated effects on the beam quality of laser are investigated. Using Collins integral and iterative method, transverse mode of an unstable resonator including a Yb:YAG active medium in disk geometry is calculated. After that the beam quality of the laser is calculated based on the generalized beam characterization method. Thermal lensing of the disk is calculated based on the OPD (Optical Path Difference) concept. Five factors influencing the OPD including temperature gradient, disk thermal expansion, photo-elastic effect, electronic lens and disk deformation are considered in our calculations. The calculations show that the effect of disk deformation factor on the quality of laser beam in the resonator is strong. However the total effect of all the thermal factors on the internal beam quality is fewer. Also it is shown that thermal effects degrade the output power, beam profile and beam quality of the output laser beam severely. As well the magnitude of each of affecting factors is evaluated distinctly.

  1. Price as an Indicator for Quality in International Trade?

    DEFF Research Database (Denmark)

    Hansen, Jørgen Drud; Nielsen, Jørgen Ulff-Møller

    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 ...

  2. Price as an indicator for quality in international trade?

    DEFF Research Database (Denmark)

    Hansen, Jørgen Drud; Nielsen, Jørgen Ulff-Møller

    2011-01-01

    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 ...

  3. Quality indicators for international benchmarking of mental health care

    DEFF Research Database (Denmark)

    Hermann, Richard C; Mattke, Soeren; Somekh, David

    2006-01-01

    To identify quality measures for international benchmarking of mental health care that assess important processes and outcomes of care, are scientifically sound, and are feasible to construct from preexisting data.......To identify quality measures for international benchmarking of mental health care that assess important processes and outcomes of care, are scientifically sound, and are feasible to construct from preexisting data....

  4. Image-rotating cavity designs for improved beam quality in nanosecond optical parametric oscillators

    International Nuclear Information System (INIS)

    Smith, Arlee V.; Bowers, Mark S.

    2001-01-01

    We show by computer simulation that high beam quality can be achieved in high-energy, nanosecond optical parametric oscillators by use of image-rotating resonators. Lateral walk-off between the signal and the idler beams in a nonlinear crystal creates correlations across the beams in the walk off direction, or equivalently, creates a restricted acceptance angle. These correlations can improve the beam quality in the walk-off plane. We show that image rotation or reflection can be used to improve beam quality in both planes. The lateral walk-off can be due to birefringent walk-off in type II mixing or to noncollinear mixing in type I or type II mixing

  5. Molecular Beam Epitaxy Growth of High Crystalline Quality LiNbO3

    Science.gov (United States)

    Tellekamp, M. Brooks; Shank, Joshua C.; Goorsky, Mark S.; Doolittle, W. Alan

    2016-12-01

    Lithium niobate is a multi-functional material with wide reaching applications in acoustics, optics, and electronics. Commercial applications for lithium niobate require high crystalline quality currently limited to bulk and ion sliced material. Thin film lithium niobate is an attractive option for a variety of integrated devices, but the research effort has been stagnant due to poor material quality. Both lattice matched and mismatched lithium niobate are grown by molecular beam epitaxy and studied to understand the role of substrate and temperature on nucleation conditions and material quality. Growth on sapphire produces partially coalesced columnar grains with atomically flat plateaus and no twin planes. A symmetric rocking curve shows a narrow linewidth with a full width at half-maximum (FWHM) of 8.6 arcsec (0.0024°), which is comparable to the 5.8 arcsec rocking curve FWHM of the substrate, while the film asymmetric rocking curve is 510 arcsec FWHM. These values indicate that the individual grains are relatively free of long-range disorder detectable by x-ray diffraction with minimal measurable tilt and twist and represents the highest structural quality epitaxial material grown on lattice mismatched sapphire without twin planes. Lithium niobate is also grown on lithium tantalate producing high quality coalesced material without twin planes and with a symmetric rocking curve of 193 arcsec, which is nearly equal to the substrate rocking curve of 194 arcsec. The surface morphology of lithium niobate on lithium tantalate is shown to be atomically flat by atomic force microscopy.

  6. Determination of neutron beam quality and evaluation of image quality (neutron radiography technique)

    International Nuclear Information System (INIS)

    Wan Muhammad Saridan Wan Hassan; Manan Munhamad Jaib; Ng Sook Kien; Lai Zhong Yuan; Azali Muhammad; Abd Aziz Mohamed; Mohd Rawi Abdullah

    2005-01-01

    The following topics were presented: beam purity Indicator (BPI) and sensitivity indicator (SI) test objects (ASTM E545-91); No Numbra (NU) test object (ASTM E803-91); MTF and Noise; parameters used in calculation; results of the experiments; summary of analysis. The resulting data consisted exposure contributors and sensitivity levels for films that were radiographed along with 0.25 and 0.5 mm Gd converters; visibility of holes and gaps on the image of the sensitivity indicator using both 0.25 and 0.5 mm Gd converters; qualitative data obtained from observation of the blurring effect on the lower boron nitride disc for both 0.25 and 0.5 mm Gd converters

  7. Cone beam computed tomography radiation dose and image quality assessments.

    Science.gov (United States)

    Lofthag-Hansen, Sara

    2010-01-01

    Diagnostic radiology has undergone profound changes in the last 30 years. New technologies are available to the dental field, cone beam computed tomography (CBCT) as one of the most important. CBCT is a catch-all term for a technology comprising a variety of machines differing in many respects: patient positioning, volume size (FOV), radiation quality, image capturing and reconstruction, image resolution and radiation dose. When new technology is introduced one must make sure that diagnostic accuracy is better or at least as good as the one it can be expected to replace. The CBCT brand tested was two versions of Accuitomo (Morita, Japan): 3D Accuitomo with an image intensifier as detector, FOV 3 cm x 4 cm and 3D Accuitomo FPD with a flat panel detector, FOVs 4 cm x 4 cm and 6 cm x 6 cm. The 3D Accuitomo was compared with intra-oral radiography for endodontic diagnosis in 35 patients with 46 teeth analyzed, of which 41 were endodontically treated. Three observers assessed the images by consensus. The result showed that CBCT imaging was superior with a higher number of teeth diagnosed with periapical lesions (42 vs 32 teeth). When evaluating 3D Accuitomo examinations in the posterior mandible in 30 patients, visibility of marginal bone crest and mandibular canal, important anatomic structures for implant planning, was high with good observer agreement among seven observers. Radiographic techniques have to be evaluated concerning radiation dose, which requires well-defined and easy-to-use methods. Two methods: CT dose index (CTDI), prevailing method for CT units, and dose-area product (DAP) were evaluated for calculating effective dose (E) for both units. An asymmetric dose distribution was revealed when a clinical situation was simulated. Hence, the CTDI method was not applicable for these units with small FOVs. Based on DAP values from 90 patient examinations effective dose was estimated for three diagnostic tasks: implant planning in posterior mandible and

  8. 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).

  9. Quality control in the geometry of the beam of a unit of volumetric modulated arcotheraphy

    International Nuclear Information System (INIS)

    Clemente Gutierrez, F.; Ramirez Ros, J. C.; Cabello Murillo, E.; Casa de Julian, M. A. de la

    2011-01-01

    We report here the evidence offered for the regular quality control (monthly) beam geometry (flatness and symmetry) for a unit of 6 MV Elekta Synergy with VMAT, belonging to the Radiation Oncology Service of the Defense Central Hospital Gomez Ulla.

  10. High beam quality and high energy short-pulse laser with MOPA

    Science.gov (United States)

    Jin, Quanwei; Pang, Yu; Jiang, JianFeng; Tan, Liang; Cui, Lingling; Wei, Bin; Sun, Yinhong; Tang, Chun

    2018-03-01

    A high energy, high beam quality short-pulse diode-pumped Nd:YAG master oscillator power-amplifier (MOPA) laser with two amplifier stages is demonstrated. The two-rod birefringence compensation was used as beam quality controlling methods, which presents a short-pulse energy of 40 mJ with a beam quality value of M2 = 1.2 at a repetition rate of 400Hz. The MOPA system delivers a short-pulse energy of 712.5 mJ with a pulse width of 12.4 ns.The method of spherical aberration compensation is improved the beam quality, a M2 factor of 2.3 and an optical-to-optical efficiency of 27.7% is obtained at the maximum laser out power.The laser obtained 1.4J out energy with polarization integration.

  11. Diode pumped 1kHz high power Nd:YAG laser with excellent beam quality

    NARCIS (Netherlands)

    Godfried, Herman; Godfried, H.P; Offerhaus, Herman L.

    1997-01-01

    The design and operation of a one kilohertz diode pumped all solid-state Nd:YAG master oscillator power amplifier system with a phase conjugate mirror is presented. The setup allows high power scaling without reduction in beam quality.

  12. Measuring quality of life in Macedonia - using human development indicators

    Directory of Open Access Journals (Sweden)

    Dimitar Eftimoski

    2006-12-01

    Full Text Available By the end of the 1980s, the central issue of development was focused on the growth of income and not on the growth of quality of life. Therefore, the development strategies were oriented towards production and left no significant space for improving the welfare of individuals.In the beginning of the 1990s, the human development concept emerged, stressing that economic development ultimately should result in growth of quality of life of individuals, while the goal of the development process was to expand the capabilities of individuals by placing them in the focus of the efforts for development.This paper if focused on the quality of life of the individuals. Moreover, in addition to the previous practice in Macedonia of calculating the human development index (HDI - as a measure of quality of life, an attempt will be made to calculate the humanpoverty index (HPI-2 - as a measure of non-income poverty, gender development index (GDI - as a measure of inequality between men and women, as well as the human development index at the level of aggregated urban and rural municipalities.We hope that it will contribute to the improvement of the quality of decisions made by the state and local authorities in Macedonia when it comes to issues concerning the human development.

  13. A feasibility study of Dynamic Phantom scanner for quality assurance of photon beam profiles at various gantry angles.

    Science.gov (United States)

    Zhang, Yunkai; Hsi, Wen C; Chu, James C H; Bernard, Damian B; Abrams, Ross A

    2005-01-01

    ) were observed. Additional profiles with the gantry at 90 degrees and 270 degrees were performed for both MLC- and jaw-shaped photon beams and electron beams to evaluate the effect of gantry rotation. General good agreement is seen (less than 1 % variation) at all field sizes for collimator-shaped 6 MV and 18 MV photon beams. Similar variations observed for MLC-shaped photon beams indicate that the uncertainty in MLC position is similar to that for the collimator jaws. We conclude that the Dynamic Phantom scanner is a useful device for the routine quality assurance on beam profiles of photon beams and for constancy check on electron beams at various gantry angles. Caution should be taken when using this device to acquire basic electron dosimetry data.

  14. Stability of electron-beam energy monitor for quality assurance of the electron-beam energy from radiotherapy accelerators

    International Nuclear Information System (INIS)

    Chida, Koichi; Zuguchi, Masayuki; Saito, Haruo; Takai, Yoshihiro; Mitsuya, Masatoshi; Sakakida, Hideharu; Yamada, Shogo; Kohzuki, Masahiro

    2002-01-01

    Information on electron energy is important in planning radiation therapy using electrons. The Geske 3405 electron beam energy monitor (Geske monitor, PTW Nuclear Associates, Carle Place, NY, USA) is a device containing nine ionization chambers for checking the energy of the electron beams produced by radiotherapy accelerators. We wondered whether this might increase the likelihood of ionization chamber trouble. In spite of the importance of the stability of such a quality assurance (QA) device, there are no reports on the stability of values measured with a Geske monitor. The purpose of this paper was therefore to describe the stability of a Geske monitor. It was found that the largest coefficient of variation (CV) of the Geske monitor measurements was approximately 0.96% over a 21-week period. In conclusion, the stability of Geske monitor measurements of the energy of electron beams from a linear accelerator was excellent. (author)

  15. Longitudinal beam parameters and quality checks of the LHC beam in the SPS: further results and comparisons

    CERN Document Server

    Papotti, G; Linnecar, T; Shaposhnikova, E; Tückmantel, Joachim; CERN. Geneva. AB Department

    2008-01-01

    Controlled longitudinal emittance blow up is used, along with other measures, to stabilize the nominal LHC beam in the SPS. Two Machine Development studies (MDs) were carried out in 2007 to evaluate the effectiveness of different noise settings for the longitudinal blow up of the beam. The noise settings are affected by both the presence of the 800 MHz RF system and intensity effects which modify the synchrotron frequency distribution inside the bunch. The results for the first MD are reported in Note [1]. This Note reports on the results of the second MD, carried out on 2007-10-17, as well as the comparison between the two in order to analyse the differences between the two occasions. Figures of merit are used that allow rapid evaluation of the quality of the beam as for example stability and bunch length uniformity across batches.

  16. 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

  17. Performance Indicators For Quality In Surgical And Laboratory ...

    African Journals Online (AJOL)

    Methodology: Hospital records were reviewed and information recorded for planned and postponed operations, laboratory equipment, reagents, laboratory tests and quality assurance programmes. Results: In the year 2001 a total of 4332 non-emergency operations were planned, 3313 operations were performed and 1019 ...

  18. Evaluation Criteria and Indicators of Quality for Internet Resources.

    Science.gov (United States)

    Wilkinson, Gene L.; And Others

    1997-01-01

    Most Web site rating systems overemphasize technological "bells and whistles." The University of Georgia's information quality criteria address site access and usability; resource identification and documentation; author identification; authority of author; information structure and design; relevance and scope, validity, and accuracy and…

  19. The Discussion of Subjective Quality of Working Life Indicators

    Czech Academy of Sciences Publication Activity Database

    Vinopal, Jiří

    2012-01-01

    Roč. 44, č. 3 (2012), s. 385-401 ISSN 0049-1225 Institutional support: RVO:68378025 Keywords : Job Satisfaction * Quality of Working Life * Work Satisfaction Subject RIV: AO - Sociology, Demography Impact factor: 0.240, year: 2012 http://www.sav.sk/journals/uploads/06251222Vinopal%203-2012.pdf

  20. Framework and indicator testing protocol for developing and piloting quality indicators for the UK quality and outcomes framework

    NARCIS (Netherlands)

    Campbell, S.M.; Kontopantelis, E.; Hannon, K.; Burke, M.; Barber, A.; Lester, H.E.

    2011-01-01

    BACKGROUND: Quality measures should be subjected to a testing protocol before being used in practice using key attributes such as acceptability, feasibility and reliability, as well as identifying issues derived from actual implementation and unintended consequences. We describe the methodologies

  1. 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.

  2. 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.

  3. Beam Quality Preservation in the CERN PS-SPS Complex

    CERN Multimedia

    Arduini, Gianluigi

    2004-01-01

    The LHC will require beams of unprecedented transverse and longitudinal brightness. Their production imposes tight constraints on the emittance growth in each element of the LHC injector chain, namely the PS-SPS Accelerator Complex. The problems encountered at the different stages of the acceleration in the complex span a wide range of topics, such as injection matching, RF gymnastics, space charge, transverse and longitudinal single- and coupled-bunch instabilities, and electron cloud effects. The measurement techniques developed and applied to identify and study the various sources of emittance dilution to the high precision required for the LHC beams and the solutions found to control such phenomena are illustrated.

  4. Design of RF chopper system for improving beam quality in FEL injector with thermionic gun

    International Nuclear Information System (INIS)

    Chen, Q.; Qin, B.; Tan, P.; Hu, T.; Pei, Y.; Zhang, F.

    2014-01-01

    For a linac-based Free Electron Laser (FEL), good beam quality largely contributes to the success of the final radiation. An imperfection confronted with the HUST THz-FEL facility is the long beam tail that emerges in the electron gun and exists through the whole beam line. This paper proposes to deploy a chopper system after the electron gun to truncate the beam tails before they enter into the linac. Physical dimensions of the chopper cavity are discussed in detail and we have developed and derived new analytical expressions applying to all frequencies for the optimal design. Also, technical issues of the cavity are considered. Beam dynamic simulation is performed to examine the truncation effect and the results show that more than 78% of the beam tail can be removed effectively, while preserving the emittance and energy spread in acceptable level

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

    Science.gov (United States)

    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.

  6. Production of high-quality electron bunches by dephasing and beam loading in channeled and unchanneled laser plasma accelerators

    International Nuclear Information System (INIS)

    Geddes, C.G.R.; Toth, Cs.; Tilborg, J. van; Esarey, E.; Schroeder, C.B.; Bruhwiler, D.; Nieter, C.; Cary, J.; Leemans, W.P.

    2005-01-01

    High-quality electron beams, with a few 10 9 electrons within a few percent of the same energy above 80 MeV, were produced in a laser wakefield accelerator by matching the acceleration length to the length over which electrons were accelerated and outran (dephased from) the wake. A plasma channel guided the drive laser over long distances, resulting in production of the high-energy, high-quality beams. Unchanneled experiments varying the length of the target plasma indicated that the high-quality bunches are produced near the dephasing length and demonstrated that channel guiding was more stable and efficient than relativistic self-guiding. Consistent with these data, particle-in-cell simulations indicate production of high-quality electron beams when trapping of an initial bunch of electrons suppresses further injection by loading the wake. The injected electron bunch is then compressed in energy by dephasing, when the front of the bunch begins to decelerate while the tail is still accelerated

  7. Active and intelligent packaging: The indication of quality and safety.

    Science.gov (United States)

    Janjarasskul, Theeranun; Suppakul, Panuwat

    2018-03-24

    The food industry has been under growing pressure to feed an exponentially increasing world population and challenged to meet rigorous food safety law and regulation. The plethora of media consumption has provoked consumer demand for safe, sustainable, organic, and wholesome products with "clean" labels. The application of active and intelligent packaging has been commercially adopted by food and pharmaceutical industries as a solution for the future for extending shelf life and simplifying production processes; facilitating complex distribution logistics; reducing, if not eliminating the need for preservatives in food formulations; enabling restricted food packaging applications; providing convenience, improving quality, variety and marketing features; as well as providing essential information to ensure consumer safety. This chapter reviews innovations of active and intelligent packaging which advance packaging technology through both scavenging and releasing systems for shelf life extension, and through diagnostic and identification systems for communicating quality, tracking and brand protection.

  8. 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

  9. Gluten-Free Diet Indications, Safety, Quality, Labels, and Challenges

    OpenAIRE

    Rostami, Kamran; Bold, Justine; Parr, Alison; Johnson, Matt W.

    2017-01-01

    A gluten-free diet (GFD) is the safest treatment modality in patient with coeliac disease (CD) and other gluten-related disorders. Contamination and diet compliance are important factors behind persistent symptoms in patients with gluten related-disorders, in particular CD. How much gluten can be tolerated, how safe are the current gluten-free (GF) products, what are the benefits and side effects of GFD? Recent studies published in Nutrients on gluten-free products? quality, availability, saf...

  10. A feasibility study of the Dynamic Phantom scanner for quality assurance of beam profiles at various gantry angles

    Science.gov (United States)

    Zhang, Yunkai; Hsi, Wen C.; Chu, James C.H.; Bernard, Damian B.; Abrams, Ross A.

    2005-01-01

    ) were observed. Additional profiles with the gantry at 90° and 270° were performed for both MLC‐ and jaw‐shaped photon beams and electron beams to evaluate the effect of gantry rotation. General good agreement is seen (less than 1 % variation) at all field sizes for collimator‐shaped 6 MV and 18 MV photon beams. Similar variations observed for MLC‐shaped photon beams indicate that the uncertainty in MLC position is similar to that for the collimator jaws. We conclude that the Dynamic Phantom scanner is a useful device for the routine quality assurance on beam profiles of photon beams and for constancy check on electron beams at various gantry angles. Caution should be taken when using this device to acquire basic electron dosimetry data. PACS number: 87.53.‐j PMID:15940212

  11. Dual-energy contrast-enhanced breast tomosynthesis: optimization of beam quality for dose and image quality

    International Nuclear Information System (INIS)

    Samei, Ehsan; Saunders, Robert S Jr

    2011-01-01

    Dual-energy contrast-enhanced breast tomosynthesis is a promising technique to obtain three-dimensional functional information from the breast with high resolution and speed. To optimize this new method, this study searched for the beam quality that maximized image quality in terms of mass detection performance. A digital tomosynthesis system was modeled using a fast ray-tracing algorithm, which created simulated projection images by tracking photons through a voxelized anatomical breast phantom containing iodinated lesions. The single-energy images were combined into dual-energy images through a weighted log subtraction process. The weighting factor was optimized to minimize anatomical noise, while the dose distribution was chosen to minimize quantum noise. The dual-energy images were analyzed for the signal difference to noise ratio (SdNR) of iodinated masses. The fast ray-tracing explored 523 776 dual-energy combinations to identify which yields optimum mass SdNR. The ray-tracing results were verified using a Monte Carlo model for a breast tomosynthesis system with a selenium-based flat-panel detector. The projection images from our voxelized breast phantom were obtained at a constant total glandular dose. The projections were combined using weighted log subtraction and reconstructed using commercial reconstruction software. The lesion SdNR was measured in the central reconstructed slice. The SdNR performance varied markedly across the kVp and filtration space. Ray-tracing results indicated that the mass SdNR was maximized with a high-energy tungsten beam at 49 kVp with 92.5 μm of copper filtration and a low-energy tungsten beam at 49 kVp with 95 μm of tin filtration. This result was consistent with Monte Carlo findings. This mammographic technique led to a mass SdNR of 0.92 ± 0.03 in the projections and 3.68 ± 0.19 in the reconstructed slices. These values were markedly higher than those for non-optimized techniques. Our findings indicate that dual

  12. Tilting the jaw to improve the image quality or to reduce the dose in cone-beam computed tomography

    International Nuclear Information System (INIS)

    Luckow, Marlen; Deyhle, Hans; Beckmann, Felix; Dagassan-Berndt, Dorothea; Müller, Bert

    2011-01-01

    Objective: The image quality in cone-beam computed tomography (CBCT) should be improved tilting the mandible that contains two dental titanium implants, within the relevant range of motion. Materials and methods: Using the mandible of a five-month-old pig, CBCT was performed varying the accelerating voltage, beam current, the starting rotation angle of the mandible in the source-detector plane and the tilt angles of the jaw with respect to the source-detector plane. The different datasets were automatically registered with respect to micro CT data to extract the common volume and the deviance to the pre-defined standard that characterizes the image quality. Results: The variations of the accelerating voltage, beam current and the rotation within the source-detection plane provided the expected quantitative behavior indicating the appropriate choice of the imaging quality factor. The tilting of the porcine mandible by about 14° improves the image quality by almost a factor of two. Conclusions: The tilting of the mandible with two dental implants can be used to significantly reduce the artifacts of the strongly X-ray absorbing materials in the CBCT images. The comparison of 14° jaw tilting with respect to the currently recommended arrangement in plane with the teeth demonstrates that the applied exposure time and the related dose can be reduced by a factor of four without decreasing the image quality.

  13. 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

  14. Quality indicators for prostate radiotherapy: are patients disadvantaged by receiving treatment in a 'generalist' centre?

    Science.gov (United States)

    Freeman, Amanda R; Roos, Daniel E; Kim, Laurence

    2015-04-01

    The purpose of this retrospective review was to evaluate concordance with evidence-based quality indicator guidelines for prostate cancer patients treated radically in a 'generalist' (as distinct from 'sub-specialist') centre. We were concerned that the quality of treatment may be lower in a generalist centre. If so, the findings could have relevance for many radiotherapy departments that treat prostate cancer. Two hundred fifteen consecutive patients received external beam radiotherapy (EBRT) and/or brachytherapy between 1.10.11 and 30.9.12. Treatment was deemed to be in line with evidence-based guidelines if the dose was: (i) 73.8-81 Gy at 1.8-2.0 Gy/fraction for EBRT alone (eviQ guidelines); (ii) 40-50 Gy (EBRT) for EBRT plus high-dose rate (HDR) brachytherapy boost (National Comprehensive Cancer Network (NCCN) guidelines); and (iii) 145 Gy for low dose rate (LDR) I-125 monotherapy (NCCN). Additionally, EBRT beam energy should be ≥6 MV using three-dimensional conformal RT (3D-CRT) or intensity-modulated RT (IMRT), and high-risk patients should receive neo-adjuvant androgen-deprivation therapy (ADT) (eviQ/NCCN). Treatment of pelvic nodes was also assessed. One hundred four high-risk, 84 intermediate-risk and 27 low-risk patients (NCCN criteria) were managed by eight of nine radiation oncologists. Concordance with guideline doses was confirmed in: (i) 125 of 136 patients (92%) treated with EBRT alone; (ii) 32 of 34 patients (94%) treated with EBRT + HDR BRT boost; and (iii) 45 of 45 patients (100%) treated with LDR BRT alone. All EBRT patients were treated with ≥6 MV beams using 3D-CRT (78%) or IMRT (22%). 84%, 21% and 0% of high-risk, intermediate-risk and low-risk patients received ADT, respectively. Overall treatment modality choice (including ADT use and duration where assessable) was concordant with guidelines for 176/207 (85%) of patients. The vast majority of patients were treated concordant with evidence-based guidelines suggesting that

  15. Gluten-Free Diet Indications, Safety, Quality, Labels, and Challenges.

    Science.gov (United States)

    Rostami, Kamran; Bold, Justine; Parr, Alison; Johnson, Matt W

    2017-08-08

    A gluten-free diet (GFD) is the safest treatment modality in patient with coeliac disease (CD) and other gluten-related disorders. Contamination and diet compliance are important factors behind persistent symptoms in patients with gluten related-disorders, in particular CD. How much gluten can be tolerated, how safe are the current gluten-free (GF) products, what are the benefits and side effects of GFD? Recent studies published in Nutrients on gluten-free products' quality, availability, safety, as well as challenges related to a GFD are discussed.

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

    Science.gov (United States)

    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.

