Continuous quality improvement program for hip and knee replacement.

Science.gov (United States)

Marshall, Deborah A; Christiansen, Tanya; Smith, Christopher; Squire Howden, Jane; Werle, Jason; Faris, Peter; Frank, Cy

2015-01-01

Improving quality of care and maximizing efficiency are priorities in hip and knee replacement, where surgical demand and costs increase as the population ages. The authors describe the integrated structure and processes from the Continuous Quality Improvement (CQI) Program for Hip and Knee Replacement Surgical Care and summarize lessons learned from implementation. The Triple Aim framework and 6 dimensions of quality care are overarching constructs of the CQI program. A validated, evidence-based clinical pathway that measures quality across the continuum of care was adopted. Working collaboratively, multidisciplinary experts embedded the CQI program into everyday practices in clinics across Alberta. Currently, 83% of surgeons participate in the CQI program, representing 95% of the total volume of hip and knee surgeries. Biannual reports provide feedback to improve care processes, infrastructure planning, and patient outcomes. CQI programs evaluating health care services inform choices to optimize care and improve efficiencies through continuous knowledge translation. © The Author(s) 2014.

Concept Evaluation Using the PDSA Cycle for Continuous Quality Improvement.

Science.gov (United States)

Laverentz, Delois Meyer; Kumm, Sharon

As concept-based nursing education gains popularity, there is little literature on how to sustain quality after initiation of the curriculum. Critical appraisal of concepts in a university program revealed varying definitions, attributes, and exemplars resulting in student confusion. The Plan, Do, Study, Act (PDSA) cycle for continuous quality improvement was used for concept evaluation. The goals of the evaluation project were: 1) to develop common definition and attributes for concepts and 2) to develop horizontal and vertical leveling of exemplars to build on prior student learning. The continuous quality improvement process can be used to prevent "concept creep" and ensure internal consistency of concept definitions, attributes, and exemplars.

Comparing microbial water quality in an intermittent and continuous piped water supply.

Science.gov (United States)

Kumpel, Emily; Nelson, Kara L

2013-09-15

Supplying piped water intermittently is a common practice throughout the world that increases the risk of microbial contamination through multiple mechanisms. Converting an intermittent supply to a continuous supply has the potential to improve the quality of water delivered to consumers. To understand the effects of this upgrade on water quality, we tested samples from reservoirs, consumer taps, and drinking water provided by households (e.g. from storage containers) from an intermittent and continuous supply in Hubli-Dharwad, India, over one year. Water samples were tested for total coliform, Escherichia coli, turbidity, free chlorine, and combined chlorine. While water quality was similar at service reservoirs supplying the continuous and intermittent sections of the network, indicator bacteria were detected more frequently and at higher concentrations in samples from taps supplied intermittently compared to those supplied continuously (p supply, with 0.7% of tap samples positive compared to 31.7% of intermittent water supply tap samples positive for E. coli. In samples from both continuously and intermittently supplied taps, higher concentrations of total coliform were measured after rainfall events. While source water quality declined slightly during the rainy season, only tap water from intermittent supply had significantly more indicator bacteria throughout the rainy season compared to the dry season. Drinking water samples provided by households in both continuous and intermittent supplies had higher concentrations of indicator bacteria than samples collected directly from taps. Most households with continuous supply continued to store water for drinking, resulting in re-contamination, which may reduce the benefits to water quality of converting to continuous supply. Copyright © 2013 Elsevier Ltd. All rights reserved.

Continuous downstream processing for high value biological products: A Review.

Science.gov (United States)

Zydney, Andrew L

2016-03-01

There is growing interest in the possibility of developing truly continuous processes for the large-scale production of high value biological products. Continuous processing has the potential to provide significant reductions in cost and facility size while improving product quality and facilitating the design of flexible multi-product manufacturing facilities. This paper reviews the current state-of-the-art in separations technology suitable for continuous downstream bioprocessing, focusing on unit operations that would be most appropriate for the production of secreted proteins like monoclonal antibodies. This includes cell separation/recycle from the perfusion bioreactor, initial product recovery (capture), product purification (polishing), and formulation. Of particular importance are the available options, and alternatives, for continuous chromatographic separations. Although there are still significant challenges in developing integrated continuous bioprocesses, recent technological advances have provided process developers with a number of attractive options for development of truly continuous bioprocessing operations. © 2015 Wiley Periodicals, Inc.

[Scientific evaluation--the basis for quality assurance in continuing medical education].

Science.gov (United States)

Haffner, Christian; Giere, Wolfgang; Loch, Ernst-Gerhard; Rieck, Gisela

2006-01-01

Scientific evaluation is a fundamental tool of effective quality assurance of continuing medical education (CME). The analysis of the evaluation system of the CME academy of one the German Regional Medical Associations has revealed both the strengths and weaknesses of this system, thus enabling the installation of a model-like quality control system. Of utmost importance is the construction of an evaluation form that must be designed for good selectivity of the items, and the quality of the event should be well represented by the evaluating questions. For comparison purposes, the evaluation form should be standardized according to international evaluation standards. The standards of the German Society of Evaluation (DeGEval) and the guidelines and recommendations of the German Medical Association are both suitable orientational aids for the evaluation form and the evaluation process. The assessment process should also follow international standardised principles; it should be timely and subjective elements of interpretation should be eliminated, which is required for the evaluation of continuing medical education to achieve credibility. Furthermore, it is also a prerequisite that consequences may follow from the evaluation of continuing medical education and the continuity of the quality assurance process.

High-quality cardiopulmonary resuscitation: current and future directions.

Science.gov (United States)

Abella, Benjamin S

2016-06-01

Cardiopulmonary resuscitation (CPR) represents the cornerstone of cardiac arrest resuscitation care. Prompt delivery of high-quality CPR can dramatically improve survival outcomes; however, the definitions of optimal CPR have evolved over several decades. The present review will discuss the metrics of CPR delivery, and the evidence supporting the importance of CPR quality to improve clinical outcomes. The introduction of new technologies to quantify metrics of CPR delivery has yielded important insights into CPR quality. Investigations using CPR recording devices have allowed the assessment of specific CPR performance parameters and their relative importance regarding return of spontaneous circulation and survival to hospital discharge. Additional work has suggested new opportunities to measure physiologic markers during CPR and potentially tailor CPR delivery to patient requirements. Through recent laboratory and clinical investigations, a more evidence-based definition of high-quality CPR continues to emerge. Exciting opportunities now exist to study quantitative metrics of CPR and potentially guide resuscitation care in a goal-directed fashion. Concepts of high-quality CPR have also informed new approaches to training and quality improvement efforts for cardiac arrest care.

[Recommendations for the evaluation and follow-up of the continuous quality improvement].

Science.gov (United States)

Maurellet-Evrard, S; Daunizeau, A

2013-06-01

Continual improvement of the quality in a medical laboratory is based on the implementation of tools for systematically evaluate the quality management system and its ability to meet the objectives defined. Monitoring through audit and management review, addressing complaints and nonconformities and performing client satisfaction survey are the key for the continual improvement.

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

DEFF Research Database (Denmark)

Seemann, T. L.; Nybo, M.

2015-01-01

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

Pulse versus continuous peracetic acid applications: Effects on rainbow trout performance, biofilm formation and water quality

DEFF Research Database (Denmark)

Liu, Dibo; Straus, David L.; Pedersen, Lars-Flemming

2017-01-01

Peracetic acid (PAA) products are being introduced to aquaculture as sustainable disinfectants. Two strategies are used to apply PAA: high dose pulse applications, or low dose continuous application. In the present study, their impacts on fish health and water quality were investigated...... by ensuring better water quality....... in triplicate flow-through tanks stocked with rainbow trout. The gentler and shorter water cortisol increase measured along twice-per-week pulse applications of 1 mg L−1 PAA indicated a progressive adaptation of fish. In contrast, the continuous application of 0.2 mg L−1 PAA caused no stress to fish...

Multidisciplinary Prerounding Meeting as a Continuous Quality Improvement Tool: Leveraging to Reduce Continuous Benzodiazepine Use at an Academic Medical Center.

Science.gov (United States)

Flannery, Alexander H; Thompson Bastin, Melissa L; Montgomery-Yates, Ashley; Hook, Corrine; Cassity, Evan; Eaton, Phillip M; Morris, Peter E

2018-01-01

Evidence-based medicine often has many barriers to overcome prior to implementation in practice, hence the importance of continuous quality improvement. We report on a brief (≤10 minutes) multidisciplinary meeting prior to rounds to establish a dashboard for continuous quality improvement and studied the success of this meeting on a particular area of focus: continuous infusion benzodiazepine minimization. This was a prospective observational study of patients admitted to the medical intensive care unit (MICU) of a large academic medical center over a 4-month period. A morning multidisciplinary prerounding meeting was implemented to report on metrics required to establish a dashboard for MICU care for the previous 24 hours. Fellows and nurse practitioners on respective teams reported on key quality metrics and other important data related to patient census. Continuous benzodiazepines were tracked daily as the number of patients per team who had orders for a continuous benzodiazepine infusion. The aim of this report is to describe the development of the morning multidisciplinary prerounding meeting and its impact on continuous benzodiazepine use, along with associated clinical outcomes. The median number of patients prescribed a continuous benzodiazepine daily decreased over this time period and demonstrated a sustained reduction at 1 year. Furthermore, sedation scores improved, corresponding to a reduction in median duration of mechanical ventilation. The effectiveness of this intervention was mapped post hoc to conceptual models used in implementation science. A brief multidisciplinary meeting to review select data points prior to morning rounds establishes mechanisms for continuous quality improvement and may serve as a mediating factor for successful implementation when initiating and monitoring practice change in the ICU.

Implications of Continuous Quality Improvement for Program Evaluation and Evaluators.

Science.gov (United States)

Mark, Melvin M.; Pines, Edward

1995-01-01

Explores the implications that continuous quality improvement (CQI) programs are likely to have for evaluation. CQI, often known as total quality management, offers a structured approach to the analysis of an organization's processes and improvement that should provide advantages to evaluators once they have gained experience with the approach.…

An Architecture for Continuous Data Quality Monitoring in Medical Centers.

Science.gov (United States)

Endler, Gregor; Schwab, Peter K; Wahl, Andreas M; Tenschert, Johannes; Lenz, Richard

2015-01-01

In the medical domain, data quality is very important. Since requirements and data change frequently, continuous and sustainable monitoring and improvement of data quality is necessary. Working together with managers of medical centers, we developed an architecture for a data quality monitoring system. The architecture enables domain experts to adapt the system during runtime to match their specifications using a built-in rule system. It also allows arbitrarily complex analyses to be integrated into the monitoring cycle. We evaluate our architecture by matching its components to the well-known data quality methodology TDQM.

Positioning Continuing Education: Boundaries and Intersections between the Domains Continuing Education, Knowledge Translation, Patient Safety and Quality Improvement

Science.gov (United States)

Kitto, Simon; Bell, Mary; Peller, Jennifer; Sargeant, Joan; Etchells, Edward; Reeves, Scott; Silver, Ivan

2013-01-01

Public and professional concern about health care quality, safety and efficiency is growing. Continuing education, knowledge translation, patient safety and quality improvement have made concerted efforts to address these issues. However, a coordinated and integrated effort across these domains is lacking. This article explores and discusses the…

Comparing Measures of Voice Quality from Sustained Phonation and Continuous Speech

Science.gov (United States)

Gerratt, Bruce R.; Kreiman, Jody; Garellek, Marc

2016-01-01

Purpose: The question of what type of utterance--a sustained vowel or continuous speech--is best for voice quality analysis has been extensively studied but with equivocal results. This study examines whether previously reported differences derive from the articulatory and prosodic factors occurring in continuous speech versus sustained phonation.…

Lubricant based determination of design space for continuously manufactured high dose paracetamol tablets.

Science.gov (United States)

Taipale-Kovalainen, Krista; Karttunen, Anssi-Pekka; Ketolainen, Jarkko; Korhonen, Ossi

2018-03-30

The objective of this study was to devise robust and stable continuous manufacturing process settings, by exploring the design space after an investigation of the lubrication-based parameters influencing the continuous direct compression tableting of high dose paracetamol tablets. Experimental design was used to generate a structured study plan which involved 19 runs. The formulation variables studied were the type of lubricant (magnesium stearate or stearic acid) and its concentration (0.5, 1.0 and 1.5%). Process variables were total production feed rate (5, 10.5 and 16kg/h), mixer speed rpm (500, 850 and 1200rpm), and mixer inlet port for lubricant (A or B). The continuous direct compression tableting line consisted of loss-in-weight feeders, a continuous mixer and a tablet press. The Quality Target Product Profile (QTPP) was defined for the final product, as the flowability of powder blends (2.5s), tablet strength (147N), dissolution in 2.5min (90%) and ejection force (425N). A design space was identified which fulfilled all the requirements of QTPP. The type and concentration of lubricant exerted the greatest influence on the design space. For example, stearic acid increased the tablet strength. Interestingly, the studied process parameters had only a very minor effect on the quality of the final product and the design space. It is concluded that the continuous direct compression tableting process itself is insensitive and can cope with changes in lubrication, whereas formulation parameters exert a major influence on the end product quality. Copyright © 2017 Elsevier B.V. All rights reserved.

Ergonomics, quality and continuous improvement--conceptual and empirical relationships in an industrial context.

Science.gov (United States)

Eklund, J

1997-10-01

This paper reviews the literature comparing the fields of ergonomics and quality, mainly in an industrial context, including mutual influences, similarities and differences. Relationships between ergonomics and the factors: work conditions, product design, ISO 9000, continuous improvements and TQM are reviewed in relation to the consequence, application, and process domains. The definitions of ergonomics and quality overlap substantially. Quality deficiencies, human errors and ergonomics problems often have the same cause, which in many cases can be traced to the design of work, workplace and environment e.g. noise, light, postures, loads, pace and work content. In addition, the possibility of performing to a high standard at work is an important prerequisite for satisfaction and well-being. Contradictions between the two fields have been identified in the view of concepts such as standardization, reduction of variability and copying of best practice, requiring further research. The field of quality would gain by incorporating ergonomics knowledge, especially in the areas of work design and human capability, since these factors are decisive for human performance and also therefore the performance of the systems involved. The field of ergonomics, on the other hand, would benefit from developing a stronger emphasis on methodologies and structures for improvement processes, including a clearer link with leadership and company strategies. Just as important is a further development of practicable participative ergonomics methods and tools for use at workplaces by the workers themselves, in order to integrate the top-down and the bottom-up processes and achieve better impact. Using participative processes for problem-solving and continuous improvement, focusing ergonomics and quality jointly has a great potential for improving working conditions and quality results simultaneously, and satisfying most of the interested parties.

The continuous improvement in quality management for nuclear fuel manufacturing in CNNC

International Nuclear Information System (INIS)

Wang Xiaoling

2004-01-01

The nuclear fuel plant has been keeping good records in quality. Only one pot failure has been found in the fuels loaded in the reactors at more than ten years. The paper describes quality management in nuclear fuel manufacturing and focuses on the continuous improvement on quality system and process by running the quality management system, process by quality control group, and data analyze, the requirements and the improvements for the quality system, the measurement system and the standardization system, the importance of clearance system. It also describes the future plans in quality management

A High-Resolution Continuous Flow Analysis System for Polar Ice Cores

DEFF Research Database (Denmark)

Dallmayr, Remi; Goto-Azuma, Kumiko; Kjær, Helle Astrid

2016-01-01

of Polar Research (NIPR) in Tokyo. The system allows the continuous analysis of stable water isotopes and electrical conductivity, as well as the collection of discrete samples from both inner and outer parts of the core. This CFA system was designed to have sufficiently high temporal resolution to detect...... signals of abrupt climate change in deep polar ice cores. To test its performance, we used the system to analyze different climate intervals in ice drilled at the NEEM (North Greenland Eemian Ice Drilling) site, Greenland. The quality of our continuous measurement of stable water isotopes has been......In recent decades, the development of continuous flow analysis (CFA) technology for ice core analysis has enabled greater sample throughput and greater depth resolution compared with the classic discrete sampling technique. We developed the first Japanese CFA system at the National Institute...

Continuous microwave pasteurization of a vegetable smoothie improves its physical quality and hinders detrimental enzyme activity.

Science.gov (United States)

Arjmandi, Mitra; Otón, Mariano; Artés, Francisco; Artés-Hernández, Francisco; Gómez, Perla A; Aguayo, Encarna

2017-01-01

The effect of a pasteurization treatment at 90 ± 2 ℃ for 35 s provided by continuous microwave under different doses (low power/long time and high power/short time) or conventional pasteurization on the quality of orange-colored smoothies and their changes throughout 45 days of storage at 5 ℃ was investigated. A better color retention of the microwave pasteurization- treated smoothie using high power/short time than in conventionally processed sample was evidenced by the stability of the hue angle. The continuous microwave heating increased the viscosity of the smoothie more than the conventional pasteurization in comparison with non-treated samples. Lower residual enzyme activities from peroxidase, pectin methylesterase and polygalacturonase were obtained under microwave heating, specifically due to the use of higher power/shorter time. For this kind of smoothie, polygalacturonase was the more thermo-resistant enzyme and could be used as an indicator of pasteurization efficiency. The use of a continuous semi-industrial microwave using higher power and shorter time, such as 1600 W/206 s and 3600 W/93 s, resulted in better quality smoothies and greater enzyme reduction than conventional thermal treatment. © The Author(s) 2016.

High-throughput continuous cryopump

International Nuclear Information System (INIS)

Foster, C.A.

1986-01-01

A cryopump with a unique method of regeneration which allows continuous operation at high throughput has been constructed and tested. Deuterium was pumped continuously at a throughput of 30 Torr.L/s at a speed of 2000 L/s and a compression ratio of 200. Argon was pumped at a throughput of 60 Torr.L/s at a speed of 1275 L/s. To produce continuous operation of the pump, a method of regeneration that does not thermally cycle the pump is employed. A small chamber (the ''snail'') passes over the pumping surface and removes the frost from it either by mechanical action with a scraper or by local heating. The material removed is topologically in a secondary vacuum system with low conductance into the primary vacuum; thus, the exhaust can be pumped at pressures up to an effective compression ratio determined by the ratio of the pumping speed to the leakage conductance of the snail. The pump, which is all-metal-sealed and dry and which regenerates every 60 s, would be an ideal system for pumping tritium. Potential fusion applications are for mpmp limiters, for repeating pneumatic pellet injection lines, and for the centrifuge pellet injector spin tank, all of which will require pumping tritium at high throughput. Industrial applications requiring ultraclean pumping of corrosive gases at high throughput, such as the reactive ion etch semiconductor process, may also be feasible

The new health-care quality: value, outcomes, and continuous improvement.

Science.gov (United States)

O'Connor, S J; Lanning, J A

1991-01-01

No longer convinced that their viewpoint on quality is the only one, different stakeholders in the health-care arena are sharing perspectives to piece together the quality picture. Although still preoccupied with the cost of health care, purchasers are concerned about value--efficiency, appropriateness, and effectiveness--as well as price. Faced with evidence of medically unnecessary procedures and unexamined medical theory, practitioners are searching for appropriateness guidelines, useful outcome measures, and methods to elicit informed patient preferences about elective surgeries. Underlying this search for reliable indicators of quality--now expanded to include patient satisfaction--is a new interest in the Japanese notion of "Kaizen" or continuous quality improvement. The end product of this ferment may determine whether good medicine drives out the bad--or vice versa.

Lean management systems: creating a culture of continuous quality improvement.

