WorldWideScience

Sample records for external quality review

  1. AIR QUALITY CRITERIA FOR PARTICULATE MATTER, VOLUMES I-III, (EXTERNAL REVIEW DRAFT, 1995)

    Science.gov (United States)

    There is no abstract available for these documents. If further information is requested, please refer to the bibliographic citation and contact the Technical Information Staff at the number listed above.Air Quality Criteria for Particulate Matter, Volume I, Extern...

  2. Thoughts on Internal and External Quality Assurance

    Science.gov (United States)

    Zhang, Jianxin

    2012-01-01

    Quality assurance of higher education is made up of two parts: internal quality assurance (IQA) and external quality assurance (EQA). Both belong to a union of the coexistence and balance of yin and yang. But in reality there exists a paradox of "confusion of quality assurance (QA) subject consciousness, singularity of social QA and lack of QA…

  3. Thoughts on Internal and External Quality Assurance

    Science.gov (United States)

    Zhang, Jianxin

    2012-01-01

    Quality assurance of higher education is made up of two parts: internal quality assurance (IQA) and external quality assurance (EQA). Both belong to a union of the coexistence and balance of yin and yang. But in reality there exists a paradox of "confusion of quality assurance (QA) subject consciousness, singularity of social QA and lack of QA…

  4. Internal versus External Quality Management

    Science.gov (United States)

    Hofman, Roelande H.; Dijkstra, Nynke J.; Hofman, W. H. Adriaan

    2008-01-01

    This article presents the findings of research into quality management in Dutch elementary schools using theories of school accountability and school improvement as fundamentals. The study is based on data gathered from almost 1000 school leaders. It attempts to determine whether different types of quality management exist in primary schools.…

  5. Internal versus External Quality Management

    Science.gov (United States)

    Hofman, Roelande H.; Dijkstra, Nynke J.; Hofman, W. H. Adriaan

    2008-01-01

    This article presents the findings of research into quality management in Dutch elementary schools using theories of school accountability and school improvement as fundamentals. The study is based on data gathered from almost 1000 school leaders. It attempts to determine whether different types of quality management exist in primary schools.…

  6. 78 FR 47016 - Submission for Review: Request for External Review

    Science.gov (United States)

    2013-08-02

    ... MANAGEMENT Submission for Review: Request for External Review AGENCY: U.S. Office of Personnel Management... on a new information collection request (ICR) 3206-NEW, Request for External Review. As required by... March 11, 2013, 78 FR 15560, which outlined an external review process that would be available...

  7. External quality assurance in Malaysia.

    Science.gov (United States)

    Nawawi, H; Lim, H H; Zakiah, I

    1999-01-01

    An activity supportive of the MOH QA Programme, the National EQAS for clinical chemistry monitors for analytical performance in core routine biochemical testing by the pathology laboratories, with unsatisfactory performance scores serving to alert against deficiencies or problems and the scores in subsequent challenges providing the feedback of effectiveness of remedial actions taken. While unacceptable individual analyte performance score (variance index score, VIS) indicated problems in instruments, reagent and calibrators, or the use of inherently poorer methods, repeated occurrence of unsatisfactory OMRVIS was traceable to generally poor laboratory management of usually inadequately-equipment small laboratories. The outcome has been one of slow but gradual improvement in the overall performance of participating laboratories, with a move towards methods upgrading and standardization to achieve greater concordance of results. Presently, the programme is limited to 61 government and 4 private hospital laboratories in the country for 12 commonly assayed clinical biochemistry analytes. It is hoped that the NEQAS could be extended to the other private laboratories and that of academic institutions. However, this is dependent to a large extent on the manpower and financial support obtainable by the organizing body of the programme in the future. Belk and Sunderman, 1947 demonstrated that laboratories participating in an quality assessment scheme could rapidly and dramatically improve their analytical performance. In some countries, participation has become mandatory, and acceptable performance is a requirement in laboratory accreditation. The need and value of the NEQAP is, therefore, evident. While there may be limitations in the national programme. efforts are being made at improving the programme within the means and resources of the organising body. The goals of the NEQAP are not just to monitor performance but also to educate. On this, matters related to and

  8. IRIS Toxicological Review of Acrylamide (External Review ...

    Science.gov (United States)

    EPA has conducted a peer review by EPA’s Science Advisory Board (SAB) of the scientific basis supporting the human health hazard and dose-response assessment of acrylamide that once finalized will appear on the Integrated Risk Information System (IRIS) database. Peer review is meant to ensure that the science is used credibly and appropriately in derivation of the dose-response assessments and toxicological characterization. The draft Toxicological Review of Acrylamide provides scientific support and rationale for the hazard identification and dose-response assessment pertaining to a chronic exposure to acrylamide.

  9. Influence of greenhouse climate and plant density on external quality of chrysanthemum (Dendranthema grandiflorum (Ramat.)Kitamura) : First steps towards a quality model

    NARCIS (Netherlands)

    Carvalho, S.M.P.; Heuvelink, E.

    2001-01-01

    The effects of greenhouse climate and plant density on external quality of chrysanthemum (Dendranthema grandiflorum syn. Chrysanthemum morifolium) are reviewed. The external quality aspects analysed in this paper are stem morphology (length, diameter and "strength"), leaf morphology (number and

  10. IRIS Toxicological Review of Methanol (Noncancer) (Revised External Review Draft)

    Science.gov (United States)

    EPA is seeking additional public comment and external peer review of the scientific basis supporting the human health hazard and dose-response assessment of methanol (noncancer). Teleconference Details: The public may participate in th...

  11. External quality control for embryology laboratories.

    Science.gov (United States)

    Castilla, Jose Antonio; Ruiz de Assín, Rafael; Gonzalvo, Maria Carmen; Clavero, Ana; Ramírez, Juan Pablo; Vergara, Francisco; Martínez, Luis

    2010-01-01

    Participation in external quality control (EQC) programmes is recommended by various scientific societies. Results from an EQC programme for embryology laboratories are presented. This 5-year programme consisted of the annual delivery of (i) materials to test toxicity and (ii) a DVD/CD-ROM with images of zygotes and embryos on days 2 and 3, on the basis of which the participants were asked to judge the embryo quality and to take a clinical decision. A high degree of agreement was considered achieved when over 75% of the laboratories produced similar classifications. With respect to the materials analysed, the specificity was 68% and the sensitivity was 83%. Concerning embryo classification, the proportion of embryos on which a high degree of agreement was achieved increased during this period from 35% to 55%. No improvement was observed in the degree of agreement on the clinical decision to be taken. Day-3 embryos produced a higher degree of agreement (58%) than did day-2 embryos (32%) (Pembryology laboratories.

  12. EXTERNAL EVALUATION OF LEARNING AS A GUARANTEE OF QUALITY EDUCATION

    Directory of Open Access Journals (Sweden)

    José Mª Arribas Estebaranz

    2014-12-01

    Almost all countries and all reports use contemplated, in varying degrees, the always-complementary external evaluation by the teachers-as an essential guarantee of educational quality at different levels of detail curriculum evaluation.

  13. External quality assurance in nongynecologic cytology: The Australasian experience.

    Science.gov (United States)

    Shield, Paul W; Frost, Felicity; Finnimore, Jo L; Wright, R Gordon; Cummings, Margaret C

    2017-05-01

    The Royal College of Pathologists of Australasia Cytopathology Quality Assurance Program has operated an external quality assurance program in nongynecologic cytopathology since 1993. Glass slide preparations of a wide range of nongynecologic cases were circulated to approximately 200 cytopathology laboratories in 16 countries. General nongynecologic cytology cases were manufactured from residual specimens after routine diagnosis. Fine-needle aspiration (FNA) cases were made by sampling fresh tissue and making direct specimens. The majority of cases consisted of both air-dried and fixed preparations. Results returned to laboratories included illustrated case discussions highlighting diagnostic features, key differential diagnoses, and useful adjunctive tests. The current study reviewed >22,000 results for 123 nongynecologic cases. Cases found to cause the most diagnostic difficulties included serous effusion cases with metastatic carcinoma in a dispersed pattern, well-differentiated carcinoma, and cellular reactive cases; urine specimens with sparse malignant cells; reactive pneumocytes in a bronchoalveolar lavage; breast FNA cases with papillary lesions; gestational specimens; and fibroadenoma. FNA specimens from the lung and thyroid, particularly papillary thyroid carcinoma, generally were well reported. The use of multiple preparations of the same specimen has allowed interlaboratory comparison, and the quality assurance program has played an educational role as well as informing the laboratory accreditation process. Cancer Cytopathol 2017;125:349-361. © 2017 American Cancer Society. © 2017 American Cancer Society.

  14. 33 CFR 385.22 - Independent scientific review and external peer review.

    Science.gov (United States)

    2010-07-01

    ... external peer review. 385.22 Section 385.22 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT... RESTORATION PLAN CERP Implementation Processes § 385.22 Independent scientific review and external peer review... and the Seminole Tribe of Florida may initiate an external peer review process to review...

  15. Lupus anticoagulant : case-based external quality assessment

    NARCIS (Netherlands)

    van den Besselaar, A. M. H. P.; Devreese, K. M. J.; de Groot, P. G.; Castel, A.

    2009-01-01

    Aims: A model for presenting case histories with quality assessment material is to be developed for the Dutch external quality assessment (EQA) scheme for blood coagulation testing. The purpose of the present study was to assess the performance of clinical laboratories in casebased EQA using the cas

  16. External Prestressing Bridge Reinforcement Technology Review

    Directory of Open Access Journals (Sweden)

    Zhu Hanbing

    2015-01-01

    Full Text Available Externally prestressed bridge can not only limit and reduce the cracks and deformation of the structure, improve the rigidity and bearing capacity of structure, improve the stress state of structure, but also have less interference for bridge operation when it is operating and have the good economic efficiency. This paper introduces the advantages and disadvantages of external prestressed strengthening technique, its calculation theory and construction technology described in detail, and finally the paper discusses the deficiency of existing research.

  17. 77 FR 21086 - Patents External Quality Survey (formerly Customer Panel Quality Survey)

    Science.gov (United States)

    2012-04-09

    ... United States Patent and Trademark Office Patents External Quality Survey (formerly Customer Panel Quality Survey) ACTION: Proposed collection; comment request. SUMMARY: The United States Patent and...@uspto.gov . Include ``0651- 0057 Patents External Quality Survey comment'' in the subject line of...

  18. External Peer Review Report on the Missile Defense Agency Office of Internal Review

    Science.gov (United States)

    2015-05-14

    No. DODIG-2015-123 M A Y 1 4 , 2 0 1 5 External Peer Review Report on the Missile Defense Agency Office of Internal Review Report Documentation...3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE External Peer Review Report on the Missile Defense Agency Office of Internal... REVIEW SUBJECT: External Peer Review Report on the Missile Defense Agency Office of Internal Review (Report No. DODIG-2015-123) Attached is the

  19. Summary of External Peer Review and Public Comments and Disposition

    Science.gov (United States)

    This document summarizes the public and external peer review comments that the EPA’s Office of Pollution Prevention and Toxics (OPPT) received for the draft work plan risk assessment for n-Methylpyrrolidone (NMP).

  20. Reconciling Organisational Culture and External Quality Assurance in Higher Education

    Science.gov (United States)

    Naidoo, Dhaya

    2013-01-01

    Organisational culture and external quality assurance have both been presented as significant drivers of effectiveness, efficiency and excellence in higher education institutions. However, these assumptions have not been critically examined given the philosophical, conceptual and methodological contestations surrounding both constructs. A…

  1. External quality assessments for microbiologic diagnosis of diphtheria in Europe.

    Science.gov (United States)

    Both, Leonard; Neal, Shona; De Zoysa, Aruni; Mann, Ginder; Czumbel, Ida; Efstratiou, Androulla

    2014-12-01

    The European Diphtheria Surveillance Network (EDSN) ensures the reliable epidemiological and microbiologic assessment of disease prevalence in the European Union. Here, we describe a survey of current diagnostic techniques for diphtheria surveillance conducted across the European Union and report the results from three external quality assessment (EQA) schemes performed between 2010 and 2014. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  2. Reconciling Organisational Culture and External Quality Assurance in Higher Education

    Science.gov (United States)

    Naidoo, Dhaya

    2013-01-01

    Organisational culture and external quality assurance have both been presented as significant drivers of effectiveness, efficiency and excellence in higher education institutions. However, these assumptions have not been critically examined given the philosophical, conceptual and methodological contestations surrounding both constructs. A…

  3. Quality electricity lines of external power systems electric traction DC

    Directory of Open Access Journals (Sweden)

    A.V. Petrov

    2012-08-01

    Full Text Available The results of studies that compare and analyze the numerical values of some key indicators quality electricity in the lines of the external power supply system the electric traction DC. As a supplement are additional and fundamental values of energy losses in them.

  4. Higher Education Quality: Perception Differences among Internal and External Stakeholders

    Science.gov (United States)

    Abidin, Munirul

    2015-01-01

    Conceptually, education quality of higher education can be determined by evaluation of their stakeholders's satisfaction level. The purpose of this study is to describe how students as external stakeholder and lecturers as internal stakeholder, perceived their satisfaction of learning experience in the university. This study was conducted in…

  5. Stepfamily Relationship Quality and Children's Internalizing and Externalizing Problems.

    Science.gov (United States)

    Jensen, Todd M; Lippold, Melissa A; Mills-Koonce, Roger; Fosco, Gregory M

    2017-03-07

    The stepfamily literature is replete with between-group analyses by which youth residing in stepfamilies are compared to youth in other family structures across indicators of adjustment and well-being. Few longitudinal studies examine variation in stepfamily functioning to identify factors that promote the positive adjustment of stepchildren over time. Using a longitudinal sample of 191 stepchildren (56% female, mean age = 11.3 years), the current study examines the association between the relationship quality of three central stepfamily dyads (stepparent-child, parent-child, and stepcouple) and children's internalizing and externalizing problems concurrently and over time. Results from path analyses indicate that higher levels of parent-child affective quality are associated with lower levels of children's concurrent internalizing and externalizing problems at Wave 1. Higher levels of stepparent-child affective quality are associated with decreases in children's internalizing and externalizing problems at Wave 2 (6 months beyond baseline), even after controlling for children's internalizing and externalizing problems at Wave 1 and other covariates. The stepcouple relationship was not directly linked to youth outcomes. Our findings provide implications for future research and practice. © 2017 Family Process Institute.

  6. Implementation of the External Quality Assessment Program in Brazil.

    Science.gov (United States)

    Fleury, Marcos Kneip; Menezes, Maria Elizabeth; Correa, José Abol

    2017-02-15

    The External Quality Assessment (EQA) in Brazil is performed by the National Health Ministry for diseases that are under supervision of Public Health Department. In addition to the government program, the Brazilian Society of Clinical Analysis and the Brazilian Society of Medical Pathology are allowed to provide their programs under the Supervision of National Agency for Sanitary Surveillance (ANVISA) that regulates laboratories to perform EQA programs.

  7. Professionalism, Profession and Quality Assurance Practitioners in External Quality Assurance Agencies in Higher Education

    Science.gov (United States)

    Cheung, Jordan C. M.

    2015-01-01

    This article seeks to spark a dialectic discussion on the establishment of a set of professional competencies for quality assurance practitioners who serve in external quality assurance agencies in higher education. Such a need is identified due to the shortage of relevant and sufficient coverage in the quality assurance literature. To…

  8. Data connectivity: A critical tool for external quality assessment

    Directory of Open Access Journals (Sweden)

    Ben Cheng

    2016-10-01

    Full Text Available Point-of-care (POC tests have been useful in increasing access to testing and treatment monitoring for HIV. Decentralising testing from laboratories to hundreds of sites around a country presents tremendous challenges in training and quality assurance. In order to address these concerns, companies are now either embedding connectivity in their new POC diagnostic instruments or providing some form of channel for electronic result exchange. These will allow automated key performance and operational metrics from devices in the field to a central database. Setting up connectivity between these POC devices and a central database at the Ministries of Health will allow automated data transmission, creating an opportunity for real- time information on diagnostic instrument performance as well as the competency of the operator through external quality assessment. A pilot programme in Zimbabwe shows that connectivity has significantly improve the turn-around time of external quality assessment result submissions and allow corrective actions to be provided in a timely manner. Furthermore, by linking the data to existing supply chain management software, stock-outs can be minimised. As countries are looking forward to achieving the 90-90-90 targets for HIV, such innovative technologies can automate disease surveillance, improve the quality of testing and strengthen the efficiency of health systems.

  9. External Quality Assurance of New Zealand Tertiary Education Providers Matters: Life Jacket or Strait-Jacket? AIR 2001 Annual Forum Paper.

    Science.gov (United States)

    Weir, Annie

    The reality of external academic/quality audit has arrived for all tertiary education providers in New Zealand under the umbrella of the New Zealand Qualifications Authority. This paper reviews the development over the past decade of external quality assurance of tertiary providers by quality assurance authorities and their associated bodies. The…

  10. Matrix models of RNA folding with external interactions: A review

    Indian Academy of Sciences (India)

    I Garg; N Deo

    2011-11-01

    The matrix model of (simplified) RNA folding with an external linear interaction in the action of the partition function is reviewed. The important results for structure combinatorics of the model are discussed and analysed in terms of the already existing models.

  11. 76 FR 74777 - National Marine Protected Areas Center External Review

    Science.gov (United States)

    2011-12-01

    ..., information resources, coordination and policy development. An external review of the MPA Center is needed to... feedback, including public comment on the program's approach to balancing competing priorities. All... of MPAs? Are resources (human and financial) allocated appropriately to effectively address the...

  12. Are External Cervical Orthoses Necessary after Anterior Cervical Discectomy and Fusion: A Review of the Literature

    Science.gov (United States)

    Ajayi, Olaide O; Asgarzadie, Farbod

    2016-01-01

    Introduction & Background: The use of external cervical orthosis (ECO) after anterior cervical discectomy and fusion (ACDF) varies from physician to physician due to an absence of clear guidelines. Our purpose is to evaluate and present evidence answering the question, “Does ECO after ACDF improve fusion rates?” through a literature review of current evidence for and against ECO after ACDF.  Review: A PubMed database search was conducted using specific ECO and ACDF related keywords. Our search yielded a total of 1,267 abstracts and seven relevant articles. In summary, one study provided low quality of evidence results supporting the conclusion that external bracing is not associated with improved fusion rates after ACDF.  The remaining six studies provide very low quality of evidence results; two studies concluded that external bracing after cervical procedures is not associated with improved fusion rates, one study concluded that external bracing after cervical procedures is associated with improved fusion rates, and the remaining three studies lacked sufficient evidence to draw an association between external bracing after ACDF and improved fusion rates. Conclusion: We recommend against the routine use of ECO after ACDF due to a lack of improved fusion rates associated with external bracing after surgery. PMID:27555986

  13. Results of external review Sandia microelectronics and microsystems program (September 2004).

    Energy Technology Data Exchange (ETDEWEB)

    Peercy, Paul S. (University of Wisconsin-Madison, Madision, WI); Myers, David R.

    2005-08-01

    The US Department of Energy requires a periodic assessment of the Microsystems Program at Sandia National Laboratories. An external review of this program is held approximately every 18 months to 24 months. The report from the External Review Panel serves as the basis for Sandia's ''self assessment'' and is a specific deliverable of the governance contract between Lockheed Martin and the Department of Energy. The External Review of Microelectronics and Microsystems for Fiscal Year 2004 was held September 27-29, 2004 at Sandia National Laboratories, Albuquerque, NM. The external review panel consisted of experts in the fields of microelectronics, photonics and microsystems from universities, industry and other Government agencies. A complete list of the panel members is included as Appendix A of the attached report. The review assessed four areas: relevance to national needs and agency mission; quality of science, technology and engineering; performance in the operation of a major facility; and program performance management and planning. Relevance to national needs and agency mission was rated as ''outstanding''. The quality of science, technology, and engineering was rated as ''outstanding''. Operation of a major facility was rated as ''outstanding'', and the category of program performance, management, and planning was rated as ''outstanding''. Sandia's Microsystems Program thus received an overall rating of ''outstanding'' [the highest possible rating].

  14. IRIS Toxicological Review of Acrylamide (External Review Draft)

    Science.gov (United States)

    EPA has conducted a peer review by EPA’s Science Advisory Board (SAB) of the scientific basis supporting the human health hazard and dose-response assessment of acrylamide that once finalized will appear on the Integrated Risk Information System (IRIS) database. Peer review is m...

  15. IRIS Toxicological Review of Tetrachloroethylene (Perchloroethylene) (External Review Draft)

    Science.gov (United States)

    EPA conducted a peer review of the scientific basis supporting the human health hazard and dose-response assessment of tetrachloroethylene that will appear on the Integrated Risk Information System (IRIS) database. Peer review is meant to ensure that science is used credibly and ...

  16. IRIS Toxicological Review of Acrylamide (External Review Draft)

    Science.gov (United States)

    EPA has conducted a peer review by EPA’s Science Advisory Board (SAB) of the scientific basis supporting the human health hazard and dose-response assessment of acrylamide that once finalized will appear on the Integrated Risk Information System (IRIS) database. Peer review is m...

  17. IRIS Toxicological Review of Hydrogen Cyanide (External Review Draft)

    Science.gov (United States)

    EPA is conducting a peer review of the scientific basis supporting the human health hazard and dose-response assessment of hydrogen cyanide and cyanide salts that will appear on the Integrated Risk Information System (IRIS) database.

  18. IRIS Toxicological Review of Hydrogen Cyanide (External Review Draft)

    Science.gov (United States)

    EPA is conducting a peer review of the scientific basis supporting the human health hazard and dose-response assessment of hydrogen cyanide and cyanide salts that will appear on the Integrated Risk Information System (IRIS) database.

  19. IRIS Toxicological Review of Trichloroethylene (TCE) (External Review Draft)

    Science.gov (United States)

    EPA is conducting a peer review and public comment of the scientific basis supporting the human health hazard and dose-response assessment of Trichloroethylene (TCE) that when finalized will appear on the Integrated Risk Information System (IRIS) database.

  20. Interpretation of differential item functioning analyses using external review

    DEFF Research Database (Denmark)

    Scott, Neil W; Fayers, Peter M; Aaronson, Neil K

    2010-01-01

    considered. Relatively few examples of blinded item reviews were identified, and these were mostly from educational studies. A case study using blinded bilingual reviewers alongside translation DIF analyses of a health-related quality of life instrument is described. Future researchers should consider...

  1. IRIS Toxicological Review of Methanol (External Review Draft, 2013)

    Science.gov (United States)

    EPA is conducting a peer review and public comment of the scientific basis supporting the human health hazard and dose-response assessment of methanol (non-cancer) that when finalized will appear on the Integrated Risk Information System (IRIS) database.

  2. External memory aids for memory problems in people with multiple sclerosis: A systematic review.

    Science.gov (United States)

    Goodwin, Rachel; Lincoln, Nadina; das Nair, Roshan; Bateman, Andrew

    2017-12-01

    Approximately 40-60% of people with multiple sclerosis (MS) have memory problems, which adversely impact on their everyday functioning. Evidence supports the use of external memory aids in people with stroke and brain injury, and suggests they may reduce everyday memory problems in people with MS. Previous reviews of people with MS have only evaluated randomised trials; therefore this review included other methodologies. The aim was to assess the efficacy of external memory aids for people with MS for improving memory functioning, mood, quality of life, and coping strategies. Seven databases were systematically searched. Intervention studies that involved training in the use of external memory aids, e.g., personal digital assistants, with at least 75% of people with MS, were included. Based on study design, quality was rated with the SCED or PEDro scale. Nine studies involving 540 participants were included. One single case experimental design (mean of 8 on SCED scale) and eight group studies (mean of 5 on PEDro scale) were included. One study reported a significant treatment effect on subjective memory functioning, two on mood, and two on coping strategies. There is insufficient evidence to support or refute the effectiveness of external memory aids for improving memory function in people with MS.

  3. An Exploratory Study: Assessment of Modeled Dioxin Exposure in Ceramic Art Studios (External Review Draft)

    Science.gov (United States)

    EPA has released an external review draft entitled, An Exploratory Study: Assessment of Modeled Dioxin Exposure in Ceramic Art Studios(External Review Draft). The public comment period and the external peer-review workshop are separate processes that provide opportunities ...

  4. International External Quality Assurance for Laboratory Diagnosis of Diphtheria ▿

    Science.gov (United States)

    Neal, S. E.; Efstratiou, A.

    2009-01-01

    The diphtheria surveillance network (DIPNET) encompassing National Diphtheria Reference Centers from 25 European countries is a Dedicated Surveillance Network recognized by the European Commission. A key DIPNET objective is the quality assessment of microbiological procedures for diphtheria across the European Union and beyond. A detailed questionnaire on the level of reference laboratory services and an external quality assessment (EQA) panel comprising six simulated throat specimens were sent to 34 centers. Twenty-three centers are designated National Diphtheria Reference Centers, with the laboratory in the United Kingdom being the only WHO Collaborating Centre. A variety of screening and identification tests were used, including the cysteinase test (20/34 centers), pyrazinamidase test (17/34 centers), and commercial kits (25/34 centers). The classic Elek test for toxigenicity testing is mostly used (28/34 centers), with variations in serum sources and antitoxin concentrations. Many laboratories reported problems obtaining Elek reagents or media. Only six centers produced acceptable results for all six specimens. Overall, 21% of identification and 13% of toxigenicity reports were unacceptable. Many centers could not isolate the target organism, and most found difficulties with the specimens that contained Corynebacterium striatum as a commensal contaminant. Nineteen centers generated either false-positive or negative toxigenic results, which may have caused inappropriate medical management. The discrepancies in this diphtheria diagnostics EQA alarmingly reflect the urgent need to improve laboratory performance in diphtheria diagnostics in Europe, standardize feasible and robust microbiological methods, and build awareness among public health authorities. Therefore, DIPNET recommends that regular workshops and EQA distributions for diphtheria diagnostics should be supported and maintained. PMID:19828749

  5. Standardization of tumor markers - priorities identified through external quality assessment.

    Science.gov (United States)

    Sturgeon, Catharine

    2016-01-01

    Tumor markers are often heterogeneous substances that may be present in elevated concentrations in the serum of cancer patients. Typically measured by immunoassay, they contribute to clinical management, particularly in screening, case-finding, prognostic assessment, and post-treatment monitoring. Data both from external quality assessment (EQA) schemes and clinical studies demonstrate significant variation in tumor marker results obtained for the same specimen using different methods. Between-method between-laboratory coefficients of variation (CV) reported by EQA schemes generally reflect the complexity of the measurand, ranging from 25% for the complex mucinous cancer antigen 19-9 (CA19-9). Improving the standardization of tumor marker measurements is particularly important for three reasons. The primary use of tumor markers is in monitoring cancer patients over long periods of time. Clinical interpretation of trends may consequently be affected if results are obtained in different laboratories using different methods or if a laboratory has to change method. Differences in results may have major implications for adoption of area-wide decision cut-offs and make implementation of these difficult. Method-related differences also make it difficult to compare clinical studies. Improving comparability of tumor marker results requires broad international agreement about which molecular forms of the measurand have clinical utility, identifying and adopting pure molecular forms as calibrants, and defining antibody specificities for their optimal detection. These aims have been achieved to varying extents for the most frequently measured serum tumor markers as described in this paper.

  6. Results of a Quality Assurance Review of External Beam Radiation Therapy in the International Society of Paediatric Oncology (Europe) Neuroblastoma Group's High-risk Neuroblastoma Trial: A SIOPEN Study

    Energy Technology Data Exchange (ETDEWEB)

    Gaze, Mark N., E-mail: mark.gaze@uclh.nhs.uk [Department of Oncology, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Boterberg, Tom [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium); Dieckmann, Karin; Hoermann, Marcus [General Hospital Vienna, Medical University Vienna (Austria); Gains, Jennifer E.; Sullivan, Kevin P. [Department of Oncology, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Ladenstein, Ruth [Children' s Cancer Research Institute, St. Anna Children' s Hospital, Vienna (Austria)

    2013-01-01

    Purpose: Radiation therapy is important for local control in neuroblastoma. This study reviewed the compliance of plans with the radiation therapy guidelines of the International Society of Paediatric Oncology (Europe) Neuroblastoma Group (SIOPEN) High-Risk Trial protocol. Methods and Materials: The SIOPEN trial central electronic database has sections to record diagnostic imaging and radiation therapy planning data. Individual centers may upload data remotely, but not all centers involved in the trial chose to use this system. A quality scoring system was devised based on how well the radiation therapy plan matched the protocol guidelines, to what extent deviations were justified, and whether adverse effects may result. Central review of radiation therapy planning was undertaken retrospectively in 100 patients for whom complete diagnostic and treatment sets were available. Data were reviewed and compared against protocol guidelines by an international team of radiation oncologists and radiologists. For each patient in the sample, the central review team assigned a quality assurance score. Results: It was found that in 48% of patients there was full compliance with protocol requirements. In 29%, there were deviations for justifiable reasons with no likely long-term adverse effects resulting. In 5%, deviations had occurred for justifiable reasons, but that might result in adverse effects. In 1%, there was a deviation with no discernible justification, which would not lead to long-term adverse events. In 17%, unjustified deviations were noted, with a risk of an adverse outcome resulting. Conclusions: Owing to concern over the proportion of patients in whom unjustified deviations were observed, a protocol amendment has been issued. This offers the opportunity for central review of radiation therapy plans before the start of treatment and the treating clinician a chance to modify plans.

  7. External Music Examiners: Micro-Macro Tasks in Quality Assurance Practices

    Science.gov (United States)

    Ross, Valerie

    2009-01-01

    External music examiners play a significant role in assessing, verifying and maintaining musical standards. Educational output endorsed by external examiners serves to verify, modify and legitimise internal behaviour. This article examines some of the "inside practices" of external music examiners in the context of quality assurance. It compares…

  8. [External quality assessment of semen analysis in Poland].

    Science.gov (United States)

    Jedrzejczak, Piotr; Talarczyk, Joanna; Taszarek-Hauke, Grazyna; Berger, Anna; Hauke, Jan; Pawelczyk, Leszek

    2012-11-01

    Semen analysis is an important part of male infertility diagnosis and should be performed according to international recommendations. The reliability of the results depends mainly on the qualifications of the laboratory analysts. External Quality Assessment Programmes (EQAP) are performed in laboratories worldwide in order to standardize the results. The aim of this study was to perform the first in Poland comparison of the results of sperm analysis from different laboratories. Forty two Polish laboratories were invited to participate in the EQAP and eight laboratories agreed to take part in the analysis. They were sent uniform semen samples, prepared in accordance with the WHO standards: one sample for the assessment of concentration, two for motility (on DVD) and two for the morphology of the sperm (Papanicolau staining). The reference group was comprised of three employees of the Andrologic Laboratory of Poznań University of Medical Sciences, who regularly take part in EQAP organized by ESHRE. The reference group analyzed the samples from the participating laboratories. Statistic features such as mean, median, standard deviation, minimal and maximal value, first and third quartile were assessed for every examined parameter Z-score index was used to compare the differences between assessed laboratories and the reference laboratory. The acceptable Z-score range was +/-1. Average concentration in the reference group was 43 mln/ml, while in the assessed laboratories (L) it was between 31 (L4) and 72.5 mln/ml (L1). Z-score for concentration analysis in three laboratories exceeded +/- 1 (2.51 for L1, 1.42 for L2 and -1.02 for L4). In the analysis of the first sample for progressive motility the reference group received 59%, while the values of participating laboratories varied from 42,5% (L1) to 80% (L4). Most of the centers achieved Z-score within the normal range, except for L1 and L4 (-1.48 and 1.88 respectively). The reference value for the second sample for

  9. 46,XY DSD with Female or Ambiguous External Genitalia at Birth due to Androgen Insensitivity Syndrome, 5-Reductase-2 Deficiency, or 17-Hydroxysteroid Dehydrogenase Deficiency: A Review of Quality of Life Outcomes

    Directory of Open Access Journals (Sweden)

    Mazur Tom

    2009-08-01

    Full Text Available Disorders of sex development refer to a collection of congenital conditions in which atypical development of chromosomal, gonadal, or anatomic sex occurs. Studies of 46,XY DSD have focused largely on gender identity, gender role, and sexual orientation. Few studies have focused on other domains, such as physical and mental health, that may contribute to a person's quality of life. The current review focuses on information published since 1955 pertaining to psychological well-being, cognition, general health, fertility, and sexual function in people affected by androgen insensitivity syndromes, 5- reductase-2 deficiency, or 17-hydroxysteroid dehydrogenase-3 deficiency—reared male or female. The complete form of androgen insensitivity syndrome has been the focus of the largest number of investigations in domains other than gender. Despite this, all of the conditions included in the current review are under-studied. Realms identified for further study include psychological well-being, cognitive abilities, general health, fertility, and sexual function. Such investigations would not only improve the quality of life for those affected by DSD but may also provide information for improving physical and mental health in the general population.

  10. Experience of Internal and External Education Quality Rate: Esg and the Legislation of the Russian Federation

    Directory of Open Access Journals (Sweden)

    Nikanorov Ivan N.

    2017-01-01

    Full Text Available Overview of regulation of internal and external education quality rate has been presented. The development of regulation an independent assessment of higher education in Russia in the context of ESG has been considered. Authors noticed, that instruments of internal and external quality rate interact in Russian legislation insufficiently.

  11. The ability of external immobilizers to restrict movement of the cervical spine: a systematic review

    NARCIS (Netherlands)

    Holla, M.; Huisman, J.M.; Verdonschot, N.J.J.; Goosen, J.; Hosman, A.J.; Hannink, G.

    2016-01-01

    Purpose To review the ability of various types of external immobilizers to restrict cervical spine movement. Methods With a systematical review of original scientific articles, data on range of motion, type of used external immobilization device and risk of bias were extracted. The described extern

  12. Results of external review Sandia National Laboratories microelectronics and photonics program (October 2002).

    Energy Technology Data Exchange (ETDEWEB)

    Peercy, Paul S. (University of Wisconsin, Madison, WI); Myers, David R.

    2003-10-01

    The US Department of Energy requires a periodic 'self assessment' of Sandia's Microsystems Program. An external panel review of this program is held approximately every 18 months, and the report from the external review panel serves as the basis for the DOE 'self assessment.' The review for this fiscal year was held on September 30-October 1, 2002 at Sandia National Laboratories, Albuquerque, NM. The panel was comprised of experts in the fields of microelectronics, photonics and microsystems from universities, industry and other Government agencies. A complete list of the panel members is shown as Appendix A to the attached report. The review assesses four areas: relevance to national needs and agency mission; quality of science technology and engineering; performance in the operation of a major facility; and program performance management and planning. Relevance to national needs and agency mission was rated as 'outstanding.' The quality of science, technology, and engineering was rated as 'outstanding.' Operation of a major facility was noted as 'outstanding,' while the category of program performance, management, and planning was rated as 'outstanding.' Sandia's Microsystems Program received an overall rating of 'outstanding' [the highest possible rating]. The attached report was prepared by the panel in a format requested by Sandia to conform with the performance criteria for the DOE self assessment.

  13. [Standardization in laboratory hematology by participating in external quality assurance programs].

    Science.gov (United States)

    Nazor, Aida; Siftar, Zoran; Flegar-Mestrić, Zlata

    2011-09-01

    Since 1985, Department of Clinical Chemistry and Laboratory Medicine, Merkur University Hospital, Zagreb, has been participating in the International External Quality Assessment Scheme for Hematology (IEQAS-H) organized by the World Health Organization (WHO). Owing to very good results, in 1987 the Department received a certificate of participation in this control scheme. Department has been cooperating in the external quality assessment program in laboratory hematology which has been continuously performed in Croatia since 1986 by the Committee for External Quality Assessment Schemes under the auspices of the Croatian Society of Medical Biochemists and School of Pharmacy and Biochemistry, University of Zagreb. Nowadays, 186 medical biochemical laboratories are included in the National External Quality Assessment program, which is performed three times per year. Our Department has participated in the international projects of the European Committee for External Quality Assurance Programs in Laboratory Medicine (EQALM).

  14. Migration and income transfers in the presence of labor quality externalities

    NARCIS (Netherlands)

    Huizinga, H.P.

    1994-01-01

    In this paper, a worker's productivity is assumed to depend on his own quality and on the average quality of other workers in the same country. The external effects associated with worker quality give rise to increasing returns to average worker quality. As a result, free migration generally reduces

  15. Anatomy and history of an external quality assessment program for interpretative comments in clinical biochemistry.

    Science.gov (United States)

    Vasikaran, Samuel D

    2015-05-01

    The provision of clinical interpretation of results, either verbally or in the printed report, may be considered an integral part of clinical biochemistry diagnostic service. Proficiency testing or external quality assessment (EQA) of such activity may be useful in education, training, continuing professional development and ensuring the quality of such service. Details of the Patient Report Comments Program (RPCProgram) developed by the Royal College of Pathologists of Australasia (RCPA) Chemical Pathology Quality Assurance Programs Pty Ltd (QAP) is described in this review. The program is aimed at pathologists, clinical scientists and trainees. Registered participants are provided a report with case details and a set of clinical biochemistry results at monthly intervals and submit an interpretative comment for the report. Comments received are broken up into components that are translated into common key phrases. An expert panel evaluates the key phrases, classifies them according to appropriateness and drafts a suggested comment, a case summary and a rationale, which are included in a summary report returned to participants. There is considerable diversity in the quality of interpretative comments received from participants of the PRCProgram. The primary purpose of EQA of interpretative commenting is educational self-assessment, and they are recognized as a continuing professional development activity. Whilst there is some evidence for the utility of interpretative comments in improving patient outcomes, evidence for the utility of EQA in improving quality of comments is awaited.

  16. 上海地区细菌鉴定项目室间质量评价的23年回顾%Review on external quality assessment of bacterial identification items in Shanghai for past 23 years

    Institute of Scientific and Technical Information of China (English)

    陈蓉; 徐蓉; 刘学杰; 葛平

    2015-01-01

    Objective To study the determination quality of microbiology external quality assessment (EQA)of bacterial identification items in Shanghai medical institutions for past 23 years.Methods Firstly,the EQA activity frequency,grouping,quality control material characteristic,transportation mode and returning way were analyzed.The results of microbiology bacterial identification items among participating laboratories in EQA of Shanghai Center for Clinical Laboratory (SCCL)from 1 992 to 201 4 were collected and analyzed statistically.The coincidence for the determinations of 1 4 major bacteria was analyzed statistically.Results EQA activity frequency reduced from 4 times per year to 2 times per year,and the number of samples increased from 3 samples per time to 5 samples per time. Subjects were not classified before,and now subjects did grouping.Before 2007,quality control materials were puncture-like semi-solid,after that,quality control materials were treated by freeze-drying technology as lyophilized form.Transportation modes were from taking by medical personnels themselves to cold chain system delivery in order to monitor whole process.Returning way was from paper to web uploading.The number of participating laboratories increased from 80 to 1 34 now,and the increasing rate was about 68%.The pass rate (score ≥80)and the excellent rate (score =1 00)increased year by year.The pass rate in 201 4 was 1 00%,and the excellent rate in 201 4 was 90%. The participating isolates were 23 genera with 1 05 kinds,and the coincidence rates of Staphylococcus,Enterococcus and Enterobacteriaceae identification were high,and many of them reached 1 00%.Conclusions The change of EQA activity mode makes it more equitable and standard for quality assessment.The microbiology bacterial identification quality increases year by year in Shanghai medical institutions,providing accurate results for clinic.%目的:了解上海市医疗机构近23年来微生物室间质量评价(EQA)细

  17. 76 FR 67439 - External Peer Review Meeting for Draft Microbial Risk Assessment Guideline: Pathogenic...

    Science.gov (United States)

    2011-11-01

    ... AGENCY External Peer Review Meeting for Draft Microbial Risk Assessment Guideline: Pathogenic... attend this peer review meeting as observers. Time will be set aside at the meeting for observers to give... the draft document, EPA intends to consider the comments from the external peer review meeting,...

  18. 75 FR 18205 - Notice of Peer Review Meeting for the External Peer Review Drafts of Two Documents on Using...

    Science.gov (United States)

    2010-04-09

    ... AGENCY Notice of Peer Review Meeting for the External Peer Review Drafts of Two Documents on Using... Agency (EPA). ACTION: Notice of Peer Review Meeting with Opportunity for Public Comment. SUMMARY: EPA is announcing that Eastern Research Group, Inc. (ERG), an EPA contractor for external scientific peer...

  19. External Integration on Agri-Food Supply Chain: A review to the state of the art

    Directory of Open Access Journals (Sweden)

    Andrés Felipe Ruiz Moreno

    2015-08-01

    Full Text Available Supply Chain Integration (SCI has been broadly taken into account due to its strategic importance; however, there are a few agri food supply chain studies. The purpose of this paper is to review the SCI focused on the external integration mechanisms impact on agri food supply chain performance. The results shows that external integration mechanisms most used have been information sharing and joint decision making, while efficiency has been frequently used as a performance indicators. The review identifies the need to assess several external integration mechanisms simultaneously on Supply Chain performance emphasizes on the importance to research in joint decision making mechanism, such as Vendor Managed Inventory (VMI and Collaborative planning, forecasting, and replenishment (CPFR. For performance measurement, it is needed to include at least one indicator for each category (Efficiency, Flexibility, Responsiveness and Food Quality of the Agri Food Supply Chain performance framework described, whereas for measuring Agri Food logistics performance is required further research on modes (process management and means (resources logistics.

  20. Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

    Science.gov (United States)

    Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

    2015-01-01

    The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

  1. Review on studies for external cost of nuclear power generation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Heung [Korea National University of Transportation, Chungju (Korea, Republic of); Ko, Won Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-12-15

    External cost is cost imposed on a third party when producing or consuming a good or service. Since the 1990s, the external costs of nuclear powered electricity production have been studied. Costs are a very important factor in policy decision and the external cost is considered for cost comparison on electricity production. As for nuclear fuel cycle, a chosen technology will determine the external cost. However, there has been little research on this issue. For this study, methods for external cost on nuclear power production have been surveyed and analyzed to develop an approach for evaluating external cost on nuclear fuel cycles. Before the Fukushima accident, external cost research had focused on damage costs during normal operation of a fuel cycle. However, accident cost becomes a major concern after the accident. Various considerations for external cost including accident cost have been used to different studies, and different methods have been applied corresponding to the considerations. In this study, the results of the evaluation were compared and analyzed to identify methodological applicability to the external cost estimation with nuclear fuel cycles.

  2. Effects of growth conditions on external quality of cut chrysanthemum; analysis and simulation

    NARCIS (Netherlands)

    Carvalho, S.M.P.

    2003-01-01

    For many years the emphasis in floricultural research laid with quantity rather than quality. Nowadays, since the prices are often determined on the basis of visual quality aspects, the so-called external quality, chrysanthemum growers aim to provide a high and constant product qualit

  3. [The external evaluation of study quality: the role in maintaining the reliability of laboratory information].

    Science.gov (United States)

    Men'shikov, V V

    2013-08-01

    The external evaluation of quality of clinical laboratory examinations was gradually introduced in USSR medical laboratories since 1970s. In Russia, in the middle of 1990 a unified all-national system of external evaluation quality was organized known as the Federal center of external evaluation of quality at the basis of laboratory of the state research center of preventive medicine. The main positions of policy in this area were neatly formulated in the guidance documents of ministry of Health. Nowadays, the center of external evaluation of quality proposes 100 and more types of control studies and permanently extends their specter starting from interests of different disciplines of clinical medicine. The consistent participation of laboratories in the cycles of external evaluation of quality intrinsically promotes improvement of indicators of properness and precision of analysis results and increases reliability of laboratory information. However, a significant percentage of laboratories does not participate at all in external evaluation of quality or takes part in control process irregularly and in limited number of tests. The managers of a number of medical organizations disregard the application of the proposed possibilities to increase reliability of laboratory information and limit financing of studies in the field of quality control. The article proposes to adopt the national standard on the basis of ISO 17043 "Evaluation of compliance. The common requirements of professional competence testing".

  4. Checklist for Reviewing EPA Quality Management Plans

    Science.gov (United States)

    This checklist will be used to review the Quality Management Plans (QMPs) that are submitted to the Quality Staff of the Office of Environmental Information (OEI) for Agency review under EPA Order 5360.1 A2.

  5. The Importance of Reagent Lot Registration in External Quality Assurance/Proficiency Testing Schemes

    National Research Council Canada - National Science Library

    Stavelin, Anne; Riksheim, Berit Oddny; Christensen, Nina Gade; Sandberg, Sverre

    2016-01-01

    Providers of external quality assurance (EQA)/proficiency testing schemes have traditionally focused on evaluation of measurement procedures and participant performance and little attention has been given to reagent lot variation...

  6. 75 FR 70160 - Affordable Care Act; Federal External Review Process; Request for Information

    Science.gov (United States)

    2010-11-17

    ... Administration 29 CFR Part 2590 Affordable Care Act; Federal External Review Process; Request for Information... Act, as amended by the Affordable Care Act, and its implementing regulations. DATES: Submit written or... and external review processes under the Affordable Care Act; those comments are being collected...

  7. Two decades of external peer review of cancer care in general hospitals; the Dutch experience

    NARCIS (Netherlands)

    Kilsdonk, M.J.; Siesling, S.; Otter, R.; Harten, van W.H.

    2015-01-01

    External peer review was introduced in general hospitals in the Netherlands in 1994 to assess and improve the multidisciplinary team approach in cancer care. This paper aims to explore the value, perceived impact, and (future) role of external peer review in cancer care. Semistructured interviews we

  8. Should Rehabilitation Specialists Use External Focus Instructions When Motor Learning Is Fostered? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Tanja H. Kakebeeke

    2013-06-01

    Full Text Available According to the Constrained Action Hypothesis, motor learning is believed to be more efficient when an external focus (EF of motor control is given to the performer instead of an internal focus (IF of motor control. This systematic review investigated whether findings of studies focusing on the Constrained Action Hypothesis may be transferred to rehabilitation settings by assessing the methodological quality and risk of bias (ROB of available randomized controlled trials (RCTs. Of the 18 selected reports representing 20 RCTs, the methodological quality was rather low, and the majority of the reports appeared to have a high ROB. The 18 reports included 68 patients tested in a rehabilitation setting and 725 healthy participants. The time scale of the motor learning processes presented in the selected articles was heterogenic. The results of this systematic review indicate that the assumption that an external focus of control is to be preferred during motor learning processes is not sufficiently substantiated. The level of available evidence is not large enough to warrant transfer to patient populations (including children and the elderly and raises doubts about research with healthy individuals. This implies that based on the methodology used so far, there seems to be insufficient evidence for the superiority of an external focus of control, neither in healthy individuals nor in clinical populations. The relationship between EF instructions and motor learning research and its effect in both patient rehabilitation settings and healthy populations requires further exploration. Future adequately powered studies with low ROB and with rehabilitation populations that are followed over extended time periods should, therefore, be performed to substantiate or refute the assumption of the superiority of an EF in motor learning.

  9. The Spanish external quality assessment scheme for lead in blood.

    Science.gov (United States)

    Marcuello, D

    1996-01-01

    In 1985 the Instituto Nacional de Seguridad e Higiene en el Trabajo (INSHT) established the "Programa Interlaboratorios de Control de Calidad de Plomo en Sangre (PICC-PbS)". The operation of this scheme is explained, criteria for evaluation of laboratory performance are defined and some results obtained are reviewed.

  10. Quality assurance of U.S.-guided external beam radiotherapy for prostate cancer: report of AAPM Task Group 154.

    Science.gov (United States)

    Molloy, Janelle A; Chan, Gordon; Markovic, Alexander; McNeeley, Shawn; Pfeiffer, Doug; Salter, Bill; Tome, Wolfgang A

    2011-02-01

    Task Group 154 (TG154) of the American Association of Physicists in Medicine (AAPM) was created to produce a guidance document for clinical medical physicists describing recommended quality assurance (QA) procedures for ultrasound (U.S.)-guided external beam radiotherapy localization. This report describes the relevant literature, state of the art, and briefly summarizes U.S. imaging physics. Simulation, treatment planning and treatment delivery considerations are presented in order to improve consistency and accuracy. User training is emphasized in the report and recommendations regarding peer review are included. A set of thorough, yet practical, QA procedures, frequencies, and tolerances are recommended. These encompass recommendations to ensure both spatial accuracy and image quality.

  11. [Significance of participation in programs of external quality assessment in molecular diagnostic--our experience].

    Science.gov (United States)

    Paro, Mirjana Mariana Kardum; Siftar, Zoran; Juretić, Dubravka; Flegar-Mestrić, Zlata

    2011-09-01

    Harmonization of molecular diagnostic tests in laboratories in the Republic of Croatia has only just started. According to laboratory accreditation standard ISO 15189 participation in external quality assessment (EQA) schemes or programs is a prerequisite and support tool for clinical laboratory accreditation process. As there are no national quality assurance schemes yet, an European external quality assessment (EQA) scheme or program should be found. Because of variation in the molecular diagnostic test performance of clinical laboratories across Europe, EQA is recognized as a system whereby a set of reagents and techniques are assessed by an external provider making inter-laboratory performance comparability possible through already integrated recommendations and practice guidelines of molecular diagnostic test performance. Today, wide range of various EQA schemes and programs already in action have been available and most of them began within the last ten years. This paper is therefore intended to present and summarize the four-year EQA activities in the Institute of Clinical Chemistry, Merkur University Hospital, in three different international EQA schemes: United Kingdom National External Quality Assessment Scheme (UK NEQAS), the European Molecular Genetic Quality Network (EMQN) and Multi-National External Quality Assay program (EQUAL- qual)) and to point out their educational role in standardization of laboratory performance of any test intended for patient testing. from a laboratory point of view.

  12. A quality audit program for external beam radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-12-31

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

  13. The Dynamics of Divorce: Marital Quality, Alternative Attractions and External Pressures.

    Science.gov (United States)

    Green, Robert G.; Sporakowski, Michael J.

    1983-01-01

    Tested Lewis and Spanier's theory of marital quality and marital stability using a sample of 131 married and 166 divorced social survey respondents. Examined the relationship between the quality and stability of their marriages and assessed the influence of alternative attractions and external pressures to remain married. (JAC)

  14. Current landscape and new paradigms of proficiency testing and external quality assessment for molecular genetics.

    Science.gov (United States)

    Kalman, Lisa V; Lubin, Ira M; Barker, Shannon; du Sart, Desiree; Elles, Rob; Grody, Wayne W; Pazzagli, Mario; Richards, Sue; Schrijver, Iris; Zehnbauer, Barbara

    2013-07-01

    Participation in proficiency testing (PT) or external quality assessment (EQA) programs allows the assessment and comparison of test performance among different clinical laboratories and technologies. In addition to the approximately 2300 tests for individual genetic disorders, recent advances in technology have enabled the development of clinical tests that quickly and economically analyze the entire human genome. New PT/EQA approaches are needed to ensure the continued quality of these complex tests. To review the availability and scope of PT/EQA for molecular genetic testing for inherited conditions in Europe, Australasia, and the United States; to evaluate the successes and demonstrated value of available PT/EQA programs; and to examine the challenges to the provision of comprehensive PT/EQA posed by new laboratory practices and methodologies. The available literature on this topic was reviewed and supplemented with personal experiences of several PT/EQA providers. Proficiency testing/EQA schemes are available for common genetic disorders tested in many clinical laboratories but are not available for most genetic tests offered by only one or a few laboratories. Provision of broad, method-based PT schemes, such as DNA sequencing, would allow assessment of many tests for which formal PT is not currently available. Participation in PT/EQA improves the quality of testing by identifying inaccuracies that laboratories can trace to errors in their testing processes. Areas of research and development to ensure that PT/EQA programs can meet the needs of new and evolving genetic tests and technologies are identified and discussed.

  15. The Spanish external quality assessment scheme for mercury in urine.

    Science.gov (United States)

    Quintana, M J; Mazarrasa, O

    1996-01-01

    In 1986 the Instituto Nacional de Seguridad e Higiene en el Trabajo (INSHT), established the "Programa interlaboratorios de control de calidad de mercurio en orina (PICC-HgU)". The operation of this scheme is explained, criteria for evaluation of laboratory performance are defined and some results obtained are reviewed. Since the scheme started, an improvement in the overall performance of laboratories has been observed. The differences in the analytical methods used by laboratories do not seem to have a clear influence on the results.

  16. Book Review: EU External Relations Law: Text, Cases and Materials

    Directory of Open Access Journals (Sweden)

    Graham Butler

    2014-06-01

    Full Text Available This latest textbook contributing to the field of EU external relations law is unique in that it is the first such book in the post-Treaty of Lisbon environment to take a wide-angled look on as many aspects of the growing area as it continues to develop within the legal parameters as set by the Treaties, and it is suitably placed to become the core text for teaching this expanding EU policy field. In their book, EU External Relations Law: Text, Cases and Materials, Van Vooren and Wessel seek to fill the gap in up-to-date literature from a legal standpoint in the field of external relations of the EU, with a book that is suitable for delivery as a core textbook for students of all levels. Their analysis covering fifteen long chapters offers the reader a comprehensive insight into the world of EU external relations law, and allows for a thoroughly better understanding of all the encapsulated issues that are at play.

  17. 75 FR 39253 - Release of Second Draft Document Related to the Review of the National Ambient Air Quality...

    Science.gov (United States)

    2010-07-08

    ... AGENCY Release of Second Draft Document Related to the Review of the National Ambient Air Quality... Assessment for the Review of the Particulate Matter National Ambient Air Quality Standards--Second External... revise the standards as part of the review of the national ambient air quality standards (NAAQS)...

  18. External suction versus water seal after selective pulmonary resection for lung neoplasm: a systematic review.

    Directory of Open Access Journals (Sweden)

    Tong Qiu

    whether external suction should be routinely applied after lung neoplasm SPR. More high-quality randomized controlled trials are needed. SYSTEMATIC REVIEW REGISTRATION: None.

  19. [Analysis of the results of the SEIMC External Quality Control Program. Year 2013].

    Science.gov (United States)

    de Gopegui Bordes, Enrique Ruiz; Orta Mira, Nieves; Del Remedio Guna Serrano, M; Medina González, Rafael; Rosario Ovies, María; Poveda, Marta; Gimeno Cardona, Concepción

    2015-07-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology, molecular microbiology and HIV-1, HCV and HBV viral loads. This manuscript presents the analysis of results obtained of the participants from the 2013 SEIMC External Quality Control Programme, except viral loads controls, that they are summarized in a manuscript abroad. As a whole, the results obtained in 2013 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests.

  20. Preliminary perspectives gaines from individual plant examination of external events (IPEEE) seismic and fire submittal review

    Energy Technology Data Exchange (ETDEWEB)

    Chen, J.T.; Connell, E.; Chokshi, N. [NRC, Washington, DC (United States)] [and others

    1997-02-01

    As a result of the U.S. Nuclear Regulatory Commission (USNRC) initiated Individual plant Examination of External Events (IPEEE) program, every operating nuclear power reactor in the United States has performed an assessment of severe accident due to external events. This paper provides a summary of the preliminary insights gained through the review of 24 IPEEE submittals.

  1. [Analysis of the results of the SEIMC External Quality Control Program. Year 2008].

    Science.gov (United States)

    Serrano, María del Remedio Guna; Mira, Nieves Orta; de Gopegui, Enrique Ruiz; Ovies, María Rosario; Cardona, Concepción Gimeno; Pérez, José L

    2010-01-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria and virology. This article present the most relevant conclusions and lessons from the 2008 controls. As a whole, the results obtained in 2008 confirm the excellent skill and good technical standards of the microbiology laboratories in Spain found in previous editions. However, a few deviations can be obtained in any laboratory, even in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal an external controls in order to assure the maximal quality of the microbiological tests.

  2. [Analysis of the results of the SEIMC External Quality Control Program. Year 2012].

    Science.gov (United States)

    de Gopegui Bordes, Enrique Ruiz; Guna Serrano, M del Remedio; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Gimeno Cardona, Concepción

    2014-02-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2012 controls. As a whole, the results obtained in 2012 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests.

  3. [Analysis of the results of the SEIMC External Quality Control Program. Year 2014].

    Science.gov (United States)

    Gopegui Bordes, Enrique Ruiz de; Guna Serrano, M Del Remedio; Orta Mira, Nieves; Medina González, Rafael; Rosario Ovies, María; Poveda, Marta; Gimeno Cardona, Concepción

    2016-07-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2014 controls. As a whole, the results obtained in 2014 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of the SEIMC program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests.

  4. Cutaneous Neuroendocrine Carcinoma of the External Auditory Canal: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Yi-Ke Li

    2012-01-01

    Full Text Available Cutaneous neuroendocrine carcinoma (cNEC is rarely seen in the external ear. In this paper, we newly describe a patient with cNEC in his right external auditory canal, followed by a further discussion on the clinical features, diagnosis, and treatments of cNEC of the external ear. A review of the literature showed that cNEC of the external auditory canal generally presents as asymptomatic and that pathology yields the most confirmative diagnosis. A wide resection with adjuvant radiotherapy and chemotherapy is recommended. The overall prognosis of this condition is poor.

  5. IRIS Toxicological Review of Hexahydro-1,3,5-Trinitro-1,3,5-Triazine (Rdx) (External Review Draft)

    Science.gov (United States)

    The IRIS Toxicological Review of Hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) was released for external peer review in September 2016. The EPA’s Science Advisory Board’s (SAB) Chemical Assessment Advisory Committee (CAAC) will conduct a peer review of the scientific basis suppor...

  6. External Quality Assessment Unravels Interlaboratory Differences in Quality of RAS Testing for Anti-EGFR Therapy in Colorectal Cancer

    NARCIS (Netherlands)

    Tack, V.; Ligtenberg, M.J.L.; Tembuyser, L.; Normanno, N.; Borght, S. van der; Krieken, J.H. van; Dequeker, E.M.

    2015-01-01

    BACKGROUND: Regulations for the selection of patients with metastatic colorectal cancer for anti-EGFR treatment changed at the end of 2013. The set of mutations to be tested extended from KRAS codons 12 and 13 to KRAS and NRAS exons 2, 3, and 4. A European external quality assessment scheme monitore

  7. International external quality assessment study for molecular detection of Lassa virus.

    Directory of Open Access Journals (Sweden)

    Sergejs Nikisins

    2015-05-01

    Full Text Available Lassa virus (LASV is a causative agent of hemorrhagic fever in West Africa. In recent years, it has been imported several times to Europe and North America. The method of choice for early detection of LASV in blood is RT-PCR. Therefore, the European Network for Diagnostics of 'Imported' Viral Diseases (ENIVD performed an external quality assessment (EQA study for molecular detection of LASV. A proficiency panel of 13 samples containing various concentrations of inactivated LASV strains Josiah, Lib-1580/121, CSF, or AV was prepared. Samples containing the LASV-related lymphocytic choriomeningitis virus (LCMV and negative sera were included as specificity controls. Twenty-four laboratories from 17 countries (13 European, one African, one Asian, two American countries participated in the study. Thirteen laboratories (54% reported correct results, 4 (17% laboratories reported 1 to 2 false-negative results, and 7 (29% laboratories reported 3 to 5 false-negative results. This EQA study indicates that most participating laboratories have a good or acceptable performance in molecular detection of LASV. However, several laboratories need to review and improve their diagnostic procedures.

