WorldWideScience

Sample records for clinical quality indicators

  1. Clinical quality indicators of venous leg ulcers

    DEFF Research Database (Denmark)

    Kjaer, Monica L; Mainz, Jan; Soernsen, Lars T;

    2005-01-01

    and reliable evidence-based quality indicators of venous leg ulcer care. A Scandinavian multidisciplinary, cross-sectional panel of wound healing experts developed clinical quality indicators on the basis of scientific evidence from the literature and subsequent group nominal consensus of the panel...

  2. 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...

  3. Complement analysis 2016: Clinical indications, laboratory diagnostics and quality control.

    Science.gov (United States)

    Prohászka, Zoltán; Nilsson, Bo; Frazer-Abel, Ashley; Kirschfink, Michael

    2016-11-01

    In recent years, complement analysis of body fluids and biopsies, going far beyond C3 and C4, has significantly enhanced our understanding of the disease process. Such expanded complement analysis allows for a more precise differential diagnosis and for critical monitoring of complement-targeted therapy. These changes are a result of the growing understanding of the involvement of complement in a diverse set of disorders. To appreciate the importance of proper complement analysis, it is important to understand the role it plays in disease. Historically, it was the absence of complement as manifested in severe infection that was noted. Since then complement has been connected to a variety of inflammatory disorders, such as autoimmune diseases and hereditary angioedema. While the role of complement in the rejection of renal grafts has been known longer, the significant impact of complement. In certain nephropathies has now led to the reclassification of some rare kidney diseases and an increased role for complement analysis in diagnosis. Even more unexpected is that complement has also been implicated in neural, ophtalmological and dermatological disorders. With this level of involvement in some varied and impactful health issues proper complement testing is clearly important; however, analysis of the complement system varies widely among laboratories. Except for a few proteins, such as C3 and C4, there are neither well-characterized standard preparations nor calibrated assays available. This is especially true for the inter-laboratory variation of tests which assess classical, alternative, or lectin pathway function. In addition, there is a need for the standardization of the measurement of complement activation products that are so critical in determining whether clinically relevant complement activation has occurred in vivo. Finally, autoantibodies to complement proteins (e.g. anti-C1q), C3 and C4 convertases (C3 and C4 nephritic factor) or to regulatory proteins

  4. 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, 1997

  5. Clinical relevance of single item quality of life indicators in cancer clinical trials

    OpenAIRE

    Bernhard, J.; Sullivan, M.; Hürny, C; Coates, A S; Rudenstam, C-M

    2001-01-01

    We investigated the hypothesis that global single-item quality-of-life indicators are less precise for specific treatment effects (discriminant validity) than multi-item scales but similarly efficient for overall treatment comparisons and changes over time (responsiveness) because they reflect the summation of the individual meaning and importance of various factors. Linear analogue self-assessment (LASA) indicators for physical well-being, mood and coping were compared with the Hospital Anxi...

  6. Conceptual Considerations on the Integration of Quality Indicators into Clinical Pathways.

    Science.gov (United States)

    Richter, Peggy; Burwitz, Martin; Esswein, Werner

    2016-01-01

    Health care systems need to cope with continuous changes such as with the current trends towards pay-for-performance and value-based health care. In this context, the article aims at analysing the potentials of the integration and utilisation of quality indicators in clinical pathways. It comprises the first steps of a design-oriented research process, i.e. problem motivation and objective definition. Therefore, a conceptual framework for pathway-integrated quality indicators is proposed. Potentials of the approach are outlined in three use case scenarios. The analysis points out great potentials for quality management on institutional and network level and for bridging the gap between medical research and practice. Further research topics are derived and summarised in an agenda. PMID:27577337

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

    International Nuclear Information System (INIS)

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

  8. Are physical measures good indicators of clinical image quality at low dose levels? A pilot study

    OpenAIRE

    Lança, Luís; Andersen, E. N.; Carvalho, G.; van Gerwen, M.; Jorge, José; Kleiker, M.; Markali, B.; Nightingale, P.; Hogg, Peter

    2016-01-01

    Background - For dose reduction actions, the principle of “image quality as good as possible” to “image quality as good as needed” requires to know whether the physical measures and visual image quality relate. Visual evaluation and objective physical measures of image quality can appear to be different. If there is no noticeable effect on the visual image quality with a low dose but there is a objective physical measure impact, then the overall dose may be reduced without compromising the di...

  9. Quality indicators in radiotherapy

    International Nuclear Information System (INIS)

    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

  10. Air quality indicators

    International Nuclear Information System (INIS)

    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 NO2, 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 km2 grid system covering the city of Oslo, winter 1994/95, calculated by the grid

  11. Arthritis Quality Indicators for the Veterans Administration: Implications for Electronic Data Collection, Storage Format, Quality Assessment, and Clinical Decision Support

    OpenAIRE

    Williams, Carl A.; Mosley-Williams, Angelia D.; Overhage, J. Marc

    2007-01-01

    The Veterans Administration (VA) uses information technology and performance measures to improve quality and efficiency. The VA stores all patient data electronically. Manual quality assessment audits are performed every three months. They are time consuming and expensive. Automated reviews would be more efficient. But the patient records are neither sufficiently coded nor structured to allow for full machine interpretability.

  12. An audit of the quality of care indicators for the management of diabetes in family practice clinics in karachi, pakistan

    International Nuclear Information System (INIS)

    Management of diabetes is a painstaking and careful approach. This study was aimed to evaluate the quality of care for the management of diabetes provided by family practitioners to their patients having diabetes. This is a retrospective audit of medical records conducted in a tertiary care teaching hospital of private sector in Karachi for one month. For this study, 150 medical records of patients with type 2 diabetes that visited family practice clinics for their diabetes care were examined. A total of 88 patient's medical records were selected and analyzed who attended the studied clinics for at least one year and had minimum of four out-patient visits. Majority (68%) of the audited medical records were of females. Of the total medical records analyzed, only one-quarter of the cases qualified the criteria of excellent or good diabetes care. Monitoring of body weight of the patient was only one indicator which was according the recommendations in 100% case at every visit. The other nearest quality of care indicator documented was blood glucose advice at every visit in 79.5% (95% CI: 71.1-87.9) of cases. Physical activity advised/reinforced at every visit was least observed (27.3%; 95% CI: 18.0-36.6). In addition, blood sugar control was reported in less than a quarter (23.9%) with 95% CI of 15.0-32.8. This work has identified a big gap in the management of type 2 diabetes provided by family practitioners. In addition, majority of the patients found to have poor glycemic control. Interventions are suggested to improve the quality of diabetes care. More such audits and research are recommended at the larger scale. (author)

  13. Chronic Biliary Pancreatitis Clinical Course Interrelation with Quality of Life and Patients Dependance on Supporting Therapy Indices

    Directory of Open Access Journals (Sweden)

    J.V. Listishenkova

    2009-06-01

    Full Text Available The analysis of clinical course influence on life quality and patients dependance on supporting therapy of chronic biliary dependent pancreatitis is represented. It has been determined that increase of life quality is in close correlation with exacerbation frequency, dyspepsia syndrome evidence and manifestations of exocrinous insufficiency of pancreas. Patients with chronic biliary dependent pancreatitis do not carry out doctor’s recommendations in appropriate manner.

  14. Improvement of clinical quality indicators through reorganization of the acute care by establishing an emergency department-a register study based on data from national indicators

    DEFF Research Database (Denmark)

    Mattsson, Maria Søe; Mattsson, N.; Jørsboe, H. B.

    2014-01-01

    . The aim of this study was to investigate the quality of acute care in a re-organized ED based on national indicator project data in a pre and post reorganizational setting. Methods: Quasi experimental design was used to examine the effect of the health care quality in relation to the reorganization of...... an ED. Patients admitted at Nykobing Falster Hospital in 2008 or 2012 were included in the study and data reports from the national databases (RKKP) regarding stroke, COPD, heart failure, bleeding and perforated ulcer or hip fracture were analysed. Holbk Hospital works as a control hospital. Chi...

  15. Power Quality Indices Estimation Platform

    Directory of Open Access Journals (Sweden)

    Eliana I. Arango-Zuluaga

    2013-11-01

    Full Text Available An interactive platform for estimating the quality indices in single phase electric power systems is presented. It meets the IEEE 1459-2010 standard recommendations. The platform was developed in order to support teaching and research activities in electric power quality. The platform estimates the power quality indices from voltage and current signals using three different algorithms based on fast Fourier transform (FFT, wavelet packet transform (WPT and least squares method. The results show that the algorithms implemented are efficient for estimating the quality indices of the power and the platform can be used according to the objectives established. 

  16. 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…

  17. Quality Indicators in Radiation Oncology

    International Nuclear Information System (INIS)

    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

  18. Compliance with clinical practice guidelines for breast cancer treatment: a population-based study of quality-of-care indicators in Italy

    Directory of Open Access Journals (Sweden)

    Sacerdote Carlotta

    2013-01-01

    Full Text Available Abstract Background It has been documented that variations exist in breast cancer treatment despite wide dissemination of clinical practice guidelines. The aim of this population-based study was to evaluate the impact of regional guidelines (Piedmont guidelines, PGL for breast cancer diagnosis and treatment on quality-of-care indicators in the Northwestern Italian region of Piedmont. Methods We included two samples of women aged 50–69 years with incident breast cancer treated in Piedmont before and after the introduction of PGL: 600 in 2002 (pre-PGL and 621 in 2004 (post-PGL. Patients were randomly selected among all incident breast cancer cases identified through the hospital discharge records database. We extracted clinical data on breast cancer cases from medical charts and ascertained vital status through linkage with town offices. We assessed compliance with 14 quality-of-care indicators from PGL recommendations, before and after their introduction in clinical practice. Results Among patients with invasive lesions, 77.1% (N = 368 and 77.5% (N = 383 in the pre-PGL and post-PGL groups, respectively, received breast conservative surgery (BCS as a first-line treatment. Following BCS, 87.7% received radiotherapy in 2002, compared to 87.9% in 2004. Of all patients at medium-to-high risk of distant metastasis, 65.5% (N = 268 and 63.6% (N = 252 received chemotherapy in 2002 and in 2004, respectively. Among the 117 patients with invasive lesions and negative estrogen receptor status in 2002, hormonal therapy was prescribed in 23 of them (19.6%. The incorrect prescription of hormonal therapy decreased to 10.8% (N = 10 among the 92 estrogen receptor-negative patients in 2004 (p Compliance with PGL recommendations was already high in the pre-PGL group, although some quality-of-care indicators did not reach the standard. In the pre/post analysis, 8 out of 14 quality-of-care indicators showed an improvement from 2002 to 2004, but only 4 out of 14

  19. Quality indicators in breast cancer care.

    Science.gov (United States)

    Del Turco, M Rosselli; Ponti, A; Bick, U; Biganzoli, L; Cserni, G; Cutuli, B; Decker, T; Dietel, M; Gentilini, O; Kuehn, T; Mano, M P; Mantellini, P; Marotti, L; Poortmans, P; Rank, F; Roe, H; Scaffidi, E; van der Hage, J A; Viale, G; Wells, C; Welnicka-Jaskiewicz, M; Wengstöm, Y; Cataliotti, L

    2010-09-01

    To define a set of quality indicators that should be routinely measured and evaluated to confirm that the clinical outcome reaches the requested standards, Eusoma has organised a workshop during which twenty four experts from different disciplines have reviewed the international literature and selected the main process and outcome indicators available for quality assurance of breast cancer care. A review of the literature for evidence-based recommendations have been performed by the steering committee. The experts have identified the quality indicators also taking into account the usability and feasibility. For each of them it has been reported: definition, minimum and target standard, motivation for selection and level of evidence (graded according to AHRO). In overall 17 main quality indicators have been identified, respectively, 7 on diagnosis, 4 on surgery and loco-regional treatment, 2 on systemic treatment and 4 on staging, counselling, follow-up and rehabilitation. Breast Units in Europe are invited to comply with these indicators and monitor them during their periodic audit meetings. PMID:20675120

  20. The effect of empowerment on the self-efficacy, quality of life and clinical and laboratory indicators of patients treated with hemodialysis: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Moattari Marzieh

    2012-09-01

    Full Text Available Abstract Background Hemodialysis patients face numerous physical and psychological stresses that result in reduced health. The aim of this study is to determine the impact of an empowerment program on self-efficacy, quality of life, clinical indicators of blood pressure and interdialytic weight gain, and laboratory results in these patients. Methods This randomized, controlled trial was conducted at Boo Ali Sina Dialysis Center, Shiraz, Iran. A total of 48 hemodialysis patients participated in this study. After acquisition of informed consent, eligible patients were randomly divided into two groups, control and experimental. Pre-test data were obtained by using a demographic data form and two questionnaires for self-efficacy and quality of life. Blood pressure and interdialytic weight gain were measured. We extracted laboratory data from patients’ charts. A six-week empowerment intervention that included four individual and two group counselling sessions was performed for the experimental group. Six weeks after intervention, post-test data were obtained from both groups in the same manner as the pre-test. Data were analyzed by ANCOVA using SPSS v11.5. Results There were no statistically significant differences in demographic variables between the groups. Pre-test mean scores for self-efficacy, quality of life, blood pressure, interdialytic weight gain and laboratory results did not differ between the groups. There was a significant difference between the experimental and control groups in terms of pre-to post-intervention changes in overall self-efficacy scores, stress reduction, and decision making, in addition to overall quality of life and all dimensions included within quality of life based on this questionnaire. Additionally, the pre- to post-intervention changes in systolic/diastolic blood pressures, interdialytic weight gain, hemoglobin and hematocrit levels significantly differed between the groups. Conclusion Our study demonstrates

  1. Air quality indices : a review

    International Nuclear Information System (INIS)

    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

  2. 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...... simple way. The paper therefore questions the procedure of using unit value differences between exported and imported goods as criteria for disentangling intra-industry trade in a vertical and a horizontal part....

  3. Measuring service quality by linear indicators

    OpenAIRE

    Peña, Daniel

    1996-01-01

    This paper presents a methodology for building linear indicators of the quality of a service. A regression model is presented in which customers evaluate the overall service quality and a set of dimensions or attributes that determine this service quality. The model assumes that overall service quality is determined by a linear combination of attribute evaluations with some unknown weights. As different customers may have different weights, the estimation of the parameters of the ...

  4. Nuevos indicadores clínicos: La calidad de vida relacionada con la salud New clinical indicators: Health-related quality of life

    Directory of Open Access Journals (Sweden)

    E. Consiglio

    2003-04-01

    Full Text Available En las últimas décadas se ha incrementado el interés por la obtención de nuevos indicadores clínicos a partir de la necesidad de evaluar mejor los desenlaces en salud. En este contexto ha surgido el estudio de la calidad de vida relacionada con la salud (CVRS, que evalúa un modelo multidimensional en el que el paciente constituye la fuente primaria de información. El objetivo último consiste en la evaluación global de las consecuencias que ocasionan las enfermedades y sus tratamientos en la vida cotidiana de los pacientes. Para ello se han desarrollado instrumentos de medición (cuestionarios, en general autoadministrados, genéricos o específicos. Estos cuestionarios deben cumplir con propiedades, denominadas psicométricas, entre las que se incluyen la fiabilidad, la validez y la sensibilidad al cambio; algunos autores incluyen también a la factibilidad. La CVRS favorece un mejor conocimiento de la historia natural de las enfermedades y del impacto global de las mismas en los enfermos, complementando a los indicadores clásicos de mortalidad y morbilidad; además facilita la comparación de estrategias de intervención terapéutica en el contexto de ensayos clínicos o de estudios epidemiológicos. Aún existen aspectos técnicos no resueltos, tales como la correlación entre las puntuaciones en términos absolutos y la clínica del paciente, su valor predictivo, y los cambios del contenido de sus instrumentos de medida de acuerdo con los cambios en la historia natural de las enfermedades en evaluación.In the last decades the need of better measurements of health outcomes has increased the interest for new clinical indicators. Health-related quality of life (HRQoL has emerged in this context as a multidimensional model approach where the patient is the exclusive source of information. The main objective of HRQoL measurement is to provide a global evaluation of the impact of diseases and the consequences of treatments over the daily

  5. Lessons from the Educational Quality Indicators Initiative.

    Science.gov (United States)

    McEwen, Nelly

    The Educational Quality Indicators (EQI) initiative was a collaboration between Alberta Education (Alberta, Canada) and 12 school jurisdictions to develop and implement indicator systems to measure the success of the educational enterprise. Ten concurrent collaborative projects were conducted between 1989 and 1992 to develop indicator systems for…

  6. Citations: Indicators of Quality? The Impact Fallacy

    OpenAIRE

    Leydesdorff, Loet; Bornmann, Lutz; Comins, Jordan; Milojević, Staša

    2016-01-01

    We argue that citation is a composed indicator: short-term citations can be considered as currency at the research front, whereas long-term citations can contribute to the codification of knowledge claims into concept symbols. Knowledge claims at the research front are more likely to be transitory and are therefore problematic as indicators of quality. Citation impact studies focus on short-term citation, and therefore tend to measure not epistemic quality, but involvement in current discours...

  7. Evaluation of headache service quality indicators

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: Evaluating quality of health care is increasingly recognized as an important contributor to the advancement of health-care delivery. We recently developed a set of quality indicators for headache care, intended to be applicable across countries, cultures and settings so that deficienc......BACKGROUND: Evaluating quality of health care is increasingly recognized as an important contributor to the advancement of health-care delivery. We recently developed a set of quality indicators for headache care, intended to be applicable across countries, cultures and settings so...... 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...

  8. Quality indicators for district heating networks

    OpenAIRE

    Pacot, Pierre-Emmanuel; Reiter, Sigrid

    2011-01-01

    District heating networks are very common energy systems all over the world but only few studies have been carried out to assess their performances through quality indicators. These indicators express district heating performances through different points of view. Four ones are developed in this study: energy sources, efficiencies, heat delivering equipments characteristics and environmental efficiency as a sum up. First, the only energy indicator generally used is the primary energy fact...

  9. Quality indicators in postoperative pain management: a validation study.

    Science.gov (United States)

    Idvall, E; Hamrin, E; Sjöström, B; Unosson, M

    2001-01-01

    Quality indicators in postoperative pain management: a validation study. In a previous study, strategic and clinical quality indicators were developed from a tentative model to assess high quality in postoperative pain management. The aim of the present study was to investigate the content validity of these 15 indicators. The indicators were compiled in a questionnaire, and two groups of nurses (n=210, n=321) scored each indicator on a 5-point scale (strongly disagree to strongly agree) from three different standpoints: whether it was essential for achieving high quality, whether it was realistic to carry out, and whether it was possible for nurses to influence management. The respondents were also asked to choose the most crucial indicators for the quality of care. The results showed that both groups of nurses judged the 15 indicators to have content validity from all three standpoints. Both groups also found the same six indicators to be the most crucial. These indicators concerned detecting and acting on signs and symptoms, performing prescriptions, informing and educating, acting on behalf of patients, competence/knowledge, and attitudes. The validated indicators should be useful to consider when implementing a strategy for postoperative pain management and when planning to evaluate the quality of care. PMID:12453175

  10. Quality of care indicators in rectal cancer.

    Science.gov (United States)

    Demetter, P; Ceelen, W; Danse, E; Haustermans, K; Jouret-Mourin, A; Kartheuser, A; Laurent, S; Mollet, G; Nagy, N; Scalliet, P; Van Cutsem, E; Van Den Eynde, M; Van de Stadt, J; Van Eycken, E; Van Laethem, J L; Vindevoghel, K; Penninckx, F

    2011-09-01

    Quality of health care is a hot topic, especially with regard to cancer. Although rectal cancer is, in many aspects, a model oncologic entity, there seem to be substantial differences in quality of care between countries, hospitals and physicians. PROCARE, a Belgian multidisciplinary national project to improve outcome in all patients with rectum cancer, identified a set of quality of care indicators covering all aspects of the management of rectal cancer. This set should permit national and international benchmarking, i.e. comparing results from individual hospitals or teams with national and international performances with feedback to participating teams. Such comparison could indicate whether further improvement is possible and/or warranted. PMID:22103052

  11. The advanced flame quality indicator system

    Energy Technology Data Exchange (ETDEWEB)

    Oman, R.; Rossi, M.J.; Calia, V.S.; Davis, F.L.; Rudin, A. [Insight Technologies, Inc., Bohemia, NY (United States)

    1997-09-01

    By combining oil tank monitoring, systems diagnostics and flame quality monitoring in an affordable system that communicates directly with dealers by telephone modem, Insight Technologies offers new revenue opportunities and the capability for a new order of customer relations to oil dealers. With co-sponsorship from New York State Energy Research and Development Authority, we have incorporated several valuable functions to a new product based on the original Flame Quality Indicator concept licensed from the US DOE`s Brookhaven National Laboratory. The new system is the Advanced Flame Quality Indicator, or AFQI. As before, the AFQI monitors and reports the intensity of the burner flame relative to a calibration established when the burner is set up at AFQI installation. Repairs or adjustments are summoned by late-night outgoing telephone calls when limits are exceeded in either direction, indicating an impending contamination or other malfunction. A independently, a pressure transducer for monitoring oil tank level and filter condition, safety lockout alarms and a temperature monitor; all reporting automatically at instructed intervals via an on-board modem to a central station PC computer (CSC). Firmware on each AFQI unit and Insight-supplied software on the CSC automatically interact to maintain a customer database for an oil dealer, an OEM, or a regional service contractor. In addition to ensuring continuously clean and efficient operation, the AFQI offers the oil industry a new set of immediate payoffs, among which are reduced outages and emergency service calls, shorter service calls from cleaner operation, larger oil delivery drops, the opportunity to stretch service intervals to as along as three years in some cases, new selling features to keep and attract customers, and greatly enhanced customer contact, quality and reliability.

  12. Indicators for the evaluation of diet quality.

    Science.gov (United States)

    Gil, Ángel; Martinez de Victoria, Emilio; Olza, Josune

    2015-01-01

    The role of diet quality and physical activity in reducing the progression of chronic disease is becoming increasingly important. Dietary Quality Indices or Indicators (DQIs) are algorithms aiming to evaluate the overall diet and categorize individuals according to the extent to which their eating behaviour is "healthy". Predefined indexes assess dietary patterns based on current nutrition knowledge and they have been developed primarily for nutritional epidemiology to assess dietary risk factors for non-communicable diseases. There are many different types of DQIs. There are three major categories of DQIs: a) nutrient-based indicators; b) food/food group based indicators; and c) combination indexes, the vast majority of DQIs, which often include a measure of diet variety within and across food groups, a measure of adequacy i.e. nutrients (compared to requirements) or food groups (quantities or servings), a measure of nutrients/foods to consume in moderation, and an overall balance of macronutrients. The Healthy Eating Index (HEI), the Diet Quality Index (DQI), the Healthy Diet Indicator (HDI) and the Mediterranean Diet Score (MDS) are the four 'original' diet quality scores that have been referred to and validated most extensively. Several indexes have been adapted and modified from those originals. In particular, many variations on the MDS have been proposed, included different alternate MDS and Mediterranean Diet Adherence Screener (MEDAS). Primary data source of DQI's are individual dietary data collection tools, namely 24 h quantitative intake recalls, dietary records and food frequency questionnaires. Nutrients found in many scores are total fat, saturated fatty acids or the ratio of monounsaturated fatty acids to saturated fatty acids or the latter SFA to polyunsaturated fatty acids. Cholesterol, protein content and quality, complex carbohydrates, mono- and disaccharides, dietary fibre and sodium are also found in various scores. All DQIs, except those that

  13. Quality indicators for woodwind reed material

    International Nuclear Information System (INIS)

    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

  14. Quality indicators for woodwind reed material

    Energy Technology Data Exchange (ETDEWEB)

    Glave, Stefan; Pallon, Jan E-mail: jan.pallon@pixe.lth.se; Bornman, Chris; Bjoern, Lars Olof; Wallen, Rita; Raastam, Jacob; Kristiansson, Per; Elfman, Mikael; Malmqvist, Klas

    1999-04-02

    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.

  15. Quality indicators for woodwind reed material

    Science.gov (United States)

    Glave, Stefan; Pallon, Jan; Bornman, Chris; Björn, Lars Olof; Wallén, Rita; Råstam, Jacob; Kristiansson, Per; Elfman, Mikael; Malmqvist, Klas

    1999-04-01

    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.

  16. Analytical quality, performance indices and laboratory service

    DEFF Research Database (Denmark)

    Hilden, Jørgen; Magid, Erik

    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...

  17. COMMERCIAL COTTON VARIETY SPINNING STUDY QUALITY INDICES

    Science.gov (United States)

    The USDA-ARS Cotton Quality Research Station has completed a comprehensive study studying the relationship of cotton fiber properties to the quality of spun yarn. Cotton was spun into yarn at the CQRS laboratory by each of three spinning methods (ring, vortex and rotor spinning). Cotton in this st...

  18. Service quality indicators for business support services

    OpenAIRE

    Ree, H.J. van

    2010-01-01

    Quality is critical to corporate success as it plays a vital role in improving organisational productivity. It can be defined as ‘the totality of inherent characteristics of a product or service that bear on its ability to increase the demand for that product or service at a fixed price’ and can best be measured by capturing customer perceptions of the performance of those characteristics. Customising the SERVPERF methodology to measure service quality in a business-to-business co...

  19. Quality Indicators for Hospital Care : Reliability and validity

    NARCIS (Netherlands)

    C. Fischer (Claudia)

    2015-01-01

    markdownabstractAbstract Hospital quality indicators are widely implemented for purposes such as accountability, transparency and the overarching aim of quality improvement. However, it is not clear whether currently used hospital quality indicators actually reflect quality of care. The aim of

  20. Effect of Colonoscopy Volume on Quality Indicators

    OpenAIRE

    Pace, David; Borgaonkar, Mark; Lougheed, Muna; Marcoux, Curtis; Evans, Brad; Hickey, Nikita; O’Leary, Meghan; Boone, Darrell; McGrath, Jerry

    2016-01-01

    Background. The purpose of this study is to determine if colonoscopy quality is associated with the annual case volume of endoscopists. Methods. A retrospective cohort study was performed on 3235 patients who underwent colonoscopy in the city of St. John’s, NL, between January and June 2012. Data collected included completion of colonoscopy (CCR) and adenoma detection rates (ADR). Endoscopists were divided into quintiles based on annual case volume. To account for potential confounding variab...

  1. Quality Indicators for Hospital Care: Reliability and validity

    OpenAIRE

    Fischer, Claudia

    2015-01-01

    markdownabstractAbstract Hospital quality indicators are widely implemented for purposes such as accountability, transparency and the overarching aim of quality improvement. However, it is not clear whether currently used hospital quality indicators actually reflect quality of care. The aim of this thesis was to expand our knowledge on how to measure quality of hospital care with the focus on external comparison. I specifically investigated reliability and validity as these are key aspects of...

  2. Electronic health records improve clinical note quality

    OpenAIRE

    Burke, Harry B; SESSUMS, LAURA L; Hoang, Albert; Becher, Dorothy A; Fontelo, Paul; Liu, Fang; Stephens, Mark; Pangaro, Louis N; O'Malley, Patrick G; Baxi, Nancy S; Bunt, Christopher W; Capaldi, Vincent F; Chen, Julie M; Cooper, Barbara A; Djuric, David A

    2014-01-01

    Background and objective The clinical note documents the clinician's information collection, problem assessment, clinical management, and its used for administrative purposes. Electronic health records (EHRs) are being implemented in clinical practices throughout the USA yet it is not known whether they improve the quality of clinical notes. The goal in this study was to determine if EHRs improve the quality of outpatient clinical notes. Materials and methods A five and a half year longitudin...

  3. Monitoring School Quality An Indicators Report

    OpenAIRE

    Daniel P Mayer John Mullens Mary T Moore

    2001-01-01

    Explores why some schools may be better than others at helping students learn by identifying and critiquing national indicator data on school leadership, goals, professional community, discipline, academic environment, teacher academic skills, teaching assignment, teacher experience, professional development, course content, pedagogy, technology and class size. Notes that teachers make a difference.

  4. Monitoring School Quality: An Indicators Report.

    OpenAIRE

    Daniel P. Mayer; John E. Mullens; Mary T. Moore

    2001-01-01

    Explores why some schools may be better than others at helping students learn by identifying and critiquing national indicator data on school leadership, goals, professional community, discipline, academic environment, teacher academic skills, teaching assignment, teacher experience, professional development, course content, pedagogy, technology and class size. Notes that teachers make a difference.

  5. Prevention and management of chronic disease in Aboriginal and Islander Community Controlled Health Services in Queensland: a quality improvement study assessing change in selected clinical performance indicators over time in a cohort of services

    OpenAIRE

    Panaretto, K S; Gardner, K L; Button, S; Carson, A; Schibasaki, R; Wason, G; Baker, D.; Mein, J.; Dellit, A; Lewis, D; Wenitong, M; Ring, I

    2013-01-01

    Objective To evaluate clinical healthcare performance in Aboriginal Medical Services in Queensland and to consider future directions in supporting improvement through measurement, target setting and standards development. Design Longitudinal study assessing baseline performance and improvements in service delivery, clinical care and selected outcomes against key performance indicators 2009–2010. Setting 27 Aboriginal and Islander Community Controlled Health Services (AICCHSs) in Queensland, w...

  6. Evaluation of Soil Quality: Application of Fuzzy Indicators

    Science.gov (United States)

    The problem of assessing soil quality is considered as the fuzzy modeling task. Fuzzy indicator concept (FIC) is used as a general platform for the assessment of soil quality as a "degree or grade of perfection”. The FIC can be realized through the utilization of fuzzy soil quality indicators (FSQI)...

  7. Quality indicators for primary care mental health services

    OpenAIRE

    Shield, T; Campbell, S; Rogers, A; Worrall, A; Chew-Graham, C; Gask, L

    2003-01-01

    Objectives: To identify a generic set of face valid quality indicators for primary care mental health services which reflect a multi-stakeholder perspective and can be used for facilitating quality improvement.

  8. Approaches to the Formation of Public Services Quality Indices

    OpenAIRE

    Olga Simagina

    2012-01-01

    The article considers the basic methodological and practical problems of forming requirements to the quality of public services. To address the problems identified, the article attaches a step by step methodology for forming a science-based system of indicators of the quality of public services. The first step is the division of quality indicators into two groups in accordance with the normative acts in which they should be reflected. The second step relates to the use of the integral quality...

  9. Community healthcare in Israel: quality indicators 2007-2009

    OpenAIRE

    Jaffe Dena H; Shmueli Amir; Ben-Yehuda Arie; Paltiel Ora; Calderon Ronit; Cohen Arnon D; Matz Eran; Rosenblum Joseph K; Wilf-Miron Rachel; Manor Orly

    2012-01-01

    Abstract Background The National Program for Quality Indicators in Community Healthcare in Israel (QICH) was developed to provide policy makers and consumers with information on the quality of community healthcare in Israel. In what follows we present the most recent results of the QICH indicator set for 2009 and an examination of changes that have occurred since 2007. Methods Data for 28 quality indicators were collected from all four health plans in Israel for the years 2007-2009. The QICH ...

  10. Characterization and modeling of urban environmental quality indicators

    Directory of Open Access Journals (Sweden)

    Francisco de Assis Cruz Melo

    2013-12-01

    Full Text Available Environmental problems in the urban area of Belém, Pará, Brazil, deny a large portion of the population critical environmental quality. The present study evaluated the environmental quality of the urban village of União, in a neighborhood called Terra Firme, Belém, Pará. An integrated urban environmental quality index was proposed, based on the modeling of indicators of urban environmental quality, urban livability and quality of treated water. These three indices encompass the variables of water supply, garbage collection, vegetation, sewage, road paving, infrastructure condition of households, the existence of urban equipment for common use, public transport, accessibility, family income, employment conditions, education and quality of treated water. The results of the indicators are: urban environmental quality index, 50.0 points (indicating a regular level of environmental quality; urban livability index, 48.6 points (representing moderate level of livability; and quality index of the treated water, 98.1 points (which is an optimal level of water quality. The arithmetic average of the three indices generated an integrated urban environmental quality of 65.6 points, a good environmental quality level of the urban village housing in União. The interpretation of this integrated index reflects the indicators measured in each index. We conclude that the modeling of urban environmental quality indicators was an important tool for the analysis of urban environmental quality in micro or macro scales, and this allowed us to propose more efficient management and restructuring of the urban environment.

  11. Characterization and modeling of urban environmental quality indicators

    OpenAIRE

    Francisco de Assis Cruz Melo; Mariko Ueno

    2013-01-01

    Environmental problems in the urban area of Belém, Pará, Brazil, deny a large portion of the population critical environmental quality. The present study evaluated the environmental quality of the urban village of União, in a neighborhood called Terra Firme, Belém, Pará. An integrated urban environmental quality index was proposed, based on the modeling of indicators of urban environmental quality, urban livability and quality of treated water. These three indices encompass the variables of w...

  12. Indicators for quality of hospital care: Beyond the numbers

    OpenAIRE

    Dishoeck, Anne-Margreet

    2015-01-01

    markdownabstractAbstract This thesis addresses two major topics in measuring, comparing and improving quality of care. We found considerable influence of random variation and case-mix in comparing hospitals using performance indicators. Although we found a significant relation between outcome and care processes, chance variation is the major limitation for the interpretability of indicators used for quality measurement or quality improvement. Like a one hand clock, we roughly know what time i...

  13. Building quality indicators for outsourced finance and accounting services

    OpenAIRE

    Jukkara, Arttu

    2011-01-01

    RESEARCH OBJECTIVES The main research question in this research project is: what are the most appropriate and easy to monitor quality indicators for the finance and accounting services in the partnership between Company A and Company B? This research project focuses on such areas as service quality, performance measurement and quality indicators in outsourcing relationships. RESEARCH APPROACH The theoretical review concentrated on finance and accounting outsourcing and some of the m...

  14. Comparative Quality Indicators for Hospital Choice: Do General Practitioners Care?

    OpenAIRE

    Ferrua, Marie; Sicotte, Claude; Lalloué, Benoît; Minvielle, Etienne

    2016-01-01

    Context The strategy of publicly reporting quality indicators is being widely promoted through public policies as a way to make health care delivery more efficient. Objective To assess general practitioners’ (GPs) use of the comparative hospital quality indicators made available by public services and the media, as well as GPs’ perceptions of their qualities and usefulness. Method A telephone survey of a random sample representing all self-employed GPs in private practice in France. Results A...

  15. 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.

  16. Quality of clinical trials: A moving target

    Directory of Open Access Journals (Sweden)

    Arun Bhatt

    2011-01-01

    Full Text Available Quality of clinical trials depends on data integrity and subject protection. Globalization, outsourcing and increasing complexicity of clinical trials have made the target of achieving global quality challenging. The quality, as judged by regulatory inspections of the investigator sites, sponsors/contract research organizations and Institutional Review Board, has been of concern to the US Food and Drug Administration, as there has been hardly any change in frequency and nature of common deficiencies. To meet the regulatory expectations, the sponsors need to improve quality by developing systems with specific standards for each clinical trial process. The quality systems include: personnel roles and responsibilities, training, policies and procedures, quality assurance and auditing, document management, record retention, and reporting and corrective and preventive action. With an objective to improve quality, the FDA has planned new inspection approaches such as risk-based inspections, surveillance inspections, real-time oversight, and audit of sponsor quality systems. The FDA has partnered with Duke University for Clinical Trials Transformation Initiative, which will conduct research projects on design principles, data quality and quantity including monitoring, study start-up, and adverse event reporting. These recent initiatives will go a long way in improving quality of clinical trials.

  17. Development of indicators for quality assurance in public health medicine.

    OpenAIRE

    Johnston, N H; K.M. Narayan; Ruta, D A

    1992-01-01

    OBJECTIVES--To develop structure, process, and outcome indicators within a quality rating index for audit of public health medicine. DESIGN--Development of an audit matrix and indicator of quality through a series of group discussions with public health physicians, from which self administered weighted questionnaires were constructed by a modified Delphi technique. SETTING--Five Scottish health boards. SUBJECTS--Public health physicians in the five health boards. MAIN MEASURES--Indicators of ...

  18. Quality Assessment for Clinical Proteomics

    OpenAIRE

    Tabb, David L.

    2012-01-01

    Proteomics has emerged from the labs of technologists to enter widespread application in clinical contexts. This transition, however, has been hindered by overstated early claims of accuracy, concerns about reproducibility, and the challenges of handling batch effects properly. New efforts have produced sets of performance metrics and measurements of variability that establish sound expectations for experiments in clinical proteomics. As researchers begin incorporating these metrics in a qual...

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

    Directory of Open Access Journals (Sweden)

    Dalal Deepan

    2011-06-01

    Full Text Available Abstract 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 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.

  20. Costs and Clinical Quality Among Medicare Beneficiaries..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Authors of Costs and Clinical Quality Among Medicare Beneficiaries - Associations with Health Center Penetration of Low-Income Residents, published in Volume 4,...

  1. Impact of hospital accreditation on patients' safety and quality indicators

    OpenAIRE

    Al-Awa, Bahjat

    2011-01-01

    Ecole de Santé Publique Université Libre de Bruxelles Academic Year 2010-2011 Al-Awa, Bahjat Impact of Hospital Accreditation on Patients' Safety and Quality Indicators Dissertation Summary I. Introduction: There is increased interest around the world in the evaluation of healthcare, coming not only from governments, but also from providers and consumers [1]. Therefore initiatives to address quality of health care have become worldwide phenomena [2]. As quality is crucial fa...

  2. Diet quality indices and postmenopausal breast cancer survival

    OpenAIRE

    Kim, Esther H.J.; Willett, Walter C; Fung, Teresa; Rosner, Bernard; Holmes, Michelle D

    2011-01-01

    Research on diet in breast cancer survival has been focused on single nutrients or foods, particularly dietary fat, fruits, vegetables, fiber, and alcohol. We hypothesized that diet quality indices decrease the risk of total and non breast cancer related deaths in women diagnosed with breast cancer. We evaluated 4 dietary quality scores: Alternate Healthy Eating Index (AHEI), Diet Quality Index-Revised (DQIR), Recommended Food Score (RFS), and the alternate Mediterranean Diet Score (aMED), am...

  3. Comparative Quality Indicators for Hospital Choice: Do General Practitioners Care?

    Science.gov (United States)

    Ferrua, Marie; Sicotte, Claude; Lalloué, Benoît; Minvielle, Etienne

    2016-01-01

    Context The strategy of publicly reporting quality indicators is being widely promoted through public policies as a way to make health care delivery more efficient. Objective To assess general practitioners’ (GPs) use of the comparative hospital quality indicators made available by public services and the media, as well as GPs’ perceptions of their qualities and usefulness. Method A telephone survey of a random sample representing all self-employed GPs in private practice in France. Results A large majority (84.1%–88.5%) of respondents (n = 503; response rate of 56%) reported that they never used public comparative indicators, available in the mass media or on government and non-government Internet sites, to influence their patients’ hospital choices. The vast majority of GPs rely mostly on traditional sources of information when choosing a hospital. At the same time, this study highlights favourable opinions shared by a large proportion of GPs regarding several aspects of hospital quality indicators, such as their good qualities and usefulness for other purposes. In sum, the results show that GPs make very limited use of hospital quality indicators based on a consumer choice paradigm but, at the same time, see them as useful in ways corresponding more to the usual professional paradigms, including as a means to improve quality of care. PMID:26840429

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

    International Nuclear Information System (INIS)

    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. 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...... simple way. The paper therefore questions empirical trade studies using unit values as an indicator for the quality of the traded goods. However, we also show that the ratio of prices is a reasonable proxy for the ratio of qualities if sunk cost is dominating in the cost structure....

  6. IMPACT OF ENERGY AND LINK QUALITY INDICATOR WITH LINK QUALITY ESTIMATORS IN WIRELESS SENSOR NETWORKS

    OpenAIRE

    Bouyahi Mohamed; Zrelli Amira; Rezig Houria; Ezzedine Tahar

    2014-01-01

    The Link Quality Indicator (LQI) and Residual Energy have a fundamental impact on the network performance in Wireless Sensor Networks (WSNs) and affects as well in the life time of nodes. This paper will provide a comparative of Link Quality Estimator, the Link Quality Estimator with Link Quality Indicator and Link Quality Estimator with Residual Energy. In this paper we develop a Collect Tree Protocol (CTP) and compare the performance of LQI and Residual Energy, and show their ef...

  7. Indicators of quality of work as predictors of quality of life

    OpenAIRE

    Alina Mariuca Ionescu

    2013-01-01

    The paper aims to analyze the extent to which the indicators of the quality of work can be seen as good predictors of the quality of life. To describe the various aspects of the quality of work and employment, data on answers to 12 questions covering 7 dimensions of quality of work were extracted from the European Working Conditions Survey (EWCS) database available on Eurofound website. Four wellknown composite indicators were considered for the assessment of the quality of life: Economist In...

  8. Community healthcare in Israel: quality indicators 2007-2009

    Directory of Open Access Journals (Sweden)

    Jaffe Dena H

    2012-01-01

    Full Text Available Abstract Background The National Program for Quality Indicators in Community Healthcare in Israel (QICH was developed to provide policy makers and consumers with information on the quality of community healthcare in Israel. In what follows we present the most recent results of the QICH indicator set for 2009 and an examination of changes that have occurred since 2007. Methods Data for 28 quality indicators were collected from all four health plans in Israel for the years 2007-2009. The QICH indicator set examined six areas of healthcare: asthma, cancer screening, cardiovascular health, child health, diabetes and immunizations for older adults. Results Dramatic increases in the documentation of anthropometric measures were observed over the measurement period. Documentation of BMI for adolescents and adults increased by 30 percentage points, reaching rates of 61% and 70%, respectively, in 2009. Modest increases (3%-7% over time were observed for other primary prevention quality measures including immunizations for older adults, cancer screening, anemia screening for young children, and documentation of cardiovascular risks. Overall, rates of recommended care for chronic diseases (asthma, cardiovascular disease and diabetes increased over time. Changes in rates of quality care for diabetes were varied over the measurement period. Conclusions The overall quality of community healthcare in Israel has improved over the past three years. Future research should focus on the adherence to quality indicators in population subgroups and compare the QICH data with those in other countries. In addition, one of the next steps in assessing and further improving healthcare quality in Israel is to relate these process and performance indicators to health outcomes.

  9. Student Learning Experience as Indicator of Teaching Quality

    Science.gov (United States)

    Zerihun, Zenawi; Beishuizen, Jos; Van Os, Willem

    2012-01-01

    The purpose of the study was to develop an improved teaching evaluation questionnaire based on students' learning experiences and selected teacher characteristics identified as indicators of teaching quality. Teaching evaluation questionnaires are commonly designed either based on agreed indicators of teaching excellence, students' suggestions of…

  10. Immunologic Indicators of Clinical Progression during Canine Leishmania infantum Infection▿

    OpenAIRE

    Boggiatto, Paola M.; Ramer-Tait, Amanda E.; Metz, Kyle; Kramer, Erin E.; Gibson-Corley, Katherine; Mullin, Kathleen; Hostetter, Jesse M.; Gallup, Jack M.; Jones, Douglas E.; Petersen, Christine A.

    2009-01-01

    In both dogs and humans Leishmania infantum infection is more prevalent than disease, as infection often does not equate with clinical disease. Previous studies additively indicate that advanced clinical visceral leishmaniasis is characterized by increased production of anti-Leishmania antibodies, Leishmania-specific lymphoproliferative unresponsiveness, and decreased production of gamma interferon (IFN-γ) with a concomitant increase of interleukin-10 (IL-10). In order to differentiate infect...

  11. Quality indicators for colonoscopy: Current insights and caveats

    Institute of Scientific and Technical Information of China (English)

    Hendrikus; JM; Pullens; Peter; D; Siersema

    2014-01-01

    Colonoscopy is the diagnostic modality of choice for investigation of symptoms suspected to be related to the colon and for the detection of polyps and colorectal cancer(CRC). Colonoscopy with removal of detected polyps has been shown to reduce the incidence and mortality of subsequent CRC. In many countries, population screening programs for CRC have been initiated, either by selection of patients for colonoscopy with fecal occult blood testing or by offering colonoscopy directly to average-risk individuals. Several endoscopy societies have formulated quality indicators for colonoscopy. These quality indicators are almost always incorporated as process indicators, rather than outcome measures. This review focuses on the quality indicators bowel preparation, cecal intubation rate, withdrawal time, adenoma detection rate, patient comfort, sedation and complication rate, and discusses the scientific evidence supporting them,as well as their potential shortcomings and issues that need to be addressed. For instance, there is still no clear and generally accepted definition of adequatebowel preparation, no robust scientific evidence is available supporting a cecal intubation rate ≥ 90% and the association between withdrawal time and occurrence of interval cancers has not been clarified. Adenoma detection rate is currently the only quality indicator that has been shown to be associated with interval colorectal cancer, but as an indicator it does not differentiate between subjects with one or more adenoma detected.

  12. Radon concentration as indicator for indoor air quality

    International Nuclear Information System (INIS)

    Energy conservation actions could cause a reduction of the air exchange rate and a degradation of the indoor air quality too. Present methods for the estimation of the indoor air quality can only be affected with limitations. In the following a method is presented, that allows an estimation of the indoor air quality under daily routine by using natural Radon as an indicator. For this via mathematical models the progression of the air exchange rate is estimated by using the Radon concentration and later the progression of several air pollutants is estimated. Via measurements in a measurement chamber the modelling could be verified. (orig.)

  13. Canadian Cardiovascular Society Quality Indicators for Heart Failure.

    Science.gov (United States)

    McKelvie, Robert S; Heckman, George A; Blais, Claudia; Cox, Jafna L; Ezekowitz, Justin A; Gong, Yanyan; Harkness, Karen; Moe, Gordon; Dai, Sulan; Dorian, Paul; Johnstone, David E; McGeachie, Erin C; Tu, Jack V; Lambert, Laurie J

    2016-08-01

    A working group was convened by the Canadian Cardiovascular Society (CCS) in 2010 to identify quality indicators (QIs) for heart failure (HF). Using the CCS "Best Practices for Developing Cardiovascular Quality Indicators" methodology, a total of 49 "long-list" QIs was identified and rated. Subsequent ranking and discussion led to the selection of an initial "short-list" of 6 QIs to evaluate quality care, including daily assessment of blood chemistry indicators, chest radiography, patient education, in-hospital use of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, assessment of left ventricular function, and 30-day hospital readmission. The short-list QIs were selected as being important for quality assurance and because the patient information, for the most part, can be captured during the inpatient setting, which would allow these QIs to be adopted more easily. These 6 QIs were subjected to a feasibility test that found that even within the inpatient setting, there is a significant gap between the existing knowledge infrastructure and the necessary information-tracking processes to measure QIs. Only 1 QI (30-day hospital readmission) can currently be measured comparatively across Canada, although the other 5 of 6 short-list QIs can be measured using other data collected by jurisdictions. Standardization and enhancements to knowledge infrastructure are essential to provide the comprehensive patient data necessary to evaluate the quality of HF care across Canada. PMID:26968392

  14. 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

  15. Indicators for quality of hospital care : Beyond the numbers

    NARCIS (Netherlands)

    A.M. van Dishoeck (Anne-Margreet)

    2015-01-01

    markdownabstractAbstract This thesis addresses two major topics in measuring, comparing and improving quality of care. We found considerable influence of random variation and case-mix in comparing hospitals using performance indicators. Although we found a significant relation between outcome

  16. Tracking of Power Quality Indicators during Wind Farm Islanding Experiment

    DEFF Research Database (Denmark)

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

    2007-01-01

    quality indicators calculated. The algorithm considers frequency as an unknown parameter and estimates it whilst determining the input signal spectrum; this ensures the algorithm is insensitive to frequency changes. The proposed algorithm was evaluated using signals acquired during a wind farm islanding...

  17. [Practice report: the process-based indicator dashboard. Visualising quality assurance results in standardised processes].

    Science.gov (United States)

    Petzold, Thomas; Hertzschuch, Diana; Elchlep, Frank; Eberlein-Gonska, Maria

    2014-01-01

    Process management (PM) is a valuable method for the systematic analysis and structural optimisation of the quality and safety of clinical treatment. PM requires a high motivation and willingness to implement changes of both employees and management. Definition of quality indicators is required to systematically measure the quality of the specified processes. One way to represent comparable quality results is the use of quality indicators of the external quality assurance in accordance with Sect. 137 SGB V—a method which the Federal Joint Committee (GBA) and the institutions commissioned by the GBA have employed and consistently enhanced for more than ten years. Information on the quality of inpatient treatment is available for 30 defined subjects throughout Germany. The combination of specified processes with quality indicators is beneficial for the information of employees. A process-based indicator dashboard provides essential information about the treatment process. These can be used for process analysis. In a continuous consideration of these indicator results values can be determined and errors will be remedied quickly. If due consideration is given to these indicators, they can be used for benchmarking to identify potential process improvements. PMID:25523849

  18. Building data quality into clinical trials.

    Science.gov (United States)

    Crerand, William J; Lamb, Jana; Rulon, Vera; Karal, Bilun; Mardekian, Jack

    2002-01-01

    Meaningful data begin with the collection process. Pharmaceutical companies are using several different strategies in clinical trials to ensure the highest quality of data. This article will examine these approaches, with an emphasis on case report form development through database release. PMID:12432815

  19. An assessment of performance indicators of higher education teaching quality

    Directory of Open Access Journals (Sweden)

    Cleina Yayoe Okoshi

    2016-03-01

    Full Text Available Higher Education Institutions (HEI are increasingly being demanded by companies and society to educate and prepare professionals with more competences and capable of interacting with the environment in a dynamic and systemic way. As a result, HEI assess the performance level of their faculty members. The aim of this paper is to identify which indicators of performance in higher education in Stricto Sensu post-graduation courses can be grouped and their influence on course quality. Multivariate statistical technique (Factor Analysis was used for analyzing. The main result was grouping the indicators in six factors: “Doctorate”, “Books”, “Fostering 1”, “Fostering 2”, “Master”, and “Paper publishing”; the indicators in each factor help to improve the group, thereby enhancing higher education quality.

  20. 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 ANS

  1. A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard

    OpenAIRE

    Azadmanjir, Zahra; Torabi, Mashallah; Safdari, Reza; Bayat, Maryam; Golmahi, Fatemeh

    2015-01-01

    Introduction: management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The pa...

  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. Development of mental health quality indicators (MHQIs) for inpatient psychiatry based on the interRAI mental health assessment

    OpenAIRE

    Perlman Christopher M; Hirdes John P; Barbaree Howard; Fries Brant E; McKillop Ian; Morris John N; Rabinowitz Terry

    2013-01-01

    Abstract Background Outcome quality indicators are rarely used to evaluate mental health services because most jurisdictions lack clinical data systems to construct indicators in a meaningful way across mental health providers. As a result, important information about the effectiveness of health services remains unknown. This study examined the feasibility of developing mental health quality indicators (MHQIs) using the Resident Assessment Instrument - Mental Health (RAI-MH), a clinical asses...

  4. Do Treatment Quality Indicators Predict Cardiovascular Outcomes in Patients with Diabetes?

    NARCIS (Netherlands)

    Sidorenkov, Grigory; Voorham, Jaco; de Zeeuw, Dick; Haaijer-Ruskamp, Flora M.; Denig, Petra

    2013-01-01

    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 devel

  5. Methods of Statistical Control for Groundwater Quality Indicators

    Science.gov (United States)

    Yankovich, E.; Nevidimova, O.; Yankovich, K.

    2016-06-01

    The article describes the results of conducted groundwater quality control. Controlled quality indicators included the following microelements - barium, manganese, iron, mercury, iodine, chromium, strontium, etc. Quality control charts - X-bar chart and R chart - were built. For the upper and the lower threshold limits, maximum permissible concentration of components in water and the lower limit of their biologically significant concentration, respectively, were selected. The charts analysis has shown that the levels of microelements content in water at the area of study are stable. Most elements in the underground water are contained in concentrations, significant for human organisms consuming the water. For example, such elements as Ba, Mn, Fe have concentrations that exceed maximum permissible levels for drinking water.

  6. 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. PMID:24360417

  7. Engaging Clinical Nurses in Quality Improvement Projects.

    Science.gov (United States)

    Moore, Susan; Stichler, Jaynelle F

    2015-10-01

    Clinical nurses have the knowledge and expertise required to provide efficient and proficient patient care. Time and knowledge deficits can prevent nurses from developing and implementing quality improvement or evidence-based practice projects. This article reviews a process for professional development of clinical nurses that helped them to define, implement, and analyze quality improvement or evidence-based practice projects. The purpose of this project was to educate advanced clinical nurses to manage a change project from inception to completion, using the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) Change Acceleration Process as a framework. One-to-one mentoring and didactic in-services advanced the knowledge, appreciation, and practice of advanced practice clinicians who completed multiple change projects. The projects facilitated clinical practice changes, with improved patient outcomes; a unit cultural shift, with appreciation of quality improvement and evidence-based projects; and engagement with colleagues. Project outcomes were displayed in poster presentations at a hospital exposition for knowledge dissemination. PMID:26430867

  8. In Vivo Patellar Tracking: Clinical Motions and Patellofemoral Indices

    OpenAIRE

    Nha, Kyung W.; Papannagari, Ramprasad; Gill, Thomas J.; Van de Velde, Samuel K.; Freiberg, Andrew A.; Rubash, Harry E.; Li, Guoan

    2008-01-01

    Patellar tracking during in vivo weightbearing knee function is not well understood. This study investigated patellar tracking of eight subjects during a full range of weightbearing flexion using magnetic resonance imaging and dual orthogonal fluoroscopy. The data were reported using a clinical description based on patellar and femoral joint coordinate systems and using patellar indices based on geometrical features of the femur and patella. The mean patellar shift was within 3 mm over the en...

  9. Classification of Performance and Quality Indicators in Manufacturing

    OpenAIRE

    Franceschini, Fiorenzo; Galetto, Maurizio; Maisano, Domenico Augusto Francesco

    2006-01-01

    A critical aspect in operations management is to represent the firm goals properly. This is usually done by translating the organisational results and objectives in ‘performance measurements'. The scientific literature shows many applications in different fields such as quality, production, logistics, marketing, etc. Nevertheless, a general theory formalising basic and application concepts is still lacking. This paper shows a classification of ‘performance indicators' in manufacturing, provid...