Science.gov (United States)

Clark, David M; Silvester, Kate; Knowles, Simon

2013-08-01

This is the first in a series of articles describing the application of Lean management systems to Laboratory Medicine. Lean is the term used to describe a principle-based continuous quality improvement (CQI) management system based on the Toyota production system (TPS) that has been evolving for over 70 years. Its origins go back much further and are heavily influenced by the work of W Edwards Deming and the scientific method that forms the basis of most quality management systems. Lean has two fundamental elements--a systematic approach to process improvement by removing waste in order to maximise value for the end-user of the service and a commitment to respect, challenge and develop the people who work within the service to create a culture of continuous improvement. Lean principles have been applied to a growing number of Healthcare systems throughout the world to improve the quality and cost-effectiveness of services for patients and a number of laboratories from all the pathology disciplines have used Lean to shorten turnaround times, improve quality (reduce errors) and improve productivity. Increasingly, models used to plan and implement large scale change in healthcare systems, including the National Health Service (NHS) change model, have evidence-based improvement methodologies (such as Lean CQI) as a core component. Consequently, a working knowledge of improvement methodology will be a core skill for Pathologists involved in leadership and management.

Process performance and product quality in an integrated continuous antibody production process.

Science.gov (United States)

Karst, Daniel J; Steinebach, Fabian; Soos, Miroslav; Morbidelli, Massimo

2017-02-01

Continuous manufacturing is currently being seriously considered in the biopharmaceutical industry as the possible new paradigm for producing therapeutic proteins, due to production cost and product quality related benefits. In this study, a monoclonal antibody producing CHO cell line was cultured in perfusion mode and connected to a continuous affinity capture step. The reliable and stable integration of the two systems was enabled by suitable control loops, regulating the continuous volumetric flow and adapting the operating conditions of the capture process. For the latter, an at-line HPLC measurement of the harvest concentration subsequent to the bioreactor was combined with a mechanistic model of the capture chromatographic unit. Thereby, optimal buffer consumption and productivity throughout the process was realized while always maintaining a yield above the target value of 99%. Stable operation was achieved at three consecutive viable cell density set points (20, 60, and 40 × 10 6 cells/mL), together with consistent product quality in terms of aggregates, fragments, charge isoforms, and N-linked glycosylation. In addition, different values for these product quality attributes such as N-linked glycosylation, charge variants, and aggregate content were measured at the different steady states. As expected, the amount of released DNA and HCP was significantly reduced by the capture step for all considered upstream operating conditions. This study is exemplary for the potential of enhancing product quality control and modulation by integrated continuous manufacturing. Biotechnol. Bioeng. 2017;114: 298-307. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Real life cost and quality of life associated with continuous intraduodenal levodopa infusion compared with oral treatment in Parkinson patients

DEFF Research Database (Denmark)

Lundqvist, C.; Beiske, A. G.; Reiertsen, O.

2014-01-01

Advanced-stage Parkinson's disease (PD) strongly affects quality of life (QoL). Continuous intraduodenal administration of levodopa (IDL) is efficacious, but entails high costs. This study aims to estimate these costs in routine care. 10 patients with advanced-PD who switched from oral medication...... was the dominant cost during IDL (45 % of total costs), it represented only 6.4 % of the total for conventional treatment. IDL improves function but is not cost effective using recommended thresholds for cost/QALY in Norway.......Advanced-stage Parkinson's disease (PD) strongly affects quality of life (QoL). Continuous intraduodenal administration of levodopa (IDL) is efficacious, but entails high costs. This study aims to estimate these costs in routine care. 10 patients with advanced-PD who switched from oral medication...... to IDL were assessed at baseline, and subsequently at 3, 6, 9 and 12 months follow-up. We used the Unified PD Rating Scale (UPDRS) for function and 15D for Quality of Life (QoL). Costs were assessed using quarterly structured patient questionnaires and hospital registries. Costs per quality adjusted life...

Increasing quality and managing complexity in neuroinformatics software development with continuous integration

Directory of Open Access Journals (Sweden)

Yury V. Zaytsev

2013-01-01

Full Text Available High quality neuroscience research requires accurate, reliable and well maintained neuroinformatics applications. As software projects become larger, offering more functionality and developing a denser web of interdependence between their component parts, we need more sophisticated methods to manage their complexity. If complexity is allowed to get out of hand, either the quality of the software or the speed of development suffer, and in many cases both. To address this issue, here we develop a scalable, low-cost and open source solution for continuous integration (CI, a technique which ensures the quality of changes to the code base during the development procedure, rather than relying on a pre-release integration phase. We demonstrate that a CI based workflow, due to rapid feedback about code integration problems and tracking of code health measures, enabled substantial increases in productivity for a major neuroinformatics project and additional benefits for three further projects. Beyond the scope of the current study, we identify multiple areas in which CI can be employed to further increase the quality of neuroinformatics projects by improving development practices and incorporating appropriate development tools. Finally, we discuss what measures can be taken to lower the barrier for developers of neuroinformatics applications to adopt this useful technique.

Increasing quality and managing complexity in neuroinformatics software development with continuous integration.

Science.gov (United States)

Zaytsev, Yury V; Morrison, Abigail

2012-01-01

High quality neuroscience research requires accurate, reliable and well maintained neuroinformatics applications. As software projects become larger, offering more functionality and developing a denser web of interdependence between their component parts, we need more sophisticated methods to manage their complexity. If complexity is allowed to get out of hand, either the quality of the software or the speed of development suffer, and in many cases both. To address this issue, here we develop a scalable, low-cost and open source solution for continuous integration (CI), a technique which ensures the quality of changes to the code base during the development procedure, rather than relying on a pre-release integration phase. We demonstrate that a CI-based workflow, due to rapid feedback about code integration problems and tracking of code health measures, enabled substantial increases in productivity for a major neuroinformatics project and additional benefits for three further projects. Beyond the scope of the current study, we identify multiple areas in which CI can be employed to further increase the quality of neuroinformatics projects by improving development practices and incorporating appropriate development tools. Finally, we discuss what measures can be taken to lower the barrier for developers of neuroinformatics applications to adopt this useful technique.

Can there be mutual support between hospital marketing and continuous quality improvement?

Science.gov (United States)

Weiland, D E

1992-01-01

Marketing the results of continuous quality improvement in hospitals builds a growing bank of loyal customers in an increasingly competitive and quality-oriented environment: If healthcare institutions want to survive and flourish, they must develop a lasting relationship with their customers. The long-term goal of CQI is to provide quality products and services. If marketing managers can sell these improved services, hospitals will build a solid client foundation.

Ongoing Evaluation of Clinical Ethics Consultations as a Form of Continuous Quality Improvement.

Science.gov (United States)

Volpe, Rebecca

2017-01-01

Ongoing evaluation of a clinical ethics consultation service (ECS) allows for continuous quality improvement, a process-based, data-driven approach for improving the quality of a service. Evaluations by stakeholders involved in a consultation can provide real-time feedback about what is working well and what might need to be improved. Although numerous authors have previously presented data from research studies on the effectiveness of clinical ethics consultation, few ECSs routinely send evaluations as an ongoing component of their everyday clinical activities. The primary purpose of this article is to equip and encourage others to engage in ongoing evaluation of their own ECS. Toward that end, the following resources are shared: (1) the survey tool used to gather the evaluation data, (2) the procedure used to elicit and collate responses, and (3) how the resulting data are used to support continuous quality improvement and justify the continued financial support of the ECS to hospital administration. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

Assessing the impact of continuous quality improvement/total quality management: concept versus implementation.

Science.gov (United States)

Shortell, S M; O'Brien, J L; Carman, J M; Foster, R W; Hughes, E F; Boerstler, H; O'Connor, E J

1995-01-01

OBJECTIVE: This study examines the relationships among organizational culture, quality improvement processes and selected outcomes for a sample of up to 61 U. S. hospitals. DATA SOURCES AND STUDY SETTING: Primary data were collected from 61 U. S. hospitals (located primarily in the midwest and the west) on measures related to continuous quality improvement/total quality management (CQI/TQM), organizational culture, implementation approaches, and degree of quality improvement implementation based on the Baldrige Award criteria. These data were combined with independently collected data on perceived impact and objective measures of clinical efficiency (i.e., charges and length of stay) for six clinical conditions. STUDY DESIGN: The study involved cross-sectional examination of the named relationships. DATA COLLECTION/EXTRACTION METHODS: Reliable and valid scales for the organizational culture and quality improvement implementation measures were developed based on responses from over 7,000 individuals across the 61 hospitals with an overall completion rate of 72 percent. Independent data on perceived impact were collected from a national survey and independent data on clinical efficiency from a companion study of managed care. PRINCIPAL FINDINGS: A participative, flexible, risk-taking organizational culture was significantly related to quality improvement implementation. Quality improvement implementation, in turn, was positively associated with greater perceived patient outcomes and human resource development. Larger-size hospitals experienced lower clinical efficiency with regard to higher charges and higher length of stay, due in part to having more bureaucratic and hierarchical cultures that serve as a barrier to quality improvement implementation. CONCLUSIONS: What really matters is whether or not a hospital has a culture that supports quality improvement work and an approach that encourages flexible implementation. Larger-size hospitals face more difficult

Quality of life in automated and continuous ambulatory peritoneal dialysis

NARCIS (Netherlands)

Michels, Wieneke M.; van Dijk, Sandra; Verduijn, Marion; le Cessie, Saskia; Boeschoten, Elisabeth W.; Dekker, Friedo W.; Krediet, Raymond T.; Apperloo, A. J.; Bijlsma, J. A.; Boekhout, M.; Boer, W. H.; van der Boog, P. J. M.; Büller, H. R.; van Buren, M.; de Charro, F. Th; Doorenbos, C. J.; van den Dorpel, M. A.; van Es, A.; Fagel, W. J.; Feith, G. W.; de Fijter, C. W. H.; Frenken, L. A. M.; Grave, W.; van Geelen, J. A. C. A.; Gerlag, P. G. G.; Gorgels, J. P. M. C.; Huisman, R. M.; Jager, K. J.; Jie, K.; Koning-Mulder, W. A. H.; Koolen, M. I.; Kremer Hovinga, T. K.; Lavrijssen, A. T. J.; Luik, A. J.; van der Meulen, J.; Parlevliet, K. J.; Raasveld, M. H. M.; van der Sande, F. M.; Schonck, M. J. M.; Schuurmans, M. M. J.; Siegert, C. E. H.; Stegeman, C. A.; Stevens, P.; Thijssen, J. G. P.; Valentijn, R. M.; Vastenburg, G. H.; Verburgh, C. A.; Vincent, H. H.; Vos, P. F.

2011-01-01

Despite a lack of strong evidence, automated peritoneal dialysis (APD) is often prescribed on account of an expected better quality of life (QoL) than that expected with continuous ambulatory peritoneal dialysis (CAPD). Our aim was to analyze differences in QoL in patients starting dialysis on APD

APPLICATION OF FAILURE MODE & EFFECT ANALYSIS (FMEA FOR CONTINUOUS QUALITY IMPROVEMENT - MULTIPLE CASE STUDIES IN AUTOMOBILE SMES

Directory of Open Access Journals (Sweden)

Jigar Doshi

2017-06-01

Full Text Available Failure Mode and Effects Analysis (FMEA is a quality tool used to identify potential failures and related effects on processes and products, so continuous improvement in quality can be achieved by reducing them. The purpose of this research paper is to showcase the contribution of FMEA to achieve Continuous Quality Improvement (CQI by multiple case study research. The outcome research conducted by implementing FMEA; one of the Auto Core Tools (ACTs, in the automobile Small and Medium Enterprises (SMEs in Gujarat, India is presented in this paper which depict various means of Continuous Quality Improvements. The case study based research was carried out in four automobile SMEs; all of them are supplied to automotive Original Equipment Manufacturer (OEM. The FMEA was implemented with the help of Cross Functional Team (CFT to identify the potential failure modes and effects, in overall effect on Continuous Quality Improvement. The outcome of FMEA at four companies' reveals the scope of improvement exists in the manufacturing process. Implementation of those improvement points shows the definite signs of continuous improvement of the quality of process and product as well. The FMEA and subsequent implementations had reduced the quality rejections around 3% to 4% in case companies.

Using Principles of Quality and Safety Education for Nurses in School Nurse Continuing Education

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Rosenblum, Ruth K.; Sprague-McRae, Julie

2014-01-01

School nurses require ongoing continuing education in a number of areas. The Quality and Safety Education for Nurses (QSEN) framework can be utilized in considering school nurses' roles and developing continuing education. Focusing on neurology continuing education, the QSEN framework is illustrated with the example of concussion management…

Continuous quality improvement in nephrology: a systematic review.

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Nunes, Julie Wright; Seagull, F Jacob; Rao, Panduranga; Segal, Jonathan H; Mani, Nandita S; Heung, Michael

2016-11-24

Continuous quality improvement (CQI) has been successfully applied in business and engineering for over 60 years. While using CQI techniques within nephrology has received increased attention, little is known about where, and with what measure of success, CQI can be attributed to improving outcomes within nephrology care. This is particularly important as payors' focus on value-based healthcare and reimbursement is tied to achieving quality improvement thresholds. We conducted a systematic review of CQI applications in nephrology. Studies were identified from PubMed, MEDLINE, Scopus, Web of Science, CINAHL, Google Scholar, ProQuest Dissertation Abstracts and sources of grey literature (i.e., available in print/electronic format but not controlled by commercial publishers) between January 1, 2004 and October 13, 2014. We developed a systematic evaluation protocol and pre-defined criteria for review. All citations were reviewed by two reviewers with disagreements resolved by consensus. We initially identified 468 publications; 40 were excluded as duplicates or not available/not in English. An additional 352 did not meet criteria for full review due to: 1. Not meeting criteria for inclusion = 196 (e.g., reviews, news articles, editorials) 2. Not nephrology-specific = 153, 3. Only available as abstracts = 3. Of 76 publications meeting criteria for full review, the majority [45 (61%)] focused on ESRD care. 74% explicitly stated use of specific CQI tools in their methods. The highest number of publications in a given year occurred in 2011 with 12 (16%) articles. 89% of studies were found in biomedical and allied health journals and most studies were performed in North America (52%). Only one was randomized and controlled although not blinded. Despite calls for healthcare reform and funding to inspire innovative research, we found few high quality studies either rigorously evaluating the use of CQI in nephrology or reporting best practices. More rigorous

Consistently high sports/exercise activity is associated with better sleep quality, continuity and depth in midlife women: the SWAN sleep study.

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Kline, Christopher E; Irish, Leah A; Krafty, Robert T; Sternfeld, Barbara; Kravitz, Howard M; Buysse, Daniel J; Bromberger, Joyce T; Dugan, Sheila A; Hall, Martica H

2013-09-01

To examine relationships between different physical activity (PA) domains and sleep, and the influence of consistent PA on sleep, in midlife women. Cross-sectional. Community-based. 339 women in the Study of Women's Health Across the Nation Sleep Study (52.1 ± 2.1 y). None. Sleep was examined using questionnaires, diaries and in-home polysomnography (PSG). PA was assessed in three domains (Active Living, Household/Caregiving, Sports/Exercise) using the Kaiser Physical Activity Survey (KPAS) up to 4 times over 6 years preceding the sleep assessments. The association between recent PA and sleep was evaluated using KPAS scores immediately preceding the sleep assessments. The association between the historical PA pattern and sleep was examined by categorizing PA in each KPAS domain according to its pattern over the 6 years preceding sleep assessments (consistently low, inconsistent/consistently moderate, or consistently high). Greater recent Sports/Exercise activity was associated with better sleep quality (diary "restedness" [P sleep continuity (diary sleep efficiency [SE; P = 0.02]) and depth (higher NREM delta electroencephalographic [EEG] power [P = 0.04], lower NREM beta EEG power [P Sports/Exercise activity was also associated with better Pittsburgh Sleep Quality Index scores (P = 0.02) and higher PSG-assessed SE (P sleep and Active Living or Household/Caregiving activity (either recent or historical pattern) were noted. Consistently high levels of recreational physical activity, but not lifestyle- or household-related activity, are associated with better sleep in midlife women. Increasing recreational physical activity early in midlife may protect against sleep disturbance in this population.

Continuous Improvement in Nursing Education through Total Quality Management (TQM

Directory of Open Access Journals (Sweden)

Tang Wai Mun

2013-11-01

Full Text Available Total Quality Management (TQM has generally been validated as a crucial revolution in the management field. Many academicians believe that the concept of TQM is applicable to academics and provides guiding principles towards improving education. Therefore, an increasing number of educational institutions such as schools, colleges and universities have started to embrace TQM philosophies to their curricula.Within the context of TQM, this paper would explore the concept of continuous improvement by using the Deming philosophy. Subsequently, this paper would elaborate on the application of TQM to bring about continuous improvement in the current education system.

High-throughput continuous hydrothermal synthesis of an entire nanoceramic phase diagram.

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Weng, Xiaole; Cockcroft, Jeremy K; Hyett, Geoffrey; Vickers, Martin; Boldrin, Paul; Tang, Chiu C; Thompson, Stephen P; Parker, Julia E; Knowles, Jonathan C; Rehman, Ihtesham; Parkin, Ivan; Evans, Julian R G; Darr, Jawwad A

2009-01-01

A novel High-Throughput Continuous Hydrothermal (HiTCH) flow synthesis reactor was used to make directly and rapidly a 66-sample nanoparticle library (entire phase diagram) of nanocrystalline Ce(x)Zr(y)Y(z)O(2-delta) in less than 12 h. High resolution PXRD data were obtained for the entire heat-treated library (at 1000 degrees C/1 h) in less than a day using the new robotic beamline I11, located at Diamond Light Source (DLS). This allowed Rietveld-quality powder X-ray diffraction (PXRD) data collection of the entire 66-sample library in <1 day. Consequently, the authors rapidly mapped out phase behavior and sintering behaviors for the entire library. Out of the entire 66-sample heat-treated library, the PXRD data suggests that 43 possess the fluorite structure, of which 30 (out of 36) are ternary compositions. The speed, quantity and quality of data obtained by our new approach, offers an exciting new development which will allow structure-property relationships to be accessed for nanoceramics in much shorter time periods.

Effect of High-Intensity Interval Versus Continuous Exercise Training on Functional Capacity and Quality of Life in Patients With Coronary Artery Disease: A RANDOMIZED CLINICAL TRIAL.

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Jaureguizar, Koldobika Villelabeitia; Vicente-Campos, Davinia; Bautista, Lorena Ruiz; de la Peña, Cesar Hernández; Gómez, María José Arriaza; Rueda, María José Calero; Fernández Mahillo, Ignacio

2016-01-01

There is strong evidence that exercise training has beneficial health effects in patients with cardiovascular disease. Most studies have focused on moderate continuous training (MCT); however, a body of evidence has begun to emerge demonstrating that high-intensity interval training (HIIT) has significantly better results in terms of morbidity and mortality. The aim of this study was to compare the effects of MCT versus HIIT on functional capacity and quality of life and to assess safety. Seventy-two patients with ischemic heart disease were assigned to either HIIT or MCT for 8 weeks. We analyzed cardiopulmonary exercise test data, quality of life, and adverse events. High-intensity interval training resulted in a significantly greater increase in (Equation is included in full-text article.)O2peak (4.5 ± 4.7 mL·kg·min) compared with MCT (2.5 ± 3.6 mL·kg·min) (P HIIT and 14% in MCT. Furthermore, there was a significant (P HIIT group (49.6 ± 6.3 m) when compared with the MCT group (29.6 ± 12.0 m). Both training protocols improved quality of life. No adverse events were reported in either of the groups. On the basis of the results of this study, HIIT should be considered for use in cardiac rehabilitation as it resulted in a greater increase in functional capacity compared with MCT. We also observed greater improvement in quality of life without any increase in cardiovascular risk.

30 CFR 18.54 - High-voltage continuous mining machines.

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2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false High-voltage continuous mining machines. 18.54... and Design Requirements § 18.54 High-voltage continuous mining machines. (a) Separation of high... ground. (e) Onboard ungrounded, three-phase power circuit. A continuous mining machine designed with an...