  8. International external quality assessment study for molecular detection of Lassa virus.

    Science.gov (United States)

    Nikisins, Sergejs; Rieger, Toni; Patel, Pranav; Müller, Rolf; Günther, Stephan; Niedrig, Matthias

    2015-05-01

    Lassa virus (LASV) is a causative agent of hemorrhagic fever in West Africa. In recent years, it has been imported several times to Europe and North America. The method of choice for early detection of LASV in blood is RT-PCR. Therefore, the European Network for Diagnostics of 'Imported' Viral Diseases (ENIVD) performed an external quality assessment (EQA) study for molecular detection of LASV. A proficiency panel of 13 samples containing various concentrations of inactivated LASV strains Josiah, Lib-1580/121, CSF, or AV was prepared. Samples containing the LASV-related lymphocytic choriomeningitis virus (LCMV) and negative sera were included as specificity controls. Twenty-four laboratories from 17 countries (13 European, one African, one Asian, two American countries) participated in the study. Thirteen laboratories (54%) reported correct results, 4 (17%) laboratories reported 1 to 2 false-negative results, and 7 (29%) laboratories reported 3 to 5 false-negative results. This EQA study indicates that most participating laboratories have a good or acceptable performance in molecular detection of LASV. However, several laboratories need to review and improve their diagnostic procedures.

  9. Lactation studies of anticonvulsants : A quality review

    NARCIS (Netherlands)

    van der Meer, Douwe H.; Wieringa, Andre; Wegner, Ilse; Wilffert, Bob; Ter Horst, Peter G.J.

    2015-01-01

    AIM: The aim of this review was to investigate the quality of the current literature on the transfer of anticonvulsants to breast milk to provide an overview of which anticonvulsants are in need of further research. METHODS: We reviewed the quality of the available lactation studies for 19 anticonvu

  10. Lactation studies of anticonvulsants : A quality review

    NARCIS (Netherlands)

    van der Meer, Douwe H.; Wieringa, Andre; Wegner, Ilse; Wilffert, Bob; Ter Horst, Peter G.J.

    2015-01-01

    AIM: The aim of this review was to investigate the quality of the current literature on the transfer of anticonvulsants to breast milk to provide an overview of which anticonvulsants are in need of further research. METHODS: We reviewed the quality of the available lactation studies for 19

  11. Assessing the Organisational Impact of External Quality Assurance: Hypothesising Key Dimensions and Mechanisms

    Science.gov (United States)

    Stensaker, Bjørn; Leiber, Theodor

    2015-01-01

    The aim of the article is to provide a framework in which the organisational impact of external quality assurance (EQA) can be assessed. Based on existing studies of the impact of EQA in universities and colleges it is suggested that greater systematisation of how impact is measured is needed for a better understanding of how EQA can be used as a…

  12. Pilot Experience with an External Quality Assurance Scheme for Acylcarnitines in Plasma/Serum

    NARCIS (Netherlands)

    Sala, P Ruiz; Ruijter, G; Acquaviva, C; Chabli, A; de Sain-van der Velden, M G M; Garcia-Villoria, J; Heiner-Fokkema, M R; Jeannesson-Thivisol, E; Leckstrom, K; Franzson, L; Lynes, G; Olesen, J; Onkenhout, W; Petrou, P; Drousiotou, A; Ribes, A; Vianey-Saban, C; Merinero, B

    2016-01-01

    The analysis of acylcarnitines (AC) in plasma/serum is established as a useful test for the biochemical diagnosis and the monitoring of treatment of organic acidurias and fatty acid oxidation defects. External quality assurance (EQA) for qualitative and quantitative AC is offered by ERNDIM and CDC i

  13. Guideline on the requirements of external quality assessment programs in molecular pathology

    NARCIS (Netherlands)

    van Krieken, J Han; Normanno, Nicola; Blackhall, Fiona; Boone, Elke; Botti, Gerardo; Carneiro, Fatima; Celik, Ilhan; Ciardiello, Fortunato; Cree, Ian A; Deans, Zandra C; Edsjö, Anders; Groenen, Patricia J T A; Kamarainen, Outi; Kreipe, Hans H; Ligtenberg, Marjolijn J L; Marchetti, Antonio; Murray, Samuel; Opdam, Frank J M; Patterson, Scott D; Patton, Simon; Pinto, Carmine; Rouleau, Etienne; Schuuring, Ed; Sterck, Silke; Taron, Miquel; Tejpar, Sabine; Timens, Wim; Thunnissen, Erik; van de Ven, Peter M; Siebers, Albert G; Dequeker, Elisabeth

    Molecular pathology is an integral part of daily diagnostic pathology and used for classification of tumors, for prediction of prognosis and response to therapy, and to support treatment decisions. For these reasons, analyses in molecular pathology must be highly reliable and hence external quality

  14. Guideline on the requirements of external quality assessment programs in molecular pathology

    NARCIS (Netherlands)

    Krieken, J.H. van; Normanno, N.; Blackhall, F.; Boone, E.; Botti, G.; Carneiro, F.; Celik, I.; Ciardiello, F.; Cree, I.A.; Deans, Z.C.; Edsjo, A.; Groenen, P.J.T.A.; Kamarainen, O.; Kreipe, H.H.; Ligtenberg, M.J.L.; Marchetti, A.; Murray, S.; Opdam, F.J.M.; Patterson, S.D.; Patton, S.; Pinto, C.; Rouleau, E.; Schuuring, E.; Sterck, S.; Taron, M.; Tejpar, S.; Timens, W.; Thunnissen, E.; Ven, P.M. van de; Siebers, A.G.; Dequeker, E.

    2013-01-01

    Molecular pathology is an integral part of daily diagnostic pathology and used for classification of tumors, for prediction of prognosis and response to therapy, and to support treatment decisions. For these reasons, analyses in molecular pathology must be highly reliable and hence external quality

  15. Pilot Experience with an External Quality Assurance Scheme for Acylcarnitines in Plasma/Serum

    NARCIS (Netherlands)

    Sala, P Ruiz; Ruijter, G; Acquaviva, C; Chabli, A; de Sain-van der Velden, M G M; Garcia-Villoria, J; Heiner-Fokkema, M R; Jeannesson-Thivisol, E; Leckstrom, K; Franzson, L; Lynes, G; Olesen, J; Onkenhout, W; Petrou, P; Drousiotou, A; Ribes, A; Vianey-Saban, C; Merinero, B

    2016-01-01

    The analysis of acylcarnitines (AC) in plasma/serum is established as a useful test for the biochemical diagnosis and the monitoring of treatment of organic acidurias and fatty acid oxidation defects. External quality assurance (EQA) for qualitative and quantitative AC is offered by ERNDIM and CDC

  16. The Impact of External Quality Assessment on Universities: The Estonian Experience

    Science.gov (United States)

    Vilgats, Birgit; Heidmets, Mati

    2011-01-01

    This article seeks to establish what impact external quality assessment had on universities in Estonia between 1997 and 2009. It is based on a study of the analysis of experts' reports of curricula accreditation and interviews with university and programme managers, undertaken between 2007 and 2009. The study included an analysis of 12 curricula…

  17. Longitudinal Associations between Externalizing Problems and Student-Teacher Relationship Quality for Young Children with ASD

    Science.gov (United States)

    Eisenhower, Abbey S.; Blacher, Jan; Bush Hurst, Hillary

    2015-01-01

    The associations between student-teacher relationship (STR) quality and externalizing behavior problems in school were examined among 166 children with ASD (82% boys, ages 4-7 years) across three assessments over a 1.5-year period; IQs in the sample range from 50 to 139 (M = 88.7). Unlike other non-ASD populations, the association between STR…

  18. Harmonisation of serum dihydrotestosterone analysis: establishment of an external quality assurance program.

    Science.gov (United States)

    Greaves, Ronda F; Jolly, Lisa; Hartmann, Michaela F; Ho, Chung Shun; Kam, Richard K T; Joseph, John; Boyder, Conchita; Wudy, Stefan A

    2017-03-01

    Serum dihydrotestosterone (DHT) is an important analyte for the clinical assessment of disorders of sex development. It is also reportedly a difficult analyte to measure. Currently, there are significant gaps in the standardisation of this analyte, including no external quality assurance (EQA) program available worldwide to allow for peer review performance of DHT. We therefore proposed to establish a pilot EQA program for serum DHT. DHT was assessed in the 2015 Royal College of Pathologists of Australasia Quality Assurance Programs' Endocrine program material. The material's target (i.e. "true") values were established using a measurement procedure based on isotope dilution gas chromatography (GC) tandem mass spectrometry (MS/MS). DHT calibrator values were based on weighed values of pure DHT material (>97.5% purity) from Sigma. The allowable limits of performance (ALP) were established as ±0.1 up to 0.5 nmol/L and ±15% for targets >0.5 nmol/L. Target values for the six levels of RCPAQAP material for DHT ranged from 0.02 to 0.43 nmol/L (0.01-0.12 ng/mL). The material demonstrated linearity across the six levels. There were seven participating laboratories for this pilot study. Results of the liquid chromatography (LC) MS/MS methods were within the ALP; whereas the results from the immunoassay methods were consistently higher than the target values and outside the ALP. This report provides the first peer comparison of serum DHT measured by mass spectrometry (MS) and immunoassay laboratories. Establishment of this program provides one of the pillars to achieve method harmonisation. This supports accurate clinical decisions where DHT measurement is required.

  19. A review of ureteral injuries after external trauma

    Science.gov (United States)

    2010-01-01

    Introduction Ureteral trauma is rare, accounting for less than 1% of all urologic traumas. However, a missed ureteral injury can result in significant morbidity and mortality. The purpose of this article is to review the literature since 1961 with the primary objective to present the largest medical literature review, to date, regarding ureteral trauma. Several anatomic and physiologic considerations are paramount regarding ureteral injuries management. Literature review Eighty-one articles pertaining to traumatic ureteral injuries were reviewed. Data from these studies were compiled and analyzed. The majority of the study population was young males. The proximal ureter was the most frequently injured portion. Associated injuries were present in 90.4% of patients. Admission urinalysis demonstrated hematuria in only 44.4% patients. Intravenous ureterogram (IVU) failed to diagnose ureteral injuries either upon admission or in the operating room in 42.8% of cases. Ureteroureterostomy, with or without indwelling stent, was the surgical procedure of choice for both trauma surgeons and urologists (59%). Complications occurred in 36.2% of cases. The mortality rate was 17%. Conclusion The mechanism for ureteral injuries in adults is more commonly penetrating than blunt. The upper third of the ureter is more often injured than the middle and lower thirds. Associated injuries are frequently present. CT scan and retrograde pyelography accurately identify ureteral injuries when performed together. Ureteroureterostomy, with or without indwelling stent, is the surgical procedure of choice of both trauma surgeons and urologists alike. Delay in diagnosis is correlated with a poor prognosis. PMID:20128905

  20. [Quality of German medical services: a review].

    Science.gov (United States)

    Braun, J; Robbers, J; Lakomek, H-J

    2016-02-01

    In the current draft of the law on the reform of the support structures of hospital provision (German Hospital Structure Law) the future quality of provision is highly significant. Quality assurance measures are mandatory for hospitals. The Federal General Committee was legally charged with developing the relevant quality indicators for structural, procedural and outcome quality that are designed to form the criteria and the basis for planning decisions in the federal states. This involves a paradigm shift in quality assurance measures in hospitals. In the future, subject to the verified quality, this should have an influence on hospital planning, and the funding or regulation of hospital departments should also adhere to this prescribed quality. This review reveals the course of quality or quality assurance measures in medical services in Germany. The status of the institutions responsible for the quality of care in hospitals and the significance of quality indicators are explained.

  1. External Quality Assessment in the Evaluation of Laboratory Performance of Faecal Culture.

    Science.gov (United States)

    Kiiskinen, Salla J; Ojanen, Tarja; Björkman, Yvonne; Laitinen, Harri; Siitonen, Anja

    2017-01-01

    In Finland, all laboratories carrying out diagnostics of infectious diseases in humans are approved by the Regional State Administrative Agencies and are obligated to participate in External Quality Assurance rounds. Performance in these rounds is thought to reflect the quality of laboratory work. In the 6-year study period, 17 Finnish laboratories received 48 simulated faecal specimens for the culturing of diarrhoeal pathogens, yielding altogether 586 faecal culture External Quality Control specimens and 581 reports. The results were correct in 92% of all reports and in 67% of all specimens. False-negative Salmonella results were given for 2 of the 18 specimens, one with biochemically atypical Salmonella strain and the other with a low count of Salmonella cells. False-negative Shigella report was given for 6 of the 7 specimens in some participating laboratory. Detection of all common faecal pathogens is especially relevant to patient safety, public health, and epidemiological surveillance.

  2. A review of ureteral injuries after external trauma

    Directory of Open Access Journals (Sweden)

    Marttos Antonio C

    2010-02-01

    Full Text Available Abstract Introduction Ureteral trauma is rare, accounting for less than 1% of all urologic traumas. However, a missed ureteral injury can result in significant morbidity and mortality. The purpose of this article is to review the literature since 1961 with the primary objective to present the largest medical literature review, to date, regarding ureteral trauma. Several anatomic and physiologic considerations are paramount regarding ureteral injuries management. Literature review Eighty-one articles pertaining to traumatic ureteral injuries were reviewed. Data from these studies were compiled and analyzed. The majority of the study population was young males. The proximal ureter was the most frequently injured portion. Associated injuries were present in 90.4% of patients. Admission urinalysis demonstrated hematuria in only 44.4% patients. Intravenous ureterogram (IVU failed to diagnose ureteral injuries either upon admission or in the operating room in 42.8% of cases. Ureteroureterostomy, with or without indwelling stent, was the surgical procedure of choice for both trauma surgeons and urologists (59%. Complications occurred in 36.2% of cases. The mortality rate was 17%. Conclusion The mechanism for ureteral injuries in adults is more commonly penetrating than blunt. The upper third of the ureter is more often injured than the middle and lower thirds. Associated injuries are frequently present. CT scan and retrograde pyelography accurately identify ureteral injuries when performed together. Ureteroureterostomy, with or without indwelling stent, is the surgical procedure of choice of both trauma surgeons and urologists alike. Delay in diagnosis is correlated with a poor prognosis.

  3. External Validity and Model Validity: A Conceptual Approach for Systematic Review Methodology

    Directory of Open Access Journals (Sweden)

    Raheleh Khorsan

    2014-01-01

    Full Text Available Background. Evidence rankings do not consider equally internal (IV, external (EV, and model validity (MV for clinical studies including complementary and alternative medicine/integrative health care (CAM/IHC research. This paper describe this model and offers an EV assessment tool (EVAT© for weighing studies according to EV and MV in addition to IV. Methods. An abbreviated systematic review methodology was employed to search, assemble, and evaluate the literature that has been published on EV/MV criteria. Standard databases were searched for keywords relating to EV, MV, and bias-scoring from inception to Jan 2013. Tools identified and concepts described were pooled to assemble a robust tool for evaluating these quality criteria. Results. This study assembled a streamlined, objective tool to incorporate for the evaluation of quality of EV/MV research that is more sensitive to CAM/IHC research. Conclusion. Improved reporting on EV can help produce and provide information that will help guide policy makers, public health researchers, and other scientists in their selection, development, and improvement in their research-tested intervention. Overall, clinical studies with high EV have the potential to provide the most useful information about “real-world” consequences of health interventions. It is hoped that this novel tool which considers IV, EV, and MV on equal footing will better guide clinical decision making.

  4. Internal versus External Control of Reinforcement: A Review of the Locus of Control Construct

    Science.gov (United States)

    Kormanik, Martin B.; Rocco, Tonette S.

    2009-01-01

    One aspect of personality, perceptions of internal versus external control of reinforcement, shifts under conditions of change. This review of the literature examines the relationship between planned organizational change and locus of control. The review includes literature from the disciplines of clinical and social psychology, adult development,…

  5. Internal versus External Control of Reinforcement: A Review of the Locus of Control Construct

    Science.gov (United States)

    Kormanik, Martin B.; Rocco, Tonette S.

    2009-01-01

    One aspect of personality, perceptions of internal versus external control of reinforcement, shifts under conditions of change. This review of the literature examines the relationship between planned organizational change and locus of control. The review includes literature from the disciplines of clinical and social psychology, adult development,…

  6. Systematic Review of the Role of External Contributors in School Substance Use Education

    Science.gov (United States)

    Buckley, Emily J.; White, David G.

    2007-01-01

    Purpose: A literature review was conducted to evaluate the effectiveness of external contributors (anyone other than a teacher at the school) in delivering school-based drug, alcohol and tobacco education (substance use education) programmes. Design/methodology/approach: The review focused upon literature published from 1990 onwards in English.…

  7. Quality of systematic reviews in pediatric oncology - A systematic review

    NARCIS (Netherlands)

    A. Lundh; S.L. Knijnenburg; A.W. Jørgensen; E.C. van Dalen; L.C.M. Kremer

    2009-01-01

    Background: To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. Methods: We identified eligible systematic reviews th

  8. 77 FR 51798 - First Draft Documents Related to the Review of the National Ambient Air Quality Standards for Ozone

    Science.gov (United States)

    2012-08-27

    ... AGENCY First Draft Documents Related to the Review of the National Ambient Air Quality Standards for... of the Ozone National Ambient Air Quality Standards: First External Review Draft. The Agency is...-001; July 2012), please contact Ms. Karen Wesson, Office of Air Quality Planning and Standards...

  9. Quality Control Review of Air Force Audit Agency’s Special Access Program Audits

    Science.gov (United States)

    2014-12-09

    22350-1500 December 9, 2014 MEMORANDUM FOR AUDITOR GENERAL, DEPARTMENT OF THE AIR FORCE SUBJECT: Quality Control Review of Air Force Audit Agency’s...appropriate internal quality control system in place and undergo an external peer review at least once every three years by reviewers independent of the...in all matters relating to the audit work, the audit organization and the individual auditor whether government or public must be independent. AFAA

  10. The WHO AFRO external quality assessment programme (EQAP: Linking laboratory networks through EQA programmes

    Directory of Open Access Journals (Sweden)

    Debrah I. Boeras

    2016-10-01

    Full Text Available External Quality Assessment (EQA surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO revealed the need for the strengthening of publichealth microbiology laboratories, particularly for testing of epidemic-prone diseases in theAfrican Region. These surveys revealed common issues such as supply chain managementskilled personnel, logistical support and overall lack of quality standards. For sustainableimprovements to health systems as well as global health security, deficiencies identified needto be actively corrected through robust quality assurance programmes and implementation oflaboratory quality management systems.Given all the pathogens of public health importance, an external quality assessment programmewith a focus on vaccine-preventable diseases and emerging and re-emerging dangerouspathogens is important, and should not be stand-alone, but integrated within laboratorynetworks as seen in polio, measles, yellow fever and rubella.In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Preventionthe London School of Hygiene & Tropical Medicine and partners in a series of consultationswith countries and national and regional EQA providers for the development of qualityassurance models to support HIV point-of-care testing and monitoring. These consultationsrevealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forthits experience in implementing quality standards for health programmes, and also openeddiscussions on how lessons learned through such established programmes can be utilised tosupporting and strengthening the introduction of early infant diagnosis of HIV and viralload point-of-care testing.An optimised external quality assessment programme will impact the ability of countries tomeet core capacities, providing improved quality management systems, improving theconfidence of diagnostic network services in Africa, and including capacities to detect eventsof

  11. District level external quality assurance (EQA of malaria microscopy in Pakistan: pilot implementation and feasibility

    Directory of Open Access Journals (Sweden)

    Khokar Nayyar

    2011-02-01

    Full Text Available Abstract Background Prompt, quality assured laboratory diagnosis is key to effective malaria case management and control, especially since the introduction of the more expensive artemisinin combination therapy (ACT. The malaria programme and its non-government partners, on the basis of WHO recommended Lot Quality Assurance methods, have developed a district level external quality assurance (EQA system. This study was designed to assess the feasibility, under programme conditions, of an integrated district level external quality assurance and supervision approach for malaria microscopy. Design and Methods A prospective study conducted over seven months period (May-November 2007. In addition to the standard WHO EQA elements, three operational innovations were introduced, with the a district laboratory supervisor: a onsite re-checking of slides, b in ensuring uninterrupted availability of laboratory reagents and supplies at diagnostic centers, and c supervision of administrative and technical components. The quantitative data for the study came from the service records/documents, whereas the qualitative data came from the key informant interviews. Results During the seven month period in four districts, a total of 8,118 slides were examined of which 209 (2.6% were found positive for malaria parasites (slide positivity range between1.6% to 6.0%. The District Laboratory Supervisors in four districts reexamined a total of 1,770 slides (22%. The proportion of slides found discordant ranged from 0.5% to 1%. The quality of smear preparation was found acceptable in 73% slides. Conclusions A district-based EQA, based on lot quality assurance methods was implemented, using context-specific operational guidelines, tools and training modules, and other inputs from the malaria control programme and partners. This EQA and supervision approach was found to be feasible and acceptable to those involved. Further study is required on the microscopy quality and cost

  12. 42 CFR 438.364 - External quality review results.

    Science.gov (United States)

    2010-10-01

    ... § 438.358: (i) Objectives. (ii) Technical methods of data collection and analysis. (iii) Description of... formats for persons with sensory impairments, when requested. (c) Safeguarding patient identity....

  13. 78 FR 70598 - Submission for Review: Request for External Review (3206-NEW); Model Notice of Final Internal...

    Science.gov (United States)

    2013-11-26

    ... Review (3206-NEW); Model Notice of Final Internal Adverse Benefit Determination and Case Intake Form... collection comprises two forms: (1) Model Notice of Final Internal Adverse Benefit Determination, and (2... benefit determinations is accepting requests for external review from MSP enrollees. In addition...

  14. IACUC evaluation and external scientific review. IACUC Overstepping its Bounds

    Energy Technology Data Exchange (ETDEWEB)

    Poston, Ted M.; Thrall, Karla D.; Penner, Jocelyn D.

    2010-08-30

    I was asked to submit a response to the Protocol Review forum for the journal LabAnimal by Dr. Jerald Silverman. This forum request views and opinions on issues that are faced by research animal welfare committees. The particular issue is: Dr. John Smith, a distinguished investigator at Great Eastern University, had spent his career searching for a treatment for hearing loss. After 20 years of research, he developed a drug that potentially could improve auditory function after damage to the inner ear. The drug was administered by injection into the middle ear with the use of a fine needle inserted through the eardrum. Smith submitted a protocol to the IACUC to conduct a small study on cats, proposing to treat one group of animals with the drug and another with saline, to determine if it prevented the changes in the anatomy of the inner ear that normally occur with aging.

  15. Handbook for the Commonwealth of Learning Review and Improvement Model: Making Quality Work in Higher Education

    Science.gov (United States)

    Commonwealth of Learning, 2010

    2010-01-01

    The Commonwealth of Learning Review and Improvement Model (COL RIM) was developed by the Commonwealth of Learning in response to two key drivers: (1) Increased global emphasis on the quality of higher education; and (2) Rising concern about the high cost and uncertain benefits of conventional approaches to external quality assurance. Any…

  16. [Analysis of the results of the SEIMC External Quality Control Program. Year 2011].

    Science.gov (United States)

    Ruiz de Gopegui Bordes, Enrique; Guna Serrano, M del Remedio; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Gimeno Cardona, Concepción

    2013-02-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica [SEIMC]) includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology, and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2011 controls. Overall, the results obtained in 2011 confirm the excellent skill and good technical standards found in previous years. Nevertheless, erroneous results can be obtained in any laboratory and in clinically relevant determinations. The results of this program highlight the need to implement both internal and external controls, such as those offered by the SEIMC program, in order to ensure maximal quality of microbiological tests. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  17. First round of external quality assessment of dengue diagnostics in the WHO Western Pacific Region, 2013

    Directory of Open Access Journals (Sweden)

    Kwoon Yong Pok

    2015-06-01

    Full Text Available Objective: Accurate laboratory testing is a critical component of dengue surveillance and control. The objective of this programme was to assess dengue diagnostic proficiency among national-level public health laboratories in the World Health Organization (WHO Western Pacific Region. Methods: Nineteen national-level public health laboratories performed routine dengue diagnostic assays on a proficiency testing panel consisting of two modules: one containing commercial serum samples spiked with cultured dengue viruses for the detection of nucleic acid and non-structural protein 1 (NS1 (Module A and one containing human serum samples for the detection of anti-dengue virus antibodies (Module B. A review of logistics arrangements was also conducted. Results: All 16 laboratories testing Module A performed reverse transcriptase polymerase chain reaction (RT-PCR for both RNA and serotype detection. Of these, 15 had correct results for RNA detection and all 16 correctly serotyped the viruses. All nine laboratories performing NS1 antigen detection obtained the correct results. Sixteen of the 18 laboratories using IgM assays in Module B obtained the correct results as did the 13 laboratories that performed IgG assays. Detection of ongoing/recent dengue virus infection by both molecular (RT-PCR and serological methods (IgM was available in 15/19 participating laboratories. Discussion: This first round of external quality assessment of dengue diagnostics was successfully conducted in national-level public health laboratories in the WHO Western Pacific Region, revealing good proficiency in both molecular and serological testing. Further comprehensive diagnostic testing for dengue virus and other priority pathogens in the Region will be assessed during future rounds.

  18. Implementation and evaluation of a National External Quality Control Program for Cervical Cytology in Mexico

    Directory of Open Access Journals (Sweden)

    Flisser Ana

    2002-01-01

    Full Text Available Objective. To evaluate cytology laboratories and the performance of cytotechnologists for establishing efficient external quality control for Mexico's National Program for the Prevention and Control of Cervical Cancer. Material and Methods. During January and February 1998, an on-site evaluation of all cytology laboratories of the Ministry of Health found that only 70% of the microscopes were in adequate working conditions, reagents were out of date, and working conditions were sub-optimal. A program for external quality control based on proficiency testing was established for cytotechnologists. Fifty slide sets with 20 Papanicolaou slides and 10 photographic slides were prepared. The sets were given to the cytotechnologists for evaluation and again one year later by courier. Results. Twenty-one percent of microscopes were repaired and 9% replaced; reagents were distributed and laboratory facilities improved. Only 16% of cytotechnologists passed the initial proficiency test. Cytotechnologists received a refresher training course: one year later 67% of them passed the proficiency test. To ascertain that each slide was correctly diagnosed, 41 sets were rescreened by expert cytopathologists or cytologists and their diagnoses compared to the original ones. Thirty-seven sets had 86% to 96% concordance. Conclusions. This new system for external quality control of cervical cytology allowed the opportune and reliable evaluation of the performance of cytotechnologists.

  19. Effects of external focus of attention on balance: a short review.

    Science.gov (United States)

    Park, Sun Hee; Yi, Chae Woo; Shin, Ju Yong; Ryu, Young Uk

    2015-12-01

    [Purpose] The present study reviewed studies that examined the effects of attentional focus on balance. [Methods] Keywords such as "attentional", "focus", and "balance" were used to find relevant research papers in PubMed (www.ncbi.nlm.nih.gov/pubmed). Forty-five papers were found, and 18 of them were used for this study, excluding review papers and papers irrelevant to the topic of this study. [Results] Among the papers used for the review, the number of papers in which external focus produced effective outcomes was 15 (83.3%). The number of papers in which both external and internal focus produced effective outcomes was 2 (11.1%). The number of paper in which no instruction about attentional focus was effective was 1 (5.5%), and the number of papers in which internal focus was effective was zero. [Conclusion] This short review suggests clinical implications about how physical therapists can use attentional focus for balance rehabilitation of patients. Instructions about external focus of attention can generally be useful as a method to improve posture and balance control. Furthermore, the present reviews indicates that external focus of attention would be more useful in a rehabilitation stage in which the difficulty level of balance performance is gradually increased.

  20. Laboratory diagnosis of the rare anaemias: external quality assessment benefits patient care

    Directory of Open Access Journals (Sweden)

    Barbara De La Salle

    2013-03-01

    Full Text Available Since its introduction in the 1960s, external quality assessment has developed to become an essential component of the quality management system of the diagnostic laboratory. External quality assessment provides a long term, retrospective view of laboratory performance, demonstrating the competence of the laboratory to others. The ENERCA project (the European Network for Rare and Congenital Anaemias has established a list of core laboratory tests that are used in the diagnosis of rare and congenital anaemias, which has been used as the basis for questionnaires to laboratories, to establish the use and quality assurance of diagnostic testing in the congenital and rare anaemias, and to European EQA providers for services in this key area. In general, the provision of EQA for rare and congenital anaemias is widely variable with little provision for the very rare disorders. For the more common congenital anaemias, such as the haemoglobinopathies and thalassaemias, provision is better but there is variation in aspects of the scheme design, especially the frequency of distribution. Where laboratories did not take part in EQA for individual tests, or there was no EQA available, a desire to participate was expressed in 66% (102/154 of cases. The provision of external quality assessment (EQA services for rare disorders is a challenge. For many of these conditions, the number of patients in any one member state is very small with only a few laboratories providing diagnostic testing. In these cases, the development of pan-European or cross-border EQA may be the only means by which standardisation of methods and results can be achieved. An EQA survey of 243 laboratories for performance in Hb A2 quantification showed encouraging results in that there was a clear differentiation in the results from a beta Thalassaemia carrier and an individual with no evidence of Thalassaemia; however, a bias was observed between different methods of measurement.

  1. 77 FR 56202 - Notification of an External Peer Review Meeting for the Draft Framework for Human Health Risk...

    Science.gov (United States)

    2012-09-12

    ... AGENCY Notification of an External Peer Review Meeting for the Draft Framework for Human Health Risk... external peer review meeting. SUMMARY: The EPA Office of the Science Advisor announces that Versar, Inc., a... attend this peer review meeting as an observer. Time will be set aside for observers to give brief...

  2. 76 FR 55384 - External Peer Review Meeting for the Draft Guidance of Applying Quantitative Data To Develop Data...

    Science.gov (United States)

    2011-09-07

    ... AGENCY External Peer Review Meeting for the Draft Guidance of Applying Quantitative Data To Develop Data... register to attend this peer review meeting as observers. Time will be set aside for observers to give... finalizing the draft document, EPA intends to consider the comments from the external peer review...

  3. Building Congruence Between Internal Quality Assurance and External Quality Assessment: The Algerian Experience

    Directory of Open Access Journals (Sweden)

    Mohamed MILIANI

    2013-12-01

    Full Text Available The Algerian higher education system has been undergoing a strong change that can be compared to a revolution to its structures, schemes, procedures ever since 2004: a date that corresponds to the launching of the ‘Licence-Master-Doctorate’ or ‘LMD’ reform. Not least of these procedures is the erection of a Quality system that started in 2010. Yet, one of the difficulties the implementation of the LMD system experienced, was due to the policy of slow and progressive setting up of new LMD learning schemes by universities from 2004 up to 2010 (date of last issued LMD training programs. The fact that universities were not forced to enter the new scheme was somehow detrimental to the overall policy’s coherence and advancement. Indeed, it took time for universities to switch from a dual system of university programs (old and LMD systems offered to freshmen to a single frame, namely that of the LMD. The concern for Quality was then on the Ministry’s agenda from 2008 first through an international conference on Quality Assurance that was held in Algiers under the aegis of the Ministry of Higher Education and Scientific Research. Part of the ministry’s strategic plan scheduled to go until 2030, is the procedure aiming at a quality system that consists of the following components: the LMD training package, the national qualifications framework, the quality assurance system, the quality assurance frame of reference, the national standards, and the key performance indicators.

  4. Internal and External Perspectives on Quality of Healthcare Services at Sanglah General Hospital Denpasar

    Directory of Open Access Journals (Sweden)

    Made Nopy Diah Sundari

    2015-04-01

    Full Text Available Background and purpose: Customer satisfaction is a primary indicator of the quality of public healthcare services. This study investigated internal (hospital staff and external (hospital clients perspectives in order to gain insight into the quality of care at Sanglah General Hospital.Methods: The study used both qualitative and quantitative methodologies with 11 informants and 106 respondents. Qualitative data obtained through in-depth interviews with hospital staff were analyzed thematically. Quantitative data obtained through self-administered questionnaire were analyzed using univariate analysis.Results: Informants from the qualitative data collection stated that Sanglah General Hospital has a relatively high level of service and that existing structures to mitigate issues are in place, which act as reinforcing factors. Data from the quantitative survey indicated that clients were satisfied with the quality of service (ServQual, with an overall percentage of 83.82%.Conclusion: Further efforts could be made in order to improve healthcare provision at Sanglah Hospital, particularly from the perspective of hospital facilities, staff support and increased implementation of clinical governance.Keywords: quality of service, internal perspectives, external perspectives, Sanglah Hospital

  5. External quality assessment on detection of hepatitis C virus RNA in clinical laboratories of China

    Institute of Scientific and Technical Information of China (English)

    WANG Lu-nan; ZHANG Rui; SHEN Zi-yu; CHEN Wen-xiang; LI Jin-ming

    2008-01-01

    Background As with many studies carried out in European countries, a quality assurance program has been established by the National Center for Clinical Laboratories in China (NCCL). The results showed that the external quality assessment significantly improves laboratory performance for quantitative evaluation of hepatitis C virus (HCV) RNA.Methods Serum panels were delivered twice annuatly to the clinical laboratories which performed HCV RNA detection in China. Each panel made up of 5 coded samples. All laboratories were requested to carry out the detection within the required time period and report on testing results which contained qualitative and/or quantitative test findings, reagents used and relevant information about apparatus. All the positive samples were calibrated against the first International Standard for HCV RNA in a collaborative study and the range of comparison target value (TG) designated as ±0.5 log.Results The numbers of laboratories reporting on qualitative testing results for the first and second time external quality assessment were 168 and 167 in the year of 2003 and increased to 209 and 233 in 2007; the numbers of laboratories reporting on quantitative testing results were 134 and 147 in 2003 and rose to 340 and 339 in 2007. Deviation between the mean value for quantitative results at home in 2003 and the target value was above 0.5 log, which was comparatively high.By 2007, the target value was close to the national average except for the low concentrated specimens (103 IU/ml). The percentage of results within the range of GM±0.5 log10 varied from 8.2% to 93.5%. Some laboratories had some difficulties in the exact quantification of the lowest (3.00 log IU/ml) as well as of the highest viral levels (6.37 log IU/ml) values, very near to the limits of the dynamic range of the assays.Conclusions The comparison of these results with the previous study confirms that a regular participation in external quality assessment (EQA) assures the

  6. [Guideline compliance in hip fracture: results of an external quality-assurance program in North Rhine Westphalia: 2003-2005].

    Science.gov (United States)

    Schulze Raestrup, U; Grams, A; Smektala, R

    2008-02-01

    Whereas the Scottish guidelines are audited annually, nobody evaluates guideline compliance in Germany. Thus, can external quality assurance data pursuant to section 137 of the German Social Code Book V be suitable for auditing guideline compliance? From North Rhine Westphalia, a total of 48,831 cases of femoral fractures near the hip joint were evaluated. Compliance with the guidelines was determined based on preoperative hospital stay, thrombosis, and antibiotic prophylaxis. Guideline rationale was reviewed in terms of mortality and thromboembolism rate. Sixty-four percent of the interventions were performed in a timely manner. Thrombosis prophylaxis was given in 99% of cases. Antibiotics were given as a single shot. There was no connection between mortality and thromboembolism rates or time to surgery. Guideline compliance is similar in German and Scotland. The external quality assurance data are suitable for evaluating guideline compliance. The literature recommends a short time to surgery. Given the short observation period, it was not possible to demonstrate any improvement in outcomes.

  7. The impact of organisational external peer review on colorectal cancer treatment and survival in the Netherlands

    NARCIS (Netherlands)

    Kilsdonk, M.J.; Dijk, van B.A.C.; Otter, R.; Siesling, S.; Harten, van W.H.

    2014-01-01

    Background: Organisational external peer review was introduced in 1994 in the Netherlands to improve multidisciplinary cancer care. We examined the clinical impact of this programme on colorectal cancer care. Methods: Patients with primary colorectal cancer were included from 23 participating hospi

  8. The impact of organisational external peer review on colorectal cancer treatment and survival in the Netherlands

    NARCIS (Netherlands)

    Kilsdonk, M. J.; van Dijk, B. A. C.; Otter, R.; Siesling, S.; van Harten, W. H.

    2014-01-01

    Background: Organisational external peer review was introduced in 1994 in the Netherlands to improve multidisciplinary cancer care. We examined the clinical impact of this programme on colorectal cancer care. Methods: Patients with primary colorectal cancer were included from 23 participating hospit

  9. 45 CFR 147.136 - Internal claims and appeals and external review processes.

    Science.gov (United States)

    2010-10-01

    ... the external review; any officer, director, or management employee of the issuer; the plan... also provide additional consumer protections to ensure that adequate clinical and scientific experience... language; and (C) To the extent the plan or issuer maintains a customer assistance process (such as...

  10. 75 FR 52597 - Availability of Interim Procedures for Federal External Review and Model Notices Relating to...

    Science.gov (United States)

    2010-08-26

    ... processes under the Patient Protection and Affordable Care Act. FOR FURTHER INFORMATION CONTACT: Amy Turner... Federal external review process. (In the case of health insurance coverage offered in connection with a... excise tax liability should be reported on IRS Form 8928 with respect to PHS Act section...

  11. Assessing Curriculum: An Internal and External Review with an Emphasis on Student Work.

    Science.gov (United States)

    Hines, Jean D.; Albanese, Carolyn A.; Brown, Robert

    1999-01-01

    An interior-design program was evaluated internally by faculty and externally by a review team. The assessment focused both on student work and on the program and resources. Differences in the two evaluations confirmed the importance of outside evaluators' perspectives for program improvement. (SK)

  12. A critical review of economic valuation studies of externalities from incineration and landfilling.

    Science.gov (United States)

    Eshet, Tzipi; Ayalon, Ofira; Shechter, Mordechai

    2005-12-01

    The primary objective of this study was to assist waste management researchers, decision-makers and waste managers at national, regional and local levels, in their decision-making processes, with most recent valuations on the environmental and social costs of externalities associated with various pollutants and disamenities related to landfilling and incineration of municipal solid waste. The aim was achieved by mapping, gathering, analysing, comparing and synthesizing various valuation estimates, based on a thorough review of existing literature. This study provides the first comprehensive review and analysis focused on primary and secondary valuation studies, conducted since 1990. The second objective was to assess the appropriateness and reliability of the valuation methods and techniques that were performed in the reviewed studies. The results of the review are summarized in tables, organized by topics and units of measure and in addition a classified list that describes the profile of the reviewed studies is provided. The results are then analysed and compared, and recommended ranges of the values are presented. The study reveals inconsistency in part of the estimates across the reviewed studies and provides reasonable explanations for the variations. Given the nature of uncertainty, and the difficulties associated with transferring values among different places and cases, these values should be considered mostly as an indication for the order of magnitude of the externalities. Nevertheless, these essential estimates of the external costs can beneficially be used with proper adjustment for each individual case to address important policy questions regarding landfilling and incineration of waste.

  13. Reviewing the Review: An Assessment of Dissertation Reviewer Feedback Quality

    Science.gov (United States)

    Lehan, Tara; Hussey, Heather; Mika, Eva

    2016-01-01

    Throughout the dissertation process, the chair and committee members provide feedback regarding quality to help the doctoral candidate to produce the highest-quality document and become an independent scholar. Nevertheless, results of previous research suggest that overall dissertation quality generally is poor. Because much of the feedback about…

  14. Integrated concurrent utilization quality review, Part one.

    Science.gov (United States)

    Caterinicchio, R P

    1987-01-01

    This article is the first of a two-part series which argues for the concurrent management of the appropriateness, necessity, and quality of patient care. Intensifying scrutiny by the credentialing groups, the PROs and all third-party payors underscores the vital need to implement cost-effective information systems which integrate the departmentalized functions of patient-physician profiling, DRG case-mix analyses, length of stay monitoring, pre-admission/admission and continued stay review, discharge planning, risk management, incident reporting and quality review. In the domain of physician performance regarding admitting and practice patterns, the ability to exercise concurrent utilization-quality review means early detection and prevention of events which would otherwise result in denials of payment and/or compromised patient care. Concurrent utilization-quality review must, by definition, be managerially invasive and focused; hence, it is integral to maintaining the integrity of the services and product lines offered by the provider. In fact, if PPO status is a marketing agenda, then the institutional objectives of cost-effectiveness, productivity, value, and competitiveness can only be achieved through concurrent utilization-quality review.

  15. Different configurations of laser vibrometry for quality control of electric motors with external rotor

    Science.gov (United States)

    Chiariotti, P.; Ciarmatori, R.; Castellini, P.; Bastari, A.; Paone, N.

    2012-06-01

    When designing a test bench for vibration based diagnostics of machines with external rotating parts, such as electric motors having a rotating external rotor, one may choose among single point vibrometry, rotational vibrometry or in-plane vibrometry. The paper discusses these different options, taking the assumption that the minimum number of measuring instruments is preferred when instrumenting a quality control system and provides an insight into advantages and limitations of each instrument. In particular the following issues are discussed: a) possible installation lay-outs; b) alignment problems (and possible advantages for diagnostics), c) typical signals and diagnostic features which can be observed. The research presented refers to electric motors for home appliances, but potentially has wider application fields to other rotating machines.

  16. The Benefits of Internalizing Air Quality and Greenhouse Gas Externalities in the US Energy System

    Science.gov (United States)

    Brown, Kristen E.

    The emission of pollutants from energy use has effects on both local air quality and the global climate, but the price of energy does not reflect these externalities. This study aims to analyze the effect that internalizing these externalities in the cost of energy would have on the US energy system, emissions, and human health. In this study, we model different policy scenarios in which fees are added to emissions related to generation and use of energy. The fees are based on values of damages estimated in the literature and are applied to upstream and combustion emissions related to electricity generation, industrial energy use, transportation energy use, residential energy use, and commercial energy use. The energy sources and emissions are modeled through 2055 in five-year time steps. The emissions in 2045 are incorporated into a continental-scale atmospheric chemistry and transport model, CMAQ, to determine the change in air quality due to different emissions reduction scenarios. A benefit analysis tool, BenMAP, is used with the air quality results to determine the monetary benefit of emissions reductions related to the improved air quality. We apply fees to emissions associated with health impacts, climate change, and a combination of both. We find that the fees we consider lead to reductions in targeted emissions as well as co-reducing non-targeted emissions. For fees on the electric sector alone, health impacting pollutant (HIP) emissions reductions are achieved mainly through control devices while Greenhouse Gas (GHG) fees are addressed through changes in generation technologies. When sector specific fees are added, reductions come mainly from the industrial and electricity generation sectors, and are achieved through a mix of energy efficiency, increased use of renewables, and control devices. Air quality is improved in almost all areas of the country with fees, including when only GHG fees are applied. Air quality tends to improve more in regions with

  17. The external quality assessment scheme: Five years experience as a participating laboratory

    Directory of Open Access Journals (Sweden)

    Chaudhary Rajendra

    2010-01-01

    Full Text Available Background and Aim : Quality assurance in blood banking includes active participation in the external quality program. Such a program offers valuable benefits to patient care, their safety, and an overall quality of laboratory practices. In the year 2002, we participated in the External Quality Assessment Scheme (EQAS under the World Health Organization (WHO, Bureau of Laboratory Quality Standards, Thailand. Materials and Methods: In the current study we evaluated our EQAS test result of the past five years, from 2003 to 2007. Test results of all blood samples such as ABO grouping, D typing, antibody screening, antibody identification, and transfusion transmitted infection (TTI testing were analyzed and documented. Results: Discordant results in one or more instances were observed with antibody identification, weak D testing, and tests for anti-HIV1/2 and HBsAg. Twice we failed to detect the ′anti-Mia′ antibody in the issued sample and that could be attributed to the absence of the corresponding antigen in the used cell panel. HBsAg was missed due to its critically low titer in the serum and the comparatively low sensitivity of our Enzyme-Linked Immunosorbent Assay (ELISA test kit. Conclusion: All these failures in the last five years have helped us to significantly improve our transfusion service in terms of performance evaluation, patient care and safety issues, and the overall quality of laboratory practices. We therefore recommend all laboratories and hospitals to participate in the EQAS program, which will definitely help them to improve from what they learn.

  18. Service Quality in Supply Chain: A Review

    Directory of Open Access Journals (Sweden)

    Tarun K. Gupta

    2012-08-01

    Full Text Available Economic development of a country generally depends upon the growth amongst its agriculture, manufacture and service sectors. Part of service sector increasing day by day therefore quality of service is very important to maintain the economic growth of a nation. It is very easy to calculate the loss due to poor sale but it is very difficult to calculate the loss due to poor service quality. Good service always built up the confidence of the customer in the firm. In This paper the author has discussed the concept of service quality in supply chain and has given a core review. A three level development of service quality in supply chain has been explored and a relationship has been established between service quality, supply chain and service quality in supply chain.

  19. Twelve years of the Brazilian External Quality Assessment Program in Immunohematology: benefits of the program.

    Science.gov (United States)

    Melo, Laércio; Pellegrino, Jordão; Bianco, Celso; Castilho, Lilian

    2005-01-01

    The Brazilian External Quality Assessment Program in Immunohematology (BEQAPI) was introduced with the objective of evaluating the quality of diagnosis in immunohematology. From 1992 to 2003, proficiency tests for ABO grouping, Rh (D, C, c, E, e), K phenotyping, direct antiglobulin testing (DAT), antibody screening (AS), and antibody identification (AI) were performed. A total of 41 evaluations were carried out in 223 institutions. Over the period of 12 years, the program included 8,014 ABO typing, 8,000 RhD typing, 5,193 Rh typing (C, c, E, e), 5,101 K phenotyping, 7,939 AS, 4,533 AI, and 7,912 DATs. Erroneous responses were classified as clerical, technical, or undetermined. A substantial proportion of erroneous responses due to clerical errors occurred in ABO typing (76/76 errors), RhD typing (34/58 errors), and Rh phenotyping (50/73 errors). Technical errors occurred predominantly for weak D (91/95 errors), AS (252/301 errors), and AI (321/335 errors). Based on these results, since 1996, participants have received "Questions and Case Studies" in Immunohematology as an incentive for training and education. The results of the present study show an improvement in the performance of participants in the course of the program. We found that a well-organized external proficiency program can contribute to the improvement of quality of testing in Immunohematology.

  20. Implementation of External Quality Assessment Scheme in Clinical Chemistry for District Laboratories in Bhutan.

    Science.gov (United States)

    Jamtsho, Rixin; Nuchpramool, Wilairat

    2012-07-01

    External Quality Assessment Scheme (EQAS) involves evaluation of a number of laboratories by an outside agency on the performance of a number of laboratories based on their analytical performance of tests on samples supplied by the external agency. In developing countries, establishment of national EQAS by preparing homemade quality control material is a useful scheme in terms of resources and time to monitor the laboratory performance. The objective of this study is to implement an EQAS to monitor the analytical performance of the district laboratories in Bhutan. Baseline information was collected through questionnaires. Lyophilized human serum including normal and abnormal levels were prepared and distributed to 19 participating laboratories. Nine routine analytes were included for the study. Their results were evaluated using Variance index scores (VIS) and Coefficient of variations (CV) was compared with Clinical Laboratory Improvement Act (CLIA) Proficiency Testing Criteria (PT) for each analyte. There was significant decrease in CV at the end of the study. The percentages of results in acceptable VIS as 'A' were 63, 60, 66, 69, 73 and 74, 75, 76 and 79 % in November 2009-July 2010 respectively. From our results, we concluded that, establishment of EQAS through distribution of home-made quality control material could be the useful scheme to monitor the laboratory performance in clinical chemistry in Bhutan.

  1. External Tank Liquid Hydrogen (LH2) Prepress Regression Analysis Independent Review Technical Consultation Report

    Science.gov (United States)

    Parsons, Vickie s.

    2009-01-01

    The request to conduct an independent review of regression models, developed for determining the expected Launch Commit Criteria (LCC) External Tank (ET)-04 cycle count for the Space Shuttle ET tanking process, was submitted to the NASA Engineering and Safety Center NESC on September 20, 2005. The NESC team performed an independent review of regression models documented in Prepress Regression Analysis, Tom Clark and Angela Krenn, 10/27/05. This consultation consisted of a peer review by statistical experts of the proposed regression models provided in the Prepress Regression Analysis. This document is the consultation's final report.

  2. The Program of External Quality Evaluation in Clinical Chemistry. An overview and evaluation after 11 years of functioning

    National Research Council Canada - National Science Library

    Martins, M C; Rodrigues, M O; Gomes, M A; Fonseca, A; Freitas, M M; Miguel, J P; Gomes, E M

    1994-01-01

    After an eleven-year period, the goals and way of functioning are remembered the External Quality Assessment Scheme in Clinical Chemistry, under the responsibility of the National Institute of Health...

  3. Five years of experience with a national external quality control program for the culture and identification of Neisseria gonorrhoeae.

    OpenAIRE

    Griffin, C W; Mehaffey, M A; Cook, E C

    1983-01-01

    In response to a need for monitoring the proficiency of public health laboratories in isolating and identifying Neisseria gonorrhoeae, a national external quality control program was developed. Essentially, three types of freeze-dried samples, representing different levels of challenge for identification, were sent to laboratories for testing. The quality of the samples was confirmed by external reference laboratories, and stability of the samples was confirmed by thermal degradation tests be...

  4. External quality assurance system (EQAS) for identification of mastitis pathogens in Denmark from 2006 to 2011

    DEFF Research Database (Denmark)

    Karlsmose, Susanne; Kunstmann, L.; Rundsten, Carsten Friis

    2013-01-01

    Bovine mastitis is the most common and costly dairy cattle disease. Mastitis is most frequently caused by bacterial species, and to ensure optimal treatment and control strategies, proper quality assured diagnosis and identification of the causative agent is important. With the aim to assess...... the capacity to isolate and identify mastitis pathogens at veterinary clinics, an external quality assurance system (EQAS) was annually (from 2006 to 2011) provided for the identification of mastitis pathogens. This study presents the setup of the proficiency test and the obtained results that enabled...... the organizers to pinpoint areas for improvement and thereby to assist veterinary practices at strengthening their mastitis diagnostics.The proficiency test consisted of 15 milk samples spiked with a pure culture of a mastitis pathogen and distributed to veterinary practices for identification. Applying...

  5. The External Quality Assurance System of the WHO Global Salm-Surv Year 2008

    DEFF Research Database (Denmark)

    Hendriksen, Rene S.; Karlsmose, Susanne; Jensen, Arne Bent

    To support laboratories participating in WHO GSS an External Quality Assurance System (EQAS) was established in 2000. The EQAS supports the assessment of the quality of serotyping and antimicrobial susceptibility testing of Salmonella in participating laboratories. In 2003, the program was extended...... to include other foodborne pathogens as well, and the number of participants has increased from 44 laboratories in 2000, to 187 laboratories in 2008. The serotyping results indicate a continuous need for improving skills in Salmonella serotyping. Future training efforts should be aimed at enhancing...... training modules on identification procedures for Campylobacter spp. Given the growing concerns over increasing macrolide resistance in Campylobacter spp., participants in the 2009 EQAS will also be offered the opportunity to perform susceptibility testing of Campylobacter spp....

  6. A Cognitive Modeling Method of the Life Quality Indicators in Terms of External Factors

    Directory of Open Access Journals (Sweden)

    L. V. Massel

    2016-01-01

    Full Text Available The article discusses a potential use of the methods of cognitive modeling in the field of quality of life. The quality of life, as a universal indicator of human self-perception to feel his sense of satisfaction from various parts of his life, is difficult to assess by strictly mathematical methods, so the authors suggest using the cognitive modeling. The quality of life in his estimation for the convenience of research activity is divided into components - indicators of the quality of life. The widespread indicator "quality of life" and the complexity of the development of its assessment methods lead to high relevance of the authors-proposed method.The introduction provides an overview of current approaches to assessing the quality of life. Among all these approaches the most advantageous is an objectively subjective one. The paper gives a brief assessment of cognitive modeling methods, which are, essentially, a way of graphic and structural elements of reflection and relationships in complex systems. As a result of the analysis of existing research in this area, was found the potential for creating cognitive models of the quality of life and its indicators and was defined the place of the proposed method, among others. The paper presents the method itself, as a series of steps, and focuses on the promising opportunities for researchers of the quality of life from its using.Among the possible lines to use cognitive modeling of the life quality indicators can be three main ones: implementation of new methods to assess the quality of life; choice of the most appropriate technique for a particular study among available methods; realization of the cognitive model and numerical experiment, which allows seeing the effect of external factors on the individual indicators of the quality of life. Thus, due to the high relevance and significant benefits from the use of the proposed method, the article is of interest to researchers of the quality of life

  7. INTERNAL AND EXTERNAL QUALITY OF COMMERCIAL LAYING HENS EGGS WITH NORMAL AND VITREOUS EGGSHELL

    Directory of Open Access Journals (Sweden)

    Daniela Reis Vilela

    2016-10-01

    Full Text Available The objective of this study was to evaluate the internal and external quality of eggs classified as eggs with normal eggshell and eggs with vitreous eggshell, produced by hens at three different ages. Forty-five eggs of each eggshell type, normal and vitreous, were sampled at the ages of 30, 50, and 70 weeks. The weight of the egg, in both types of eggshell, increased with the advancing age of the hen. Higher concentration of calcium was found in eggs with normal eggshells comparing to eggs with vitreous eggshells. The eggshell type did not affect phosphorus percentage. The mineral deposition of the eggshell was constant. The skin thickness increased irrespective of the shell along the reproductive life of the chicken and decreased when the bird became older. The percentage of albumen increased, while the percentage of albumen protein and pH decreased throughout the ages. Percentage of egg yolk, humidity, and pH decreased with increase of age of the laying hen, whereas crude protein and lipid increased. Eggs with vitreous eggshell showed eggshell with lower quality compared to those with normal eggshell, without, however, compromising the internal quality of albumen and yolk. Keywords: egg quality; eggshell types; physical analysis.

  8. Computation of External Quality Factors for RF Structures by Means of Model Order Reduction and a Perturbation Approach

    CERN Document Server

    Flisgen, Thomas; van Rienen, Ursula

    2016-01-01

    External quality factors are significant quantities to describe losses via waveguide ports in radio frequency resonators. The current contribution presents a novel approach to determine external quality factors by means of a two-step procedure: First, a state-space model for the lossless radio frequency structure is generated and its model order is reduced. Subsequently, a perturbation method is applied on the reduced model so that external losses are accounted for. The advantage of this approach results from the fact that the challenges in dealing with lossy systems are shifted to the reduced order model. This significantly saves computational costs. The present paper provides a short overview on existing methods to compute external quality factors. Then, the novel approach is introduced and validated in terms of accuracy and computational time by means of commercial software.

  9. An update of preliminary perspectives gained from Individual Plant Examination of External Events (IPEEE) submittal reviews

    Energy Technology Data Exchange (ETDEWEB)

    Rubin, A.M.; Chen, J.T.; Chokshi, N. [Nuclear Regulatory Commission, Washington, DC (United States); Nowlen, S.P.; Bohn, M.P. [Sandia National Labs., Albuquerque, NM (United States); Sewell, R.; Kazarians, M.; Lambright, J. [Energy Research, Inc., Rockville, MD (United States)

    1998-03-01

    As a result of the US Nuclear Regulatory Commission (USNRC) initiated Individual Plant Examination of External Events (IPEEE) program, virtually every operating commercial nuclear power reactor in the US has performed an assessment of severe accident risk due to external events. To date, the USNRC staff has received 63 IPEEE submittals and will receive an additional 11 by mid 1998. Currently, 49 IPEEE submittals are under various stages ore view. This paper is based on the information available for those 41 plants for which at least preliminary Technical Evaluation Reports have been prepared by the review teams. The goal of the review is to ascertain whether the licensee`s IPEEE process is capable of identifying external events-induced severe accident vulnerabilities and cost-effective safety improvements to either eliminate or reduce the impact of these vulnerabilities. The review does not, however, attempt to validate or verify the results of the licensee`s IPEEE. The primary objective of this paper is to provide an update on the preliminary perspectives and insights gained from the IPEEE process.

  10. [External assessment of analytic quality in hematology: a necessity in Latin America].

    Science.gov (United States)

    Fink, N E; Fernández Alberti, A; Mazziotta, D

    1997-09-01

    The assurance of analytical quality in a clinical laboratory is achieved through an internal system of quality control complemented by an external evaluation program. Quality assurance provides a foundation for the confidence that is placed in laboratory results and their use in the diagnosis and treatment of diseases. Many laboratories in Latin American countries do not have appropriate systems in place to evaluate and control quality. Given the importance of diagnoses based on hematologic data, the Pan American Health Organization sponsored a course in quality control in hematology during the XI Latin American Congress of Clinical Biochemistry (Mexico, 1993), in which representatives from Argentina, Chile, Cuba, Mexico, Paraguay, Dominican Republic, and Uruguay participated. As part of the course, the following control materials were produced: secondary standard solution of cyanmethemoglobin, stabilized concentrated hemoglobin solution, and preserved human whole blood with pseudoleukocytes. These materials were sent to laboratories in the seven participating countries for use in analytical procedures, and the results were then subjected to an external evaluation to assess individual performance and the comparability of results among the group. The specific tasks carried out were: (1) determination of values for hemoglobin, hematocrit, and red and white blood cell counts by the procedures normally used in each laboratory; (2) recording of the data on special reporting forms; and (3) transmittal of those forms to the coordinator in each country. The results were analyzed with regard to both the procedure used and the participating country. Reference values were established by consensus following application of a statistical method to eliminate outlying values. Comparative analysis of the results showed the coefficients of variation (CV) of the hematocrit (4.5%), red blood cell count (11.0%), and white blood cell count (22.2%) to be higher than those reported from

  11. External suction versus water seal after selective pulmonary resection for lung neoplasm: a systematic review.

    Science.gov (United States)

    Qiu, Tong; Shen, Yi; Wang, Ming-zhao; Wang, Yao-peng; Wang, Dong; Wang, Zi-zong; Jin, Xiang-feng; Wei, Yu-cheng

    2013-01-01

    To evaluate whether external suction is more advantageous than water seal in patients undergoing selective pulmonary resection (SPR) for lung neoplasm. Whether external suction should be routinely applied in postoperative chest drainage is still unclear, particularly for lung neoplasm patients. To most surgeons, the decision is based on their clinical experience. Randomized control trials were selected. The participants were patients undergoing SPR with lung neoplasm. Lung volume reduction surgery and pneumothorax were excluded. Suction versus non-suction for the intervention. The primary outcome was the incidence of persistent air leak (PAL). The definition of PAL was air leak for more than 3-7 days. The secondary outcomes included air leak duration, time of drainage, postoperative hospital stay and the incidence of postoperative pneumothorax. Studies were identified from literature collections through screening. Bias was analyzed and meta-analysis was used. From the 1824 potentially relevant trials, 6 randomized control trials involving 676 patients were included. There was no difference between external suction and water seal in decreasing the incidence of PAL [95% confidence interval (CI) 0.81-2.16; z = 1.10; P = 0.27]. Regarding secondary outcomes, there were no differences in time of drainage (95% CI-0.36-1.56, P = 0.22), postoperative hospital stay (95% CI -.31-.54, P = 0.87) or incidence of postoperative pneumothorax (95% CI 0.18-.02, P = 0.05) between external suction and water seal. For participants, no differences are identified in terms of PAL incidence, drainage time, length of postoperative hospital stay or incidence of postoperative pneumothorax between external suction and water seal. The bias analysis should be emphasized. To the limitations of the bias and methodological differences among the included studies, we have no recommendation on whether external suction should be routinely applied after lung neoplasm SPR. More high-quality

  12. Perceived external prestige as a mediator between quality of work life and organisational commitment of public sector employees in Ghana

    Directory of Open Access Journals (Sweden)

    Oluyinka Ojedokun

    2015-02-01

    Full Text Available Orientation: Research efforts have been directed at understanding the relationship between quality of work life and organisational commitment, but these studies have not elucidated the mediating role of perceived external prestige in this relationship.Research purpose: This research seeks to close a research gap by determining the role of perceived external prestige in the relationship between quality of work life and organisational commitment amongst public sector employees in Ghana.Research approach, design and method: Theoretically guided hypotheses and models were formulated and tested with hierarchical multiple regression statistics using data from a sample of 137 employees from two public sector organisations in Ghana.Main findings: The results support the hypothesis that quality of work life is positively related to both perceived external prestige and organisational commitment. Also, perceived external prestige was found to predict organisational commitment and partially mediate the relationship between quality of work life and organisational commitment.Practical/managerial implications: The findings imply that one sure way to enhance organisational commitment of employees is by improving their quality of work life and boosting their perceptions of external prestige of the organisation. These results will be of particular interest to policymakers, public organisations and stakeholders interested in increasing organisational commitment of their employees.Contribution/value-add: The findings extend previous research by establishing the mediating role of perceived external prestige in the relationship between quality of work life and organisational commitment. If managers of organisations wish to improve organisational commitment, it is wise to institutionalise an organisational culture that promotes good quality of work life and boost the external prestige of the organisation in the employees’ mind.