  10. Clinical and postextraction evaluation of periodontal disease indicators

    Directory of Open Access Journals (Sweden)

    Rajashri Kolte

    2016-01-01

    Full Text Available Background: Clinical attachment level is the most frequently used and acceptable parameter in monitoring periodontal status in diseased individual and denotes patterns of periodontal destruction. Awareness of root morphology and the condition of the periodontal tissues is essential for reliable periodontal pocket probing and for effective debridement of root surfaces. Clinically, it is challenging to observe exact nature of complex periodontal attachment loss. The aim of the present study was to evaluate patterns of periodontal destruction based on vertical and horizontal attachment loss. Materials and Methods: A total of 200 extracted teeth were obtained from chronic periodontitis patients. Prior to extraction, clinical measurements were recorded and after extraction, the teeth were stained with crystal violet. Root length, vertical and horizontal attachment loss were measured using digital caliper. Results: There was a significant difference between clinical attachment level and vertical attachment loss for both maxillary and mandibular teeth. Mean vertical attachment loss varied between 5.17 mm and 9.17 mm. Interproximal surfaces exhibited statistically significant vertical attachment loss in both maxillary and mandibular dentition. Results indicated that vertical attachment loss was more severe with teeth belonging to the anterior sextant whereas the horizontal attachment loss was more pronounced with posterior teeth. Conclusion: Both vertical and horizontal attachment loss were observed in all periodontally involved teeth. There was a difference in clinical measurements and actual periodontal status denoted by postextraction staining. These findings have an impact on determining the prognosis and appropriate treatment plan for patients.

  11. Clinical and postextraction evaluation of periodontal disease indicators

    Science.gov (United States)

    Kolte, Rajashri; Kolte, Abhay; Wattamwar, Pooja

    2016-01-01

    Background: Clinical attachment level is the most frequently used and acceptable parameter in monitoring periodontal status in diseased individual and denotes patterns of periodontal destruction. Awareness of root morphology and the condition of the periodontal tissues is essential for reliable periodontal pocket probing and for effective debridement of root surfaces. Clinically, it is challenging to observe exact nature of complex periodontal attachment loss. The aim of the present study was to evaluate patterns of periodontal destruction based on vertical and horizontal attachment loss. Materials and Methods: A total of 200 extracted teeth were obtained from chronic periodontitis patients. Prior to extraction, clinical measurements were recorded and after extraction, the teeth were stained with crystal violet. Root length, vertical and horizontal attachment loss were measured using digital caliper. Results: There was a significant difference between clinical attachment level and vertical attachment loss for both maxillary and mandibular teeth. Mean vertical attachment loss varied between 5.17 mm and 9.17 mm. Interproximal surfaces exhibited statistically significant vertical attachment loss in both maxillary and mandibular dentition. Results indicated that vertical attachment loss was more severe with teeth belonging to the anterior sextant whereas the horizontal attachment loss was more pronounced with posterior teeth. Conclusion: Both vertical and horizontal attachment loss were observed in all periodontally involved teeth. There was a difference in clinical measurements and actual periodontal status denoted by postextraction staining. These findings have an impact on determining the prognosis and appropriate treatment plan for patients. PMID:27143828

  12. Selection indices for yield and quality traits in sweet corn

    International Nuclear Information System (INIS)

    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)

  13. Amino acid quality indices of the leaves of Clerodendrum volubile

    Directory of Open Access Journals (Sweden)

    Ochuko Lucky Erukainure

    2016-04-01

    Full Text Available Objective: To evaluate the amino acid profile and quality indices of Clerodendrum volubile (C. volubile leaves. Methods: Dried leaves of C. volubile were blended, defatted and subjected to amino acid analysis using the technicon sequential multi-sample amino acid analyzer. The amino acid quality indices which covers for chemical score, essential amino acid index, nutritional index, true digestibility, protein digestibility corrected amino acid score, and digestible indispensable amino acid score were evaluated using standard formulas. Results: Amino acid analysis revealed glutamic acid to have the highest concentration, with cysteine having the least. Aspartic acid had the highest chemical score, this was followed by glycine, histidine and arginine, respectively. The least scores were observed in serine and methionine. Glutamic acid had the highest value for true digestibility and protein digestibility corrected amino acid score, with the least observed in cysteine. Digestible indispensable amino acid score evaluation showed histidine to have the highest value for infants (birth to 6 months, threonine for children (6 months to 3 years, while isoleucine was observed to have the highest value for older children, adolescents and adults. The essential amino acid index value was less than 4, while nutritional index value was less than 0.5. Conclusions: These results indicated the leaves of C. volubile as a potential source of amino acids in the human diet as portrayed by its amino acids profile and qualities.

  14. Development of river water quality indices-a review.

    Science.gov (United States)

    Sutadian, Arief Dhany; Muttil, Nitin; Yilmaz, Abdullah Gokhan; Perera, B J C

    2016-01-01

    The use of water quality indices (WQIs) as a tool to evaluate the status of water quality in rivers has been introduced since the 1960s. The WQI transforms selected water quality parameters into a dimensionless number so that changes in river water quality at any particular location and time could be presented in a simple and easily understandable manner. Although many WQIs have been developed, there is no worldwide accepted method for implementing the steps used for developing a WQI. Thus, there is a continuing interest to develop accurate WQIs that suit a local or regional area. This paper aimed to provide significant contribution to the development of future river WQIs through a review of 30 existing WQIs based on the four steps needed to develop a WQI. These steps are the selection of parameters, the generation of sub-indices, the generation of parameter weights and the aggregation process to compute the final index value. From the 30 reviewed WQIs, 7 were identified as most important based on their wider use and they were discussed in detail. It was observed that a major factor that influences wider use of a WQI is the support provided by the government and authorities to implement a WQI as the main tool to evaluate the status of rivers. Since there is a lot of subjectivity and uncertainty involved in the steps for developing and applying a WQI, it is recommended that the opinion of local water quality experts is taken, especially in the first three steps (through techniques like Delphi method). It was also observed that uncertainty and sensitivity analysis was rarely undertaken to reduce uncertainty, and hence such an analysis is recommended for future studies. PMID:26707404

  15. Preoperative indicators of clinical outcome following stereotaxic pallidotomy.

    Science.gov (United States)

    Kazumata, K; Antonini, A; Dhawan, V; Moeller, J R; Alterman, R L; Kelly, P; Sterio, D; Fazzini, E; Beric, A; Eidelberg, D

    1997-10-01

    We assessed the utility of preoperative clinical assessment and functional brain imaging with 18F-fluorodeoxyglucose (FDG) and positron emission tomography (PET) in predicting the clinical outcome of stereotaxic pallidotomy for the treatment of advanced Parkinson's disease (PD). Twenty-two PD patients undergoing posteroventral pallidotomy were assessed preoperatively with the Core Assessment Program for Intracerebral Transplantation (CAPIT) ratings measured on and off levodopa; quantitative FDG/PET was also performed before surgery. Preoperative clinical and metabolic measurements were correlated with changes in off-state CAPIT ratings determined 3 months after surgery. Clinical outcome following pallidotomy was also correlated with intraoperative measures of spontaneous pallidal single-unit activity as well as postoperative MRI measurements of lesion volume and location. We found that unilateral pallidotomy resulted in variable clinical improvement in off-state CAPIT scores for the contralateral limbs (mean change 30.9 +/- 15.5%). Postoperative MRI revealed that pallidotomy lesions were comparable in location and volume across the patients. Clinical outcome following surgery correlated significantly with preoperative measures of CAPIT score change with levodopa administration (r = 0.60, p < 0.005) and with preoperative FDG/PET measurements of lentiform glucose metabolism (r = 0.71, p < 0.0005). Operative outcome did not correlate with intraoperative measures of spontaneous pallidal neuronal firing rate. We conclude that preoperative measurements of lentiform glucose metabolism and levodopa responsiveness may be useful indicators of motor improvement following pallidotomy. Both preoperative quantitative measures, either singly or in combination, may be helpful in selecting optimal candidates for surgery. PMID:9339694

  16. Multimodal heart beat detection using signal quality indices.

    Science.gov (United States)

    Johnson, Alistair E W; Behar, Joachim; Andreotti, Fernando; Clifford, Gari D; Oster, Julien

    2015-08-01

    The electrocardiogram (ECG) is a well studied signal from which many clinically relevant parameters can be derived, such as heart rate. A key component in the estimation of these parameters is the accurate detection of the R peak in the QRS complex. While corruption of the ECG by movement artefact or sensor failure can result in poor delineation of the R peak, use of synchronously measured signals could allow for resolution of the R peak even scenarios with poor quality ECG recordings. Robust estimation of R peak locations from multimodal signals facilitates real time monitoring and is likely to reduce false alarms due to inaccurate derived parameters.We propose a method which fuses R peaks detected on the ECG using an energy detector with those detected on the arterial blood pressure (ABP) waveform using the length transform. A signal quality index (SQI) for the two signals is then derived. The ECG SQI is based upon the agreement between two distinct peak detectors. The ABP SQI estimates the blood pressure at various phases in the cardiac cycle and only accepts the signal as good quality if the values are physiologically plausible. Detections from these two signals were merged by selecting the R peak detections from the signal with a higher SQI. The approach presented in this paper was evaluated on datasets provided for the Physionet/Computing in Cardiology Challenge 2014. The algorithm achieved a sensitivity of 95.1% and positive predictive value of 89.3% on an external evaluation set, and achieved a score of 91.5%.The method here demonstrated excellent performance across a variety of signal morphologies collected during clinical practice. Fusion of R peaks from other signals has the potential to provide informed estimates of the R peak location in situations where the ECG is noisy or completely absent. Source code for the algorithm is made available freely online. PMID:26218060

  17. Categorical course in radiation therapy: Hyperthermia clinical indications for hyperthermia

    International Nuclear Information System (INIS)

    In delineating the current clinical indications for local-regional hyperthermia used in conjunction with radiation therapy, two aspects are considered. The first addresses the question of which disease sites can be heated safely with currently available hyperthermia equipment. The results of an extensive equipment evaluation study at Stanford University involving 996 hyperthermia treatments in 268 fields are summarized, characterizing the temperature distributions obtained for a variety of microwave and ultrasound devices on both a device-specific and disease site-specific basis. The second aspect explored is, In which clinical disease sites should hyperthermia be used? The potential use of hyperthermia in the treatment of recurrent, metastatic, or locally advanced tumor in the pelvis (including prostatic carcinoma, colorectal cancers, urinary bladder cancers, and cancers of the uterine corpus and uterine cervix) is reviewed, and the use of hyperthermia in soft-tissue sarcomeas, bone tumors, and high-grade brain tumors is discussed

  18. Y sign: clinical indicator to stop trenching and start cracking.

    Science.gov (United States)

    Kurian, Mathew; Das, Sudeep; Umarani, B; Nagappa, Somshekar; Shetty, Rohit; Shetty, Bhujang K

    2013-04-01

    Phacoemulsification is challenging in soft cataracts due to the difficulty in cracking the nucleus by a divide-and-conquer technique or by chopping. We describe another technique, the Y sign for trenching endpoint: a clinical sign that indicates the surgeon should stop trenching and start cracking during classical divide-and-conquer nucleofractis emulsification using proximal downslope trenching. This technique exploits the morphological structure of the lens to precisely gauge the depth of the trench at which the surgeon can split even a soft nucleus into small wedges without instrument cheese-wiring and thus perform safer phacoemulsification while reducing the risk for posterior capsule rupture. PMID:23522581

  19. Assessing groundwater quality for irrigation using indicator kriging method

    Science.gov (United States)

    Delbari, Masoomeh; Amiri, Meysam; Motlagh, Masoud Bahraini

    2014-09-01

    One of the key parameters influencing sprinkler irrigation performance is water quality. In this study, the spatial variability of groundwater quality parameters (EC, SAR, Na+, Cl-, HCO3 - and pH) was investigated by geostatistical methods and the most suitable areas for implementation of sprinkler irrigation systems in terms of water quality are determined. The study was performed in Fasa county of Fars province using 91 water samples. Results indicated that all parameters are moderately to strongly spatially correlated over the study area. The spatial distribution of pH and HCO3 - was mapped using ordinary kriging. The probability of concentrations of EC, SAR, Na+ and Cl- exceeding a threshold limit in groundwater was obtained using indicator kriging (IK). The experimental indicator semivariograms were often fitted well by a spherical model for SAR, EC, Na+ and Cl-. For HCO3 - and pH, an exponential model was fitted to the experimental semivariograms. Probability maps showed that the risk of EC, SAR, Na+ and Cl- exceeding the given critical threshold is higher in lower half of the study area. The most proper agricultural lands for sprinkler irrigation implementation were identified by evaluating all probability maps. The suitable areas for sprinkler irrigation design were determined to be 25,240 hectares, which is about 34 percent of total agricultural lands and are located in northern and eastern parts. Overall the results of this study showed that IK is an appropriate approach for risk assessment of groundwater pollution, which is useful for a proper groundwater resources management.

  20. 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

  1. Student evaluation: a performance indicator of quality in nurse education.

    Science.gov (United States)

    Cowman, S

    1996-09-01

    This study, which forms part of a doctoral thesis, is derived from the increasing demand for economic models of nurse education as a process within a wider economic agenda which converts inputs (e.g. training costs) into outputs (e.g. registered nurses). In such a climate the pursuance and determination of quality in nurse education should be of fundamental concern to the nursing profession. The development of models for evaluation and measurement of quality must take due cognisance of the stakeholders' interests and concerns, and student nurses, as the consumers of nurse education, must be regarded as major stakeholders. This paper describes the use of the course experience questionnaire, an instrument designed to investigate the students' perspective on teaching and learning. The study incorporates a comparative analysis between Project 2000 students in Northern Ireland and students in the apprenticeship programme in the Republic of Ireland, from general, psychiatric, sick children's and mental handicap nursing. This comparative analysis does provide the nursing profession with a level of feedback on which to make decisions in the interest of quality. Nurse teachers should examine potential reasons why their programmes are poorly or highly rated and the actions that may be required to remedy imperfections on the one hand and the actions that may be taken to promote excellence on the other. As nurse education continues to forge links with universities, nurse teachers, by adopting student evaluation as a performance indicator, can maximize an essential element in the web of public accountability. PMID:8876425

  2. Quality-control: from record keeping to key performance indicators: manging quality in compounding pharmacies.

    Science.gov (United States)

    Braga, Glaucia Karime; Fonseca, Maria Jose Viera

    2010-01-01

    Record keeping is fundamental in any quality-management system. Compounding pharmacies use a quality-management system that is based on the Good Compounding Practices, which emphasizes the necessity and therefore the importance of maintaining records. However, the activity of recording without conducting further data analysis does not assure continuous improvement of the preparations, services, and of the system itself. The purpose of this article is to suggest some nonfinancial key performance indicators that can be easily implemented by compounding pharmacies to assist in the development of an organizational procedure for measuring the quality of products and services. This is a new paradigm for managing quality in compounding pharmacies. PMID:23965425

  3. Associations among milk quality indicators in raw bulk milk.

    Science.gov (United States)

    Pantoja, J C F; Reinemann, D J; Ruegg, P L

    2009-10-01

    The objective of this study was to determine characteristics and associations among bulk milk quality indicators from a cohort of dairies that used modern milk harvest, storage, and shipment systems and participated in an intensive program of milk quality monitoring. Bulk milk somatic cell count (SCC), total bacteria count (TBC), coliform count (CC), and laboratory pasteurization count (LPC) were monitored between July 2006 and July 2007. Bulk milk samples were collected 3 times daily (n = 3 farms), twice daily (n = 6 farms), once daily (n = 4 farms), or once every other day (n = 3 farms). Most farms (n = 11) had direct loading of milk into tankers on trucks, but 5 farms had stationary bulk tanks. The average herd size was 924 cows (range = 200 to 2,700), and daily milk produced per herd was 35,220 kg (range = 7,500 to 105,000 kg). Thresholds for increased bacterial counts were defined according to the 75th percentile and were >8,000 cfu/mL for TBC, >160 cfu/mL for CC, and >or=310 cfu/mL for LPC. Means values were 12,500 (n = 7,241 measurements), 242 (n = 7,275 measurements), and 226 cfu/mL (n = 7,220 measurements) for TBC, CC, and LPC, respectively. Increased TBC was 6.3 times more likely for bulk milk loads with increased CC compared with loads containing fewer coliforms. Increased TBC was 1.3 times more likely for bulk milk with increased LPC. The odds of increased TBC increased by 2.4% for every 10,000-cells/mL increase in SCC in the same milk load. The odds of increased CC increased by 4.3% for every 10,000-cells/mL increase in SCC. The odds of increased CC increased by 1% for every 0.1 degrees C increase in the milk temperature upon arrival at the dairy plant (or at pickup for farms with bulk tank). Laboratory pasteurization count was poorly associated with other milk quality indicators. Seasonal effects on bacterial counts and milk temperature varied substantially among farms. Results of this study can be used to aid the interpretation and analysis of

  4. 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.

  5. Toward the next generation of air quality monitoring indicators

    Science.gov (United States)

    Hsu, Angel; Reuben, Aaron; Shindell, Drew; de Sherbinin, Alex; Levy, Marc

    2013-12-01

    This paper introduces an initiative to bridge the state of scientific knowledge on air pollution with the needs of policymakers and stakeholders to design the “next generation” of air quality indicators. As a first step this initiative assesses current monitoring and modeling associated with a number of important pollutants with an eye toward identifying knowledge gaps and scientific needs that are a barrier to reducing air pollution impacts on human and ecosystem health across the globe. Four outdoor air pollutants were considered - particulate matter, ozone, mercury, and Persistent Organic Pollutants (POPs) - because of their clear adverse impacts on human and ecosystem health and because of the availability of baseline data for assessment for each. While other papers appearing in this issue will address each pollutant separately, this paper serves as a summary of the initiative and presents recommendations for needed investments to provide improved measurement, monitoring, and modeling data for policy-relevant indicators. The ultimate goal of this effort is to enable enhanced public policy responses to air pollution by linking improved data and measurement methods to decision-making through the development of indicators that can allow policymakers to better understand the impacts of air pollution and, along with source attribution based on modeling and measurements, facilitate improved policies to solve it. The development of indicators represents a crucial next step in this process.

  6. A comprehensive framework for quality assurance in clinical trials

    Science.gov (United States)

    El Gazzar, Omar; Onken, Michael; Eichelberg, Marco; Hein, Andreas; Kotter, Elmar

    2012-02-01

    Biomarkers captured by medical images are increasingly used as indicators for the efficacy or safety of a certain drug or treatment for clinical trials. For example, medical images such as CT or MR are often used for extracting quantitative measurements for the assessment of tumor treatment response while evaluating a chemotherapy drug for therapeutic cancer trials. Quality assurance is defined as "All those planned and systematic actions that are established to ensure that the trial is performed and the data are generated, documented (recorded), and reported in compliance with good clinical practice (GCP) and the applicable regulatory requirement(s)" [1]. Our objective is to build a generalized and an automated framework for quality assurance within the clinical trials workflow. In order to reach this goal, a set of standardized software tools have been developed for quality assurance. Furthermore, we outline some guidelines as recommendations for the users handling the image data within the research workflow. The software tools developed include tools for image selection, image pseudonymization and image quality conformance check. The export tools are developed based on the specifications of the Integrating the Healthcare Enterprise (IHE) Teaching and Clinical Trial Export (TCE) profile. A DICOM-based quality conformance approach has been developed by validating the DICOM header attributes required for a certain imaging application (e.g. CAD, MPR, 3D) and comparing imaging acquisition parameters against the protocol specification. A formal description language is used to represent such quality requirements. For evaluation, imaging data collected from a clinical trial site were validated against Multi-Planar Reconstruction (MPR). We found that out of 60 studies, about 30% of image series volumes failed the MPR check for some common reasons.

  7. Hospital quality reports in Germany: patient and physician opinion of the reported quality indicators

    Directory of Open Access Journals (Sweden)

    Molzahn Tanja

    2007-09-01

    Full Text Available Abstract Background Starting in 2005, Germany's health law required hospital quality reports to be published every two years by all acute care hospitals. The reports were intended to help patients and physicians make informed choices of hospitals. However, while establishing the quality indicators that form the content of the reports, the information needs of the target groups were not explicitly taken into account. Therefore, the aim of our study was to determine patient and physician opinion of the relevance of the reported quality indicators for choosing or referring to a hospital. Methods Convenience samples of 50 patients and 50 physicians were asked to rate the understandability (patients, suitability (physicians and relevance (both groups of a set of 29 quality indicators. The set was drawn from the reports (24 indicators and supplemented by five indicators commonly used in hospital quality reports. We analysed the differences in patient and physician ratings of relevance of all indicators by applying descriptive statistics, t-tests and Wilcoxon tests. Results Only three indicators were considered not understandable by the interviewed patients and unsuitable by the interviewed physicians. The patients rated 19 indicators as highly or very relevant, whereas the physicians chose 15 indicators. The most relevant indicator for the patients was "qualification of doctors", and for the physicians "volume of specified surgical procedures". Patient and physician rankings of individual indicators differed for 25 indicators. However, three groups of indicators could be differentiated, in which the relevance ratings of patients and physicians differed only within the groups. Four of the five indicators that were added to the existing set of reported indicators ranked in the first or second group ("kindness of staff", "patient satisfaction", "recommendation", and "distance to place of living". Conclusion Most of the content of Germany's hospital

  8. Clinical efficiency, image quality and dosimetric considerations

    International Nuclear Information System (INIS)

    Three decades have passed since the first clinical use of the famous EMI Computed Axial Tomography (Cat) scanner. At the time, the prospects for clinical success of this innovative idea were not very good. Time, however, has proven otherwise as what is now simply known as Computed tomography (CT) has been boosted in each one of these decades for different reasons. In the 1970s, technological progress augmented by the realization of the importance of tomographic imaging got everything started; in the 1980s, the boom in health care demand in the US solidified its position and in the 1990s the technological explosion in computers and the imperative need to lower costs in the health care industry have prompted the most dramatic changes in the wy CT is utilized in the year 2000. Thus, different motivations have led the way of progress in CT at various times, and in spite of amazing developments in other crucial imaging modalities, such as ultrasound, Doppler ultrasound, digital subtraction angiography and magnetic resonance imaging, CT maintains its rightful place as the premiere imaging modality in the modern radiology department. This work covers the basic principles of tomographic image reconstruction, and how axial CT scanners progressed historically in the first two decades. Developments in X-ray tubes, and detection systems are highlighted, as well as the impact of clinical efficiency, image quality and patient doses. The basic construction of translate-rotate (1st and 2nd generation, rotate-rotate (3rd generation) and detector ring (4th generation) scanners are described. The so-called 5th generation scanner, the electron beam scanner, is also described, with its clinical and technical advantages and its inherent financial and maintenance disadvantages, which brought the advent of spiral and multi-slice scanners. These most recent developments in CT technology have opened a new era in the clinical use of CT; and although image quality has reached an expected

  9. Clinical audit and quality systems - practical implementation in Finland

    International Nuclear Information System (INIS)

    Clinical audit is a new concept of significant importance for the quality of radiological practices, introduced by the EC Medical Exposure Directive (MED, 97/43/EURATOM). By definition, clinical audit means 'a systematic examination or review of medical radiological procedures which seeks to improve the quality and the outcome of patient care, through structured review whereby radiological practices, procedures, and results are examined against agreed standards for good medical radiological procedures, with modifications of the practices where indicated and the application of new standards if necessary'. In its most profound meaning, being introduced in the medical exposure directive, clinical audit can be seen as a review of the success in implementing the justification and optimization principles, and therefore, it is to a large extent an issue of radiation safety for the patient. According to the directive, clinical audits shall be 'carried out in accordance with national procedures'. For the last few years, parallel to the development of the MED in Europe, there has been a worldwide tendency to implement appropriate quality systems (QS) in the health care organizations, in accordance with the international quality standards (ISO 9000 series etc). Such quality systems have been applied for a long time and very widely by the industry. It is a strong belief that the development of quality systems for health care would result in equal benefits as trusted in industry, in terms of efficiency and safety of health care services. For radiological practices, the quality systems are expected to become a framework for improving the optimization of practices and for maintaining good radiation safety, as well as providing a mechanism to prevent mistakes and accidents. In some countries, like the UK and The Netherlands, there are legal requirements to establish and maintain quality systems at certain type of radiological units. In some countries and some radiological units

  10. A clinical study of intestinal stomas: its indications and complications

    Directory of Open Access Journals (Sweden)

    Zeeshanuddin Ahmad

    2013-08-01

    Full Text Available Background: Intestinal stoma is an opening for fecal diversion. The purpose of the present study was to identify indications for commonly performed intestinal stomas and to study complications related to it. Methods: This is a prospective study was carried out in a surgical unit of Hamidia Hospital, Gandhi Medical College, Bhopal from January, 2012 to December,2012. Data was collected by meticulous history taking including age, gender, indication, type of stoma, type of surgery, careful clinical examination, appropriate operative findings and follow up of the cases. The results were collected, analyzed and compared with other studies. Results: A total of 100 patients were evaluated age ranged between 12- 85 years (50.5 ± 29.01 years Male to female ratio was 7:3. Of the 100 patients 97 were admitted in emergency while 3 in out-patient department. The most common type of stoma made was loop ileostomy (64% followed by sigmoid colostomy (11% and transverse loop colostomy (9%. Main indication for a stoma formation was enteric perforation (38% followed by Koch’s abdomen (18%. Of the various complications encountered with intestinal stoma, peristomal skin irritation (36% was the most consistent complication followed by laparotomy wound infection (13%. Conclusions: Inspite of vast exposure of general surgeons towards stoma formation the complications are inevitable. Early detection of complication and its timely management is the keystone. [Int J Res Med Sci 2013; 1(4.000: 536-540

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

    International Nuclear Information System (INIS)

    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)

  12. Indications for quality assurance in conformal radiotherapy in Italy

    International Nuclear Information System (INIS)

    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

  13. Quality indicators in a computerized technology information system

    International Nuclear Information System (INIS)

    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

  14. Methods to identify the target population: implications for prescribing quality indicators

    Directory of Open Access Journals (Sweden)

    Braspenning Jozé

    2010-05-01

    Full Text Available Abstract Background Information on prescribing quality is increasingly used by policy makers, insurance companies and health care providers. For reliable assessment of prescribing quality it is important to correctly identify the patients eligible for recommended treatment. Often either diagnostic codes or clinical measurements are used to identify such patients. We compared these two approaches regarding the outcome of the prescribing quality assessment and their ability to identify treated and undertreated patients. Methods The approaches were compared using electronic health records for 3214 diabetes patients from 70 general practitioners. We selected three existing prescribing quality indicators (PQI assessing different aspects of treatment in patients with hypertension or who were overweight. We compared population level prescribing quality scores and proportions of identified patients using definitions of hypertension or being overweight based on diagnostic codes, clinical measurements or both. Results The prescribing quality score for prescribing any antihypertensive treatment was 93% (95% confidence interval 90-95% using the diagnostic code-based approach, and 81% (78-83% using the measurement-based approach. Patients receiving antihypertensive treatment had a better registration of their diagnosis compared to hypertensive patients in whom such treatment was not initiated. Scores on the other two PQI were similar for the different approaches, ranging from 64 to 66%. For all PQI, the clinical measurement -based approach identified higher proportions of both well treated and undertreated patients compared to the diagnostic code -based approach. Conclusions The use of clinical measurements is recommended when PQI are used to identify undertreated patients. Using diagnostic codes or clinical measurement values has little impact on the outcomes of proportion-based PQI when both numerator and denominator are equally affected. In situations

  15. Quantifying Clinical Data Quality Using Relative Gold Standards

    OpenAIRE

    Kahn, Michael G.; Eliason, Brian B.; Bathurst, Janet

    2010-01-01

    As the use of detailed clinical data expands for strategic planning, clinical quality measures, and research, the quality of the data contained in source systems, such as electronic medical records, becomes more critical. Methods to quantify and monitor clinical data quality in large operational databases involve a set of predefined data quality queries that attempt to detect data anomalies such as missing or unrealistic values based on meta-knowledge about a data domain. However, descriptive...

  16. Quality assessment of clinical computed tomography

    Science.gov (United States)

    Berndt, Dorothea; Luckow, Marlen; Lambrecht, J. Thomas; Beckmann, Felix; Müller, Bert

    2008-08-01

    Three-dimensional images are vital for the diagnosis in dentistry and cranio-maxillofacial surgery. Artifacts caused by highly absorbing components such as metallic implants, however, limit the value of the tomograms. The dominant artifacts observed are blowout and streaks. Investigating the artifacts generated by metallic implants in a pig jaw, the data acquisition for the patients in dentistry should be optimized in a quantitative manner. A freshly explanted pig jaw including related soft-tissues served as a model system. Images were recorded varying the accelerating voltage and the beam current. The comparison with multi-slice and micro computed tomography (CT) helps to validate the approach with the dental CT system (3D-Accuitomo, Morita, Japan). The data are rigidly registered to comparatively quantify their quality. The micro CT data provide a reasonable standard for quantitative data assessment of clinical CT.

  17. The New Antiepileptic Drugs: Their Neuropharmacology and Clinical Indications.

    Science.gov (United States)

    Hanaya, Ryosuke; Arita, Kazunori

    2016-05-15

    The administration of antiepileptic drugs (AEDs) is the first treatment of epilepsy, one of the most common neurological diseases. Therapeutic guidelines include newer AEDs as front-line drugs; monotherapy with new AEDs is delivered in Japan. While about 70% of patients obtain good seizure control by taking one to three AEDs, about 60% experience adverse effects and 33% have to change drugs. Compared to traditional AEDs, the prolonged administration of new AEDs elicits fewer adverse effects and fewer drug interactions and their teratogenicity may be lower. These characteristics increase drug compliance and allow combination therapy for drug-resistant epilepsy, although the antiepileptic effects of the new AEDs are not greater than of traditional AEDs. Comorbidities are not rare in epileptics; many adult patients present with stroke and brain tumors. In stroke patients requiring risk control and in chemotherapy-treated brain tumor patients, their fewer drug interactions render the new AEDs advantageous. Also, new AEDs offer favorable side benefits for concurrent diseases and conditions. Patients with stroke and traumatic brain injury often present with psychiatric/behavioral symptoms and cognitive impairment and some new AEDs alleviate such symptoms. This review presents an outline of the new AEDs used to treat adult patients based on the pharmacological activity of the drugs and discusses possible clinical indications from the perspective of underlying causative diseases and comorbidities. PMID:26935782

  18. 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

  19. Anaesthesia related mortality in ASA-1 and 2 patients as a quality improvement indicator

    International Nuclear Information System (INIS)

    Quality and safety in anesthesia is usually monitored by analysis of perioperative mortality-morbidity and incidents. Clinical quality indicator, death within 48 hours of anaesthesia exposure is considered to be a flag that can alert to possible problems in individual patient care. The measurement of perioperative mortality as a quality indicator is a continuous peer reviewed quality improvement activity. Medical records and morbidity and mortality files were reviewed to see the trends and finding the benchmark of mortality in ASA-1 and 2 patient who died between 1992-2006 within 48 hours of anaesthesia exposure. Mortality in class 1 was nil. Anaesthetic mortality in ASA-1 and 2 patients were 0.35 per 10,000 and 0.74 per 10,000 of ASA-2 patient's volume. Anaesthesia-related mortality was 0.17 per 10,000 and 0.37 per 10,000 of ASA-2 patient's volume which is almost double of the overall calculated incidence. We suggest continuing monitoring of anaesthesia related mortality as a continuous quality indicator in developing countries. The reporting and analyzing of data according to the ASA status volume should be taken as a denominator. The available benchmark will help in evaluating the confounding factors and perioperative care of a particular group of patients. (author)

  20. The Impact of Quality indicators on Quality of Primary Education in Khyber Pakhtunkhwa

    Directory of Open Access Journals (Sweden)

    Sayyed Farooq Shah

    2015-03-01

    Full Text Available Education plays a major role in the development of a state. It is extensively accredited that quality of primary education is the solo most important tool in strengthening human capabilities and achieving the desired goals. The major purpose of the study was to know how the quality indicators  impact the quality education in government boys and girls primary schools of the selected five southern districts of Khyber Pakhtunkhwa, Pakistan. All the head teachers and teachers of government primary schools of southern districts of Khyber Pakhtunkhwa constituted the population of the study. The sample of the study was consisted of 100 head teachers (50 male and 50 female and 300 teachers (one hundred & fifty male and one hundred & fifty female. The study was a survey type in nature. To collect the relevant information on the selected quality indicators (quality of learning environment, quality of contents, quality of process, and quality of outcomes a self-developed questionnaire was used. Statistical tools chi square test of goodness of equal probability and chi square test of independence were used to analyze the data. In the light of conclusions it is recommended that separate staffrooms should be constructed for teachers, sufficient books for learners and supplementary/allied reading materials for teachers should be provided well in time, students should be encouraged to ask relevant questions during the teaching.  Furthermore, examination and assessment systems should be impartial and transparent. Therefore examinations conducting bodies/ authorities should be appointed on merit basis, papers or assessment work may be done by expert teachers, supervisory staff may necessarily be nominated on best performance basis, and evaluation process might to be administered by skilled personals.

  1. Correlating Wine Quality Indicators to Chemical and Sensory Measurements

    Directory of Open Access Journals (Sweden)

    Helene Hopfer

    2015-05-01

    Full Text Available Twenty-seven commercial Californian Cabernet Sauvignon wines of different quality categories were analyzed with sensory and chemical methods. Correlations between five quality proxies—points awarded during a wine competition, wine expert scores, retail price, vintage, and wine region—were correlated to sensory attributes, volatile compounds, and elemental composition. Wine quality is a multi-faceted construct, incorporating many different layers. Depending on the quality proxy studied, significant correlations between quality and attributes, volatiles and elements were found, some of them previously reported in the literature.

  2. Do quality indicators for general practice teaching practices predict good outcomes for students?

    Science.gov (United States)

    Bartlett, Maggie; Potts, Jessica; McKinley, Bob

    2016-07-01

    Keele medical students spend 113 days in general practices over our five-year programme. We collect practice data thought to indicate good quality teaching. We explored the relationships between these data and two outcomes for students; Objective Structured Clinical Examination (OSCE) scores and feedback regarding the placements. Though both are surrogate markers of good teaching, they are widely used. We collated practice and outcome data for one academic year. Two separate statistical analyses were carried out: (1) to determine how much of the variation seen in the OSCE scores was due to the effect of the practice and how much to the individual student. (2) to identify practice characteristics with a relationship to student feedback scores. (1) OSCE performance: 268 students in 90 practices: six quality indicators independently influenced the OSCE score, though without linear relationships and not to statistical significance. (2) Student satisfaction: 144 students in 69 practices: student feedback scores are not influenced by practice characteristics. The relationships between the quality indicators we collect for practices and outcomes for students are not clear. It may be that neither the quality indicators nor the outcome measures are reliable enough to inform decisions about practices' suitability for teaching. PMID:27117344

  3. Air Quality Indicators at Lake Merritt, Oakland, California

    Science.gov (United States)

    Bulatov, D.; Collins, B.; Hsiao, J.; Majors, A.; Liang, J.

    2007-12-01

    Lake Merritt is significant in its role as both a recreational center for humans, as well as a refuge for migratory wild birds. It is, however, closely surrounded by streets and highways, and even sees a large amount of water traffic by motor-driven boats and pontoons. These two factors contribute to what we suspect is a generally high level of emissions in the atmosphere surrounding the lake. While the harmful components of these emissions can be measured directly using specialized and generally expensive tools, the goal of our research is to explore the use of tree leaves as indicators of air quality. Properties of atmospheric air directly affect the quality of leaves because of plants' reliance on photosynthesis. In brief, photosynthesis requires the input of sunlight, water, and carbon dioxide to produce oxygen and glucose. The gateways through which many of these inputs and outputs pass are essential to every leaf's survival and are called stomata. However, water is an exception; since its entry into the plant's vascular system is through the roots, water generally diffuses outward at stomatal openings rather than inward. Therefore, plants must strike a balance between gaining carbon dioxide and losing water, as well as risk exposure to toxic compounds in the air itself. Primarily, guard cells fulfill this purpose by closing over stomatal openings to conserve water. However, we also believe that over generations of leaves, the absolute number of stomata itself can change to reflect the surrounding environment. That is, increases in carbon dioxide must coincide with higher levels of toxic compounds, which force the number of stomata to decrease over time. Our research examined the relationship between quantitative presence of stomata for several species of trees and the levels of carbon dioxide, oxygen, and wind-speed for ten sites around Lake Merritt. Wind-speed is one of our primary measures because increasing wind velocity leads to water diffusing out of the

  4. 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

    , clinical microbiologists, and clinical pharmacologists were asked to rate the relevance of 59 quality indicators for diagnosis and treatment of respiratory tract infections with regard to reducing antimicrobial resistance and improving patient health. A thorough literature review was carried out to ensure......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...... that all potential quality indicators were considered. OUTCOME: Consensus for a quality indicator was reached if > or =75% of experts scored the item > or =5 on a 7-point Likert scale, ranging from 1 (=completely disagree) through 4 (=uncertain) to 7 (=completely agree). RESULTS: A 96% response rate...

  5. Clinical Indications and Adverse Reactions of Platelet Apheresis

    International Nuclear Information System (INIS)

    Objective: To determine the clinical indications and adverse reactions of platelet apheresis procedure. Study Design: Cross-sectional, observational study. Place and Duration of Study: Blood Bank of Pakistan Atomic Energy Commission General Hospital, Islamabad, from January 2010 to December 2014. Methodology: Indications and adverse reaction verified for 200 consecutive platelet apheresis donations performed for 125 patients was included in this study. Data was analysed for descriptive variables using SPSS version 16. Results: Donor deferral rate in the study was 63.83 percentage. All the donors were males (100 percentage) and replacement donors. Most prevalent blood type was B-positive (n=63, 31.5 percentage), followed by O-positive (n=59, 29.5 percentage). Rh negative groups constituted 13.5 percentage (n=27) of all the donors. Average age of platelet apheresis donors was 28.56 ± 5.77 years. Maximum numbers of donors were in age range 20 - 30 years. Average weight of the donors was 73.96 ± 11.96 kg. Mean pre-procedure platelet count of donors was 268,000/ micro L. The postprocedure average platelet count was approximately 200,000/ micro L. The mean duration of a platelet apheresis session was 78.27 ± 26.07 minutes. Average volume of the final product was 412.53 ± 45.33 ml. Average volume of anti-coagulant acid citrate dextrose used per procedure was 300 ± 40 ml, 245 ml returned to donor along with returned blood while 55 ml used as anticoagulant in final concentrate. Of total 200, two (1 percentage) final products were contaminated with red cells. Three (1.5 percentage) products were not issued and finally expired. Of the 125 patients for which plateletpheresis procedures were performed, 54 (43.2 percentage) patients were males and 71 (56.8 percentage) were females (M: F=0.76:1). Six donors (3 percentage) had adverse events: three donors (1.5 percentage) had mild reactions, two (1 percentage) moderate reaction, and one donor (0.5 percentage) developing

  6. Current status on performance of CT colonography and clinical indications

    International Nuclear Information System (INIS)

    CT colonography (CTC) is a robust and reliable imaging test of the colon. Accuracy for the detection of colorectal cancer (CRC) is as high as conventional colonoscopy (CC). Identification of polyp is size dependent, with large lesions (≥10 mm) accurately detected and small lesions (6–9 mm) identified with moderate to good sensitivity. Recent studies show good sensitivity for the identification of nonpolypoid (flat) lesions as well. Current CTC indications include the evaluation of patients who had undergone a previous incomplete CC or those who are unfit for CC (elderly and frail individuals, patients with underlying severe clinical conditions, or with contraindication to sedation). CTC can also be efficiently used in the assessment of diverticular disease (excluding patients with acute diverticulitis, where the exam should be postponed), before laparoscopic surgery for CRC (to have an accurate localization of the lesion), in the evaluation of colonic involvement in the case of deep pelvic endometriosis (replacing barium enema). CTC is also a safe procedure in patients with colostomy. For CRC screening, CTC should be considered an opportunistic screening test (not available for population, or mass screening) to be offered to asymptomatic average-risk individuals, of both genders, starting at age 50. The use in individuals with positive family history should be discussed with the patient first. Absolute contraindication is to propose CTC for surveillance of genetic syndromes and chronic inflammatory bowel diseases (in particular, ulcerative colitis). The use of CTC in the follow-up after surgery for CRC is achieving interesting evidences despite the fact that literature data are still relatively weak in terms of numerosity of the studied populations. In patients who underwent previous polypectomy CTC cannot be recommended as first test because debate is still open. It is desirable that in the future CTC would be the first-line and only diagnostic test for

  7. Current status on performance of CT colonography and clinical indications

    Energy Technology Data Exchange (ETDEWEB)

    Laghi, Andrea, E-mail: andrea.laghi@uniroma1.it [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Polo Pontino, I.C.O.T. Hospital, Via Franco Faggiana 43, 04100 Latina (Italy); Rengo, Marco [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Polo Pontino, I.C.O.T. Hospital, Via Franco Faggiana 43, 04100 Latina (Italy); Graser, Anno [InstitutfürKlinische Radiologie, Klinikumder Ludwig-Maximilians-Universität München, Campus Großhadern, Marchioninistr. 15, 81377 München (Germany); Iafrate, Franco [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Policlinico Umberto I, Viale Regina Elena 324, 00161 Rome (Italy)

    2013-08-15

    CT colonography (CTC) is a robust and reliable imaging test of the colon. Accuracy for the detection of colorectal cancer (CRC) is as high as conventional colonoscopy (CC). Identification of polyp is size dependent, with large lesions (≥10 mm) accurately detected and small lesions (6–9 mm) identified with moderate to good sensitivity. Recent studies show good sensitivity for the identification of nonpolypoid (flat) lesions as well. Current CTC indications include the evaluation of patients who had undergone a previous incomplete CC or those who are unfit for CC (elderly and frail individuals, patients with underlying severe clinical conditions, or with contraindication to sedation). CTC can also be efficiently used in the assessment of diverticular disease (excluding patients with acute diverticulitis, where the exam should be postponed), before laparoscopic surgery for CRC (to have an accurate localization of the lesion), in the evaluation of colonic involvement in the case of deep pelvic endometriosis (replacing barium enema). CTC is also a safe procedure in patients with colostomy. For CRC screening, CTC should be considered an opportunistic screening test (not available for population, or mass screening) to be offered to asymptomatic average-risk individuals, of both genders, starting at age 50. The use in individuals with positive family history should be discussed with the patient first. Absolute contraindication is to propose CTC for surveillance of genetic syndromes and chronic inflammatory bowel diseases (in particular, ulcerative colitis). The use of CTC in the follow-up after surgery for CRC is achieving interesting evidences despite the fact that literature data are still relatively weak in terms of numerosity of the studied populations. In patients who underwent previous polypectomy CTC cannot be recommended as first test because debate is still open. It is desirable that in the future CTC would be the first-line and only diagnostic test for

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

    OpenAIRE

    Desi Kartikasari; Catur Retnaningdyah; Endang Arisoesilaningsih

    2013-01-01

    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 calcu...

  9. 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....

  10. 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...

  11. Quality indicators of preventable adverse drug events in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Thomsen, Linda Aagaard

    need quality improvement. One study concerned the four indicators on inadequate preventive treatment after acute myocardial infarction (AMI) (Article 4), and another study concerned the four indicators on inadequate monitoring of HbA1c resulting in admission with hyper- or iii hypoglycemia (Article 5...... preventable adverse drug events in the primary care setting (Article 1). Construction of the preventable adverse drug events assessment model required four steps. The first step consisted of the development, validation, and feasibility of preventable adverse drug event indicators for type 2 diabetes (Articles...... 10% of the Danish population receiving oral antihyperglycaemic treatment (9,791 persons) was set up, and indicator positives identified (Articles no. 2 and 3). The third step in the model consisted of a risk assessment of preventable adverse drug events, including an assessment of clinical areas that...

  12. Canonical Correlation between the Leaf Quality Indicators of "Moderate Aroma" Flue-cured Tobacco

    Institute of Scientific and Technical Information of China (English)

    Lin; MENG; Yuangang; DAI; Chengdong; WANG; Shusheng; WANG; Wenjing; SONG; Yuanhua; WU; Yimin; XU

    2015-01-01

    In order to find out the correlation between tobacco quality evaluation indicators in China’s traditional " moderate aroma" tobaccoproducing areas and simplify the tobacco quality evaluation indicators,we evaluate the appearance quality and smoking quality of 143 flue-cured tobacco leaf samples in China’s " moderate aroma" tobacco-producing areas,test the physical traits and chemical component,and analyze the canonical correlation between four quality evaluation indicators. The results show that there is significant or extremely significant canonical correlation between four evaluation indicators( tobacco smoking quality,chemical component,appearance quality and physical trait quality); the cumulative variance contribution rate of evaluation indicators is in the order of chemical component( 69. 17%) > appearance quality( 68. 76%) > physical traits( 64. 13%); appearance quality is most closely related to physical traits( 93. 84%). The individual indicators for tobacco quality evaluation make different contribution to the correlation between quality evaluation indicators. The chemical component evaluation indicators mainly include total sugar and ratio of total sugar to betaine; sensory taste indicators mainly include aroma volume,smoke concentration,irritation and softness degree; physical trait evaluation indicators mainly include leaf weight,leaf length and leaf density; appearance quality indicators mainly include leaf organizational structure,color,maturity and identity. Studies have shown that in the large-scale ecoregion,using canonical correlation analysis to simplify tobacco quality evaluation indicators is feasible.

  13. A semi-automated tool for treatment plan-quality evaluation and clinical trial quality assurance

    Science.gov (United States)

    Wang, Jiazhou; Chen, Wenzhou; Studenski, Matthew; Cui, Yunfeng; Lee, Andrew J.; Xiao, Ying

    2013-07-01

    The goal of this work is to develop a plan-quality evaluation program for clinical routine and multi-institutional clinical trials so that the overall evaluation efficiency is improved. In multi-institutional clinical trials evaluating the plan quality is a time-consuming and labor-intensive process. In this note, we present a semi-automated plan-quality evaluation program which combines MIMVista, Java/MATLAB, and extensible markup language (XML). More specifically, MIMVista is used for data visualization; Java and its powerful function library are implemented for calculating dosimetry parameters; and to improve the clarity of the index definitions, XML is applied. The accuracy and the efficiency of the program were evaluated by comparing the results of the program with the manually recorded results in two RTOG trials. A slight difference of about 0.2% in volume or 0.6 Gy in dose between the semi-automated program and manual recording was observed. According to the criteria of indices, there are minimal differences between the two methods. The evaluation time is reduced from 10-20 min to 2 min by applying the semi-automated plan-quality evaluation program.

  14. A semi-automated tool for treatment plan-quality evaluation and clinical trial quality assurance

    International Nuclear Information System (INIS)

    The goal of this work is to develop a plan-quality evaluation program for clinical routine and multi-institutional clinical trials so that the overall evaluation efficiency is improved. In multi-institutional clinical trials evaluating the plan quality is a time-consuming and labor-intensive process. In this note, we present a semi-automated plan-quality evaluation program which combines MIMVista, Java/MATLAB, and extensible markup language (XML). More specifically, MIMVista is used for data visualization; Java and its powerful function library are implemented for calculating dosimetry parameters; and to improve the clarity of the index definitions, XML is applied. The accuracy and the efficiency of the program were evaluated by comparing the results of the program with the manually recorded results in two RTOG trials. A slight difference of about 0.2% in volume or 0.6 Gy in dose between the semi-automated program and manual recording was observed. According to the criteria of indices, there are minimal differences between the two methods. The evaluation time is reduced from 10–20 min to 2 min by applying the semi-automated plan-quality evaluation program. (note)

  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. MDS 2.0 Public Quality Indicator and Resident Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Minimum Data Set (MDS) is part of the federally mandated process for clinical assessment of all residents in Medicare or Medicaid certified nursing homes. This...

  17. Clinical image quality evaluation for panoramic radiography in Korean dental clinics

    OpenAIRE

    Choi, Bo-ram; Choi, Da-Hye; Huh, Kyung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Choi, Soon-Chul; Bae, Kwang-Hak; Lee, Sam-Sun

    2012-01-01

    Purpose The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Materials and Methods Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the p...

  18. Review of current and evolving clinical indications forendoscopic ultrasound

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    For the first several years after its development,endoscopic ultrasound (EUS) was primarily limited toidentification of pancreatic malignancies. Since thistime, the field of EUS has advanced at a tremendousspeed in terms of additional clinical diagnostic andtherapeutic uses. The combination of ultrasound withendoscopy provides a unique interventional modalitythat is a minimally invasive alternative to various surgicalinterventions. Given the expanding recommendedindications for EUS, this article will serve to review themost common uses with supporting evidence, while alsoexploring innovative endeavors that may soon becomecommon clinical practice.

  19. Clinical quality assurance for 106Ru ophthalmic applicators

    International Nuclear Information System (INIS)

    Background and purpose: Episcleral brachytherapy using 106Ru/106Rh ophthalmic applicators is a proven method of therapy of uveal melanomas sparing the globe and in many cases sparing the vision. In the year 2001, an internal clinical quality assurance procedure revealed that part of the ophthalmic applicators leaked and that the calibration was erroneous. Consequently, the producer modernized its production procedures and, in May 2002, introduced a dose rate calibration that is traceable to the NIST standard. This NIST calibration confirmed that the previous calibration had been incorrect. In order to study the effects of the producer's new internal quality assurance procedures on the ophthalmic applicators, applicators of this new generation were submitted to a newly improved internal clinical acceptance test. Patients and methods: The internal clinical acceptance test consists of a leakage test and a dosimetric test of the ophthalmic applicators. The leakage test simulates contact of the ophthalmic applicators with chloride containing body fluid. The dosimetric tests measure depth dose curves and dose rate with a plastic scintillator dosimetric system and compare them with the indications in the producer's certificate. Furthermore, the depth dose profile of the most frequently used applicator (type CCB) was compared with published data. Results: The internal clinical leakage test showed that all of the tested ophthalmic applicators belonging to the new generation (n=17) were tight and not contaminated. The dosimetric acceptance tests applied to seven different types of applicators revealed that the relative depth dose profiles in the therapeutically relevant range (up to a depth of ≤7 mm) deviate from the producer's indications only by -2.7 to +3.2%. The acceptance test of the dose rate values of the ophthalmic applicators at a distance of 2 mm from the surface of the applicators resulted in a coefficient of variation of 1.7% (n=17). In the evaluation of the

  20. [Extension bridges. A bibliographic evaluation and the clinical indications].

    Science.gov (United States)

    Irato, A; Garrone, P; Catapano, S; Carossa, S

    1990-11-01

    Extension bridges are a valid alternative to partial and implanted prostheses for the rehabilitation of small intercalary or distal lacunae. Following a critical review of published reports on the subject and the assessment of longitudinal studies, the authors examine the clinical parameters and technical procedures used to implement these prosthetic reconstructions. PMID:2084528

  1. Subjective Well-Being as an Indicator for Clinical Depression

    Science.gov (United States)

    Gargiulo, R.; Stokes, Mark A.

    2009-01-01

    The Theory of Homeostasis posits that Subjective Well-being (SWB) is regulated by a dynamic biological mechanism, assisting to maintain a positive view of life. Further, the theory suggests that clinical depression is the loss of SWB due to the defeat of this homeostatic defence system. To test this hypothesis it was predicted that people who were…

  2. Professional practice assessment. Pertinence of positron emission tomography clinical indications in oncology

    International Nuclear Information System (INIS)

    Introduction As part of the health care quality and safety policy in France, Professional Practice Assessment (P.P.A.) are mandatory in the health services 'certification' process. We present our study regarding the pertinence of Positron Emission Tomography (PET) indications in oncology. Materials and methods A multidisciplinary task group used the Quick Audit method with two rounds of 100 request forms each. The assessment list of criteria comprised four items of decreasing relevance grading the PET scans clinical indications, which were derived from the three French published guidelines (S.O.R. [F.N.C.L.C.C]., 'Guide du bon usage des examens d'imagerie medicale' [S.F.R.-S.F.M.N.], 'Guide pour la redaction de protocoles pour la TEP au F.D.G. en cancerologie' [S.F.M.N.]) and five additional items: clinical information, patient's body weight, previous treatments dates, diabetes, claustrophobia. Results The first round showed that 68% of the requested scans corresponded to the two most relevant groups of indications (S.O.R. Standards and Options). The request forms were correctly filled in regarding the clinical information, but this was not the case for the other items we tested. Several actions were conducted: dedicated PET request form, availability of the S.O.R. on the hospital intranet, boost of the referring physicians awareness during the multidisciplinary oncology meetings (Reunions de Concertation Pluridisciplinaires RCP). The second round showed a better pertinence of the PET scans indications (75% versus 68%); the patient's body weight was more frequently mentioned on the request form. Discussion This study is an example of P.P.A. in our discipline. It led to an improvement of the oncologic PET scans clinical indications in our hospital. This work is pursued in everyday discussion with the referring clinicians, especially during the RCP. (authors)

  3. Determining indicators of quality of life differences in European cities

    OpenAIRE

    W. Breuer; D. Schaeling

    2012-01-01

    The comparison of cities by indicators covering several topics of urban life is crucial for policy decisions such as funding allocation for urban development. Simply adding up a high number of indicators to one single index evokes reasonable criticism due to opacity and very limited interpretation possibilities. Nevertheless, the same arguments can be made against using large sets of disaggregated indicators for city comparison. This paper helps to steer a middle course by identifying of a sm...

  4. 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

  5. Development of on package indicator sensor for real-time monitoring of meat quality

    OpenAIRE

    Vivek Shukla; Kandeepan, G.; M. R. Vishnuraj

    2015-01-01

    Aim: The aim was to develop an indicator sensor for real-time monitoring of meat quality and to compare the response of indicator sensor with meat quality parameters at ambient temperature. Materials and Methods: Indicator sensor was prepared using bromophenol blue (1% w/v) as indicator solution and filter paper as indicator carrier. Indicator sensor was fabricated by coating indicator solution onto carrier by centrifugation. To observe the response of indicator sensor buffalo meat was packed...

  6. Clinical measurement of tooth wear: tooth Wear Indices

    OpenAIRE

    López Frías, J.; Castellanos Cosano, Lizett; Martín González, Jenifer; Llamas Carreras, José María; Segura-Egea, Juan J.

    2012-01-01

    Attrition, erosion, and abrasion result in alterations to the tooth and manifest as tooth wear. Each classification corresponds to a different process with specific clinical features. Classifications made so far have no accurate prevalence data because the indexes do not necessarily measure a specific etiology, or because the study populations can be diverse in age and characteristics. Tooth wears (attrition, erosion and abrasion) is perceived internationally as a growing problem. However, th...