CONTINUOUS QUALITY IMPROVEMENT (CQI FRAMEWORK: A CASE OF INDUSTRIAL ENGINEERING DEPARTMENT

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Tooba Sikander

2017-06-01

Full Text Available This paper aims to present an educational framework for outcomes based continuous quality improvement. Well defined program outcomes, program educational objectives and assessment process have been developed to ensure graduates’ outcomes achievement. Direct and indirect tools have been used for assessment process. Course evaluation surveys, alumni surveys, and employer surveys have been deployed for indirect outcome assessment. Exams, quizzes, assignments and projects, on the other hand, have been used for direct outcome assessment. In developed framework, the educational processes committees and facilities committees have been integrated to continuously evaluate and monitor the educational processes. Furthermore, program outcomes and course learning outcomes are proposed to be evaluated and continuously monitored by programs goals committee and continuous course improvement committee respectively. Forms and procedures have been developed to assess student outcomes.

Quality assurance system for sitting high risk facilities

International Nuclear Information System (INIS)

Rodriguez, Aymee; Peralta, Jose L.; Fernandez, Manuel

1999-01-01

The paper shows how we have conceived and designed the quality assurance system for the site selection process of an area for sitting the facility of high risk in correspondence with the approved methodology. The results obtained in the implementation of the system have permitted the satisfactory performance of each one the expected stage, defining the most favorable sectors in order to continue the studies of the repository site for the disposal of low and intermedium. (author)

Assessing the relationship between technology readiness and continuance intention in an E-appointment system: relationship quality as a mediator.

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Chen, Shih-Chih; Jong, Din; Lai, Min-Tsai

2014-09-01

Numerous types of self-service technologies have prevailed due to innovations in network and information technology. To hospitals, patient intentions to continue to use the e-appointment system are crucial. Previous investigations discussed only the relationships between the technology readiness of users and their continuance intentions, and ignored the most important mediator, relationship quality. This study explored the relationships among technology readiness, relationship quality, and continuance intention. The research results demonstrated that both optimism and innovativeness significantly and positively influenced continuance intention through the mediating effect of relationship quality. However, discomfort and insecurity hid not significantly influence relationship quality or continuance intention. Finally, theoretical contributions, managerial implications and future research directions were discussed.

Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety.

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McFadden, Kathleen L; Stock, Gregory N; Gowen, Charles R

2014-10-01

Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. The results provide empirical evidence that a safety climate, which is connected to the chief executive officer's transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

Using measures to guide the continuous improvement journey: a partnership between quality assurance and toxicology.

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Gentry, P E; Sites, D L

1994-03-01

It has been said that you cannot improve what you cannot measure. At Eli Lilly and Company, measurement is one of the five pillars of Total Quality. Quality Assurance and Toxicology have partnered in the use of measures to drive improvements in both areas. Quality Assurance and Toxicology have embarked on a journey in Total Quality to achieve customer satisfaction and drive continuous improvement. Measurement in the research and development world has traditionally not been well received. Contrary to popular belief, we have found that many processes can be measured in the research and development environment. Measurement is critical to the continuous improvement of processes because improvements are made using data. In Quality Assurance and Toxicology, the initial measures were put in place to gather baseline data. As we learned from our measures, we customized them to align with all of our processes. This article describes the journey of measuring Quality Assurance and Toxicology, including highlights of implementation strategies and lessons learned along the way.

[General practice has to contribute to the continuous improvement of quality of care and integrate health promotion].

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Vanmeerbeek, Marc

2009-09-01

Quality of care in general practice is mainly based on effectiveness of clinical and inter-personal care, and access to care. Assessment has to focus on structures and processes, more than on outcomes. The sets of clinical indicators used in some european countries, though good starting points are still incomplete to encompass the complexity of activity. Assessment of care quality by the public authorities must be acceptable to the doctors who are the object of this assessment; otherwise its conclusions will be rejected. Continuous quality improvement can maintain quality of care at a high level and maintain costs under control. Health has to be managed, and doctors have a collective responsibility towards their patients. The procedures of the quality cycle are applicable in general practice for the development of community-based projects of health promotion, within the network of care. The discipline can find in it a new lease of life and perhaps curb the loss of interest among young doctors.

Perioperative Care and the Importance of Continuous Quality Improvement—A Controlled Intervention Study in Three Tanzanian Hospitals

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Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus–Dieter; Spies, Claudia

2015-01-01

Introduction Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. Methods All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Results Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, pimproved to then decline again (63.3% in 2009; 70% in 2010; 58.6% in 2011). In the control group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Conclusion Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach. PMID:26327392

PERCEIVED QUALITY AS A KEY ANTECEDENT IN CONTINUANCE INTENTION ON MOBILE COMMERCE

OpenAIRE

Hsiang-Ming Lee; Tsai Chen

2014-01-01

Based on the smart phone and 3G communication boom in recent years, mobile commerce has become increasingly popular. This study empirically investigated the continuance usage intention of m-commerce consumers. The proposed model is an extension of the expectation-confirmation model, with perceived quality as the antecedent variable of confirmation and perceived usefulness. This model employed three dimensions of perceived quality from DeLone and Mclean’s IS success model. Survey data were col...

Influence of Continuing Medical Education on Rheumatologists? Performance on National Quality Measures for Rheumatoid Arthritis

OpenAIRE

Sapir, Tamar; Rusie, Erica; Greene, Laurence; Yazdany, Jinoos; Robbins, Mark L.; Ruderman, Eric M.; Carter, Jeffrey D.; Patel, Barry; Moreo, Kathleen

2015-01-01

Introduction: In recent years researchers have reported deficits in the quality of care provided to patients with rheumatoid arthritis (RA), including low rates of performance on quality measures. We sought to determine the influence of a quality improvement (QI) continuing education program on rheumatologists’ performance on national quality measures for RA, along with other measures aligned with National Quality Strategy priorities. Performance was assessed through baseline and post-educati...

Integration study of high quality teaching resources in universities

Directory of Open Access Journals (Sweden)

Honglu Liu

2012-12-01

Full Text Available Purpose: The development level and quality of education depend on the merits and efficiency in the use of teaching resources, especially in the case of obvious contradiction between the demand and supply of teaching resources. So to integrate teaching resources, improve the efficiency in the use of high quality teaching resources, and take the road of content development to enhance the competitiveness of education has become very important and urgent.Design/methodology/approach: On the basis of analysis on the teaching resources of universities and the problems they faced, this paper introduced the basic concepts of cloud storage, and built the integration architecture of high quality teaching resources in universities based on the cloud storage.Findings and Originality/value: The HDFS-based cloud storage proposed in this paper is a dynamically adjustable and Internet-based storage solution, and the users can access storage targets using the network through a common and easy-to-use protocol and application programming interfaces. This new technology is useful for end users benefits. With the continuous development and improvement of cloud storage, it will necessarily result in more and more applications in the institutions of higher learning and education network.Originality/value: This paper introduced the cloud storage into the integration of high quality teaching resources in universities first and as a new form of service, it can be a good solution.

A pilot study examining the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular risk factors in cancer survivors.

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Toohey, Kellie; Pumpa, Kate L; Arnolda, Leonard; Cooke, Julie; Yip, Desmond; Craft, Paul S; Semple, Stuart

2016-01-01

The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular disease risk factors in cancer survivors. Cancer survivors within 24 months post-diagnosis were randomly assigned into the low-volume high-intensity interval training group ( n  = 8) or the continuous low to moderate intensity training group ( n  = 8) group for 36 sessions (12 weeks) of supervised exercise. The low-volume high-intensity interval training (LVHIIT) group performed 7 × 30 s intervals (≥85% maximal heart rate) and the continuous low to moderate intensity training (CLMIT) group performed continuous aerobic training for 20 min (≤55% maximal heart rate) on a stationary bike or treadmill. Significant improvements (time) were observed for 13 of the 23 dependent variables (ES 0.05-0.61, p  ≤ 0.05). An interaction effect was observed for six minute walk test (18.53% [32.43-4.63] ES 0.50, p  ≤ 0.01) with the LVHIIT group demonstrating greater improvements. These preliminary findings suggest that both interventions can induce improvements in quality of life, functional capacity and selected cardiovascular disease risk factors. The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness (6MWT); it remains to be seen which intervention elicits the most clinically relevant outcomes for patients. A larger sample size with a control group is required to confirm the significance of these findings.

Continuous quality improvement for the clinical decision unit.

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Mace, Sharon E

2004-01-01

Clinical decision units (CDUs) are a relatively new and growing area of medicine in which patients undergo rapid evaluation and treatment. Continuous quality improvement (CQI) is important for the establishment and functioning of CDUs. CQI in CDUs has many advantages: better CDU functioning, fulfillment of Joint Commission on Accreditation of Healthcare Organizations mandates, greater efficiency/productivity, increased job satisfaction, better performance improvement, data availability, and benchmarking. Key elements include a database with volume indicators, operational policies, clinical practice protocols (diagnosis specific/condition specific), monitors, benchmarks, and clinical pathways. Examples of these important parameters are given. The CQI process should be individualized for each CDU and hospital.

Accreditation of Medical Education Programs: Moving From Student Outcomes to Continuous Quality Improvement Measures.

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Blouin, Danielle; Tekian, Ara

2018-03-01

Accreditation of undergraduate medical education programs aims to ensure the quality of medical education and promote quality improvement, with the ultimate goal of providing optimal patient care. Direct linkages between accreditation and education quality are, however, difficult to establish. The literature examining the impact of accreditation predominantly focuses on student outcomes, such as performances on national examinations. However, student outcomes present challenges with regard to data availability, comparability, and contamination.The true impact of accreditation may well rest in its ability to promote continuous quality improvement (CQI) within medical education programs. The conceptual model grounding this paper suggests accreditation leads medical schools to commit resources to and engage in self-assessment activities that represent best practices of CQI, leading to the development within schools of a culture of CQI. In line with this model, measures of the impact of accreditation on medical schools need to include CQI-related markers. The CQI orientation of organizations can be measured using validated instruments from the business and management fields. Repeated determinations of medical schools' CQI orientation at various points throughout their accreditation cycles could provide additional evidence of the impact of accreditation on medical education. Strong CQI orientation should lead to high-quality medical education and would serve as a proxy marker for the quality of graduates and possibly for the quality of care they provide.It is time to move away from a focus on student outcomes as measures of the impact of accreditation and embrace additional markers, such as indicators of organizational CQI orientation.

Identifying effective pathways in a successful continuous quality improvement programme: the GEDAPS study.

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Bodicoat, Danielle H; Mundet, Xavier; Gray, Laura J; Cos, Xavier; Davies, Melanie J; Khunti, Kamlesh; Cano, Juan-Franciso

2014-12-01

Continuous quality improvement programmes often target several aspects of care, some of which may be more effective meaning that resources could be focussed on these. The objective was to identify the effective and ineffective aspects of a successful continuous quality improvement programme for individuals with type 2 diabetes in primary care. Data were from a series of cross-sectional studies (GEDAPS) in primary care, Catalonia, Spain, in 55 centres (2239 participants) in 1993, and 92 centres (5819 participants) in 2002. A structural equation modelling approach was used. The intervention was associated with improved microvascular outcomes through microalbuminuria and funduscopy screening, which had a direct effect on microvascular outcomes, and through attending 2-4 nurse visits and having ≥1 blood pressure measurement, which acted through reducing systolic blood pressure. The intervention was associated with improved macrovascular outcomes through blood pressure measurement and attending 2-4 nurse visits (through systolic blood pressure) and having ≥3 education topics, ≥1 HbA1c measurement and adequate medication (through HbA1c). Cholesterol measurement, weight measurement and foot examination did not contribute towards the effectiveness of the intervention. The pathways through which a continuous quality improvement programme appeared to act to reduce microvascular and macrovascular complications were driven by reductions in systolic blood pressure and HbA1c, which were attained through changes in nurse and education visits, measurement and medication. This suggests that these factors are potential areas on which future quality improvement programmes should focus. © 2014 John Wiley & Sons, Ltd.

Continuous quality improvement in the ambulatory endoscopy center.

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Johanson, John F

2002-04-01

of improvement. Second, learning must be viewed as a process. A quality improvement plan that is successful in one setting may not be as favorable in another situation. Clinicians must be able to focus on their individual situations and adapt what others have implemented to their own practice. Third, the most important aspect of the quality improvement is the implementation step. It matters little if elegant studies of endoscopic complications or patient satisfaction are completed if the information is not used to improve the delivery of health care to every single patient. The delivery of medical care continues to evolve. Resources are becoming increasingly scarce and the progressive rise of health care expenditures suggests a need for control. In this zeal for cost constraint, quality must not be sacrificed. This new-found attention to quality must be extended to the level of the individual practitioner to ensure that individual patients' interests are protected and the best possible care is delivered regardless of the economic implications. As providers of health care, endoscopists need to take an active role in these efforts both in understanding and implementing the techniques of quality assessment into their practices. If physicians are not actively involved in data collection and measurement to improve the quality and value of their own work, someone else will undoubtedly assume this role.

A continuous quality improvement program to focus a college of pharmacy on programmatic advancement.

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Hall, Philip D; Dipiro, Joseph T; Rowen, Randall C; McNair, David

2013-08-12

To enhance the achievement of a college of pharmacy's goals for education, research, and service missions by implementing an excellence program based on the Studer Group model for continuous quality improvement. The Studer model was combined with university strategic planning for a comprehensive quality-improvement program that was implemented over 5 years. The program included identifying and measuring key performance indicators, establishing specific "pillar" goals, aligning behaviors with goals and values, and training leaders. Assessment of key performance indicators over 5 years demonstrated progress toward achieving college goals for student and faculty satisfaction, research funding, numbers of students seeking formal postgraduate training, and private giving. Implementation of a continuous quality-improvement program based on the Studer program enabled the college to focus on and meet its yearly and strategic goals for all components of its mission.

A Report Card on Continuous Quality Improvement

Science.gov (United States)

Blumenthal, David; Kilo, Charles M.

1998-01-01

Efforts to incorporate the principles of continuous quality improvement (CQI) into health care have been underway for about ten years. In order to understand the lessons of this decade of experience, senior organizational leaders and experts in the field of health care were interviewed. This select group agreed that there have been concrete accomplishments: the tactic of assigning blame for mistakes to individuals is gradually giving way to an emphasis on detecting problems with process; there is a new focus on the health care customer; and many valuable projects have been inaugurated. Nevertheless, the interviews underlined the reality that the movement has not yet made a sizable impact on the U.S. health care system. Until there is a profound, organization-wide recognition of the need for change, universal commitment to CQI principles will not be achieved. PMID:9879305

Effects of High-Intensity Interval Training versus Continuous Training on Physical Fitness, Cardiovascular Function and Quality of Life in Heart Failure Patients.

Directory of Open Access Journals (Sweden)

Nathalie M M Benda

Full Text Available Physical fitness is an important prognostic factor in heart failure (HF. To improve fitness, different types of exercise have been explored, with recent focus on high-intensity interval training (HIT. We comprehensively compared effects of HIT versus continuous training (CT in HF patients NYHA II-III on physical fitness, cardiovascular function and structure, and quality of life, and hypothesize that HIT leads to superior improvements compared to CT.Twenty HF patients (male:female 19:1, 64±8 yrs, ejection fraction 38±6% were allocated to 12-weeks of HIT (10*1-minute at 90% maximal workload-alternated by 2.5 minutes at 30% maximal workload or CT (30 minutes at 60-75% of maximal workload. Before and after intervention, we examined physical fitness (incremental cycling test, cardiac function and structure (echocardiography, vascular function and structure (ultrasound and quality of life (SF-36, Minnesota living with HF questionnaire (MLHFQ.Training improved maximal workload, peak oxygen uptake (VO2peak related to the predicted VO2peak, oxygen uptake at the anaerobic threshold, and maximal oxygen pulse (all P<0.05, whilst no differences were present between HIT and CT (N.S.. We found no major changes in resting cardiovascular function and structure. SF-36 physical function score improved after training (P<0.05, whilst SF-36 total score and MLHFQ did not change after training (N.S..Training induced significant improvements in parameters of physical fitness, although no evidence for superiority of HIT over CT was demonstrated. No major effect of training was found on cardiovascular structure and function or quality of life in HF patients NYHA II-III.Nederlands Trial Register NTR3671.

The association between event learning and continuous quality improvement programs and culture of patient safety.

Science.gov (United States)

Mazur, Lukasz; Chera, Bhishamjit; Mosaly, Prithima; Taylor, Kinley; Tracton, Gregg; Johnson, Kendra; Comitz, Elizabeth; Adams, Robert; Pooya, Pegah; Ivy, Julie; Rockwell, John; Marks, Lawrence B

2015-01-01

To present our approach and results from our quality and safety program and to report their possible impact on our culture of patient safety. We created an event learning system (termed a "good catch" program) and encouraged staff to report any quality or safety concerns in real time. Events were analyzed to assess the utility of safety barriers. A formal continuous quality improvement program was created to address these reported events and make improvements. Data on perceptions of the culture of patient safety were collected using the Agency for Health Care Research and Quality survey administered before, during, and after the initiatives. Of 560 good catches reported, 367 could be ascribed to a specific step on our process map. The calculated utility of safety barriers was highest for those embedded into the pretreatment quality assurance checks performed by physicists and dosimetrists (utility score 0.53; 93 of 174) and routine checks done by therapists on the initial day of therapy. Therapists and physicists reported the highest number of good catches (24% each). Sixty-four percent of events were caused by performance issues (eg, not following standardized processes, including suboptimal communications). Of 31 initiated formal improvement events, 26 were successfully implemented and sustained, 4 were discontinued, and 1 was not implemented. Most of the continuous quality improvement program was conducted by nurses (14) and therapists (7). Percentages of positive responses in the patient safety culture survey appear to have increased on all dimensions (p continuous quality improvement programs can be successfully implemented and that there are contemporaneous improvements in the culture of safety. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Responses of Aboriginal and Torres Strait Islander Primary Health-Care Services to Continuous Quality Improvement Initiatives.

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Larkins, Sarah; Woods, Cindy E; Matthews, Veronica; Thompson, Sandra C; Schierhout, Gill; Mitropoulos, Maxwell; Patrao, Tania; Panzera, Annette; Bailie, Ross Stewart

2015-01-01

Indigenous primary health-care (PHC) services participating in continuous quality improvement (CQI) cycles show varying patterns of performance over time. Understanding this variation is essential to scaling up and sustaining quality improvement initiatives. The aim of this study is to examine trends in quality of care for services participating in the ABCD National Research Partnership and describe patterns of change over time and examine health service characteristics associated with positive and negative trends in quality of care. PHC services providing care for Indigenous people in urban, rural, and remote northern Australia that had completed at least three annual audits of service delivery for at least one aspect of care (n = 73). Longitudinal clinical audit data from use of four clinical audit tools (maternal health, child health, preventive health, Type 2 diabetes) between 2005 and 2013 were analyzed. Health center performance was classified into six patterns of change over time: consistent high improvement (positive), sustained high performance (positive), decline (negative), marked variability (negative), consistent low performance (negative), and no specific increase or decrease (neutral). Backwards stepwise multiple logistic regression analyses were used to examine the associations between health service characteristics and positive or negative trends in quality of care. Trends in quality of care varied widely between health services across the four audit tools. Regression analyses of health service characteristics revealed no consistent statistically significant associations of population size, remoteness, governance model, or accreditation status with positive or negative trends in quality of care. The variable trends in quality of care as reflected by CQI audit tools do not appear to be related to easily measurable health service characteristics. This points to the need for a deeper or more nuanced understanding of factors that moderate the

Defining quality criteria for online continuing medical education modules using modified nominal group technique.

Science.gov (United States)

Shortt, S E D; Guillemette, Jean-Marc; Duncan, Anne Marie; Kirby, Frances

2010-01-01

The rapid increase in the use of the Internet for continuing education by physicians suggests the need to define quality criteria for accredited online modules. Continuing medical education (CME) directors from Canadian medical schools and academic researchers participated in a consensus process, Modified Nominal Group Technique, to develop agreement on the most important quality criteria to guide module development. Rankings were compared to responses to a survey of a subset of Canadian Medical Association (CMA) members. A list of 17 items was developed, of which 10 were deemed by experts to be important and 7 were considered secondary. A quality module would: be needs-based; presented in a clinical format; utilize evidence-based information; permit interaction with content and experts; facilitate and attempt to document practice change; be accessible for later review; and include a robust course evaluation. There was less agreement among CMA members on criteria ranking, with consensus on ranking reached on only 12 of 17 items. In contrast to experts, members agreed that the need to assess performance change as a result of an educational experience was not important. This project identified 10 quality criteria for accredited online CME modules that representatives of Canadian organizations involved in continuing education believe should be taken into account when developing learning products. The lack of practitioner support for documentation of change in clinical behavior may suggest that they favor traditional attendance- or completion-based CME; this finding requires further research.