  17. CHEMICAL WATER QUALITY INDICATORS IN BASIN FOREST PARCZEW

    Directory of Open Access Journals (Sweden)

    Antoni Grzywna

    2014-10-01

    Full Text Available This paper presents the characteristics of the chemistry of surface and ground water in the bottom of the river valley reclaimed Ochoza. Drained grassland accounts for 20% of the total catchment area and are located on organic soils in the valley Tyśmienica classified to the Natura 2000 sites. Analysis of physico-chemical properties of water are to assess the effects of anthropogenic transformation and identify factors that influence water quality in the study area. Water samples were collected in the years 2011–2012 in several points. The walls were characterized by surface water stagnant in the trenches, in July, blueberry plantation. Characterized by the highest quality of surface water runoff river with the test object. Occurring here throughout the growing season water flow reed growing on the bed and temporary impoundment of water contribute to the self-cleaning effect of water. Conducted at different times of the growing season (winter, spring, summer, autumn of water chemistry analysis allows to assess the impact of vegetation on the process of self-purification of water. Based on the survey it was found that the river is reduced by 26% BOD 5, COD by 37%, 12% phosphate and potassium by 13%. Concurrently, an increase in the content of nitrogen compounds – ammonia at 27% and 15% nitrate. The increase in the content of nitrogen compounds is particularly evident in the bottom of the object, which is probably associated with the deep trench causing excessive drying of the soil. The highest values of pollutants were recorded mostly in the spring probably due to the outflow of water from the drans.

  18. Study of the tomographic image quality provided by a conical beam system kilo voltage

    International Nuclear Information System (INIS)

    Garayoa Roca, J.; Castro Tejero, P.

    2011-01-01

    Imaging systems play an increasingly important role in radiotherapy, and to ensure the quality of the process, you must know the characteristics and limitations of available imaging systems. In this study we sought to evaluate the image quality of an IGRT system based on a kilo voltage cone beam.

  19. Constancy check of beam quality in conventional diagnostic X-ray equipment

    International Nuclear Information System (INIS)

    Costa, Alessandro M.; Badin, Romulo S.; Leite, Marina S.; Caldas, Linda V.E.

    2008-01-01

    A tandem ionization chamber was developed for quality control programs of X-ray equipment used in conventional radiography and mammography. A methodology for the use of the tandem chamber in the constancy check of diagnostic X-ray beam qualities was established. The application at a medical X-ray imaging facility of this established methodology is presented. The use of the tandem chamber in the constancy check of diagnostic X-ray beam qualities is a useful method to control the performance of the X-ray equipment

  20. Methods for slow axis beam quality improvement of high power broad area diode lasers

    Science.gov (United States)

    An, Haiyan; Xiong, Yihan; Jiang, Ching-Long J.; Schmidt, Berthold; Treusch, Georg

    2014-03-01

    For high brightness direct diode laser systems, it is of fundamental importance to improve the slow axis beam quality of the incorporated laser diodes regardless what beam combining technology is applied. To further advance our products in terms of increased brightness at a high power level, we must optimize the slow axis beam quality despite the far field blooming at high current levels. The later is caused predominantly by the built-in index step in combination with the thermal lens effect. Most of the methods for beam quality improvements reported in publications sacrifice the device efficiency and reliable output power. In order to improve the beam quality as well as maintain the efficiency and reliable output power, we investigated methods of influencing local heat generation to reduce the thermal gradient across the slow axis direction, optimizing the built-in index step and discriminating high order modes. Based on our findings, we have combined different methods in our new device design. Subsequently, the beam parameter product (BPP) of a 10% fill factor bar has improved by approximately 30% at 7 W/emitter without efficiency penalty. This technology has enabled fiber coupled high brightness multi-kilowatt direct diode laser systems. In this paper, we will elaborate on the methods used as well as the results achieved.

  1. Effect of electron beam on quality and physiological metabolism of blueberry

    International Nuclear Information System (INIS)

    Zhou Huijuan; Ye Zhengwen; Zhang Xueying; Su Mingshen; Du Jihong; Zhang Minqian

    2013-01-01

    In order to explore safe, simple and effective storage technology, experiment was conducted with 'ai li ao te' blueberry for studying the effect of electron beam on quality and physiological metabolism. Fruit was stored at temperature of (1 ± 0.5)℃, with RH of 80% ∼ 85%, and treated with electron beam of 0.5, 1, 1.5, 2, 3 kGy. The results showed that the proper dose of electron beam could decline the bad fruit rate and weightlessness, restrain respiration intensity, alleviate the decline of soluble solids, acid and Vc content. Meanwhile it did not have significant negative effects on pulp colour. All these showed that electron beam of 1 kGy treatment could keep the best storage quality of blueberry, keep the sound berry and weightlessness rate at > 90% and < 10% respectively, prolong the effective storage time from 30d to 60d. (authors)

  2. Formation of a high quality electron beam using photo cathode RF electron gun

    International Nuclear Information System (INIS)

    Washio, Masakazu

    2000-01-01

    Formation of a high quality electron beam using photo cathode RF electron gun is expected for formation of a next generation high brilliant X-ray beam and a source for electron and positron collider. And, on a field of material science, as is possible to carry out an experiment under ultra short pulse and extremely high precision in time, it collects large expectation. Recently, formation of high quality beam possible to develop for multi directions and to use by everyone in future has been able to realize. Here were explained on electron beam source, principle and component on RF electron gun, working features on RF gun, features and simulation of RF gun under operation, and some views in near future. (G.K.)

  3. 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.

  4. Radiochromic film calibration for the RQT9 quality beam

    Science.gov (United States)

    Costa, K. C.; Gomez, A. M. L.; Alonso, T. C.; Mourao, A. P.

    2017-11-01

    When ionizing radiation interacts with matter it generates energy deposition. Radiation dosimetry is important for medical applications of ionizing radiation due to the increasing demand for diagnostic radiology and radiotherapy. Different dosimetry methods are used and each one has its advantages and disadvantages. The film is a dose measurement method that records the energy deposition by the darkening of its emulsion. Radiochromic films have a little visible light sensitivity and respond better to ionizing radiation exposure. The aim of this study is to obtain the resulting calibration curve by the irradiation of radiochromic film strips, making it possible to relate the darkening of the film with the absorbed dose, in order to measure doses in experiments with X-ray beam of 120 kV, in computed tomography (CT). Film strips of GAFCHROMIC XR-QA2 were exposed according to RQT9 reference radiation, which defines an X-ray beam generated from a voltage of 120 kV. Strips were irradiated in "Laboratório de Calibração de Dosímetros do Centro de Desenvolvimento da Tecnologia Nuclear" (LCD / CDTN) at a dose range of 5-30 mGy, corresponding to the range values commonly used in CT scans. Digital images of the irradiated films were analyzed by using the ImageJ software. The darkening responses on film strips according to the doses were observed and they allowed obtaining the corresponding numeric values to the darkening for each specific dose value. From the numerical values of darkening, a calibration curve was obtained, which correlates the darkening of the film strip with dose values in mGy. The calibration curve equation is a simplified method for obtaining absorbed dose values using digital images of radiochromic films irradiated. With the calibration curve, radiochromic films may be applied on dosimetry in experiments on CT scans using X-ray beam of 120 kV, in order to improve CT acquisition image processes.

  5. 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)

  6. Optical components of adaptive systems for improving laser beam quality

    Science.gov (United States)

    Malakhov, Yuri I.; Atuchin, Victor V.; Kudryashov, Aleksis V.; Starikov, Fedor A.

    2008-10-01

    The short overview is given of optical equipment developed within the ISTC activity for adaptive systems of new generation allowing for correction of high-power laser beams carrying optical vortices onto the phase surface. They are the kinoform many-level optical elements of new generation, namely, special spiral phase plates and ordered rasters of microlenses, i.e. lenslet arrays, as well as the wide-aperture Hartmann-Shack sensors and bimorph deformable piezoceramics- based mirrors with various grids of control elements.

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

    Science.gov (United States)

    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

  8. Mixing layer height as an indicator for urban air quality?

    Directory of Open Access Journals (Sweden)

    A. Geiß

    2017-08-01

    Full Text Available The mixing layer height (MLH is a measure for the vertical turbulent exchange within the boundary layer, which is one of the controlling factors for the dilution of pollutants emitted near the ground. Based on continuous MLH measurements with a Vaisala CL51 ceilometer and measurements from an air quality network, the relationship between MLH and near-surface pollutant concentrations has been investigated. In this context the uncertainty of the MLH retrievals and the representativeness of ground-based in situ measurements are crucial. We have investigated this topic by using data from the BAERLIN2014 campaign in Berlin, Germany, conducted from June to August 2014. To derive the MLH, three versions of the proprietary software BL-VIEW and a novel approach COBOLT were compared. It was found that the overall agreement is reasonable if mean diurnal cycles are considered. The main advantage of COBOLT is the continuous detection of the MLH with a temporal resolution of 10 min and a lower number of cases when the residual layer is misinterpreted as mixing layer. We have calculated correlations between MLH as derived from the different retrievals and concentrations of pollutants (PM10, O3 and NOx for different locations in the metropolitan area of Berlin. It was found that the correlations with PM10 are quite different for different sites without showing a clear pattern, whereas the correlation with NOx seems to depend on the vicinity of emission sources in main roads. In the case of ozone as a secondary pollutant, a clear correlation was found. We conclude that the effects of the heterogeneity of the emission sources, chemical processing and mixing during transport exceed the differences due to different MLH retrievals. Moreover, it seems to be unrealistic to find correlations between MLH and near-surface pollutant concentrations representative for a city like Berlin (flat terrain, in particular when traffic emissions are dominant. Nevertheless it is

  9. 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

  10. Absorbed dose beam quality factors for cylindrical ion chambers: Experimental determination at 6 and 15 MV photon beams

    Energy Technology Data Exchange (ETDEWEB)

    Caporali, C; Guerra, A S; Laitano, R F; Pimpinella, M [ENEA-Casaccia, Inst. Nazionale di Meterologia delle Radiazioni Ionizzanti, Rome (Italy). Dipt. Ambiente

    1996-08-01

    Ion chambers calibrated in terms of absorbed dose to water need an additional factor conventionally designed by k{sub Q} in order to determine the absorbed dose. The quantity k{sub Q} depends on beam quality and chamber characteristics. Rogers and Andreo provided calculations of the k{sub Q} factors for most commercially available ionization chambers for clinical dosimetry. Experimental determinations of the k{sub Q} factors for a number of cylindrical ion chambers have been made and are compared with the calculated values so far published. Measurements were made at 6 MV and 15 MV clinical photon beams at a point in water phantom where the ion chambers and a Fricke dosimeter were alternatively irradiated. The uncertainty on the experimental k{sub Q} factors resulted about {+-} 0.6%. The theoretical and experimental k{sub Q} values are in fairly good agreement. (author). 12 refs, 3 tabs.

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

    Science.gov (United States)

    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.

  12. SU-E-T-464: On the Equivalence of the Quality Correction Factor for Pencil Beam Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Sorriaux, J; Paganetti, H; Testa, M; Giantsoudi, D; Schuemann, J; Bertrand, D; Orban de Xivry, J.; Lee, J; Palmans, H; Vynckier, S; Sterpin, E

    2014-01-01

    Purpose: In current practice, most proton therapy centers apply IAEA TRS-398 reference dosimetry protocol. Quality correction factors (kQ) take into account in the dose determination process the differences in beam qualities used for calibration unit and for treatment unit. These quality correction factors are valid for specific reference conditions. TRS-398 reference conditions should be achievable in both scattered proton beams (i.e. DS) and scanned proton beams (i.e. PBS). However, it is not a priori clear if TRS-398 kQ data, which are based on Monte Carlo (MC) calculations in scattered beams, can be used for scanned beams. Using TOPAS-Geant4 MC simulations, the study aims to determine whether broad beam quality correction factors calculated in TRS-398 can be directly applied to PBS delivery modality. Methods: As reference conditions, we consider a 10×10×10 cm 3 homogeneous dose distribution delivered by PBS system in a water phantom (32/10 cm range/modulation) and an air cavity placed at the center of the spread-out-Bragg-peak. In order to isolate beam differences, a hypothetical broad beam is simulated. This hypothetical beam reproduces exactly the same range modulation, and uses the same energy layers than the PBS field. Ion chamber responses are computed for the PBS and hypothetical beams and then compared. Results: For an air cavity of 2×2×0.2 cm 3 , the ratio of ion chamber responses for the PBS and hypothetical beam qualities is 0.9991 ± 0.0016. Conclusion: Quality correction factors are insensitive to the delivery pattern of the beam (broad beam or PBS), as long as similar dose distributions are achieved. This investigation, for an air cavity, suggests that broad beam quality correction factors published in TRS-398 can be applied for scanned beams. J. Sorriaux is financially supported by a public-private partnership involving the company Ion Beam Applications (IBA)

  13. Proton beam therapy in the management of skull base chordomas: systematic review of indications, outcomes, and implications for neurosurgeons.

    Science.gov (United States)

    Matloob, Samir A; Nasir, Haleema A; Choi, David

    2016-08-01

    Chordomas are rare tumours affecting the skull base. There is currently no clear consensus on the post-surgical radiation treatments that should be used after maximal tumour resection. However, high-dose proton beam therapy is an accepted option for post-operative radiotherapy to maximise local control, and in the UK, National Health Service approval for funding abroad is granted for specific patient criteria. To review the indications and efficacy of proton beam therapy in the management of skull base chordomas. The primary outcome measure for review was the efficacy of proton beam therapy in the prevention of local occurrence. A systematic review of English and non-English articles using MEDLINE (1946-present) and EMBASE (1974-present) databases was performed. Additional studies were reviewed when referenced in other studies and not available on these databases. Search terms included chordoma or chordomas. The PRISMA guidelines were followed for reporting our findings as a systematic review. A total of 76 articles met the inclusion and exclusion criteria for this review. Limitations included the lack of documentation of the extent of primary surgery, tumour size, and lack of standardised outcome measures. Level IIb/III evidence suggests proton beam therapy given post operatively for skull base chordomas results in better survival with less damage to surrounding tissue. Proton beam therapy is a grade B/C recommended treatment modality for post-operative radiation therapy to skull base chordomas. In comparison to other treatment modalities long-term local control and survival is probably improved with proton beam therapy. Further, studies are required to directly compare proton beam therapy to other treatment modalities in selected patients.

  14. Determination of the quality index (Q) for photon beams at arbitrary field sizes.

    Science.gov (United States)

    Sauer, Otto A

    2009-09-01

    A commonly used beam quality index (Q) for high-energy photon beams is the tissue phantom ratio (TPR20,10) for a square field of 10 x 10 cm2 and SDD of 100 cm. On some specialized radiotherapy treatment equipment such a reference collimator setting is not achievable. Likewise a flat beam profile, not explicitly required in dosimetry protocols, but certainly influences the measurement of Q, is not always produced. In this work, a method was developed in order to determine Q at any field size, especially for small and nonflattened beams. An analytical relationship was derived between TPR20,10 for arbitrary field sizes and Q [the TPR20,10 (10 x 10 cm2)] as quality index. The proposed model equation was fitted to the measured and published data in order to achieve three general fit parameters. The procedure was then tested with published data from TomoTherapy and CyperKnife treatment devices. For standard flattened photon fields, the uncertainty in Q measured at any field size using the parameters derived from this study is better than 1%. In flattening-filter free beams, the proposed procedure results in a reliable Q for any field size setting. A method is introduced and successfully tested in order to measure the beam quality under nonstandard conditions. It can be used, e.g., to get energy dependent correction factors as tabulated in dosimetry codes of practice even if standard conditions are not adjustable.

  15. 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,

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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,...

  19. 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

  20. 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

  1. Clinical Ion Beam Applications: Basic Properties, Application, Quality Control, Planning

    International Nuclear Information System (INIS)

    Kraft, Gerhard

    2009-01-01

    Heavy-ion therapy using beam scanning and biological dose optimization is a novel technique of high-precision external radiotherapy. It yields a better perspective for tumor cure of radio-resistant tumors. However, heavy-ion therapy is not a general solution for all types of tumors. As compared to conventional radiotherapy, heavy-ion radiotherapy has the advantages of higher tumor dose, improved sparing of normal tissue in the entrance channel, a more precise concentration of the dose in the target volume with steeper gradients to the normal tissue, and a higher radiobiological effectiveness for tumors which are radio-resistant in conventional therapy. These properties make it possible to treat radio-resistant tumors with great success, including those in close vicinity to critical organs.

  2. Direct measurement of electron beam quality conversion factors using water calorimetry

    Energy Technology Data Exchange (ETDEWEB)

    Renaud, James, E-mail: james.renaud@mail.mcgill.ca; Seuntjens, Jan [Medical Physics Unit, McGill University, Montréal, Québec H3G 1A4 (Canada); Sarfehnia, Arman [Medical Physics Unit, McGill University, Montréal, Québec H3G 1A4, Canada and Department of Radiation Oncology, University of Toronto, Toronto, Ontario M5S 3E2 (Canada); Marchant, Kristin [Allan Blair Cancer Centre, Saskatchewan Cancer Agency, Regina, Saskatchewan S4T 7T1, Canada and Department of Oncology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5A1 (Canada); McEwen, Malcolm; Ross, Carl [Ionizing Radiation Standards, National Research Council of Canada, Ottawa, Ontario K1A 0R6 (Canada)

    2015-11-15

    Purpose: In this work, the authors describe an electron sealed water calorimeter (ESWcal) designed to directly measure absorbed dose to water in clinical electron beams and its use to derive electron beam quality conversion factors for two ionization chamber types. Methods: A functioning calorimeter prototype was constructed in-house and used to obtain reproducible measurements in clinical accelerator-based 6, 9, 12, 16, and 20 MeV electron beams. Corrections for the radiation field perturbation due to the presence of the glass calorimeter vessel were calculated using Monte Carlo (MC) simulations. The conductive heat transfer due to dose gradients and nonwater materials was also accounted for using a commercial finite element method software package. Results: The relative combined standard uncertainty on the ESWcal dose was estimated to be 0.50% for the 9–20 MeV beams and 1.00% for the 6 MeV beam, demonstrating that the development of a water calorimeter-based standard for electron beams over such a wide range of clinically relevant energies is feasible. The largest contributor to the uncertainty was the positioning (Type A, 0.10%–0.40%) and its influence on the perturbation correction (Type B, 0.10%–0.60%). As a preliminary validation, measurements performed with the ESWcal in a 6 MV photon beam were directly compared to results derived from the National Research Council of Canada (NRC) photon beam standard water calorimeter. These two independent devices were shown to agree well within the 0.43% combined relative uncertainty of the ESWcal for this beam type and quality. Absorbed dose electron beam quality conversion factors were measured using the ESWcal for the Exradin A12 and PTW Roos ionization chambers. The photon-electron conversion factor, k{sub ecal}, for the A12 was also experimentally determined. Nonstatistically significant differences of up to 0.7% were found when compared to the calculation-based factors listed in the AAPM’s TG-51 protocol

  3. Theoretical and numerical studies on the transport of transverse beam quality in plasma-based accelerators

    International Nuclear Information System (INIS)

    Mehrling, Timon Johannes

    2014-11-01

    This work examines effects, which impact the transverse quality of electron-beams in plasma-based accelerators, by means of theoretical and numerical methods. Plasma-based acceleration is a promising candidate for future particle accelerator technologies. In plasma-based acceleration, highly intense laser beams or high-current relativistic particle beams are focused into a plasma to excite plasma-waves with extreme transverse and longitudinal electric fields. The amplitude of these fields exceed with 10-100 GV/m the ones in today's radio-frequency accelerators by several orders of magnitude, hence, in principle allowing for accordingly shorter and cheaper accelerators based on plasma. Despite the tremendous progress in the recent decade, beams from plasma accelerators are not yet achieving the quality as demanded for pivotal applications of relativistic electron-beams, e.g. free-electron lasers (FELs).Studies within this work examine how the quality can be optimized in the production of the beams and preserved during the acceleration and transport to the interaction region. Such studies cannot be approached purely analytical but necessitate numerical methods, such as the Particle-In-Cell (PIC) method, which can model kinetic, electrodynamic and relativistic plasma phenomena. However, this method is computationally too expensive for parameter-scans in three-dimensional geometries. Hence, a quasi-static PIC code was developed in connection with this work, which is significantly more effective than the full PIC method for a class of problems in plasma-based acceleration.The evolution of the emittance of beams which are injected into plasma modules was studied in this work by means of theoretical and the above numerical methods. It was shown that the beam parameters need to be matched accurately into the focusing plasma-channel in order to allow for beam-quality preservation. This suggested that new extraction and injection-techniques are required in staged plasma

  4. Direct measurement of electron beam quality conversion factors using water calorimetry.

    Science.gov (United States)

    Renaud, James; Sarfehnia, Arman; Marchant, Kristin; McEwen, Malcolm; Ross, Carl; Seuntjens, Jan

    2015-11-01

    In this work, the authors describe an electron sealed water calorimeter (ESWcal) designed to directly measure absorbed dose to water in clinical electron beams and its use to derive electron beam quality conversion factors for two ionization chamber types. A functioning calorimeter prototype was constructed in-house and used to obtain reproducible measurements in clinical accelerator-based 6, 9, 12, 16, and 20 MeV electron beams. Corrections for the radiation field perturbation due to the presence of the glass calorimeter vessel were calculated using Monte Carlo (MC) simulations. The conductive heat transfer due to dose gradients and nonwater materials was also accounted for using a commercial finite element method software package. The relative combined standard uncertainty on the ESWcal dose was estimated to be 0.50% for the 9-20 MeV beams and 1.00% for the 6 MeV beam, demonstrating that the development of a water calorimeter-based standard for electron beams over such a wide range of clinically relevant energies is feasible. The largest contributor to the uncertainty was the positioning (Type A, 0.10%-0.40%) and its influence on the perturbation correction (Type B, 0.10%-0.60%). As a preliminary validation, measurements performed with the ESWcal in a 6 MV photon beam were directly compared to results derived from the National Research Council of Canada (NRC) photon beam standard water calorimeter. These two independent devices were shown to agree well within the 0.43% combined relative uncertainty of the ESWcal for this beam type and quality. Absorbed dose electron beam quality conversion factors were measured using the ESWcal for the Exradin A12 and PTW Roos ionization chambers. The photon-electron conversion factor, kecal, for the A12 was also experimentally determined. Nonstatistically significant differences of up to 0.7% were found when compared to the calculation-based factors listed in the AAPM's TG-51 protocol. General agreement between the relative

  5. Metrology and quality of radiation therapy dosimetry of electron, photon and epithermal neutron beams

    Energy Technology Data Exchange (ETDEWEB)

    Kosunen, A

    1999-08-01

    In radiation therapy using electron and photon beams the dosimetry chain consists of several sequential phases starting by the realisation of the dose quantity in the Primary Standard Dosimetry Laboratory and ending to the calculation of the dose to a patient. A similar procedure can be described for the dosimetry of epithermal neutron beams in boron neutron capture therapy (BNCT). To achieve the required accuracy of the dose delivered to a patient the quality of all steps in the dosimetry procedure has to be considered. This work is focused on two items in the dosimetry chains: the determination of the dose in the reference conditions and the evaluation of the accuracy of dose calculation methods. The issues investigated and discussed in detail are: a)the calibration methods of plane parallel ionisation chambers used in electron beam dosimetry, (b) the specification of the critical dosimetric parameter i.e. the ratio of stopping powers for water to air, (S I ?){sup water} {sub air}, in photon beams, (c) the feasibility of the twin ionization chamber technique for dosimetry in epithermal neutron beams applied to BNCT and (d) the determination accuracy of the calculated dose distributions in phantoms in electron, photon, and epithermal neutron beams. The results demonstrate that up to a 3% improvement in the consistency of dose determinations in electron beams is achieved by the calibration of plane parallel ionisation chambers in high energy electron beams instead of calibrations in {sup 60}Co gamma beams. In photon beam dosimetry (S I ?){sup water} {sub air} can be determined with an accuracy of 0.2% using the percentage dose at the 10 cm depth, %dd(10), as a beam specifier. The use of %odd(10) requires the elimination of the electron contamination in the photon beam. By a twin ionisation chamber technique the gamma dose can be determined with uncertainty of 6% (1 standard deviation) and the total neutron dose with an uncertainty of 15 to 20% (1 standard deviation

  6. Metrology and quality of radiation therapy dosimetry of electron, photon and epithermal neutron beams

    International Nuclear Information System (INIS)

    Kosunen, A.

    1999-08-01

    In radiation therapy using electron and photon beams the dosimetry chain consists of several sequential phases starting by the realisation of the dose quantity in the Primary Standard Dosimetry Laboratory and ending to the calculation of the dose to a patient. A similar procedure can be described for the dosimetry of epithermal neutron beams in boron neutron capture therapy (BNCT). To achieve the required accuracy of the dose delivered to a patient the quality of all steps in the dosimetry procedure has to be considered. This work is focused on two items in the dosimetry chains: the determination of the dose in the reference conditions and the evaluation of the accuracy of dose calculation methods. The issues investigated and discussed in detail are: a)the calibration methods of plane parallel ionisation chambers used in electron beam dosimetry, (b) the specification of the critical dosimetric parameter i.e. the ratio of stopping powers for water to air, (S I ?) water air , in photon beams, (c) the feasibility of the twin ionization chamber technique for dosimetry in epithermal neutron beams applied to BNCT and (d) the determination accuracy of the calculated dose distributions in phantoms in electron, photon, and epithermal neutron beams. The results demonstrate that up to a 3% improvement in the consistency of dose determinations in electron beams is achieved by the calibration of plane parallel ionisation chambers in high energy electron beams instead of calibrations in 60 Co gamma beams. In photon beam dosimetry (S I ?) water air can be determined with an accuracy of 0.2% using the percentage dose at the 10 cm depth, %dd(10), as a beam specifier. The use of %odd(10) requires the elimination of the electron contamination in the photon beam. By a twin ionisation chamber technique the gamma dose can be determined with uncertainty of 6% (1 standard deviation) and the total neutron dose with an uncertainty of 15 to 20% (1 standard deviation). To improve the accuracy

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

    Directory of Open Access Journals (Sweden)

    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

  8. Environmental Indicator Principium with Case References to Agricultural Soil, Water, and Air Quality and Model-Derived Indicators.