  7. A clinical study of intestinal stomas: its indications and complications

    OpenAIRE

    Zeeshanuddin Ahmad; Apoorv Sharma; Pradeep Saxena; Anuradha Choudhary; Minhajuddin Ahmed

    2013-01-01

    Background: Intestinal stoma is an opening for fecal diversion. The purpose of the present study was to identify indications for commonly performed intestinal stomas and to study complications related to it. Methods: This is a prospective study was carried out in a surgical unit of Hamidia Hospital, Gandhi Medical College, Bhopal from January, 2012 to December,2012. Data was collected by meticulous history taking including age, gender, indication, type of stoma, type of surgery, careful clini...

  8. Development of quality indicators for monitoring outcomes of frail elderly hospitalised in acute care health settings: Study Protocol

    Directory of Open Access Journals (Sweden)

    Travers Catherine M

    2011-10-01

    Full Text Available Abstract Background Frail older people admitted to acute care hospitals are at risk of a range of adverse outcomes, including geriatric syndromes, although targeted care strategies can improve health outcomes for these patients. It is therefore important to assess inter-hospital variation in performance in order to plan and resource improvement programs. Clinical quality outcome indicators provide a mechanism for identifying variation in performance over time and between hospitals, however to date there has been no routine use of such indicators in acute care settings. A barrier to using quality indicators is lack of access to routinely collected clinical data. The interRAI Acute Care (AC assessment system supports comprehensive geriatric assessment of older people within routine daily practice in hospital and includes process and outcome data pertaining to geriatric syndromes. This paper reports the study protocol for the development of aged care quality indicators for acute care hospitals. Methods/Design The study will be conducted in three phases: 1. Development of a preliminary inclusive set of quality indicators set based on a literature review and expert panel consultation, 2. A prospective field study including recruitment of 480 patients aged 70 years or older across 9 Australian hospitals. Each patient will be assessed on admission and discharge using the interRAI AC, and will undergo daily monitoring to observe outcomes. Medical records will be independently audited, and 3. Analysis and compilation of a definitive quality indicator set, including two anonymous voting rounds for quality indicator inclusion by the expert panel. Discussion The approach to quality indicators proposed in this protocol has four distinct advantages over previous efforts: the quality indicators focus on outcomes; they can be collected as part of a routinely applied clinical information and decision support system; the clinical data will be robust and will

  9. Rationale for indicator quality of integrated information security system

    Directory of Open Access Journals (Sweden)

    Z. P. Stashevskiy

    2014-04-01

    Full Text Available The justification of index of functional quality of the system of informational security in structural departments of Government service of emergency situations of Ukraine is carried out. Basic parameters which can influence on qualitative work of SSI are determined. These parameters assess the cost of its projecting and allow making such its variant of realization which will better for constant functioning of is of rescue service.

  10. SOME INDICATORS OF WATER QUALITY OF THE TAMIŠ RIVER

    Directory of Open Access Journals (Sweden)

    DRAGAN MARKOVIĆ

    2011-03-01

    Full Text Available This paper shows the results obtained in field analysis performed at the Tamiš River, starting from the settlement Jaša Tomić (the border between Serbia and Romania to Pančevo (the confluence of Tamiš into the Danube. The Tamiš is a 359 km long river rising in the southern Carpathian Mountains. It flows through the Banat region and flows into the Danube near Pančevo. Over the years, the water quality of the river has severely deteriorated and badly affected the environment and the river ecosystem. In situ measurements enabled determination of physico-chemical parameters of water quality of the Tamiš River at every 400 m of the watercourse, such as: water temperature, pH value, electrical conductivity, contents of dissolved oxygen and oxygen saturation. The main reason of higher pollution of Tamiš is seen in connection to DTD hydro system. Sampling was performed at 7 points with regard to color, turbidity, total hardness, alkalinity, concentration of ammonium nitrogen, nitrite nitrogen, nitrate nitrogen, iron, chlorides and sulphates in samples. The aim of the present work was to evaluate water quality in the Tamiš River taking into account significant pollution, which originates from settlements, industry and agriculture, and to suggest appropriate preventive measures to further decrease the pollution of the river's water.

  11. Pharmacists' Perceptions of the Barriers and Facilitators to the Implementation of Clinical Pharmacy Key Performance Indicators

    Science.gov (United States)

    Minard, Laura V; Deal, Heidi; Harrison, Megan E; Toombs, Kent; Neville, Heather; Meade, Andrea

    2016-01-01

    Background In hospitals around the world, there has been no consensus regarding which clinical activities a pharmacist should focus on until recently. In 2011, a Canadian clinical pharmacy key performance indicator (cpKPI) collaborative was formed. The goal of the collaborative was to advance pharmacy practice in order to improve patient outcomes and enhance the quality of care provided to patients by hospital pharmacists. Following a literature review, which indicated that pharmacists can improve patient outcomes by carrying out specific activities, and an evidence-informed consensus process, a final set of eight cpKPIs were established. Canadian hospitals leading the cpKPI initiative are currently in the early stages of implementing these indicators. Objective To explore pharmacists' perceptions of the barriers and facilitators to the implementation of cpKPIs. Methods Clinical pharmacists employed by the Nova Scotia Health Authority were invited to participate in focus groups. Focus group discussions were audio-recorded and transcribed, and data was analyzed using thematic analysis. Findings Three focus groups, including 26 pharmacists, were conducted in February 2015. Three major themes were identified. Resisting the change was comprised of documentation challenges, increased workload, practice environment constraints, and competing priorities. Embracing cpKPIs was composed of seeing the benefit, demonstrating value, and existing supports. Navigating the unknown was made up of quality versus quantity battle, and insights into the future. Conclusions Although pharmacists were challenged by documentation and other changes associated with the implementation of cpKPIs, they demonstrated significant support for cpKPIs and were able to see benefits of the implementation. Pharmacists came up with suggestions for overcoming resistance associated with the implementation of cpKPIs and provided insights into the future of pharmacy practice. The identification of barriers

  12. Developing the Use of Quality Indicators in Sterilization Practices

    Directory of Open Access Journals (Sweden)

    E Mehrabi

    2012-07-01

    Full Text Available Background: Health-care-associated infections are a major threat to the safety of patient care. Control of such problem is a major criterion for hospital accreditation. This study was aimed to determine the developing use of chemical (class 6 products and biological indicators in Tabriz district hospitals since 1997 to 2011.Methods: We conducted this time-trend interventional study with all of the public and private hospitals, which counted to 21 in Tabriz district as a sample. The situations of indicator use were presented for each time in the base of indicator groups. Furthermore, the results were showed in the base of hospital groups.Results: All of district hospital (n=21 with 74 autoclave machine and 22 central sterilization room were studied. The result of second time study in 2008 showed a markedly improvement in the control of sterilization processes. Furthermore, we continued our intervention results 6 month later in 2009 and 2 years later in 2011. The most striking result were use of chemical indicator in 100% of hospitals. However, there are defects in the use of biological indicators (63.65%.Conclusion: The most obvious finding was significant improvement in sterilization control especially in development the use of chemical indicators. The finding of this study has a number of important implications for hospital managers and infection control practitioners such as continuous practical training of CSSD personnel in hospitals and mandating of indicator using in all sterilization process with controlling of this subject in evaluation and accreditation of hospital programs.

  13. Clinical indicators for severe prognosis of scrub typhus

    Directory of Open Access Journals (Sweden)

    Sriwongpan P

    2013-10-01

    Full Text Available Pamornsri Sriwongpan,1,2 Pornsuda Krittigamas,3 Pacharee Kantipong,4 Naowarat Kunyanone,5 Jayanton Patumanond,1 Sirianong Namwongprom1,61Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Department of Social Medicine, Chiang Rai Prachanukroh Hospital, Chiang Rai, Thailand; 3Department of General Pediatrics, Nakornping Hospital, Chiang Mai, Thailand; 4Department of Internal Medicine, 5Department of Medical Technology, Chiang Rai Prachanukroh Hospital, Chiang Rai, Thailand; 6Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandBackground: The study explored clinical risk characteristics that may be used to forecast scrub typhus severity under routine clinical practices.Methods: Retrospective data were collected from patients registered at two university-affiliated tertiary care hospitals in the north of Thailand, from 2004 to 2010. Key information was retrieved from in-patient records, out patient cards, laboratory reports and registers. Patients were classified into three severity groups: nonsevere, severe (those with at least one organ involvement, and deceased. Prognostic characteristics for scrub typhus severity were analyzed by a multivariable ordinal continuation ratio regression.Results: A total of 526 patients were classified into nonsevere (n = 357, severe (n = 100, and deceased (n = 69. The significant multivariable prognostic characteristics for scrub typhus severity were increased body temperature (odds ratio [OR] = 0.58, 95% confidence interval [CI] = 0.45–0.74, P < 0.001, increased pulse rate (OR = 1.03, 95% CI = 1.01–1.05, P < 0.001, presence of crepitation (OR = 3.25, 95% CI = 1.52–6.96, P = 0.001, increased percentage of lymphocytes (OR = 0.97, 95% CI = 0.95–0.98, P = 0.001, increased aspartate aminotransferase (every 10 IU/L (OR = 1.04, 95% CI = 1.02–1.06, P < 0.001, increased serum albumin (OR = 0.47, 95% CI = 0.27–0.80, P = 0

  14. Clinical performance feedback and quality improvement opportunities for perioperative physicians

    Directory of Open Access Journals (Sweden)

    Kaye AD

    2014-05-01

    Full Text Available Alan David Kaye,1 Olutoyin J Okanlawon,2 Richard D Urman21Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, 2Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston MA, USAAbstract: Clinical performance feedback is an important component of the ongoing development and education of health care practitioners. For physicians, feedback about their clinical practice and outcomes is central to developing both confidence and competence at all stages of their medical careers. Cultural and financial infrastructures need to be in place, and the concept of feedback needs to be readily embraced and encouraged by clinical leadership and other stakeholders. The "buy-in" includes the expectation and view that feedback occurs on a routine basis, and those engaged in the process are both encouraged to participate and held accountable. Feedback must be part of an overarching quality improvement and physician education agenda; it is not meant to be an isolated, fragmented initiative that is typically undermined by lack of resources or systemic barriers to gaining improvement within programs. Effective feedback should be an integral part of clinical practice. Anesthesiologists and other perioperative physicians are identifying specialty-specific indicators that can be used when creating a broader quality improvement agenda. Placing a more immediate formal feedback strategy that focuses on goal-oriented behavior is rapidly becoming a mainstay. Physicians may use their individual feedback reports for reflection and designing personal development plans as lifelong learners and leaders in improving patient care.Keywords: physician education, outcomes measurement, performance improvement, anesthesiology

  15. 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.

  16. Quality of life: consideration about indicators and measurement instruments

    OpenAIRE

    Alves, Everton Fernando

    2011-01-01

    International audience The measuring instruments are developed for many different purposes and directions, being held by generic scales of health status and specific scales to a given situation. This study aimed to discuss the important issues that permeate the use of measuring instruments and provide a systematic way of indicators and measuring instruments used in QL and validated in Brazil. It was conducted a study of narrative review of available knowledge in the literature, consultatio...

  17. Diabetes quality management in care groups and outpatient clinics

    OpenAIRE

    Campmans-Kuijpers, M.J.E.

    2015-01-01

    This research project relates to diabetes quality management in Dutch care groups (40-200 GP practices) and outpatient clinics. Improvement of quality management at an organisational level on top of the existing quality management in separate general practices is expected to be associated with better outcomes in diabetes care. Quality management was measured with newly developed questionnaires about organisation of care, multidisciplinary teamwork, patient centeredness, performance results, q...

  18. Improving the quality of clinical coding: a comprehensive audit model

    OpenAIRE

    Hamid Moghaddasi; Reza Rabiei; Nasrin Sadeghi

    2014-01-01

    Introduction: The review of medical records with the aim of assessing the quality of codes has long been conducted in different countries. Auditing medical coding, as an instructive approach, could help to review the quality of codes objectively using defined attributes, and this in turn would lead to improvement of the quality of codes. Method: The current study aimed to present a model for auditing the quality of clinical codes. The audit model was formed after reviewing other a...

  19. Clinical indication for immunoscintigraphy in infectious diseases and colorectal cancer

    International Nuclear Information System (INIS)

    Tc-99m/I-123 labelled antibodies against granulocytes (BW250/183; AK47) and against CEA (BW431/26) for tumor diagnosis are the most widely used monoclonal antibodies for immunoscintigraphy due to their commerical availability and the ease of handling. Main indications for CEA immunoscintigraphy are the differential diagnosis of the local recurrence of colorectal carcinoma (sensitivity: 80-95%; specificity: 87-95%) and the rising CEA-serum level without a possible localization of tumor manifestation (additional information: 6-33%). The indication for granulocyte antibody scintigraphy comprises due to the high sensitivity (24 h: 86%) and specificity (24 h: 89%) of the method a wide spectrum of inflammatory diseases starting from bone and soft tissue diseases, abdominal infections and ending up with vascular prosthetic infections. The diagnostic accuracy of the method is comparable with the results of the scintigraphy with autologous granulocytes (In-111-oxin; Tc-99m-HMPAO). The disadvantage of human antimouse antibody response with a HAMA frequency up to 30% after the first application. Already now and in the near future the application of low antibody doses and the use of Fab'-fragments are practicable alternatives. (orig.)

  20. Research on Evaluation Indicator System for Teaching Quality of College Teachers

    Science.gov (United States)

    Wen, Shuhong; Wang, Xiaohong

    2008-01-01

    This paper conducts research on the connotations and characteristics of evaluation indicator system for teaching quality of college teachers, constructs the contents of the evaluation indicator system for teaching quality of college teachers and applies the contents in the practice of teaching quality monitoring and evaluation so as to prove their…

  1. MR arthrography of the shoulder: possible indications for clinical use

    International Nuclear Information System (INIS)

    In a prospective study possible indications for MR arthrography of the shoulder were evaluated. 37 patients were examined before and after intraarticular administration of a 2-mmolar solution of Gd-DTPA. MR arthrography was performed if there was no joint effusion and/or an uncertain finding concerning the rotator cuff or the capsulolabral complex on plain MR images. MR arthrography leads to a better demonstration of labrum pathology in 11/22 patients and to a superior delineation of the capsuloligamentous apparatus in 20/22 cases. In 9/15 patients with impingement lesions MR arthrography allowed a differentiation of severe tendinitis from partial and small full-thickness tears of the rotator cuff. MR arthrography of the shoulder joint enhances the accuracy of MR in case of an uncertain finding on plain MR images. (orig.)

  2. Analysis of quality data based on national clinical databases

    DEFF Research Database (Denmark)

    Utzon, Jan; Petri, A.L.; Christophersen, S.

    2009-01-01

    There is little agreement on the philosophy of measuring clinical quality in health care. How data should be analyzed and transformed to healthcare information is an ongoing discussion. To accept a difference in quality between health departments as a real difference, one should consider to which...... extent the selection of patients, random variation, confounding and inconsistency may have influenced results. The aim of this article is to summarize aspects of clinical healthcare data analyses provided from the national clinical quality databases and to show how data may be presented in a way which...

  3. 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. PMID:27356165

  4. Epicondylopathia humeri. Indication, technique and clinical results of radiotherapy

    International Nuclear Information System (INIS)

    Background: The efficacy of radiotherapy for degenerative-inflammatory disorders is well known, but so far long-term observations and reliable assessment of symptoms according to objective criteria and scores for validation are still missing. Results: Forty-three patients (ot totally 85)(50 elbows of totally 93) achieved 'complete pain relief (CR)' in all pain categories: 59% elbows with pain at strain had 'complete pain relief', 79% with pain at night, 84% with permanent pain, 80% with pain at rest and 81% with pain at initiation or morning stiffness. Nineteen elbows gained 'major pain relief (PR)', i.e. had minor symptoms (maximum grade 1) in all categories. Thus, a total of 69 (74%) elbows responded to radiotherapy. Seventeen patients (19 elbows) were operated because of persistent symptoms or dissatisfaction in long-term follow-up; 7 of those became completely free of symptoms. The Morrey-Score improved by a mean of 18 points from 78 prior to radiotherapy to 96 points at last follow-up. According to the Morrey-Score only 2 patients became worse in long-term follow-up. Two parameters indicated a negative prognosis in multivariate analysis: Long symptom duration prior to radiotherapy and immobilisation with plaster (p<0.05). Conclusions: Radiotherapy for refractory epicondylopathia humeri is highly effective. Long symptom duration and long-term immobilisation by plaster are negative prognostic factors for treatment outcome. Due to the low side effects and treatment costs, radiotherapy is a good therapeutic option in comparison to conventional treatment methods and surgery in the chronic stage of epicondylopathia humeri. (orig./VHE)

  5. Hospital Inpatient Prevention Quality Indicators (PQI) for Adult Discharges by Zip Code (SPARCS): Beginning 2009

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset is one of two datasets that contain observed and expected rates for Agency for Healthcare Research and Quality Prevention Quality Indicators – Adult...

  6. Target for improvement: a cluster randomised trial of public involvement in quality-indicator prioritisation (intervention development and study protocol

    Directory of Open Access Journals (Sweden)

    Burgers Jako

    2011-05-01

    Full Text Available Abstract Background Public priorities for improvement often differ from those of clinicians and managers. Public involvement has been proposed as a way to bridge the gap between professional and public clinical care priorities but has not been studied in the context of quality-indicator choice. Our objective is to assess the feasibility and impact of public involvement on quality-indicator choice and agreement with public priorities. Methods We will conduct a cluster randomised controlled trial comparing quality-indicator prioritisation with and without public involvement. In preparation for the trial, we developed a 'menu' of quality indicators, based on a systematic review of existing validated indicator sets. Participants (public representatives, clinicians, and managers will be recruited from six participating sites. In intervention sites, public representatives will be involved through direct participation (public representatives, clinicians, and managers will deliberate together to agree on quality-indicator choice and use and consultation (individual public recommendations for improvement will be collected and presented to decision makers. In control sites, only clinicians and managers will take part in the prioritisation process. Data on quality-indicator choice and intended use will be collected. Our primary outcome will compare quality-indicator choice and agreement with public priorities between intervention and control groups. A process evaluation based on direct observation, videorecording, and participants' assessment will be conducted to help explain the study's results. The marginal cost of public involvement will also be assessed. Discussion We identified 801 quality indicators that met our inclusion criteria. An expert panel agreed on a final set of 37 items containing validated quality indicators relevant for chronic disease prevention and management in primary care. We pilot tested our public-involvement intervention with 27

  7. Statistical quality indicators for electron-density maps

    International Nuclear Information System (INIS)

    A likelihood-based metric for scoring the local agreement of a structure model with the observed electron density is described. The commonly used validation metrics for the local agreement of a structure model with the observed electron density, namely the real-space R (RSR) and the real-space correlation coefficient (RSCC), are reviewed. It is argued that the primary goal of all validation techniques is to verify the accuracy of the model, since precision is an inherent property of the crystal and the data. It is demonstrated that the principal weakness of both of the above metrics is their inability to distinguish the accuracy of the model from its precision. Furthermore, neither of these metrics in their usual implementation indicate the statistical significance of the result. The statistical properties of electron-density maps are reviewed and an improved alternative likelihood-based metric is suggested. This leads naturally to a χ2 significance test of the difference density using the real-space difference density Z score (RSZD). This is a metric purely of the local model accuracy, as required for effective model validation and structure optimization by practising crystallographers prior to submission of a structure model to the PDB. A new real-space observed density Z score (RSZO) is also proposed; this is a metric purely of the model precision, as a substitute for other precision metrics such as the B factor

  8. Development of disease-specific quality indicators for danish chiropractic patients with low back pain

    DEFF Research Database (Denmark)

    Sorensen, Line P; Krog, Birgitte R; Kongsted, Alice; Bronfort, Gert; Hartvigsen, Jan

    2011-01-01

    The purpose of this study is to develop disease-specific quality indicators for Danish chiropractic patients with low back pain (LBP) as an initial effort to include chiropractors in the Danish Health Care Quality Programme.......The purpose of this study is to develop disease-specific quality indicators for Danish chiropractic patients with low back pain (LBP) as an initial effort to include chiropractors in the Danish Health Care Quality Programme....

  9. 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…

  10. 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

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

    OpenAIRE

    Stalpers, Dewi; Kieft, Renate A. M. M.; 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 screening indicators and nurse-perceived quality of care. Methods To calculate a composite performance score for each of six Dutch non-university teaching hospitals, the percentage scores of the public...

  12. Improving palliative care in selected settings in England using quality indicators: a realist evaluation

    OpenAIRE

    Iliffe, S.; Davies, N; Manthorpe, J; Crome, P; Ahmedzai, S.; Vernooij-Dassen, M; Engels, Y.

    2016-01-01

    Background: There is a gap between readily available evidence of best practice and its use in everyday palliative care. The IMPACT study evaluated the potential of facilitated use of Quality Indicators as tools to improve palliative care in different settings in England. / Methods: 1) Modelling palliative care services and selecting a set of Quality Indicators to form the core of an intervention, 2) Case studies of intervention using the Quality Indicator set supported by an expert in service...

  13. Improving palliative care in selected settings in England using quality indicators: a realist evaluation

    OpenAIRE

    Iliffe, Steve; Davies, Nathan; Manthorpe, Jill; Crome, Peter; Ahmedzai, Sam H; Vernooij-Dassen, Myrra; Engels, Yvonne

    2016-01-01

    Background: There is a gap between readily available evidence of best practice and its use in everyday palliative care. The IMPACT study evaluated the potential of facilitated use of Quality Indicators as tools to improve palliative care in different settings in England.Methods: 1) Modelling palliative care services and selecting a set of Quality Indicators to form the core of an intervention, 2) Case studies of intervention using the Quality Indicator set supported by an expert in service ch...

  14. Contributions to variability of clinical measures for use as indicators of udder health status in a clinical protocol

    Directory of Open Access Journals (Sweden)

    Houe H

    2006-08-01

    Full Text Available Abstract A cross-sectional observational study with repeated observations was conducted on 16 Danish dairy farms to quantify the influence of observer, parity, time (stage in lactation and farm on variables routinely selected for inclusion in clinical protocols, thereby to enable a more valid comparison of udder health between different herds. During 12 months, participating herds were visited 5 times by project technicians, who examined 20 cows and scored the selected clinical variables. The estimates of effect on variables were derived from a random regression model procedure. Statistical analyses revealed that, although estimates for occurrence of several the variables, e.g. degree of oedema, varied significantly between observers, the effects on many of these estimates were similar in size. Almost all estimates for occurrences of variables were significantly affected either parity and lactation stage, or by both e.g. udder tissue consistency. Some variables, e.g. mange, had high estimates for the farm component, and others e.g. teat skin quality had a high individual component. Several of the variables, e.g. wounds on warts, had a high residual component indicating that a there still was a major part of the variation in data, which was unexplained. It was concluded that most of the variables were relevant for implementation in herd health management, but that adjustments need to be made to improve reliability.

  15. [Clinical trial data management and quality metrics system].

    Science.gov (United States)

    Chen, Zhao-hua; Huang, Qin; Deng, Ya-zhong; Zhang, Yue; Xu, Yu; Yu, Hao; Liu, Zong-fan

    2015-11-01

    Data quality management system is essential to ensure accurate, complete, consistent, and reliable data collection in clinical research. This paper is devoted to various choices of data quality metrics. They are categorized by study status, e.g. study start up, conduct, and close-out. In each category, metrics for different purposes are listed according to ALCOA+ principles such us completeness, accuracy, timeliness, traceability, etc. Some general quality metrics frequently used are also introduced. This paper contains detail information as much as possible to each metric by providing definition, purpose, evaluation, referenced benchmark, and recommended targets in favor of real practice. It is important that sponsors and data management service providers establish a robust integrated clinical trial data quality management system to ensure sustainable high quality of clinical trial deliverables. It will also support enterprise level of data evaluation and bench marking the quality of data across projects, sponsors, data management service providers by using objective metrics from the real clinical trials. We hope this will be a significant input to accelerate the improvement of clinical trial data quality in the industry. PMID:26911027

  16. Quality evaluation of controlled clinical information service trials.

    OpenAIRE

    Balas, E A; Austin, S. M.; Brown, G.D.; Mitchell, J. A.

    1993-01-01

    Randomized controlled clinical trials are increasingly accepted as tools of computer technology assessment and, therefore, quality evaluation of trials has great theoretical and practical significance. The purpose of this study was to assist the design of evaluation studies and synthesis of published results by developing and validating an easy-to-use quality scoring method. The development of the new scoring system was based on the available quality evaluation methods and the analysis of 19 ...

  17. Randomized trial interpreting sputum quality in a clinical laboratory.

    OpenAIRE

    Mizrachi, H H; Valenstein, P N

    1987-01-01

    The role for laboratory interpretation of microbiologic results remains controversial, and many laboratories leave the interpretation of culture results entirely to physicians. We examined the effects of furnishing a laboratory interpretation of sputum quality on physician decision making. Quality of sputum was determined on Gram-stained smears by using a modification of the criteria of Bartlett (R. C. Bartlett, Medical Microbiology: Quality, Cost, and Clinical Relevance, p. 24-31, 1974). A t...

  18. Healthcare reform from the inside: A neurosurgical clinical quality program

    OpenAIRE

    Afsar-manesh, Nasim; Martin, Neil A.; Ausman, James I.

    2012-01-01

    During the past decade, the U.S. health care system has faced increasing challenges in delivering high quality of care, ensuring patient safety, providing access to care, and maintaining manageable costs. While reform progresses at a national level, health care providers have a responsibility and obligation to advance quality and safety. In 2009, the authors implemented a department-wide Clinical Quality Program. This Program comprised of an inter-disciplinary group of providers and staff wor...

  19. Clinical image quality evaluation for panoramic radiography in Korean dental clinics

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

  20. 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)...

  1. Minimally invasive transforaminal lumbar interbody fusion—indications and clinical experience

    Directory of Open Access Journals (Sweden)

    Akshay Hari

    2016-01-01

    Conclusions: Our clinical experience along with a review of the medical literature indicates that TLIF can be effectively and safely performed in a minimally invasive fashion for a wide variety of indications.

  2. Information systems as a quality management tool in clinical laboratories

    International Nuclear Information System (INIS)

    This article describes information systems as a quality management tool in clinical laboratories. The quality of laboratory analyses is of fundamental importance for health professionals in aiding appropriate diagnosis and treatment. Information systems allow the automation of internal quality management processes, using standard sample tests, Levey-Jennings charts and Westgard multirule analysis. This simplifies evaluation and interpretation of quality tests and reduces the possibility of human error. This study proposes the development of an information system with appropriate functions and costs for the automation of internal quality control in small and medium-sized clinical laboratories. To this end, it evaluates the functions and usability of two commercial software products designed for this purpose, identifying the positive features of each, so that these can be taken into account during the development of the proposed system

  3. Information systems as a quality management tool in clinical laboratories

    Science.gov (United States)

    Schmitz, Vanessa; Rosecler Bez el Boukhari, Marta

    2007-11-01

    This article describes information systems as a quality management tool in clinical laboratories. The quality of laboratory analyses is of fundamental importance for health professionals in aiding appropriate diagnosis and treatment. Information systems allow the automation of internal quality management processes, using standard sample tests, Levey-Jennings charts and Westgard multirule analysis. This simplifies evaluation and interpretation of quality tests and reduces the possibility of human error. This study proposes the development of an information system with appropriate functions and costs for the automation of internal quality control in small and medium-sized clinical laboratories. To this end, it evaluates the functions and usability of two commercial software products designed for this purpose, identifying the positive features of each, so that these can be taken into account during the development of the proposed system.

  4. 78 FR 13365 - Prospective Grant of Exclusive License: Food Quality Indicators

    Science.gov (United States)

    2013-02-27

    ... Quality Indicator;'' ] Patent application No. Territory Filing date Status 61/052,674 US July 16, 1997... published by the United States Patent and Trademark Office or the World Intellectual Property Organization... thereto) intended for licensure describe and claim indicator strips for monitoring food quality...

  5. Relation Between Quality-of-Care Indicators for Diabetes and Patient Outcomes : A Systematic Literature Review

    NARCIS (Netherlands)

    Sidorenkov, Grigory; Haaijer-Ruskamp, Flora M.; de Zeeuw, Dick; Bilo, Henk; Denig, Petra

    2011-01-01

    The authors conducted a systematic literature review to assess whether quality indicators for diabetes care are related to patient outcomes. Twenty-four studies were included that formally tested this relationship. Quality indicators focusing on structure or processes of care were included. Descript

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

    OpenAIRE

    Dargahi H; Rezaian M

    2007-01-01

    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 performanc...

  7. Quality Indicators for Safe Medication Preparation and Administration: A Systematic Review

    OpenAIRE

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

    2015-01-01

    Background 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. Objectives The aim of study was to identify evidence-based quality indicators (structure, process and outcome) for safe in-hospital medication preparation and administration. Methods MEDLI...

  8. Www.airqualitynow.eu, a common website and air quality indices to compare cities across europe

    OpenAIRE

    Leger, Karine; Van Den Elshout, Sef; Ung, Anthony; Malherbe, Laure; Meleux, Frédérik; Songeur, Charlotte; Honore, Cécile; Pernot, Delphine

    2010-01-01

    Air quality is a public concern. This is partly due to the "right to know" principle embodied in European legislation. Despite this common legislation, the way air quality is being interpreted and communicated differs considerably. For specialists raw monitoring data for Europe are available but these are not usable by the general public. Easy to understand and internationally comparable air quality information from one city to another is scarce: there are almost as many air quality indices a...

  9. Quality Assurance Policies and Indicators for Long-Term Care in the European Union

    OpenAIRE

    Fermon, Béatrice; Joël, Marie-Eve

    2012-01-01

    Quality assurance policies for long-term care in France are founded on a law passed in 2002, but the organisation of the system is still underway. It is principally based on a legal framework that sets out requirements for quality monitoring and quality improvement. Quality assessment is related to outcomes, indicators and guidelines. It pertains to formal care and is related to administrative authorisation and financial conditions. In the public sector, the aim is to develop continuous quali...

  10. Quality Assurance Policies and Indicators for Long-Term Care in the European Union.

    OpenAIRE

    Fermon, Béatrice; Joël, Marie-Eve

    2012-01-01

    Quality assurance policies for long-term care in France are founded on a law passed in 2002, but the organisation of the system is still underway. It is principally based on a legal framework that sets out requirements for quality monitoring and quality improvement. Quality assessment is related to outcomes, indicators and guidelines. It pertains to formal care and is related to administrative authorisation and financial conditions. In the public sector, the aim is to develop continuous quali...

  11. Professional practice assessment. Pertinence of positron emission tomography clinical indications in oncology; Evaluation des pratiques professionnelles. Pertinence des indications de la tomographie a emission de positons en cancerologie

    Energy Technology Data Exchange (ETDEWEB)

    Le Stanc, E.; Tainturier, C. [Hopital Foch, Service de Medecine Nucleaire, 92 - Suresnes (France); Swaenepoel, J. [Hopital Foch, Cellule Qualite, 92 - Suresnes (France)

    2009-09-15

    Introduction As part of the health care quality and safety policy in France, Professional Practice Assessment (P.P.A.) are mandatory in the health services 'certification' process. We present our study regarding the pertinence of Positron Emission Tomography (PET) indications in oncology. Materials and methods A multidisciplinary task group used the Quick Audit method with two rounds of 100 request forms each. The assessment list of criteria comprised four items of decreasing relevance grading the PET scans clinical indications, which were derived from the three French published guidelines (S.O.R. [F.N.C.L.C.C]., 'Guide du bon usage des examens d'imagerie medicale' [S.F.R.-S.F.M.N.], 'Guide pour la redaction de protocoles pour la TEP au F.D.G. en cancerologie' [S.F.M.N.]) and five additional items: clinical information, patient's body weight, previous treatments dates, diabetes, claustrophobia. Results The first round showed that 68% of the requested scans corresponded to the two most relevant groups of indications (S.O.R. Standards and Options). The request forms were correctly filled in regarding the clinical information, but this was not the case for the other items we tested. Several actions were conducted: dedicated PET request form, availability of the S.O.R. on the hospital intranet, boost of the referring physicians awareness during the multidisciplinary oncology meetings (Reunions de Concertation Pluridisciplinaires RCP). The second round showed a better pertinence of the PET scans indications (75% versus 68%); the patient's body weight was more frequently mentioned on the request form. Discussion This study is an example of P.P.A. in our discipline. It led to an improvement of the oncologic PET scans clinical indications in our hospital. This work is pursued in everyday discussion with the referring clinicians, especially during the RCP. (authors)

  12. [External quality assessment for clinical microbiology and good laboratory management].

    Science.gov (United States)

    Kumasaka, K

    1998-02-01

    The Tokyo Metropolitan external quality assessment (EQA) program has revealed some serious problems in private independent microbiology laboratories in Tokyo since 1982. The poor performance in the EQA surveys closely related to poor laboratory managements, the type of training, experience of the medical technologists or technicians, and supervisory ability of the consultant physicians in independent laboratories. Social factors impede the reform of the quality assurance of clinical microbiology. Such factors include poor infrastructure of continuing education for small private laboratories, closure of the central clinical laboratories in the hospitals and outsourcing of laboratory tests due to restructuring in response to economic problems, and limited numbers of certified clinical pathologists of the Japan Society of Clinical Pathology (JSCP). Therefore, the Tokyo Metropolitan EQA Scheme is still confidential and its main role is educational. Good two way communication between participants and the organizers' clinical pathologists is essential, if the quality of laboratory tests is to be improved. The new JSCP edition of the postgraduate training requirement in clinical pathology includes "Laboratory Administration and Management". Good laboratory management(GLM) is an increasingly important component of good laboratory practice. The practice activities of clinical pathologists must include general management in addition to exercising there specialized knowledge in medicine and technology. Whereas leadership of a good clinical pathologist provides the direction of where a good laboratory is going, good management provides the steps of how to get there. And I believe quality system models from business and industry may provide us with strong guidance to build a quality system for the good laboratory that will endure into the next century. PMID:9528335

  13. Quality indicators for pharmaceutical care: a comprehensive set with national scores for Dutch community pharmacies.

    Science.gov (United States)

    Teichert, Martina; Schoenmakers, Tim; Kylstra, Nico; Mosk, Berend; Bouvy, Marcel L; van de Vaart, Frans; De Smet, Peter A G M; Wensing, Michel

    2016-08-01

    Background The quality of pharmaceutical care in community pharmacies in the Netherlands has been assessed annually since 2008. The initial set has been further developed with pharmacists and patient organizations, the healthcare inspectorate, the government and health insurance companies. The set over 2012 was the first set of quality indicators for community pharmacies which was validated and supported by all major stakeholders. The aims of this study were to describe the validated set of quality indicators for community pharmacies and to report their scores over 2012. In subanalyses the score development over 5 years was described for those indicators, that have been surveyed before and remained unchanged. Methods Community pharmacists in the Netherlands were invited in 2013 to provide information for the set of 2012. Quality indicators were mapped by categories relevant for pharmaceutical care and defined for structures, processes and dispensing outcomes. Scores for categorically-measured quality indicators were presented as the percentage of pharmacies reporting the presence of a quality aspect. For numerical quality indicators, the mean of all reported scores was expressed. In subanalyses for those indicators that had been questioned previously, scores were collected from earlier measurements for pharmacies providing their scores in 2012. Multilevel analysis was used to assess the consistency of scores within one pharmacy over time by the intra-class correlation coefficient (ICC). Results For the set in 2012, 1739 Dutch community pharmacies (88 % of the total) provided information for 66 quality indicators in 10 categories. Indicator scores on the presence of quality structures showed relatively high quality levels. Scores for processes and dispensing outcomes were lower. Subanalyses showed that overall indicators scores improved within pharmacies, but this development differed between pharmacies. Conclusions A set of validated quality indicators provided

  14. Correlation of bone quality in radiographic images with clinical bone quality classification

    International Nuclear Information System (INIS)

    To investigate the validity of digital image processing on panoramic radiographs in estimating bone quality before endosseous dental implant installation by correlating bone quality in radiographic images with clinical bone quality classification. An experienced surgeon assessed and classified bone quality for implant sites with tactile sensation at the time of implant placement. Including fractal dimension eighteen morphologic features of trabecular pattern were examined in each anatomical sites on panoramic radiographs. Finally bone quality of 67 implant sites were evaluated in 42 patients. Pearson correlation analysis showed that three morphologic parameters had weak linear negative correlation with clinical bone quality classification showing correlation coefficients of -0.276, -0.280, and -0.289, respectively (p<0.05). And other three morphologic parameters had obvious linear negative correlation with clinical bone quality classification showing correlation coefficients of -0.346, -0.488, and -0.343 respectively (p<0.05). Fractal dimension also had a linear correlating with clinical bone quality classification with correlation coefficients -0.506 significantly (P<0.05). This study suggests that fractal and morphometric analysis using digital panoramic radiographs can be used to evaluate bone quality for implant recipient sites

  15. Processes for Quality Improvements in Radiation Oncology Clinical Trials

    International Nuclear Information System (INIS)

    Quality assurance in radiotherapy (RT) has been an integral aspect of cooperative group clinical trials since 1970. In early clinical trials, data acquisition was nonuniform and inconsistent and computational models for radiation dose calculation varied significantly. Process improvements developed for data acquisition, credentialing, and data management have provided the necessary infrastructure for uniform data. With continued improvement in the technology and delivery of RT, evaluation processes for target definition, RT planning, and execution undergo constant review. As we move to multimodality image-based definitions of target volumes for protocols, future clinical trials will require near real-time image analysis and feedback to field investigators. The ability of quality assurance centers to meet these real-time challenges with robust electronic interaction platforms for imaging acquisition, review, archiving, and quantitative review of volumetric RT plans will be the primary challenge for future successful clinical trials

  16. Processes for quality improvements in radiation oncology clinical trials.

    Science.gov (United States)

    FitzGerald, T J; Urie, Marcia; Ulin, Kenneth; Laurie, Fran; Yorty, Jeffrey; Hanusik, Richard; Kessel, Sandy; Jodoin, Maryann Bishop; Osagie, Gani; Cicchetti, M Giulia; Pieters, Richard; McCarten, Kathleen; Rosen, Nancy

    2008-01-01

    Quality assurance in radiotherapy (RT) has been an integral aspect of cooperative group clinical trials since 1970. In early clinical trials, data acquisition was nonuniform and inconsistent and computational models for radiation dose calculation varied significantly. Process improvements developed for data acquisition, credentialing, and data management have provided the necessary infrastructure for uniform data. With continued improvement in the technology and delivery of RT, evaluation processes for target definition, RT planning, and execution undergo constant review. As we move to multimodality image-based definitions of target volumes for protocols, future clinical trials will require near real-time image analysis and feedback to field investigators. The ability of quality assurance centers to meet these real-time challenges with robust electronic interaction platforms for imaging acquisition, review, archiving, and quantitative review of volumetric RT plans will be the primary challenge for future successful clinical trials. PMID:18406943

  17. Quality assurance for clinical high intensity focused ultrasound fields.

    Science.gov (United States)

    Civale, John; Rivens, Ian; ter Haar, Gail

    2015-03-01

    As the use of HIFU in the clinic becomes more widespread there is an ever increasing need to standardise quality assurance protocols, an important step in facilitating the wider acceptance of HIFU as a therapeutic modality. This article reviews pertinent aspects of HIFU treatment delivery, encompassing the closely related aspects of quality assurance and calibration. Particular attention is given to the description and characterisation of relevant acoustic field parameters and the measurement of acoustic power. Where appropriate, recommendations are made. PMID:25677839

  18. Quality assurance in clinical trials : a multi-disciplinary approach

    International Nuclear Information System (INIS)

    Full text: Multi-disciplinary groups, such as medical physicists and radiation therapists, which work effectively together, can ensure continued improvements in radiation therapy quality. The same is also true for clinical trials, which have the added complication of requiring multi-institutional participation to collate sufficient data to effectively assess treatment benefits. It can be difficult to manage quality across all aspects of a multi-disciplinary and multi-institutional trial. A planned system of quality assurance is necessary to provide support for participating centres and facilitate a collaborative approach. To ensure protocol compliance a good relationship between the clinical trial group and treatment centre is idea with definition of mutual goals and objectives before and during the trial, and ongoing consultation and feedback throughout the trial process. To ensure good quality data and maximise the validity of results the study protocol must be strictly adhered to. Because of the need for meticulous attention to detail, both in treatment delivery and standards of documentation, clinical trials are often seen to further complicate the process of delivery of radiation therapy treatment. The Declaration of Helsinki and Good Clinical Practise Guidelines (adopted in May 1996, ICH) provide 'international ethical and scientific standards for designing, conducting, recording and reporting clinical research' and multi-disciplinary groups in each participating centre should also adhere to these guidelines. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

  19. A pilot qualitative study to explore stakeholder opinions regarding prescribing quality indicators

    Directory of Open Access Journals (Sweden)

    Martirosyan Liana

    2012-07-01

    Full Text Available Abstract Background Information on prescribing quality of diabetes care is required by health care providers, insurance companies, policy makers, and the public. Knowledge regarding the opinions and preferences of all involved parties regarding prescribing quality information is important for effective use of prescribing quality indicators. Methods Between June and December 2009 we conducted semi structured interviews with 16 key-informants representing eight different organizations in the Netherlands involved in healthcare quality measurement and improvement. The interview guide included topics on participants’ opinions and preferences regarding existing types of prescribing quality indicators in relation to their aim of using quality information. Content analysis methods were used to process the resulting transcripts following the framework of predetermined themes. Results Findings from this qualitative study of stakeholder preferences showed that indicators focusing on undertreatment are found important by all participants. Furthermore, health care providers and policy makers valued prescribing safety indicators, insurance companies prioritized indicators focusing on prescribing costs, and patients’ organization representatives valued indicators focusing on interpersonal side of prescribing. Representatives of all stakeholders preferred positive formulation of the indicators to motivate health care providers to participate in health improvement programs. A composite score was found to be most useful by all participants as a starting point of prescribing quality assessment. Lack of information on reasons for deviating from guidelines recommendations appeared to be the most important barrier for using prescribing quality indicators. According to the health care providers, there are many legitimate reasons for not prescribing the recommended treatment and these reasons are not always taken into account by external evaluators. The latter may

  20. Mammography calibration qualities establishment in a Mo- Mo clinical system

    Science.gov (United States)

    Corrêa, E. L.; dos Santos, L. R.; Vivolo, V.; Potiens, M. P. A.

    2016-07-01

    In this study the mammography calibration qualities were established in a clinical mammography system. The objective is to provide the IPEN instruments calibration laboratory with both mammography calibration methods (using a clinical and an industrial system). The results showed a good behavior of mammography equipment, in terms of kVp, PPV and exposure time. The additional filtration of molybdenum is adequate, air-kerma rates were determined and spectra were obtained.

  1. PROCESSES FOR QUALITY IMPROVEMENTS IN RADIATION ONCOLOGY CLINICAL TRIALS

    OpenAIRE

    FitzGerald, TJ; Urie, Marcia; Ulin, Kenneth; Laurie, Fran; Yorty, Jeffrey; Hanusik, Richard; Kessel, Sandy; Jodoin, Maryann Bishop; Osagie, Gani; Giulia Cicchetti, M.; Pieters, Richard; McCarten, Kathleen; Rosen, Nancy

    2008-01-01

    Quality assurance in radiation therapy has been an integral aspect of cooperative group clinical trials since 1970. In early clinical trials data acquisition was non-uniform and inconsistent; computational models for radiation dose calculation varied significantly. Process improvements developed for data acquisition, credentialing, and data management have provided the necessary infrastructure for uniform data. With continued improvement in the technology and delivery of radiation therapy, ev...

  2. 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.

  3. 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 62 (61%) responded. Quality indicators focusing on the frequency of prescribing of narrow-spectrum penicillin were rated as suitable by more than 80% of the Danish GPs, while quality indicators concerning cephalosporins or quinolones were rated suitable by less than half of the GPs. The antibiotic...... treatment of RTIs, only a few of them were rated suitable by the GPs, who are supposed to use them....

  4. Quality of care of nurse-led and allied health personnel-led primary care clinics

    OpenAIRE

    Chin, WY; Lam, CLK; Lo, SV

    2011-01-01

    Objectives To review the literature regarding quality of care of nurse-led and allied health personnel-led primary care clinics with specific attention to the quality indicators for fall prevention, continence care, pulmonary rehabilitation, mental health, pharmaceutical care, and wound care services. Data sources Literature search from 1990 to 2010 including Ovid Medline, Cochrane Database, RAND (Research and Development) Corporation Health Database, the ACOVE (Assessing the Care of Vulnerab...

  5. Clinical image quality evaluation for panoramic radiography in Korean dental clinics

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Bo Ram; Choi, Da Hye; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Choi, Soon Chul; Bae, Kwang Hak; Lee, Sam Sun [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2012-09-15

    The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

  6. 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. PMID:19708970

  7. Features Performance Indicators and Quality Engineering and Maintenance and Cold Storage Complex

    Directory of Open Access Journals (Sweden)

    Dyakova Yu. A.

    2013-01-01

    Full Text Available The article discusses the features of efficiency and quality indicators of engineering and technical maintenance of storage and refrigeration facilities. The concept of engineering and maintenance of such systems is explained; it includes design, installation and commissioning of refrigeration, ventilation and air-conditioning, as well as warranty, post-warranty, preventative and advisory services. General definition of the quality index applied to the quality of the service process and definition of the complex index of the quality of services are clarified. Individual indicators of quality engineering and technical services are described. The article defines the dependence of integral complex index of quality, efficiency, maintenance costs on specific parties to a contract for the provision of engineering and technical services. The concept of weighting factors of such costs are introduced.

  8. 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…

  9. 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...... indicators were considered. The experts were asked to rate the relevance of 59 quality indicators with regard to reducing antimicrobial resistance and improving patient health. Consensus for a quality indicator was reached if ≥ 75 % of experts scored the item ≥ 5 on a 7-point Likert scale, ranging from 1...... (completely disagree) through 4 (=uncertain) to 7 (completely agree). Results: A 96% response rate was achieved in both Delphi rounds. A total of 41 of the proposed 59 indicators attained consensus. None of the indicators focusing on the diagnostic process achieved consensus. Consensus was attained for 14...

  10. 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.

  11. 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…

  12. 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. ...

  13. Infra red express method of definition of the main biochemical indices of winter wheat seed quality

    International Nuclear Information System (INIS)

    Callibrie equations are received to analyse quality indices of winter wheat seed that is the main task in the case of development of the programmes of infrared method analysis. Comparison of the results both chemical and infra red analysis of quality of winter wheat seed shows their high simularity

  14. Assessment of Ganga river ecosystem at Haridwar, Uttarakhand, India with reference to water quality indices

    Science.gov (United States)

    Bhutiani, R.; Khanna, D. R.; Kulkarni, Dipali Bhaskar; Ruhela, Mukesh

    2016-06-01

    The river Ganges is regarded as one of the most holy and sacred rivers of the world from time immemorial. The evaluation of river water quality is a critical element in the assessment of water resources. The quality/potability of water that is consumed defines the base line of protection against many diseases and infections. The present study aimed to calculate Water Quality Index (WQI) by the analysis of sixteen physico-chemical parameters on the basis of River Ganga index of Ved Prakash, weighted arithmetic index and WQI by National sanitation foundation (NSF) to assess the suitability of water for drinking, irrigation purposes and other human uses. These three water quality indices have been used to assess variation in the quality of the River Ganga at monitored locations over an 11-year period. Application of three different indexes to assess the water quality over a period of 11 years shows minor variations in water quality. Index values as per River Ganga Index by Ved Prakash et al. from 2000 to 2010 ranged between medium to good, Index values as per NSF Index for years 2000-2010 indicate good water quality, while Index values as per the weighted arithmetic index method for the study period indicate poor water quality.

  15. Development of an Index for Evaluating National Quality Competitiveness based on WEF and IMD Compiled Indices

    OpenAIRE

    Insu Cho; Kiwon Lee; Heejun Park; Myungho Park; Joseph Kichul Kim

    2014-01-01

    This study was conducted to develop a national quality competitiveness index (NQCI), necessary to establish national policy standards for quality improvements. For the NQCI, the World Economic Forum (WEF) and the International Institute for Management Development (IMD), internationally recognized indices for national competitiveness, were used. Based on the WEF and IMD, a NQCI composed of four perspectives (capabilities) and 34 indicators was devised. Through the results of implementing the N...

  16. Criteria of objectification diagnostics and indicators of quality of vestibular schwannoma surgical treatment

    OpenAIRE

    Pedachenko, Eugene; Skobska, Oksana; Malysheva, Aleksandra

    2016-01-01

    The article is sanctified to the problem of standardization and objectification diagnosis and the development of indicators of the quality of surgical treatment of patients with vestibular schwannomas (VS).Purpose. Objectification and standardization of diagnostic criteria and indicators of the quality of surgical treatment of patients with VS accordance to international standards.Materials and methods. Locations retro prospective analysis of complex examination results and treatment of 227 p...

  17. A bio-indicator for the evaluation of quality forestry and landscape fragmentation

    OpenAIRE

    Kappers EF; Fanfani A.; Salvati L

    2013-01-01

    A bio-indicator for the evaluation of quality forestry and landscape fragmentation. Intensive agricultural practices, as well as tourism development, summer fires, urbanization and air pollution represent a serious threat for many woodlands in Mediterranean Europe. Tawny owls, Strix aluco, is a valuable indicator of habitat quality and shows high sensitivity to wood fragmentation. Assessing the association between Tawny owls and their habitat may provide useful tools for conservation and mana...

  18. Ultrasound Image Quality Assessment: A framework for evaluation of clinical image quality

    DEFF Research Database (Denmark)

    Hemmsen, Martin Christian; Pedersen, Mads Møller; Nikolov, Svetoslav Ivanov;

    2010-01-01

    Improvement of ultrasound images should be guided by their diagnostic value. Evaluation of clinical image quality is generally performed subjectively, because objective criteria have not yet been fully developed and accepted for the evaluation of clinical image quality. Based on recommendation 500...... from the International Telecommunication Union - Radiocommunication (ITU-R) for such subjective quality assessment, this work presents equipment and a methodology for clinical image quality evaluation for guiding the development of new and improved imaging. The system is based on a BK-Medical 2202 Pro......Focus scanner equipped with a UA2227 research interface, connected to a PC through X64-CL Express camera link. Data acquisition features subject data recording, loading/saving of exact scanner settings (for later experiment reproducibility), free access to all system parameters for beamformation and is...

  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. PMID:27045960

  20. Patient Safety in Critical Care Unit: Development of a Nursing Quality Indicator System.

    Science.gov (United States)

    Lima, Camila S P; Barbosa, Sayonara F F

    2015-01-01

    This is a methodological study and technological production that aims to describe the development of a computerized system of nursing care quality indicators for the Intensive Care Unit. The study population consisted of a systems analyst and fifteen critical care nurses. For the development of the system we adopted some of the best practices of the Unified Process methodology using the Unified Modeling Language and the programming language Java Enterprise Edition 7. The system consists of an access menu with the following functions: Home (presents general information), New Record (records the indicator), Record (record search), Census (add information and indicators of the patient), Report (generates report of the indicators) and Annex (accesses the Braden Scale). This information system allows for measurement of the quality of nursing care and to evaluate patient safety in intensive care unit by monitoring quality indicators in nursing. PMID:26262049

  1. 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.

  2. Postoperative radiotherapy in DBCG during 30 years. Techniques, indications and clinical radiobiological experience

    Energy Technology Data Exchange (ETDEWEB)

    Overgaard, Marie; Juul Christensen, Jens (Dept. of Oncology and Dept. of Medical Physics, Aarhus Univ. Hospital, Aarhus (Denmark))

    2008-05-15

    During the time period 1977-2007 postoperative radiotherapy in DBCG has varied considerably with regard to techniques and indications together with changes in the extent of surgery and adjuvant systemic therapy. The radiation treatment has been developed on the basis of clinical, radiophysical and radiobiological principles, encompassing also practical problems such as available equipment in the different centres and at times lack of sufficient machine capacity. The paper focus especially on the comprehensive work done prior to the DBCG 82 b and c studies, in order to optimize radiotherapy in all aspects prior to the evaluation of the efficacy of this treatment modality. The results from these trials did succeed in clear evidence that radiotherapy has an important role in the multidisciplinary treatment of early breast cancer. In parallel to these studies a new and challenging use of radiotherapy after breast conserving surgery was evaluated in the DBCG TM 82 protocol. The experience obtained with different techniques in this study formed the basis for the current principles of radiotherapy after lumpectomy. Reduction of radiation related morbidity has been a major issue for the DBCG radiotherapy group, and in this aspect several studies, including quality control visits, have been carried out to make the relevant modifications and to evaluate deviations from the guidelines between the centres. The background for the changes in radiotherapy is described for each of the programme periods as well as future perspectives which will include further refinements of the target and adjustments of dose and fractionation in selected patients

  3. Impact of quality management on clinical nuclear medicine practice

    International Nuclear Information System (INIS)

    systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Correct indications to imaging are furthermore mandatory when applying tests which imply radiation exposure. Radiation exposure of the general population for medical purposes has doubled in the last decade due to an intensive application of radiology and nuclear medicine studies. It is important to underline that an exposure to 10 mSievert corresponds to an increase of 15 year lethal cancer rate by 2-3 new cancers every 10 000 exposures. When the decision of prescribing a nuclear medicine test is taken, the second step is the selection of labs practicing severe quality control procedures on imaging. A practical advice for lab selection is to verify if the report contains the following items: Clinical reason for performing the test; Description of the adopted procedure; Detailed descriptions of findings; Clinical conclusions; Presence of an interpretable hard copy of results. All imaging tests are affected by artefacts causing false interpretations and determining a fall in specificity. Specifically, nuclear imaging is affected by artefacts which can deteriorate image quality and limit interpretation of SPECT and PET results. Each organ or apparatus present specific problems. Imaging of the heart is a difficult task with all different technologies due to the asymmetrical shape and the asymmetrical position inside the thorax. Moreover the contractile function determines a variation of shape, geometry, position and density during the cardiac cycle. Similar problems affect tests evaluating lung anatomy and function when the time needed to complete test acquisition is too long to allow the completion of acquisition during apnoea or the patient cannot hold breath. Conversely, imaging of brain needs an accurate patient positioning for symmetrical evaluation of both hemispheres, whose evaluation is usually due by comparison of symmetrical

  4. Quality indicators for permanent I-125 prostate seed implants : seven years post implant dosimetry evaluation

    International Nuclear Information System (INIS)

    Full text: The aim of the current work is to assess the progress of prostate implant quality via post implant dosimetry over a 7-year time period. The roles of post implant dosimetry (PID) after permanent 1-125 implant are to: identify suboptimal implants; assess the dosimetric quality indicators and evaluate dose to organs at risk. The 7-years PID learning-curve shows clear changes in dosimetric trend. Beside the expected improvement in technique the following factors were investigated: the replacement of the computed tomography (CT)-delineation based PID with ultrasound (US)-CT fusion based, and the evolution and influence of parameters such as 090 and V I 00. The correlation between dosimetric parameters and clinical outcome was also evaluated. Results A study on 30 patients showed manual target contouring on CT tends to overestimate the prostate volume when compared to ultrasound data (mean difference 38.3%), translating to CT based D90 values being lower than US-CT D90 by an average of 6%. There was 4.7% patient relapse and urinary retention was reported in 2.7% of the patients. CT-based PID was found less reliable than US-CT fusion due to target overestimation. This result shows the biased interpretation of low D90 based on CT targeting and may not relate to patient relapse data. The low urinary retention statistics are in accordance with the PID data for the organ, as only 5.2% of patients had their PID D I 0 >218 Gy, i.e. above recommended GEC-ESTRO guidelines. Besides the 'learning' component, the 7-years PID D90 curve is influenced by PID technique.