Improving Reference Service: The Case for Using a Continuous Quality Improvement Method.

Science.gov (United States)

Aluri, Rao

1993-01-01

Discusses the evaluation of library reference service; examines problems with past evaluations, including the lack of long-term planning and a systems perspective; and suggests a method for continuously monitoring and improving reference service using quality improvement tools such as checklists, cause and effect diagrams, Pareto charts, and…

Perioperative Care and the Importance of Continuous Quality Improvement--A Controlled Intervention Study in Three Tanzanian Hospitals.

Science.gov (United States)

Bosse, Goetz; Abels, Wiltrud; Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus-Dieter; Spies, Claudia

2015-01-01

Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, pcontrol group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p hospital declined (1.89% before intervention; 0.96% after intervention, p = 0.006). Surgical Case Fatality Rate in the intervention hospital declined from 5.67% before intervention to 2.93% after intervention (pcontrol group was 4% before intervention and 3.8% after intervention (p = 0.411). Anaesthetic Complication Rate in the control group was not available. Immediate outcome indicators initially improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach.

[Quality management is associated with high quality services in health care].

Science.gov (United States)

Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn

2013-12-09

In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.

Quality assurance during fabrication of high-damping rubber isolation bearings

Energy Technology Data Exchange (ETDEWEB)

Way, D.; Greaves, W.C. [Base Isolation Consultants, Inc., San Francisco, CA (United States)

1995-12-01

Successful implementation of a high-damping rubber (HDR) base isolation project requires the application of Quality Assurance/Quality Control (QA/QC) methodology through all phases of the bearing fabrication process. HDR base isolation bearings must be fabricated with uniform physical characteristics while being produced in large quantities. To satisfy this requirement, manufacturing processes must be controlled. Prototype tests that include dynamic testing of small samples of rubber are necessary. Stringent full scale bearing testing must be carried out prior to beginning production, during which manufacturing is strictly regulated by small rubber sample and production bearing testing. All such activities should be supervised and continuously inspected by independent and experienced QA/QC personnel.

A method of quality control in continuous for the thyroid hormones radioimmunoassay

International Nuclear Information System (INIS)

Savoie, J.C.; Kawadry, G.; Leger, F.A.; Hantour, Z.; Baulieu, J.L.

1980-01-01

The exploration of the thyroid function requires nowadays the T4, T3 and TSH radioimmunoassays. These assays, performed several times each week, raise the problem as to how control the quality of every new series and of every result. The authors describe the principle features of a program devised to automatically control 'in continuous' the quality of the radioimmunoassays. This program was developed on a SIMIS 3-INFORMATEK system. It is derived from Rodbard's work, uses Logit-Log transformation and ensures the consistent interseries control of many characteristic parameters. No series nor individual results are exploited i.e. edited without prior control of quality a decision from which is made to validate or reject. This program is but one solution -among many others possible- corresponding to a necessity: the need presently felt and perhaps to-morrow requested for some permanent quality control of the results of radioimmunoassays [fr

Continuous and discrete water-quality data collected at five sites on Lake Houston near Houston, Texas, 2006-08

Science.gov (United States)

Beussink, Amy M.; Burnich, Michael R.

2009-01-01

Lake Houston, a reservoir impounded in 1954 by the City of Houston, Texas, is a primary source of drinking water for Houston and surrounding areas. The U.S. Geological Survey, in cooperation with the City of Houston, developed a continuous water-quality monitoring network to track daily changes in water quality in the southwestern quadrant of Lake Houston beginning in 2006. Continuous water-quality data (the physiochemical properties water temperature, specific conductance, pH, dissolved oxygen concentration, and turbidity) were collected from Lake Houston to characterize the in-lake processes that affect water quality. Continuous data were collected hourly from mobile, multi-depth monitoring stations developed and constructed by the U.S. Geological Survey. Multi-depth monitoring stations were installed at five sites in three general locations in the southwestern quadrant of the lake. Discrete water-quality data (samples) were collected routinely (once or twice each month) at all sites to characterize the chemical and biological (phytoplankton and bacteria) response to changes in the continuous water-quality properties. Physiochemical properties (the five continuously monitored plus transparency) were measured in the field when samples were collected. In addition to the routine samples, discrete water-quality samples were collected synoptically (one or two times during the study period) at all sites to determine the presence and levels of selected constituents not analyzed in routine samples. Routine samples were measured or analyzed for acid neutralizing capacity; selected major ions and trace elements (calcium, silica, and manganese); nutrients (filtered and total ammonia nitrogen, filtered nitrate plus nitrite nitrogen, total nitrate nitrogen, filtered and total nitrite nitrogen, filtered and total orthophosphate phosphorus, total phosphorus, total nitrogen, total organic carbon); fecal indicator bacteria (total coliform and Escherichia coli); sediment

A global survey of clinicians' awareness, accessibility, utilization of e-continuous education, and quality of clinical blood use: policy considerations

Directory of Open Access Journals (Sweden)

Smit Sibinga CT

2017-07-01

Full Text Available Cees Th Smit Sibinga,1 Maruff A Oladejo,2 Olamide Hakeem Adejumo,3 Quentin Eichbaum,4 Midori Kumagawa,5 Shuichi Kino,5 Sima Zolfaghari,6 Silvano Wendel,7 Gordana Rasovic,8 Namjil Erdenebayar,9 Maya Makhmudova,10 Loyiso Mpuntsha,11 Charlotte Ingram,11 Bakyt B Kharabaev,12 Isaac Kajja,13 Zainab Mukhtar Hussain Sanji,14 Maria M M Satti15 1IQM Consulting for International Development of Quality Management in Transfusion Medicine, University of Groningen, Groningen, the Netherlands; 2Department of Educational Management, University of Lagos, Lagos, 3Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria; 4Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA; 5Japanese Red Cross Hokkaido Block Blood Center, Japan; 6IBTO, Tehran, Iran; 7Blood Bank, Hospital Sirio Libanês, Sao Paulo, Brazil; 8Montenegro National Blood Transfusion Center, Podgorica, Montenegro; 9National Center for Transfusion Medicine, Ulaanbaatar, Mongolia; 10Consultant IQM Consulting, Tashkent, Uzbekistan; 11South Africa National Blood Transfusion Service, Johannesburg, South Africa; 12National Blood Transfusion Service, Bishkek, Kyrgyzstan; 13Department of Orthopedics, Mulago Hospital, Makerere University, Uganda; 14Consultant, Dow University of Health Sciences, Karachi, Pakistan; 15National Blood Transfusion Service, Khartoum, Sudan Introduction: Clinical use of blood has shown the least developed part in the vein-to-vein transfusion chain. This global study was carried out in order to investigate the level of awareness, accessibility and utilization of continuous e-learning and education, and quality of blood use among blood prescribing clinicians and nurses.Approach: Descriptive ex post facto survey design.Methods: A total of 264 purposively selected blood prescribing clinicians and nurses from the four Human Development Index (HDI groups of countries (low, medium, high, and very high participated in this study

Continuous software quality analysis for the ATLAS experiment

CERN Document Server

Washbrook, Andrew; The ATLAS collaboration

2017-01-01

The software for the ATLAS experiment on the Large Hadron Collider at CERN has evolved over many years to meet the demands of Monte Carlo simulation, particle detector reconstruction and data analysis. At present over 3.8 million lines of C++ code (and close to 6 million total lines of code) are maintained by an active worldwide developer community. In order to run the experiment software efficiently at hundreds of computing centres it is essential to maintain a high level of software quality standards. The methods proposed to improve software quality practices by incorporating checks into the new ATLAS software build infrastructure.

QUALITY ASSURANCE IN CONTINUING ADULT EDUCATION: FROM THE EUROPEAN TO THE NATIONAL LEVEL

Directory of Open Access Journals (Sweden)

Nina Aniskina

2015-11-01

Full Text Available The paper is devoted to the process of formation of competences professional, social, and personal as a component of the process of continuing adult education. The quality assurance model for this process is presented considering the international and Russian experience.

Employing continuous quality improvement in community-based substance abuse programs.

Science.gov (United States)

Chinman, Matthew; Hunter, Sarah B; Ebener, Patricia

2012-01-01

This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community-based organization setting. CQI (e.g., plan-do-study-act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine-month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined. Results indicated that CQI was feasible and acceptable for community-based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes. The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes. Practical implications- This project shows that it is feasible to adapt CQI techniques and processes for community-based programs substance abuse prevention and treatment programs. These techniques may help community-based program managers to improve service quality and achieve program outcomes. This is one of the first studies to adapt traditional CQI techniques for community-based settings delivering substance abuse prevention and treatment programs.

Moderator/collimator for a proton/deuteron linac to produce a high-intensity, high-quality thermal neutron beam for neutron radiography

International Nuclear Information System (INIS)

Singleterry, R.C. Jr.; Imel, G.R.; McMichael, G.E.

1995-01-01

Reactor based high resolution neutron radiography facilities are able to deliver a well-collimated (L/D ≥100) thermal flux of 10 6 n/cm 2 ·sec to an image plane. This is well in excess of that achievable with the present accelerator based systems such as sealed tube D-T sources, Van der Graaff's, small cyclotrons, or low duty factor linacs. However, continuous wave linacs can accelerate tens of milliamperes of protons to 2.5 to 4 MeV. The MCNP code has been used to analyze target/moderator configurations that could be used with Argonne's Continuous Wave Linac (ACWL). These analyses have shown that ACWL could be modified to generate a neutron beam that has a high intensity and is of high quality

How can we recognize continuous quality improvement?

Science.gov (United States)

Rubenstein, Lisa; Khodyakov, Dmitry; Hempel, Susanne; Danz, Margie; Salem-Schatz, Susanne; Foy, Robbie; O'Neill, Sean; Dalal, Siddhartha; Shekelle, Paul

2014-02-01

Continuous quality improvement (CQI) methods are foundational approaches to improving healthcare delivery. Publications using the term CQI, however, are methodologically heterogeneous, and labels other than CQI are used to signify relevant approaches. Standards for identifying the use of CQI based on its key methodological features could enable more effective learning across quality improvement (QI) efforts. The objective was to identify essential methodological features for recognizing CQI. Previous work with a 12-member international expert panel identified reliably abstracted CQI methodological features. We tested which features met rigorous a priori standards as essential features of CQI using a three-phase online modified-Delphi process. Primarily United States and Canada. 119 QI experts randomly assigned into four on-line panels. Participants rated CQI features and discussed their answers using online, anonymous and asynchronous discussion boards. We analyzed ratings quantitatively and discussion threads qualitatively. Main outcome measure(s) Panel consensus on definitional CQI features. /st> Seventy-nine (66%) panelists completed the process. Thirty-three completers self-identified as QI researchers, 18 as QI practitioners and 28 as both equally. The features 'systematic data guided activities,' 'designing with local conditions in mind' and 'iterative development and testing' met a priori standards as essential CQI features. Qualitative analyses showed cross-cutting themes focused on differences between QI and CQI. We found consensus among a broad group of CQI researchers and practitioners on three features as essential for identifying QI work more specifically as 'CQI.' All three features are needed as a minimum standard for recognizing CQI methods.

High-precision terahertz frequency modulated continuous wave imaging method using continuous wavelet transform

Science.gov (United States)

Zhou, Yu; Wang, Tianyi; Dai, Bing; Li, Wenjun; Wang, Wei; You, Chengwu; Wang, Kejia; Liu, Jinsong; Wang, Shenglie; Yang, Zhengang

2018-02-01

Inspired by the extensive application of terahertz (THz) imaging technologies in the field of aerospace, we exploit a THz frequency modulated continuous-wave imaging method with continuous wavelet transform (CWT) algorithm to detect a multilayer heat shield made of special materials. This method uses the frequency modulation continuous-wave system to catch the reflected THz signal and then process the image data by the CWT with different basis functions. By calculating the sizes of the defects area in the final images and then comparing the results with real samples, a practical high-precision THz imaging method is demonstrated. Our method can be an effective tool for the THz nondestructive testing of composites, drugs, and some cultural heritages.

High temperature continuous operation in the HTTR (HP-11). Summary of the test results in the high temperature operation mode

International Nuclear Information System (INIS)

Takamatsu, Kuniyoshi; Ueta, Shohei; Sumita, Junya; Goto, Minoru; Nakagawa, Shigeaki; Hamamoto, Shimpei; Tochio, Daisuke

2010-11-01

A high temperature (950 degrees C) continuous operation has been performed for 50 days on the HTTR from January to March in 2010, and the potential to supply stable heat of high temperature for hydrogen production for a long time was demonstrated for the first time in the world. JAEA has evaluated the experimental data obtained by this operation and past rated continuous one, and built the database necessary for commercial HTGRs. According to the results, the concentration of FP released from the fuels in the HTTR was a single through triple-digit lower than that in the foreign HTGRs. It became apparent that the fuels used in the HTTR are the best quality in the world. This successful operation could establish technological basis of HTGRs and show potential of nuclear energy as heat source for innovative thermo-chemical-based hydrogen production, emitting greenhouse gases on a 'low-carbon path' for the first time in the world. We have a plan to progress R and D for practical use of hydrogen production system with HTGRs in the future. (author)

Quality Time: Temporal Constraints to Continual Process Development in the Air Force

Science.gov (United States)

2017-06-01

Simultaneously , forces of entropy or chaos continually degrade the efficiency of that same system. The strength and speed with which quality management...cause impact in the same direction (negative or inverse ) and logically result in a less-efficient unit. The SD concept of clustering variables behavior...working overtime but simultaneously maintaining morale. 30 Recall this test case was establish to test the logical

Mesoporous Bragg reflectors: block-copolymer self-assembly leads to building blocks with well defined continuous pores and high control over optical properties

KAUST Repository

Guldin, S.; Kolle, M.; Stefik, M.; Wiesner, U.; Steiner, U.

2011-01-01

dened. Following a 30 min annealing protocol after each layer deposition enables the fast and reliable stacking of MDBRs which exhibit a continuous TiO2 network with large accessible pores and high optical quality.

Continuous quality improvement in a Maltese hospital using logical framework analysis.

Science.gov (United States)

Buttigieg, Sandra C; Gauci, Dorothy; Dey, Prasanta

2016-10-10

Purpose The purpose of this paper is to present the application of logical framework analysis (LFA) for implementing continuous quality improvement (CQI) across multiple settings in a tertiary care hospital. Design/methodology/approach This study adopts a multiple case study approach. LFA is implemented within three diverse settings, namely, intensive care unit, surgical ward, and acute in-patient psychiatric ward. First, problem trees are developed in order to determine the root causes of quality issues, specific to the three settings. Second, objective trees are formed suggesting solutions to the quality issues. Third, project plan template using logical framework (LOGFRAME) is created for each setting. Findings This study shows substantial improvement in quality across the three settings. LFA proved to be effective to analyse quality issues and suggest improvement measures objectively. Research limitations/implications This paper applies LFA in specific, albeit, diverse settings in one hospital. For validation purposes, it would be ideal to analyse in other settings within the same hospital, as well as in several hospitals. It also adopts a bottom-up approach when this can be triangulated with other sources of data. Practical implications LFA enables top management to obtain an integrated view of performance. It also provides a basis for further quantitative research on quality management through the identification of key performance indicators and facilitates the development of a business case for improvement. Originality/value LFA is a novel approach for the implementation of CQI programs. Although LFA has been used extensively for project development to source funds from development banks, its application in quality improvement within healthcare projects is scant.

Safety implications of standardized continuous quality improvement programs in community pharmacy.

Science.gov (United States)

Boyle, Todd A; Ho, Certina; Mackinnon, Neil J; Mahaffey, Thomas; Taylor, Jeffrey M

2013-06-01

Standardized continuous quality improvement (CQI) programs combine Web-based technologies and standardized improvement processes, tools, and expectations to enable quality-related events (QREs) occurring in individual pharmacies to be shared with pharmacies in other jurisdictions. Because standardized CQI programs are still new to community pharmacy, little is known about how they impact medication safety. This research identifies key aspects of medication safety that change as a result of implementing a standardized CQI program. Fifty-three community pharmacies in Nova Scotia, Canada, adopted the SafetyNET-Rx standardized CQI program in April 2010. The Institute for Safe Medication Practices (ISMP) Canada's Medication Safety Self-Assessment (MSSA) survey was administered to these pharmacies before and 1 year into their use of the SafetyNET-Rx program. The nonparametric Wilcoxon signed-rank test was used to explore where changes in patient safety occurred as a result of SafetyNETRx use. Significant improvements occurred with quality processes and risk management, staff competence, and education, and communication of drug orders and other information. Patient education, environmental factors, and the use of devices did not show statistically significant changes. As CQI programs are designed to share learning from QREs, it is reassuring to see that the largest improvements are related to quality processes, risk management, staff competence, and education.

Study of relation of continuing medical education to quality of family physicians' care.

Science.gov (United States)

Dunn, E V; Bass, M J; Williams, J I; Borgiel, A E; MacDonald, P; Spasoff, R A

1988-10-01

A random sample of 120 physicians in Ontario was studied to assess quality of care in primary care and test an hypothesis that quality of care was related to continuing medical education (CME) activities. The quality-of-care scores were obtained by an in-office audit of a random selection of charts. The scores were global scores for charting, prevention, the use of 13 classes of drugs, and care of a two-year period for 182 different diagnoses. There were no relationships between global quality-of-care scores based on these randomly chosen charts and either the type or quantity of the physicians' CME activities. These activities were reading journals, attending rounds, attending scientific conferences, having informal consultations, using audio and video cassettes, and engaging in self-assessment. The implications of these findings are significant for future research in CME and for planners of present CME programs.

Factors Influencing Team Performance in a Continuous Quality Improvement Process in the Wisconsin Technical College System

Science.gov (United States)

Pietz, Victoria Lynn

2014-01-01

Continuous Quality Improvement (CQI) programs are growing in popularity in higher education settings and a key component is the use of work groups, which require active employee involvement. The problem addressed in this research was the lack of employee engagement in the Quality Review Process (QRP), which is a statewide CQI model developed by…

Pump Early, Pump Often: A Continuous Quality Improvement Project.

Science.gov (United States)

Spatz, Diane L; Froh, Elizabeth B; Schwarz, Jessica; Houng, Kathy; Brewster, Isabel; Myers, Carey; Prince, Judy; Olkkola, Michelle

2015-01-01

Research demonstrates that although many mothers initiate pumping for their critically ill children, few women are successful at maintaining milk supply throughout their infants' entire hospital stay. At the Garbose Family Special Delivery Unit (SDU) at the Children's Hospital of Philadelphia, we care for mothers who have critically ill infants born with complex cardiac and congenital anomalies. Human milk is viewed as a medical intervention at our institution. Therefore, nurses on the SDU wanted to ensure best practice in terms of pumping initiation. This article describes a continuous quality improvement project that ensured mothers pumped early and often. Childbirth educators can play a key role in preparing mothers who are anticipating an infant who will require hospitalization immediately post-birth.

Compression planning for continuous improvement in quality programs

International Nuclear Information System (INIS)

Willis, Y.A.; Hood, F.C.

1992-01-01

This paper describes Compression Planning, an innovative approach for planning in groups. This participative and structured approach is especially suitable for technical and highly regulated organizations. Compression Planning was applied to the first organization-wide effort at training integration for regulatory compliance, at Battelle Pacific Northwest Laboratory (PNL), a multi-program national laboratory. The planning process was judged as measurably superior to PNL's customary planning. Within 10 days a training policy was issued and an action plan drafted. The participants produced a report identifying and prioritizing 33 key training issues; began to data gather and solicit input from personnel Lab-wide, producing a 2-volume training inventory; and formulated 14 recommendations for implementation. Two years later the plan is still evolving, as PNL training continues to develop, consistent with Continuous Improvement Process objectives

Quality comparison of continuous steam sterilization segmented-flow aseptic processing versus conventional canning of whole and sliced mushrooms.