  13. Determinants of Quality Perception in Educational Administration: Potential Conflict between the Requirements of Internal and External Customers.

    Science.gov (United States)

    Galloway, R. L.; Wearn, Katrina

    1998-01-01

    Attempts to measure perceived quality, based on customers' views within the context of a (British) university faculty office, using a modified SERVQUAL instrument. Internal customers demonstrated that perceived quality is driven by task-focused issues, stressing clarity, accuracy, and reliability. External customers, whose usage is more casual,…

  14. Performance of Different Mono- and Multiplex Nucleic Acid Amplification Tests on a Multipathogen External Quality Assessment Panel

    NARCIS (Netherlands)

    Loens, K.; van Loon, A. M.; Coenjaerts, F.; van Aarle, Y.; Goossens, H.; Wallace, P.; Claas, E. J. C.; Ieven, M.

    2012-01-01

    An external quality assessment (EQA) panel consisting of a total of 48 samples in bronchoalveolar lavage (BAL) fluid or transport medium was prepared in collaboration with Quality Control for Molecular Diagnostics (QCMD) (www.qcmd.org). The panel was used to assess the proficiency of the three labor

  15. KRAS mutations testing in colorectal carcinoma patients in Italy: from guidelines to external quality assessment.

    Directory of Open Access Journals (Sweden)

    Nicola Normanno

    Full Text Available BACKGROUND: Monoclonal antibodies directed against the epidermal growth factor receptor (EGFR have been approved for the treatment of patients with metastatic colorectal carcinoma (mCRC that do not carry KRAS mutations. Therefore, KRAS testing has become mandatory to chose the most appropriate therapy for these patients. METHODOLOGY/PRINCIPAL FINDINGS: In order to guarantee the possibility for mCRC patients to receive an high quality KRAS testing in every Italian region, the Italian Association of Medical Oncology (AIOM and the Italian Society of Pathology and Cytopathology -Italian division of the International Academy of Pathology (SIAPEC-IAP started a program to improve KRAS testing. AIOM and SIAPEC identified a large panel of Italian medical oncologists, pathologists and molecular biologists that outlined guidelines for KRAS testing in mCRC patients. These guidelines include specific information on the target patient population, the biological material for molecular analysis, the extraction of DNA, and the methods for the mutational analysis that are summarized in this paper. Following the publication of the guidelines, the scientific societies started an external quality assessment scheme for KRAS testing. Five CRC specimens with known KRAS mutation status were sent to the 59 centers that participated to the program. The samples were validated by three referral laboratories. The participating laboratories were allowed to use their own preferred method for DNA extraction and mutational analysis and were asked to report the results within 4 weeks. The limit to pass the quality assessment was set at 100% of true responses. In the first round, only two centers did not pass (3%. The two centers were offered to participate to a second round and both centers failed again to pass. CONCLUSIONS: The results of this first Italian quality assessment for KRAS testing suggest that KRAS mutational analysis is performed with good quality in the majority of

  16. Detecting and Attributing External Influences on the Climate System: A Review of Recent Advances

    Energy Technology Data Exchange (ETDEWEB)

    Barnett, T; Zwiers, F; Hegerl, G; Allen, M; Crowley, T; Gillett, N; Hasselmann, K; Jones, P; Santer, B; Schnur, R; Stott, P; Taylor, K; Tett, S

    2005-01-26

    We review recent research that assesses evidence for the detection of anthropogenic and natural external influences on the climate. Externally driven climate change has been detected by a number of investigators in independent data covering many parts of the climate system, including surface temperature on global and large regional scales, ocean-heat content, atmospheric circulation, and variables of the free atmosphere, such as atmospheric temperature and tropopause height. The influence of external forcing is also clearly discernible in reconstructions of hemispheric scale temperature of the last millennium. These observed climate changes are very unlikely to be due only to natural internal climate variability, and they are consistent with the responses to anthropogenic and natural external forcing of the climate system that are simulated with climate models. The evidence indicates that natural drivers such as solar variability and volcanic activity are at most partially responsible for the large-scale temperature changes observed over the past century, and that a large fraction of the warming over the last 50 years can be attributed to greenhouse gas increases. Thus the recent research supports and strengthens the IPCC Third Assessment Report conclusion that ''most of the global warming over the past 50 years is likely due to the anthropogenic increase in greenhouse gases''.

  17. Comparison of Complications for Internal and External Fixation for Charcot Reconstruction: A Systematic Review.

    Science.gov (United States)

    Dayton, Paul; Feilmeier, Mindi; Thompson, Mitchell; Whitehouse, Paul; Reimer, Rachel A

    2015-01-01

    The surgical reconstruction of Charcot deformity can be a challenge for foot and ankle surgeons. Consensus is lacking among surgeons regarding the best method of surgical fixation to be used in reconstruction, and clear strong evidence is also lacking in published studies. We undertook a systematic review of electronic databases and other relevant sources in an attempt to better understand the complications and outcomes associated with internal and external fixation for Charcot foot and ankle reconstruction. A total of 23 level 4 studies with 616 procedures were identified. Of these, 12 studies with 275 procedures used internal fixation, and 11 studies with 341 procedures used external fixation. The odds of a successful outcome with internal fixation was 6.86. The odds of a successful outcome with external fixation was 13.20 (odds ratio 0.52, 95% confidence interval 0.30 to 0.90). The odds of success for internal fixation was 0.52 times as likely as the odds of success with external fixation. Because the odds ratio did not include 1, this difference was statistically significant at the p foot and ankle surgeons when making decisions regarding fixation for Charcot reconstruction.

  18. [Quality analysis by external users of the non-medical health transport unit of Alicante].

    Science.gov (United States)

    Soriano Clemor, C; Cano, F Soriano; Gimeno, F Morant

    2011-01-01

    Non-medical health transport has great health, media and social repercussions and requires a very considerable amount of human and economic resources. To describe the quality, evaluated by external users of our Health Department, in order to know what are the most important elements for external users. Cross-sectional, descriptive observational study. Population to study: patients with a social security health card who come to the Hospital of Alicante and are non-medical health transport unit users. Waiting time to be delivered to hospital in 92.7% of the cases was less than an hour, and was between one and two hours for 7.2%. The most frequent destinations were rehabilitation service and outpatient clinics. When users were asked if the would recommend this service, 60.9% said "for sure" and 39.1% said "probably yes". This study allows us to know patient needs and expectations, as well as the factors they value the most and which of our work areas to improve. Copyright © 2009 SECA. Published by Elsevier Espana. All rights reserved.

  19. [External quality control system in medical microbiology and parasitology in the Czech Republic].

    Science.gov (United States)

    Slosárek, M; Petrás, P; Kríz, B

    2004-11-01

    The External Quality Control System (EQAS) of laboratory activities in medical microbiology and parasitology was implemented in the Czech Republic in 1993 with coded sera samples for diagnosis of viral hepatitis and bacterial strains for identification distributed to first participating laboratories. The number of sample types reached 31 in 2003 and the number of participating laboratories rised from 79 in 1993 to 421 in 2003. As many as 15.130 samples were distributed to the participating laboratories in 2003. Currently, almost all microbiology and parasitology laboratories in the Czech Republic involved in examination of clinical material participate in the EQAS. Based on the 11-year experience gained with the EQAS in the Czech Republic, the following benefits were observed: higher accuracy of results in different tests, standardisation of methods and the use of most suitable test kits.

  20. The Czech External Quality Control system in medical microbiology and parasitology.

    Science.gov (United States)

    Slosárek, M; Kríz, B

    2000-11-01

    The External Quality Control (EQC) system in activities of laboratories engaged in medical microbiology and parasitology was established in the Czech Republic in 1993 when to the first laboratories which applied coded serum samples were sent for diagnosis of viral hepatitis and bacterial strains for identification. In the course of years the number of control areas increased and in 2000 there were 31 and the number of those interested in participation in EQC increased from 79 in 1993 to 434 in 2000. This year a total of 13,239 samples will be sent to laboratories. Gradually thus almost all microbiological and parasitological laboratories concerned with examination of clinical material became involved. Seven-year experience with EQC in the Czech Republic revealed that gradually the results of various examinations became more accurate, that methods became standardized and the most suitable examination sets are used.

  1. The quality and testing PH-SFT infrastructure for the external LHC software packages deployment

    CERN Document Server

    CERN. Geneva; MENDEZ LORENZO, Patricia; MATO VILA, Pere

    2015-01-01

    The PH-SFT group is responsible for the build, test, and deployment of the set of external software packages used by the LHC experiments. This set includes ca. 170 packages including Grid packages and Montecarlo generators provided for different versions. A complete build structure has been established to guarantee the quality of the packages provided by the group. This structure includes an experimental build and three daily nightly builds, each of them dedicated to a specific ROOT version including v6.02, v6.04, and the master. While the former build is dedicated to the test of new packages, versions and dependencies (basically SFT internal used), the three latter ones are the responsible for the deployment to AFS of the set of stable and well tested packages requested by the LHC experiments so they can apply their own builds on top. In all cases, a c...

  2. [Development of external quality control protocol for CyberKnife beams dosimetry: preliminary tests multicentre].

    Science.gov (United States)

    Guinement, L; Marchesi, V; Veres, A; Lacornerie, T; Buchheit, I; Peiffert, D

    2013-01-01

    To develop an external quality control procedure for CyberKnife(®) beams. This work conducted in Nancy, has included a test protocol initially drawn by the medical physicist of Nancy and Lille in collaboration with Equal-Estro Laboratory. A head and neck anthropomorphic phantom and a water-equivalent homogeneous cubic plastic test-object, so-called "MiniCube", have been used. Powder and solid thermoluminescent dosimeters as well as radiochromic films have been used to perform absolute and relative dose studies, respectively. The comparison between doses calculated by Multiplan treatment planning system and measured doses have been studied in absolute dose. The dose distributions measured with films and treatment planning system calculations have been compared via the gamma function, configured with different tolerance criteria. This work allowed, via solid thermoluminescent dosimeter measurements, verifying the beam reliability with a reproducibility of 1.7 %. The absolute dose measured in the phantom irradiated by the seven participating centres has shown an error inferior to the standard tolerance limits (± 5 %), for most of participating centres. The relative dose measurements performed at Nancy and by the Equal-Estro laboratory allowed defining the most adequate parameters for gamma index (5 %/2mm--with at least 95 % of pixels satisfying acceptability criteria: γsoftware. This work allowed defining a dosimetric external quality control for CyberKnife(®) systems, based on a reproducible irradiation plan through measurements performed with thermoluminescent dosimeters and radiochromic films. This protocol should be validated by a new series of measurement and taking into account the lessons of this work. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  3. Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries.

    Science.gov (United States)

    Burnett, Susan; Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

    2016-04-01

    Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. The development of hospital leaders' skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. © The Author(s) 2015.

  4. Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries

    Science.gov (United States)

    Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

    2015-01-01

    Objectives Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. Methods An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. Results How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. Conclusions The development of hospital leaders’ skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. PMID:26683885

  5. External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis.

    Science.gov (United States)

    Metcalfe, David; Hickson, Craig J; McKee, Lesley; Griffin, Xavier L

    2015-12-01

    It is uncertain whether external fixation or open reduction internal fixation (ORIF) is optimal for patients with bicondylar tibial plateau fractures. A systematic review using Ovid MEDLINE, Embase Classic, Embase, AMED, the Cochrane Library, Open Grey, Orthopaedic Proceedings, WHO International Clinical Trials Registry Platform, Current Controlled Trials, US National Institute for Health Trials Registry, and the Cochrane Central Register of Controlled Trials. The search was conducted on 3rd October 2014 and no language limits were applied. Inclusion criteria were all clinical study designs comparing external fixation with open reduction internal fixation of bicondylar tibial plateau fractures. Studies of only one treatment modality were excluded, as were those that included unicondylar tibial plateau fractures. Treatment effects from studies reporting dichotomous outcomes were summarised using odds ratios. Continuous outcomes were converted to standardized mean differences to assess the treatment effect, and inverse variance methods used to combine data. A fixed effect model was used for meta-analyses. Patients undergoing external fixation were more likely to have returned to preinjury activities by six and twelve months (P = 0.030) but not at 24 months follow-up. However, external fixation was complicated by a greater number of infections (OR 2.59, 95 % CI 1.25-5.36, P = 0.01). There were no statistically significant differences in the rates of deep infection, venous thromboembolism, compartment syndrome, or need for re-operation between the two groups. Although external fixation and ORIF are associated with different complication profiles, both are acceptable strategies for managing bicondylar tibial plateau fractures.

  6. IRIS TOXICOLOGICAL REVIEW AND SUMMARY DOCUMENTS FOR BORON AND COMPOUNDS (THIRD EXTERNAL REVIEW DRAFT 2002)

    Science.gov (United States)

    The U. S. EPA has conducted a peer review of the scientific basis supporting the health hazard and dose response assessment for Boron that will appear on the Agency's online data base, the Integrated Risk Information System (IRIS). Peer Review is meant to ensure that science is u...

  7. The Influence external signals on perceived quality and purchase intention products of high involvement (case study: Laptop)

    OpenAIRE

    MOHSEN NAZARI; ROGHAYEH REZAEE ARAB

    2014-01-01

    Nowadays, increasing competition in supplying and complexity of products caused information asymmetry between buyers and manufacturers that will eventually lead to adverse selection by purchasers. Thus, the role of external signals that are independent of the actual features of products become more important in quality perception and purchase intention of consumers. In this study, the effect of external signal (price, brand, Store brand, advertising, packaging, country of origin, friends, pre...

  8. Advanced Instrumentation, Information, and Control Systems Technologies Pathway: FY 2016 External Review

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Kenneth David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hallbert, Bruce Perry [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-11-01

    This report describes an External Review conducted by the LWRS Program Advanced Instrumentation, Information, and Control (II&C) Systems Technologies Pathway to solicit feedback on the topics and results of the ongoing II&C research program. This review was held in conjunction with the Nuclear Energy Institute (NEI) Digital I&C Working Group meeting that was held at Idaho National Laboratory (INL) on August 9-10, 2016. Given the opportunity to visit INL and see the pathway research projects, NEI agreed that the Working Group would serve as the External Review panel for the purpose of obtaining expert input on the value and timing of the research projects. This consisted of demonstrations in the Human Systems Simulation Laboratory followed by presentations on the II&C research program in general as well as the five technology development areas. Following the meeting, the presentations were sent to each of the attendees so they could review them in more detail and refer to them in completing the feedback form. Follow-up activities were conducted with the attendees following the meeting to obtain the completed feedback forms. A total of 13 forms were returned. The feedback forms were reviewed by the pathway to compile the data and comments received, which are documented in the report. In all, the feedback provided by the External Review participants is taken to be a strong endorsement of the types of projects being conducted by the pathway, the value they hold for the nuclear plants, and the general timing of need. The feedback aligns well with the priorities, levels of efforts allocated for the research projects, and project schedules. The feedback also represents realistic observations on the practicality of some aspects of implementing these technologies. In some cases, the participants provided thoughtful challenges to certain assumptions in the formulation of the technologies or in deployment plans. These deserve further review and revision of plans if warranted

  9. Peer Review and Quality Assessment in Complete Denture Education.

    Science.gov (United States)

    Novetsky, Marvin; Razzoog, Michael E.

    1981-01-01

    A program in peer review and quality assessment at the University of Michigan denture department is described. The program exposes students to peer review in order to assess the quality of their treatment. (Author/MLW)

  10. Quality of basic life support education and automated external defibrillator setting in schools in Ishikawa, Japan.

    Science.gov (United States)

    Takamura, Akiteru; Ito, Sayori; Maruyama, Kaori; Ryo, Yusuke; Saito, Manami; Fujimura, Shuhei; Ishiura, Yuna; Hori, Ariyuki

    2017-03-01

    Automated external defibrillators (AED) have been installed in schools in Japan since 2004, and the government strongly recommends teaching basic life support (BLS). We therefore examined the quality of BLS education and AED installation in schools. We conducted a prefecture-wide questionnaire survey of all primary and junior high schools in 2016, to assess BLS education and AED installation against the recommendations of the Japan Circulation Society. The results were analyzed using descriptive statistics and chi-squared test. In total, 195 schools out of 315 (62%) responded, of which 38% have introduced BLS education for children. BLS training was held in a smaller proportion of primary schools (18%) than junior high schools (86%). More than 90% of primary school staff had undergone BLS training in the previous 2 years. The most common locations of AED were the gymnasium (32%) followed by entrance hall (28%), staffroom (25%), and infirmary (12%). The reasons given for location were that it was obvious (34%), convenient for staff (32%), could be used out of hours (17%), and the most likely location for a heart attack (15%). Approximately 18% of schools reported that it takes >5 min to reach the AED from the furthest point. BLS training, AED location, and understanding of both are not sufficient to save children's lives efficiently. Authorities should make recommendations about the correct number of AED, and their location, and provide more information to improve the quality of BLS training in schools. © 2016 Japan Pediatric Society.

  11. Representation of External Qualities of the Person in the Russian And French Animalistic Phraseological Units

    Directory of Open Access Journals (Sweden)

    Vyacheslav Olegovich Puchkov

    2015-11-01

    Full Text Available Russian and French phraseological units with an animal name are considered with a special focus on their anthropomorphous semantics (external qualities of the person. The relevance of this research is caused by the urgent need of comparative studies of ethnocultural maps of the world that are encoded in phraseological corpus of any ethnos. Universal and ethno-specific features of animalistic phraseology are revealed in the article. The author states that the main function of animalistic phraseological units is not only pointing to some physical qualities of a person but assessing them. In the French map of the world the aesthetic criterion (beauty / ugliness dominates, whereas in the Russian map it is a physiological and social criteria (mainly, health and wellbeing. Superiority of the esthetic criterion in French is hidden in the mentality and is called the hedonism; opposing to it is Russian animalistic phraseology which is said to be originated from country folk traditions and is focused on physiological and social details in assessing the man's appearance. It is stated in the article that the lack of attention to esthetic criterion in the Russian phraseology may be explained by the influence of Orthodoxy on the content of the world map, the corporal beauty is opposed to internal, spiritual beauty. Contrary to it, under the influence of Catholicism an esthetic attitude to church rituals and corporal beauty was forwarded in the French culture. Finally, the author offers anthropological mechanism and an assessment function to be universal features of phraseology.

  12. External quality assessment of malaria microscopy in the Democratic Republic of the Congo

    Directory of Open Access Journals (Sweden)

    Lokombe Jean

    2011-10-01

    Full Text Available Abstract Background External quality assessments (EQA are an alternative to cross-checking of blood slides in the quality control of malaria microscopy. This study reports the findings of an EQA of malaria microscopy in the Democratic Republic of the Congo (DRC. Methods After validation, an EQA slide panel and a questionnaire were delivered to diagnostic laboratories in four provinces of DRC. The panel included three samples for diagnosis (sample 1: Plasmodium falciparum, 177,000/μl, sample 2: P. falciparum, 2,500/μl, sample 3: no parasites seen, one didactic sample (Howell-Jolly bodies and one sample for assessing the quality of staining. Participating laboratories were addressed and selected through the network of the National Tuberculosis Control Programme. Participants were asked to return the responses together with a stained thin and thick blood film for evaluation of Giemsa stain quality. Results Among 174 participants (response rate 95.1%, 26.2% scored samples 1, 2 and 3 correctly and 34.3%, 21.5% and 5.8% of participants reported major errors in one, two or three samples respectively. Major errors included reporting "no malaria" or "non-falciparum malaria" for Plasmodium falciparum-positive samples 1 and 2 (16.1% and 34.9% of participants respectively and "P. falciparum" for Plasmodium negative sample 3 (24.0%. Howell-Jolly bodies (didactic sample were not recognized by any of the participants but reported as "P. falciparum" by 16.7% of participants. With parasite density expressed according to the "plus system", 16.1% and 21.5% of participants scored one "+" different from the reference score for samples 1 and 2 respectively and 9.7% and 2.9% participants scored more than two "+" different. When expressed as counts of asexual parasites/μl, more than two-thirds of results were outside the mean ± 2SD reference values. The quality of the Giemsa stain was poor, with less than 20% slides complying with all criteria assessed. Only one

  13. The effect of competition from open source software on the quality of proprietary software in the presence of network externalities

    Directory of Open Access Journals (Sweden)

    Mingqing Xing

    2015-05-01

    Full Text Available Purpose: A growing number of open source software emerges in many segments of the software market. In addition, software products usually exhibit network externalities. The purpose of this paper is to study the impact of open source software on the quality choices of proprietary software vendors when the market presents positive network externalities. Design/methodology: To analyze how open source software affects the optimal quality of proprietary software, this paper constructs two vertical differentiation models: the basic model considers proprietary software monopolizing the market, and its extended one considers proprietary software competing with open source substitute. Findings: This paper mainly finds that the presence of open source software does not necessarily lead to the quality of proprietary software decreases (or increases. The network externalities and compatibility between open source and proprietary software may change the impact of open source software on the quality of proprietary software and may affect the quality choices of proprietary software vendors. Originality/value: The main contribution of this paper is to examine the effect of open source software on the quality choices for proprietary software vendors in software markets exhibiting positive network externalities.

  14. Impact of external industrial sources on the regional and local air quality of Mexico Megacity

    Directory of Open Access Journals (Sweden)

    V. H. Almanza

    2013-10-01

    Full Text Available The air quality of megacities can be influenced by external emissions sources on both global and regional scale, and at the same time their outflow emissions can exert an important impact to the surrounding environment. The present study evaluates an SO2 peak observed on 24 March 2006 at the suburban supersite T1 and ambient air quality monitoring stations located in the north region of the Mexico City Metropolitan Area (MCMA during MILAGRO campaign. We found that this peak could be related to an important episodic emission event from Tizayuca region, northeast of the MCMA. Back trajectories analyses suggest that the emission event started in the early morning at 04:00 LST and lasted for about 9 h. The estimated emission rate is noticeably high, about 2 kg s−1. This finding suggests the possibility of "overlooked" emission sources in this region that could influence the air quality of the MCMA. This further motivated us to study the cement plants, including those in the State of Hidalgo and in the State of Mexico, and we found that they can contribute in the NE region of the basin (about 41.7%, at the suburban supersite T1 (41.23% and at some monitoring stations their contribution can be even higher than from the Tula Industrial Complex. The contribution of Tula Industrial Complex to regional ozone levels is estimated. The model suggests low contribution to the MCMA (1 ppb to 4 ppb and slightly higher at the suburban T1 (6 ppb and rural T2 (5 ppb supersites. However, the contribution could be as high as 10 ppb in the upper northwest region of the basin and in the southwest and south-southeast regions of State of Hidalgo. In addition, a first estimate of the potential contribution from flaring activities to regional ozone levels is presented. Emission rates are estimated with a CFD combustion model. Results suggest that up to 30% of the total regional ozone from TIC could be related to flaring activities. Finally, the influence in SO2 levels

  15. External hemipelvectomy as treatment for solitary coxofemoral metastasis from endometrial carcinoma: case report and review of the literature.

    Science.gov (United States)

    Vizzielli, Giuseppe; Fanfani, Francesco; Costantini, Barbara; Gallotta, Valerio; Scambia, Giovanni; Fagotti, Anna

    2012-05-01

    The best treatment for bone metastasis from endometrial cancer as a presenting feature is unclear. We report the first case in the literature of coxofemoral metastases from endometrial cancer treated by surgical approach. Then, after a careful review of the literature, we discuss the best therapeutic option for this subset of patients. A 62-year-old woman with pain, erythema and swelling of the left leg and no history of postmenopausal bleeding underwent biopsy of the leg, which revealed a moderately differentiated endometrial carcinoma, infiltrating muscle and adipose tissues. There were no other sites of distal spread. A literature review was conducted by searching the items 'endometrial cancer' and 'bone metastasis' in MEDLINE and EnBase up to September 2010. The patient was treated with neoadjuvant chemotherapy, but she did not show a clinical response. By considering her prognosis and quality of life, we decided to perform for the first time a total abdominal hysterectomy with bilateral salpingo-oophorectomy in addition to an external hemipelvectomy with a limb amputation and partial ilium and pubic preservation. Thirty months after the procedure the patient is still alive. No other similar results are present in the literature. Patients in good clinical condition with a single bone metastasis of endometrial cancer should be treated aggressively with surgery, as survival can be extended with an acceptable quality of life.

  16. IRIS Toxicological Review of Ethylene Glycol Mono-Butyl Ether (Egbe) (External Review Draft)

    Science.gov (United States)

    EPA has conducted a peer review of the scientific basis supporting the human health hazard and dose-response assessment of ethylene glycol monobutyl ether that will appear on the Integrated Risk Information System (IRIS) database.

  17. IRIS Toxicological Review of Halogenated Platinum Salts and Platinum Compounds (External Review Draft)

    Science.gov (United States)

    EPA released the draft toxicological review for public comment under the Integrated Risk Information System (IRIS) Program. The original draft assessment (January 2009) has been archived but is available on this web page for the sake of transparency.

  18. IRIS Toxicological Review of Beryllium and Compounds (2008 External Review Draft)

    Science.gov (United States)

    EPA is conducting a peer review and public comment of the scientific basis supporting the human health hazard and dose-response assessment of Beryllium that when finalized will appear on the Integrated Risk Information System (IRIS) database.

  19. External beam radiotherapy in thyroid carcinoma: clinical review and recommendations of the AIRO "Radioterapia Metabolica" Group.

    Science.gov (United States)

    Mangoni, Monica; Gobitti, Carlo; Autorino, Rosa; Cerizza, Lorenzo; Furlan, Carlo; Mazzarotto, Renzo; Monari, Fabio; Simontacchi, Gabriele; Vianello, Federica; Basso, Michela; Zanirato Rambaldi, Giuseppe; Russi, Elvio; Tagliaferri, Luca

    2017-03-24

    The therapeutic approach to thyroid carcinoma usually involves surgery as initial treatment. The use of external beam radiotherapy (EBRT) is limited to high-risk patients and depends on clinical stage and histologic type. Different behavior patterns and degrees of aggressiveness of thyroid carcinomas require different management for differentiated, medullary, and anaplastic carcinoma. However, the role of EBRT is an issue of debate. Most clinical studies are retrospective and based on single-institution experiences. In this article, we review the main literature and give recommendations for the use of EBRT in thyroid carcinoma on behalf of the "Radioterapia Metabolica" Group of the Italian Radiation Oncology Association.

  20. Lactation studies of anticonvulsants: a quality review.

    Science.gov (United States)

    van der Meer, Douwe H; Wieringa, Andre; Wegner, Ilse; Wilffert, Bob; Ter Horst, Peter G J

    2015-04-01

    The aim of this review was to investigate the quality of the current literature on the transfer of anticonvulsants to breast milk to provide an overview of which anticonvulsants are in need of further research. We reviewed the quality of the available lactation studies for 19 anticonvulsants against the guidelines of the Food and Drug Administration (FDA) and the International Lactation Consultant Association (ILCA). Except for one study on lamotrigine and one case report on gabapentin, no study on anticonvulsants had both the absolute infant dose (AID) and milk to plasma ratio (M : P) correctly assessed. Only one study on carbamazepine, phenytoin and vigabatrin was found that correctly assessed the AID. The main cause for this low number is the lack of essential details in published studies, since 25 of 62 studies were case reports, letters or abstracts. Other major shortcomings were the lack of information on sampling methods, the number of samples in a particular dose interval as well as the low number of study participants. The quality of the current literature on the transfer of anticonvulsants to breast milk is low, except for lamotrigine, which makes it hard to draw conclusions about the safety of the use of anticonvulsants during the lactation period. Therefore, further research is needed. © 2014 The British Pharmacological Society.

  1. Impact of external industrial sources on the regional and local air quality of Mexico Megacity

    Science.gov (United States)

    Almanza, Victor; Molina, Luisa T.; Li, Guohui; Fast, Jerome; Sosa, Gustavo

    2014-05-01

    The air quality of megacities can be influenced by external emissions sources on both regional and global scales. At the same time their outflow emissions can exert an important impact to the surrounding environment. The present study evaluates an SO2 peak observed on 24 March 2006 at the suburban supersite and ambient air quality monitoring stations located in the northern region of the Mexico City Metropolitan Area (MCMA) during MILAGRO campaign. We found that this peak could be related to an important episodic emission event coming from Tizayuca region, northeast of the MCMA. Back trajectories analyses suggest that the emission event started in the early morning at 04:00 LST and lasted for about 9 hours. The estimated emission rate is high, about 2 kg s-1. This finding suggests the possibility of 'overlooked' emission sources in Tizayuca region that could influence the air quality of the MCMA. This further motivated us to study the cement plants, including those in the State of Hidalgo and the State of Mexico. We found that they can also contribute SO2 in the NE region of the basin, at the suburban supersite and that at some monitoring stations; their contribution can be even higher than from the Tula Industrial Complex (TIC). The contribution of TIC to regional ozone levels is also estimated. The model suggests low contribution to the MCMA and slightly higher contribution at the suburban and rural supersites. However, the contribution could be high in the upper northwest region of the basin and in the southwest and south-southeast regions of the State of Hidalgo. In addition, a first estimate of the potential contribution from flaring activities to regional ozone levels is presented. Results suggest that part of the total regional ozone from TIC-generated precursors could be related to flaring activities.

  2. The development and validation of dried blood spots for external quality assurance of syphilis serology

    Directory of Open Access Journals (Sweden)

    Smit Pieter W

    2013-02-01

    Full Text Available Abstract Background Syphilis causes up to 1,500,000 congenital syphilis cases annually. These could be prevented if all pregnant women were screened, and those with syphilis treated with a single dose of penicillin before 28 weeks gestation. In recent years, rapid point-of-care tests have allowed greater access to syphilis screening, especially in rural or remote areas, but the lack of quality assurance of rapid testing has been a concern. We determined the feasibility of using dried blood spots (DBS as specimens for quality assurance of syphilis serological assays. Methods We developed DBS extraction protocols for use with Treponema pallidum particle agglutination assay (TPPA, Treponema pallidum haemagglutination assay (TPHA and an enzyme immunoassay (EIA and compared the results with those using matching plasma samples from the same patient. Results Since DBS samples showed poor performance with TPHA and EIA (TPHA sensitivity was 50.5% (95% confidence interval: 39.9–61.2% and EIA specificity was 50.4% (95% CI: 43.7–57.1%, only the DBS TPPA was used in the final evaluation. DBS TPPA showed an sensitivity of 95.5% (95% CI: 91.3–98.0% and a specificity of 99.0% (95% CI: 98.1–99.5% compared to TPPA using plasma samples as a reference. Conclusion DBS samples can be recommended for use with TPPA, and may be of value for external quality assurance of point-of-care syphilis testing.

  3. 7 CFR 275.21 - Quality control review reports.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Quality control review reports. 275.21 Section 275.21... Reporting on Program Performance § 275.21 Quality control review reports. (a) General. Each State agency shall submit reports on the performance of quality control reviews in accordance with the...

  4. Final Independent External Peer Review Report for the Intake Diversion Dam Modification Lower Yellowstone Project, Montana Draft Supplement to the 26 April 2010 Environmental Assessment and Appendices

    Science.gov (United States)

    2013-02-08

    February 8, 2013 Final Independent External Peer Review Report for the Intake Diversion Dam Modification Lower Yellowstone Project, Montana...Final Independent External Peer Review Report for the Intake Diversion Dam Modification Lower Yellowstone Project, Montana Draft Supplement to the...Intake Project IEPR Final IEPR Report Intake Project IEPR Final IEPR Report Final Independent External Peer Review Report for the

  5. Basins 4.0 Climate Assessment Tool (Cat): Supporting Documentation and User Manual (External Review Draft)

    Science.gov (United States)

    EPA has released of the draft document solely for the purpose of pre-dissemination peer review under applicable Information Quality Guidelines (IQGs). This document has not been formally disseminated by EPA. It does not represent and should not be construed to represent any Agenc...

  6. The organization of multidisciplinary care teams: modeling internal and external influences on cancer care quality.

    Science.gov (United States)

    Fennell, Mary L; Das, Irene Prabhu; Clauser, Steven; Petrelli, Nicholas; Salner, Andrew

    2010-01-01

    Quality cancer treatment depends upon careful coordination between multiple treatments and treatment providers, the exchange of technical information, and regular communication between all providers and physician disciplines involved in treatment. This article will examine a particular type of organizational structure purported to regularize and streamline the communication between multiple specialists and support services involved in cancer treatment: the multidisciplinary treatment care (MDC) team. We present a targeted review of what is known about various types of MDC team structures and their impact on the quality of treatment care, and we outline a conceptual model of the connections between team context, structure, process, and performance and their subsequent effects on cancer treatment care processes and patient outcomes. Finally, we will discuss future research directions to understand how MDC teams improve patient outcomes and how characteristics of team structure, culture, leadership, and context (organizational setting and local environment) contribute to optimal multidisciplinary cancer care.

  7. [Systematic review of the Brazilian academic production about external causes and violence against the elderly].

    Science.gov (United States)

    Minayo, Maria Cecília de Souza; de Souza, Edinilsa Ramos; de Paula, Danúzia da Rocha

    2010-09-01

    This article presents a review about violence against the elderly, covering the period of 2000 to 2009. The database used in this research was the collection of articles, books, book chapters, manuals and plans of action of the Virtual Library on Violence and Health. We analyzed 115 documents divided into the following categories: falls; external causes and violence in general; epidemiological and socio-epidemiological studies; prevention of violence; violence and accidents in the family; conceptual and methodological review; legal order and denunciation; violence from the elderly's point of view; health services, professionals and caretakers; and construction and validation of research instruments. The results show a relevant increase in production and methodological improvement in public health, social work, law, physiotherapy, nursing, psychology and otorhinolaryngology. However, there are issues that have not been sufficiently approached such as traffic accidents, homicides, suicides, drowning and suffocation.

  8. IRIS Toxicological Review of Methanol (Non-Cancer) (External Review Draft; April 2011)

    Science.gov (United States)

    EPA is conducting a peer review and public comment of the scientific basis supporting the human health hazard and dose-response assessment of methanol (non-cancer) that when finalized will appear on the Integrated Risk Information System (IRIS) database.

  9. IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (Etbe) (External Review Draft, 2009)

    Science.gov (United States)

    EPA is conducting a peer review and public comment of the scientific basis supporting the human health hazard and dose-response assessment of ethyl tertiary butyl ether (ETBE) that when finalized will appear on the Integrated Risk Information System (IRIS) database.

  10. External quality assessment/proficiency testing and internal quality control for the PFA-100 and PFA-200: an update.

    Science.gov (United States)

    Favaloro, Emmanuel J; Bonar, Roslyn

    2014-03-01

    Platelet function testing is an essential component of comprehensive hemostasis evaluation within the framework of bleeding and/or bruising investigations, and it may also be performed to evaluate antiplatelet medication effects. Globally, the platelet function analyzer (PFA)-100 (Siemens Healthcare, Marburg, Germany) is the most used primary hemostasis-screening instrument and has also been recently remodeled/upgraded to the PFA-200. The PFA-100 is sensitive to a wide range of associated disorders, including platelet function defects and von Willebrand disease (VWD), as well as to various antiplatelet medications. The PFA-100 is also useful in therapy monitoring, especially in VWD. External quality assessment (EQA) (or proficiency testing) and internal quality control (IQC) are critical to ensuring quality of test practice, inclusive of all hemostasis tests. However, both EQA and IQC for platelet function testing, including the PFA-100, is logistically challenging, given theoretical requirements for production, storage, and shipment of large volumes of "stabilized" normal and pathological blood/platelets covering both normal function plus a wide variety of potential defects. We accordingly describe the development and testing of novel feasible approaches to both EQA and IQC of PFA-100/PFA-200 instruments, whereby a range of formulated "platelet function antagonist" materials are utilized. For EQA purposes, these are distributed to participants, and citrated normal whole blood collected on site is then added locally, thereby creating test material that can be locally evaluated. Several exercises have been conducted by the Royal College of Pathologists of Australasia Quality Assurance Program (RCPAQAP) over the past 6 years. A total of 26 challenges, with most designed to mimic moderate to severe primary hemostasis defects, have been tested in 26 to 50 laboratories depending on the year of dispatch. Numerical results for PFA-100/PFA-200 closure times (CTs) and

  11. Peer review to ensure quality in forensic mental health publication.

    Science.gov (United States)

    Felthous, Alan R; Wettstein, Robert M

    2014-01-01

    Peer reviewers have been called the gatekeepers of science. For journal publications in forensic psychiatry, as well as other disciplines, the purposes of peer review are to assist in the selection of manuscripts to publish, improve the quality of manuscripts before their publication, and promote the fairness of the process. In this article, we examine, in particular, characteristics of high-quality peer reviewers, selection of peer reviewers, recruitment and retention of peer reviewers, desired quality of peer-reviewer ratings, and the value of peer review. We conclude with specific, albeit largely untested, recommendations for improvements in peer review of forensic mental health publications.

  12. External Peer Review Team Report Underground Testing Area Subproject for Frenchman Flat, Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Sam Marutzky

    2010-09-01

    An external peer review was conducted to review the groundwater models used in the corrective action investigation stage of the Underground Test Area (UGTA) subproject to forecast zones of potential contamination in 1,000 years for the Frenchman Flat area. The goal of the external peer review was to provide technical evaluation of the studies and to assist in assessing the readiness of the UGTA subproject to progress to monitoring activities for further model evaluation. The external peer review team consisted of six independent technical experts with expertise in geology, hydrogeology,'''groundwater modeling, and radiochemistry. The peer review team was tasked with addressing the following questions: 1. Are the modeling approaches, assumptions, and model results for Frenchman Flat consistent with the use of modeling studies as a decision tool for resolution of environmental and regulatory requirements? 2. Do the modeling results adequately account for uncertainty in models of flow and transport in the Frenchman Flat hydrological setting? a. Are the models of sufficient scale/resolution to adequately predict contaminant transport in the Frenchman Flat setting? b. Have all key processes been included in the model? c. Are the methods used to forecast contaminant boundaries from the transport modeling studies reasonable and appropriate? d. Are the assessments of uncertainty technically sound and consistent with state-of-the-art approaches currently used in the hydrological sciences? 3. Are the datasets and modeling results adequate for a transition to Corrective Action Unit monitoring studies—the next stage in the UGTA strategy for Frenchman Flat? The peer review team is of the opinion that, with some limitations, the modeling approaches, assumptions, and model results are consistent with the use of modeling studies for resolution of environmental and regulatory requirements. The peer review team further finds that the modeling studies have accounted

  13. Customer satisfaction survey to improve the European cystic fibrosis external quality assessment scheme.

    Science.gov (United States)

    Berwouts, Sarah; Dequeker, Elisabeth

    2011-08-01

    The Cystic Fibrosis European Network, coordinated from within the Katholieke Universiteit Leuven, is the provider of the European cystic fibrosis external quality assessment (EQA) scheme. The network aimed to seek feedback from laboratories that participated in the cystic fibrosis scheme in order to improve services offered. In this study we analysed responses to an on-line customer satisfaction survey conducted between September and November 2009. The survey was sent to 213 laboratories that participated in the cystic fibrosis EQA scheme of 2008; 69 laboratories (32%) responded. Scores for importance and satisfaction were obtained from a five-point Likert scale for 24 attributes. A score of one corresponded to very dissatisfied/very unimportant and five corresponded to very satisfied/very important. Means were calculated and placed in a two-dimensional grid (importance-satisfaction analysis). Means were subtracted from each other to obtain gap values (gap-analysis). No attribute had a mean score below 3.63. The overall mean of satisfaction was 4.35. Opportunities for improvement enclosed clarity, usefulness and completeness of the general report and individual comments, and user-friendliness of the electronic datasheet. This type of customer satisfaction survey was a valuable instrument to identify opportunities to improve the cystic fibrosis EQA scheme. It should be conducted on a regular basis to reveal new opportunities in the future and to assess effectiveness of actions taken. Moreover, it could be a model for other EQA providers seeking feedback from participants. Overall, the customer satisfaction survey provided a powerful quality of care improvement tool.

  14. Second external quality assurance study for the serological diagnosis of hantaviruses in Europe.

    Directory of Open Access Journals (Sweden)

    Camille Escadafal

    Full Text Available Hantaviruses are endemic throughout the world and hosted by rodents and insectivores. Two human zoonoses, hemorrhagic fever with renal syndrome (HFRS and hantavirus pulmonary syndrome (HPS, are caused by hantaviruses and case fatality rates have reached 12% for HFRS and 50% for HPS in some outbreaks. Symptomatic hantavirus infections in Europe are summarised as HFRS mainly due to Puumala, Dobrava-Belgrade and Saaremaa virus. While HFRS has an overall low incidence in Europe, the number of cases varies from 100 per year in all Eastern and Southern Europe up to 1,000 per year only in Finland. To assess the quality of hantavirus diagnostics, the European Network for the Diagnostics of "Imported" Viral Diseases (ENIVD organised a first external quality assurance (EQA in 2002. The purpose of this second EQA study is to collect updated information on the efficiency and accurateness of hantavirus serological methods applied by expert laboratories. A serum panel of 14 samples was sent to 28 participants in Europe of which 27 sent results. Performance in hantavirus diagnosis varied not only on the method used but also on the laboratories and the subclass of antibodies tested. Commercial and in-house assays performed almost equally. Enzyme immunoassays were mainly used but did not show the best performances while immunoblot assays were the less employed and showed overall better performances. IgM antibodies were not detected in 61% of the positive IgM samples and IgM detection was not performed by 7% of the laboratories indicating a risk of overlooking acute infections in patients. Uneven performances using the same method is indicating that there is still a need for improving testing conditions and standardizing protocols.

  15. Detection of outliers and establishment of targets in external quality assessment programs.

    Science.gov (United States)

    Zhou, Qi; Li, Shaonan; Li, Xiaopeng; Wang, Wei; Wang, Zhiguo

    2006-10-01

    The establishment of target values is important in external quality assessment (EQA) programs since most of the programs use the target as the assessment criterion. Results submitted to EQA programs usually are not Gaussian-distributed due to the contamination with outliers. The traditional or robust statistical method can be chosen for the truncation of outliers. We investigated the two methods when setting targets for glucose in an EQA program. The results of glucose were analyzed as an all-methods group and divided into four subgroups according to the analytical methods prior to testing of each data distribution. Based on the distribution, the traditional or robust statistical method was used to detect outliers. After removal of outliers, the data distributions were retested and if Gaussian distributions were obtained, the mean values were used as the target. Original data sets were not Gaussian-distributed for all tested groups. Therefore, the robust statistical method was employed to detect outliers. After truncation of outliers, the data sets showed Gaussian distributions and the means were used to set target values. The targets of glucose were determined for all-methods and individual methods from the mean values following removal of outliers using the robust statistical method. This led to comparable targets among the tested groups.

  16. External quality assessment of the detection of rickettsioses inChina

    Institute of Scientific and Technical Information of China (English)

    Lijuan Zhang; Daxin Ni; Zijian Feng

    2010-01-01

    Objective:To report a training course on the laboratory diagnoses of rickettsioses that10 provincial/cityCDCs participated in laboratory external quality assurance(EQA)based on the serological specific antibodies detection and rapidPCR amplifying targeted genes of rickettsiae. Methods: An EQA program to evaluate the following laboratory procedures was developed to detect rickettsiae: (1)immunofluorescent assay (IFA) to detect specific antibodies ofA. phagocytophilum, R. heilongjiangensis andO. tsutsugamshi respectively.(2) Two sets of nested PCRwere used amplifying groEL genes for most members of the familyRickettsiaceae and amplifying16SrRNA genes for the most members of familyanaplasmae, respectively. A scoring scheme based on the distribution of the median antibody titer values of the serologic assays was designed and a ranking list of the scores of the PCRresults based on the detected minimal copy numbers of referenceDNA was created.Results: Among nine laboratories who reported the results on time, eight laboratories gave acceptable serologic results, the other one provided an unacceptable antibody titer (1:2 vs median1:64) results forO. tsutsugamshi. The limits of detection(LOD)for thePCR amplifying for five referencesDNA ranged from 1copy/μL to106 copy/μL.Conclusions:We successfully trained and popularized modern diagnostic methods of rickettsiae in10 provincialCDCs in China and first conducted the EQA projects and evaluated the results.

  17. Quantification of an External Motion Surrogate for Quality Assurance in Lung Cancer Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Jens Wölfelschneider

    2014-01-01

    Full Text Available The purpose of this work was to validate the stability of the end exhale position in deep expiration breath hold (DEBH technique for quality assurance in stereotactic lung tumor radiation therapy. Furthermore, a motion analysis was performed for 20 patients to evaluate breathing periods and baseline drifts based on an external surrogate. This trajectory was detected using stereo infrared (IR cameras and reflective body markers. The respiratory waveform showed large interpatient differences in the end exhale position during irradiation up to 18.8 mm compared to the global minimum. This position depends significantly on the tumor volume. Also the baseline drifts, which occur mostly in posterior direction, are affected by the tumor size. Breathing periods, which depend mostly on the patient age, were in a range between 2.4 s and 7.0 s. Fifteen out of 20 patients, who showed a reproducible end exhale position with a deviation of less than 5 mm, might benefit from DEBH due to smaller planning target volumes (PTV compared to free breathing irradiation and hence sparing of healthy tissue. Patients with larger uncertainties should be treated with more complex motion compensation techniques.

  18. External quality assurance system for antibiotic resistance in bacteria of animal origin in Europe (ARBAO-II), 2003

    NARCIS (Netherlands)

    Fo Wong, Lo D.M.A.; Hendriksen, R.S.; Mevius, D.J.; Veldman, K.T.; Aarestrup, F.M.

    2006-01-01

    Initiated in 2003 by the European Union, ARBAO-II aims to establish a monitoring of antimicrobial susceptibility among the veterinary laboratories in all European countries based on validated methodologies. This includes an external quality control system for the most important bacterial pathogens.

  19. GLYCOHEMOGLOBIN - COMPARISON OF 12 ANALYTICAL METHODS, APPLIED TO LYOPHILIZED HEMOLYSATES BY 101 LABORATORIES IN AN EXTERNAL QUALITY ASSURANCE PROGRAM

    NARCIS (Netherlands)

    WEYKAMP, CW; PENDERS, TJ; MUSKIET, FAJ; VANDERSLIK, W

    1993-01-01

    Stable lyophilized ethylenediaminetetra-acetic acid (EDTA)-blood haemolysates were applied in an external quality assurance programme (SKZL, The Netherlands) for glycohaemoglobin assays in 101 laboratories using 12 methods. The mean intralaboratory day-to-day coefficient of variation (CV), calculate

  20. External Quality Assessment in The Netherlands: time to introduce commutable survey specimens. Lessons from the Dutch "Calibration 2000" project.

    NARCIS (Netherlands)

    Baadenhuijsen, H.; Kuypers, A.W.H.M.; Weykamp, C.W.; Cobbaert, C.; Jansen, R.

    2005-01-01

    The performance of suitable secondary reference material for the use of trueness control of six routinely measured clinical enzymes in the Dutch External Quality Assessment (EQA) scheme is described. The reference material of choice was selected using the split-patient-sample between-field method (t

  1. The Impact of Identifying a Specific Purpose and External Audience for Writing on Second Graders' Writing Quality

    Science.gov (United States)

    Block, Meghan K.

    2013-01-01

    The Common Core State Standards for English Language Arts and Literacy in History/Social Studies, Science, and Technical Subjects (CCSS) emphasize the importance of writing and specify that students should write for external, and, at times, unfamiliar audiences. Given the relationship between audience specification and quality writing in older…

  2. Physical activity promotion in Latin American populations: a systematic review on issues of internal and external validity.

    Science.gov (United States)

    Galaviz, Karla I; Harden, Samantha M; Smith, Erin; Blackman, Kacie Ca; Berrey, Leanna M; Mama, Scherezade K; Almeida, Fabio A; Lee, Rebecca E; Estabrooks, Paul A

    2014-06-17

    The purpose of this review was to determine the degree to which physical activity interventions for Latin American populations reported on internal and external validity factors using the RE-AIM framework (reach & representativeness, effectiveness, adoption, implementation, maintenance). We systematically identified English (PubMed; EbscoHost) and Spanish (SCIELO; Biblioteca Virtual en Salud) language studies published between 2001 and 2012 that tested physical activity, exercise, or fitness promotion interventions in Latin American populations. Cross-sectional/descriptive studies, conducted in Brazil or Spain, published in Portuguese, not including a physical activity/fitness/exercise outcome, and with one time point assessment were excluded. We reviewed 192 abstracts and identified 46 studies that met the eligibility criteria (34 in English, 12 in Spanish). A validated 21-item RE-AIM abstraction tool was used to determine the quality of reporting across studies (0-7 = low, 8-14 = moderate, and 15-21 = high). The number of indicators reported ranged from 3-14 (mean = 8.1 ± 2.6), with the majority of studies falling in the moderate quality reporting category. English and Spanish language articles did not differ on the number of indicators reported (8.1 vs. 8.3, respectively). However, Spanish articles reported more across reach indicators (62% vs. 43% of indicators), while English articles reported more across effectiveness indicators (69% vs 62%). Across RE-AIM dimensions, indicators for reach (48%), efficacy/effectiveness (67%), and implementation (41%) were reported more often than indicators of adoption (25%) and maintenance (10%). Few studies reported on the representativeness of participants, staff that delivered interventions, or the settings where interventions were adopted. Only 13% of the studies reported on quality of life and/or potential negative outcomes, 20% reported on intervention fidelity, and 11% on cost of implementation

  3. Engineering Strategies and Methods for Avoiding Air-Quality Externalities: Dispersion Modeling, Home Energy Conservation, and Scenario Planning

    Science.gov (United States)

    Knox, Andrew James

    Energy conservation can improve air quality by reducing emissions from fuel combustion. The human health value retained through better air quality can then offset the cost of energy conservation. Through this thesis' innovative yet widely-accessible combination of air pollution dispersion modeling and atmospheric chemistry, it is estimated that the health value retained by avoiding emissions from Ontario's former coal-fired generating stations is 5.74/MWh (using an upper-bound value of 265,000 per year of life lost). This value is combined with energy modeling of homes in the first-ever assessment of the air-quality health benefits of low-energy buildings. It is shown that avoided health damages can equal 7% of additional construction costs of energy efficient buildings in Ontario. At 7%, health savings are a significant item in the cost analysis of efficient buildings. Looking to energy efficiency in the context of likely future low-resource natural gas scenarios, building efficient buildings today is shown to be more economically efficient than any building retrofit option. Considering future natural gas scarcity in the context of Ontario's Long-Term Energy Plan reveals that Ontario may be forced to return to coal-fired electricity. Projected coal use would result in externalities greater than $600 million/year; 80% more than air-quality externalities from Ontario's electricity in 1985. Radically aggressive investment in electricity conservation (75% reduction per capita by 2075) is one promising path forward that keeps air-quality externalities below 1985 levels. Non-health externalities are an additional concern, the quantification, and ultimately monetization, of which could be practical using emerging air pollution monitoring technologies. Energy, conservation, energy planning, and energy's externalities form a complex situation in which today's decisions are critical to a successful future. It is clear that reducing the demand for energy is essential and

  4. External Use of Propolis for Oral, Skin, and Genital Diseases: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Sung, Soo-Hyun; Choi, Gwang-Ho; Lee, Nam-Woo

    2017-01-01

    Objective. The aim of this review is to provide the available evidence on the external use of propolis (EUP) for oral, skin, and genital diseases. Method. We searched twelve electronic databases for relevant studies up to June 2016. Randomized clinical trials (RCTs) were included and analysed. Results. Of the 286 articles identified, twelve potentially relevant studies met our inclusion criteria. A meta-analysis of two studies on recurrent oral aphthae (ROA) indicated that there were no significant differences in total effective rate (TER) for pain disappearance between EUP and placebo groups (RR = 1.96, 95% CI = 0.97–3.98, and P = 0.06). In two studies on skin diseases, the combined treatment of EUP with other interventions revealed significant effects on the duration of treatment or TER. In one study on genital diseases, EUP showed significant differences in genital herpes outcome measures compared to placebo. Conclusions. Our results on the effectiveness of EUP for treating oral, skin, and genital diseases are not conclusive because of the low methodological qualities and small sample sizes. Further well-designed randomized controlled trials, with high quality and large samples for specific disorders, must be conducted to obtain firm conclusions.

  5. How to assess the external validity and model validity of therapeutic trials: a conceptual approach to systematic review methodology.

    Science.gov (United States)

    Khorsan, Raheleh; Crawford, Cindy

    2014-01-01

    Background. Evidence rankings do not consider equally internal (IV), external (EV), and model validity (MV) for clinical studies including complementary and alternative medicine/integrative medicine (CAM/IM) research. This paper describe this model and offers an EV assessment tool (EVAT©) for weighing studies according to EV and MV in addition to IV. Methods. An abbreviated systematic review methodology was employed to search, assemble, and evaluate the literature that has been published on EV/MV criteria. Standard databases were searched for keywords relating to EV, MV, and bias-scoring from inception to Jan 2013. Tools identified and concepts described were pooled to assemble a robust tool for evaluating these quality criteria. Results. This study assembled a streamlined, objective tool to incorporate for the evaluation of quality of EV/MV research that is more sensitive to CAM/IM research. Conclusion. Improved reporting on EV can help produce and provide information that will help guide policy makers, public health researchers, and other scientists in their selection, development, and improvement in their research-tested intervention. Overall, clinical studies with high EV have the potential to provide the most useful information about "real-world" consequences of health interventions. It is hoped that this novel tool which considers IV, EV, and MV on equal footing will better guide clinical decision making.

  6. Does mentoring new peer reviewers improve review quality? A randomized trial

    Directory of Open Access Journals (Sweden)

    Houry Debra

    2012-08-01

    Full Text Available Abstract Background Prior efforts to train medical journal peer reviewers have not improved subsequent review quality, although such interventions were general and brief. We hypothesized that a manuscript-specific and more extended intervention pairing new reviewers with high-quality senior reviewers as mentors would improve subsequent review quality. Methods Over a four-year period we randomly assigned all new reviewers for Annals of Emergency Medicine to receive our standard written informational materials alone, or these materials plus a new mentoring intervention. For this program we paired new reviewers with a high-quality senior reviewer for each of their first three manuscript reviews, and asked mentees to discuss their review with their mentor by email or phone. We then compared the quality of subsequent reviews between the control and intervention groups, using linear mixed effects models of the slopes of review quality scores over time. Results We studied 490 manuscript reviews, with similar baseline characteristics between the 24 mentees who completed the trial and the 22 control reviewers. Mean quality scores for the first 3 reviews on our 1 to 5 point scale were similar between control and mentee groups (3.4 versus 3.5, as were slopes of change of review scores (-0.229 versus -0.549 and all other secondary measures of reviewer performance. Conclusions A structured training intervention of pairing newly recruited medical journal peer reviewers with senior reviewer mentors did not improve the quality of their subsequent reviews.

  7. Exploring the role of external criticism in Obsessive Compulsive Disorder: a narrative review.

    Science.gov (United States)

    Pace, Sonia M; Thwaites, Richard; Freeston, Mark H

    2011-04-01

    The concept of external criticism has been associated with different aspects of Obsessive Compulsive phenomena. The various threads of evidence highlight the potential role of criticism within different areas of the cognitive model of Obsessive Compulsive Disorder (OCD) with often overlapping ideas. However, the fragmented nature of the findings makes it difficult to identify how or why criticism impacts on OCD. This review collates the existing findings and maps these onto the cognitive model of OCD to provide a better understanding of the potential role of criticism. It proposes criticism could play a role in OCD as a vulnerability factor, but also as a perpetuating factor. Furthermore potential research questions have been generated which could help inform future understanding. Future research should consider the complexity of the concept when defining criticism as well as developing methodological designs which could answer questions of causality.

  8. Human internal and external exposure to PBDEs - A review of levels and sources

    DEFF Research Database (Denmark)

    Frederiksen, Marie; Vorkamp, Katrin; Thomsen, Marianne

    2009-01-01

    ingest more dust than adults. Infants are also exposed to PBDEs via breast milk. Internal human exposure has generally been found to be one order of magnitude larger in North America than in Europe and Asia. These differences cannot solely be explained by the dietary intake as meat products are the only......This paper reviews the existing literature on human exposure to polybrominated diphenyl ethers (PBDEs), with particular focus on external exposure routes (e.g. dust, diet, and air) and the resulting internal exposure to PBDEs (e.g. breast milk and blood). Being lipophilic and persistent organic...... compounds, PBDEs accumulate in lipid-rich tissues. Consequently, food items like fish from high trophic levels or lipid-rich oils have been found to contain relatively high concentrations of PBDEs, thus presenting an important exposure pathway to humans. The presence of PBDEs in various products of everyday...