  5. PET imaging clinical trials: standards for good image quality

    International Nuclear Information System (INIS)

    Full text: Imaging holds a promising place in the drug development process and clinical trials. In recent times, scientists and researchers have realized that imaging enables them to look for new surrogate endpoints and accelerate the process of drug development. As the number of such trials is increasing every year, there is a growing awareness for the need of quality in imaging trials, so as to avoid imaging issues, reduce losses due to non-evaluable imaging and improve subject safety. This paper is an attempt to address the need of standards for good quality image in clinical trials which use imaging. The main focus of the paper is to describe the various acquisition options in PET-CT available for medical imaging, their applicability in drug development process and clinical trials, emphasize the need to identify possible sources that could possibly impact the quality of images, ways of standardizing the equipments and minimizing the variability of different scanners. Additionally this paper will look into the importance of an expert medical imaging group, imaging protocols, quality assurance programs, and image assessment post acquisition for technical compliance and image quality. A reference of standards as prescribed by various scientific bodies and organizations will also be reviewed. In this paper the focus will be mainly to discuss aspects of PET-CT imaging in clinical trials. PET-CT has the potential to be best for response monitoring to therapy and early detection of disease compared to all other imaging modalities such as CT, MRI, gamma camera, SPECT, ultrasonography etc. In research, PET imaging can help in understanding the pharmacokinetics of a molecule, i.e. kinetic modeling and provides various imaging options, qualitative and quantitative. PET-CT provides anatomical as well as functional information and has the potential to be highly reproducible. The paper emphasizes good imaging practices and its relevance, especially when we are not just

  6. [Construction and implementation of quality control index for clinical safety of Chinese medicine injection].

    Science.gov (United States)

    Jiang, Jun-jie; Xie, Yan-ming

    2015-12-01

    In order to ensure the authenticity and accuracy of traditional Chinese medicine injection safety monitoring data, Chinese medicine injection safety monitoring quality control indicators, including the monitoring center, monitoring personnel, hardware conditions, monitoring progress and the number of patients into the group, original documents and archives management, electronic data, adverse events, quality management were constructed. Its application in the creation of major new drugs technology major projects, 10 kinds of traditional Chinese medicine injections clinical safety monitoring quality control work, found the missing case surveillance, not reported adverse events, only reported adverse reactions, electronic data reporting lag, lack of level of efforts to control the problem, and corrected, the traditional Chinese medicine injection safety monitoring of quality control and quality assurance, and subsequent Chinese medicine safety monitoring quality control to provide the reference. PMID:27245020

  7. 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.

  8. Evaluation Quality Indicators of Academic Interdisciplinary Sciences: A Tool for Planning

    OpenAIRE

    M. Mehrmohammadi; A. H. Kayzouri

    2010-01-01

    Academic interdisciplinary sciences require their own standards of excellence. The purpose of this study is to design and develop evaluation quality indicators of academic interdisciplinary sciences by applying descriptive and analytical methods. In this regard, firstly, conceptual aspects and the basic components and principles of Academic Interdisciplinary Sciences are identified. Accordingly, appropriate factors, criteria and indicators are developed. The statistical population of the rese...

  9. Studies on Tomato Seedling Quality Indices Under Simulated Shipping and Storage Conditions

    Institute of Scientific and Technical Information of China (English)

    NING Wei; GE Xiao-guang; LI Tian-lai

    2004-01-01

    Indices of the tomato seedling quality maintenance level after production before field planting were studied through simulated experiments, small--scale operation, indoor analyses and measurements, and field observation. The results showed that under simulated shipping and storage conditions, seedling quality change following different durations (days) of shipping and storage was correlated significantly or even very significantly with certain physiological and morphological indices. With various measured indices following different periods of shipping and storage treatment subjected to multinomial successive regressive correlation analysis, the principal factors influencing seedling quality maintenance level are identified to be chlorophyll content→dry short weight→ leaf freshness index in order of their importance. Significance analysis with multinomial fitted equation indicated that correlations between any one of above three factors and the growth index after field planting reached very significant difference level.

  10. Strategies for clinical implementation and quality management of PET tracers

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) methodologies, which visualize in vivo biochemical, physiological and pharmacological processes, together with the availability of hybrid imaging modalities (PET with computer tomography (PET/CT) imaging), have revolutionized patient diagnosis, disease staging, disease management and therapy follow-up. These technologies have opened up fascinating possibilities for new non-invasive medical care and individualized patient management unlike those seen before in a clinical setting. There is immense global interest in PET, with accelerated investment in the clinical setting. The radiotracers used for PET are very different from conventional nuclear medicine radiopharmaceuticals. They have extremely short half-lives, which means that they have to be produced close to the clinical user. The time available for the labelling of PET molecules (including purification and quality control) is very limited, which presents new challenges and a need for more proficient systems to be established before clinical use. The busy and demanding nature of clinical settings adds to the complexities and creates a need for more robust quality management programmes. This publication focuses on clinical settings and was compiled following several IAEA Consultants Meetings and with the benefit of the contributions of individual experts. It aims to raise awareness of the issues involved and suggests ways of reducing risk. The purpose of these guidelines is to encourage a proactive approach to each aspect of parametric release and to propose practical test methods for each criterion for parametric acceptance, thereby helping end users to ensure the quality of PET products. It is hoped that these criteria will stimulate further cooperation among various countries worldwide in the development of a set of harmonized acceptance test criteria for PET systems and sensible quality assurance (QA) standards for all PET tracers. Many countries and IAEA Member States are

  11. Recommended concentration limits of indoor air pollution indicators for requirement of acceptable indoor air quality

    OpenAIRE

    Wang J., Zhang X.

    2010-01-01

    Object and goals of indoor air pollution control with ventilation may influence improvement of indoor air quality, building energy consumption and even carbon emissions. Indicators of indoor air pollution caused by occupants-related sources and building-related sources were chosen based on sources emitting characteristics, pollutants composition, indicator choosing principles and indoor air pollution situation in China. Then the recommended concentration limits of indicators were given for un...

  12. Escherichia coli as an indicator of bacteriological quality of water: an overview

    OpenAIRE

    Stephen T. Odonkor; Joseph K. Ampofo

    2013-01-01

    Monitoring the microbiological quality of drinking water relies largely on examination of indicator bacteria such as coliforms, Escherichia coli, and Pseudomonas aeruginosa. E. coli is a member of the faecal coliform group and is a more specific indicator of faecal pollution than other faecal coliforms. Two key factors have led to the trend toward the use of E. coli as the preferred indicator for the detection of faecal contamination, not only in drinking water, but also in other matrices as ...

  13. Receiver Operating Characteristic Curve Analysis of Beach Water Quality Indicator Variables

    OpenAIRE

    Morrison, Ann Michelle; Coughlin, Kelly; Shine, James P.; Coull, Brent A.; Rex, Andrea C.

    2003-01-01

    Receiver operating characteristic (ROC) curve analysis is a simple and effective means to compare the accuracies of indicator variables of bacterial beach water quality. The indicator variables examined in this study were previous day's Enterococcus density and antecedent rainfall at 24, 48, and 96 h. Daily Enterococcus densities and 15-min rainfall values were collected during a 5-year (1996 to 2000) study of four Boston Harbor beaches. The indicator variables were assessed for their ability...

  14. 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. PMID:27118461

  15. 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." PMID:23035127

  16. Quality Indicator Development for Positive Screen Follow-up for Sickle Cell Disease and Trait.

    Science.gov (United States)

    Faro, Elissa Z; Wang, C Jason; Oyeku, Suzette O

    2016-07-01

    Extensive variation exists in the follow-up of positive screens for sickle cell disease. Limited quality indicators exist to measure if the public health goals of screening-early initiation of treatment and enrollment to care-are being achieved. This manuscript focuses on the development of quality indicators related to the follow-up care for individuals identified with sickle cell disease and trait through screening processes. The authors used a modified Delphi method to develop the indicators. The process included a comprehensive literature review with rating of the evidence followed by ratings of draft indicators by an expert panel held in September 2012. The expert panel was nominated by leaders of various professional societies, the Health Resources and Services Administration, and the National Heart, Lung, and Blood Institute and met face to face to discuss and rate each indicator. The panel recommended nine quality indicators focused on key aspects of follow-up care for individuals with positive screens for sickle cell disease and trait. Public health programs and healthcare institutions can use these indicators to assess the quality of follow-up care and provide a basis for improvement efforts to ensure appropriate family education, early initiation of treatment, and appropriate referral to care for individuals identified with sickle cell disease and trait. PMID:27320465

  17. Application of soil quality indices to assess the status of agricultural soils irrigated with treated wastewaters

    Directory of Open Access Journals (Sweden)

    A. Morugán-Coronado

    2013-03-01

    Full Text Available The supply of water is limited in some parts of the Mediterranean region, such as southeastern Spain. The use of treated wastewater for the irrigation of agricultural soils is an alternative to using better-quality water, especially in semi-arid regions. On the other hand, this practice can modify some soil properties, change their relationships and influence soil quality. In this work two soil quality indices were used to evaluate the effects of irrigation with treated wastewater in soils. The indices were developed studying different soil properties in undisturbed soils in SE Spain, and the relationships between soil parameters were established using multiple linear regressions. These indices represent the balance reached among properties in "steady state" soils. This study was carried out in four study sites from SE Spain irrigated with wastewater, including four study sites. The results showed slight changes in some soil properties as a consequence of irrigation with wastewater, the obtained levels not being dangerous for agricultural soils, and in some cases they could be considered as positive from an agronomical point of view. In one of the study sites, and as a consequence of the low quality wastewater used, a relevant increase in soil organic matter content was observed, as well as modifications in most of the soil properties. The application of soil quality indices indicated that all the soils of study sites are in a state of disequilibrium regarding the relationships between properties independent of the type of water used. However, there were no relevant differences in the soil quality indices between soils irrigated with wastewater with respect to their control sites for all except one of the sites, which corresponds to the site where low quality wastewater was used.

  18. Beyond clinical engagement:a pragmatic model for quality improvement interventions, aligning clinical and managerial priorities

    OpenAIRE

    Pannick, Samuel; Sevdalis, Nick; Athanasiou, Thanos

    2015-01-01

    Despite taking advantage of established learning from other industries, quality improvement initiatives in healthcare may struggle to outperform secular trends. The reasons for this are rarely explored in detail, and are often attributed merely to difficulties in engaging clinicians in quality improvement work. In a narrative review of the literature, we argue that this focus on clinicians, at the relative expense of managerial staff, has proven counterproductive. Clinical engagement is not a...

  19. Clinical microsystems: a critical framework for crossing the quality chasm.

    Science.gov (United States)

    Likosky, Donald S

    2014-03-01

    Patients, payers, and the public have increased expectations concerning the quality, safety and costs of our health care delivery systems. Whether or not to redesign our complex delivery systems is no longer in question. In order to succeed in optimizing care and outcomes (clinical and financial) for our stakeholders, we must design and evaluate tests of change. This journey will require a fundamental shift in our traditional thinking about healthcare delivery systems, including how: (1) each of us relates (effectively or not) to one another, and (2) the value of our patient's care is impacted accordingly. With this challenge in mind, this article will provide insight to the reader concerning clinical microsystems, small groups of professionals who work together on a regular basis to provide care to discrete populations of patients. The reader will learn how to leverage these microsystems to meet our stakeholders' expectations, namely to optimize the quality, safety and costs of our health care delivery systems. PMID:24779117

  20. Measuring quality in maternal-newborn care: developing a clinical dashboard.

    Science.gov (United States)

    Sprague, Ann E; Dunn, Sandra I; Fell, Deshayne B; Harrold, Joann; Walker, Mark C; Kelly, Sherrie; Smith, Graeme N

    2013-01-01

    Pregnancy, birth, and the early newborn period are times of high use of health care services. As well as opportunities for providing quality care, there are potential missed opportunities for health promotion, safety issues, and increased costs for the individual and the system when quality is not well defined or measured. There has been a need to identify key performance indicators (KPIs) to measure quality care within the provincial maternal-newborn system. We also wanted to provide automated audit and feedback about these KPIs to support quality improvement initiatives in a large Canadian province with approximately 140 000 births per year. We therefore worked to develop a maternal-newborn dashboard to increase awareness about selected KPIs and to inform and support hospitals and care providers about areas for quality improvement. We mapped maternal-newborn data elements to a quality domain framework, sought feedback via survey for the relevance and feasibility of change, and examined current data and the literature to assist in setting provincial benchmarks. Six clinical performance indicators of maternal-newborn quality care were identified and evidence-informed benchmarks were set. A maternal-newborn dashboard with "drill down" capacity for detailed analysis to enhance audit and feedback is now available for implementation. While audit and feedback does not guarantee individuals or institutions will make practice changes and move towards quality improvement, it is an important first step. Practice change and quality improvement will not occur without an awareness of the issues. PMID:23343794

  1. Checking the Quality of Clinical Guidelines using Automated Reasoning Tools

    OpenAIRE

    Hommersom, A.J.; Lucas, P.J.F.; Bommel, P.

    2008-01-01

    Requirements about the quality of clinical guidelines can be represented by schemata borrowed from the theory of abductive diagnosis, using temporal logic to model the time-oriented aspects expressed in a guideline. Previously, we have shown that these requirements can be verified using interactive theorem proving techniques. In this paper, we investigate how this approach can be mapped to the facilities of a resolution-based theorem prover, Otter, and a complementary program that searches fo...

  2. Clinical Microsystems: A Critical Framework for Crossing the Quality Chasm

    OpenAIRE

    Likosky, Donald S.

    2014-01-01

    Patients, payers, and the public have increased expectations concerning the quality, safety and costs of our health care delivery systems. Whether or not to redesign our complex delivery systems is no longer in question. In order to succeed in optimizing care and outcomes (clinical and financial) for our stakeholders, we must design and evaluate tests of change. This journey will require a fundamental shift in our traditional thinking about healthcare delivery systems, including how: (1) each...

  3. Effect of staff attitudes on quality in clinical microbiology services.

    Science.gov (United States)

    Pitt, Sarah J; Sands, Richard L

    2002-01-01

    Technical quality of the work of clinical pathology laboratories is monitored regularly by both internal and external sources. Among the factors that might affect quality, laboratory staff attitudes are rarely considered. In this study, the psychological concepts of 'job satisfaction' and 'climate' are measured among microbiology biomedical scientists in the United Kingdom. A self-report questionnaire was developed and distributed (between November 1998 and February 1999) to biomedical scientists in 161 microbiology laboratories throughout the UK From 2415 questionnaires distributed, 931 replies were received--a response rate of 39%. A separate set of questions covering customer service and participation in internal and external quality assurance schemes was sent to laboratory managers. Biomedical scientists reported lower job satisfaction than did medical technologists in a previous study in the USA. Perception of climate was influenced by several demographic factors, the most important of which being the size of the laboratory. Optimal number of staff in a department was found to be less than 30. Aggregation of climate scores from members of the same department showed that a positive laboratory climate was important for good performance in internal and external measures of technical quality. For the best service, laboratory climate must be supported by a staff perception that the department is committed to enhancing quality--a climate for laboratory quality. PMID:12113406

  4. Evaluation of soil quality indicators in paddy soils under different crop rotation systems

    Science.gov (United States)

    Nadimi-Goki, Mandana; Bini, Claudio; Haefele, Stephan; Abooei, Monireh

    2013-04-01

    Evaluation of soil quality indicators in paddy soils under different crop rotation systems Soil quality, by definition, reflects the capacity to sustain plant and animal productivity, maintain or enhance water and air quality, and promote plant and animal health. Soil quality assessment is an essential issue in soil management for agriculture and natural resource protection. This study was conducted to detect the effects of four crop rotation systems (rice-rice-rice, soya-rice-rice, fallow-rice and pea-soya-rice) on soil quality indicators (soil moisture, porosity, bulk density, water-filled pore space, pH, extractable P, CEC, OC, OM, microbial respiration, active carbon) in paddy soils of Verona area, Northern Italy. Four adjacent plots which managed almost similarly, over five years were selected. Surface soil samples were collected from each four rotation systems in four times, during growing season. Each soil sample was a composite of sub-samples taken from 3 points within 350 m2 of agricultural land. A total of 48 samples were air-dried and passed through 2mm sieve, for some chemical, biological, and physical measurements. Statistical analysis was done using SPSS. Statistical results revealed that frequency distribution of most data was normal. The lowest CV% was related to pH. Analysis of variance (ANOVA) and comparison test showed that there are significant differences in soil quality indicators among crop rotation systems and sampling times. Results of multivariable regression analysis revealed that soil respiration had positively correlation coefficient with soil organic matter, soil moisture and cation exchange capacity. Overall results indicated that the rice rotation with legumes such as bean and soybean improved soil quality over a long time in comparison to rice-fallow rotation, and this is reflected in rice yield. Keywords: Soil quality, Crop Rotation System, Paddy Soils, Italy

  5. Quality of life among university students in Cagliari. A synthetic indicator

    OpenAIRE

    Sulis , Isabella; Tedesco, Nicola

    2007-01-01

    This article reports findings from a survey addressed to measure university students’ quality of life in Cagliari. The aim to build up a synthetic indicator of students’ ‘quality of life at the university’ has been pursued by adopting an ad hoc modeling approach to scale ordered items (Item Response Models) which belongs to the family of the Generalized Linear and non Linear Mixed Models . The sensibility of the results has been deeply analyzed by setting up several models w...

  6. Constructing the composite indicator "Quality of work" from the third European survey on working conditions

    OpenAIRE

    Tangian, Andranik S.

    2004-01-01

    "The composite indicator 'Quality of work' for comparing European countries is constructed from data of the Third European Survey on Working Conditions. The main findings are as follows: (a) European countries differ with respect to working conditions statistically more significantly than with respect to earnings; it implies a quite accurate discrimination threshold in ranking countries with respect to quality of work, (b) working conditions and earnings positively depend over the whole of Eu...

  7. Constructing the composite indicator "Quality of work" from the third European survey on working conditions

    OpenAIRE

    Tangian, Andranik S.

    2004-01-01

    The composite indicator "Quality of work" for comparing European countries is con- structed from data of the Third European Survey on Working Conditions. The main findings are as follows: (a) European countries differ with respect to working conditions statistically more significantly than with respect to earnings; it implies a quite accurate discrimination threshold in ranking countries with respect to quality of work, (b) working conditions and earnings positively depend over the whole of E...

  8. Quality indicators for pharmaceutical care: a comprehensive set with national scores for Dutch community pharmacies

    OpenAIRE

    Teichert, Martina; Schoenmakers, Tim; Kylstra, Nico; Mosk, Berend; Bouvy, Marcel L; van de Vaart, Frans; De Smet, Peter A G M; Wensing, Michel

    2016-01-01

    Background The quality of pharmaceutical care in community pharmacies in the Netherlands has been assessed annually since 2008. The initial set has been further developed with pharmacists and patient organizations, the healthcare inspectorate, the government and health insurance companies. The set over 2012 was the first set of quality indicators for community pharmacies which was validated and supported by all major stakeholders. The aims of this study were to describe the validated set of q...

  9. Soil quality indices for evaluating smallholder agricultural land uses in northern Ethiopia

    OpenAIRE

    Aweke M. Gelaw; Singh, B R; Lal, R.

    2015-01-01

    Population growth and increasing resource demands in Ethiopia are stressing and degrading agricultural landscapes. Most Ethiopian soils are already exhausted by several decades of over exploitation and mismanagement. Since many agricultural sustainability issues are related to soil quality, its assessment is very important. We determined integrated soil quality indices (SQI) within the surface 0–15 cm depth increment for three agricultural land uses: rain fed cultivation (RF); agroforestry (...

  10. Sustainable land use and soil quality: organic matter as an indicator

    OpenAIRE

    2003-01-01

    In this review the most recent approach to sustainable land use and the role that soil quality plays therein are described briefly. The requirements to which indicators must conform for the meaningful evaluation of the quality of soil and sustainability of land use are also elucidated. Thereafter the processes of physical, chemical and biological soil degradation are given. A concise discussion follows on the extent of physical and chemical soil degradation in South Africa, of which there is ...

  11. Latgale Seniors' Satisfaction with Life as One of the Indicators of Quality of Life

    OpenAIRE

    Ušča, Svetlana; Ļubkina, Velta; Kaupužs, Aivars

    2015-01-01

    Aging rates and pace of Latvia population are higher and more rapid, the number of people over the working age increases. In this context, such questions as how to prolong their economic and socially active life period appear. One of the solutions would be to create opportunities to increase seniors' satisfaction with life by improving the quality of life according to their needs. Objective of the paper is to study indicators of seniors' quality of life and analyze Latgale seniors' satisfacti...

  12. Temporal dependency of yield and quality estimation through spectral vegetation indices in pear orchards

    OpenAIRE

    Jonathan Van Beek; Laurent Tits; Ben Somers; Tom Deckers; Wim Verjans; Dany Bylemans; Pieter Janssens; Pol Coppin

    2015-01-01

    Yield and quality estimations provide vital information to fruit growers, yet require accurate monitoring throughout the growing season. To this end, the temporal dependency of fruit yield and quality estimations through spectral vegetation indices was investigated in irrigated and rainfed pear orchards. Both orchards were monitored throughout three consecutive growing seasons, including spectral measurements (i.e., hyperspectral canopy reflectance measurements) as well as yield determination...

  13. The use of oxygen indicators - elements of intelligent packaging for monitoring of food quality

    OpenAIRE

    Renata Dobrucka

    2014-01-01

    Background: Producers and researchers are looking at not only the methods of protection against ingress of oxygen into the package, but also want to provide consumers with guarantees of quality food they buy. Therefore, large-scale studies are conducted and implementation of intelligent packaging. The operation of these packages is the use of interactive, the most colorful indicators to assess the quality of the packaged product. Methods: This article describes intelligent packaging tech...

  14. Indicators of pedagogical quality for the design of a Massive Open Online Course for teacher training

    OpenAIRE

    Gómez Zermeño, Marcela Georgina; Sancho-Vinuesa, Teresa; Alemán de la Garza, Lorena Yadira

    2015-01-01

    Abstract Massive Open Online Courses (MOOCs) have generated high expectations and revolutionized some educational practices by providing open educational resources for reference, usage and adaptation; therefore, their pedagogical quality is often questioned. The objective of this study is to identify indicators related to pedagogical, functional, technological and time factors in order to assess the quality of the MOOC entitled “Liderazgo en gestión educativa estratégica a...

  15. The Relation between Diverse Phenotypes of PCOS with Clinical Manifestations, Anthropometric Indices and Metabolic Characteristics

    OpenAIRE

    Seyedeh Hajar Shahrami; Zahra Abbasi Ranjbar; Forozan Milani; Ehsan Kezem-Nejad; Afagh Hassanzadeh Rad; Seyedeh Fatemeh Dalil Heirat

    2016-01-01

    Critical issue regarding to variation of findings based on different phenotypes led investigators to define whether they are distinct features or overlapping ones. Therefore, we aimed to investigate the association between diverse phenotypes of PCOS (Poly Cystic Ovary Syndrome) with clinical manifestations, anthropometric indices, and metabolic characteristics. This was a descriptive cross-sectional study conducted in 15-39 years old women with PCOS referred to infertility clinics in the nort...

  16. Application of soil quality indices to assess the status of agricultural soils irrigated with treated wastewaters

    Directory of Open Access Journals (Sweden)

    A. Morugán-Coronado

    2012-12-01

    Full Text Available The supply of water is limited in some parts of the Mediterranean region, such as southeastern Spain. The use of treated wastewater for the irrigation of agricultural soils is an alternative to using better-quality water, especially in semi-arid regions. On the other hand, this practice can modify some soil properties, change their relationships, the equilibrium reached and influence soil quality. In this work two soil quality indices were used to evaluate the effects of irrigation with treated wastewater in soils. The indices were developed studying different soil properties in undisturbed soils in SE Spain, and the relationships between soil parameters were established using multiple linear regressions. This study was carried out in three areas of Alicante Province (SE Spain irrigated with wastewater, including four study sites. The results showed slight changes in some soil properties as a consequence of irrigation with wastewater, the obtained levels not being dangerous for agricultural soils, and in some cases they could be considered as positive from an agronomical point of view. In one of the study sites, and as a consequence of the low quality wastewater used, a relevant increase in soil organic matter content was observed, as well as modifications in most of the soil properties. The application of soil quality indices indicated that all the soils of study sites are in a state of disequilibrium regarding the relationships between properties independent of the type of water used. However, there were no relevant differences in the soil quality indices between soils irrigated with wastewater with respect to their control sites for all except one of the sites, which corresponds to the site where low quality wastewater was used.

  17. Checking the Quality of Clinical Guidelines using Automated Reasoning Tools

    CERN Document Server

    Hommersom, Arjen; van Bommel, Patrick

    2008-01-01

    Requirements about the quality of clinical guidelines can be represented by schemata borrowed from the theory of abductive diagnosis, using temporal logic to model the time-oriented aspects expressed in a guideline. Previously, we have shown that these requirements can be verified using interactive theorem proving techniques. In this paper, we investigate how this approach can be mapped to the facilities of a resolution-based theorem prover, Otter, and a complementary program that searches for finite models of first-order statements, Mace. It is shown that the reasoning required for checking the quality of a guideline can be mapped to such fully automated theorem-proving facilities. The medical quality of an actual guideline concerning diabetes mellitus 2 is investigated in this way.

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

    International Nuclear Information System (INIS)

    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)

  19. 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....

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

    Directory of Open Access Journals (Sweden)

    de Keizer Nicolette F

    2010-07-01

    Full Text Available 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 managers of intensive care units (ICUs is advocated. Methods All intensivists, ICU nurses, and managers (n = 142 working at 54 Dutch ICUs who participated in training sessions to support future implementation of quality indicators completed a questionnaire on perceived barriers and facilitators. Three types of barriers related to knowledge, attitude, and behaviour were assessed using a five-point Likert scale (1 = strongly disagree to 5 = strongly agree. Results Behaviour-related barriers such as time constraints were most prominent (Mean Score, MS = 3.21, followed by barriers related to knowledge and attitude (MS = 3.62; MS = 4.12, respectively. Type of profession, age, and type of hospital were related to knowledge and behaviour. The facilitating factor perceived as most important by intensivists was administrative support (MS = 4.3; p = 0.02; for nurses, it was education (MS = 4.0; p = 0.01, and for managers, it was receiving feedback (MS = 4.5; p = 0.001. Conclusions Our results demonstrate that healthcare professionals and managers are familiar with using quality indicators to improve care, and that they have positive attitudes towards the implementation of quality indicators. Despite these facts, it is necessary to lower the barriers related to behavioural factors. In addition, as the barriers and facilitating factors differ among professions, age groups, and settings, tailored strategies are needed to implement quality indicators in daily practice.

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

    International Nuclear Information System (INIS)

    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

  2. Evaluation Quality Indicators of Academic Interdisciplinary Sciences: A Tool for Planning

    Directory of Open Access Journals (Sweden)

    M. Mehrmohammadi

    2010-04-01

    Full Text Available Academic interdisciplinary sciences require their own standards of excellence. The purpose of this study is to design and develop evaluation quality indicators of academic interdisciplinary sciences by applying descriptive and analytical methods. In this regard, firstly, conceptual aspects and the basic components and principles of Academic Interdisciplinary Sciences are identified. Accordingly, appropriate factors, criteria and indicators are developed. The statistical population of the research consists of documents in accessible databases and the research sample is specified through purposeful sampling method. The results indicate that the evaluation of academic interdisciplinary sciences should include five conceptual dimensions: multi-faceted issues, interdisciplinary insights, adhering to integrative process, Interdisciplinary understanding and interdisciplinary structure. Meanwhile it should also pay attention to five main factors: objectives, curriculum, teaching- learning process, faculty and management. Accordingly, in order to evaluate the quality of Academic Interdisciplinary Sciences, 5 factors, 14 criteria and 59 indicators are identified and designed in this study.

  3. The use of oxygen indicators - elements of intelligent packaging for monitoring of food quality

    Directory of Open Access Journals (Sweden)

    Renata Dobrucka

    2014-06-01

    Full Text Available Background: Producers and researchers are looking at not only the methods of protection against ingress of oxygen into the package, but also want to provide consumers with guarantees of quality food they buy. Therefore, large-scale studies are conducted and implementation of intelligent packaging. The operation of these packages is the use of interactive, the most colorful indicators to assess the quality of the packaged product. Methods: This article describes intelligent packaging technologies and presents research for different types of oxygen indicators. Results and conclusion: Indicators for the detection of oxygen allows the consumer to provide some information on the suitability of the product for consumption. Apart from that, they are a simple tool that allows you to reduce the costs associated with loss replacement, repair damaged products or their disposal. Construction of indicator contained in the package is related to the specific product and factor to be controlled.

  4. 30-Day Survival Probabilities as a Quality Indicator for Norwegian Hospitals: Data Management and Analysis.

    Directory of Open Access Journals (Sweden)

    Sahar Hassani

    Full Text Available The Norwegian Knowledge Centre for the Health Services (NOKC reports 30-day survival as a quality indicator for Norwegian hospitals. The indicators have been published annually since 2011 on the website of the Norwegian Directorate of Health (www.helsenorge.no, as part of the Norwegian Quality Indicator System authorized by the Ministry of Health. Openness regarding calculation of quality indicators is important, as it provides the opportunity to critically review and discuss the method. The purpose of this article is to describe the data collection, data pre-processing, and data analyses, as carried out by NOKC, for the calculation of 30-day risk-adjusted survival probability as a quality indicator.Three diagnosis-specific 30-day survival indicators (first time acute myocardial infarction (AMI, stroke and hip fracture are estimated based on all-cause deaths, occurring in-hospital or out-of-hospital, within 30 days counting from the first day of hospitalization. Furthermore, a hospital-wide (i.e. overall 30-day survival indicator is calculated. Patient administrative data from all Norwegian hospitals and information from the Norwegian Population Register are retrieved annually, and linked to datasets for previous years. The outcome (alive/death within 30 days is attributed to every hospital by the fraction of time spent in each hospital. A logistic regression followed by a hierarchical Bayesian analysis is used for the estimation of risk-adjusted survival probabilities. A multiple testing procedure with a false discovery rate of 5% is used to identify hospitals, hospital trusts and regional health authorities with significantly higher/lower survival than the reference. In addition, estimated risk-adjusted survival probabilities are published per hospital, hospital trust and regional health authority. The variation in risk-adjusted survival probabilities across hospitals for AMI shows a decreasing trend over time: estimated survival probabilities

  5. Long-term effects of soil management practices on selected indicators of chemical soil quality

    Directory of Open Access Journals (Sweden)

    Alicja Pecio

    2016-06-01

    Full Text Available The study was conducted in scope of Catch-C project “Compatibility of agricultural management practices and types of farming in the EU to enhance climate change mitigation and soil health” (7FP, realized in 2012–2014 by the consortium of partners from 10 European countries (http://www.catch-c.eu. This work reports the effects of soil management practices – under different soil and climatic conditions – on the selected soil chemical quality indicators, based on the analysis of data extracted from literature on long term experiments (LTEs in Europe, as well as from LTEs held by the Catch-C consortium partners. The dataset related to soil chemical quality indicators consisted of 1044 records and referred to 59 long-term trials. The following indicators of chemical soil quality were analyzed: pH, N total content, N total stock, C:N ratio, N mineral content, P and K availability. They are the most frequently used indicators in the European literature on long-term experiments collected in the Catch-C project database. Soil organic carbon, however, the most important indicator was not presented here, due to it was covered by a separate study on indicators for climate change mitigation. The indicators were analyzed using their response ratio (RR to a management practice. For a given treatment (management practice, this ratio was calculated as the quotient between the indicator value obtained in the treatment, and the indicator value in the reference treatment. The examples were: rotation (with cereals, with legume crops, with tuber or root crops, with grassland vs. adequate monoculture, catch/cover crops vs. no catch/cover crops, no-tillage and no-inversion tillage vs. conventional tillage, mineral fertilization vs. no fertilization, organic fertilization (compost, farmyard manure, slurry vs. mineral fertilization at the same available nitrogen input, crop residue incorporation vs. removal. All tested practices influenced soil chemical quality

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

    OpenAIRE

    Milca PETROVICI; Maria - Mirela BOGDĂNESCU; Mălina PÎRVU

    2012-01-01

    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 the...

  7. Monitoring marine recreational water quality using multiple microbial indicators in an urban tropical environment

    OpenAIRE

    Shibata, Tomoyuki; Solo-Gabriele, Helena M.; Fleming, Lora E; Elmir, Samir

    2004-01-01

    The microbial water quality at two beaches, Hobie Beach and Crandon Beach, in Miami-Dade County, Florida, USA was measured using multiple microbial indicators for the purpose of evaluating correlations between microbes and for identifying possible sources of contamination. The indicator microbes chosen for this study (enterococci, Escherichia coli, fecal coliform, total coliform and C. perfringens) were evaluated through three different sampling efforts. These efforts included daily measureme...

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

    OpenAIRE

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

    2014-01-01

    BACKGROUND: 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. OBJECTIVE: To systematically review the literature and identify quality indicators specific to the assessment and managemen...

  9. PREDICTIVE POWER – THE BEST INDICATOR OF THE QUALITY OF THE DIAGNOSTIC ALGORITHM

    OpenAIRE

    Orlov A. I.

    2014-01-01

    Inexpediency of use of probability of correct diagnostics as a quality indicator of diagnostic algorithm is shown. The new indicator - the prognostic strength based on Mahalanobis distance between classes is offered and studied. We have found asymptotic distribution of the prognostic strength; the way of testing of adequacy of its application has been specified. In a problem of testing of two simple hypotheses the prognostic strength connection is established with Hellinger distance

  10. Quality indicators for colonoscopy procedures: a prospective multicentre method for endoscopy units.

    Directory of Open Access Journals (Sweden)

    Romain Coriat

    Full Text Available BACKGROUND AND AIMS: Healthcare professionals are required to conduct quality control of endoscopy procedures, and yet there is no standardised method for assessing quality. The topic of the present study was to validate the applicability of the procedure in daily practice, giving physicians the ability to define areas for continuous quality improvement. METHODS: In ten endoscopy units in France, 200 patients per centre undergoing colonoscopy were enrolled in the study. An evaluation was carried out based on a prospectively developed checklist of 10 quality-control indicators including five dependent upon and five independent of the colonoscopy procedure. RESULTS: Of the 2000 procedures, 30% were done at general hospitals, 20% at university hospitals, and 50% in private practices. The colonoscopies were carried out for a valid indication for 95.9% (range 92.5-100. Colon preparation was insufficient in 3.7% (range 1-10.5. Colonoscopies were successful in 95.3% (range 81-99. Adenoma detection rate was 0.31 (range 0.17-0.45 in successful colonoscopies. CONCLUSION: This tool for evaluating the quality of colonoscopy procedures in healthcare units is based on standard endoscopy and patient criteria. It is an easy and feasible procedure giving the ability to detect suboptimal practice and differences between endoscopy-units. It will enable individual units to assess the quality of their colonoscopy techniques.

  11. Quality Indicators for Colonoscopy Procedures: A Prospective Multicentre Method for Endoscopy Units

    Science.gov (United States)

    Coriat, Romain; Lecler, Augustin; Lamarque, Dominique; Deyra, Jacques; Roche, Hervé; Nizou, Catherine; Berretta, Olivier; Mesnard, Bruno; Bouygues, Martin; Soupison, Alain; Monnin, Jean-Luc; Podevin, Philippe; Cassaz, Carole; Sautereau, Denis; Prat, Frédéric; Chaussade, Stanislas

    2012-01-01

    Background and Aims Healthcare professionals are required to conduct quality control of endoscopy procedures, and yet there is no standardised method for assessing quality. The topic of the present study was to validate the applicability of the procedure in daily practice, giving physicians the ability to define areas for continuous quality improvement. Methods In ten endoscopy units in France, 200 patients per centre undergoing colonoscopy were enrolled in the study. An evaluation was carried out based on a prospectively developed checklist of 10 quality-control indicators including five dependent upon and five independent of the colonoscopy procedure. Results Of the 2000 procedures, 30% were done at general hospitals, 20% at university hospitals, and 50% in private practices. The colonoscopies were carried out for a valid indication for 95.9% (range 92.5–100). Colon preparation was insufficient in 3.7% (range 1–10.5). Colonoscopies were successful in 95.3% (range 81–99). Adenoma detection rate was 0.31 (range 0.17–0.45) in successful colonoscopies. Conclusion This tool for evaluating the quality of colonoscopy procedures in healthcare units is based on standard endoscopy and patient criteria. It is an easy and feasible procedure giving the ability to detect suboptimal practice and differences between endoscopy-units. It will enable individual units to assess the quality of their colonoscopy techniques. PMID:22509267

  12. 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; Aguilar-Quesada, Rocío

    2016-08-01

    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

  13. Beyond clinical engagement: a pragmatic model for quality improvement interventions, aligning clinical and managerial priorities.

    Science.gov (United States)

    Pannick, Samuel; Sevdalis, Nick; Athanasiou, Thanos

    2016-09-01

    Despite taking advantage of established learning from other industries, quality improvement initiatives in healthcare may struggle to outperform secular trends. The reasons for this are rarely explored in detail, and are often attributed merely to difficulties in engaging clinicians in quality improvement work. In a narrative review of the literature, we argue that this focus on clinicians, at the relative expense of managerial staff, has proven counterproductive. Clinical engagement is not a universal challenge; moreover, there is evidence that managers-particularly middle managers-also have a role to play in quality improvement. Yet managerial participation in quality improvement interventions is often assumed, rather than proven. We identify specific factors that influence the coordination of front-line staff and managers in quality improvement, and integrate these factors into a novel model: the model of alignment. We use this model to explore the implementation of an interdisciplinary intervention in a recent trial, describing different participation incentives and barriers for different staff groups. The extent to which clinical and managerial interests align may be an important determinant of the ultimate success of quality improvement interventions. PMID:26647411

  14. Virtual glaucoma clinics: patient acceptance and quality of patient education compared to standard clinics

    Directory of Open Access Journals (Sweden)

    Court JH

    2015-04-01

    Full Text Available Jennifer H Court,1 Michael W Austin1,21Department of Ophthalmology, Singleton Hospital, Swansea, Wales, UK; 2Department of Ophthalmology, Neath Port Talbot Hospital, Swansea, Wales, UKPurpose: Virtual glaucoma clinics allow rapid, reliable patient assessment but the service should be acceptable to patients and concordance with treatment needs to be maintained with adequate patient education. This study compares experiences and understanding of patients reviewed via the virtual clinic versus the standard clinic by way of an extended patient satisfaction questionnaire (PSQ.Patients and methods: One hundred PSQs were given to consecutive patients attending glaucoma clinics in October 2013. All 135 patients reviewed via the virtual clinic from April 2013 until August 2013 were sent postal PSQs in September 2013. Data were obtained for demographics, understanding of glaucoma, their condition, satisfaction with their experience, and quality of information. Responses were analyzed in conjunction with the clinical records.Results: Eighty-five percent of clinic patients and 63% of virtual clinic patients responded to the PSQ. The mean satisfaction score was over 4.3/5 in all areas surveyed. Virtual clinic patients’ understanding of their condition was very good, with 95% correctly identifying their diagnosis as glaucoma, 83% as ocular hypertension and 78% as suspects. There was no evidence to support inferior knowledge or self-perceived understanding compared to standard clinic patients. Follow-up patients knew more about glaucoma than new patients. Over 95% of patients found our information leaflet useful. Forty percent of patients sought additional information but less than 20% used the internet for this.Conclusion: A substantial proportion of glaucoma pathway patients may be seen by non-medical staff supervised by glaucoma specialists via virtual clinics. Patients are accepting of this format, reporting high levels of satisfaction and non

  15. Sustainable land use and soil quality: organic matter as an indicator

    Directory of Open Access Journals (Sweden)

    C. C. du Preez

    2003-09-01

    Full Text Available In this review the most recent approach to sustainable land use and the role that soil quality plays therein are described briefly. The requirements to which indicators must conform for the meaningful evaluation of the quality of soil and sustainability of land use are also elucidated. Thereafter the processes of physical, chemical and biological soil degradation are given. A concise discussion follows on the extent of physical and chemical soil degradation in South Africa, of which there is reliable information. Biological soil degradation is treated in more detail. Attention is given firstly to the role of soil organic matter in biogeochemical cycles. Thereafter the influence of different land use systems in the central parts of South Africa on the organic matter content and consequently the nitrogen, phosphorus and sulphur reserves of soils is discussed by using examples. The conclusion is that organic matter is an important indicator of soil quality and thus also of sustainable land use.

  16. Five patellar proximodistal positioning indices compared in clinically normal Greenland sled dogs

    DEFF Research Database (Denmark)

    Miles, James E; Dickow, Marlene; Nielsen, Dorte H;

    2012-01-01

    Patellar luxation in large-breed dogs is associated with abnormal proximodistal patellar positioning. Using a clinically normal population of Greenland sled dogs, measurement reliability and the effect of limb position were compared for five patellar proximodistal positioning indices based on the...

  17. Development and validation of quality indicators for dementia diagnosis and management in a primary care setting.

    NARCIS (Netherlands)

    Perry, M.; Draskovic, I.; Achterberg, T. van; Eijken, M.I.J. van; Lucassen, P.L.B.J.; Vernooij-Dassen, M.J.F.J.; Olde Rikkert, M.G.M.

    2010-01-01

    OBJECTIVES: To construct a set of quality indicators (QIs) for dementia diagnosis and management in a primary care setting. DESIGN: RAND modified Delphi method, including a postal survey, a stakeholders consensus meeting, a scientific expert consensus meeting, and a demonstration project. SETTING: P

  18. Evidence-Based Practice: Quality Indicator Analysis of Antecedent Exercise in Autism Spectrum Disorders

    Science.gov (United States)

    Kasner, Melanie; Reid, Greg; MacDonald, Cathy

    2012-01-01

    The purpose of the research was to conduct a quality indicator analysis of studies exploring the effects of antecedent exercise on self-stimulatory behaviors of individuals with autism spectrum disorders (ASD). Educational Resources Information Center (ERIC), Google Scholar, SPORTDiscus, PsychINFO, and PubMed/MedLine databases from 1980 to October…

  19. Are Mathematics and Science Test Scores Good Indicators of Labor-Force Quality?

    Science.gov (United States)

    Chen, Shiu-Sheng; Luoh, Ming-Ching

    2010-01-01

    Using data from the Programme for International Student Assessment (PISA) and the Trends in International Mathematics and Science Study (TIMSS), we investigate the link between test scores (mathematics and science) and cross-country income differences. We would like to know whether test scores are good indicators of labor-force quality. The…

  20. An Administrator and Teacher Perspective on Program Quality Indicators for Students with Severe Disabilities.

    Science.gov (United States)

    Echinger, Joanne; Downing, June

    1992-01-01

    Forty-eight teachers and 41 program administrators working with learners with severe disabilities completed the Program Quality Indicator checklist. Both groups consistently rated the majority of the 123 criteria as important or very important. The two dimensions considered most important were also ranked most important by six professional groups…

  1. Qualidade de vida e indicadores clínicos na insuficiência cardíaca: análise multivariada Calidad de vida e indicadores clínicos en la insuficiencia cardiaca: análisis multivariado Quality of life and clinical indicators in heart failure: a multivariate analysis

    Directory of Open Access Journals (Sweden)

    Jefferson Jovelino Amaral dos Santos

    2009-08-01

    brasileños, con la utilización del cuestionario de Minnesota (Minnesota Living with Heart Failure Questionnaire, incluyendo sus subescalas y su correlación con las variables clínicas y psicológicas, tales como edad, etnia, género, parámetros ecocardiográficos, índice de masa corporal, presión arterial promedio de reposo, tiempo de diagnóstico, Clasificación Funcional de acuerdo con la NYHA, capacidad funcional a través de una Escala de Actividad Específica, comorbilidades, Score de Riesgo de Framingham (ERF, prueba de función pulmonar (espirometría y composición corporal. RESULTADOS: La CDV presentó correlaciones univariadas significantes con el ecocardiograma: fracción de eyección (p=0,0415, diámetro diastólico del ventrículo izquierdo (DDVI (p=0,004, diámetro sistólico del ventrículo izquierdo (DSVI (p=0,0001; comorbilidades (p=0,002 y prueba de función pulmonar: Capacidad Vital Forzada (CVF (pBACKGROUND: In Heart Failure (HF, special attention must be given not only to objective or isolated aspects, but also to the patient's health self-perceptions. Subjective aspects can help healthcare providers understand and better treat HF. OBJECTIVE: The objective of this study was to evaluate the simultaneous effects of clinical indicators of HF on the Quality-of-Life (QOL. METHODS: We investigated, through a multivariate analysis, the QOL of 101 Brazilian HF outpatients using the Minnesota Living with Heart Failure Questionnaire (including subscales and its correlation to clinical and physiological variables such as age, ethnicity, gender, echocardiogram parameters, body mass index, mean blood pressure at rest, time since diagnosis, Functional Classification according to the NYHA, functional capacity by a Specific Activity Scale, comorbidities, Framingham Score of Cardiac Risk (CR, Lung Function Test (spirometry and Body Composition. RESULTS: QOL showed significant univariate correlations to the echocardiogram: ejection fraction (p=0.0415, left

  2. Student in information society: indicators of socio-moral development of individual in quality education evaluation

    Directory of Open Access Journals (Sweden)

    Naydenova Natalia N.

    2016-01-01

    Full Text Available Urgent questions for measuring a quality of education and its most important component, a personal development of students in the digital environment is raised in this article. The aims and outcomes of today’s school activities are to improve the quality of education, which is measured not only in knowledge and skills or competences, but also in acquiring by student’s ethical moral culture and moral values and norms of world civilization and our society. The most important indicator of the quality of education today are characteristics of personal development of pupils, their ethical, moral and ethical culture, ethical principles of behavior motivation. However, diagnosis in the field of pedagogical activity seems to researchers one of the most complex and elusive. Especially it concerns the evaluation criteria of pupils’ upbringing. The paper analyzes the techniques that are operated today in a pedagogical science and practice in the field of measurement of a direction of the quality of education.

  3. 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.

  4. 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.

  5. Integrated Indicators-based Gradation of Cultivated Land Quality in Mountainous Region of Southwestern China

    Institute of Scientific and Technical Information of China (English)

    SHAO Jing'an; WEI Chaofu; XIE Deti; ZHOU Yan

    2006-01-01

    The gradation of cultivated land is to assess the suitability of cultivated land for agricultural production in terms of natural and economic properties of land. It can be used to evaluate sustainability of land use and soil management practices. Formal and informal surveys, Delphi and comprehensive index method are adopted to identify appropriate integrated indicators, and measure the gradation of cultivated land quality. The determination of integrated indicators presents three basic features of cultivated land quality: stable plant productivity, social acceptability and maintenance of environmental quality.Pronounced concentration-dissipation law of total function score value occurs in paddy field units, with three ranges, I.e., 79-68.5, 68.5~59 and 59-51. Total function score value in dryland units mainly ranges from 40 to 70, but slight concentration-dissipation law of each unit is still observed, with four ranges, I.e., 79~68, 68~51, 51~37 and 37~15. Paddy field quality is divided into three gradations, and the scales are 18 220.9 ha, 5410.6 ha and 2890.9 ha. Dryland quality is classified into four gradations, and the scales are 1548.6 ha, 8153.8 ha, 3316.3 ha and 685.2 ha. The total function score value of every gradation unit is conformed to the results of farmers' assessment. Research results meet with the needs of accurate degree of the gradation of cultivated land quality. Integrated indicators-based gradation of cultivated land assessment accords with the characteristics of land resources and human preference in the mountains of southwestern China. This study will be useful to promote the monitoring of cultivated land quality, and to supply fine ground and knowledge for establishing appropriate cultivated land management practices in Southwestern China.

  6. 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

  7. Attachment Quality and Psychopathological Symptoms in Clinically Referred Adolescents: The Mediating Role of Early Maladaptive Schema

    OpenAIRE

    Roelofs, Jeffrey; Onckels, Linda; Muris, Peter

    2012-01-01

    This study investigated relationships between attachment insecurity, maladaptive cognitive schemas, and various types of psychopathological symptoms in a sample of clinically referred adolescents (N = 82). A mediation model was tested in which maladaptive schemas operated as mediators in the relations between indices of attachment quality and conduct, peer, and emotional problems. Results revealed partial support for the hypothesized mediation effect: the schema domain of disconnection/reject...

  8. Selecting process quality indicators for the integrated care of vulnerable older adults affected by cognitive impairment or dementia

    Directory of Open Access Journals (Sweden)

    Lebel Paule

    2007-11-01

    Full Text Available Abstract Background This study aimed at evaluating face and content validity, feasibility and reliability of process quality indicators developed previously in the United States or other countries. The indicators can be used to evaluate care and services for vulnerable older adults affected by cognitive impairment or dementia within an integrated service system in Quebec, Canada. Methods A total of 33 clinical experts from three major urban centres in Quebec formed a panel representing two medical specialties (family medicine, geriatrics and seven health or social services specialties (nursing, occupational therapy, psychology, neuropsychology, pharmacy, nutrition, social work, from primary or secondary levels of care, including long-term care. A modified version of the RAND®/University of California at Los Angeles (UCLA appropriateness method, a two-round Delphi panel, was used to assess face and content validity of process quality indicators. The appropriateness of indicators was evaluated according to a agreement of the panel with three criteria, defined as a median rating of 7–9 on a nine-point rating scale, and b agreement among panellists, judged by the statistical measure of the interpercentile range adjusted for symmetry. Feasibility of quality assessment and reliability of appropriate indicators were then evaluated within a pilot study on 29 patients affected by cognitive impairment or dementia. For measurable indicators the inter-observer reliability was calculated with the Kappa statistic. Results Initially, 82 indicators for care of vulnerable older adults with cognitive impairment or dementia were submitted to the panellists. Of those, 72 (88% were accepted after two rounds. Among 29 patients for whom medical files of the preceding two years were evaluated, 63 (88% of these indicators were considered applicable at least once, for at least one patient. Only 22 indicators were considered applicable at least once for ten or more out

  9. Microfinance investments in quality at private clinics in Uganda: a case-control study

    Directory of Open Access Journals (Sweden)

    Seiber Eric E

    2007-10-01

    Full Text Available Abstract Background Small private-sector health care providers can play an important role in meeting the developing country health care needs, but a lack of credit can prove major constraint to small-provider expansion. This study examines the potential of small, microfinance loans to strengthen the private health sector and improve access to quality preventive and curative health services in Uganda. Methods This study estimates logistic regressions using 2,387 client exit interviews to assess the impact of microfinance loans on perceived quality and the viability and sustainability of small, private clinics. Results The study finds perceived quality improved with loan recipients' clients being more likely to choose clinics on the basis of drug availability, fair charges, cleanliness, and confidentiality. In addition, the assessment found evidence of increased client flows, but the changes produced mixed results for sustainability with respondents being only half as likely to "always" visit a particular clinic. Conclusion The results indicate that the microfinance program improved perceived quality at loan recipient clinics, especially as reliable drug outlets.

  10. Quality-of-care standards for early arthritis clinics.

    Science.gov (United States)

    Ivorra, José Andrés Román; Martínez, Juan Antonio; Lázaro, Pablo; Navarro, Federico; Fernandez-Nebro, Antonio; de Miguel, Eugenio; Loza, Estibaliz; Carmona, Loreto

    2013-10-01

    The diagnosis and treatment of early arthritis is associated with improved patient outcomes. One way to achieve this is by organising early arthritis clinics (EACs). The objective of this project was to develop standards of quality for EACs. The standards were developed using the two-round Delphi method. The questionnaire, developed using the best-available scientific evidence, includes potentially relevant items describing the dimensions of quality of care in the EAC. The questionnaire was completed by 26 experts (physicians responsible for the EACs in Spain and chiefs of the rheumatology service in Spanish hospitals). Two hundred and forty-four items (standards) describing the quality of the EAC were developed, grouped by the following dimensions: (1) patient referral to the EAC; (2) standards of structure for an EAC; (3) standards of process; (4) relation between primary care physicians and the EAC; (5) diagnosis and assessment of early arthritis; (6) patient treatment and follow-up in the EAC; (7) research and training in an EAC; and (8) quality of care perceived by the patient. An operational definition of early arthritis was also developed based on eight criteria. The standards developed can be used to measure/establish the requirements, resources, and processes that EACs have or should have to carry out their treatment, research, and educational activities. These standards may be useful to health professionals, patient associations, and health authorities. PMID:23568381

  11. Clinical implementation and quality assurance for intensity modulated radiation therapy

    International Nuclear Information System (INIS)

    The paper describes the clinical implementation and quality assurance of intensity modulated radiation therapy (IMRT), based on experience at the Fox Chase Cancer Center, and reviews the procedures for the clinical implementation of the IMRT technique and the requirements for patient immobilization, target delineation, treatment optimization, beam delivery and system administration. The dosimetric requirements and measurement procedures for beam commissioning and dosimetry verification for IMRT are discussed and the details of model based dose calculation for IMRT treatment planning and the potential problems with such dose calculation algorithms are examined. The paper also discusses the effect of beam delivery systems on the actual dose distributions received by the patient and the methods to incorporate such effects in the treatment optimization process. Finally, the use of the Monte Carlo method for dose calculation and treatment verification for IMRT is investigated. (author)

  12. Clinical implementation and quality assurance for intensity modulated radiation therapy

    International Nuclear Information System (INIS)

    This paper describes the clinical implementation and quality assurance (QA) for intensity-modulated radiation therapy (IMRT) based on the experience at Fox Chase Cancer Center, Philadelphia, USA. We will review our procedures for the clinical implementation of the IMRT technique and the requirements for patient immobilization, target delineation, treatment optimization, beam delivery and system administration. We will discuss the dosimetric requirements and measurement procedures for beam commissioning and dosimetry verification for IMRT. We will examine the details of model-based dose calculation for IMRT treatment planning and the potential problems with such dose calculation algorithms. We will discuss the effect of beam delivery systems on the actual dose distributions received by the patients and the methods to incorporate such effects in the treatment optimization process. We will investigate the use of the Monte Carlo method for dose calculation and treatment verification for IMRT

  13. Identification of sensitive indicators to assess the interrelationship between soil quality, management practices and human health

    Science.gov (United States)

    Zornoza, R.; Acosta, J. A.; Bastida, F.; Domínguez, S. G.; Toledo, D. M.; Faz, A.