Science.gov (United States)

Anderson, N M; Walker, P N

2011-08-01

This study was carried out to investigate segmented-flow aseptic processing of particle foods. A pilot-scale continuous steam sterilization unit capable of producing shelf stable aseptically processed whole and sliced mushrooms was developed. The system utilized pressurized steam as the heating medium to achieve high temperature-short time processing conditions with high and uniform heat transfer that will enable static temperature penetration studies for process development. Segmented-flow technology produced a narrower residence time distribution than pipe-flow aseptic processing; thus, whole and sliced mushrooms were processed only as long as needed to achieve the target F₀  = 7.0 min and were not overcooked. Continuous steam sterilization segmented-flow aseptic processing produced shelf stable aseptically processed mushrooms of superior quality to conventionally canned mushrooms. When compared to conventionally canned mushrooms, aseptically processed yield (weight basis) increased 6.1% (SD = 2.9%) and 6.6% (SD = 2.2%), whiteness (L) improved 3.1% (SD = 1.9%) and 4.7% (SD = 0.7%), color difference (ΔE) improved 6.0% (SD = 1.3%) and 8.5% (SD = 1.5%), and texture improved 3.9% (SD = 1.7%) and 4.6% (SD = 4.2%), for whole and sliced mushrooms, respectively. Segmented-flow aseptic processing eliminated a separate blanching step, eliminated the unnecessary packaging of water and promoted the use of bag-in-box and other versatile aseptic packaging methods. Segmented-flow aseptic processing is capable of producing shelf stable aseptically processed particle foods of superior quality to a conventionally canned product. This unique continuous steam sterilization process eliminates the need for a separate blanching step, reduces or eliminates the need for a liquid carrier, and promotes the use of bag-in-box and other versatile aseptic packaging methods. © 2011 Institute of Food Technologists®

Performance indicators: A tool for continuous quality improvement

Directory of Open Access Journals (Sweden)

Nidhi M Bhatnagar

2016-01-01

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

Performance indicators: A tool for continuous quality improvement.

Science.gov (United States)

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

2016-01-01

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

78 FR 72863 - Circular Welded Carbon-Quality Steel Pipe From the People's Republic of China: Continuation of...

Science.gov (United States)

2013-12-04

...-Quality Steel Pipe From the People's Republic of China: Continuation of Antidumping Duty Order AGENCY... circular welded carbon-quality steel pipe (``circular welded pipe'') from the People's Republic of China...\\ See Initiation of Five-Year (``Sunset'') Review, 78 FR 33063 (June 3, 2013). \\2\\ See Circular Welded...

Intergenerational continuity in high conflict family environments

Science.gov (United States)

Rothenberg, W. Andrew; Hussong, Andrea M.; Chassin, Laurie

2016-01-01

In the current study, we examined continuity in conflict across generations and explored potential mediators and moderators that could explain this continuity. We followed 246 targets from adolescence to adulthood and examined family conflict as reported by multiple reporters in targets' family of origin and current families. Results showed that conflict in the current family was strongly correlated with that of the family of origin in women but not in men. Continuity in family conflict across generations was mediated by patterns of elevated adolescent externalizing behavior in members of the second generation (G2). Additionally, analyses revealed an interaction between both G2 partners' externalizing behavior such that if one partner in the G2 family demonstrated high levels of externalizing behavior, elevated levels of family conflict resulted. Potential explanations and implications of these findings are considered. PMID:26018605

78 FR 72863 - Circular Welded Carbon Quality Steel Pipe From the People's Republic of China: Continuation of...

Science.gov (United States)

2013-12-04

... Quality Steel Pipe From the People's Republic of China: Continuation of Countervailing Duty Order AGENCY...) from the People's Republic of China (PRC) would likely lead to continuation or recurrence of net... reasonably foreseeable time.\\3\\ \\1\\ See Initiation of Five-Year (``Sunset'') Review, 78 FR 33063 (June 3...

High-quality compressive ghost imaging

Science.gov (United States)

Huang, Heyan; Zhou, Cheng; Tian, Tian; Liu, Dongqi; Song, Lijun

2018-04-01

We propose a high-quality compressive ghost imaging method based on projected Landweber regularization and guided filter, which effectively reduce the undersampling noise and improve the resolution. In our scheme, the original object is reconstructed by decomposing of regularization and denoising steps instead of solving a minimization problem in compressive reconstruction process. The simulation and experimental results show that our method can obtain high ghost imaging quality in terms of PSNR and visual observation.

High Yield Chemical Vapor Deposition Growth of High Quality Large-Area AB Stacked Bilayer Graphene

Science.gov (United States)

Liu, Lixin; Zhou, Hailong; Cheng, Rui; Yu, Woo Jong; Liu, Yuan; Chen, Yu; Shaw, Jonathan; Zhong, Xing; Huang, Yu; Duan, Xiangfeng

2012-01-01

Bernal stacked (AB stacked) bilayer graphene is of significant interest for functional electronic and photonic devices due to the feasibility to continuously tune its band gap with a vertical electrical field. Mechanical exfoliation can be used to produce AB stacked bilayer graphene flakes but typically with the sizes limited to a few micrometers. Chemical vapor deposition (CVD) has been recently explored for the synthesis of bilayer graphene but usually with limited coverage and a mixture of AB and randomly stacked structures. Herein we report a rational approach to produce large-area high quality AB stacked bilayer graphene. We show that the self-limiting effect of graphene growth on Cu foil can be broken by using a high H2/CH4 ratio in a low pressure CVD process to enable the continued growth of bilayer graphene. A high temperature and low pressure nucleation step is found to be critical for the formation of bilayer graphene nuclei with high AB stacking ratio. A rational design of a two-step CVD process is developed for the growth of bilayer graphene with high AB stacking ratio (up to 90 %) and high coverage (up to 99 %). The electrical transport studies demonstrated that devices made of the as-grown bilayer graphene exhibit typical characteristics of AB stacked bilayer graphene with the highest carrier mobility exceeding 4,000 cm2/V·s at room temperature, comparable to that of the exfoliated bilayer graphene. PMID:22906199

Influences of continuous femoral nerve block on knee function and quality of life in patients following total knee arthroplasty.

Science.gov (United States)

Wang, Fen; Zhou, Yingjie; Sun, Jiajun; Yang, Chunxi

2015-01-01

Continuous femoral nerve block (CFNB), guided by ultrasound combined nerve stimulations, offers advantages for both sides and provides effective postoperative analgesia after total knee arthroplasty (TKA). The objective of this study was to evaluate the medium-term impact of continuous femoral nerve block on knee function and quality of life in patients following TKA. This was a follow-up study. Total 168 adult patients scheduled for elective TKA were randomly allocated to receive postoperative continuous femoral nerve block guided by ultrasound combined nerve stimulator (group CFNB, n = 82) or patient-controlled epidural analgesia (group PCEA, n = 86). Quality of life, knee function, patient satisfaction, pain medication and associated adverse effects were compared at 1, 3, 6, and 12 months postoperatively. Quality of life was assessed using the Medical Outcomes Study Short Form-36 Health Survey (MOS SF-36), and clinical results were assessed using the Hospital for Special Surgery (HSS) Knee Scoring System. Patient satisfaction scores were divided into four categories. A total of 162 patients completed the 12-month follow-up. The CFNB group patients had significantly improved SF-36 scores and physical function at 1 month postoperatively (P quality of life in patients at one month postoperatively. Continuous femoral nerve block is a good choice for postoperative analgesia after TKA.

Software product quality control

CERN Document Server

Wagner, Stefan

2013-01-01

Quality is not a fixed or universal property of software; it depends on the context and goals of its stakeholders. Hence, when you want to develop a high-quality software system, the first step must be a clear and precise specification of quality. Yet even if you get it right and complete, you can be sure that it will become invalid over time. So the only solution is continuous quality control: the steady and explicit evaluation of a product's properties with respect to its updated quality goals.This book guides you in setting up and running continuous quality control in your environment. Star

Improving prehospital trauma care in Rwanda through continuous quality improvement: an interrupted time series analysis.

Science.gov (United States)

Scott, John W; Nyinawankusi, Jeanne D'Arc; Enumah, Samuel; Maine, Rebecca; Uwitonze, Eric; Hu, Yihan; Kabagema, Ignace; Byiringiro, Jean Claude; Riviello, Robert; Jayaraman, Sudha

2017-07-01

Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures. Targets of >90% were set for each metric and daily team meetings and monthly feedback sessions were implemented to address opportunities for improvement. These five pre-hospital quality metrics were assessed monthly before and after implementation of the CQIP. Met and unmet needs for O2, IVF, and c-collar were combined into a summative monthly SAMU Trauma Quality Scores (STQ score). An interrupted time series linear regression model compared the STQ score during 14 months before the CQIP implementation to the first 14 months after. During the 29-month study period 3,822 patients met study criteria. 1,028 patients needed one or more of the five studied interventions during the study period. All five endpoints had a significant increase between the pre-CQI and post-CQI periods (pRwanda. This programme may be used as an example for additional efforts engaging frontline staff with real-time data feedback in order to rapidly translate data collection efforts into improved care for the injured in a resource-limited setting. Copyright © 2017 Elsevier Ltd. All rights reserved.

Fabrication of high-quality brazed joints

International Nuclear Information System (INIS)

Orlov, A.V.

1980-01-01

Problem of ensuring of joint high-quality when brazing different parts in power engineering is considered. To obtain high-quality joints it is necessary to correctly design brazed joint and to choose a gap width, overlap length and fillet radius; to clean up carefully the surfaces to be brazed and fix them properly one relative to another; to apply a solder so as to provide its flowing into the gap and sticking in it; to exactly regulate thermal conditions of brazing. High quality and reliability of brazed joints are ensured by the application of solders based on noble metals, and cheap solders based on nickel, manganese and copper. Joints brazed with nickel base solders may operate at temperatures as high as 888 deg C

Increasing the use of 'smart' pump drug libraries by nurses: a continuous quality improvement project.

Science.gov (United States)

Harding, Andrew D

2012-01-01

The use of infusion pumps that incorporate "smart" technology (smart pumps) can reduce the risks associated with receiving IV therapies. Smart pump technology incorporates safeguards such as a list of high-alert medications, soft and hard dosage limits, and a drug library that can be tailored to specific patient care areas. Its use can help to improve patient safety and to avoid potentially catastrophic harm associated with medication errors. But when one independent community hospital in Massachusetts switched from older mechanical pumps to smart pumps, it neglected to assign an "owner" to oversee the implementation process. One result was that nurses were using the smart pump library for only 37% of all infusions.To increase pump library usage percentage-thereby reducing the risks associated with infusion and improving patient safety-the hospital undertook a continuous quality improvement project over a four-month period in 2009. With the involvement of direct care nurses, and using quantitative data available from the smart pump software, the nursing quality and pharmacy quality teams identified ways to improve pump and pump library use. A secondary goal was to calculate the hospital's return on investment for the purchase of the smart pumps. Several interventions were developed and, on the first of each month, implemented. By the end of the project, pump library usage had nearly doubled; and the hospital had completely recouped its initial investment.

Water Quality and Quantity in Intermittent and Continuous Piped Water Supplies in Hubli-Dharwad, India

OpenAIRE

Kumpel, Emily Katherine

2013-01-01

In at least 45 low- and middle-income countries, piped water systems deliver water for limited durations. Few data are available of the impact of intermittent water supply (IWS) on the water quality and quantity delivered to households. This thesis examines the impact of intermittently supplied piped water on the quality and quantity of water delivered to residential taps in Hubli-Dharwad, India, when compared to continuous piped water supply. A framework for understanding the pathways throug...

Rationale for continuing R&D in direct coal conversion to produce high quality transportation fuels

Energy Technology Data Exchange (ETDEWEB)

Srivastava, R.D.; McIlvried, H.G. [Burns and Roe Services Corp., Pittsburgh, PA (United States); Gray, D. [Mitre Corp, McLean, VA (United States)] [and others

1995-12-31

For the foreseeable future, liquid hydrocarbon fuels will play a significant role in the transportation sector of both the United States and the world. Factors favoring these fuels include convenience, high energy density, and the vast existing infrastructure for their production and use. At present the U.S. consumes about 26% of the world supply of petroleum, but this situation is expected to change because of declining domestic production and increasing competition for imports from countries with developing economies. A scenario and time frame are developed in which declining world resources will generate a shortfall in petroleum supply that can be allieviated in part by utilizing the abundant domestic coal resource base. One option is direct coal conversion to liquid transportation fuels. Continued R&D in coal conversion technology will results in improved technical readiness that can significantly reduce costs so that synfuels can compete economically in a time frame to address the shortfall.

Model documentation for relations between continuous real-time and discrete water-quality constituents in Cheney Reservoir near Cheney, Kansas, 2001--2009

Science.gov (United States)

Stone, Mandy L.; Graham, Jennifer L.; Gatotho, Jackline W.

2013-01-01

Cheney Reservoir, located in south-central Kansas, is one of the primary water supplies for the city of Wichita, Kansas. The U.S. Geological Survey has operated a continuous real-time water-quality monitoring station in Cheney Reservoir since 2001; continuously measured physicochemical properties include specific conductance, pH, water temperature, dissolved oxygen, turbidity, fluorescence (wavelength range 650 to 700 nanometers; estimate of total chlorophyll), and reservoir elevation. Discrete water-quality samples were collected during 2001 through 2009 and analyzed for sediment, nutrients, taste-and-odor compounds, cyanotoxins, phytoplankton community composition, actinomycetes bacteria, and other water-quality measures. Regression models were developed to establish relations between discretely sampled constituent concentrations and continuously measured physicochemical properties to compute concentrations of constituents that are not easily measured in real time. The water-quality information in this report is important to the city of Wichita because it allows quantification and characterization of potential constituents of concern in Cheney Reservoir. This report updates linear regression models published in 2006 that were based on data collected during 2001 through 2003. The update uses discrete and continuous data collected during May 2001 through December 2009. Updated models to compute dissolved solids, sodium, chloride, and suspended solids were similar to previously published models. However, several other updated models changed substantially from previously published models. In addition to updating relations that were previously developed, models also were developed for four new constituents, including magnesium, dissolved phosphorus, actinomycetes bacteria, and the cyanotoxin microcystin. In addition, a conversion factor of 0.74 was established to convert the Yellow Springs Instruments (YSI) model 6026 turbidity sensor measurements to the newer YSI

Continuous quality improvement: a shared governance model that maximizes agent-specific knowledge.

Science.gov (United States)

Burkoski, Vanessa; Yoon, Jennifer

2013-01-01

Motivate, Innovate, Celebrate: an innovative shared governance model through the establishment of continuous quality improvement (CQI) councils was implemented across the London Health Sciences Centre (LHSC). The model leverages agent-specific knowledge at the point of care and provides a structure aimed at building human resources capacity and sustaining enhancements to quality and safe care delivery. Interprofessional and cross-functional teams work through the CQI councils to identify, formulate, execute and evaluate CQI initiatives. In addition to a structure that facilitates collaboration, accountability and ownership, a corporate CQI Steering Committee provides the forum for scaling up and spreading this model. Point-of-care staff, clinical management and educators were trained in LEAN methodology and patient experience-based design to ensure sufficient knowledge and resources to support the implementation.

Estimated Quality of Multistage Process on the Basis of Probabilistic Approach with Continuous Response Functions

Directory of Open Access Journals (Sweden)

Yuri B. Tebekin

2011-11-01

Full Text Available The article is devoted to the problem of the quality management for multiphase processes on the basis of the probabilistic approach. Method with continuous response functions is offered from the application of the method of Lagrange multipliers.

In situ high-temperature gas sensors: continuous monitoring of the combustion quality of different wood combustion systems and optimization of combustion process

Directory of Open Access Journals (Sweden)

H. Kohler

2018-03-01

Full Text Available The sensing characteristics and long-term stability of different kinds of CO ∕ HC gas sensors (non-Nernstian mixed potential type during in situ operation in flue gas from different types of low-power combustion systems (wood-log- and wood-chip-fuelled were investigated. The sensors showed representative but individual sensing behaviour with respect to characteristically varying flue gas composition over the combustion process. The long-term sensor signal stability evaluated by repeated exposure to CO ∕ H2 ∕ N2 ∕ synthetic air mixtures showed no sensitivity loss after operation in the flue gas. Particularly for one of the sensors (Heraeus GmbH, this high signal stability was observed in a field test experiment even during continuous operation in the flue gas of the wood-chip firing system over 4 months. Furthermore, it was experimentally shown that the signals of these CO ∕ HC sensing elements yield important additional information about the wood combustion process. This was demonstrated by the adaptation of an advanced combustion airstream control algorithm on a wood-log-fed fireplace and by the development of a combustion quality monitoring system for wood-chip-fed central heaters.

Pipe Rolling from Continuous Cast Metal

International Nuclear Information System (INIS)

Zhordania, I.; Chkhartishvili, I.; Lordkipanidze, J.; Melashvili, Z.; Papava, K.; Khundadze, K.

2007-01-01

The approach to manufacturing of high quality pipes as a result of solid and hollow billet rolling from continuous cast metal is shown. Optimal parameters of piercing, temperature of piercing and piercing rolling mill rollers speed have been experimentally established. (author)

Marketing Realities in Continuing Professional Education.

Science.gov (United States)

Craven, Ruth F.; DuHamel, Martha B.

2000-01-01

Describes tenets of continuing professional education marketing: identify target audience, define mission, assess community needs, identify competition, establish credibility, develop marketing plans, provide options, evaluate, and develop high-quality programs. Offers advice for pricing, cancellations, new courses, promotion expenses, direct…

Sperm quality in New Zealand: Is the downward trend continuing?

Science.gov (United States)

Birdsall, Mary A; Peek, John; Valiapan, Sumithra

2015-10-16

To investigate whether the decline in sperm concentration in New Zealand sperm donors observed from 1987 to 2007 continued in the period 2008-2014. A retrospective study from 2008 to 2014. The first semen sample of 285 men presenting as sperm donors in Auckland and Wellington was analysed for sperm concentration, seminal fluid volume and the percentage of motile sperm. These results were compared to results from 1987 to 2007 from the same clinics. The decline in semen volume and sperm concentration observed between 1987 and 2007 did not continue in 2008-2014. Sperm concentration decreased from 1987 until some time between 1997 and 2001, and has remained stable at an average of 62x106/ml between 2001 and 2014. Sperm motility declined significantly (8%) in the period 2008-2014, but there was no significant change over the total period studied, between 1987 and 2014. After a decline between 1987 and sometime during 1997-2001, the sperm concentration in men presenting as donors remained unchanged between 2002 and 2014, suggesting semen quality has not changed in New Zealand men over the last decade.

Demystifying Data: Designing and Implementing Data-Driven Systems and Practices for Continuous Quality Improvement

Science.gov (United States)

Krugly, Andrew; Stein, Amanda; Centeno, Maribel G.

2014-01-01

Data-based decision making should be the driving force in any early care and education setting. Data usage compels early childhood practitioners and leaders to make decisions on the basis of more than just professional instinct. This article explores why early childhood schools should be using data for continuous quality improvement at various…

Continuous water-quality monitoring to improve lake management at Lake Mattamuskeet National Wildlife Refuge

Science.gov (United States)

Michelle Moorman; Tom Augspurger

2016-01-01

The U.S. Fish and Wildlife Service has partnered with U.S. Geological Survey to establish 2 continuous water-quality monitoring stations at Lake Mattamuskeet. Stations on the east and west side of the lake measure water level, clarity, dissolved oxygen, pH, temperature, salinity, and conductivity.