    Science.gov (United States)

    Zhang, T Q; Zheng, Z M; Lal, R; Lin, Z Q; Sharpley, A N; Shober, A L; Smith, D; Tan, C S; Van Cappellen, P

    2018-03-01

    Environmental indicators are powerful tools for tracking environmental changes, measuring environmental performance, and informing policymakers. Many diverse environmental indicators, including agricultural environmental indicators, are currently in use or being developed. This special collection of technical papers expands on the peer-reviewed literature on environmental indicators and their application to important current issues in the following areas: (i) model-derived indicators to indicate phosphorus losses from arable land to surface runoff and subsurface drainage, (ii) glutathione-ascorbate cycle-related antioxidants as early-warning bioindicators of polybrominated diphenyl ether toxicity in mangroves, and (iii) assessing the effectiveness of using organic matrix biobeds to limit herbicide dissipation from agricultural fields, thereby controlling on-farm point-source pollution. This introductory review also provides an overview of environmental indicators, mainly for agriculture, with examples related to the quality of the agricultural soil-water-air continuum and the application of model-derived indicators. Current knowledge gaps and future lines of investigation are also discussed. It appears that environmental indicators, particularly those for agriculture, work efficiently at the field, catchment, and local scales and serve as valuable metrics of system functioning and response; however, these indicators need to be refined or further developed to comprehensively meet community expectations in terms of providing a consistent picture of relevant issues and/or allowing comparisons to be made nationally or internationally. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  9. Assessment of load of beam-balanced pumping units by electric motor power indicators

    Directory of Open Access Journals (Sweden)

    Д. И. Шишлянников

    2017-10-01

    Full Text Available The results of experimental studies on the loading of beam-balanced pumping units (BP of sucker rod- pumping equipment (SRPE are presented. It is noted that the key factor that has the most significant effect causing the SRPE failure is the balance of the beam pumping unit, which determines the amount of specific energy consumption for the rise of reservoir fluid and the level of dynamic loads on the machine units. The urgency of using software-recording systems for estimating the loading of units of oil field pumping installations is substantiated. The principle of operation and design of the «AKD-SK» software recording system is described. The prospects of using this method for controlling the performance parameters and evaluating the technical state of the sicker rod-pumping units is proved on the basis of an analysis of the magnitude and nature of the changes in the loads of drive motors determined by the registration of the instantaneous values of the consumed power. The main provisions of the methodology for analyzing the watt-meters of drive motors of the sucker rod-pumping units are outlined. The nature of the manifestation of the main defects of submersible pumps and beam-balanced pumping units is described. The results of pilot-industrial tests of the beam-balanced pumping units equipped with advanced permanent magnet motors and intelligent control stations are presented. It is proved that the use of permanent magnet motors allows to reduce the specific energy consumption for the rise of reservoir fluid, which increases the efficiency of the SRPE.However, the presence of transient processes and generator operating modes of the permanent magnet motors results in the occurrence of significant dynamic loads, which, due to the rigid fixing of the rotor of magnet motor on the reducer shaft, negatively affect the life of the gearbox bearings. It has been shown that the lack of its own bearings in the tested motors causes a high probability

  10. 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.

  11. 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.

  12. 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.

  13. Quality indicators for the hospital transfusion chain : A national survey conducted in 100 dutch hospitals

    NARCIS (Netherlands)

    Zijlker-Jansen, Pauline Y.; Janssen, M. P.; van Tilborgh-de Jong, A. J W; Schipperus, M. R.; Wiersum-Osselton, J. C.

    2015-01-01

    Background: The 2011 Dutch Blood Transfusion Guideline for hospitals incorporates seven internal quality indicators for evaluation of the hospital transfusion chain. The indicators aim to measure guideline compliance as shown by the instatement of a hospital transfusion committee and transfusion

  14. 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...

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

    Science.gov (United States)

    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

  16. Procedure for field axes measurement, beam indication adjustment, and figure of convergence determination within performance tests for radiation therapy equipment

    Energy Technology Data Exchange (ETDEWEB)

    Quast, U; Krause, K; Rassow, J [Essen Univ. (Gesamthochschule) (Germany, F.R.). Abt. fuer Klinische Strahlenphysik

    1976-09-01

    A routine measuring procedure for the verification of radiation field axes and figure of convergence within a spatial resolution of +- 0.5 mm is described. Measurements are done in two parallel planes in a certain distance before and behind the presumed isocentre. The used test arrangement permits rapid check and controlled adjustment of the alignment of beam or isocentre indicating devices for all isocentric radiation therapy equipment.

  17. Quality assurance of computed tomography scanner beams in diagnostic radiology

    International Nuclear Information System (INIS)

    Lindskoug, B.A.

    1989-01-01

    The number of computed tomography (CT) scanners in diagnostic radiology is increasing, to the extent that they are now found in relatively small hospitals. These hospitals do not have local physicists available and so methods must be developed to allow quality assurance to be carried out at distant laboratories. Several different types of solid water phantoms are available with various built-in test objects that may supply sufficient information about the many parameters that must be checked. The dose distributions, however, are usually not so well considered, although the connection between image quality and absorbed dose must be known for optimal use of a CT scanner. By introducing thermoluminescent dosemeters (TLDs) into a commercial phantom (RMI), it was possible to measure the absorbed dose profile and the line integral of the absorbed dose across the slit. The computer-guided readout of the TLDs gives the absorbed dose, the average dose and half maximum width, absorbed dose curve, and also the line integral of the peak. The only modification of the phantom was five holes, drilled at strategic positions, that did not influence the built-in test objects. This single measurement provides an appropriate monthly quality assurance check of the CT scanner with little extra effort. (author)

  18. Novel imaging and quality assurance techniques for ion beam therapy a Monte Carlo study

    CERN Document Server

    Rinaldi, I; Jäkel, O; Mairani, A; Parodi, K

    2010-01-01

    Ion beams exhibit a finite and well defined range in matter together with an “inverted” depth-dose profile, the so-called Bragg peak. These favourable physical properties may enable superior tumour-dose conformality for high precision radiation therapy. On the other hand, they introduce the issue of sensitivity to range uncertainties in ion beam therapy. Although these uncertainties are typically taken into account when planning the treatment, correct delivery of the intended ion beam range has to be assured to prevent undesired underdosage of the tumour or overdosage of critical structures outside the target volume. Therefore, it is necessary to define dedicated Quality Assurance procedures to enable in-vivo range verification before or during therapeutic irradiation. For these purposes, Monte Carlo transport codes are very useful tools to support the development of novel imaging modalities for ion beam therapy. In the present work, we present calculations performed with the FLUKA Monte Carlo code and pr...

  19. CALiPER Report 20.1: Subjective Evaluation of Beam Quality, Shadow Quality, and Color Quality for LED PAR38 Lamps

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2013-11-07

    This report focuses on human-evaluated characteristics, including beam quality, shadow quality, and color quality. Using a questionnaire that included rank-ordering, opinions on 27 of the Report 20 PAR38 lamps were gathered during a demonstration event for members of the local Illuminating Engineering Society (IES) chapter. This was not a rigorous scientific experiment, and the data should not be extrapolated beyond the scope of the demonstration. The results suggest that many of the LED products compared favorably to halogen PAR38 benchmarks in all attributes considered. LED lamps using a single-emitter design were generally preferred for their beam quality and shadow quality, and the IES members' ranking of color quality did not always match the rank according to the color rendering index (CRI).

  20. DOE CALiPER Program, Report 20.1 Subjective Evaluation of Beam Quality, Shadow Quality, and Color Quality for LED PAR38 Lamps

    Energy Technology Data Exchange (ETDEWEB)

    Royer, Michael P.; Poplawski, Michael E.; Miller, Naomi J.

    2013-10-01

    This report focuses on human-evaluated characteristics, including beam quality, shadow quality, and color quality. Using a questionnaire that included rank ordering, opinions on 27 of the Report 20 PAR38 lamps were gathered during a demonstration event for members of the local Illuminating Engineering Society (IES) chapter. This was not a rigorous scientific experiment, and the data should not be extrapolated beyond the scope of the demonstration. The results suggest that many of the LED products compared favorably to halogen PAR38 benchmarks in all attributes considered. LED lamps using a single-emitter design were generally preferred for their beam quality and shadow quality, and the IES members ranking of color quality did not always match the rank according to the color rendering index (CRI).

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

    Directory of Open Access Journals (Sweden)

    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.

  2. A sextupole ion beam guide to improve the efficiency and beam quality at IGISOL

    International Nuclear Information System (INIS)

    Karvonen, P.; Moore, I.D.; Sonoda, T.; Kessler, T.; Penttilae, H.; Peraejaervi, K.; Ronkanen, P.; Aystoe, J.

    2008-01-01

    The laser ion source project at the IGISOL facility, Jyvaeskylae, has motivated the development and construction of an rf sextupole ion beam guide (SPIG) to replace the original skimmer electrode. The SPIG has been tested both off-line and on-line in proton-induced fission, light-ion and heavy-ion induced fusion-evaporation reactions and, in each case, has been directly compared to the skimmer system. For both fission and light-ion induced fusion, the SPIG has improved the mass-separated ion yields by a factor of typically 4-8. Correspondingly, the transmission efficiency of both systems has been studied in simulations with and without space charge effects. The transport capacity of the SPIG has been experimentally determined to be ∼10 12 ions s -1 before space charge effects start to take effect. A direct comparison with the simulation has been made using data obtained via light-ion fusion evaporation. Both experiment and simulation show an encouraging agreement as a function of current extracted from the ion guide.

  3. Investigating the effect of electron emission pattern on RF gun beam quality

    Energy Technology Data Exchange (ETDEWEB)

    Rajabi, A. [Laser and Plasma Research Institute, Shahid Beheshti University, G.C., Velenjak, 1983963113, Tehran (Iran, Islamic Republic of); Shokri, B., E-mail: b-shokri@sbu.ac.ir [Laser and Plasma Research Institute, Shahid Beheshti University, G.C., Velenjak, 1983963113, Tehran (Iran, Islamic Republic of); Physics Department, Shahid Beheshti University, G.C., Velenjak, 1983963113, Tehran (Iran, Islamic Republic of)

    2016-05-11

    Thermionic radio frequency gun is one of the most promising choices to gain a high quality electron beam, used in the infrared free electron lasers and synchrotron radiation injectors. To study the quality of the beam in a compact electron source, the emission pattern effect on the beam dynamics should be investigated. In the presented work, we developed a 3D simulation code to model the real process of thermionic emission and to investigate the effect of emission pattern, by considering geometrical constraints, on the beam dynamics. According to the results, the electron bunch emittance varies considerably with the emission pattern. Simulation results have been validated via comparison with the well-known simulation codes such as ASTRA simulation code and CST microwave studio, as well as other simulation results in the literature. It was also demonstrated that by using a continuous wave laser beam for heating the cathode, the emission pattern full width at half maximum (FWHM) of the transverse emission distribution is proportional to FWHM of the Gaussian profile for the laser beam. Additionally, by using the developed code, the effect of wall structure around the cathode on the back bombardment effect has been studied. According to the results, for a stable operation of the RF gun, one should consider the nose cone in vicinity of the cathode surface to reduce the back-bombardment effect. - Highlights: • We developed a 3D code to simulate the beam dynamics of thermionic RF gun. • Te impact of the emission pattern on the beam dynamic was investigated. • Different emission pattern results different emittance in the gun exit. • Using a nosecone around the cathode adjacent wall reduces back bombardment effect.

  4. Practical use of a plastic scintillator for quality assurance of electron beam therapy.

    Science.gov (United States)

    Yogo, Katsunori; Tatsuno, Yuya; Tsuneda, Masato; Aono, Yuki; Mochizuki, Daiki; Fujisawa, Yoshiki; Matsushita, Akihiro; Ishigami, Minoru; Ishiyama, Hiromichi; Hayakawa, Kazushige

    2017-06-07

    Quality assurance (QA) of clinical electron beams is essential for performing accurate and safe radiation therapy. However, with advances in radiation therapy, QA has become increasingly labor-intensive and time-consuming. In this paper, we propose a tissue-equivalent plastic scintillator for quick and easy QA of clinical electron beams. The proposed tool comprises a plastic scintillator plate and a charge-coupled device camera that enable the scintillation light by electron beams to be recorded with high sensitivity and high spatial resolution. Further, the Cerenkov image is directly subtracted from the scintillation image to discriminate Cerenkov emissions and accurately measure the dose profiles of electron beams with high spatial resolution. Compared with conventional methods, discrepancies in the depth profile improved from 7% to 2% in the buildup region via subtractive corrections. Further, the output brightness showed good linearity with dose, good reproducibility (deviations below 1%), and dose rate independence (within 0.5%). The depth of 50% dose measured with the tool, an index of electron beam quality, was within  ±0.5 mm of that obtained with an ionization chamber. Lateral brightness profiles agreed with the lateral dose profiles to within 4% and no significant improvement was obtained using Cerenkov corrections. Field size agreed to within 0.5 mm with those obtained with ionization chamber. For clinical QA of electron boost treatment, a disk scintillator that mimics the shape of a patient's breast is applied. The brightness distribution and dose, calculated using a treatment planning system, was generally acceptable for clinical use, except in limited zones. Overall, the proposed plastic scintillator plate tool efficiently performs QA for electron beam therapy and enables simultaneous verification of output constancy, beam quality, depth, and lateral dose profiles during monthly QAs at lower doses of irradiation (small monitor units, MUs).

  5. 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.

  6. Evaluating the beam quality of double-cladding fiber lasers in applications.

    Science.gov (United States)

    Yan, Ping; Wang, Xuejiao; Gong, Mali; Xiao, Qirong

    2016-08-10

    We put forward a new βFL factor, which is used exclusively in fiber lasers and is suitable to assess beam quality and choose the LP01 mode as the new suitable ideal beam. We present a new simple measurement method and verify the reasonability of the βFL factor in experiment in a 20/400 μm fiber laser. Furthermore, we use the βFL factor to evaluate the beam quality of a 3-kW-level fiber laser. It can be concluded that βFL is a key factor not only for assessing the performance of the high-power fiber laser that is our main focus, but also for the simple measurement.

  7. 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.

  8. Long-term stability of beam quality and output of conventional X-ray units

    OpenAIRE

    Fukuda, Atsushi; Matsubara, Kosuke; Miyati, Toshiaki

    2015-01-01

    Conventional diagnostic X-ray units are used for radiographic imaging in many countries. For obtaining entrance surface doses, a numerical dose determination method has been applied in Japan. Although this technique is effective, it has to account for errors, particularly fluctuations, due to the beam quality and output of X-ray tubes. As a part of our quality control procedures, we recorded the entrance surface air kerma, tube voltage, and half-value layer measurements made for four diagnost...

  9. Commissioning and quality assurances of the CMS XIO radiotherapy treatment planning system for external beam photons

    International Nuclear Information System (INIS)

    Muralidhar, K.R.; Anurupa; Soubhagya; Sudhakar; Shiva; Krishnam Raju, A.; Narayana Murthy, P.

    2008-01-01

    The commissioning of XIO treatment planning system (TPS) was carried out by Computerized Medical Devices, USA for Siemens and Elekta linear accelerators. The Commissioning and quality assurance of the CMS XIO radiotherapy treatment planning system involves many steps, beginning from beam data acquisition and entry into the computerized TPS, through patient data acquisition, to treatment plan generation and the final transfer of data to the treatment machine and quality assurance of TPS

  10. 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.…

  11. 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…

  12. OECD Health Care Quality Indicator Project. The expert panel on primary care prevention and health promotion

    NARCIS (Netherlands)

    Marshall, Martin; Klazinga, Niek; Leatherman, Sheila; Hardy, Charlie; Bergmann, Eckhard; Pisco, Luis; Mattke, Soeren; Mainz, Jan

    2006-01-01

    PURPOSE: This article describes a project undertaken as part of the Organization for Economic Co-operation and Development (OECD)'s Healthcare Quality Indicator (HCQI) Project, which aimed to develop a set of quality indicators representing the domains of primary care, prevention and health

  13. 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

  14. 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...

  15. 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

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

    Science.gov (United States)

    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.

  17. 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

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

    Science.gov (United States)

    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.

  19. Beam quality management by periodic reproduction of wavefront aberrations in end-pumped Nd:YVO4 laser amplifiers.

    Science.gov (United States)

    Liu, Bin; Liu, Chong; Shen, Lifeng; Wang, Chunhua; Ye, Zhibin; Liu, Dong; Xiang, Zhen

    2016-04-18

    A method for beam quality management is presented in a master oscillator power amplifier (MOPA) using Nd:YVO4 as the gain medium by extra-cavity periodic reproduction of wavefront aberrations. The wavefront aberration evolution of the intra-cavity beams is investigated for both symmetrical and asymmetrical resonators. The wavefront aberration reproduction process is successfully realized outside the cavity in four-stage amplifiers. In the MOPA with a symmetrical oscillator, the laser power increases linearly and the beam quality hardly changes. In the MOPA with an asymmetrical oscillator, the beam quality is deteriorated after the odd-stage amplifier and is improved after the even-stage amplifier. The wavefront aberration reproduction during the extra-cavity beam propagation in the amplifiers is equivalent to that during the intra-cavity propagation. This solution helps to achieve the effective beam quality management in laser amplifier chains.

  20. 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.

  1. 2000W high beam quality diode laser for direct materials processing

    Science.gov (United States)

    Qin, Wen-bin; Liu, You-qiang; Cao, Yin-hua; Gao, Jing; Pan, Fei; Wang, Zhi-yong

    2011-11-01

    This article describes high beam quality and kilowatt-class diode laser system for direct materials processing, using optical design software ZEMAX® to simulate the diode laser optical path, including the beam shaping, collimation, coupling, focus, etc.. In the experiment, the diode laser stack of 808nm and the diode laser stack of 915nm were used for the wavelength coupling, which were built vertical stacks up to 16 bars. The threshold current of the stack is 6.4A, the operating current is 85A and the output power is 1280W. Through experiments, after collimating the diode laser beam with micro-lenses, the fast axis BPP of the stack is less than 60mm.mrad, and the slow-axis BPP of the stack is less than 75mm.mrad. After shaping the laser beam and improving the beam quality, the fast axis BPP of the stack is still 60mm.mrad, and the slow-axis BPP of the stack is less than 19mm.mrad. After wavelength coupling and focusing, ultimately the power of 2150W was obtained, focal spot size of 1.5mm * 1.2mm with focal length 300mm. The laser power density is 1.2×105W/cm2, and that can be used for metal remelting, alloying, cladding and welding. The total optical coupling conversion efficiency is 84%, and the total electrical - optical conversion efficiency is 50%.

  2. Improved image quality for asymmetric double-focal cone-beam SPECT

    International Nuclear Information System (INIS)

    Cao, Z.J.; Tsui, B.M.W.

    1993-01-01

    To optimize both spatial resolution and detection efficiency in brain SPECT imaging using a rectangular camera, an asymmetric double-focal cone-beam collimator is proposed with the focal points located near the base plane of the patient's head. To fit the entire head into the field-of-view of the collimator with dimensions of 50cmx40cm and at a radius-of-rotation of 15 cm, the focal lengths of the collimator are 55 and 70 cm, respectively, in the transverse and axial directions. With this geometry, the artifacts in the reconstructed image produced by the Feldkamp algorithm are more severe compared to those in a symmetric cone-beam geometry, due to the larger vertex angle between the top of the head and the base plane. To improve the reconstructed image quality, a fully three-dimensional (3D) reconstruction algorithm developed previously for single-focal cone-beam SPECT was extended to the asymmetric double-focal cone-beam geometry. The algorithm involves nonstationary 2D filtering and a reprojection technique for estimation of the missing data caused by a single-orbit cone-beam geometry. The results from simulation studies with the 3D Defrise slab phantom demonstrated that the fully 3D algorithm provided a much improved image quality in terms of reduced slice-to-slice cross talks and shape elongation compared to that produced by the conventional Feldkamp algorithm

  3. Quality of 'Climax' blueberries after low dosage electron beam irradiation

    International Nuclear Information System (INIS)

    Miller, W.R.; McDonald, R.E.; McCollum, T.G.; Smittle, B.J.

    1994-01-01

    Fruit of 'Climax' rabbiteye blueberries (Vaccinium ashei Reade) were irradiated by a linear accelerator at 0, 0.25, 0.5, 0.75, 1.0, and 1.25 kGy and evaluated for various quality attributes after storage for 1, 3, 7, or 14 days at 1C plus 2 days at 15C, respectively. Weight loss increased during storage and averaged 4.2% after the final inspection and was not affected by irradiation dosage. About 5% of total berries were decayed after 14 days at 1C, about 6% after the final inspection at 15C, but decay was not affected by the level of irradiation. Electrolyte leakage, skin color, total soluble solids, acidity, and pH were also not affected by irradiation dosage. There was a significant decline in berry firmness, flavor, and texture as dosage increased. Berries treated at 1.0 kGy or above were softer and had lower flavor and texture preference scores than berries treated at lower dosages or nontreated berries

  4. Use of a two-dimensional ionization chamber array for proton therapy beam quality assurance

    International Nuclear Information System (INIS)

    Arjomandy, Bijan; Sahoo, Narayan; Ding Xiaoning; Gillin, Michael

    2008-01-01

    Two-dimensional ion chamber arrays are primarily used for conventional and intensity modulated radiotherapy quality assurance. There is no commercial device of such type available on the market that is offered for proton therapy quality assurance. We have investigated suitability of the MatriXX, a commercial two-dimensional ion chamber array detector for proton therapy QA. This device is designed to be used for photon and electron therapy QA. The device is equipped with 32x32 parallel plate ion chambers, each with 4.5 mm diam and 7.62 mm center-to-center separation. A 250 MeV proton beam was used to calibrate the dose measured by this device. The water equivalent thickness of the buildup material was determined to be 3.9 mm using a 160 MeV proton beam. Proton beams of different energies were used to measure the reproducibility of dose output and to evaluate the consistency in the beam flatness and symmetry measured by MatriXX. The output measurement results were compared with the clinical commissioning beam data that were obtained using a 0.6 cc Farmer chamber. The agreement was consistently found to be within 1%. The profiles were compared with film dosimetry and also with ion chamber data in water with an excellent agreement. The device is found to be well suited for quality assurance of proton therapy beams. It provides fast two-dimensional dose distribution information in real time with the accuracy comparable to that of ion chamber measurements and film dosimetry

  5. 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

  6. 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

  7. Response of TLD-100"T"M microtubes to two RQR3 quality radiation beams

    International Nuclear Information System (INIS)

    Nunes, M.G.; Villani, D.; Almeida, S.B.; Vivolo, V.; Yoriyaz, H.; Louis, G.M.J.

    2016-01-01

    The present work compares the response of TLD-100"T"M microcubes to two RQR 3 diagnostic radiology reference quality radiation beams, defined by IEC-61267 norm, aiming to evaluate the detectability of TLD-100"T"M energy dependence reported in literature within the same reference quality radiation range. TLD-100"T"M microcubes reproducibility is assessed through the response of a second set of TLD-100"T"M microcubes, evaluated in a second thermoluminescence reader, to the RQR 3 diagnostic radiology reference quality radiation beam implemented at the Laboratorio de Calibracao de Instrumentos of IPEN, Sao Paulo, SP, Brazil. The dependence of TLD-100"T"M microcubes TL response was not detectable in these conditions and the reproducibility of the measurements is 90,2%. (author)

  8. 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.

  9. 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.

  10. 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...

  11. WATER QUALITY ANALYSIS OF LOTIC ECOSYSTEMS FROM UPPER MUREŞ RIVER CATCHMENT AREA USING DIFFERENT BIOTIC INDICES

    Directory of Open Access Journals (Sweden)

    Milca PETROVICI

    2012-01-01

    Full Text Available Present paper approach the issue of assessing the water quality of tributaries located in the upper basin of the river Mureş, taking into account changes in the value of biotic indices. In this sense, have been selected the next five biotic indices: Ephemeroptera Plecoptera Trichoptera index (EPT, Total Invertebrates index (T, Chironomidae index (Ch, EPT / Total invertebrates index (EPT / T, EPT / Chironomidae index (EPT / Ch and % Chironomidae index (% Chironomidae. Considering all these indices, it was found existence of a medium to best quality water in Mureş tributaries from Harghita Mountains and a good quality water which comes from the Maramureş Mountains and Transylvania Plateau.

  12. Quality Indicators for Family Support Services and Their Relationship to Organizational Social Context

    Science.gov (United States)

    Olin, S. Serene; Williams, Nate; Pollock, Michele; Armusewicz, Kelsey; Kutash, Krista; Glisson, Charles; Hoagwood, Kimberly E.

