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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......In the clinical setting, diagnosis and treatment of venous leg ulcers can vary considerably from patient to patient. The first step to reducing this variation is to document venous leg ulcer care through use of quantitative scientific documentation principles. This requires the development of valid......; an independent medical doctor tested the feasibility and reliability of these clinical indicators, assessing the quality of medical technical care on 100 consecutive venous leg ulcer patients. Main outcome measures were healing, recurrence, pain, venous disease diagnosis, differential diagnosis and treatment...

  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 is......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...... poor indicators...

  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. 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

  5. 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

  6. 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...

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

    Science.gov (United States)

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

    2014-04-30

    The traditional criteria for acceptability of analytic quality may not be objective in clinical laboratories. To establish quality control procedures intended to enhance Westgard multi-rules for improving the quality of clinical biochemistry tests, we applied the Cp and Cpk quality-control indices to monitor tolerance fitting and systematic variation of clinical biochemistry test results. Daily quality-control data of a large Taiwanese hospital in 2009 were analyzed. The test items were selected based on an Olympus biochemistry machine and included serum albumin, aspartate aminotransferase, cholesterol, glucose and potassium levels. Cp and Cpk values were calculated for normal and abnormal levels, respectively. The tolerance range was estimated with data from 50 laboratories using the same instruments and reagents. The results showed a monthly trend of variation for the five items under investigation. The index values of glucose were lower than those of the other items, and their values were usually <2. In contrast to the Cp value for cholesterol, Cpk of cholesterol was lower than 2, indicating a systematic error that should be further investigated. This finding suggests a degree of variation or failure to meet specifications that should be corrected. The study indicated that Cp and Cpk could be applied not only for monitoring variations in quality control, but also for revealing inter-laboratory qualitycontrol capability differences.

  8. 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

  9. 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...

  10. 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. 

  11. A utilidade dos indicadores da qualidade no gerenciamento de laboratórios clínicos Usefulness of quality indicators in the management of clinical laboratories

    Directory of Open Access Journals (Sweden)

    Keila Furtado Vieira

    2011-06-01

    Full Text Available O uso dos indicadores da qualidade vem sendo valorizado na gestão dos laboratórios clínicos para otimizar a qualificação e a quantificação das falhas nos diferentes processos laboratoriais, bem como para auxiliar a implantação de medidas corretivas e preventivas e apontar a eficácia das ações tomadas. O objetivo deste trabalho é discorrer sobre a evolução da qualidade na área da saúde, com ênfase na área laboratorial. Alguns indicadores laboratoriais citados na literatura nas fases pré-analítica, analítica e pós-analítica também são apresentados e discutidos neste artigo. Por fim, destaca-se a experiência brasileira do Programa de Indicadores Laboratoriais desenvolvido pela Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial (SBPC/ML em parceria com a Control-Lab e o projeto Model of Quality Indicator, em fase de desenvolvimento pela International Federation of Clinical Chemistry and Laboratory Medicine (IFCC.The use of quality indicators has been appreciated in laboratory management so as to optimize quality and error quantification in several laboratory processes. Furthermore, it assists in the implementation of preventive and corrective measures and it shows their corresponding efficiency. The objective of the present study is to discuss the evolution of quality, mainly in the laboratory area, focusing on the importance of quality indicators in laboratory management. Some pre-analytical, analytical and post-analytical laboratory indicators are also presented and discussed in this work. Finally, we highlight the Brazilian initiative in the Laboratory Indicator Program developed by the Brazilian Society of Clinical Pathology and Laboratory Medicine (SBPC/ML in partnership with Control-Lab and the Model of Quality Indicator project, which has been developed by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC.

  12. 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

    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......-square test was used for analysing significant differences from pre-and post intervention and Z-test to compare the experimental groups to the control group (HOL). P ...-intervention data were compared for both NFS and HOL (p = 0.024). Conclusions: During the organisation of the new EDs, several of the indicators improved and the overall 30 days mortality decreased in the five diseases. The development of a common set of indicators for monitoring acute treatment at EDs in Denmark...

  13. Quality indicators for acute myocardial infarction

    DEFF Research Database (Denmark)

    Schiele, Francois; Gale, Chris P; Bonnefoy, Eric;

    2016-01-01

    infarction (AMI), but no such indicators exist in Europe. In this context, the European Society of Cardiology (ESC) Acute Cardiovascular Care Association (ACCA) has reflected on the measurement of quality of care in the context of AMI (ST segment elevation myocardial infarction (STEMI) and non-ST segment...... be estimated solely on the basis of patients' clinical outcomes. Thus, measuring the process of care through quality indicators (QIs) has become a widely used practice in this context. Other professional societies have published QIs for the evaluation of quality of care in the context of acute myocardial...... elevation myocardial infarction (NSTEMI)) and created a set of QIs, with a view to developing programmes to improve quality of care for the management of AMI across Europe. We present here the list of QIs defined by the ACCA, with explanations of the methodology used, scientific justification and reasons...

  14. 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

  15. 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

  16. 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

  17. 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 ...

  18. Quality assurance in clinical trials.

    NARCIS (Netherlands)

    Ottevanger, P.B.; Therasse, P.; Veld, C.J.H. van de; Bernier, J.; Krieken, J.H.J.M. van; Grol, R.P.T.M.; Mulder, P.H.M. de

    2003-01-01

    From the literature that was initially searched by electronic databases using the keywords quality, quality control and quality assurance in combination with clinical trials, surgery, pathology, radiotherapy, chemotherapy and data management, a comprehensive review is given on what quality assurance

  19. 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 ...

  20. 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…

  1. 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

  2. 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...

  3. 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

  4. 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

  5. [Requirements for quality indicators. The relevance of current developments in outcomes research for quality management].

    Science.gov (United States)

    Schmitt, Jochen; Petzold, Thomas; Eberlein-Gonska, Maria; Neugebauer, Edmund A M

    2013-01-01

    The assessment of the health state in patients and changes in their health state for the purpose of diagnosis, prognosis and monitoring of treatment response plays a central role in clinical practice. Quality criteria for measurements in medicine include validity, reliability, responsiveness, interpretability, and feasibility. High-quality measurement instruments are a prerequisite for evidence-based medicine. Therefore, international outcomes research groups have developed methods for quality assurance and for the standardisation of measurement instruments. Quality indicators are instruments to measure the quality of care. Due to the increasing relevance of quality assessment for all stakeholders in healthcare and due to the political intention to draw relevant conclusions from the assessment of the quality of care, quality indicators must at least meet the same high standards that are required for clinical trial end points. However, independent researchers and clinicians do not engage in the validation and standardisation of quality indicators in Germany; currently, only the AQUA institute (as assigned by the German GBA) deals with this important issue. Current activities concerning the validation of quality indicators do not meet the requirements of evidence-based healthcare. This is a critical barrier to achieving the political goals of quality medicine. Therefore, the authors propose a multi-step, multi-professional, evidence-driven and evidence-generating consensus process on the basis of established methods of outcomes research for the advancement of quality assessment with quality indicators in Germany. All relevant stakeholders should participate in this process.

  6. Soil quality indicators in Urban watersheds.

    Science.gov (United States)

    Damame, D. B.; Longo, R. M.; Nardi, L. A. A.; Fengler, F. H.

    2015-12-01

    Soil quality can be defined as the ability of this function within the boundaries of an ecosystem can be assessed three different aspects: physical, biological and chemical. As no indicator alone able to quantify the quality of the soil and should relate various attributes. In this context, this study aimed to characterize soil quality in urban sub basins to the northwest of the city of Campinas / SP-Brazil. These are characterized by strong urbanization, with the presence of rural areas and fragmented native vegetation. Disturbed soil samples were collected along the area in which the parameters were analyzed: potential acidity, pH, organic matter, potassium (K) and calcium (Ca) base saturation (SB) and cation exchange capacity (CTC). Data were discussed by cluster analysis using Ward clustering strategy and using as the similarity coefficient between pairs Euclidean distance. Thus, one can divide the points collected from three different groups: Group 1 consists of 91% of the points belonging to the urban and rural use; group 2 showed about 73% of the points belonging to vegetated areas; Group 3 had 82% of points distributed between rural and vegetated areas. In terms of soil quality, it follows that on average the group 1 had the worst scores. Group 2 presented the best characteristics, except for K, higher in group 3, which can be attributed to chemical fertilizer used in agricultural areas. Knowing also that the acceptable limits for pH, in tropical soils vary between 5.5 and 6.8 is observed that the groups 2 and 3 were within this range, only the group 1 presented below this standard. In terms of soil quality indicators, group 2 stood out positively, with good quality, group 3 was between the two groups, with median values of quality, while the group 1 showed the most deterioration of the research group, It can be attributed to the fact that 54.5% of the points in this group have urban wear, indicating the need for recovery.

  7. 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.

  8. 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.

  9. Evaluation of diet quality indicators in adults

    Directory of Open Access Journals (Sweden)

    Katarína Fatrcová-Šramková

    2013-11-01

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

  10. Using business intelligence to monitor clinical quality metrics.

    Science.gov (United States)

    Resetar, Ervina; Noirot, Laura A; Reichley, Richard M; Storey, Patricia; Skiles, Ann M; Traynor, Patrick; Dunagan, W Claiborne; Bailey, Thomas C

    2007-10-11

    BJC HealthCare (BJC) uses a number of industry standard indicators to monitor the quality of services provided by each of its hospitals. By establishing an enterprise data warehouse as a central repository of clinical quality information, BJC is able to monitor clinical quality performance in a timely manner and improve clinical outcomes.

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

    Directory of Open Access Journals (Sweden)

    Burke Martyn

    2011-08-01

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

  12. 浙江省15项临床检验质量指标调查结果与分析%Analysis of 15 quality indicators in clinical laboratory in Zhejiang province

    Institute of Scientific and Technical Information of China (English)

    郦卫星; 王治国; 康凤凤; 单志明; 宋超; 陈兵权; 王敏琦; 周杰

    2016-01-01

    目的:建立并实施临床检验质量指标调查体系,分析浙江省15项临床检验质量指标的现状。方法设计并开发质量指标网络平台,统一向473家实验室发放电子调查表,要求1个月内在线回报结果。统计分析采用开发的软件结合SPSS13.0,以率表示的13项指标再用西格玛度量评价。采用各质量指标总体分布的P75、P50和P25探索最佳、适当和最低质量规范。结果444家实验室回报结果。10/13项指标其总体σ水平>3σ,但其中室内质控项目CV不合格率和室间质评项目不合格率<3σ的实验室比例仍有15.8%和9.2%。不同等级医院实验室和不同专业之间存在明显差异。常规检验前TAT生化和免疫平均约50 min,三大常规和凝血试验为30 min,急诊检验前TAT均为10~15 min。实验室内TAT免疫最长,常规和急诊检验分别为154 min和40 min。8/13项指标的最佳质量规范要求达到6σ水平,而4/13项指标的最低质量规范都小于1σ。结论浙江省临床实验室检验前阶段的质量指标总体水平优于检验中和检验后阶段,实验室应加强信息化建设,保证可靠的数据采集和长期监控。(中华检验医学杂志,2016,39:23-28)%Objective To establish and apply the procedure of survey on quality indicator in clinical laboratory and to analyze the status in quo of the 15 quality indicators in Zhejiang province .Methods A network platform for the survey on quality indicator in clinical laboratory was designed and developed by our center.The online questionnaires that should be reported back within one month were assigned to 473 laboratories.The developed software and SPSS 13.0 were used for statistical analysis .13 indicators expressed in rate were further evaluated with sigma scales .The 25th percentile, 50th percentile, and 75th percentile of the distribution of each quality indicator were regarded as the minimum

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

    Directory of Open Access Journals (Sweden)

    Márcio Flávio Moura de Araújo

    2014-12-01

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

  14. 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

  15. Indicators of quality in primary healthcare.

    NARCIS (Netherlands)

    Berg, M.J. van den; Bakker, D.H. de

    2004-01-01

    Background: GPs play a pivotal role in the Dutch healthcare system. Since GPs have a so-called gatekeeper-function, the overwhelming majority of medical problems is served by GPs. The Inspectorate of Health Care (IHC) is charged with the supervision of public health, including the quality of care pr

  16. 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...

  17. 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.

  18. 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.

  19. 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)...

  20. Defining Quality Indicators for Best-Practice Management of Inflammatory Bowel Disease in Canada

    Directory of Open Access Journals (Sweden)

    Geoffrey C Nguyen

    2014-01-01

    Full Text Available BACKGROUND: There is a paucity of published data regarding the quality of care of inflammatory bowel disease (IBD in Canada. Clinical quality indicators are quantitative end points used to guide, monitor and improve the quality of patient care. In Canada, where universal health care can vary significantly among provinces, quality indicators can be used to identify potential gaps in the delivery of IBD care and standardize the approach to interprovincial management.

  1. 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...

  2. 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 ...

  3. 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.

  4. Institutional Quality Assessment of Higher Education: Dimensions, Criteria and Indicators

    Science.gov (United States)

    Savickiene, Izabela; Pukelis, Kestutis

    2004-01-01

    The article discusses dimensions and criteria, which are used to assess the quality of higher education in different countries. The paper presents dimensions and criteria that could be appropriate for assessment of the quality of higher education at Lithuanian universities. Quality dimensions, assessment criteria and indicators are defined and…

  5. 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...

  6. Identifying Quality Indicators of SAE and FFA: A Delphi Approach

    Science.gov (United States)

    Jenkins, Charles Cordell, III; Kitchel, Tracy

    2009-01-01

    The purpose of this study was to determine quality indicators for SAE and FFA according to 36 experts across the United States. This is a part of a larger study looking at all components of the traditional three-circle model. The study utilized the Delphi technique to garner expert opinion about quality indicators in Agricultural Education. For…

  7. 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...

  8. 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...

  9. 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.

  10. 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 ...

  11. 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.

  12. 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...

  13. 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...

  14. 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...... simple way. The paper therefore questions empirical trade studies using unit values as an indicator for the quality of the traded goods....

  15. 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.

  16. Air quality as respiratory health indicator: a critical review.

    Science.gov (United States)

    Moshammer, Hanns; Wallner, Peter

    2011-09-01

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

  17. 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....

  18. Interpretation of 15 quality control indicators in clinical laboratory service (2015) published by National Health and Family Planning Commission%国家卫生计生委发布临床检验专业15项医疗质量控制指标(2015年版)内容及解读

    Institute of Scientific and Technical Information of China (English)

    王治国; 费阳; 康凤凤; 王薇; 张路; 何法霖; 钟堃; 陈文祥

    2015-01-01

    临床检验专业医疗质量控制指标(质量指标)是对一组固有特征满足要求的程度的衡量,它可用于监测和评价检验全过程(检验前、检验中和检验后阶段)中各个关键步骤的性能满足要求的程度,通过量化各个阶段的质量水平,继而有针对性地持续改进.为进一步加强医疗质量管理,规范临床诊疗行为,促进医疗服务的标准化、同质化,国家卫生计生委于2015年发布了包含检验全过程的15项临床检验专业医疗质量控制指标(国卫办医函[2015]252号).%Quality control indicator in clinical laboratory is defined as the measure of the degree of a set of inherent characteristics fulfils requirements.It is a powerful tool for laboratory quality improvement which can be used to monitor and evaluate the performance throughout critical aspects of pre-examination, examination and post-examination processes.Targeted quality improvement can be obtained by quantizing the quality levels in each phase with the use of quality control indicators.To enhance the quality management of health care, regulate the behavior of clinical diagnosis and treatment, and promote the standardization and harmonization of medical service, National Health and Family Planning Commission has published 15 quality indicators in clinical laboratory.Interpretation, internal monitoring, and external assessment of these quality indicators are stated in this artide to provide reference for clinical laboratories.

  19. 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.

  20. 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…

  1. 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,...

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    Carla A. Chrusch

    2016-01-01

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

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

    Science.gov (United States)

    Chrusch, Carla A; Martin, Claudio M; Project, The Quality Improvement In Critical Care

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  6. 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...... was achieved in both Delphi rounds. A total of 41 of the proposed 59 quality indicators attained consensus. None of the quality indicators focusing on the diagnostic process achieved consensus. Consensus was attained for 14 quality indicators focusing on the decision regarding antibiotic treatment and for 27...... quality indicators focusing on the choice of antibiotics. CONCLUSION: This study resulted in a final set of 41 quality indicators concerning respiratory tract infections in general practice. These quality indicators may be used to strengthen general practitioners' focus on their management of patients...

  7. Irrigation water quality as indicator of sustainable rural development

    Directory of Open Access Journals (Sweden)

    Trajković Slaviša 1

    2004-01-01

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

  8. 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

  9. Selection indices for quality evaluation in wheat breeding.

    Science.gov (United States)

    Branlard, G; Pierre, J; Rousset, M

    1992-06-01

    From multilocation trials involving 125 cultivars of wheat of mainly French and European origin four tests - protein content, Pelshenke, modified Zeleny and the mixograph - were used to establish six selection indices. Three of these indices - IW1, IW2 and IW3 - were calculated in order to evaluate the genetic potentiality of the lines for dough strength as given by the Chopin alveograph. The indices IV1, IV2 and IV3 were established to evaluate loaf volume as measured by the French bread-making standard. A quality index IQ was calculated from the allelic effects of the high-molecular-weight (HMW) subunits of glutenin from 195 cultivars assessed by the Chopin alveograph and the Pelshenke test. Comparison of the relative efficiency of each of the six indices to the individual tests revealed the superiority of the indices over one or several technological parameters. The six selection indices and the quality index were compared using 30 very diverse F4 lines. Their ability to retain the good quality lines is discussed in particular. PMID:24203028

  10. 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

  11. Quality indicators to measure appropriate antibiotic use in hospitalized adults

    NARCIS (Netherlands)

    Bosch, C.M.A. van den; Geerlings, S.E.; Natsch, S.S.; Prins, J.M.; Hulscher, M.

    2015-01-01

    BACKGROUND: An important requirement for an effective antibiotic stewardship program is the ability to measure appropriateness of antibiotic use. The aim of this study was to develop quality indicators (QIs) that can be used to measure appropriateness of antibiotic use in the treatment of all bacter

  12. [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.

  13. [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

  14. 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

  15. 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?

  16. 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.

  17. 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

  18. 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...

  19. Crown lengthening: basic principles, indications, techniques and clinical case reports.

    Science.gov (United States)

    Yeh, Simon; Andreana, Sebastiano

    2004-11-01

    Sometimes, in order to properly restore teeth, surgical intervention in the form of a crown-lengthening procedure is required. Crown lengthening is a periodontal resective procedure, aimed at removing supporting periodontal structures to gain sound tooth structure above the alveolar crest level. Periodontal health is of paramount importance for all teeth, both sound and restored. For the restorative dentist to utilize crown lengthening, it is important to understand the concept of biologic width, indications, techniques and other principles. This article reviews these basic concepts of clinical crown lengthening and presents four clinical cases utilizing crown lengthening as an integral part of treatments, to restore teeth and their surrounding tissues to health.

  20. 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

  1. Relevance of guideline-based ICD indications to clinical practice.

    Science.gov (United States)

    Al-Jefairi, Nora; Burri, Haran

    2014-01-01

    The implantable cardioverter-defibrillator (ICD) has established itself as life-saving therapy in patients at risk for sudden cardiac death. Remarkable technological advances have made ICDs easier and safer to implant, with improved therapeutic and diagnostic functions and reduced morbidity. Guidelines on ICD indications have been proposed by American and European scientific societies since a number of years, based upon trials and expert opinion. In the context of variable economic and political constraints, it is questionable whether these guidelines may be applied to all settings. This review discusses the guideline-based indications, critically examines their applicability to clinical practice, and discusses alternatives to ICD therapy.

  2. 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...

  3. Improving quality indicator report cards through Bayesian modeling

    Directory of Open Access Journals (Sweden)

    Mahnken Jonathan D

    2008-11-01

    Full Text Available Abstract Background The National Database for Nursing Quality Indicators® (NDNQI® was established in 1998 to assist hospitals in monitoring indicators of nursing quality (eg, falls and pressure ulcers. Hospitals participating in NDNQI transmit data from nursing units to an NDNQI data repository. Data are summarized and published in reports that allow participating facilities to compare the results for their units with those from other units across the nation. A disadvantage of this reporting scheme is that the sampling variability is not explicit. For example, suppose a small nursing unit that has 2 out of 10 (rate of 20% patients with pressure ulcers. Should the nursing unit immediately undertake a quality improvement plan because of the rate difference from the national average (7%? Methods In this paper, we propose approximating 95% credible intervals (CrIs for unit-level data using statistical models that account for the variability in unit rates for report cards. Results Bayesian CrIs communicate the level of uncertainty of estimates more clearly to decision makers than other significance tests. Conclusion A benefit of this approach is that nursing units would be better able to distinguish problematic or beneficial trends from fluctuations likely due to chance.