  9. External quality assessment for KRAS testing is needed: setup of a European program and report of the first joined regional quality assessment rounds

    DEFF Research Database (Denmark)

    Bellon, Ellen; Ligtenberg, Marjolijn J L; Tejpar, Sabine

    2011-01-01

    . In an effort to ensure optimal, uniform, and reliable community-based KRAS testing throughout Europe, a KRAS external quality assessment (EQA) scheme was set up. The first large assessment round included 59 laboratories from eight different European countries. For each country, one regional scheme organizer...... expand this program to more laboratories to provide a robust estimate of the quality of KRAS testing in Europe, and provide the basis for remedial measures and harmonization....

  10. First international external quality assessment of molecular detection of Crimean-Congo hemorrhagic fever virus.

    Directory of Open Access Journals (Sweden)

    Camille Escadafal

    Full Text Available Crimean-Congo hemorrhagic fever (CCHF is a zoonosis caused by a Nairovirus of the family Bunyaviridae. Infection is transmitted to humans mostly by Hyalomma ticks and also by direct contact with the blood or tissues of infected humans or viremic livestock. Clinical features usually include a rapid progression characterized by hemorrhage, myalgia and fever, with a lethality rate up to 30%. CCHF is one of the most widely distributed viral hemorrhagic fevers and has been reported in Africa, the Middle East and Asia, as well as parts of Europe. There is no approved vaccine or specific treatment against CCHF virus (CCHFV infections. In this context, an accurate diagnosis as well as a reliable surveillance of CCHFV infections is essential. Diagnostic techniques include virus culture, serology and molecular methods, which are now increasingly used. The European Network for the Diagnostics of "Imported" Viral Diseases organized the first international external quality assessment of CCHVF molecular diagnostics in 2011 to assess the efficiency and accurateness of CCHFV molecular methods applied by expert laboratories. A proficiency test panel of 15 samples was distributed to the participants including 10 different CCHFV preparations generated from infected cell cultures, a preparation of plasmid cloned with the nucleoprotein of CCHFV, two CCHFV RNA preparations and two negative controls. Forty-four laboratories worldwide participated in the EQA study and 53 data sets were received. Twenty data sets (38% met all criteria with optimal performance, 10 (19% with acceptable performance, while 23 (43% reported results showing a need for improvement. Differences in performance depended on the method used, the type of strain tested, the concentration of the sample tested and the laboratory performing the test. These results indicate that there is still a need for improving testing conditions and standardizing protocols for the molecular detection of Crimean

  11. External quality assessment of patient HLA-B*57:01 testing prior to abacavir prescription.

    Science.gov (United States)

    Darke, C; Corbin, S A

    2014-08-01

    Hypersensitivity reactions to the drug abacavir are strongly associated with possession of HLA-B*57:01. Hence, patients with HIV/AIDS who may be prescribed abacavir should be tested for this HLA allele and the drug withheld from those that possess B*57:01. The UK National External Quality Assessment Service for Histocompatibility and Immunogenetics has operated a scheme for B*57:01 testing since 2008 which, in 2013, involved 47 participants from 12 countries. A total of 24 B*57:01-positive, 2 B*57:03-positive and 22 B*57-negative blood samples (including 2 B*58 samples) were distributed to between 28 and 47 laboratories each year over 6 years. Participants, who were unaware of the samples' HLA types, tested and reported on their B*57/B*57:01 status. A total of 1868 reports were assessed over the 6 years. Of the 880 reports on B*57:01 samples, 93.4% were correctly assigned as B*57:01, 2.8% were assigned as groups of B*57 alleles including B*57:01, and 3.3% were reported as B*57 positive only. Over the 6 years, there were four (0.46%) false B*57:01 negative reports. All the B*57:03-positive and B*57-negative samples, involving 72 and 916 assignments, respectively, were essentially reported as B*57:01 negative. Thus, there were no false B57:01 positive assignments. The reporting of B*57:01 status over the last 3 years of the scheme was 99.8% sensitive and 100% specific. Over the last year, it was 100% sensitive and 100% specific.

  12. External quality assessment of dengue and chikungunya diagnostics in the Asia Pacific region, 2015

    Directory of Open Access Journals (Sweden)

    Li Ting Soh

    2016-04-01

    Full Text Available Objective: To conduct an external quality assessment (EQA of dengue and chikungunya diagnostics among national-level public health laboratories in the Asia Pacific region following the first round of EQA for dengue diagnostics in 2013. Methods: Twenty-four national-level public health laboratories performed routine diagnostic assays on a proficiency testing panel consisting of two modules. Module A contained serum samples spiked with cultured dengue virus (DENV or chikungunya virus (CHIKV for the detection of nucleic acid and DENV non-structural protein 1 (NS1 antigen. Module B contained human serum samples for the detection of anti-DENV antibodies. Results: Among 20 laboratories testing Module A, 17 (85% correctly detected DENV RNA by reverse transcription polymerase chain reaction (RT-PCR, 18 (90% correctly determined serotype and 19 (95% correctly identified CHIKV by RT-PCR. Ten of 15 (66.7% laboratories performing NS1 antigen assays obtained the correct results. In Module B, 18/23 (78.3% and 20/20 (100% of laboratories correctly detected anti-DENV IgM and IgG, respectively. Detection of acute/recent DENV infection by both molecular (RT-PCR and serological methods (IgM was available in 19/24 (79.2% participating laboratories. Discussion: Accurate laboratory testing is a critical component of dengue and chikungunya surveillance and control. This second round of EQA reveals good proficiency in molecular and serological diagnostics of these diseases in the Asia Pacific region. Further comprehensive diagnostic testing, including testing for Zika virus, should comprise future iterations of the EQA.

  13. International external quality assessment of molecular detection of Rift Valley fever virus.

    Directory of Open Access Journals (Sweden)

    Camille Escadafal

    Full Text Available Rift Valley fever (RVF is a viral zoonosis that primarily affects animals resulting in considerable economic losses due to death and abortions among infected livestock. RVF also affects humans with clinical symptoms ranging from an influenza-like illness to a hemorrhagic fever. Over the past years, RVF virus (RVFV has caused severe outbreaks in livestock and humans throughout Africa and regions of the world previously regarded as free of the virus. This situation prompts the need to evaluate the diagnostic capacity and performance of laboratories worldwide. Diagnostic methods for RVFV detection include virus isolation, antigen and antibody detection methods, and nucleic acid amplification techniques. Molecular methods such as reverse-transcriptase polymerase chain reaction and other newly developed techniques allow for a rapid and accurate detection of RVFV. This study aims to assess the efficiency and accurateness of RVFV molecular diagnostic methods used by expert laboratories worldwide. Thirty expert laboratories from 16 countries received a panel of 14 samples which included RVFV preparations representing several genetic lineages, a specificity control and negative controls. In this study we present the results of the first international external quality assessment (EQA for the molecular diagnosis of RVF. Optimal results were reported by 64% of the analyses, 21% of the analyses achieved acceptable results and 15% of the results revealed that there is need for improvement. Evenly good performances were achieved by specific protocols which can therefore be recommended as an accurate molecular protocol for the diagnosis of RVF. Other protocols showed uneven performances revealing the need for improved optimization and standardization of these protocols.

  14. External quality assessment for the determination of diphtheria antitoxin in human serum.

    Science.gov (United States)

    Di Giovine, Paolo; Pinto, Antonella; Olander, Rose-Marie; Sesardic, Dorothea; Stickings, Paul; Berbers, Guy; Neal, Shona; Efstratiou, Androulla; Paberza, Ruta; Dauksiene, Snieguole; Bujko, Marina; Detcheva, Antoaneta; Joks, Unna; Levent, Belkis; von Hunolstein, Christina

    2010-08-01

    Accurate determination of diphtheria toxin antibodies is of value in determining the rates of immunity within broad populations or the immune status of individuals who may be at risk of infection, by assessing responses to vaccination and immunization schedule efficacy. Here we report the results of an external quality assessment (EQA) study for diphtheria serology, performed within the dedicated surveillance network DIPNET. Twelve national laboratories from 11 European countries participated by testing a standard panel of 150 sera using their current routine method: Vero cell neutralization test (NT), double-antigen enzyme-linked immunosorbent assay (ELISA; DAE), dual double-antigen time-resolved fluorescence immunoassay (dDA-DELFIA), passive hemagglutination assay (PHA), toxin binding inhibition assay (ToBI), and in-house or commercial ELISAs. The objective of the study was not to identify the best assay, as the advantages and drawbacks of methods used were known, but to verify if laboratories using their routine method would have categorized (as negative, equivocal, or positive) a serum sample in the same way. The performance of each laboratory was determined by comparing its results on a quantitative and qualitative basis to NT results from a single reference laboratory, as this test is considered the in vitro "gold standard." The performance of laboratories using NT was generally very good, while the laboratories' performance using other in vitro methods was variable. Laboratories using ELISA and PHA performed less well than those using DAE, dDA-DELFIA, or ToBI. EQA is important for both laboratories that use in vitro nonstandardized methods and those that use commercial ELISA kits.

  15. External quality assessment of urine particle identification: a Northern European experience.

    Science.gov (United States)

    Kouri, Timo T; Makkonen, Pirjo

    2015-11-01

    External quality assessment (EQA) schemes for urinalysis have been provided by Labquality Ltd, the publicly owned EQA service provider in Finland, since the 1980s. In 2014, the scheme on urine particle identification had 329 participating laboratories, out of which 60% from 19 countries were outside Finland. Each of the four annual web-based rounds were distributed with four Sternheimer-stained images from a single patient sample, as viewed both by bright-field and phase-contrast optics. Participants reported classified categories either at the basic or at the advanced level. Participating laboratories received assessment of their analytical performance as compared to their peers, including reflections from clinical data and preanalytical detail of the specimen. In general, reporting of basic urine particles succeeded in the eight schemes during the years 2013-2014 as follows: red blood cells 82%-92%, white blood cells 82%-97%, squamous epithelial cells 92%-98%, casts 84%-94%, and small epithelial cells 73%-83% (minimum and maximum of expected or accepted reports). This basic level of differentiation is used in routine laboratory reports, or as verification of results produced by automated instruments. Considerable effort is needed to standardise national procedures and reporting formats, in order to improve the shown figures internationally. Future technologies may help to alleviate limitations created by single digital images. Despite improvements, degenerating cells and casts always exhibit intermediate forms creating disputable classifications. That is why assessment of performance should encompass justified acceptable categories into the assessed outcomes. Preanalytical and clinical detail provide essential added value to morphological findings.

  16. External validation of a measurement tool to assess systematic reviews (AMSTAR.

    Directory of Open Access Journals (Sweden)

    Beverley J Shea

    Full Text Available BACKGROUND: Thousands of systematic reviews have been conducted in all areas of health care. However, the methodological quality of these reviews is variable and should routinely be appraised. AMSTAR is a measurement tool to assess systematic reviews. METHODOLOGY: AMSTAR was used to appraise 42 reviews focusing on therapies to treat gastro-esophageal reflux disease, peptic ulcer disease, and other acid-related diseases. Two assessors applied the AMSTAR to each review. Two other assessors, plus a clinician and/or methodologist applied a global assessment to each review independently. CONCLUSIONS: The sample of 42 reviews covered a wide range of methodological quality. The overall scores on AMSTAR ranged from 0 to 10 (out of a maximum of 11 with a mean of 4.6 (95% CI: 3.7 to 5.6 and median 4.0 (range 2.0 to 6.0. The inter-observer agreement of the individual items ranged from moderate to almost perfect agreement. Nine items scored a kappa of >0.75 (95% CI: 0.55 to 0.96. The reliability of the total AMSTAR score was excellent: kappa 0.84 (95% CI: 0.67 to 1.00 and Pearson's R 0.96 (95% CI: 0.92 to 0.98. The overall scores for the global assessment ranged from 2 to 7 (out of a maximum score of 7 with a mean of 4.43 (95% CI: 3.6 to 5.3 and median 4.0 (range 2.25 to 5.75. The agreement was lower with a kappa of 0.63 (95% CI: 0.40 to 0.88. Construct validity was shown by AMSTAR convergence with the results of the global assessment: Pearson's R 0.72 (95% CI: 0.53 to 0.84. For the AMSTAR total score, the limits of agreement were -0.19+/-1.38. This translates to a minimum detectable difference between reviews of 0.64 'AMSTAR points'. Further validation of AMSTAR is needed to assess its validity, reliability and perceived utility by appraisers and end users of reviews across a broader range of systematic reviews.

  17. Checklists for external validity

    DEFF Research Database (Denmark)

    Dyrvig, Anne-Kirstine; Kidholm, Kristian; Gerke, Oke;

    2014-01-01

    RATIONALE, AIMS AND OBJECTIVES: The quality of the current literature on external validity varies considerably. An improved checklist with validated items on external validity would aid decision-makers in judging similarities among circumstances when transferring evidence from a study setting...... to an implementation setting. In this paper, currently available checklists on external validity are identified, assessed and used as a basis for proposing a new improved instrument. METHOD: A systematic literature review was carried out in Pubmed, Embase and Cinahl on English-language papers without time restrictions....... The retrieved checklist items were assessed for (i) the methodology used in primary literature, justifying inclusion of each item; and (ii) the number of times each item appeared in checklists. RESULTS: Fifteen papers were identified, presenting a total of 21 checklists for external validity, yielding a total...

  18. Review of SKB's Safety Assessment SR-Can: Contributions in Support of SKI's and SSI's Review by External Consultants

    Energy Technology Data Exchange (ETDEWEB)

    2008-03-15

    The Swedish Nuclear Fuel and Waste Management Co (SKB) plans to submit a license application for the construction of a repository for spent nuclear fuel in Sweden 2010. In support of this application SKB will present a safety report, SR-Site, on the repository's long-term safety and radiological consequences. As a preparation for SR-Site, SKB published the preliminary safety assessment SR-Can in November 2006. The purposes were to document a first evaluation of long-term safety for the two candidate sites at Forsmark and Laxemar and to provide feedback to SKB's future programme of work. An important objective of the authorities' review of SR-Can is to provide guidance to SKB on the complete safety reporting for the license application. The authorities have engaged external experts for independent modelling, analysis and review, with the aim to provide a range of expert opinions related to the sufficiency and appropriateness of various aspects of SR-Can. The conclusions and judgments in this report are those of the authors and may not necessarily coincide with those of SKI and SSI. The authorities own review will be published separately (SKI Report 2008:23, SSI Report 2008:04 E). This report compiles contributions from several specific research projects. The separate reviews cover topics regarding the engineered barrier system, the quality assurance, the climate evolution and its effects, and the ecosystems and environmental impacts. All contributions are in English apart from the review concerning ecosystems and environmental impacts, which is presented in Swedish

  19. IPEEE Review of other external events of the NPP Asco; Revision del IPEEE de sucesos externos de C.N. Asco

    Energy Technology Data Exchange (ETDEWEB)

    Canadell, F.; Aleman, A.; Beltran, F.; Pifarre, D.; Hernandez, H.; Gasca, C.

    2011-07-01

    Within the process of maintaining and updating the risk analysis of the NPP Asco, results from the review of the vulnerability study of the plant against severe accidents caused by external success (Individual Plant Examination of External Events, IPEEE).

  20. EVALUATING THE ROLE OF THE REGULATORS OF THE EXTERNAL AUDIT PROFESSION IN ACHIEVING THE AUDIT QUALITY IN IRAQ

    Directory of Open Access Journals (Sweden)

    Fedaa Abd Almajid Sabbar Alaraji

    2016-12-01

    Full Text Available The profession of quality auditing can have direct or indirect effects on the performance of accountants and auditors. Both particular research and professional recommendations provided evidence on measuring and evaluating service performance of audit profession by taking into account the relationship between quality and accountant performance. Applied research was developed in Republic of Iraq to reveal the function of bodies that regulate external audit for achieving the required level of audit quality and for identifying the obstacles that prevent the compliance with International Auditing Standards. Research focuses on the role of these bodies in order to achieve the quality of audit by implementing a quality control system. Its benefits reduce chances of criticisms and weaknesses, improving the auditing environment in Iraq.

  1. 42 CFR 412.44 - Medical review requirements: Admissions and quality review.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Medical review requirements: Admissions and quality... Capital-Related Costs § 412.44 Medical review requirements: Admissions and quality review. Beginning on... completeness, adequacy, and quality of the services furnished in the hospital. (e) Other medical or other...

  2. 7 CFR 90.102 - Quality assurance review.

    Science.gov (United States)

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS INTRODUCTION Quality Assurance § 90.102 Quality assurance review. (a) Each laboratory performing tests...

  3. External Peer Review Team Report Underground Testing Area Subproject for Frenchman Flat, Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Sam Marutzky

    2010-09-01

    An external peer review was conducted to review the groundwater models used in the corrective action investigation stage of the Underground Test Area (UGTA) subproject to forecast zones of potential contamination in 1,000 years for the Frenchman Flat area. The goal of the external peer review was to provide technical evaluation of the studies and to assist in assessing the readiness of the UGTA subproject to progress to monitoring activities for further model evaluation. The external peer review team consisted of six independent technical experts with expertise in geology, hydrogeology,'''groundwater modeling, and radiochemistry. The peer review team was tasked with addressing the following questions: 1. Are the modeling approaches, assumptions, and model results for Frenchman Flat consistent with the use of modeling studies as a decision tool for resolution of environmental and regulatory requirements? 2. Do the modeling results adequately account for uncertainty in models of flow and transport in the Frenchman Flat hydrological setting? a. Are the models of sufficient scale/resolution to adequately predict contaminant transport in the Frenchman Flat setting? b. Have all key processes been included in the model? c. Are the methods used to forecast contaminant boundaries from the transport modeling studies reasonable and appropriate? d. Are the assessments of uncertainty technically sound and consistent with state-of-the-art approaches currently used in the hydrological sciences? 3. Are the datasets and modeling results adequate for a transition to Corrective Action Unit monitoring studies—the next stage in the UGTA strategy for Frenchman Flat? The peer review team is of the opinion that, with some limitations, the modeling approaches, assumptions, and model results are consistent with the use of modeling studies for resolution of environmental and regulatory requirements. The peer review team further finds that the modeling studies have accounted

  4. External Application of Traditional Chinese Medicine for Venous Ulcers: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Xin Li

    2015-01-01

    Full Text Available Objective. To evaluate the effectiveness of external application of traditional Chinese medicine (EA-TCM on venous ulcers. Methods. Seven databases were searched until April 2015 for randomized controlled trials (RCTs of EA-TCM for venous ulcers. Risk of bias was assessed using Cochrane Handbook guidelines. Study outcomes were presented as risk ratios (RRs for dichotomous data or mean differences (MDs for continuous data. Results. Sixteen of 193 potentially relevant trials met the inclusion criteria; however, their methodological qualities were low. Comparison of the same intervention strategies revealed significant differences in total effectiveness rates between EA-TCM and conventional therapy groups (RR = 1.22, 95% confidence interval [CI] = 1.16–1.29, and P<0.00001. Compared to conventional therapy, EA-TCM combined with conventional therapy had a superior total effectiveness rate (RR = 1.11, 95% CI = 1.04–1.19, and P=0.003. There were no significant differences in recurrence rates during followup and final pain measurements between the experimental and those in the control groups (RR = 0.86, 95% CI = 0.31–2.39, and P=0.85; MD −0.75, 95% CI = −2.15–0.65, and P=0.29. Conclusion. The evidence that EA-TCM is an effective treatment for venous ulcers is encouraging, but not conclusive due to the low methodological quality of the RCTs. Therefore, more high-quality RCTs with larger sample sizes are required.

  5. Internal and External Resources as Determinants of Health and Quality of Life.

    Directory of Open Access Journals (Sweden)

    Elfriede Greimel

    Full Text Available The salutogenic model has been established as a health promoting resource that is related to a strong sense of coherence (SOC, positive subjective health and quality of life (QoL. The aim of the study was to compare internal and external resources, life style factors, perceived health and QoL in Japan and Austria and to determine associations among these factors.A survey was conducted in a Japanese (N = 460 and an Austrian (N = 421 student sample using the following self-report health questionnaires: Sense of Coherence Scale (SOC-13, Social and Gender Role Scale, Multidimensional Scale of Perceived Social Support (MSPSS, Dutch Eating Behaviour Questionnaire (DEBQ, SF-12 Health Survey, and the Cross-cultural Health Survey. Analyses of data showed that age (ß -0.12, and stress (ß -0.21 were negatively related and SOC (ß 0.47, family support are (ß -0.35 positively related to mental QoL. Significant predictors for emotional strain, were female gender (ß -0.24, older age (ß-0.14, lower SOC (ß 0.28, less traditional gender and social role patterns (ß 0.10, more restrained eating (ß -0.20, more alcohol intake (ß -0.16, and more stress (ß -0.25 explaining 42% of the variance in Austrian students. In Japan stress (ß -0.38 was negatively related and SOC (ß 0.37 positively related to mental QoL. Older age (ß -0.20, lower SOC (ß 0.29 and more stress (ß -0.33 were identified as significant predictors explaining 35% of the variance in Japanese students.SOC and stress are strongly associated with QoL and perceived health in Austria as well as in Japan. SOC seems to be a crucial predictor for stress, and emotional health independent of the cultural context. A major challenge of cross-cultural research is to understand perceived health and QoL and the extent in which it is individually, socially, or culturally determined.

  6. External audit quality and ownership structure: interaction and impact on earnings management of industrial and commercial Tunisian sectors

    Directory of Open Access Journals (Sweden)

    Amel Kouaib

    2014-12-01

    Full Text Available This article emphasizes the significance of researching the cross effect of using jointly external audit quality and ownership structure over managerial discretion in a largely unexplored, non-Western and emerging context. The analysis is based on a sample of 61 Tunisian firms listed and unlisted on the Tunis Stock Exchange and operating in the industrial and commercial sectors during the period 2007-2011. To provide evidence on this topic, we conduct an empirical examination. First, we examine the effect of external audit quality and ownership structure on the discretionary accruals for the whole sample. We find that only auditor reputation has a negative and significant effect on earnings management. Second, this article provides empirical evidence on the cross effect of external audit quality variables and capital concentration on earnings management. This test suggests that this combination has a negative and significant effect on earnings management in industrial firms but it has a positive and non significant effect in commercial firms. Finally, the third empirical test concerns the combined effect of external audit quality and institutional property on earnings management. We find that the cross effect of this combined relation is negatively and significantly associated with earnings management of industrial firms but it has no significant effect on the earnings management of commercial firms. As for the cross effect of the auditor seniority and the institutional property, it has a positive and a significant effect in the commercial sectors, while, it is positively and non-significantly associated with earnings management of industrial firms.

  7. Quality of systematic reviews in pediatric oncology--a systematic review

    DEFF Research Database (Denmark)

    Lundh, Andreas; Knijnenburg, Sebastiaan L; Jørgensen, Anders W

    2009-01-01

    BACKGROUND: To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. METHODS: We identified eligible systematic reviews...... through a systematic search of the literature. Data on clinical and methodological characteristics of the included systematic reviews were extracted. The methodological quality of the included systematic reviews was assessed using the overview quality assessment questionnaire, a validated 10-item quality...... assessment tool. We compared the methodological quality of systematic reviews published in regular journals with that of Cochrane systematic reviews. RESULTS: We included 117 systematic reviews, 99 systematic reviews published in regular journals and 18 Cochrane systematic reviews. The average methodological...

  8. Parenting quality, DRD4, and the prediction of externalizing and internalizing behaviors in early childhood.

    Science.gov (United States)

    Propper, C; Willoughby, M; Halpern, C T; Carbone, M A; Cox, M

    2007-09-01

    Recent research has found that the dopamine D4 receptor (DRD4) gene and maternal insensitivity may interact to predict externalizing behavior in preschoolers. The current study attempted to replicate and extend this finding in a sample of 18-30-month-old children. The current study examined two distinct dimensions of parenting (warm-responsive and negative-intrusive) as predictors of childhood externalizing and internalizing behavior. Further, race was investigated as a moderator of gene-environment relationships. Results revealed that high warm-responsive parenting was associated with decreased externalizing behavior only for African American children possessing the short polymorphism of DRD4. The data indicate that children may be differentially susceptible to different aspects of parenting depending on their genotype, and it is important to consider differences in racial composition when studying these relationships. .

  9. External quality assessment of tumour marker analysis: state of the art and consequences for estimating diagnostic sensitivity and specificity

    Directory of Open Access Journals (Sweden)

    Wood, William Graham

    2005-05-01

    Full Text Available This review shows the current analytical quality for the following analytes used as tumour markers in the external quality assessment (EQA-programmes of Instand e.V., a national EQA-organiser in Germany: Corticotropin (ACTH, growth hormone (GH, hGH, prolactin (PRL, chorionic gonadotropin (CG, hCG, calcitonin (CT, hCT, thyroglobulin (Tg, carcinoembryonic antigen (CEA, CA-Antigens 125, 72-4, 15-3 and 19-9, alpha foetoprotein (AFP and prostate-specific antigen (PSA. The results from the participants show a large variation in the precision of the methods used as well as in the comparability of results between methods for the same analyte. In general, the hormones used as tumour markers show better performance than the "CA-markers", which are often inadequately standardised and defined. In the case of one CA-marker (CA 72-4/TAG 72-4, the differences between the lowest kit median concentration and highest kit median concentration for one sample pair were 440% and 580%. The corresponding figures for ACTH were 123% and 156% and for CEA 180% and 184%. The classical tumour markers such as carcinoembryonic antigen (CEA and alpha foetoprotein (AFP performed markedly better than the CA-markers and PSA with regards to both inter- and intra-method comparability. The inter-laboratory precision for a given kit and marker was acceptable in many cases. The results show that only results from the same kit/method for each tumour marker can be used for cumulative or time-dependent comparison of results - for example pre-operative and post-operative follow up. In the case of prostate specific antigen (PSA, the kits used for free and total PSA must come from the same producer, if the generally accepted ratios are to have any diagnostic value. The need for kit- and laboratory-specific reference ranges and cut-off values for setting diagnostic specificity and sensitivity is highlighted from the EQA-results. The situation for inter-method comparability for the CA

  10. Peer Review Improves the Quality of MCQ Examinations

    Science.gov (United States)

    Malau-Aduli, Bunmi S.; Zimitat, Craig

    2012-01-01

    The aim of this study was to assess the effect of the introduction of peer review processes on the quality of multiple-choice examinations in the first three years of an Australian medical course. The impact of the peer review process and overall quality assurance (QA) processes were evaluated by comparing the examination data generated in earlier…

  11. Prediction models for the mortality risk in chronic dialysis patients: a systematic review and independent external validation study.

    Science.gov (United States)

    Ramspek, Chava L; Voskamp, Pauline Wm; van Ittersum, Frans J; Krediet, Raymond T; Dekker, Friedo W; van Diepen, Merel

    2017-01-01

    In medicine, many more prediction models have been developed than are implemented or used in clinical practice. These models cannot be recommended for clinical use before external validity is established. Though various models to predict mortality in dialysis patients have been published, very few have been validated and none are used in routine clinical practice. The aim of the current study was to identify existing models for predicting mortality in dialysis patients through a review and subsequently to externally validate these models in the same large independent patient cohort, in order to assess and compare their predictive capacities. A systematic review was performed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. To account for missing data, multiple imputation was performed. The original prediction formulae were extracted from selected studies. The probability of death per model was calculated for each individual within the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD). The predictive performance of the models was assessed based on their discrimination and calibration. In total, 16 articles were included in the systematic review. External validation was performed in 1,943 dialysis patients from NECOSAD for a total of seven models. The models performed moderately to well in terms of discrimination, with C-statistics ranging from 0.710 (interquartile range 0.708-0.711) to 0.752 (interquartile range 0.750-0.753) for a time frame of 1 year. According to the calibration, most models overestimated the probability of death. Overall, the performance of the models was poorer in the external validation than in the original population, affirming the importance of external validation. Floege et al's models showed the highest predictive performance. The present study is a step forward in the use of a prediction model as a useful tool for nephrologists, using evidence-based medicine that

  12. External validity of randomized controlled trials in older adults, a systematic review

    Science.gov (United States)

    van Deudekom, Floor J.; Postmus, Iris; van der Ham, Danielle J.; Pothof, Alexander B.; Broekhuizen, Karen; Blauw, Gerard J.; Mooijaart, Simon P.

    2017-01-01

    Background To critically assess the external validity of randomized controlled trials (RCTs) it is important to know what older adults have been enrolled in the trials. The aim of this systematic review is to study what proportion of trials specifically designed for older patients report on somatic status, physical and mental functioning, social environment and frailty in the patient characteristics. Methods PubMed was searched for articles published in 2012 and only RCTs were included. Articles were further excluded if not conducted with humans or only secondary analyses were reported. A random sample of 10% was drawn. The current review analyzed this random sample and further selected trials when the reported mean age was ≥ 60 years. We extracted geriatric assessments from the population descriptives or the in- and exclusion criteria. Results In total 1396 trials were analyzed and 300 trials included. The median of the reported mean age was 66 (IQR 63–70) and the median percentage of men in the trials was 60 (IQR 45–72). In 34% of the RCTs specifically designed for older patients somatic status, physical and mental functioning, social environment or frailty were reported in the population descriptives or the in- and exclusion criteria. Physical and mental functioning was reported most frequently (22% and 14%). When selecting RCTs on a mean age of 70 or 80 years the report of geriatric assessments in the patient characteristics was 46% and 85% respectively but represent only 5% and 1% of the trials. Conclusion Somatic status, physical and mental functioning, social environment and frailty are underreported even in RCTs specifically designed for older patients published in 2012. Therefore, it is unclear for clinicians to which older patients the results can be applied. We recommend systematic to transparently report these relevant characteristics of older participants included in RCTs. PMID:28346503

  13. Evaluation of the integrity of the deltoid ligament in supination external rotation ankle fractures: a systematic review of the literature

    NARCIS (Netherlands)

    van den Bekerom, M.P.J.; Mutsaerts, E.L.A.R.; van Dijk, C.N.

    2009-01-01

    BACKGROUND AND PURPOSE: Review the literature concerning modalities to evaluate the integrity of the deltoid ligament in patients with supination external rotation ankle fractures. METHODS: The electronic databases Pubmed/Medline, CINAHL and Embase were searched from 1987 to November 2007 to

  14. 77 FR 44613 - Notice of Availability of the External Review Draft of Framework for Human Health Risk Assessment...

    Science.gov (United States)

    2012-07-30

    ... AGENCY Notice of Availability of the External Review Draft of Framework for Human Health Risk Assessment... health risk assessments that are responsive to the needs of decision making processes at the EPA. The... established history of conducting human health risk assessments. The Framework is intended to foster increased...

  15. Evaluation of the integrity of the deltoid ligament in supination external rotation ankle fractures: a systematic review of the literature

    NARCIS (Netherlands)

    van den Bekerom, M.P.J.; Mutsaerts, E.L.A.R.; van Dijk, C.N.

    2009-01-01

    BACKGROUND AND PURPOSE: Review the literature concerning modalities to evaluate the integrity of the deltoid ligament in patients with supination external rotation ankle fractures. METHODS: The electronic databases Pubmed/Medline, CINAHL and Embase were searched from 1987 to November 2007 to identif

  16. Unemployment Benefits and Redistributive Taxes in the Presence of Labor Quality Externalities

    NARCIS (Netherlands)

    Huizinga, H.P.

    1996-01-01

    In this paper, a worker s productivity is assumed to depend on his own quality and on the average quality of other employed workers.In this setting, unemployment benefits that induce low quality workers to leave the labor force have important efficiency as well as equity implications.In addition to

  17. Review of the Elementary Particles Physics in the External Electromagnetic Fields Studies at KEK

    Science.gov (United States)

    Konstantinova, O. Tanaka

    2017-03-01

    High Energy Accelerator Research Organization (KEK [1]) is a world class accelerator-based research laboratory. The field of its scientific interests spreads widely from the study of fundamental properties of matter, particle physics, nuclear physics to materials science, life science, technical researches, and industrial applications. Research outcomes from the laboratory achieved making use of high-energy particle beams and synchrotron radiation. Two synchrotron facilities of KEK, the Photon Factory (PF) ring and the Photon Factory Advanced Ring (PF-AR) are the second biggest synchrotron light source in Japan. A very wide range of the radiated light, from visible light to X-ray, is provided for a variety of materials science, biology, and life science [2]. KEK strives to work closely with national and international research institutions, promoting collaborative research activities. Advanced research and facilities provision are key factors to be at the frontier of the accelerator science. In this review I am going to discuss KEK overall accelerator-based science, and to consider light sources research and development. The state of arts of the current projects with respect to the elementary particles physics in the external electromagnetic fields is also stressed here.

  18. Review of the Elementary Particles Physics in the External Electromagnetic Fields Studies at KEK

    Science.gov (United States)

    (Konstantinova), O. Tanaka

    2017-03-01

    High Energy Accelerator Research Organization (KEK [1]) is a world class accelerator-based research laboratory. The field of its scientific interests spreads widely from the study of fundamental properties of matter, particle physics, nuclear physics to materials science, life science, technical researches, and industrial applications. Research outcomes from the laboratory achieved making use of high-energy particle beams and synchrotron radiation. Two synchrotron facilities of KEK, the Photon Factory (PF) ring and the Photon Factory Advanced Ring (PF-AR) are the second biggest synchrotron light source in Japan. A very wide range of the radiated light, from visible light to X-ray, is provided for a variety of materials science, biology, and life science [2]. KEK strives to work closely with national and international research institutions, promoting collaborative research activities. Advanced research and facilities provision are key factors to be at the frontier of the accelerator science. In this review I am going to discuss KEK overall accelerator-based science, and to consider light sources research and development. The state of arts of the current projects with respect to the elementary particles physics in the external electromagnetic fields is also stressed here.

  19. Interface mechanics in lower-limb external prosthetics: a review of finite element models.

    Science.gov (United States)

    Zachariah, S G; Sanders, J E

    1996-12-01

    The distribution of mechanical stress at the interface between a residual limb and prosthetic socket is an important design consideration in lower-limb prosthetics. Stresses must be distributed so that the amputee is stable and comfortable, while avoiding trauma to the tissues of the residual limb. Numerical estimation of the stresses at the interface through finite element (FE) modeling can potentially provide researchers and prosthetists with a tool to aid in the design of the prosthetic socket. This review addresses FE modeling of interface stresses in lower-limb external prosthetics. The modeling methodologies adopted by analysts are described. Verification of FE estimates of interface stress against experimental data by different analysts is presented and the likely sources of error discussed. While the performance of the models is encouraging, there are definite limitations to all of them, necessitating further improvements. Parametric analysis of the sensitivity of interface stress to model parameters provides a tool to identify model weaknesses and to suggest possible refinements. Parametric analyses by different analysts are also presented and potential refinements discussed. Finally, directions for future work in prosthetic FE modeling are suggested.

  20. A Review on quality by design approach (QBD for Pharmaceuticals

    Directory of Open Access Journals (Sweden)

    Vemuri Pavan Kumar

    2015-03-01

    Full Text Available Quality by Design is the modern approach for quality of pharmaceuticals. It describes use of Quality by Design to ensure quality of Pharmaceuticals. In this review, the Quality by Design is described and some of its elements identified. Process parameters and quality attributes are identified for each unit operation. Benefits, opportunities and steps involved in Quality by Design of Pharmaceutical products are described. It is based on the ICH Guidelines Q8 for pharmaceutical development, Q9 for quality risk management, Q10 for pharmaceutical quality systems. It also gives application of Quality by Design in pharmaceutical development and manufacturing of pharmaceuticals. The aim of the pharmaceutical development is to design a quality product and its manufacturing process to consistently deliver the intended performance of the product. Quality cannot be tested into products but quality should be built in by design. It includes the Quality target product profile, critical quality attributes and key aspects of Quality by Design. It also gives comparison between product quality by end product testing and product quality by Quality by Design. The foundation of Quality by Design is ICH Guidelines.

  1. Key components of external facilitation in an acute stroke quality improvement collaborative in the Veterans Health Administration.

    Science.gov (United States)

    Bidassie, Balmatee; Williams, Linda S; Woodward-Hagg, Heather; Matthias, Marianne S; Damush, Teresa M

    2015-05-14

    Facilitation is a key component for successful implementation in several implementation frameworks; however, there is a paucity of research specifying this component. As part of a stroke quality improvement intervention in the Veterans Health Administration (VHA), facilitation plus data feedback was compared to data feedback alone in 11 VA medical facilities. The objective of this study was to elucidate upon the facilitation components of the stroke quality improvement. We conducted a secondary evaluation of external facilitation using semi-structured interviews. Five facilitators and two program directors were interviewed. Qualitative analysis was performed on transcribed interviews to gain an understanding of the role and activities of external facilitators during the on-site and telephone facilitation. Quantitative frequencies were calculated from the self-reported time spent in facilitation tasks by facilitators. The external facilitators saw their role as empowering the clinical teams to take ownership of the process changes at the clinical sites to improve their performance quality. To fulfill this role, they reported engaging in a number of core tasks during telephone and on-site visits including: assessing the context in which the teams were currently operating, guiding the clinical teams through their planned changes and use of process improvement tools, identifying resources and making referrals, holding teams accountable for plan implementation with on-site visits, and providing support and encouragement to the teams. Time spent in facilitation activities changed across time from guiding change (early) to supporting efforts made by the clinical teams (later). Facilitation activity transitioned to more monitoring, problem solving, and intentional work to hand over the clinical improvement process to the site teams with the coach's role being increasingly that of a more distant consultant. Overall, this study demonstrated that external facilitation is not

  2. Water quality in New Zealand's planted forests: A review

    Science.gov (United States)

    Brenda R. Baillie; Daniel G. Neary

    2015-01-01

    This paper reviewed the key physical, chemical and biological water quality attributes of surface waters in New Zealand’s planted forests. The purpose was to: a) assess the changes in water quality throughout the planted forestry cycle from afforestation through to harvesting; b) compare water quality from planted forests with other land uses in New Zealand; and c)...

  3. QUALITY IN HIGHER EDUCATION FROM DIFFERENT PERSPECTIVES: A LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Goutam Kumar Kundu

    2017-03-01

    Full Text Available The purpose of this paper is to provide an overview of existing research and present a holistic understanding of quality in higher education. This literature review builds on major sources of relevant research relating to educational quality methodologies, quality literacy and multi-dimensional concept of quality. The paper attempts to understand quality in education as a relationship amongst all the participants and resources of an educational institution. Based on the results of the literature review, the paper attempts to establish the foundation for a comprehensive understanding and analysis of quality focussing on higher education. This literature review provides a frame of reference that serves as a basis for future research regarding role of quality in education.

  4. Writing Quality Peer Reviews of Research Manuscripts

    Science.gov (United States)

    Ward, Phillip; Graber, Kim C.; van der Mars, Hans

    2015-01-01

    Peer review is an important mechanism for advancing knowledge in a manner deemed as acceptable by the research community. It can also serve the function of providing guidance to an author(s) to improve the likelihood that manuscripts will be accepted in peer reviewed journals. There is, however, little assistance for new or existing reviewers of…

  5. Prediction Models and Their External Validation Studies for Mortality of Patients with Acute Kidney Injury: A Systematic Review

    Science.gov (United States)

    Ohnuma, Tetsu; Uchino, Shigehiko

    2017-01-01

    Objectives To systematically review AKI outcome prediction models and their external validation studies, to describe the discrepancy of reported accuracy between the results of internal and external validations, and to identify variables frequently included in the prediction models. Methods We searched the MEDLINE and Web of Science electronic databases (until January 2016). Studies were eligible if they derived a model to predict mortality of AKI patients or externally validated at least one of the prediction models, and presented area under the receiver-operator characteristic curves (AUROC) to assess model discrimination. Studies were excluded if they described only results of logistic regression without reporting a scoring system, or if a prediction model was generated from a specific cohort. Results A total of 2204 potentially relevant articles were found and screened, of which 12 articles reporting original prediction models for hospital mortality in AKI patients and nine articles assessing external validation were selected. Among the 21 studies for AKI prediction models and their external validation, 12 were single-center (57%), and only three included more than 1,000 patients (14%). The definition of AKI was not uniform and none used recently published consensus criteria for AKI. Although good performance was reported in their internal validation, most of the prediction models had poor discrimination with an AUROC below 0.7 in the external validation studies. There were 10 common non-renal variables that were reported in more than three prediction models: mechanical ventilation, age, gender, hypotension, liver failure, oliguria, sepsis/septic shock, low albumin, consciousness and low platelet count. Conclusions Information in this systematic review should be useful for future prediction model derivation by providing potential candidate predictors, and for future external validation by listing up the published prediction models. PMID:28056039

  6. Can we predict plan quality for external beam partial breast irradiation: results of a multicenter feasibility study (Trans Tasman Radiation Oncology Group Study 06.02).

    Science.gov (United States)

    Kron, Tomas; Willis, David; Link, Emma; Lehman, Margot; Campbell, Gillian; O'Brien, Peter; Chua, Boon

    2013-11-15

    Partial breast irradiation (PBI) after lumpectomy may be an option for selected patients with early breast cancer. A feasibility study of accelerated PBI delivered using external beam 3-dimensional conformal radiation therapy (RT) was undertaken at 8 Australasian centers. The present study evaluated the impact of patient, tumor, and RT technique-related factors on the quality of RT plans as determined by the dose-volume parameters of organs at risk. Forty-eight patients were enrolled in the study. All RT plans were centrally reviewed using predefined dosimetric criteria before commencement and after completion of protocol therapy. The RT plans of 47 patients met the dose-volume constraints, and all 47 patients received PBI to a prescribed dose of 38.5 Gy in 10 fractions. The RT plan quality was determined by volumes of the ipsilateral whole breast, lung, and heart that received 50% and 95%; 30%; and 5% of the prescribed dose, respectively. Patient, tumor, and RT technique-related factors were investigated for association with the parameters of RT plan quality. The ratio of the planning target volume to the ipsilateral whole-breast volume was significantly associated with the ipsilateral breast doses on multiple variable analyses. The distance of the postlumpectomy surgical cavity from the heart and lung were predictive for heart and lung doses, respectively. A distance between surgical cavity and heart of >4 cm typically resulted in planning target volume to ipsilateral whole-breast volume and the distance of surgical cavity from the heart were significant predictors of the quality of treatment plan for external beam PBI. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Can We Predict Plan Quality for External Beam Partial Breast Irradiation: Results of a Multicenter Feasibility Study (Trans Tasman Radiation Oncology Group Study 06.02)

    Energy Technology Data Exchange (ETDEWEB)

    Kron, Tomas, E-mail: Tomas.Kron@petermac.org [Peter MacCallum Cancer Centre, Departments of Radiation Oncology, Physical Sciences and Radiation Therapy, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria (Australia); School of Science, Engineering and Technology, Royal Melbourne Institute of Technology University, Melbourne, Victoria (Australia); Willis, David; Link, Emma [Peter MacCallum Cancer Centre, Departments of Radiation Oncology, Physical Sciences and Radiation Therapy, Melbourne, Victoria (Australia); Lehman, Margot [Princess Alexandra Hospital, Department of Radiation Oncology, Brisbane, Queensland (Australia); Campbell, Gillian [Auckland City Hospital, Department of Radiation Oncology, Auckland (New Zealand); O' Brien, Peter [Newcastle Calvary Mater Hospital, Department of Radiation Oncology, Newcastle, NSW (Australia); Chua, Boon [Peter MacCallum Cancer Centre, Departments of Radiation Oncology, Physical Sciences and Radiation Therapy, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria (Australia)

    2013-11-15

    Purpose: Partial breast irradiation (PBI) after lumpectomy may be an option for selected patients with early breast cancer. A feasibility study of accelerated PBI delivered using external beam 3-dimensional conformal radiation therapy (RT) was undertaken at 8 Australasian centers. The present study evaluated the impact of patient, tumor, and RT technique-related factors on the quality of RT plans as determined by the dose–volume parameters of organs at risk. Methods and Materials: Forty-eight patients were enrolled in the study. All RT plans were centrally reviewed using predefined dosimetric criteria before commencement and after completion of protocol therapy. The RT plans of 47 patients met the dose–volume constraints, and all 47 patients received PBI to a prescribed dose of 38.5 Gy in 10 fractions. The RT plan quality was determined by volumes of the ipsilateral whole breast, lung, and heart that received 50% and 95%; 30%; and 5% of the prescribed dose, respectively. Patient, tumor, and RT technique-related factors were investigated for association with the parameters of RT plan quality. Results: The ratio of the planning target volume to the ipsilateral whole-breast volume was significantly associated with the ipsilateral breast doses on multiple variable analyses. The distance of the postlumpectomy surgical cavity from the heart and lung were predictive for heart and lung doses, respectively. A distance between surgical cavity and heart of >4 cm typically resulted in <1% of the heart volume receiving 5 Gy or less. It was more difficult to meet the heart dose constraint for left-sided and medially located tumors. Conclusions: Partial breast irradiation using 3-dimensional conformal RT was feasible within the study constraints. The ratio of planning target volume to ipsilateral whole-breast volume and the distance of surgical cavity from the heart were significant predictors of the quality of treatment plan for external beam PBI.

  8. The Effects of Externally Solidified Product on Wave Celerity and Quality of Die Cast Products

    Energy Technology Data Exchange (ETDEWEB)

    Carroll Mobley; Yogeshwar Sahai; Jerry Brevick

    2003-10-10

    The cold chamber die casting process is used to produce essentially all the die cast aluminum products and about 50% of the die cast magnesium products made today. Modeling of the cold chamber die casting process and metallographic observations of cold chamber die cast products indicate that typically 5 to 20% of the shot weight is solidified in the shot sleeve before or during cavity filling. The protion of the resulting die casting which is solidified in the shot sleeve is referred to as externally solidified product, or, when identified as a casting defect, as cold flakes. This project was directed to extending the understanding of the effects of externally solidified product on the cold chamber die casting process and products to enable the production of defect-free die castings and reduce the energy associated with these products. The projected energy savings from controlling the fraction of externally solidified product in die cast components is 40 x 10 Btu through the year 2025.

  9. Poor reliability between Cochrane reviewers and blinded external reviewers when applying the Cochrane risk of bias tool in physical therapy trials.

    Directory of Open Access Journals (Sweden)

    Susan Armijo-Olivo

    Full Text Available OBJECTIVES: To test the inter-rater reliability of the RoB tool applied to Physical Therapy (PT trials by comparing ratings from Cochrane review authors with those of blinded external reviewers. METHODS: Randomized controlled trials (RCTs in PT were identified by searching the Cochrane Database of Systematic Reviews for meta-analysis of PT interventions. RoB assessments were conducted independently by 2 reviewers blinded to the RoB ratings reported in the Cochrane reviews. Data on RoB assessments from Cochrane reviews and other characteristics of reviews and trials were extracted. Consensus assessments between the two reviewers were then compared with the RoB ratings from the Cochrane reviews. Agreement between Cochrane and blinded external reviewers was assessed using weighted kappa (κ. RESULTS: In total, 109 trials included in 17 Cochrane reviews were assessed. Inter-rater reliability on the overall RoB assessment between Cochrane review authors and blinded external reviewers was poor (κ  =  0.02, 95%CI: -0.06, 0.06]. Inter-rater reliability on individual domains of the RoB tool was poor (median κ  = 0.19, ranging from κ  =  -0.04 ("Other bias" to κ  =  0.62 ("Sequence generation". There was also no agreement (κ  =  -0.29, 95%CI: -0.81, 0.35] in the overall RoB assessment at the meta-analysis level. CONCLUSIONS: Risk of bias assessments of RCTs using the RoB tool are not consistent across different research groups. Poor agreement was not only demonstrated at the trial level but also at the meta-analysis level. Results have implications for decision making since different recommendations can be reached depending on the group analyzing the evidence. Improved guidelines to consistently apply the RoB tool and revisions to the tool for different health areas are needed.

  10. Reporting and methodologic quality of Cochrane Neonatal review group systematic reviews

    Directory of Open Access Journals (Sweden)

    Al Faleh Khalid

    2009-06-01

    Full Text Available Abstract Background The Cochrane Neonatal Review Group (CNRG has achieved a lot with limited resources in producing high quality systematic reviews to assist clinicians in evidence-based decision-making. A formal assessment of published CNRG systematic reviews has not been undertaken; we sought to provide a comprehensive assessment of the quality of systematic reviews (both methodologic and reporting quality published in CNRG. Methods We selected a random sample of published CNRG systematic reviews. Items of the QUOROM statement were utilized to assess quality of reporting, while items and total scores of the Oxman-Guyatt Overview Quality Assessment Questionnaire (OQAQ were used to assess methodologic quality. Two reviewers independently extracted data and assessed quality. A Student t-test was used to compare quality scores pre- and post-publication of the QUOROM statement. Results Sixty-one systematic reviews were assessed. Overall, the included reviews had good quality with minor flaws based on OQAQ total scores (mean, 4.5 [0.9]; 95% CI, 4.27–4.77. However, room for improvement was noted in some areas, such as the title, abstract reporting, a priori plan for heterogeneity assessment and how to handle heterogeneity in case it exists, and assessment of publication bias. In addition, reporting of agreement among reviewers, documentation of trials flow, and discussion of possible biases were addressed in the review process. Reviews published post the QUOROM statement had a significantly higher quality scores. Conclusion The systematic reviews published in the CNRG are generally of good quality with minor flaws. However, efforts should be made to improve the quality of reports. Readers must continue to assess the quality of published reports on an individual basis prior to implementing the recommendations.

  11. External quality assessment schemes raise standards: evidence from the UKNEQAS parasitology subschemes

    OpenAIRE

    Kettelhut, M M; Chiodini, P L; Edwards, H.; Moody, A

    2003-01-01

    Background: The burden of parasitic disease imported into the temperate zone is increasing, and in the tropics remains very high. Thus, high quality diagnostic parasitology services are needed, but to implement clinical governance a measure of quality of service is required.

  12. Process and quality of peer review in scientific Nursing journals

    Directory of Open Access Journals (Sweden)

    Wai Tong Chien

    2011-09-01

    Full Text Available To be high quality and international recognized scientific journal for health care professions, such as medical and nursing disciplines, a well-structured and effective peer review system is of an utmost importance. Beckstead (2009 in his guest editorial published in the September issue of International Journal of Nursing Studies suggested that it was important for authors, as well as editors and publishers, to have a clear understanding of whom the intended readers of the journal are; and for the peer reviewers, to answer a key question: whom are we writing to? and more importantly, to assure a transparent, rigorous and quality peer-review. Their questions and declarations stimulated us to think about two important issues: first, the importance of a high quality and effective peer-review in a scientific nursing journal and second, the peer-review system, its monitoring and contribution to quality improvement.

  13. Does Enhanced External Counterpulsation (EECP Significantly Affect Myocardial Perfusion?: A Systematic Review & Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Xiaoxia Qin

    Full Text Available Enhanced external counterpulsation (EECP is currently applied for treating coronary artery disease (CAD patients. However, the mechanism(s by which EECP ameliorates angina pectoris and long-term left ventricular function remain largely unknown. The aim of this study will be to assess whether EECP significantly affects myocardial perfusion in CAD patients through a systematic review and meta-analysis of the available literature.MEDLINE, EMBASE, and Cochrane CENTRAL databases were searched for prospective studies on CAD patients that underwent EECP and reported myocardial perfusion data pre- and post-EECP. The impact of EECP was assessed based on the weighted mean difference (WMD in myocardial perfusion from pre-EECP to post-EECP. Statistical heterogeneity was assessed by the I2 index. Publication bias was assessed through visual inspection of the funnel plot as well as Begg's and Egger's testing.Standard EECP therapy (i.e., 35-36 one-hour sessions within a seven-week period significantly increased myocardial perfusion in CAD patients (pooled WMD: -0.19, 95% CI: -0.38 to 0.00, p = 0.049. A random effects analysis was applied on account of significant heterogeneity (I2 = 89.1%, p = 0.000. There was no evidence of significant publication bias (Begg's p = 0.091; Egger's p = 0.282.Standard EECP therapy significantly increases myocardial perfusion in CAD patients. This study's findings support the continued use of standard EECP therapy in CAD patients and provides one putative physiological mechanism to help explain the improvements in angina pectoris and long-term left ventricular function observed in CAD patients after EECP therapy.

  14. External Quality Assessment for the Detection of Measles Virus by Reverse Transcription-PCR Using Armored RNA.

    Directory of Open Access Journals (Sweden)

    Dong Zhang

    Full Text Available In recent years, nucleic acid tests for detection of measles virus RNA have been widely applied in laboratories belonging to the measles surveillance system of China. An external quality assessment program was established by the National Center for Clinical Laboratories to evaluate the performance of nucleic acid tests for measles virus. The external quality assessment panel, which consisted of 10 specimens, was prepared using armored RNAs, complex of noninfectious MS2 bacteriophage coat proteins encapsulated RNA of measles virus, as measles virus surrogate controls. Conserved sequences amplified from a circulating measles virus strain or from a vaccine strain were encapsulated into these armored RNAs. Forty-one participating laboratories from 15 provinces, municipalities, or autonomous regions that currently conduct molecular detection of measles virus enrolled in the external quality assessment program, including 40 measles surveillance system laboratories and one diagnostic reagent manufacturer. Forty laboratories used commercial reverse transcription-quantitative PCR kits, with only one laboratory applying a conventional PCR method developed in-house. The results indicated that most of the participants (38/41, 92.7% were able to accurately detect the panel with 100% sensitivity and 100% specificity. Although a wide range of commercially available kits for nucleic acid extraction and reverse transcription polymerase chain reaction were used by the participants, only two false-negative results and one false-positive result were generated; these were generated by three separate laboratories. Both false-negative results were obtained with tests performed on specimens with the lowest concentration (1.2 × 104 genomic equivalents/mL. In addition, all 18 participants from Beijing achieved 100% sensitivity and 100% specificity. Overall, we conclude that the majority of the laboratories evaluated have reliable diagnostic capacities for the detection

  15. The relationship of previous training and experience of journal peer reviewers to subsequent review quality.

    Directory of Open Access Journals (Sweden)

    Michael L Callaham

    2007-01-01

    Full Text Available BACKGROUND: Peer review is considered crucial to the selection and publication of quality science, but very little is known about the previous experiences and training that might identify high-quality peer reviewers. The reviewer selection processes of most journals, and thus the qualifications of their reviewers, are ill defined. More objective selection of peer reviewers might improve the journal peer review process and thus the quality of published science. METHODS AND FINDINGS: 306 experienced reviewers (71% of all those associated with a specialty journal completed a survey of past training and experiences postulated to improve peer review skills. Reviewers performed 2,856 reviews of 1,484 separate manuscripts during a four-year study period, all prospectively rated on a standardized quality scale by editors. Multivariable analysis revealed that most variables, including academic rank, formal training in critical appraisal or statistics, or status as principal investigator of a grant, failed to predict performance of higher-quality reviews. The only significant predictors of quality were working in a university-operated hospital versus other teaching environment and relative youth (under ten years of experience after finishing training. Being on an editorial board and doing formal grant (study section review were each predictors for only one of our two comparisons. However, the predictive power of all variables was weak. CONCLUSIONS: Our study confirms that there are no easily identifiable types of formal training or experience that predict reviewer performance. Skill in scientific peer review may be as ill defined and hard to impart as is "common sense." Without a better understanding of those skills, it seems unlikely journals and editors will be successful in systematically improving their selection of reviewers. This inability to predict performance makes it imperative that all but the smallest journals implement routine review ratings

  16. External Quality Assessment Scheme for Biological Monitoring of Occupational Exposure to Toxic Chemicals

    Directory of Open Access Journals (Sweden)

    Mi-Young Lee

    2011-09-01

    Conclusion: The EQAS has taken a primary role in improving the reliability of analytical data. A total quality assurance scheme is suggested, including the validation of technical documentation for the whole analytical procedure.

  17. Same review quality in open versus blinded peer review in "Ugeskrift for Læger"

    DEFF Research Database (Denmark)

    Vinther, Siri; Nielsen, Ole Haagen; Rosenberg, Jacob

    2012-01-01

    Research into the peer review process has previously been conducted in English-language journals. This study deals with a Danish general medical journal with a relatively small pool of both reviewers and readers. The aim of the study was to compare the quality of reviews produced by identifiable...... and anonymous reviewers, and further to characterize authors' and reviewers' attitudes towards different peer review systems....

  18. Same review quality in open versus blinded peer review in "Ugeskrift for Læger"

    DEFF Research Database (Denmark)

    Vinther, Siri; Nielsen, Ole Haagen; Rosenberg, Jacob

    2012-01-01

    Research into the peer review process has previously been conducted in English-language journals. This study deals with a Danish general medical journal with a relatively small pool of both reviewers and readers. The aim of the study was to compare the quality of reviews produced by identifiable...... and anonymous reviewers, and further to characterize authors' and reviewers' attitudes towards different peer review systems....

  19. Cholesteatoma associated with squamous cell carcinoma of the external auditory canal: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Olfa Ben Gamra

    2015-11-01

    Conclusion: SCC of the external auditory canal can mimic cholesteatoma. A precise diagnosis of the disease is important to predict the treatment outcome. Optimal management relies on early surgery and postoperative radiotherapy, thus offering the greatest chance of cure.

  20. Effect of storage at different temperatures on development of external color and quality of pineapple fruits cv. Gold Extra Sweet

    Directory of Open Access Journals (Sweden)

    Luis Ulloa

    2015-11-01

    Full Text Available In order to improve the quality of the fruit, judged at the market as the degree of yellowing of the peel, 2 experiments were performed to evaluate the effect of storage temperature on change in external color of pineapple (Ananas comosus fruit cv. “Gold Extra Sweet”. The temperatures evaluated were 7.5°C; 10.0°C; 12.5°C and 15.0°C, and their effect on the color change and the chlorophyll content in the peel, respiration rate and parameters of external and internal quality were measured. The fruit was stored at different temperatures for 21 days and then transferred to 18.0°C during 4 additional days. At the end of the storage period, pineapples at 7.5°C showed the highest content of chlorophyll a (200 μg.g-1 f.w and the lowest degree of external color (0.32-0.70, fruits stored at 15.0°C had the lowest content of chlorophyll a (40 μg.g-1 f.w and the highest color grade (4.42-5.25. Pineapples stored at 7.5°C showed the lowest respiration rate at 21 days (6.4 ml CO2/kg*h, while fruit stored at 15.0°C had the highest respiration rate (15.8 ml CO2/kg*h. As the storage temperature increased the weight loss and mold growth in the peduncle increased. At the end of storage at 18.0°C, the color advance in the fruits previously stored at 7.5°C was the lowest, while the highest external yellow color developed on the fruits previously kept at 15.0°C. The results suggest that the storage temperature affects chlorophyll degradation and development of external yellow color, which could be useful in the commercial management of pineapple fruit.