    2013-01-01

    Quality measurement is an important component of healthcare reform. The relationship of quality indicators (QIs) for parent-delivered family support services to organizational social contexts known to improve quality is unexamined. This study employs data collected from 21 child mental health programs that deliver team-based family support services. Performance on two levels of QIs —those targeting the program and staff -- were significantly associated with organizational social context profiles and dimensions. High quality program policies are associated with positive organizational cultures and engaging climates. Inappropriate staff practices are associated with resistant cultures. Implications for organizational strategies to improve service quality are discussed. PMID:23709286

  13. An Overview of Key Indicators and Evaluation Tools for Assessing Housing Quality: A Literature Review

    Science.gov (United States)

    Sinha, Rajan Chandra; Sarkar, Satyaki; Mandal, Nikhil Ranjan

    2017-09-01

    The issue of the housing quality has been addressed for various stakeholders at different levels. There exist varied opinion about its measurability and possible applications. Thus the study is carried out to have an insight into the concept of housing quality and its relevance in the changing demographics, technological, socio-economic and socio-cultural conditions. This study attempts to summarize the literature that addresses past research concerned with factors related to housing quality, its measurement methodology and critically examines the broad key indicators identified to have impact upon enhancing the housing quality. This work discusses the recent techniques which are extensively used for analysis of housing quality.

  14. Pilot Quality Control Program for Audit RT External Beams at Mexican Hospitals

    International Nuclear Information System (INIS)

    Alvarez R, J T; Tovar M, V M

    2008-01-01

    A pilot quality control program for audit 18 radiotherapy RT external beams at 13 Mexican hospitals is described--for eleven 60 Co beams and seven photon beams of 6, 10 and 15 MV from accelerators. This program contains five parts: a) Preparation of the TLD-100 powder: washing, drying and annealing (one hour 400 deg. C plus 24 hrs 80 deg. C). b) Sending two IAEA type capsules to the hospitals for irradiation at the hospital to a nominal D W = 2 Gy·c) Preparation at the SSDL of ten calibration curves CC in the range of 0.5 Gy to 6 Gy in terms of absorbed dose to water D W for 60 Co with traceability to primary laboratory NRC (Canada), according to a window irradiation: 26/10/2007-7/12/2007. d) Reading all capsules that match their hospital time irradiation and the SSDL window irradiation. f) Evaluation of the Dw imparted by the hospitals

  15. Pilot Quality Control Program for Audit RT External Beams at Mexican Hospitals

    Science.gov (United States)

    Álvarez R., J. T.; Tovar M., V. M.

    2008-08-01

    A pilot quality control program for audit 18 radiotherapy RT external beams at 13 Mexican hospitals is described—for eleven 60 Co beams and seven photon beams of 6, 10 and 15 MV from accelerators. This program contains five parts: a) Preparation of the TLD-100 powder: washing, drying and annealing (one hour 400 °C plus 24 hrs 80 °C). b) Sending two IAEA type capsules to the hospitals for irradiation at the hospital to a nominal DW = 2 Gy ṡ c ) Preparation at the SSDL of ten calibration curves CC in the range of 0.5 Gy to 6 Gy in terms of absorbed dose to water DW for 60 Co with traceability to primary laboratory NRC (Canada), according to a window irradiation: 26/10/2007-7/12/2007. d) Reading all capsules that match their hospital time irradiation and the SSDL window irradiation. f) Evaluation of the Dw imparted by the hospitals.

  16. Leaflet manual of external beam radiation therapy for hepatocellular carcinoma: a review of the indications, evidences, and clinical trials

    Directory of Open Access Journals (Sweden)

    Rim CH

    2018-05-01

    Full Text Available Chai Hong Rim, Won Sup Yoon Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan, Republic of Korea Abstract: The use of external beam radiation therapy (EBRT in the treatment of hepatocellular carcinoma (HCC, which was rarely performed due to liver toxicity with a previous technique, has increased. Palliation of portal vein thrombosis, supplementation for insufficient transarterial chemoembolization, and provision of new curative opportunities using stereotactic body radiotherapy are the potential indications for use of EBRT. The mechanism of EBRT treatment, with its radiobiological and physical perspectives, differs from those of conventional medical treatment or surgery. Therefore, understanding the effects of EBRT may be unfamiliar to physicians other than radiation oncologists, especially in the field of HCC, where EBRT has recently begun to be applied. The first objective of this review was to concisely explain the indications for use of EBRT for HCC for all physicians treating HCC. Therefore, this review focuses on the therapeutic outcomes rather than the detailed biological and physical background. We also reviewed recent clinical trials that may extend the indications for use of EBRT. Finally, we reviewed the current clinical practice guidelines for the treatment of HCC and discuss the current recommendations and future perspectives. Keywords: hepatocellular carcinoma, liver neoplasm, external beam radiotherapy, stereotactic body radiotherapy, clinical trials, sorafenib, guidelines

  17. 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.

  18. Pork loin quality is not indicative of fresh belly or fresh and cured ham quality.

    Science.gov (United States)

    Arkfeld, E K; Wilson, K B; Overholt, M F; Harsh, B N; Lowell, J E; Hogan, E K; Klehm, B J; Bohrer, B M; Mohrhauser, D A; King, D A; Wheeler, T L; Dilger, A C; Shackelford, S D; Boler, D D

    2016-12-01

    The objective was to characterize the relationship between fresh loin quality with fresh belly or fresh and cured ham quality. Pigs raised in 8 barns representing 2 seasons [cold ( = 4,290) and hot ( = 3,394)] and 2 production focuses [lean ( = 3,627) and quality ( = 4,057)] were used. Carcass characteristics and other meat quality data were collected on 7,684 carcasses. All of the carcasses were evaluated for HCW, LM depth, tenth rib fat depth, leg (ham primal) weight, instrumental color on the gluteus medius and gluteus profundus of the ham face, and subjective loin quality. Instrumental loin color and ultimate pH (≥ 22 h postmortem) were collected on the ventral side of loins along with dimensions and firmness scores of fresh bellies from 50% of the carcasses. Ten percent of the boneless loins and fresh hams were evaluated for slice shear force (SSF) or cured ham characteristics. Correlation coefficients between traits were computed using the CORR procedure of SAS and considered significantly different from 0 at ≤ 0.05. Temperature decline, beginning at 31 min postmortem and concluding at 22 h postmortem, for the longissimus dorsi and semimembranosus muscles were evaluated on 10% of the carcasses. Ultimate loin pH was correlated with dimensional belly characteristics ( ≥ |0.07|; ham instrumental color ( ≥ |0.03|; ≤ 0.05), and semimembranosus ultimate pH ( = 0.33; hams. Instrumental L*on the ventral surface of the loin was related to L* on both muscles of the ham face ( ≤ 0.0001). Even though significant relationships between the loin, belly, and ham were detected, the variability in belly and ham quality explained by variability in loin quality was poor (≤ 22.09%). Compositional differences between the loin and belly may have contributed to those poor relationships. Additionally, differences in temperature declines during chilling between the loin and ham likely contributed to the weak nature of relationships. Equilibration of longissimus dorsi

  19. 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.

  20. [Obsessive compulsive disorder and the internet. An evaluation of Dutch-language websites and quality indicators].

    Science.gov (United States)

    Serdobbel, Y; Pieters, G; Joos, S

    2006-01-01

    The Internet is an important source of information about health matters. The quality of the information about Obsessive Compulsive Disorder (OCD) has not been investigated. Possible indicators of quality are the DISCERN rating tool, Google PageRank and cooperation from health care professionals. To investigate the quality of the information given on Dutch-language websites relating to OCD and to determine whether the quality of the contents is correlated with site characteristics, scores on DISCERN and Google PageRank. We selected 27 Dutch-language websites via Google and Ixquick and investigated the correlation between the quality of the contents measured by 4 parameters and the presence of incorrect information, site characteristics, the DISCERN score and Google PageRank. The quality of the information was generally poor. The only investigated site characteristic that was found to be associated with basic criteria relating to symptoms and diagnosis was the size of the site. The DISCERN score was significantly correlated with the quality of the information. The occurrence of incorrect information was independent of the quality of the content, site characteristics, Google PageRank and DISCERN scores. The quality of Dutch-language websites on the subject of OCD is inadequate. Site characteristics and Google PageRank are not good predictors of the quality of information. The DISCERN rating tool is a potentially valuable indicator of content quality with regard to treatment options.

  1. 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.

  2. Building Quality Foundations: Indicators and Instruments to Measure the Quality of Vocational Education and Training

    Science.gov (United States)

    Coates, Hamish

    2009-01-01

    Vocational education and training plays a major and increasing role in developing the knowledge and skills that underpin Australia's economy and society. It is vital, accordingly, that training outcomes are of high quality. This paper reports work undertaken to develop a new evidence-based and outcomes-focused national approach to monitoring and…

  3. Image simulation and a model of noise power spectra across a range of mammographic beam qualities

    Energy Technology Data Exchange (ETDEWEB)

    Mackenzie, Alistair, E-mail: alistairmackenzie@nhs.net; Dance, David R.; Young, Kenneth C. [National Coordinating Centre for the Physics of Mammography, Royal Surrey County Hospital, Guildford GU2 7XX, United Kingdom and Department of Physics, University of Surrey, Guildford GU2 7XH (United Kingdom); Diaz, Oliver [Centre for Vision, Speech and Signal Processing, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom and Computer Vision and Robotics Research Institute, University of Girona, Girona 17071 (Spain)

    2014-12-15

    Purpose: The aim of this work is to create a model to predict the noise power spectra (NPS) for a range of mammographic radiographic factors. The noise model was necessary to degrade images acquired on one system to match the image quality of different systems for a range of beam qualities. Methods: Five detectors and x-ray systems [Hologic Selenia (ASEh), Carestream computed radiography CR900 (CRc), GE Essential (CSI), Carestream NIP (NIPc), and Siemens Inspiration (ASEs)] were characterized for this study. The signal transfer property was measured as the pixel value against absorbed energy per unit area (E) at a reference beam quality of 28 kV, Mo/Mo or 29 kV, W/Rh with 45 mm polymethyl methacrylate (PMMA) at the tube head. The contributions of the three noise sources (electronic, quantum, and structure) to the NPS were calculated by fitting a quadratic at each spatial frequency of the NPS against E. A quantum noise correction factor which was dependent on beam quality was quantified using a set of images acquired over a range of radiographic factors with different thicknesses of PMMA. The noise model was tested for images acquired at 26 kV, Mo/Mo with 20 mm PMMA and 34 kV, Mo/Rh with 70 mm PMMA for three detectors (ASEh, CRc, and CSI) over a range of exposures. The NPS were modeled with and without the noise correction factor and compared with the measured NPS. A previous method for adapting an image to appear as if acquired on a different system was modified to allow the reference beam quality to be different from the beam quality of the image. The method was validated by adapting the ASEh flat field images with two thicknesses of PMMA (20 and 70 mm) to appear with the imaging characteristics of the CSI and CRc systems. Results: The quantum noise correction factor rises with higher beam qualities, except for CR systems at high spatial frequencies, where a flat response was found against mean photon energy. This is due to the dominance of secondary quantum noise

  4. 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

  5. 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.

  6. EVALUATION OF QUALITY INDICATORS RELATED TO QUALITY BREAD WHEAT PROMISING LINES

    Directory of Open Access Journals (Sweden)

    Watson Munyanyi

    2014-01-01

    Full Text Available The bread waste is one of the important socio-economic's issues country now, the urgent need is feeling to improve the wheat quality. Therefore, using the methods of farming and breeding is necessary to improve the quality of this strategic product. As a result, tests of quality's traits in wheat promising lines in Isfahan climate took place. In this study, the choice 17 advanced lines of compare the performances,s experiments, an experiment was conducted for two consecutive cropping (2011-2012 at cultural experiment and research centre in Isfahan located in Kabutar Abad region. Randomized complete block designs with 3 replications were compared with Spring variety (for control. Traits including: 1000 grain weight, hectolitre weight, protein content, Zeleny sedimentation rate, bread volume, grain moisture content, grain hardness, water absorption, falling number, percentage of dry gluten, gluten index, sedimentation rates were SDS.The results of the combined analysis of variance qualitative characteristics,s for two consecutive cropping showed that treatments with compare together and control variety had significant influence in 1% probability.Correlation coefficients of two years showed that the compound test significant positive correlation within grain hardness index and protein content, wet gluten and dry deposition rates of SDS. Also, significant positive correlation with the percentage of protein content of dry gluten. In view of the high correlation with protein content of dry gluten (quantity. However, grain hardness and relatively high correlation with SDS sedimentation as an important measure of protein quality. Therefore, the test results of dry gluten grains can be tough to choose in order to improve the quality of wheat bread may be used.

  7. 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

  8. Teaching Quality Management Model for the Training of Innovation Ability and the Multilevel Decomposition Indicators

    Science.gov (United States)

    Lu, Xingjiang; Yao, Chen; Zheng, Jianmin

    2013-01-01

    This paper focuses on the training of undergraduate students' innovation ability. On top of the theoretical framework of the Quality Function Deployment (QFD), we propose a teaching quality management model. Based on this model, we establish a multilevel decomposition indicator system, which integrates innovation ability characterized by four…

  9. 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…

  10. 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. ...

  11. 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,

  12. 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.

  13. Development of quality indicators based on a multidisciplinary, evidence-based guideline on pediatric constipation

    NARCIS (Netherlands)

    Stienen, J.J.C.; Tabbers, M.M.; Benninga, M.A.; Harmsen, M.; Ouwens, M.M.T.J.

    2011-01-01

    Several clinical guidelines for childhood functional constipation have been developed, but none of them is accompanied by a set of quality indicators. It is important to gain insight into the quality of care in daily practice in order to improve the implementation of clinical guidelines. This can be

  14. 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…

  15. 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

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

    Science.gov (United States)

    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.

  17. 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.

  18. 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 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.

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

    Science.gov (United States)

    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.

  20. ISTC Projects from RFNC-VNIIEF Devoted to Improving Laser Beam Quality

    Science.gov (United States)

    Starikov, F.; Kochemasov, G.

    Information is given about the Projects # 1929 and # 2631 supported by ISTC and concerned with improving laser beam quality and interesting for adaptive optics community. One of them, Project # 1929 has been recently finished. It has been devoted to development of an SBS phase conjugation mirror of superhigh conjugation quality employing the kinoform optics for high-power lasers with nanosecond scale pulse duration. With the purpose of reaching ideal PC fidelity, the SBS mirror includes the raster of small lenses that has been traditionally used as the lenslet in Shack-Hartmann wavefront sensor in adaptive optics. The second of them, Project # 2631, is concerned with the development of an adaptive optical system for phase correction of laser beams with wavefront vortex. The principles of operation of modern adaptive systems are based on the assumption that the phase is a smooth continuous function in space. Therefore the solution of the Project tasks will assume a new step in adaptive optics.

  1. ATLAS tile calorimeter data quality assessment and performance with calibration, cosmic and first beam data

    International Nuclear Information System (INIS)

    Volpi, Matteo

    2010-01-01

    The commissioning of the barrel hadronic calorimeter (Tile) of the ATLAS detector at the Large Hadron Collider (LHC) has been the focus of an extensive project over the last several years. Work with Tile has resulted in a fully operational detector before the first LHC beam test on 10 September 2008. A set of tools has been developed spanning from the hardware and software systems of the detector and online monitoring to the offline reconstruction. This set of tools constitutes the final Tile data quality system and is highly integrated with all ATLAS online and offline frameworks. A review of the final data quality system of the Tile hadronic calorimeter will be presented together with selected results on hardware reliability. This will be followed by the detector performance checks performed on cosmic data and on the first LHC beam data taken on 10 September 2008.

  2. Impact of coherent synchrotron radiation on beam qualities in a Chicane

    International Nuclear Information System (INIS)

    Xiang Dao; Huang Wenhui; He Xiaozhong

    2004-01-01

    When the bunch goes through a Chicane, the energy will be redistributed within the bunch due to CSR (coherent synchrotron radiation), which would cause nonlinearity. Present theory states that this nonlinearity would add a huge amount to emittance growth. Based on simulation results, this paper would point out that the theory is only valid under an ideal condition that the bunch initially has no nonlinearity and under some given parameters there could be a cancellation between the nonlinearity caused by CSR and the initial nonlinearity. So under these circumstances authors can expect CSR to improve the beam quality. This paper provides a brief information about CSR and a full estimation of effects of CSR on beam qualities

  3. 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.

  4. 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...

  5. 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

  6. TU-FG-BRB-12: Real-Time Visualization of Discrete Spot Scanning Proton Therapy Beam for Quality Assurance

    International Nuclear Information System (INIS)

    Matsuzaki, Y; Jenkins, C; Yang, Y; Xing, L; Yoshimura, T; Fujii, Y; Umegaki, K

    2016-01-01

    Purpose: With the growing adoption of proton beam therapy there is an increasing need for effective and user-friendly tools for performing quality assurance (QA) measurements. The speed and versatility of spot-scanning proton beam (PB) therapy systems present unique challenges for traditional QA tools. To address these challenges a proof-of-concept system was developed to visualize, in real-time, the delivery of individual spots from a spot-scanning PB in order to perform QA measurements. Methods: The PB is directed toward a custom phantom with planar faces coated with a radioluminescent phosphor (Gd2O2s:Tb). As the proton beam passes through the phantom visible light is emitted from the coating and collected by a nearby CMOS camera. The images are processed to determine the locations at which the beam impinges on each face of the phantom. By so doing, the location of each beam can be determined relative to the phantom. The cameras are also used to capture images of the laser alignment system. The phantom contains x-ray fiducials so that it can be easily located with kV imagers. Using this data several quality assurance parameters can be evaluated. Results: The proof-of-concept system was able to visualize discrete PB spots with energies ranging from 70 MeV to 220 MeV. Images were obtained with integration times ranging from 20 to 0.019 milliseconds. If not limited by data transmission, this would correspond to a frame rate of 52,000 fps. Such frame rates enabled visualization of individual spots in real time. Spot locations were found to be highly correlated (R"2=0.99) with the nozzle-mounted spot position monitor indicating excellent spot positioning accuracy Conclusion: The system was shown to be capable of imaging individual spots for all clinical beam energies. Future development will focus on extending the image processing software to provide automated results for a variety of QA tests.

  7. TU-FG-BRB-12: Real-Time Visualization of Discrete Spot Scanning Proton Therapy Beam for Quality Assurance

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzaki, Y [Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo, Hokkaido (Japan); Jenkins, C; Yang, Y; Xing, L [Stanford University, Stanford, California (United States); Yoshimura, T; Fujii, Y [Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido (Japan); Umegaki, K [Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Hokkaido (Japan)

    2016-06-15

    Purpose: With the growing adoption of proton beam therapy there is an increasing need for effective and user-friendly tools for performing quality assurance (QA) measurements. The speed and versatility of spot-scanning proton beam (PB) therapy systems present unique challenges for traditional QA tools. To address these challenges a proof-of-concept system was developed to visualize, in real-time, the delivery of individual spots from a spot-scanning PB in order to perform QA measurements. Methods: The PB is directed toward a custom phantom with planar faces coated with a radioluminescent phosphor (Gd2O2s:Tb). As the proton beam passes through the phantom visible light is emitted from the coating and collected by a nearby CMOS camera. The images are processed to determine the locations at which the beam impinges on each face of the phantom. By so doing, the location of each beam can be determined relative to the phantom. The cameras are also used to capture images of the laser alignment system. The phantom contains x-ray fiducials so that it can be easily located with kV imagers. Using this data several quality assurance parameters can be evaluated. Results: The proof-of-concept system was able to visualize discrete PB spots with energies ranging from 70 MeV to 220 MeV. Images were obtained with integration times ranging from 20 to 0.019 milliseconds. If not limited by data transmission, this would correspond to a frame rate of 52,000 fps. Such frame rates enabled visualization of individual spots in real time. Spot locations were found to be highly correlated (R{sup 2}=0.99) with the nozzle-mounted spot position monitor indicating excellent spot positioning accuracy Conclusion: The system was shown to be capable of imaging individual spots for all clinical beam energies. Future development will focus on extending the image processing software to provide automated results for a variety of QA tests.

  8. Project outline of high quality electron beam generation at Waseda University

    Energy Technology Data Exchange (ETDEWEB)

    Washio, M.; Hama, Y.; Kashiwagi, S.; Kuroda, R.; Kobuki, T. [Waseda Univ., Advanced Research Institute for Science and Engineering, Shinjuku, Tokyo (Japan); Hirose, T. [Tokyo Metropolitan Univ. (Japan). Dept. of Physics

    2000-03-01

    High quality electron beam generation project has been started at Waseda University under the grant of Ministry of Education, named High-Tech Research Center Project. In the project, we will install a laser photo-cathode RF Gun system with 1.6 accelerating structure cells of s-band and a stabilized RF power source. This RF Gun is expected to produce single electron bunch up to 1 or 2nC with around 10ps pulse duration. (author)

  9. Project outline of high quality electron beam generation at Waseda University

    International Nuclear Information System (INIS)

    Washio, M.; Hama, Y.; Kashiwagi, S.; Kuroda, R.; Kobuki, T.; Hirose, T.

    2000-01-01

    High quality electron beam generation project has been started at Waseda University under the grant of Ministry of Education, named High-Tech Research Center Project. In the project, we will install a laser photo-cathode RF Gun system with 1.6 accelerating structure cells of s-band and a stabilized RF power source. This RF Gun is expected to produce single electron bunch up to 1 or 2nC with around 10ps pulse duration. (author)

  10. 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.

  11. 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.

  12. Application of electron-beam irradiation combined with antioxidants for fermented sausage and its quality characteristic

    International Nuclear Information System (INIS)

    Lim, D.G.; Seol, K.H.; Jeon, H.J.; Jo, C.; Lee, M.

    2008-01-01

    The effects of various doses of electron-beam irradiation on the changes in microbiological attributes of fermented sausage and the combined effect of electron-beam irradiation and various antioxidants on the oxidative stability and sensory properties during cold storage were investigated. Results indicated that 2 kGy of irradiation was the most effective in manufacturing a fermented sausage, and the addition of rosemary extracts was effective in controlling the production of off-flavor and development of lipid oxidation during cold storage

  13. Application of electron-beam irradiation combined with antioxidants for fermented sausage and its quality characteristic

    Science.gov (United States)

    Lim, D. G.; Seol, K. H.; Jeon, H. J.; Jo, C.; Lee, M.

    2008-06-01

    The effects of various doses of electron-beam irradiation on the changes in microbiological attributes of fermented sausage and the combined effect of electron-beam irradiation and various antioxidants on the oxidative stability and sensory properties during cold storage were investigated. Results indicated that 2 kGy of irradiation was the most effective in manufacturing a fermented sausage, and the addition of rosemary extracts was effective in controlling the production of off-flavor and development of lipid oxidation during cold storage.

  14. Quality control and radioprotection in dental cone beam computed tomography - case study

    International Nuclear Information System (INIS)

    Rodrigues, Ligiane C.N.; Ferreira, Nadya M.P.D.

    2011-01-01

    The radiological protection in medical and odontologic radiology follows The Order (Portaria) 453/98 of the Ministry of Health, which presents the minimum set of tests for the constancy X-ray equipment. These tests follow the procedures set forth in the Resolution no. 64, the National Agency for Sanitary Vigilance. This work aims to show a study on dental cone beam computed tomography (CBCT), evaluating the physical parameters that influence the performance and image quality and presenting the appropriate tests to this new system. The authors analyzed the tests specific for computed tomography (CT) of the Resolution no. 64, feasibility assessment of them and if their interpretations are compatible with CBCT. Once determined if testing is feasible, compare with those presented in the manual provided by the equipment manufacturer. The CT scanner used was the Mini-Cat Tomography Scanner Xoran Technologies of KAVO. In the study it was verified that four tests could be reproduced in CBCT: noise, accuracy and uniformity in the number of CT of water and spatial resolution. Considering experimental data, the methodology and tolerance of manufacturer for the first two tests were more appropriate. For the uniformity test of the CT number, we recommend using the phantom quality control. Three new tests were suggested to be made in the quality control of the Cone Beam: linearity, artifacts and alignment of the beam. (author)

  15. Quality control and radioprotection in dental cone beam computed tomography - case study

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, Ligiane C.N.; Ferreira, Nadya M.P.D., E-mail: lnadya@ime.eb.br [Instituto Militar de Engenharia (IME), Rio de Janeiro, RJ (Brazil)

    2011-07-01

    The radiological protection in medical and odontologic radiology follows The Order (Portaria) 453/98 of the Ministry of Health, which presents the minimum set of tests for the constancy X-ray equipment. These tests follow the procedures set forth in the Resolution no. 64, the National Agency for Sanitary Vigilance. This work aims to show a study on dental cone beam computed tomography (CBCT), evaluating the physical parameters that influence the performance and image quality and presenting the appropriate tests to this new system. The authors analyzed the tests specific for computed tomography (CT) of the Resolution no. 64, feasibility assessment of them and if their interpretations are compatible with CBCT. Once determined if testing is feasible, compare with those presented in the manual provided by the equipment manufacturer. The CT scanner used was the Mini-Cat Tomography Scanner Xoran Technologies of KAVO. In the study it was verified that four tests could be reproduced in CBCT: noise, accuracy and uniformity in the number of CT of water and spatial resolution. Considering experimental data, the methodology and tolerance of manufacturer for the first two tests were more appropriate. For the uniformity test of the CT number, we recommend using the phantom quality control. Three new tests were suggested to be made in the quality control of the Cone Beam: linearity, artifacts and alignment of the beam. (author)

  16. Morphometric analysis - Cone beam computed tomography to predict bone quality and quantity.

    Science.gov (United States)

    Hohlweg-Majert, B; Metzger, M C; Kummer, T; Schulze, D

    2011-07-01

    Modified quantitative computed tomography is a method used to predict bone quality and quantify the bone mass of the jaw. The aim of this study was to determine whether bone quantity or quality was detected by cone beam computed tomography (CBCT) combined with image analysis. MATERIALS AND PROCEDURES: Different measurements recorded on two phantoms (Siemens phantom, Comac phantom) were evaluated on images taken with the Somatom VolumeZoom (Siemens Medical Solutions, Erlangen, Germany) and the NewTom 9000 (NIM s.r.l., Verona, Italy) in order to calculate a calibration curve. The spatial relationships of six sample cylinders and the repositioning from four pig skull halves relative to adjacent defined anatomical structures were assessed by means of three-dimensional visualization software. The calibration curves for computer tomography (CT) and cone beam computer tomography (CBCT) using the Siemens phantom showed linear correlation in both modalities between the Hounsfield Units (HU) and bone morphology. A correction factor for CBCT was calculated. Exact information about the micromorphology of the bone cylinders was only available using of micro computer tomography. Cone-beam computer tomography is a suitable choice for analysing bone mass, but, it does not give any information about bone quality. 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  17. Monitoring of performance management using Quality Assurance Indicators and ISO requirement

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. Enchytraeids as indicator of soil quality in temporary organic grass-clover leys under contrasting management

    DEFF Research Database (Denmark)

    Maraldo, Kristine; Schmelz, Rüdiger; Larsen, Thomas

    2015-01-01

    One objective in organic farming is to sustain the quality of the soil resource. Because enchytraeids are an important soil faunal component, they stand as bioindicators of soil quality. We tested this candidature in a field experiment on loamy sand soil with 1- and 4-year old grass-clover leys...... interactions among soil physical, chemical and biological properties suggest that enchytraeid abundance is not a feasible stand-alone indicator of management impacts on soil quality in temporary grass-clover leys but may candidate as one of several biological key parameters in more comprehensive soil quality...