The Quality Control of the LHC Continuous Cryostat Interconnections

CERN Document Server

Bertinelli, F; Bozzini, D; Cruikshank, P; Fessia, P; Grimaud, A; Kotarba, A; Maan, W; Olek, S; Poncet, A; Russenschuck, Stephan; Savary, F; Sulek, Z; Tock, J P; Tommasini, D; Vaudaux, L; Williams, L

2008-01-01

The interconnections between the Large Hadron Collider (LHC) magnets have required some 40 000 TIG welded joints and 65 000 electrical splices. At the level of single joints and splices, non-destructive techniques find limited application: quality control is based on the qualification of the process and of operators, on the recording of production parameters and on production samples. Visual inspection and process audits were the main techniques used. At the level of an extended chain of joints and splices - from a 53.5 m half-cell to a complete 2.7 km arc sector - quality control is based on vacuum leak tests, electrical tests and RF microwave reflectometry that progressively validated the work performed. Subsequent pressure tests, cryogenic circuits flushing with high pressure helium and cool-downs revealed a few unseen or new defects. This paper presents an overview of the quality control techniques used, seeking lessons applicable to similar large, complex projects.

[Study of continuous quality improvement for clinical laboratory processes via the platform of Hospital Group].

Science.gov (United States)

Song, Wenqi; Shen, Ying; Peng, Xiaoxia; Tian, Jian; Wang, Hui; Xu, Lili; Nie, Xiaolu; Ni, Xin

2015-05-26

The program of continuous quality improvement in clinical laboratory processes for complete blood count (CBC) was launched via the platform of Beijing Children's Hospital Group in order to improve the quality of pediatric clinical laboratories. Fifteen children's hospitals of Beijing Children's Hospital group were investigated using the method of Chinese adapted continuous quality improvement with PDCA (Plan-Do-Check-Action). The questionnaire survey and inter-laboratory comparison was conducted to find the existing problems, to analyze reasons, to set forth quality targets and to put them into practice. Then, targeted training was conducted to 15 children's hospitals and the second questionnaire survey, self examinations by the clinical laboratories was performed. At the same time, the Group's online internal quality control platform was established. Overall effects of the program were evaluated so that lay a foundation for the next stage of PDCA. Both quality of control system documents and CBC internal quality control scheme for all of clinical laboratories were improved through this program. In addition, standardization of performance verification was also improved, especially with the comparable verification rate of precision and internal laboratory results up to 100%. In terms of instrument calibration and mandatory diagnostic rates, only three out of the 15 hospitals (20%) failed to pass muster in 2014 from 46.67% (seven out of the 15 hospitals) in 2013. The abnormal data of intraday precision variance coefficients of the five CBC indicator parameters (WBC, RBC, Hb, Plt and Hct) of all the 15 laboratories accounted for 1.2% (2/165) in 2014, a marked decrease from 9.6% (14/145) in 2013. While the number of the hospitals using only one horizontal quality control object for daily quality control has dropped to three from five. The 15 hospitals organized a total of 263 times of training in 2014 from 101 times in 2013, up 160%. The quality improvement program for

White paper on continuous bioprocessing. May 20-21, 2014 Continuous Manufacturing Symposium.

Science.gov (United States)

Konstantinov, Konstantin B; Cooney, Charles L

2015-03-01

There is a growing interest in realizing the benefits of continuous processing in biologics manufacturing, which is reflected by the significant number of industrial and academic researchers who are actively involved in the development of continuous bioprocessing systems. These efforts are further encouraged by guidance expressed in recent US FDA conference presentations. The advantages of continuous manufacturing include sustained operation with consistent product quality, reduced equipment size, high-volumetric productivity, streamlined process flow, low-process cycle times, and reduced capital and operating cost. This technology, however, poses challenges, which need to be addressed before routine implementation is considered. This paper, which is based on the available literature and input from a large number of reviewers, is intended to provide a consensus of the opportunities, technical needs, and strategic directions for continuous bioprocessing. The discussion is supported by several examples illustrating various architectures of continuous bioprocessing systems. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Multidisciplinary interventions and continuous quality improvement to reduce unplanned extubation in adult intensive care units: A 15-year experience.

Science.gov (United States)

Chao, Chien-Ming; Lai, Chih-Cheng; Chan, Khee-Siang; Cheng, Kuo-Chen; Ho, Chung-Han; Chen, Chin-Ming; Chou, Willy

2017-07-01

We conduct a retrospective study of patients with unplanned extubation (UE) in adult intensive care units (ICU) at a medical center. In 2001, a multidisciplinary team of intensivists, senior residents, nurses, and respiratory therapists was established at Chi Mei Medical Center. The improvement interventions, implemented between 2001 and 2015, were organized around 8 key areas: standardizing procedures, improving communication skills, revising sedation and weaning protocols, changing strategies for restraints, establishing a task force for identifying and managing high-risk patients, using new quality-improvement models as breakthrough series and team resource management, using the strategy of accountability without assigning blame, and changing a new method to secure endotracheal tube. We measured the outcome as the annual event and the rate of UE. During this 15-year period, there were 1404 episodes of UE, with 44,015 episodes of mechanical ventilation (MV) (319,158 ventilator-days). The overall rate of UE was 3.19/100 ventilated patients (4.40/1000 ventilator-days). In 2001, there were 188 episodes of UE and the rate of UE was 6.82/100 ventilated patients or 9.0/1000 ventilator-days. After this continue quality improvement project had been implemented, the annual number of episodes of UE declined to 27, and the rate fell to 0.95/100 ventilated patients or 1.36/1000 ventilator-days in 2015. Overall, the trend analysis showed the change was significant with P continuously and effectively reduced using multidisciplinary and sequential quality improvement interventions.

Availability of high quality weather data measurements

DEFF Research Database (Denmark)

Andersen, Elsa; Johansen, Jakob Berg; Furbo, Simon

In the period 2016-2017 the project “Availability of high quality weather data measurements” is carried out at Department of Civil Engineering at the Technical University of Denmark. The aim of the project is to establish measured high quality weather data which will be easily available...... for the building energy branch and the solar energy branch in their efforts to achieve energy savings and for researchers and students carrying out projects where measured high quality weather data are needed....

Using Surgeon-Specific Outcome Reports and Positive Deviance for Continuous Quality Improvement.

Science.gov (United States)

Ivanovic, Jelena; Anstee, Caitlin; Ramsay, Tim; Gilbert, Sebastien; Maziak, Donna E; Shamji, Farid M; Sundaresan, R Sudhir; Villeneuve, P James; Seely, Andrew J E

2015-10-01

Using the thoracic morbidity and mortality classification to document all postoperative adverse events between October 2012 and February 2014, we created surgeon-specific outcome reports (SSORs) to promote self-assessment and to implement a divisional continuous quality improvement (CQI) program, on the construct of positive deviance, to improve individual surgeon's clinical performance. Mixed-methods study within a division of six thoracic surgeons, involving (1) development of real-time, Web-based, risk-adjusted SSORs; (2) implementation of CQI seminars (n = 6; September 2013 to June 2014) for evaluation of results, collegial discussion on quality improvement based on identification of positive outliers, and selection of quality indicators for future discussion; and (3) in-person interviews to identify facilitators and barriers to using SSORs and CQI. Interview transcripts were analyzed using thematic analysis. Interviews revealed enthusiastic support for SSORs as a means to improve patient care through awareness of personal outcomes with blinded divisional comparison for similar operations and diseases, and apply the learning objectives to continuous professional development and maintenance of certification. Perceived limitations of SSORs included difficulty measuring surgeon expertise, limited understanding of risk adjustment, resistance to change, and belief that knowledge of sensitive data could lead to punitive actions. All surgeons believed CQI seminars led to collegial discussions, whereas perceived limitations included quorum participation and failing to circle back on actionable items. Real-time performance feedback using SSORs can motivate surgeons to improve their practice, and CQI seminars offer the opportunity to review and interpret results and address issues in a supportive environment. Whether SSORs and CQI can lead to improvements in rates of postoperative adverse events is a matter of ongoing research. Copyright © 2015 The Society of Thoracic

Continuous production of glycerol by catalytic high pressure hydrogenolysis of sucrose

NARCIS (Netherlands)

van Ling, Gerrit; Driessen, Alfons J.; Piet, Arie C.; Vlugter, Jozef C.

1970-01-01

Several continuous reactor systems have been discussed for the catalytic high pressure hydrogenolysis of sucrose to glycerol. Theoretically and actually, continuous reactors lead to lower glycerol yields than in a batch process. Two continuous stirred tank reactors in cascade constitute a reasonable

Continuity of care is an important and distinct aspect of childbirth experience : Findings of a survey evaluating experienced continuity of care, experienced quality of care and women's perception of labor

NARCIS (Netherlands)

Perdok, Hilde; Verhoeven, Corine J.; van Dillen, Jeroen; Schuitmaker, Tjerk Jan; Hoogendoorn, Karla; Colli, Jolanda; Schellevis, François G.; de Jonge, Ank

2018-01-01

Background: To compare experienced continuity of care among women who received midwife-led versus obstetrician-led care. Secondly, to compare experienced continuity of care with a. experienced quality of care during labor and b. perception of labor. Methods: We conducted a questionnaire survey in a

High perfomance liquid chromatography fingerprint analysis for quality control of brotowali (Tinospora crispa)

Science.gov (United States)

Syarifah, V. B.; Rafi, M.; Wahyuni, W. T.

2017-05-01

Brotowali (Tinospora crispa) is widely used in Indonesia as ingredient of herbal medicine formulation. To ensure the quality, safety, and efficacy of herbal medicine products, its chemical constituents should be continuously evaluated. High performance liquid chromatography (HPLC) fingerprint is one of powerful technique for this quality control process. In this study, HPLC fingerprint analysis method was developed for quality control of brotowali. HPLC analysis was performed in C18 column and detection was performed using photodiode array detector. The optimum mobile phase for brotowali fingerprint was acetonitrile (ACN) and 0.1% formic acid in gradient elution mode at a flow rate of 1 mL/min. The number of peaks detected in HPLC fingerprint of brotowali was 32 peaks and 23 peaks for stems and leaves, respectively. Berberine as marker compound was detected at retention time of 20.525 minutes. Evaluation of analytical performance including precision, reproducibility, and stability prove that this HPLC fingerprint analysis was reliable and could be applied for quality control of brotowali.

CMOS continuous-time adaptive equalizers for high-speed serial links

CERN Document Server

Gimeno Gasca, Cecilia; Aldea Chagoyen, Concepción

2015-01-01

This book introduces readers to the design of adaptive equalization solutions integrated in standard CMOS technology for high-speed serial links. Since continuous-time equalizers offer various advantages as an alternative to discrete-time equalizers at multi-gigabit rates, this book provides a detailed description of continuous-time adaptive equalizers design - both at transistor and system levels-, their main characteristics and performances. The authors begin with a complete review and analysis of the state of the art of equalizers for wireline applications, describing why they are necessary, their types, and their main applications. Next, theoretical fundamentals of continuous-time adaptive equalizers are explored. Then, new structures are proposed to implement the different building blocks of the adaptive equalizer: line equalizer, loop-filters, power comparator, etc.  The authors demonstrate the design of a complete low-power, low-voltage, high-speed, continuous-time adaptive equalizer. Finally, a cost-...

Promoting Continuous Quality Improvement in Online Teaching: The META Model

Science.gov (United States)

Dittmar, Eileen; McCracken, Holly

2012-01-01

Experienced e-learning faculty members share strategies for implementing a comprehensive postsecondary faculty development program essential to continuous improvement of instructional skills. The high-impact META Model (centered around Mentoring, Engagement, Technology, and Assessment) promotes information sharing and content creation, and fosters…

Record of Assessment Moderation Practice (RAMP): Survey Software as a Mechanism of Continuous Quality Improvement

Science.gov (United States)

Johnson, Genevieve Marie

2015-01-01

In higher education, assessment integrity is pivotal to student learning and satisfaction, and, therefore, a particularly important target of continuous quality improvement. This paper reports on the preliminary development and application of a process of recording and analysing current assessment moderation practices, with the aim of identifying…

(Mis)Perceptions of Continuing Education: Insights from Knowledge Translation, Quality Improvement, and Patient Safety Leaders

Science.gov (United States)

Kitto, Simon C.; Bell, Mary; Goldman, Joanne; Peller, Jennifer; Silver, Ivan; Sargeant, Joan; Reeves, Scott

2013-01-01

Introduction: Minimal attention has been given to the intersection and potential collaboration among the domains of continuing education (CE), knowledge translation (KT), quality improvement (QI), and patient safety (PS), despite their overlapping objectives. A study was undertaken to examine leaders' perspectives of these 4 domains and their…

Radiological Protection and Quality Assurance in Health Sciences: Tele-Education for continued Postgraduate Training

International Nuclear Information System (INIS)

Alcaraz, M.; Chico, P.; Armero, D.; Saura Iniesta, A. M.; Vicente, V.

2003-01-01

The establishment of an inter departmental project, financed by the Spanish Ministry of Education, has made possible the development to specific didactic materials on Radiological Protection and Quality Assurance in Medical Radiodiagnostic Practices. These have been published as a manual and practical notebook. This material constitutes the grounding work for the first continuous tele-education training course via Internet that Spanish professionals exposed to ionising radiation are following. Interactive multimedia training and tele-education may become one of the alternatives that allow health science professionals to receive continuous training, provided that adequate content and aims had been established during undergraduate training. (Author) 18 refs

Highly qualified does not equal high quality: A study of urban stakeholders' perceptions of quality in science teaching

Science.gov (United States)

Miranda, Rommel Joseph

By employing qualitative methods, this study sought to determine the perceptions that urban stakeholders hold about what characteristics should distinguish a high school science teacher whom they would consider to demonstrate high quality in science teaching. A maximum variation sample of six science teachers, three school administrators, six parents and six students from a large urban public school district were interviewed using semi-structured, in-depth interview techniques. From these data, a list of observable characteristics which urban stakeholders hold as evidence of high quality in science teaching was generated. Observational techniques were utilized to determine the extent to which six urban high school science teachers, who meet the NCLB Act criteria for being "highly qualified", actually possessed the characteristics which these stakeholders hold as evidence of high quality in science teaching. Constant comparative analysis was used to analyze the data set. The findings suggest that urban stakeholders perceive that a high school science teacher who demonstrates high quality in science teaching should be knowledgeable about their subject matter, their student population, and should be resourceful; should possess an academic background in science and professional experience in science teaching; should exhibit professionalism, a passion for science and teaching, and a dedication to teaching and student learning; should be skillful in planning and preparing science lessons and in organizing the classroom, in presenting the subject matter to students, in conducting a variety of hands-on activities, and in managing a classroom; and should assess whether students complete class goals and objectives, and provide feedback about grades for students promptly. The findings further reveal that some of the urban high school science teachers who were deemed to be "highly qualified", as defined by the NCLB Act, engaged in practices that threatened quality in science

Continuous event recorders did not affect anxiety or quality of life in patients with palpitations

NARCIS (Netherlands)

Hoefman, Emmy; Boer, Kimberly R.; van Weert, Henk C. P. M.; Reitsma, Johannes B.; Koster, Rudolf W.; Bindels, Patrick J. P.

2007-01-01

OBJECTIVES: Palpitations can generate feelings of anxiety and decrease quality of life (QoL) due to fear of a cardiac abnormality. Continuous event recorders (CERs) have proven to be successful in diagnosing causes of palpitations but may affect patient QoL and anxiety. The aim is to determine

Fast High-Quality Noise

DEFF Research Database (Denmark)

Frisvad, Jeppe Revall; Wyvill, Geoff

2007-01-01

At the moment the noise functions available in a graphics programmer's toolbox are either slow to compute or they involve grid-line artifacts making them of lower quality. In this paper we present a real-time noise computation with no grid-line artifacts or other regularity problems. In other words......, we put a new tool in the box that computes fast high-quality noise. In addition to being free of artifacts, the noise we present does not rely on tabulated data (everything is computed on the fly) and it is easy to adjust quality vs. quantity for the noise. The noise is based on point rendering (like...... spot noise), but it extends to more than two dimensions. The fact that it is based on point rendering makes art direction of the noise much easier....

Assuring quality in high-consequence engineering

Energy Technology Data Exchange (ETDEWEB)

Hoover, Marcey L.; Kolb, Rachel R.

2014-03-01

In high-consequence engineering organizations, such as Sandia, quality assurance may be heavily dependent on staff competency. Competency-dependent quality assurance models are at risk when the environment changes, as it has with increasing attrition rates, budget and schedule cuts, and competing program priorities. Risks in Sandia's competency-dependent culture can be mitigated through changes to hiring, training, and customer engagement approaches to manage people, partners, and products. Sandia's technical quality engineering organization has been able to mitigate corporate-level risks by driving changes that benefit all departments, and in doing so has assured Sandia's commitment to excellence in high-consequence engineering and national service.

Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study.

Science.gov (United States)

Bailie, Ross; Matthews, Veronica; Larkins, Sarah; Thompson, Sandra; Burgess, Paul; Weeramanthri, Tarun; Bailie, Jodie; Cunningham, Frances; Kwedza, Ru; Clark, Louise

2017-10-05

To examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians. Mixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care. Indigenous primary healthcare services across five states/territories of Australia. 175 Indigenous primary healthcare services. A range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research. PRIMARY AND SECONDARY OUTCOME MEASURES: (i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines). Progressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities. Health authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Continuous-tone applications in digital hard-copy output devices

Science.gov (United States)

Saunders, Jeffrey C.

1990-11-01

Dye diffusion technology has made a recent entry into the hardcopy printer arena making it now possible to achieve near-photographic quality images from digital raster image data. Whereas the majority of low cost printers utilizing ink-jet, thermal wax, or dotmatrix technologies advertise high resolution printheads, the restrictions which dithering algorithms apply to these inherently binary printing systems force them to sacrifice spatial resolution capability for tone scale reproduction. Dye diffusion technology allows a fully continuous range of density at each pixel location thus preserving the full spatial resolution capability of the printhead; spatial resolution is not sacrificed for tone scale. This results in images whose quality is far superior to the ink-jet or wax-transfer products; image quality so high in fact, to the unaided eye, dye diffusion images are indistinguishable from their silver-halide counterparts. Eastman Kodak Co. offers a highly refined application of dye diffusion technology in the Kodak XL 7700 Digital Continuous Tone Printer and Kodak EKTATHERM media products. The XL . 7700 Printer represents a serious alternative to expensive laser-based film recorders for applications which require high quality image output from digital data files. This paper presents an explanation of dye diffusion printing, what distinguishes it from other technologies, sensitometric control and image quality parameters, and applications within the industry, particularly that of Airborne Reconnaissance and Remote Sensing.

Air quality and disease

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Climate change is an important determinant of air quality. Climate change is an important determinant of air quality. Poor air quality associated with higher levels of respiratory and cardiovascular disease. Exposure to high levels of ground-level ozone associated with ...

New vision technology for multidimensional quality monitoring of continuous frying of meat

DEFF Research Database (Denmark)

Daugaard, Søren Blond; Adler-Nissen, Jens; Carstensen, Jens Michael

2010-01-01

. The vision technology can also detect even slight increases in the agglutination of the fried minced meat during the process. This agglutination is undesirable, but very difficult to measure on-line. The results indicate that multi-spectral vision technology may partially or totally Substitute visual......The potential of using multi-spectral vision technology for quality control in a continuous frying process was investigated. canonical discriminant analysis of the multi-spectral images of samples of fried minced meat and diced turkey Could clearly visualise the effect of different heat treatments...

Control systems engineering in continuous pharmaceutical manufacturing. May 20-21, 2014 Continuous Manufacturing Symposium.