  4. 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

  5. Quality indicators as a tool in improving the introduction of new medicines.

    Science.gov (United States)

    Campbell, Stephen M; Godman, Brian; Diogene, Eduardo; Fürst, Jurij; Gustafsson, Lars L; MacBride-Stewart, Sean; Malmström, Rickard E; Pedersen, Hanne; Selke, Gisbert; Vlahović-Palčevski, Vera; van Woerkom, Menno; Wong-Rieger, Durhane; Wettermark, Björn

    2015-02-01

    Quality indicators are increasingly used as a tool to achieve safe and quality clinical care, cost-effective therapy, for professional learning, remuneration, accreditation and financial incentives. A substantial number focus on drug therapy but few address the introduction of new medicines even though this is a burning issue. The objective was to describe the issues and challenges in designing and implementing a transparent indicator framework and evaluation protocol for the introduction of new medicines and to provide guidance on how to apply quality indicators in the managed entry of new medicines. Quality indicators need to be developed early to assess whether new medicines are introduced appropriately. A number of key factors need to be addressed when developing, applying and evaluating indicators including dimensions of quality, suggested testing protocols, potential data sources, key implementation factors such as intended and unintended consequences, budget impact and cost-effectiveness, assuring the involvement of the medical professions, patients and the public, and reliable and easy-to-use computerized tools for data collection and management. Transparent approaches include the need for any quality indicators developed to handle conflict of interests to enhance their validity and acceptance. The suggested framework and indicator testing protocol may be useful in assessing the applicability of indicators for new medicines and may be adapted to healthcare settings worldwide. The suggestions build on existing literature to create a field testing methodology that can be used to produce country-specific quality indicators for new medicines as well as a cross international approach to facilitate access to new medicines.

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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

  12. Aggregate Indices Method in Soil Quality Evaluation Using the Relative Soil Quality Index

    Directory of Open Access Journals (Sweden)

    Ho Ngoc Pham

    2015-01-01

    Full Text Available This paper presents a new approach to assess the soil quality by aggregate indices using the Relative Soil Quality Index (RSQI proposed by Ho Ngoc Pham. RSQI is integrated from the individual indices into a simple formula for overall assessment of the soil quality. RSQI is different from other approaches. Particularly, the individual indices and the weighting factors of Pham are calculated from the analytical laboratory data and the environmental standards, respectively, and not self-regulated as in methods of some other authors. In this paper, the authors applied the RSQI to assess the Soil Environmental Quality of rice intensive cultivation areas through a case study in Haiduong province in 2013. The RSQI is calculated for sampling points in 12 districts and simulated the Soil Environmental Quality on GIS map. The results show that the Soil Environmental Quality of rice intensive cultivation areas in Haiduong is predominantly divided into three levels: good, moderate, and poor. According to the report of General Statistics Office for Haiduong province, rice intensive cultivation areas in 2013 achieved a relatively high average rice yield of 5.90 tonnes per hectare; it means actual soil properties are in line with results of the research.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-01

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

  14. 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

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. Clinical laboratory indices in the treatment of acromegaly.

    Science.gov (United States)

    Clemmons, David R

    2011-02-20

    Measurement of serum growth hormone (GH) and insulin-like growth factor-I (IGF-) is used to monitor the degree of improvement that occurs following treatment of patients with acromegaly. Improvement in GH assay sensitivity has led to changes in the definition of normal GH however many studies that assess the predictive value of GH were conducted in an era where assays were less sensitive. Other problems that have occurred with GH measurements include utilization of different standards and failure to prove commutability of commonly accepted standard. GH reference ranges vary in their quality and are not stratified for age, sex or body mass index. IGF-I measurements are associated with similar problems. They do not use a common standard that has been proven to be commutable and results can vary widely when the same specimens are assayed in different laboratories. Although age and sex stratified reference ranges exist, these do not always have adequate numbers of subjects and BMI adjusted ranges are not available. These problems have led to significant discordance in a significant number of patients wherein the IGF-I and GH values may yield a discrepant prediction of disease stabilization. In these cases in general the IGF-I values correlate better with the presence of persistent symptoms. Patients who fail to suppress GH to normal but have a normal IGF-I have to be monitored carefully for recurrence but usually do not require further therapy if they are asymptomatic. For the long term assessment of outcome and clinical disease activity measurement of both hormones is recommended. PMID:21075098

  20. 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

  1. Quality indicators and performance measures in diabetes care.

    Science.gov (United States)

    Aron, David C

    2014-03-01

    The operations of any portion of the healthcare delivery system, eg, ambulatory care, the consultation and referral process, or hospital care, are critically dependent upon their control systems. The quality of health care produced by the system and its components is also subject to "control." One of the regulatory mechanisms involves performance measures. The development of good measures of quality is a complex and dynamic process. Within endocrinology, most measures have addressed diabetes care and most quality measurement in diabetes has focused on the ambulatory setting and mainly includes measures of process and intermediate outcomes. This review addresses quality and performance measures for diabetes, their development, characteristics, use, misuse, and future prospects.

  2. 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

  3. Quality indicators for international benchmarking of mental health care

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  4. 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...

  5. 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

  6. 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

  7. [Pressure ulcer care quality indicator: analysis of medical records and incident report].

    Science.gov (United States)

    dos Santos, Cássia Teixeira; Oliveira, Magáli Costa; Pereira, Ana Gabriela da Silva; Suzuki, Lyliam Midori; Lucena, Amália de Fátima

    2013-03-01

    Cross-sectional study that aimed to compare the data reported in a system for the indication of pressure ulcer (PU) care quality, with the nursing evolution data available in the patients' medical records, and to describe the clinical profile and nursing diagnosis of those who developed PU grade 2 or higher Sample consisted of 188 patients at risk for PU in clinical and surgical units. Data were collected retrospectively from medical records and a computerized system of care indicators and statistically analyzed. Of the 188 patients, 6 (3%) were reported for pressure ulcers grade 2 or higher; however, only 19 (10%) were recorded in the nursing evolution records, thus revealing the underreporting of data. Most patients were women, older adults and patients with cerebrovascular diseases. The most frequent nursing diagnosis was risk of infection. The use of two or more research methodologies such as incident reporting data and retrospective review of patients' records makes the results trustworthy.

  8. Quality indicators and performance measures in diabetes care.

    Science.gov (United States)

    Aron, David C

    2014-03-01

    The operations of any portion of the healthcare delivery system, eg, ambulatory care, the consultation and referral process, or hospital care, are critically dependent upon their control systems. The quality of health care produced by the system and its components is also subject to "control." One of the regulatory mechanisms involves performance measures. The development of good measures of quality is a complex and dynamic process. Within endocrinology, most measures have addressed diabetes care and most quality measurement in diabetes has focused on the ambulatory setting and mainly includes measures of process and intermediate outcomes. This review addresses quality and performance measures for diabetes, their development, characteristics, use, misuse, and future prospects. PMID:24496919

  9. 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...

  10. 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.

  11. 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

  12. Quality indicators for in-hospital pharmaceutical care of Dutch elderly patients : development and validation of an ACOVE-based quality indicator set

    NARCIS (Netherlands)

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

    2011-01-01

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

  13. Measuring patient safety: the Agency for Healthcare Research and Qualityís patient safety indicators

    Directory of Open Access Journals (Sweden)

    Edward Kelley

    2005-12-01

    Full Text Available

    There is a lot of interest in patient safety, but there is still little useable national level information on the actual magnitude of patient safety problems that can be used by providers and policy makers to judge performance.

    The AHRQ Patient Safety Indicators (PSIs are a set of measures that can be used with hospital inpatient administrative (discharge data to provide a perspective on patient safety. They screen for problems that patients experience as a result of exposure to the healthcare system and that are likely amenable to prevention by changes at the system or provider level. There is a growing interest in the possible use of the AHRQ PSIs in international settings.

    The Organization for Economic Cooperation and Development (OECD maintains an ongoing project on Health Care Quality Indicators (HCQI and whose goal is to develop a set of quality indicators that can be used to reliably assess quality of care across countries and raise questions about differences in quality of care internationally. Work is ongoing though a partnership between AHRQ and the Italian National Observatory on Health in the Italian Regions to test the AHRQ QIs with the Italian national hospital discharge data set. Preliminary results indicate that many of the operational issues associated with differences in coding schemes and data set structure are surmountable. With additional refinements on their clinical specificity, increased stability in their definitions over time to permit long-term monitoring and country interest within organizations such as the OECD to build on the existing scientific work of these indicators, their to help answer questions about patient safety worldwide will be significantly enhanced.

  14. CHEMICAL WATER QUALITY INDICATORS IN BASIN FOREST PARCZEW

    OpenAIRE

    Antoni Grzywna

    2014-01-01

    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 collect...

  15. 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.

  16. 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.

  17. The population value of quality indicator reporting: a framework for prioritizing health care performance measures.

    Science.gov (United States)

    Meltzer, David O; Chung, Jeanette W

    2014-01-01

    The Agency for Healthcare Research and Quality (AHRQ) National Healthcare Quality and Disparities Reports contain more than 250 quality indicators, such as whether a patient with a suspected heart attack received an aspirin. The Department of Health and Human Services National Quality Measures Clearinghouse identifies more than 2,100 such indicators. Because resources for making quality improvements are limited, there is a need to prioritize among these indicators. We propose an approach to assess how reporting specific quality indicators would change care to improve the length and quality of life of the US population. Using thirteen AHRQ quality indicators with readily available data on the benefits of indicator reporting, we found that seven of them account for 93 percent of total benefits, while the remaining six account for only 7 percent of total benefits. Use of a framework such as this could focus resources on indicators having the greatest expected impact on population health.

  18. [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

  19. 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

  20. 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.

  1. 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.

  2. 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...

  3. 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...

  4. Measurement of quality of life in clinical trials.

    Science.gov (United States)

    Kaasa, S

    1992-01-01

    Information on patients' quality of life (QOL) will give a more comprehensive evaluation of the treatment outcome than only measures of tumour response and survival. Psychosocial indicators have rarely been used in clinical trials. This may in part be explained by physicians' lack of familiarity with these measures, methodological insufficiency and a basic philosophical reason, i.e., most doctors tend to focus on curative treatment and not on palliative treatment. A series of QOL questionnaires has been validated in the last decade for use in cancer clinical trials. Selection of the optimal method in the given trial is important. The trial ought to be designed so the proportion of missing data is low. QOL should be used as an end point in selective trials with an optimal study design and with a study coordinator who is willing to collect QOL data.

  5. [Drinking water quality indices in the Orenburg Region].

    Science.gov (United States)

    Golubkina, N A; Burtseva, T I; Gatsenko, A Iu

    2011-01-01

    The quality of underground waters from 22 areas of the Orenburg Region was studied from the values of mineralization and pH and the amounts of the ions of Se, Cl, Pb, Cd, F, and phenols. High fluorine ion concentrations (5-12 mg/l), high mineralization (> 1 g/l), and alkalinity (pH > 8.0) were shown to be human risk factors in a considerable number of areas. Districts with cadmium, lead, and phenol ion-polluted underground waters were identified. The amount of selenium in the drinking water (18-319 ng/l) and in the sera of donors in Orenburg, Buzuluk, and Orsk (86-97 microg/l) fails to support the data available in the literature on environmental selenium pollution and is comparable with the relevant data for the Moscow Region.

  6. 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

  7. 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.

  8. 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...

  9. Microbial Activity Indices: Sensitive Soil Quality Indicators for Trace Metal Stress

    Institute of Scientific and Technical Information of China (English)

    LI Yong-Tao; T.BECQUER; C.QUANTIN; M.BENEDETTI; P.LAVELLE; DAI Jun

    2005-01-01

    Physicochemical properties, total and DTPA (diethylenetriaminepentaacetic acid)-extractable Cu, Zn, Pb and Cd contents, microbial biomass carbon (C) content and the organic C mineralization rate of the soils in a long-term trace metal-contaminated paddy region of Guangdong, China were determined to assess the sensitivity of microbial indices to moderately metal-contaminated paddy soils. The mean contents of total Cu, Zn, Pb and Cd were 251,250, 171, and 2.4mg kg-1 respectively. DTPA-extractable metals were correlated positively and significantly with total metals, CEC, and organic C (except for DTPA-extractable Cd), while they were negatively and highly significantly correlated with pH, total Fe and Mn. Metal stress resulted in relatively low ratios of microbial biomass C to organic C and in remarkable inhibition of the microbial metabolic quotient and C mineralization rate, which eventually led to increases in soil organic C and C/N. Moreover, microbial respiratory activity showed a stronger correlation to DTPA-extractable metals than to total metal content. Likewise, in the acid paddy soils some "linked" microbial activity indices, such as metabolic quotient and ratios of basal respiration to organic C, especially during initial incubation, were found to be more sensitive indicators of soil trace metal contamination than microbial biomass C or basal respiration alone.

  10. 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

  11. 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…

  12. 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

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

    Directory of Open Access Journals (Sweden)

    Vivek Shukla

    2015-03-01

    Full Text Available 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 in polystyrene foam trays covered with PVC film and indicator sensor was attached to the inner side of packaging film. The pattern of color change in indicator sensor was monitored and compared with meat quality parameters viz. total volatile basic nitrogen, D-glucose, standard plate count and tyrosine value to correlate ability of indicator sensor for its suitability to predict the meat quality and storage life. Results: The indicator sensor changed its color from yellow to blue starting from margins during the storage period of 24 h at ambient temperature and this correlated well with changes in meat quality parameters. Conclusions: The indicator sensor can be used for real-time monitoring of meat quality as the color of indicator sensor changed from yellow to blue starting from margins when meat deteriorates with advancement of the storage period. Thus by observing the color of indicator sensor quality of meat and shelf life can be predicted.

  14. 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

  15. 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;

    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....

  16. 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…

  17. 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

  18. 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

  19. 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

  20. 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...

  1. 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...

  2. Validation of quality indicators for the organization of palliative care: a modified RAND Delphi study in seven European countries (the Europall project)

    NARCIS (Netherlands)

    Woitha, K.; Beek, K.; Ahmed, N.; Jaspers, B.; Mollard, J.M.; Ahmedzai, S.H.; Hasselaar, J.; Menten, J.; Vissers, K.; Engels, Y.M.

    2014-01-01

    BACKGROUND: Validated quality indicators can help health-care professionals to evaluate their medical practices in a comparative manner to deliver optimal clinical care. No international set of quality indicators to measure the organizational aspects of palliative care settings exists. AIM: To devel

  3. 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...

  4. 78 FR 22883 - AHRQ Standing Workgroup for Quality Indicator Measure Specification

    Science.gov (United States)

    2013-04-17

    ... reporting ] One or more individuals with expertise in developing algorithms using ICD-9-CM codes to... of more individuals with expertise in developing algorithms for relevant quality indicators...

  5. Quality assessment of clinical guidelines in China: 1993-2010

    Institute of Scientific and Technical Information of China (English)

    CHEN Yao-long; XIE Chang-chun; YANG Ke-hu; YAO Liang; XIAO Xiao-juan; WANG Qi; WANG Ze-hao; LIANG Fu-xiang; LIANG Hui; WANG Xin; SHEN Xi-ping

    2012-01-01

    Background Clinical practice guidelines (CPGs) play an important role in healthcare in China as well as in the world.However,the current status and trends of Chinese CPGs are unknown.The aim of this study was to systematically review the present situation and the quality of Chinese CPGs published in the peer-reviewed medical literature.Methods To identify Chinese CPGs,a systematic search of relevant literature databases (CBM,WANFANG,VIP,and CNKI) was performed for the period January 1978 to December 2010.We used the AGREE Ⅱ instrument to assess the quality of the included guidelines.Results We evaluated 269 guidelines published in 115 medical journals from 1993 to 2010 and produced by 256different developers.Only four guidelines (1%) described the systematic methods for searching and selecting the evidence,14 (5%) guidelines indicated an explicit link between the supporting evidence and the recommendations,only one guideline used the Grading of Recommendations Assessment,Development and Evaluation (GRADE) system.Thirty-one guidelines (12%) mentioned updates and the average frequency of update was 5.5 years; none described a procedure for updating the guideline.From the assessment with the Appraisal of Guidelines for Research and Ecaluation Ⅱ (AGREE Ⅱ),the mean scores were low for the domains "scope and purpose" (19%) and "clarity of presentation" (26%)and very low for the other domains ("rigour of development" 7%,"stakeholder involvement" 8%,"applicability" 6% and "editorial independence" 2%).Conclusions Compared with other studies on the quality of guidelines assessed with the AGREE instrument in other countries,Chinese CPGs received lower scores,which indicates a relatively poor quality of the guidelines.However,there was some increase over time.

  6. 质量监控指标体系构建研究%Establishment of Quality Control Indicator System

    Institute of Scientific and Technical Information of China (English)

    郎婧婧; 赵颖旭; 张智国; 于丽华; 江芹

    2011-01-01

    From the perspective of monitoring quality from local government to health institutes, the paper discussed the approaches of a set of quality indicator system. With the analysis of the case of NQB, it is suggested that producing a scientific and complete quality system should across three dimensions including effectiveness, patient experience and safety. The paper considered that the selected quality indicators should have been related with the distilled quality standards including their clinical and e-conomical evidences, which provided by clinical guidelines. It also discussed the reasonable methods to estimate the individual data result of every quality indicator.%通过分析英国国家质量平台,提出从有效性、满意度和安全性3个纬度出发建立质量指标体系.认为质量指标的选取与临床指南提供的质量标准以及对应的临床证据和经济证据直接相关,并进一步探讨了质量指标转化为数据结果的合理方式,为构建医疗机构质量指标体系提供了新的方法和思路.

  7. 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)...

  8. Use of plasma: clinical indications and types of plasma components in Sweden.

    Science.gov (United States)

    Norda, R; Tynell, E

    2007-12-01

    The use of plasma in Sweden is relatively high compared to other countries in the European Union. An analysis of all transfusion recipients in Orebro county during the whole year 2000 was performed. There were 3159 transfusion recipients of whom 96% had a registered diagnosis and 50% had undergone a "true" operation. Seven hundred and eleven patients (23%) had received plasma. Significantly more operated than nonoperated and more men than women received plasma. The typical plasma recipient was a man undergoing cardiovascular surgery. In Sweden there are two main types of plasma components: fresh frozen (FFP) and nonfrozen liquid plasma stored for up to 14 days, both considered to be clinically equal for most indications. The quality of these components as well as stored thawed FFP has been studied. The major storage effect was cold-induced contact activation and thereby consumption of C1 esterase inhibitor (C1INH) by day 14 in 22%. The citrate content in plasma sustained the overall coagulation function over 14 days. Other studies have shown that the levels of FV and ADAMTS 13 after 14 days remain at 70% or more compared to those for FFP. Since it is immediately available, liquid, nonfrozen or thawed, plasma is of great value in emergencies. Quality criteria for plasma components need to be assessed against evidence based indications and published in guidelines.

  9. [Quality assurance and quality improvement in medical practice. Part 3: Clinical audit in medical practice].

    Science.gov (United States)

    Godény, Sándor

    2012-02-01

    The first two articles in the series were about the definition of quality in healthcare, the quality approach, the importance of quality assurance, the advantages of quality management systems and the basic concepts and necessity of evidence based medicine. In the third article the importance and basic steps of clinical audit are summarised. Clinical audit is an integral part of quality assurance and quality improvement in healthcare, that is the responsibility of any practitioner involved in medical practice. Clinical audit principally measures the clinical practice against clinical guidelines, protocols and other professional standards, and sometimes induces changes to ensure that all patients receive care according to principles of the best practice. The clinical audit can be defined also as a quality improvement process that seeks to identify areas for service improvement, develop and carry out plans and actions to improve medical activity and then by re-audit to ensure that these changes have an effect. Therefore, its aims are both to stimulate quality improvement interventions and to assess their impact in order to develop clinical effectiveness. At the end of the article key points of quality assurance and improvement in medical practice are summarised.

  10. Proposal for Indicators to Evaluate the Quality of a Postgraduate Program in Education

    Directory of Open Access Journals (Sweden)

    Edgar Oliver Cardoso Espinosa

    2011-11-01

    Full Text Available It is now imperative for those postgraduate programs oriented toward Education to meet the quality standards set by the National Postgraduate-Quality Program (PNPC, since this constitutes the Federal Government's main guideline for allocating resources. The present study aims to propose indicators that would allow assessment of postgraduate-program quality in Education by using the following criteria as a basis for analysis: efficacy, efficiency, importance, equity and relevance. It also indicates the status of these programs to the CONACYT, a minimal involvement, demonstrating the need to establish indicators that would serve as a guide for cataloguing programs according to their quality.

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

    Science.gov (United States)

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

    2015-01-01

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

  12. 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

  13. The Information Quality Triangle: a methodology to assess clinical information quality.

    Science.gov (United States)

    Choquet, Rémy; Qouiyd, Samiha; Ouagne, David; Pasche, Emilie; Daniel, Christel; Boussaïd, Omar; Jaulent, Marie-Christine

    2010-01-01

    Building qualitative clinical decision support or monitoring based on information stored in clinical information (or EHR) systems cannot be done without assessing and controlling information quality. Numerous works have introduced methods and measures to qualify and enhance data, information models and terminologies quality. This paper introduces an approach based on an Information Quality Triangle that aims at providing a generic framework to help in characterizing quality measures and methods in the context of the integration of EHR data in a clinical datawarehouse. We have successfully experimented the proposed approach at the HEGP hospital in France, as part of the DebugIT EU FP7 project.

  14. 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...

  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.

  16. 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.

  17. 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...... is understandable to readers without specialised knowledge of statistics Udgivelsesdato: 2009/9/14...

  18. 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

  19. 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...