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Evaluation of multiple water quality indices for drinking and irrigation purposes for the Karoon river, Iran.

    Science.gov (United States)

    Aminiyan, Milad Mirzaei; Aitkenhead-Peterson, Jacqueline; Aminiyan, Farzad Mirzaei

    2018-06-16

    The main purpose of this study was to evaluate the water quality of the Karoon river, which is a main river in Iran country. For this purpose, hydrochemical analyses of a database that maintained by the Water Resources Authority of Khuzestan Province, Iran's Ministry of Energy, were carried out. These data were compared with the maximum permissible limit values recommended by World Health Organization and Food and Agriculture Organization water standards for drinking and agricultural purposes, respectively. Also in this regard, multiple indices of water quality were utilized. However, not all indices gave similar rankings for water quality. According to the USSL diagram and Kelly ratio, Karoon's water quality is not suitable for irrigation purposes due to high salinity and moderate alkalinity. However, the results of the magnesium hazard analysis suggested that water quality for irrigation is acceptable. A Piper diagram illustrated that the most dominant water types during the 15 years of the study were Na-Cl and Na-SO 4 . The mineral saturation index also indicated that Na-Cl is the dominant water type. The water quality for drinking purpose was evaluated using a Schoeller diagram and water quality index (WQI). According to the computed WQI ranging from 111.9 to 194.0, the Karoon's water in the Khuzestan plain can be categorized as "poor water" for drinking purposes. Based on hydrochemical characteristics, years 2000-2007 and 2008-2014 were categorized into two clusters illustrating a decline in water quality between the two time periods.

  3. Quality control beam of radiation through imaging system using a flat panel (ILD)

    International Nuclear Information System (INIS)

    Benitez Serrano, J. A.; Gomez Barrado, A.; Sanchez-Reyes, A.

    2013-01-01

    The daily quality checks of the accelerator include, among others, checks of the daily calibration, symmetry and uniformity of the radiation beam. Usually verification systems daily are used for this purpose, which employ arrays of detectors of solid-state or ionization chambers. This paper intends to carry out the control of quality through the irradiation of a number of fields in the portal imaging system and its subsequent analysis in software's own creation, as well as the comparison of results with the daily verification system. (Author)

  4. SU-C-201-07: Towards Clinical Cherenkov Emission Dosimetry: Stopping Power-To-Cherenkov Power Ratios and Beam Quality Specification of Clinical Electron Beams

    International Nuclear Information System (INIS)

    Zlateva, Y; Seuntjens, J; El Naqa, I

    2016-01-01

    Purpose: We propose a Cherenkov emission (CE)-based reference dosimetry method, which in contrast to ionization chamber-based dosimetry, employs spectrum-averaged electron restricted mass collision stopping power-to-Cherenkov power ratios (SCRs), and we examine Monte Carlo-calculated SCRs and beam quality specification of clinical electron beams. Methods: The EGSnrc user code SPRRZnrc was modified to compute SCRs instead of stopping-power ratios (single medium: water; cut-off: CE threshold (observing Spencer-Attix conditions); CE power: Frank-Tamm). SCRs are calculated with BEAMnrc for realistic electron beams with nominal energies of 6–22 MeV from three Varian accelerators (TrueBeam Clinac 21EX, Clinac 2100C/D) and for mono-energetic beams of energies equal to the mean electron energy at the water surface. Sources of deviation between clinical and mono-energetic SCRs are analyzed quantitatively. A universal fit for the beam-quality index R_5_0 in terms of the depth of 50% CE C_5_0 is carried out. Results: SCRs at reference depth are overestimated by mono-energetic values by up to 0.2% for a 6-MeV beam and underestimated by up to 2.3% for a 22-MeV beam. The variation is mainly due to the clinical beam spectrum and photon contamination. Beam angular spread has a small effect across all depths and energies. The influence of the electron spectrum becomes increasingly significant at large depths, while at shallow depths and high beam energies photon contamination is predominant (up to 2.0%). The universal data fit reveals a strong linear correlation between R_5_0 and C_5_0 (ρ > 0.99999). Conclusion: CE is inherent to radiotherapy beams and can be detected outside the beam with available optical technologies, which makes it an ideal candidate for out-of-beam high-resolution 3D dosimetry. Successful clinical implementation of CE dosimetry hinges on the development of robust protocols for converting measured CE to radiation dose. Our findings constitute a key step

  5. Key team physical and technical performance indicators indicative of team quality in the soccer Chinese super league.

    Science.gov (United States)

    Yang, Gai; Leicht, Anthony S; Lago, Carlos; Gómez, Miguel-Ángel

    2018-01-01

    The aim of this study was to identify the key physical and technical performance variables related to team quality in the Chinese Super League (CSL). Teams' performance variables were collected from 240 matches and analysed via analysis of variance between end-of-season-ranked groups and multinomial logistic regression. Significant physical performance differences between groups were identified for sprinting (top-ranked group vs. upper-middle-ranked group) and total distance covered without possession (upper and upper-middle-ranked groups and lower-ranked group). For technical performance, teams in the top-ranked group exhibited a significantly greater amount of possession in opponent's half, number of entry passes in the final 1/3 of the field and the Penalty Area, and 50-50 challenges than lower-ranked teams. Finally, time of possession increased the probability of a win compared with a draw. The current study identified key performance indicators that differentiated end-season team quality within the CSL.

  6. 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.

  7. 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.

  8. Image quality improvement in megavoltage cone beam CT using an imaging beam line and a sintered pixelated array system

    International Nuclear Information System (INIS)

    Breitbach, Elizabeth K.; Maltz, Jonathan S.; Gangadharan, Bijumon; Bani-Hashemi, Ali; Anderson, Carryn M.; Bhatia, Sudershan K.; Stiles, Jared; Edwards, Drake S.; Flynn, Ryan T.

    2011-01-01

    Purpose: To quantify the improvement in megavoltage cone beam computed tomography (MVCBCT) image quality enabled by the combination of a 4.2 MV imaging beam line (IBL) with a carbon electron target and a detector system equipped with a novel sintered pixelated array (SPA) of translucent Gd 2 O 2 S ceramic scintillator. Clinical MVCBCT images are traditionally acquired with the same 6 MV treatment beam line (TBL) that is used for cancer treatment, a standard amorphous Si (a-Si) flat panel imager, and the Kodak Lanex Fast-B (LFB) scintillator. The IBL produces a greater fluence of keV-range photons than the TBL, to which the detector response is more optimal, and the SPA is a more efficient scintillator than the LFB. Methods: A prototype IBL + SPA system was installed on a Siemens Oncor linear accelerator equipped with the MVision TM image guided radiation therapy (IGRT) system. A SPA strip consisting of four neighboring tiles and measuring 40 cm by 10.96 cm in the crossplane and inplane directions, respectively, was installed in the flat panel imager. Head- and pelvis-sized phantom images were acquired at doses ranging from 3 to 60 cGy with three MVCBCT configurations: TBL + LFB, IBL + LFB, and IBL + SPA. Phantom image quality at each dose was quantified using the contrast-to-noise ratio (CNR) and modulation transfer function (MTF) metrics. Head and neck, thoracic, and pelvic (prostate) cancer patients were imaged with the three imaging system configurations at multiple doses ranging from 3 to 15 cGy. The systems were assessed qualitatively from the patient image data. Results: For head and neck and pelvis-sized phantom images, imaging doses of 3 cGy or greater, and relative electron densities of 1.09 and 1.48, the CNR average improvement factors for imaging system change of TBL + LFB to IBL + LFB, IBL + LFB to IBL + SPA, and TBL + LFB to IBL + SPA were 1.63 (p -8 ), 1.64 (p -13 ), 2.66 (p -9 ), respectively. For all imaging doses, soft tissue contrast was more

  9. 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.

  10. Dynamic Database for Quality Indicators Comparison in Education. Working Paper N. 04/2010

    Science.gov (United States)

    Poliandri, Donatella; Cardone, Michele; Muzzioli, Paola; Romiti, Sara

    2010-01-01

    The purpose of this study is to explore aspects and indicators most commonly used to assess the quality of education systems in different countries through the comparison of 12 national publications describing the state of the educational system. To compare indicators the CIPP model was chosen. This model is organized in four main parts: Context,…

  11. Quality indicators for the assessment and management of pain in the emergency department: a systematic review.

    Science.gov (United States)

    Stang, Antonia Schirmer; Hartling, Lisa; Fera, Cassandra; Johnson, David; Ali, Samina

    2014-01-01

    Evidence indicates that pain is undertreated in the emergency department (ED). The first step in improving the pain experience for ED patients is to accurately and systematically assess the actual care being provided. Identifying gaps in the assessment and treatment of pain and improving patient outcomes requires relevant, evidence-based performance measures. To systematically review the literature and identify quality indicators specific to the assessment and management of pain in the ED. Four major bibliographical databases were searched from January 1980 to December 2010, and relevant journals and conference proceedings were manually searched. Original research that described the development or collection of data on one or more quality indicators relevant to the assessment or management of pain in the ED was included. The search identified 18,078 citations. Twenty-three articles were included: 15 observational (cohort) studies; three before-after studies; three audits; one quality indicator development study; and one survey. Methodological quality was moderate, with weaknesses in the reporting of study design and methodology. Twenty unique indicators were identified, with the majority (16 of 20) measuring care processes. Overall, 91% (21 of 23) of the studies reported indicators for the assessment or management of presenting pain, as opposed to procedural pain. Three of the studies included children; however, none of the indicators were developed specifically for a pediatric population. Gaps in the existing literature include a lack of measures reflecting procedural pain, patient outcomes and the pediatric population. Future efforts should focus on developing indicators specific to these key areas.

  12. 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...

  13. 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.

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

    Science.gov (United States)

    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.

  15. A Comprehensive Real-Time Indoor Air-Quality Level Indicator

    Directory of Open Access Journals (Sweden)

    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.

  16. Evaluation of various approaches for assessing dose indicators and patient organ doses resulting from radiotherapy cone-beam CT

    International Nuclear Information System (INIS)

    Rampado, Osvaldo; Giglioli, Francesca Romana; Rossetti, Veronica; Ropolo, Roberto; Fiandra, Christian; Ragona, Riccardo

    2016-01-01

    Purpose: The aim of this study was to evaluate various approaches for assessing patient organ doses resulting from radiotherapy cone-beam CT (CBCT), by the use of thermoluminescent dosimeter (TLD) measurements in anthropomorphic phantoms, a Monte Carlo based dose calculation software, and different dose indicators as presently defined. Methods: Dose evaluations were performed on a CBCT Elekta XVI (Elekta, Crawley, UK) for different protocols and anatomical regions. The first part of the study focuses on using PCXMC software (PCXMC 2.0, STUK, Helsinki, Finland) for calculating organ doses, adapting the input parameters to simulate the exposure geometry, and beam dose distribution in an appropriate way. The calculated doses were compared to readouts of TLDs placed in an anthropomorphic Rando phantom. After this validation, the software was used for analyzing organ dose variability associated with patients’ differences in size and gender. At the same time, various dose indicators were evaluated: kerma area product (KAP), cumulative air-kerma at the isocenter (K_a_i_r), cone-beam dose index, and central cumulative dose. The latter was evaluated in a single phantom and in a stack of three adjacent computed tomography dose index phantoms. Based on the different dose indicators, a set of coefficients was calculated to estimate organ doses for a range of patient morphologies, using their equivalent diameters. Results: Maximum organ doses were about 1 mGy for head and neck and 25 mGy for chest and pelvis protocols. The differences between PCXMC and TLDs doses were generally below 10% for organs within the field of view and approximately 15% for organs at the boundaries of the radiation beam. When considering patient size and gender variability, differences in organ doses up to 40% were observed especially in the pelvic region; for the organs in the thorax, the maximum differences ranged between 20% and 30%. Phantom dose indexes provided better correlation with organ doses

  17. 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.

  18. LD-pumped erbium and neodymium lasers with high energy and output beam quality

    Science.gov (United States)

    Kabanov, Vladimir V.; Bezyazychnaya, Tatiana V.; Bogdanovich, Maxim V.; Grigor'ev, Alexandr V.; Lebiadok, Yahor V.; Lepchenkov, Kirill V.; Ryabtsev, Andrew G.; Ryabtsev, Gennadii I.; Shchemelev, Maxim A.

    2013-05-01

    Physical and fabrication peculiarities which provide the high output energy and beam quality for the diode pumped erbium glass and Nd:YAG lasers are considered. Developed design approach allow to make passively Q-switched erbium glass eye-safe portable laser sources with output energy 8 - 12 mJ (output pulse duration is less than 25 ns, pulse repetition rate up to 5 Hz) and beam quality M2 less than 1.3. To reach these values the erbium laser pump unit parameters were optimized also. Namely, for the powerful laser diode arrays the optimal near-field fill-factor, output mirror reflectivity and heterostructure properties were determined. Construction of advanced diode and solid-state lasers as well as the optical properties of the active element and the pump unit make possible the lasing within a rather wide temperature interval (e.g. from minus forty till plus sixty Celsius degree) without application of water-based chillers. The transversally pumped Nd:YAG laser output beam uniformity was investigated depending on the active element (AE) pump conditions. In particular, to enhance the pump uniformity within AE volume, a special layer which practically doesn't absorb the pump radiation but effectively scatters the pump and lasing beams, was used. Application of such layer results in amplified spontaneous emission suppression and improvement of the laser output beam uniformity. The carried out investigations allow us to fabricate the solid-state Nd:YAG lasers (1064 nm) with the output energy up to 420 mJ at the pulse repetition rate up to 30 Hz and the output energy up to 100 mJ at the pulse repetition rate of of 100 Hz. Also the laser sources with following characteristics: 35 mJ, 30 Hz (266 nm); 60 mJ, 30 Hz (355 nm); 100 mJ, 30 Hz (532 nm) were manufactured on the base of the developed Nd:YAG quantrons.

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

    Science.gov (United States)

    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

  20. Large deflection angle, high-power adaptive fiber optics collimator with preserved near-diffraction-limited beam quality.

    Science.gov (United States)

    Zhi, Dong; Ma, Yanxing; Chen, Zilun; Wang, Xiaolin; Zhou, Pu; Si, Lei

    2016-05-15

    We report on the development of a monolithic adaptive fiber optics collimator, with a large deflection angle and preserved near-diffraction-limited beam quality, that has been tested at a maximal output power at the 300 W level. Additionally, a new measurement method of beam quality (M2 factor) is developed. Experimental results show that the deflection angle of the collimated beam is in the range of 0-0.27 mrad in the X direction and 0-0.19 mrad in the Y direction. The effective working frequency of the device is about 710 Hz. By employing the new measurement method of the M2 factor, we calculate that the beam quality is Mx2=1.35 and My2=1.24, which is in agreement with the result from the beam propagation analyzer and is preserved well with the increasing output power.

  1. [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.

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

    Science.gov (United States)

    Lester, Helen; Schmittdiel, Julie; Selby, Joe; Fireman, Bruce; Campbell, Stephen; Lee, Janelle; Whippy, Alan; Madvig, Philip

    2010-05-11

    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. Longitudinal analysis. 35 medical facilities of Kaiser Permanente Northern California, 1997-2007. 2 523 659 adult members of Kaiser Permanente Northern California. Main outcomes measures Yearly assessment of patient level glycaemic control (HbA(1c) financial incentives were attached to screening for diabetic retinopathy (1999-2003), the rate rose from 84.9% to 88.1%. This was followed by four years without incentives when the rate fell year on year to 80.5%. During the two initial years when financial incentives were attached to cervical cancer screening (1999-2000), the screening rate rose slightly, from 77.4% to 78.0%. During the next five years when financial incentives were removed, screening rates fell year on year to 74.3%. Incentives were then reattached for two years (2006-7) and screening rates began to increase. Across the 35 facilities, the removal of incentives was associated with a decrease in performance of about 3% per year on average for screening for diabetic retinopathy and about 1.6% per year for cervical cancer screening. Policy makers and clinicians should be aware that removing facility directed financial incentives from clinical indicators may mean that performance levels decline.

  3. 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.

  4. SU-E-I-52: Effect of Various X-Ray Beam Qualities On the Exposure Index

    International Nuclear Information System (INIS)

    Yasumatsu, S; Iwase, K; Shimizu, Y; Tanaka, N; Morishita, J

    2015-01-01

    Purpose: The exposure index (EI) proposed by the International Electrotechnical Commission (IEC) 62494-1 is expected to be utilized as a standard dose index by every manufacturer. The IEC recommended the usage of RQA5 for the EI. However, X-ray beam qualities, particularly in clinical practices, vary depending on the examination objects and exposure conditions, including usage of anti-scatter grids. We investigated the effects of the X-ray beam qualities other than RQA5 on the EI. Methods: The Xray beam qualities of RQA3, 5, 7, and 9 in IEC 61267 Ed. 1.0 were adopted in a computed radiography system. A uniform exposure without objects was performed to measure the exposure indicators (S values) and air kerma (K). The relational equations between the S values and K were derived for the determination of the EI values. The EI values for RQA3, 7, and 9 were compared to those for RQA5 at the fixed S values of 100, 200, 400, and 600. Finally, the half-value layers (HVLs) using four grids (ratio 6:1, 8:1, 10:1, and 12:1) for the RQA5 X-ray were compared to those with RQA3–9. Results: The EI values for RQA3, 7, and 9 were up to 35.3%, 11.8%, and 38.7% higher, respectively, than that for RQA5 at the S value of 600. The HVLs without grids and with various grids for RQA5 were 6.85 mm Al. and in the range of 6.94–7.29 mm Al. (ΔHVL: up to 0.44 mm Al.), respectively. This variation in the HVLs with grids was smaller than that observed for RQA3–9 (ΔHVL: 2.0–7.5 mm Al.). Conclusion: Although the usage of grids may not greatly affect the EI, the X-ray beam quality for the determination of the EI cannot be ignored in the clinical evaluation of the dose index

  5. 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."

  6. [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.

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

    Science.gov (United States)

    Sowińska-Świerkosz, Barbara Natalia; Chmielewski, Tadeusz J

    2016-12-15

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

  8. [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.

  9. [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.

  10. 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.

  11. 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.

  12. Modelling lateral beam quality variations in pencil kernel based photon dose calculations

    International Nuclear Information System (INIS)

    Nyholm, T; Olofsson, J; Ahnesjoe, A; Karlsson, M

    2006-01-01

    Standard treatment machines for external radiotherapy are designed to yield flat dose distributions at a representative treatment depth. The common method to reach this goal is to use a flattening filter to decrease the fluence in the centre of the beam. A side effect of this filtering is that the average energy of the beam is generally lower at a distance from the central axis, a phenomenon commonly referred to as off-axis softening. The off-axis softening results in a relative change in beam quality that is almost independent of machine brand and model. Central axis dose calculations using pencil beam kernels show no drastic loss in accuracy when the off-axis beam quality variations are neglected. However, for dose calculated at off-axis positions the effect should be considered, otherwise errors of several per cent can be introduced. This work proposes a method to explicitly include the effect of off-axis softening in pencil kernel based photon dose calculations for arbitrary positions in a radiation field. Variations of pencil kernel values are modelled through a generic relation between half value layer (HVL) thickness and off-axis position for standard treatment machines. The pencil kernel integration for dose calculation is performed through sampling of energy fluence and beam quality in sectors of concentric circles around the calculation point. The method is fully based on generic data and therefore does not require any specific measurements for characterization of the off-axis softening effect, provided that the machine performance is in agreement with the assumed HVL variations. The model is verified versus profile measurements at different depths and through a model self-consistency check, using the dose calculation model to estimate HVL values at off-axis positions. A comparison between calculated and measured profiles at different depths showed a maximum relative error of 4% without explicit modelling of off-axis softening. The maximum relative error

  13. Application of the entropy concept to describe the quality of a X-ray beam

    International Nuclear Information System (INIS)

    Oliveira, A.D.

    2002-01-01

    In a previous work (Oliveira and Pedroso de Lima, 2000), we introduced the concept of entropy to describe the degradation of the energy of a photon beam incident in a material. We pointed out the relation between both, the entropy of the distribution of the energy deposited in matter and the traditional quality factor of the radiation protection. From the point of view of the entropy, we showed that, in what concerns to the monoenergetic approximation to a polyenergetic beam, we can hardly speak in an approximation (Oliveira 2001). In fact, the behaviour of the entropy is very different for both, an X-ray and a monoenergetic beam. In this work we developed further the study of the degradation of the energy of X-ray photons, from the point of view of the entropy, introducing the concepts of surface entropy, S surf , equilibrium entropy, S eq , and concepts of entropy variation, namely, primary to surface variation, S ps , and total entropy variation, S T . These are characteristic parameters of the X-ray beams describing the degradation of the primary photons while they interact with matter

  14. Improving the beam quality of high-power laser diodes by introducing lateral periodicity into waveguides

    Science.gov (United States)

    Sobczak, Grzegorz; DÄ browska, ElŻbieta; Teodorczyk, Marian; Kalbarczyk, Joanna; MalÄ g, Andrzej

    2013-01-01

    Low quality of the optical beam emitted by high-power laser diodes is the main disadvantage of these devices. The two most important reasons are highly non-Gaussian beam profile with relatively wide divergence in the junction plane and the filamentation effect. Designing laser diode as an array of narrow, close to each other single-mode waveguides is one of the solutions to this problem. In such devices called phase locked arrays (PLA) there is no room for filaments formation. The consequence of optical coupling of many single-mode waveguides is the device emission in the form of few almost diffraction limited beams. Because of losses in regions between active stripes the PLA devices have, however, somewhat higher threshold current and lower slope efficiencies compared to wide-stripe devices of similar geometry. In this work the concept of the high-power laser diode resonator consisted of joined PLA and wide stripe segments is proposed. Resulting changes of electro-optical characteristics of PLA are discussed. The devices are based on the asymmetric heterostructure designed for improvement of the catastrophic optical damage threshold as well as thermal and electrical resistances. Due to reduced distance from the active layer to surface in this heterostructure, better stability of current (and gain) distribution with changing drive level is expected. This could lead to better stability of optical field distribution and supermodes control. The beam divergence reduction in the direction perpendicular of the junction plane has been also achieved.

  15. Competition and quality indicators in the health care sector: empirical evidence from the Dutch hospital sector.

    Science.gov (United States)

    Croes, R R; Krabbe-Alkemade, Y J F M; Mikkers, M C

    2018-01-01

    There is much debate about the effect of competition in healthcare and especially the effect of competition on the quality of healthcare, although empirical evidence on this subject is mixed. The Netherlands provides an interesting case in this debate. The Dutch system could be characterized as a system involving managed competition and mandatory healthcare insurance. Information about the quality of care provided by hospitals has been publicly available since 2008. In this paper, we evaluate the relationship between quality scores for three diagnosis groups and the market power indicators of hospitals. We estimate the impact of competition on quality in an environment of liberalized pricing. For this research, we used unique price and production data relating to three diagnosis groups (cataract, adenoid and tonsils, bladder tumor) produced by Dutch hospitals in the period 2008-2011. We also used the quality indicators relating to these diagnosis groups. We reveal a negative relationship between market share and quality score for two of the three diagnosis groups studied, meaning that hospitals in competitive markets have better quality scores than those in concentrated markets. We therefore conclude that more competition is associated with higher quality scores.

  16. High-quality electron beam generation in a proton-driven hollow plasma wakefield accelerator

    Science.gov (United States)

    Li, Y.; Xia, G.; Lotov, K. V.; Sosedkin, A. P.; Hanahoe, K.; Mete-Apsimon, O.

    2017-10-01

    Simulations of proton-driven plasma wakefield accelerators have demonstrated substantially higher accelerating gradients compared to conventional accelerators and the viability of accelerating electrons to the energy frontier in a single plasma stage. However, due to the strong intrinsic transverse fields varying both radially and in time, the witness beam quality is still far from suitable for practical application in future colliders. Here we demonstrate the efficient acceleration of electrons in proton-driven wakefields in a hollow plasma channel. In this regime, the witness bunch is positioned in the region with a strong accelerating field, free from plasma electrons and ions. We show that the electron beam carrying the charge of about 10% of 1 TeV proton driver charge can be accelerated to 0.6 TeV with a preserved normalized emittance in a single channel of 700 m. This high-quality and high-charge beam may pave the way for the development of future plasma-based energy frontier colliders.

  17. 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)

  18. 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

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

    Science.gov (United States)

    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.