    2015-02-01

    Soil quality (SQ) assessment has long been a challenging issue, since soils present high variability in properties and functions. This paper aims to increase the understanding of SQ through the review of SQ assessments in different scenarios providing evidence about the interrelationship between SQ, land use and human health. There is a general consensus that there is a need to develop methods to assess and monitor SQ for assuring sustainable land use with no prejudicial effects on human health. This review points out the importance of adopting indicators of different nature (physical, chemical and biological) to achieve a holistic image of SQ. Most authors use single indicators to assess SQ and its relationship with land uses - soil organic carbon and pH being the most used indicators. The use of nitrogen and nutrient content has resulted sensitive for agricultural and forest systems, together with physical properties such as texture, bulk density, available water and aggregate stability. These physical indicators have also been widely used to assess SQ after land use changes. The use of biological indicators is less generalized, with microbial biomass and enzyme activities being the most selected indicators. Although most authors assess SQ using independent indicators, it is preferable to combine some of them into models to create a soil quality index (SQI), since it provides integrated information about soil processes and functioning. The majority of revised articles used the same methodology to establish an SQI, based on scoring and weighting of different soil indicators, selected by means of multivariate analyses. The use of multiple linear regressions has been successfully used for forest land use. Urban soil quality has been poorly assessed, with a lack of adoption of SQIs. In addition, SQ assessments where human health indicators or exposure pathways are incorporated are practically inexistent. Thus, further efforts should be carried out to establish new

  14. 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.

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

    International Nuclear Information System (INIS)

    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.

  16. Clinical and course indicators of bipolar disorder type I with and without opioid dependence

    Directory of Open Access Journals (Sweden)

    Amir Shabani

    2010-01-01

    Full Text Available Background: The existing evidence about the clinical situations of the bipolar patients with opioid dependence is scarce. The present study was carried out to compare the clinical features and course of the bipolar disorder type I re-garding the two subgroups of opioid dependent and non- dependent. Methods: There were 178 adult patients with bipolar disorder type I consecutively referred to the Iran Hospital of Psy-chiatry, Tehran, Iran, from January 2008 to January 2009 who enrolled in the study. The Persian Structured Clinical Interview for DSM- IV axis I disorders (SCID- I, HDRS- 17, and Y- MRS were administered for all patients. Other clini-cal information was gathered through the face- to- face interviews with the probands and the hospital records. The T test, Chi square test and logistic regression were used to analyze the data. Results: The mean age of probands were 33.6 ± 11.1 years old and they were mostly male. Among the evaluated indi-ces, the factors gender, anxiety disorders comorbidity, non- adherence, and positive family history were different sig-nificantly and independently from the other studied factors between opioid dependent and non- dependent bipolar pa-tients. Conclusions: Despite some differences, the opioid dependent and non- dependent bipolar patients did not have any significant difference regarding most of the examined clinical and course indices.

  17. Bridging the gap between patient needs and quality indicators: a qualitative study with chronic heart failure patients

    Science.gov (United States)

    Baudendistel, Ines; Noest, Stefan; Peters-Klimm, Frank; Herzberg, Heidrun; Scherer, Martin; Blozik, Eva; Joos, Stefanie

    2015-01-01

    Background The German National Disease Management Guideline (NDMG) on chronic heart failure (CHF) derived nine clinical quality indicators (QIs) to enable assessment of quality of health care in patients with CHF. These QIs epitomize an evidence-based and somatic point of view of guided treatment, but little is known about the experiences and views of patients with their guideline-based treatment across multiple health care sectors. Objective The purpose of this qualitative study was to explore patient perspectives on guided treatment of CHF across multiple health care sectors. Furthermore, it was investigated to what extent patient perspectives are represented by the QIs of the German NDMG. Methods Using a qualitative approach, semistructured interviews were carried out with 17 CHF patients. Interviews were audio-recorded and transcribed verbatim. Data were analyzed using qualitative content analysis. Results Patient-identified needs focused primarily on aspects like the doctor–patient relationship, communication, quality of individual-tailored information, and professional advice. Patients perceived shortcomings in processes of care such as communication and cooperation across health care sectors, especially at the transition between hospital and outpatient care. Discussion From the patient perspectives, the QIs do represent relevant somatic and clinical aims for quality measurement. However, deficits were identified, especially related to communication and cooperation across health care sectors. Given the fact that the inclusion of patient perspectives in quality improvement processes provides an important contribution to patient-centered health care, possible approaches for QI development such as direct and indirect patient involvement or generic vs disease-specific patient-related QIs should be the subject of future discussions. PMID:26491268

  18. Temporal Dependency of Yield and Quality Estimation through Spectral Vegetation Indices in Pear Orchards

    Directory of Open Access Journals (Sweden)

    Jonathan Van Beek

    2015-08-01

    Full Text Available Yield and quality estimations provide vital information to fruit growers, yet require accurate monitoring throughout the growing season. To this end, the temporal dependency of fruit yield and quality estimations through spectral vegetation indices was investigated in irrigated and rainfed pear orchards. Both orchards were monitored throughout three consecutive growing seasons, including spectral measurements (i.e., hyperspectral canopy reflectance measurements as well as yield determination (i.e., total yield and number of fruits per tree and quality assessment (i.e., fruit firmness, total soluble solids and fruit color. The results illustrated a clear association between spectral vegetation indices and both fruit yield and fruit quality (|r| > 0.75; p < 0.001. However, the correlations between vegetation indices and production variables varied throughout the growing season, depending on the phenological stage of fruit development. In the irrigated orchard, index values showed a strong association with production variables near time of harvest (|r| > 0.6; p < 0.001, while in the rainfed orchard, index values acquired during vegetative growth periods presented stronger correlations with fruit parameters (|r| > 0.6; p < 0.001. The improved planning of remote sensing missions during (rainfed orchards and after (irrigated orchards vegetative growth periods could enable growers to more accurately predict production outcomes and improve the production process.

  19. Predictive indices of empirical clinical diagnosis of malaria among under-five febrile children attending paediatric outpatient clinic

    Directory of Open Access Journals (Sweden)

    Hassan A Elechi

    2015-01-01

    Full Text Available Background: Malaria has remained an important public health problem in Nigeria with children under 5 years of age bearing the greatest burden. Accurate and prompt diagnosis of malaria is an important element in the fight against the scourge. Due to the several limitations of microscopy, diagnosis of malaria has continued to be made based on clinical ground against several World Health Organization (WHO recommendations. Thus, we aim to assess the performance of empirical clinical diagnosis among febrile children under 5 years of age in a busy pediatric outpatient clinic. Materials and Methods: The study was a cross-sectional study. Children aged <5 years with fever or 72 h history of fever were recruited. Children on antimalarial prophylaxis or on treatment for malaria were excluded. Relevant information was obtained from the caregiver and clinical note of the child using interviewer administered questionnaire. Two thick and two thin films were made, stained, and read for each recruited child. Data was analysed using SPSS version 16. Results: Of the 433 children studied, 98 (22.6% were empirically diagnosed as having malaria and antimalarial drug prescribed. Twenty-three (23.5% of these children were confirmed by microscopy to have malaria parasitemia, while 75 (76.5% were negative for malaria parasitemia. Empirical clinical diagnosis show poor predictive indices with sensitivity of 19.2%, specificity of 76.0%, positive predictive value of 23.5% and negative predictive value of 71%. Conclusion and Recommendations: Empirical clinical diagnosis of malaria among the under-five children with symptoms suggestive of acute malaria is highly not reliable and hence the need to strengthen parasitological diagnosis.

  20. Quality of COPD care in hospital outpatient clinics in Denmark: The KOLIBRI study

    DEFF Research Database (Denmark)

    Lange, P.; Andersen, Klaus Kaae; Munch, E.;

    2009-01-01

    Background: We studied the quality of care for COPD patients in 22 hospital-based outpatient clinics in Denmark and evaluated if participation by the staff in an educational programme could improve the quality of care and adherence to the COPD guidelines. Methods: We performed two audits of the...... hospital records one year apart before and after the educational programme for the participating doctors and nurses. A total of 941 patient records were included in the first audit and 927 in the second. The indicators of quality of care comprised amongst others referral to pulmonary rehabilitation......, smoking cessation advice, nutritional advice, instruction in inhalation technique and assessment of BMI, smoking status, pack years, lung function parameters, dyspnoea oxygen saturation and comorbidities. Results. In general, the quality of care for COPD patients in Denmark was suboptimal and not in...

  1. Indicators to assess the quality of programs to prevent occupational risk for tuberculosis: are they feasible?

    Science.gov (United States)

    dos Santos, Talita Raquel; Padoveze, Maria Clara; Nichiata, Lúcia Yasuko Izumi; Takahashi, Renata Ferreira; Ciosak, Suely Itsuko; Gryschek, Anna Luiza de Fátima Pinho Lins

    2016-01-01

    Abstract Objective: to analyze the feasibility of quality indicators for evaluation of hospital programs for preventing occupational tuberculosis. Method: a descriptive cross-sectional study. We tested indicators for evaluating occupational tuberculosis prevention programs in six hospitals. The criterion to define feasibility was the time spent to calculate the indicators. Results: time spent to evaluate the indicators ranged from 2h 52min to 15h11min 24sec. The indicator for structure evaluation required less time; the longest time was spent on process indicators, including the observation of healthcare workers' practices in relation to the use of N95 masks. There was an hindrance to test one of the indicators for tuberculosis outcomes in five situations, due to the lack of use of tuberculin skin test in these facilities. The time requires to calculate indicators in regarding to the outcomes for occupational tuberculosis largely depends upon the level of organizational administrative structure for gathering data. Conclusions: indicators to evaluate the structure for occupational tuberculosis prevention are highly feasible. Nevertheless, the feasibility of indicators for process and outcome is limited due to relevant variations in administrative issues at healthcare facilities. PMID:27276016

  2. 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.

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

    Science.gov (United States)

    Avigliano, Esteban; Schenone, Nahuel

    2016-08-01

    The South American Atlantic rainforest is a one-of-a-kind ecosystem considered as a biodiversity hotspot; however, in the last decades, it was intensively reduced to 7 % of its original surface. Water resources and water quality are one of the main goods and services this system provides to people. For monitoring and management recommendations, the present study is focused on (1) determining the nutrient content (nitrate, nitrite, ammonium, and phosphate) and physiochemical parameters (temperature, pH, electrical conductivity, turbidity, dissolved oxygen, and total dissolved solids) in surface water from 24 rainforest mountain rivers in Argentina, (2) analyzing the human health risk, (3) assessing the environmental distribution of the determined pollutants, and (4) analyzing water quality indices (WQIobj and WQImin). In addition, for total coliform bacteria, a dataset was used from literature. Turbidity, total dissolved solids, and nitrite (NO2 (-)) exceeded the guideline value recommended by national or international guidelines in several sampling stations. The spatial distribution pattern was analyzed by Principal Component Analysis and Factor Analysis (PCA/FA) showing well-defined groups of rivers. Both WQI showed good adjustment (R (2) = 0.89) and rated water quality as good or excellent in all sampling sites (WQI > 71). Therefore, this study suggests the use of the WQImin for monitoring water quality in the region and also the water treatment of coliform, total dissolved solids, and turbidity. PMID:27083909

  4. Health-related restrictions of choices and choosing: implications for quality of life and clinical interventions

    Directory of Open Access Journals (Sweden)

    Barry J Gurland

    2010-08-01

    Full Text Available Barry J Gurland1, Huai Cheng2, Mathew S Maurer31Columbia University Department of Psychiatry, Stroud Center for Study of Quality of Life, New York, NY, USA; 2Anderson Cancer Center, Houston, TX, USA; 3Columbia Presbyterian Medical Center, New York, NY, USABackground: The process of “accessing choices and choosing among them” (c-c has been proposed as a model for understanding, evaluating, and assisting a patient’s management of quality of life. If desired choices are freely accessible, and the act of choosing is efficient and unconstrained, then the outcome is optimized quality of life. The c-c model fits many clinical situations where improved quality of life is a goal, and interventions may be aimed at relieving health-related restrictions of the patient’s desired activities. Aims: To determine the impact of health restrictions of choices and choosing on indicators and outcomes reflecting quality of life. Method: Secondary analysis of a community-based health survey of three ethnic groups, 65 years and older (n = 2,130, repeated after 18 months, with mortality over 6 years. Findings: Complaints of health restrictions of desired activities accounted for about half the variance of all determinants of a quality of life proxy indicator, and had a high frequency. Such complaints also predicted declines in mood and function, higher death rates, and increased service use.Conclusions: Clinical trials are warranted of the efficacy for quality of life improvement of interventions that focus on the relief of health-induced restrictions of desired activities.Keywords: choice, quality of life, aging, health restrictions

  5. Development of mental health quality indicators (MHQIs for inpatient psychiatry based on the interRAI mental health assessment

    Directory of Open Access Journals (Sweden)

    Perlman Christopher M

    2013-01-01

    Full Text Available Abstract Background Outcome quality indicators are rarely used to evaluate mental health services because most jurisdictions lack clinical data systems to construct indicators in a meaningful way across mental health providers. As a result, important information about the effectiveness of health services remains unknown. This study examined the feasibility of developing mental health quality indicators (MHQIs using the Resident Assessment Instrument - Mental Health (RAI-MH, a clinical assessment system mandated for use in Ontario, Canada as well as many other jurisdictions internationally. Methods Retrospective analyses were performed on two datasets containing RAI-MH assessments for 1,056 patients from 7 facilities and 34,788 patients from 70 facilities in Ontario, Canada. The RAI-MH was completed by clinical staff of each facility at admission and follow-up, typically at discharge. The RAI-MH includes a breadth of information on symptoms, functioning, socio-demographics, and service utilization. Potential MHQIs were derived by examining the empirical patterns of improvement and incidence in depressive symptoms and cognitive performance across facilities in both sets of data. A prevalence indicator was also constructed to compare restraint use. Logistic regression was used to evaluate risk adjustment of MHQIs using patient case-mix index scores derived from the RAI-MH System for Classification of Inpatient Psychiatry. Results Subscales from the RAI-MH, the Depression Severity Index (DSI and Cognitive Performance Scale (CPS, were found to have good reliability and strong convergent validity. Unadjusted rates of five MHQIs based on the DSI, CPS, and restraints showed substantial variation among facilities in both sets of data. For instance, there was a 29.3% difference between the first and third quartile facility rates of improvement in cognitive performance. The case-mix index score was significantly related to MHQIs for cognitive performance

  6. Improving Indicators in a Brazilian Hospital Through Quality-Improvement Programs Based on STS Database Reports

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    Pedro Gabriel Melo de Barros e Silva

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVE: To report the initial changes after quality-improvement programs based on STS-database in a Brazilian hospital. METHODS: Since 2011 a Brazilian hospital has joined STS-Database and in 2012 multifaceted actions based on STS reports were implemented aiming reductions in the time of mechanical ventilation and in the intensive care stay and also improvements in evidence-based perioperative therapies among patients who underwent coronary artery bypass graft surgeries. RESULTS: All the 947 patients submitted to coronary artery bypass graft surgeries from July 2011 to June 2014 were analyzed and there was an improvement in all the three target endpoints after the implementation of the quality-improvement program but the reduction in time on mechanical ventilation was not statistically significant after adjusting for prognostic characteristics. CONCLUSION: The initial experience with STS registry in a Brazilian hospital was associated with improvement in most of targeted quality-indicators.

  7. Paper 3: EUROCAT data quality indicators for population-based registries of congenital anomalies

    DEFF Research Database (Denmark)

    Loane, Maria; Dolk, Helen; Garne, Ester;

    2011-01-01

    The European Surveillance of Congenital Anomalies (EUROCAT) network of population-based congenital anomaly registries is an important source of epidemiologic information on congenital anomalies in Europe covering live births, fetal deaths from 20 weeks gestation, and terminations of pregnancy for...... fetal anomaly. EUROCAT's policy is to strive for high-quality data, while ensuring consistency and transparency across all member registries. A set of 30 data quality indicators (DQIs) was developed to assess five key elements of data quality: completeness of case ascertainment, accuracy of diagnosis......, completeness of information on EUROCAT variables, timeliness of data transmission, and availability of population denominator information. This article describes each of the individual DQIs and presents the output for each registry as well as the EUROCAT (unweighted) average, for 29 full member registries for...

  8. Quality of life and physical activity as indicators of health-preserving competence of teachers

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    Pavlova Iu.A.

    2012-03-01

    Full Text Available The quality of life and physical activity of teachers of physical culture, basic of health, labour, the defense of Motherland and pedagogue-organizers from secondary schools Lviv region (Ukraine were investigated. The 402 persons (age 24-78 years were surveyed with the use of questionnaires MOS SF 36 and IPAQ. The highest quality of life and level of physical activity have teachers of physical culture. It is considered the quality of life of teachers of other subjects similar to persons with chronic diseases. The level of physical activity in leisure time was particularly low for teachers of Basic of Health and pedagogue-organizers. The teachers spent no more than 433 MET-min/ week for moderate- and vigorous-intensity activity. The level of physical activity of teachers (besides the physical education teachers was insufficient to improve health and indicate about low level of health-preserving competence.

  9. Analysis of medication incidents and development of a Medication Incident Rate Clinical Indicator.

    Science.gov (United States)

    Headford, C; McGowan, S; Clifford, R

    2001-07-01

    Most health service organisations depend solely upon spontaneous voluntary reporting of medication incidents and a wide variety of available denominators are used in order to calculate the Medication Incident Rate (MIR). This paper describes how nursing staff and clinical pharmacists reviewed medication incident data, revised and established new systems of reporting and developed a clinically useful, rate-based MIR Clinical Indicator. In order to make the MIR more meaningful, the frequency of occurrence of incidents was considered within the context of the total number of medications given to patients. This was achieved by undertaking a point prevalence audit of all inpatient medication charts (n=372) to determine the total number of doses of medication given to patients during a 24 hour period (n=3211). This value was then used as the denominator for the MIR indicator. During 1998, a total of 475 medication incidents were reported; the average number of incidents was 1.3 per 24 hours. The MIR per 1000 doses was calculated to be 0.4. In most cases (77%) the incident caused no harm to the patient and no change in treatment was required, and the most 'severe' category for any incident was that active treatment was required (3% of reported incidents). The most common type of incident was the omission of a dose of medication (50%). A wide range of drugs were involved in the incidents, most commonly morphine (3.4%). The authors consider that the development and use of the MIR Clinical Indicator has positively influenced clinical practice in some areas at the authors' hospital. PMID:15484647

  10. Reoperation for rhegmatogenous retinal detachment as quality indicator for disease management

    DEFF Research Database (Denmark)

    Hajari, Javad N; Christensen, Ulrik; Kiilgaard, Jens F;

    2015-01-01

    identified by diagnosis and surgical codes. RESULTS: A total of 6522 cases were operated for a primary RRD in the study period, and 22% (1434 patients) were reoperated for a redetachment. A Cox regression analysis showed that the risk of redetachment was equal to or less than detachment on the fellow eye 1...... year after primary surgery with techniques not using silicone oil. The same was true 1.5 years after surgery for techniques using silicone oil. Based on this, we established a quality indicator defining failure as the need for operation for redetachment within 1 year from initial surgery when using...... techniques without oil and after 1.5 years for techniques using oil. Also the lack of oil removal within 1 year from initial surgery should be noted as an operational failure. We applied the quality indicators on the cohort of 6522 RRDs and found that in Denmark the need for redetachment surgery has...

  11. Soil Quality Indices for Evaluating Smallholder Agricultural Land Uses in Northern Ethiopia

    Directory of Open Access Journals (Sweden)

    Aweke M. Gelaw

    2015-02-01

    Full Text Available Population growth and increasing resource demands in Ethiopia are stressing and degrading agricultural landscapes. Most Ethiopian soils are already exhausted by several decades of over exploitation and mismanagement. Since many agricultural sustainability issues are related to soil quality, its assessment is very important. We determined integrated soil quality indices (SQI within the surface 0–15 cm depth increment for three agricultural land uses: rain fed cultivation (RF; agroforestry (AF and irrigated crop production (IR. Each land use was replicated five times within a semi-arid watershed in eastern Tigray, Northern Ethiopia. Using the framework suggested by Karlen and Stott (1994; four soil functions regarding soil’s ability to: (1 accommodate water entry (WE; (2 facilitate water movement and availability (WMA; (3 resist degradation (RD; and (4 supply nutrients for plant growth (PNS were estimated for each land use. The result revealed that AF affected all soil quality functions positively more than the other land uses. Furthermore, the four soil quality functions were integrated into an overall SQI; and the values for the three land uses were in the order: 0.58 (AF > 0.51 (IR > 0.47 (RF. The dominant soil properties influencing the integrated SQI values were soil organic carbon (26.4%; water stable aggregation (20.0%; total porosity (16.0%; total nitrogen (11.2%; microbial biomass carbon (6.4%; and cation exchange capacity (6.4%. Collectively, those six indicators accounted for more than 80% of the overall SQI values.

  12. Method of magnetobiological indication in clinical laboratory practice. [considering immunobiological activation

    Science.gov (United States)

    Sosunov, A. V.; Dubova, V. M.; Parfenov, Y. S.; Piksina, L. D.; Borisov, F. O.; Semenov, L. N.

    1974-01-01

    Data are presented on the use of the method of magnetobiological indication for defining the immunobiological state of patients with very serious diseases. It has been found that the enzymes of a patient react more sensitively to the energy from a magnetic field. It is important that the magnetoreactivity of the enzymes, like the cell forms of the blood in the patients, have a certain relationship to the clinical-nosological forms and the dynamics of the illness of the subject.

  13. Clinical Indicators for Bacterial Co-Infection in Ghanaian Children with P. falciparum Infection

    OpenAIRE

    Nielsen, Maja Verena; Amemasor, Solomon; Agyekum, Alex; Loag, Wibke; Marks, Florian; Sarpong, Nimako; Dekker, Denise; Adu-Sarkodie, Yaw; May, Jürgen

    2015-01-01

    Differentiation of infectious causes in severely ill children is essential but challenging in sub- Saharan Africa. The aim of the study was to determine clinical indicators that are able to identify bacterial co-infections in P. falciparum infected children in rural Ghana. In total, 1,915 severely ill children below the age of 15 years were recruited at Agogo Presbyterian Hospital in Ghana between May 2007 and February 2011. In 771 (40%) of the children malaria parasites were detected. This g...

  14. Bridging the gap between patient needs and quality indicators: a qualitative study with chronic heart failure patients

    Directory of Open Access Journals (Sweden)

    Baudendistel I

    2015-09-01

    Full Text Available Ines Baudendistel,1 Stefan Noest,1 Frank Peters-Klimm,1 Heidrun Herzberg,2 Martin Scherer,3 Eva Blozik,3 Stefanie Joos1,4 1Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany; 2Faculty of Health, Nursing, Administration, University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany; 3Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 4Institute for General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany Background: The German National Disease Management Guideline (NDMG on chronic heart failure (CHF derived nine clinical quality indicators (QIs to enable assessment of quality of health care in patients with CHF. These QIs epitomize an evidence-based and somatic point of view of guided treatment, but little is known about the experiences and views of patients with their guideline-based treatment across multiple health care sectors. Objective: The purpose of this qualitative study was to explore patient perspectives on guided treatment of CHF across multiple health care sectors. Furthermore, it was investigated to what extent patient perspectives are represented by the QIs of the German NDMG. Methods: Using a qualitative approach, semistructured interviews were carried out with 17 CHF patients. Interviews were audio-recorded and transcribed verbatim. Data were analyzed using qualitative content analysis. Results: Patient-identified needs focused primarily on aspects like the doctor–patient relationship, communication, quality of individual-tailored information, and professional advice. Patients perceived shortcomings in processes of care such as communication and cooperation across health care sectors, especially at the transition between hospital and outpatient care. Discussion: From the patient perspectives, the QIs do represent relevant somatic and clinical aims for quality measurement

  15. Comparative Study between the Quality Management Indicators, Marker of Major Psychiatric Disorders in Evolution

    OpenAIRE

    BONDARI, D.; Bondari, Simona; GHEONEA, IOANA; ANDRONACHE, ANDREEA

    2014-01-01

    Indicators of quality management are represented by: accounting hospitalization days (duration of stay); mortality rate; the rate of nosocomial infections; patients readmitted in 30 days; the percentage patients transferred; inconsistent diagnoses. The hospitalization period is a marker of evolution. The present study reflects comparative data between duration and the number of hospitalisations in patients with major psychiatric disorders. Introduction. Medical Psychiatry as a discipline has ...

  16. Quality of care in one Italian nursing home measured by ACOVE process indicators.

    Directory of Open Access Journals (Sweden)

    Claudia Pileggi

    Full Text Available To adapt the Assessing Care of Vulnerable Elders Quality Indicators (ACOVE QIs for use in Italy, to assess the adherence to these indicators as reported in the medical records of residents in a nursing home (NH, to compare this adherence for general medical and geriatric conditions, and eventually, to identify the relationships between patients' characteristics and reported processes of care.Two physicians collected the data by reviewing medical records of all NH residents in the previous 5 years, for a period of one year. Patients aged <65 years were excluded. A total of 245 patients were reviewed during the study period. The ACOVE QIs set, developed for NH processes of care, was used to assess the quality of care. Multivariate analysis was performed to identify and to assess the role of patients' characteristics on quality of processes of care by several domains of care in general medical and geriatric conditions.With the exception of diabetes management, quality of processes of care for general medical conditions approached adequate adherence. Care falls substantially short of acceptable levels for geriatric conditions (pressure ulcers, falls, dementia. On the contrary, the recommended interventions for urinary incontinence were commonly performed. Adherence to indicators varied for the different domains of care and was proven worse for the screening and prevention indicators both for geriatric and general medical conditions. Statistical analysis showed disparities in provision of appropriate processes of care associated with gender, age, co-morbidities, level of function and mobility, length of stay and modality of discharge by NHs.Adherence to recommended processes of care delivered in NH is inadequate. Substantial work lies ahead for the improvement of care. Efforts should focus particularly on management of geriatric conditions and on preventive healthcare.

  17. h-index, h-type Indices, and the Role of Corrected Quality Ratio

    OpenAIRE

    Tahira, Muzammil; Alias, Rose Alinda; Bakri, Arayti; Shabri, Ani

    2014-01-01

    This study examines the foremost concerns related to most noted research performance index. The most popular and widely acceptable h-index underestimates the highly visible scientist, the middle order group, due to citation distribution issues. The study addresses this issue and uses 'Corrected Quality Ratio' (CQ) to check the implicit underpinnings as evident in h-index. CQ helps to incorporate the aspects of a good research performance indicator. This simple revision performs more intimatel...

  18. Faecal nitrogen: a potential indicator of red and roe deer diet quality in forest habitats

    Czech Academy of Sciences Publication Activity Database

    Kamler, Jiří; Homolka, Miloslav

    2005-01-01

    Roč. 54, 1-2 (2005), s. 89-98. ISSN 0139-7893 R&D Projects: GA ČR(CZ) GA206/99/D053; GA AV ČR(CZ) IBS6093003 Institutional research plan: CEZ:AV0Z60930519 Keywords : free-living ungulates * faecal indicators * diet quality Subject RIV: EG - Zoology Impact factor: 0.585, year: 2005 http://www.ivb.cz/folia/54/1-2/89-98.pdf

  19. Indicators of Good Governance: Developing an Index of Governance Quality at the LGU Level

    OpenAIRE

    Manasan, Rosario G.; Gaffud, Romualdo; Gonzalez, Eduardo T.

    1999-01-01

    Governance is a complex concept. It includes the state’s institutions and structures, its decision-making process, its capacity to implement guidelines and the relationship between government officials and the public. Hence, this study attempts to develop a composite index of the quality of governance at the local government level. It also defines limited indicators, which can be measured consistently and can capture the substance of each dimension and their compatibility over time and space....

  20. Estimation of Power Quality Indicators During a Real Wind Farm Islanding Experiment

    DEFF Research Database (Denmark)

    Terzija, Vladimir; Stanojević, V.; Štrbac, G.;

    2008-01-01

    voltages and currents are estimated. Frequency and its rate of change are directly estimated from voltage input signals. In the second algorithm stage the power quality indicators are calculated. The algorithm considers frequency as an unknown model parameter simultaneously estimated with the voltage...... spectrum. The proposed algorithm is implemented for the analysis of transient processes during a real islanding experiment on the Rejsby Hede wind farm in Denmark....

  1. Evaluating Journal Quality: A Review of Journal Citation Indicators and Ranking in Business and Management

    OpenAIRE

    Mingers, John; Yang, Liying

    2016-01-01

    Abstract: Evaluating the quality of academic journal is becoming increasing important within the context of research performance evaluation. Traditionally, journals have been ranked by peer review lists such as that of the Association of Business Schools (UK) or though their journal impact factor (JIF). However, several new indicators have been developed, such as the h-index, SJR, SNIP and the Eigenfactor which take into account different factors and therefore have their own particular biases...

  2. The influences of SE infection on layers’ production performance, egg quality and blood biochemical indicators

    OpenAIRE

    Fan, Shijie; Zheng, Jiangxia; Duan, Zhongyi; Yang, Ning; Xu, Guiyun

    2014-01-01

    Background Salmonella enterica serovar Enteritidis (SE), as a major cause of foodborn illness, infects humans mainly through the egg. However, the symptom of laying hens usually is not typical and hard to diagnosis. In the present study, it is studied that the influences of SE infection on layers’ performance, egg quality and blood biochemical indicators. It will help us to improve the strategy to control SE infection in commercial layers. One hundred layers at 20 wk of age were divided into ...

  3. Developing the Service Quality Assessment Indicators for Learning Commons at University Libraries

    Directory of Open Access Journals (Sweden)

    王梅玲、侯淳凡 Mei-Ling Wang,Chun-Fan Hou

    2014-04-01

    Full Text Available The Learning Commons representing their innovation and transition is important service in university libraries. The article mainly studies on developing the service quality assessment indicators for Learning Commons at university libraries ,there are main purposes including: (1exploring the meaning and components of the Learning Commons in the Universities’ libraries;(2 understanding the method to evaluate the Learning Commons and constructing adequate indicators for evaluating service quality; (3 understanding the usage and users satisfaction of the Learning Commons in order to assess its service quality , analyzing and evaluating the Learning Commons of libraries. The study has formed the focus groups to better understand themeaning of Learning Commons in Taiwan, and the participants of the focus groups also agreed to conduct the evaluation by applying the assessment of service quality. They came up with three evaluation dimensions and 23 indicators of the Learning Commons. For testing the feasibility of the indicators, the questionnaire was constructed and sent to the users of the Learning Commonsof the N University Library. The research results are as follows: (1 the frequency of using internet affects the number of physically entering to the libraries in both universities; (2 the users recognize the learning value of the libraries; (3 the users used the technological facilities most; (4 the most important services of the Learning Common include a comfortable environment and sufficient resources; (5 the most satisfactory services are the attitudes and responses of the service providers;(6 the services need to be firstly improved include dividing the discussion space from the study space; (7 the overall satisfactory degree still requires more efforts to improve and the libraries should pay more attention on providing resources. Finally, some conclusion and suggestions were proposed by the article. pp. 101-121

  4. META-COMPONENTS OF INTELLECTUAL AUTONOMY AS HIGHER EDUCATION TEACHING QUALITY INDICATORS

    OpenAIRE

    Grozdanka Gojkov; Aleksandar Stojanovic; Aleksandra Gojkov-Rajic

    2014-01-01

    The paper presents findings of an explorative research (non-probable sample, N-147), aiming at considering the level of development of meta-components of learning autonomy, (metacognitive abilities, learning strategies and critical thinking), as indicators of higher education teaching quality, which were involved as components of the European qualification framework. Theoretical grounds of the paper are contemporary didactical concepts of emancipatory learning, implying intellectual autonomy ...

  5. Aerobics, Quality of Life, and Physiological Indicators of Inactive Male Students’ Cardiovascular Endurances, in Kashan

    OpenAIRE

    Bahram, Mohammad Ebrahim; Akkasheh, Gudarz; Akkasheh, Negar

    2014-01-01

    Background: Studies show that lack of exercise and physical activity during childhood and teenage years is directly related to different diseases in adulthood. Objectives: The main purpose of this study was to investigate the effects of an eight-week aerobic exercise on the quality of life as well as physiological indicators of cardiovascular endurance of inactive high school male students in Kashan. Materials and Methods: The study was a field trial using pretest and post-test. Three hundred...

  6. CUSTOMER SATISFACTION AS AN INDICATOR OF SERVICE QUALITY IN TOURISM AND HOSPITALITY

    OpenAIRE

    Ana Stranjancevic; Iva Bulatovic

    2015-01-01

    One of the greatest challenges for stakeholders is to ensure customer satisfaction, especially in service industries such as tourism and hospitality. The aim of this paper is to show that restaurant guest satisfaction depends on numerous factors as well as to show the connection between satisfaction and loyalty. Customer satisfaction and loyalty are excellent indicators of service quality. For the purpose of this paper, empirical survey was conducted and the results of the research were analy...

  7. Existing data sources for clinical epidemiology: the Danish Quality Database of Mammography Screening

    Directory of Open Access Journals (Sweden)

    Langagergaard V

    2013-03-01

    Full Text Available Vivian Langagergaard,1 Jens P Garne,2 Ilse Vejborg,3 Walter Schwartz,4 Martin Bak,5 Anders Lernevall,1 Nikolaj B Mogensen,6 Heidi Larsson,7 Berit Andersen,1 Ellen M Mikkelsen7 1Department of Public Health Programs, Randers Hospital, Randers, Denmark; 2Department of Breast Surgery, Aalborg Hospital, Aalborg, Denmark; 3Diagnostic Imaging Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 4Center of Mammography, 5Department of Pathology, Odense University Hospital, Denmark; 6Department of Radiology, Ringsted Hospital, Ringsted, Denmark; 7Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark Abstract: The Danish Quality Database of Mammography Screening (DKMS was established in 2007, when screening was implemented on a nationwide basis and offered biennially to all Danish women aged 50–69 years. The primary aims of the database are to monitor and evaluate the quality of the screening program and – after years of follow-up – to evaluate the effect of nationwide screening on breast cancer-specific mortality. Here, we describe the database and present results for quality assurance from the first round of national screening. The steering committee for the DKMS defined eleven organizational and clinical quality indicators and standards to monitor the Danish breast cancer screening program. We calculated the relevant proportions and ratios with 95% confidence intervals for each quality indicator. All indicators were assessed on a national and regional level. Of 670,039 women invited for mammography, 518,823 (77.4% participated. Seventy-one percent of the women received the result of their mammography examination within 10 days of screening, and 3% of the participants were recalled for further investigation. Among all detected cancers, 86% were invasive cancers, and the proportion of women with node negative cancer was 67%. There were 36% women with small cancers, and the ratio of surgery for

  8. Total knee arthroplasty: indication of blood transfusion according to hematimetric variation and clinical symptoms of hypoperfusion,

    Directory of Open Access Journals (Sweden)

    Rodrigo Tavares Cardozo

    2014-10-01

    Full Text Available Objective:To analyze the relationship between hematimetric variation and the presence of clinical symptoms of hypoperfusion for indicating blood transfusion in patients undergoing total knee arthroplasty.Methods:A retrospective analysis was conducted on data gathered from the medical files of 55 patients with a diagnosis of gonarthrosis, who underwent total knee arthroplasty at a hospital orthopedics and traumatology service between February 2011 and December 2012. The patients studied presented unilateral joint degeneration and fitted into the indications for surgical treatment. All the patients underwent a preoperative cardiological evaluation, presenting a pattern of ASA I–III and absence of blood dyscrasia, and preoperative hemoglobin measurements were made. However, no minimum hematimetric value was established for the surgical treatment; there were only clinical criteria for blood perfusion.Results:Among the 55 patients, 35 were female and 20 were male, and the mean age was 68 years. Six patients underwent homologous blood transfusion, because of their clinical condition of tissue hypoperfusion, persistent hypotension, loss of consciousness, sweating and coercible vomiting. They presented postoperative hemoglobin of 7.5–8.8 g/dL.Conclusion:For patients with falls in hemoglobin counts greater than 20% and values lower than 9 g/dL after the surgery, there is a possible need for blood transfusion, which should only be indicated when accompanied by major symptoms of tissue hypoperfusion.

  9. Number of drugs in the medication list as an indicator of prescribing quality: a validation study of polypharmacy indicators in older hip fracture patients

    OpenAIRE

    Belfrage, Björn; Koldestam, Anders; Sjöberg, Christina; Wallerstedt, Susanna M.

    2015-01-01

    Purpose Indicators based on the number of drugs in the medication list are sometimes used to reflect quality of drug treatment. This study aimed to evaluate the concurrent validity of such polypharmacy indicators, i.e., their ability to differentiate between appropriate and suboptimal drug treatment. Methods In 200 hip fracture patients (≥65 years of age), consecutively recruited to a randomized controlled study in Sahlgrenska University Hospital in 2009, quality of drug treatment at study en...

  10. Fecal nitrogen concentration as a nutritional quality indicator for European rabbit ecological studies.

    Directory of Open Access Journals (Sweden)

    Esperanza Gil-Jiménez

    Full Text Available Measuring the quality of the nutritional resources available to wild herbivores is critical to understanding trophic regulation processes. However, the direct assessment of dietary nutritional characteristics is usually difficult, which hampers monitoring nutritional constraints in natural populations. The feeding ecology of ruminant herbivores has been often assessed by analyzing fecal nitrogen (FN concentrations, although this method has been less evaluated in other taxa. This study analyzed the suitability of FN as an indicator of ingesta quality in the European rabbit (Oryctolagus cuniculus, which is a keystone lagomorph species in Mediterranean ecosystems and of great conservation interest. Firstly, domestic O. cuniculus were used to evaluate under experimental conditions the accuracy of total FN and the metabolic FN as diet quality indicators of forages with characteristics similar to those available under natural conditions. Secondly, the accuracy of Near-Infrared Spectroscopy (NIRS to calculate FN was tested using partial least squares regression. Thirdly, a pilot field study was conducted to monitor FN dynamics from wild O. cuniculus in three different habitats during wet and drought periods. A strong association was found between diet type and total FN and metabolic FN (Pseudo-R(2 ≥ 0.89. It was also found that NIRS calibrations were accurate for depicting nitrogen concentrations (R(2 > 0.98 between NIRS and chemical results. Finally, the seasonal FN dynamics measured in the field were consistent with current knowledge on vegetation dynamics and forage limitations in the three habitats. The results support the use of NIRS methods and FN indices as a reliable and affordable approach to monitoring the nutritional quality of rabbit habitats. Potential applications include the assessment of the mechanistic relationships between resource limitations and population abundance, e.g., in relation to natural drought cycles and to habitat

  11. The efficiency and quality dilemma: What drives South African call centre management performance indicators?

    Directory of Open Access Journals (Sweden)

    Diane Banks

    2011-02-01

    Full Text Available Orientation: Call centres have become principal channels of communication with customers. Therefore, companies attempt to reduce costs and improve the quality of their interactions with customers simultaneously. These objectives are often conflicting and call centre managers struggle to balance the efficiency and quality priorities of the business.Research purpose: This study explored the key performance indicators that drive management practices in the South African call centre industry in the context of the dilemma between efficiency and quality.Motivation for the study: The South African government has identified call centres as a method of creating jobs and foreign investment. Management practices affect centres’ performance. Understanding these practices will help to achieve these aims.Research design: The researchers used a web-based questionnaire in a survey with South African call centre managers in more than 44 different organisations that represented nine industry sectors.Main findings: This study indicated that the dilemma between efficiency and quality is prevalent in South African call centres and that efficiency key performance indicators drive management practices.Practical/managerial implications: The inconsistencies the study reported mean that South African organisations should assess the alignment between their organisational visions, the strategic intentions of their call centres and the performance measures they use to assess their call centre managers.Contribution/value-add: This study adds to the relatively small amount of empirical research available on the call centre industry in South Africa. It contributes to the industry’s attempt to position itself favourably for local and international outsourcing opportunities.

  12. Quality assessment of urban trees using growth visual and chlorophyll fluorescence indicators

    Directory of Open Access Journals (Sweden)

    Uhrin Peter

    2016-06-01

    Full Text Available Urbanised landscape represents composed structures of technical and biotic elements where social and economy activities create living space for human society but with strongly changed environment. To dominant characters belong climate changes with increased air temperature, drought and emission load, which has developed wide spectrum of stress factors influencing the urban vegetation. For the assessment of plant growth and adaptation response, we have used Sycamore maple (Acer pseudoplatanus L. as study model woody plant. In the framework of visual characters, we assessed the following indicators: (a assimilation organs (leaf necrosis; (b crown quality (degree of foliage and degree of dead tree crown; (c trunk and branch quality (mechanical damage, incidence of wood destroying fungus and trunk cavities and callus healing of trunk wounds. Each indicator was assessed in five-point scale, and in the end, the common index of quality was calculated. The quality index achieved 9.33 points in the first and 10.33 in the second evaluation periods in the Nitra city and 2.66 at the both assessed periods in the comparable rural park. In the group of physiological indicators, chlorophyll a fluorescence marker and its Fv/Fm parameter were used. Within three repeating assessment during growing season (June, August and September, the average values reached Fv/Fm = 0.814 in the city and Fv/Fm = 0.829 in rural park. The results confirmed statistical significances between loaded city conditions and relatively clean rural locality. Used markers have shown as appropriate tools for growth response measurements of street trees in a changed urban environment.

  13. Confirmatory factor analysis for indicators of perceived environmental quality of the stadium (IPEQS).

    Science.gov (United States)

    Manca, Sara; Fornara, Ferdinando

    2015-09-01

    Studies conducted in the 1980s (see Canter et al. in Football in its place. An environmental psychology of football grounds. Routledge, London, 1989) highlighted the prominent role of the spatial-physical features of football grounds in influencing users' perception of safety, comfort, and general satisfaction towards the stadium experience. In particular, the importance of fulfilling the spectators' needs of personal space (e.g. presence of an open view, proper distance between the seats) and movement opportunity was analysed. The aim of this study is to confirm the factorial structure of a set of indicators--the IPEQS--concerning the perceived quality of an array of aspects (i.e. architectural, social, functional, and safety issues) related to the stadium design. Participants (N = 255), who were selected on the basis of their stadium experience, filled in a self-report questionnaire measuring a set of indicators developed on the basis of both validated tools [i.e. the perceived residential environment quality indicators (PREQIs): Bonaiuto et al. in J Environ Psychol 19:331-352, 1999] and outcomes of semi-structured interviews. Confirmatory factor analyses (CFA) were performed for each scale, and reliability assessments were then carried out for each indicator. IPEQS' factorial structures found through the CFA procedure substantially confirm the results of exploratory factor analyses run with previous data. Outcomes of this study should provide a useful tool for managers and designers of football grounds, in order to improve the overall experience of the spectators. PMID:26239754

  14. Water quality assessment of the DTD canal system by diatom indices

    Directory of Open Access Journals (Sweden)

    Jakovljević Olga S.

    2014-01-01

    Full Text Available The main objective of this paper is to evaluate the water quality based on diatom indices in the study area of the Danube-Tisa-Danube (DTD canal system. We used four diatom indices: Watanabe’s index (DAIpo, biological diatom index (BDI or IBD, the trophic diatom index (TDI and index of pollution sensitivity (IPS. Benthic samples were collected in the spring and autumn 2002 and 2003 from nine sampling sites. The standard method with concentrated sulfuric acid was used for treatment of the algological samples [Krammer and Lange-Bertalot 1986] and then permanent slides of diatoms were made. The abundance was estimated by counting 400 valves of each taxa present on slide [Round 1991, 1993]. Investigation of the DTD canal system resulted in description of 145 diatom taxa. Based on the indicator values of identified taxa we calculated four diatom indices (DAIpo, BDI, TDI and IPS and estimated water quality in the study area of the DTD canal system. [[Projekat Ministarstva nauke Republike Srbije, br. TR 037009

  15. Associations between HIV-RNA-based indicators and virological and clinical outcomes

    DEFF Research Database (Denmark)

    Laut, Kamilla G.; Shepherd, Leah C.; Pedersen, Court;

    2016-01-01

    measurements after baseline (the latest of 01/01/2001 or entry into EuroSIDA). Using multivariate Poisson regression, we modelled the association between short-term (resistance, triple-class failure) and long-term (all-cause mortality, any AIDS/non-AIDS clinical event) outcomes and the indicators: viraemia...... copy years; consecutive months with viral load ≥50 copies/ml; percentage of time on ART spent fully suppressed (%FS); stable on ART; 48 weeks snapshot; and current viral load. Indicators were compared using area under the ROC curve (AUC) and different measures of model fit. Results: Adjusted incidence...... rate ratios for all outcomes tended to increase with increasing viraemia copy years, number of consecutive months with viral load ≥50 copies/ml, current viral load and with lower %FS, but the gradient of increased risk was weak across strata. None of the indicators reliably identified those at risk...

  16. A bio-indicator for the evaluation of quality forestry and landscape fragmentation

    Directory of Open Access Journals (Sweden)

    Kappers EF

    2013-11-01

    Full Text Available A bio-indicator for the evaluation of quality forestry and landscape fragmentation. Intensive agricultural practices, as well as tourism development, summer fires, urbanization and air pollution represent a serious threat for many woodlands in Mediterranean Europe. Tawny owls, Strix aluco, is a valuable indicator of habitat quality and shows high sensitivity to wood fragmentation. Assessing the association between Tawny owls and their habitat may provide useful tools for conservation and management of forested habitats. Populations of woodland birds are influenced by forest characteristics, wood proportion being a key factor explaining breeding density and regularity in nest spacing. Populations of the Tawny Owl reach their highest densities in old deciduous forests. The distribution of territories remains almost constant for many years, and the period during which any particular wood maintains suitable conditions for nesting depends on factors like tree species and management, especially on the timing and extent of thinning. To assure the maintenance of good habitat quality in most woodlands, regulation of water diversion, prevention of summer fires, and a general reduction of human activities inside forests seem to be useful conservation tools.

  17. Is Deqi an Indicator of Clinical Efficacy of Acupuncture? A Systematic Review

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    Shuo Zhang

    2013-01-01

    Full Text Available Objective. Despite the systematic literature review of the current evidence, we aim to answer the question “ is Deqi an indicator of clinical effects in acupuncture treatment?” Methods. We systematically searched CNKI, VIP, Wanfang Data, PubMed, Embase, and the CENTRAL for three types of study: (1 empirical research probing into the role of Deqi in acupuncture; (2 mechanism studies examining the effect of Deqi on physiological parameters in animal models and human subjects; (3 clinical studies that compared the outcome of acupuncture with Deqi with that of acupuncture without Deqi. Two reviewers independently extracted data, undertook qualitative or quantitative analysis, and summarized findings. Results. The ancient Chinese acupuncturists valued the role of Deqi as a diagnostic tool, a prognosis predictor, and a necessary part of the therapeutic procedure. Findings from modern experimental research provided preliminary evidence for the physiological mechanism that produced Deqi. Few clinical studies generated conflicting evidence of the comparative effectiveness of acupuncture with Deqi versus acupuncture without Deqi for a variety of conditions. Conclusion. The current evidence base is not solid enough to draw any conclusion regarding the predicative value of natural Deqi for clinical efficacy or the therapeutic value of manipulation-facilitated Deqi.

  18. Monitoring and assessment of water health quality in the Tajan River, Iran using physicochemical, fish and macroinvertebrates indices

    OpenAIRE

    Aazami, J.; S. Kosten; Abdoli, A.; Sohrabi, H; Brink, van den, L.

    2015-01-01

    Background - Nowadays, aquatic organisms are used as bio-indicators to assess ecological water quality in western regions, but have hardly been used in an Iranian context. We, therefore, evaluated the suitability of several indices to assess the water quality for an Iranian case study. Methods - Measured data on biotic (fish and macroinvertebrates) and abiotic elements (28 physicochemical and habitat parameters), were used to calculate six indices for assessment of water quality and the impac...

  19. Reliability of indicators of nursing care quality: testing interexaminer agreement and reliability

    Directory of Open Access Journals (Sweden)

    Dagmar Willamowius Vituri

    2014-04-01

    Full Text Available OBJECTIVE: this study sought to test the interexaminer agreement and reliability of 15 indicators of nursing care quality.METHODS: this was a quantitative, methodological, experimental, and applied study conducted at a large, tertiary, public teaching hospital in the state of Paraná. For data analysis, the Kappa (k statistic was applied to the categorical variables - indicators 1 to 11 and 15 - and the interclass correlation coefficient (ICC to the continuous variables - indicators 12, 13, and 14, with the corresponding 95% confidence intervals. The categorical data were analyzed using the Lee software, elaborated by the Laboratory of Epidemiology and Statistics of Dante Pazzanese Institute of Cardiology - Brazil, and the continuous data were assessed using BioEstat 5.0.RESULTS: the k-statistic results indicated excellent agreement, which was statistically significant, and the values of the ICC denoted excellent and statistically significant reproducibility/agreement relative to the investigated indicators.CONCLUSION: the investigated indicators exhibited excellent reliability and reproducibility, thus showing that it is possible to formulate valid and reliable assessment instruments for the management of nursing care.

  20. The relationship between general practice characteristics and quality of care: a national survey of quality indicators used in the UK Quality and Outcomes Framework, 2004–5

    Directory of Open Access Journals (Sweden)

    Armstrong David

    2006-11-01

    Full Text Available Abstract Background The descriptive information now available for primary care in the UK is unique in international terms. Under the 'Quality and Outcomes Framework' (QOF, data for 147 performance indicators are available for each general practice. We aimed to determine the relationship between the quality of primary care, as judged by the total QOF score, social deprivation and practice characteristics. Methods We obtained QOF data for each practice in England and linked these with census derived data (deprivation indices and proportion of patients born in a developing country. Characteristics of practices were also obtained. QOF and census data were available for 8480 practices. Results The median QOF score was 999.7 out of a possible maximum of 1050 points. Three characteristics were independently associated with higher QOF scores: training practices, group practices and practices in less socially deprived areas. In a regression model, these three factors explained 14.6% of the variation in QOF score. Higher list sizes per GP, turnover of registered patients, chronic disease prevalence, proportions of elderly patients or patients born in a developing country did not contribute to lower QOF scores in the final model. Conclusion Socially deprived areas experience a lower quality of primary care, as judged by QOF scores. Social deprivation itself is an independent predictor of lower quality. Training and group practices are independent predictors of higher quality but these types of practices are less well represented in socially deprived areas.

  1. Evaluating real-time air-quality data as earthquake indicator

    International Nuclear Information System (INIS)

    A catastrophic earthquake, namely the 921-earthquake, occurred with a magnitude of ML = 7.3 in Taiwan on September 21, 1999, causing severe disaster. The evaluation of real-time air-quality data, obtained by the Taiwan Environmental Protection Administration (EPA), revealed a staggering increase in ambient SO2 concentrations by more than one order of magnitude across the island several hours prior to the earthquake, particularly at background stations. The abrupt increase in SO2 concentrations likely resulted from seismic-triggered degassing instead of air pollution. An additional case of a large earthquake (ML = 6.8), occurring on March 31, 2002, was examined to confirm our observations of significantly enhanced SO2 concentrations in ambient air prior to large earthquakes. The coincidence between large earthquakes and increases in trace gases during the pre-quake period (several hours) indicates the potential of employing air-quality monitoring data to forecast catastrophic earthquakes.

  2. Air quality indication in Blace (Southeastern Serbia using lichens as bioindicators

    Directory of Open Access Journals (Sweden)

    Stamenković S.M.