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  1. 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)

  2. The impact of clinical indications on visual search behaviour in skeletal radiographs

    Science.gov (United States)

    Rutledge, A.; McEntee, M. F.; Rainford, L.; O'Grady, M.; McCarthy, K.; Butler, M. L.

    2011-03-01

    The hazards associated with ionizing radiation have been documented in the literature and therefore justifying the need for X-ray examinations has come to the forefront of the radiation safety debate in recent years1. International legislation states that the referrer is responsible for the provision of sufficient clinical information to enable the justification of the medical exposure. Clinical indications are a set of systematically developed statements to assist in accurate diagnosis and appropriate patient management2. In this study, the impact of clinical indications upon fracture detection for musculoskeletal radiographs is analyzed. A group of radiographers (n=6) interpreted musculoskeletal radiology cases (n=33) with and without clinical indications. Radiographic images were selected to represent common trauma presentations of extremities and pelvis. Detection of the fracture was measured using ROC methodology. An eyetracking device was employed to record radiographers search behavior by analysing distinct fixation points and search patterns, resulting in a greater level of insight and understanding into the influence of clinical indications on observers' interpretation of radiographs. The influence of clinical information on fracture detection and search patterns was assessed. Findings of this study demonstrate that the inclusion of clinical indications result in impressionable search behavior. Differences in eye tracking parameters were also noted. This study also attempts to uncover fundamental observer search strategies and behavior with and without clinical indications, thus providing a greater understanding and insight into the image interpretation process. Results of this study suggest that availability of adequate clinical data should be emphasized for interpreting trauma radiographs.

  3. Quality indicators for family support services and their relationship to organizational social context.

    Science.gov (United States)

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

    2014-01-01

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

  4. 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.

  5. 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....

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

    Directory of Open Access Journals (Sweden)

    Roy Jason

    2003-11-01

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

  7. Correlation of basic oil quality indices and electrical properties of model vegetable oil systems.

    Science.gov (United States)

    Prevc, Tjaša; Cigić, Blaž; Vidrih, Rajko; Poklar Ulrih, Nataša; Šegatin, Nataša

    2013-11-27

    Model vegetable oil mixtures with significantly different basic oil quality indices (free fatty acid, iodine, and Totox values) were prepared by adding oleic acids, synthetic saturated triglycerides, or oxidized safflower oil ( Carthamus tinctorius ) to the oleic type of sunflower oil. Dielectric constants, dielectric loss factors, quality factors, and electrical conductivities of model lipids were determined at frequencies from 50 Hz to 2 MHz and at temperatures from 293.15 to 323.15 K. The dependence of these dielectric parameters on basic oil quality indices was investigated. Adding oleic acids to sunflower oil resulted in lower dielectric constants and conductivities and higher quality factors. Reduced iodine values resulted in increased dielectric constants and quality factors and decreased conductivities. Higher Totox values resulted in higher dielectric constants and conductivities at high frequencies and lower quality factors. Dielectric constants decreased linearly with temperature, whereas conductivities followed the Arrhenius law.

  8. 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.

  9. 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…

  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. The 'off-hour' effect in trauma care: a possible quality indicator with appealing characteristics

    Directory of Open Access Journals (Sweden)

    Di Bartolomeo Stefano

    2011-06-01

    Full Text Available Abstract A recent paper has drawn attention to the paucity of widely accepted quality indicators for trauma care. At the same time, several studies have measured whether mortality of trauma patients changes between normal working time and other parts of the day/week, i.e. the so-called 'off-hour' or 'weekend' effect. This measure has the characteristics to become an accepted quality indicator because it combines the advantages of both outcome and process indicators. As an outcome indicator it would not need validation, a procedure particularly difficult in trauma care where gathering scientific evidence is more difficult than in other disciplines. As a process indicator it would provide indications about where to intervene to improve quality.

  12. 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...... and is applicable for clinical use. The free access to all system parameters enables the ability to capture standardized images as found in the clinic and experimental data from new processing or beamformation methods. The length of the data sequences is only restricted by the memory of the external PC. Data may...

  13. [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

  14. 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. ...

  15. 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

  16. 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…

  17. 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.

  18. 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...

  19. 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...

  20. 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...

  1. 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

  2. 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

  3. 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.

  4. Reflective, causal, and composite indicators of quality of life: A conceptual or an empirical distinction?

    Science.gov (United States)

    Costa, Daniel S J

    2015-09-01

    Items (or indicators) that constitute "quality of life" instruments can be classified as either reflective (manifestations of some underlying construct), causal (the construct is an effect of the indicators), or composite (the construct is an exact linear combination of the indicators). Psychometric methods based on inter-item associations are only appropriate for reflective indicators, whereas other statistical and non-statistical validation methods can be used for composite or causal indicators. Thus, the distinction has important practical, as well as theoretical, implications. Attempts have been made to empirically identify which items of the EORTC QLQ-C30, a cancer-specific instrument, are causal and which are reflective. Such attempts, however, first require commitment to a particular definition of quality of life, of which there are many. Whether an indicator forms a composite, is causal or reflective of quality of life will depend on the definition adopted, and therefore, the reflective-composite-causal distinction is, arguably, best established on conceptual rather empirical grounds, guided by the "mental experiments" suggested by Bollen (Structural equations with latent variables, Wiley, New York, 1989). Conceptual models of health status and quality of life, as well as a cognitive-linguistic approach to quality of life assessment, may make some contribution to this practice. Theoretical consideration of indicator content can guide not only instrument development and validation, but also the selection of an appropriate instrument. PMID:25725599

  5. 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.

  6. 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.

  7. 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...

  8. 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.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  10. A functional evaluation of three indicator sets for assessing soil quality

    NARCIS (Netherlands)

    Lima, A.C.R.; Brussaard, L.; Totola, M.R.; Hoogmoed, W.B.; Goede, de R.G.M.

    2013-01-01

    Efforts to define and quantify soil quality are not new, but establishing consensus about a set of standardized indicators remains difficult. Also, the view of land managers is usually not taken into account when evaluating various sets of indicators. Our objective was to compare, in functional term

  11. 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.

  12. 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

  13. 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

  14. 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 ...

  15. 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...

  16. Identification and alignment of strategic indicators for socio-environmental quality - Case Fosfértil

    Directory of Open Access Journals (Sweden)

    William Barbosa Vianna

    2009-08-01

    Full Text Available The objective of this paper is to identify the quality indicators that are aligned with competitive sustainable strategies. It is a case study, with exploratory character, that analyzes the implemented processes: 5S, QMS, certifications ISO 9000 and 14000 and MIS.The results bring indicators that favor the alignment of products and processes to the strategical objectives to be integrated in a general management plan. Some results and benefits of the evaluation method that use Indicators are also discussed.

  17. 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

  18. 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

  19. 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.

  20. The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

    Directory of Open Access Journals (Sweden)

    Stephan Brenner

    Full Text Available A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs, a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC, the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example.We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi.Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks.The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining

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

    DEFF Research Database (Denmark)

    Langagergaard, Vivian; Garne, Jens Peter; Vejborg, Ilse Merete Munk;

    2013-01-01

    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 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...... with node negative cancer was 67%. There were 36% women with small cancers, and the ratio of surgery for benign lesions to malignant lesions was 1:6.3. A total of 80% of women with invasive cancers were treated with breast conserving therapy. Screening interval and interval cancers were not relevant...

  2. 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

  3. 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...

  4. 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...

  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. 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...

  7. 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...

  8. 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.

  9. 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

    The two-stage Newton Type Algorithm for the tracking of the power quality indicators, frequency and rate of frequency changes is presented in the paper. By this definitions for power quality indicators according to the IEEE Standard 1459-2000 were used. In the first algorithm stage the spectra of...... 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....... of 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...

  10. [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

  11. 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

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

    Science.gov (United States)

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

    2015-10-01

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

  13. 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.

  14. [Quality indicators pertinence and limits in medicine: example of nosocomial infections].

    Science.gov (United States)

    Petitmermet, D; Troillet, N; Wasserfallen, J B

    2001-11-01

    Insuring that quality indicators really measure quality of care and not other factors, such as the type of intervention or the patients' characteristics, is notoriously difficult. In order to avoid as much as possible these potential methodological pitfalls, the association FoQual (www.hospvd.ch/quality/foqual) requested in the year 2000 the opinion of experts on the scientific value of some indicators, considered for introduction into practice by the commission on quality of care representing the Swiss hospital association and the health insurers' association (H+/CAMS), as well as on theoretical and practical aspects essential to guarantee their efficiency. The expert group Swiss-NOSO (www.hospvd.ch/swiss-noso) was asked to assess the indicator "nosocomial infection". This example illustrates some pitfalls to avoid, the importance of including infectious surveillance into a global prevention program and ask professionals with a specific training and independence from hospital wards to perform this activity. It shows the complexity of setting up and exploiting quality indicators in health care and the side effects that they might have.

  15. Future vision for the quality assurance of oncology clinical trials

    Directory of Open Access Journals (Sweden)

    Thomas eFitzGerald, MD

    2013-03-01

    Full Text Available The National Cancer Institute clinical cooperative groups have been instrumental over the past 50 years in developing clinical trials and evidence based process improvements for clinical oncology patient care. The cooperative groups are undergoing a transformation process as we further integrate molecular biology into personalized patient care and move to incorporate international partners in clinical trials. To support this vision, data acquisition and data management informatics tools must become both nimble and robust to support transformational research at an enterprise level. Information, including imaging, pathology, molecular biology, radiation oncology, surgery, systemic therapy and patient outcome data needs to be integrated into the clinical trial charter using adaptive clinical trial mechanisms for design of the trial. This information needs to be made available to investigators using digital processes for real time data analysis. Future clinical trials will need to be designed and completed in a timely manner facilitated by nimble informatics processes for data management. This paper discusses both past experience and future vision for clinical trials as we move to develop data management and quality assurance processes to meet the needs of the modern trial.

  16. Health-Related Quality of Life Indicators in Ghana: Comparing Type 2 Diabetic and Control Groups

    Directory of Open Access Journals (Sweden)

    Jacob Owusu Sarfo

    2015-08-01

    Full Text Available One hundred participants, comprising of 50 individuals with Type 2 diabetes (DM2 and 50 control group members were matched on both age and education. Using a battery of behavioural measures, data collection was done at the Korle-Bu Teaching Hospital. The results showed that, depression, anxiety, negative health beliefs, cognitive failures, interpersonal sensitivity, hostility and number of complications / clinical manifestations predicted health-related quality of life (HRQOL among the overall sample. In addition, depression and negative health beliefs predicted HRQOL among individuals with DM2, while cognitive failures predicted HRQOL among HCG. Findings have implications for clinical management and future studies.

  17. Concordance and robustness of quality indicator sets for hospitals: an analysis of routine data

    Directory of Open Access Journals (Sweden)

    Färber Robert

    2011-05-01

    Full Text Available Abstract Background Hospitals are increasingly being evaluated with respect to the quality of provided care. In this setting, several indicator sets compete with one another for the assessment of effectiveness and safety. However, there have been few comparative investigations covering different sets. The objective of this study was to answer three questions: How concordant are different indicator sets on a hospital level? What is the effect of applying different reference values? How stable are the positions of a hospital ranking? Methods Routine data were made available to three companies offering the Patient Safety Indicators, an indicator set from the HELIOS Hospital Group, and measurements based on Disease Staging™. Ten hospitals from North Rhine-Westphalia, comprising a total of 151,960 inpatients in 2006, volunteered to participate in this study. The companies provided standard quality reports for the ten hospitals. Composite measures were defined for strengths and weaknesses. In addition to the different indicator sets, different reference values for one set allowed the construction of several comparison groups. Concordance and robustness were analyzed using the non-parametric correlation coefficient and Kendall's W. Results Indicator sets differing only in the reference values of the indicators showed significant correlations in most of the pairs with respect to weaknesses (maximum r = 0.927, CI 0.714-0.983, p Conclusions Our results reveal an unsettling lack of concordance in estimates of hospital performance when different quality indicator sets are used. These findings underline the lack of consensus regarding optimal validated measures for judging hospital quality. The indicator sets shared a common definition of quality, independent of their focus on patient safety, mortality, or length of stay. However, for most of the hospitals, changing the indicator set or the reference value resulted in a shift from the superior to the

  18. 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.

  19. Analytical performance specifications: relating laboratory performance to quality required for intended clinical use.

    Science.gov (United States)

    Dalenberg, Daniel A; Schryver, Patricia G; Klee, George G

    2013-03-01

    This article proposes analytic performance goals for five quality indicators: precision, trueness, linearity, detection limits, and consistency across instruments and time. We defined our goals using methods linked to clinical practice data. Goals for desirable precision and trueness are based on biological variation. Linearity goals are related to total error recommendations. Detection limit goals are derived from 0.1 percentile of patient values. Goals for consistency are derived from the variability of distributions of patient test values. Data were collected and evaluated for each of these quality indicators for 46 chemistry tests measured on the Roche cobas 8000 analyzer.

  20. 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

  1. 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

  2. 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...

  3. 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

  4. Human enteric viruses–potential indicators for enhanced monitoring of recreational water quality

    Institute of Scientific and Technical Information of China (English)

    Erin; Allmann; Updyke; Zi; Wang; Si; Sun; Christina; Connell; Marek; Kirs; Mayee; Wong; Yuanan; Lu

    2015-01-01

    Recreational waters contaminated with human fecal pollution are a public health concern, and ensuring the safety of recreational waters for public use is a priority of both the Environmental Protection Agency(EPA) and the Centers for Disease Control and Prevention(CDC). Current recreational water standards rely on fecal indicator bacteria(FIB) levels as indicators of human disease risk. However present evidence indicates that levels of FIB do not always correspond to the presence of other potentially harmful organisms, such as viruses. Thus, enteric viruses are currently tested as water quality indicators, but have yet to be successfully implemented in routine monitoring of water quality. This study utilized enteric viruses as possible alternative indicators of water quality to examine 18 different fresh and offshore recreational waters on O‘ahu, Hawai‘i, by using newly established laboratory techniques including highly optimized PCR, real time PCR, and viral infectivity assays. All sample sites were detected positive for human enteric viruses by PCR including enterovirus, norovirus genogroups I and II, and male specific FRNA coliphage. A six time-point seasonal study of enteric virus presence indicated significant variation in virus detection between the rainy and dry seasons. Quantitative PCR detected the presence of norovirus genogroup II at levels at which disease risk may occur, and there was no correlation found between enteric virus presence and FIB counts. Under the present laboratory conditions, no infectious viruses were detected from the samples PCR-positive for enteric viruses. These data emphasize both the need for additional indicators for improved monitoring of water quality, and the feasibility of using enteric viruses as these indicators.

  5. 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

  6. 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.

  7. Prediction of banana quality indices from color features using support vector regression.

    Science.gov (United States)

    Sanaeifar, Alireza; Bakhshipour, Adel; de la Guardia, Miguel

    2016-01-01

    Banana undergoes significant quality indices and color transformations during shelf-life process, which in turn affect important chemical and physical characteristics for the organoleptic quality of banana. A computer vision system was implemented in order to evaluate color of banana in RGB, L*a*b* and HSV color spaces, and changes in color features of banana during shelf-life were employed for the quantitative prediction of quality indices. The radial basis function (RBF) was applied as the kernel function of support vector regression (SVR) and the color features, in different color spaces, were selected as the inputs of the model, being determined total soluble solids, pH, titratable acidity and firmness as the output. Experimental results provided an improvement in predictive accuracy as compared with those obtained by using artificial neural network (ANN). PMID:26653423

  8. 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…

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

    NARCIS (Netherlands)

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

    2005-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  11. Detection and persistence of fecal Bacteroidales as water quality indicators in unchlorinated drinking water

    DEFF Research Database (Denmark)

    Saunders, Aron M.; Kristiansen, Anja; Lund, Marie B.;

    2009-01-01

    The results of this study support the use of fecal Bacteroidales qPCR as a rapid method to complement traditional, culture-dependent, water quality indicators in systems where drinking water is supplied without chlorination or other forms of disinfection. A SYBR-green based, quantitative PCR assa...

  12. 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…

  13. 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

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

    Science.gov (United States)

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

    2013-01-01

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

  15. [POSSIBILITY OF OBTAINING ALLOGENEIC ANTIMENINGOCOCCUS FRESH FROZEN PLASMA AND CONTROL OF ITS QUALITY INDICATORS].

    Science.gov (United States)

    Tereshchuk, T O

    2015-01-01

    Results of the study identifying the titer of natural antimeningococcus antibodies serogroup B of non-immunized donor population of Zhytomyr Region aged 18-54 years, all AB0 blood groups are presented for further use of these results in the organization of the immune donation. Indicators of quality of antimeningococcus fresh frozen plasma obtained by different methods are characterized.

  16. 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.

  17. 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.

  18. 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.

  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. 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...

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. Quality Indices Of Jaw Bone Tissue In Screening Diagnostics Of Parodontal Diseases

    Directory of Open Access Journals (Sweden)

    V.P. Konev

    2009-12-01

    Full Text Available The objective of the work is to develop and motivate screening methods of the estimation of paradontal tissues by digital X-ray study. The used methods are X-ray digital scene with estimation of bone tissue density in program Trophy 2000, clinically anatomical parallels of bone tissue density and their qualitative indices. Parallels between qualitative indices of bones of mandibular alveolar process and bone tissue density of these areas have been revealed. It is reasonable to carry out the estimation of bone tissue density indices for revealing early stages of parodontal pathology

  8. 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.

  9. Chemical and biological indicators of water quality in three agricultural watersheds of the Po valley, Italy

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    Linda Pieri

    2011-12-01

    Full Text Available Agriculture has both direct and indirect effects on quality of surface water and is one of the key activities causing water quality degradation. Its environmental impact can be evaluated by the determination of indicators of the quality of water bodies that collect drainage and runoff waters from agricultural watersheds. For this research, the water quality draining from three watersheds, totally or partially cultivated, all within the Po river valley (Italy, was determined, using chemical indicators (N-NO3 and N-NH4 concentration, N balance, trophic status (chlorophyll-a concentration and benthic population indexes. Together, they should provide an overview of the water status, which is supposed to be strictly related to the land use and the management. Results show that the chemical parameters are well related to land use and farming management: intensive agricultural activity leads to high N-NO3 concentration in water and N surplus and vice versa. The chlorophyll-a concentration follows the same trend, being linked to nitrogen loads and land use. Not always there is accordance between chemical and biological indicators: no direct correspondence is evident between the N-NO3 concentration in waters and benthic community. Its presence and abundance seems to be mostly correlated with the geomorphology, hydrology, riparian strips, etc. of the habitat than to the land use. Only the integration of chemical and biological parameters allows a correct understanding of the state of health of water body and benthic communities.

  10. 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

  11. 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

  12. 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...

  13. Water quality indicators in the Mantiqueira Range region, Minas Gerais state

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    Leandro Campos Pinto

    2013-12-01

    Full Text Available Maintaining the quality of water resources is of great importance for environmental preservation and the quality of life of consumers, and is one of the greatest challenges facing humanity today. Land-use for agriculture and animal farming significantly changes the biological, physical and chemical characteristics of natural systems. This study comprised monitoring of two subbasins located in the Mantiqueira Range region, from which water samples were collected on a monthly basis between June 2010 and May 2011 for analysis. Each subbasin has a distinct vegetation cover, one being predominantly covered by pastureland and the other being entirely covered by Atlantic Forest. The following water quality indicators were analyzed: turbidity, pH, electrical conductivity, total dissolved solids, dissolved oxygen, temperature, nitrate, phosphate, BOD,COD, total and fecal coliforms, and respective discharge measurement. The results showed that water quality degradation in both environments coincided with the local rainy season and was influenced by transport of organic material to watercourses by direct surface runoff. The high concentrations of fecal coliforms found affected the water quality, particularly in the rainy season, and are associated with agriculture and animal farming, the main economic activities in the region. The Atlantic Forest environment, however, had statistically better water quality over time in relation to the pastureland environment, due to the buffering it provides to direct surface runoff.

  14. 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

  15. Quality indicators for implementation of safety promotion: towards valid and reliable global certification of local programmes.

    Science.gov (United States)

    Timpka, Toomas; Nordqvist, Cecilia; Festin, Karin; Lindqvist, Kent

    2012-01-01

    The theoretical underpinnings of safety promotion have not yet been integrated with implementation practice to ascertain between-community programme quality. This study sets out to develop a framework for verifying of the quality of community-based safety-promotion programmes in the global context. We analysed the certification indicators deployed in the international Safe Community movement in light of systems theory. Data were collected from focus group interviews with representatives from 10 certified Swedish communities and then analysed by qualitative methods. The community representatives were found to have used the present indicators mainly for marketing the safety-promotion concept to stakeholders rather than as benchmarks for safety practice. When appraised in regard to systems theory, it was found that the indicators did not cover important aspects of health-services implementation. Attainment of outcomes at the population level was not included. Consequently, that information about programme effects in high-risk groups and in risk environments could be neglected. We conclude that programme processes and outcomes at both organisational and population levels must be assessed when the quality of safety-promotion programmes is being certified. A revised set of indicators for certification of safety-promotion programmes fulfilling these criteria is presented.

  16. 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

  17. 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.

  18. 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.

  19. 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

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

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    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

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

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    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.