  1. Review of external ocular compression: clinical applications of the ocular pressure estimator

    Directory of Open Access Journals (Sweden)

    Korenfeld MS

    2016-02-01

    Full Text Available Michael S Korenfeld,1,2 David K Dueker3 1Comprehensive Eye Care, Ltd. Washington, MO, USA; 2Washington University Department of Ophthalmology and Visual Sciences, St Louis, MO, USA; 3Ophthalmology, Hamad Medical Corporation, Doha, Qatar Purpose: The authors have previously validated an Ocular Pressure Estimator (OPE that can estimate the intraocular pressure (IOP during external ocular compression (EOC. The authors now apply the OPE in clinical states where EOC is clinically important. The original work is described for two periods of risk: during sleep and during the digital ocular massage (DOM maneuver used by surgeons after trabeculectomy to keep the operation functional. Other periods of risk for external ocular compression are then reviewed.Methods: The first protocol estimated the IOP in the dependent eye during simulated sleep. Subjects had their IOPs initially measured in an upright-seated position, immediately upon assuming a right eye dependent side sleeping position (with nothing contacting the eye, and then 5 minutes later while still in this position. While maintaining this position, the fluid filled bladder of the OPE was then placed between the subject’s closed eye and a pillow during simulated sleep. The IOP was continuously estimated in this position for 5 minutes. The subjects then had the IOP measured in both eyes in an upright-seated position. The second protocol determined if a larger vertical cup-to-disc ratio was more common on the side that patients reported they preferred to sleep on. The hypothesis was that chronic asymmetric, compression induced, elevations of IOP during sleep would be associated with otherwise unexplained asymmetry of the vertical cup-to-disc ratio. The third protocol assessed the IOP during DOM. The OPE was used to characterize the IOP produced during the DOM maneuver of five glaucoma surgeons. After this, 90 mmHg was chosen as a target pressure for DOM. The surgeons were then verbally coached

  2. Effect of External Quality Assurance Evaluation for Chest Radiography: 3-Year Follow-Up in the Medical Institution for Pneumoconiosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Jeong; Choi, Soon Byung [Clinical Research Team, Occupational Lung Diseases Institute, Korea Worker' s Compensation and Welfare Service, Ansan (Korea, Republic of)

    2012-04-15

    The aim of this study was to determine the effect of external quality assurance (QA) evaluation for chest radiography in the medical institution for pneumoconiosis (MIP). The chest radiography of the MIPs were evaluated for a radiological technique (RT), image quality (IQ), and reading environment (RE), during a 3-year follow up according to the Korean guidelines. Same methods were implemented each year to ensure that the results are reliable. RT, IQ, and RE were compared between examination and medical care (EMP), and only medical care (MCP) for pneumoconiosis, film-screen (FSR) and digital (DR) radiography. Uneducated and educated for QA during a 3-year follow up referencing with 2008 were realized. RT and IQ of the MIPs showed a significantly higher score in 2009 and 2010 compared with 2008 (p < 0.01). However, RE was not significantly improved. The score of RT, IQ, and RE of the EMPs were higher than those of MCPs every year, and FSR showed a lower score in all evaluations, although, more improvement was seen than the DR. The chest radiography of the MIPs showed a significant effect as a result of a repeated external QA evaluation. However, the MIPs need to transfer from FSR to DR, and maintain a continuous QA evaluation for the MCPs.

  3. External Quality Assessment for Detection of Fetal Trisomy 21, 18, and 13 by Massively Parallel Sequencing in Clinical Laboratories.

    Science.gov (United States)

    Zhang, Rui; Zhang, Hongyun; Li, Yulong; Han, Yanxi; Xie, Jiehong; Li, Jinming

    2016-03-01

    An external quality assessment for detection of trisomy 21, 18, and 13 by massively parallel sequencing was implemented by the National Center for Clinical Laboratories of People's Republic of China in 2014. Simulated samples were prepared by mixing fragmented abnormal DNA with plasma from non-pregnant women. The external quality assessment panel, comprising 5 samples from pregnant healthy women, 2 samples with sex chromosome aneuploidies, and 13 samples with different concentrations of fetal fractions positive for trisomy 21, 18, and 13, was then distributed to participating laboratories. In total, 55.6% (47 of 84) of respondents correctly identified each of the samples in the panel. Seventeen false-negative and 87 gray zone results were reported, most [102 of 104 (98.1%)] of which were derived from for trisomy samples with effective fetal fractions trisomy sample generated by BGISEQ-100. Overall, most clinical laboratories detected samples containing effective fetal fractions >4%. Our study shows need for further laboratory training in the management of samples with low fetal fractions. For some assays, precision of Z values needs to be improved.

  4. Review of personal monitoring techniques for the measurement of absorbed dose from external beta and low energy photon radiation

    DEFF Research Database (Denmark)

    Christensen, Poul

    1986-01-01

    The techniques available at present for personal monitoring of doses from external beta and low energy photon radiation are reviewed. The performance of currently used dosimetry systems is compared with that recommended internationally, and developments for improving the actual performance...... are outlined. The subjects dealt with compromise: the quantity to be measured, the required accuracy of measurement, calibration procedures, and dosemeter design including the main parameters influencing the energy and angular response of the dosemeter, such as detector thickness, filter thickness, dosemeter...

  5. External Quality Assurance in Higher Education: How Can It Address Corruption and Other Malpractices?

    Science.gov (United States)

    Martin, Michaela

    2016-01-01

    Corruption and malpractices in higher education are today a major concern in nearly all higher education systems worldwide. It is a multifaceted phenomenon and has become particularly visible in the academic domain. This paper represents an exploration of the possible role that quality assurance can play in addressing corruption and malpractices.…

  6. Enhancement of external quantum efficiency and quality of heterojunction white LEDs by varying the size of ZnO nanorods.

    Science.gov (United States)

    Bano, N; Hussain, I; Sawaf, S; Alshammari, Abeer; Saleemi, F

    2017-06-16

    The size of ZnO nanorods (NRs) plays an important role in tuning the external quantum efficiency (EQE) and quality of light generated by white light emitting diodes (LEDs). In this work, we report on the enhancement of EQE and the quality of ZnO NR-based hetrojunction white LEDs fabricated on a p-GaN substrate using a low temperature solution method. Cathodoluminescence spectra demonstrate that ultraviolet (UV) emission decreases and visible deep band emission increases with an increase in the length of the ZnO NRs. The UV emission could be internally reabsorbed by the ZnO NR excitation, thus enhancing the emission intensity of the visible deep band. Photocurrent measurements validated the fact that the EQE depends on the size of ZnO NRs, increasing by 87% with an increase in the length of the ZnO NRs. Furthermore, the quality of white light was measured and clearly indicated an increase in the color rendering indices of the LEDs with an increase in the length of the ZnO NRs, confirming that the quality of light generated by LEDs can be tuned by varying the length of the ZnO NRs. These results suggest that the EQE and visible deep band emission from n-ZnONRs/p-GaN heterojunction LEDs can be effectively controlled by adjusting the length of the ZnO NRs, which can be useful for realizing tunable white LEDs.

  7. [External quality assessment in clinical biochemistry laboratories: pilot study in 11 laboratories of Lomé (Togo)].

    Science.gov (United States)

    Kouassi, Kafui; Fétéké, Lochina; Assignon, Selom; Dorkenoo, Ameyo; Napo-Koura, Gado

    2015-01-01

    This study aims to evaluate the performance of a few biochemistry analysis and make recommendations to the place of the stakeholders. It is a cross-sectional study conducted between the October 1(st), 2012 and the July 31, 2013 bearing on the results of 5 common examinations of clinical biochemistry, provided by 11 laboratories volunteers opening in the public and private sectors. These laboratories have analysed during the 3 cycles, 2 levels (medium and high) of serum concentration of urea, glucose, creatinine and serum aminotransferases. The performance of laboratories have been determined from the acceptable limits corresponding to the limits of total errors, defined by the French Society of Clinical Biology (SFBC). A system of internal quality control is implemented by all laboratories and 45% of them participated in international programs of external quality assessment (EQA). The rate of acceptable results for the entire study was of 69%. There was a significant difference (p<0.002) between the performance of the group of laboratories engaged in a quality approach and the group with default implementation of the quality approach. Also a significant difference was observed between the laboratories of the central level and those of the peripheral level of our health system (p<0.047). The performance of the results provided by the laboratories remains relatively unsatisfactory. It is important that the Ministry of Health put in place a national program of EQA with mandatory participation.

  8. Evaluation of the integrity of the deltoid ligament in supination external rotation ankle fractures: a systematic review of the literature.

    Science.gov (United States)

    van den Bekerom, Michel P J; Mutsaerts, Eduard L A R; van Dijk, C Niek

    2009-02-01

    Review the literature concerning modalities to evaluate the integrity of the deltoid ligament in patients with supination external rotation ankle fractures. The electronic databases Pubmed/Medline, CINAHL and Embase were searched from 1987 to November 2007 to identify all published original studies concerning diagnostic modalities to evaluate the integrity of the deltoid ligament in adult ankle fractures. This review included nine studies involving 423 ankle fractures. Three trails investigated medial tenderness; two studies, ecchymosis; two studies, swelling; one study, an injury radiograph; six studies, a type of radiographic stress view; one study, the Lauge-Hansen classification; one study, MRI; and one article studied arthroscopy in the evaluation of the deltoid ligament integrity. Swelling, ecchymosis, medial tenderness, initial injury radiographs and the Lauge-Hansen classification are less adequate predictors of the integrity of the deltoid ligament. Manual or the less painful variant, the gravity external rotation stress radiographs are considered the gold standard. The amount of medial clear space widening indicative of a positive external rotation stress test has been somewhat variable in the literature but > or =5 mm is generally regarded as most reliable. Achieving adequate external rotation of the foot when obtaining stress radiographs is more important than positioning the ankle in the appropriate degree of ankle flexion. The amount of applied force necessary when performing an external rotation stress radiograph is not well defined and mainly determined by the patient's pain level. The indication for surgery should not be based on the absolute value of one parameter but on the combination of several parameters. If nonoperative treatment is chosen despite a positive stress radiograph, close follow-up is critical because subluxation of the ankle joint is still possible. MRI could be useful in individual cases.

  9. Quality function deployment in the food industry: a review

    NARCIS (Netherlands)

    Costa, A.I.A.; Dekker, M.; Jongen, W.M.F.

    2001-01-01

    This paper presents a detailed literature review on the topic of the application of quality function deployment (QFD) in the food industry. This review is extended with a thorough description of the methodologies involved in the practice of QFD within food companies, exemplified with the help of a c

  10. A critical review of predefined diet quality scores

    NARCIS (Netherlands)

    Waijers, P.M.C.M.; Feskens, E.J.M.; Ocke, M.C.

    2007-01-01

    The literature on predefined indexes of overall diet quality is reviewed. Their association with nutrient adequacy and health outcome is considered, but our primary interest is in the make-up of the scores. In total, twenty different indexes have been reviewed, four of which have gained most attenti

  11. Internal and External Dialogue: a Swedish Approach to Quality Work in Courts

    Directory of Open Access Journals (Sweden)

    Marie B. Hagsgård

    2014-12-01

    Full Text Available When evaluation shows that a court is not delivering justice in the best possible way, change in the way a court operates can be hard to accomplish. One way is to engage all judges and staff in an internal and external dialogue about the way the court is functioning and how to improve it. When judges and staff are actively involved in evaluating the present situation, in analyzing, suggesting and implementing new measures and in evaluating the effects of those measures, improvements can be reached in the way the court operates in a range of areas. The deployment of such approach in a growing number of Swedish courts is an indicator of the success of the method.At present the majority of Swedish courts are involved in a broad external dialogue, where judges and staff attend meetings with prosecutors and lawyers and interview court users. The aim of the dialogue is to evaluate and improve information and treatment of parties and witnesses and the writing of intelligible judgments. Cuando una evaluación muestra que un tribunal no está administrando justicia de la mejor manera posible, puede ser difícil lograr cambiar la forma en que ese tribunal funciona. Una opción es involucrar a todos los jueces y personal en un diálogo interno y externo sobre el funcionamiento del tribunal y cómo se podría mejorar. Cuando los jueces y el personal participan activamente en la evaluación de la situación actual, analizando, sugiriendo y desarrollando nuevas medidas y evaluando los efectos de esas medidas, se pueden conseguir mejoras en la forma en la que el tribunal opera en diferentes áreas. El uso de este enfoque en un número creciente de tribunales suecos es un indicador del éxito del método.En la actualidad la mayoría de los tribunales suecos están involucrados en un amplio diálogo externo, en el que jueces y personal participan en reuniones con fiscales y abogados y se entrevistan con usuarios de los tribunales. El objetivo del diálogo es

  12. Efficacy and External Validity of Electronic and Mobile Phone-Based Interventions Promoting Vegetable Intake in Young Adults: A Systematic Review Protocol.

    Science.gov (United States)

    Nour, Monica Marina; Chen, Juliana; Allman-Farinelli, Margaret

    2015-07-28

    Despite social marketing campaigns and behavior change interventions, young adults remain among the lowest consumers of vegetables. The digital era offers potential new avenues for both social marketing and individually tailored programs, through texting, web, and mobile applications. The effectiveness and generalizability of such programs have not been well documented. The aim of this systematic review is to evaluate the efficacy and external validity of social marketing, electronic, and mobile phone-based (mHealth) interventions aimed at increasing vegetable intake in young adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol will be used to conduct this systematic review. The search strategy will be executed across eleven electronic databases using combinations of the following search terms: "online intervention", "computer-assisted therapy", "internet", "website", "cell phones", "cyber", "telemedicine", "email", "social marketing", "social media", "mass media", "young adult", and "fruit and vegetables". The reference lists of included studies will also be searched for additional citations. Titles and abstracts will be screened against inclusion criteria and full texts of potentially eligible papers will be assessed by two independent reviewers. Data from eligible papers will be extracted. Quality and risk of bias will be assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies and The Cochrane Collaboration Risk of Bias assessment tool respectively. The external validity of the studies will be determined based on components such as reach, adoption, and representativeness of participants; intervention implementation and adaption; and program maintenance and institutionalization. Results will be reported quantitatively and qualitatively. Our research is in progress. A draft of the systematic review is currently being produced for publication by the end of 2015

  13. Optimal freeware quality in the presence of network externalities: an evolutionary game theoretical approach

    OpenAIRE

    Ernan Haruvy; Ashutosh Prasad

    2001-01-01

    New software products often face difficulty in achieving market penetration. A potential remedy is to offer a freeware version of the software to encourage initial adoption and establish a larger user base for the software, thereby increasing the commercial version's value to adopters in future periods. However, to avoid complete cannibalization of the commercial version, the freeware version's quality must be sufficiently low and the price of the commercial version must not be too high. We m...

  14. The impact of legal responsibility of external auditors on auditing quality and investment level

    OpenAIRE

    Matar, Soud

    2012-01-01

    This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London. This research aims to study the effects of legal liability rules on auditing quality in order to devise and implement a guideline for the optimal liability rules that can be applied to the auditing profession within society, and thus encourage investment. In an emerging market like Kuwait state, there is a weakness in the legal system, which may cause users to place less reliance on...

  15. Management by objectives and its impact on specialist prescription quality at discharge and in external consultations.

    Science.gov (United States)

    Olmo, M; Galvan, L; Capdevila, J; Serna, C; Mangues, I; Schoenenberger, J A

    2011-01-01

    To verify that implementing a policy of management by objectives, based on collaboration between hospital pharmacy, primary care and specialised medical managers, improves prescription quality indicators in specialised care and reduces unwanted "induced" prescriptions (i.e. those issued by specialists, hospital doctors or the patients themselves) in primary care. A four year quasi-experimental controlled intervention study on prescription at discharge and in outpatient hospital consultations was conducted. In hospital A, a quality cycle was applied: assessment, identifying improvement opportunities, implementing corrective actions and re-assessment. However, it was not applied in control hospital B. The indicators chosen were the percentage of generic medicines prescribed, the percentage of prescriptions for new therapies with no added value and the percentage of prescriptions for ACE inhibitors recommended. In hospital A, an increase in indicators 1 and 3 has been observed, both being statistically significant, between the last year of intervention and the year previous to intervention. Hospital A managed to reduce indicator 2 to 4.5%, while this indicator increased in hospital B to 8.8%. Furthermore, a statistically significant difference in indicators between the two hospitals has been registered. Pay-for-Performance programs in prescription practices of hospital physicians are effective actions to improve quality indicators of medication use. Copyright © 2010 SEFH. Published by Elsevier Espana. All rights reserved.

  16. Martial arts participation and externalizing behavior in juveniles : A meta-analytic review

    NARCIS (Netherlands)

    Gubbels, J.; van der Stouwe, T.; Spruit, A.; Stams, G.J.J.M.

    2016-01-01

    Martial arts are very popular among juveniles all over the world, but the relation between martial arts and externalizing behavior in juveniles remains unclear. The current multilevel meta-analysis of 12 studies, including 94 effect sizes and N = 5949 juveniles, was conducted to examine the relation

  17. Martial arts participation and externalizing behavior in juveniles : A meta-analytic review

    NARCIS (Netherlands)

    Gubbels, J.; van der Stouwe, T.; Spruit, A.; Stams, G.J.J.M.

    2016-01-01

    Martial arts are very popular among juveniles all over the world, but the relation between martial arts and externalizing behavior in juveniles remains unclear. The current multilevel meta-analysis of 12 studies, including 94 effect sizes and N = 5949 juveniles, was conducted to examine the relation

  18. Radial nerve injury following elbow external fixator: report of three cases and literature review.

    Science.gov (United States)

    Trigo, Luis; Sarasquete, Juan; Noguera, Laura; Proubasta, Ignacio; Lamas, Claudia

    2017-07-01

    Radial nerve palsy is a rare but serious complication following elbow external fixation. Only 11 cases have been reported in the literature to date, but the incidence may be underreported. We present three new cases of this complication. We analyzed the three cases of radial palsy seen in our center following the application of an external fixator as treatment for complex elbow injuries. Mean patient age at surgery was 50 years. Two patients were female and one was male. In the three cases, the initial lesion was a posterior elbow dislocation, associated with a fracture of the radial shaft in one and a radial head fracture and coronoid fracture, respectively, in the other two. Due to persistent elbow instability, an external fixator was applied in all three cases. The fixator pins were introduced percutaneously in two cases and under direct vision in an open manner in the third case. Radial palsy was noted immediately postoperatively in all cases. It was permanent in two cases and temporary in the third. Radial nerve palsy after placement of an external elbow fixator was resolved in only 1 of our 3 cases and in 6 of the 11 cases in the literature to date. Although the event is rare, these alarming results highlight the need for recommendations to avoid this complication.

  19. Fibroepithelial Polyp of the External Auditory Canal: A Case Report and a Literature Review

    Directory of Open Access Journals (Sweden)

    Nobuaki Tanaka

    2013-01-01

    Full Text Available This paper reports the first case of fibroepithelial polyp arising independently of the external auditory canal. A 16-year-old female patient presented to our clinic for aural fullness of the left side. Physical examination revealed a papillomatous tumor at the posterior wall of the inlet of the left external auditory canal. After biopsy, which yielded a diagnosis of benign papilloma, the patient underwent tumor excision. Final diagnosis was fibroepithelial polyp. One week after resection, aural fullness had resolved. Fibroepithelial polyp is a benign lesion and occurs mainly in the skin, ureteropelvic system, and genitals. In the head and neck area, there are reports on fibroepithelial polyp of the tongue, piriform fossa, inferior nasal turbinate, and tonsil, in addition to the skin, but none on independent fibroepithelial polyp of the external auditory canal. Excision of fibroepithelial polyp of the external auditory canal is advisable, especially in the presence of any symptoms, and should be preceded by confirmation of nonmalignancy by biopsy, if possible.

  20. Low-Cost Alternative External Rotation Shoulder Brace and Review of Treatment in Acute Shoulder Dislocations

    Directory of Open Access Journals (Sweden)

    Lacy, Kyle

    2015-01-01

    Full Text Available Traumatic dislocations of the shoulder commonly present to emergency departments (EDs. Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7-11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers. This brace is particularly suited for the uninsured patient, who lacks the financial resources to pay for a pre-fabricated brace out of pocket. We also performed a cost analysis for our low-cost external rotation shoulder brace, and a cost comparison with pre-fabricated brand name braces. At our institution, the total materials cost for our brace was $19.15. The cost of a pre-fabricated shoulder brace at our institution is $150 with markup, which is reimbursed on average at $50.40 according to our hospital billing data. The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation. [West J Emerg Med. 2015;16(1:114–120.

  1. Contraindications for external cephalic version in breech position at term: A systematic review

    NARCIS (Netherlands)

    Rosman, A.N.; Guijt, A.; Vlemmix, F.; Rijnders, M.; Mol, B.W.J.; Kok, M.

    2013-01-01

    Objective. External cephalic version (ECV) is a safe and effective intervention that can prevent breech delivery, thus reducing the need for cesarean delivery. It is recommended in national guidelines. These guidelines also mention contraindications for ECV, and thereby restrict the application of E

  2. A review of mothers' prenatal and postnatal quality of life

    Directory of Open Access Journals (Sweden)

    Symon Andrew

    2003-09-01

    Full Text Available Abstract Background Contemporary broad descriptions of health and well-being are reflected in an increasing appreciation of quality of life issues; in turn this has led to a growing number of tools to measure this. Methods This paper reviews articles cited in MEDLINE, CINAHL and BIDS which have addressed the concept of quality of life in pregnancy and the period following childbirth. Results It describes five groups of articles: those explicitly assessing quality of life in this area; those using broader health assessments as an indicator of quality of life; those articles equating quality of life with certain pregnancy outcomes in identified groups of patients; those studies which identify the possibility of pregnancy as an outcome measure and infer from this that quality of life has been improved; and those articles which are themselves reviews or commentaries of pregnancy and childbirth and which identify quality of life as a feature. Conclusions The term 'quality of life' is used inconsistently in the literature. There are few quality of life tools specifically designed for the maternity care setting. Improved or adversely affected quality of life is frequently inferred from certain clinical conditions.

  3. Design, control, and sensory feedback of externally powered hand prostheses: a literature review.

    Science.gov (United States)

    Cloutier, Aimee; Yang, James

    2013-01-01

    In recent years, there has been a steep rise in the quality of prostheses for patients with upper limb amputations. Researchers have begun to identify methods of making prosthetic hands both functional and cosmetically appealing, in contrast to past designs. Many improvements have occurred because of novel design strategies, such as the use of underactuated mechanisms, which allow for more degrees of freedom (DOF) or help reduce the weight of the prosthesis. The increase in functionality is also due in large part to advancements in control strategies for prosthetic hands. One common control method, using electromyographic (EMG) signals generated by muscle contractions, has allowed for an increase in the DOF of hand designs and a larger number of available grip patterns with little added complexity for the wearer. Another recent improvement in prosthetic hand design instead employs electroneurographic (ENG) signals, requiring an interface directly with the peripheral nervous system (PNS) or the central nervous system (CNS). Despite the recent progress in design and control strategies, however, prosthetic hands are still far more limited than the actual human hand. This review outlines the recent progress in the development of electrode-based prosthetic hands, detailing advancements in the areas of design, sensory feedback, and control through EMG and ENG signals (with a particular focus on interfaces with the PNS). The potential benefits and limitations of both control strategies, in terms of signal classification, invasiveness, and sensory feedback, are discussed. Finally, a brief overview of interfaces with the CNS is provided, and potential future developments for prosthetic hand design are discussed.

  4. Harmonisation and dosimetric quality assurance in individual monitoring for external radiation

    DEFF Research Database (Denmark)

    Bartlett, D.T.; Ambrosi, P.; Back, C.

    2001-01-01

    The current situation amongst Member States is that there are widely differing national requirements for dosimetric services and for dosemeter performance. It is clear that with the free movement of workers within the European Union (EU) and the requirements for individual dosimetry given...... in Council Directive 96/29 EURATOM, a degree of harmonisation of requirements and procedures of EU Member States would be desirable. A EURADOS action group, made up of members from each of the EU Member States plus Switzerland, was set up with the overall objectives of consolidating within the EU the quality...

  5. Relating Child Care during Infancy to Externalizing and Internalizing Behaviors in Toddlerhood: How Specific Features of Child Care Quality Matter Depending on a Child's Gender and Temperament

    Science.gov (United States)

    Lemay, Lise; Bigras, Nathalie; Bouchard, Caroline

    2014-01-01

    This study explored whether the relationships between specific features of child care quality and externalizing and internalizing behaviors in 24-month-old children are moderated by gender and temperament. Questionnaires were used to record children's gender and measure their temperament. Child care quality was observed with the "Échelles…

  6. Quality assurance of qualitative research: a review of the discourse

    Science.gov (United States)

    2011-01-01

    Background Increasing demand for qualitative research within global health has emerged alongside increasing demand for demonstration of quality of research, in line with the evidence-based model of medicine. In quantitative health sciences research, in particular clinical trials, there exist clear and widely-recognised guidelines for conducting quality assurance of research. However, no comparable guidelines exist for qualitative research and although there are long-standing debates on what constitutes 'quality' in qualitative research, the concept of 'quality assurance' has not been explored widely. In acknowledgement of this gap, we sought to review discourses around quality assurance of qualitative research, as a first step towards developing guidance. Methods A range of databases, journals and grey literature sources were searched, and papers were included if they explicitly addressed quality assurance within a qualitative paradigm. A meta-narrative approach was used to review and synthesise the literature. Results Among the 37 papers included in the review, two dominant narratives were interpreted from the literature, reflecting contrasting approaches to quality assurance. The first focuses on demonstrating quality within research outputs; the second focuses on principles for quality practice throughout the research process. The second narrative appears to offer an approach to quality assurance that befits the values of qualitative research, emphasising the need to consider quality throughout the research process. Conclusions The paper identifies the strengths of the approaches represented in each narrative and recommend these are brought together in the development of a flexible framework to help qualitative researchers to define, apply and demonstrate principles of quality in their research. PMID:22182674

  7. Quality assurance of qualitative research: a review of the discourse

    Directory of Open Access Journals (Sweden)

    Reynolds Joanna

    2011-12-01

    Full Text Available Abstract Background Increasing demand for qualitative research within global health has emerged alongside increasing demand for demonstration of quality of research, in line with the evidence-based model of medicine. In quantitative health sciences research, in particular clinical trials, there exist clear and widely-recognised guidelines for conducting quality assurance of research. However, no comparable guidelines exist for qualitative research and although there are long-standing debates on what constitutes 'quality' in qualitative research, the concept of 'quality assurance' has not been explored widely. In acknowledgement of this gap, we sought to review discourses around quality assurance of qualitative research, as a first step towards developing guidance. Methods A range of databases, journals and grey literature sources were searched, and papers were included if they explicitly addressed quality assurance within a qualitative paradigm. A meta-narrative approach was used to review and synthesise the literature. Results Among the 37 papers included in the review, two dominant narratives were interpreted from the literature, reflecting contrasting approaches to quality assurance. The first focuses on demonstrating quality within research outputs; the second focuses on principles for quality practice throughout the research process. The second narrative appears to offer an approach to quality assurance that befits the values of qualitative research, emphasising the need to consider quality throughout the research process. Conclusions The paper identifies the strengths of the approaches represented in each narrative and recommend these are brought together in the development of a flexible framework to help qualitative researchers to define, apply and demonstrate principles of quality in their research.

  8. Beef quality attributes: A systematic review of consumer perspectives.

    Science.gov (United States)

    Henchion, Maeve M; McCarthy, Mary; Resconi, Virginia C

    2017-06-01

    Informed by quality theory, this systematic literature review seeks to determine the relative importance of beef quality attributes from a consumer perspective, considering search, experience and credence quality attributes. While little change is anticipated in consumer ranking of search and experience attributes in the future, movement is expected in terms of ranking within the credence category and also in terms of the ranking of credence attributes overall. This highlights an opportunity for quality assurance schemes (QAS) to become more consumer focused through including a wider range of credence attributes. To capitalise on this opportunity, the meat industry should actively anticipate new relevant credence attributes and researchers need to develop new or better methods to measure them. This review attempts to identify the most relevant quality attributes in beef that may be considered in future iterations of QAS, to increase consumer satisfaction and, potentially, to increase returns to industry.

  9. Impact of physical fitness and biometric data on the quality of external chest compression: a randomised, crossover trial

    Directory of Open Access Journals (Sweden)

    Russo Sebastian G

    2011-11-01

    Full Text Available Abstract Background During circulatory arrest, effective external chest compression (ECC is a key element for patient survival. In 2005, international emergency medical organisations changed their recommended compression-ventilation ratio (CVR from 15:2 to 30:2 to acknowledge the vital importance of ECC. We hypothesised that physical fitness, biometric data and gender can influence the quality of ECC. Furthermore, we aimed to determine objective parameters of physical fitness that can reliably predict the quality of ECC. Methods The physical fitness of 30 male and 10 female healthcare professionals was assessed by cycling and rowing ergometry (focussing on lower and upper body, respectively. During ergometry, continuous breath-by-breath ergospirometric measurements and heart rate (HR were recorded. All participants performed two nine-minute sequences of ECC on a manikin using CVRs of 30:2 and 15:2. We measured the compression and decompression depths, compression rates and assessed the participants' perception of exhaustion and comfort. The median body mass index (BMI; male 25.4 kg/m2 and female 20.4 kg/m2 was used as the threshold for subgroup analyses of participants with higher and lower BMI. Results HR during rowing ergometry at 75 watts (HR75 correlated best with the quality of ECC (r = -0.57, p 75, the compression depth decreased over time, beginning after four minutes for the 15:2 CVR and after three minutes for the 30:2 CVR. Although found to be more exhausting, a CVR of 30:2 was rated as being more comfortable. Conclusion The quality of the ECC and fatigue can both be predicted by BMI and physical fitness. An evaluation focussing on the upper body may be a more valid predictor of ECC quality than cycling based tests. Our data strongly support the recommendation to relieve ECC providers after two minutes.

  10. An Internet-based external quality assessment in cytogenetics that audits a laboratory's analytical and interpretative performance.

    Science.gov (United States)

    Hastings, Rosalind J; Maher, Eddy J; Quellhorst-Pawley, Bettina; Howell, Rodney T

    2008-10-01

    A novel approach to external quality assessment (EQA) using the Internet mimics the diagnostic situation so that multiple tests can be requested and EQA cases can be 'tailor made' to address a specific chromosome syndrome, disease, or clinical dilemma. The web-based EQA system was trialled on a large UK EQA scheme, UK NEQAS for Clinical Cytogenetics. It has also been used to implement a new Cytogenetics European Quality Assessment scheme, CEQA, set up with the intention of providing laboratories in countries without access to a local EQA scheme the opportunity of participation in EQA. Overall, Internet-based EQA allows for a varied EQA programme. Poor performance was detected in both CEQA and UK NEQAS constitutional EQA schemes and also in the UK NEQAS oncology EQA scheme. The Internet-based EQA overcomes submission delays due to international surface mail. There is also a reduction in administration and assessors' time compared to a retrospective EQA involving the submission of unique cases for EQA assessment, as participants analyse the same three Internet-based EQA cases simultaneously. Many EU27 (EU member states) laboratories still do not participate in their national EQA schemes, so until EQA participation becomes mandatory as a component of compulsory laboratory accreditation, the quality of laboratory diagnostic service is unpredictable.

  11. Quality of cervical cancer screening in Brazil: external assessment of the PMAQ.

    Science.gov (United States)

    Barcelos, Mara Rejane Barroso; Lima, Rita de Cássia Duarte; Tomasi, Elaine; Nunes, Bruno Pereira; Duro, Suele Manjourany Silva; Facchini, Luiz Augusto

    2017-07-20

    To examine whether demographic and socioeconomic variables and the variables of the organization of services are associated with the quality of cervical cancer screening. This is a survey carried out in the health services of the five Brazilian regions in 2012. The sample consisted of users of basic health units participating in the Program for Improving Access and Quality of the Primary Care. The independent variables analyzed were: socioeconomic characteristics (municipal context), demographic characteristics (user profile), and two domains related to the organization of basic services (work structure and process). The low quality of the screening was assessed from the lack of access, late examination, and lack of guidance. Crude and adjusted analyses by Poisson regression assessed the association between outcomes and independent variables. The values of lack of access, late examination, and lack of guidance were 6.7%, 11.2%, and 19.2%, respectively. Problems of quality were lower according to the increase in Municipal Human Development Index and per capita household income, increasing with population size and municipal coverage of the Family Health Strategy. The Midwest region of the country presented the highest occurrences of low quality outcomes. Indigenous and yellow women had the highest prevalence of outcomes. Women with partner, who received the Bolsa Família Program, and who had paid work had less chances of having lack of access, late examination, and lack of guidance. The appropriate work process in health services decreased the likelihood of low quality in all indicators. Investments in the work process of health teams, social cash transfer programs, and social conditions of the population are essential to improve the quality of the program of cervical cancer screening in Brazil. Analisar se as variáveis demográficas, socioeconômicas e da organização dos serviços estão associadas à qualidade do rastreamento do câncer de colo uterino. Inqu

  12. Quality assurance in personal dosimetry of external radiation: present situation and future needs

    Energy Technology Data Exchange (ETDEWEB)

    Ma, N. [Malaysian Institue For Nuclear Technology Research (MINT), Bangi, Selangor (Malaysia)

    2006-07-01

    Whole body personal dosimetry is well established for the individual monitoring of radiation workers. High quality radiation dosimetry is essential for workers who rely upon personal dosemeters to record the amount of radiation to which they are exposed. The mandate has been given to the Personal Dosimetry, (secondary standard dosimetry laboratories) S.S.D.L., (Malaysian institute for nuclear energy research) M.I.N.T. to assure the individual monitoring for radiation workers in Malaysia. In 2005, the S.S.D.L;-M.I.N.T. supply, process and read out of personal dosemeters of nearly 13,000 dosimeters monthly, whereby. 12,000 are films and 1,000 are T.L.D.s. The objective of individual monitoring is not limited to the measurement of doses delivered to individuals, but it should demonstrate that limits of exposure have not been exceeded and that working conditions have not unexpectedly deteriorated. Dosimetry measurements are an important component of radiation protection programs and must be of high quality. The exposure of workers to radiation must be controlled and monitored in order to comply with regulatory requirements. S.S.D.L.-M.I.N.T; demonstrates that its performance is at an acceptable level by implementing overall system performance, as evidenced by the ISO 9001 certification of the Personal Dosimetry Service in 2002 and ISO/I.E.C. 17025 accreditation to the calibration laboratory in 2004. The certification and accreditation processes achieved the goal by formalizing the recognition of satisfactory performance, and providing evidence of this performance. Overall performances are assessed, personnel operating the system will be trained and are well qualified and all actions will be documented. The paper describes the overview of the Q.M.S. carried out at the S.S. D.L.-M.I.N.T.. During the implementation of Q.M.S. a few areas has been identified for future consideration. These include performance specification and type testing of dosemeters, which provide a

  13. IPEEE review of external events of the Asco I nuclear plant; Revision del IPEEE de sucesos externos de la Central Nuclear Asco I

    Energy Technology Data Exchange (ETDEWEB)

    Aleman, A.; Canadell, F.; Beltran, F.; Pifarre, D.; Hernandez, H.; Gasca, C.

    2012-07-01

    During the risk analysis update of Asco PP (2010), it has been carried out a review of the vulnerabilities against severe accidents caused by external events (individual Plant Examination of external Events, IPEEE). The assessment has included analysis of accidents in industrial and military facilities nearby and transportation accidents (i.e., rail, road and aircraft impact) release of hazardous materials on site, external flooding, turbine missiles and strong winds. (Author)

  14. Decadal regional air quality simulations over Europe in present climate: near surface ozone sensitivity to external meteorological forcing

    Directory of Open Access Journals (Sweden)

    E. Katragkou

    2009-05-01

    Full Text Available Regional air quality decadal simulations were carried out using the air quality model CAMx driven off-line by the regional climate model RegCM3 for the time slice 1991–2000 using two different datasets of external meteorological forcing to constrain RegCM3: the ERA40 global atmospheric reanalysis dataset and the output from the GCM ECHAM5. The focus of this work is to compare the perfect lateral boundary conditions experiment with the GCM driven control experiment and to investigate how this external meteorological forcing affects near surface ozone. The different RegCM3 meteorological forcings resulted in changes of near surface ozone over Europe ranging between ±5 ppb for winter and summer, while all model parameterizations and anthropogenic emissions remained unchanged. Changes in near surface ozone are induced by changes in meteorological fields and biogenic emissions, which are on-line calculated and meteorology-dependent. The model simulations suggest that the change in solar radiation is the factor that mostly modulates the ozone changes in summer. During winter season it is found that the induced changes in NOx explain about 40% of the ozone variability. The meteorological induced changes in biogenic emissions are quite low for winter with rather small impact on ozone while they are more temperature than radiation dependent. Using multiple regression analysis to associate the changes in near surface ozone with the respective changes in selected meteorological parameters and ozone precursors, an explained variance of 70% in summer and 60% in winter is reproduced.

  15. Peer Review Certifies Quality and Innovation in Clinical Pharmacology & Therapeutics.

    Science.gov (United States)

    Waldman, S A; Terzic, A

    2017-09-01

    Clinical Pharmacology & Therapeutics (CPT) is an established voice of the discipline, a trusted source of new knowledge showcasing discovery, translation, and application of novel therapeutic paradigms to advance the management of patients and populations. Identifying, evaluating, prioritizing, and disseminating the best science along the discovery-development-regulatory-utilization continuum are responsibilities shared through peer review. To enhance the uniformity of this essential component of quality assurance and innovation, and maximize the value of the journal and its contents to authors, reviewers, and the readership, we review key concepts concerning peer review as it specifically relates to CPT. © 2017 ASCPT.

  16. Prolonged Unilateral Disuse Osteopenia 14 Years Post External Fixator Removal: A Case History and Critical Review

    Directory of Open Access Journals (Sweden)

    Karen M. Knapp

    2010-01-01

    Full Text Available Disuse osteopenia is a complication of immobilisation, with reversal generally noted upon remobilisation. This case report focuses on a patient who was seen 18 years following a road traffic collision when multiple fractures were sustained. The patient had an external fixator fitted for a tibia and fibula fracture, which remained in situ for a period of 4 years. Following removal, the patient was mobilised but, still required a single crutch to aid walking. Fourteen years post removal of the fixator, the patient had a DXA scan which, demonstrated a T-score 2.5 SD lower on the affected hip. This places the patient at an increased risk of hip fracture on this side, which requires monitoring. There appear to be no current studies investigating prolonged disuse-osteopenia in patients following removal of long-term external fixators. Further research is required to quantify unilateral long-term effects to bone health and fracture risk in this population.

  17. Hypofractionated external-beam radiation therapy (HEBRT versus conventional external-beam radiation (CEBRT in patients with localized prostate cancer: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Botrel TEA

    2013-03-01

    Full Text Available Tobias Engel Ayer Botrel,1 Otávio Clark,1 Antônio Carlos Lima Pompeo,2 Francisco Flávio Horta Bretas,2 Marcus Vinicius Sadi,2 Ubirajara Ferreira,2 Rodolfo Borges dos Reis21CoBEU and Evidencias, 2Comitê Brasileiro de Estudos em Uro-Oncologia – CoBEU, BrazilBackground: The purpose of this work was to conduct a systematic review and meta-analysis of all randomized controlled trials comparing the efficacy and side effect profile of hypofractionated versus conventional external-beam radiation therapy for prostate cancer.Methods: Several databases were searched, including Medline, EmBase, LiLACS, and Central. The endpoints were freedom from biochemical failure and side effects. We performed a meta-analysis of the published data. The results are expressed as the hazard ratio (HR or risk ratio (RR, with the corresponding 95% confidence interval (CI.Results: The final analysis included nine trials comprising 2702 patients. Freedom from biochemical failure was reported in only three studies and was similar in patients who received hypofractionated or conventional radiotherapy (fixed effect, HR 1.03, 95% CI 0.88–1.20; P = 0.75, with heterogeneity [χ2 = 15.32, df = 2 (P = 0.0005; I2 = 87%]. The incidence of acute adverse gastrointestinal events was higher in the hypofractionated group (fixed effect, RR 2.02, 95% CI 1.45–2.81; P < 0.0001. We also found moderate heterogeneity on this analysis [χ2 = 7.47, df = 5 (P = 0.19; I2 = 33%]. Acute genitourinary toxicity was similar among the groups (fixed effect, RR 1.19, 95% CI 0.95–1.49; P = 0.13, with moderate heterogeneity [χ2 = 5.83, df = 4 (P = 0.21; I2 = 31%]. The incidence of all late adverse events was the same in both groups (fixed effect, gastrointestinal toxicity, RR 1.17, 95% CI 0.79–1.72, P = 0.44; and acute genitourinary toxicity, RR 1.16, 95% CI 0.80–1.68, P = 0.44.Conclusion: Hypofractionated radiotherapy in localized prostate cancer was not superior to conventional radiotherapy and

  18. Which technique is better for reduction of anterior shoulder dislocation? External rotation or Milch method. A review of literature

    Directory of Open Access Journals (Sweden)

    Niaz Mohammad Jafari Chokan

    2016-11-01

    Full Text Available Anterior shoulder dislocation is the most common joint dislocation in human body. Many methods are traditionally described for reduction of shoulder dislocation. Most of these techniques are painful to patients and may be associated with further injury. An ideal method should be easy, effective, and less painful, not associated with iatrogenic complications and should be easy to teach and learn. Among different methods of reduction, external rotation and Milch methods are more popular. Both methods are found to be atraumatic, relatively painless and can be performed without anesthesia. In this article, we aimed to review the literatures regarding these two methods of reduction and comparing their success rate and outcome. We reviewed the literature to find articles related to reduction of anterior shoulder dislocations applying one of two techniques described above. We searched PubMed and Google Scholar. In total, 46 articles were found, of them 17 articles -which mainly focused on anterior shoulder dislocation reduction by means of two above methods-were included in this review. The results showed that both techniques were effective, safe, relatively painless, and were well tolerated with no complications, but the external rotation method was superior.

  19. An integrative review of skin assessment tools used to evaluate skin injury related to external beam radiation therapy.

    Science.gov (United States)

    Baines, Carol R; McGuiness, William; O'Rourke, Geraldine A

    2017-04-01

    To review literature associated with external beam radiotherapy and skin damage. A focus of the literature search is to highlight and discuss the myriad of skin assessment tools that are available to the clinician when assessing skin injury in patients receiving external beam radiation therapy. It is apparent that despite considerable work being progressed in the development of individualised skin assessment tools, uptake and use is poor. These tools are designed to assist the clinician in the evaluation of damaged skin and predict the radiation wound development pathway. An integrated review can be used to address a mature or new and emerging topic through a systematic methodology, which is either theoretical or empirical, gained from research, practice or policy initiatives (Whittemore & Knafl, Journal of Advanced Nursing, 52, 2005, 546). This review is particularly concerned with the employment of skin assessment tools by clinicians in patients with radiation damaged skin. Using the search terms synonyms for radiation, skin and epidermal damage, PubMed/MEDLINE, Medical Complete and Web of Science databases were searched. Consulting professional peers was employed as part of the inclusion and exclusion process. There is a high level of unpredictability about which patient will have an uncomplicated course of external beam radiotherapy. Variables may include, but are not limited to, an acute reaction, a delayed reaction resulting in actual skin damage or no visible skin disturbance. The skin assessment tools that are readily available are not regularly referenced in clinical practice when attempting to manage the many side effects of radiation therapy. Skin assessment tools require ongoing clinical validation, so they can be used to guide practitioners to undertake further assessment of skin integrity. The current body of knowledge suggests clinicians caring for patients receiving therapeutic radiotherapy should consider integrating a recognised patient assessment

  20. Quality Assessment of TPB-Based Questionnaires: A Systematic Review

    Science.gov (United States)

    Oluka, Obiageli Crystal; Nie, Shaofa; Sun, Yi

    2014-01-01

    Objective This review is aimed at assessing the quality of questionnaires and their development process based on the theory of planned behavior (TPB) change model. Methods A systematic literature search for studies with the primary aim of TPB-based questionnaire development was conducted in relevant databases between 2002 and 2012 using selected search terms. Ten of 1,034 screened abstracts met the inclusion criteria and were assessed for methodological quality using two different appraisal tools: one for the overall methodological quality of each study and the other developed for the appraisal of the questionnaire content and development process. Both appraisal tools consisted of items regarding the likelihood of bias in each study and were eventually combined to give the overall quality score for each included study. Results 8 of the 10 included studies showed low risk of bias in the overall quality assessment of each study, while 9 of the studies were of high quality based on the quality appraisal of questionnaire content and development process. Conclusion Quality appraisal of the questionnaires in the 10 reviewed studies was successfully conducted, highlighting the top problem areas (including: sample size estimation; inclusion of direct and indirect measures; and inclusion of questions on demographics) in the development of TPB-based questionnaires and the need for researchers to provide a more detailed account of their development process. PMID:24722323

  1. Review of personal monitoring techniques for the measurement of absorbed dose from external beta and low energy photon radiation

    DEFF Research Database (Denmark)

    Christensen, Poul

    1986-01-01

    The techniques available at present for personal monitoring of doses from external beta and low energy photon radiation are reviewed. The performance of currently used dosimetry systems is compared with that recommended internationally, and developments for improving the actual performance...... materials and detector/filter geometry. Improvements in the energy and angular response of dosemeters for the measurements of doses from beta and low energy photon radiation can be achieved essentially through two different approaches: either by using thin detectors or multi-element dosemeters...

  2. Metabolic syndrome and quality of life: a systematic review 1

    OpenAIRE

    Saboya, Patrícia Pozas; Bodanese,Luiz Carlos; Zimmermann,Paulo Roberto; Gustavo,Andréia da Silva; Assumpção, Caroline Melo; Londero, Fernanda

    2016-01-01

    ABSTRACT Objectives: to present currently available evidence to verify the association between metabolic syndrome and quality of life. Method: Cochrane Library, EMBASE, Medline and LILACS databases were studied for all studies investigating the association with metabolic syndrome and quality of life. Two blinded reviewers extracted data and one more was chosen in case of doubt. Results: a total of 30 studies were included, considering inclusion and exclusion criteria, which involved 62.063 pa...

  3. A Survey of Quality Prediction of Product Reviews

    Directory of Open Access Journals (Sweden)

    H.Almagrabi

    2015-11-01

    Full Text Available With the help of Web-2.0, the Internet offers a vast amount of reviews on many topics and in different domains. This has led to an explosive growth of product reviews and customer feedback, which presents the problem of how to handle the abundant volume of data. It is an expensive and time-consuming task to analyze this huge content of opinions. Therefore, the need for automated sentiment analysis systems is vital. However, these systems encounter many challenges; assessing the content quality of the posted opinions is an important area of study that is related to sentiment analysis. Currently, review helpfulness is assessed manually; however the task of automatically assessing it has gained more attention in recent years. This paper provides a survey of approaches to the challenge of identifying the content quality of product reviews.

  4. External influences on Europe's air quality: Baseline methane, carbon monoxide and ozone from 1990 to 2030 at Mace Head, Ireland

    Science.gov (United States)

    Derwent, R. G.; Simmonds, P. G.; O'Doherty, S.; Stevenson, D. S.; Collins, W. J.; Sanderson, M. G.; Johnson, C. E.; Dentener, F.; Cofala, J.; Mechler, R.; Amann, M.

    A global 3-D chemistry-transport model STOCHEM has been employed to study trends in the mole fractions of methane, carbon monoxide and ozone in baseline air masses entering Europe from the Atlantic Ocean over the period from 1990 to 2030. With a range of emission scenarios for man-made ozone precursor emission sources available, a wide range of model trends were predicted for the period up to 2030. In the scenario based on current planned air pollution controls, IIASA CLE, methane shows a strong upward trend, ozone shows a weaker upward trend, and carbon monoxide is approximately flat in baseline air masses. In one of the more pessimistic IPCC SRES scenarios, A2, all three gases show future increases. However, in the scenario based on maximum feasible emission reductions, IIASA MFR all three trace gases decline. By 2030, projected climate change reduces the growth in CH 4, but has insignificant effects on baseline CO and O 3 in these simulations. Global or hemispheric ozone precursor emissions and their controls exert a potentially large external influence on Europe's air quality. This influence is currently not taken into account in future European air quality policy formulation.

  5. Intensive educational efforts combined with external quality assessment improve the preanalytical phase in general practitioner offices and nursing homes.

    Science.gov (United States)

    Sølvik, Una Ørvim; Bjelkarøy, Wenche Iren; Berg, Kari van den; Saga, Anne Lise; Hager, Helle Borgstrøm; Sandberg, Sverre

    2017-05-05

    Errors in the preanalytical phase in clinical laboratories affect patient safety. The aim of this study was to evaluate the effect of intensive educational efforts together with external quality assessment (EQA) of the preanalytical phase from 2013 to 2015 to improve patient identification in primary health care in Norway. In addition, routines for venous and capillary blood sampling were investigated. A preanalytical EQA was circulated in 2013 by the Norwegian Quality Improvement of Laboratory Examinations (Noklus) to general practitioner offices and nursing homes (n=2000) to obtain information about important issues to focus on before launching an intensive educational program with courses, posters and visits in 2013-2015. Preanalytical EQA surveys were further circulated in 2014 and 2015. The response rate varied between 42% and 55%. The percentages of participants asking for the patients' name and the Norwegian identification number increased from about 8% in 2013 to about 35% in 2015. The increase was similar for those participating in only one EQA survey and for those who participated in EQA surveys both in 2013 and 2015. Guidelines for venous and capillary blood sampling were not always followed. Educational efforts more than the preanalytical EQA influenced the actions and resulted in an increase in the percentages of participants that followed the guidelines for patient identification. Some aspects of blood sampling routines need improvement.

  6. Health-related quality of life of patients with endometrial cancer who are disease-free following external irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Klee, Marianne; Machin, David [Rigshospitalet, Copenhagen (Denmark). Dept. of Oncology

    2001-11-01

    Health-related quality of life (HQoL) is assessed through the patients' own evaluation of the impact that a disease and its treatment may have on some of the physical, psychological and social aspects of their lives. The purpose of this study is to describe the HQoL of patients with endometrial cancer who are free of disease after undergoing external irradiation. An HQoL questionnaire was designed and validated, and consisted of the EORTC QLQ-C30 and 80 additional questions. The patients provided self-reported assessments at the end of radiotherapy, and 1, 3, 6, 12, 18 and 24 months later. Forty-nine out of 66 potential subjects participated in the study, which was confined to the period during which the women were disease free. Most patients experience physical side effects at the end of treatment and up to 6 months thereafter; 10% of the patients have chronic local symptoms and a large number of the patients think about their treatment even two years later. The patients' overall evaluation of their quality of life is lower than that of a matched population of healthy women.

  7. 40 CFR 131.20 - State review and revision of water quality standards.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.20 State review and revision of water quality standards. (a) State review. The State shall... reviewing applicable water quality standards and, as appropriate, modifying and adopting standards. Any...

  8. [Assessment of the quality of laboratory diagnosis of intestinal parasitic diseases by the laboratories participating in the Federal System of External Quality Assessment of Clinical Laboratory Testing].

    Science.gov (United States)

    Malakhov, V N; Dovgalev, A S; Astanina, S Iu; Serdiuk, A P

    2014-01-01

    In 2010-2013, the quality of microscopic detection of the causative agents ofparasitic diseases in the feces has been assessed by the specialists of the laboratories of the therapeutic-and-prophylactic institutions (TPIs) and Hygiene and Epidemiology Centers, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare, which are participants of the Federal System of External Quality Assessment of Clinical Laboratory Testing. Thirty-two specimens containing 16 species of human helminths and 4 species of enteric protozoa in different combinations were examined. The findings suggest that the quality of microscopic detection of the causative agents of parasitic diseases is low in the laboratories of health care facilities and that the specialists of the laboratories of TPIs and Hygiene and Epidemiology Centers, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare, do not not possess the knowledge and skills necessary to make a laboratory diagnosis of helminths and enteric protozoa. The average detection rates of helminths and protozoa were at a level of 64 and 36%, respectively. The correct results showed that the proportion of helminths and protozoa were 94.5 and 5.5%, respectively. According to the biological and epidemiological classification of helminths, there were higher detection rates for contact group parasites (Enterobius vermicularis and Hymenolepis nana) and geohelminths (Ascaris, Trichuris trichiura, and others). Biohelminths (Opisthorchis, tapeworms, and others) Were detectable slightly worse.

  9. Assessing Air Pollutant-Induced, Health-Related External Costs in the Context of Nonmarginal System Changes: A Review.

    Science.gov (United States)

    Bachmann, Till M

    2015-08-18

    Marginal analysis is the usual approach to environmental economic assessment, for instance, of health-related external costs due to energy-associated air pollutant emissions. However, nonlinearity exists in all steps of their assessment, i.e., atmospheric dispersion, impact assessment, and monetary valuation. Dedicated assessments thus appear necessary when evaluating large systems or their changes such as in green accounting or the implications of economy-wide energy transitions. Corresponding approaches are reviewed. Tools already exist that allow assessing a marginal change (e.g., one power plant's emissions) for different background emission scenarios that merely need to be defined and implemented. When assessing nonmarginal changes, the top-down approach is considered obsolete, and four variants of the bottom-up approach with different application domains were identified. Variants 1 and 2 use precalculated external cost factors with different levels of sophistication, suitable for energy systems modeling, optimizing for social (i.e., private and external) costs. Providing more reliable results due to more detailed modeling, emission sources are assessed individually or jointly in variants 3 and 4, respectively. Aiming at considering nonlinearity more fully and simultaneously following marginal analysis principles, I propose a variant 3-based approach, subdividing an aggregate (i.e., a nonmarginal change) into several smaller changes. Its strengths and drawbacks, notably the associated effort, are discussed.

  10. Assessment of the Potential Impacts of Hydraulic Fracturing for Oil and Gas on Drinking Water Resources (External Review Draft)

    Science.gov (United States)

    This assessment provides a review and synthesis of available scientific literature and data to assess the potential for hydraulic fracturing for oil and gas to impact the quality or quantity of drinking water resources, and identifies factors affecting the frequency or severity o...

  11. The Internal, External, and Diagnostic Validity of Sluggish Cognitive Tempo: A Meta-Analysis and Critical Review.

    Science.gov (United States)

    Becker, Stephen P; Leopold, Daniel R; Burns, G Leonard; Jarrett, Matthew A; Langberg, Joshua M; Marshall, Stephen A; McBurnett, Keith; Waschbusch, Daniel A; Willcutt, Erik G

    2016-03-01

    To conduct the first meta-analysis evaluating the internal and external validity of the sluggish cognitive tempo (SCT) construct as related to or distinct from attention-deficit/hyperactivity disorder (ADHD) and as associated with functional impairment and neuropsychological functioning. Electronic databases were searched through September 2015 for studies examining the factor structure and/or correlates of SCT in children or adults. The search procedures identified 73 papers. The core SCT behaviors included across studies, as well as factor loadings and reliability estimates, were reviewed to evaluate internal validity. Pooled correlation effect sizes using random effects models were used to evaluate SCT in relation to external validity domains (i.e., demographics, other psychopathologies, functional impairment, and neuropsychological functioning). Strong support was found for the internal validity of the SCT construct. Specifically, across factor analytic studies including more than 19,000 individuals, 13 SCT items loaded consistently on an SCT factor as opposed to an ADHD factor. Findings also support the reliability (i.e., internal consistency, test-retest reliability, interrater reliability) of SCT. In terms of external validity, there is some indication that SCT may increase with age (r = 0.11) and be associated with lower socioeconomic status (r = 0.10). Modest (potentially negligible) support was found for SCT symptoms being higher in males than females in children (r = 0.05) but not in adults. SCT is more strongly associated with ADHD inattention (r = 0.63 in children, r = 0.72 in adults) than with ADHD hyperactivity-impulsivity (r = 0.32 in children, r = 0.46 in adults), and it likewise appears that SCT is more strongly associated with internalizing symptoms than with externalizing symptoms. SCT is associated with significant global, social, and academic impairment (r = 0.38-0.44). Effects for neuropsychological functioning are mixed, although

  12. How quality affects the bottom line?: A literature review

    Directory of Open Access Journals (Sweden)

    Joaquín Texeira-Quirós

    2010-10-01

    Full Text Available Improving quality is one of the tools that companies have to improve or maintain their market position. However, despite the large number of papers published, a clear conclusion of the impact of ISO9000 standards on business results has yet to be reached, given there are many conflicting opinions. Thus, the aim of this paper is to review the literature on some of the many published research papers, seeking some way to analyse the existing relationship between the implementation of systems of quality management, ISO9000 certification, quality costs, results, and their effect on company performance.

  13. Duplication of the External Auditory Canal: Two Cases and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    John K. Goudakos

    2012-01-01

    Full Text Available The objective of the present paper is to describe the clinical presentation, diagnostic process, surgical treatment, and outcome of 2 patients with first branchial cleft anomaly. The first case was an 8-year-old girl presented with an elastic lesion located in the left infra-auricular area, in close relation with the lobule, duplicating the external auditory canal. The magnetic resonance imaging revealed a lesion, appearing as a rather well-circumscribed mass within the left parotid gland and duplicating the ear canal. A superficial parotidectomy was subsequently performed, with total excision of the cyst. The second patient was a 15-year-old girl presented with a congenital fistula of the right lateral neck. At superficial parotidectomy, a total excision of the fistula was performed. During the operation the tract was recorded to lay between the branches of the facial nerve, extending with a blind ending canal parallel to the external acoustic meatus. Conclusively, first branchial cleft anomalies are rare malformations with cervical, parotid, or auricular clinical manifestations. Diagnosis of first branchial cleft lesions is achieved mainly through careful physical examination. Complete surgical excision with wide exposure of the lesion is essential in order to achieve permanent cure and avoid recurrence.

  14. Improving maternal health quality: reviewing the context and consequences

    Directory of Open Access Journals (Sweden)

    Anshul Chauhan

    2017-06-01

    Full Text Available Background: Approximately 99% of pregnancy-related deaths in developing countries are due to preventable causes related to pregnancy and childbirth which signifies that around 800 women die every day due to such causes. Major causes that lead to maternal deaths are post-partum hemorrhage, infections, high blood pressure and unsafe abortion. There are several facilities being provided for pregnant mothers yet the quality of care needs to be analyzed. Objectives: To understand the quality perspective of maternal health services and to review available evidence for strengthening maternal health services. Material & Methods: Research studies published between 2006 and 2016 were selected by specific inclusion criteria. Pub Med and Google Scholar were used to search studies on the topic, and few articles were identified through references and citations. Results: The result of the review highlighted the evidence of pitfalls, gaps in quality care, and need for interventions and approaches to improve the quality of maternal health care. Conclusion: Quality care encompasses various elements which stride towards improving the health of women and the interventions are to be scaled up to improve the quality of care. Generation of public health evidence and uniformity in quality assessments can help interventions to achieve desirable standards.