Science.gov (United States)

Myerson, Allan S; Krumme, Markus; Nasr, Moheb; Thomas, Hayden; Braatz, Richard D

2015-03-01

drug manufacturing that are easily transportable to industry. Industry can facilitate the move to continuous manufacturing by working with universities on the conception of new continuous pharmaceutical manufacturing process unit operations that have the potential to make major improvements in product quality, controllability, or reduced capital and/or operating costs. Regulatory bodies should ensure that: (1) regulations and regulatory practices promote, and do not derail, the development and implementation of continuous manufacturing and control systems engineering approaches; (2) the individuals who approve specific regulatory filings are sufficiently trained to make good decisions regarding control systems approaches; (3) provide regulatory clarity and eliminate/reduce regulatory risks; (4) financially support the development of high-quality training materials for use of undergraduate students, graduate students, industrial employees, and regulatory staff; (5) enhance the training of their own technical staff by financially supporting joint research projects with universities in the development of continuous pharmaceutical manufacturing processes and the associated control systems engineering theory, numerical algorithms, and software; and (6) strongly encourage the federal agencies that support research to fund these research areas. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Improving the Quality of Voluntary Medical Male Circumcision through Use of the Continuous Quality Improvement Approach: A Pilot in 30 PEPFAR-Supported Sites in Uganda

Science.gov (United States)

Opio, Alex; Calnan, Jacqueline; Njeuhmeli, Emmanuel

2015-01-01

Background Uganda adopted voluntary medical male circumcision (VMMC) (also called Safe Male Circumcision in Uganda), as part of its HIV prevention strategy in 2010. Since then, the Ministry of Health (MOH) has implemented VMMC mostly with support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through its partners. In 2012, two PEPFAR-led external quality assessments evaluated compliance of service delivery sites with minimum quality standards. Quality gaps were identified, including lack of standardized forms or registers, lack of documentation of client consent, poor preparedness for emergencies and use of untrained service providers. In response, PEPFAR, through a USAID-supported technical assistance project, provided support in quality improvement to the MOH and implementing partners to improve quality and safety in VMMC services and build capacity of MOH staff to continuously improve VMMC service quality. Methods and Findings Sites were supported to identify barriers in achieving national standards, identify possible solutions to overcome the barriers and carry out improvement plans to test these changes, while collecting performance data to objectively measure whether they had bridged gaps. A 53-indicator quality assessment tool was used by teams as a management tool to measure progress; teams also measured client-level indicators through self-assessment of client records. At baseline (February-March 2013), less than 20 percent of sites scored in the “good” range (>80%) for supplies and equipment, patient counseling and surgical procedure; by November 2013, the proportion of sites scoring “good” rose to 67 percent, 93 percent and 90 percent, respectively. Significant improvement was noted in post-operative follow-up at 48 hours, sexually transmitted infection assessment, informed consent and use of local anesthesia but not rate of adverse events. Conclusion Public sector providers can be engaged to address the quality of

Improving the Quality of Voluntary Medical Male Circumcision through Use of the Continuous Quality Improvement Approach: A Pilot in 30 PEPFAR-Supported Sites in Uganda.

Science.gov (United States)

Byabagambi, John; Marks, Pamela; Megere, Humphrey; Karamagi, Esther; Byakika, Sarah; Opio, Alex; Calnan, Jacqueline; Njeuhmeli, Emmanuel

2015-01-01

Uganda adopted voluntary medical male circumcision (VMMC) (also called Safe Male Circumcision in Uganda), as part of its HIV prevention strategy in 2010. Since then, the Ministry of Health (MOH) has implemented VMMC mostly with support from the United States President's Emergency Plan for AIDS Relief (PEPFAR) through its partners. In 2012, two PEPFAR-led external quality assessments evaluated compliance of service delivery sites with minimum quality standards. Quality gaps were identified, including lack of standardized forms or registers, lack of documentation of client consent, poor preparedness for emergencies and use of untrained service providers. In response, PEPFAR, through a USAID-supported technical assistance project, provided support in quality improvement to the MOH and implementing partners to improve quality and safety in VMMC services and build capacity of MOH staff to continuously improve VMMC service quality. Sites were supported to identify barriers in achieving national standards, identify possible solutions to overcome the barriers and carry out improvement plans to test these changes, while collecting performance data to objectively measure whether they had bridged gaps. A 53-indicator quality assessment tool was used by teams as a management tool to measure progress; teams also measured client-level indicators through self-assessment of client records. At baseline (February-March 2013), less than 20 percent of sites scored in the "good" range (>80%) for supplies and equipment, patient counseling and surgical procedure; by November 2013, the proportion of sites scoring "good" rose to 67 percent, 93 percent and 90 percent, respectively. Significant improvement was noted in post-operative follow-up at 48 hours, sexually transmitted infection assessment, informed consent and use of local anesthesia but not rate of adverse events. Public sector providers can be engaged to address the quality of VMMC using a continuous quality improvement approach.

A high throughput DNA extraction method with high yield and quality

Directory of Open Access Journals (Sweden)

Xin Zhanguo

2012-07-01

Full Text Available Abstract Background Preparation of large quantity and high quality genomic DNA from a large number of plant samples is a major bottleneck for most genetic and genomic analyses, such as, genetic mapping, TILLING (Targeting Induced Local Lesion IN Genome, and next-generation sequencing directly from sheared genomic DNA. A variety of DNA preparation methods and commercial kits are available. However, they are either low throughput, low yield, or costly. Here, we describe a method for high throughput genomic DNA isolation from sorghum [Sorghum bicolor (L. Moench] leaves and dry seeds with high yield, high quality, and affordable cost. Results We developed a high throughput DNA isolation method by combining a high yield CTAB extraction method with an improved cleanup procedure based on MagAttract kit. The method yielded large quantity and high quality DNA from both lyophilized sorghum leaves and dry seeds. The DNA yield was improved by nearly 30 fold with 4 times less consumption of MagAttract beads. The method can also be used in other plant species, including cotton leaves and pine needles. Conclusion A high throughput system for DNA extraction from sorghum leaves and seeds was developed and validated. The main advantages of the method are low cost, high yield, high quality, and high throughput. One person can process two 96-well plates in a working day at a cost of $0.10 per sample of magnetic beads plus other consumables that other methods will also need.

Determination of the Relationship between the Quality of Working Life and Tendency for Continuing Education in the Nurses working in Selected Hospitals of Isfahan Medical University

Directory of Open Access Journals (Sweden)

Maryam Javidmoghadam

2016-07-01

Full Text Available In the past, the main role of nurses was providing care and comfort during nursing duties. However, today due to the changes in the health-related systems, more emphasis is put on the health promotion, disease prevention, and paying attention to the patient as a whole and considering all of his aspects (holistic care. Therefore, in the current societies, the nurses play a more varied roles and professional responsibilities which are expanding in line with the changes in society. The working life quality is among the important and effective factors on the nurses' productivity. Also, regarding the high sensitivity of the health-care fields which are directly related to the human life, their education, knowledge, and working ability for better performing the duties is vital. The current study aimed at evaluation and investigation of the working life quality on the tendency to continue education in the nurses working in Isfahan Medical University. the current study is of descriptive - cross sectional bivariate correlation type conducted on 123 nurses working in four departments as internal medicine, surgery, emergency and intensive care in five hospitals as Al-Zahra, Amin, Ayatollah Kashani, Noor, and Ali Asghar (pbuh, which were under supervision of Isfahan Medical University. The data collection instrument was a questionnaire including the demographic information, working life quality, job satisfaction, and tendency to continue education. For data analysis, In addition to the descriptive statistical indicators (mean and standard deviation, the Chi Square test was also used for qualitative variables as well as paired sample t-test for comparison between the means of the two groups. All the analysis were performed in SPSS with the significance level 0.05.there is significant relationship between the nurses' education and their working life quality however there were no relationships between the years in service and marital status with people working

Concrete Waste Recycling Process for High Quality Aggregate

International Nuclear Information System (INIS)

Ishikura, Takeshi; Fujii, Shin-ichi

2008-01-01

Large amount of concrete waste generates during nuclear power plant (NPP) dismantling. Non-contaminated concrete waste is assumed to be disposed in a landfill site, but that will not be the solution especially in the future, because of decreasing tendency of the site availability and natural resources. Concerning concrete recycling, demand for roadbeds and backfill tends to be less than the amount of dismantled concrete generated in a single rural site, and conventional recycled aggregate is limited of its use to non-structural concrete, because of its inferior quality to ordinary natural aggregate. Therefore, it is vital to develop high quality recycled aggregate for general uses of dismantled concrete. If recycled aggregate is available for high structural concrete, the dismantling concrete is recyclable as aggregate for industry including nuclear field. Authors developed techniques on high quality aggregate reclamation for large amount of concrete generated during NPP decommissioning. Concrete of NPP buildings has good features for recycling aggregate; large quantity of high quality aggregate from same origin, record keeping of the aggregate origin, and little impurities in dismantled concrete such as wood and plastics. The target of recycled aggregate in this development is to meet the quality criteria for NPP concrete as prescribed in JASS 5N 'Specification for Nuclear Power Facility Reinforced Concrete' and JASS 5 'Specification for Reinforced Concrete Work'. The target of recycled aggregate concrete is to be comparable performance with ordinary aggregate concrete. The high quality recycled aggregate production techniques are assumed to apply for recycling for large amount of non-contaminated concrete. These techniques can also be applied for slightly contaminated concrete dismantled from radiological control area (RCA), together with free release survey. In conclusion: a technology on dismantled concrete recycling for high quality aggregate was developed

Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement.

Science.gov (United States)

Dupont, Corinne; Occelli, Pauline; Deneux-Tharaux, Catherine; Touzet, Sandrine; Duclos, Antoine; Bouvier-Colle, Marie-Hélène; Rudigoz, René-Charles; Huissoud, Cyril

2014-07-01

Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement To use statistical process control charts to describe trends in the prevalence of severe postpartum haemorrhage after vaginal delivery. This assessment was performed 7 years after we initiated a continuous quality improvement programme that began with regular criteria-based audits Observational descriptive study, in a French maternity unit in the Rhône-Alpes region. Quarterly clinical audit meetings to analyse all cases of severe postpartum haemorrhage after vaginal delivery and provide feedback on quality of care with statistical process control tools. The primary outcomes were the prevalence of severe PPH after vaginal delivery and its quarterly monitoring with a control chart. The secondary outcomes included the global quality of care for women with severe postpartum haemorrhage, including the performance rate of each recommended procedure. Differences in these variables between 2005 and 2012 were tested. From 2005 to 2012, the prevalence of severe postpartum haemorrhage declined significantly, from 1.2% to 0.6% of vaginal deliveries (pcontrol limits, that is, been out of statistical control. The proportion of cases that were managed consistently with the guidelines increased for all of their main components. Implementation of continuous quality improvement efforts began seven years ago and used, among other tools, statistical process control charts. During this period, the prevalence of severe postpartum haemorrhage after vaginal delivery has been reduced by 50%. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Reduction of radiation exposure while maintaining high-quality fluoroscopic images during interventional cardiology using novel x-ray tube technology with extra beam filtering.

Science.gov (United States)

den Boer, A; de Feyter, P J; Hummel, W A; Keane, D; Roelandt, J R

1994-06-01

Radiographic technology plays an integral role in interventional cardiology. The number of interventions continues to increase, and the associated radiation exposure to patients and personnel is of major concern. This study was undertaken to determine whether a newly developed x-ray tube deploying grid-switched pulsed fluoroscopy and extra beam filtering can achieve a reduction in radiation exposure while maintaining fluoroscopic images of high quality. Three fluoroscopic techniques were compared: continuous fluoroscopy, pulsed fluoroscopy, and a newly developed high-output pulsed fluoroscopy with extra filtering. To ascertain differences in the quality of images and to determine differences in patient entrance and investigator radiation exposure, the radiated volume curve was measured to determine the required high voltage levels (kVpeak) for different object sizes for each fluoroscopic mode. The fluoroscopic data of 124 patient procedures were combined. The data were analyzed for radiographic projections, image intensifier field size, and x-ray tube kilovoltage levels (kVpeak). On the basis of this analysis, a reference procedure was constructed. The reference procedure was tested on a phantom or dummy patient by all three fluoroscopic modes. The phantom was so designed that the kilovoltage requirements for each projection were comparable to those needed for the average patient. Radiation exposure of the operator and patient was measured during each mode. The patient entrance dose was measured in air, and the operator dose was measured by 18 dosimeters on a dummy operator. Pulsed compared with continuous fluoroscopy could be performed with improved image quality at lower kilovoltages. The patient entrance dose was reduced by 21% and the operator dose by 54%. High-output pulsed fluoroscopy with extra beam filtering compared with continuous fluoroscopy improved the image quality, lowered the kilovoltage requirements, and reduced the patient entrance dose by 55% and

Fast Batch Production of High-Quality Graphene Films in a Sealed Thermal Molecular Movement System.

Science.gov (United States)

Xu, Jianbao; Hu, Junxiong; Li, Qi; Wang, Rubing; Li, Weiwei; Guo, Yufen; Zhu, Yongbo; Liu, Fengkui; Ullah, Zaka; Dong, Guocai; Zeng, Zhongming; Liu, Liwei

2017-07-01

Chemical vapor deposition (CVD) growth of high-quality graphene has emerged as the most promising technique in terms of its integrated manufacturing. However, there lacks a controllable growth method for producing high-quality and a large-quantity graphene films, simultaneously, at a fast growth rate, regardless of roll-to-roll (R2R) or batch-to-batch (B2B) methods. Here, a stationary-atmospheric-pressure CVD (SAPCVD) system based on thermal molecular movement, which enables fast B2B growth of continuous and uniform graphene films on tens of stacked Cu(111) foils, with a growth rate of 1.5 µm s -1 , is demonstrated. The monolayer graphene of batch production is found to nucleate from arrays of well-aligned domains, and the films possess few defects and exhibit high carrier mobility up to 6944 cm 2 V -1 s -1 at room temperature. The results indicate that the SAPCVD system combined with single-domain Cu(111) substrates makes it possible to realize fast batch-growth of high-quality graphene films, which opens up enormous opportunities to use this unique 2D material for industrial device applications. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Refractory thermowell for continuous high temperature measurement of molten metal

International Nuclear Information System (INIS)

Thiesen, T.J.

1992-01-01

This patent describes a vessel for handling molten metal having an interior refractory lining, apparatus for continuous high temperature measurement of the molten metal. It comprises a thermowell; the thermowell containing a multiplicity of thermocouples; leads being coupled to a means for continuously indicating the temperature of the molten metal in the vessel

The Role of Motivation in Continuing Education for Pharmacists

OpenAIRE

Tjin a Tsoi, Sharon

2017-01-01

Healthcare professionals, including pharmacists, need to continuously update their knowledge and are, therefore, expected to participate in Continuing Education (CE) and Continuous Professional Development (CPD) activities on a regular basis. Lack of intrinsic (or autonomous) motivation appears to be an important barrier for engaging in high quality learning and can have consequences for poor performance and patient safety. This thesis aims to enhance our understanding of pharmacists’ motivat...

Influence of raw material properties upon critical quality attributes of continuously produced granules and tablets

DEFF Research Database (Denmark)

Fonteyne, Margot; Wickström, Henrika; Peeters, Elisabeth

2014-01-01

over a range of raw material attributes, manufacturing process options and process parameters. This fits further into the Process Analytical Technology (PAT) and Quality by Design (QbD) framework. The present study evaluates the effect of variation in critical raw material properties on the critical......-Lactose-PVP (30-67.5-2.5%) was used as model formulation. Seven different grades of theophylline were granulated. Afterward, the obtained granules were tableted. Both the characteristics of granules and tablets were determined. The results show that differences in raw material properties both affect...... quality attributes of granules and tablets, produced by a continuous from-powder-to-tablet wet granulation line. The granulation process parameters were kept constant to examine the differences in the end product quality caused by the variability of the raw materials properties only. Theophylline...

Effect of forage quality in faeces from different ruminant species fed high and low quality forage

DEFF Research Database (Denmark)

Jalali, A R; Nørgaard, P; Nielsen, M O

2010-01-01

Effect of forage quality in faeces from different ruminant species fed high and low quality forage......Effect of forage quality in faeces from different ruminant species fed high and low quality forage...

Quality control of coated fuel particles for high temperature gas-cooled reactor

International Nuclear Information System (INIS)

Kaneko, Mitsunobu

1987-01-01

The quality control of the coated fuel particles for high temperature gas-cooled reactors is characterized by the fact that the size of the target product to be controlled is very small, and the quantity is very large. Accordingly, the sampling plan and the method of evaluating the population through satisfically treating the measured data of the samples are the important subjects to see and evaluate the quality of a batch or a lot. This paper shows the fabrication process and the quality control procedure for the coated fuel particles. The development work of a HTGR was started by Japan Atomic Energy Research Institute in 1969, and as for the production technology for coated fuel particles, Nuclear Fuel Industries, Ltd. has continued the development work. The pilot plan with the capacity of about 40 kg/year was established in 1972. The fuel product fabricated in this plant was put to the irradiation experiment and out-of-pile evaluation test. In 1983, the production capacity was expanded to 200 kg/year, and the fuel compacts for the VHTRC in JAERI were produced for two years. The basic fuel design, the fabrication process, the quality control, the process control and the quality assurance are reported. For the commercial product, the studies from the viewpoint of production and quality control costs are required. (Kako, I.)

Effects of High-Intensity Interval Training versus Continuous Training on Physical Fitness, Cardiovascular Function and Quality of Life in Heart Failure Patients.

NARCIS (Netherlands)

Benda, N.M.M.; Seeger, J.P.; Stevens, G.G.; Hijmans-Kersten, B.T.P.; Dijk, A.P.J. van; Bellersen, L.; Lamfers, E.J.; Hopman, M.T.E.; Thijssen, D.H.J.

2015-01-01

INTRODUCTION: Physical fitness is an important prognostic factor in heart failure (HF). To improve fitness, different types of exercise have been explored, with recent focus on high-intensity interval training (HIT). We comprehensively compared effects of HIT versus continuous training (CT) in HF

TOTAL QUALITY MANAGEMENT IN HIGH EDUCATION

Directory of Open Access Journals (Sweden)

Hasan SERİN, Alper AYTEKİN

2009-01-01

Full Text Available The approach of Total Quality Management (TQM has been even more common and most recently its use in high education has been discussed. Likewise the enterprises producing various products, universities have also inputs, processes, and outputs. Due to conditions of competition, universities have to improve the qualities of these inputs, processes, and outputs, according to satisfaction, demands, and expectations of internal and external customers. If the TQM has been implemented in the universities with a manner that aims for customer satisfaction (students, lecturers, public and private establishments, and families, supports constant development, ensures participatory approach, and encourages working in groups, it will provide universities with effectiveness, efficiency, dynamics, and economics. In this study, common problems of universities, definitions of quality and TQM in high education, customer concept at universities, and factors affecting the quality of education have been explained. Besides, in order TQM approach to be successfully implemented in the universities, various suggestions have been presented.

The Continuing Development of Primary Sector Physical Education: Working Together to Raise Quality of Provision

Science.gov (United States)

Sloan, Stephen

2010-01-01

This paper sets out to provide further insight as to the reasons why many schools within the primary sector continue to find it difficult to ensure quality provision for physical education (PE) and school sport. It examines why class teachers, including the subject coordinator, possess concerns about teaching PE. It asks the question of who is…

Structural and electrical properties of high-quality 0.41 μm-thick InSb films grown on GaAs (1 0 0) substrate with InxAl1−xSb continuously graded buffer

International Nuclear Information System (INIS)

Shin, Sang Hoon; Song, Jin Dong; Lim, Ju Young; Koo, Hyun Cheol; Kim, Tae Geun

2012-01-01

High-quality InSb was grown on a GaAs (1 0 0) substrate with an InAlSb continuously graded buffer (CGB). The temperatures of In, Al K-cells and substrate were modified during the growth of InAlSb CGB. The cross-section TEM image reveals that the defects due to lattice-mismatch disappear near lateral structures in CGB. The measured electron mobility of 0.41 μm-thick InSb was 46,300 cm 2 /Vs at 300 K. These data surpass the electron mobility of state-of-the-art InSb grown by other methods with similar thickness of InSb.

Phrenic palsy and analgesic quality of continuous supraclavicular vs. interscalene plexus blocks after shoulder surgery.