  2. Nursing postoperative visit as a quality indicator for surgical patient care.

    Science.gov (United States)

    Silva, R; Martins, M M; Jardim, H G

    2016-06-01

    The postoperative visit as a quality indicator for surgical patient care, demands some consideration from perioperative nurses. We evaluated the nursing perioperative interventions on postoperative visits, and adjusted them to the needs of the patients with postoperative pain. Our study indicated that 73% of patients visited didn't have postoperative pain whereas 27% had pain. The pain is aggravated when the patient is mobilised, one of the most common signs and symptoms being gastrointestinal changes. Pharmacological and non-pharmacological measures were used in pain management. The results showed that the percentage of patients with postoperative visits needs to be improved. We aim to have high quality perioperative nursing interventions which raise levels of patient satisfaction. PMID:27498440

  3. 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

    PURPOSE: To establish a quality indicator that could be used in optimizing treatment for rhegmatogenous retinal detachment (RRD). METHODS: The Danish National Patient Registry was used to identify surgery conducted in Denmark for RRD in the period 01 January 2001-31 December 2009. Cases were...... 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...

  4. 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 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

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

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    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.

  6. 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

  7. 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 ...

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

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    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

  9. 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 ...

  10. 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...

  11. 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...

  12. 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.

  13. 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...

  14. 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 ...

  15. 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...

  16. Does ICD indication affect quality of life and levels of distress?

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Sears, Samuel F; Burg, Matthew M;

    2009-01-01

    on patients' lives, particularly whether primary prophylaxis implantation may impact adversely on patient-centered outcomes such as quality of life (QoL) and distress. We examined the evidence for a role of ICD indication on these patient-centered outcomes. A literature search was conducted on PubMed and Web......The implantable cardioverter defibrillator (ICD) is the treatment of choice for life-threatening arrhythmias, with ICD indications having recently been extended to include primary prophylaxis. Despite the medical benefits of the ICD, there is an ongoing debate as to the impact of the ICD...

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

    OpenAIRE

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

    2016-01-01

    Summary We determined adherence to nine fall-related ACOVE quality indicators to investigate the quality of management of falls in the elderly population by general practitioners in the Netherlands. Our findings demonstrate overall low adherence to these indicators, possibly indicating insufficiency in the quality of fall management. Most indicators showed a positive association between increased risk for functional decline and adherence, four of which with statistical significance. Introduct...

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

    Directory of Open Access Journals (Sweden)

    Mariel GULLIAN-KLANIAN

    2016-01-01

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

  19. Amino acid quality indices of the leaves ofClerodendrum volubile

    Institute of Scientific and Technical Information of China (English)

    Ochuko Lucky Erukainure; Folashade Oluwayemisi Owolabi; Temiloluwa Adebola Adesioye; Deborah Olabisi Akinyele; Grace Ijeoma Okonrokwo

    2016-01-01

    Objective: To evaluate the amino acid profile and quality indices ofClerodendrumvolubile (C. volubile) leaves. Methods:Dried leaves ofC. 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 ofC. volubile as a potential source of amino acids in the human diet as portrayed by its amino acids profile and qualities.

  20. 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

  1. 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...

  2. Are diagnosis specific outcome indicators based on administrative data useful in assessing quality of hospital care?

    Science.gov (United States)

    Scott, I; Youlden, D; Coory, M

    2004-01-01

    Background: Hospital performance reports based on administrative data should distinguish differences in quality of care between hospitals from case mix related variation and random error effects. A study was undertaken to determine which of 12 diagnosis-outcome indicators measured across all hospitals in one state had significant risk adjusted systematic (or special cause) variation (SV) suggesting differences in quality of care. For those that did, we determined whether SV persists within hospital peer groups, whether indicator results correlate at the individual hospital level, and how many adverse outcomes would be avoided if all hospitals achieved indicator values equal to the best performing 20% of hospitals. Methods: All patients admitted during a 12 month period to 180 acute care hospitals in Queensland, Australia with heart failure (n = 5745), acute myocardial infarction (AMI) (n = 3427), or stroke (n = 2955) were entered into the study. Outcomes comprised in-hospital deaths, long hospital stays, and 30 day readmissions. Regression models produced standardised, risk adjusted diagnosis specific outcome event ratios for each hospital. Systematic and random variation in ratio distributions for each indicator were then apportioned using hierarchical statistical models. Results: Only five of 12 (42%) diagnosis-outcome indicators showed significant SV across all hospitals (long stays and same diagnosis readmissions for heart failure; in-hospital deaths and same diagnosis readmissions for AMI; and in-hospital deaths for stroke). Significant SV was only seen for two indicators within hospital peer groups (same diagnosis readmissions for heart failure in tertiary hospitals and inhospital mortality for AMI in community hospitals). Only two pairs of indicators showed significant correlation. If all hospitals emulated the best performers, at least 20% of AMI and stroke deaths, heart failure long stays, and heart failure and AMI readmissions could be avoided

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. Quality management in clinical application of mass spectrometry measurement systems.

    Science.gov (United States)

    Vogeser, Michael; Seger, Christoph

    2016-09-01

    Thanks to highly specific analyte detection and potentially complete compensation for matrix variables based on the principle of stable isotope derivative internal standardisation, mass spectrometry methods allow the development of diagnostic tests of outstanding analytical quality. However, these features per se do not guarantee reliability of tests. A wide range of factors can introduce analytical errors and inaccuracy due to the extreme complexity of the methods involved. Furthermore, it can be expected that the application patterns of MS methods in diagnostic laboratories will change substantially during the coming years - with presumably less specialised laboratories implementing mass spectrometry. Introduction of highly automated test solutions by manufacturers will require some trade-off between operation convenience, sample throughput and analytical performance. Structured and careful quality and risk management is therefore crucial to translate the analytical power of mass spectrometry into actionable and reliable results for individual patients' care and to maintain the degree of reliability that is expected from MS methods in clinical pathology. This reflection review discusses whether particular quality assurance tools have to be applied for MS-based diagnostic tests and whether these tools are different from those applied for optical- and affinity-based standard tests. Both pre-implementation strategies and surveillance of assays with assessment of metadata in routine testing are addressed. The release of the CLSI guideline C62-A in 2014 was a substantial achievement in this context because it addresses a wide spectrum of relevant issues in quality assurance of mass spectrometry-based clinical tests. However, the translation of this best practice document into individual laboratory settings is likely to be heterogeneous.

  8. Improving the quality of NHS out-patient clinics: the applications and misapplications of TQM.

    Science.gov (United States)

    Hart, M

    1996-01-01

    Presents and discusses the results of a monitoring programme instituted to comply with the objectives laid down in The Patient's Charter. Explores the dangers inherent in attempting to assess the quality of out-patient clinics by the use of single, simplistic indicators such as a waiting time. Examines the ways in which total quality management has been deployed in a health-service context and pays particular attention to the way in which the concept of ¿the customer¿ may need considerable refinement. Suggests incorporating more user-centered approaches into evaluations of quality in the National Health Service, such as the patient satisfaction survey and the application of the SERVQUAL model of consumer satisfaction. Refines the concept of ¿ecological validity¿ in an attempt to capture the perceptions and world views of all of the participants in episodes of out-patient care in order to derive more complete measures of quality. PMID:10157561

  9. Improving the quality of NHS out-patient clinics: the applications and misapplications of TQM.

    Science.gov (United States)

    Hart, M

    1996-01-01

    Presents and discusses the results of a monitoring programme instituted to comply with the objectives laid down in The Patient's Charter. Explores the dangers inherent in attempting to assess the quality of out-patient clinics by the use of single, simplistic indicators such as a waiting time. Examines the ways in which total quality management has been deployed in a health-service context and pays particular attention to the way in which the concept of ¿the customer¿ may need considerable refinement. Suggests incorporating more user-centered approaches into evaluations of quality in the National Health Service, such as the patient satisfaction survey and the application of the SERVQUAL model of consumer satisfaction. Refines the concept of ¿ecological validity¿ in an attempt to capture the perceptions and world views of all of the participants in episodes of out-patient care in order to derive more complete measures of quality.

  10. 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.

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

    Science.gov (United States)

    Gil-Jiménez, Esperanza; Villamuelas, Miriam; Serrano, Emmanuel; Delibes, Miguel; Fernández, Néstor

    2015-01-01

    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 interventions

  12. 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

  13. 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.

  14. Clinical signs indicative of temporomandibular disorders in adults: time trends and associated factors.

    Science.gov (United States)

    Köhler, Alkisti Anastassaki; Hugoson, Anders; Magnusson, Tomas

    2013-01-01

    The study aimed to examine possible time trends in the prevalence of clinical signs indicative of temporomandibular disorder (TMD) in an adult population, to analyse possible associations between TMD signs and associated factors and to estimate the need for TMD treatment. Three independent, stratified and randomly selected samples of around 100 individuals in the age groups of 20, 30, 40, 50, 60 and 70 years participated in the Jönköping studies in 1983,1993 and 2003. The study material consisted of 1,693 subjects who, after answering a questionnaire and being interviewed about the presence of TMD symptoms, were clinically examined in terms of the presence of TMD signs according to the Clinical Dysfunction Index (Di) by Helkimo. Associations between clinical signs and the Di as dependent variables and each of the independent variables of age group, gender, reported bruxism, trauma, self-perceived healthiness and the year of investigation were analysed in binary logistic regression models. Estimates of the need for TMD treatment were based on the presence of a combination of severe symptoms and clinical signs. The prevalence of severely impaired jaw movement capacity, relating to horizontal movements, had increased in 2003. The prevalence of muscle pain and temporomandibular joint pain upon posterior palpation was found to vary statistically significantly between 1993 and 2003. Gender differences were noted in these changes overtime. Female gender, advancing age, awareness of bruxism, self-perceived health impairment and the wearing of complete dentures were associated with TMD signs and a higher degree of clinical dysfunction. The estimated need for TMD treatment increased from 5% in 1983 to 8% in 2003 and was higher in women than in men. In conclusion, the results indicate that the prevalence of some TMD signs and of estimated treatment need increased during the period 1983-2003.

  15. The Relation between Environmental Quality Indices and Energy Consumption in the Selected Countries

    Directory of Open Access Journals (Sweden)

    Ali Pourali

    2014-04-01

    Full Text Available This study is regarded as an applied research in terms of objective and an ex post facto research in terms of data collection, because past data of the research variables is used. Also it is a descriptive- correlative research. Data is gathered by using the library method. Also a major part of data pertaining to the research variables has been derived from time series data of the World Bank and Yale University. To determine the relation between environmental quality indices and energy consumption, data pertaining to the research variables namely, energy consumption based on oil consumption (ENERGY, under-5 children mortality (CHMORT, agricultural subsidies (AGSUB, access to drinking water (WATSUP, access to sanitation (ACSAT, CO2 per capita (CO2CAP during 2007 to 2011 was used. The statistical universe of this study comprises high energy-consuming countries namely, America, China, Japan, India and Russia. Panel data and Chow Test (constrained F test have been applied to select the fixed effects. The main result of this study indicates that there is a significant relation between life quality indices (Agricultural subsidies, access to sanitation, under-5 children mortality, CO2 per capita, access to drinking water and energy consumption. The effect of this relation for agricultural subsidies, access to sanitation, under-5 children mortality, CO2 capitation, access to drinking water indices are 17.8, 68.57, 21.16, 129.77, 4.03, respectively.

  16. 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

  17. 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

  18. 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.

  19. 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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  1. 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.

  2. 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 (air pollutants other than for THC (increasing in Fort McKay 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.

  3. 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.

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

    DEFF Research Database (Denmark)

    Maraldo, Kristine; Schmelz, Rüdiger; Larsen, Thomas;

    2015-01-01

    interactions among soil physical, chemical and biological properties suggest that enchytraeid abundance is not a feasible stand-alone indicator of management impacts on soil quality in temporary grass-clover leys but may candidate as one of several biological key parameters in more comprehensive soil quality...... subject to contrasting management regimes (cutting, slurry injection, grazing). Enchytraeid density, biomass and species composition was determined in 0–18 cm soil sampled in October, and again in March and May before and after slurry application, respectively. For soils retrieved in October, ley age had...... than in the spring, regardless of management regime. Compared with leys used for cutting, grazed leys had consistently lower enchytraeid density and biomass. This was ascribed to soil compaction induced by heifer trampling. The number of species ranged from 11 to 18 in the autumn and from 7 to 13...

  5. 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

  6. 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

  7. Quality of longer term mental health facilities in Europe: validation of the quality indicator for rehabilitative care against service users' views.

    Directory of Open Access Journals (Sweden)

    Helen Killaspy

    Full Text Available BACKGROUND: The Quality Indicator for Rehabilitative Care (QuIRC is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. METHOD: At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. RESULTS: 1750/2495 (70% users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning. A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. CONCLUSIONS: Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care

  8. 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.

  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. 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

  11. 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

  12. 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.

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. Quality indicators in subtropical soils of Formosa, Argentina: Changes for agriculturization process

    Directory of Open Access Journals (Sweden)

    Juan Esteban Baridón

    2014-12-01

    The changes produced in the Typic Hapludolls and Typic Argiudolls after 25 years of continuously using native forests, agriculture, fruit plantations and pastures were analyzed. These changes were in pH, electrical conductivity, total organic carbon, particulate organic carbon, total nitrogen, structural stability, hydraulic conductivity, respiration and dehydrogenase and urease and enzyme activity. Variables with significant differences between diverse uses were evaluated by multivariate methods, Principal Component Analysis, and Correlation Analysis. The results of this study showed that total organic carbon, particulate organic carbon, structural stability and dehydrogenase activity are the quality indicators most affected by agriculturization. All are related to organic matter.

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

    Science.gov (United States)

    Gort, Marjan; Broekhuis, Manda; Regts, Gerdien

    2013-11-01

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

  20. 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.

  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. Water quality in Lake Xochimilco, Mexico: zooplankton indicators and Vibrio cholerae

    Directory of Open Access Journals (Sweden)

    Sarma Nandini

    2015-08-01

    Full Text Available Lake Xochimilco is a eutrophic water body in Mexico City used by the local population for aquaculture and agriculture. Water level is maintained with inputs of partially treated waste water from the Cerro de la Estrella treatment plant. In this study we analysed the water quality at two sites of Lake Xochimilco, Lake Xaltocan and the Santa Cruz Canal using various indicators such as zooplankton diversity, saprobic indices, bacterial concentrations and physico-chemical variables. Eighty litres of water was filtered from Lake Xochimilco from each site, once a month from March to October of 2012, and the rotifers, cladocerans and copepods were enumerated and identified. Physico-chemical parameters such as temperature, pH, Secchi depth, water depth, nitrogen and phosphorus and chlorophyll a concentrations, and bacterial densities were measured. During the study we recorded 33 species of rotifers, the most abundant being Brachionus angularis, B. calyciflorus and B. havanaensis.  Among the microcrustaceans the most abundant were the cladoceran Moina micrura and the copepods Acanthocyclops americanus and Arctodiaptomus dorsalis. The species diversity was around 2 bits/ind. and the saprobic index between 1.5-2.0, indicating that both sites were β meso-saprobic.  At both sites nitrogen was <1 mg/L and phosphorus ranged between 2.5-7.8 mg/L. Chlorophyll a concentrations were between 66-136 µg/L. The toxigenic (Vibrio cholerae No-O1/No-O139 and the non-toxigenic (Vibrio cholerae No-O135 strains of the bacterium were recorded, closely associated with littoral rotifers and cladocerans particularly Brachionus quadridentatus and  Alona sp. All variables indicate that these sites in Lake Xochimilco are eutrophic and highly contaminated and that the water quality needs to be improved.

  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. 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.

  7. Feather conditions and clinical scores as indicators of broilers welfare at the slaughterhouse.

    Science.gov (United States)

    Saraiva, S; Saraiva, C; Stilwell, G

    2016-08-01

    The objective of this study was to evaluate the welfare of 64 different broiler farms on the basis of feather conditions and clinical scores measures collected at the slaughterhouse. A 3-point scale (0, 1 or 2) was used to classify dirty feathers, footpad dermatitis and hock burns measures, and a 2-point scale (present or absent) was used to classify breast burns, breast blisters and breast ulcer measures. Flocks were allocated into three body weight (BW) classes (A, B, C): class A (light) ≥1.43 and ≤1.68kg, class B (medium) ≥1.69 and ≤1.93kg; class C (heavy) ≥1.94 and ≤2.41kg. The absence of hock burns was more common in class A, while mild hock burns was more common in class B flocks. Breast ulcer was observed in class C flocks. The association observed for mild hock burns, breast burns and severe footpad dermatitis can indicate a simultaneous occurrence of these painful lesions. Very dirty feathers and severe footpad dermatitis relationship suggest litter humidity to be the common underlying cause. In conclusion, it was shown that clinical indicators can be used at the slaughterhouse to identify welfare problems. In the studied flocks, footpad dermatitis, feather conditions and hock burns were the main restrictions for good welfare and should be considered significant welfare indicators of the on-farm rearing conditions. PMID:27473978

  8. 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

  9. Characterizing multi-pollutant air pollution in China: Comparison of three air quality indices.

    Science.gov (United States)

    Hu, Jianlin; Ying, Qi; Wang, Yungang; Zhang, Hongliang

    2015-11-01

    Multi-pollutant air pollution (i.e., several pollutants reaching very high concentrations simultaneously) frequently occurs in many regions across China. Air quality index (AQI) is used worldwide to inform the public about levels of air pollution and associated health risks. The current AQI approach used in China is based on the maximum value of individual pollutants, and does not consider the combined health effects of exposure to multiple pollutants. In this study, two novel alternative indices--aggregate air quality index (AAQI) and health-risk based air quality index (HAQI)--were calculated based on data collected in six megacities of China (Beijing, Shanghai, Guangzhou, Shjiazhuang, Xi'an, and Wuhan) during 2013 to 2014. Both AAQI and HAQI take into account the combined health effects of various pollutants, and the HAQI considers the exposure (or concentration)-response relationships of pollutants. AAQI and HAQI were compared to AQI to examine the effectiveness of the current AQI in characterizing multi-pollutant air pollution in China. The AAQI and HAQI values are higher than the AQI on days when two or more pollutants simultaneously exceed the Chinese Ambient Air Quality Standards (CAAQS) 24-hour Grade II standards. The results of the comparison of the classification of risk categories based on the three indices indicate that the current AQI approach underestimates the severity of health risk associated with exposure to multi-pollutant air pollution. For the AQI-based risk category of 'unhealthy', 96% and 80% of the days would be 'very unhealthy' or 'hazardous' if based on AAQI and HAQI, respectively; and for the AQI-based risk category of 'very unhealthy', 67% and 75% of the days would be 'hazardous' if based on AAQI and HAQI, respectively. The results suggest that the general public, especially sensitive population groups such as children and the elderly, should take more stringent actions than those currently suggested based on the AQI approach during

  10. 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

  11. 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

  12. 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.

  13. 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 h......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...... and not in accordance with the recently published guidelines both in the 1st and the 2nd audit. Yet, we observed a substantial improvement from the 1st to the 2nd audit. For example, referral to rehabilitation improved from 56.3 to 62.7% (p = 0.006) Assessment of BMI improved from 7.8 to 56.1% and assessment...

  14. Prediction of dengue disease severity among pediatric Thai patients using early clinical laboratory indicators.

    Directory of Open Access Journals (Sweden)

    James A Potts

    Full Text Available Dengue virus is endemic in tropical and sub-tropical resource-poor countries. Dengue illness can range from a nonspecific febrile illness to a severe disease, Dengue Shock Syndrome (DSS, in which patients develop circulatory failure. Earlier diagnosis of severe dengue illnesses would have a substantial impact on the allocation of health resources in endemic countries.We compared clinical laboratory findings collected within 72 hours of fever onset from a prospective cohort children presenting to one of two hospitals (one urban and one rural in Thailand. Classification and regression tree analysis was used to develop diagnostic algorithms using different categories of dengue disease severity to distinguish between patients at elevated risk of developing a severe dengue illness and those at low risk. A diagnostic algorithm using WBC count, percent monocytes, platelet count, and hematocrit achieved 97% sensitivity to identify patients who went on to develop DSS while correctly excluding 48% of non-severe cases. Addition of an indicator of severe plasma leakage to the WHO definition led to 99% sensitivity using WBC count, percent neutrophils, AST, platelet count, and age.This study identified two easily applicable diagnostic algorithms using early clinical indicators obtained within the first 72 hours of illness onset. The algorithms have high sensitivity to distinguish patients at elevated risk of developing severe dengue illness from patients at low risk, which included patients with mild dengue and other non-dengue febrile illnesses. Although these algorithms need to be validated in other populations, this study highlights the potential usefulness of specific clinical indicators early in illness.

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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...

  1. Quality assurance in clinical trials--the role of pathology.

    Science.gov (United States)

    Röcken, Christoph

    2016-01-01

    In the last two decades, our knowledge about cancer genetics and cancer biology increased exponentially. Deep sequencing now allows rapid and cost-effective analysis of entire cancer genomes. Dysregulation of cell growth, cell survival, tissue homeostasis, and immune surveillance have been recognized as hallmarks of cancer. In parallel, diagnostic surgical pathology has been harmonized and consensus diagnostic criteria for cancer classification have been developed by initiatives of the World Health Organization, the International Agency for Research on Cancer, and the Union for International Cancer Control. Pharmaceutical companies developed novel drugs targeting specific molecules in signaling pathways, which has allowed the development of the concept of precision medicine. Now, we are facing a large number of clinical trials which bring together these advances and will explore efficacy of novel treatment regimens. Assessment of the efficacy of a new drug is often coupled with the simultaneous assessment of the capacity of tissue-based biomarkers to predict response of individual patients (companion diagnostics/precision medicine). Patients with histologically similar tumors might respond differently to the same drug. This review summarizes the diverse roles played by surgical pathologists involved in clinical trials, with a special focus on quality assurance of diagnostic, laboratory, and reporting standards.