  15. Production, review, and impact of technical quality control guidelines in a national context.

    Science.gov (United States)

    Nielsen, Michelle K; Malkoske, Kyle E; Brown, Erika; Diamond, Kevin; Frenière, Normand; Grant, John; Pomerleau-Dalcourt, Natalie; Schella, Jason; Schreiner, L John; Tantôt, Laurent; Villarreal-Barajas, J Eduardo; Bissonnette, Jean-Pierre

    2016-11-01

    A close partnership between the Canadian Partnership for Quality Radiotherapy (CPQR) and the Canadian Organization of Medical Physicist's (COMP) Quality Assurance and Radiation Safety Advisory Committee (QARSAC) has resulted in the development of a suite of Technical Quality Control (TQC) guidelines for radiation treatment equipment; they outline specific performance objectives and criteria that equipment should meet in order to assure an acceptable level of radiation treatment quality. The adopted framework for the development and maintenance of the TQCs ensures the guidelines incorporate input from the medical physics community during development, measures the workload required to perform the QC tests outlined in each TQC, and remain relevant (i.e., "living documents") through subsequent planned reviews and updates. The framework includes consolidation of existing guidelines and/or literature by expert reviewers, structured stages of public review, external field-testing, and ratification by COMP. This TQC development framework is a cross-country initiative that allows for rapid development of robust, community-driven living guideline documents that are owned by the community and reviewed to keep relevant in a rapidly evolving technical environment. Community engagement and uptake survey data shows 70% of Canadian centers are part of this process and that the data in the guideline documents reflect, and are influencing, the way Canadian radiation treatment centers run their technical quality control programs. For a medium-sized center comprising six linear accelerators and a comprehensive brachytherapy program, we evaluate the physics workload to 1.5 full-time equivalent physicists per year to complete all QC tests listed in this suite. PACS number(s): 87.55.Qr, 87.56.Fc, 87.56.-v. © 2016 The Authors.

  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. Evaluation of the Carcinogenicity of Ethylene Oxide (2006 External Review Draft)

    Science.gov (United States)

    EPA conducted a peer review and public comment of the scientific basis supporting the human health hazard and dose-response assessment of ethylene oxide (cancer) that when finalized will appear on the Integrated Risk Information System (IRIS) database.

  18. [Analysis of the results of the 2010 External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology].

    Science.gov (United States)

    Ruiz de Gopegui Bordes, Enrique; Serrano, M del Remedio Guna; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Cardona, Concepción Gimeno

    2011-12-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most important conclusions and lessons of the 2010 controls. As a whole, the results obtained in 2010 confirm the excellent skill and good technical standards found in previous years. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. The results of this program highlight the need to implement both internal and external controls to ensure maximal quality of microbiological tests(1).

  19. External Costs of Risky Health Behaviors Associated with Leading Actual Causes of Death in the U.S.: A Review of the Evidence and Implications for Future Research

    Directory of Open Access Journals (Sweden)

    Armineh Zohrabian

    2010-06-01

    Full Text Available This paper reviews the evidence on external costs of risky behaviors in the U.S. and provides a framework for estimating them. External costs arise when a person does not bear all the costs of his or her behavior. They provide one of the strongest rationales for government interventions. Although the earlier estimates of external costs no longer have policy relevance, they demonstrated that the existence of external costs was an empirical question. We recommend that the estimates of external costs be updated as insurance structures, environments, and knowledge about these behaviors change. The general aspects of external costs may apply to countries other than the U.S. after taking into account differences in institutional, policy and epidemiological characteristics.

  20. A qualitative systematic review of internal and external influences on shared decision-making in all health care settings.

    Science.gov (United States)

    Truglio-Londrigan, Marie; Slyer, Jason T; Singleton, Joanne K; Worral, Priscilla

    2012-01-01

    noted. Additional research points to patient satisfaction and enhanced quality of life. There is some evidence to suggest that shared decision-making does facilitate positive health outcomes.In today's healthcare environment there is greater emphasis on patient-centered care that exemplifies patient engagement, participation, partnership, and shared decision-making. Given the shift from the more autocratic delivery of care to the shared approach there is a need to more fully understand the what of shared decision-making as well as how shared decision-making takes place along with what internal and external influences may encourage, support, and facilitate the shared decision-making process. These influences are intervening variables that may be of significance for the successful development of practice-based strategies that may foster shared decision-making in practice. The purpose of this qualitative systematic review is to identify internal and external influences on shared decision-making in all health care settings.A preliminary search of the Joanna Briggs Library of Systematic Reviews, MEDLINE, CINAHL, and PROSPERO did not identify any previously conducted qualitative systematic reviews on the meaningfulness of internal and external influences on shared decision-making.

  1. The efficacy of systemic therapy for childhood and adolescent externalizing disorders: a systematic review of 47 RCT.

    Science.gov (United States)

    von Sydow, Kirsten; Retzlaff, Ruediger; Beher, Stefan; Haun, Markus W; Schweitzer, Jochen

    2013-12-01

    Systemic (family) therapy is a widely used psychotherapy approach. However, most systematic efficacy reviews have focused solely on "family-based treatment" rather than on the theoretic orientation "systemic therapy." We systematically review trials on the efficacy of systemic therapy for the treatment of childhood and adolescent externalizing disorders. All randomized (or matched) controlled trials (RCT) evaluating systemic/systems-oriented therapy in various forms (family, individual, group, multi-family group therapy) with child or adolescent index patients (0-17 years) suffering from mental disorders were identified by data base searches and cross-references. Inclusion criteria were as follows: index patient diagnosed with a DSM- or ICD-listed mental disorder, and trial published in any language up to the end of 2011. The RCTs were analyzed for their research methodology, interventions applied, and results (postintervention; follow-up). A total of 47 trials from the United States, Europe, and China, published in English, German, and Mandarin, were identified. A total of 42 of them showed systemic therapy to be efficacious for the treatment of attention deficit hyperactivity disorders, conduct disorders, and substance use disorders. Results were stable across follow-up periods of up to 14 years. There is a sound evidence base for the efficacy of systemic therapy for children and adolescents (and their families) diagnosed with externalizing disorders.

  2. Critical Readiness Review EHS Water Quality and Microbiology

    Science.gov (United States)

    Woo, Cindy

    2010-01-01

    Presentation reviews the status in reference to the Environmental, Health and Safety (EHS) of the water quality and microbiology for the International Space Station. It includes information about crew training, hardware delivery, and those items that will be returned for study.

  3. Methods of Quality Appraisal for Studies Reviewed by Evidence Clearinghouses

    Science.gov (United States)

    Wilson, Sandra Jo; Tanner-Smith, Emily

    2015-01-01

    This presentation will discuss quality appraisal methods for assessing research studies used in systematic reviews, research syntheses, and evidence-based practice repositories such as the What Works Clearinghouse. The different ways that the methodological rigor and risk of bias of primary studies included in syntheses is assessed means that…

  4. Indexes of overall diet quality - A review of the literature

    NARCIS (Netherlands)

    Waijers PMCM; Feskens EJM; CVG

    2005-01-01

    A total diet approach provides an appealing way to evaluate the diet of the Dutch population. We have reviewed the existing literature and found that currently used methods contain several drawbacks and limitations and therefore propose to construct a diet quality index specific for the Netherlands

  5. SU-E-T-571: Newly Emerging Integrated Transmission Detector Systems Provide Online Quality Assurance of External Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, D; Chung, E; Hess, C; Stern, R; Benedict, S [UC Davis Cancer Center, Sacramento, CA (United States)

    2015-06-15

    Purpose: Two newly emerging transmission detectors positioned upstream from the patient have been evaluated for online quality assurance of external beam radiotherapy. The prototype for the Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area ion chamber mounted on the linac accessory tray to monitor photon fluence, energy, beam shape, and gantry position during treatment. The ion chamber utilizes a thickness gradient which records variable response dependent on beam position. The prototype of Delta4 Discover™, developed by ScandiDos (Uppsala, Sweden) is a linac accessory tray mounted 4040 diode array that measures photon fluence during patient treatment. Both systems are employable for patient specific QA prior to treatment delivery. Methods: Our institution evaluated the reproducibility of measurements using various beam types, including VMAT treatment plans with both the IQM ion chamber and the Delta4 Discover diode array. Additionally, the IQM’s effect on photon fluence, dose response, simulated beam error detection, and the accuracy of the integrated barometer, thermometer, and inclinometer were characterized. The evaluated photon beam errors are based on the annual tolerances specified in AAPM TG-142. Results: Repeated VMAT treatments were measured with 0.16% reproducibility by the IQM and 0.55% reproducibility by the Delta4 Discover. The IQM attenuated 6, 10, and 15 MV photon beams by 5.43±0.02%, 4.60±0.02%, and 4.21±0.03% respectively. Photon beam profiles were affected <1.5% in the non-penumbra regions. The IQM’s ion chamber’s dose response was linear and the thermometer, barometer, and inclinometer agreed with other calibrated devices. The device detected variations in monitor units delivered (1%), field position (3mm), single MLC leaf positions (13mm), and photon energy. Conclusion: We have characterized two new transmissions detector systems designed to provide in-vivo like measurements upstream

  6. Systematic review adherence to methodological or reporting quality

    DEFF Research Database (Denmark)

    Pussegoda, Kusala; Turner, Lucy; Garritty, Chantelle

    2017-01-01

    and with the increased uptake of SR evidence for decision-making, methodological quality and standard of reporting of SRs is of interest. The objective of this study is to evaluate SR adherence to the Quality of Reporting of Meta-analyses (QUOROM) and PRISMA reporting guidelines and the A Measurement Tool to Assess......-text screening were conducted independently by two reviewers. Reports assessing the quality or reporting of a cohort of SRs of interventions using PRISMA, QUOROM, OQAQ, or AMSTAR were included. All results are reported as frequencies and percentages of reports and SRs respectively. RESULTS: Of the 20......,765 independent records retrieved from electronic searching, 1189 reports were reviewed for eligibility at full text, of which 56 reports (5371 SRs in total) evaluating the PRISMA, QUOROM, AMSTAR, and/or OQAQ tools were included. Notable items include the following: of the SRs using PRISMA, over 85% (1532...

  7. Best peer reviewers and the quality of peer review in biomedical journals.

    Science.gov (United States)

    Gasparyan, Armen Yuri; Kitas, George D

    2012-08-01

    Current scholarly publications heavily rely on high quality peer review. Peer review, albeit imperfect, is aimed at improving science writing and editing. Evidence supporting peer review as a guarantor of the quality of biomedical publications is currently lacking. Its outcomes are largely dependent on the credentials of the reviewers. Several lines of evidence suggest that predictors of the best contributors to the process include affiliation to a good University and proper research training. Though the options to further improve peer review are currently limited, experts are in favor of formal education and courses on peer review for all contributors to this process. Long-term studies are warranted to assess the strengths and weaknesses of this approach.

  8. Evaluation of the Inhalation Carcinogenicity of Ethylene Oxide (Revised August 2014 External Review Draft) (SAB Review Draft)

    Science.gov (United States)

    EPA is seeking peer review of the scientific basis supporting the human health hazard and dose-response assessment of ethylene oxide (cancer) that will appear in the Integrated Risk Information System (IRIS) database.

  9. Prediction models for intracranial hemorrhage or major bleeding in patients on antiplatelet therapy: a systematic review and external validation study.

    Science.gov (United States)

    Hilkens, N A; Algra, A; Greving, J P

    2016-01-01

    ESSENTIALS: Prediction models may help to identify patients at high risk of bleeding on antiplatelet therapy. We identified existing prediction models for bleeding and validated them in patients with cerebral ischemia. Five prediction models were identified, all of which had some methodological shortcomings. Performance in patients with cerebral ischemia was poor. Background Antiplatelet therapy is widely used in secondary prevention after a transient ischemic attack (TIA) or ischemic stroke. Bleeding is the main adverse effect of antiplatelet therapy and is potentially life threatening. Identification of patients at increased risk of bleeding may help target antiplatelet therapy. This study sought to identify existing prediction models for intracranial hemorrhage or major bleeding in patients on antiplatelet therapy and evaluate their performance in patients with cerebral ischemia. We systematically searched PubMed and Embase for existing prediction models up to December 2014. The methodological quality of the included studies was assessed with the CHARMS checklist. Prediction models were externally validated in the European Stroke Prevention Study 2, comprising 6602 patients with a TIA or ischemic stroke. We assessed discrimination and calibration of included prediction models. Five prediction models were identified, of which two were developed in patients with previous cerebral ischemia. Three studies assessed major bleeding, one studied intracerebral hemorrhage and one gastrointestinal bleeding. None of the studies met all criteria of good quality. External validation showed poor discriminative performance, with c-statistics ranging from 0.53 to 0.64 and poor calibration. A limited number of prediction models is available that predict intracranial hemorrhage or major bleeding in patients on antiplatelet therapy. The methodological quality of the models varied, but was generally low. Predictive performance in patients with cerebral ischemia was poor. In order to

  10. Quality assurance in digital dental imaging: a systematic review.

    Science.gov (United States)

    Metsälä, Eija; Henner, Anja; Ekholm, Marja

    2014-07-01

    Doses induced by individual dental examinations are low. However, dental radiography accounts for nearly one third of the total number of radiological examinations in the European Union. Therefore, special attention is needed with regard to radiation protection. In order to lower patient doses, the staff performing dental examinations must have competence in imaging as well as in radiation protection issues. This paper presents a systematic review about the core competencies needed by the healthcare staff in performing digital dental radiological imaging quality assurance. The following databases were searched: Pubmed, Cinahl, Pro Quest and IEEXplore digital library. Also volumes of some dental imaging journals and doctoral theses of the Finnish universities educating dentists were searched. The search was performed using both MeSH terms and keywords using the option 'search all text'. The original keywords were: dental imaging, digital, x-ray, panoramic, quality, assurance, competence, competency, skills, knowledge, radiographer, radiologist technician, dentist, oral hygienist, radiation protection and their Finnish synonyms. Core competencies needed by the healthcare staff performing digital dental radiological imaging quality assurance described in the selected studies were: management of dental imaging equipment, competence in image quality and factors associated with it, dose optimization and quality assurance. In the future there will be higher doses in dental imaging due to increasing use of CBCT and digital imaging. The staff performing dental imaging must have competence in dental imaging quality assurance issues found in this review. They also have to practice ethical radiation safety culture in clinical practice.

  11. Health impact of external funding for HIV, tuberculosis and malaria: systematic review

    NARCIS (Netherlands)

    Jongh, T.E. de; Harnmeijer, J.H.; Atun, R.; Korenromp, E.L.; Zhao, J.; Puvimanasinghe, J.; Baltussen, R.M.P.M.

    2014-01-01

    BACKGROUND: Since 2002, development assistance for health has substantially increased, especially investments for HIV, tuberculosis (TB) and malaria control. We undertook a systematic review to assess and synthesize the existing evidence in the scientific literature on the health impacts of these in

  12. Health impact of external funding for HIV, tuberculosis and malaria: Systematic review

    NARCIS (Netherlands)

    T.E. De Jongh (Thyra E.); J.H. Harnmeijer (Joanne H.); R. Atun (Rifat); E.L. Korenromp (Eline); J. Zhao (Jinkou); J.P.A. Puvimanasinghe (John); R.M.P.M. Baltussen (Rob)

    2014-01-01

    textabstractBackground Since 2002, development assistance for health has substantially increased, especially investments for HIV, tuberculosis (TB) and malaria control. We undertook a systematic review to assess and synthesize the existing evidence in the scientific literature on the health impacts

  13. Demonstrating and Communicating Research Impact. Preparing NIOSH Programs for External Review

    Science.gov (United States)

    2009-01-01

    Technometrics, sociometrics, bibliometrics , value- mapping, expert review, and case studies represent both quantitative and qualitative means of assessing...such as bibliometrics , econometrics, and social analysis. However, the value of panels continues to be emphasized, and other methods have been advocated...lists of facili- ties and offices, budget information, bibliometric data, conference materials, biblio- graphies from criterion documents, research

  14. Analytical performance specifications based on how clinicians use laboratory tests. Experiences from a post-analytical external quality assessment programme.

    Science.gov (United States)

    Thue, Geir; Sandberg, Sverre

    2015-05-01

    Analytical performance specifications can be based on three different models: the effect of analytical performance on clinical outcome, based on components of biological variation of the measurand or based on state-of-the-art. Models 1 and 3 may to some degree be combined by using case histories presented to a large number of clinicians. The Norwegian Quality Improvement of Primary Care Laboratories (Noklus) has integrated vignettes in its external quality assessment programme since 1991, focusing on typical clinical situations in primary care. Haemoglobin, erythrocyte sedimentation rate (ESR), HbA1c, glucose, u-albumin, creatinine/estimated glomerular filtration rate (eGFR), and Internationl Normalised Ratio (INR) have been evaluated focusing on critical differences in test results, i.e., a change from a previous result that will generate an "action" such as a change in treatment or follow-up of the patient. These critical differences, stated by physicians, can translate into reference change values (RCVs) and assumed analytical performance can be calculated. In general, assessments of RCVs and therefore performance specifications vary both within and between groups of doctors, but with no or minor differences regarding specialisation, age or sex of the general practitioner. In some instances state-of-the-art analytical performance could not meet clinical demands using 95% confidence, whereas clinical demands were met using 80% confidence in nearly all instances. RCVs from vignettes should probably not be used on their own as a basis for setting analytical performance specifications, since clinicians seem "uninformed" regarding important principles. They could rather be used as a background for focus groups of "informed" physicians in discussions of performance specifications tailored to "typical" clinical situations.

  15. CARE - curriculum quality analysis and impact review of European ECEC

    DEFF Research Database (Denmark)

    Jensen, Bente; Iannone, Rosa Lisa

    children in particular. Results from this review showed that several initiatives have been taken to raise professionals' knowledge and skills, and overall competences to implement high quality interventions in day care. However findings also showed that resources and support at the policy or municipal...... to child outcomes including cognitive, language, social and emotional and educational development, as well as more general indicators of leaning and well-being. Research, mostly from the US, suggests that life-chances and child development are dependent on the quality of educational opportunities available...... that it is possible to identify different ways for improving ECEC quality, both structurally and processually. We know from research, that processual quality, e.g. positive interactions between children and adults, is the most important factor to improving child outcomes in general and for socially disadvantaged...

  16. Results of Use of WHO Global Salm-Surv External Quality Assurance System for Antimicrobial Susceptibility Testing of Salmonella Isolates from 2000 to 2007

    DEFF Research Database (Denmark)

    Hendriksen, Rene S.; Seyfarth, Anne Mette; Jensen, Arne Bent;

    2009-01-01

    . In particular, further training and dissemination of information on quality control, appropriate interpretive criteria (breakpoints), and harmonization of the methodology worldwide through WHO Global Salm-Surv and other programs will contribute to the generation of comparable and reliable antimicrobial......An international External Quality Assurance System (EQAS) for antimicrobial susceptibility testing of Salmonella was initiated in 2000 by the World Health Organization (WHO) Global Salm-Surv in order to enhance the capacities of national reference laboratories to obtain reliable data...

  17. [Implementation of quality standard UNE-EN ISO/IEC 17043 in the External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology].

    Science.gov (United States)

    Poveda Gabaldón, Marta; Ovies, María Rosario; Orta Mira, Nieves; Serrano, M del Remedio Guna; Avila, Javier; Giménez, Alicia; Cardona, Concepción Gimeno

    2011-12-01

    The quality standard "UNE-EN-ISO 17043: 2010. Conformity assessment. General requirements for proficiency testing" applies to centers that organize intercomparisons in all areas. In the case of clinical microbiology laboratories, these intercomparisons must meet the management and technical standards required to achieve maximum quality in the performance of microbiological analysis and the preparation of test items (sample, product, data or other information used in the proficiency test) to enable them to be accredited. Once accredited, these laboratories can operate as a tool for quality control laboratories and competency assessment. In Spain, accreditation is granted by the Spanish Accreditation Body [Entidad Nacional de Acreditación (ENAC)]. The objective of this review is to explain how to apply the requirements of the standard to laboratories providing intercomparisons in the field of clinical microbiology (the organization responsible for all the tasks related to the development and operation of a proficiency testing program). This requires defining the scope and specifying the technical requirements (personnel management, control of equipment, facilities and environment, the design of the proficiency testing and data analysis for performance evaluation, communication with participants and confidentiality) and management requirements (document control, purchasing control, monitoring of complaints / claims, non-compliance, internal audits and management reviews).

  18. Routine internal- and external-quality control data in clinical laboratories for estimating measurement and diagnostic uncertainty using GUM principles.

    Science.gov (United States)

    Magnusson, Bertil; Ossowicki, Haakan; Rienitz, Olaf; Theodorsson, Elvar

    2012-05-01

    Healthcare laboratories are increasingly joining into larger laboratory organizations encompassing several physical laboratories. This caters for important new opportunities for re-defining the concept of a 'laboratory' to encompass all laboratories and measurement methods measuring the same measurand for a population of patients. In order to make measurement results, comparable bias should be minimized or eliminated and measurement uncertainty properly evaluated for all methods used for a particular patient population. The measurement as well as diagnostic uncertainty can be evaluated from internal and external quality control results using GUM principles. In this paper the uncertainty evaluations are described in detail using only two main components, within-laboratory reproducibility and uncertainty of the bias component according to a Nordtest guideline. The evaluation is exemplified for the determination of creatinine in serum for a conglomerate of laboratories both expressed in absolute units (μmol/L) and relative (%). An expanded measurement uncertainty of 12 μmol/L associated with concentrations of creatinine below 120 μmol/L and of 10% associated with concentrations above 120 μmol/L was estimated. The diagnostic uncertainty encompasses both measurement uncertainty and biological variation, and can be estimated for a single value and for a difference. This diagnostic uncertainty for the difference for two samples from the same patient was determined to be 14 μmol/L associated with concentrations of creatinine below 100 μmol/L and 14 % associated with concentrations above 100 μmol/L.

  19. High-intensity tasks with external load in military applications: a review.

    Science.gov (United States)

    O'Neal, Eric K; Hornsby, Jared H; Kelleran, Kyle J

    2014-09-01

    This article provides a synopsis of the limited investigations examining the impact of external load (EL) on performance of high-intensity tasks under load (HITL), EL training intervention effects on HITL performance, and injuries from EL training. Repetitive lifting tasks and initiation of locomotion, such as rapidly moving from a prone position to sprinting appear to be more hindered by EL than maximal sprinting velocity and may explain why training with EL does not improve obstacle course or prolonged (200-300 yard shuttle) drills. EL training appears to offer very little if any benefit for HITL in lesser trained populations. This contrast results of multiple studies incorporating ≥ 3 weeks of prolonged hypergravity interventions (wearing EL during daily activities) in elite anaerobic athletes, indicating EL training stimulus is likely only beneficial to well-trained soldiers. Women and lesser trained individuals appear to be more susceptible to increased injury with EL training. A significant limitation concerning current HITL knowledge is the lack of studies incorporating trained soldiers. Future investigations concerning the effects of HITL on marksmanship, repetitive lifting biomechanics, efficacy of hypergravity training for military personnel, and kinematics of sprinting from tactical positions with various EL displacements and technique training are warranted.

  20. A pilot evaluation of external quality assessment of GenoType MTBDRplus versions 1 and 2 using dried culture spot material.

    Science.gov (United States)

    Gous, N; Isherwood, L E; David, A; Stevens, W; Scott, L E

    2015-04-01

    Dried culture spots (DCS) of inactivated Mycobacteria strains designed as part of an external quality assessment (EQA) program for the GeneXpert system has applications to other molecular tuberculosis (TB) diagnostic platforms. DCS tested on the GenoType MTBDRplus and Mycobacterium CM assays performed well with MTBDRplus version 2 but require increased bacterial concentration for use with version 1.

  1. Research on External Evaluation of the Quality of Internal Audit%内部审计质量外部评估探讨

    Institute of Scientific and Technical Information of China (English)

    范经华

    2012-01-01

    内部审计质量外部评估是由内部审计机构以外的其他机构和人员对内部审计质量所进行的检查、考核和评价活动。内部审计质量外部评估所涉及的内容十分广泛,除了涵盖对内部审计业务质量产生直接影响的各主要因素外,还涵盖对内部审计质量产生重要影响的内部审计环境中的各主要因素。内部审计质量外部评估对于改善内部审计环境,提升内部审计质量,提高内部审计人员的专业胜任能力等方面都有明显作用。基于中铁大桥局集团有限公司2012年5月已通过的内部审计质量外部评估的基本经验,指出了当前企业参与内部审计质量外部评估必须做好的各项基本工作,并提出了如何加强和完善我国内部审计质量外部评估的若干建议及思考。%External evaluation of internal auditing quality refers to the examination, assessment and appraisalconducted by other institutions and staffs other than internal auditing institution. The external evaluation of internal auditing quality contains a wide range of content, covering not only the main factors which will exert a direct influence on business quality of internal auditing, but also relating to main factors of internal audit environment which has greatly influenced internal audit quality. The external evaluation of internal auditing quality plays an active role in terms of improving internal audit environment, upgrading internal auditing quality and promoting professional capability of internal audit staffs. Based on the experience and understanding regarding the external evaluation of internal audit quality which China Railway Major Bridge Engineering Group Co., Ltd. passed in May 2012, this paper is to present the basic works whilst attending external evaluation of internal audit quality, and also to elaborate several suggestions and thinking on how to reinforce and improve external evaluation of internal audit quality

  2. Many quality measurements, but few quality measures assessing the quality of breast cancer care in women: A systematic review

    Directory of Open Access Journals (Sweden)

    Zhang Li

    2006-12-01

    Full Text Available Abstract Background Breast cancer in women is increasingly frequent, and care is complex, onerous and expensive, all of which lend urgency to improvements in care. Quality measurement is essential to monitor effectiveness and to guide improvements in healthcare. Methods Ten databases, including Medline, were searched electronically to identify measures assessing the quality of breast cancer care in women (diagnosis, treatment, followup, documentation of care. Eligible studies measured adherence to standards of breast cancer care in women diagnosed with, or in treatment for, any histological type of adenocarcinoma of the breast. Reference lists of studies, review articles, web sites, and files of experts were searched manually. Evidence appraisal entailed dual independent assessments of data (e.g., indicators used in quality measurement. The extent of each quality indicator's scientific validation as a measure was assessed. The American Society of Clinical Oncology (ASCO was asked to contribute quality measures under development. Results Sixty relevant reports identified 58 studies with 143 indicators assessing adherence to quality breast cancer care. A paucity of validated indicators (n = 12, most of which assessed quality of life, only permitted a qualitative data synthesis. Most quality indicators evaluated processes of care. Conclusion While some studies revealed patterns of under-use of care, all adherence data require confirmation using validated quality measures. ASCO's current development of a set of quality measures relating to breast cancer care may hold the key to conducting definitive studies.

  3. A review of hydrological/water-quality models

    Directory of Open Access Journals (Sweden)

    Liangliang GAO,Daoliang LI

    2014-12-01

    Full Text Available Water quality models are important in predicting the changes in surface water quality for environmental management. A range of water quality models are wildly used, but every model has its advantages and limitations for specific situations. The aim of this review is to provide a guide to researcher for selecting a suitable water quality model. Eight well known water quality models were selected for this review: SWAT, WASP, QUALs, MIKE 11, HSPF, CE-QUAL-W2, ELCOM-CAEDYM and EFDC. Each model is described according to its intended use, development, simulation elements, basic principles and applicability (e.g., for rivers, lakes, and reservoirs and estuaries. Currently, the most important trends for future model development are: (1 combination models─individual models cannot completely solve the complex situations so combined models are needed to obtain the most appropriate results, (2 application of artificial intelligence and mechanistic models combined with non-mechanistic models will provide more accurate results because of the realistic parameters derived from non-mechanistic models, and (3 integration with remote sensing, geographical information and global position systems (3S ─3S can solve problems requiring large amounts of data.

  4. Review of SKB's Quality Assurance Programme

    Energy Technology Data Exchange (ETDEWEB)

    Baldwin, Tamara D.; Hicks, Timothy W. (Galson Sciences LTD, Oakham, Rutland (United Kingdom))

    2009-06-15

    SKB is preparing a license application for the construction of a final repository for spent nuclear fuel in Sweden. This application will be supported by the safety assessment SR-Site for the post-closure phase. The assessment of long-term safety is based on a broad range of experimental results from laboratory scale, intermediate scale and up to full scale experiments. It is essential that there is a satisfactory level of assurance that experiments have been carried of with sufficient quality, so that results can be considered to be reliable within the context of their use in safety assessment. SSM has initiated a series of reviews of SKB's methods of quality assurance and their implementation. This project includes reviews of the quality assurance (QA) procedures and instructions that have been prepared for the SR-Site assessment as well as reviews of QA implementation at the canister and buffer/backfill laboratories in Oskarshamn, Sweden. The purpose of this project is to assess SKB's quality assurance with the view of providing a good basis for subsequent quality reviews in the context of future licensing. This has been achieved by examination of a number of SKB experiments using a check list, visits to the relevant facilities, and meetings with contractors and a few members of the SKB staff. Overall, the reviewed set of QA documents and instructions do provide reasonably comprehensive coverage of quality-affecting issues relating to the SR-Site safety assessment and, if implemented correctly, will generate confidence in the reliability of the safety assessment results. The results show that the efforts involving quality assurance are increasing within the SKB programme and in general appear to be satisfactory for ongoing experiments and measurements. However, progress in development of the QA documents and instructions has been relatively recent and it may be difficult for these to be fully implemented in the short period remaining before the planned

  5. Review of SKB's Quality Assurance Programme

    Energy Technology Data Exchange (ETDEWEB)

    Baldwin, Tamara D.; Hicks, Timothy W. (Galson Sciences LTD, Oakham, Rutland (United Kingdom))

    2009-06-15

    SKB is preparing a license application for the construction of a final repository for spent nuclear fuel in Sweden. This application will be supported by the safety assessment SR-Site for the post-closure phase. The assessment of long-term safety is based on a broad range of experimental results from laboratory scale, intermediate scale and up to full scale experiments. It is essential that there is a satisfactory level of assurance that experiments have been carried of with sufficient quality, so that results can be considered to be reliable within the context of their use in safety assessment. SSM has initiated a series of reviews of SKB's methods of quality assurance and their implementation. This project includes reviews of the quality assurance (QA) procedures and instructions that have been prepared for the SR-Site assessment as well as reviews of QA implementation at the canister and buffer/backfill laboratories in Oskarshamn, Sweden. The purpose of this project is to assess SKB's quality assurance with the view of providing a good basis for subsequent quality reviews in the context of future licensing. This has been achieved by examination of a number of SKB experiments using a check list, visits to the relevant facilities, and meetings with contractors and a few members of the SKB staff. Overall, the reviewed set of QA documents and instructions do provide reasonably comprehensive coverage of quality-affecting issues relating to the SR-Site safety assessment and, if implemented correctly, will generate confidence in the reliability of the safety assessment results. The results show that the efforts involving quality assurance are increasing within the SKB programme and in general appear to be satisfactory for ongoing experiments and measurements. However, progress in development of the QA documents and instructions has been relatively recent and it may be difficult for these to be fully implemented in the short period remaining before the planned

  6. Radiologically determined orthodontically induced external apical root resorption in incisors after non-surgical orthodontic treatment of class II division 1 malocclusion: a systematic review.

    Science.gov (United States)

    Tieu, Long D; Saltaji, Humam; Normando, David; Flores-Mir, Carlos

    2014-07-23

    This study aims to critically evaluate orthodontically induced external apical root resorption (OIEARR) in incisors of patients undergoing non-surgical orthodontic treatment of class II division 1 malocclusion by a systematic review of the published data. An electronic search of two databases was performed; the bibliographies of relevant articles were also reviewed. Studies were included if they examined the amount of OIEARR in incisors produced during non-surgical orthodontic treatment of individuals with class II division I malocclusion in the permanent dentition. Individuals had no previous history of OIEARR, syndromes, pathologies, or general diseases. Study selections, risk of bias assessment, and data extraction were performed in duplicate. Eight studies of moderate methodological quality were finally included. An increased prevalence (65.6% to 98.1%) and mild to moderate severity of OIEARR (resorption was found. For the maxillary incisors, there was no evidence that either the central or lateral incisor was more susceptible to OIEARR. A weak to moderate positive correlation between treatment duration and root resorption, and anteroposterior apical displacement and root resorption was found. Current limited evidence suggests that non-surgical comprehensive orthodontic treatment to correct class II division 1 malocclusions causes increased prevalence and severity of OIEARR the more the incisor roots are displaced and the longer this movement takes.

  7. External quality-assurance results for the National Atmospheric Deposition Program/National Trends Network, 2002-03

    Science.gov (United States)

    Wetherbee, Gregory A.; Latysh, Natalie E.; Burke, Kevin P.

    2005-01-01

    Six external quality-assurance programs were operated by the U.S. Geological Survey (USGS) External Quality-Assurance (QA) Project for the National Atmospheric Deposition Program/National Trends Network (NADP/NTN) from 2002 through 2003. Each program measured specific components of the overall error inherent in NADP/NTN wet-deposition measurements. The intersite-comparison program assessed the variability and bias of pH and specific conductance determinations made by NADP/NTN site operators twice per year with respect to accuracy goals. The percentage of site operators that met the pH accuracy goals decreased from 92.0 percent in spring 2002 to 86.3 percent in spring 2003. In these same four intersite-comparison studies, the percentage of site operators that met the accuracy goals for specific conductance ranged from 94.4 to 97.5 percent. The blind-audit program and the sample-handling evaluation (SHE) program evaluated the effects of routine sample handling, processing, and shipping on the chemistry of weekly NADP/NTN samples. The blind-audit program data indicated that the variability introduced by sample handling might be environmentally significant to data users for sodium, potassium, chloride, and hydrogen ion concentrations during 2002. In 2003, the blind-audit program was modified and replaced by the SHE program. The SHE program was designed to control the effects of laboratory-analysis variability. The 2003 SHE data had less overall variability than the 2002 blind-audit data. The SHE data indicated that sample handling buffers the pH of the precipitation samples and, in turn, results in slightly lower conductivity. Otherwise, the SHE data provided error estimates that were not environmentally significant to data users. The field-audit program was designed to evaluate the effects of onsite exposure, sample handling, and shipping on the chemistry of NADP/NTN precipitation samples. Field-audit results indicated that exposure of NADP/NTN wet-deposition samples

  8. Using additional external inputs to forecast water quality with an artificial neural network for contamination event detection in source water

    Science.gov (United States)

    Schmidt, F.; Liu, S.

    2016-12-01

    Source water quality plays an important role for the safety of drinking water and early detection of its contamination is vital to taking appropriate countermeasures. However, compared to drinking water, it is more difficult to detect contamination events because its environment is less controlled and numerous natural causes contribute to a high variability of the background values. In this project, Artificial Neural Networks (ANNs) and a Contamination Event Detection Process (CED Process) were used to identify events in river water. The ANN models the response of basic water quality sensors obtained in laboratory experiments in an off-line learning stage and continuously forecasts future values of the time line in an on-line forecasting step. During this second stage, the CED Process compares the forecast to the measured value and classifies it as regular background or event value, which modifies the ANN's continuous learning and influences its forecasts. In addition to this basic setup, external information is fed to the CED Process: A so-called Operator Input (OI) is provided to inform about unusual water quality levels that are unrelated to the presence of contamination, for example due to cooling water discharge from a nearby power plant. This study's primary goal is to evaluate how well the OI fits into the design of the combined forecasting ANN and CED Process and to understand its effects on the online forecasting stage. To test this, data from laboratory experiments conducted previously at the School of Environment, Tsinghua University, have been used to perform simulations highlighting features and drawbacks of this method. Applying the OI has been shown to have a positive influence on the ANN's ability to handle a sudden change in background values, which is unrelated to contamination. However, it might also mask the presence of an event, an issue that underlines the necessity to have several instances of the algorithm run in parallel. Other difficulties

  9. Quality of pharmaceutical advertisements in medical journals: a systematic review.

    Science.gov (United States)

    Othman, Noordin; Vitry, Agnes; Roughead, Elizabeth E

    2009-07-22

    Journal advertising is one of the main sources of medicines information to doctors. Despite the availability of regulations and controls of drug promotion worldwide, information on medicines provided in journal advertising has been criticized in several studies for being of poor quality. However, no attempt has been made to systematically summarise this body of research. We designed this systematic review to assess all studies that have examined the quality of pharmaceutical advertisements for prescription products in medical and pharmacy journals. Studies were identified via searching electronic databases, web library, search engine and reviewing citations (1950 - February 2006). Only articles published in English and examined the quality of information included in pharmaceutical advertisements for prescription products in medical or pharmacy journals were included. For each eligible article, a researcher independently extracted the data on the study methodology and outcomes. The data were then reviewed by a second researcher. Any disagreements were resolved by consensus. The data were analysed descriptively. The final analysis included 24 articles. The studies reviewed advertisements from 26 countries. The number of journals surveyed in each study ranged from four to 24 journals. Several outcome measures were examined including references and claims provided in advertisements, availability of product information, adherence to codes or guidelines and presentation of risk results. The majority of studies employed a convenience-sampling method. Brand name, generic name and indications were usually provided. Journal articles were commonly cited to support pharmaceutical claims. Less than 67% of the claims were supported by a systematic review, a meta-analysis or a randomised control trial. Studies that assessed misleading claims had at least one advertisement with a misleading claim. Two studies found that less than 28% of claims were unambiguous clinical claims

  10. Quality of pharmaceutical advertisements in medical journals: a systematic review.

    Directory of Open Access Journals (Sweden)

    Noordin Othman

    Full Text Available BACKGROUND: Journal advertising is one of the main sources of medicines information to doctors. Despite the availability of regulations and controls of drug promotion worldwide, information on medicines provided in journal advertising has been criticized in several studies for being of poor quality. However, no attempt has been made to systematically summarise this body of research. We designed this systematic review to assess all studies that have examined the quality of pharmaceutical advertisements for prescription products in medical and pharmacy journals. METHODS AND FINDINGS: Studies were identified via searching electronic databases, web library, search engine and reviewing citations (1950 - February 2006. Only articles published in English and examined the quality of information included in pharmaceutical advertisements for prescription products in medical or pharmacy journals were included. For each eligible article, a researcher independently extracted the data on the study methodology and outcomes. The data were then reviewed by a second researcher. Any disagreements were resolved by consensus. The data were analysed descriptively. The final analysis included 24 articles. The studies reviewed advertisements from 26 countries. The number of journals surveyed in each study ranged from four to 24 journals. Several outcome measures were examined including references and claims provided in advertisements, availability of product information, adherence to codes or guidelines and presentation of risk results. The majority of studies employed a convenience-sampling method. Brand name, generic name and indications were usually provided. Journal articles were commonly cited to support pharmaceutical claims. Less than 67% of the claims were supported by a systematic review, a meta-analysis or a randomised control trial. Studies that assessed misleading claims had at least one advertisement with a misleading claim. Two studies found that less

  11. Preservation of the External Jugular Vein in Bilateral Radical Neck Dissections: Technique in Two Cases and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Rodrigo Lima Bastos da Rocha

    2015-01-01

    Full Text Available Context. The possibility of cephalic venous hypertension with the resultant facial edema and elevated cerebrospinal fluid pressure continues to challenge head and neck surgeons who perform bilateral radical neck dissections during simultaneous or staged procedures. Case Report. The staged procedure in patients who require bilateral neck dissections allows collateral venous drainage to develop, mainly through the internal and external vertebral plexuses, thereby minimizing the risks of deleterious consequences. Nevertheless, this procedure has disadvantages, such as a delay in definitive therapy, the need for a second hospitalization and anesthesia, and the risk of cutting lymphatic vessels and spreading viable cancer cells. In this paper, we discuss the rationale and feasibility of preserving the external jugular vein. Considering the limited number of similar reports in the literature, two cases in which this procedure was accomplished are described. The relevant anatomy and technique are reviewed and the patients’ outcomes are discussed. Conclusion. Preservation of the EJV during bilateral neck dissections is technically feasible, fast, and safe, with clinically and radiologically demonstrated patency.

  12. A Review of the External Validity of Clinical Trials with Beta-Blockers in Heart Failure

    Science.gov (United States)

    Iyngkaran, Pupalan; Toukhsati, Samia R.; Thomas, Merlin C.; Jelinek, Michael V.; Hare, David L.; Horowitz, John D.

    2016-01-01

    BACKGROUND Beta-blockers (BBs) are the mainstay prognostic medication for all stages of chronic heart failure (CHF). There are many classes of BBs, each of which has varying levels of evidence to support its efficacy in CHF. However, most CHF patients have one or more comorbid conditions such as diabetes, renal impairment, and/or atrial fibrillation. Patient enrollment to randomized controlled trials (RCTs) often excludes those with certain comorbidities, particularly if the symptoms are severe. Consequently, the extent to which evidence drawn from RCTs is generalizable to CHF patients has not been well described. Clinical guidelines also underrepresent this point by providing generic advice for all patients. The aim of this review is to examine the evidence to support the use of BBs in CHF patients with common comorbid conditions. METHODS We searched MEDLINE, PubMed, and the reference lists of reviews for RCTs, post hoc analyses, systematic reviews, and meta-analyses that report on use of BBs in CHF along with patient demographics and comorbidities. RESULTS In total, 38 studies from 28 RCTs were identified, which provided data on six BBs against placebo or head to head with another BB agent in ischemic and nonischemic cardiomyopathies. Several studies explored BBs in older patients. Female patients and non-Caucasian race were underrepresented in trials. End points were cardiovascular hospitalization and mortality. Comorbid diabetes, renal impairment, or atrial fibrillation was detailed; however, no reference to disease spectrum or management goals as a focus could be seen in any of the studies. In this sense, enrollment may have limited more severe grades of these comorbidities. CONCLUSIONS RCTs provide authoritative information for a spectrum of CHF presentations that support guidelines. RCTs may provide inadequate information for more heterogeneous CHF patient cohorts. Greater Phase IV research may be needed to fill this gap and inform guidelines for a more

  13. [Bringing criteria for external assessment of the quality of biochemical studies within the framework of the Federal System for External Evaluation of the Quality of Clinical Laboratory Studies, in conformity with requirements of the Order No. 45 of the Ministry of Health of Russia, 2/7/2000].

    Science.gov (United States)

    Zaikin, E V; Malakhov, V N

    2000-07-01

    Criteria for external assessment of the quality of evaluation of 23 biochemical parameters of the blood, meeting the standards of accuracy determined by the Order No. 45 of Ministry of Health of Russia of February 7, 2000 for intralaboratory quality control have been estimated. According to the data of the Federal System for External Evaluation of the Quality of Clinical Laboratory Studies, the percentage of results of analyses of test sera meeting these criteria has been estimated. Introduction of new criteria for external assessment of the quality of biochemical tests into the practice of the Federal System will not notably modify the currently used criteria with regard to the majority of biochemical parameters, except introduction of more stringent criteria for albumin and magnesium and less stringent for creatine kinase.

  14. Assessing Quality of Care of Elderly Patients Using the ACOVE Quality Indicator Set: A Systematic Review

    NARCIS (Netherlands)

    Askari, M.; Wierenga, P.C.; Eslami, S.; Medlock, S.; de Rooij, S.E.; Abu-Hanna, A.

    2011-01-01

    Background: Care of the elderly is recognized as an increasingly important segment of health care. The Assessing Care Of Vulnerable Elderly (ACOVE) quality indicators (QIs) were developed to assess and improve the care of elderly patients. Objectives: The purpose of this review is to summarize studi

  15. Quality of assessments within reach: Review study of research and results of the quality of assessments

    NARCIS (Netherlands)

    Maassen, N.A.M.; Otter, den D.; Wools, S.; Hemker, B.T.; Straetmans, G.J.J.M.; Eggen, T.J.H.M.

    2015-01-01

    Educational tests and assessments are important instruments to measure a student’s knowledge and skills. The question that is addressed in this review study is: “which aspects are currently considered as important to the quality of educational assessments?” Furthermore, it is explored how this infor

  16. Development of a quality assessment tool for systematic reviews of observational studies (QATSO of HIV prevalence in men having sex with men and associated risk behaviours

    Directory of Open Access Journals (Sweden)

    Hart Graham J

    2008-11-01

    Full Text Available Abstract Background Systematic reviews based on the critical appraisal of observational and analytic studies on HIV prevalence and risk factors for HIV transmission among men having sex with men are very useful for health care decisions and planning. Such appraisal is particularly difficult, however, as the quality assessment tools available for use with observational and analytic studies are poorly established. Methods We reviewed the existing quality assessment tools for systematic reviews of observational studies and developed a concise quality assessment checklist to help standardise decisions regarding the quality of studies, with careful consideration of issues such as external and internal validity. Results A pilot version of the checklist was developed based on epidemiological principles, reviews of study designs, and existing checklists for the assessment of observational studies. The Quality Assessment Tool for Systematic Reviews of Observational Studies (QATSO Score consists of five items: External validity (1 item, reporting (2 items, bias (1 item and confounding factors (1 item. Expert opinions were sought and it was tested on manuscripts that fulfil the inclusion criteria of a systematic review. Like all assessment scales, QATSO may oversimplify and generalise information yet it is inclusive, simple and practical to use, and allows comparability between papers. Conclusion A specific tool that allows researchers to appraise and guide study quality of observational studies is developed and can be modified for similar studies in the future.

  17. The relevance of external quality assessment for molecular testing for ALK positive non-small cell lung cancer: results from two pilot rounds show room for optimization.

    Directory of Open Access Journals (Sweden)

    Lien Tembuyser

    Full Text Available Molecular profiling should be performed on all advanced non-small cell lung cancer with non-squamous histology to allow treatment selection. Currently, this should include EGFR mutation testing and testing for ALK rearrangements. ROS1 is another emerging target. ALK rearrangement status is a critical biomarker to predict response to tyrosine kinase inhibitors such as crizotinib. To promote high quality testing in non-small cell lung cancer, the European Society of Pathology has introduced an external quality assessment scheme. This article summarizes the results of the first two pilot rounds organized in 2012-2013.Tissue microarray slides consisting of cell-lines and resection specimens were distributed with the request for routine ALK testing using IHC or FISH. Participation in ALK FISH testing included the interpretation of four digital FISH images.Data from 173 different laboratories was obtained. Results demonstrate decreased error rates in the second round for both ALK FISH and ALK IHC, although the error rates were still high and the need for external quality assessment in laboratories performing ALK testing is evident. Error rates obtained by FISH were lower than by IHC. The lowest error rates were observed for the interpretation of digital FISH images.There was a large variety in FISH enumeration practices. Based on the results from this study, recommendations for the methodology, analysis, interpretation and result reporting were issued. External quality assessment is a crucial element to improve the quality of molecular testing.

  18. Minimal requirements for quality controls in radiotherapy with external beams; Controlli di qualita' essenziali in radioterapia con fasci esterni

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-07-01

    Physical dosimetric guidelines have been developed by the Italian National Institute of Health study group on quality assurance in radiotherapy to define protocols for quality controls in external beam radiotherapy. While the document does not determine strict rules or firm recommendations, it suggests minimal requirements for quality controls necessary to guarantee an adequate degree of accuracy in external beam radiotherapy. [Italian] Il gruppo di studio Assicurazione di qualita' in radioterapia dell'Istituto Superiore di Sanita' presenta le linee guida per la stesura dei protocolli di controllo di qualita' essenziali necessari a garantire un adeguato livello di accuratezza del trattamento radiante e rappresenta pertanto una parte essenziale del contributo fisico-dosimetrico globale di assicurazione di qualita' in radioterapia con fasci esterni.

  19. Does Elite Sport Degrade Sleep Quality? A Systematic Review

    OpenAIRE

    Gupta, Luke; Morgan, Kevin; Gilchrist, Sarah

    2016-01-01

    Background Information on sleep quality and insomnia symptomatology among elite athletes remains poorly systematised in the sports science and medicine literature. The extent to which performance in elite sport represents a risk for chronic insomnia is unknown. Objectives The purpose of this systematic review was to profile the objective and experienced characteristics of sleep among elite athletes, and to consider relationships between elite sport and insomnia symptomatology. Methods Studies...

  20. Current concept review: quality and process improvement in orthopedics

    Directory of Open Access Journals (Sweden)

    Pinney SJ

    2015-12-01

    Full Text Available Stephen J Pinney,1 Alexandra E Page,2 David S Jevsevar,3 Kevin J Bozic4 1Department of Orthopaedic Surgery, St Mary's Medical Center, San Francisco, CA, USA; 2Orthopaedic Surgery, AAOS Health Care Systems Committee, San Diego, CA, USA; 3Department of Orthopaedics, Geisel School of Medicine, Dartmouth University, Hanover, NH, USA; 4Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas, Austin, TX, USAAbstract: Multiple health care stakeholders are increasingly scrutinizing musculoskeletal care to optimize quality and cost efficiency. This has led to greater emphasis on quality and process improvement. There is a robust set of business strategies that are increasingly being applied to health care delivery. These quality and process improvement tools (QPITs have specific applications to segments of, or the entire episode of, patient care. In the rapidly changing health care world, it will behoove all orthopedic surgeons to have an understanding of the manner in which care delivery processes can be evaluated and improved. Many of the commonly used QPITs, including checklist initiatives, standardized clinical care pathways, lean methodology, six sigma strategies, and total quality management, embrace basic principles of quality improvement. These principles include focusing on outcomes, optimizing communication among health care team members, increasing process standardization, and decreasing process variation. This review summarizes the common QPITs, including how and when they might be employed to improve care delivery. Keywords: clinical care pathway, musculoskeletal care, outcomes, quality management, six sigma, lean thinking

  1. International Expert Review of SRCan: Engineered Barrier Issues. External review contribution in support of SKI's and SSI's review of SR-Can

    Energy Technology Data Exchange (ETDEWEB)

    Savage, David (Quintessa Limited, Henley-on-Thames (GB)); Bennett, David (TerraSalus Limited, Oakham (GB)); Apted, Mick (Monitor Scientific LLC, Denver, CO (US)); Saellfors, Goeran (Chalmers Univ. of Technology, Goeteborg (SE)); Saario, Timo (VTT Materials and Building (FI)); Segle, Peter (Inspecta, Stockholm (SE))

    2008-03-15

    of uncertainties in SKB's programme and safety reports, some of which relate to issues that appear to be of sufficient significance that they will need to be thoroughly addressed in the SR-Site safety report in time for the repository licence application. Other less urgent issues might be identified in SR-Can as uncertainties to be addressed through an appropriate performance confirmation programme. Performance confirmation may be defined as the programme of tests, experiments and analyses, conducted to evaluate the adequacy of the information used to demonstrate compliance with long-term safety standards for a geological repository. The most significant of the issues identified by the EBS review group include: - Demonstration of the feasibility of EBS emplacement. SKB will need to present more details on the reference EBS design, on its reference repository construction method, and on the specifications for the EBS materials. In particular, SKB still needs to demonstrate satisfactorily that the EBS can be successfully fabricated and emplaced in the appropriate configuration under repository conditions and at the rates that are projected to be required during waste disposal. SKB needs to develop and test quality assurance and quality control procedures for repository construction and operation, including EBS emplacement. SKB also needs to conduct further tests of EBS emplacement, and to characterise the as-emplaced EBS components. More generally, SKB should describe and explain in more detail how its schedule for developing plans and procedures and for conducting laboratory experiments and underground tests relates to the schedules for safety assessment and licensing. - Canister manufacture and integrity. The view of the review group is that SKB should consider a number of issues in greater detail to build further confidence in the proposed approach for canister manufacture and in the assessments of canister integrity and performance. For example, SKB could

  2. Does Elite Sport Degrade Sleep Quality? A Systematic Review.

    Science.gov (United States)

    Gupta, Luke; Morgan, Kevin; Gilchrist, Sarah

    2017-07-01

    Information on sleep quality and insomnia symptomatology among elite athletes remains poorly systematised in the sports science and medicine literature. The extent to which performance in elite sport represents a risk for chronic insomnia is unknown. The purpose of this systematic review was to profile the objective and experienced characteristics of sleep among elite athletes, and to consider relationships between elite sport and insomnia symptomatology. Studies relating to sleep involving participants described on a pre-defined continuum of 'eliteness' were located through a systematic search of four research databases: SPORTDiscus, PubMed, Science Direct and Google Scholar, up to April 2016. Once extracted, studies were categorised as (1) those mainly describing sleep structure/patterns, (2) those mainly describing sleep quality and insomnia symptomatology and (3) those exploring associations between aspects of elite sport and sleep outcomes. The search returned 1676 records. Following screening against set criteria, a total of 37 studies were identified. The quality of evidence reviewed was generally low. Pooled sleep quality data revealed high levels of sleep complaints in elite athletes. Three risk factors for sleep disturbance were broadly identified: (1) training, (2) travel and (3) competition. While acknowledging the limited number of high-quality evidence reviewed, athletes show a high overall prevalence of insomnia symptoms characterised by longer sleep latencies, greater sleep fragmentation, non-restorative sleep, and excessive daytime fatigue. These symptoms show marked inter-sport differences. Two underlying mechanisms are implicated in the mediation of sport-related insomnia symptoms: pre-sleep cognitive arousal and sleep restriction.

  3. 42 CFR 438.354 - Qualifications of external quality review organizations.

    Science.gov (United States)

    2010-10-01

    ... ensure that an EQRO meets the requirements of this section. (b) Competence. The EQRO must have at a... statistical analysis. (2) Sufficient physical, technological, and financial resources to conduct EQR or EQR... other State entity must be governed by a Board or similar body the majority of whose members are...

  4. Quality of life measurement in bone metastases: A literature review

    Directory of Open Access Journals (Sweden)

    Sukirtha Tharmalingam

    2008-12-01

    Full Text Available Sukirtha Tharmalingam, Edward Chow, Kristin Harris, Amanda Hird, Emily SinclairRapid Response Radiotherapy Program, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, CanadaAbstract: Quality of life (QOL has become an important consideration in the care of patients with bone metastases as prevalence, incidence and patient survival are on the rise. As a result, more interventional studies now measure patient’s QOL as a meaningful endpoint. However, well-developed bone metastases specific quality of life instruments are lacking. A literature review was conducted to better understand the nature of QOL instruments used in bone metastases trials. A total of 47 articles evaluating QOL in patients with bone metastases were identified. Twenty-five different instruments were used to evaluate QOL with study-designed questionnaires and the EORTC QLQ-C30 being most commonly employed. Many studies used more than one scale or instrument to measure QOL. This makes it difficult to compare QOL in bone metastases patients across studies and come to any formal conclusions. Therefore, this review demonstrates the need to develop a bone module that can be used across countries in future clinical trials.Keywords: bone metastases, quality of life, QOL instrument, review

  5. Insulin therapy and quality of life. A review

    DEFF Research Database (Denmark)

    Pouwer, Francois; Hermanns, Norbert

    2009-01-01

    Three central goals in the treatment of diabetes mellitus are (1) the avoidance of hyperglycaemia to prevent the development or progression of diabetes complications over time, (2) the avoidance of hypoglycaemia and (3) the maintenance or achievement of good quality of life. Insulin is the most...... powerful agent that can be used to control blood glucose levels. This article reviews the studies that have investigated the effects of different types of insulin and insulin delivery techniques on quality of life of patients with type 1 or type 2 diabetes. First, the concept of 'quality of life' (Qo......-acting insulin analogues or biphasic mixtures; (3) multiple daily injections versus pump therapy. Having multiple complications of diabetes is clearly associated with decreased QoL. Results from large studies such as the Diabetes Control and Complications Trial (DCCT) and United Kingdom Prospective Diabetes...

  6. First External Quality Assessment of Molecular and Serological Detection of Rift Valley Fever in the Western Mediterranean Region.

    Directory of Open Access Journals (Sweden)

    Federica Monaco

    Full Text Available Rift Valley fever (RVF is a mosquito-borne viral zoonosis which affects humans and a wide range of domestic and wild ruminants. The large spread of RVF in Africa and its potential to emerge beyond its geographic range requires the development of surveillance strategies to promptly detect the disease outbreaks in order to implement efficient control measures, which could prevent the widespread of the virus to humans. The Animal Health Mediterranean Network (REMESA linking some Northern African countries as Algeria, Egypt, Libya, Mauritania, Morocco, Tunisia with Southern European ones as France, Italy, Portugal and Spain aims at improving the animal health in the Western Mediterranean Region since 2009. In this context, a first assessment of the diagnostic capacities of the laboratories involved in the RVF surveillance was performed. The first proficiency testing (external quality assessment--EQA for the detection of the viral genome and antibodies of RVF virus (RVFV was carried out from October 2013 to February 2014. Ten laboratories participated from 6 different countries (4 from North Africa and 2 from Europe. Six laboratories participated in the ring trial for both viral RNA and antibodies detection methods, while four laboratories participated exclusively in the antibodies detection ring trial. For the EQA targeting the viral RNA detection methods 5 out of 6 laboratories reported 100% of correct results. One laboratory misidentified 2 positive samples as negative and 3 positive samples as doubtful indicating a need for corrective actions. For the EQA targeting IgG and IgM antibodies methods 9 out of the 10 laboratories reported 100% of correct results, whilst one laboratory reported all correct results except one false-positive. These two ring trials provide evidence that most of the participating laboratories are capable to detect RVF antibodies and viral RNA thus recognizing RVF infection in affected ruminants with the diagnostic methods

  7. Non-Destructive and rapid evaluation of staple foods quality by using spectroscopic techniques: A review.

    Science.gov (United States)

    Su, Wen-Hao; He, Hong-Ju; Sun, Da-Wen

    2017-03-24

    Staple foods, including cereals, legumes, and root/tuber crops, dominate the daily diet of humans by providing valuable proteins, starch, oils, minerals, and vitamins. Quality evaluation of staple foods is primarily carried out on sensory (e.g. external defect, color), adulteration (e.g. species, origin), chemical (e.g. starch, proteins), mycotoxin (e.g. Fusarium toxin, aflatoxin), parasitic infection (e.g. weevil, beetle), and internal physiological (e.g. hollow heart, black heart) aspects. Conventional methods for the quality assessment of staple foods are always laborious, destructive, and time-consuming. Requirements for online monitoring of staple foods have been proposed to encourage the development of rapid, reagentless, and noninvasive techniques. Spectroscopic techniques, such as visible-infrared spectroscopy, Raman spectroscopy, nuclear magnetic resonance spectroscopy, and spectral imaging, have been introduced as promising analytical tools and applied for the quality evaluation of staple foods. This review summarizes the recent applications and progress of such spectroscopic techniques in determining various qualities of staple foods. Besides, challenges and future trends of these spectroscopic techniques are also presented.

  8. Metabolic syndrome and quality of life: a systematic review

    Directory of Open Access Journals (Sweden)

    Patrícia Pozas Saboya

    Full Text Available ABSTRACT Objectives: to present currently available evidence to verify the association between metabolic syndrome and quality of life. Method: Cochrane Library, EMBASE, Medline and LILACS databases were studied for all studies investigating the association with metabolic syndrome and quality of life. Two blinded reviewers extracted data and one more was chosen in case of doubt. Results: a total of 30 studies were included, considering inclusion and exclusion criteria, which involved 62.063 patients. Almost all studies suggested that metabolic syndrome is significantly associated with impaired quality of life. Some, however, found association only in women, or only if associated with depression or Body Mass Index. Merely one study did not find association after adjusted for confounding factors. Conclusion: although there are a few studies available about the relationship between metabolic syndrome and quality of life, a growing body of evidence has shown significant association between metabolic syndrome and the worsening of quality of life. However, it is necessary to carry out further longitudinal studies to confirm this association and verify whether this relationship is linear, or only an association factor.