  20. Investigation of cone-beam CT image quality trade-off for image-guided radiation therapy

    Science.gov (United States)

    Bian, Junguo; Sharp, Gregory C.; Park, Yang-Kyun; Ouyang, Jinsong; Bortfeld, Thomas; El Fakhri, Georges

    2016-05-01

    It is well-known that projections acquired over an angular range slightly over 180° (so-called short scan) are sufficient for fan-beam reconstruction. However, due to practical imaging conditions (projection data and reconstruction image discretization, physical factors, and data noise), the short-scan reconstructions may have different appearances and properties from the full-scan (scans over 360°) reconstructions. Nevertheless, short-scan configurations have been used in applications such as cone-beam CT (CBCT) for head-neck-cancer image-guided radiation therapy (IGRT) that only requires a small field of view due to the potential reduced imaging time and dose. In this work, we studied the image quality trade-off for full, short, and full/short scan configurations with both conventional filtered-backprojection (FBP) reconstruction and iterative reconstruction algorithms based on total-variation (TV) minimization for head-neck-cancer IGRT. Anthropomorphic and Catphan phantoms were scanned at different exposure levels with a clinical scanner used in IGRT. Both visualization- and numerical-metric-based evaluation studies were performed. The results indicate that the optimal exposure level and number of views are in the middle range for both FBP and TV-based iterative algorithms and the optimization is object-dependent and task-dependent. The optimal view numbers decrease with the total exposure levels for both FBP and TV-based algorithms. The results also indicate there are slight differences between FBP and TV-based iterative algorithms for the image quality trade-off: FBP seems to be more in favor of larger number of views while the TV-based algorithm is more robust to different data conditions (number of views and exposure levels) than the FBP algorithm. The studies can provide a general guideline for image-quality optimization for CBCT used in IGRT and other applications.

  1. Chemical, biochemical and microbiological indicators to assess soil quality in temperate agro-ecosystems

    OpenAIRE

    Giacometti, Caterina

    2013-01-01

    Soil is a critically important component of the earth’s biosphere. Developing agricultural production systems able to conserve soil quality is essential to guarantee the current and future capacity of soil to provide goods and services. This study investigates the potential of microbial and biochemical parameters to be used as early and sensitive soil quality indicators. Their ability to differentiate plots under contrasting fertilization regimes is evaluated based also on their sensitivi...

  2. Using Latent Semantic Analysis to Identify Quality in Use (QU) Indicators from User Reviews

    OpenAIRE

    Syn, Wendy Tan Wei; How, Bong Chih; Atoum, Issa

    2015-01-01

    The paper describes a novel approach to categorize users' reviews according to the three Quality in Use (QU) indicators defined in ISO: effectiveness, efficiency and freedom from risk. With the tremendous amount of reviews published each day, there is a need to automatically summarize user reviews to inform us if any of the software able to meet requirement of a company according to the quality requirements. We implemented the method of Latent Semantic Analysis (LSA) and its subspace to predi...

  3. 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

  4. 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.

  5. 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.

  6. Development of the information model for consumer assessment of key quality indicators by goods labelling

    Science.gov (United States)

    Koshkina, S.; Ostrinskaya, L.

    2018-04-01

    An information model for “key” quality indicators of goods has been developed. This model is based on the assessment of f standardization existing state and the product labeling quality. According to the authors’ opinion, the proposed “key” indicators are the most significant for purchasing decision making. Customers will be able to use this model through their mobile technical devices. The developed model allows to decompose existing processes in data flows and to reveal the levels of possible architectural solutions. In-depth analysis of the presented information model decomposition levels will allow determining the stages of its improvement and to reveal additional indicators of the goods quality that are of interest to customers in the further research. Examining the architectural solutions for the customer’s information environment functioning when integrating existing databases will allow us to determine the boundaries of the model flexibility and customizability.

  7. STUDY ON WATER QUALITY INDICATORS AT TAIA TREATMENT PLANT HUNDEDOARA COUNTY

    Directory of Open Access Journals (Sweden)

    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

  8. 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.

  9. The intake of saturated fat and dietary fibre: a possible indicator of diet quality

    DEFF Research Database (Denmark)

    Biltoft-Jensen, Anja Pia; Fagt, Sisse; Groth, Margit Velsing

    2008-01-01

    The aim of the present study was to assess if a simple dietary quality index (SDQI) is a useful indicator for nutritional quality in the Danish diet. Data from the Danish National Dietary Survey 2000-2 for adults (n 3151; age 18-75 years) were used to construct an SDQI based on the intake of diet......-dense foods, for example, salty snacks, confectionery, and beverages, for example, soft drinks and alcohol. The SDQI is a simple and useful tool to characterise the diet quality of Danish adults....

  10. Radon concentration as an indicator of the indoor air quality: development of an efficient measurement method

    International Nuclear Information System (INIS)

    Roessler, F.A.

    2015-01-01

    Document available in abstract form only. Full text of publication follows: Energy conservation regulation could lead to a reduction of the air exchange rate and also a degradation of the indoor air quality. Present methods for the estimating the indoor air quality can only be implemented with limitations. This paper presents a method that allows the estimation of the indoor air quality under normal conditions by using natural radon as an indicator. With mathematical models, the progression of the air exchange rate is estimated by using the radon concentration. Furthermore, the progression of individual air pollutants is estimated. Through series of experiments in a measurement chamber, the modelling could be verified. (author)

  11. Electron beam irradiation: a novel technology to enhance the quality of soybean seeds

    International Nuclear Information System (INIS)

    Bhalla, Shashi; Srinivasan, K.; Singh, Subadas; Thakur, Manju; Sharma, S.K.; Pramod, R.; Dwivedi, J.; Bapna, S.C.

    2010-01-01

    Soybean seeds, rich in protein and oil, maintain their germinability only for short durations under ambient conditions. Loss of viability of stored seeds often hampers soybean production in harsh environments worldwide. Physiological factors favored by high temperature and high moisture content accelerate the seed deterioration in the tropics. Several chemical and physical treatments are being used to enhance quality. Irradiation is a novel technology for food preservation and is gaining importance all over the world. Low doses of irradiation bring about improvement in quality of food/seeds, which can be beneficial in several ways. Electron Beam (EB) irradiation is a new approach in this area. The objective of present study was to investigate the effect of EB irradiation in enhancing the quality of low vigour soybean seeds

  12. 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.

  13. 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.

  14. Leaflet manual of external beam radiation therapy for hepatocellular carcinoma: a review of the indications, evidences, and clinical trials.

    Science.gov (United States)

    Rim, Chai Hong; Yoon, Won Sup

    2018-01-01

    The use of external beam radiation therapy (EBRT) in the treatment of hepatocellular carcinoma (HCC), which was rarely performed due to liver toxicity with a previous technique, has increased. Palliation of portal vein thrombosis, supplementation for insufficient transarterial chemoembolization, and provision of new curative opportunities using stereotactic body radiotherapy are the potential indications for use of EBRT. The mechanism of EBRT treatment, with its radiobiological and physical perspectives, differs from those of conventional medical treatment or surgery. Therefore, understanding the effects of EBRT may be unfamiliar to physicians other than radiation oncologists, especially in the field of HCC, where EBRT has recently begun to be applied. The first objective of this review was to concisely explain the indications for use of EBRT for HCC for all physicians treating HCC. Therefore, this review focuses on the therapeutic outcomes rather than the detailed biological and physical background. We also reviewed recent clinical trials that may extend the indications for use of EBRT. Finally, we reviewed the current clinical practice guidelines for the treatment of HCC and discuss the current recommendations and future perspectives.

  15. 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.

  16. 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

  17. 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...

  18. Evaluation of Skin Dose and Image Quality on Cone Beam Computed Tomography

    International Nuclear Information System (INIS)

    Ahn, Jong Ho; Hong, Chae Seon; Kim, Jin Man; Jang, Jun Young

    2008-01-01

    Cone-beam CT using linear accelerator attached to on-board imager is a image guided therapy equipment. Because it is to check the patient's set-up error, correction, organ and target movement. But imaging dose should be cause of the secondary cancer when taking a image. The aim of this study is investigation of appropriate cone beam CT scan mode to compare and estimate the image quality and skin dose. Measurement by Thermoluminescence dosimeter (TLD-100, Harshaw) with using the Rando phantom are placed on each eight sites in separately H and N, thoracic, abdominal section. each 4 methods of scan modes of are measured the for skin dose in three time. Subsequently, obtained average value. Following image quality QA protocol of equipment manufacturers using the catphan 504 phantom, image quality of each scan mode is compared and analyzed. The results of the measured skin dose are described in here. The skin dose of Head and Neck are measured mode A: 8.96 cGy, mode B: 4.59 cGy, mode C: 3.46 cGy mode D: 1.76 cGy and thoracic mode A: 9.42 cGy, mode B: 4.58 cGy, mode C: 3.65 cGy, mode D: 1.85 cGy, and abdominal mode A: 9.97 cGy, mode B: 5.12 cGy, mode C: 4.03 cGy, mode D: 2.21 cGy. Approximately, dose of mode B are reduced 50%, mode C are reduced 60%, mode D are reduced 80% a point of reference dose of mode A. the results of analyzed HU reproducibility, low contrast resolution, spatial resolution (high contrast resolution), HU uniformity in evaluation item of image quality are within the tolerance value by recommended equipment manufacturer in all scan mode. Maintaining the image quality as well as reducing the image dose are very important in cone beam CT. In the result of this study, we are considered when to take mode A when interested in soft tissue. And we are considered to take mode D when interested in bone scan and we are considered to take mode B, C when standard scan. Increasing secondary cancer risk due to cone beam CT scan should be reduced by low m

  19. Soft X-ray generation via inverse compton scattering between high quality electron beam and high power laser

    International Nuclear Information System (INIS)

    Masakazu Washio; Kazuyuki Sakaue; Yoshimasa Hama; Yoshio Kamiya; Tomoko Gowa; Akihiko Masuda; Aki Murata; Ryo Moriyama; Shigeru Kashiwagi; Junji Urakawa

    2007-01-01

    High quality beam generation project based on High-Tech Research Center Project, which has been approved by Ministry of Education, Culture, Sports, Science and Technology in 1999, has been conducted by advance research institute for science and engineering, Waseda University. In the project, laser photo-cathode RF-gun has been selected for the high quality electron beam source. RF cavities with low dark current, which were made by diamond turning technique, have been successfully manufactured. The low emittance electron beam was realized by choosing the modified laser injection technique. The obtained normalized emmitance was about 3 m.mrad at 100 pC of electron charge. The soft x-ray beam generation with the energy of 370 eV, which is in the energy region of so-called water window, by inverse Compton scattering has been performed by the collision between IR laser and the low emmitance electron beams. (Author)

  20. H{sub 2}O{sub 2}-molecular beam epitaxy of high quality ZnO

    Energy Technology Data Exchange (ETDEWEB)

    El Shaer, A.; Bakin, A.; Che Mofor, A.; Kreye, M.; Waag, A. [Technical University Braunschweig, Institute of Semiconductor Technology, Braunschweig (Germany); Blaesing, J.; Krost, A. [Otto-von-Guericke-University, Institute of Experimental Physics, Magdeburg (Germany); Stoimenos, J. [Aristotele University, Physics Department, Thessaloniki (Greece); Pecz, B. [Hungarian Academy of Sciences, Research Institute for Technical Physics and Materials Science, P.O. Box 49, Budapest (Hungary)

    2007-07-15

    We have studied the growth and characterization of ZnO epilayers on (0001)-sapphire by H{sub 2}O{sub 2}-molecular beam epitaxy (MBE). A high temperature (HT) MgO buffer followed by a low-temperature ZnO buffer was introduced in order to accommodate the lattice mismatch between ZnO and sapphire. The surface morphology of the samples was studied using atomic force microscopy (AFM), and scanning electron microscopy (SEM). The crystalline quality of the layers was investigated by employing high resolution X-ray diffractometry (HRXRD) and high resolution transmission electron microscopy (HRTEM). The electrical properties of the grown ZnO layers were studied by Hall-effect measurements in a standard van der Pauw configuration. The measured surface roughness for the best layers is as low as 0.26 nm rms. HRXRD measurements of the obtained ZnO layers show excellent quality of the single crystalline ZnO heteroepitaxially grown on (0001)-sapphire with a HT MgO buffer layers. The influence of the growth conditions on the crystalline quality is discussed. The FWHM of the HRXRD (0002) rocking curves measured for the 2-inch ZnO-on-sapphire is as low as 27 arcsec with a very high lateral homogeneity across the whole 2-inch ZnO epilayers. The results indicate that H{sub 2}O{sub 2}-MBE is a suitable technique to fabricate ZnO epilayers of very high quality. (orig.)

  1. Dosimetry quality audit of high energy photon beams in greek radiotherapy centers

    International Nuclear Information System (INIS)

    Hourdakis, Constantine J.; Boziari, A.

    2008-01-01

    Background and purpose: Dosimetry quality audits and intercomparisons in radiotherapy centers is a useful tool in order to enhance the confidence for an accurate therapy and to explore and dissolve discrepancies in dose delivery. This is the first national comprehensive study that has been carried out in Greece. During 2002 - 2006 the Greek Atomic Energy Commission performed a dosimetry quality audit of high energy external photon beams in all (23) Greek radiotherapy centers, where 31 linacs and 13 Co-60 teletherapy units were assessed in terms of their mechanical performance characteristics and relative and absolute dosimetry. Materials and Methods: The quality audit in dosimetry of external photon beams took place by means of on-site visits, where certain parameters of the photon beams were measured, calculated and assessed according to a specific protocol and the IAEA TRS 398 dosimetry code of practice. In each radiotherapy unit (Linac or Co-60), certain functional parameters were measured and the results were compared to tolerance values and limits. Doses in water under reference and non reference conditions were measured and compared to the stated values. Also, the treatment planning systems (TPS) were evaluated with respect to irradiation time calculations. Results: The results of the mechanical tests, dosimetry measurements and TPS evaluation have been presented in this work and discussed in detail. This study showed that Co-60 units had worse performance mechanical characteristics than linacs. 28% of all irradiation units (23% of linacs and 42% of Co-60 units) exceeded the acceptance limit at least in one mechanical parameter. Dosimetry accuracy was much worse in Co60 units than in linacs. 61% of the Co60 units exhibited deviations outside ±3% and 31% outside ±5%. The relevant percentages for the linacs were 24% and 7% respectively. The results were grouped for each hospital and the sources of errors (functional and human) have been investigated and

  2. Dosimetry quality audit of high energy photon beams in greek radiotherapy centers.

    Science.gov (United States)

    Hourdakis, Constantine J; Boziari, A

    2008-04-01

    Dosimetry quality audits and intercomparisons in radiotherapy centers is a useful tool in order to enhance the confidence for an accurate therapy and to explore and dissolve discrepancies in dose delivery. This is the first national comprehensive study that has been carried out in Greece. During 2002--2006 the Greek Atomic Energy Commission performed a dosimetry quality audit of high energy external photon beams in all (23) Greek radiotherapy centers, where 31 linacs and 13 Co-60 teletherapy units were assessed in terms of their mechanical performance characteristics and relative and absolute dosimetry. The quality audit in dosimetry of external photon beams took place by means of on-site visits, where certain parameters of the photon beams were measured, calculated and assessed according to a specific protocol and the IAEA TRS 398 dosimetry code of practice. In each radiotherapy unit (Linac or Co-60), certain functional parameters were measured and the results were compared to tolerance values and limits. Doses in water under reference and non reference conditions were measured and compared to the stated values. Also, the treatment planning systems (TPS) were evaluated with respect to irradiation time calculations. The results of the mechanical tests, dosimetry measurements and TPS evaluation have been presented in this work and discussed in detail. This study showed that Co-60 units had worse performance mechanical characteristics than linacs. 28% of all irradiation units (23% of linacs and 42% of Co-60 units) exceeded the acceptance limit at least in one mechanical parameter. Dosimetry accuracy was much worse in Co60 units than in linacs. 61% of the Co60 units exhibited deviations outside +/-3% and 31% outside +/-5%. The relevant percentages for the linacs were 24% and 7% respectively. The results were grouped for each hospital and the sources of errors (functional and human) have been investigated and discussed in details. This quality audit proved to be a

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

    Science.gov (United States)

    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.

  4. Development of sustainable water treatment technology using scientifically based calculated indexes of source water quality indicators

    Directory of Open Access Journals (Sweden)

    А. С. Трякина

    2017-10-01

    Full Text Available The article describes selection process of sustainable technological process flow chart for water treatment procedure developed on scientifically based calculated indexes of quality indicators for water supplied to water treatment facilities. In accordance with the previously calculated values of the indicators of the source water quality, the main purification facilities are selected. A more sustainable flow chart for the modern water quality of the Seversky Donets-Donbass channel is a two-stage filtering with contact prefilters and high-rate filters. The article proposes a set of measures to reduce such an indicator of water quality as permanganate oxidation. The most suitable for these purposes is sorption purification using granular activated carbon for water filtering. The increased water hardness is also quite topical. The method of ion exchange on sodium cation filters was chosen to reduce the water hardness. We also evaluated the reagents for decontamination of water. As a result, sodium hypochlorite is selected for treatment of water, which has several advantages over chlorine and retains the necessary aftereffect, unlike ozone. A technological flow chart with two-stage purification on contact prefilters and two-layer high-rate filters (granular activated carbon - quartz sand with disinfection of sodium hypochlorite and softening of a part of water on sodium-cation exchangers filters is proposed. This technological flow chart of purification with any fluctuations in the quality of the source water is able to provide purified water that meets the requirements of the current sanitary-hygienic standards. In accordance with the developed flow chart, guidelines and activities for the reconstruction of the existing Makeevka Filtering Station were identified. The recommended flow chart uses more compact and less costly facilities, as well as additional measures to reduce those water quality indicators, the values of which previously were in

  5. Monte Carlo calculations of kQ, the beam quality conversion factor

    International Nuclear Information System (INIS)

    Muir, B. R.; Rogers, D. W. O.

    2010-01-01

    Purpose: To use EGSnrc Monte Carlo simulations to directly calculate beam quality conversion factors, k Q , for 32 cylindrical ionization chambers over a range of beam qualities and to quantify the effect of systematic uncertainties on Monte Carlo calculations of k Q . These factors are required to use the TG-51 or TRS-398 clinical dosimetry protocols for calibrating external radiotherapy beams. Methods: Ionization chambers are modeled either from blueprints or manufacturers' user's manuals. The dose-to-air in the chamber is calculated using the EGSnrc user-code egs c hamber using 11 different tabulated clinical photon spectra for the incident beams. The dose to a small volume of water is also calculated in the absence of the chamber at the midpoint of the chamber on its central axis. Using a simple equation, k Q is calculated from these quantities under the assumption that W/e is constant with energy and compared to TG-51 protocol and measured values. Results: Polynomial fits to the Monte Carlo calculated k Q factors as a function of beam quality expressed as %dd(10) x and TPR 10 20 are given for each ionization chamber. Differences are explained between Monte Carlo calculated values and values from the TG-51 protocol or calculated using the computer program used for TG-51 calculations. Systematic uncertainties in calculated k Q values are analyzed and amount to a maximum of one standard deviation uncertainty of 0.99% if one assumes that photon cross-section uncertainties are uncorrelated and 0.63% if they are assumed correlated. The largest components of the uncertainty are the constancy of W/e and the uncertainty in the cross-section for photons in water. Conclusions: It is now possible to calculate k Q directly using Monte Carlo simulations. Monte Carlo calculations for most ionization chambers give results which are comparable to TG-51 values. Discrepancies can be explained using individual Monte Carlo calculations of various correction factors which are more

  6. 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.

  7. Quality of care indicators for the rehabilitation of children with traumatic brain injury.

    Science.gov (United States)

    Rivara, Frederick P; Ennis, Stephanie K; Mangione-Smith, Rita; MacKenzie, Ellen J; Jaffe, Kenneth M

    2012-03-01

    To develop measurement tools for assessing compliance with identifiable processes of inpatient care for children with traumatic brain injury (TBI) that are reliable, valid, and amenable to implementation. Literature review and expert panel using the RAND/UCLA Appropriateness Method and a Delphi technique. Not applicable. Children with TBI. Not applicable. Quality of care indicators. A total of 119 indicators were developed across the domains of general management; family-centered care; cognitive-communication, speech, language, and swallowing impairments; gross and fine motor skill impairments; neuropsychologic, social, and behavioral impairments; school reentry; and community integration. There was a high degree of agreement on these indicators as valid and feasible quality measures for children with TBI. These indicators are an important step toward building a better base of evidence about the effectiveness and efficiency of the components of acute inpatient rehabilitation for pediatric patients with TBI. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. 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

  9. ASSESSMENT OF LAND QUALITY USING ECOPEDOLOGICAL INDICATORS - JEBEL AREA, TIMIŞ COUNTY, ROMANIA

    Directory of Open Access Journals (Sweden)

    Costina Roxana URUIOC

    2012-01-01

    Full Text Available The studied area is placed in North-East Jebel locality. Based on the physical and chemical characteristics and soil morphology profile, the following types of soil were identified: typical preluvosol, typical and gleyic eutricambosols, luvic solonet, gleysol, gleyic vertisol and gleyic-stagnic vertisol. The assessment of land quality (fertility was determined by bonitation. For the notes of bonitation calculation, the following ecopedological indicatories have been used: annual medium temperature, annual medium precipitations, depth of the underground water, texture in Ap horizon, gleization, pseudogleization, salinization, edafic volume, porosity, soil reaction (pH, humus reserve and content of CaCO3. The way that these indicators influence the notes of bonitation is different from a type of soil to another and the use of land. Thus, for grassland, typical preluvosol, the note of bonitate is 81 and it’s included in class II of quality (favorability, luvic solonet with 63 points in class IV of quality, typical eutricambosols with 58 points and vertisol with 57 points, in class V of quality, gleysol with 32 points and gleyic eutricambosol with 36 points, in class VII of quality. In case of using the land for growing maize, we have the following: typical preluvosol with 90 points which is in class II of quality, typical eutricambosol with 54 points and gleyic vertisol with 60 points, in class V of quality, luvic solonet with 49 points in class VI of quality, gleyic-stagnic vertisol with 35 points, in class VII of quality, gleysol with 24 points and gleyic eutricambosol with 29 points, in class VIII of quality. The notes of bonitation calculation, including them in the favorability classes, showed up that lands from Jebel area are good and very good quality, exception those that develop on gleysol and gleyic eutricambosols soils.

  10. Performance Assesment of Bauchi Polytechnics and Technical Colleges Using Quality Assurance Indicators in Nigeria Qualification Framework

    Directory of Open Access Journals (Sweden)

    Idris Adamu

    2016-07-01

    Full Text Available Technical and Vocational Education emphases skill acquisition, Quality Assurance in vocational education is concept that is concerned with high performance involved activities with vocational education such as teaching, learning, infrastructures, student’s behavior and entire academic process. Good quality education is very necessary in the total development of staff and students which ensures proper development, job prospects and the realization of academic goals and objects. Enhanced and sustained to ensure accountability and improve performance. Higher educational institutions in Nigeria continue to experience carelessly attitude about the use of Quality Assurance to understand the risk they are exposed to poor standard. To address these issues, the study embarked upon to determine the level of performance and difference usability of Quality Assurance in Polytechnics and Technical Colleges in Bauchi state. Quantitative method technique was employed using survey questionnaires, 60 staff both senior and junior within these institutions were selected and a questionnaire distributed for their responses. The data were analysed using SPSS software. The result reveals that Federal Polytechnic Bauchi and State Polytechnic Bauchi has high level of Performance about Quality Assurance indicators while College of Education Azare has medium level of Performance. College of education Azare has highest mean rank of 29.87 and percentage of 31.8% obtained from the output result indicated that it has high usability to Quality Assurance, followed by Federal Polytechnic Bauchi with medium usability then State Polytechnic Bauchi has low usability to Quality Assurance. The study concluded by Quality Assurance Unit be made aware to each institution staff to enable recognize the benefits of it. Federal government should give more funding and employ staff to cater the need of Quality Assurance Unit in every institution so that it will help the students to develop

  11. LHCB: A LHCb-VELO module as beam quality monitor for proton therapy beam at the Clatterbridge Centre for Oncology

    CERN Multimedia

    Casse, G; Patel, G D; Smith, N A; Kacperek, A; Marsland, B

    2010-01-01

    The progress in detector technology, driven by the needs of particle tracking and vertexing in the present LHC and its upgrade (sLHC), has led to the design of silicon sensors with low mass, high granularity, high speed and unprecedented radiation hardness. The sensors designed for such a harsh environment can be profitably used for instrumenting the control systems of therapeutic hadron beams. The high granularity and readout clock speed are well suited for monitoring continuous beam currents. The low mass allows reduced interference with the beam whilst monitoring its profile with high precision. The high resolution and sensitivity to minimum ionising particles allows monitoring of the beam spot position by measurement of the halo in real time, without any interference with the beam spot used in therapy.

  12. Development of quality indicators for physiotherapy for patients with PAOD in the Netherlands: a Delphi study.

    Science.gov (United States)

    Gijsbers, H J H; Lauret, G J; van Hofwegen, A; van Dockum, T A; Teijink, J A W; Hendriks, H J M

    2016-06-01

    The aim of the study was to develop quality indicators (QIs) for physiotherapy management of patients with intermittent claudication (IC) in the Netherlands. As part of an international six-step method to develop QIs, an online survey Delphi-procedure was completed. After two Delphi-rounds a validation round was performed. Twenty-six experts were recruited to participate in this study. Twenty-four experts completed two Delphi-rounds. A third round was conducted inviting 1200 qualified and registered physiotherapists of the Dutch integrated care network 'Claudicationet' to validate a draft set of quality indicators. Out of 83 potential QIs in the Dutch physiotherapy guideline on 'Intermittent claudication', consensus among the experts selected nine indicators. All nine quality indicators were validated by 300 physiotherapists. A final set of nine indicators was derived from (1) a Dutch evidence-based physiotherapy guideline, (2) an expert Delphi procedure and (3) a validation by 300 physiotherapists. This set of indicators should be validated in clinical practice. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    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.