  2. 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...

  3. Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline.

    Science.gov (United States)

    Dumonceau, J-M; Tringali, A; Blero, D; Devière, J; Laugiers, R; Heresbach, D; Costamagna, G

    2012-03-01

    This article is part of a combined publication that expresses the current view of the European Society of Gastrointestinal Endoscopy about endoscopic biliary stenting. The present Clinical Guideline describes short-term and long-term results of biliary stenting depending on indications and stent models; it makes recommendations on when, how, and with which stent to perform biliary drainage in most common clinical settings, including in patients with a potentially resectable malignant biliary obstruction and in those who require palliative drainage of common bile duct or hilar strictures. Treatment of benign conditions (strictures related to chronic pancreatitis, liver transplantation, or cholecystectomy, and leaks and failed biliary stone extraction) and management of complications (including stent revision) are also discussed. A two-page executive summary of evidence statements and recommendations is provided. A separate Technology Review describes the models of biliary stents available and the stenting techniques, including advanced techniques such as insertion of multiple plastic stents, drainage of hilar strictures, retrieval of migrated stents and combined stenting in malignant biliary and duodenal obstructions.The target readership for the Clinical Guideline mostly includes digestive endoscopists, gastroenterologists, oncologists, radiologists, internists, and surgeons while the Technology Review should be most useful to endoscopists who perform biliary drainage.

  4. Comparison between clinical indicators of transmembrane oxygenator thrombosis and multidetector computed tomographic analysis.

    Science.gov (United States)

    Panigada, Mauro; L'Acqua, Camilla; Passamonti, Serena Maria; Mietto, Cristina; Protti, Alessandro; Riva, Roberto; Gattinoni, Luciano

    2015-04-01

    This study aims to assess whether multidetector computed tomography (MDCT) could accurately confirm the clinical suspicion of transmembrane oxygenator thrombosis (MOT) during extracorporeal membrane oxygenation (ECMO). Twenty-seven oxygenators were examined using MDCT at the end of patient treatment. Transmembrane oxygenator thrombosis was suspected in 15 of them according to the presence of at least 2 of the following clinical indicators: (1) increase in d-dimer, (2) decrease in platelet count, (3) decrease in oxygenator performance, and (4) presence of clots on the surface of the oxygenator. Transmembrane oxygenator thrombosis was confirmed by MDCT in 5 (33%) of them. Transmembrane oxygenator thrombosis was unexpectedly found in 5 (41%) of the remaining 12 oxygenators not suspected for MOT. Eight (80%) of these oxygenators had clots accounting for less than 1% of total volume. Clots were mainly detectable at the apical corner of the oxygenator, most likely due to greater blood stasis. We found a significant increase in d-dimer and in membrane oxygenator shunt and a decrease in platelet count from the start to the discontinuation of ECMO. Hemostatic abnormalities significantly reverted 48 hours after oxygenator removal, suggesting the role of ECMO in activation of the coagulation cascade. Multidetector computed tomographic scan could not accurately confirm the clinical suspicion of MOT.

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. Soil Physical Characteristics and Biological Indicators of Soil Quality Under Different Biodegradable Mulches

    Science.gov (United States)

    Schaeffer, S. M.; Flury, M.; Sintim, H.; Bandopadhyay, S.; Ghimire, S.; Bary, A.; DeBruyn, J.

    2015-12-01

    Application of conventional polyethylene (PE) mulch in crop production offers benefits of increased water use efficiency, weed control, management of certain plant diseases, and maintenance of a micro-climate conducive for plant growth. These factors improve crop yield and quality, but PE must be retrieved and safely disposed of after usage. Substituting PE with biodegradable plastic mulches (BDM) would alleviate disposal needs, and is potentially a more sustainable practice. However, knowledge of potential impacts of BDMs on agricultural soil ecosystems is needed to evaluate sustainability. We (a) monitored soil moisture and temperature dynamics, and (b) assessed soil quality upon usage of different mulches, with pie pumpkin (Cucurbita pepo) as the test crop. Experimental field trials are ongoing at two sites, one at Northwestern Washington Research and Extension Center, Mount Vernon, WA, and the other at East Tennessee Research and Education Center, Knoxville, TN. The treatments constitute four different commercial BDM products, one experimental BDM; no mulch and PE served as the controls. Soil quality parameters being examined include: organic matter content, aggregate stability, water infiltration rate, CO2 flux, pH, and extracellular enzyme activity. In addition, lysimeters were installed to examine the soil water and heat flow dynamics. We present baseline and the first field season results from this study. Mulch cover appeared to moderate soil temperatures, but biodegradable mulches also appeared to lose water more quickly than PE. All mulch types, with the exception of cellulose, reduced the diurnal fluctuations in soil temperature at 10cm depth from 1 to 4ºC. However, volumetric water content ranged from 0.10 to 0.22 m3 m-3 under the five biodegradable mulches compared to 0.22 to 0.28 m3 m-3 under conventional PE. Results from the study will be useful for management practices by providing knowledge on how different mulches impact soil physical and

  10. [Deep frozen fresh plasma in blood component therapy: preparation--quality control--indications].

    Science.gov (United States)

    Koerner, K; Stampe, D; Kubanek, B

    1981-10-01

    Fresh frozen plasma is prepared within 6 hrs after collection in a double bag system. A second centrifugation at 4600 x g is necessary to obtain a platelet poor plasma. A special bag freezing system fitted to a conventional cryostat and cooled with ethanol to -50 degrees C was developed to reach the required cooling rate. It is possible to freeze 25 plasma bags simultaneously within 30 min in this new apparatus. Fresh frozen plasma prepared in this manner contains all coagulation factors and inhibitors with almost normal activities. Freezing at -40 degrees C in the air, prolonged storage of the starting material, or insufficient cooling of the frozen product deteriorate its quality. The influence of these variables with the discussed in detail. Indications of fresh frozen plasma, especially for dilution- and posttraumatic consumption coagulopathy as well as liver disease, are presented.

  11. 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.

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

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    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

  13. Evaluation of the quality indices of landslide databases for their use in susceptibility models

    Science.gov (United States)

    Iadanza, C.; Trigila, A.; Spizzichino, D.

    2009-04-01

    The aim of this study is to define quality indices for evaluation of the homogeneity, completeness and accuracy of landslide databases. This evaluation is absolutely essential if the databases are to be used for the definition and implementation of predictive models for estimation of landslide susceptibility. In particular, descriptions are given of the quality indices defined for the Italian Landslide Inventory (IFFI Project). The IFFI Project, with the funding of 4.1 million Euro in 1997 by the Italian Government, is implemented by ISPRA (Institute for Environmental Protection and Research/Geological Survey of Italy) and by the Regions and the Self-Governing Provinces. The Project collects and maps the landslides over the entire Italian territory in accordance with standardised and shared methods. A specific "Landslide Data Sheet" has been prepared in order to collect all the landslide information, subdivided into three levels of progressively increasing detail. A detailed landslide mapping (scale 1:10,000) has been adopted throughout most of Italy. A scale of 1:25,000 has been used in high mountainous areas or in low population areas. With regard to the mapping, every landslide is represented by a georeferenced point placed, by convention, at the highest point of the landslide crown; a polygon, if the landslide may be mapped at the adopted survey scale; a line when the landslides have a very elongated form with a width which may not be mapped. The Inventory contains 482,272 landslides covering an area of approximately 20,500 km2, which is equivalent to 6.8% of the Italian territory. With regard to the homogeneity and completeness indices, comparisons have been made of the landslide indices for areas with the same outcropping lithology, statistical analyses of the landslide area have been carried out and information from the IFFI Inventory has been compared with that contained in other databases (e.g. AVI - Inventory of information on sites historically affected

  14. 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

  15. 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

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

    Directory of Open Access Journals (Sweden)

    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

  17. Hepatic resection beyond barcelona clinic liver cancer indication: When and how

    Science.gov (United States)

    Garancini, Mattia; Pinotti, Enrico; Nespoli, Stefano; Romano, Fabrizio; Gianotti, Luca; Giardini, Vittorio

    2016-01-01

    Hepatocellular carcinoma (HCC) is the main common primary tumour of the liver and it is usually associated with cirrhosis. The barcelona clinic liver cancer (BCLC) classification has been approved as guidance for HCC treatment algorithms by the European Association for the Study of Liver and the American Association for the Study of Liver Disease. According to this algorithm, hepatic resection should be performed only in patients with small single tumours of 2-3 cm without signs of portal hypertension (PHT) or hyperbilirubinemia. BCLC classification has been criticised and many studies have shown that multiple tumors and large tumors, as wide as those with macrovascular infiltration and PHT, could benefit from liver resection. Consequently, treatment guidelines should be revised and patients with intermediate/advanced stage HCC, when technically resectable, should receive the opportunity to be treated with radical surgical treatment. Nevertheless, the surgical treatment of HCC on cirrhosis is complex: The goal to be oncologically radical has always to be balanced with the necessity to minimize organ damage. The aim of this review was to analyze when and how liver resection could be indicated beyond BCLC indication. In particular, the role of multidisciplinary approach to assure a proper indication, of the intraoperative ultrasound for intra-operative restaging and resection guidance and of laparoscopy to minimize surgical trauma have been enhanced. PMID:27099652

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

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    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.

  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. 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.

  1. 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

  2. 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

  3. 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.

  4. Clinical indications for plasma protein assays: transthyretin (prealbumin) in inflammation and malnutrition.

    Science.gov (United States)

    Myron Johnson, A; Merlini, Giampaolo; Sheldon, Joanna; Ichihara, Kiyoshi

    2007-01-01

    A large number of circumstances are associated with reduced serum concentrations of transthyretin (TTR), or prealbumin. The most common of these is the acute phase response, which may be due to inflammation, malignancy, trauma, or many other disorders. Some studies have shown a decrease in hospital stay with nutritional therapy based on TTR concentrations, but many recent studies have shown that concentrations of albumin, transferrin, and transthyretin correlate with severity of the underlying disease rather than with anthropometric indicators of hypo- or malnutrition. There are few if any conditions in which the concentration of this protein by itself is more helpful in diagnosis, prognosis, or follow up than are other clinical findings. In the majority of cases, the serum concentration of C-reactive protein is adequate for detection and monitoring of acute phase responses and for prognosis. Although over diagnosis and treatment of presumed protein energy malnutrition is probably not detrimental to most patients, the failure to detect other causes of decreased concentrations (such as serious bacterial infections or malignancy) of the so-called visceral or hepatic proteins could possibly result in increased morbidity or even mortality. In addition to these caveats, assays for TTR have a relatively high level of uncertainty ("imprecision"). Clinical evaluation--history and physical examination--should remain the mainstay of nutritional assessment.

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

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    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.

  6. 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.)

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

    Science.gov (United States)

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

    2016-02-01

    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 north part of Iran, Rasht during 2010-2011. Data were gathered through an interview by a form consisted of demographic characteristics, laboratory findings, ovarian volume and anthropometric indices. A total of 214 patients consisted of 161 PCOS (cases) and 53 normal women (controls) participated in this study. The most prevalent phenotype in PCOS population was IM/PCO/HA (54%), followed by IM/HA (28%) and IM/PCO (13%). PCO/HA was present only in 6 PCOS patients (5%). PCOS patients were significantly younger than controls (P=0.07). Results showed that increased ovarian volume were higher in PCOS group in comparison with controls and IM/PCO/HA, and IM/PCO had respectively the largest ovarian volumes. Also, a significant relation was observed based on Cholesterol, 17OHP, LH, TG, 2hpp, and LH/FSH between patients with PCOS and control groups. There were significant differences in demographic, anthropometric, hormonal and ultrasound findings between PCOS and controls. Therefore, it seems that classification of the characteristics of each phenotype could offer an appropriate guide for screening risks of PCOS and may facilitate performing most favorable treatment for these complications.

  8. 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.

  9. Broadening our understanding of clinical quality: from attribution error to situated cognition.

    Science.gov (United States)

    Artino, A R; Durning, S J; Waechter, D M; Leary, K L; Gilliland, W R

    2012-02-01

    The tendency to overestimate the influence of personal characteristics on outcomes, and to underestimate the influence of situational factors, is known as the fundamental attribution error. We argue that medical-education researchers and policy makers may be guilty of this error in their quest to understand clinical quality. We suggest that to truly understand clinical quality, they must examine situational factors, which often have a strong influence on the quality of clinical encounters.

  10. 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

  11. 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

  12. The Indications and Clinical Curative Effects of Modified Neck Dissection in Head and Neck Cancers

    Institute of Scientific and Technical Information of China (English)

    GuohaoWu; WeiweiUu; FujinChen; ZongyuanZeng; HaoLi; MingSong; MaowenWei; QuanZhang; AnkuiYang; WenkuanChen

    2004-01-01

    OBJECTIVE Functional neck dissection was first described by Bocca and Pignataro in 1967. It has been used in clinical practice for years, but remains controversial among neck-surgery experts. This study was designed to evaluate indications and curative effects of functional-neck dissection (FND). METHODS One hundred and fifty-two cases which underwent FND were reviewed with an analysis of pathological specimens and follow-up datas. RESULTS The series of FND included 20 cases of tongue carcinoma, 23 cases of larynx carcinoma, 96 cases of thyroid papillary adenocarcinoma, 9 cases of follicular adenocarcinoma and 4 cases of medullary adenocarcinoma; the five-year recurrence rate for tongue carcinoma was 12.5%, 14.3%, 40.0% and for a larynx carcinoma was 20.0%, 16.7%, 50.0% in N0 stage, N1 stage, N2a stage, respectively. The 5-year recurrence rate of thyroid papillary adenocarcinoma was 6.5%, 7.1% in N1a, N1b, respectively. CONCLUSION Functional neck dissection is indicated in early and low malignant head and neck neoplasms and results in satisfactory curative effects.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. 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

  15. 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.

  16. 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;

    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......Background. Social differences in prostate cancer (PC) incidence and mortality might be related to testing for prostate-specific antigen (PSA). Although routine PSA screening is not recommended in Denmark, testing without clinical indication increased during the past decade. We evaluated...

  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. 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.

  19. 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...

  20. Enhancing quantity and quality of clinical experiences in a baccalaureate nursing program.

    Science.gov (United States)

    Andresen, Kathleen; Levin, Pamela

    2014-01-01

    Nursing programs encounter barriers to clinical education, which may include limited clinical capacity for nursing students. Congestion of clinical placements compounded by multiple external influences prompted a need to develop an alternative approach for meeting program standards pertaining to clinical education. A curriculum improvement project was implemented within a school of nursing with the primary goal of expanding clinical learning opportunities while maintaining program quality. The unique aspect of this project was a comprehensive evaluative design, including qualitative responses from students, faculty, and clinical site stakeholders, as well as standardized student test scores. Augmenting the tools and processes for evaluation of clinical learning required collaboration from the faculty. Project outcomes include expanded clinical capacity, increased variety of clinical learning experiences, and improved quality of the clinical experiences. Collaborative partnerships yielded valuable lessons, which have implications for other nursing programs challenged with clinical placements. PMID:25205733

  1. 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)

  2. 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.

  3. Oropharyngeal dysphagia, free water protocol and quality of life: an update from a prospective clinical trial.

    Science.gov (United States)

    Karagiannis, Martha; Karagiannis, Tom C

    2014-01-01

    Oropharyngeal dysphagia, typically associated with older adults, represents a spectrum of swallowing disorders with potentially serious complications and a negative impact on quality of life. A major complication of dysphagia is caused by aspiration, predominantly of thin liquids, which may cause aspiration pneumonia. Given that thin liquids are typically aspirated, the conventional therapy involves altering the diet to one consisting of modified solid consistencies and thickened fluids. While it is well known that this approach is appropriate for aspiration, it does represent difficulties with compliancy and quality of life. We have undertaken a relatively large scale clinical trial to investigate the relationships between the effects of free access to water and the development of aspiration, aspects of hydration and issues related to quality in people with dysphagia. Along with clinical observations and findings from others we have previously stratified people with dysphagia, namely those that are immobile or who have low mobility and severe degenerative neurological dysfunction, at highest risk of developing aspiration pneumonia following intake of water. In the present study, we have extended our previous clinical results. Our findings indicate that following purposeful selection of people with dysphagia with their own mobility and relatively healthy cognitive function, free access to water did not result in aspiration pneumonia, improved measures of hydration and in particular, significantly increased quality of life when compared to a diet consisting of thickened fluids only. Overall, we conclude that in people with good mobility and cognitive ability, there is no need to deviate from the Frazier Rehabilitation Centre free water protocol, which allows for the provision of water to people with dysphagia with strict guidelines particularly in relation to good physical ability.

  4. 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

  5. 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

  6. Infliximab for the Treatment of Crohn'S Disease: Review and Indications for Clinical Use in Canada

    Directory of Open Access Journals (Sweden)

    Remo Panaccione

    2001-01-01

    Full Text Available Crohn's disease is a chronic inflammatory disorder of the gastrointestinal tract. It may affect any portion of the gastrointestinal tract from the mouth to the anus. Symptoms typically include cramping abdominal pain, diarrhea (which may be bloody and nausea. As the severity of the illness worsens, patients may experience constant abdominal pain, vomiting, weight loss and fever. From the perspective of the patient, disease symptoms significantly impair quality of life, and interfere with their work environment and activities of daily living. Unfortunately, there is no cure for Crohn's disease. Patients experience a chronic, relapsing course characterized by recurrent flares of their disease. Conventional medical treatment of Crohn's disease includes the use of non-specific anti-inflammatory drugs (5-aminosalicylic acid agents, prednisone, budesonide, immunosuppressives (6-mercaptopurine, azathioprine, methotrexate and antibiotics. A variable onset of action, incomplete response rates and a significant risk of adverse effects characterize current therapies. Although surgery is frequently used to treat complications or medically refractory disease, postoperative recurrence is a common problem. Infliximab, a murine chimeric monoclonal antibody directed toward tumour necrosis factor-alpha, is a highly effective treatment of active Crohn's disease. In randomized, placebo-controlled clinical trials, 33% of patients treated with infliximab 5 mg/kg achieved remission (Crohn's Disease Activity Index score less than 150, compared with only 4% of those receiving placebo (P<0.001. Additionally, infliximab is the only drug therapy shown to be effective for the treatment of fistulizing Crohn's disease. In studies done to date, infliximab appears to be well tolerated and has a favourable side effect profile.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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.)

  9. 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.

  10. 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

  11. 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

  12. Quality-of-life indicators and falls due to vitamin D deficiency

    Directory of Open Access Journals (Sweden)

    Cheema MR

    2016-02-01

    Full Text Available Muhammad Raza Cheema, Ahmad Yar Chaudhry Department of Geriatrics, University Hospitals Coventry and Warwickshire, NHS Hospitals, Coventry, UK Objective: To determine whether the number of falls and quality-of-life indicators relate to serum levels of vitamin D, parathyroid hormone (PTH, and calcium levels.Design: A prospective study.Participants: Patients being admitted with a fall with or without sustaining a fragility fracture post fall.Measurements: Measured frequency of falling, SF-12 questionnaire, serum concentrations of 25-hydroxyvitamin D, calcium, and PTH levels before and after treatment with vitamin D supplementation.Results: The mean age (N=38 of the cohort was 80.2±12. In all, 76.3% of the cohort had sustained a fragility fracture after the fall. The cohort was vitamin D deficient with the pretreatment mean value of 24.2±17 nmol/L and posttreatment mean value of 99±40 nmol/L with a statistically significant mean difference of 74.7 nmol/L (confidence interval [CI] 61.27–88.3, P=0.001. The levels of calcium and PTH were statistically significant after treatment with a mean difference of 0.16 (CI 0.1–0.2, P=0.001, and 3.7 (CI –4.8 to –2.5, P=0.001, respectively. After treatment, the mean difference of physical component score (PCS and mental component score for the whole cohort was 2.9 (CI –0.69 to 6.6, P=0.10, and 1.05 (CI –2.6 to 4.7, P=0.56, respectively. However, a subgroup analysis for cohort aged ≤70 years provided a statistically significant effect on PCS with a mean difference of 8.9 (CI 1.3–16.4, P=0.03, but a statistically insignificant improvement in mental component score with a mean difference of 6.0 (CI –17 to –5.0, P=0.20. However, a statistically significant improvement in PCS SF-12 was observed in patients ≤70 years of age 2.9 (1.3–16.4, P=0.03. The mean number of falls for the whole cohort pre- and posttreatment was 1.11±0.92 vs 0.97±0.99 (P=0.68, respectively.Conclusion: Patients who had

  13. 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...

  14. 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.

  15. 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

  16. 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.

  17. 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

  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. How can the research potential of the clinical quality databases be maximized? The Danish experience.