  9. Metabolic syndrome and quality of life: a systematic review 1

    Science.gov (United States)

    Saboya, Patrícia Pozas; Bodanese, Luiz Carlos; Zimmermann, Paulo Roberto; Gustavo, Andréia da Silva; Assumpção, Caroline Melo; Londero, Fernanda

    2016-01-01

    ABSTRACT Objectives: to present currently available evidence to verify the association between metabolic syndrome and quality of life. Method: Cochrane Library, EMBASE, Medline and LILACS databases were studied for all studies investigating the association with metabolic syndrome and quality of life. Two blinded reviewers extracted data and one more was chosen in case of doubt. Results: a total of 30 studies were included, considering inclusion and exclusion criteria, which involved 62.063 patients. Almost all studies suggested that metabolic syndrome is significantly associated with impaired quality of life. Some, however, found association only in women, or only if associated with depression or Body Mass Index. Merely one study did not find association after adjusted for confounding factors. Conclusion: although there are a few studies available about the relationship between metabolic syndrome and quality of life, a growing body of evidence has shown significant association between metabolic syndrome and the worsening of quality of life. However, it is necessary to carry out further longitudinal studies to confirm this association and verify whether this relationship is linear, or only an association factor. PMID:27901223

  10. External quality assurance for HIV point-of-care testing in Africa: A collaborative country-partner approach to strengthen diagnostic services

    Directory of Open Access Journals (Sweden)

    Debrah I. Boeras

    2016-10-01

    Full Text Available It is important to consider the role of diagnostics and the critical need for quality diagnostics services in resource-limited settings. Accurate diagnostic tests play a key role in patient management and the prevention and control of most infectious diseases. As countries plan for implementation of HIV early infant diagnosis and viral load point-of-care testing, the London School of Hygiene & Tropical Medicine has worked with countries and partners with an interest in external quality assurance to support quality point-of-care testing on the continent. Through a series of collaborative consultations and workshops, the London School of Hygiene & Tropical Medicine has gathered lessons learned, tools, and resources and developed quality assurance models that will support point-of-care testing. The London School of Hygiene & Tropical Medicine is committed to the continued advancement of laboratory diagnostics in Africa and quality laboratory services and point-of-care testing.

  11. External quality assurance for HIV point-of-care testing in Africa: A collaborative country-partner approach to strengthen diagnostic services.

    Science.gov (United States)

    Boeras, Debrah I; Peeling, Rosanna W

    2016-01-01

    It is important to consider the role of diagnostics and the critical need for quality diagnostics services in resource-limited settings. Accurate diagnostic tests play a key role in patient management and the prevention and control of most infectious diseases. As countries plan for implementation of HIV early infant diagnosis and viral load point-of-care testing, the London School of Hygiene & Tropical Medicine has worked with countries and partners with an interest in external quality assurance to support quality point-of-care testing on the continent. Through a series of collaborative consultations and workshops, the London School of Hygiene & Tropical Medicine has gathered lessons learned, tools, and resources and developed quality assurance models that will support point-of-care testing. The London School of Hygiene & Tropical Medicine is committed to the continued advancement of laboratory diagnostics in Africa and quality laboratory services and point-of-care testing.

  12. Impact of interventions to improve the quality of peer review of biomedical journals: a systematic review and meta-analysis

    OpenAIRE

    Bruce, Rachel; Chauvin, Anthony; Trinquart, Ludovic; Ravaud, Philippe; Boutron, Isabelle

    2016-01-01

    Background The peer review process is a cornerstone of biomedical research. We aimed to evaluate the impact of interventions to improve the quality of peer review for biomedical publications. Methods We performed a systematic review and meta-analysis. We searched CENTRAL, MEDLINE (PubMed), Embase, Cochrane Database of Systematic Reviews, and WHO ICTRP databases, for all randomized controlled trials (RCTs) evaluating the impact of interventions to improve the quality of peer review for biomedi...

  13. A Scoping Review of Empirical Research Relating to Quality and Effectiveness of Research Ethics Review

    Science.gov (United States)

    Nicholls, Stuart G.; Hayes, Tavis P.; Brehaut, Jamie C.; McDonald, Michael; Weijer, Charles; Saginur, Raphael; Fergusson, Dean

    2015-01-01

    Background To date there is no established consensus of assessment criteria for evaluating research ethics review. Methods We conducted a scoping review of empirical research assessing ethics review processes in order to identify common elements assessed, research foci, and research gaps to aid in the development of assessment criteria. Electronic searches of Ovid Medline, PsychInfo, and the Cochrane DSR, ACP Journal Club, DARE, CCTR, CMR, HTA, and NHSEED, were conducted. After de-duplication, 4234 titles and abstracts were reviewed. Altogether 4036 articles were excluded following screening of titles, abstracts and full text. A total of 198 articles included for final data extraction. Results Few studies originated from outside North America and Europe. No study reported using an underlying theory or framework of quality/effectiveness to guide study design or analyses. We did not identify any studies that had involved a controlled trial - randomised or otherwise – of ethics review procedures or processes. Studies varied substantially with respect to outcomes assessed, although tended to focus on structure and timeliness of ethics review. Discussion Our findings indicate a lack of consensus on appropriate assessment criteria, exemplified by the varied study outcomes identified, but also a fragmented body of research. To date research has been largely quantitative, with little attention given to stakeholder experiences, and is largely cross sectional. A lack of longitudinal research to date precludes analyses of change or assessment of quality improvement in ethics review. PMID:26225553

  14. A Scoping Review of Empirical Research Relating to Quality and Effectiveness of Research Ethics Review.

    Directory of Open Access Journals (Sweden)

    Stuart G Nicholls

    Full Text Available To date there is no established consensus of assessment criteria for evaluating research ethics review.We conducted a scoping review of empirical research assessing ethics review processes in order to identify common elements assessed, research foci, and research gaps to aid in the development of assessment criteria. Electronic searches of Ovid Medline, PsychInfo, and the Cochrane DSR, ACP Journal Club, DARE, CCTR, CMR, HTA, and NHSEED, were conducted. After de-duplication, 4234 titles and abstracts were reviewed. Altogether 4036 articles were excluded following screening of titles, abstracts and full text. A total of 198 articles included for final data extraction.Few studies originated from outside North America and Europe. No study reported using an underlying theory or framework of quality/effectiveness to guide study design or analyses. We did not identify any studies that had involved a controlled trial--randomised or otherwise--of ethics review procedures or processes. Studies varied substantially with respect to outcomes assessed, although tended to focus on structure and timeliness of ethics review.Our findings indicate a lack of consensus on appropriate assessment criteria, exemplified by the varied study outcomes identified, but also a fragmented body of research. To date research has been largely quantitative, with little attention given to stakeholder experiences, and is largely cross sectional. A lack of longitudinal research to date precludes analyses of change or assessment of quality improvement in ethics review.

  15. Air quality inside subway metro indoor environment worldwide: A review.

    Science.gov (United States)

    Xu, Bin; Hao, Jinliang

    2017-10-01

    The air quality in the subway metro indoor microenvironment has been of particular public concern. With specific reference to the growing demand of green transportation and sustainable development, subway metro systems have been rapidly developed worldwide in last decades. The number of metro commuters has continuously increased over recent years in metropolitan cities. In some cities, metro system has become the primary public transportation mode. Although commuters typically spend only 30-40min in metros, the air pollutants emitted from various interior components of metro system as well as air pollutants carried by ventilation supply air are significant sources of harmful air pollutants that could lead to unhealthy human exposure. Commuters' exposure to various air pollutants in metro carriages may cause perceivable health risk as reported by many environmental health studies. This review summarizes significant findings in the literature on air quality inside metro indoor environment, including pollutant concentration levels, chemical species, related sources and health risk assessment. More than 160 relevant studies performed across over 20 countries were carefully reviewed. These comprised more than 2000 individual measurement trips. Particulate matters, aromatic hydrocarbons, carbonyls and airborne bacteria have been identified as the primary air pollutants inside metro system. On this basis, future work could focus on investigating the chronic health risks of exposure to various air pollutants other than PM, and/or further developing advanced air purification unit to improve metro in-station air quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Quantifying the quality of peer reviewers through Zipf's law

    CERN Document Server

    Ausloos, Marcel; Fronczak, Agata; Fronczak, Piotr

    2015-01-01

    This paper introduces a statistical and other analysis of peer reviewers in order to approach their "quality" through some quantification measure, thereby leading to some quality metrics. Peer reviewer reports for the Journal of the Serbian Chemical Society are examined. The text of each report has first to be adapted to word counting software in order to avoid jargon inducing confusion when searching for the word frequency: e.g. C must be distinguished, depending if it means Carbon or Celsius, etc. Thus, every report has to be carefully "rewritten". Thereafter, the quantity, variety and distribution of words are examined in each report and compared to the whole set. Two separate months, according when reports came in, are distinguished to observe any possible hidden spurious effects. Coherence is found. An empirical distribution is searched for through a Zipf-Pareto rank-size law. It is observed that peer review reports are very far from usual texts in this respect. Deviations from the usual (first) Zipf's l...

  17. Review of Articles Related to Responsiveness as a Characteristic of Quality of Life Instruments

    Directory of Open Access Journals (Sweden)

    Rostam Jalali

    2015-04-01

    Full Text Available Introduction: Responsiveness is a concept introduced in the mid-eighties by bio-medical researchers. It is considered as a fundamental feature of health-related quality of life questionnaires, which was different from reliability and validity. Responsiveness is defined as the ability of an instrument to detect the minimal clinically important differences. Most authors agree that responsiveness focuses on the ability of a criterion in measuring changes, but there is a wide variety of opinions about the nature of quantified change. This review study was performed to determine the responsiveness by using the valid and available articles. Methods: Keywords of "responsiveness" and "quality of life" were searched in Cumulative Index to Nursing and Allied Health Literature (CINAHL, ProQuest, PsycINFO, Science Direct, Scopus, and Medline databases. Results: Multiple definitions for responsiveness and different procedures for calculating it were investigated in various studies. A total of 30 articles were used as references. Responsiveness has been divided into two groups: External and internal. “Internal responsiveness” is defined as the ability of a measure to change over a specified time frame. “External responsiveness” reflects the extent to which changes in a measure over a specified time frame relate to corresponding changes in a reference measure of health status. Conclusion: Despite the fact that some authors consider the responsiveness as the most basic characteristics for assessment of a tool, its measurement methodology is different. Meanwhile, there are different methods to assess responsiveness, but the researchers used one of them, and in development and validation of quality of life questionnaires must be regarded.

  18. 40 CFR 131.21 - EPA review and approval of water quality standards.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.21 EPA review and approval of water quality standards. (a) After the State submits its... analysis. (b) The Regional Administrator's approval or disapproval of a State water quality standard shall...

  19. External quality assurance for HIV point-of-care testing in Africa: A collaborative country-partner approach to strengthen diagnostic services

    OpenAIRE

    Debrah I. Boeras; Peeling, Rosanna W

    2016-01-01

    It is important to consider the role of diagnostics and the critical need for quality diagnostics services in resource-limited settings. Accurate diagnostic tests play a key role in patient management and the prevention and control of most infectious diseases. As countries plan for implementation of HIV early infant diagnosis and viral load point-of-care testing, the London School of Hygiene & Tropical Medicine has worked with countries and partners with an interest in external quali...

  20. Current air quality analytics and monitoring: a review.

    Science.gov (United States)

    Marć, Mariusz; Tobiszewski, Marek; Zabiegała, Bożena; de la Guardia, Miguel; Namieśnik, Jacek

    2015-01-01

    This review summarizes the different tools and concepts that are commonly applied in air quality monitoring. The monitoring of atmosphere is extremely important as the air quality is an important problem for large communities. Main requirements for analytical devices used for monitoring include a long period of autonomic operation and portability. These instruments, however, are often characterized by poor analytical performance. Monitoring networks are the most common tools used for monitoring, so large-scale monitoring programmes are summarized here. Biomonitoring, as a cheap and convenient alternative to traditional sample collection, is becoming more and more popular, although its main drawback is the lack of standard procedures. Telemonitoring is another approach to air monitoring, which offers some interesting opportunities, such as ease of coverage of large or remote areas, constituting a complementary approach to traditional strategies; however, it requires huge costs.

  1. Most but not all laboratories can detect the recently emerged Neisseria gonorrhoeae porA mutants - results from the QCMD 2013 N. gonorrhoeae external quality assessment programme.

    Science.gov (United States)

    Luijt, D; Di Lorenzo, C; van Loon, A M; Unemo, M

    2014-02-27

    We describe the results of the Quality Control for Molecular Diagnostics 2013 Neisseria gonorrhoeae external quality assessment programme that included an N. gonorrhoeae strain harbouring an N. meningitidis porA gene which causes false-negative results in molecular diagnostic assays targeting the gonococcal porA pseudogene. Enhanced awareness of the international transmission of such gonococcal strains is needed to avoid false-negative results in both in-house and commercial molecular diagnostic assays used in laboratories worldwide, but particularly in Europe.

  2. The Italian National External Quality Assessment Program in Molecular Genetic Testing: Results of the VII Round (2010-2011

    Directory of Open Access Journals (Sweden)

    F. Censi

    2013-01-01

    Full Text Available Since 2001 the Istituto Superiore di Sanità established a quality assurance programme for molecular genetic testing that covers four pathologies: Cystic Fibrosis (CF, Beta Thalassemia (BT, Fragile X Syndrome (FX, and Familial Adenomatous Polyposis Coli (APC. Since 2009 this activity is an institutional activity and participation is open to both public and private laboratories. Seven rounds have been performed until now and the eighth is in progress. Laboratories receive 4 DNA samples with mock clinical indications. They analyze the samples using their routine procedures. A panel of assessors review the raw data and the reports; all data are managed through a web utility. In 2010 the number of participants was 43, 17, 15, 5 for CF, BT, FX, APC schemes respectively. Genotyping results were correct in 96%, 98.5%, 100%, and 100% of CF, BT, FX, and APC samples, respectively. Interpretation was correct in 74%, 91%, 88%, and 60% of CF, BT, FX, and APC reports, respectively; however in most of them it was not complete but a referral to genetic counseling was given. Reports were satisfactory in more than 60% of samples in all schemes. This work presents the 2010 results in detail comparing our data with those from other European schemes.

  3. Assessing quality of care of elderly patients using the ACOVE quality indicator set: a systematic review.

    Directory of Open Access Journals (Sweden)

    Marjan Askari

    Full Text Available BACKGROUND: Care of the elderly is recognized as an increasingly important segment of health care. The Assessing Care Of Vulnerable Elderly (ACOVE quality indicators (QIs were developed to assess and improve the care of elderly patients. OBJECTIVES: The purpose of this review is to summarize studies that assess the quality of care using QIs from or based on ACOVE, in order to evaluate the state of quality of care for the reported conditions. METHODS: We systematically searched MEDLINE, EMBASE and CINAHL for English-language studies indexed by February 2010. Articles were included if they used any ACOVE QIs, or adaptations thereof, for assessing the quality of care. Included studies were analyzed and relevant information was extracted. We summarized the results of these studies, and when possible generated an overall conclusion about the quality of care as measured by ACOVE for each condition, in various settings, and for each QI. RESULTS: Seventeen studies were included with 278 QIs (original, adapted or newly developed. The quality scores showed large variation between and within conditions. Only a few conditions showed a stable pass rate range over multiple studies. Overall, pass rates for dementia (interquartile range (IQR: 11%-35%, depression (IQR: 27%-41%, osteoporosis (IQR: 34%-43% and osteoarthritis (IQR: 29-41% were notably low. Medication management and use (range: 81%-90%, hearing loss (77%-79% and continuity of care (76%-80% scored higher than other conditions. Out of the 278 QIs, 141 (50% had mean pass rates below 50% and 121 QIs (44% had pass rates above 50%. Twenty-three percent of the QIs scored above 75%, and 16% scored below 25%. CONCLUSIONS: Quality of care per condition varies markedly across studies. Although there has been much effort in improving the care for elderly patients in the last years, the reported quality of care according to the ACOVE indicators is still relatively low.

  4. Protective Factors Interrupting the Continuity from School Bullying to Later Internalizing and Externalizing Problems: A Systematic Review of Prospective Longitudinal Studies

    Science.gov (United States)

    Ttofi, Maria M.; Bowes, Lucy; Farrington, David P.; Lösel, Friedrich

    2014-01-01

    A systematic review is presented, based on prospective longitudinal studies, on protective factors that interrupt the continuity from bullying perpetration at school to externalizing problem behaviors later in life; and from bullying victimization to later internalizing problems. Some common factors were established, which seem to interrupt the…

  5. Regional variation in breast cancer treatment in the Netherlands and the role of external peer review : a cohort study comprising 63,516 women

    NARCIS (Netherlands)

    Kilsdonk, Melvin J.; van Dijk, Boukje A. C.; Otter, Renee; van Harten, Wim H.; Siesling, Sabine

    2014-01-01

    Background: Treatment variation is an important issue in health care provision. An external peer review programme for multidisciplinary cancer care was introduced in 1994 in the Netherlands to improve the multidisciplinary organisation of cancer care in hospitals. So far the clinical impact of exter

  6. Quality and the academic library reviewing, assessing and enhancing service provision

    CERN Document Server

    2016-01-01

    Quality and the Academic Library: Reviewing, Assessing and Enhancing Service Provision provides an in-depth review and analysis of quality management and service quality in academic libraries. All aspects of quality are considered in the book, including quality assessment, quality review, and quality enhancement. An overview of quality management and service quality concepts, principles, and methods leads to a detailed consideration of how they have been applied in universities and their libraries. A case study approach is used with different perspectives provided from the different stakeholders involved in the quality processes. All contributors adopt a critical reflection approach, reflecting on the implications, impact, and significance of the activities undertaken and the conclusions that can be drawn for future developments. The book concludes with an overall reflection on quality management and service quality in academic libraries with a final analysis of priorities for the future.

  7. 临床生物化学室间质评回报结果分析%External Quality Assessment of Clinical Biochemistry Laboratories

    Institute of Scientific and Technical Information of China (English)

    魏琦; 常中宝; 黎春宝; 张明亮; 王春亮; 袁征; 申梦来

    2015-01-01

    Objective:To analyze the results of clinical laboratorycs external quality assessment by using the Industry Standard WS/T403-2012 and six sigma quality management criterion.Methods:Data were collected from routine internal quality control and external quality assess-ment in clinical chemistry laboratory in 2014.Allowable analytical error was defined according to the Industry Standard WS/T403-2012.Inde-xes such asσlevel, quality goal index(QGI),priority improvement measure and performance evaluation were calculated in projects of external quality assessment launched in this department.Results:In 22 routine tests,8 analytes were reached more than 6 Sigma Quality Level,5 analytes were reached more than 3 Sigma Quality Level ,the other 9 analytes were less than 3 Sigma metrics.Conclusion:Application of industry standard WS/T403-2012 and 6 Sigma methodology can improve the level of quality management in clinical chemistry laboratory.%目的:根据行业标准WS/T403-2012和6σ标准分析临床生物化学室间质评回报数据。方法:收集2014年度临床生化检验项目室内质量控制及室间质量评价数据;按照行业标准WS/T403-2012中允许总误差( TEa )标准,计算该室已开展的室间质评项目进行σ水平、质量目标指数( QGI)、优先改进措施及性能评定等指标。结果:全部22个常规生化检测项目,其中8个项目的σ水平>6σ,5个项目的σ水平>3σ,其余9个项目均<3σ。结论:应用行业标准WS/T403-2012和6σ标准分析室间质评数据,有助于了解和提高临床生化检验质量水平。

  8. Methodological quality of a systematic review on physical therapy for temporomandibular disorders : influence of hand search and quality scales

    NARCIS (Netherlands)

    Craane, Bart; Dijkstra, Pieter Ubele; Stappaerts, Karel; De Laat, Antoon; De, Laat A.

    2012-01-01

    The validity of a systematic review depends on completeness of identifying randomised clinical trials (RCTs) and the quality of the included RCTs. The aim of this study was to analyse the effects of hand search on the number of identified RCTs and of four quality lists on the outcome of quality asse

  9. Friends’ Knowledge of Youth Internalizing and Externalizing Adjustment: Accuracy, Bias, and the Influences of Gender, Grade, Positive Friendship Quality, and Self-Disclosure

    Science.gov (United States)

    Rose, Amanda J.

    2012-01-01

    Some evidence suggests that close friends may be knowledgeable of youth’s psychological adjustment. However, friends are understudied as reporters of adjustment. The current study examines associations between self- and friend-reports of internalizing and externalizing adjustment in a community sample of fifth-, eighth-, and eleventh-grade youth. The study extends prior work by considering the degree to which friends’ reports of youth adjustment are accurate (i.e., predicted by youths’ actual adjustment) versus biased (i.e., predicted by the friend reporters’ own adjustment). Findings indicated stronger bias effects than accuracy effects, but the accuracy effects were significant for both internalizing and externalizing adjustment. Additionally, friends who perceived their relationships as high in positive quality, friends in relationships high in disclosure, and girls perceived youths’ internalizing symptoms most accurately. Knowledge of externalizing adjustment was not influenced by gender, grade, relationship quality, or self-disclosure. Findings suggest that friends could play an important role in prevention efforts. PMID:19377867

  10. The effectiveness of external sensory cues in improving functional performance in individuals with Parkinson's disease: a systematic review with meta-analysis.

    Science.gov (United States)

    Cassimatis, Constantine; Liu, Karen P Y; Fahey, Paul; Bissett, Michelle

    2016-09-01

    A systematic review with meta-analysis was performed to investigate the effect external sensory cued therapy on activities of daily living (ADL) performance that include walking and daily tasks such as dressing for individuals with Parkinson's disease (PD). A detailed computer-aided search of the literature was applied to MEDLINE, Cumulative Index to Nursing and Allied Health Literature, EMBASE and PubMed. Studies investigating the effects of external sensory cued therapy on ADL performance for individuals with PD in all stages of disease progression were collected. Relevant articles were critically reviewed and study results were synthesized by two independent researchers. A data-analysis method was used to extract data from selected articles. A meta-analysis was carried out for all randomized-controlled trials. Six studies with 243 individuals with PD were included in this review. All six studies yielded positive findings in favour of external sensory cues. The meta-analysis showed that external sensory cued therapy improved statistically after treatment (P=0.011) and at follow-up (Psensory into a training programme focused on improving daily task performance.

  11. Generation of dried tube specimen for HIV-1 viral load proficiency test panels: a cost-effective alternative for external quality assessment programs.

    Science.gov (United States)

    Ramos, Artur; Nguyen, Shon; Garcia, Albert; Subbarao, Shambavi; Nkengasong, John N; Ellenberger, Dennis

    2013-03-01

    Participation in external quality assessment programs is critical to ensure quality clinical laboratory testing. Commercially available proficiency test panels for HIV-1 virus load testing that are used commonly in external quality assessment programs remain a financial obstacle to resource-limited countries. Maintaining cold-chain transportation largely contributes to the cost of traditional liquid proficiency test panels. Therefore, we developed and evaluated a proficiency test panel using dried tube specimens that can be shipped and stored at ambient temperature. This dried tube specimens panel consisted of 20 μl aliquots of a HIV-1 stock that were added to 2 ml tubes and left uncapped for drying, as a preservation method. The stability of dried tube specimens at concentrations ranging from 10² to 10⁶·⁵ RNA copies/ml was tested at different temperatures over time, showing no viral load reduction at 37 °C and a decrease in viral load smaller than 0.5 Log₁₀ at 45 °C for up to eight weeks when compared to initial results. Eight cycles of freezing-thawing had no effect on the stability of the dried tube specimens. Comparable viral load results were observed when dried tube specimen panels were tested on Roche CAPTAQ, Abbott m2000, and Biomerieux easyMAG viral load systems. Preliminary test results of dried proficiency test panels shipped to four African countries at ambient temperature demonstrated a low inter assay variation (SD range: 0.29-0.41 Log₁₀ RNA copies/ml). These results indicated that HIV-1 proficiency test panels generated by this methodology might be an acceptable alternative for laboratories in resource-limited countries to participate in external quality assessment programs.

  12. External quality assurance project report for the National Atmospheric Deposition Program’s National Trends Network and Mercury Deposition Network, 2013–14

    Science.gov (United States)

    Wetherbee, Gregory A.; Martin, RoseAnn

    2016-07-05

    The U.S. Geological Survey Branch of Quality Systems operated five distinct programs to provide external quality assurance monitoring for the National Atmospheric Deposition Program’s (NADP) National Trends Network and Mercury Deposition Network during 2013–14. The National Trends Network programs include (1) a field audit program to evaluate sample contamination and stability, (2) an interlaboratory comparison program to evaluate analytical laboratory performance, and (3) a colocated sampler program to evaluate bias from precipitation sampler upgrades. The Mercury Deposition Network programs include the (4) system blank program and (5) an interlaboratory comparison program. The results indicate that NADP data continue to be of sufficient quality for the analysis of spatial distributions and time trends for chemical constituents in wet deposition.

  13. External quality assessment of platelet disorder investigations: results of international surveys on diagnostic tests for dense granule deficiency and platelet aggregometry interpretation.

    Science.gov (United States)

    Hayward, Catherine P M; Moffat, Karen A; Plumhoff, Elizabeth; Timleck, Marnie; Hoffman, Suzanne; Spitzer, Ernie; Van Cott, Elizabeth M; Meijer, Piet

    2012-09-01

    The quality of platelet aggregation and dense granule deficiency testing is important for diagnosing platelet function disorders. After a successful pilot exercise on diagnosing platelet dense granule deficiency by electron microscopy (EM), the North American Specialized Coagulation Laboratory Association (NASCOLA) has launched regular external quality assurance (EQA) for dense granule EM, as well as for the interpretation of platelet aggregation findings. EQA records were analyzed to assess performance. For EM EQA, between 2009 and 2011, there was excellent performance in distinguishing normal from dense granule-deficient samples and good (>70%) agreement on classifying most electron dense structures in platelets. For aggregation EQA, some normal variants were misclassified and overall case interpretations were more acceptable for rare disorders than for common findings. NASCOLA experiences with these EQAs indicate that there is a need to improve the quality of platelet disorder evaluations. For aggregometry interpretations, deficits in performance could be addressed by translating guideline recommendations into practice.

  14. Adolescents who are less religious than their parents are at risk for externalizing and internalizing symptoms: the mediating role of parent-adolescent relationship quality.

    Science.gov (United States)

    Kim-Spoon, Jungmeen; Longo, Gregory S; McCullough, Michael E

    2012-08-01

    Parents generally take pains to insure that their children adopt their own religious beliefs and practices, so what happens psychologically to adolescents who find themselves less religious than their parents? We examined the relationships among parents' and adolescents' religiousness, adolescents' ratings of parent-adolescent relationship quality, and adolescents' psychological adjustment using data from 322 adolescents and their parents. Adolescent boys who had lower organizational and personal religiousness than their parents, and girls who had lower personal religiousness than their parents, had more internalizing and externalizing psychological symptoms than did adolescents whose religiousness better matched their parents'. The apparent effects of subparental religiousness on adolescents' psychological symptoms were mediated by their intermediate effects on adolescents' ratings of the quality of their relationships with their parents. These findings identify religious discrepancies between parents and their children as an important influence on the quality of parent-adolescent relationships, with important implications for adolescents' psychological well-being.

  15. 42 CFR 422.153 - Use of quality improvement organization review information.

    Science.gov (United States)

    2010-10-01

    ... § 422.153 Use of quality improvement organization review information. CMS will acquire from quality... 42 Public Health 3 2010-10-01 2010-10-01 false Use of quality improvement organization review information. 422.153 Section 422.153 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...

  16. Determinants of seafarers’ fatigue: a systematic review and quality assessment

    DEFF Research Database (Denmark)

    Bøggild Dohrmann, Solveig; Leppin, Anja

    2017-01-01

    in the review. The main reason for exclusion was fatigue not being the outcome variable. Results: Most evidence was available for work time-related factors suggesting that working nights was most fatiguing, that fatigue levels were higher toward the end of watch or shift, and that the 6-h on–6-h off watch...... system was the most fatiguing. Specific work demands and particularly the psychosocial work environment have received little attention, but preliminary evidence suggests that stress may be an important factor. A majority of 12 studies were evaluated as potentially having a high risk of bias. Conclusions......, knowledge derived from studies of high methodological quality investigating different factors, including psychosocial work environments, are needed to support future preventive programs...

  17. Quality of Life Outcomes of Bariatric Surgery: A Systematic Review.

    Science.gov (United States)

    Hachem, Aleeya; Brennan, Leah

    2016-02-01

    Bariatric surgery is often pursued to improve quality of life (QOL). This paper systematically reviews the literature examining QOL following bariatric surgery. Fifteen controlled trials examined changes in QOL in obese (BMI > 30) adults (18–65 years) following bariatric surgery; seven compared bariatric surgery to non-surgical interventions and six compared different types of bariatric surgery. Bariatric surgery resulted in greater improvements in QOL than other obesity treatments. Significant differences in QOL improvements were found between different types of bariatric surgery. QOL improvements were more likely to occur within the first 2 years following surgery, with greater improvements in physical QOL than mental QOL. Bariatric surgery improves QOL. Future research is needed to investigate changes in QOL in different domains in the short- and long-term following bariatric surgery.

  18. Reporting quality of systematic reviews/meta-analyses of acupuncture.

    Directory of Open Access Journals (Sweden)

    Yali Liu

    Full Text Available The QUOROM and PRISMA statements were published in 1999 and 2009, respectively, to improve the consistency of reporting systematic reviews (SRs/meta-analyses (MAs of clinical trials. However, not all SRs/MAs adhere completely to these important standards. In particular, it is not clear how well SRs/MAs of acupuncture studies adhere to reporting standards and which reporting criteria are generally ignored in these analyses.To evaluate reporting quality in SRs/MAs of acupuncture studies.We performed a literature search for studies published prior to 2014 using the following public archives: PubMed, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews (CDSR, the Chinese Biomedical Literature Database (CBM, the Traditional Chinese Medicine (TCM database, the Chinese Journal Full-text Database (CJFD, the Chinese Scientific Journal Full-text Database (CSJD, and the Wanfang database. Data were extracted into pre-prepared Excel data-extraction forms. Reporting quality was assessed based on the PRISMA checklist (27 items.Of 476 appropriate SRs/MAs identified in our search, 203, 227, and 46 were published in Chinese journals, international journals, and the Cochrane Database, respectively. In 476 SRs/MAs, only 3 reported the information completely. By contrast, approximately 4.93% (1/203, 8.81% (2/227 and 0.00% (0/46 SRs/Mas reported less than 10 items in Chinese journals, international journals and CDSR, respectively. In general, the least frequently reported items (reported≤50% in SRs/MAs were "protocol and registration", "risk of bias across studies", and "additional analyses" in both methods and results sections.SRs/MAs of acupuncture studies have not comprehensively reported information recommended in the PRISMA statement. Our study underscores that, in addition to focusing on careful study design and performance, attention should be paid to comprehensive reporting standards in SRs/MAs on acupuncture studies.

  19. Reporting Quality of Systematic Reviews/Meta-Analyses of Acupuncture

    Science.gov (United States)

    Liu, Yali; Zhang, Rui; Huang, Jiao; Zhao, Xu; Liu, Danlu; Sun, Wanting; Mai, Yuefen; Zhang, Peng; Wang, Yajun; Cao, Hua; Yang, Ke hu

    2014-01-01

    Background The QUOROM and PRISMA statements were published in 1999 and 2009, respectively, to improve the consistency of reporting systematic reviews (SRs)/meta-analyses (MAs) of clinical trials. However, not all SRs/MAs adhere completely to these important standards. In particular, it is not clear how well SRs/MAs of acupuncture studies adhere to reporting standards and which reporting criteria are generally ignored in these analyses. Objectives To evaluate reporting quality in SRs/MAs of acupuncture studies. Methods We performed a literature search for studies published prior to 2014 using the following public archives: PubMed, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews (CDSR), the Chinese Biomedical Literature Database (CBM), the Traditional Chinese Medicine (TCM) database, the Chinese Journal Full-text Database (CJFD), the Chinese Scientific Journal Full-text Database (CSJD), and the Wanfang database. Data were extracted into pre-prepared Excel data-extraction forms. Reporting quality was assessed based on the PRISMA checklist (27 items). Results Of 476 appropriate SRs/MAs identified in our search, 203, 227, and 46 were published in Chinese journals, international journals, and the Cochrane Database, respectively. In 476 SRs/MAs, only 3 reported the information completely. By contrast, approximately 4.93% (1/203), 8.81% (2/227) and 0.00% (0/46) SRs/Mas reported less than 10 items in Chinese journals, international journals and CDSR, respectively. In general, the least frequently reported items (reported≤50%) in SRs/MAs were “protocol and registration”, “risk of bias across studies”, and “additional analyses” in both methods and results sections. Conclusions SRs/MAs of acupuncture studies have not comprehensively reported information recommended in the PRISMA statement. Our study underscores that, in addition to focusing on careful study design and performance, attention should be paid to comprehensive reporting standards

  20. Role of Gender in Reviewers' Appraisals of Quality in Political Science Books: A Content Analysis

    Science.gov (United States)

    McGinty, Stephen; Moore, Anne C.

    2008-01-01

    This study examines the changing roles for women in academia from 1991 to 2001 through a content analysis of quality characteristics in 626 "American Political Science Review" book reviews. Results revealed increases for women over men in quantity of books and reviews published, as well as quality appraisals of books written. (Contains 2 tables…

  1. The Operation Mechanisms of External Quality Assurance Frameworks of Foreign Higher Education and Implications for Graduate Education

    Science.gov (United States)

    Lin, Mengquan; Chang, Kai; Gong, Le

    2016-01-01

    The higher education quality evaluation and assurance frameworks and their operating mechanisms of countries such as the United Kingdom, France, and the United States show that higher education systems, traditional culture, and social background all impact quality assurance operating mechanisms. A model analysis of these higher education quality…

  2. External Quality Assurance System (EQAS) of the WHO Global Salmonella Surveillance and Laboratory Support Project (Global Salm-Surv)

    DEFF Research Database (Denmark)

    Petersen, A.; Aarestrup, Frank Møller; Wong, S.

    To assure the quality of methods for serotyping and antimicrobial susceptibility testing among laboratories in WHO Global Salm-Surv, an international collaborative study on serotyping and antimicrobial susceptibility testing of eight Salmonella enterica strains was performed. A total of 44...... of the quality control range specified by NCCLS guidelines....

  3. On the relative effect of spawning asynchrony, sperm quantity and sperm quality on paternity under sperm competition in an external fertilizer

    Directory of Open Access Journals (Sweden)

    Torvald Blikra Egeland

    2015-07-01

    Full Text Available How much of a fitness benefit is obtained by dominant males of external fertilizers from releasing ejaculates in synchrony with female egg-release when engaging in sperm competition, and what is the most important sperm trait for paternity in these situations? The Arctic charr (Salvelinus alpinus is an external fertilizer experiencing intense male-male competition over reproductive opportunities including sperm competition. To compensate for their disadvantage the sneaker males, which often spawn out of synchrony with the female, produce more and faster sperm than the guarding males. We used controlled in vitro fertilization trials with experimentally produced dominant and subordinate, sneaker males to test what effect relative synchrony in gamete release, sperm quality (i.e., motility and velocity and sperm quantity have on a male’s fertilization success in pair-wise sperm competitions. When the sneaker males released ejaculates after the guarding male there was no overall difference in fertilization success. The quality (i.e., motility and velocity of a male’s sperm relative to that of the competing male was the best predictor of male fertilization success regardless of their mating tactic and spawning synchrony. The relative number of sperm cells also had an effect on fertilization success, but mainly when the dominant and sneaker male ejaculated synchronously. Our close imitation of natural sperm competition in charr shows that the sneaker males of external fertilizing species may fully compensate for their disadvantaged mating role by producing ejaculates of higher quality - an adjustment strangely not met by dominants.

  4. Making electronic health records support quality management: A narrative review.

    Science.gov (United States)

    Triantafillou, Peter

    2017-08-01

    Since the 1990s many hospitals in the OECD countries have introduced electronic health record (EHR) systems. A number of studies have examined the factors impinging on EHR implementation. Others have studied the clinical efficacy of EHR. However, only few studies have explored the (intermediary) factors that make EHR systems conducive to quality management (QM). Undertake a narrative review of existing studies in order to identify and discuss the factors conducive to making EHR support three dimensions of QM: clinical outcomes, managerial monitoring and cost-effectiveness. A narrative review of Web of Science, Cochrane, EBSCO, ProQuest, Scopus and three Nordic research databases. most studies do not specify the type of EHR examined. 39 studies were identified for analysis. 10 factors were found to be conducive to make EHR support QM. However, the contribution of EHR to the three specific dimensions of QM varied substantially. Most studies (29) included clinical outcomes. However, only half of these reported EHR to have a positive impact. Almost all the studies (36) dealt with the ability of EHR to enhance managerial monitoring of clinical activities, the far majority of which showed a positive relationship. Finally, only five dealt with cost-effectiveness of which two found positive effects. The findings resonates well with previous reviews, though two factors making EHR support QM seem new, namely: political goals and strategies, and integration of guidelines for clinical conduct. Lacking EHR type specification and diversity in study method imply that there is a strong need for further research on the factors that may make EHR may support QM. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. TQM (Total Quality Management) SPARC (Special Process Action Review Committees) Handbook

    Science.gov (United States)

    1989-08-01

    improvement; Logistics information; Process analysis; Quality control; Quality assurance; Total Quality Management ; Statistical processes; Management Planning and control; Management training; Management information systems.... Quality Management (TQM). It includes concepts and definitions, checklists, sample formats, and assessment criteria. Keywords: Continuous process...This document describes the techniques used to support and guide the Special Process Action Review Committees for accomplishing their goals for Total

  6. Quality of life after laparoscopic and open colorectal surgery: A systematic review

    Institute of Scientific and Technical Information of China (English)

    Sanne; AL; Bartels; Malaika; S; Vlug; Dirk; T; Ubbink; Willem; A; Bemelman

    2010-01-01

    This study was a systematic review of the available evidence on quality of life in patients after laparoscopic or open colorectal surgery. A systematic review was performed of all randomized clinical trials (RCTs) that compared laparoscopic with open colorectal surgery. Study selection, quality assessment and data extraction were carried out independently by two reviewers. Primary endpoint was quality of life after laparoscopic and open colorectal surgery, as assessed by validated questionnaires. The search...

  7. Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries

    OpenAIRE

    Robert, Glenn Brian; Anderson, Janet

    2015-01-01

    Objectives: Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. Methods: An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies i...

  8. Automated Assessment of the Quality of Peer Reviews Using Natural Language Processing Techniques

    Science.gov (United States)

    Ramachandran, Lakshmi; Gehringer, Edward F.; Yadav, Ravi K.

    2017-01-01

    A "review" is textual feedback provided by a reviewer to the author of a submitted version. Peer reviews are used in academic publishing and in education to assess student work. While reviews are important to e-commerce sites like Amazon and e-bay, which use them to assess the quality of products and services, our work focuses on…

  9. Absent external oblique musculo-aponeurotic complex during inguinal hernioplasty: a case report and review of literature.

    Science.gov (United States)

    Dsouza, Royson; Shankar, Nachiket; Gurubatham, Rohin; Rajaleelan, Wesley; Menon, Nandakumar

    2017-03-03

    The external oblique musculo-aponeurotic complex is an important contributor to the strength of the inguinal canal. The present case report describes the bilateral absence of the external oblique muscle in a patient. A 40-year-old male patient presented with a history of intermittent lower abdominal pain for 15 years which had increased over the past 2 years. Abdominal examination revealed bilateral reducible, incomplete, direct inguinal hernia. Elective bilateral Lichtenstein's mesh hernioplasty was planned for the patient. Intraoperatively, there was no evidence of the external oblique aponeurosis and the spermatic cord was noted deep to the membranous fascial layer. The inguinal ligament was thin and atrophic and was attached to the pubic tubercle medially and anterior superior iliac spine laterally. There was no evidence of any superior aponeurotic connection to the inguinal ligament. A postoperative ultrasound examination of the abdomen confirmed the bilateral absence of the external oblique musculo-aponeurotic complex. The isolated absence of the external oblique musculo-aponeurotic complex in adults is an exceedingly rare anomaly. The possibility of such an anomaly should be considered in patients without other risk factors for hernia.

  10. Electronic health records. A systematic review on quality requirements.

    Science.gov (United States)

    Hoerbst, A; Ammenwerth, E

    2010-01-01

    Since the first concepts for electronic health records (EHRs) in the 1990s, the content, structure, and technology of such records were frequently changed and adapted. The basic idea to support and enhance health care stayed the same over time. To reach these goals, it is crucial that EHRs themselves adhere to rigid quality requirements. The present review aims at describing the currently available, mainly non-functional, quality requirements with regard to electronic health records. A combined approach - systematic literature analysis and expert interviews - was used. The literature analysis as well as the expert interviews included sources/experts from different domains such as standards and norms, scientific literature and guidelines, and best practice. The expert interviews were performed by using problem-centric qualitative computer-assisted telephone interviews (CATIs) or face-to-face interviews. All of the data that was obtained was analyzed using qualitative content analysis techniques. In total, more than 1200 requirements were identified of which 203 requirements were also mentioned during the expert interviews. The requirements are organized according to the ISO 9126 and the eEurope 2002 criteria. Categories with the highest number of requirements found include global requirements, (general) functional requirements and data security. The number of non-functional requirements found is by contrast lower. The manuscript gives comprehensive insight into the currently available, primarily non-functional, EHR requirements. To our knowledge, there are no other publications that have holistically reported on this topic. The requirements identified can be used in different ways, e.g. the conceptual design, the development of EHR systems, as a starting point for further refinement or as a basis for the development of specific sets of requirements.

  11. Amblyopia and quality of life: a systematic review

    Science.gov (United States)

    Carlton, J; Kaltenthaler, E

    2011-01-01

    Amblyopia is a common condition, which can affect up to 5% of the general population. Health-related quality-of-life (HRQoL) implications of amblyopia and/or its treatment have been explored in the literature. A systematic literature search was undertaken during the period of 7–14 May 2010 to identify the HRQoL implications of amblyopia and/or its treatment. A total of 35 papers were included in the literature review. The HRQoL implications of amblyopia related specifically to amblyopia treatment, rather than to the condition itself. These included impact on family life, social interactions, difficulties in undertaking daily activities, as well as feelings and behaviour. The identified studies adopted a number of methodologies. The study populations included children with the condition, parents of children with amblyopia, and adults who had undertaken amblyopia treatment as a child. Some studies developed their own measures of HRQoL, and others determined HRQoL through proxy measures. The reported findings of the HRQoL implications are of importance when considering the management of cases of amblyopia. The issues identified in the literature review are discussed with respect to how HRQoL is measured (treatment compliance vs proxy measures), and whether HRQoL is taken from a child's or a parent's perspective. Changing societal views over glasses and occlusion therapy are also discussed. Further research is required to assess the immediate and long-term effects of amblyopia and/or its treatment on HRQoL using a more standardised approach. PMID:21274010

  12. Quality assurance program in the External dosimetry laboratory of the CPHR; Programa de aseguramiento de la calidad en el laboratorio de dosimetria externa del CPHR

    Energy Technology Data Exchange (ETDEWEB)

    Molina P, D.; Pernas S, R.; Martinez H, E.; Cardenas H, J. [Centro de Proteccion e Higiene de las Radiaciones, Calle 20 No. 4113 e/41 y 47. Playa, C.P. 11300, A.P. 6195, C.P. 10600 La Habana (Cuba)

    2006-07-01

    From 1999 the Laboratory of External Dosimetry of the Radiation Protection and Hygiene Center comes applying in its service of personal dosimetry a Program of Quality Assurance. This program was designed according to the recommendations of national and international organizations as the National Assuring Office of the Republic of Cuba (ONARC), the International Standards Organization (ISO), the International Electro technique Commission (IEC) and the International Atomic Energy Agency (IAEA). In this work it is presented in a summarized way the operation of this Program of Quality Assurance which includes the administration and conservation of the results and the documentation of the service, the controls that are carried out to the equipment, the acceptance tests that are applied to the equipment and new dosemeters, the shipment and prosecution of the dosemeters, the evaluation, storage and conservation of the doses, the report of the results, the traceability and reproducibility of the measurements, the attention to the reclamations and the clients complaints and the internal and external audits to those that it undergoes periodically the laboratory. (Author)

  13. The efficacy of computer reminders on external quality assessment for point-of-care testing in Danish general practice

    DEFF Research Database (Denmark)

    Waldorff, Frans B; Siersma, Volkert; Ertmann, Ruth;

    2011-01-01

    BACKGROUND: Point-of-care testing (POCT) is increasingly being used in general practice to assist general practitioners (GPs) in their management of patients with diseases. However, low adherence to quality guidelines in terms of split test procedures has been observed among GPs in parts...... of the Capital Region in Denmark. Computer reminders embedded in GPs electronic medical records (ComRem) may facilitate improved quality control behaviour, but more research is needed to identify what types of reminders work and when. The overall aim of this study is to evaluate the efficacy of ComRem to improve...... GPs adherence to quality guidelines. This article describes the rationale and methods of the study that constitute this research project. METHODS/DESIGN: The study is conducted as two randomised controlled trials (RCTs) among general practices in two districts of the Capital Region in Denmark...

  14. Variation in external beam treatment plan quality: An inter-institutional study of planners and planning systems.

    Science.gov (United States)

    Nelms, Benjamin E; Robinson, Greg; Markham, Jay; Velasco, Kyle; Boyd, Steve; Narayan, Sharath; Wheeler, James; Sobczak, Mark L

    2012-01-01

    This study quantifies variation in radiation treatment plan quality for plans generated by a population of treatment planners given very specific plan objectives. A "Plan Quality Metric" (PQM) with 14 submetrics, each with a unique value function, was defined for a prostate treatment plan, serving as specific goals of a hypothetical "virtual physician." The exact PQM logic was distributed to a population of treatment planners (to remove ambiguity of plan goals or plan assessment methodology) as was a predefined computed tomographic image set and anatomic structure set (to remove anatomy delineation as a variable). Treatment planners used their clinical treatment planning system (TPS) to generate their best plan based on the specified goals and submitted their results for analysis. One hundred forty datasets were received and 125 plans accepted and analyzed. There was wide variability in treatment plan quality (defined as the ability of the planners and plans to meet the specified goals) quantified by the PQM. Despite the variability, the resulting PQM distributions showed no statistically significant difference between TPS employed, modality (intensity modulated radiation therapy versus arc), or education and certification status of the planner. The PQM results showed negligible correlation to number of beam angles, total monitor units, years of experience of the planner, or planner confidence. The ability of the treatment planners to meet the specified plan objectives (as quantified by the PQM) exhibited no statistical dependence on technologic parameters (TPS, modality, plan complexity), nor was the plan quality statistically different based on planner demographics (years of experience, confidence, certification, and education). Therefore, the wide variation in plan quality could be attributed to a general "planner skill" category that would lend itself to processes of continual improvement where best practices could be derived and disseminated to improve the

  15. The methodological and reporting quality of systematic reviews from China and the USA are similar.

    Science.gov (United States)

    Tian, Jinhui; Zhang, Jun; Ge, Long; Yang, Kehu; Song, Fujian

    2017-05-01

    To compare the methodological and reporting quality of systematic reviews by authors from China and those from the United States (USA). From systematic reviews of randomized trials published in 2014 in English, we randomly selected 100 from China and 100 from the USA. The methodological quality was assessed using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool, and reporting quality assessed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) tool. Compared with systematic reviews from the USA, those from China were more likely to be a meta-analysis, published in low-impact journals, and a non-Cochrane review. The mean summary Assessing the Methodological Quality of Systematic Reviews score was 6.7 (95% confidence interval: 6.5, 7.0) for reviews from China and 6.6 (6.1, 7.1) for reviews from the USA, and the mean summary Preferred Reporting Items for Systematic Reviews and Meta-analyses score was 21.2 (20.7, 21.6) for reviews from China and 20.6 (19.9, 21.3) for reviews from the USA. The differences in summary quality scores between China and the USA were statistically nonsignificant after adjusting for multiple review factors. The overall methodological and reporting quality of systematic reviews by authors from China are similar to those from the USA, although the quality of systematic reviews from both countries could be further improved. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  16. Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries

    NARCIS (Netherlands)

    S. Burnett (Susan); Mendel, P. (Peter); F. Nunes (Francisco); S. Wiig (Siri); van den Bovenkamp, H. (Hester); Karltun, A. (Anette); G. Robert (Glenn); J.E. Anderson (Janet); C. Vincent (Charles); N.J. Fulop (Naomi)

    2016-01-01

    textabstractObjectives: Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusi

  17. The Influence external signals on perceived quality and purchase intention products of high involvement (case study: Laptop

    Directory of Open Access Journals (Sweden)

    MOHSEN NAZARI

    2014-09-01

    Data analysis has been done by use of SMARTPLS software. A questionnaire was collected data. The results showed the price, brand, freinds, ranked brand, previous experience, warranty and ingredients can affect the laptop perceived quality. Also, price, brand, country of origin, friends, previous experience, ranked brand and warranty influence the intention to buy a laptop

  18. Assessing U.S. Public School Quality: The Advantages of Combining Internal "Consumer Ratings" with External NCLB Ratings

    Science.gov (United States)

    Price, Heather E.

    2016-01-01

    The school quality assessment process under No Child Left Behind (NCLB) is criticized for oversimplifying and overemphasizing standardized test results and unfairly targeting diverse, urban schools. There has been much development in alternative test score evaluations, especially value-added models. These developments have tilted the public…

  19. Fruit Quality Evaluation Using Spectroscopy Technology: A Review

    Science.gov (United States)

    Wang, Hailong; Peng, Jiyu; Xie, Chuanqi; Bao, Yidan; He, Yong

    2015-01-01

    An overview is presented with regard to applications of visible and near infrared (Vis/NIR) spectroscopy, multispectral imaging and hyperspectral imaging techniques for quality attributes measurement and variety discrimination of various fruit species, i.e., apple, orange, kiwifruit, peach, grape, strawberry, grape, jujube, banana, mango and others. Some commonly utilized chemometrics including pretreatment methods, variable selection methods, discriminant methods and calibration methods are briefly introduced. The comprehensive review of applications, which concentrates primarily on Vis/NIR spectroscopy, are arranged according to fruit species. Most of the applications are focused on variety discrimination or the measurement of soluble solids content (SSC), acidity and firmness, but also some measurements involving dry matter, vitamin C, polyphenols and pigments have been reported. The feasibility of different spectral modes, i.e., reflectance, interactance and transmittance, are discussed. Optimal variable selection methods and calibration methods for measuring different attributes of different fruit species are addressed. Special attention is paid to sample preparation and the influence of the environment. Areas where further investigation is needed and problems concerning model robustness and model transfer are identified. PMID:26007736

  20. A review of how the quality of HIV clinical services has been evaluated or improved.

    Science.gov (United States)

    Hung, Anna; Pradel, Françoise

    2015-06-01

    To examine approaches being used to evaluate and improve quality of HIV clinical services we searched the MEDLINE, Cochrane Library collection, EMBASE, Global Health, and Web of Science databases for articles and abstracts focused on evaluating or improving quality of HIV clinical services. We extracted country income level, targeted clinical services, and quality evaluation approaches, data sources, and criteria. Fifty journal articles and 46 meeting abstracts were included. Of the 96 studies reviewed, 65% were programme evaluations, 71% focused on low- and middle-income countries, and 65% focused on antiretroviral therapy services. With regard to quality, 45% used a quality improvement model or programme, 13% set a quality threshold, and 51% examined patient records to evaluate quality. No studies provided a definition for quality HIV care. Quality assurance and improvement of HIV clinical services is increasingly important. This review highlights gaps in knowledge for future research, and may also help countries and programmes develop their HIV care quality improvement frameworks.

  1. Fat deposition, fatty acid composition and meat quality: A review.

    Science.gov (United States)

    Wood, J D; Enser, M; Fisher, A V; Nute, G R; Sheard, P R; Richardson, R I; Hughes, S I; Whittington, F M

    2008-04-01

    This paper reviews the factors affecting the fatty acid composition of adipose tissue and muscle in pigs, sheep and cattle and shows that a major factor is the total amount of fat. The effects of fatty acid composition on meat quality are also reviewed. Pigs have high levels of polyunsaturated fatty acids (PUFA), including the long chain (C20-22) PUFA in adipose tissue and muscle. The full range of PUFA are also found in sheep adipose tissue and muscle whereas cattle 'conserve' long chain PUFA in muscle phospholipid. Linoleic acid (18:2n-6) is a major ingredient of feeds for all species. Its incorporation into adipose tissue and muscle in relation to the amount in the diet is greater than for other fatty acids. It is deposited in muscle phospholipid at a high level where it and its long chain products eg aracidonic acid (20:4n-6) compete well for insertion into phospholipid molecules. Its proportion in pig adipose tissue declines as fat deposition proceeds and is an index of fatness. The same inverse relationships are not seen in ruminant adipose tissue but in all species the proportion of 18:2n-6 declines in muscle as fat deposition increases. The main reason is that phospholipid, where 18:2n-6 is located, declines as a proportion of muscle lipid and the proportion of neutral lipid, with its higher content of saturated and monounsaturated fatty acids, increases. Oleic acid (18:1cis-9), formed from stearic acid (18:0) by the enzyme stearoyl Co-A desaturase, is a major component of neutral lipid and in ruminants the same enzyme forms conjugated linoleic acid (CLA), an important nutrient in human nutrition. Like 18:2n-6, α-linolenic acid (18:3n-3) is an essential fatty acid and is important to ruminants since it is the major fatty acid in grass. However it does not compete well for insertion into phospholipid compared with 18:2n-6 and its incorporation into adipose tissue and muscle is less efficient. Greater biohydrogenation of 18:3n-3 and a long rumen transit time

  2. A systematic review of the quality of conduct and reporting of systematic reviews and meta-analyses in paediatric surgery

    Science.gov (United States)

    Gudlaugsdottir, Katrin; Andrews, James

    2017-01-01

    Objective Our objective was to evaluate quality of conduct and reporting of published systematic reviews and meta-analyses in paediatric surgery. We also aimed to identify characteristics predictive of review quality. Background Systematic reviews summarise evidence by combining sources, but are potentially prone to bias. To counter this, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was published to aid in reporting. Similarly, the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) measurement tool was designed to appraise methodology. The paediatric surgical literature has seen an increasing number of reviews over the past decade, but quality has not been evaluated. Methods Adhering to PRISMA guidelines, we performed a systematic review with a priori design to identify systematic reviews and meta-analyses of interventions in paediatric surgery. From 01/2010 to 06/2016, we searched: MEDLINE, EMBASE, Cochrane, Centre for Reviews and Dissemination, Web of Science, Google Scholar, reference lists and journals. Two reviewers independently selected studies and extracted data. We assessed conduct and reporting using AMSTAR and PRISMA. Scores were calculated as the sum of reported items. We also extracted author, journal and article characteristics, and used them in exploratory analysis to determine which variables predict quality. Results 112 articles fulfilled eligibility criteria (53 systematic reviews; 59 meta-analyses). Overall, 68% AMSTAR and 56.8% PRISMA items were reported adequately. Poorest scores were identified with regards a priori design, inclusion of structured summaries, including the grey literature, citing excluded articles and evaluating bias. 13 reviews were pre-registered and 6 in PRISMA-endorsing journals. The following predicted quality in univariate analysis:, word count, Cochrane review, journal h-index, impact factor, journal endorses PRISMA, PRISMA adherence suggested in author guidance

  3. A review to collate information on external communication as a basis of innovation success (Deliverable 2.2)

    NARCIS (Netherlands)

    Reinders, M.J.; Lans, van der I.A.; Fischer, A.R.H.; Trijp, van J.C.M.

    2013-01-01

    The objective of work package 2: “Identify success factors” is to identify relevant success factors and barriers in the scientific literature on internal (between relevant disciplines) and external (from and to the public and end-users) communication strategies to enhance food technology innovation

  4. External Fixation versus two-stage Open Reduction Internal Fixation of distal intra-articular Tibia fractures; a Systematic Review

    DEFF Research Database (Denmark)

    Ladeby Erichsen, Julie; Jensen, Carsten; Damborg, Frank Lindhøj

    Internal Fixation (ORIF) or External Fixation (EF). Method : A search was conducted using PUBMED, Embase, Cochrane Central, Open Grey, Orthopaedic Proceedings and WHO International Clinical Trials Registry Platform. Studies with level of evidence I-IV comparing EF with two-stage ORIF of DIATF in patients...

  5. External validity of sentiment mining reports: Can current methods identify demographic biases, event biases, and manipulation of reviews?

    NARCIS (Netherlands)

    Wijnhoven, Fons; Bloemen, Oscar

    2014-01-01

    Many publications in sentiment mining provide new techniques for improved accuracy in extracting features and corresponding sentiments in texts. For the external validity of these sentiment reports, i.e., the applicability of the results to target audiences, it is important to well analyze data of t

  6. Underlying Mechanisms of Gene-Environment Interactions in Externalizing Behavior: A Systematic Review and Search for Theoretical Mechanisms

    NARCIS (Netherlands)

    Weeland, J.; Overbeek, G.; Orobio de Castro, B.; Matthys, W.

    2015-01-01

    Over the last decade, several candidate genes (i.e., MAOA, DRD4, DRD2, DAT1, 5-HTTLPR, and COMT) have been extensively studied as potential moderators of the detrimental effects of postnatal family adversity on child externalizing behaviors, such as aggression and conduct disorder. Many studies on s

  7. Peer Review Quality and Transparency of the Peer-Review Process in Open Access and Subscription Journals.

    Science.gov (United States)

    Wicherts, Jelte M

    2016-01-01

    Recent controversies highlighting substandard peer review in Open Access (OA) and traditional (subscription) journals have increased the need for authors, funders, publishers, and institutions to assure quality of peer-review in academic journals. I propose that transparency of the peer-review process may be seen as an indicator of the quality of peer-review, and develop and validate a tool enabling different stakeholders to assess transparency of the peer-review process. Based on editorial guidelines and best practices, I developed a 14-item tool to rate transparency of the peer-review process on the basis of journals' websites. In Study 1, a random sample of 231 authors of papers in 92 subscription journals in different fields rated transparency of the journals that published their work. Authors' ratings of the transparency were positively associated with quality of the peer-review process but unrelated to journal's impact factors. In Study 2, 20 experts on OA publishing assessed the transparency of established (non-OA) journals, OA journals categorized as being published by potential predatory publishers, and journals from the Directory of Open Access Journals (DOAJ). Results show high reliability across items (α = .91) and sufficient reliability across raters. Ratings differentiated the three types of journals well. In Study 3, academic librarians rated a random sample of 140 DOAJ journals and another 54 journals that had received a hoax paper written by Bohannon to test peer-review quality. Journals with higher transparency ratings were less likely to accept the flawed paper and showed higher impact as measured by the h5 index from Google Scholar. The tool to assess transparency of the peer-review process at academic journals shows promising reliability and validity. The transparency of the peer-review process can be seen as an indicator of peer-review quality allowing the tool to be used to predict academic quality in new journals.

  8. Hospital board oversight of quality and patient safety: a narrative review and synthesis of recent empirical research.