    2013-01-01

    Full Text Available Air quality investigations have not been undertaken in Blace until now. Identifying the presence of different types of epiphytic lichens was performed in the summer 2012 in Blace (southeastern Serbia, and selected rural settlements around Blace, in order to establish the air quality of the area. The analysis of samples from described localities indicated the presence of 25 lichen taxa from 19 genera. Using the Index of Atmospheric Purity (IAP, it was found that there are 2 different air pollution zones in Blace: “lichen desert” and “transitional” or “struggle zone”, which includes the periphery of the city. In these zones the air is moderately polluted. In the urban area of Blace there is no “normal” zone, but one was detected in the surrounding rural areas. [Projekat Ministarstva nauke Republike Srbije, br. OI 171025 i br. III 41018

  3. Epiphytic lichens as indicators of environmental quality around a municipal solid waste landfill (C Italy).

    Science.gov (United States)

    Paoli, Luca; Grassi, Alice; Vannini, Andrea; Maslaňáková, Ivana; Bil'ová, Ivana; Bačkor, Martin; Corsini, Adelmo; Loppi, Stefano

    2015-08-01

    Epiphytic lichens have been used as indicators of environmental quality around a municipal solid waste landfill in C Italy. An integrated approach, using the diversity of epiphytic lichens, as well as element bioaccumulation and physiological parameters in the lichen Flavoparmelia caperata (L.) Hale was applied along a transect from the facility. The results highlighted the biological effects of air pollution around the landfill. The Index of Lichen Diversity (ILD) increased and the content of heavy metals (Cr, Cd, Cu, Fe, Ni and Zn) decreased with distance from the landfill. Clear stress signals were observed in lichens growing in front of the facility, i.e. discoloration, necrosis, membrane lipid peroxidation, lower ergosterol content, higher dehydrogenase activity. Decreased photosynthetic efficiency, altered chlorophyll integrity and production of secondary metabolites were also found. The results suggested that lichens can be profitably used as bioindicators of environmental quality around landfills. PMID:25987289

  4. Quality assurance of radiotherapy and its clinical assessment

    International Nuclear Information System (INIS)

    We investigated the clinical quality assurance (QA) of radiotherapy in Japan since 1981. The aim of this study was to establish the QA of a radiotherapy system and its clinical assessment in Japan. We introduced the Patterns of Care Study (PCS) into Japan to perform this study in 1996. The PCS is a retrospective study designed to establish the national practice for cancer patients during a specific period and should be a complementary study to a prospective randomized controlled study. We collected precise data for 4399 patients with carcinomas of the breast, cervix, esophagus, lung and prostate by means of external audits for 96 institutes from 1998 through 2001. Patients were randomly sampled with two-stage cluster sampling. We stratified 556 institutes into four categories according to the academic condition and annual number of radiotherapy patients. National and regional averages of various factors of radiotherapy could be calculated and were used to measure QA of radiotherapy. Using a standard score, we could compare the process of individual institutions with national averages and feed back the evaluation score to each institution. With a PCS process survey, we could observe the dissemination of the treatment method under evidence-based medicine from the prospective randomized controlled study. We proposed future prediction of the number of radiotherapy patients and a counter plan for equipment and personnel. The first US-Japan PCS Workshop was held at San Francisco in 2001. We could establish QA of a radiotherapy system using PCS 1995-97 in Japan. (author)

  5. Automated characterization of perceptual quality of clinical chest radiographs: Validation and calibration to observer preference

    International Nuclear Information System (INIS)

    Purpose: The authors previously proposed an image-based technique [Y. Lin et al. Med. Phys. 39, 7019–7031 (2012)] to assess the perceptual quality of clinical chest radiographs. In this study, an observer study was designed and conducted to validate the output of the program against rankings by expert radiologists and to establish the ranges of the output values that reflect the acceptable image appearance so the program output can be used for image quality optimization and tracking. Methods: Using an IRB-approved protocol, 2500 clinical chest radiographs (PA/AP) were collected from our clinical operation. The images were processed through our perceptual quality assessment program to measure their appearance in terms of ten metrics of perceptual image quality: lung gray level, lung detail, lung noise, rib–lung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm–lung contrast, and subdiaphragm area. From the results, for each targeted appearance attribute/metric, 18 images were selected such that the images presented a relatively constant appearance with respect to all metrics except the targeted one. The images were then incorporated into a graphical user interface, which displayed them into three panels of six in a random order. Using a DICOM calibrated diagnostic display workstation and under low ambient lighting conditions, each of five participating attending chest radiologists was tasked to spatially order the images based only on the targeted appearance attribute regardless of the other qualities. Once ordered, the observer also indicated the range of image appearances that he/she considered clinically acceptable. The observer data were analyzed in terms of the correlations between the observer and algorithmic rankings and interobserver variability. An observer-averaged acceptable image appearance was also statistically derived for each quality attribute based on the collected individual acceptable ranges

  6. Automated characterization of perceptual quality of clinical chest radiographs: Validation and calibration to observer preference

    Energy Technology Data Exchange (ETDEWEB)

    Samei, Ehsan, E-mail: samei@duke.edu [Carl E. Ravin Advanced Imaging Laboratories, Departments of Radiology, Physics, Biomedical Engineering, Electrical and Computer Engineering, Medical Physics Graduate Program, Duke Clinical Imaging Physics Group, Duke University, Durham, North Carolina 27710 (United States); Lin, Yuan [Carl E. Ravin Advanced Imaging Laboratories, Departments of Radiology and Physics, Duke University, Durham, North Carolina 27710 (United States); Choudhury, Kingshuk R. [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology and Biostatistics and Bioinformatics, Duke University, Durham, North Carolina 27710 (United States); Page McAdams, H. [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University, Durham, North Carolina 27710 (United States)

    2014-11-01

    Purpose: The authors previously proposed an image-based technique [Y. Lin et al. Med. Phys. 39, 7019–7031 (2012)] to assess the perceptual quality of clinical chest radiographs. In this study, an observer study was designed and conducted to validate the output of the program against rankings by expert radiologists and to establish the ranges of the output values that reflect the acceptable image appearance so the program output can be used for image quality optimization and tracking. Methods: Using an IRB-approved protocol, 2500 clinical chest radiographs (PA/AP) were collected from our clinical operation. The images were processed through our perceptual quality assessment program to measure their appearance in terms of ten metrics of perceptual image quality: lung gray level, lung detail, lung noise, rib–lung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm–lung contrast, and subdiaphragm area. From the results, for each targeted appearance attribute/metric, 18 images were selected such that the images presented a relatively constant appearance with respect to all metrics except the targeted one. The images were then incorporated into a graphical user interface, which displayed them into three panels of six in a random order. Using a DICOM calibrated diagnostic display workstation and under low ambient lighting conditions, each of five participating attending chest radiologists was tasked to spatially order the images based only on the targeted appearance attribute regardless of the other qualities. Once ordered, the observer also indicated the range of image appearances that he/she considered clinically acceptable. The observer data were analyzed in terms of the correlations between the observer and algorithmic rankings and interobserver variability. An observer-averaged acceptable image appearance was also statistically derived for each quality attribute based on the collected individual acceptable ranges

  7. 78 FR 22883 - AHRQ Standing Workgroup for Quality Indicator Measure Specification

    Science.gov (United States)

    2013-04-17

    ... health care quality measures based on ICD-coded administrative data Knowledge of current quality... Measure Specification AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Notice...

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

    Science.gov (United States)

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

    2014-05-01

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

  9. Application of Iron Oxide as a pH-dependent Indicator for Improving the Nutritional Quality

    Science.gov (United States)

    2016-01-01

    Acid food indicators can be used as pH indicators for evaluating the quality and freshness of fermented products during the full course of distribution. Iron oxide particles are hardly suspended in water, but partially or completely agglomerated. The agglomeration degree of the iron oxide particles depends on the pH. The pH-dependent particle agglomeration or dispersion can be useful for monitoring the acidity of food. The zeta potential of iron oxide showed a decreasing trend as the pH increased from 2 to 8, while the point of zero charge (PZC) was observed around at pH 6.0-7.0. These results suggested that the size of the iron oxide particles was affected by the change in pH levels. As a result, the particle sizes of iron oxide were smaller at lower pH than at neutral pH. In addition, agglomeration of the iron oxide particles increased as the pH increased from 2 to 7. In the time-dependent aggregation test, the average particle size was 730.4 nm and 1,340.3 nm at pH 2 and 7, respectively. These properties of iron oxide particles can be used to develop an ideal acid indicator for food pH and to monitor food quality, besides a colorant or nutrient for nutrition enhancement and sensory promotion in food industry. PMID:27482521

  10. Evaluation of features to support safety and quality in general practice clinical software

    Directory of Open Access Journals (Sweden)

    Schattner Peter

    2011-05-01

    Full Text Available Abstract Background Electronic prescribing is now the norm in many countries. We wished to find out if clinical software systems used by general practitioners in Australia include features (functional capabilities and other characteristics that facilitate improved patient safety and care, with a focus on quality use of medicines. Methods Seven clinical software systems used in general practice were evaluated. Fifty software features that were previously rated as likely to have a high impact on safety and/or quality of care in general practice were tested and are reported here. Results The range of results for the implementation of 50 features across the 7 clinical software systems was as follows: 17-31 features (34-62% were fully implemented, 9-13 (18-26% partially implemented, and 9-20 (18-40% not implemented. Key findings included: Access to evidence based drug and therapeutic information was limited. Decision support for prescribing was available but varied markedly between systems. During prescribing there was potential for medicine mis-selection in some systems, and linking a medicine with its indication was optional. The definition of 'current medicines' versus 'past medicines' was not always clear. There were limited resources for patients, and some medicines lists for patients were suboptimal. Results were provided to the software vendors, who were keen to improve their systems. Conclusions The clinical systems tested lack some of the features expected to support patient safety and quality of care. Standards and certification for clinical software would ensure that safety features are present and that there is a minimum level of clinical functionality that clinicians could expect to find in any system.

  11. Evaluation of features to support safety and quality in general practice clinical software

    Science.gov (United States)

    2011-01-01

    Background Electronic prescribing is now the norm in many countries. We wished to find out if clinical software systems used by general practitioners in Australia include features (functional capabilities and other characteristics) that facilitate improved patient safety and care, with a focus on quality use of medicines. Methods Seven clinical software systems used in general practice were evaluated. Fifty software features that were previously rated as likely to have a high impact on safety and/or quality of care in general practice were tested and are reported here. Results The range of results for the implementation of 50 features across the 7 clinical software systems was as follows: 17-31 features (34-62%) were fully implemented, 9-13 (18-26%) partially implemented, and 9-20 (18-40%) not implemented. Key findings included: Access to evidence based drug and therapeutic information was limited. Decision support for prescribing was available but varied markedly between systems. During prescribing there was potential for medicine mis-selection in some systems, and linking a medicine with its indication was optional. The definition of 'current medicines' versus 'past medicines' was not always clear. There were limited resources for patients, and some medicines lists for patients were suboptimal. Results were provided to the software vendors, who were keen to improve their systems. Conclusions The clinical systems tested lack some of the features expected to support patient safety and quality of care. Standards and certification for clinical software would ensure that safety features are present and that there is a minimum level of clinical functionality that clinicians could expect to find in any system.

  12. Clinical indicators for bacterial co-infection in Ghanaian children with P. falciparum infection.

    Science.gov (United States)

    Nielsen, Maja Verena; Amemasor, Solomon; Agyekum, Alex; Loag, Wibke; Marks, Florian; Sarpong, Nimako; Dekker, Denise; Adu-Sarkodie, Yaw; May, Jürgen

    2015-01-01

    Differentiation of infectious causes in severely ill children is essential but challenging in sub- Saharan Africa. The aim of the study was to determine clinical indicators that are able to identify bacterial co-infections in P. falciparum infected children in rural Ghana. In total, 1,915 severely ill children below the age of 15 years were recruited at Agogo Presbyterian Hospital in Ghana between May 2007 and February 2011. In 771 (40%) of the children malaria parasites were detected. This group was analyzed for indicators of bacterial co-infections using bivariate and multivariate regression analyses with 24 socio-economic variables, 16 terms describing medical history and anthropometrical information and 68 variables describing clinical symptoms. The variables were tested for sensitivity, specificity, positive predictive value and negative predictive value. In 46 (6.0%) of the children with malaria infection, bacterial co-infection was detected. The most frequent pathogens were non-typhoid salmonellae (45.7%), followed by Streptococcus spp. (13.0%). Coughing, dehydration, splenomegaly, severe anemia and leukocytosis were positively associated with bacteremia. Domestic hygiene and exclusive breastfeeding is negatively associated with bacteremia. In cases of high parasitemia (>10,000/μl), a significant association with bacteremia was found for splenomegaly (OR 8.8; CI 1.6-48.9), dehydration (OR 18.2; CI 2.0-166.0) and coughing (OR 9.0; CI 0.7-118.6). In children with low parasitemia, associations with bacteremia were found for vomiting (OR 4.7; CI 1.4-15.8), severe anemia (OR 3.3; CI 1.0-11.1) and leukocytosis (OR 6.8 CI 1.9-24.2). Clinical signs of impaired microcirculation were negatively associated with bacteremia. Ceftriaxone achieved best coverage of isolated pathogens. The results demonstrate the limitation of clinical symptoms to determine bacterial co-infections in P. falciparum infected children. Best clinical indicators are dependent on the parasitemia

  13. On the use of cyclostationary indicators in IC engine quality control by cold tests

    Science.gov (United States)

    Delvecchio, S.; D'Elia, G.; Dalpiaz, G.

    2015-08-01

    This paper addresses the use of first- and second-order cyclostationary (CS1 and CS2) tools to process the vibration signals picked up from internal combustion (IC) engines during cold tests. This type of analysis is needed in order to detect and diagnose irregular operations for quality control purposes. The effectiveness of indicators such as Mean Instantaneous Power (MIP), Degree of Cyclostationarity (DCSα) and Indicator of Cyclostationarity (ICSnx) in detecting assembly faults has been tested on real signals concerning three faulty conditions: inverted piston, connecting rod with incorrectly tightened screws, connecting rod without one bearing cap. In the past several authors have mainly used cyclostationary metrics for diagnostics purposes in rolling bearings and gear systems. Moreover, a signal model, qualitatively reproducing the features of actual cold test signals, has been formulated and used in order to preliminarily study the influence of signal parameters on the Indicators of Cyclostationarity. The results indicate that the cyclostationary tools - mainly CS2 tools - are effective in detecting and diagnosing all tested faulty conditions. In particular, indicator IC⌢S2x is highly sensitive to faults and it is suitable as pass/fail tool in quality control at the end of the engine assembly line. As a further second-order cyclostationary metric, the MIP is effective for detection, as well for fault identification, since it is able to localize regular and fault events within the engine cycle. In addition DCSα effectively characterizes the CS2 periodicities, giving the cyclic order distribution. Since these CS2 tools require a moderate computation cost, they can be considered ready for on-line industrial applications.

  14. PSA testing without clinical indication for prostate cancer in relation to socio-demographic and clinical characteristics in the Danish Diet, Cancer and Health Study

    DEFF Research Database (Denmark)

    Karlsen, Randi V; Larsen, Signe B; Christensen, Jane; Brasso, Klaus; Friis, Søren; Tjønneland, Anne; Dalton, Susanne Oksbjerg

    2013-01-01

    associations between socio-demographic or clinical characteristics and PSA testing without clinical indication. Material and methods. In the Danish Diet, Cancer and Health Cohort, we identified 1051 men with PC diagnosed in 1993-2008. Diagnostic and clinical characteristics were obtained from medical records......, and socio-demographic information was retrieved from administrative registers. We used general logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between socio-demographic or clinical characteristics and PSA testing without clinical...... indication. Cox regression analysis was used to examine associations with mortality. Results. PSA testing without clinical indication was less likely among patients > 67 years (OR 0.7; 0.5-1.0). Men who were, PSA tested without clinical indication, were more likely to have vocational training (OR 1.8; 1...

  15. Preparation of a beam quality indicator for effective energy determinations of continuum beams: establishment of traceability

    CERN Document Server

    Matsubayashi, M; Kobayashi, H

    1999-01-01

    A new beam quality indicator (BQI) was designed and fabricated to determine effective energies of beams extracted from neutron radiography facilities. Performances of the five new BQIs were compared with the original BQI which was recently proposed and tested by various beams. Non-filtered thermal neutrons, filtered thermal neutrons, and cold neutrons from a guide tube were used in the performance test program. The new BQIs were also examined by four different detection systems using a combination of a Gd converter and a X-ray film, a neutron imaging plate, a cooled charge coupled device camera, and a silicon intensified target tube camera.

  16. h-index, h-type Indices, and the Role of Corrected Quality Ratio

    Directory of Open Access Journals (Sweden)

    Tahira, Muzammil

    2014-12-01

    Full Text Available This study examines the foremost concerns related to most noted research performance index. The most popular and widely acceptable h-index underestimates the highly visible scientist, the middle order group, due to citation distribution issues. The study addresses this issue and uses 'Corrected Quality Ratio' (CQ to check the implicit underpinnings as evident in h-index. CQ helps to incorporate the aspects of a good research performance indicator. This simple revision performs more intimately and logically to gauge the broader research impact for all groups and highly visible scientists with less statistical error.

  17. Metamorphosis of Benthic Invertebrate Larvae: A Sensitive Indicator for Detection of Changes in Marine Environmental Quality

    Directory of Open Access Journals (Sweden)

    Xuelei Zhang

    2002-01-01

    Full Text Available Many marine coastal ecosystems are threatened by increasing waste discharge, and bioassays are needed because chemical and physical tests alone are not sufficient to assess potential effects on aquatic biota. In light of the fact that larval metamorphosis of benthic invertebrates is usually very sensitive to environmental changes, this paper reviews sensitivity comparisons of larval metamorphosis with other common bioassays in different species and those in different developmental stages of the same species, and it discusses the potential use of larval metamorphosis as an indicator of marine environmental quality.

  18. Escherichia coli as an indicator of bacteriological quality of water: an overview

    Directory of Open Access Journals (Sweden)

    Stephen T. Odonkor

    2013-06-01

    Full Text Available Monitoring the microbiological quality of drinking water relies largely on examination of indicator bacteria such as coliforms, Escherichia coli, and Pseudomonas aeruginosa. E. coli is a member of the faecal coliform group and is a more specific indicator of faecal pollution than other faecal coliforms. Two key factors have led to the trend toward the use of E. coli as the preferred indicator for the detection of faecal contamination, not only in drinking water, but also in other matrices as well: first, the finding that some faecal coliforms were non faecal in origin, and second, the development of improved testing methods for E. coli. The faecal coliform definition has also been revised to coincide better with the genetic make-up of its members and now includes newly identified environmental species. As a result, faecal coliforms are increasingly being referred to as thermotolerant coliforms. This, combined with improved detection methods for E. coli, has started a trend toward the use of E. coli in place of thermotolerant coliforms as a more reliable indicator of faecal pollution in drinking water. At present, E. coli appears to provide the best bacterial indication of faecal contamination in drinking water. This is based on the prevalence of thermotolerant (faecal coliforms in temperate environments as compared to the rare incidence of E. coli, the prevalence of E. coli in human and animal faeces as compared to other thermotolerant coliforms, and the availability of affordable, fast, sensitive, specific and easier to perform detection methods for E. coli.

  19. Assessment of two Carolina watersheds using land and stream habitat quality indices

    Energy Technology Data Exchange (ETDEWEB)

    McQuaid, B.F.; Norfleet, L.

    1999-07-01

    The US Department of Agriculture (USDA) Natural Resources Conservation Service (NRCS) has been directed to assist local landowners and communities to implement watershed improvement practices. The purpose of this study was to document current conditions in the Rocky River Watershed in North Carolina and the Saluda River Watershed in South Carolina. A variety of watershed assessment tools, including the NRCS Visual Stream Assessment (VSA), Stream Habitat Assessment (SHA), Riparian Vegetation Index (RVI), Index of Biotic Integrity (IBI), and Land Quality Index (LQI) were used on a statistically representative portion of both watersheds. Overall, the SHA, VSA, and RVI rated the watershed's condition as good, whereas the IBI rated them as fair. Correlations between IBI and the other indices were poor, perhaps indicating these indices measure different features within the watersheds. The LQI emphasized the need for better characterization of urban land and riparian corridors. Inclusion of suburban lawns with the urban land indicator improved correlations between IBI and LQI by 20%. This pilot study suggests further scrutiny in applying quantitative stream physical habitat measures to assess watershed conditions. It also indicates additional study of the IBI by NRCS. Resources devoted to statistical design were valuable and should provide the NRCS with a framework for conducting future watershed studies.

  20. Patients' perceptions of safety and quality of maternity clinical handover

    Directory of Open Access Journals (Sweden)

    Chin Georgiana SM

    2011-08-01

    Full Text Available Abstract Background Maternity clinical handover serves to address the gaps in knowledge existing when transitions between individuals or groups of clinicians occur throughout the antenatal, intra-partum and postnatal period. There are limited published studies on maternity handover and a paucity of information about patients' perceptions of the same. This paper reports postnatal patients' perceptions of how maternity handover contributes to the quality and safety of maternity care. Methods This paper reports on a mixed-methods study consisting of qualitative interviews and quantitative medical record analysis. Thirty English-speaking postnatal patients who gave birth at an Australian tertiary maternity hospital participated in a semi-structured interview prior to discharge from hospital. Interview data were coded thematically using the constant comparative method and managed via NVivo software; this data set was supplemented by medical record data analysed using STATA. Results Almost half of the women were aware of a handover process. Clinician awareness of patient information was seen as evidence that handover had taken place and was seen as representing positive aspects of teamwork, care and communication by participants, all important factors in the perception of quality health care. Collaborative cross-checking, including the use of cognitive artefacts such as hand held antenatal records and patient-authored birth plans, and the involvement of patients and their support people in handover were behaviours described by participants to be protective mechanisms that enhanced quality and safety of care. These human factors also facilitated team situational awareness (TSA, shared decision making and patient motivation in labour. Conclusions This study illustrates that many patients are aware of handover processes. For some patients, evidence of handover, through clinician awareness of information, represented positive aspects of teamwork, care and

  1. Derivation of sky quality indicators from photometrically calibrated all-sky image mosaics

    Science.gov (United States)

    Duriscoe, Dan M.; Moore, Chadwick A.; Luginbuhl, Christian B.

    2015-08-01

    A large database of high resolution all-sky measurements of V-band night sky brightness at sites in U.S. National Parks and astronomical observatories is utilized to describe sky quality over a wide geographic area. Mosaics of photometrically calibrated V-band imagery are processed with a semi-automated procedure to reveal the effects of artificial sky glow through graphical presentation and numeric indicators of artificial sky brightness. Comparison with simpler methods such as the use of the Unihedron SQM and naked eye limiting magnitude reveal that areas near the horizon, which are not typically captured with single-channel measurements, contribute significantly to the indicators maximum vertical illuminance, maximum sky luminance, and average all-sky luminance. Distant sources of sky glow may represent future threats to areas of the sky nearer the zenith. Timely identification and quantification of these threats may allow mitigating strategies to be implemented.

  2. Photometric indicators of visual night sky quality derived from all-sky brightness maps

    Science.gov (United States)

    Duriscoe, Dan M.

    2016-09-01

    Wide angle or fisheye cameras provide a high resolution record of artificial sky glow, which results from the scattering of escaped anthropogenic light by the atmosphere, over the sky vault in the moonless nocturnal environment. Analysis of this record yields important indicators of the extent and severity of light pollution. The following indicators were derived through numerical analysis of all-sky brightness maps: zenithal, average all-sky, median, brightest, and darkest sky brightness. In addition, horizontal and vertical illuminance, resulting from sky brightness were computed. A natural reference condition to which the anthropogenic component may be compared is proposed for each indicator, based upon an iterative analysis of a high resolution natural sky model. All-sky brightness data, calibrated in the V band by photometry of standard stars and converted to luminance, from 406 separate data sets were included in an exploratory analysis. Of these, six locations representing a wide range of severity of impact from artificial sky brightness were selected as examples and examined in detail. All-sky average brightness is the most unbiased indicator of impact to the environment, and is more sensitive and accurate in areas of slight to moderate light pollution impact than zenith brightness. Maximum vertical illuminance provides an excellent indicator of impacts to wilderness character, as does measures of the brightest portions of the sky. Zenith brightness, the workhorse of field campaigns, is compared to the other indicators and found to correlate well with horizontal illuminance, especially at relatively bright sites. The median sky brightness describes a brightness threshold for the upper half of the sky, of importance to telescopic optical astronomy. Numeric indicators, in concert with all-sky brightness maps, provide a complete assessment of visual sky quality at a site.

  3. Performance indicators for initial regional medical response to major incidents: a possible quality control tool

    Directory of Open Access Journals (Sweden)

    Nilsson Heléne

    2012-12-01

    used as a structured quality control tool as well as constitute measurable parts of a nationally based follow-up system for major incidents. Additional indicators need to be developed for hospital-related incidents such as interference with hospital infrastructure.

  4. Can Examination of WWW Usage Statistics and other Indirect Quality Indicators Help to Distinguish the Relative Quality of Medical websites?

    Science.gov (United States)

    Macías-Cervi, Pablo; Gaspar-Guardado, María Asunción; DeArcaya, María Luisa Torres-Álvarez; Ruiz-Rabaza, Ana; Jiménez-Sosa, Alejandro

    1999-01-01

    Background The Internet offers a great amount of health related websites, but concern has been raised about their reliability. Several subjective evaluation criteria and websites rating systems have been proposed as a help for the Internet users to distinguish among web resources with different quality, but their efficacy has not been proven. Objective To evaluate the agreement of a subset of Internet rating systems editorial boards regarding their evaluations of a sample of pediatric websites. To evaluate certain websites characteristics as possible quality indicators for pediatric websites. Methods Comparative survey of the results of systematic evaluations of the contents and formal aspects of a sample of pediatric websites, with the number of daily visits to those websites, the time since their last update, the impact factor of their authors or editors, and the number of websites linked to them. Results 363 websites were compiled from eight rating systems. Only 25 were indexed and evaluated by at least two rating systems. This subset included more updated and more linked websites. There was no correlation among the results of the evaluation of these 25 websites by the rating systems. The number of inbound links to the websites significantly correlated with their updating frequency (p<.001), with the number of daily visits (p=.005), and with the results of their evaluation by the largest rating system, HealthAtoZ (p<.001). The websites updating frequency also significantly correlated with the results of the websites evaluation by HealthAtoZ, both about their contents (p=.001) and their total values (p<.05). The number of daily visits significantly correlated (p<.05) with the results of the evaluations by Medical Matrix. Conclusions Some websites characteristics as the number of daily visits, their updating frequency and, overall, the number of websites linked to them, correlate with their evaluation by some of the largest rating systems on the Internet, what

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

    Science.gov (United States)

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

    2016-04-01

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

  6. A potential to monitor nutrients as an indicator of rangeland quality using space borne remote sensing

    International Nuclear Information System (INIS)

    Global change consisting of land use and climate change could have huge impacts on food security and the health of various ecosystems. Leaf nitrogen (N) is one of the key factors limiting agricultural production and ecosystem functioning. Leaf N can be used as an indicator of rangeland quality which could provide information for the farmers, decision makers, land planners and managers. Leaf N plays a crucial role in understanding the feeding patterns and distribution of wildlife and livestock. Assessment of this vegetation parameter using conventional methods at landscape scale level is time consuming and tedious. Remote sensing provides a synoptic view of the landscape, which engenders an opportunity to assess leaf N over wider rangeland areas from protected to communal areas. Estimation of leaf N has been successful during peak productivity or high biomass and limited studies estimated leaf N in dry season. The objective of this study is to monitor leaf N as an indicator of rangeland quality using WorldView 2 satellite images in the north-eastern part of South Africa. Series of field work to collect samples for leaf N were undertaken in the beginning of May (end of wet season) and July (dry season). Several conventional and red edge based vegetation indices were computed. Simple regression was used to develop prediction model for leaf N. Using bootstrapping, indicator of precision and accuracy were analyzed to select a best model for the combined data sets (May and July). The may model for red edge based simple ratio explained over 90% of leaf N variations. The model developed from the combined data sets with normalized difference vegetation index explained 62% of leaf N variation, and this is a model used to estimate and map leaf N for two seasons. The study demonstrated that leaf N could be monitored using high spatial resolution with the red edge band capability

  7. CUSTOMER SATISFACTION AS AN INDICATOR OF SERVICE QUALITY IN TOURISM AND HOSPITALITY

    Directory of Open Access Journals (Sweden)

    Ana Stranjancevic

    2015-12-01

    Full Text Available One of the greatest challenges for stakeholders is to ensure customer satisfaction, especially in service industries such as tourism and hospitality. The aim of this paper is to show that restaurant guest satisfaction depends on numerous factors as well as to show the connection between satisfaction and loyalty. Customer satisfaction and loyalty are excellent indicators of service quality. For the purpose of this paper, empirical survey was conducted and the results of the research were analyzed by statistical method. Factors which affect customer satisfaction are: kind staff, professionalism, speed of service, food quality, ambience and comfort. This implicates a special need for the introduction of strong Human Resource Management, food safety standards (e.g. HACCP and effective space planning. The study implies that the care for quality of products and services is necessary at all levels and that it is impossible to ensure the customer satisfaction or create customer loyalty without strong management system (including space projecting and without controlling it.

  8. Behavioural and psychological symptoms of dementia in Down syndrome: Early indicators of clinical Alzheimer's disease?

    Science.gov (United States)

    Dekker, Alain D; Strydom, André; Coppus, Antonia M W; Nizetic, Dean; Vermeiren, Yannick; Naudé, Petrus J W; Van Dam, Debby; Potier, Marie-Claude; Fortea, Juan; De Deyn, Peter P

    2015-12-01

    Behavioural and Psychological Symptoms of Dementia (BPSD) are a core symptom of dementia and are associated with suffering, earlier institutionalization and accelerated cognitive decline for patients and increased caregiver burden. Despite the extremely high risk for Down syndrome (DS) individuals to develop dementia due to Alzheimer's disease (AD), BPSD have not been comprehensively assessed in the DS population. Due to the great variety of DS cohorts, diagnostic methodologies, sub-optimal scales, covariates and outcome measures, it is questionable whether BPSD have always been accurately assessed. However, accurate recognition of BPSD may increase awareness and understanding of these behavioural aberrations, thus enabling adaptive caregiving and, importantly, allowing for therapeutic interventions. Particular BPSD can be observed (long) before the clinical dementia diagnosis and could therefore serve as early indicators of those at risk, and provide a new, non-invasive way to monitor, or at least give an indication of, the complex progression to dementia in DS. Therefore, this review summarizes and evaluates the rather limited knowledge on BPSD in DS and highlights its importance and potential for daily clinical practice. PMID:26343344

  9. Aerobics, Quality of Life, and Physiological Indicators of Inactive Male Students’ Cardiovascular Endurances, in Kashan

    Science.gov (United States)

    Bahram, Mohammad Ebrahim; Akkasheh, Gudarz; Akkasheh, Negar

    2014-01-01

    Background: Studies show that lack of exercise and physical activity during childhood and teenage years is directly related to different diseases in adulthood. Objectives: The main purpose of this study was to investigate the effects of an eight-week aerobic exercise on the quality of life as well as physiological indicators of cardiovascular endurance of inactive high school male students in Kashan. Materials and Methods: The study was a field trial using pretest and post-test. Three hundred high school male students in Kashan, Iran, were recruited and interviewed by the researchers, using a questionnaire. Of the inactive ones, 30 who reached the highest criteria standards, were selected as samples and randomly divided to two equal groups. The maximum consumed oxygen (VO2max) and resting heart rate were measured by Quinn aerobic test, and the quality of life was measured by the World Health Organization Quality of Life (WHOQOL-26-Breef) questionnaire. The exercise program included an eight-week aerobic exercise, three times per week, with 60%-75% of the maximum heart beat. During the exercise, the subjects had no other sport activity. To check the normal distribution of the data, Kolmogorov-Smirnov test was used. To evaluate the pretest and post-test results, paired t-test was used and for comparing the groups, independent t-test was applied. All the analyses were performed by SPSS software version 16. Results: The mean ages of intervention and control groups were 17.46 ± 1.30 and 17.53 ± 1.18, respectively. The mean weight of the intervention group was 56.73 ± 9.91 kg and its mean body mass index (BMI) was 19.88 ± 3.42. In the control group, the mean weigh and BMI were 60.06 ± 11.96 kg and 20.79 ± 3.51, respectively. The quality of life and its components improved significantly in the intervention group (physical (P = 0.0001), mental (P = 0.0001), social (P = 0.0001), and environmental (P = 0.0001) aspects). VO2max (P = 0.001) and the resting heart beat (P

  10. Prospects and quality indices for groundwater development in Ibadan metropolis, southwestern Nigeria

    Directory of Open Access Journals (Sweden)

    Ajibade, O.M.

    2013-03-01

    Full Text Available An integrated geophysical and hydrogeochemical studies were conducted in part of Ibadan metropolis, Southwestern Nigeria to investigate the groundwater potential and quality for sustainable development. Interpreted results of vertical electrical sounding data revealed three to four geo-electric layers; top soil (22.1-441.4 Ωm, lateritic horizon (402.1-712.2 Ωm, clayey/sandyclay layer (2.95-66.0 Ωm and weathered/fractured bedrock (66.3-1056.7 Ωm. Stacked overburden isopach and basement isoresitivity maps revealed few areas with thick overburden and fractured basement, hence of apparently high groundwater prospect. Hydrogeochemical study indicates that groundwater in the study area is generally fresh, soft- moderately hard, slightly acidic and dominated by Na, Ca, Mg, Cl and HCO3 ions. The dominant hydrochemical facies is Na-Cl type with minor mixed Ca-Na-Cl and Ca-Cl types. Many of the analyzed parameters fall within recommended limits and thus, most of the groundwater in the study area are chemically suitable for drinking. A few however, recorded TDS, pH, NO3, Al, Mg and Cl concentrations above permissible levels, suggesting some concern in terms of potability. The groundwater quality for agricultural purposes was assessed using Sodium absorption ratio, permeability index and electrical conductivity values along with USSL and Wilcox diagrams, all indicating that most of the samples are excellent to good for irrigation.

  11. Context dependency of baseline glucocorticoids as indicators of individual quality in a capital breeder.

    Science.gov (United States)

    Jaatinen, Kim; Seltmann, Martin W; Hollmén, Tuula; Atkinson, Shannon; Mashburn, Kendall; Öst, Markus

    2013-09-15

    Identifying markers of individual quality is a central goal of life-history theory and conservation biology. The 'corticosterone (CORT)-fitness hypothesis' postulates that low fitness signals impaired ability to cope with the environment, resulting in elevated baseline CORT levels. CORT can, however, be negatively, positively or neutrally related to fitness, depending on the context. In order to clarify this controversial issue, we elucidate the utility of using baseline CORT as a correlate of individual fitness in incubating female eiders across variable environments. An increase in serum CORT with decreasing body condition was evident in older, more experienced breeders, while increased clutch mass was associated with elevated serum CORT in females breeding late in the season. For faecal CORT, the expected negative association with body condition was observed only in early breeders. We found a strong increase in faecal CORT with increasing baseline body temperature, indicating the utility of body temperature as a complementary stress indicator. Females in good body condition had a lower baseline body temperature, but this effect was only observed on open islands, a harsher breeding habitat less buffered against weather variability. Females with higher reproductive investment also maintained a lower baseline body temperature. Nest success strongly decreased with increasing serum and faecal CORT concentrations, and individual stress hormone and body temperature profiles were repeatable over years. Although our data support the tenet that baseline CORT is negatively related to fitness, the complex context-dependent effects call for cautious interpretation of relationships between stress physiology and phenotypic quality. PMID:23851039

  12. Technical aspects of using human adenovirus as a viral water quality indicator.

    Science.gov (United States)

    Rames, Emily; Roiko, Anne; Stratton, Helen; Macdonald, Joanne

    2016-06-01

    Despite dramatic improvements in water treatment technologies in developed countries, waterborne viruses are still associated with many of cases of illness each year. These illnesses include gastroenteritis, meningitis, encephalitis, and respiratory infections. Importantly, outbreaks of viral disease from waters deemed compliant from bacterial indicator testing still occur, which highlights the need to monitor the virological quality of water. Human adenoviruses are often used as a viral indicator of water quality (faecal contamination), as this pathogen has high UV-resistance and is prevalent in untreated domestic wastewater all year round, unlike enteroviruses and noroviruses that are often only detected in certain seasons. Standard methods for recovering and measuring adenovirus numbers in water are lacking, and there are many variations in published methods. Since viral numbers are likely under-estimated when optimal methods are not used, a comprehensive review of these methods is both timely and important. This review critically evaluates how estimates of adenovirus numbers in water are impacted by technical manipulations, such as during adenovirus concentration and detection (including culturing and polymerase-chain reaction). An understanding of the implications of these issues is fundamental to obtaining reliable estimation of adenovirus numbers in water. Reliable estimation of HAdV numbers is critical to enable improved monitoring of the efficacy of water treatment processes, accurate quantitative microbial risk assessment, and to ensure microbiological safety of water. PMID:27065054

  13. Amphipod densities and indices of wetland quality across the upper-Midwest, USA

    Science.gov (United States)

    Anteau, M.J.; Afton, A.D.

    2008-01-01

    Nutritional, behavioral, and diet data for lesser scaup (Aythya affinis [Eyton, 1838]) indicates that there has been a decrease in amphipod (Gammarus lacustris [G. O. Sars, 1863] and Hyalella azteca [Saussure, 1858]) density and wetland quality throughout the upper-Midwest, USA. Accordingly, we estimated densities of Gammarus and Hyalella in six eco-physiographic regions of Iowa, Minnesota, and North Dakota; 356 randomly selected semipermanent and permanent wetlands were sampled during springs 2004 and 2005. We also examined indices of wetland quality (e.g., turbidity, fish communities, aquatic vegetation) among regions in a random subset of these wetlands (n = 267). Gammarus and Hyalella were present in 19% and 54% of wetlands sampled, respectively. Gammarus and Hyalella densities in North Dakota were higher than those in Iowa and Minnesota. Although historical data are limited, our regional mean (1 to 12 m-3) amphipod densities (Gammarus + Hyalella) were markedly lower than any of the historical density estimates. Fish, important predators of amphipods, occurred in 31%-45% of wetlands in North Dakota, 84% of wetlands in the Red River Valley, and 74%-84% of wetlands in Iowa and Minnesota. Turbidity in wetlands of Minnesota Morainal (4.0 NTU geometric mean) and Red River Valley (6.1 NTU) regions appeared low relative to that of the rest of the upper-Midwest (13.2-17.5 NTU). We conclude that observed estimates of amphipods, fish, and turbidity are consistent with low wetland quality, which has resulted in lower food availability for various wildlife species, especially lesser scaup, which use these wetlands in the upper-Midwest. ?? 2008, The Society of Wetland Scientists.

  14. Generation and utilisation of quality indicators for satellite-derived atmospheric motion vectors

    Science.gov (United States)

    Holmlund, Kenneth

    The extraction of Atmospheric Motion Vectors (AMVs) from cloud and moisture features from successive geostationary satellite images is an established and important part of the global observing system. One of the main problems in the utilisation of this data is the variable quality of the derived displacement vectors. Furthermore the AMVs are still currently used as single point measurements, even though they are generally based on targets that represent large areas and the height that is assigned to the vectors often represents a layer mean. In the early AMV derivation schemes the derived vector fields were quality controlled by experienced meteorologists and poor vectors were removed. Furthermore any suspect vector showing any kind of deviations in time and space was rejected and hence only about 17% of all possible vectors were disseminated. Today the high production frequency and the increased resolution make manual quality control unfeasible. Furthermore the new assimilation schemes utilised in Numerical Weather Prediction (NWP) require qualitative information on the errors of the individual AMVs. This Thesis describes an Automatic Quality Control (AQC) scheme that is based on the statistical properties of the derived AMVs. The properties of the AMVs, i.e. their consistency in time and space, are interpreted with a number of tests. The outcome of each test is normalised such that they can be combined to a Quality Indicator (QI) that gives an estimation of the expected quality of every individual vector as is shown by statistics against radiosondes and verified by the positive impact in data assimilation schemes. The QIs are currently derived and disseminated together with the derived AMVs by several operational AMV derivation centres. Only a small number of vectors are now removed before dissemination. The QIs are used operationally for data selection at various NWT centres and have alleviated some of the problems related to the assimilation of this data in NWT

  15. Evaluation of air quality indicators in Alberta, Canada - An international perspective.

    Science.gov (United States)

    Bari, Md Aynul; Kindzierski, Warren B

    2016-01-01

    There has been an increase in oil sands development in northern Alberta, Canada and an overall increase in economic activity in the province in recent years. An evaluation of the state of air quality was conducted in four Alberta locations - urban centers of Calgary and Edmonton, and smaller communities of Fort McKay and Fort McMurray in the Athabasca Oil Sands Region (AOSR). Concentration trends, diurnal hourly and monthly average concentration profiles, and exceedances of provincial, national and international air quality guidelines were assessed for several criteria air pollutants over the period 1998 to 2014. Two methods were used to evaluate trends. Parametric analysis of annual median 1h concentrations and non-parametric analysis of annual geometric mean 1h concentrations showed consistent decreasing trends for NO2 and SO2 (Little consistency in trends was observed among the methods for the same air pollutants other than for THC (increasing in Fort McKay <0.1ppm per year and no trend in Fort McMurray), PM2.5 in Fort McKay and Fort McMurray (no trend) and CO (decreasing <0.1ppm per year in Fort McMurray) over the same period. Levels of air quality indicators at the four locations were compared with other Canadian and international urban areas to judge the current state of air quality. Median and annual average concentrations for Alberta locations tended to be the smallest in Fort McKay and Fort McMurray. Other than for PM2.5, Calgary and Edmonton tended to have median and annual average concentrations comparable to and/or below that of larger populated Canadian and U.S. cities, depending upon the air pollutant. PMID:27071052

  16. Morphological indicators of the quality of one-year-old bare-root seedlings of wild cherry (Prunus avium L.

    Directory of Open Access Journals (Sweden)

    Stjepanović Stefan

    2013-01-01

    Full Text Available This paper presents morphological indicators of the quality of one-year-old seedlings of wild cherry (Prunus avium L. with special reference to their correlations. The examined parameters were: length, diameter, weight of the aboveground and underground parts, number of buds, root volume, root length and leaf area. The ratio of heights was determined on the basis of the parameters derived: diameter, and the ratio of aboveground and underground parts of a seedling and the Quality Index. Height and diameter have proven to be good indicators of quality. Root volume has proven to be a better indicator of the quality of seedlings than root length. The weight ratio of the aboveground and underground parts of broadleaved trees in the dry state must be defined in advance, both when the measurements are carried out with and without leaves. The Quality Index has proven to be the most comprehensive morphological indicator of quality.

  17. Monitoring and assessment of water health quality in the Tajan River, Iran using physicochemical, fish and macroinvertebrates indices

    NARCIS (Netherlands)

    Aazami, J.; Kosten, S.; Abdoli, A.; Sohrabi, H.; Brink, van den P.J.

    2015-01-01

    Background - Nowadays, aquatic organisms are used as bio-indicators to assess ecological water quality in western regions, but have hardly been used in an Iranian context. We, therefore, evaluated the suitability of several indices to assess the water quality for an Iranian case study. Methods - Mea

  18. Assessing Ecological Impacts of Shrimp and Sewage Effluent: Biological Indicators with Standard Water Quality Analyses

    Science.gov (United States)

    Jones, A. B.; O'Donohue, M. J.; Udy, J.; Dennison, W. C.

    2001-01-01

    Despite evidence linking shrimp farming to several cases of environmental degradation, there remains a lack of ecologically meaningful information about the impacts of effluent on receiving waters. The aim of this study was to determine the biological impact of shrimp farm effluent, and to compare and distinguish its impacts from treated sewage effluent. Analyses included standard water quality/sediment parameters, as well as biological indicators including tissue nitrogen (N) content, stable isotope ratio of nitrogen (δ 15N), and amino acid composition of inhabitant seagrasses, mangroves and macroalgae. The study area consisted of two tidal creeks, one receiving effluent from a sewage treatment plant and the other from an intensive shrimp farm. The creeks discharged into the western side of Moreton Bay, a sub-tropical coastal embayment on the east coast of Australia. Characterization of water quality revealed significant differences between the creeks, and with unimpacted eastern Moreton Bay. The sewage creek had higher concentrations of dissolved nutrients (predominantly NO-3/NO-2 and PO3-4, compared to NH+4 in the shrimp creek). In contrast, the shrimp creek was more turbid and had higher phytoplankton productivity. Beyond 750 m from the creek mouths, water quality parameters were indistinguishable from eastern Moreton Bay values. Biological indicators detected significant impacts up to 4 km beyond the creek mouths (reference site). Elevated plant δ 15N values ranged from 10·4-19·6‰ at the site of sewage discharge to 2·9-4·5‰ at the reference site. The free amino acid concentration and composition of seagrass and macroalgae was used to distinguish between the uptake of sewage and shrimp derived N. Proline (seagrass) and serine (macroalgae) were high in sewage impacted plants and glutamine (seagrass) and alanine (macroalgae) were high in plants impacted by shrimp effluent. The δ 15N isotopic signatures and free amino acid composition of inhabitant

  19. Application of the Stockholm Hierarchy to Defining the Quality of Reference Intervals and Clinical Decision Limits

    OpenAIRE

    Sikaris, Ken

    2012-01-01

    The Stockholm Hierarchy is a professional consensus created to define the preferred approaches to defining analytical quality. The quality of a laboratory measurement can also be classified by the quality of the limits that the value is compared with, namely reference interval limits and clinical decision limits. At the highest level in the hierarchy would be placed clinical decision limits based on clinical outcome studies. The second level would include both formal reference interval studie...

  20. Discourse and Review of Environmental Quality of River Bodies in India: An Appraisal of Physico-chemical and Biological Parameters as Indicators of Water Quality

    OpenAIRE

    Kumar Manoj; Pratap Kumar Padhy

    2015-01-01

    The present manuscript is an account of the studies conducted on some well known surface water bodies in India, with special emphasis on the river systems, to evaluate their quality status. The review covers the water quality estimation and identification of sources contributing to water quality deterioration. Commonly employed physicochemical and biological parameters as indicators of water quality have been thoroughly discussed. Some possible measures to prevent and control pollution of wat...

  1. Assessing different agricultural managements with the use of soil quality indices in a Mediteranean calcareous soil

    Science.gov (United States)

    Morugán-Coronado, Alicia; García-Orenes, Fuensanta; Mataix-Solera, Jorge; Arcenegui, Vicky; Cerdà, Artemi

    2013-04-01

    Soil erosion is a major problem in the Mediterranean region due to the arid conditions and torrential rainfalls, which contribute to the degradation of agricultural land. New strategies must be developed to reduce soil losses and recover or maintain soil functionality in order to achieve a sustainable agriculture. An experiment was designed to evaluate the effect of different agricultural management on soil properties and soil quality. Ten different treatments (contact herbicide, systemic herbicide, ploughing, Oat mulch non-plough, Oats mulch plough, leguminous plant, straw rice mulch, chipped pruned branches, residual-herbicide and agro geo-textile, and three control plots including no tillage or control and long agricultural abandonment (shrub on marls and shrub on limestone) were established in 'El Teularet experimental station' located in the Sierra de Enguera (Valencia, Spain). The soil is a Typic Xerorthent developed over Cretaceous marls in an old agricultural terrace. The agricultural management can modify the soil equilibrium and affect its quality. In this work two soil quality indices (models) developed by Zornoza et al. (2007) are used to evaluate the effects of the different agricultural management along 4 years. The models were developed studying different soil properties in undisturbed forest soils in SE Spain, and the relationships between soil parameters were established using multiple linear regressions. Model 1, that explained 92% of the variance in soil organic carbon (SOC) showed that the SOC can be calculated by the linear combination of 6 physical, chemical and biochemical properties (acid phosphatase, water holding capacity (WHC), electrical conductivity (EC), available phosphorus (P), cation exchange capacity (CEC) and aggregate stability (AS). Model 2 explains 89% of the SOC variance, which can be calculated by means of 7 chemical and biochemical properties (urease, phosphatase, and ß-glucosidase activities, pH, EC, P and CEC). We use the

  2. A framework for evidence-adaptive quality assessment that unifies guideline-based and performance-indicator approaches.

    OpenAIRE

    Advani, Aneel; Goldstein, Mary; Musen, Mark A.

    2002-01-01

    Automated quality assessment of clinician actions and patient outcomes is a central problem in guideline- or standards-based medical care. In this paper we describe a unified model representation and algorithm for evidence-adaptive quality assessment scoring that can: (1) use both complex case-specific guidelines and single-step population-wide performance-indicators as quality measures; (2) score adherence consistently with quantitative population-based medical utilities of the quality measu...

  3. Quality of care indicators and their related outcomes: A population-based study in prostate cancer patients treated with radiotherapy

    International Nuclear Information System (INIS)

    Background and purpose: We describe variations across the regional cancer centres in Ontario, Canada for five prostate cancer radiotherapy (RT) quality indicators: incomplete pre-treatment assessment, follow-up care, leg immobilization, bladder filling, and portal film target localization. Along with cancer centre volume, we examined each indicator’s association with relevant outcomes: long-term cause-specific survival, urinary incontinence, and gastrointestinal and genitourinary late morbidities. Materials and methods: We conducted a population-based retrospective cohort study of 924 prostate cancer patients diagnosed between 1990 and 1998 who received RT within 9 months of diagnosis. Data sources included treating charts and registry and administrative data. The associations between indicators and outcomes were analysed using regression techniques to control for potential confounders. Results: Practice patterns varied across the regional cancer centres for all indicators (p < 0.0001). Incomplete pre-treatment assessment was associated with worse cause-specific survival although this result was not significant when adjusted for confounding (adjusted RR = 1.78, 95% CI = 0.79–3.98). Treatment without leg immobilization (adjusted RR = 1.72, 95% CI = 1.16–2.56) and with an empty bladder (adjusted RR = 1.98, 95% CI = 1.08–3.63) was associated with genitourinary late morbidities. Treatment without leg immobilization was also associated with urinary incontinence (adjusted RR = 2.18, 95% CI = 1.23–3.87). Conclusions: We documented wide variations in practice patterns. We demonstrated that measures of quality of care can be shown to be associated with clinically relevant outcomes in a population-based sample of prostate cancer patients

  4. Indications of a new antibiotic in clinical practice: results of the tigecycline initial use registry

    Directory of Open Access Journals (Sweden)

    Daniel Curcio

    2008-06-01

    Full Text Available Tigecycline is the first of a new class of antibiotics named glycylcyclines and it was approved for the treatment of complicated intra-abdominal infections and complicated skin and skin structure infections. Notwithstanding this, tigecycline's pharmacological and microbiological profile which includes multidrug-resistant pathogens encourages physicians' use of the drug in other infections. We analyzed, during the first months after its launch, the tigecycline prescriptions for 113 patients in 12 institutions. Twenty-five patients (22% received tigecycline for approved indications, and 88 (78% for "off label" indications (56% with scientific support and 22% with limited or without any scientific support. The most frequent "off label" use was ventilator associated pneumonia (VAP (63 patients. The etiology of infections was established in 105 patients (93%. MDR-Acinetobacter spp. was the microorganism most frequently isolated (50% of the cases. Overall, attending physicians reported clinical success in 86 of the 113 patients (76%. Our study shows that the "off label" use of tigecycline is frequent, especially in VAP. due to MDR-Acinetobacter spp., where the therapeutic options are limited (eg: colistin. Physicians must evaluate the benefits/risks of using this antibiotic for indications that lack rigorous scientific support.

  5. Meat Quality Indicators and their Correlation in Two Crosses of Pigs

    Directory of Open Access Journals (Sweden)

    Goran Kušec

    2003-06-01

    Full Text Available The study was performed on 53 carcasses of three way crossed castrated pigs divided into two groups regarding the breed of the terminal sire (1st group; Pietrain, n=25 and 2nd group; Large White, n=28. After the slaughter at approximately 100 kg, following measurements were taken from MLD samples: pH45, pH24, water holding capacity (w.h.c., consistency and Minolta L*a*b* values. Significant differences between the groups were found for pH45 (p<0.01 values and Minolta L* (p<0.01, a* (p<0.05 and b* (p<0.01 values, while no significant differences were found for pH24, w.h.c. and consistency. The classification of meat from both groups according to quality (PSE, suspicious, .normal. by different criteria (pH45, pH24, Minolta L* showed obvious discrepancies which may have occurred due to recently determined additional quality classes such as RSE, RFN and PFN which points out the need of further investigations in that direction. In the 1st group pH45 was not correlated with any other meat qulity traits, while in 2nd group significant correlations for this trait were found with pH24 (r=0.43 and w.h.c. (r=-0.51. Ultimate pH values measured on the pig carcasses of the 1st group were correlated with w.h.c (r=-0.46 and Minolta L* value (r=- 0.43, while in 2nd group this trait was significantly correlated with all other indicators of meat quality (p<0.01. In the 1st group of samples minolta L* values were significantly correlated also with w.h.c. (r=0.40, while in the 2nd group this indicator was in significant correlation with all other indicators with exception of pH45.

  6. Percutaneous treatment of lumbar disc herniation by oxygen-ozone injection -clinical study with indication

    International Nuclear Information System (INIS)

    Objective: To study the clinical effect and the range of indications of oxygen-ozone treatment for lumber disc herniation. Methods: 6-15 ml of oxygen-ozone (35-45 μg/ml) were injected percutaneously into lumbar disc. In case of multiple disc herniations, the procedure could be taken with two discs for once. Results: 323 patients with 433 discs were treated by oxygen-ozone injection procedure. Total effective rate was 77.7%. Conclusions: The treatment of lumber disc herniation by oxygen-ozone injection is simple, safe and effective with mild trauma. Oxygen-ozone not only can oxidize the proteoglycan in the nucleus leading to the contraction of nucleus, but also provide anti-inflammation effect with pain relief and without complication yet. (authors)

  7. Clinical relevance and indications for cardiac magnetic resonance imaging 2013. An interdisciplinary expert statement

    International Nuclear Information System (INIS)

    During the last years the indications of Cardiac Magnetic Resonance Imaging (CMRI) have been continuously expanded. However, the acceptance of the method by cardiologists and radiologists does not correlate with respect to the diagnostic potential. Several factors, such as expensive equipment, relatively long examination times, high technical know how and lack of remuneration, limit the application of CMRI in everyday clinical practice. Furthermore, doctors tend to apply more conventional, well established diagnostic procedures, the access to the method is still limited and there exist difficulties in the interdisciplinary collaboration. The interdisciplinary Austrian approach to Cardiac Imaging is aimed to improve the aforementioned problems and to support the implementation of CMRI in the diagnostic tree of cardiac diseases thus enabling a cost efficient management of patients in cardiology. (orig.)

  8. Influence of clinical and socioeconomic indicators on dental trauma in preschool children

    Directory of Open Access Journals (Sweden)

    Patrícia CORRÊA-FARIA

    2015-01-01

    Full Text Available The aim of the present study was to determine the prevalence of traumatic dental injury (TDI in the primary dentition and investigate associations with clinical and socioeconomic indicators. A population-based, cross-sectional study was carried out with a randomly selected sample of 301 children aged one to five years. Data were collected through clinical oral examinations and interviews with parents/guardians during immunization campaigns. Statistical analysis involved Pearson’s Chi-squared test and Poisson regression with robust variance. The prevalence of TDI was 33.9%. TDI was more prevalent in children with overjet > 3 mm (p < 0.001 and those with inadequate lip coverage (p < 0.001. A statistically significant association was also found between TDI and household income (p = 0.024. According to the adjusted Poisson regression model, greater prevalence rates of TDI were found for children from families with a monthly income ≥ twice the Brazilian minimum monthly wage (PR: 1.52; 95%CI: 1.10-2.12, those with accentuated overjet (PR: 1.53; 95%CI: 1.05-2.22 and those with inadequate lip coverage (PR: 2.00; 95%CI: 1.41-2.84. The prevalence of TDI was high in the present study and was associated with a higher family income, accentuated overjet and inadequate lip coverage.