    Science.gov (United States)

    Nørgaard, M; Johnsen, S P

    2016-02-01

    In Denmark, the need for monitoring of clinical quality and patient safety with feedback to the clinical, administrative and political systems has resulted in the establishment of a network of more than 60 publicly financed nationwide clinical quality databases. Although primarily devoted to monitoring and improving quality of care, the potential of these databases as data sources in clinical research is increasingly being recognized. In this review, we describe these databases focusing on their use as data sources for clinical research, including their strengths and weaknesses as well as future concerns and opportunities. The research potential of the clinical quality databases is substantial but has so far only been explored to a limited extent. Efforts related to technical, legal and financial challenges are needed in order to take full advantage of this potential. PMID:26785952

  20. The Quality of Care Provided to Women with Urinary Incontinence in Two Clinical Settings

    Science.gov (United States)

    Anger, Jennifer T.; Alas, Alexandriah; Litwin, Mark S.; Chu, Stephanie D.; Bresee, Catherine; Roth, Carol P.; Rashid, Rezoana; Shekelle, Paul; Wenger, Neil S.

    2016-01-01

    Purpose Our aim was to test the feasibility of a set of quality-of-care indicators for urinary incontinence (UI) and, at the same time, measure the care provided to women with UI in two different clinical settings. Materials and Methods This was a pilot test of a set of quality-of-care indicators (QIs). This was a pilot test of a set of quality-of-care indicators (QIs). Twenty QIs were previously developed using the RAND Appropriateness method. These QIs were used to measure care received for 137 women with a urinary incontinence (UI) diagnosis in a 120-physician hospital-based multi-specialty medical group (MSG). We also performed an abstraction of 146 patient records from primary care offices in Southern California. These charts were previously used as part of the Assessing Care of Vulnerable Elders Project (ACOVE). As a post-hoc secondary analysis, the two populations were compared with respect to quality, as measured by compliance with the QIs. Results In the ACOVE population, 37.7% of patients with UI underwent a pelvic examination, versus 97.8% in the MSG. Only 15.6% of cases in the MSG and 14.2% in ACOVE (p=0.86) had documentation that pelvic floor exercises were offered. Relatively few women with a body mass index (BMI) of >25 were counseled about weight loss in either population (20.9% MSG vs. 26.1% ACOVE, p=0.76). For women undergoing sling surgery, documentation of counseling about risks was lacking, and only 9.3% of eligible cases (MSG only) had documentation of the risks of mesh. Conclusions QIs are a feasible means to measure the care provided to women with UI. Care varied by population studied, yet deficiencies in care were prevalent in both patient populations studied. PMID:27164512

  1. 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

  2. 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.)

  3. 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

  4. 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 %.

  5. 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...

  6. 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...

  7. Formal indicators to assess the quality of radio systems perimeter security facilities

    Directory of Open Access Journals (Sweden)

    Kolesnik K. V.

    2012-08-01

    Full Text Available Quality estimation method based on the use of formal parameters, which greatly simplifies the process of creating effective radio systems for perimeter security of distributed objects in the design phase is proposed.

  8. 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...

  9. 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.

  10. 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 ...

  11. 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...

  12. Hypermutation in mantle cell lymphoma does not indicate a clinical or biological subentity

    NARCIS (Netherlands)

    Schraders, Margit; Oeschger, Sabine; Kluin, Philip M.; Hebeda, Konnie; Schuuring, Ed; Groenen, Patricia J. T. A.; Hansmann, Martin-Leo; van Krieken, Johan H. J. M.

    2009-01-01

    Mantle cell lymphoma is a prime example of a well-defined entity based on morphology, phenotype, genetics and also clinical features. Although most patients have an adverse clinical course, some have a better survival than others. The most consistently reported adverse prognostic parameter is a high

  13. 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-

  14. 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...

  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. 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...

  17. 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.

  18. 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.

  19. 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...

  20. Perfil clínico-demográfico e indicadores de qualidade da insuficiência cardíaca em uma área rural Perfil clínico demográfico e indicadores de calidad de la insuficiencia cardíaca en un área rural Clinical and demographic profile and quality indicators for heart failure in a rural area

    Directory of Open Access Journals (Sweden)

    Henrique Miller Balieiro

    2009-12-01

    proporciones, así como el test t de Student para las variables numéricas, con el objetivo de establecer las características de la población. RESULTADOS: La edad promedio era de 61±14 años, siendo 85 (51% hombres; 88 (53% afrobrasileños y 85 (51% con ICFER. Comorbilidades prevalentes: HAS 151 (91% y síndrome metabólico (SM 103 (62%. Etiologías más comunes: hipertensiva 77 (46%, isquémica 62 (37%. Indicadores de calidad en la IC: 43 (26% con ecocardiograma previo; 102 (62%; utilizaban betabloqueante; 147 (88% recibieron IECA o BRA; y 22% de los portadores de FA utilizaban anticoagulación oral. En la ICFEN predominó el sexo femenino p=0,001 RR 0,32 CI (0,17-0,60; SM p=0,004 RR 0,28 CI (1,31-4,78; y etiología hipertensiva pBACKGROUND: data on heart failure (HF in Brazil are ensued from tertiary centers. This information can not be extended to the rural population, for it reflects distinct social, economic and cultural characteristics. OBJECTIVE: To establish the clinical and demographic profile and quality indicators for HF in rural areas. METHODS: Transversal cohort study that included 166 patients from the rural area of Valença, Rio de Janeiro, Brazil. After the evaluation of clinical, laboratorial and echocardiograph data, chi-square and Fisher's exact tests were used for analysis of proportion, as well as the Student's t-test for numeric variables, in order to establish the population's characteristics. RESULTS: Mean age was 61±14 years old, as 85 of them (51% were men, 88 (53% were afro-Brazilian and 85 (51% had heart failure with reduced ejection fraction (HFREF. Systemic arterial hypertension (151 patients, 91% and metabolic syndrome (103 patients, 62% were prevalent comorbidities. The most common etiologies were: hypertensive (77 patients, 46% and ischemic (62 patients, 37%. Quality indicators in HF were: 43 patients (26% with previous echocardiogram, 102 patients (62% were in use of beta-blockers, 147 patients (88% received angiotensin converter enzyme

  1. 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.

  2. 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.

  3. 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

  4. A 37-year-old man trying to choose a high-quality hospital: review of hospital quality indicators.

    Science.gov (United States)

    Howell, Michael D

    2009-12-01

    Mr A, a previously healthy 37-year-old man, was diagnosed as having Prinzmetal angina and a hypercoagulable state 3 years ago after an ST-elevation myocardial infarction. Now, his cardiologist is moving and Mr A must select a new physician and health system. Geographic relocation, insurance changes, and other events force millions in the United States to change physicians and hospitals every year. Mr A should begin by choosing a primary care physician, since continuity and coordination of care improves outcomes. Evidence for evaluating specific physicians is less robust, though a variety of sources are available. A broad range of detailed quality information, such as Medicare's Hospital Compare (http://www.hospitalcompare.hhs.gov/), is available for selecting a hospital. However, the relationship of these metrics to patient outcomes is variable, and different Web sites provide meaningfully different rankings and data interpretations. For Mr A in particular, a warfarin management team, the hospital's location, and a cardiologist with whom he feels comfortable and who can communicate with his primary care physician are important factors. Nevertheless, hospital quality information and metrics are an important component of the strategy Mr A should take to solve this challenging problem.

  5. 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,...

  6. 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)

  7. 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

  8. 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...

  9. 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.

  10. Clinical mentorship of nurse initiated antiretroviral therapy in Khayelitsha, South Africa: a quality of care assessment.

    Directory of Open Access Journals (Sweden)

    Ann Green

    Full Text Available INTRODUCTION: To combat the AIDS epidemic and increase HIV treatment access, the South African government implemented a nurse-based, doctor-supported model of care that decentralizes administration of antiretroviral treatment (ART for HIV positive patients through nurse initiated and managed ART. Médecins Sans Frontières (MSF implemented a mentorship programme to ensure successful task-shifting, subsequently assessing the quality of clinical care provided by nurses. METHODS: A before-after cross-sectional study was conducted on nurses completing the mentorship programme in Khayelitsha, South Africa, from February 2011-September 2012. Routine clinical data from 229 patient folders and 21 self-assessment questionnaires was collected to determine the number of patients initiated on ART by nurses; quality of ART management before-after mentorship; patient characteristics for doctor and nurse ART initiations; and nurse self-assessments after mentorship. RESULTS: Twenty one nurses were authorized by one nurse mentor with one part-time medical officer's support, resulting in nurses initiating 77% of ART eligible patients. Improvements in ART management were found for drawing required bloods (91% vs 99%, p = 0.03, assessing adherence (50% vs 78%, p<0.001 and WHO staging (63% vs 91%, p<0.001. Nurse ART initiation indicators were successfully completed at 95-100% for 11 of 16 indicators: clinical presentation; patient weight; baseline blood work (CD4, creatinine, haemoglobin; STI screening; WHO stage, correlating medical history; medications prescribed appropriately; ART start date; and documented return date. Doctors initiated more patients with TB/HIV co-infection and WHO Stage 3 and 4 disease than nurses. Nurse confidence improved for managing HIV-infected children and pregnant women, blood result interpretation and long-term side effects. CONCLUSIONS: Implementation of a clinical mentorship programme in Khayelitsha led to nurse initiation of a

  11. Reflectance spectroscopy of biochemical components as indicators of tea, Camellia Sinensis, quality

    NARCIS (Netherlands)

    Bian, B.M.; Skidmore, A.K.; Schlerf, M.; Fei, T.; Liu, Y.F.; Wang, T.

    2010-01-01

    The potential of reflectance spectroscopy to estimate the concentration of biochemical compounds related to tea (Camellia sinensis (L.)) quality (total tea polyphenols and free amino acids) is demonstrated. Partial least squares regression (PLSR) was performed to establish the relationship between r

  12. Social Responsibility as a Key Performance Indicator for the Quality of Educational Processes

    OpenAIRE

    Gueorguiev, Tzvetelin

    2015-01-01

    Quality of education is a key issue in providing a sustainable future. University rankings have remarkable reputation among various stakeholders but they lack personality. This paper raises questions and proposes alternatives for possible solution for the problem. The change for the better is seen as implementing and in the same time adapting international standards to different regional, national and cultural settings

  13. Soil quality indicators of a mature alley-cropping agroforestry system in temperate North America

    Science.gov (United States)

    Although agroforestry practices are believed to improve soil quality, reports on long-term effects of alley cropping on soils within agroforestry in the temperate zone are limited. The objective of this study was to examine effects of management, landscape, and soil depth of an established agrofores...

  14. Adherence to process of care quality indicators after percutaneous coronary intervention in Ontario, Canada: a retrospective observational cohort study

    OpenAIRE

    Czarnecki, Andrew; Prasad, Treesa J; Wang, Julie; Wijeysundera, Harindra C; Cheema, Asim N.; Dz̆avík, Vladimír; Natarajan, Madhu K.; Simpson, Chris S.; So, Derek Y.; Syed, Jaffer; Tu, Jack V.; Ko, Dennis T

    2015-01-01

    Background Public reporting of percutaneous coronary intervention (PCI) outcomes has been established in many jurisdictions to ensure optimal delivery of care. The majority of PCI report cards examine in-hospital mortality, but relatively little is known regarding the adherence to processes of care. Methods A modified Delphi panel comprising cardiovascular experts was assembled to develop a set of PCI quality indicators. Indicators such as prescription of aspirin, dual antiplatelet therapy, s...

  15. Indicators of prescribing quality in drug utilisation research: report of a European meeting (DURQUIM, 13-15 May 2004)

    OpenAIRE

    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 Utilization Research Group (EuroDURG), the Belgian National Health Insurance Institute (RIZIV-INAMI), and the World Health Organisation Regional Office for Europe (WHO-Euro). The field of prescribing q...

  16. Chironomus larvae (Chironomidae: Diptera) as water quality indicators along an environmental gradient in a neotropical urban stream

    OpenAIRE

    Nadja Gomes Machado; Danielle Christine Stenner Nassarden; Francyele dos Santos; Isabelle Christina Gonçalves Boaventura; Gregory Perrier; Fernanda Silveira Carvalho de Souza; Eucarlos de Lima Martins; Marcelo Sacardi Biudes

    2015-01-01

    Anthropogenic interference in urban lotic systems is a factor affecting the biota of waterbodies. Aquatic macro invertebrates are an important food source for fish and are valuable indicators of water quality. The objective of this work was to study Chironomus larvae (Chironomidae: Diptera) distribution along an environmental gradient in Barbado Stream, Cuiabá, MT, Brazil. No individual Chironomus was found in the springs of Barbado Stream, which may indicate preservation of the area. During ...

  17. Development of a Microbial Time/Temperature Indicator Prototype for Monitoring the Microbiological Quality of Chilled Foods▿

    OpenAIRE

    Vaikousi, Hariklia; Biliaderis, Costas G.; Koutsoumanis, Konstantinos P.

    2008-01-01

    A time/temperature indicator (TTI) system based on the growth and metabolic activity of a Lactobacillus sakei strain was developed for monitoring food quality throughout the chilled-food chain. In the designed system, an irreversible color change of a chemical chromatic indicator (from red to yellow) progressively occurs due to the pH decline that results from microbial growth and metabolism in a selected medium. The relation of the TTI response (color change) to the growth and metabolic acti...

  18. 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.

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

    NARCIS (Netherlands)

    Luitjes, S.H.; Wouters, M.G.A.J.; Franx, A.; Bolte, A.C.; Groot, C.J. de; Tulder, M.W. van; Hermens, R.P.M.G.

    2013-01-01

    Objective. Hypertensive disorders in pregnancy are one of the main causes of maternal morbidity and mortality. Internationally, several organizations have developed clinical guidelines to assist professionals and to supply patients with the best possible care. To improve the care for this group of p

  20. Measuring the Contribution of Agricultural Conservation Practices to Observed Trends and Recent Condition in Water Quality Indicators in Ohio, USA.

    Science.gov (United States)

    Miltner, Robert J

    2015-11-01

    Over the last three decades, significant investments made to upgrade wastewater infrastructure and manage pollution from diffuse sources have resulted in measurably improved water quality and biological conditions in Ohio's rivers and streams. Conservation measures to reduce soil loss appear to have contributed significantly to the improvement witnessed over the last two decades and should therefore be continued. Within the most recent timeframe examined, little difference was found in either total phosphorus or suspended sediment concentration in relation to conservation measures, indicating that the environmental benefits of measures targeting soil loss may be approaching an asymptote. Conservation measures targeting livestock and forage management, however, appear to have reduced nitrogen concentrations within the recent time frame. An examination of the interrelationships between habitat quality, conservation measures, and land use indicated that water quality was generally mediated by interactions with stream habitat quality. However, the positive effect of habitat quality was reduced in catchments draining fine-textured soils. The implication of these latter two findings suggest that proscriptively adding natural function to the large network of ditched and maintained conveyances draining agricultural lands would substantially improve water quality, but management at the field level is necessary to minimize phosphorus losses. PMID:26641334

  1. Performance and quality indicators for the management of non-cancer chronic pain: a scoping review protocol

    Science.gov (United States)

    Zidarov, Diana; Visca, Regina; Gogovor, Amédé; Ahmed, Sara

    2016-01-01

    Introduction Chronic pain is a public health problem of epidemic proportion in most countries with important physical, psychological, social and economic consequences. The management of chronic pain is complex and requires an integrated network approach between all levels of the healthcare system and the involvement of several health professionals from different disciplines. Measuring the performance of organisations that provide care to individuals with chronic pain is essential to improve quality of care and requires the use of relevant performance and quality indicators. A scoping review methodology will be used to synthesise the evidence on performance and quality indicators developed for non-cancer chronic pain management across the continuum of care. Methods and analysis The following electronic databases will be searched from 2000 onwards: Cochrane Effective Practice and Organisation of Care (EPOC) Review Group Specialised Register; Cochrane Library; EMBASE; PubMed; CINAHL; PsycINFO; ProQuest Dissertations and Theses. All types of studies will be included if these are concerned with performance or quality indicators in adults with chronic non-cancer pain. In addition, searches will be conducted on provincial, national and international health organisations as well as health professional and scientific associations’ websites. A qualitative descriptive approach will be used to describe characteristics of each indicator. All identified indicators will be classified according to dimensions covered by Donabedian and the Triple Aim frameworks. Ethics and dissemination The scoping review findings will inform the development of a performance measurement system comprising a list of performance indicators with their level of evidence which can be used by stakeholders to evaluate the quality of care for individuals with chronic non-cancer pain at the patient, institutional and system level. The results will be disseminated via several knowledge translation strategies

  2. Evaluación de la calidad de suelos mediante el uso de indicadores e índices Soil quality evaluation using indicators and indices

    Directory of Open Access Journals (Sweden)

    Mario Pablo Cantú

    2007-12-01

    Full Text Available El avance de la agricultura en áreas con cierto grado de fragilidad hace necesario realizar evaluaciones del estado del sistema suelo mediante indicadores. El objetivo del trabajo fue desarrollar y aplicar un set mínimo de indicadores del estado del recurso suelo para evaluar la calidad del suelo en agroecosistemas con Molisoles de bajo a moderado desarrollo. La metodología se probó en una unidad ambiental homogénea, con Hapludoles típicos, bajo diferentes sistemas de uso y manejo, en una cuenca pedemontana del SO de la provincia de Córdoba. A las propiedades medidas (carbono orgánico, pH, saturación de bases, agregados estables en agua, velocidad de infiltración, densidad aparente y el espesor horizonte A se le establecieron rangos de calidad a partir de los cuales se normalizaron los indicadores. Los indicadores seleccionados son un número mínimo de variables con alto grado de agregación, fáciles de medir y repetibles, representando las condiciones locales. Estos indicadores de estado del recurso suelo no son universales ya que fueron elegidos en función del tipo de ambiente y suelo de la región en estudio.The expansion of agriculture in areas with a certain degree of fragility, make it necessary to evaluate the state of soil system by means of indicators. The aim of this paper was to develop and apply a minimum set of indicators of the state of the resource to assess soil quality in agroecosystems with low to moderate development Mollisols. The methodology was tested in a homogeneous environmental unit (with Typic Hapludolls under different uses and management systems in a piedmont basin in SW Córdoba province. Quality ranges were established for the measured properties (organic carbon, pH, base saturation, water stable aggregates, infiltration rate, bulk density, A horizon depth to normalize the indicators. Selected indicators constitute a minimum number of variables with a high aggregation degree, easy to measure and

  3. 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

  4. Self-care assessment as an indicator for clinical supervision in nursing

    Directory of Open Access Journals (Sweden)

    Sílvia Marlene Monteiro Teixeira

    2016-01-01

    Full Text Available Objective : to evaluate the needs of clinical supervision for nurses to assess the degree of dependence on self- care and planning of nursing interventions. Methods : analytical study, cross-cutting nature, collecting data from a sample of 110 patients. Results : it was shown the differences in the identification of the degree of dependence between registers and experts, as well as the selection of operations for each self-care and failures to the original assessment of the filling level (no evaluation self-care/no identification of the degree of dependence. Conclusion : there were gaps in the nursing process; they have proposed strategies such as clinical supervision sessions, training, case studies, protocols and guidance documents, to be included in a clinical supervision in nursing model.

  5. Self-care assessment as an indicator for clinical supervision in nursing

    Directory of Open Access Journals (Sweden)

    Sílvia Marlene Monteiro Teixeira

    2016-06-01

    Full Text Available Objective: to evaluate the needs of clinical supervision for nurses to assess the degree of dependence on self-care and planning of nursing interventions. Methods: analytical study, cross-cutting nature, collecting data from a sample of 110 patients. Results: it was shown the differences in the identification of the degree of dependence between registers and experts, as well as the selection of operations for each self-care and failures to the original assessment of the filling level (no evaluation self-care/no identification of the degree of dependence. Conclusion: there were gaps in the nursing process; they have proposed strategies such as clinical supervision sessions, training, case studies, protocols and guidance documents, to be included in a clinical supervision in nursing model.

  6. Detecting Long-term Trend of Water Quality Indices of Dong-gang River, Taiwan Using Quantile Regression

    Science.gov (United States)

    Yang, D.; Shiau, J.

    2013-12-01

    ABSTRACT BODY: Abstract Surface water quality is an essential issue in water-supply for human uses and sustaining healthy ecosystem of rivers. However, water quality of rivers is easily influenced by anthropogenic activities such as urban development and wastewater disposal. Long-term monitoring of water quality can assess whether water quality of rivers deteriorates or not. Taiwan is a population-dense area and heavily depends on surface water for domestic, industrial, and agricultural uses. Dong-gang River is one of major resources in southern Taiwan for agricultural requirements. The water-quality data of four monitoring stations of the Dong-gang River for the period of 2000-2012 are selected for trend analysis. The parameters used to characterize water quality of rivers include biochemical oxygen demand (BOD), dissolved oxygen (DO), suspended solids (SS), and ammonia nitrogen (NH3-N). These four water-quality parameters are integrated into an index called river pollution index (RPI) to indicate the pollution level of rivers. Although widely used non-parametric Mann-Kendall test and linear regression exhibit computational efficiency to identify trends of water-quality indices, limitations of such approaches include sensitive to outliers and estimations of conditional mean only. Quantile regression, capable of identifying changes over time of any percentile values, is employed in this study to detect long-term trend of water-quality indices for the Dong-gang River located in southern Taiwan. The results show that Dong-gang River 4 stations from 2000 to 2012 monthly long-term trends in water quality.To analyze s Dong-gang River long-term water quality trends and pollution characteristics. The results showed that the bridge measuring ammonia Long-dong, BOD5 measure in that station on a downward trend, DO, and SS is on the rise, River Pollution Index (RPI) on a downward trend. The results form Chau-Jhou station also ahowed simialar trends .more and more near the

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

    DEFF Research Database (Denmark)

    Dumonceau, J-M; Polkowski, M; Larghi, A;

    2011-01-01

    This article is part of a combined publication that expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about endoscopic ultrasound (EUS)-guided sampling in gastroenterology, including EUS-guided fine needle aspiration (EUS-FNA) and EUS-guided trucut biopsy (EUS......-positive cytopathological results and needle tract seeding are also discussed. The present Clinical Guideline describes the results of EUS-guided sampling in the different clinical settings, considers the role of this technique in patient management, and makes recommendations on circumstances that warrant its use. A two...