  14. [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.

  15. External beam radiotherapy for head and neck carcinomas with preservation of parotid function: indications, techniques and long term results

    International Nuclear Information System (INIS)

    Ding-Jen, Lee; Fairbanks, Robert; Lee, Frank C.

    1995-01-01

    Purpose/Objective: To reduce the incidence of radiotherapy induced xerostomia, we developed techniques of external beam irradiation with preservation of parotid function for patients with early to intermediate stage carcinomas of the head and neck. This analysis reports the efficacy of our methods. Materials and Methods: From 1985 to 1993, 42 patients with early to intermediate stage (T 1-3 N 0-2 M 0 ) head and neck carcinomas received a course of external beam radiotherapy. There were 13 patients with carcinoma of the oropharynx, 26 with carcinomas of the oral cavity and 3 with carcinomas of the hypopharynx (lateral wall). 7 patients received a course of definitive radiotherapy (66 to 72 Gy), while 35 patients received a course of postoperative radiotherapy (60-66 Gy). The fraction size was 2 Gy per day. In terms of treatment planning, the primary site (plus a margin) and the ipsilateral neck were covered by the irradiation volume. The ipsilateral parotid gland was within the treatment volume while the contralateral parotid gland was not. The most frequently used field arrangement was a paired wedge fields with an AP (medially just across the mid-line) and an ipsilateral posterior oblique field (usually 30 deg. off vertical axis with a spinal cord block). Multiple level of contours were taken and transmission blocks were used to improve dose homogeneity. In all patients, the ipsilateral parotid gland (and the neck) was irradiated while the contralateral parotid gland (and the neck) was not. Results: With a median follow up of 4 years (ranged from 1.5 to 9 years), only one patient developed symptomatic xerostomia. None had radiation induced dental caries. No patient developed recurrent disease in the contralateral neck. The local control rate was (38(42)) (90%) in the primary site and(41(42)) (98%) in the ipsilateral neck. Conclusion: With appropriate treatment planning, external beam irradiation with parotid function preservation can be achieved. Our results

  16. Quality indicators for acute myocardial infarction: A position paper of the Acute Cardiovascular Care Association.

    Science.gov (United States)

    Schiele, Francois; Gale, Chris P; Bonnefoy, Eric; Capuano, Frederic; Claeys, Marc J; Danchin, Nicolas; Fox, Keith Aa; Huber, Kurt; Iakobishvili, Zaza; Lettino, Maddalena; Quinn, Tom; Rubini Gimenez, Maria; Bøtker, Hans E; Swahn, Eva; Timmis, Adam; Tubaro, Marco; Vrints, Christiaan; Walker, David; Zahger, Doron; Zeymer, Uwe; Bueno, Hector

    2017-02-01

    Evaluation of quality of care is an integral part of modern healthcare, and has become an indispensable tool for health authorities, the public, the press and patients. However, measuring quality of care is difficult, because it is a multifactorial and multidimensional concept that cannot be estimated solely on the basis of patients' clinical outcomes. Thus, measuring the process of care through quality indicators (QIs) has become a widely used practice in this context. Other professional societies have published QIs for the evaluation of quality of care in the context of acute myocardial infarction (AMI), but no such indicators exist in Europe. In this context, the European Society of Cardiology (ESC) Acute Cardiovascular Care Association (ACCA) has reflected on the measurement of quality of care in the context of AMI (ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI)) and created a set of QIs, with a view to developing programmes to improve quality of care for the management of AMI across Europe. We present here the list of QIs defined by the ACCA, with explanations of the methodology used, scientific justification and reasons for the choice for each measure.

  17. DNA Source Selection for Downstream Applications Based on DNA Quality Indicators Analysis

    Science.gov (United States)

    Lucena-Aguilar, Gema; Sánchez-López, Ana María; Barberán-Aceituno, Cristina; Carrillo-Ávila, José Antonio; López-Guerrero, José Antonio

    2016-01-01

    High-quality human DNA samples and associated information of individuals are necessary for biomedical research. Biobanks act as a support infrastructure for the scientific community by providing a large number of high-quality biological samples for specific downstream applications. For this purpose, biobank methods for sample preparation must ensure the usefulness and long-term functionality of the products obtained. Quality indicators are the tool to measure these parameters, the purity and integrity determination being those specifically used for DNA. This study analyzes the quality indicators in DNA samples derived from 118 frozen human tissues in optimal cutting temperature (OCT) reactive, 68 formalin-fixed paraffin-embedded (FFPE) tissues, 119 frozen blood samples, and 26 saliva samples. The results obtained for DNA quality are discussed in association with the usefulness for downstream applications and availability of the DNA source in the target study. In brief, if any material is valid, blood is the most approachable option of prospective collection of samples providing high-quality DNA. However, if diseased tissue is a requisite or samples are available, the recommended source of DNA would be frozen tissue. These conclusions will determine the best source of DNA, according to the planned downstream application. Furthermore our results support the conclusion that a complete procedure of DNA quantification and qualification is necessary to guarantee the appropriate management of the samples, avoiding low confidence results, high costs, and a waste of samples. PMID:27158753

  18. An automated procedure for the quality assurance of electron beam output and energy

    International Nuclear Information System (INIS)

    Woo, M.K.; Videla, N.G.

    2004-01-01

    In this article, we report on the development of a simple and accurate method for quality assurance of electron beam output and energy. Aluminum disks of thicknesses d max or d 50 of the particular electron energy are positioned sequentially over a parallel-plate ion chamber and the ratio of the two signals is compared to the standard. The positioning of the aluminum disks is carried out remotely and automatically to eliminate the necessity of multiple setups. One method utilizes the remote control feature of the treatment couch and another employs a motor-driven carousel. The superior sensitivity over a commercially available energy monitor is illustrated

  19. Method of controlling coherent synchroton radiation-driven degradation of beam quality during bunch length compression

    Science.gov (United States)

    Douglas, David R [Newport News, VA; Tennant, Christopher D [Williamsburg, VA

    2012-07-10

    A method of avoiding CSR induced beam quality defects in free electron laser operation by a) controlling the rate of compression and b) using a novel means of integrating the compression with the remainder of the transport system: both are accomplished by means of dispersion modulation. A large dispersion is created in the penultimate dipole magnet of the compression region leading to rapid compression; this large dispersion is demagnified and dispersion suppression performed in a final small dipole. As a result, the bunch is short for only a small angular extent of the transport, and the resulting CSR excitation is small.

  20. A service for monitoring the quality of intraoperative cone beam CT images

    Directory of Open Access Journals (Sweden)

    Heckel Frank

    2016-09-01

    Full Text Available In recent years, operating rooms (ORs have transformed into integrated operating rooms, where devices are able to communicate, exchange data, or even steer and control each other. However, image data processing is commonly done by dedicated workstations for specific clinical use-cases. In this paper, we propose a concept for a dynamic service component for image data processing on the example of automatic image quality assessment (AQUA of intraoperative cone beam computed tomography (CBCT images. The service is build using the Open Surgical Communication Protocol (OSCP and the standard for Digital Imaging and Communications in Medicine (DICOM. We have validated the proposed concept in an integrated demonstrator OR.

  1. Quality indicators for diagnosis and treatment of respiratory tract infections in general practice:

    DEFF Research Database (Denmark)

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

    Objective: To develop a set of quality indicators focusing on the diagnosis and treatment of respiratory tract infections in general practice.  Material and methods: A modified 2-round Delphi study was conducted from April to July 2008. A panel of 27 experts (13 countries) comprising mainly general...

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

    NARCIS (Netherlands)

    Smit, M.; Chan, K.L.L.; Middeldorp, J.M.; van Roosmalen, J.

    2014-01-01

    Background: 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

  3. 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.

  4. Novel indicators of recreational water quality and swimming-associated illness

    Science.gov (United States)

    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...

  5. Quality of life before and after lung transplantation in patients with emphysema versus other indications

    NARCIS (Netherlands)

    TenVergert, EM; Vermeulen, KM; van Enckevort, PJ

    2001-01-01

    Whether lung transplantation improves Health-related Quality of Life in patients with emphysema and other end-stage lung diseases before and after lung transplantation was examined. Between 1992 and 1999, 23 patients with emphysema and 19 patients with other indications completed self-administered

  6. Development of quality indicators for physiotherapy for patients with PAOD in the Netherlands: a Delphi study

    NARCIS (Netherlands)

    Gijsbers, H. J. H.; Lauret, G. J.; van Hofwegen, A.; van Dockum, T. A.; Teijink, J. A. W.; Hendriks, H. J. M.

    2016-01-01

    The aim of the study was to develop quality indicators (QIs) for physiotherapy management of patients with intermittent claudication (IC) in the Netherlands. As part of an international six-step method to develop QIs, an online survey Delphi-procedure was completed. After two Delphi-rounds a

  7. Audit of cases with uterine rupture: A process indicator of quality of ...

    African Journals Online (AJOL)

    Audit of uterine rupture (UR) used as a process indicator, can identify factors considered avoidable to improve future quality of obstetric care. Records of UR cases at a referral maternity in Luanda were studied retrospectively (n=43) and prospectively (n=67) including basic obstetric information, maternal and foetal outcome, ...

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

    Science.gov (United States)

    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…

  9. Productivity as an Indication of Quality in Higher Education: The Views of Employed Graduates in Greece

    Science.gov (United States)

    Eliophotou Menon, Maria

    2016-01-01

    The paper investigates the views of Greek university graduates on the link between higher education and productivity in order to determine the extent to which productivity can be considered to be an indication of quality in higher education. It also investigates the perceived effect of the type and content of higher education on productivity;…

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

    NARCIS (Netherlands)

    Engels, Y.M.P.; Campbell, S.M.; Dautzenberg, M.G.H.; Hombergh, P. van den; Brinkmann, H.; Szecsenyi, J.; Falcoff, H.; Seuntjens, L.; Kuenzi, B.; Grol, R.P.T.M.

    2005-01-01

    OBJECTIVES: To develop a framework for general practice management made up of quality indicators shared by six European countries. METHODS: Two-round postal Delphi questionnaire in the setting of general practice in Belgium, France, Germany, The Netherlands, Switzerland and the United Kingdom. Six

  11. The Minimum Data Set Depression Quality Indicator: Does It Reflect Differences in Care Processes?

    Science.gov (United States)

    Simmons, S.F.; Cadogan, M.P.; Cabrera, G.R.; Al-Samarrai, N.R.; Jorge, J.S.; Levy-Storms, L.; Osterweil, D.; Schnelle, J.F.

    2004-01-01

    Purpose. The objective of this work was to determine if nursing homes that score differently on prevalence of depression, according to the Minimum Data Set (MDS) quality indicator, also provide different processes of care related to depression. Design and Methods. A cross-sectional study with 396 long-term residents in 14 skilled nursing…

  12. Environmental Learning Workshop: Lichen as Biological Indicator of Air Quality and Impact on Secondary Students' Performance

    Science.gov (United States)

    Samsudin, Mohd Wahid; Daik, Rusli; Abas, Azlan; Meerah, T. Subahan Mohd; Halim, Lilia

    2013-01-01

    In this study, the learning of science outside the classroom is believe to be an added value to science learning as well as it offers students to interact with the environment. This study presents data obtained from two days' workshop on Lichen as Biological Indicator for Air Quality. The aim of the workshop is for the students to gain an…

  13. Quality indicators for physiotherapy care in hip and knee osteoarthritis: development and clinimetric properties

    NARCIS (Netherlands)

    Peter, W.F.; Wees, P.J. van der; Hendriks, E.J.; Bie, R.A. de; Verhoef, J.; Jong, Z. de; Bodegom-Vos, L. van; Hilberdink, W.K.H.A.; Vlieland, T.P.

    2013-01-01

    OBJECTIVE: The aim of the present study was to develop process quality indicators for physiotherapy care based on key recommendations of the Dutch physiotherapy guideline on hip and knee osteoarthritis (OA). METHODS: Guideline recommendations were rated for their relevance by an expert panel,

  14. Comparison of indicators assessing the quality of drug prescribing for asthma

    NARCIS (Netherlands)

    Veninga, C.C.M.; Denig, P.; Pont, L.G.; Haaijer-Ruskamp, F.M.

    Objective. To compare different indicators for assessing the quality of drug prescribing and establish their agreement in identifying doctors who may not adhere to treatment guidelines. Data Sources/Study Setting. Data from 181 general practitioners (GPs) from The Netherlands. The case of asthma is

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

    Directory of Open Access Journals (Sweden)

    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

  16. 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.

  17. 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.

  18. Improvement in beam quality of the JAEA AVF cyclotron for focusing heavy-ion beams with energies of hundreds of MeV

    International Nuclear Information System (INIS)

    Kurashima, Satoshi; Miyawaki, Nobumasa; Okumura, Susumu; Oikawa, Masakazu; Yoshida, Ken-ichi; Kamiya, Tomihiro; Fukuda, Mitsuhiro; Satoh, Takahiro; Nara, Takayuki; Agematsu, Takashi; Ishibori, Ikuo; Yokota, Watalu; Nakamura, Yoshiteru

    2007-01-01

    In order to achieve a heavy-ion microbeam with an energy of hundreds of MeV applied to the research fields of biotechnology and materials science, the JAEA AVF cyclotron (K = 110) has been upgraded to provide a high quality beam with a smaller energy spread and a higher current stability. A flat-top (FT) acceleration system of the cyclotron, designed to produce ion beams with an energy spread of ΔE/E ≤ 0.02%, has been developed to reduce chromatic aberrations in the lenses of the focusing microbeam system. The FT acceleration system provides uniform energy gain of the beam by superimposing a fifth-harmonic voltage on the fundamental one. In addition, stabilization of the acceleration rf voltage and the phase were achieved to accelerate the high quality beam and to provide it stably to the microbeam system connected to a cyclotron beam line. In the latest experiment, we have succeeded to accelerate 260 MeV 20 Ne 7+ with an energy spread of 0.05% in FWHM using the FT acceleration system

  19. A quality monitoring program for red blood cell components: in vitro quality indicators before and after implementation of semiautomated processing.

    Science.gov (United States)

    Acker, Jason P; Hansen, Adele L; Kurach, Jayme D R; Turner, Tracey R; Croteau, Ioana; Jenkins, Craig

    2014-10-01

    Canadian Blood Services has been conducting quality monitoring of red blood cell (RBC) components since 2005, a period spanning the implementation of semiautomated component production. The aim was to compare the quality of RBC components produced before and after this production method change. Data from 572 RBC units were analyzed, categorized by production method: Method 1, RBC units produced by manual production methods; Method 2, RBC units produced by semiautomated production and the buffy coat method; and Method 3, RBC units produced by semiautomated production and the whole blood filtration method. RBC units were assessed using an extensive panel of in vitro tests, encompassing regulated quality control criteria such as hematocrit (Hct), hemolysis, and hemoglobin (Hb) levels, as well as adenosine triphosphate, 2,3-diphosphoglycerate, extracellular K(+) and Na(+) levels, methemoglobin, p50, RBC indices, and morphology. Throughout the study, all RBC units met mandated Canadian Standards Association guidelines for Hb and Hct, and most (>99%) met hemolysis requirements. However, there were significant differences among RBC units produced using different methods. Hb content was significantly lower in RBC units produced by Method 2 (51.5 ± 5.6 g/unit; p levels were lowest in units produced by Method 1 (p < 0.001). While overall quality was similar before and after the production method change, the observed differences, although small, indicate a lack of equivalency across RBC products manufactured by different methods. © 2014 AABB.

  20. The use of citation indicators to identify and support high-quality research in Poland.

    Science.gov (United States)

    Pilc, Andrzej

    2008-01-01

    In large, mostly English-speaking countries, where the "critical mass" of scientists working in different subfields of science is achieved, the peer review system may be sufficient to assess the quality of scientific research. However, in smaller countries, outside the Anglo-American circle, it is important to introduce different systems to identify research of high quality. In Poland, a parametric system for assessing the quality of research has been introduced. It was largely based on the impact factor of scientific journals. While the use of this indicator to assess research quality is highly questionable, the implementation of the system in the Polish reality is even worse. Therefore it is important to change and improve the system currently used by the Ministry of Science and Higher Education to both evaluate and, more importantly, finance science in Poland. Here, a system based on three factors, i.e. the impact factor, the institutional h-index, and the institutional number of citations, is proposed. The scientific quality of institutions in Division VI: Medical Sciences of the Polish Academy of Sciences were evaluated and the results were compared with the existing system. Moreover, a method to identify high-quality researchers and institutions at the national level based on the quantity of highly cited papers is shown. Additionally, an attempt to identify the highest quality Polish research on an international level is proposed. This is based on the number of individual citations, the individual h-index, the number of publications, and the priority of the discovery.

  1. Experiences from the evaluation of two global quality indicators in a radiology service

    International Nuclear Information System (INIS)

    Hernandez Lopez, L. Y.; Valdes Arce, Y.; Fleitas Estevez, I.

    2013-01-01

    The main objective in radiology is to obtain images of good quality for certain diagnosis, without unnecessarily irradiating the patient. This paper shows the results of the reject films and clinical image quality evaluations in the radiology service of the Hospital 'Abel Santamaria Cuadrado', Pinar del Rio, Cuba. Data were collected during March and September of 2012. Reject films analysis was done for conventional and mammography studies. Clinical image quality evaluated following the European Guidelines on Quality Criteria. The results show that reject films rate decreased from 6% on March to 1.3% on September, after applying corrective actions; while chests studies have the highest reject rate. The mean causes for rejections were maladjustments in the collimation system, equipment faults, sub exposure and overexposure. For mammography studies the initial reject rate was 29.3% and decreased to 5.9% on September. Mean causes for rejection were related to faults in the automatic processor and the mammography x-ray unit. Image quality also improved: only 48.3% of chest images and 10% of mammography images were considered to be acceptable for diagnosis at the first moment; while these percentages increased to 68.3% and 70% for chest and mammography studies, respectively in the September's evaluation. The study demonstrated that the frequently evaluation of the quality's indicators allows to identify the main causes of the image's detriment to propose corrective actions. Still in situations of insufficient resources it is possible to improve quality with simple interventions on the main faults detected. (Author)

  2. High quality electron beams from a plasma channel guided laser wakefield accelerator

    International Nuclear Information System (INIS)

    Geddes, C.G.R.; Toth, Cs.; Tilborg, J. van; Esarey, E.; Schroeder, C.B.; Bruhwiler, D.; Nieter, C.; Cary, J.; Leemans, W.P.

    2004-01-01

    Laser driven accelerators, in which particles are accelerated by the electric field of a plasma wave driven by an intense laser, have demonstrated accelerating electric fields of hundreds of GV/m. These fields are thousands of times those achievable in conventional radiofrequency (RF) accelerators, spurring interest in laser accelerators as compact next generation sources of energetic electrons and radiation. To date however, acceleration distances have been severely limited by lack of a controllable method for extending the propagation distance of the focused laser pulse. The ensuing short acceleration distance results in low energy beams with 100% electron energy spread, limiting applications. Here we demonstrate that a relativistically intense laser can be guided by a preformed plasma density channel and that the longer propagation distance can result in electron beams of percent energy spread with low emittance and increased energy, containing >10 9 electrons above 80 MeV. The preformed plasma channel technique forms the basis of a new class of accelerators, combining beam quality comparable to RF accelerators with the high gradients of laser accelerators to produce compact tunable high brightness electron and radiation sources

  3. Effects of data sampling rate on image quality in fan-beam-CT system

    International Nuclear Information System (INIS)

    Iwata, Akira; Yamagishi, Nobutoshi; Suzumura, Nobuo; Horiba, Isao.

    1984-01-01

    Investigation was made into the relationship between spatial resolution or artifacts and data sampling rate in order to pursue the causes of the degradation of CT image quality by computer simulation. First the generation of projection data and reconstruction calculating process are described, and then the results are shown about the relation between angular sampling interval and spatical resolution or artifacts, and about the relation between projection data sampling interval and spatial resolution or artifacts. It was clarified that the formulation of the relationship between spatial resolution and data sampling rate performed so far for parallel X-ray beam was able to be applied to fan beam. As a conclusion, when other reconstruction parameters are the same in fan beam CT systems, spatial resolution can be determined by projection data sampling rate rather than angular sampling rate. The mechanism of artifact generation due to the insufficient number of angular samples was made clear. It was also made clear that there was a definite relationship among measuring region, angular sampling rate and projection data sampling rate, and the amount of artifacts depending upon projection data sampling rate was proportional to the amount of spatial frequency components (Aliasing components) of a test object above the Nyquist frequency of projection data. (Wakatsuki, Y.)

  4. 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

  5. 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.

  6. Quality indicators for physiotherapy care in hip and knee osteoarthritis: development and clinimetric properties.

    Science.gov (United States)

    Peter, W F; van der Wees, P J; Hendriks, E J M; de Bie, R A; Verhoef, J; de Jong, Z; van Bodegom-Vos, L; Hilberdink, W K H A; Vliet Vlieland, T P M

    2013-12-01

    The aim of the present study was to develop process quality indicators for physiotherapy care based on key recommendations of the Dutch physiotherapy guideline on hip and knee osteoarthritis (OA). Guideline recommendations were rated for their relevance by an expert panel, transformed into potential indicators and incorporated into a questionnaire, the Quality Indicators for Physiotherapy in Hip and Knee Osteoarthritis (QIP-HKOA). Adherence with each indicator was rated on a Likert scale (0 = never to 4 = always). The QIP-HKOA was administered to groups of expert (n = 51) and general (n = 134) physiotherapists (PTs) to test its discriminative power. Reliability was tested in a subgroup of 118 PTs by computing the intraclass correlation coefficient (ICC). QIP-HKOA items were included if they were considered to be related to the cornerstones of physiotherapy in hip and knee OA (exercises and education), had discriminative power and/or if they were followed by physiotherapy care; six indicators had discriminative power and/or were followed by physiotherapy guideline on hip and knee OA was found to be reliable and discriminated between expert and general PTs. Its ability to measure improvement in the quality of the process of physiotherapy care needs to be further examined. Copyright © 2012 John Wiley & Sons, Ltd.

  7. 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.

  8. 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.

  9. Megavoltage planar and cone-beam imaging with low-Z targets: dependence of image quality improvement on beam energy and patient separation.

    Science.gov (United States)

    Robar, James L; Connell, Tanner; Huang, Weihong; Kelly, Robin G

    2009-09-01

    The purpose of this study is to investigate the improvement of megavoltage planar and cone-beam CT (CBCT) image quality with the use of low atomic number (Z) external targets in the linear accelerator. In this investigation, two experimental megavoltage imaging beams were generated by using either 3.5 or 7.0 MeV electrons incident on aluminum targets installed above the level of the carousel in a linear accelerator (2100EX, Varian Medical, Inc., Palo Alto, CA). Images were acquired using an amorphous silicon detector panel. Contrast-to-noise ratio (CNR) in planar and CBCT images was measured as a function of dose and a comparison was made between the imaging beams and the standard 6 MV therapy beam. Phantoms of variable diameter were used to examine the loss of contrast due to beam hardening. Porcine imaging was conducted to examine qualitatively the advantages of the low-Z target approach in CBCT. In CBCT imaging CNR increases by factors as high as 2.4 and 4.3 for the 7.0 and 3.5 MeV/Al beams, respectively, compared to images acquired with 6 MV. Similar factors of improvement are observed in planar imaging. For the imaging beams, beam hardening causes a significant loss of the contrast advantage with increasing phantom diameter; however, for the 3.5 MeV/Al beam and a phantom diameter of 25 cm, a contrast advantage remains, with increases of contrast by factors of 1.5 and 3.4 over 6 MV for bone and lung inhale regions, respectively. The spatial resolution is improved slightly in CBCT images for the imaging beams. CBCT images of a porcine cranium demonstrate qualitatively the advantages of the low-Z target approach, showing greater contrast between tissues and improved visibility of fine detail. The use of low-Z external targets in the linear accelerator improves megavoltage planar and CBCT image quality significantly. CNR may be increased by a factor of 4 or greater. Improvement of the spatial resolution is also apparent.

  10. Monte Carlo-based investigations on the impact of removing the flattening filter on beam quality specifiers for photon beam dosimetry.