    Science.gov (United States)

    Millar, Ross; Mannion, Russell; Freeman, Tim; Davies, Huw T O

    2013-12-01

    Recurring problems with patient safety have led to a growing interest in helping hospitals' governing bodies provide more effective oversight of the quality and safety of their services. National directives and initiatives emphasize the importance of action by boards, but the empirical basis for informing effective hospital board oversight has yet to receive full and careful review. This article presents a narrative review of empirical research to inform the debate about hospital boards' oversight of quality and patient safety. A systematic and comprehensive search identified 122 papers for detailed review. Much of the empirical work appeared in the last ten years, is from the United States, and employs cross-sectional survey methods. Recent empirical studies linking board composition and processes with patient outcomes have found clear differences between high- and low-performing hospitals, highlighting the importance of strong and committed leadership that prioritizes quality and safety and sets clear and measurable goals for improvement. Effective oversight is also associated with well-informed and skilled board members. External factors (such as regulatory regimes and the publication of performance data) might also have a role in influencing boards, but detailed empirical work on these is scant. Health policy debates recognize the important role of hospital boards in overseeing patient quality and safety, and a growing body of empirical research has sought to elucidate that role. This review finds a number of areas of guidance that have some empirical support, but it also exposes the relatively inchoate nature of the field. Greater theoretical and methodological development is required if we are to secure more evidence-informed governance systems and practices that can contribute to safer care. © 2013 Milbank Memorial Fund.

  9. Effectiveness of Acupressure in Promoting Sleep Quality: A Systematic Review of Randomized Controlled Trials.

    Science.gov (United States)

    Hmwe, Nant Thin Thin; Subramaniam, Pathmawathi; Tan, Li Ping

    2016-01-01

    This review aimed to evaluate the effectiveness of acupressure in promoting sleep quality among adults. Study findings included in the review showed that acupressure significantly improved sleep quality compared with the control group, but no superior effect of acupressure was found compared with sham acupressure.

  10. Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

    Science.gov (United States)

    Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

    2010-01-01

    This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…

  11. Stuttering Treatment Research 1970-2005: II. Systematic Review Incorporating Trial Quality Assessment of Pharmacological Approaches

    Science.gov (United States)

    Bothe, Anne K.; Davidow, Jason H.; Bramlett, Robin E.; Franic, Duska M.; Ingham, Roger J.

    2006-01-01

    Purpose: To complete a systematic review, incorporating trial quality assessment, of published research about pharmacological treatments for stuttering. Goals included the identification of treatment recommendations and research needs based on the available high-quality evidence. Method: Multiple readers reviewed 31 articles published between 1970…

  12. Quality of Life as Medicine: Interventions that Induce Salutogenesis. A Review of the Literature

    Science.gov (United States)

    Ventegodt, Soren; Omar, Hatim A.; Merrick, Joav

    2011-01-01

    This paper reviews the medical (salutogenic) effect of interventions that aim to improve quality of life. Review of studies where the global quality of life in chronically ill patients was improved independently of subjective and objective factors (like physical and mental health, yearly income, education, social network, self-esteem, sexual…

  13. Quality of life after laparoscopic and open colorectal surgery: A systematic review

    NARCIS (Netherlands)

    Bartels, S.A.; Vlug, M.S.; Ubbink, D.T.; Bemelman, W.A.

    2010-01-01

    This study was a systematic review of the available evidence on quality of life in patients after laparoscopic or open colorectal surgery. A systematic review was performed of all randomized clinical trials (RCTs) that compared laparoscopic with open colorectal surgery. Study selection, quality

  14. Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

    Science.gov (United States)

    Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

    2010-01-01

    This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…

  15. Evaluating investment in quality improvement capacity building: a systematic review.

    Science.gov (United States)

    Mery, Gustavo; Dobrow, Mark J; Baker, G Ross; Im, Jennifer; Brown, Adalsteinn

    2017-02-20

    Leading health systems have invested in substantial quality improvement (QI) capacity building, but little is known about the aggregate effect of these investments at the health system level. We conducted a systematic review to identify key steps and elements that should be considered for system-level evaluations of investment in QI capacity building. We searched for evaluations of QI capacity building and evaluations of QI training programmes. We included the most relevant indexed databases in the field and a strategic search of the grey literature. The latter included direct electronic scanning of 85 relevant government and institutional websites internationally. Data were extracted regarding evaluation design and common assessment themes and components. 48 articles met the inclusion criteria. 46 articles described initiative-level non-economic evaluations of QI capacity building/training, while 2 studies included economic evaluations of QI capacity building/training, also at the initiative level. No system-level QI capacity building/training evaluations were found. We identified 17 evaluation components that fit within 5 overarching dimensions (characteristics of QI training; characteristics of QI activity; individual capacity; organisational capacity and impact) that should be considered in evaluations of QI capacity building. 8 key steps in return-on-investment (ROI) assessments in QI capacity building were identified: (1) planning-stakeholder perspective; (2) planning-temporal perspective; (3) identifying costs; (4) identifying benefits; (5) identifying intangible benefits that will not be included in the ROI estimation; (6) discerning attribution; (7) ROI calculations; (8) sensitivity analysis. The literature on QI capacity building evaluation is limited in the number and scope of studies. Our findings, summarised in a Framework to Guide Evaluations of QI Capacity Building, can be used to start closing this knowledge gap. Published by the BMJ Publishing

  16. WHO global salm-surv external quality assurance system (EQAS): an important step toward improving the quality of Salmonella serotyping and antimicrobial susceptibility testing worldwide

    DEFF Research Database (Denmark)

    Petersen, A.; Aarestrup, Frank Møller; Angulo, F. J.

    2002-01-01

    (NCCLS) guidelines. These EQAS results demonstrate the need for further training to improve the performance of some of the laboratories. WHO Global Salm-Surv activities, including international training courses and EQAS, represent an important step toward improving the quality of Salmonella serotyping......% of the results were correct. For susceptibility testing, 92% of the results were in agreement with the expected results. However, only 78% of the performed tests with the E. coli ATCC 25922 reference strain were within the quality control range specified by National Committee for Clinical Laboratory Standards...

  17. 78 FR 25445 - Federal Acquisition Regulation; Submission for OMB Review; Quality Assurance Requirements

    Science.gov (United States)

    2013-05-01

    ... Regulation; Submission for OMB Review; Quality Assurance Requirements AGENCY: Department of Defense (DOD... information collection requirement concerning quality assurance requirements. A notice was published in the..., Quality Assurance Requirements, by any of the following methods: Regulations.gov : http://www.regulations...

  18. 42 CFR 456.6 - Review by State medical agency of appropriateness and quality of services.

    Science.gov (United States)

    2010-10-01

    ... and quality of services. 456.6 Section 456.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Provisions § 456.6 Review by State medical agency of appropriateness and quality of services. (a) The... professional health personnel of the appropriateness and quality of Medicaid services. (b) The purpose of this...

  19. A Review of Relationships Between Wood Quality and Silvicultural Practices

    Directory of Open Access Journals (Sweden)

    Tomy Listyanto

    2009-07-01

    Full Text Available The effect of silviculture on wood quality has been approached from different perspectives. This relationship is being a critical concern of forest managers, landowners, and also researchers. Reliable information is needed to support forest managers in predicting the consequences of various silvicultural practices in terms of quantity and wood quality. Wood has beed used for a variety of products. Each product has particular requirements regarding quality. The variation of wood quality requirement allows industries to decide to use timber resource appropriate for their products. Silvicultural practives cover all treatments applied in forest stand management especially to improve the quality of stand, including manipulation of the availability of sunlight, nutrient and water by using several treatments such as thinning, control of spacing, fertilizing, and pruning. The quality of stand is aimed to achieve particular forest management objectives including higher wood quality. There is no broad generalization regarding the relation between silvicultural practice and wood quality. Many investigators showed positive results in relation to producing high quality of wood products, while other researchers revealed negative effects. Reliable information is needed to support forest managers in predicting the consequences of various silvicultural practices in relation to the wood quantity and quality. Continuous research is needed to find methods of producing wood of high quality based on silvicultural practices and genetic improvement which can be used in wider area by considering limitation including environment and geographic variation.

  20. Quality assurance in packaging design through the peer review process

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, J.A.

    1983-01-01

    The formulation of a peer design review group, the method for accomplishing the study, and the organization and scope of the task are presented by using the recently accomplished TRUPACT preliminary design peer review as a case study.

  1. Quality Control Review of the Defense Finance and Accounting Service Internal Audit Organization

    Science.gov (United States)

    2014-12-01

    No. DODIG-2015-043 D E C E M B E R 1 , 2 0 1 4 Quality Control Review of the Defense Finance and Accounting Service Internal Audit Organization... FINANCE AND ACCOUNTING SERVICE SUBJECT: Quality Control Review of the Defense Finance and Accounting Service Internal Audit Organization (Report No...organization, Defense Finance and Accounting Service Office of Internal Review (DFAS IR), in effect for the period ended June 30, 2014. The generally

  2. Peer review quality and transparency of the peer-review process in open access and subscription journals

    NARCIS (Netherlands)

    Wicherts, J.M.

    2016-01-01

    Background Recent controversies highlighting substandard peer review in Open Access (OA) and traditional (subscription) journals have increased the need for authors, funders, publishers, and institutions to assure quality of peer-review in academic journals. I propose that transparency of the

  3. Peer review quality and transparency of the peer-review process in open access and subscription journals

    NARCIS (Netherlands)

    Wicherts, J.M.

    2016-01-01

    Background Recent controversies highlighting substandard peer review in Open Access (OA) and traditional (subscription) journals have increased the need for authors, funders, publishers, and institutions to assure quality of peer-review in academic journals. I propose that transparency of the peer-r

  4. Voluntary peer review as innovative tool for quality improvement in the intensive care unit – a retrospective descriptive cohort study in German intensive care units

    Directory of Open Access Journals (Sweden)

    Kumpf, Oliver

    2014-12-01

    Full Text Available [english] Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports.Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interestingConclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators.

  5. Voluntary peer review as innovative tool for quality improvement in the intensive care unit – a retrospective descriptive cohort study in German intensive care units

    Science.gov (United States)

    Kumpf, Oliver; Bloos, Frank; Bause, Hanswerner; Brinkmann, Alexander; Deja, Maria; Marx, Gernot; Kaltwasser, Arnold; Dubb, Rolf; Muhl, Elke; Greim, Clemens-A.; Weiler, Norbert; Chop, Ines; Jonitz, Günther; Schaefer, Henning; Felsenstein, Matthias; Liebeskind, Ursula; Leffmann, Carsten; Jungbluth, Annemarie; Waydhas, Christian; Pronovost, Peter; Spies, Claudia; Braun, Jan-Peter

    2014-01-01

    Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports. Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interesting Conclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators. PMID:25587245

  6. A critical appraisal of the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing interventions: a systematic review of reviews

    Science.gov (United States)

    Jin, Ying-Hui; Wang, Guo-Hao; Sun, Yi-Rong; Li, Qi; Zhao, Chen; Li, Ge; Si, Jin-Hua; Li, Yan; Lu, Cui; Shang, Hong-Cai

    2016-01-01

    Objective To assess the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing (TCMN) interventions in Chinese journals. These interventions include acupressure, massage, Tai Chi, Qi Gong, electroacupuncture and use of Chinese herbal medicines—for example, in enemas, foot massage and compressing the umbilicus. Design A systematic literature search for systematic reviews and meta-analyses of TCMN interventions was performed. Review characteristics were extracted. The methodological quality and the quality of the evidence were evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approaches. Result We included 20 systematic reviews and meta-analyses, and a total of 11 TCMN interventions were assessed in the 20 reviews. The compliance with AMSTAR checklist items ranged from 4.5 to 8 and systematic reviews/meta-analyses were, on average, of medium methodological quality. The quality of the evidence we assessed ranged from very low to moderate; no high-quality evidence was found. The top two causes for downrating confidence in effect estimates among the 31 bodies of evidence assessed were the risk of bias and inconsistency. Conclusions There is room for improvement in the methodological quality of systematic reviews/meta-analyses of TCMN interventions published in Chinese journals. Greater efforts should be devoted to ensuring a more comprehensive search strategy, clearer specification of the interventions of interest in the eligibility criteria and identification of meaningful outcomes for clinicians and patients (consumers). The overall quality of evidence among reviews remains suboptimal, which raise concerns about their roles in influencing clinical practice. Thus, the conclusions in reviews we assessed must be treated with caution and their roles in influencing clinical practice should be limited. A critical

  7. Does radiography advanced practice improve patient outcomes and health service quality? A systematic review.

    Science.gov (United States)

    Hardy, Maryann; Johnson, Louise; Sharples, Rachael; Boynes, Stephen; Irving, Donna

    2016-06-01

    To investigate the impact of radiographer advanced practice on patient outcomes and health service quality. Using the World Health Organization definition of quality, this review followed the Centre for Reviews and Dissemination guidance for undertaking reviews in healthcare. A range of databases were searched using a defined search strategy. Included studies were assessed for quality using a tool specifically developed for reviewing studies of diverse designs, and data were systematically extracted using electronic data extraction pro forma. 407 articles were identified and reviewed against the inclusion/exclusion criteria. Nine studies were included in the final review, the majority (n = 7) focusing on advanced radiography practice within the UK. Advanced practice activities considered were radiographer reporting, leading patient review clinics and barium enema examinations. The articles were generally considered to be of low-to-moderate quality, with most evaluating advanced practice within a single centre. With respect to specific quality dimensions, the included studies considered cost reduction, patient morbidity, time to treatment and patient satisfaction. No articles reported data relating to time to diagnosis, time to recovery or patient mortality. Radiographer advanced practice is an established activity both in the UK and internationally. However, evidence of the impact of advanced practice in terms of patient outcomes and service quality is limited. This systematic review is the first to examine the evidence base surrounding advanced radiography practice and its impact on patient outcomes and health service quality.

  8. Metabolic syndrome and quality of life: a systematic review.

    Science.gov (United States)

    Saboya, Patrícia Pozas; Bodanese, Luiz Carlos; Zimmermann, Paulo Roberto; Gustavo, Andréia da Silva; Assumpção, Caroline Melo; Londero, Fernanda

    2016-11-28

    to present currently available evidence to verify the association between metabolic syndrome and quality of life. Cochrane Library, EMBASE, Medline and LILACS databases were studied for all studies investigating the association with metabolic syndrome and quality of life. Two blinded reviewers extracted data and one more was chosen in case of doubt. a total of 30 studies were included, considering inclusion and exclusion criteria, which involved 62.063 patients. Almost all studies suggested that metabolic syndrome is significantly associated with impaired quality of life. Some, however, found association only in women, or only if associated with depression or Body Mass Index. Merely one study did not find association after adjusted for confounding factors. although there are a few studies available about the relationship between metabolic syndrome and quality of life, a growing body of evidence has shown significant association between metabolic syndrome and the worsening of quality of life. However, it is necessary to carry out further longitudinal studies to confirm this association and verify whether this relationship is linear, or only an association factor. apresentar as evidências disponíveis atuais para verificar a associação entre síndrome metabólica e qualidade de vida. Cochrane Library, EMBASE, Medline e LILACS foram as bases de dados consultadas na identificação de todos os estudos que investigavam a associação entre síndrome metabólica e qualidade de vida. Dois revisores de forma independente e cegados extraíram os dados e, em caso de dúvidas, um outro revisor foi escolhido. um total de 30 estudos foram incluídos, considerando os critérios de inclusão e exclusão, os quais envolveram 62.063 pacientes. A maioria dos estudos sugerem que a síndrome metabólica é significativamente associada à piora da qualidade de vida. Alguns, no entanto, demonstram associação apenas em mulheres, ou somente se associadas à depressão ou índice de

  9. The accuracy of platelet counting in thrombocytopenic blood samples distributed by the UK National External Quality Assessment Scheme for General Haematology.

    Science.gov (United States)

    De la Salle, Barbara J; McTaggart, Paul N; Briggs, Carol; Harrison, Paul; Doré, Caroline J; Longair, Ian; Machin, Samuel J; Hyde, Keith

    2012-01-01

    A knowledge of the limitations of automated platelet counting is essential for the effective care of thrombocytopenic patients and management of platelet stocks for transfusion. For this study, 29 external quality assessment specimen pools with platelet counts between 5 and 64 × 10(9)/L were distributed to more than 1,100 users of 23 different hematology analyzer models. The same specimen pools were analyzed by the international reference method (IRM) for platelet counting at 3 reference centers. The IRM values were on average lower than the all-methods median values returned by the automated analyzers. The majority (~67%) of the automated analyzer results overestimated the platelet count compared with the IRM, with significant differences in 16.5% of cases. Performance differed between analyzer models. The observed differences may depend in part on the nature of the survey material and analyzer technology, but the findings have implications for the interpretation of platelet counts at levels of clinical decision making.

  10. Mixed environmental quality indexes for hedonic housing price models: an alternative with area-to-point kriging with external drift

    Directory of Open Access Journals (Sweden)

    José-María Montero

    2009-10-01

    Full Text Available (a When environmental variables are included in hedonic house price models, the locations where a property transaction has been taken place are more than those equipped with an environmental monitoring station. (b When environmental variables are numerous, an environmental quality index (EQI is needed. The solution is to interpolate (kriging environmental variables and, subsequently, elaborate an EQI, because of the lower prediction variance. (c Environmental informations can be both objective and subjective. The potential mismatch between the spatial support for both the objective informations and the subjective ones is solved by using a kriging strategy (area-to-point kriging that forces scarce objective environmental informations to be coherent with dense subjective ones. These options for elaborating EQIs are compared in Madrid City (Spain.

  11. Sublingual immunotherapy in children with allergic rhinitis : quality of systematic reviews

    NARCIS (Netherlands)

    de Bot, Cindy M. A.; Moed, Heleen; Berger, Marjolein Y.; Roeder, Esther; van Wijk, Roy G.; van der Wouden, Johannes C.

    Systematic reviews have gained popularity as a way to combine the increasing amount of research information. This study assessed the quality of systematic reviews and meta-analyses of sublingual immunotherapy (SLIT) for allergic rhinitis in children, published since 2000. Eligible reviews were

  12. Sublingual immunotherapy in children with allergic rhinitis : quality of systematic reviews

    NARCIS (Netherlands)

    de Bot, Cindy M. A.; Moed, Heleen; Berger, Marjolein Y.; Roeder, Esther; van Wijk, Roy G.; van der Wouden, Johannes C.

    2011-01-01

    Systematic reviews have gained popularity as a way to combine the increasing amount of research information. This study assessed the quality of systematic reviews and meta-analyses of sublingual immunotherapy (SLIT) for allergic rhinitis in children, published since 2000. Eligible reviews were ident

  13. Evolution of an International External Quality Assurance Model To Support Laboratory Investigation of Streptococcus pneumoniae, Developed for the SIREVA Project in Latin America, from 1993 to 2005▿

    Science.gov (United States)

    Lovgren, Marguerite; Talbot, James A.; Brandileone, Maria Cristina; Casagrande, Silvana T.; Agudelo, Clara Inés; Castañeda, Elizabeth; Regueira, Mabel; Corso, Alejandra; Heitmann, Ingrid; Maldonado, Aurora; Echániz-Avilés, Gabriela; Soto-Noguerón, Araceli; Hortal, María; Camou, Teresa; Gabastou, Jean-Marc; Fabio, José Luis Di

    2007-01-01

    In 1993 the Pan American Health Organization initiated a laboratory-based surveillance system, called the SIREVA project, to learn about Streptococcus pneumoniae invasive disease in Latin American children. In 1994, National Laboratories in six countries were trained to perform serotyping and antibiotic susceptibility testing using broth microdilution to determine the MIC for specified antibiotics. An international External Quality Assurance (EQA) program was developed to monitor and support ongoing laboratory performance. The EQA program was coordinated by the National Centre for Streptococcus (NCS), Edmonton, Canada, and included external proficiency testing (EPT) and a validation process requiring regular submission of a sample of isolates from each laboratory to the NCS for verification of the serotype and MIC. In 1999, the EQA program was decentralized to use three of the original laboratories as regional quality control centers to address operational concerns and to accommodate the growth of the laboratory network to more than 20 countries including the Caribbean region. The overall EPT serotyping accuracies for phase I (1993 to 1998) and phase II (1999 to 2005) were 88.0 and 93.8%, respectively; the MIC correlations within ±1 log2 dilution of the expected result were 83.0 and 91.0% and the interpretive category agreements were 89.1 and 95.3%. Overall, the validation process serotyping accuracies for phases I and II were 81.9 and 88.1%, respectively, 80.4 and 90.5% for MIC agreement, and 85.8 and 94.3% for category agreement. These results indicate a high level of testing accuracy in participating National Laboratories and a sustained increase in EQA participation in Latin America and the Caribbean. PMID:17687007

  14. Five-year external reviews of the eight Department of Interior Climate Science Centers: Alaska Climate Science Center

    Science.gov (United States)

    Shasby, Mark; Dolloff, C. Andrew; Hicke, Jeffrey A.; Marcot, Bruce G; McCarl, Bruce; McMahon, Gerard; Morton, John M.

    2017-01-01

    This report primarily addresses the first two purposes of the review while providing comments on the third as identified by the science review team (SRT). A separate report of recommendations for the recompetition, based upon compiled observation from all three reviews conducted in 2016, was submitted to NCCWSC on April 15, 2016 to assist with the development of recompetition documents. To further address host-university administrative competencies and efficiencies, separate interviews of host-university faculty and administrators were conducted by NCCWSC staff in conjunction with the on-site component of the reviews.

  15. Quality standards and requirements for solid recovered fuels: a review.

    Science.gov (United States)

    Flamme, Sabine; Geiping, Julia

    2012-04-01

    The utilization of solid recovered fuels (SRF) for energy recovery has been increasing steadily in recent years, and this development is set to continue. In order to use SRF efficiently, it is necessary to define quality standards and introduce targeted quality assurance measures. SRF can be used both in mono-incineration and in co-incineration systems, for instance in power generation and cement plants; but as quality requirements differ, it is necessary to unambiguously define the term 'solid recovered fuel'. The purpose of this article is to provide an overview of the origin, development and the current status of quality assurance for SRF. The basic principles of quality assurance for SRF are explained with reference to the development of the German RAL Quality Assurance System and in addition specifications that have emerged from European standardization work of CEN/TC 343 are analysed.

  16. A Review of Data Quality Assessment Methods for Public Health Information Systems

    Science.gov (United States)

    Chen, Hong; Hailey, David; Wang, Ning; Yu, Ping

    2014-01-01

    High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users’ concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process. PMID:24830450

  17. A review of data quality assessment methods for public health information systems.

    Science.gov (United States)

    Chen, Hong; Hailey, David; Wang, Ning; Yu, Ping

    2014-05-14

    High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users' concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process.

  18. 针灸治疗肱骨外上髁炎文献质量评价%Literature Quality Evaluation for Acupuncture Treatment of External Humeral Epicondylitis

    Institute of Scientific and Technical Information of China (English)

    王一先; 陈少宗

    2012-01-01

    Objective : To research quality evaluation of literature of acupuncture and moxihustion in the treatment of external humeral epicondylitis. Methods : The retrieval of Chinese Academic Journal Full-text Database ( CNKI ) was made, retrieval time deadline was November of 2010. All related literatures of acupuncture and moxibustion in the treatment of external humeral epicondylitis with randomized controlled trials were selected in accordance with the inclusion criteria lor clinical trials, evaluating the method. Results : The randomized controlled trials accounted for 32%, 21.54% of the documents had eomparsions between groups of statistics, the balance between groups was reliable. 32.31% literature had a clear diagnostic criteria. The correct use of stochastic grouping method accounted lor 2.56%, 17 articles had follow-up record, 2 mentioned blind method, 3 papers mentioned treatment safety and adverse reaction. Conclusion : The limited inlcusion criteria shows acupuncture and moxibustion in the treatment of external humeral epicondylitis superiority still needs more high quality, inner reality of randomized controlled trials.%目的:对针灸治疗肱骨外上髁的试验研究进行文献质量评价.方法:检索中文学术期刊全文数据库(CNKI),检索时间截止至2010年11月.获取所有涉及针灸治疗肱骨外上髁炎的随机对照试验,选择符合纳入标准的临床试验,评价其方法.结果:其中随机对照试验占32%,21.54%的文献进行细间可比性的统计,组间均衡性比较可靠,有明确诊断标准的文献占32.31%,正确运用随机分组方法的文献占2.56%,17篇文献有随访记录,2篇提及盲法,3篇提及治疗安全性及不良反应.结论:目前有限的纳入试验显示,对于针灸治疗肱骨外上髁炎的优越性尚需更多的质量高、内在真实性好的随机对照试验来证实.

  19. Intrathecal/intraventricular colistin in external ventricular device-related infections by multi-drug resistant Gram negative bacteria: case reports and review.

    Science.gov (United States)

    Bargiacchi, O; Rossati, A; Car, P; Brustia, D; Brondolo, R; Rosa, F; Garavelli, P L; De Rosa, F G

    2014-10-01

    We report three cases of external ventricular derivation infections caused by multidrug-resistant Gram-negative rods and treated successfully with intraventricular colistin. The intrathecal or intraventricular use of colistin have been reported in more than 100 cases without any consensus on dosage, duration and type (monotherapy or combination therapy) of treatment. Based on our comprehensive review of the relevant literature relating to both clinical and pharmacokinetic data, we conclude that the intrathecal/intraventricular administration of colistin is a safe and effective option to treat central nervous system infections caused by multidrug-resistant Gram-negative bacteria.

  20. Unravelling Quality Culture in Higher Education: A Realist Review

    Science.gov (United States)

    Bendermacher, G. W. G.; oude Egbrink, M. G. A.; Wolfhagen, I. H. A. P.; Dolmans, D. H. J. M.

    2017-01-01

    There is a growing belief that higher education institutions should nurture a "quality culture" in which structural/managerial and cultural/psychological elements act in synergy to continuously improve education. Notwithstanding the positive connotation of the "quality culture" concept, its exact configuration remains subject…

  1. Kinetic Modeling of Food Quality: A Critical Review

    NARCIS (Netherlands)

    Boekel, van T.

    2008-01-01

    ABSTRACT: This article discusses the possibilities to study relevant quality aspects of food, such as color, nutrient content, and safety, in a quantitative way via mathematical models. These quality parameters are governed by chemical, biochemical, microbial, and physical changes. It is argued that

  2. Unravelling Quality Culture in Higher Education: A Realist Review

    Science.gov (United States)

    Bendermacher, G. W. G.; oude Egbrink, M. G. A.; Wolfhagen, I. H. A. P.; Dolmans, D. H. J. M.

    2017-01-01

    There is a growing belief that higher education institutions should nurture a "quality culture" in which structural/managerial and cultural/psychological elements act in synergy to continuously improve education. Notwithstanding the positive connotation of the "quality culture" concept, its exact configuration remains subject…

  3. Quality Control Review of the Defense Logistics Agency Audit Organization

    Science.gov (United States)

    2014-12-19

    all auditors are required to follow, and established an internal quality assurance division that performs ongoing, periodic assessments of work...audit organization performing audits or attestation engagements or both have an appropriate internal quality control system in place and undergo an...2010, the DLA OIG addressed our recommendation to implement official policies and procedures, which all auditors are required to follow. The DLA

  4. Ensuring the Quality, Fairness, and Integrity of Journal Peer Review: A Possible Role of Editors.

    Science.gov (United States)

    Resnik, David B; Elmore, Susan A

    2016-02-01

    A growing body of literature has identified potential problems that can compromise the quality, fairness, and integrity of journal peer review, including inadequate review, inconsistent reviewer reports, reviewer biases, and ethical transgressions by reviewers. We examine the evidence concerning these problems and discuss proposed reforms, including double-blind and open review. Regardless of the outcome of additional research or attempts at reforming the system, it is clear that editors are the linchpin of peer review, since they make decisions that have a significant impact on the process and its outcome. We consider some of the steps editors should take to promote quality, fairness and integrity in different stages of the peer review process and make some recommendations for editorial conduct and decision-making.

  5. Does updating improve the methodological and reporting quality of systematic reviews?

    Directory of Open Access Journals (Sweden)

    Hamel Candyce

    2006-06-01

    Full Text Available Abstract Background Systematic reviews (SRs must be of high quality. The purpose of our research was to compare the methodological and reporting quality of original versus updated Cochrane SRs to determine whether updating had improved these two quality dimensions. Methods We identifed updated Cochrane SRs published in issue 4, 2002 of the Cochrane Library. We assessed the updated and original versions of the SRs using two instruments: the 10 item enhanced Overview Quality Assessment Questionnaire (OQAQ, and an 18-item reporting quality checklist and flow chart based upon the Quality of Reporting of Meta-analyses (QUOROM statement. At least two reviewers extracted data and assessed quality. We calculated the percentage (with a 95% confidence interval of 'yes' answers to each question. We calculated mean differences in percentage, 95% confidence intervals and p-values for each of the individual items and the overall methodological quality score of the updated and pre-updated versions using OQAQ. Results We assessed 53 SRs. There was no significant improvement in the global quality score of the OQAQ (mean difference 0.11 (-0.28; 0.70 p = 0.52. Updated reviews showed a significant improvement of 18.9 (7.2; 30.6 p Conclusion The overall quality of Cochrane SRs is fair-to-good. Although reporting quality improved on certain individual items there was no overall improvement seen with updating and methodological quality remained unchanged. Further improvement of quality of reporting is possible. There is room for improvement of methodological quality as well. Authors updating reviews should address identified methodological or reporting weaknesses. We recommend to give full attention to both quality domains when updating SRs.

  6. Quality Assurance Peer Review Chart Rounds in 2011: A Survey of Academic Institutions in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, Yaacov Richard, E-mail: yaacovla@gmail.com [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, Sheba Medical Center, Tel HaShomer (Israel); Sackler School of Medicine, Tel Aviv University (Israel); Whiton, Michal A. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, Skagit Valley Hospital Regional Cancer Care Center, Mt. Vernon, Washington (United States); Symon, Zvi [Department of Radiation Oncology, Sheba Medical Center, Tel HaShomer (Israel); Sackler School of Medicine, Tel Aviv University (Israel); Wuthrick, Evan J. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, Ohio State University, Columbus, Ohio (United States); Doyle, Laura; Harrison, Amy S.; Dicker, Adam P. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States)

    2012-11-01

    Purpose: In light of concerns regarding the quality of radiation treatment delivery, we surveyed the practice of quality assurance peer review chart rounds at American academic institutions. Methods and Materials: An anonymous web-based survey was sent to the chief resident of each institution across the United States. Results: The response rate was 80% (57/71). The median amount of time spent per patient was 2.7 minutes (range, 0.6-14.4). The mean attendance by senior physicians and residents was 73% and 93%, respectively. A physicist was consistently present at peer review rounds in 66% of departments. There was a close association between attendance by senior physicians and departmental organization: in departments with protected time policies, good attendance was 81% vs. 31% without protected time (p = 0.001), and in departments that documented attendance, attending presence was 69% vs. 29% in departments without documentation (p < 0.05). More than 80% of institutions peer review all external beam therapy courses; however, rates were much lower for other modalities (radiosurgery 58%, brachytherapy 40%-47%). Patient history, chart documentation, and dose prescription were always peer reviewed in >75% of institutions, whereas dosimetric details (beams, wedges), isodose coverage, intensity-modulated radiation therapy constraints, and dose-volume histograms were always peer reviewed in 63%, 59%, 42%, and 50% of cases, respectively. Chart rounds led to both minor (defined as a small multileaf collimator change/repeated port film) and major (change to dose prescription or replan with dosimetry) treatment changes. Whereas at the majority of institutions changes were rare (<10% of cases), 39% and 11% of institutions reported that minor and major changes, respectively, were made to more than 10% of cases. Conclusion: The implementation of peer review chart rounds seems inconsistent across American academic institutions. Brachytherapy and radiosurgical procedures are

  7. The Production of Quality Choral Performance: A Review of Literature

    Science.gov (United States)

    Rolsten, Kathy

    2016-01-01

    This review of literature is a synthesis of research surrounding the production of superior choral performance. Findings described in this review suggest director characteristics, rehearsal techniques, singer behaviors, and auxiliary supports that are important to, or common in, the creation of meritorious performance. Effects of instructional…

  8. First experience of a multicenter external quality assessment of molecular 16S rRNA gene detection in bone and joint infections.

    Science.gov (United States)

    Plouzeau, Chloé; Bémer, Pascale; Valentin, Anne Sophie; Héry-Arnaud, Geneviève; Tandé, Didier; Jolivet-Gougeon, Anne; Vincent, Pascal; Kempf, Marie; Lemarié, Carole; Guinard, Jérôme; Bret, Laurent; Cognée, Anne Sophie; Gibaud, Sophie; Burucoa, Christophe; Corvec, Stéphane

    2015-02-01

    The objective of this study was to assess the performance of seven French laboratories for 16S rRNA gene detection by real-time PCR in the diagnosis of bone and joint infection (BJI) to validate a large multicenter study. External quality control (QC) was required owing to the differences in extraction procedures and the molecular equipment used in the different laboratories. Three proficiency sets were organized, including four bacterial DNA extracts and four bead mill-pretreated osteoarticular specimens. Extraction volumes, 16S rRNA gene primers, and sequencing interpretation rules were standardized. In order to assess each laboratory's ability to achieve the best results, scores were assigned, and each QC series was classified as optimal, acceptable, or to be improved. A total of 168 QCs were sent, and 160 responses were analyzed. The expected results were obtained for 93.8%, with the same proportion for extracts (75/80) and clinical specimens (75/80). For the specimens, there was no significant difference between manual and automated extraction. This QC demonstrated the ability to achieve good and homogeneous results using the same 16S rRNA gene PCR with different equipment and validates the possibility of high-quality multicenter studies using molecular diagnosis for BJI.

  9. [The external quality assessment schemes for lead in blood organized by the French national agency for medicine and health product safety: a synthesis of 15 years of activity].

    Science.gov (United States)

    Pineau, Alain; Otz, Jocelyne; Guillard, Olivier; Fauconneau, Bernard; Dumont, Gilles; François-Burg, Elisabeth

    2014-01-01

    In 1992, at the request of the French labor ministry following questions on the ability of medical biology laboratories to satisfactorily measure blood lead level (PbB), a national PbB quality control came into being. Only in 1996 did this external quality control include a number of laboratories sufficient to allow for a significant retrospective evaluation. After fifteen years (1996-2011), The French National Agency for Medicines and Health Products Safety wished to exploit the database collected. The number of participating laboratories went down from 73 to 41. On the other hand, the key finding pertained to the highly improved performance of the laboratories, which was associated with a spread decrease of the results over the entire range of tested PbBs (9 to 700 μg/L). Since 2006, we have observed increasing use of the inductively coupled plasma with mass spectrometry and decreasing use of electrothermal atomic absorption spectrometry. Provided that they rely on identical metrology expertise, the two analytical techniques lead to results on all the tested concentrations that are not statistically different.

  10. Hybrid video quality prediction: reviewing video quality measurement for widening application scope

    OpenAIRE

    Barkowsky, Marcus; Sedano, Inigo; Brunnstrom, Kjell; Leszczuk, Mikolaj; Staelens, Nicolas

    2015-01-01

    A tremendous number of objective video quality measurement algorithms have been developed during the last two decades. Most of them either measure a very limited aspect of the perceived video quality or they measure broad ranges of quality with limited prediction accuracy. This paper lists several perceptual artifacts that may be computationally measured in an isolated algorithm and some of the modeling approaches that have been proposed to predict the resulting quality from those algorithms....

  11. Evaluation of external beam hardening filters on image quality of computed tomography and single photon emission computed tomography/computed tomography.

    Science.gov (United States)

    Rana, Nivedita; Rawat, Dinesh; Parmar, Madan; Dhawan, Devinder Kumar; Bhati, Ashok Kumar; Mittal, Bhagwant Rai

    2015-01-01

    This study was undertaken to evaluate the effect of external metal filters on the image quality of computed tomography (CT) and single photon emission computed tomography (SPECT)/CT images. Images of Jaszack phantom filled with water and containing iodine contrast filled syringes were acquired using CT (120 kV, 2.5 mA) component of SPECT/CT system, ensuring fixation of filter on X-ray collimator. Different thickness of filters of Al and Cu (1 mm, 2 mm, 3 mm, and 4 mm) and filter combinations Cu 1 mm, Cu 2 mm, Cu 3 mm each in combination with Al (1 mm, 2 mm, 3 mm, and 4 mm), respectively, were used. All image sets were visually analyzed for streak artifacts and contrast to noise ratio (CNR) was derived. Similar acquisition was done using Philips CT quality control (QC) phantom and CNR were calculated for its lexan, perspex, and teflon inserts. Attenuation corrected SPECT/CT images of Jaszack phantom filled with 444-555 MBq (12-15 mCi) of (99m)Tc were obtained by applying attenuation correction map generated by hardened X-ray beam for different filter combination, on SPECT data. Uniformity, root mean square (rms) and contrast were calculated in all image sets. Less streak artifacts at iodine water interface were observed in images acquired using external filters as compared to those without a filter. CNR for syringes, spheres, and inserts of Philips CT QC phantom was almost similar to Al 2 mm, Al 3 mm, and without the use of filters. CNR decreased with increasing copper thickness and other filter combinations. Uniformity and rms were lower, and value of contrast was higher for SPECT/CT images when CT was acquired with Al 2 mm and 3 mm filter than for images acquired without a filter. The study suggests that for Infinia Hawkeye 4, SPECT/CT system, Al 2 mm, and 3 mm are the optimum filters for improving image quality of SPECT/CT images of Jaszack or Philips CT QC phantom keeping other parameters of CT constant.

  12. Evaluation of the Inhalation Carcinogenicity of Ethylene Oxide (Revised July 2013 External Review Draft) (Public Comment Draft)

    Science.gov (United States)

    EPA is initiating a public comment period prior to peer review of the scientific basis supporting the human health hazard and dose-response assessment of ethylene oxide (cancer) that will appear in the Integrated Risk Information System (IRIS) database.

  13. ANALYSIS OF THE EXTERNAL QUALITY ASSESSMENT OF CLINICAL BLOOD TRANSFUSION COMPATIBILITY%临床输血相容性室间质评分析体会

    Institute of Scientific and Technical Information of China (English)

    乔姝; 胡同平

    2011-01-01

    [目的]通过室间质评来完善实验方法和提高检测水平,使实验结果更加可靠,为临床输血提供安全保障.[方法]依据卫生部临床检验中心对临床输血相容性室间质评的要求,每年3次,每次5个项目包括ABO血型正反定型和Rh(D)血型鉴定、受血者和献血者抗体筛检及交叉配血实验,每个项目有5个被检测标本;对影响检测质量的标本、检测方法、试剂、操作过程及结果分析等诸多因素进行评估.[结果]2008年081批次结果较差,仅ABO正定型,Rh(D)血型鉴定两项为100%;082批次交叉配血较差为40%.2008年083批次及2009年091、092、093批次结果较为满意.[结论]临床输血相容性室间质控工作是临床输血质量管理体系中的重要环节,室间质评可增加临床实践经验,增强鉴别判断能力,规范临床输血相容性检测工作,达到安全输血的目的.%[Objective]To improve the experimental methods and detection level through the external quality assessment so that to provide more reliable and security results for the clinical transfusion.[Methods]According to the requirements of the Ministry of Health Clinical Laboratory Centre for external quality assessment of clinical blood transfusion compatibility: 3 times per year and 5 items each time including ABO blood group typing and reversed typing, Rh (D) group identification, recipient and donor antibody screening and cross-matching test.Each item had five specimens.Impact of testing on the quality of the specimens, test methods, reagents, process of operation, results analysis and other factors were assessed.[Results]081 batches had poor results in 2008, only positive-type ABO group, Rh (D) blood group identification were 100%.082 batches of cross matching was 40%.083 batches of 2008 and 091, 092, 093 batches of 2009 had satisfactory results.[Conclusion]The external quality assessment (EQC) of clinical blood transfusion compatibility is an important part of the

  14. The role of hospital managers in quality and patient safety: a systematic review

    Science.gov (United States)

    Parand, Anam; Dopson, Sue; Renz, Anna; Vincent, Charles

    2014-01-01

    Objectives To review the empirical literature to identify the activities, time spent and engagement of hospital managers in quality of care. Design A systematic review of the literature. Methods A search was carried out on the databases MEDLINE, PSYCHINFO, EMBASE, HMIC. The search strategy covered three facets: management, quality of care and the hospital setting comprising medical subject headings and key terms. Reviewers screened 15 447 titles/abstracts and 423 full texts were checked against inclusion criteria. Data extraction and quality assessment were performed on 19 included articles. Results The majority of studies were set in the USA and investigated Board/senior level management. The most common research designs were interviews and surveys on the perceptions of managerial quality and safety practices. Managerial activities comprised strategy, culture and data-centred activities, such as driving improvement culture and promotion of quality, strategy/goal setting and providing feedback. Significant positive associations with quality included compensation attached to quality, using quality improvement measures and having a Board quality committee. However, there is an inconsistency and inadequate employment of these conditions and actions across the sample hospitals. Conclusions There is some evidence that managers’ time spent and work can influence quality and safety clinical outcomes, processes and performance. However, there is a dearth of empirical studies, further weakened by a lack of objective outcome measures and little examination of actual actions undertaken. We present a model to summarise the conditions and activities that affect quality performance. PMID:25192876

  15. Review of US Navy VSTOL handling qualities requirements

    Science.gov (United States)

    Hutchings, D. E.

    1977-01-01

    Handling qualities requirements for V/STOL operations from small ships are considered in terms of the ship operating environment. Turbulence, wind over the deck, ship motion, visibility, and severe weather and sea conditions are among the factors discussed.

  16. Review: Quality of life in lower limb peripheral vascular surgery

    NARCIS (Netherlands)

    Donker, J.M.; de Vries, Jolanda; Ho, G.H.; Bastos Gonçalves, F.; Hoeks, S.E.; Verhagen, H.J.M.; van der Laan, L.

    2015-01-01

    Purpose Vascular intervention studies generally consider patency and limb salvage as primary outcomes. However, quality of life is increasingly considered an important patient-oriented outcome measurement of vascular interventions. Existing literature was analyzed to determine the effect of differen

  17. Quality of life in cancer survivors: an integrative review

    Directory of Open Access Journals (Sweden)

    Bruna Knob Pinto

    2013-09-01

    Full Text Available This study aims at identifying factors related to the quality of life of cancer survivors. The databases PubMed, LILACS and SciELO were used, being quality of life, survival and neoplasms the main keywords entered. Sixty-eight articles were found and ten that approached aspects related to quality of life of cancer survivors were selected. The results analysis was performed in stages. Several factors were identified and grouped into physical (chewing, pain and others, psychological (disease conception, social, financial (high cost of treatment and miscellaneous (age, treatment performance among others. It is believed that the analysis of the different areas that comprise the quality of life of patients can assist health professionals in the implementation of assistance practices that consider the multidimensionality of cancer survival.

  18. What is the value and impact of quality and safety teams? A scoping review

    Directory of Open Access Journals (Sweden)

    Norris Jill M

    2011-08-01

    Full Text Available Abstract Background The purpose of this study was to conduct a scoping review of the literature about the establishment and impact of quality and safety team initiatives in acute care. Methods Studies were identified through electronic searches of Medline, Embase, CINAHL, PsycINFO, ABI Inform, Cochrane databases. Grey literature and bibliographies were also searched. Qualitative or quantitative studies that occurred in acute care, describing how quality and safety teams were established or implemented, the impact of teams, or the barriers and/or facilitators of teams were included. Two reviewers independently extracted data on study design, sample, interventions, and outcomes. Quality assessment of full text articles was done independently by two reviewers. Studies were categorized according to dimensions of quality. Results Of 6,674 articles identified, 99 were included in the study. The heterogeneity of studies and results reported precluded quantitative data analyses. Findings revealed limited information about attributes of successful and unsuccessful team initiatives, barriers and facilitators to team initiatives, unique or combined contribution of selected interventions, or how to effectively establish these teams. Conclusions Not unlike systematic reviews of quality improvement collaboratives, this broad review revealed that while teams reported a number of positive results, there are many methodological issues. This study is unique in utilizing traditional quality assessment and more novel methods of quality assessment and reporting of results (SQUIRE to appraise studies. Rigorous design, evaluation, and reporting of quality and safety team initiatives are required.

  19. REVIEW ON THE EVOLVING RELATIONSHIP BETWEEN QUALITY AND PRODUCTIVITY

    Directory of Open Access Journals (Sweden)

    Ephrem Gidey

    2014-03-01

    Full Text Available Quality and productivity concepts were confusing and sometimes used interchangeably by experts both in industry and academics. Though researches, to some extent, tried to show the developments of quality and productivity, as yet, no research was devoted to study their evolution in a way to know how they reached into their existing form and their relationship, whether it existed. This study intends to disclose the reason behind the confusion and concept - intermix by studying the main advancements in the evolution of the two concepts. Their evolution is chronologically determined by grouping basic advancements in to distinct timeframes and their corresponding relationship is identified using natural selection and biased mutation approaches of evolution. The paper revealed that in the first period there was Seemingly Productivity; in the second Primarily Productivity; in the third Primarily Quality; in the fourth Primarily Quality-based Productivity (i.e. one after the other norm; and in the fifth period both quality and productivity will be equally primarily focus of firms (Primarily Quality and Productivity. Through logical justifications, observations made in the existing literature, and based on the nature of future competitiveness orientation, future relationship between the two concepts needs intelligence in that they will be equally, seemingly with trade-off, and concurrently important for organizational growth, agility, and excellence; one will never exist without the other, and after the other.

  20. Caregivers’ Quality of Life and Quality of Services for Children with Cancer: A Review from Iran

    Science.gov (United States)

    Sajjadi, Homeira; Vameghi, Meroe; Ghazinour, Mehdi; KhodaeiArdakani, Mohammadreza

    2013-01-01

    Objective: Caregivers of cancer patients are exposed to different types of psychosocial stress which influence their quality of life. The purposes of this study were to assess quality of life in caregivers of children with cancer and to investigate the relationship between the caregivers’ quality of life and quality of services in the social work section. Method: 125 caregivers were recruited. Quality of life was measured by the Iranian version of the WHOQOL-BREF questionnaire and data concerning service quality were obtained from the Iranian version of the SERVQUAL questionnaire. Findings: Scores in physical health, psychological status and environmental conditions for caregivers of children with cancer were significantly lower than the general population. There was a negative correlation between the tangible domain of SERVQUAL and the psychological status and environmental conditions of quality of life. The tangible dimension was the only aspect of service quality to predict caregivers’ quality of life regarding psychological status and environmental conditions. Conclusion: Caregivers of children with a disease are care consumers and, like all consumers, they expect good service. Delivering high quality services consistently is difficult but profitable for a service organization. In other words, trying to deliver more appropriate services than patients expect to receive from their social work care is one of the most reliable ways to promote caregivers’ satisfaction and quality of life. PMID:23618487

  1. External Beam Radiotherapy for Focal Lymphoepithelioma-Like Carcinoma in the Urinary Bladder: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Nobuhiro Kushida

    2015-01-01

    Full Text Available Lymphoepithelioma is a malignant epithelial tumor in the nasopharynx characterized by prominent lymphoid infiltration. Carcinomas that resemble lymphoepitheliomas have been called lymphoepithelioma-like carcinomas and have been reported in other organs. A tumor in the bladder is categorized by the percentage of the total area occupied by the lymphoepithelioma-like carcinoma pattern, with the prognosis dependent on the percentage. We present an 81-year-old man with stage 3 chronic obstructive pulmonary disease and a history of aortic aneurysm repair. The computed tomography scans indicated thickening and irregularity of the bladder wall, with left external iliac lymph node metastasis. His diagnosis was bladder cancer, and the clinical stage was evaluated as T3N1M0. Transurethral resection of the bladder tumor was performed, and the pathological specimen showed that the tumor was composed of undifferentiated malignant cells with sheets and nests arranged in a syncytial pattern, as well as an urothelial carcinoma lesion. A prominent lymphoid reaction accompanied the tumor. The pathological diagnosis was focal-type lymphoepithelioma-like carcinoma containing a component of urothelial carcinoma G3>G2. His general condition was such that he could not tolerate radical cystectomy or systemic chemotherapy. External beam radiotherapy (total 60 Gy was given to the bladder, including the lymph node metastatic lesion. No cancer recurrence was detected by regular follow-up computed tomography and cystoscopy. He eventually died of other causes 48 months later. Although treatment for focal lymphoepithelioma-like carcinoma generally requires multifocal therapies, in the present case, the bladder became tumor free. We also summarize previously reported lymphoepithelioma-like carcinoma cases treated with radiotherapy.

  2. Poor quality of reporting confounding bias in observational intervention studies : a systematic review

    NARCIS (Netherlands)

    Groenwold, Rolf H H; Van Deursen, Anna M M; Hoes, Arno W; Hak, Eelko

    2008-01-01

    PURPOSE: To systematically review observational studies on medical interventions to determine the quality of reporting of confounding. METHODS: Articles on observational studies on medical interventions in five general medical journals and five epidemiological journals published between January 2004

  3. Poor quality of reporting confounding bias in observational intervention studies : a systematic review

    NARCIS (Netherlands)

    Groenwold, Rolf H H; Van Deursen, Anna M M; Hoes, Arno W; Hak, Eelko

    2008-01-01

    PURPOSE: To systematically review observational studies on medical interventions to determine the quality of reporting of confounding. METHODS: Articles on observational studies on medical interventions in five general medical journals and five epidemiological journals published between January 2004

  4. Aid to Families with Dependent Children Quality Control Review Panel Decisions

    Data.gov (United States)

    U.S. Department of Health & Human Services — Decisions issued by the Aid to Families with Dependent Children (AFDC) Quality Control Review Panel of the Departmental Appeals Board concerning the AFDC program...

  5. A Field-Based Aquatic Life Benchmark for Conductivity in Central Appalachian Streams (2010) (External Review Draft)

    Science.gov (United States)

    This report adapts the standard U.S. EPA methodology for deriving ambient water quality criteria. Rather than use toxicity test results, the adaptation uses field data to determine the loss of 5% of genera from streams. The method is applied to derive effect benchmarks for disso...

  6. 76 FR 76972 - Release of Final Integrated Review Plan for the National Ambient Air Quality Standards for Lead

    Science.gov (United States)

    2011-12-09

    ... AGENCY Release of Final Integrated Review Plan for the National Ambient Air Quality Standards for Lead... the National Ambient Air Quality Standards for Lead. This document contains the plans for the review of the air quality criteria and national ambient air quality standards (NAAQS) for lead (Pb). The...

  7. 76 FR 20347 - Release of Draft Integrated Review Plan for the National Ambient Air Quality Standards for Lead

    Science.gov (United States)

    2011-04-12

    ... AGENCY Release of Draft Integrated Review Plan for the National Ambient Air Quality Standards for Lead... National Ambient Air Quality Standards for Lead (draft IRP). This document contains the plans for the review of the air quality criteria and national ambient air quality standards (NAAQS) for lead (Pb)....

  8. 42 CFR 476.72 - Review of the quality of care of risk-basis health maintenance organizations and competitive...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Review of the quality of care of risk-basis health... Quality Improvement Organizations (QIOs) General Provisions § 476.72 Review of the quality of care of risk... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY...

  9. Soil and soil environmental quality monitoring in China: a review.

    Science.gov (United States)

    Teng, Yanguo; Wu, Jin; Lu, Sijin; Wang, Yeyao; Jiao, Xudong; Song, Liuting

    2014-08-01

    Over the past few decades, numerous concerns have been raised in China over the issue of environmental sustainability. Various soil survey and monitoring programs have been carried out in China to study soil quality, and to provide a scientific basis for environment policy making. This paper provides an overview of past and current soil quality surveys and monitoring activities in China. This paper includes a summary of concerns over background concentrations of elements in soil, and soil environmental standards and guidelines in China. Levels of pollution in urban soil, agricultural soil, and soil in mining and smelting areas were compared using the concentrations and pollution indexes. In addition to soil surveys, soil monitoring is essential to study the data and to examine the effects of contaminants in soils. However, the current soil quality monitoring system was insufficient to accurately determine the soil quality status of soils across China. For accurate soil monitoring in China, it will be necessary to set up routine monitoring systems at various scales (national, provincial, and local scales), taking into consideration monitoring indicators and quality assurance. This is currently an important priority for the environmental protection administration of China.

  10. CMS Nonpayment Policy, Quality Improvement, and Hospital-Acquired Conditions: An Integrative Review.

    Science.gov (United States)

    Bae, Sung-Heui

    This integrative review synthesized evidence on the consequences of the Centers for Medicare & Medicaid Services (CMS) nonpayment policy on quality improvement initiatives and hospital-acquired conditions. Fourteen articles were included. This review presents strong evidence that the CMS policy has spurred quality improvement initiatives; however, the relationships between the CMS policy and hospital-acquired conditions are inconclusive. In future research, a comprehensive model of implementation of the CMS nonpayment policy would help us understand the effectiveness of this policy.

  11. Review of power quality applications of energy storage systems

    Energy Technology Data Exchange (ETDEWEB)

    Swaminathan, S.; Sen, R.K. [Sentech, Inc., Bethesda, MD (United States)

    1997-05-01

    Under the sponsorship of the US Department of Energy (DOE) Office of Utility Technologies, the Energy Storage Systems Analysis and Development Department at Sandia National Laboratories contracted Sentech, Inc., to assess the impact of power quality problems on the electricity supply system. This report contains the results of several studies that have identified the cost of power quality events for electricity users and providers. The large annual cost of poor power quality represents a national inefficiency and is reflected in the cost of goods sold, reducing US competitiveness. The Energy Storage Systems (ESS) Program takes the position that mitigation merits the attention of not only the DOE but affected industries as well as businesses capable of assisting in developing solutions to these problems. This study represents the preliminary stages of an overall strategy by the ESS Program to understand the magnitude of these problems so as to begin the process of engaging industry partners in developing solutions.

  12. External Peer Review Report on the United States Special Operations Command Office of Inspector General Audit Division

    Science.gov (United States)

    2016-08-15

    audit evidence obtained and its source, and the conclusions reached, including evidence that supports the auditors’ significant judgements and...identify organizations, geographic locations, and period covered?” For one of the four reports reviewed, the sampling methodology was not fully... sampling methodology was used to support the items tested. Recommendation 3 The USSOCOM OIG audit manager should ensure that the sampling methodology

  13. Development of a Relative Potency Factor (Rpf) Approach for Polycyclic Aromatic Hydrocarbon (PAH) Mixtures (External Review Draft)

    Science.gov (United States)

    EPA is conducting a peer review and public comment of the scientific basis supporting the human health hazard and dose-response assessment of polycyclic aromatic hydrocarbon (PAH) mixtures that when finalized will appear on the Integrated Risk Information System (IRIS) database. ...

  14. An Assessment of Potential Mining Impacts on Salmon Ecosystems of Bristol Bay, Alaska (Second External Review Draft)

    Science.gov (United States)

    [UPDATE] In March 2014, EPA released a response to public comments on the second draft document, "An Assessment of the Potential Mining Impacts on Salmon Ecosystems of Bristol Bay, Alaska" (see downloads). In Jan 2014, EPA released a response to peer review comme...

  15. An Assessment of Potential Mining Impacts on Salmon Ecosystems of Bristol Bay, Alaska (First External Review Draft)

    Science.gov (United States)

    [UPDATE] In March 2014, EPA released a response to public comments on the draft document, "An Assessment of the Potential Mining Impacts on Salmon Ecosystems of Bristol Bay, Alaska" (see downloads). In Jan 2014, EPA released a response to peer review comments on ...

  16. A PRISMA assessment of the reporting quality of systematic reviews in orthodontics.

    Science.gov (United States)

    Fleming, Padhraig S; Seehra, Jadbinder; Polychronopoulou, Argy; Fedorowicz, Zbys; Pandis, Nikolaos

    2013-01-01

    To assess the reporting quality of Cochrane and non-Cochrane systematic reviews (SR) in orthodontics and to compare the reporting quality (PRISMA score) with methodological quality (AMSTAR criteria). Systematic reviews (n  =  109) published between January 2000 and July 2011 in five leading orthodontic journals were identified and included. The quality of reporting of the included reviews was assessed by two authors in accordance with the PRISMA guidelines. Each article was assigned a cumulative grade based on fulfillment of the applicable criteria, and an overall percentage score was assigned. Descriptive statistics and simple and multiple linear regression analyses were undertaken. The mean overall PRISMA score was 64.1% (95% confidence interval [CI], 62%-65%). The quality of reporting was considerably better in reviews published in the Cochrane Database of Systematic Reviews (P journal of publication and number of authors was significantly associated with the PRISMA score. The association between AMSTAR score and modified PRISMA score was also found to be highly statistically significant. Compliance of orthodontic SRs published in orthodontic journals with PRISMA guidelines was deficient in several areas. The quality of reporting assessed using PRISMA guidelines was significantly better in orthodontic SRs published in the Cochrane Database of Systematic Reviews.

  17. Prosthetic interventions for people with transtibial amputation: Systematic review and metaanalysis of high-quality prospective literature and systematic reviews

    Directory of Open Access Journals (Sweden)

    M. Jason Highsmith, PhD, DPT, CP, FAAOP

    2016-03-01

    Full Text Available Considering transtibial amputation (TTA rehabilitation costs and complexity, high-quality literature should inform clinical practice. Systematic reviews (SRs suggest this is not the case. This article's purpose was to review the highest-quality evidence available to guide clinical practice for TTA regarding five prosthetic intervention areas. Six databases were searched for high-quality SRs and prospective clinical trials (randomized clinical trials [RCTs]. Reviewers screened, sorted, rated (i.e., methodologic quality, bias risk, and extracted article data. Meta-analyses were conducted when possible. Thirty-one references were included (25 RCTs and 6 SRs. Five topical areas emerged (alignment, feet and ankles, interface, postoperative care, pylons. Twenty-three evidence statements were supported by level 2 evidence and eight by level 1 evidence. All RCTs reported randomization and reasonable data presentation. Concealed allocation and blinding were not widely used. Mean attrition was 11%. SRs included no meta-analyses. Functional level was poorly reported. Grouping feet and ankle components by functional classification enabled meta-analyses, though variance was considerable given the small sample sizes. Prosthetic interventions are generally safe for TTAs. High-quality literature enabled formulation of evidence statements to support select clinical practice areas, though quantity was lacking. Thus, numerous topics related to TTA care lack rigorous evidence. Although blinding in prosthetic research requires increased funding and effort, it could greatly improve the methodologic quality of prosthetic research.

  18. 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

    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.

  19. 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

  20. Process quality indicators for chronic kidney disease risk management : a systematic literature review

    NARCIS (Netherlands)

    Smits, Kirsten P J; Sidorenkov, Grigory; Bilo, Henk J G; Bouma, Margriet; Navis, Gerjan J; Denig, Petra

    2016-01-01

    BACKGROUND AND OBJECTIVES: Quality indicators (QIs) can be used for measuring the quality of actions of healthcare providers. This systematic review gives an overview of such QIs measuring processes of care for chronic kidney disease (CKD), and identifies the QIs that have content, face, operational