  9. Soil quality indicators in a rhodic kandiudult under different uses in northern Parana, Brazil

    Directory of Open Access Journals (Sweden)

    Biana Harumi Kuwano

    2014-02-01

    Full Text Available Sustainable use of soil, maintaining or improving its quality, is one of the goals of diversification in farmlands. From this point of view, bioindicators associated with C, N and P cycling can be used in assessments of land-use effects on soil quality. The aim of this study was to investigate chemical, microbiological and biochemical properties of soil associated with C, N and P under different land uses in a farm property with diversified activity in northern Parana, Brazil. Seven areas under different land uses were assessed: fragment of native Atlantic Forest; growing of peach-palm (Bactrys gasipaes; sugarcane ratoon (Saccharum officinarum recently harvested, under renewal; growing of coffee (Coffea arabica intercropped with tree species; recent reforestation (1 year with native tree species, previously under annual crops; annual crops under no-tillage, rye (Cecale cereale; secondary forest, regenerated after abandonment (for 20 years of an avocado (Persea americana orchard. The soil under coffee, recent reforestation and secondary forest showed higher concentrations of organic carbon, but microbial biomass and enzyme activities were higher in soils under native forest and secondary forest, which also showed the lowest metabolic coefficient, followed by the peach-palm area. The lowest content of water-dispersible clay was found in the soil under native forest, differing from soils under sugarcane and secondary forest. Soil cover and soil use affected total organic C contents and soil enzyme and microbial activities, such that more intensive agricultural uses had deeper impacts on the indicators assessed. Calculation of the mean soil quality index showed that the secondary forest was closest to the fragment of native forest, followed by the peach-palm area, coffee-growing area, annual crop area, the area of recent reforestation and the sugarcane ratoon area.

  10. Technical and clinical breast cancer screening performance indicators for computed radiography versus direct digital radiography

    Energy Technology Data Exchange (ETDEWEB)

    Bosmans, Hilde; Lemmens, Kim; Zanca, Federica; Ongeval, Chantal van; Steen, Andre van [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Hauwere, An de; Thierens, Hubert [Ghent University, QCC, Ghent (Belgium); Herck, Koen van; Bleyen, Luc; Mortier, Griet [Ghent University, Centrum voor Preventie en Vroegtijdige Opsporing van Kanker, Department of Public Health, Ghent (Belgium); Martens, Patrick [Vroegtijdige Opsporing Borstklierkanker West-Vlaanderen vzw, Bruges (Belgium); Putte, Gretel vande; Kellen, Eliane; Limbergen, Erik van [Leuven University Center of Cancer Screening, Leuven (Belgium)

    2013-10-15

    To compare technical and clinical screening performance parameters between computed radiography (CR) and direct digital radiography (DR) systems. The number of women screened with CR was 73,008 and with DR 116,945. Technical and patient dose survey data of 25 CR and 37 DR systems were available. Technical performance was expressed by threshold thickness values at the mean glandular dose (MGD) level of routine practice. Clinical indicators included recall rate (RR), cancer detection rate (CDR), percentage of ductal carcinoma in situ (DCIS), percentage of cancers with T-scores smaller than 1 cm and positive predictive value (PPV). Contrast threshold values for the 0.1-mm gold disk were 1.44 {mu}m (SD 0.13 {mu}m) for CR and 1.20 {mu}m (SD 0.13 {mu}m for DR). MGD was 2.16 mGy (SD 0.36 mGy) and 1.35 mGy (SD 0.32 mGy) for CR and DR respectively. We obtained for CR, respectively DR, the following results: RR in the first round of 5.48 % versus 5.61 %; RR in subsequent rounds of 2.52 % versus 2.65 %; CDR of 0.52 % versus 0.53 %; DCIS of 0.08 % versus 0.11 %; a rate of cancers with T-scores smaller than 1 cm of 0.11 % versus 0.11 %; PPV of 18.45 % versus 18.64 %; none of them was significantly different. Our screening indicators are reassuring for the use of CR and DR, with CR operating at 60 % higher MGD. (orig.)

  11. Retrospective Analysis of Indication of Bone Scintigraphy Performed in Our Clinic

    Directory of Open Access Journals (Sweden)

    Fusun Aydogan

    2014-03-01

    Full Text Available Aim: Bone scintigraphy is one of the commonly used radionuclide imaging and it is successfully used in the diagnosis and follow-up of many diseases. The aim of this study is to determine the indications and filming protocols of bone scintigraphy which was performed in our clinic. Material and Method: Two hundred and fifty two patients (132 male, 120 female who was performed bone scintigprapy in our clinic between December 2011 and June 2013 included the study. Mean age was 50.1±20.2 years. Scintigraphic protocols were made in two ways as late static whole body imaging and three-phase bone scintigraphy according to the type of the diseases. Indications of scintigraphies and scintigraphic protocols were detected. Results: Bone scintigraphy was performed for diagnosis and monitoring of metastatic bone disease to 102 patients (40,5 %, for orthopedic applications to 57 patients (22,6 %, for diagnosis and monitoring of primary bone tumors to 29 patients (11,5 %, for diagnosis of osteomyelitis to 17 patients (6,7 %, for differential diagnosis of infection and loosening of the prosthesis to 12 patients (4,8 %, investigate the viability of the graft in 14 patients (4,6 %, for rheumatologic diseases to 9 patients (3,6 %, for investigate the pathological vertebral fractures and osteoporosis to 4 patients (1,6 %, for diagnosis the metabolic bone disease to 2 patients (0,8 %, for diagnosis of otitis externa to 5 patients (1,98 % and for for suspicion of malignancy to 1 patient (0,4 %. Late static whole body imaging protocol was applied to 136 patients (54 % and three-phase imaging protocol was applied to 116 patients (46 %. Discussion: The most common use of bone scintigraphy is the diagnosis and follow-up of metastatic bone disease. It is followed by reasons such as orthopedic applications, monitoring and diagnosis of primary bone tumors and diagnosis of osteomyelitis.

  12. Selected Indicators Of The Root Quality Of Fifteen Cultivars Of Red Beet (Beta Vulgaris L.

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    Nizioł-Łukaszewska Zofia

    2015-06-01

    Full Text Available Evaluation of the quality of 15 cultivars of red beet has been made during four successive vegetative seasons. The study involved cultivars ‘Astar F1’, ‘Boro F1’, ‘Ceryl’, ‘Chrobry’, ‘Czerwona Kula’, ‘Egipski’, ‘Karmazyn’, ‘Nabab F1’, ‘Nochowski’, ‘Opolski’, ‘Pablo F1’, ‘Patryk’, ‘Regulski Cylinder’, ‘Okrągły Regulski’ and ‘Rywal’. The mass, diameter of roots, antioxidant activity, the content of dry mass, soluble sugars, betanin and vulgaxanthin in roots were evaluated. The study indicated ‘Chrobry’ as the cultivar of the most favorable quality features. It was characterized by high antioxidant activity, high content of dry mass, soluble sugars and betalain pigments. Among cultivars of cylindrical shaped roots, content of soluble sugars and antiradical activity was the highest in ‘Regulski Cylinder’ roots.

  13. Indicative and pathogenic microbiological quality of aquacultured finfish grown in different production systems.

    Science.gov (United States)

    Pullela, S; Fernandes, C F; Flick, G J; Libey, G S; Smith, S A; Coale, C W

    1998-02-01

    The nature and number of indicator and pathogenic microbes in fish reared using recirculating and nonrecirculating water systems were compared. For each system, 20 samples of rainbow trout (Oncorhynchus mykiss), tilapia (Oreochromis spp.), hybrid striped bass (Morone saxatilis x M. chrysops), and pacu (Piaractus mesopotamicus) were randomly selected and gutted, and microbial analyses were performed using AOAC procedures. Five fish were subsampled and analyzed for indicative microbial quality with 3M Petrifilm (). The general microbial quality differed significantly (P systems, except for total coliform counts. Rainbow trout cultured in recirculating and nonrecirculating water systems had lower counts for aerobes (2.00 to 3.11 log CFU/g) (p recirculating water system had significantly lower psychrotrophic numbers (0.86 to 1.85 log CFU/g). Pacu had the highest fecal coliform counts (2.74 to 3.70 log CFU/g), whereas hybrid striped bass and rainbow trout grown in nonrecirculating systems had lower fecal coliform counts (0.00 to 1.39 log CFU/g). Rainbow trout grown in a nonrecirculating system had significantly higher Escherichia coli counts (0.00 to 2.11 log CFU/g). The human bacterial pathogens Listeria monocytogenes, Yersinia enterocolitica, Escherichia coli O157:H7 and Salmonella spp. were not isolated form the fish sampled. However, Clostridium botulinum botulinum was isolated from all the aquacultured fish sampled except pacu and tilapia grown in a recirculating aquaculture system. However, the counts were very low, ranging from 0.0 to 2.3 MPN/g. PMID:9708283

  14. A clinical investigation of the relationship between the quality of conventional complete dentures and the patients’ quality of life

    OpenAIRE

    Sara A. Alfadda; Hayam A. Al-Fallaj; Al-Banyan, Hajar A.; Ruba M. Al-Kadhi

    2015-01-01

    Objective: The purpose of this study was to determine whether there is a correlation between the clinical quality of conventional complete dentures and patient quality of life. Materials and methods: This study included a random sample of 32 completely edentulous patients (15 males and 17 females) who were treated with conventional complete dentures. Using a validated questionnaire, three investigators evaluated the dentures independently on the basis of seven clinical parameters: esthetic...

  15. The influences of SE infection on layers’ production performance, egg quality and blood biochemical indicators

    Science.gov (United States)

    2014-01-01

    Background Salmonella enterica serovar Enteritidis (SE), as a major cause of foodborn illness, infects humans mainly through the egg. However, the symptom of laying hens usually is not typical and hard to diagnosis. In the present study, it is studied that the influences of SE infection on layers’ performance, egg quality and blood biochemical indicators. It will help us to improve the strategy to control SE infection in commercial layers. One hundred layers at 20 wk of age were divided into 2 groups, 60 hens for experiment and others for control. The experiment group was fed with the dosage of 108 CFU SE per hen. The specific PCR was used to detect the deposition of SE. On the 8 d after SE infection, 10 hens from the control group and 30 hens from the experimental group were slaughtered to detect the SE colonization. The production performance, egg quality and blood biochemical indices were also analyzed. Results The results showed that the colonization rate of SE was highest in caecum contents (55.17%) and lowest in vagina (17.24%). For the eggs the detection rate of SE was highest on the eggshell (80.00%) and lowest in yolk (18.81%). SE infection had no significant influence on production performance and egg qualities (P > 0.05). The difference of laying rate between the experimental and control groups was less than 0.30%, and both were approximately equal to 82.00%. The blood analysis showed that the aspartic aminotransferase (AST) and alanine aminotransferase (ALT) of experimental group was significantly higher than those of control group (P < 0.05). For experimental and control groups AST values were 236.22 U/l and 211.84 U/l respectively, and ALT values were 32.19 U/l and 24.55 U/l. All of coefficients were less than 20%. The colonization of SE in organs increases the enzyme activities of AST and ALT in blood. Conclusions SE in feed could invade the oviduct and infect the forming eggs. It significantly increased the concentration of ALT and AST in blood

  16. The influences of SE infection on layers’ production performance, egg quality and blood biochemical indicators

    Institute of Scientific and Technical Information of China (English)

    Shijie Fan; Jiangxia Zheng; Zhongyi Duan; Ning Yang; Guiyun Xu

    2014-01-01

    Background:Salmonella enterica serovar Enteritidis (SE), as a major cause of foodborn illness, infects humans mainly through the egg. However, the symptom of laying hens usually is not typical and hard to diagnosis. In the present study, it is studied that the influences of SE infection on layers’ performance, egg quality and blood biochemical indicators. It will help us to improve the strategy to control SE infection in commercial layers. One hundred layers at 20 wk of age were divided into 2 groups, 60 hens for experiment and others for control. The experiment group was fed with the dosage of 108 CFU SE per hen. The specific PCR was used to detect the deposition of SE. On the 8 d after SE infection, 10 hens from the control group and 30 hens from the experimental group were slaughtered to detect the SE colonization. The production performance, egg quality and blood biochemical indices were also analyzed. Results:The results showed that the colonization rate of SE was highest in caecum contents (55.17%) and lowest in vagina (17.24%). For the eggs the detection rate of SE was highest on the eggshell (80.00%) and lowest in yolk (18.81%). SE infection had no significant influence on production performance and egg qualities (P>0.05). The difference of laying rate between the experimental and control groups was less than 0.30%, and both were approximately equal to 82.00%. The blood analysis showed that the aspartic aminotransferase (AST) and alanine aminotransferase (ALT) of experimental group was significantly higher than those of control group (P<0.05). For experimental and control groups AST values were 236.22 U/l and 211.84 U/l respectively, and ALT values were 32.19 U/l and 24.55 U/l. All of coefficients were less than 20%. The colonization of SE in organs increases the enzyme activities of AST and ALT in blood. Conclusions:SE in feed could invade the oviduct and infect the forming eggs. It significantly increased the concentration of ALT and AST in blood

  17. The use of soil quality indicators to assess soil functionality in restored semi-arid ecosystems

    Science.gov (United States)

    Muñoz-Rojas, Miriam; Erickson, Todd E.; Dixon, Kingsley W.; Merritt, David J.

    2016-04-01

    Keywords: Pilbara, 1-day CO2 test, microbial activity, mine restoration, soil health, ecosystem services. Introduction Semi-arid and arid environments are highly vulnerable to land degradation and their restoration has commonly showed low rates of success (James et al., 2013). A systematic knowledge of soil functionality is critical to successful restoration of degraded ecosystems since approximately 80% of ecosystem services can be connected to soil functions. The assessment of soil functionality generally involves the evaluation of soil properties and processes as they relate to the ability of soil to function effectively as a component of a healthy ecosystem (Costantini et al., 2015) Using soil quality indicators may be a valuable approach to assess functionality of topsoil and novel substrates used in restoration (Muñoz-Rojas et al., 2014; 2015). A key soil chemical indicator is soil organic C, that has been widely used as an attribute of soil quality because of the many functions that it provides and supports (Willaarts et al., 2015). However, microbial indicators can be more sensitive to disturbances and could be a valuable addition in soil assessment studies in restoration programs. Here, we propose a set of soil quality indicators to assess the soil status in restored soils (topsoil and waste material) of semi-arid environments. The study was conducted during March 2015 in the Pilbara biogeographical region (northwestern Australia) at an iron ore mine site rehabilitated in 2011. Methods Soil samples were collected from two sub-areas with different soil materials used as growth media: topsoil retrieved from nearby stockpiles and a lateritic waste material utilised for its erosive stability and physical competence. An undisturbed natural shrub-grassland ecosystem dominated by Triodia spp. and Acacia spp. representative of the restored area was selected as the analogue reference site. Soil physicochemical analysis were undertaken according to standard methods

  18. Effect of different feed supplements on selected quality indicators of chicken meat

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    Peter Haščík

    2015-12-01

    Full Text Available The aim of the study was to evaluate the effect of different feed additives (bee pollen extract, propolis extract, and probiotic on meat quality of broiler chickens. A total of 180 one day-old broiler chicks of mixed sex (Ross 308 were randomly divided into 3 groups. Dietary treatments were as follows: basal diet, free of supplements (control group; C;  basal diet  plus 400 mg bee pollen extract per 1 kg of feed mixtures and 3.3 g probiotic preparation added to drinking water (group E1; basal diet  plus 400 mg propolis extract per 1 kg of feed mixtures and 3.3 g probiotic preparation added to drinking water (group E2. In the experiment, the probiotic preparation based on Lactobacillus fermentum (1.109 CFU.g-1 of bearing medium was used. Fattening period lasted for 42 days. Feed mixtures were produced without any antibiotic preparations and coccidiostatics. Meat quality was evaluated by following technological properties: cooling, freezing and roasting loss; colour parameters based on CIELab system; and shear force. Both dietary supplementations led to decrease in cooling (p ≤0.05 and freezing (p ≥0.05 losses compared with control. On the contrary, the supplemented diet tended to increase roasting losses (p ≤0.05 and shear force values in thigh muscle (p ≤0.05. Significantly higher L* values (p ≤0.05 in breast and thigh muscles, as well as the b* values in thigh muscle, were found when broiler chickens were fed the supplements, especially bee pollen extract and probiotics. In addition, the supplements improve redness (a* of meat. The redness of breast muscle appeared to be the most affected (p ≥0.05 by propolis extract plus probiotics supplementation, while thigh muscle had the highest value (p ≤0.05 in bee pollen extract plus probiotics supplemented group. These findings suggested that the supplements have a beneficial effect on quality of chicken meat due to positive changes in most of quality indicators investigated in the

  19. 78 FR 5810 - AHRQ Standing Workgroup for Quality Indicator Measure Specification

    Science.gov (United States)

    2013-01-28

    ... health care quality measures based on ICD-coded administrative data Knowledge of current quality... Measure Specification AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Notice of... stakeholders, consumers and other users, quality alliances, medical or specialty societies, measure...

  20. Quality control of CT systems by automated monitoring of key performance indicators: a two-year study.

    Science.gov (United States)

    Nowik, Patrik; Bujila, Robert; Poludniowski, Gavin; Fransson, Annette

    2015-01-01

    The purpose of this study was to develop a method of performing routine periodical quality controls (QC) of CT systems by automatically analyzing key performance indicators (KPIs), obtainable from images of manufacturers' quality assurance (QA) phantoms. A KPI pertains to a measurable or determinable QC parameter that is influenced by other underlying fundamental QC parameters. The established KPIs are based on relationships between existing QC parameters used in the annual testing program of CT scanners at the Karolinska University Hospital in Stockholm, Sweden. The KPIs include positioning, image noise, uniformity, homogeneity, the CT number of water, and the CT number of air. An application (MonitorCT) was developed to automatically evaluate phantom images in terms of the established KPIs. The developed methodology has been used for two years in clinical routine, where CT technologists perform daily scans of the manufacturer's QA phantom and automatically send the images to MonitorCT for KPI evaluation. In the cases where results were out of tolerance, actions could be initiated in less than 10 min. 900 QC scans from two CT scanners have been collected and analyzed over the two-year period that MonitorCT has been active. Two types of errors have been registered in this period: a ring artifact was discovered with the image noise test, and a calibration error was detected multiple times with the CT number test. In both cases, results were outside the tolerances defined for MonitorCT, as well as by the vendor. Automated monitoring of KPIs is a powerful tool that can be used to supplement established QC methodologies. Medical physicists and other professionals concerned with the performance of a CT system will, using such methods, have access to comprehensive data on the current and historical (trend) status of the system such that swift actions can be taken in order to ensure the quality of the CT examinations, patient safety, and minimal disruption of service

  1. How to limit the burden of data collection for Quality Indicators based on medical records? The COMPAQH experience

    Directory of Open Access Journals (Sweden)

    Grenier Catherine

    2008-10-01

    Full Text Available Abstract Background Our objective was to limit the burden of data collection for Quality Indicators (QIs based on medical records. Methods The study was supervised by the COMPAQH project. Four QIs based on medical records were tested: medical record conformity; traceability of pain assessment; screening for nutritional disorders; time elapsed before sending copy of discharge letter to the general practitioner. Data were collected by 6 Clinical Research Assistants (CRAs in a panel of 36 volunteer hospitals and analyzed by COMPAQH. To limit the burden of data collection, we used the same sample of medical records for all 4 QIs, limited sample size to 80 medical records, and built a composite score of only 10 items to assess medical record completeness. We assessed QI feasibility by completing a grid of 19 potential problems and evaluating time spent. We assessed reliability (κ coefficient as well as internal consistency (Cronbach α coefficient in an inter-observer study, and discriminatory power by analysing QI variability among hospitals. Results Overall, 23 115 data items were collected for the 4 QIs and analyzed. The average time spent on data collection was 8.5 days per hospital. The most common feasibility problem was misunderstanding of the item by hospital staff. QI reliability was good (κ: 0.59–0.97 according to QI. The hospitals differed widely in their ability to meet the quality criteria (mean value: 19–85%. Conclusion These 4 QIs based on medical records can be used to compare the quality of record keeping among hospitals while limiting the burden of data collection, and can therefore be used for benchmarking purposes. The French National Health Directorate has included them in the new 2009 version of the accreditation procedure for healthcare organizations.

  2. A Clinical Indications Prediction Scale Based on TWIST1 for Human Mesenchymal Stem Cells

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    Siddaraju V. Boregowda

    2016-02-01

    Full Text Available In addition to their stem/progenitor properties, mesenchymal stem cells (MSCs also exhibit potent effector (angiogenic, antiinflammatory, immuno-modulatory functions that are largely paracrine in nature. It is widely believed that effector functions underlie most of the therapeutic potential of MSCs and are independent of their stem/progenitor properties. Here we demonstrate that stem/progenitor and effector functions are coordinately regulated at the cellular level by the transcription factor Twist1 and specified within populations according to a hierarchical model. We further show that manipulation of Twist1 levels by genetic approaches or by exposure to widely used culture supplements including fibroblast growth factor 2 (Ffg2 and interferon gamma (IFN-gamma alters MSC efficacy in cell-based and in vivo assays in a predictable manner. Thus, by mechanistically linking stem/progenitor and effector functions our studies provide a unifying framework in the form of an MSC hierarchy that models the functional complexity of populations. Using this framework, we developed a CLinical Indications Prediction (CLIP scale that predicts how donor-to-donor heterogeneity and culture conditions impact the therapeutic efficacy of MSC populations for different disease indications.

  3. A Clinical Indications Prediction Scale Based on TWIST1 for Human Mesenchymal Stem Cells.

    Science.gov (United States)

    Boregowda, Siddaraju V; Krishnappa, Veena; Haga, Christopher L; Ortiz, Luis A; Phinney, Donald G

    2016-02-01

    In addition to their stem/progenitor properties, mesenchymal stem cells (MSCs) also exhibit potent effector (angiogenic, antiinflammatory, immuno-modulatory) functions that are largely paracrine in nature. It is widely believed that effector functions underlie most of the therapeutic potential of MSCs and are independent of their stem/progenitor properties. Here we demonstrate that stem/progenitor and effector functions are coordinately regulated at the cellular level by the transcription factor Twist1 and specified within populations according to a hierarchical model. We further show that manipulation of Twist1 levels by genetic approaches or by exposure to widely used culture supplements including fibroblast growth factor 2 (Ffg2) and interferon gamma (IFN-gamma) alters MSC efficacy in cell-based and in vivo assays in a predictable manner. Thus, by mechanistically linking stem/progenitor and effector functions our studies provide a unifying framework in the form of an MSC hierarchy that models the functional complexity of populations. Using this framework, we developed a CLinical Indications Prediction (CLIP) scale that predicts how donor-to-donor heterogeneity and culture conditions impact the therapeutic efficacy of MSC populations for different disease indications. PMID:26981553

  4. Nicotine dependence in the mental disorders, relationship with clinical indicators, and the meaning for the user

    Directory of Open Access Journals (Sweden)

    Renata Marques de Oliveira

    2014-08-01

    Full Text Available OBJECTIVE: to identify the degree of nicotine dependence among patients with schizophrenia and other mental disorders hospitalized in a general hospital, correlating these indices with clinical indicators and the meaning for the user.METHOD: the study was performed in the psychiatric unit of a general hospital, interviewing 270 patients with mental disorders using a questionnaire and the application of the Fagerstrom test. A descriptive statistical analysis of the data and thematic analysis of the content were performed.RESULTS: among the 270 patients with mental disorders, 35.6% were smokers; of whom, 53.2% presented high or very high nicotine dependence. Of the 96 smokers, 32 (33.3% were schizophrenic, among whom, 59.4% presented high or very high dependence. Higher levels of dependence were also found among the 59 elderly people (61.5% and 60 subjects with somatic comorbidities (62.5%. Meanings of smoking for the subjects: helps to forget problems and face daily conflicts; alleviates side effects of the medications; self-control; distraction; part of life.CONCLUSION: more intense tobacco dependence among schizophrenic patients is justified due to it helping them to cope with the difficulties of the disease. Nurses occupy a strategic position in the care.

  5. Systematic review about data quality and protocol compliance in clinical trials

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    Strenge-Hesse, Anke

    2008-02-01

    compliance in a clinical trial is the quality management system. Quality management covers several other measures apart from monitoring. In order to assess monitoring strategies, all quality assurance procedures within a clinical trial have to be taken into consideration. For the comparison of different monitoring strategies adequate outcome parameter have to be defined (e.g. severe deficits with respect to inclusion and exclusion criteria, safety. The analysis indicates that with good quality management and no extensive on-site monitoring severe errors were detected only at relative low frequency. It could well be that with an efficient quality management system differences between monitoring strategies would be small. In order to demonstrate statistical equivalence of monitoring strategies, only small differences can be accepted which again leads to consequences for the sample-size calculation. In addition, it must be taken into consideration that within a controlled trial an independent audit is necessary to assess the effect of different monitoring strategies on the safety of patients and the quality of data. Audits however may be a possible influence factor for data quality and protocol compliance and may complicate the evaluation of the benefit of a monitoring strategy.

  6. Signal-quality indices for the electrocardiogram and photoplethysmogram: derivation and applications to wireless monitoring.

    Science.gov (United States)

    Orphanidou, Christina; Bonnici, Timothy; Charlton, Peter; Clifton, David; Vallance, David; Tarassenko, Lionel

    2015-05-01

    The identification of invalid data in recordings obtained using wearable sensors is of particular importance since data obtained from mobile patients is, in general, noisier than data obtained from nonmobile patients. In this paper, we present a signal quality index (SQI), which is intended to assess whether reliable heart rates (HRs) can be obtained from electrocardiogram (ECG) and photoplethysmogram (PPG) signals collected using wearable sensors. The algorithms were validated on manually labeled data. Sensitivities and specificities of 94% and 97% were achieved for the ECG and 91% and 95% for the PPG. Additionally, we propose two applications of the SQI. First, we demonstrate that, by using the SQI as a trigger for a power-saving strategy, it is possible to reduce the recording time by up to 94% for the ECG and 93% for the PPG with only minimal loss of valid vital-sign data. Second, we demonstrate how an SQI can be used to reduce the error in the estimation of respiratory rate (RR) from the PPG. The performance of the two applications was assessed on data collected from a clinical study on hospital patients who were able to walk unassisted. PMID:25069129

  7. Developing a national indicator of soil quality on U.S forestlands: methods and initial results.

    Science.gov (United States)

    O'Neill, Katherine P; Amacher, Michael C; Palmer, Craig J

    2005-08-01

    The Montreal Process was formed in 1994 to develop an internationally agreed upon set of criteria and indicators for the conservation and sustainable management of temperate and boreal forests. In response to this initiative, the Forest Inventory and Analysis (FIA) and Forest Health Monitoring (FHM) programs of the United States Department of Agriculture Forest Service have implemented soil measurements as part of a national monitoring program to address specific questions related to the conservation of soil and water resources. Integration of soil assessments into the national FIA program provides for systematic monitoring of soil properties across all forested regions of the U.S. using standardized collection, laboratory, and statistical procedures that are compatible with existing forest inventory data. The resulting information will provide quantitative benchmarks for regional, national, and international reporting on sustainable forest management and enhance our understanding of management effects on soil quality. This paper presents an overview of the FIA soil monitoring program, outlines the field and laboratory protocols as currently implemented, and provides examples of how these data may be used to assess indicators of sustainable management as defined by the Montreal Process. PMID:16418905

  8. Tritium levels in the environment of KAPS - an indicator of quality performance

    International Nuclear Information System (INIS)

    Tritium is produced in the Pressurized Heavy Water Reactor by the activation of Heavy water used as moderator and coolant. Due to its large abundance in the reactor and its presence in both liquid and gaseous effluents, Tritium concentration in environmental matrices is an indicator of radioactivity releases from PHWR type reactors. Kakrapar Atomic Power Station (KAPS) is a PHWR type power station located at Kakrapar Village in the Surat district. The station is operating since 1993 and a comprehensive environmental survey program was carried out at this site by Health Physics Division, BARC for radioactivity levels in the environment. The survey carried out at KAPS environment for the past ten years (1994-2003) reveals that there is no increase in radiation levels and tritium is the only radionuclide detected in environmental matrices. The yearly average committed effective dose due to Tritium in the environment works out to be about 2.2 μSv, which is a conservative figure and is of very low significance. The life time stochastic risk to the total population (all age group) attributable to 2 μSv effective dose works out to be 1x10-7 which is also a conservative estimate and can be considered to be very safe. The very low committed dose observed in KAPS environment, indicate the quality performance of the station. (author)

  9. Benthic Foraminifera as ecological indicators for water quality on the Great Barrier Reef

    Science.gov (United States)

    Uthicke, Sven; Nobes, Kristie

    2008-07-01

    Benthic foraminifera are established indicators for Water Quality (WQ) in Florida and the Caribbean. However, nearshore coral reefs of the Great Barrier Reef (GBR) and other Pacific regions are also subjected to increased nutrient and sediment loads. Here, we investigate the use of benthic foraminifera as indicators to assess status and trends of WQ on GBR reefs. We quantified several sediment parameters and the foraminiferan assemblage composition on 20 reefs in four geographic regions of the GBR, and along a water column nutrient and turbidity gradient. Twenty-seven easily recognisable benthic foraminiferan taxa (>63 μm) were distinguished. All four geographic regions differed significantly ( p plastids ( Elphidium sp.) where highly characteristic for low light, higher nutrient conditions. Application of the FORAM index to GBR assemblage composition showed a significant increase in the value of this index with increased distance from the mainland in the Whitsunday region ( r2 = 0.75, p < 0.001), and therefore with increasing light and decreased nutrient availability. We conclude that it will be possible to apply this index to GBR and possibly other Pacific reefs after some adaptations and additional experimental work on species-specific limiting factors.

  10. Determination of correction factor for X-ray radiographic sensitivity when image quality indicator is placed on film side

    International Nuclear Information System (INIS)

    The X-ray radiographic sensitivity was studied by a simultaneous exposure of two sets of image quality indicator where one of them was placed on the stainless steel spectrum facing X-ray source while the other was placed under the specimen facing the film. Single wall single image and double wall single image exposure techniques were used. A significant difference in radiographic sensitivity was obtained between these two positions of image quality indicator when specimen thickness exceeding 3 mm. A correction factor curve was obtained for correcting the radiographic sensitivity data when the image quality indicator is placed on the specimen facing the film. (author)

  11. I Brazilian Registry of Heart Failure - Clinical Aspects, Care Quality and Hospitalization Outcomes

    Directory of Open Access Journals (Sweden)

    Denilson Campos de Albuquerque

    2015-06-01

    Full Text Available Background: Heart failure (HF is one of the leading causes of hospitalization in adults in Brazil. However, most of the available data is limited to unicenter registries. The BREATHE registry is the first to include a large sample of hospitalized patients with decompensated HF from different regions in Brazil. Objective: Describe the clinical characteristics, treatment and prognosis of hospitalized patients admitted with acute HF. Methods: Observational registry study with longitudinal follow-up. The eligibility criteria included patients older than 18 years with a definitive diagnosis of HF, admitted to public or private hospitals. Assessed outcomes included the causes of decompensation, use of medications, care quality indicators, hemodynamic profile and intrahospital events. Results: A total of 1,263 patients (64±16 years, 60% women were included from 51 centers from different regions in Brazil. The most common comorbidities were hypertension (70.8%, dyslipidemia (36.7% and diabetes (34%. Around 40% of the patients had normal left ventricular systolic function and most were admitted with a wet-warm clinical-hemodynamic profile. Vasodilators and intravenous inotropes were used in less than 15% of the studied cohort. Care quality indicators based on hospital discharge recommendations were reached in less than 65% of the patients. Intrahospital mortality affected 12.6% of all patients included. Conclusion: The BREATHE study demonstrated the high intrahospital mortality of patients admitted with acute HF in Brazil, in addition to the low rate of prescription of drugs based on evidence.

  12. From the study of fire effects on individual soil properties to the development of soil quality indices. 2. Application of indices

    Science.gov (United States)

    Zornoza, Raul; Mataix-Solera, Jorge

    2013-04-01

    Wildfires are one of the most serious environmental problems in the Mediterranean region. The loss of vegetation and the progressive incapability of soils to appropriately regenerate the vegetative cover have led to severe degradation. Therefore, the establishment of soil quality indices is needed at sites affected by forest fires in order to evaluate the state of degradation so that we can enhance the soil quality. The use of soil quality indices is useful since the integration of several indicators of different nature is expressed as one value, being more effective than individual soil properties for land management. Soils from natural ecosystems have specific physical, chemical and biochemical properties determined by the conditions in which these soils develop. Thus, the creation of a model that represents the established balance among different soil properties from stable forest ecosystems can be used as a soil quality index. In addition, any perturbation, such as wildfires, must lead to modifications in this natural balance. Two models with soils from five undisturbed forest regions in eastern Spain were developed, which represented the balance between organic carbon and some physical, chemical and biochemical properties (aggregate stability, water holding capacity, cation exchange capacity, available phosphorus, electrical conductivity and acid phosphatase activity). These models have been applied to soils affected by different wildfires sampled at different dates after the wildfire to evaluate how this perturbation can modify the natural balance among organic matter and different soil properties. Our results confirm that wildfires, either directly or indirectly, have provoked an imbalance among organic carbon content and physical, chemical and biochemical properties. Moreover, soils affected by recent fires showed the greatest deviation in the natural balance, indicating higher perturbation. Hence, these models (indices) are sensitive to changes provoked by

  13. Study on Nursing Clinical Teachers' Comprehensive Quality Evaluation Model on the Basis of Fuzzy Mathematics

    Directory of Open Access Journals (Sweden)

    Zhijuan Liu

    2013-04-01

    Full Text Available In this study, we study on the nursing clinical teachers' comprehensive quality evaluation model on the basis of fuzzy mathematics. First, it obtains the nursing clinical teachers' comprehensive quality evaluation index framework by making use of Delphi method. Then, it constructs the comprehensive quality evaluation hierarchy model by applying the analytic hierarchy process, to obtain the weight for each index, based on which to establish fuzzy comprehensive evaluation model, thus acquiring new method for nursing clinical teachers' comprehensive quality evaluation. Examples have proven the feasibility and effectiveness of this method.

  14. Clinical diagnostic indicators of renal and bone damage in rats intramuscularly injected with depleted uranium

    International Nuclear Information System (INIS)

    The toxic effects and changes in biochemical markers related to kidney and bone in depleted uranium (DU)-injected rats were examined in order to clarify the relation between clinical biochemical markers and the degree of damage in these organs. Male Wistar rats received a single injection in the femoral muscles of 0.2, 1.0 or 2.0 mg kg-1 of DU which was dissolved in nitric acid solution adjusted to pH 3.2, for comparison with the group injected with nitric acid solution, and the control group. Urine and faeces were collected periodically over a 24 h period. Thereafter, the rats were killed at 28 d after DU injection. The body weights of the DU-injected groups decreased dose-dependently for the first 3-7 d, and then began to increase. The DU concentrations in the urine and faeces decreased rapidly within 3-7 d after DU injection. Urinary N-acetyl-β-D-glucosaminidase (NAG)/ creatinine peaked at the third day after DU injection, with a high correlation to the injected DU doses. There were high correlations among the injected DU doses, DU concentrations in the kidney and urinary NAG/ creatinine values that were obtained at 28 d, respectively. The blood urea nitrogen (BUN) and creatinine in the serum also showed a high correlation with the DU-injected doses. The results indicated that urinary NAG/creatinine, BUN and creatinine in serum were useful indicators to diagnose the renal damage by DU, as well as to estimate the DU intake and concentration in the kidney when the intake is >2 mg kg-1 DU. The total bone mineral density of the proximal metaphysis of the tibia decreased in the 2 mg kg-1 DU group. In addition, alterations of the trabecular bone structure by inhibiting bone formation and promoting bone resorption were observed by bone histo-morphometry. The bone biochemical markers osteo-calcin, tartrate-resistance acid phosphatase, pyridinoline and rat-parathyroid hormone increased in all the DU injected groups, indicating that these markers were useful as sensitive

  15. Daily quality check: its importance in clinical SPECT gamma camera imaging

    International Nuclear Information System (INIS)

    Performance characteristics of 'SPECT gamma camera systems' (GCS) are likely to vary with time. This is evaluated by running a defined Quality Control Program (QCP) which includes set of tests. Basically, daily quality check is to ensure detection of the changes in the performance of SPECT GCS that may adversely affect the interpretation of the clinical studies. These quality parameters gives Technologist/ Physicist/Nuclear Medicine Specialist the data with which to decide whether: a) to continue image patient normally. b) to image patients while putting in a call to have the system serviced, or rectified. c) to put off the imaging of the patients until the system has been rectified. In this study we share our experience of daily quality checks (DQC) of the parameters for evaluating the performance of both the detectors of gamma camera comprising of 'Peaking status' and 'Extrinsic flood images' over a period of six years, before the actual acquisition of the patient study was allowed. These parameters have been our indicators for deciding whether to proceed normally with the equipment or to send a call to service engineer or to put off the machine

  16. [The perceived quality of service at a family planning clinic: a marketing focus].

    Science.gov (United States)

    Moliner Tena, M A; Moliner Tena, J

    1996-04-15

    183 women attending the family planning clinic in Burriana, Castellon, were interviewed for this survey of the perceived quality of family planning services. The anonymous, self-administered questionnaire was adapted from two existing questionnaires, SERVQUAL and SERVPERF, developed for commercial marketing. Attitudes were measured using a 7-part Likert type scale. The first 20 items referred to different aspects of quality, the second 4 measured satisfaction, total quality, the importance of the service, and reported use, and the final 6 examined respondent characteristics. 28 incompletely completed questionnaires were eliminated, leaving 155. The results indicate that perceived quality and client satisfaction were both high. Using factorial analysis of principal components, 6 factors were identified that explained 63.3% of the variance. The components were high personal attention of services, limited bureaucracy, modern facilities and equipment, professionalism and competence of the staff, accessibility and easy transportation, and reputation and layout. The Cronbach alpha coefficients, which measure internal consistency, were not acceptable for 3 factors. The overall results suggest that marketing tools can be adapted to the needs of health services. PMID:8672645

  17. Constructing quality-adjusted price indices from revenue and cost data

    Directory of Open Access Journals (Sweden)

    Sergio Aquino DeSouza

    2007-12-01

    Full Text Available This paper shows how to construct quality adjusted price indices without direct observation of product-level data (prices, quantities and characteristics. The technique used here allows for a welfare based measurement of price change using commonly available (at least for the manufacturing sector plant-level data on revenue and cost. However, one has to be explicit about the evolution of the outside good quality and the structure of demand and supply. Using data on the Colombian beer industry and combining the methodologies originally proposed by Katayama, Lu and Tybout (2003, DeSouza (2006a and Trajtenberg (1990 I am able to uncover the demand parameters and build welfare-based price indices for the 1977-1990 period.Este artigo demonstra como construir um índice de preços ajustados pela qualidade sem a observação direta de dados ao nível de produto (preços, quantidades e características. A técnica aplicada no artigo permite medir a inflação dos preços com base na variação intertemporal de bem-estar através do uso de dados de receita e despesa comumente disponíveis (pelo menos para o setor industrial ao nível de empresas. No entanto, tal técnica exige a imposição de hipóteses sobre a evolução da qualidade do bem externo assim como a estrutura da demanda e da oferta. Com dados sobre a indústria colombiana de cerveja e combinando metodologias originalmente desenvolvidas por Katayama, Lu e Tybout (2003, DeSouza (2006a e Trajtenberg (1990 estimam-se os parâmetros da demanda e constroem-se índices de preços para o período de 1977 a 1990 a partir da mensuração do bem-estar dos consumidores.

  18. Inter-observer variation in masked and unmasked images for quality evaluation of clinical radiographs

    International Nuclear Information System (INIS)

    Purpose: To investigate the influence of masking on the inter-observer variation in image quality evaluation of clinical radiographs of chest and lumbar spine. Background: Inter-observer variation is a big problem in image quality evaluation since this variation is often much bigger than the variation in image quality between, for example, two radiographic systems. In this study, we have evaluated the effect of masking on the inter-observer variation. The idea of the masking was to force every observer to view exactly the same part of the image and to avoid the effect of the overall 'first impression' of the image. A discussion with a group of European expert radiologists before the study indicated that masking might be a good way to reduce the inter-observer variation. Methods: Five chest and five lumbar spine radiographs were collected together with detailed information regarding exposure conditions. The radiographs were digitised with a high-performance scanner and five different manipulations were performed, simulating five different exposure conditions. The contrast, noise and spatial resolution were manipulated by this method. The images were printed onto the film and the individual masks were produced for each film, showing only the parts of the images that were necessary for the image quality evaluation. The quality of the images was evaluated on ordinary viewing boxes by a large group of experienced radiologists. The images were examined with and without the masks with a set of image criteria (if fulfilled, 1 point; and not fulfilled, 0 point), and the mean score was calculated for each simulated exposure condition. Results: The results of this study indicate that - contrary to what was supposed - the inter-observer variation increased when the images were masked. In some cases, especially for chest, this increase was statistically significant. Conclusions: Based on the results of this study, image masking in studies of fulfilment of image criteria cannot

  19. DETERMINATION OF THE OPTIMUM LEVEL TO REDUCE POLLUTION AND OF THE INDICATOR OF ENVIRONMENTAL QUALITY A TECHNOLOGICAL PROCESS

    Directory of Open Access Journals (Sweden)

    Dan DOBROTA

    2013-05-01

    Full Text Available The deployment of anytechnologicalprocesscauseenvironmentalpollution, andthisimplies a reductionin the quality of theworkenvironmentandthe ambient environment. In theseconditions, inthispaperwasaimedtoestablishingtheoptimumpointto reduce pollutionaccordingtoexpenditure made to reduceandpreventenvironmentalpollution , but it wasdeterminedthepoint of reduction of ofpollutionbased onthecostsand social utilities. It wasalsodeterminedhowthecorrect design of a technologicalprocess or anactivitywithenvironmental impact consideringenvironmental quality indicator for eachstage of it.

  20. Survey regarding the clinical practice of cardiac CT in Germany. Indications, scanning technique and reporting

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, Marc H.; Hamm, B.; Dewey, M. [Inst. fuer Radiologie, Charite - Universitaetsmedizin Berlin (Germany)

    2009-12-15

    Purpose: to obtain an overview of the current clinical practice of cardiac computed tomography (CT) in Germany. Materials and methods: a 30-item question-naire was mailed to 149 providers of cardiac CT in Germany. The items asked about indications, scanning technique and reporting, data storage, and cost of the examination. Results: overall 45 questionnaires could be analyzed (30%). The majority of centers (76%, 34 of 45 centers) used CT scanners of the latest generation (at least 64 rows). The most common appropriate indications were exclusion of coronary artery disease (91%, 41/45), coronary anomalies (80%, 36/45), and follow-up after coronary artery bypass grafting (53%, 24/45). Each center examined on average 243 {+-} 310 patients in 2007 and the number of centers performing cardiac CT increased significantly in 2007 (p = 0.035) compared with the preceding year. Most used sublingual nitroglycerin (84%, 38/45; median of 2 sprays = 0.8 mg) and/or a beta blocker (86%, 39/44; median of 5 mg IV, median heart rate threshold: 70 beats/min). Many providers used ECG-triggered tube current modulation (65%, 29/44) and/or adjusted the tube current to the body mass index or body weight (63%, 28/44). A median slice thickness of 0.75 mm with a 0.5 mm increment and a 20 cm field-of-view was most commonly used. Source images in orthogonal planes (96%, 43/45), curved MPRs (93%, 42/45), and thin-slice MIPs (69%, 31/45) were used most frequently for interpretation. Extracardiac structures were also evaluated by 84% of the centers (38/45). The mean examination time was 16.2 min and reporting took an average of 28.8 min. (orig.)

  1. Indications for the clinical use of deep local and regional hyperthermia in conjunction with radiation therapy

    International Nuclear Information System (INIS)

    From September 1981 through April 1986, 51 patients with eccentrically-located or deep-seated tumors underwent 173 hyperthermia treatments to 54 separate local-regional fields. 78% of the tumors were in the pelvis and were relatively large. Patients had, in general, received extensive prior treatment including surgery, radiation therapy, chemotherapy, and immunotherapy. Regarding the results the following conclusions are drawn: The clinical use of deep local and regional hyperthermia as an adjunct to radiation therapy should be considered in situations in which a) the probability of palliation or local-regional control is low by currently available standard treatment modalities and b) hyperthermia can be safely administered to the tumor site. With the currently commercially available hyperthermia applicators, it would appear that potentially effective deep local and regional heating may be obtainable in pelvic tumors. Such treatment may be indicated as an adjunct to radiation therapy in the treatment of locally advanced or recurrent deep-seated pelvic malignancies including cancers of the colorectum, prostate, urinary bladder, and uterine cervix and corpus. As better equipment is developed, the treatment of pancreatic cancer with multi-modality regimens including hyperthermia should be considered. Hyperthermia may also be of value in the treatment of unresectable soft-tissue sarcomas and bone tumors and may be useful with preoperative radiation therapy in tumors of these sites. The roles and indications for the use of interstitial hyperthermia remain to the better defined. However, the combination of interstitial hyperthermia and interstitial brachytherapy treatment may be valuable in the management of advanced gynecologic, head and neck, breast, and malignant brain tumors. (orig./MG)

  2. Assessing the quality of clinical teachers: a systematic review of content and quality of questionnaires for assessing clinical teachers.

    NARCIS (Netherlands)

    Fluit, C.R.M.G.; Bolhuis, S.; Grol, R.P.T.M.; Laan, R.F.J.M.; Wensing, M.J.P.

    2010-01-01

    BACKGROUND: Learning in a clinical environment differs from formal educational settings and provides specific challenges for clinicians who are teachers. Instruments that reflect these challenges are needed to identify the strengths and weaknesses of clinical teachers. OBJECTIVE: To systematically r

  3. Rapidly Measured Indicators of Recreational Water Quality Are Predictive of Swimming-Associated Gastrointestinal Illness

    OpenAIRE

    Wade, Timothy J.; Calderon, Rebecca L.; Sams, Elizabeth; Beach, Michael; Brenner, Kristen P.; Williams, Ann H.; Dufour, Alfred P

    2005-01-01

    Standard methods to measure recreational water quality require at least 24 hr to obtain results, making it impossible to assess the quality of water within a single day. Methods to measure recreational water quality in ≤ 2 hr have been developed. Application of rapid methods could give considerably more accurate and timely assessments of recreational water quality. We conducted a prospective study of beachgoers at two Great Lakes beaches to examine the association between recreational water q...

  4. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: Indications, Complications, and Outcomes in 5803 Patients

    NARCIS (Netherlands)

    J. de la Rosette; D. Assimos; M. Desai; J. Gutierrez; J. Lingeman; R. Scarpa; A. Tefekli

    2011-01-01

    Purpose: To assess the current indications, perioperative morbidity, and stone-free outcomes for percutaneous nephrolithotomy (PCNL) worldwide. Patients and Methods: The Clinical Research Office of the Endourological Society (CROES) collected prospective data for consecutive patients who were treate

  5. Validation of an image-based technique to assess the perceptual quality of clinical chest radiographs with an observer study

    Science.gov (United States)

    Lin, Yuan; Choudhury, Kingshuk R.; McAdams, H. Page; Foos, David H.; Samei, Ehsan

    2014-03-01

    We previously proposed a novel image-based quality assessment technique1 to assess the perceptual quality of clinical chest radiographs. In this paper, an observer study was designed and conducted to systematically validate this technique. Ten metrics were involved in the observer study, i.e., lung grey level, lung detail, lung noise, riblung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm-lung contrast, and subdiaphragm area. For each metric, three tasks were successively presented to the observers. In each task, six ROI images were randomly presented in a row and observers were asked to rank the images only based on a designated quality and disregard the other qualities. A range slider on the top of the images was used for observers to indicate the acceptable range based on the corresponding perceptual attribute. Five boardcertificated radiologists from Duke participated in this observer study on a DICOM calibrated diagnostic display workstation and under low ambient lighting conditions. The observer data were analyzed in terms of the correlations between the observer ranking orders and the algorithmic ranking orders. Based on the collected acceptable ranges, quality consistency ranges were statistically derived. The observer study showed that, for each metric, the averaged ranking orders of the participated observers were strongly correlated with the algorithmic orders. For the lung grey level, the observer ranking orders completely accorded with the algorithmic ranking orders. The quality consistency ranges derived from this observer study were close to these derived from our previous study. The observer study indicates that the proposed image-based quality assessment technique provides a robust reflection of the perceptual image quality of the clinical chest radiographs. The derived quality consistency ranges can be used to automatically predict the acceptability of a clinical chest radiograph.

  6. Analysis of X-Ray Film Quality in Primary Health Care Clinics in Riyadh

    OpenAIRE

    Mohammad Omar Alsubael

    2009-01-01

    The relationship between image quality and processing conditions was assessed in a survey of 26 primary health care clinics in Riyadh City. Each clinic is equipped with a basic X-ray room and a darkroom that has a small table-top automatic processor. Rooms were evaluated for the quality of safe light, light leakage, storage of films and chemicals and processor temperature setting. A relationship was obtained between the quality of these parameters and the analysis of characteristic curves (H ...

  7. A LABOR LIFE QUALITY AS A SOCIО-ECONOMIC INDICATOR OF ORGANIZATION WELFARE

    OpenAIRE

    Andruhov V.A.

    2012-01-01

    In this article basic conceptions and factors qualities of organization labor life are given. It is also considered and revealed its basic characteristics in detail. A labor life quality definition are explored and specified. Also ordering and classification of a labour life quality formation factors is carried out.

  8. Age, Stigma, Adherence and Clinical Indicators in HIV-Infected Women

    Science.gov (United States)

    McCoy, Katryna; Higgins, Melinda; Zuñiga, Julie Ann; Holstad, Marcia McDonnell

    2016-01-01

    Stigma has become a gendered phenomenon that affects increasing numbers of HIV-infected women worldwide. This study examined the role of age as a possible moderator of the relationship between stigma and antiretroviral therapy adherence, CD4% and viral load among 120 HIV-infected women. A secondary analysis was conducted using data from the Keeping Healthy and Active with Risk Reduction and Medication Adherence (KHARMA) Project, an National Institutes of Health (NIH) funded randomized controlled trial to improve Antiretroviral treatment (ART) adherence and reduce risky behaviors in HIV-infected women at five clinical sites in a South-eastern city from 2005 to 2008. Stigma was measured using the Perceived Personal Stigma of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) scale. Among participants 50 years old, age was not significantly associated with viral load, stigma or CD4%, and there was no significant association between stigma and CD4% (r=.07, p=.70). These findings indicate the need for further study regarding this potential moderating effect and possible interventions to address the susceptibility of younger women to the harmful effects of stigma.

  9. Sarcopenic obesity is associated with lower indicators of psychological health and quality of life in Koreans.

    Science.gov (United States)

    Cho, Yoonsu; Shin, So-Youn; Shin, Min-Jeong

    2015-05-01

    Sarcopenic obesity (SO) is known to contribute to morbidity and mortality from chronic diseases. However, there exists limited information regarding its effect on psychological health. The aim of this study was to evaluate association of SO with several indices of psychological health and quality of life (QoL) in Korean adults. This cross-sectional study was conducted with 11521 participants older than 20 years from the Korea National Health and Nutrition Examination Survey 2008-2011. Sarcopenic obesity was defined by a low appendicular skeletal muscle mass divided by body weight less than 1 standard deviation below the sex-specific mean for the young reference group, and by a high waist circumference of at least 90 cm for men and at least 85 cm for women. Psychological health status, including depressive symptoms, perceived stress, and suicidal ideation, as well as QoL, was assessed by a self-reporting questionnaire. Association between SO and psychological health status was assessed under a logistic regression model. After multivariate adjustment for demographics and lifestyle factors, SO was significantly associated with perceived stress (odds ratio, 1.24; 95% confidence interval, 1.07-1.44; P value = .004) and suicidal ideation (odds ratio, 1.26; 95% confidence interval, 1.06-1.50; P value = .010). In addition, SO was found to have a negative association with a range of QoL indicators. Interestingly, these association patterns were more significant in participants younger than 60 years. In conclusion, our results suggest that SO was associated with adverse psychological health and lower QoL more than body mass index-based general obesity. PMID:25931418

  10. The Relation Between the Presence of Aspiration or Penetration and the Clinical Indicators of Dysphagia in Poststroke Survivors

    OpenAIRE

    Han, Hyeju; Shin, Gayoung; Jun, Ahyoung; Park, Taeok; Ko, Doheung; Choi, Eunhee; Kim, Youngsun

    2016-01-01

    Objective To examine the relation between the presence of penetration or aspiration and the occurrence of the clinical indicators of dysphagia. The presence of penetration or aspiration is closely related to the clinical indicators of dysphagia. It is essential to understand these relationships in order to implement proper diagnosis and treatment of dysphagia. Methods Fifty-eight poststroke survivors were divided into two groups: patients with or without penetration or aspiration. Medical rec...

  11. Historical variations of Bera Lake (Malaysia) sediments geochemistry using radioisotopes and sediment quality indices

    International Nuclear Information System (INIS)

    The Bera Lake basin is a lacustrine mire system and the largest natural lake in Peninsular Malaysia. Three cores were collected from the lake sediments in order to assess sediment quality and ecological risks for aquatic life and human health. An index analysis approach (Cf , Cd , Er , and IR) and fallout 210Pb and 137Cs radioisotopes were applied to assess the impacts of environmental evolutionary changes. Sediment chronology was determined using the Constant Rate of Supply model with the resultant ages verified by 137Cs horizons. Although the general contamination factors indicate low risk conditions in Bera Lake the risks associated with individual layers ranged from moderate to considerable. Five deforestation phases can be identified in the dated sediment cores with distinct variations in heavy metal influxes since 1972. These phases are in excellent agreement with the dates of land clearance and development projects undertaken over the past four decades. This study has highlighted the capability of contamination factors and chronological methods in environmental evolutionary studies where catchments have experienced extensive land use changes. The destiny of heavy metal influxes into a lake can also be revealed using this methodology. (author)

  12. AUSTROPOTAMOBIUS TORRENTIUM AS AN INDICATOR FOR HABITAT QUALITY IN RUNNING WATERS?

    Directory of Open Access Journals (Sweden)

    PÖCKL M.

    2005-07-01

    Full Text Available In the present study we tried to quantify the indication value of A. torrentium referring to habitat quality. This variable is expressed as the availability of appropriate refuge stones on the bottom and banks of running waters. The brooks occupied by the indigenous stone crayfish in Lower Austria show a high variability in the current velocity and substrate heterogeneity. Having some experience in hand searching we assumed that the distribution pattern of the crayfish on the stream bed is strongly correlated with the distribution of cobble and pebbles within a certain grain size. The aim of our study was to quantify the dependence of the shelter requirements for A. torrentium on grain size and water velocity, as well as the seasonal mobility of the crayfish. Shelters where velocity exceeded 25 cm s-1 were not occupied. Pebbles with a bearing surface greater than 300 cm2 were preferred, and the probability of crayfish occupation rose quickly as the stone’s bearing surface increased up to 900 cm2. Most individuals changed their location only a few meters (median 4 m. The distance from the point of first capture increased only little within the length of time passed until re-capture, suggesting a conservative use of space.