  8. Digoxin serum levels with respect to some biochemical and clinical indicators

    Energy Technology Data Exchange (ETDEWEB)

    Sedlak, J.; Curilla, E. (Univerzita P.J. Safarika, Kosice (Czechoslovakia). Lekarska Fakulta)

    1984-10-01

    Digoxin serum levels were examined in 40 patients using enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) and correlated with levels of potassium, magnesium, creatinine, urea, glomerular filtration (GF) and with clinical signs of different degrees of digitalis serum concentration. The digoxin level assessed by ELISA and RIA methods correlated fairly closely. An average dependence was found between digoxin levels and levels of creatinine, urea and GF. A correlation was observed between a high level of digoxin and clinical signs of digitalis intoxication.

  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...

  10. Results of a Quality of Work Life Index in Spain. A Comparison of Survey Results and Aggregate Social Indicators

    Science.gov (United States)

    Royuela, Vicente; Lopez-Tamayo, Jordi; Surinach, Jordi

    2009-01-01

    The European Union launched the Lisbon Strategy in 2000 with the aim of establishing itself as the world's most powerful economy. The importance of job quality has returned to the top of the European employment and social policy agenda. As targets are set, significant progress has been made in the creation of indicators. In this study, we compute…

  11. Quality of Longer Term Mental Health Facilities in Europe : Validation of the Quality Indicator for Rehabilitative Care against Service Users' Views

    NARCIS (Netherlands)

    Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L.; Turton, Penny; Kallert, Thomas; Schuster, Mirjam; Cervilla, Jorge A.; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitris; Gonidakis, Fragiskos; Caldas-de-Almeida, Jose Miguel; Cardoso, Graca; King, Michael

    2012-01-01

    Background: The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise wit

  12. Is dietary diversity an indicator of food security or dietary quality?

    OpenAIRE

    Ruel, Marie T.

    2002-01-01

    Although dietary diversity is universally recognized as a key component of healthy diets, there is still a lack of consensus on how to measure and operationalize it. This paper focuses on the issues of dietary diversity in developing countries. It also draws upon experience from developed countries to address the following questions: 1. How is dietary diversity conceptualized, operationalized, and measured, and how does it relate operationally to dietary quality? 2. Is there an association be...

  13. Methodology for developing quality indicators for the care of older people in the Emergency Department

    OpenAIRE

    Martin-Khan, Melinda; Burkett, Ellen; Schnitker, Linda; Jones, Richard N.; Gray,Leonard C

    2013-01-01

    Background Compared with younger people, older people have a higher risk of adverse health outcomes when presenting to emergency departments. As the population ages, older people will make up an increasing proportion of the emergency department population. Therefore it is timely that consideration be given to the quality of care received by older persons in emergency departments, and to consideration of those older people with special needs. Particular attention will be focused on important g...

  14. Methodology for developing quality indicators for the care of older people in the Emergency Department

    OpenAIRE

    Martin-Khan, Melinda; Burkett, Ellen; Schnitker, Linda; Jones, Richard N.; Gray,Leonard C

    2013-01-01

    Background: Compared with younger people, older people have a higher risk of adverse health outcomes when presenting to emergency departments. As the population ages, older people will make up an increasing proportion of the emergency department population. Therefore it is timely that consideration be given to the quality of care received by older persons in emergency departments, and to consideration of those older people with special needs. Particular attention will be focused on important ...

  15. Ossification score is a better indicator of maturity related changes in eating quality than animal age.

    Science.gov (United States)

    Bonny, S P F; Pethick, D W; Legrand, I; Wierzbicki, J; Allen, P; Farmer, L J; Polkinghorne, R J; Hocquette, J-F; Gardner, G E

    2016-04-01

    Ossification score and animal age are both used as proxies for maturity-related collagen crosslinking and consequently decreases in beef tenderness. Ossification score is strongly influenced by the hormonal status of the animal and may therefore better reflect physiological maturity and consequently eating quality. As part of a broader cross-European study, local consumers scored 18 different muscle types cooked in three ways from 482 carcasses with ages ranging from 590 to 6135 days and ossification scores ranging from 110 to 590. The data were studied across three different maturity ranges; the complete range of maturities, a lesser range and a more mature range. The lesser maturity group consisted of carcasses having either an ossification score of 200 or less or an age of 987 days or less with the remainder in the greater maturity group. The three different maturity ranges were analysed separately with a linear mixed effects model. Across all the data, and for the greater maturity group, animal age had a greater magnitude of effect on eating quality than ossification score. This is likely due to a loss of sensitivity in mature carcasses where ossification approached and even reached the maximum value. In contrast, age had no relationship with eating quality for the lesser maturity group, leaving ossification score as the more appropriate measure. Therefore ossification score is more appropriate for most commercial beef carcasses, however it is inadequate for carcasses with greater maturity such as cull cows. Both measures may therefore be required in models to predict eating quality over populations with a wide range in maturity.

  16. Noise as an Indicator of Residential Areas’ Quality in the Municipality of Velenje, Slovenia

    OpenAIRE

    Natalija Špeh; Blaž Barborič

    2014-01-01

    Noise has been recognized as the air pollutant since it affects the environmental quality. Its effect depends on its level; it may be slightly uncomfortable or so annoying that hinder our business or in extreme cases dangerous to health. The project was focussed on measurements required to produce professional bases, in order to assess degree of exposure of individual sites (and their population) to different sources of noise to prepare an exact spatial presentation and a set of the most urge...

  17. Ossification score is a better indicator of maturity related changes in eating quality than animal age.

    Science.gov (United States)

    Bonny, S P F; Pethick, D W; Legrand, I; Wierzbicki, J; Allen, P; Farmer, L J; Polkinghorne, R J; Hocquette, J-F; Gardner, G E

    2016-04-01

    Ossification score and animal age are both used as proxies for maturity-related collagen crosslinking and consequently decreases in beef tenderness. Ossification score is strongly influenced by the hormonal status of the animal and may therefore better reflect physiological maturity and consequently eating quality. As part of a broader cross-European study, local consumers scored 18 different muscle types cooked in three ways from 482 carcasses with ages ranging from 590 to 6135 days and ossification scores ranging from 110 to 590. The data were studied across three different maturity ranges; the complete range of maturities, a lesser range and a more mature range. The lesser maturity group consisted of carcasses having either an ossification score of 200 or less or an age of 987 days or less with the remainder in the greater maturity group. The three different maturity ranges were analysed separately with a linear mixed effects model. Across all the data, and for the greater maturity group, animal age had a greater magnitude of effect on eating quality than ossification score. This is likely due to a loss of sensitivity in mature carcasses where ossification approached and even reached the maximum value. In contrast, age had no relationship with eating quality for the lesser maturity group, leaving ossification score as the more appropriate measure. Therefore ossification score is more appropriate for most commercial beef carcasses, however it is inadequate for carcasses with greater maturity such as cull cows. Both measures may therefore be required in models to predict eating quality over populations with a wide range in maturity. PMID:26687476

  18. Dietary total antioxidant capacity: a novel indicator of diet quality in healthy young adults

    OpenAIRE

    B. Puchau; Zulet, M.A. (María Ángeles); Gonzalez-de-Echavarri, A. (Amaia); Hermsdorff, H.H. (H. H.); Martinez, J. A.

    2009-01-01

    Background: Overall diet quality measurements have been suggested as a useful tool to assess diet-disease relationships. Oxidative stress has been related to the development of obesity and other chronic diseases. Furthermore, antioxidant intake is being considered as protective against cell oxidative damage and related metabolic complications. Objective: To evaluate potential associations between the dietary total antioxidant capacity of foods (TAC), the energy density of the diet, and ot...

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

    DEFF Research Database (Denmark)

    Thomsen, Linda Aagaard

    . 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). In the AMI study...... the necessary laboratory data. iv The screening study (Article 3) revealed that most cases of preventable adverse drug events concern admissions with hyperglycemia, reduced renal function and recurrent AMI, related to inadequate treatment or monitoring. The AMI indicator study (Article 4) revealed that 77...

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

    Directory of Open Access Journals (Sweden)

    Claudia Eiko Yoshida

    2012-09-01

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

  1. New indicators of beef sensory quality revealed by expression of specific genes.

    Science.gov (United States)

    Bernard, Carine; Cassar-Malek, Isabelle; Le Cunff, Martine; Dubroeucq, Hervé; Renand, Gilles; Hocquette, Jean-François

    2007-06-27

    To identify new molecular markers of beef sensory quality, the transcriptomes of Longissimus thoracis muscle from 25 Charolais bull calves were analyzed using microarrays and compared between high and low meat quality groups; 215 genes were differentially expressed according to tenderness, juiciness, and/or flavor. Among these, 23 were up-regulated in the tenderest, juiciest, and tastiest meats, and 18 were highly correlated with both flavor and juiciness (e.g., PRKAG1), explaining up to 60% of their variability. Nine were down-regulated in the same meats, but only DNAJA1 [the results relating to DNAJA1 and its relationship with tenderness have been patented (Genomic marker for meat tenderness; Patent EP06300943.5, September 12, 2006)], which encodes a heat shock protein, showed a strong negative correlation with tenderness that alone explained 63% of its variability. This protein, known for its anti-apoptotic role, could be involved in meat aging. Thus, DNAJA1 could constitute a new marker of beef sensory quality. PMID:17547415

  2. Association of bisphenol A exposure with dietary quality indices in Spanish schoolchildren.

    Science.gov (United States)

    Rivas, Ana; Monteagudo, Celia; Heras-Gonzalez, Leticia; Mariscal-Arcas, Miguel; Lorenzo-Tovar, Maria Luisa; Olea-Serrano, Fátima

    2016-08-01

    Young children, whose growth and development are highly dependent on the endocrine system, are particularly vulnerable to endocrine disruptor exposure. The main objectives of this study were to measure BPA migration levels from cans, fruit juice bottles/packs, and microwave containers used for food/drinks consumed by a sample of 6- to 8-year old schoolchildren in Spain and to estimate the relationship between their resulting BPA exposure and diet quality index scores (Mediterranean Diet Score and Breakfast Quality Index). The mean BPA concentration was 11.8 ng/mL for vegetable cans, 22.1 ng/mL for pulse cans, 3.6 ng/mL for juice bottles/packs, and 1.2 ng/mL for microwave containers. Results revealed a significant association between the Mediterranean Diet Score and low BPA exposure of the children. BPA exposure below the median level was significantly associated with a higher score in both the first-grade (P = 0.030) and second-grade (p = 0.0001) groups. However, no association was found between BPA exposure and the Breakfast Quality Index. In conclusion, children with a stronger adherence to a Mediterranean-like diet appear to be less exposed to BPA migrating from food packaging and microwave containers. Further research is warranted on the inadvertent exposure of children to endocrinedisrupting chemicals from these sources. PMID:27208728

  3. Student’s Satisfaction - An Indicator of Quality in Physical Education

    Directory of Open Access Journals (Sweden)

    Cristiana POP

    2014-06-01

    Full Text Available 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 and students. The difference between the positive and negative answers is consistent and statistically proved by the "t" test results (t=19,05; p<0.001 Methods and subjects: Willing to collect information about the student’s opinion related with physical education and sport department activity, I did work out a 10 items questionnaire. It was applied to 142 students in 10 faculties of our university, randomly selected. The questions are related with a large range of teaching aspects: planning, teaching relationship and environment, effects, results, or student’s preferences. Conclusions and recommendations: Considering the high scores, (75-97% positive answers and the statistical confidence, we conclude that our activity aims to fulfill the students needs, requires and expectations. Because quality enhance is a continuous process, in the recommendation section I include some aspects can be improved for a better teaching approach with better results for students.

  4. Service Delivery Indicators : Kenya

    OpenAIRE

    Martin, Gayle H.; Pimhidzai, Obert

    2013-01-01

    Without consistent and accurate information on the quality of services, it is difficult for citizens or politicians (the principal) to assess how service providers (the agent) are performing and to take corrective action. The service delivery indicators (SDI) provide a set of metrics to benchmark the performance of schools and health clinics in Africa. The indicators can be used to track p...

  5. Effective NSAID treatment indicates that hyperprostaglandinism is affecting the clinical severity of childhood hypophosphatasia

    Directory of Open Access Journals (Sweden)

    Collmann H

    2006-06-01

    Full Text Available Abstract Background Hypophosphatasia (HP is an inborn error of bone metabolism characterized by a genetic defect in the gene encoding the tissue-nonspecific alkaline phosphatase (TNSALP. There is a lack of knowledge as to how the variability and clinical severity of the HP phenotype (especially pain and walking impairment are related to metabolic disturbances or impairments, subsequent to the molecular defect. Methods We analyzed the changes in clinical symptoms and the prostaglandin (PG metabolism in response to treatment with non-steroidal anti-inflammatory drugs (NSAIDs in six children affected by childhood HP. In addition, by exposing HP fibroblasts to pyridoxal phosphate and/or calcium pyrophosphate in vitro, we analyzed whether the alterations in PG levels are sequelae related to the metabolic defect. Results Childhood HP patients, who often complain about pain in the lower limbs without evident fractures, have systemic hyperprostaglandinism. Symptomatic anti-inflammatory treatment with NSAIDs significantly improved pain-associated physical impairment. Calcium pyrophosphate, but not pyridoxal phosphate, induced cyclooxygenase-2 (COX-2 gene expression and PG production in HP and normal fibroblasts in vitro. Conclusion Clinical features of childhood HP related to pain in the lower legs may be, at least in part, sequelae related to elevated PG levels, secondary to the primary metabolic defect. Consequently, NSAID treatment does improve the clinical features of childhood HP.

  6. Economic constraints and quality assurance in mental health services: sensitive indicators.

    Science.gov (United States)

    el-Guebaly, N; Papineau, D

    1984-03-01

    Clinicians in the field of mental health are met with the dual challenge of increased accountability and shrinking resources. Funds are often allocated through the use of crude administrative monitors. This is of little solace to the clinician faced with unmet patients' wants and needs. A set of clinical monitors is outlined requiring the practitioner's cooperation. The presentation of an accurate composite picture is a must in the process of resource allocation. Such clinical monitors include the analysis of characteristics of patients such as the repeaters at emergency, "the revolving door" pool of patients and those falling in between networks. Reviews of waiting lists and lengths of stay, an evaluation of nursing care variables, the auditing of the choice of therapeutic modalities and the use of restraints are other suggested contributors to the assessment of service needs. PMID:6426770

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

    OpenAIRE

    Nilsson Heléne; Vikström Tore; Jonson Carl-Oscar

    2012-01-01

    Abstract Background Timely decisions concerning mobilization and allocation of resources and distribution of casualties are crucial in medical management of major incidents. The aim of this study was to evaluate documented initial regional medical responses to major incidents by applying a set of 11 measurable performance indicators for regional medical command and control and test the feasibility of the indicators. Methods Retrospective data were collected from documentation from regional me...

  8. Soil Quality Indicators as Affected by a Long Term Barley-Maize and Maize Cropping Systems

    Directory of Open Access Journals (Sweden)

    Anna Corsini

    2011-02-01

    Full Text Available Most soil studies aim a better characterization of the system through indicators. In the present study nematofauna and soil structure were chosen as indicators to be assess soil health as related to agricultural practices. The field research was carried out on the two fodder cropping systems continuous maize (CM, Zea mays L. and a 3-year rotation of silage-maize – silage-barley (Hordeum vulgare L. with Italian ryegrass (R3 and grain-maize maintained in these conditions for 18 years. Each crop system was submitted to two management options: 1 the high input level (H, done as a conventional tillage, 2 the low input level (L, where the tillage was replaced by harrowing and the manure was reduced by 30%. The effects of the two different cropping systems was assessed on soil nematofauna and soil physic parameters (structure or aggregate stability. Comparison was made of general composition, trophic structure and biodiversity of the nematofauna collected in both systems. Differences in nematode genera composition and distribution between the two systems were also recorded. The monoculture, compared to the three year rotation, had a negative influence on the nematofauna composition and its ecological succession. The Structural Stability Index (SSI values indicate that both the cropping systems had a negative effect on the aggregate stability. The results indicate that nematofauna can be used to assess the effects of cropping systems on soil ecosystem, and therefore be considered a good indicator of soil health to integrate information from different chemical or physical indicators.

  9. Soil Quality Indicators as Affected by a Long Term Barley-Maize and Maize Cropping Systems

    Directory of Open Access Journals (Sweden)

    Barbara Manachini

    2009-03-01

    Full Text Available Most soil studies aim a better characterization of the system through indicators. In the present study nematofauna and soil structure were chosen as indicators to be assess soil health as related to agricultural practices. The field research was carried out on the two fodder cropping systems continuous maize (CM, Zea mays L. and a 3-year rotation of silage-maize – silage-barley (Hordeum vulgare L. with Italian ryegrass (R3 and grain-maize maintained in these conditions for 18 years. Each crop system was submitted to two management options: 1 the high input level (H, done as a conventional tillage, 2 the low input level (L, where the tillage was replaced by harrowing and the manure was reduced by 30%. The effects of the two different cropping systems was assessed on soil nematofauna and soil physic parameters (structure or aggregate stability. Comparison was made of general composition, trophic structure and biodiversity of the nematofauna collected in both systems. Differences in nematode genera composition and distribution between the two systems were also recorded. The monoculture, compared to the three year rotation, had a negative influence on the nematofauna composition and its ecological succession. The Structural Stability Index (SSI values indicate that both the cropping systems had a negative effect on the aggregate stability. The results indicate that nematofauna can be used to assess the effects of cropping systems on soil ecosystem, and therefore be considered a good indicator of soil health to integrate information from different chemical or physical indicators.

  10. 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...

  11. 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...

  12. Sleep quantity, quality, and insomnia symptoms of medical students during clinical years

    OpenAIRE

    Alsaggaf, Mohammed A.; Wali, Siraj O; 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 ...

  13. Using Plant Clinic Registers to Assess the Quality of Diagnoses and Advice Given to Farmers: A Case Study from Uganda

    Science.gov (United States)

    Danielsen, Solveig; Boa, Eric; Mafabi, Moses; Mutebi, Emmanuel; Reeder, Robert; Kabeere, Flavia; Karyeija, Robert

    2013-01-01

    Purpose: This study developed a framework for quality assessment of diagnoses and advice given at plant clinics. Design/methodology/approach: Clinic registers from five plant clinics in Uganda (2006-2010) were used to develop quality assessment protocols for diagnoses and advice given by plant doctors. Assessment of quality of diagnoses was based…

  14. An examination of water quality indicators in swim sites located in the upper Los Angeles River Watershed

    Science.gov (United States)

    Lee, C. M.; Morris, K.; Fingland, N. K.; Johnstone, K.; Pendleton, L.; Ponce, A.; Tang, C.; Griffith, J. F.; Steele, N. L.

    2013-12-01

    Multiple sites in the upper Los Angeles River watershed were sampled during summer 2012 and measured for Escherichia coli, enterococci, and Clostridium perfringens (vegetative cells and spores) using culture-based analyses and preserved for quantitative polymerase chain reaction (qPCR) analysis. The objective of this work includes the characterization of how well indicators correlated with each other, with respect to background levels and to 'spikes' from background, possibly indicative of a pollution input, environmental/physicochemical parameters, as well as in the context of recreational water quality standards. The 2nd objective of this work was to evaluate the economic impact of implementing qPCR at our study sites for rapid water quality monitoring. None of the species of indicators correlated well with each other (R2 holiday sampling days and will be examined further. In general, the number of swimmers present was not linked with indicator concentrations; however, incidence of water quality exceedances (for E. coli 235 CFU or MPN/100 mL sample) were more likely to occur on the weekend or holidays (for E. coli, , suggesting that the presence/absence of swimmers may be an important variable at our sites. Clostridium perfringens may be a useful indicator at our study sites, as a comparison of vegetative to endospore forms of this organism may be used to understand how recently a contamination event or input occurred.