    Science.gov (United States)

    Czarnecki, Damian; Poppe, Björn; Zink, Klemens

    2017-06-01

    The impact of removing the flattening filter in clinical electron accelerators on the relationship between dosimetric quantities such as beam quality specifiers and the mean photon and electron energies of the photon radiation field was investigated by Monte Carlo simulations. The purpose of this work was to determine the uncertainties when using the well-known beam quality specifiers or energy-based beam specifiers as predictors of dosimetric photon field properties when removing the flattening filter. Monte Carlo simulations applying eight different linear accelerator head models with and without flattening filter were performed in order to generate realistic radiation sources and calculate field properties such as restricted mass collision stopping power ratios (L¯/ρ)airwater, mean photon and secondary electron energies. To study the impact of removing the flattening filter on the beam quality correction factors k Q , this factor for detailed ionization chamber models was calculated by Monte Carlo simulations. Stopping power ratios (L¯/ρ)airwater and k Q values for different ionization chambers as a function of TPR1020 and %dd(10) x were calculated. Moreover, mean photon energies in air and at the point of measurement in water as well as mean secondary electron energies at the point of measurement were calculated. The results revealed that removing the flattening filter led to a change within 0.3% in the relationship between %dd(10) x and (L¯/ρ)airwater, whereby the relationship between TPR1020 and (L¯/ρ)airwater changed up to 0.8% for high energy photon beams. However, TPR1020 was a good predictor of (L¯/ρ)airwater for both types of linear accelerator with energies filter within 1.1% and 1.6% was observed for TPR1020 and %dd(10) x respectively. The results of this study have shown that removing the flattening filter led to a change in the relationship between the well-known beam quality specifiers and dosimetric quantities at the point of measurement

  11. High quality atomically thin PtSe2 films grown by molecular beam epitaxy

    Science.gov (United States)

    Yan, Mingzhe; Wang, Eryin; Zhou, Xue; Zhang, Guangqi; Zhang, Hongyun; Zhang, Kenan; Yao, Wei; Lu, Nianpeng; Yang, Shuzhen; Wu, Shilong; Yoshikawa, Tomoki; Miyamoto, Koji; Okuda, Taichi; Wu, Yang; Yu, Pu; Duan, Wenhui; Zhou, Shuyun

    2017-12-01

    Atomically thin PtSe2 films have attracted extensive research interests for potential applications in high-speed electronics, spintronics and photodetectors. Obtaining high quality thin films with large size and controlled thickness is critical. Here we report the first successful epitaxial growth of high quality PtSe2 films by molecular beam epitaxy. Atomically thin films from 1 ML to 22 ML have been grown and characterized by low-energy electron diffraction, Raman spectroscopy and x-ray photoemission spectroscopy. Moreover, a systematic thickness dependent study of the electronic structure is revealed by angle-resolved photoemission spectroscopy (ARPES), and helical spin texture is revealed by spin-ARPES. Our work provides new opportunities for growing large size single crystalline films to investigate the physical properties and potential applications of PtSe2.

  12. Field Scale Studies on the Spatial Variability of Soil Quality Indicators in Washington State, USA

    Directory of Open Access Journals (Sweden)

    Jeffrey L. Smith

    2011-01-01

    Full Text Available Arable lands are needed for sustainable agricultural systems to support an ever-growing human population. Soil quality needs to be defined to assure that new land brought into crop production is sustainable. To evaluate soil quality, a number of soil attributes will need to be measured, evaluated, and integrated into a soil-quality index using the multivariable indicator kriging (MVIK procedure. This study was conducted to determine the spatial variability and correlation of indicator parameters on a field scale with respect to soil quality and suitability for use with MVIK. The variability of the biological parameters decreased in the order of respiration > enzyme assays and qCO2 > microbial biomass C. The distribution frequency of all parameters except respiration were normal although the spatial distribution across the landscape was highly variable. The biological parameters showed little correlation with each other when all data points were considered; however, when grouped in smaller sections, the correlations were more consistent with observed patterns across the field. To accurately assess soil quality, and arable land use, consideration of spatial and temporal variability, soil conditions, and other controlling factors must be taken into account.

  13. 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.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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.

  17. 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.

  18. Quality control of a kV cone beam computed tomography imaging system

    International Nuclear Information System (INIS)

    Marguet, M.; Bodez, V.

    2009-01-01

    Purpose: This work presents the introduction of a quality assurance program for the On-Board Imager (O.B.I., Varian) kV cone beam computed tomography (kV C.B.C.T.) system, together with the results of 1 year monthly testing. Materials and methods: Firstly the geometric precision and stability of the equipment and of the associated software were evaluated using the Marker phantom. The coincidence of the accelerator isocenter and the imager isocenter was verified as well as the accuracy of the registration of kV cone beam computed tomography (kV C.B.C.T.) with reference CT images. Then, the kV C.B.C.T. image quality was evaluated using the Catphan 504 phantom and ArtiScan software (Aquilab) for both full-fan (F.F.) and half-fan (H.F.) imaging modes. Results: The kV C.B.C.T. isocenter and image registration with correction of the table position were found to be within a tolerance of 2.0 mm. Concerning the kV C.B.C.T. image quality, image noise and uniformity, the Hounsfield units (HU) stability and linearity, geometric distortion and high contrast resolution were all found to be within the manufacturer's recommendations for both F.F. and H.F. modes. However, the low contrast resolution for the HF mode did not meet the manufacturer's specifications. Conclusion: The quality assurance tests introduced have defined the initial system characteristics and their evolution during a period of 1 year, demonstrating the stability of the O.B.I.. (authors)

  19. TLD postal dose quality audit service for Co-60 beams in reference conditions in Cuba

    International Nuclear Information System (INIS)

    Gutierrez Lores, S.; Walwyn Salas, G.; Alonso Villanueva, G.

    2008-01-01

    This report presents the methodology and experience of the Cuban's Secondary Standard Dosimetry Laboratory for the implementation of postal dose quality audits service for Co-60 beams in reference conditions, using TLDs. Under coordinated research project (Contract 10794) were bought (TLD -100) Tl rods type JR 1152F made in China, with dimensions of 6 mm x 1 mm x 1 mm. All of these rods were identified individually with a consecutive number made over one of its sides, using a fine tip of graphite. The method used to determinate the individual sensibility of the TL detectors was: irradiating a group of them, with the same history of irradiation and readout (100 rods approximately), four serial times in the same geometrical conditions, to read them out and to attribute to each of them a sensitivity factor. This sensitivity factor is equal to average for the 4 cycle of irradiation and readout of the quote between the TL readout from dosimeter i and the mean of all values for each cycle. The TLD signal was read using HARSHAW 2000C/B reader. The results obtained in the external verification of the accuracy of the dose determination by the TLD system were performed in cooperation with IAEA Dosimetry Laboratory at Seibersdorf in different years are shown, the results obtained of the quality audits carried out to the different services of radiotherapy of the country are analysed also. The quality audits are an useful tool for the improvement of the accuracy in the dosimetry of clinical beams of radiotherapy with Co-60, contributing this way to the improvement of the life quality to cancer patients of the Cuban system of health. (author)

  20. Quality control of JEOL JBX-9500FSZ e-beam lithography system in a multi-user laboratory

    DEFF Research Database (Denmark)

    Greibe, Tine; Anhøj, Thomas Aarøe; Johansen, Leif

    2016-01-01

    designed quality control procedure characterized using a scanning electron microscope. We inspect position accuracy, dynamic focus, and dynamic astigmatism, as well as single and multi-pixel lines in thin resist. Beam shape quality is inspected in the corners of the writing field at 6 different beam...... currents between 2 and 60 nA. We use positive-tone resist AR-P6200 (CSAR 62) from All Resist. With our quality control procedure, we routinely write 11 nm lines on a 40 nm pitch, and obtain a field stitching accuracy better than 3 nm and overlay accuracy less than 7 nm....

  1. Psychometric analysis of the TRANSIT quality indicators for cardiovascular disease prevention in primary care.

    Science.gov (United States)

    Khanji, Cynthia; Bareil, Céline; Hudon, Eveline; Goudreau, Johanne; Duhamel, Fabie; Lussier, Marie-Thérèse; Perreault, Sylvie; Lalonde, Gilles; Turcotte, Alain; Berbiche, Djamal; Martin, Élisabeth; Lévesque, Lise; Gagnon, Marie-Mireille; Lalonde, Lyne

    2017-12-01

    To assess a selection of psychometric properties of the TRANSIT indicators. Using medical records, indicators were documented retrospectively during the 14 months preceding the end of the TRANSIT study. Primary care in Quebec, Canada. Indicators were documented in a random subsample (n = 123 patients) of the TRANSIT study population (n = 759). For every patient, the mean compliance to all indicators of a category (subscale score) and to the complete set of indicators (overall scale score) were established. To evaluate test-retest and inter-rater reliabilities, indicators were applied twice, two months apart, by the same evaluator and independently by different evaluators, respectively. To evaluate convergent validity, correlations between TRANSIT indicators, Burge et al. indicators and Institut national d'excellence en santé et en services sociaux (INESSS) indicators were examined. Test-retest reliability, inter-rater reliability, and convergent validity. Test-retest reliability, as measured by intraclass correlation coefficients (ICCs) was equal to 0.99 (0.99-0.99) for the overall scale score while inter-rater reliability was equal to 0.95 (0.93-0.97) for the overall scale score. Convergent validity, as measured by Pearson's correlation coefficients, was equal to 0.77 (P TRANSIT indicators were compared to Burge et al. indicators and to 0.82 (P TRANSIT indicators were compared to INESSS indicators. Reliability was excellent except for eleven indicators while convergent validity was strong except for domains related to the management of CVD risk factors. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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

    Directory of Open Access Journals (Sweden)

    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

  3. Effects of gamma and electron beam irradiation on the microbial quality of steamed tofu rolls

    International Nuclear Information System (INIS)

    Jia, Qian; Gao, Meixu; Li, Shurong; Wang, Zhidong

    2013-01-01

    The effectiveness of two kinds of radiation processing, gamma and electron beam (ebeam) irradiation, for the inactivation of Staphylococcus aureus, Salmonella enteritidis and Listeria innocua which were inoculated in pre-sterilised steamed tofu rolls was studied. The corresponding effects of both irradiation types on total bacterial counts (TBCs) in commercial steamed tofu rolls available in the market were also examined. The microbiological results demonstrated that gamma irradiation yielded D 10 values of 0.20, 0.24 and 0.22 kGy for S. aureus, S. enteritidis and L. innocua, respectively. The respective D 10 values for ebeam irradiation were 0.31, 0.35 and 0.27 kGy. Gamma and ebeam irradiation yielded D 10 values of 0.48 and 0.43 kGy for total bacterial counts in commercial steamed tofu rolls, respectively. The results suggest that ebeam irradiation has similar effect on decreasing TBCs in steamed tofu rolls, and gamma irradiation is slightly more effective than ebeam irradiation in reducing the populations of pathogenic bacteria. The observed differences in D 10 -values between them might be due to the significant differences in dose rate applied, and radiation processing of soybean products to improve their microbial quality could be available for other sources of protein. - Highlights: ► Our research material is steamed tofu rolls, a kind of soybean products. ► We compared the effects of gamma ray and electron beam irradiation. ► Total bacterial and three strains of pathogens are studied in our research. ► We reported electron beam has similar decontamination effect as gamma ray. ► Radiation processing of soybean products to improve their microbial quality could be available for other sources of protein.

  4. The effect of propofol-remifentanil anesthesia on selected seizure quality indices in electroconvulsive therapy.

    Science.gov (United States)

    Dinwiddie, Stephen H; Glick, David B; Goldman, Morris B

    2012-07-01

    Use of a short-acting opiate to potentiate anesthetic induction agents has been shown to increase seizure duration in electroconvulsive therapy (ECT), but little is known of the effect of this combination on indices of seizure quality. To determine whether anesthetic modality affects commonly provided indices of seizure quality. Twenty-five subjects were given propofol 2 mg/kg body weight for their first ECT session, at which time seizure threshold was titrated. Subjects thereafter alternated between that anesthetic regimen or propofol 0.5 mg/kg plus remifentanil 1 mcg/kg. Linear mixed models with random subject effect, adjusting for electrode placement, electrical charge, and number of treatments, were fit to estimate effect of anesthesia on seizure duration and several standard seizure quality indices (average seizure energy, time to peak electroencephalography (EEG) power, maximum sustained power, interhemispheric coherence, early and midictal EEG amplitude, and maximum sustained interhemispheric EEG coherence). Propofol-remifentanil anesthesia significantly lengthened seizure duration and was associated with longer time to reach maximal EEG power and coherence as well as maximal degree of interhemispheric EEG coherence. No effect was seen on early ictal amplitude or average seizure energy index. Propofol-remifentanil anesthesia prolongs seizure duration and has a significant effect on some, but not all, measures of seizure quality. This effect may be of some benefit in cases where adequate seizures are otherwise difficult to elicit. Varying anesthetic technique may allow more precise investigation of the relationships between and relative impacts of commonly used seizure quality indices on clinical outcomes and ECT-related cognitive side effects. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Evaluation of the Beam Quality of Intraoral X-ray Equipment using Intraoral Standard Films

    International Nuclear Information System (INIS)

    Lee, Sang Sub; Kwon, Hyok Rak; Sim, Woo Hyoun; Oh, Seung Hyoun; Lee, Ji Youn; Jeon, Kug Jin; Kim, Kee Deog; Park, Chang Seo

    2000-01-01

    This study was to evaluate the beam quality of intraoral X-ray equipment used at Yonsei University Dental Hospital (YUDH) using the half value layer (HVL) and the characteristic curve of intraoral standard X-ray film. The study was done using the intraoral X-ray equipment used at each clinical department at YUDH. Aluminum filter was used to determine the HVL. Intraoral standard film was used to get the characteristic curve of each intraoral X-ray equipment. Most of the HVLs of intraoral X-ray equipment were higher than the least recommended thickness, but the REX 601 model used at the operative dentistry department and the X-707 model used at the pediatric dentistry department had HVLs lower than the recommended thickness. The slopes of the characteristic curves of films taken using the PANPAS 601 model and REX 601 model at operative dentistry department, the X-70S model of prosthodontic dentistry department, and the REX 601 model at the student clinic were relatively low. HVL and the characteristic curve of X-ray film can be used to evaluate the beam quality of intraoral X-ray equipment. In order to get the best X-ray films with the least radiation exposure to patients and best diagnostic information in clinical dentistry, X-ray equipment should be managed in the planned and organized fashion.

  6. Should image rotation be addressed during routine cone-beam CT quality assurance?

    International Nuclear Information System (INIS)

    Ayan, Ahmet S; Lin Haibo; Yeager, Caitlyn; Deville, Curtiland; McDonough, James; Zhu, Timothy C; Anderson, Nathan; Ad, Voichita Bar; Both, Stefan; Lu, Hsiao-Ming

    2013-01-01

    The purpose of this study is to investigate whether quality assurance (QA) for cone-beam computed tomography (CBCT) image rotation is necessary in order to ensure the accuracy of CBCT based image-guided radiation therapy (IGRT) and adaptive radiotherapy (ART). Misregistration of angular coordinates during CBCT acquisition may lead to a rotated reconstructed image. If target localization is performed based on this image, an under- or over-dosage of the target volume (TV) and organs at risk (OARs) may occur. Therefore, patient CT image sets were rotated by 1° up to 3° and the treatment plans were recalculated to quantify changes in dose–volume histograms. A computer code in C++ was written to model the TV displacement and overlap area of an ellipse shape at the target and dose prescription levels corresponding to the image rotation. We investigated clinical scenarios in IGRT and ART in order to study the implications of image rotation on dose distributions for: (1) lateral TV and isocenter (SBRT), (2) central TV and isocenter (IMRT), (3) lateral TV and isocenter (IMRT). Mathematical analysis showed the dose coverage of TV depends on its shape, size, location, and orientation relative to the isocenter. Evaluation of three first scenario for θ = 1° showed variations in TV D95 in the context of IGRT and ART when compared to the original plan were within 2.7 ± 2.6% and 7.7 ± 6.9% respectively while variations in the second and third scenarios were less significant (<0.5%) for the angular range evaluated. However a larger degree of variation was found in terms of minimum and maximum doses for target and OARs. The rotation of CBCT image data sets may have significant dosimetric consequences in IGRT and ART. The TV's location relative to isocenter and shape determine the extent of alterations in dose indicators. Our findings suggest that a CBCT QA criterion of 1° would be a reasonable action level to ensure accurate dose delivery. (paper)

  7. Should image rotation be addressed during routine cone-beam CT quality assurance?

    Science.gov (United States)

    Ayan, Ahmet S.; Lin, Haibo; Yeager, Caitlyn; Deville, Curtiland; McDonough, James; Zhu, Timothy C.; Anderson, Nathan; Bar Ad, Voichita; Lu, Hsiao-Ming; Both, Stefan

    2013-02-01

    The purpose of this study is to investigate whether quality assurance (QA) for cone-beam computed tomography (CBCT) image rotation is necessary in order to ensure the accuracy of CBCT based image-guided radiation therapy (IGRT) and adaptive radiotherapy (ART). Misregistration of angular coordinates during CBCT acquisition may lead to a rotated reconstructed image. If target localization is performed based on this image, an under- or over-dosage of the target volume (TV) and organs at risk (OARs) may occur. Therefore, patient CT image sets were rotated by 1° up to 3° and the treatment plans were recalculated to quantify changes in dose-volume histograms. A computer code in C++ was written to model the TV displacement and overlap area of an ellipse shape at the target and dose prescription levels corresponding to the image rotation. We investigated clinical scenarios in IGRT and ART in order to study the implications of image rotation on dose distributions for: (1) lateral TV and isocenter (SBRT), (2) central TV and isocenter (IMRT), (3) lateral TV and isocenter (IMRT). Mathematical analysis showed the dose coverage of TV depends on its shape, size, location, and orientation relative to the isocenter. Evaluation of three first scenario for θ = 1° showed variations in TV D95 in the context of IGRT and ART when compared to the original plan were within 2.7 ± 2.6% and 7.7 ± 6.9% respectively while variations in the second and third scenarios were less significant (<0.5%) for the angular range evaluated. However a larger degree of variation was found in terms of minimum and maximum doses for target and OARs. The rotation of CBCT image data sets may have significant dosimetric consequences in IGRT and ART. The TV's location relative to isocenter and shape determine the extent of alterations in dose indicators. Our findings suggest that a CBCT QA criterion of 1° would be a reasonable action level to ensure accurate dose delivery.

  8. CRITERIA AND QUALITY INDICATORS OF INFORMATION AND COMMUNICATION TECHNOLOGIES OF LEARNING

    Directory of Open Access Journals (Sweden)

    Oleg M. Spirin

    2013-03-01

    Full Text Available In the article the concept of information and communication technology and information and communication technology of learning is specified. It is grounded an external and internal criteria of information and communication technologies of learning quality assessment based on experience of information and communication technology quality assessment of the methodical system of informatics teachers vocational training. There are considered the external indexes – design, structural, organizational, communicative and gnostic criteria, and internal – differentiation, individualization, intensification of teaching process and effectiveness of educational activity. There are presented the approaches to assess the indicators for determination of criteria demonstration degree.

  9. [The respect of the right to freedom of movement, an indicator of good quality patient management].

    Science.gov (United States)

    Pothain, Alexandre

    Freedom of movement is at the centre of contradictory challenges for the different people working in psychiatry, faced with a society demanding social regulation and safety, and the desire of institutions to provide high quality care. This freedom, and more globally the respect of patients' civil rights, are an indicator of the expected quality of care. Taking these rights into consideration does not mean neglecting safety, but attempts to put it into perspective. This article presents the clinical case of a patient. Copyright © 2017. Published by Elsevier Masson SAS.

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

    OpenAIRE

    GULLIAN-KLANIAN,Mariel; SÁNCHEZ-SOLÍS,María José; TERRATS-PRECIAT,Montserrat; DELGADILLO-DÍAZ,Mariana; ARANDA,Javier

    2016-01-01

    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 h...

  11. Turbidity as an Indicator of Water Quality in Diverse Watersheds of the Upper Pecos River Basin

    Directory of Open Access Journals (Sweden)

    Gregory M. Huey

    2010-06-01

    Full Text Available Microbial concentrations, total suspended solids (TSS and turbidity vary with stream hydrology and land use. Turbidity, TSS, and microbial concentrations, loads and yields from four watersheds were assessed: an unburned montane forest, a catastrophically burned montane forest, urban land use and rangeland prairie. Concentrations and loads for most water quality variables were greatest during storm events. Turbidity was an effective indicator of TSS, E. coli and Enterococci spp. The greatest threat to public health from microbial contamination occurs during storm runoff events. Efforts to manage surface runoff and erosion would likely improve water quality of the upper Pecos River basin in New Mexico, USA.

  12. Application of indices Cp and Cpk to improve quality control capability in clinical biochemistry laboratories.

    Science.gov (United States)

    Chen, Ming-Shu; Wu, Ming-Hsun; Lin, Chih-Ming

    2014-04-30

    The traditional criteria for acceptability of analytic quality may not be objective in clinical laboratories. To establish quality control procedures intended to enhance Westgard multi-rules for improving the quality of clinical biochemistry tests, we applied the Cp and Cpk quality-control indices to monitor tolerance fitting and systematic variation of clinical biochemistry test results. Daily quality-control data of a large Taiwanese hospital in 2009 were analyzed. The test items were selected based on an Olympus biochemistry machine and included serum albumin, aspartate aminotransferase, cholesterol, glucose and potassium levels. Cp and Cpk values were calculated for normal and abnormal levels, respectively. The tolerance range was estimated with data from 50 laboratories using the same instruments and reagents. The results showed a monthly trend of variation for the five items under investigation. The index values of glucose were lower than those of the other items, and their values were usually quality control, but also for revealing inter-laboratory qualitycontrol capability differences.

  13. Quality indicators in the treatment of patients with depression, bipolar disorder or schizophrenia. Consensus study.

    Science.gov (United States)

    Bernardo, Miquel; de Dios, Consuelo; Pérez, Víctor; Ignacio, Emilio; Serrano, Manuel; Vieta, Eduard; Mira, José Joaquín; Guilabert, Mercedes; Roca, Miquel

    To define a set of indicators for mental health care, monitoring quality assurance in schizophrenia, depression and bipolar disorders in Spain. Qualitative research. Consensus-based study involving 6 psychiatrists on the steering committee and a panel of 43 psychiatrists working in several health services in Spain. An initial proposal of 44 indicators for depression, 42 for schizophrenia and 58 for bipolar disorder was elaborated after reviewing the literature. This proposal was analysed by experts using the Delphi technique. The valuation of these indicators in successive rounds allowed those with less degree of consensus to be discarded. Feasibility, sensitivity and clinical relevance were considered. The study was carried out between July 2015 and March 2016. Seventy indicators were defined by consensus: 17 for major depression, 16 for schizophrenia, 17 for bipolar disorder and 20 common to all three pathologies. These indicators included measures related to adequacy, patient safety, exacerbation, mechanical restraint, suicidal behaviour, psychoeducation, adherence, mortality and physical health. This set of indicators allows quality monitoring in the treatment of patients with schizophrenia, depression or bipolar disorder. Mental health care authorities and professionals can use this proposal for developing a balanced scorecard adjusted to their priorities and welfare objectives. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. 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.

  15. 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...

  16. Utility of the computed tomography indices on cone beam computed tomography images in the diagnosis of osteoporosis in women

    International Nuclear Information System (INIS)

    Koh, Kwang Joon; Kim, Kyung A

    2011-01-01

    This study evaluated the potential use of the computed tomography indices (CTI) on cone beam CT (CBCT) images for an assessment of the bone mineral density (BMD) in postmenopausal osteoporotic women. Twenty-one postmenopausal osteoporotic women and 21 postmenopausal healthy women were enrolled as the subjects. The BMD of the lumbar vertebrae and femur were calculated by dual energy X-ray absorptiometry (DXA) using a DXA scanner. The CBCT images were obtained from the unilateral mental foramen region using a PSR-9000N Dental CT system. The axial, sagittal, and coronal images were reconstructed from the block images using OnDemend3D. The new term 'CTI' on CBCT images was proposed. The relationship between the CT measurements and BMDs were assessed and the intra-observer agreement was determined. There were significant differences between the normal and osteoporotic groups in the computed tomography mandibular index superior (CTI(S)), computed tomography mandibular index inferior (CTI(I)), and computed tomography cortical index (CTCI). On the other hand, there was no difference between the groups in the computed tomography mental index (CTMI: inferior cortical width). CTI(S), CTI(I), and CTCI on the CBCT images can be used to assess the osteoporotic women.

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

    Science.gov (United States)

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

    2014-08-01

    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 its own advantages and disadvantages, and we give some pointers on how to balance these pros and cons while taking into account the aim of the measurement initiative. Especially within initiatives that link payment or reputation to indicator measurement, this balancing should be done with utmost care to avoid potential, unintended consequences. Furthermore, we suggest consideration of (i) a causal chain-i.e. subsequent aspects of care connected by evidence-based links-as a starting point for composing a performance indicator set and (ii) adequate case-mix adjustment, not only of (surrogate) outcomes, but also of process indicators in order to obtain fair comparisons between facilities and within facilities over time. © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  18. The Psychometric Properties and the Development of the Indicators of Quality Nursing Work Environments in Taiwan.

    Science.gov (United States)

    Lin, Chiou-Fen; Lu, Meei-Shiow; Huang, Hsiu-Ying

    2016-03-01

    The nursing shortage in medical institutions in Taiwan averaged 9% in 2012, considerably higher than the 5% indicated in the literature. As a result, many hospitals have been forced to close wards or reduce beds. Despite the acute need, the percentage of registered nurses who are employed as nurses in Taiwan (60.4%) is considerably lower than those in Canada or the United States. This low rate may be because of the poor working environment for nurses in Taiwan. This study aimed to develop a set of nursing work environment quality indicators for Taiwan and to test the reliability and validity of the resulting survey tool. Multiple methods were used in this study. In Phase 1, we organized an expert panel, reviewed the literature, and conducted seven rounds of expert panel discussion and six focus group discussions with nursing directors. The goal was to draft indicators representing a quality nursing work environment to fit current conditions in Taiwan. In Phase 2, we conducted an expert review for content validity, held three public hearings, and conducted a survey. Four hundred twenty-seven questionnaires were sent out, with 381 returned. The goal was to test the content validity, construct validity, and internal consistency reliability. The study produced a set of indicators of a quality nursing work environment with eight dimensions and 65 items. The content validity index for importance and suitability dimensions were 1.0, whereas the internal consistency was 0.91. The eight dimensions were safe practice environment (16 items), quality and quantity of staff (four items), salary and welfare (seven items), professional specialization and teamwork (seven items), work simplification (five items), informatics (five items), career development (nine items), and support and caring (12 items). The overall load for the indicators was 77.57%. The developed indicators may be used to evaluate the quality of nursing work environments. Furthermore, the indicators may be used