  13. A Validation of Object-Oriented Design Metrics as Quality Indicators

    Science.gov (United States)

    Basili, Victor R.; Briand, Lionel C.; Melo, Walcelio

    1997-01-01

    This paper presents the results of a study in which we empirically investigated the suits of object-oriented (00) design metrics introduced in another work. More specifically, our goal is to assess these metrics as predictors of fault-prone classes and, therefore, determine whether they can be used as early quality indicators. This study is complementary to the work described where the same suite of metrics had been used to assess frequencies of maintenance changes to classes. To perform our validation accurately, we collected data on the development of eight medium-sized information management systems based on identical requirements. All eight projects were developed using a sequential life cycle model, a well-known 00 analysis/design method and the C++ programming language. Based on empirical and quantitative analysis, the advantages and drawbacks of these 00 metrics are discussed. Several of Chidamber and Kamerer's 00 metrics appear to be useful to predict class fault-proneness during the early phases of the life-cycle. Also, on our data set, they are better predictors than 'traditional' code metrics, which can only be collected at a later phase of the software development processes.

  14. Air Quality and Indoor Environmental Exposures: Clinical Impacts

    Science.gov (United States)

    Indoor air quality (IAQ) is a term which refers to the air quality within and around buildings and homes as it relates to the health and comfort of the occupants. Many ambient (outdoor) air pollutants readily permeate indoor spaces. Because indoor air can be considerably more pol...

  15. Data-driven analysis of soil quality indicators using limited data

    Science.gov (United States)

    Pulido Moncada, Mansonia; Gabriels, Donald; Cornelis, Wim

    2016-04-01

    The difficult question of which variables to include as a minimum data set of soil quality (SQ) indicators may be simplified by statistical methods, which allow working with databases including categorical and numerical variables commonly used for assessing SQ. The aims of this study were: i) to identify soil structural related parameters that may associate to SQ at different geographic areas and ii) to test the potential power of using decision trees in setting up a framework for SQ assessment, and in determining structural soil properties, visually evaluated, that could be included in the estimation of soil physical properties such as saturated hydraulic conductivity (Ks). SQ was evaluated by visual soil assessment (VSA) in the field and a limited number of physical and chemical soil properties (bulk density (BD), air capacity, plant available water capacity (PAWC), saturated hydraulic conductivity (Ks), water stable aggregates (WSA), particle size distribution, soil organic carbon (SOC) and cation exchange capacity (CEC)) determined in the laboratory. Using categorical and numerical data of those physical, chemical and morphological properties of soils in both tropical and temperate areas, classification trees and model trees were grown. Parameters related to SQ differed between geographic areas. Ks was the strongest variable determining the SQ in 'tropical' soils, but WSA, SOC and PAWC were also key variables in determining differences in SQ. For 'temperate' soils PAWC was the only variable selected by the tree building algorithm. SOC, clay, and CEC were the discriminating variables of the model constructed from the combined data set. Statistically significant relationships between measured and visual parameters are promising in demonstrating the SQ description required for merging morphological, physical and chemical properties for minimum data set of SQ indicators. Thresholds of different predicting variables could be better established when SQ frameworks

  16. A study of electrical power network of renewable energies and water desalination research center using power quality phenomena and indices

    International Nuclear Information System (INIS)

    Renewable energies and water distillation research center (REWDRC) is a very strategic research facility and contains many important and critical industrial and electrical loads that must to be operated as a group to fulfill the requirements and the needs of the center in the operation of the main research facility of the center which a 10 MW reactor. Faults on the electrical or the industrial system can occur on many ways such as a malfunction in the questioned system, power quality related problem, or a failure of any of the loads (such as central ventilation or water circulation system or one of the substations) have a great diverse effect on the operation of the main research facility (reactor). In this research common problems due to power quality phenomena were studied, assessed through a assigning some power quality indices to the electrical network of the center so that the operational condition of the REWDRC electrical and industrial network could be evaluated. power quality indices (PQI) were assigned based on results of real time measurements at the points of common coupling of the network (PCC) and the initial power quality survey report. indices analysis was done using three methods which were the normalization method, method of comparing to the limit value and analysis of measurement data time function profile. As a result of this research a recommendation for safe operation against power quality disturbances was pointed out through a continuous monitoring of assigned power quality indices. (Author)

  17. Heart beat detection in multimodal physiological data using a hidden semi-Markov model and signal quality indices.

    Science.gov (United States)

    A F Pimentel, Marco; Santos, Mauro D; Springer, David B; Clifford, Gari D

    2015-08-01

    Accurate heart beat detection in signals acquired from intensive care unit (ICU) patients is necessary for establishing both normality and detecting abnormal events. Detection is normally performed by analysing the electrocardiogram (ECG) signal, and alarms are triggered when parameters derived from this signal exceed preset or variable thresholds. However, due to noisy and missing data, these alarms are frequently deemed to be false positives, and therefore ignored by clinical staff. The fusion of features derived from other signals, such as the arterial blood pressure (ABP) or the photoplethysmogram (PPG), has the potential to reduce such false alarms. In order to leverage the highly correlated temporal nature of the physiological signals, a hidden semi-Markov model (HSMM) approach, which uses the intra- and inter-beat depolarization interval, was designed to detect heart beats in such data. Features based on the wavelet transform, signal gradient and signal quality indices were extracted from the ECG and ABP waveforms for use in the HSMM framework. The presented method achieved an overall score of 89.13% on the hidden/test data set provided by the Physionet/Computing in Cardiology Challenge 2014: Robust Detection of Heart Beats in Multimodal Data. PMID:26218536

  18. Quality Indicators for Colonoscopy Procedures: A Prospective Multicentre Method for Endoscopy Units

    OpenAIRE

    Coriat, Romain; Lecler, Augustin; Lamarque, Dominique; Deyra, Jacques; Roche, Hervé; Nizou, Catherine; Berretta, Olivier; Mesnard, Bruno; Bouygues, Martin; Soupison, Alain; Monnin, Jean-Luc; Podevin, Philippe; Cassaz, Carole; Sautereau, Denis; Prat, Frédéric

    2012-01-01

    Background and Aims Healthcare professionals are required to conduct quality control of endoscopy procedures, and yet there is no standardised method for assessing quality. The topic of the present study was to validate the applicability of the procedure in daily practice, giving physicians the ability to define areas for continuous quality improvement. Methods In ten endoscopy units in France, 200 patients per centre undergoing colonoscopy were enrolled in the study. An evaluation was carrie...

  19. Quality of life and physical activity as indicators of health-preserving competence of teachers

    OpenAIRE

    Pavlova Iu.A.

    2012-01-01

    The quality of life and physical activity of teachers of physical culture, basic of health, labour, the defense of Motherland and pedagogue-organizers from secondary schools Lviv region (Ukraine) were investigated. The 402 persons (age 24-78 years) were surveyed with the use of questionnaires MOS SF 36 and IPAQ. The highest quality of life and level of physical activity have teachers of physical culture. It is considered the quality of life of teachers of other subjects similar to persons wit...

  20. IN SEARCH OF ACADEMIC SUCCESS INDICATORS: AN ANALYSIS FROM THE STUDENTS’ PERCEPTIONS ABOUT QUALITY OF EDUCATION

    OpenAIRE

    Cid, Marília; Rebelo, Hugo; Oliveira, Maria Manuela; Saraiva, Margarida; Bonito, Jorge

    2009-01-01

    Characterizing the quality of education may encompass the analysis of several variables, such as human resources, financial resources, teaching methodologies, good academic results, personal and social development. Nevertheless, all elements of the education system matter and may contribute to improve its quality. Ultimately, the success of an education system depends on the interaction of all elements. In order to study the representations of quality, a longitudinal research project is takin...

  1. Investigations of portable cadmium telluride (CdTe(Cl)) detectors for clinical studies with radioactive indicators

    International Nuclear Information System (INIS)

    The combination of small, portable γ-radiation-sensitive Cadmium Telluride (CdTE(Cl)) crystal detectors and portable solid state data storage memories makes it feasible to extend the measuring period in a number of clinical investigations based on the use of various radioisotopes and external detection. Blood sampling can be avoided in some cases. Continuous ambulatory monitoring of relevant physiological parameters is practicable, e.g. kidney function (GFR), left ventricular ejection fraction, subcutaneous blood flow, muscle blood flow and insulin absorption in diabetic patients. In the present methodological study the applicability of the 133-Xe washout technique to subcutaneous (s.c.) adipose tissue blood flow (SBF) has been investigated and adapted to the use of CdTe(Cl) detectors attached to the skin surface for the measurement of local 133-Xe-disappearance rate constants (k). Physical characterization of CdTe(Cl) detectors as γ-sensitive devices has been performed, and adequate counting sensitivities were found without detector energy-resolution properties. The CdTe(Cl) detectors are therefore suitable for single indicator studies. The measuring geometry of CdTe(Cl) detectors was studied and compared with that of stationary Sodium Iodide (NaI(Tl)) detectors in both phantom and in vivo investigations. The spatial properties of CdTe(Cl) detectors could to some extent be adjusted by pulse height discrimination and lead collimation. When long-term measurements were complicated by for instance physical activity of the patients, the small CdTe(Cl) detectors in general showed equal or better performance than the heavy and voluminous NaI(Tl) detectors. The free movement of the ambulatory patient and the avoidance of cable connections to stationary data-collecting systems gave improved possibilities for measurements of the relevant parameters. From this point of view, portable CdTe(Cl) detectors must be considered an important advance for radioactivity studies in

  2. Smoking cessation can improve quality of life among COPD patients: Validation of the clinical COPD questionnaire into Greek

    Directory of Open Access Journals (Sweden)

    Linardis Apostolos

    2011-02-01

    Full Text Available Abstract Background Chronic obstructive pulmonary disease (COPD remains a major public health problem that affects the quality of life of patients, however smoking cessation may emeliorate the functional effects of COPD and alter patient quality of life. Objective-design The aim of this study was to validate the Clinical COPD Questionnaire (CCQ into Greek and with such to evaluate the quality of life in patients with different stages of COPD, as also assess their quality of life before and after smoking cessation. Results The internal validity of questionnaire was high (Cronbach's a = 0.92. The reliability of equivalent types in 16 stabilized patients also was high (ICC = 0.99. In general the domains within the CCQ were strongly correlated with each other, while each domain in separate was strongly correlated with the overall CCQ score (r2 = 0.953, r2 = 0.915 and r2 = 0.842 in regards to the functional, symptomatic and mental domain, respectively. The CCQ scores were also correlated with FEV1, (r2 = -0.252, p 1/FVC, (r2 = -0.135, p 2 = -0.384, p Conclusions The self administered CCQ indicates satisfactory validity, reliability and responsiveness and may be used in clinical practice to assess patient quality of life. Moreover the CCQ indicated the health related quality of life gains attributable to smoking cessation among COPD patients, projecting smoking cessation as a key target in COPD patient management.

  3. Quality metrics can help the expert during neurological clinical trials

    Science.gov (United States)

    Mahé, L.; Autrusseau, F.; Desal, H.; Guédon, J.; Der Sarkissian, H.; Le Teurnier, Y.; Davila, S.

    2016-03-01

    Carotid surgery is a frequent act corresponding to 15 to 20 thousands operations per year in France. Cerebral perfusion has to be tracked before and after carotid surgery. In this paper, a diagnosis support using quality metrics is proposed to detect vascular lesions on MR images. Our key stake is to provide a detection tool mimicking the human visual system behavior during the visual inspection. Relevant Human Visual System (HVS) properties should be integrated in our lesion detection method, which must be robust to common distortions in medical images. Our goal is twofold: to help the neuroradiologist to perform its task better and faster but also to provide a way to reduce the risk of bias in image analysis. Objective quality metrics (OQM) are methods whose goal is to predict the perceived quality. In this work, we use Objective Quality Metrics to detect perceivable differences between pairs of images.

  4. Where is information quality lost at clinical level? A mixed-method study on information systems and data quality in three urban Kenyan ANC clinics

    Directory of Open Access Journals (Sweden)

    Daniel Hahn

    2013-08-01

    Full Text Available Background: Well-working health information systems are considered vital with the quality of health data ranked of highest importance for decision making at patient care and policy levels. In particular, health facilities play an important role, since they are not only the entry point for the national health information system but also use health data (and primarily for patient care. Design: A multiple case study was carried out between March and August 2012 at the antenatal care (ANC clinics of two private and one public Kenyan hospital to describe clinical information systems and assess the quality of information. The following methods were developed and employed in an iterative process: workplace walkthroughs, structured and in-depth interviews with staff members, and a quantitative assessment of data quality (completeness and accurate transmission of clinical information and reports in ANC. Views of staff and management on the quality of employed information systems, data quality, and influencing factors were captured qualitatively. Results: Staff rated the quality of information higher in the private hospitals employing computers than in the public hospital which relies on paper forms. Several potential threats to data quality were reported. Limitations in data quality were common at all study sites including wrong test results, missing registers, and inconsistencies in reports. Feedback was seldom on content or quality of reports and usage of data beyond individual patient care was low. Conclusions: We argue that the limited data quality has to be seen in the broader perspective of the information systems in which it is produced and used. The combination of different methods has proven to be useful for this. To improve the effectiveness and capabilities of these systems, combined measures are needed which include technical and organizational aspects (e.g. regular feedback to health workers and individual skills and motivation.

  5. Health-related quality of life and cancer clinical trials

    OpenAIRE

    Osoba, David

    2011-01-01

    The measurement of patient-reported outcomes, including health-related quality of life, is a new initiative which has emerged and grown over the past four decades. Following the development of reliable and valid self-report questionnaires, health-related quality of life has been assessed in tens of thousands of patients and a wide variety of cancers. This review is based on a selection of data published in the last decade and is intended primarily for healthcare professionals. The assessments...

  6. Indicators of prescribing quality in drug utilisation research : report of a European meeting (DURQUIM, 13-15 May 2004)

    NARCIS (Netherlands)

    Hoven, JL; Haaijer-Ruskamp, FM; Vander Stichele, RH

    2005-01-01

    An invitational expert meeting on indicators of prescribing quality was held on 13-15 May 2004, bringing together-from 19 European countries, the US, Canada, and Australia-40 researchers specialized in the development and application of indicators. The meeting was organized by the European Drug Util

  7. Physical Quality Indicators and Mechanical Behavior of Agricultural Soils of Argentina

    Science.gov (United States)

    Pires da Silva, Alvaro; Ghiberto, Pablo J.; Tormena, Cássio A.; Pilatti, Miguel A.; Libardi, Paulo L.

    2016-01-01

    Mollisols of Santa Fe have different tilth and load support capacity. Despite the importance of these attributes to achieve a sustainable crop production, few information is available. The objectives of this study are i) to assess soil physical indicators related to plant growth and to soil mechanical behavior; and ii) to establish relationships to estimate the impact of soil loading on the soil quality to plant growth. The study was carried out on Argiudolls and Hapludolls of Santa Fe. Soil samples were collected to determine texture, organic matter content, bulk density, water retention curve, soil resistance to penetration, least limiting water range, critical bulk density for plant growth, compression index, pre-consolidation pressure and soil compressibility. Water retention curve and soil resistance to penetration were linearly and significantly related to clay and organic matter (R2 = 0.91 and R2 = 0.84). The pedotransfer functions of water retention curve and soil resistance to penetration allowed the estimation of the least limiting water range and critical bulk density for plant growth. A significant nonlinear relationship was found between critical bulk density for plant growth and clay content (R2 = 0.98). Compression index was significantly related to bulk density, water content, organic matter and clay plus silt content (R2 = 0.77). Pre-consolidation pressure was significantly related to organic matter, clay and water content (R2 = 0.77). Soil compressibility was significantly related to initial soil bulk density, clay and water content. A nonlinear and significantly pedotransfer function (R2 = 0.88) was developed to predict the maximum acceptable pressure to be applied during tillage operations by introducing critical bulk density for plant growth in the compression model. The developed pedotransfer function provides a useful tool to link the mechanical behavior and tilth of the soils studied. PMID:27099925

  8. Evaluation of Soil Quality Indicators in Sugarcane Management in Sandy Loam Soil

    Institute of Scientific and Technical Information of China (English)

    S.A.C.SANT'ANNA; M.F.FERNANDES; W.M.P.M.IVO; J.L.S.COSTA

    2009-01-01

    An important factor for the sustainability of soils highly susceptible to degradation is the use of monitoring tools that promptly and realistically reflect changes imposed on soil by different cropping systems.To select soil quality indicator variables in sugarcane (Saccharum offcinarum L.) production areas that fulfill the criteria of sensitivity to management practices and between-season consistency in the management discrimination,ten composite soil samples (0-10 cm) were collected in July 2005 (rainy season) and again in March 2006 (dry season) from areas under cultivation of organic sugarcane (OS),green sugarcane (GS),burned sugarcane (BS) and from an adjacent native forest (NF) area at Usina Triunfo,Boca da Mata,Alagoas,Brazil.Microbial biomass-C (MBC),total organic C (TOC),soil enzyme activity expressed as the rate of fluorescein diacetate (FDA) hydrolysis,mean weight diameter of water-stable soil aggregates (MWD),and percentage of water-stable macroaggregates (PWSA) were analyzed.Although MBC and TOC were higher in NF than in the cultivated areas,no differences were observed in these C pools between the three sugarcane systems.The response of FDA to the site management was dependent on the sampling time.In the rainy period,the activity followed the order:NF > OS > GS > BS,whereas in the dry season,only NF differed from the other treatments.Irrespective of the sampling time,MWD and PWSA decreased in the order NF > OS = GS > BS.The variables MWD and PWSA are quite sensitive for discriminating between site management histories regardless the sampling season.

  9. The effect of iodine in production of broiler chickens and selected quality indicators of breast muscles

    Directory of Open Access Journals (Sweden)

    Marieta Semivanová

    2013-07-01

    Full Text Available Due to the different effects on the human health it is necessary to avoid excessive or insufficient consumption of iodine. Iodine deficiency weakens the synthesis of the thyroid hormones, causes hypothyroidism and can lead to various developmental and functional disturbances known as the disorders from iodine deficiency. The latest literary knowledge about the use of iodine in the broiler chickens identifies the concentration of iodine 5 mg per kg feed as safe for a given group of the animals. Working Group on Additives and Products or Substances used in Animal Feed of  Panel on Additives and Products or Substances used in Animal Feed notes that the maximum authorized limit of iodine in the feed of the broiler chickens 10 mg per kg does not represent a health risk. The aim of our research was an observation and assessment of the effect of feed mixtures with iodized oil on production quality of the line hybrid chickens Cobb 500 and selected indicators of breast muscle. For comparison, a control group consists of the chickens, which were fed the feed mixtures without iodized oil. Dietary iodine in the form of potassium iodide was applied to sunflower oil. The mixture was heated at 70 °C with continuous stirring until dissolution of potassium iodide. The content of iodine in iodine suplement was 0.04  mg per g per 1 kg of feed mixture of starter, growth and the finisher was used 5 g of iodine supplement. The oil mixture was mixed into kibbled grain of corn and carefully homogenized with other components of  the feed mixtures. To meet the aim of research, we realized an experiment, where body weight of the chickens was observed at the end of the experiment, the breast muscle weight and chemical analysis was made from selected indicators of breast muscle. A body weight of broiler chickens at the beginning and the end of the experiment and a breast muscle weight were observed by weighing on the Kern ECB 20K20 type scale with an accuracy of d = 0

  10. Clinical characteristics,prognosis and indicators of glucose metabolism of liver cirrhosis complicated with diabetes

    Institute of Scientific and Technical Information of China (English)

    吴娟

    2013-01-01

    Objective To investigate clinical characteristics and outcome of patients with liver cirrhosis complicated with diabetes,and to explore the differences of clinical characteristics and prognosis between hepatogenous diabetes (HD) and type 2 diabetes mellitus (T2DM) .Methods From November 2010 to April 2012,246 patients with liver cirrhosis were collected and divided into liver cir-

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

    OpenAIRE

    Esposito, Pasquale; Dal Canton, Antonio

    2014-01-01

    Evaluation and improvement of quality of care provided to the patients are of crucial importance in the daily clinical practice and in the health policy planning and financing. Different tools have been developed, including incident analysis, health technology assessment and clinical audit. The clinical audit consist of measuring a clinical outcome or a process, against well-defined standards set on the principles of evidence-based medicine in order to identify the changes needed to improve t...

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

    International Nuclear Information System (INIS)

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

  13. Clinical use of quantitative cardiac perfusion PET: rationale, modalities and possible indications. Position paper of the Cardiovascular Committee of the European Association of Nuclear Medicine (EANM).

    Science.gov (United States)

    Sciagrà, Roberto; Passeri, Alessandro; Bucerius, Jan; Verberne, Hein J; Slart, Riemer H J A; Lindner, Oliver; Gimelli, Alessia; Hyafil, Fabien; Agostini, Denis; Übleis, Christopher; Hacker, Marcus

    2016-07-01

    Until recently, PET was regarded as a luxurious way of performing myocardial perfusion scintigraphy, with excellent image quality and diagnostic capabilities that hardly justified the additional cost and procedural effort. Quantitative perfusion PET was considered a major improvement over standard qualitative imaging, because it allows the measurement of parameters not otherwise available, but for many years its use was confined to academic and research settings. In recent years, however, several factors have contributed to the renewal of interest in quantitative perfusion PET, which has become a much more readily accessible technique due to progress in hardware and the availability of dedicated and user-friendly platforms and programs. In spite of this evolution and of the growing evidence that quantitative perfusion PET can play a role in the clinical setting, there are not yet clear indications for its clinical use. Therefore, the Cardiovascular Committee of the European Association of Nuclear Medicine, starting from the experience of its members, decided to examine the current literature on quantitative perfusion PET to (1) evaluate the rationale for its clinical use, (2) identify the main methodological requirements, (3) identify the remaining technical difficulties, (4) define the most reliable interpretation criteria, and finally (5) tentatively delineate currently acceptable and possibly appropriate clinical indications. The present position paper must be considered as a starting point aiming to promote a wider use of quantitative perfusion PET and to encourage the conception and execution of the studies needed to definitely establish its role in clinical practice. PMID:26846913

  14. Recommendations for improving the quality of reporting clinical electrochemotherapy studies based on qualitative systematic review

    Directory of Open Access Journals (Sweden)

    Campana Luca G.

    2016-03-01

    Full Text Available Electrochemotherapy is becoming a well-established treatment for malignancies of skin and non-skin origin and its use is widening across Europe. The technique was developed and optimized from solid experimental and clinical evidence. A consensus document is now warranted to formalize reporting results, which should strengthen evidence-based practice recommendations. This consensus should be derived from high quality clinical data collection, clinical expertise and summarizing patient feedback. The first step, which is addressed in this paper, aims to critically analyze the quality of published studies and to provide the recommendations for reporting clinical trials on electrochemotherapy.

  15. Leveraging network connectivity for quality assurance of clinical display monitors.

    Science.gov (United States)

    Gersten, Jennifer

    2012-01-01

    The VA Midwest Health Care Network, VISN 23, is one of 21 veteran integrated health service networks (VISN) under the Department of Veterans Affairs. There are approximately 300,000 imaging studies generated per year and currently more than 14,000 picture archiving and communication system (PACS) users in VISN 23. Biomedical Engineering Services within VISN 23 coordinates the provision of medical technology support. One emerging technology leverages network connectivity as a method of calibrating and continuously monitoring clinical display monitors in support of PACS. Utilizing a continuous calibration monitoring system, clinical displays can be identified as out of Digital Imaging and Communications in Medicine (DICOM) compliance through a centralized server. The technical group can receive immediate notification via e-mail and respond proactively. Previously, this problem could go unnoticed until the next scheduled preventive maintenance was performed. This system utilizes simple network management protocols (SNMP) and simple mail transfer protocols (SMTP) across a wide area network for real-time alerts from a centralized location. This central server supports and monitors approximately 320 clinical displays deployed across five states. Over the past three years of implementation in VISN 23, the remote calibration and monitoring capability has allowed for more efficient support of clinical displays and has enhanced patient safety by ensuring a consistent display of images on these clinical displays. PMID:22239357

  16. Effect of the Cardio First Angel™ device on CPR indices: a randomized controlled clinical trial

    OpenAIRE

    Vahedian-Azimi, Amir; Hajiesmaeili, Mohammadreza; Amirsavadkouhi, Ali; Jamaati, Hamidreza; Izadi, Morteza; Madani, Seyed J.; Hashemian, Seyed M. R.; Miller, Andrew C

    2016-01-01

    Background A number of cardiopulmonary resuscitation (CPR) adjunct devices have been developed to improve the consistency and quality of manual chest compressions. We investigated whether a CPR feedback device would improve CPR quality and consistency, as well as patient survival. Methods We conducted a randomized controlled study of patients undergoing CPR for cardiac arrest in the mixed medical-surgical intensive care units of four academic teaching hospitals. Patients were randomized to re...

  17. Quality and safety based management of radiological and clinical equipment

    International Nuclear Information System (INIS)

    TQM (Total quality management) is the 'buzz' acronym expected in almost every aspect of industrial manufacturing, product development and services solicited by the outside agencies. The correct management of the many technological resources in health institutions in terms of efficiency, effectiveness and safety is a necessity in view of the criteria on which modern medicine is based. Almost all activities -be they diagnostic, therapeutic and rehabilitative - carried out within a modern hospital are based on widespread application of equipment and technology, the efficiency of which can directly influence the quality of service offered to the patient

  18. Influence of the fertilizers use on indices of chernozem’s quality

    Directory of Open Access Journals (Sweden)

    N. N. Tsvetkova

    2010-08-01

    Full Text Available Influence of fertilizers application on the change of indexes of soil quality is studied. As a result of experiment for a period of 2005–2009 we established that the productivity of agricultural plants is multiplied under applying chemical matter in soil. The mobile forms of microelements are accumulated; indexes stipulating exchange processes in soil diminish. There are tendencies to oxidization and toxicity of land arable layer. Quality of land is appraised according to the 100-grade scale with a correction factor by the salt pH for the forest-steppe – 0.96. As a result the quality is decrease on 9.3 %.

  19. Evaluation of normalized total dose as a clinical prognostic indicator for spinal cord myelitis

    International Nuclear Information System (INIS)

    The aim of this study was to apply Normalized Total Dose (NTD) to compiled clinical literature data in order to arrive at tolerance NTD value for acceptable level of probability of spinal cord myelitis

  20. Assessment of water quality at selected sites in the White River Basin, Indiana, 1993 and 1995 using biological indices

    Science.gov (United States)

    Frey, Jeffrey W.; Baker, N.T.; Lydy, M.J.; Stone, W.W.

    1996-01-01

    As part of the National Water Quality Assessment (NAWQA) Program, fish communities were sampled at 11 sites in the White River Basin, Indiana, in 1993 and 1995 to help determine water-quality conditions. Ninety-one species of fish with representatives from 18 families were collected in the basin. Total numbers of fish collected at every site increased between collection years. The Index of Biological Integrity (IBI) and Qualitative Habitat Evaluation Index (QHEI) were calculated for all 11 sites in 1995. The QHEI scores indicated six sites had excellent habitat to support fish communities. Only three sites were rated in the “good” to “excellent” IBI water-quality categories, indicating some type of nonhabitat environmental degradation to the fish communities. Eight of the sites were rated in the “fair,” “poor,” or “very poor” IBI water-quality categories.

  1. Attachment Quality and Psychopathological Symptoms in Clinically Referred Adolescents: The Mediating Role of Early Maladaptive Schema.

    Science.gov (United States)

    Roelofs, Jeffrey; Onckels, Linda; Muris, Peter

    2013-04-01

    This study investigated relationships between attachment insecurity, maladaptive cognitive schemas, and various types of psychopathological symptoms in a sample of clinically referred adolescents (N = 82). A mediation model was tested in which maladaptive schemas operated as mediators in the relations between indices of attachment quality and conduct, peer, and emotional problems. Results revealed partial support for the hypothesized mediation effect: the schema domain of disconnection/rejection acted as a mediator in the links between insecure attachment and peer problems and emotional problems. Further analysis of these effects revealed that different types of maladaptive schemas were involved in both types of psychopathology. Altogether, findings suggest that treatment of adolescent psychological problems may need to target the improvement of attachment relationships with peers and parents and the correction of underlying cognitive schemas. PMID:23524954

  2. Clinical and course indicators of bipolar disorder type I with and without opioid dependence

    OpenAIRE

    amir shabani; Atefeh Ghanbari Jolfaei; Hajar Ahmadi Vazmalaei; Azizeh Afkham Ebrahimi; Morteza Naserbakht

    2010-01-01

    Abstract BACKGROUND: The existing evidence about the clinical situations of the bipolar patients with opioid dependence is scarce. The present study was carried out to compare the clinical features and course of the bipolar disorder type I regarding the two subgroups of opioid dependent and non-dependent. METHODS: 178 adult inpatients with bipolar disorder type I consecutively referred to the Iran Hospital of Psychiatry, Tehran, Iran, from January 2008 to January 2009 we...

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

    Directory of Open Access Journals (Sweden)

    Miccoli F. P.

    2013-10-01

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

  4. The methodology of the study desserts with encapsulated probiotic microorganisms indicators quality

    OpenAIRE

    Кондратюк, Н. .В.

    2015-01-01

    Проведено дослідження показників якості солодких страв з капсульованими мікроорганізмами (Bifidobacterium lactis BB 12). Вивчено вплив капсульованих об’єктів на основні властивості кінцевих продуктів (солодких страв із пінною структурою). Встановлено закономірності керування процесами формування показників якості нових видів кулінарної продукції. At the article discusses the procedure of quality indicators studying in samples of desserts (cream, mousse and sambuc) with encapsulated prob...

  5. Application of water quality indices NSF, DINIUS and BMWP to Ayura Creek, Antioquia, Colombia

    International Nuclear Information System (INIS)

    This investigation evaluates the quality of water in the creek The Ayura (municipality of Envigado, Antioquia, Colombia), through application of the National Sanitation Foundation (NSF) and Dinius quality indexes, and the biotic index BMWP/Col. the estimate of these indexes was conducted with data collected in three sites and three moments. Physicochemical and microbiological variables were determinate; we also performed a qualitative and quantitative sampling of aquatic macroinvertebrates. Using this methodology the behavior of physical-chemical and biological community in the different sites was studied. The physicochemical and aquatic macroinvertebrate indexes results showed that site 1 provides a good quality of water and the sites 2 and 3 a middle deteriorated water quality.

  6. RELEVANCE OF ROOTED VASCULAR PLANTS AS INDICATORS OF ESTUARINE SEDIMENT QUALITY

    Science.gov (United States)

    Toxicity assessments and numerical quality assessment guidelines for estuarine sediments are rarely based on information for aquatic plants. The effect of this lack of information on contaminated sediment evaluations is largely unknown. For this reason, the toxicities of whole se...

  7. Reliability testing across the Environmental Quality Index and national environmental indices.

    Science.gov (United States)

    One challenge in environmental epidemiology is the exploration of cumulative environmental exposure across multiple domains (e.g. air, water, land). The Environmental Quality Index (EQI), created by the U.S. EPA, uses principle component analyses combining environmental domains (...

  8. Quality of Type II Diabetes Care in Primary Health Care Centers in Kuwait: Employment of a Diabetes Quality Indicator Set (DQIS)

    OpenAIRE

    Dalia Badawi; Shadi Saleh; Nabil Natafgi; Yara Mourad; Kazem Behbehani

    2015-01-01

    Diabetes Mellitus is one of the major public health challenges, affecting more than 347 million adults worldwide. The impact of diabetes necessitates assessing the quality of care received by people with diabetes, especially in countries with a significant diabetes burden such as Kuwait. This paper aimed at piloting an approach for measuring Type II diabetes care performance through the use of a diabetes quality indicator set (DQIS) in primary health care. The DQIS for Kuwait was adapted from...

  9. Performance indicators for an objective measure of public transport service quality

    OpenAIRE

    Eboli, Laura; Mazzulla, Gabriella

    2012-01-01

    The measurement of transit performance represents a very useful tool for ensuring continuous increase of the quality of the delivered transit services, and for allocating resources among competing transit agencies. Transit service quality can be evaluated by subjective measures based on passengers’ perceptions, and objective measures represented by disaggregate performance measures expressed as numerical values, which must be compared with fixed standards or past performances. The proposed re...

  10. Student’s Satisfaction - An Indicator of Quality in Physical Education

    OpenAIRE

    Cristiana POP

    2014-01-01

    A quality social service is one which fulfils a set of demands and rules according to a standard and especially according to the internal and external client’s expectations. Reaching these goals implies a new relationship between the service provider and the beneficiary as well. As a consequence, in educational system is expected also a change regarding the improvement of the educational offer, the educational context, the quality of the human resources and the relationship between teacher an...

  11. Land Use Effects on Soil Quality Indicators: A Case Study of Abo-Wonsho Southern Ethiopia

    OpenAIRE

    Fantaw Yimer; Melku Dagnachew; Awdenegest Moges

    2013-01-01

    Soil quality assessment is valuable for evaluating agroecosystem sustainability, soil degradation, and identifying sustainable land management practices. This study compared soil quality within culturally protected forest areas and adjacent grassland, grazing land, and farmland in Abo-Wonsho, Southern Ethiopia. A total of 40 soil samples (4 land uses × 5 replications × 2 soil depth layers: 0 to 10 cm and 10 to 20 cm) were collected for analysis. Soil textural fractions (i.e., sand, silt, and ...

  12. Quality Indicators For Shapping The Communication Process In The University Type Of Public Organization

    OpenAIRE

    Ţîţu Mihail Aurel; Flucsă Daniela Maria

    2014-01-01

    In the context of competition in higher education environment the university type of public institution ensures high quality, accessible, challenging university and research programs, expertise services based on a strong motivation, commitment and professional attitude from the teaching body and students. National documents promoted by ARACIS show that “The internal dimension of academic quality is built based on the legislation in force and according to the specific of each university, its t...

  13. Effects of organic amendment on soil quality as assessed by biological indicators

    OpenAIRE

    Sultana, Salma

    2011-01-01

    Soil quality decline is one of the most predominant effect deriving from human activities. In particular, intensive agricultural management can affect negatively soils, principally due to rapid depletion of soil organic matter, that affects, in turn, soil physical, chemical and biological properties. The declining trend of soil quality coupled with mismanagement of agricultural production is pose a serious threat to sustainability of intensive agriculture. Sustainable intensive agriculture is...

  14. Influence of the fertilizers use on indices of chernozem’s quality

    OpenAIRE

    N. N. Tsvetkova; I. I. Saranenko

    2010-01-01

    Influence of fertilizers application on the change of indexes of soil quality is studied. As a result of experiment for a period of 2005–2009 we established that the productivity of agricultural plants is multiplied under applying chemical matter in soil. The mobile forms of microelements are accumulated; indexes stipulating exchange processes in soil diminish. There are tendencies to oxidization and toxicity of land arable layer. Quality of land is appraised according to the 100-grade scale ...

  15. Validation of the Enterococci indicator for bacteriological quality monitoring of beaches in Malaysia using a multivariate approach

    OpenAIRE

    Ahmad, Asmat; Dada, Ayokunle C; Usup, Gires; Lee Y. Heng

    2013-01-01

    There is currently no established bacteriological beach quality monitoring (BQM) program in place in Malaysia. To initiate cost-effective, sustainable bacteriological BQM schemes for the ultimate goal of protecting public health, policy decision makers need to be provided robust, indigenous empirical findings that validate appropriate water quality parameters for inclusion in such monitoring programs. This is the first study that assesses the validity of enterococci as an ideal indicator for ...

  16. Patent statistics: a good indicator for innovation in China? Assessment of impacts of patent subsidy programs on patent quality

    OpenAIRE

    Dang, Jangwei; Motohashi, Kazuyuki

    2013-01-01

    This paper investigates whether patent subsidy programs aimed at promoting regional innovations have aroused a large number of low-quality applications in China and created biased patent statistics as an indicator for innovations. We found that patent filing fee subsidies encouraged filing of low-quality patent, resulting in a decreased grant rate. Though reward conditioned on grants increased patent grant rate, it also brought patents with narrow claim breadth. Our empirical results confirme...

  17. Synthesis of oxidic powder in nonequilibrium low- temperature plasma with increase of indicators of quality of process

    International Nuclear Information System (INIS)

    Ways of synthesis of powders in low-temperature plasma define various approaches in the solution of technological tasks for receiving difficult oxidic connections with various quality of a product. Research of model of electrothermal reactor installation with generation of low-temperature plasma is of special interest for synthesis of oxidic powder with the raised quality indicators. This approach defines technology of receiving details from powder materials of modern production

  18. Gender Differences on Perceptions of Employee Quality of Working Life Indicators in Five Star Hotels in Turkey

    OpenAIRE

    Derya Kara

    2012-01-01

    The aim of the study is to examine gender differences on perceptions of employees’ quality of working life indicators in five star hotels in Turkey. 443 hotel employees participated in this study. Quality of work life was measured using 7 dimension and 16 items scale. All these dimensions were investigated with respect to gender variable. According these results male employees reported significantly different mean scores in health & safety needs, actualization needs, and knowledge needs in qu...

  19. The Relation Between the Presence of Aspiration or Penetration and the Clinical Indicators of Dysphagia in Poststroke Survivors

    Science.gov (United States)

    Han, Hyeju; Shin, Gayoung; Jun, Ahyoung; Park, Taeok; Ko, Doheung; Choi, Eunhee

    2016-01-01

    Objective To examine the relation between the presence of penetration or aspiration and the occurrence of the clinical indicators of dysphagia. The presence of penetration or aspiration is closely related to the clinical indicators of dysphagia. It is essential to understand these relationships in order to implement proper diagnosis and treatment of dysphagia. Methods Fifty-eight poststroke survivors were divided into two groups: patients with or without penetration or aspiration. Medical records and videofluoroscopic swallowing examinations were reviewed. The occurrence of clinical indicators of dysphagia between two groups was analyzed with Cross Tabulation and the Pearson chi-square test (p<0.05). Results Poststroke survivors with penetration or aspiration had significantly high occurrences of delayed initiation of the swallow (p=0.04) and reduced hyolaryngeal elevation (p<0.01) than those without penetration or aspiration. Conclusion The results of this study indicate that delayed initiation of the swallow is a strong physiological indicator of penetration or aspiration during the oral stage of swallowing in poststroke survivors. For the pharyngeal stage of swallowing, hyoid and laryngeal elevation is a key event related to occurrence of penetration or aspiration. Clinical indicators should be investigated further to allow appropriate implementation of treatment strategies for stroke survivors. PMID:26949674

  20. 77 FR 32975 - AHRQ Workgroups on ICD-10-CM/PCS Conversion of Quality Indicators (QIs)

    Science.gov (United States)

    2012-06-04

    ..., neurologic disease, orthopedic and musculoskeletal disease, obstetrics and gynecologic disease, surgery... individuals with relevant clinical expertise (e.g., cardiovascular disease, neurologic disease, orthopedic and musculoskeletal disease, obstetrics and gynecologic disease, surgery, critical care and pulmonary...

  1. Methodological quality of clinical trials in pediatric dentistry research published in ISI journals, 2008-2012.

    OpenAIRE

    Ana Jaime; Carolina Rodríguez; Pedro Christian Aravena

    2015-01-01

    ABSTRACT There are many studies about the methodological quality of articles in pediatric dentistry. However, there is no up-to-date information or the use of measurement guidelines designed and validated for this purpose. The aim of this article is to determine the methodological quantity and quality of clinical trials (CT) in pediatric dentistry published in four Web of Knowledge (ISI-indexed journals) between 2008 and 2012. Clinical trials published in four ISI pediatric dentistry ...

  2. Costs, Quality and Value in Cardiovascular Interventions: Implications for clinical decision-making and policy development

    OpenAIRE

    Osnabrugge, Ruben

    2015-01-01

    markdownabstract__Abstract__ The aim of this thesis is to study the clinical, economic and quality-of-life considerations for clinical decision-making and policy development in cardiovascular interventions. More specifi cally the goals are: 1. To investigate the disease prevalence, adoption trends, quality of life, and economic aspects associated with therapies of aortic stenosis. 2. To explore the economic and policy aspects of alternative revascularization therapies for coronary artery dise...

  3. Prevalence of clinical and subclinical mastitis and quality of milk on smallholder dairy farms in Tanzania

    OpenAIRE

    Mdegela, R.H.; R. Ryoba; E.D. Karimuribo; E.J. Phiri; T. Loken; Reksen, O.; E. Mtengeti; N.A. Urio

    2009-01-01

    A cross sectional study was conducted during October and November 2006 on 69 smallholder dairy farms with lactating cows in Mvomero and Njombe districts Tanzania, to determine the prevalence of mastitis and to assess the milk quality on the study farms. Clinical mastitis was investigated using clinical changes of udder and milk at animal level. Cow-side California Mastitis Test (CMT) and microbiological cultures were used to assess subclinical mastitis at quarter level. Milk quality was deter...

  4. Quality management systems for your in vitro fertilization clinic's laboratory: Why bother?

    OpenAIRE

    Olofsson, Jan I; Banker, Manish R; Late Peter Sjoblom

    2013-01-01

    Several countries have in recent years introduced prescribed requirements for treatment and monitoring of outcomes, as well as a licensing or accreditation requirement for in vitro fertilization (IVF) clinics and their laboratories. It is commonplace for Assisted Reproductive Technology (ART) laboratories to be required to have a quality control system. However, more effective Total Quality Management systems are now being implemented by an increasing number of ART clinics. In India, it is no...

  5. Evaluation of Acne Quality of Life and Clinical Severity in Acne Female Adults

    OpenAIRE

    Amal Kokandi

    2010-01-01

    Acne is a common disease especially among teenagers. It has a considerable psychological impact on affected individuals. The aim of this paper was to assess if the effect of acne on acne-related quality of life is correlated to acne clinical severity. 112 university female students attending the university medical clinics with acne complaints were examined. Cardiff Acne Disability Index (CADI) was used to assess acne-related quality of life, and global acne grading system (GAGS) was used to a...

  6. Sleep quantity, quality, and insomnia symptoms of medical students during clinical years

    OpenAIRE

    Alsaggaf, Mohammed A.; Siraj O Wali; Merdad, Roah A.; Merdad, Leena A

    2016-01-01

    Objectives: To determine sleep habits and sleep quality in medical students during their clinical years using validated measures; and to investigate associations with academic performance and psychological stress. Methods: In this cross-sectional study, medical students (n=320) were randomly selected from a list of all enrolled clinical-year students in a Saudi medical school from 2011-2012. Students filled a questionnaire including demographic and lifestyle factors, Pittsburgh Sleep Quality ...

  7. Quality of life data as prognostic indicators of survival in cancer patients: an overview of the literature from 1982 to 2008

    Directory of Open Access Journals (Sweden)

    Montazeri Ali

    2009-12-01

    Full Text Available Abstract Background Health-related quality of life and survival are two important outcome measures in cancer research and practice. The aim of this paper is to examine the relationship between quality of life data and survival time in cancer patients. Methods A review was undertaken of all the full publications in the English language biomedical journals between 1982 and 2008. The search was limited to cancer, and included the combination of keywords 'quality of life', 'patient reported-outcomes' 'prognostic', 'predictor', 'predictive' and 'survival' that appeared in the titles of the publications. In addition, each study was examined to ensure that it used multivariate analysis. Purely psychological studies were excluded. A manual search was also performed to include additional papers of potential interest. Results A total of 451 citations were identified in this rapid and systematic review of the literature. Of these, 104 citations on the relationship between quality of life and survival were found to be relevant and were further examined. The findings are summarized under different headings: heterogeneous samples of cancer patients, lung cancer, breast cancer, gastro-oesophageal cancers, colorectal cancer, head and neck cancer, melanoma and other cancers. With few exceptions, the findings showed that quality of life data or some aspects of quality of life measures were significant independent predictors of survival duration. Global quality of life, functioning domains and symptom scores - such as appetite loss, fatigue and pain - were the most important indicators, individually or in combination, for predicting survival times in cancer patients after adjusting for one or more demographic and known clinical prognostic factors. Conclusion This review provides evidence for a positive relationship between quality of life data or some quality of life measures and the survival duration of cancer patients. Pre-treatment (baseline quality of life

  8. The German quality indicators in intensive care medicine 2013 – second edition [Intensivmedizinische Qualitätsindikatoren für Deutschland 2013 – zweite Auflage

    Directory of Open Access Journals (Sweden)

    Weiler, Norbert

    2013-07-01

    Full Text Available [english] Quality indicators are key elements of quality management. The quality indicators for intensive care medicine of the German Interdisciplinary Society of Intensive Care Medicine (DIVI from the year 2010 were recently evaluated when their validity time expired after two years. Overall one indicator was replaced and further three were in part changed. The former indicator I “elevation of head of bed” was replaced by the indic “Daily multi-professional ward rounds with the documentation of daily therapy goals” and added to the indicator IV “Weaning and other measures to prevent ventilator associated pneumonias (short: Weaning/VAP Bundle” (VAP = ventilator-associated pneumonia which aims at the reduction of VAP incidence. The indicator VIII “Documentation of structured relative-/next-of-kin communication” was refined. The indic X “Direction of the ICU by a specially trained certified intensivist with no other clinical duties in a department” was also updated according to recent study results. These updated quality indicators are part of the Peer Review in intensive care medicine. The next update of the quality indicators is due in 2016.[german] Qualitätsindikatoren sind elementare Bestandteile des Qualitätsmanagements. Die Qualitätsindikatoren für die Intensivmedizin der Deutschen Interndisziplinären Vereinigung für Intensivmedizin (DIVI aus dem Jahre 2010 sind nun im Rahmen der geplanten Geltungsdauer überarbeitet und angepasst worden. Insgesamt wurde ein Indikator ersetzt und drei weitere zum Teil wesentlich überarbeitet. Der alte Indikator I „Oberkörperhochlagerung“ wurde durch den Indikator „Tägliche multiprofessionelle, klinische Visite mit Dokumentation von Tageszielen“ ersetzt und in den neu geschaffenen Indikator IV „Weaning und Maßnahmen zur Vermeidung von ventilatorassoziierten Pneumonien (kurz: Weaning/VAP Bundle“ (VAP = ventilator-assoziierte Pneumonie integriert, der auf ein

  9. Facility versus unit level reporting of quality indicators in nursing homes when performance monitoring is the goal

    OpenAIRE

    Norton, Peter G.; Murray, Michael; Doupe, Malcolm B; Greta G. Cummings; Poss, Jeff W.; Janet E. Squires; Teare, Gary F; Estabrooks, Carole A

    2014-01-01

    Objectives To demonstrate the benefit of defining operational management units in nursing homes and computing quality indicators on these units as well as on the whole facility. Design Calculation of adjusted Resident Assessment Instrument – Minimum Data Set 2.0 (RAI–MDS 2.0) quality indicators for: PRU05 (prevalence of residents with a stage 2–4 pressure ulcer), PAI0X (prevalence of residents with pain) and DRG01 (prevalence of residents receiving an antipsychotic with no diagnosis of psycho...

  10. Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

    International Nuclear Information System (INIS)

    There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

  11. A global scientific literature of research on water quality indices: trends, biases and future directions

    Directory of Open Access Journals (Sweden)

    Maria Tereza Ribeiro Alves

    2014-09-01

    Full Text Available AIM: Water quality has been the subject of many recent studies, moreover, the physical, chemical and biological parameters of water are used to investigate water quality and can be combined into a single index, the Water Quality Index (WQI, for use by water resource managers and the general public. The aim of this study was to use scientometrics to evaluate how water quality has been addressed in the international scientific literature. METHOD: For the quantitative analysis of the publications on WQI, we used the search database SCOPUS (http://www.scopus.com. The search was performed using the words "QUALIT* WATER* INDEX*" in papers published in all databases (through 2011. RESULTS: We found 554 articles that dealt with the use of WQI the number of publications has increased significantly over the last 20 years. India had the most studies, with 177 articles, followed by China, Brazil and the United States. These four countries together published 57% of studies on WQI. We generated 15 linear models to explain the number of publication by study sit (country. According to the Akaike Information Criterion (AIC, the best model to explain the number of publications by country was the model that combined Sanitation and Public Supply. CONCLUSION: Finally, this paper presents the state of scientific literature on WQI and demonstrates the growing interest of the scientific community in this issue, which is certainly due to the importance of the quantity and quality of water for human supply, economics, health and the conservation of water resources.

  12. The music therapy clinical intern: performance skills, academic knowledge, personal qualities, and interpersonal skills necessary for a student seeking clinical training.

    Science.gov (United States)

    Brookins, L M

    1984-01-01

    The music therapy curriculum consists of two distinct parts: the academic phase and the internship. The music therapy student must apply for a clinical internship during the last year of the academic phase, and the student is expected to evolve from student to professional music therapist during the internship phase. The present study sought to determine the skills, knowledge, and qualities clinical training directors considered most important for a prospective intern to possess. The sample population of the survey consisted of 25 clinical training directors from the Great Lakes Region. Results of the survey indicated that piano skills, knowledge of psychology, emotional maturity, and the ability to express needs and feelings were considered most important for the prospective intern to possess. PMID:10269791

  13. Quality of Reporting of Randomized Clinical Trials in Tai Chi Interventions—A Systematic Review

    Directory of Open Access Journals (Sweden)

    Jing-Yi Li

    2011-01-01

    Full Text Available Objectives. To evaluate the reporting quality of published randomized clinical trials (RCTs in the Tai Chi literature following the publication of the CONSORT guidelines in 2001. Data Sources. The OVID MEDLINE and PUBMED databases. Review Methods. To survey the general characteristics of Tai Chi RCTs in the literature, we included any report if (i it was an original report of the trial; (ii its design was RCT; (iii one of the treatments being tested was Tai Chi; and (iv it was in English. In addition, we assessed the reporting quality of RCTs that were published between 2002 and 2007, using a modified CONSORT checklist of 40 items. The adequate description of Tai Chi interventions in these trials was examined against a 10-item checklist adapted from previous reviews. Results. The search yielded 31 Tai Chi RCTs published from 2002 to 2007 and only 11 for 1992–2001. Among trials published during 2002–2007, the most adequately reported criteria were related to background, participant eligibility and interpretation of the study results. Nonetheless, the most poorly reported items were associated with randomization allocation concealment, implementation of randomization and the definitions of period of recruitment and follow-up. In addition, only 23% of RCTs provided adequate details of Tai Chi intervention used in the trials. Conclusion. The findings in this review indicated that the reporting quality of Tai Chi intervention trials is sub-optimal. Substantial improvement is required to meet the CONSORT guidelines and allow assessment of the quality of evidence. We believe that not only investigators, but also journal editors, reviewers and funding agencies need to follow the CONSORT guidelines to improve the standards of research and strengthen the evidence base for Tai Chi and for complementary and alternative medicine.

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

    Directory of Open Access Journals (Sweden)

    Raquel Maria de Oliveira

    2010-04-01

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

  15. Word Transition Entropy as an Indicator for Expected Machine Translation Quality

    DEFF Research Database (Denmark)

    Carl, Michael; Schaeffer, Moritz

    2014-01-01

    While most machine translation evaluation techniques (BLEU, NIST, TER, METEOR) assess translation quality based on a set of reference translations, we suggest to evaluate the literality of a set of (human or machine generated) translations to infer their potential quality. We provide evidence which...... suggests that more literal translations are produced more easily, by humans and machine, and are also less error prone. Literal translations may not be appropriate or even possible for all languages, types of texts, and translation purposes. However, in this paper we show that an assessment of the...... literality of translations allows us to (1) evaluate human and machine translations in a similar fashion and (2) may be instrumental to predict machine translation quality scores,...

  16. Impact of power ultrasound on chemical and physicochemical quality indicators of strawberries dried by convection.

    Science.gov (United States)

    Gamboa-Santos, Juliana; Montilla, Antonia; Soria, Ana C; Cárcel, Juan A; García-Pérez, José V; Villamiel, Mar

    2014-10-15

    A study on the quality parameters of strawberries dehydrated by convection assisted by power ultrasound (US) at 40-70°C and 30 and 60W has been carried out for the first time. In general, the quality of US-treated samples was higher than that of commercial samples. Even under the most severe conditions used (US at 70°C and 60W), high values of vitamin C retention (>65%) and scarce advance of Maillard reaction (2-furoylmethyl derivatives of Lys and Argconvectively-treated samples. According to the results here presented, US is a suitable example of an emerging and environmentally friendly technology that accelerates convective drying, allowing the obtainment of dried strawberries with premium quality. PMID:24837919

  17. Quality index in medical radiology; Indice de qualidade em radiologia medica

    Energy Technology Data Exchange (ETDEWEB)

    Travassos, Paulo Cesar B.; Magalhaes, Luis Alexandre Goncalves; Drexler, Gunter G.; Almeida, Carlos E. de, E-mail: luisalexandregm@hotmail.com [Universidade do Estado do Rio de Janeiro (IBRAG/UERJ), RJ (Brazil). Instituto de Biologia. Laboratorio de Ciencias Radiologicas; Navarro, Marcus V. [Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia (IFBA), Salvador, BA (Brazil)

    2012-08-15

    In the literature there are articles with methods for the calculation of potential risk in medical radiodiagnostics institutions: Evaluation Model for Potential Risk (MARP). These articles present results based on documental evaluation of the institutions, but they suggest that quantitative data from the equipment's quality assurance can be included. This article proposes an evaluation of medical radiology institutions with a variation of the Potential Risk model, which considers, besides the administrative factors, quantitative results from equipment's quality assurance: the quality index. Results of the application of this proposition in 42 institutions are presented, with 52 evaluated conventional X-Ray equipment, located in the state of Rio de Janeiro, Brazil. (author)

  18. A CIS (Clinical Information System) Quality Evaluation Tool for Nursing Care Services

    Science.gov (United States)

    Lee, Seon Ah

    2010-01-01

    The purpose of this study was to develop a tool to evaluate the quality of a clinical information system (CIS) conceived by nurses and conduct a pilot test with the developed tool as an initial assessment. CIS quality is required for successful implementation in information technology (IT) environments. The study started with the realization that…

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

    International Nuclear Information System (INIS)

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

  20. The Application of Hypoxanthine Activity as a Quality Indicator of Cold Stored Fish Burgers

    OpenAIRE

    METİN, Suhendan; ERKAN, Nuray; VARLIK, Candan

    2002-01-01

    Seafoods are very perishable, and many different methods are used for the determination of their quality. Sensory and hypoxanthine values of cold stored trout burgers, which we prepared, were determined during a 28-day period. Burgers spoiled after the 21st day of storage. The TVB-N values were still very low when the burgers spoiled and the pH values decreased during their storage. Therefore total volatile bases nitrogen and pH analyses were not useful for the determination of the quality...