  15. Chironomus larvae (Chironomidae: Diptera as water quality indicators along an environmental gradient in a neotropical urban stream

    Directory of Open Access Journals (Sweden)

    Nadja Gomes Machado

    2015-04-01

    Full Text Available Anthropogenic interference in urban lotic systems is a factor affecting the biota of waterbodies. Aquatic macro invertebrates are an important food source for fish and are valuable indicators of water quality. The objective of this work was to study Chironomus larvae (Chironomidae: Diptera distribution along an environmental gradient in Barbado Stream, Cuiabá, MT, Brazil. No individual Chironomus was found in the springs of Barbado Stream, which may indicate preservation of the area. During the study period, we found 40.3 and 94.4 individuals/m2 at points 3 and 4 (low course, respectively. There is eutrophication in these sites due to domestic sewage discharges, indicating low quality water. The Barbado Stream needs restoration projects that include an awareness of the residents of their neighborhood’s environmental importance, and investments in the sanitation sector to prioritize the collection and treatment of wastewater and solid waste collection.

  16. Indicator bacteria and associated water quality constituents in stormwater and snowmelt from four urban catchments

    Science.gov (United States)

    Galfi, H.; Österlund, H.; Marsalek, J.; Viklander, M.

    2016-08-01

    Four indicator bacteria were measured in association with physico-chemical constituents and selected inorganics during rainfall, baseflow and snowmelt periods in storm sewers of four urban catchments in a northern Swedish city. The variation patterns of coliforms, Escherichia coli, enterococci and Clostridium perfringens concentrations were assessed in manually collected grab samples together with those of phosphorus, nitrogen, solids, and readings of pH, turbidity, water conductivity, temperature and flow rates to examine whether these constituents could serve as potential indicators of bacteria sources. A similar analysis was applied to variation patterns of eight selected inorganics typical for baseflow and stormwater runoff to test the feasibility of using these inorganics to distinguish between natural and anthropogenic sources of inflow into storm sewers. The monitored catchments varied in size, the degree of development, and land use. Catchment and season (i.e., rainy or snowmelt periods) specific variations were investigated for sets of individual stormwater samples by the principal component analysis (PCA) to identify the constituents with variation patterns similar to those of indicator bacteria, and to exclude the constituents with less similarity. In the reduced data set, the similarities were quantified by the clustering correlation analysis. Finally, the positive/negative relationships found between indicator bacteria and the identified associated constituent groups were described by multilinear regressions. In the order of decreasing concentrations, coliforms, E. coli and enterococci were found in the highest mean concentrations during both rainfall and snowmelt generated runoff. Compared to dry weather baseflow, concentrations of these three indicators in stormwater were 10 (snowmelt runoff) to 102 (rain runoff) times higher. C. perfringens mean concentrations were practically constant regardless of the season and catchment. The type and number of

  17. 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.

  18. Indications, advantages and limitations of perinatal postmortem imaging in clinical practice

    International Nuclear Information System (INIS)

    Just as there is a range of paediatric imaging techniques available during life, a similar repertoire is available as part of the foetal and perinatal postmortem examination. In this article, we review the literature regarding the diagnostic utility of postmortem radiography, US, CT and MRI in this clinical setting. There is limited direct evidence on the diagnostic utility of any of these techniques, apart from postmortem MRI, which when combined with other noninvasive investigations, has been shown to be highly sensitive and specific for many foetal postmortem diagnoses. The main disadvantages of postmortem MRI include the longer duration of imaging, the need for appropriate training in the interpretation of normal postmortem changes, and possible non-diagnostic imaging examinations in early gestation fetuses. As less-invasive autopsy becomes increasingly available, the true utility of these techniques will evolve, and clinical guidelines for maximal diagnostic yield can be developed. (orig.)

  19. Indications, advantages and limitations of perinatal postmortem imaging in clinical practice

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Taylor, Andrew M. [Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiorespiratory Division, London (United Kingdom); Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London (United Kingdom); Sebire, Neil J. [University College London, Institute of Child Health, London (United Kingdom); Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Histopathology, London (United Kingdom)

    2015-04-01

    Just as there is a range of paediatric imaging techniques available during life, a similar repertoire is available as part of the foetal and perinatal postmortem examination. In this article, we review the literature regarding the diagnostic utility of postmortem radiography, US, CT and MRI in this clinical setting. There is limited direct evidence on the diagnostic utility of any of these techniques, apart from postmortem MRI, which when combined with other noninvasive investigations, has been shown to be highly sensitive and specific for many foetal postmortem diagnoses. The main disadvantages of postmortem MRI include the longer duration of imaging, the need for appropriate training in the interpretation of normal postmortem changes, and possible non-diagnostic imaging examinations in early gestation fetuses. As less-invasive autopsy becomes increasingly available, the true utility of these techniques will evolve, and clinical guidelines for maximal diagnostic yield can be developed. (orig.)

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

    DEFF Research Database (Denmark)

    Dumonceau, J-M; Polkowski, M; Larghi, A;

    2011-01-01

    This article is part of a combined publication that expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about endoscopic ultrasound (EUS)-guided sampling in gastroenterology, including EUS-guided fine needle aspiration (EUS-FNA) and EUS-guided trucut biopsy (EUS......-positive cytopathological results and needle tract seeding are also discussed. The present Clinical Guideline describes the results of EUS-guided sampling in the different clinical settings, considers the role of this technique in patient management, and makes recommendations on circumstances that warrant its use. A two......-page executive summary of evidence statements and recommendations is provided. A separate Technical Guideline describes the general technique of EUS-guided sampling, particular techniques to maximize the diagnostic yield depending on the nature of the target lesion, and sample processing. The target readership...

  1. Prediction of Dengue Disease Severity among Pediatric Thai Patients Using Early Clinical Laboratory Indicators

    OpenAIRE

    James A Potts; Gibbons, Robert V.; Rothman, Alan L.; Anon Srikiatkhachorn; Thomas, Stephen J.; Pra-On Supradish; Lemon, Stephenie C.; Libraty, Daniel H.; Sharone Green; Siripen Kalayanarooj

    2010-01-01

    Background Dengue virus is endemic in tropical and sub-tropical resource-poor countries. Dengue illness can range from a nonspecific febrile illness to a severe disease, Dengue Shock Syndrome (DSS), in which patients develop circulatory failure. Earlier diagnosis of severe dengue illnesses would have a substantial impact on the allocation of health resources in endemic countries. Methods and Findings We compared clinical laboratory findings collected within 72 hours of fever onset from a pros...

  2. Whole-body magnetic resonance imaging: techniques, clinical indications, and future applications.

    Science.gov (United States)

    Walker, R E; Eustace, S J

    2001-01-01

    This article reviews developments in both pulse sequence design and gradient technology that facilitate rapid imaging of the whole body. It discusses its application in patients with bone marrow neoplasms, including metastases, lymphoma, and myeloma and emphasizes the value of whole-body magnetic resonance imaging in patients with known vertebral lesions to detect other bone lesions that are easier to biopsy. It outlines possible applications in well-defined clinical situations, including pregnancy and unknown primary tumor.

  3. Age-Matched, Case-Controlled Comparison of Clinical Indicators for Development of Entropion and Ectropion

    Directory of Open Access Journals (Sweden)

    Kevin S. Michels

    2014-01-01

    Full Text Available Purpose. To analyze the clinical findings associated with involutional entropion and ectropion and compare them to each other and to age-matched controls. Methods. Prospective, age-matched cohort study involving 30 lids with involutional entropion, 30 lids with involutional ectropion, and 52 age-matched control lids. Results. The statistically significant differences associated with both the entropion and ectropion groups compared to the control group were presence of a retractor dehiscence, presence of a “white line,” occurrence of orbital fat prolapse in the cul-de-sac, decreased lower lid excursion, increased lid laxity by the snapback test, and an increased lower lid distraction. Entropion also differed from the control group with an increased lid crease height and decreased lateral canthal excursion. Statistically significant differences associated with entropion compared to ectropion were presence of a retractor dehiscence, decreased lateral canthal excursion, and less laxity in the snapback test. Conclusion. Entropic and ectropic lids demonstrate clinically and statistically significant anatomical and functional differences from normal, age-matched lids. Many clinical findings associated with entropion are also present in ectropion. Entropion is more likely to develop with a pronounced retractor deficiency. Ectropion is more likely to develop with diminished elasticity as measured by the snapback test.

  4. New oral anticoagulants: clinical indications, monitoring and treatment of acute bleeding complications.

    Science.gov (United States)

    Fenger-Eriksen, C; Münster, A-M; Grove, E L

    2014-07-01

    New oral anticoagulants like the direct thrombin inhibitor, dabigatran (Pradaxa®), and factor Xa-inhibitors, rivaroxaban (Xarelto®) and apixaban (Eliquis®) are available for prophylaxis and treatment of thromboembolic disease. They are emerging alternatives to warfarin and provide equal or better clinical outcome together with reduced need for routine monitoring. Methods for measuring drug concentrations are available, although a correlation between plasma drug concentrations and the risk of bleeding has not been firmly established. Standard laboratory measures like prothrombin time and activated partial thromboplastin time are not sensitive enough to detect thrombin or factor Xa inhibition provided by new oral anticoagulants. Thus, these standard tests may only be used as a crude estimation of the actual anticoagulation status. Further challenges regarding patients receiving new oral anticoagulants who presents with major bleeding or need for emergency surgery pose a unique problem. No established agents are clinically available to reverse the anticoagulant effect, although preclinical data report prothrombin complex concentrate as more efficient than fresh frozen plasma or other prohaemostatic agents. This review summaries current knowledge on approved new oral anticoagulants and discusses clinical aspects of monitoring, with particular focus on the management of the bleeding patient.

  5. Combining natural background levels (NBLs) assessment with indicator kriging analysis to improve groundwater quality data interpretation and management.

    Science.gov (United States)

    Ducci, Daniela; de Melo, M Teresa Condesso; Preziosi, Elisabetta; Sellerino, Mariangela; Parrone, Daniele; Ribeiro, Luis

    2016-11-01

    The natural background level (NBL) concept is revisited and combined with indicator kriging method to analyze the spatial distribution of groundwater quality within a groundwater body (GWB). The aim is to provide a methodology to easily identify areas with the same probability of exceeding a given threshold (which may be a groundwater quality criteria, standards, or recommended limits for selected properties and constituents). Three case studies with different hydrogeological settings and located in two countries (Portugal and Italy) are used to derive NBL using the preselection method and validate the proposed methodology illustrating its main advantages over conventional statistical water quality analysis. Indicator kriging analysis was used to create probability maps of the three potential groundwater contaminants. The results clearly indicate the areas within a groundwater body that are potentially contaminated because the concentrations exceed the drinking water standards or even the local NBL, and cannot be justified by geogenic origin. The combined methodology developed facilitates the management of groundwater quality because it allows for the spatial interpretation of NBL values. PMID:27371772

  6. Water supply, demand, and quality indicators for assessing the spatial distribution of water resource vulnerability in the Columbia River Basin

    Science.gov (United States)

    Chang, Heejun; Jung, Il-Won; Strecker, Angela; Wise, Daniel; Lafrenz, Martin; Shandas, Vivek; Moradkhani; Yeakley, Alan; Pan, Yangdong; Johnson, Gunnar; Psaris, Mike

    2013-01-01

    We investigated water resource vulnerability in the US portion of the Columbia River basin (CRB) using multiple indicators representing water supply, water demand, and water quality. Based on the US county scale, spatial analysis was conducted using various biophysical and socio-economic indicators that control water vulnerability. Water supply vulnerability and water demand vulnerability exhibited a similar spatial clustering of hotspots in areas where agricultural lands and variability of precipitation were high but dam storage capacity was low. The hotspots of water quality vulnerability were clustered around the main stem of the Columbia River where major population and agricultural centres are located. This multiple equal weight indicator approach confirmed that different drivers were associated with different vulnerability maps in the sub-basins of the CRB. Water quality variables are more important than water supply and water demand variables in the Willamette River basin, whereas water supply and demand variables are more important than water quality variables in the Upper Snake and Upper Columbia River basins. This result suggests that current water resources management and practices drive much of the vulnerability within the study area. The analysis suggests the need for increased coordination of water management across multiple levels of water governance to reduce water resource vulnerability in the CRB and a potentially different weighting scheme that explicitly takes into account the input of various water stakeholders.

  7. Change in quality management in diabetes care groups and outpatient clinics after feedback and tailored support

    NARCIS (Netherlands)

    Campmans-Kuijpers, Marjo J.; Baan, Caroline A.; Lemmens, Lidwien C.; Rutten, Guy E.

    2015-01-01

    OBJECTIVE: To assess the change in level of diabetes quality management in primary care groups and outpatient clinics after feedback and tailored support. RESEARCH DESIGN AND METHODS: This before-and-after study with a 1-year follow-up surveyed qualitymanagers on six domains of quality management. Q

  8. 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…

  9. Determinants of tinnitus’ impact in Quality of Life in an outpatient clinic protocol.

    NARCIS (Netherlands)

    Magali Roggerone, [No Value

    2010-01-01

    Summary Background: Tinnitus is a chronic condition that can cause substantial handicap for certain patients and affects their Quality of Life. Our study focuses on Quality of Life for the tinnitus patients who participated in the protocol of an outpatient clinic established at the ENT department of

  10. 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

  11. Waist hip ratio in early pregnancy as a clinical indicator of serum lipid levels and predictor of pregnancy complications

    Directory of Open Access Journals (Sweden)

    Divya Khare

    2016-06-01

    Conclusions: The waist hip ratio in early pregnancy has the potential to serve as a clinical indicator of lipid levels. It can also be explored as a predictor of pregnancy complications such as gestational hypertension in larger cohort studies. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1709-1713

  12. The Clinical Research Office of the Endourological Society Ureteroscopy Global Study: Indications, Complications, and Outcomes in 11885 Patients

    DEFF Research Database (Denmark)

    De La Rosette, Jean; Denstedt, John D; Geavlete, Petrisor A;

    2013-01-01

    Purpose: To assess the current indications for ureteroscopy (URS) treatment, outcome in terms of stone-free rate, and intra- and postoperative complications using the modified Clavien grading system. Patients and Methods: The Clinical Research Office of the Endourological Society (CROES) collecte...

  13. A measure of quality of life for clinical trials in chronic lung disease.

    OpenAIRE

    Guyatt, G. H.; Berman, L B; Townsend, M.; Pugsley, S. O.; Chambers, L W

    1987-01-01

    Since the relationships between pulmonary function, exercise capacity, and functional state or quality of life are generally weak, a self report questionnaire has been developed to determine the effect of treatment on quality of life in clinical trials. One hundred patients with chronic airflow limitation were asked how their quality of life was affected by their illness, and how important their symptoms and limitations were. The most frequent and important items were used to construct a ques...

  14. Assessment of quality in psychiatric nursing documentation-a clinical audit

    OpenAIRE

    2014-01-01

    Background: Quality in nursing documentation facilitates continuity of care and patient safety. Lack of communication between healthcare providers is associated with errors and adverse events. Shortcomings are identified in nursing documentation in several clinical specialties, but very little is known about the quality of how nurses document in the field of psychiatry. Therefore, the aim of this study was to assess the quality of the written nursing documentation in a psychiatric...

  15. The Effects of Childhood Abuse on Relationship Quality: Gender Differences and Clinical Implications

    Science.gov (United States)

    Larsen, Carly D.; Sandberg, Jonathan G.; Harper, James M.; Bean, Roy

    2011-01-01

    This study examined the relationship between self-reported childhood physical and sexual abuse, romantic relationship quality, possible gender differences, and clinical implications. Three hundred thirty-eight women and 296 men who sought services at a university mental health clinic in the northeast region of the United States completed a…

  16. The Dutch Consumer Quality Index: an example of stakeholder involvement in indicator development

    Directory of Open Access Journals (Sweden)

    Rademakers Jany JDJM

    2010-04-01

    Full Text Available Abstract Background Like in several other Western countries, in the Dutch health care system regulated competition has been introduced. In order to make this work, comparable information is required about the performance of health care providers in terms of effectiveness, safety and patient experiences. Without further coordination, external actors will all try to force health care providers to be transparent. For health care providers this might result in a situation in which they have to deliver data for several sets of indicators, defined by different actors. Therefore, in the Netherlands an effort is made to define national sets of performance indicators and related measuring instruments. In this article, the following questions are addressed, using patient experiences as an example: - When and how are stakeholders involved in the development of indicators and instruments that measure the patients' experiences with health care providers? - Does this involvement lead to indicators and instruments that match stakeholders' information needs? Discussion The Dutch experiences show that it is possible to implement national indicator sets and to reach consensus about what needs to be measured. Preliminary evaluations show that for health care providers and health insurers the benefits of standardization outweigh the possible loss of tailor-made information. However, it has also become clear that particular attention should be given to the participation of patient/consumer organisations. Summary Stakeholder involvement is complex and time-consuming. However, it is the only way to balance the information needs of all the parties that ask for and benefit from transparency, without frustrating the health care system.

  17. Clinical indicators of child development in the capitals of nine Brazilian states: the influence of regional cultural factors

    Directory of Open Access Journals (Sweden)

    André Laranjeira de Carvalho

    2008-01-01

    Full Text Available OBJECTIVE: Evaluating the interaction between mother or caregiver and infant through the Clinical Indicators of Risks in Infant Development and investigating whether local and cultural influences during infant development affect these clinical indicators. INTRODUCTION: The Clinical Indicators of Risks in Infant Development was created in order to fully assess infants' development and the subjective relationship between the babies and their caregivers. The absence of two or more Clinical Indicators of Risks in Infant Developments suggests a possibly inadequate mental development. Given the continental size of Brazil and its accentuated cultural differences, one might question how trustworthy these indicators can be when applied to each of the geographical regions of the country. METHODS: This was a cross-sectional study with 737 infants from the capitals of 9 Brazilian states. The size of the initial sample population was based on a pilot study carried out in the cities of São Paulo and Brasília. The ages of children were grouped: 0-3 months, 4-7 months, 8-11 months and 12-18 months. The chi-square test was used together with analyses by the statistical software SPSS 13.0. RESULTS: Statistical analysis of results from the different municipalities against the total sample did not reveal any statistically significant differences. Municipalities represented were Belém (p=0.486, Brasília (p=0.371, Porto Alegre (p=0.987, Fortaleza (p=0.259, Recife (p=0.630, Salvador (0.370, São Paulo (p=0.238, Curitiba (p=0.870, and Rio de Janeiro (p= 0.06. DISCUSSION: Care for mental development should be considered a public health issue. Its evaluation and follow-up should be part of the already available mother-child assistance programs, which would then be considered to provide "full" care to children. CONCLUSIONS: Local habits and culture did not affect the results of the Clinical Indicators of Risks in Infant Development indicators. Clinical Indicators of

  18. Is there a possibility of ranking benthic quality assessment indices to select the most responsive to different human pressures?

    Science.gov (United States)

    Borja, Ángel; Marín, Sandra L; Muxika, Iñigo; Pino, Loreto; Rodríguez, José G

    2015-08-15

    Although a plethora of benthic indices exist, there is no agreement on what index or indices should be used by environmental managers to establish benthic quality. The objective of this investigation was to rank 35 benthic quality assessment indices used in different countries to evaluate the impact produced by 15 different human pressures (including multipressure, aquaculture, sewage discharges, eutrophication, physical alteration, chemical pollution, climate change, etc.). The ranking was determined by taking into account the coverage area of biogeographical provinces, number of citations testing a pressure and number of citations with significant correlation with pressure. We analysed 363 references, of which 169 showed quantitative data. Over a potential total score of 100, the highest values were obtained by the following indices: (i) AZTI's Marine Biotic Index (AMBI), which scored 77, tested by using 14 pressures in 14 provinces from the Arctic to tropical seas; (ii) multivariate AMBI (M-AMBI), which scored 74, tested with 12 pressures in 13 provinces; (iii) Bentix (BENTIX), which scored 68, tested with nine pressures in six provinces; (iv) Benthic Quality Index (BQI), which scored 66, tested with five pressures in seven provinces; and (v) Benthic Opportunistic Polychaetes Amphipods (BOPA) index, which scored 62, tested with eight pressures in six provinces.

  19. The development of education indicators for measuring quality in the English-speaking Caribbean: how far have we come?

    Science.gov (United States)

    Bowe, Anica G

    2015-02-01

    Education evaluation has become increasingly important in the English-speaking Caribbean. This has been in response to assessing the progress of four regional initiatives aimed at improving the equity, efficiency, and quality of education. Both special interest groups and local evaluators have been responsible for assessing the progress of education and providing an overall synthesis and summary of what is taking place in the English-speaking Caribbean. This study employed content analysis to examine the indicators used in these education evaluation studies since the declaration of the Caribbean Plan of Action 2000-2015 to determine these indicators' appropriateness to the Caribbean context in measuring education progress. Findings demonstrate that the English-speaking Caribbean has made strides in operationalizing quality input, process, and output indicators; however quality outcome indicators beyond test scores are yet to be realized in a systematic manner. This study also compared the types of collaborative partnerships in conducting evaluation studies used by special interest groups and local evaluators and pinpointed the one that appears most suitable for special interest groups in this region.

  20. 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

    in food and nutrient intake between these subgroups were identified by intakes of food groups and intakes of nutrients followed by non-parametric tests. Compared with the Nordic Nutrition Recommendations 2004 and the Danish Dietary Guidelines 2005, compliers had a significantly better nutrient profile...... than intermediates and non-compliers, as the diet of compliers contained more whole-grain cereals, fruits, vegetables and fish, and more frequently low-fat dairy products, lean meats and boiled potatoes. The diet of all subgroups, especially non-compliers, had a high content of nutrient-poor, energy-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....