Science.gov (United States)

Wiesmann, T; Feldmann, C; Müller, H H; Nentwig, L; Beermann, A; El-Zayat, B F; Zoremba, M; Wulf, H; Steinfeldt, T

2016-09-01

Hemidiaphragmatic palsy is a common consequence of the interscalene brachial plexus block. It occurs less commonly with the supraclavicular approach. Register data suggest that the analgesic quality of a supraclavicular blockade is sufficient for arthroscopic shoulder surgery, although data on the post-operative analgesic effect are lacking. After approval by the ethics committee, patients having arthroscopic shoulder surgery under general anaesthesia were randomized to receive a continuous interscalene or supraclavicular blockade. Phrenic nerve function was evaluated through ultrasound examination of the diaphragm in combination with spirometry. Pain scores at rest and activity etc. were determined before catheter insertion, during observation in the post- anaesthesia care unit (PACU) and on post-operative day 1 (POD1). The initial application of 10 ml of ropivacaine 0.2% was followed by continuous application of 4 ml of ropivacaine 0.2%, plus a patient controlled analgesia (PCA) bolus of 4 ml/h. One hundred and twenty patients were randomized, of which 114 data sets were analysed. Complete hemidiaphragmatic paresis occurred in 43% of the interscalene group vs. 24% in the supraclavicular group during PACU stay. Rates of dyspnoea and hoarseness were similar. Horner's syndrome occurred in 21% of the interscalene but only 3% of the supraclavicular group on POD1. Pain scores were comparable for pain at rest and during stress at each time point. This trial showed a significantly greater incidence of phrenic nerve palsy of the interscalene group in PACU, but not on POD1. Post-operative analgesic quality was similar in both groups. Continuous supraclavicular blockade is a suitable alternative to the continuous interscalene technique. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Analysis of high-quality modes in open chaotic microcavities

International Nuclear Information System (INIS)

Fang, W.; Yamilov, A.; Cao, H.

2005-01-01

We present a numerical study of the high-quality modes in two-dimensional dielectric stadium microcavities. Although the classical ray mechanics is fully chaotic in a stadium billiard, all of the high-quality modes show a 'strong scar' around unstable periodic orbits. When the deformation (ratio of the length of the straight segments over the diameter of the half circles) is small, the high-quality modes correspond to whispering-gallery-type trajectories and their quality factors decrease monotonically with increasing deformation. At large deformation, each high-quality mode is associated with multiple unstable periodic orbits. Its quality factor changes nonmonotonically with the deformation, and there exists an optimal deformation for each mode at which its quality factor reaches a local maximum. This unusual behavior is attributed to the interference of waves propagating along different constituent orbits that could minimize light leakage out of the cavity

Implementing a Course Review Process for a Continuous Quality Improvement Model for a Medical School Curriculum.

Science.gov (United States)

Ward, Cassandra S; Andrade, Amy; Walker-Winfree, Lena

2018-01-01

In 1901, Abraham Flexner, a research scholar at the Carnegie Foundation for the Advancement of Teaching, visited 155 medical schools in the United States and Canada to assess medical education. Flexner's recommendations became the foundation for the Liaison Committee on Medical Education accreditation, a voluntary, peer-reviewed quality assurance process to determine whether a medical education program meets established standards. The Meharry Medical College School of Medicine, a historically Black college/university (HBCU) established the Office of Curriculum Evaluation and Effectiveness in 2013 to ensure the consistent monitoring of the medical education program's compliance with accreditation standards. The motto and logo, LCME 24/7, highlight the school's emphasis on meeting accreditation standards. The school uses the 1994 Plan-Do-Study-Act Cycle for Learning and Improvement for continuous review of course content, outcomes, and evaluations. This process identifies strengths, challenges, and opportunities for innovative steps for continuous quality improvements to the curriculum.

Expanding Continuous Quality Improvement Capacity in the Medical Intensive Care Unit: Prehealth Volunteers as a Solution.

Science.gov (United States)

Priest, Kelsey C; Lobingier, Hannah; McCully, Nancy; Lombard, Jackie; Hansen, Mark; Uchiyama, Makoto; Hagg, Daniel S

2016-01-01

Health care delivery systems are challenged to support the increasing demands for improving patient safety, satisfaction, and outcomes. Limited resources and staffing are common barriers for making significant and sustained improvements. At Oregon Health & Science University, the medical intensive care unit (MICU) leadership team faced internal capacity limitations for conducting continuous quality improvement, specifically for the implementation and evaluation of the mobility portion of an evidence-based care bundle. The MICU team successfully addressed this capacity challenge using the person power of prehealth volunteers. In the first year of the project, 52 trained volunteers executed an evidence-based mobility intervention for 305 critically ill patients, conducting more than 200 000 exercise repetitions. The volunteers contributed to real-time evaluation of the project, with the collection of approximately 26 950 process measure data points. Prehealth volunteers are an untapped resource for effectively expanding internal continuous quality improvement capacity in the MICU and beyond.

Mechanical design and fabrication of the VHF-gun, the Berkeley normal-conducting continuous-wave high-brightness electron source

Science.gov (United States)

Wells, R. P.; Ghiorso, W.; Staples, J.; Huang, T. M.; Sannibale, F.; Kramasz, T. D.

2016-02-01

A high repetition rate, MHz-class, high-brightness electron source is a key element in future high-repetition-rate x-ray free electron laser-based light sources. The VHF-gun, a novel low frequency radio-frequency gun, is the Lawrence Berkeley National Laboratory (LBNL) response to that need. The gun design is based on a normal conducting, single cell cavity resonating at 186 MHz in the VHF band and capable of continuous wave operation while still delivering the high accelerating fields at the cathode required for the high brightness performance. The VHF-gun was fabricated and successfully commissioned in the framework of the Advanced Photo-injector EXperiment, an injector built at LBNL to demonstrate the capability of the gun to deliver the required beam quality. The basis for the selection of the VHF-gun technology, novel design features, and fabrication techniques are described.

Involving vendors in continuous quality improvement efforts.

Science.gov (United States)

McDevitt, M C

1995-03-01

In the hospital environment, vendors supply a wide range of items, from surgical sutures to the latest in high-cost technological equipment. Also, many clinical and support services, such as respiratory therapy, transcription, and computer databanks are now outsourced to commercial vendors. Interaction with such vendors is often less than satisfactory, with prolonged timelines and disruption of an important process that is being computerized. Although hospitals deal with very few vendors in long-term relationships, such as those seen in manufacturing, this should not preclude the formation of a supplier-customer relationship that goes beyond management's interaction with the sales representative in response to a request for proposal. This is especially true when a process improvement team has studied an internal process and defined a key quality characteristic.

Evaluating the impact of continuous quality improvement methods at hospitals in Tanzania: a cluster-randomized trial.

Science.gov (United States)

Kamiya, Yusuke; Ishijma, Hisahiro; Hagiwara, Akiko; Takahashi, Shizu; Ngonyani, Henook A M; Samky, Eleuter

2017-02-01

To evaluate the impact of implementing continuous quality improvement (CQI) methods on patient's experiences and satisfaction in Tanzania. Cluster-randomized trial, which randomly allocated district-level hospitals into treatment group and control group, was conducted. Sixteen district-level hospitals in Kilimanjaro and Manyara regions of Tanzania. Outpatient exit surveys targeting totally 3292 individuals, 1688 in the treatment and 1604 in the control group, from 3 time-points between September 2011 and September 2012. Implementation of the 5S (Sort, Set, Shine, Standardize, Sustain) approach as a CQI method at outpatient departments over 12 months. Cleanliness, waiting time, patient's experience, patient's satisfaction. The 5S increased cleanliness in the outpatient department, patients' subjective waiting time and overall satisfaction. However, negligible effects were confirmed for patient's experiences on hospital staff behaviours. The 5S as a CQI method is effective in enhancing hospital environment and service delivery; that are subjectively assessed by outpatients even during the short intervention period. Nevertheless, continuous efforts will be needed to connect CQI practices with the further improvement in the delivery of quality health care. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Continuing Medical Education Improves Gastroenterologists' Compliance with Inflammatory Bowel Disease Quality Measures.

Science.gov (United States)

Sapir, Tamar; Moreo, Kathleen; Carter, Jeffrey D; Greene, Laurence; Patel, Barry; Higgins, Peter D R

2016-07-01

Low rates of compliance with quality measures for inflammatory bowel disease (IBD) have been reported for US gastroenterologists. We assessed the influence of quality improvement (QI) education on compliance with physician quality reporting system (PQRS) measures for IBD and measures related to National Quality Strategy (NQS) priorities. Forty community-based gastroenterologists participated in the QI study; 20 were assigned to educational intervention and control groups, respectively. At baseline, randomly selected charts of patients with moderate-to-severe ulcerative colitis were retrospectively reviewed for the gastroenterologists' performance of 8 PQRS IBD measures and 4 NQS-related measures. The intervention group participated in a series of accredited continuing medical education (CME) activities focusing on QI. Follow-up chart reviews were conducted 6 months after the CME activities. Independent t tests were conducted to compare between-group differences in baseline-to-follow-up rates of documented compliance with each measure. The analysis included 299 baseline charts and 300 follow-up charts. The intervention group had significantly greater magnitudes of improvement than the control group for the following measures: assessment of IBD type, location, and activity (+14 %, p = 0.009); influenza vaccination (+13 %, p = 0.025); pneumococcal vaccination (+20 %, p = 0.003); testing for latent tuberculosis before anti-TNF-α therapy (+10 %, p = 0.028); assessment of hepatitis B virus status before anti-TNF-α therapy (+9 %, p = 0.010); assessment of side effects (+17 %, p = 0.048), and counseling patients about cancer risks (+13 %, p = 0.013). QI-focused CME improves community-based gastroenterologists' compliance with IBD quality measures and measures aligned with NQS priorities.

Integrating Quality Improvement and Continuing Professional Development at an Academic Medical Center: A Partnership Between Practice Plan, Hospital, and Medical School.

Science.gov (United States)

Gold, Barbara; England, Dawn; Riley, William; Jacobs-Halsey, Ginny; Webb, Corinne; Daniels, Bobbi

2016-01-01

While quality improvement (QI) initiatives can be a highly effective means for improving health care delivery in academic medical centers (AMCs), many health care professionals are not formally trained in basic QI methodology, engaging clinicians in QI activities can be challenging, and there is often a lack of integration and coordination among QI functions (eg, Departments of Quality and Safety, Continuing Professional Development). In our AMC, we undertook a collaborative approach to achieve better vertical and horizontal integration of our QI education efforts. This article provides a case example describing our organizational context, what was done, and with what effect and makes our example and lessons learned available to others. We developed a new educational QI program that was jointly planned and implemented by a group comprising major QI stakeholders. This project was intended to create horizontal organizational linkages between continuing professional development, clinicians, the hospital, and QI department and produce QI activities that aligned with the strategic objectives of senior management. The group developed and implemented a curriculum based on Lean methodology and concepts from the Institute for Health Care Improvement Model for Improvement. Two cohorts (27 teams) completed the training and planned and implemented QI projects. All projects were aligned with organizational quality, safety, and patient experience goals. The majority of projects met their aim statements. This case description provides an example of successful horizontal integration of an AMCs' QI functions to disseminate knowledge and implement meaningful QI aligned with strategic objectives (vertical integration).

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

Science.gov (United States)

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

2018-03-01

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

Strategic Market Planning in Conglomerate Continuing Education Programs.

Science.gov (United States)

Pappas, James P.

1987-01-01

The author tells how very large, multidivision continuing education programs can use their size as a marketing advantage. Some advantages include (1) superior service, (2) an image of high quality, (3) the bandwagon effect, and (4) stronger buying power. (CH)

Two-stage continuous process of methyl ester from high free fatty acid mixed crude palm oil using static mixer coupled with high-intensity of ultrasound

International Nuclear Information System (INIS)

Somnuk, Krit; Smithmaitrie, Pruittikorn; Prateepchaikul, Gumpon

2013-01-01

Highlights: • Mixed crude palm oil was used in the two-step continuous process. • Two-step continuous process was performed using static mixer coupled with ultrasound. • The maximum obtained yield was 92.5 vol.% after the purification process. • The residence time less than 20 s was achieved in ultrasonic reactors. - Abstract: The two-stage continuous process of methyl ester from high free fatty acid (FFA) mixed crude palm oil (MCPO) was performed by using static mixer coupled with high-intensity of ultrasound. The 2 × 1000 W ultrasonic homogenizers were operated at 18 kHz frequency in the 2 × 100 mL continuous reactors. For the first-step, acid-catalyzed esterification was employed with 18 vol.% of methanol, 2.7 vol.% of sulfuric acid, 60 °C of temperature, and 20 L h −1 of MCPO flow rate, for reducing the acid value from 28 mg KOH g −1 to less than 2 mg KOH g −1 . For the second-step, base-catalyzed transesterification was carried out under 18 vol.% of methanol, 8 g KOH L −1 of oil, and 20 L h −1 of esterified oil flow rate at 30 °C. The high yields of esterified oil and crude biodiesel were attained within the residence time of less than 20 s in the ultrasonic reactors. The yields of each stage process were: 103.3 vol.% of esterified oil, 105.4 vol.% of crude biodiesel, and 92.5 vol.% of biodiesel when compared with 100 vol.% MCPO. The quality of the biodiesel meets the specification of biodiesel standard in Thailand

High quality-factor optical resonators

International Nuclear Information System (INIS)

Henriet, Rémi; Salzenstein, Patrice; Coillet, Aurélien; Saleh, Khaldoun; Chembo, Yanne K; Ristic, Davor; Ferrari, Maurizio; Mortier, Michel; Rasoloniaina, Alphonse; Dumeige, Yannick; Féron, Patrice; Cibiel, Gilles; Llopis, Olivier

2014-01-01

Various resonators are investigated for microwave photonic applications. Micro-sphere, disk and fiber ring resonators were designed, realized and characterized. Obtained quality factors are as high as Q = 10 10 . (paper)

Understanding the continuous renal replacement therapy circuit for acute renal failure support: a quality issue in the intensive care unit.

Science.gov (United States)

Boyle, Martin; Baldwin, Ian

2010-01-01

Delivery of renal replacement therapy is now a core competency of intensive care nursing. The safe and effective delivery of this form of therapy is a quality issue for intensive care, requiring an understanding of the principles underlying therapy and the functioning of machines used. Continuous hemofiltration, first described in 1977, used a system where blood flowed from arterial to venous cannulas through a small-volume, low-resistance, and high-flux filter. Monitoring of these early systems was limited, and without a machine interface, less nursing expertise was required. Current continuous renal replacement therapy machines offer user-friendly interfaces, cassette-style circuits, and comprehensive circuit diagnostics and monitoring. Although these machines conceal complexity behind a user-friendly interface, it remains important that nurses have sufficient knowledge for their use and the ability to compare and contrast circuit setups and functions for optimal and efficient treatment.

Usability, Quality, Value and E-Learning Continuance Decisions

Science.gov (United States)

Chiu, Chao-Min; Hsu, Meng-Hsiang; Sun, Szu-Yuan; Lin, Tung-Ching; Sun, Pei-Chen

2005-01-01

Previous research suggests that an eventual information technology (IT) success depend on both its initial adoption (acceptance) and subsequent continued usage (continuance). Expectancy disconfirmation theory (EDT) has been successfully used to predict users' intention to continue using information technologies. This study proposed a decomposed…

Summary and interpretation of discrete and continuous water-quality monitoring data, Mattawoman Creek, Charles County, Maryland, 2000-11

Science.gov (United States)

Chanat, Jeffrey G.; Miller, Cherie V.; Bell, Joseph M.; Majedi, Brenda Feit; Brower, David P.

2013-01-01

Discrete samples and continuous (15-minute interval) water-quality data were collected at Mattawoman Creek (U.S. Geological Survey station number 01658000) from October 2000 through January 2011, in cooperation with the Charles County (Maryland) Department of Planning and Growth Management, the Maryland Department of the Environment, and the Maryland Geological Survey. Mattawoman Creek is a fourth-order Maryland tributary to the tidal freshwater Potomac River; the creek’s watershed is experiencing development pressure due to its proximity to Washington, D.C. Data were analyzed for the purpose of describing ambient water quality, identifying potential contaminant sources, and quantifying nutrient and sediment loads to the tidal freshwater Mattawoman estuary. Continuous data, collected at 15-minute intervals, included discharge, derived from stage measurements made using a pressure transducer, as well as water temperature, pH, specific conductance, dissolved oxygen, and turbidity, all measured using a water-quality sonde. In addition to the continuous data, a total of 360 discrete water-quality samples, representative of monthly low-flow and targeted storm conditions, were analyzed for suspended sediment and nutrients. Continuous observations gathered by a second water-quality sonde, which was temporarily deployed in 2011 for quality-control purposes, indicated substantial lateral water-quality gradients due to inflow from a nearby tributary, representing about 10 percent of the total gaged area upstream of the sampling location. These lateral gradients introduced a time-varying bias into both the continuous and discrete data, resulting in observations that were at some times representative of water-quality conditions in the main channel and at other times biased towards conditions in the tributary. Despite this limitation, both the continuous and discrete data provided insight into the watershed-scale factors that influence water quality in Mattawoman Creek

Economic Impact of a Peritoneal Dialysis Continuous Quality Improvement Program in Colombia.

Science.gov (United States)

Makhija, Dilip U; Walton, Surrey M; Mora, Juan P; Sanabria, Rafael M

2017-01-01

♦ BACKGROUND: There is little information regarding the financial burden of peritonitis and the economic impact of continuous quality improvement (CQI) programs in peritoneal dialysis (PD) patients. The objectives of this study were to measure the costs of peritonitis, and determine the net savings of a PD CQI program in Colombia. ♦ METHODS: The Renal Therapy Services (RTS) network in Colombia, along with Coomeva EPS, provided healthcare resource utilization data for PD patients with and without peritonitis between January 2012 and December 2013. Propensity score matching and regression analysis were performed to estimate the incremental cost of peritonitis. Patient months at risk, episodes of peritonitis pre- and post-CQI, and costs of CQI were obtained. Annual net savings of the CQI program were estimated based on the number of peritonitis events prevented. ♦ RESULTS: The incremental cost of a peritonitis episode was $250. In an 8-year period, peritonitis decreased from 1,837 episodes per 38,596 patient-months in 2006 to 841 episodes per 50,910 patient-months in 2014. Overall, the CQI program prevented an estimated 10,409 episodes of peritonitis. The cost of implementing the CQI program was $147,000 in the first year and $119,000 annually thereafter. Using a five percent discount rate, the net present value of the program was $1,346,431, with an average annual net savings of $207,027. The return on investment (i.e. total savings-program cost/program cost) of CQI was 169%. ♦ CONCLUSION: Continuous quality improvement initiatives designed to reduce rates of peritonitis have a strong potential to generate cost savings. Copyright © 2017 International Society for Peritoneal Dialysis.

High Quality Data for Grid Integration Studies

Energy Technology Data Exchange (ETDEWEB)

Clifton, Andrew; Draxl, Caroline; Sengupta, Manajit; Hodge, Bri-Mathias

2017-01-22

As variable renewable power penetration levels increase in power systems worldwide, renewable integration studies are crucial to ensure continued economic and reliable operation of the power grid. The existing electric grid infrastructure in the US in particular poses significant limitations on wind power expansion. In this presentation we will shed light on requirements for grid integration studies as far as wind and solar energy are concerned. Because wind and solar plants are strongly impacted by weather, high-resolution and high-quality weather data are required to drive power system simulations. Future data sets will have to push limits of numerical weather prediction to yield these high-resolution data sets, and wind data will have to be time-synchronized with solar data. Current wind and solar integration data sets are presented. The Wind Integration National Dataset (WIND) Toolkit is the largest and most complete grid integration data set publicly available to date. A meteorological data set, wind power production time series, and simulated forecasts created using the Weather Research and Forecasting Model run on a 2-km grid over the continental United States at a 5-min resolution is now publicly available for more than 126,000 land-based and offshore wind power production sites. The National Solar Radiation Database (NSRDB) is a similar high temporal- and spatial resolution database of 18 years of solar resource data for North America and India. The need for high-resolution weather data pushes modeling towards finer scales and closer synchronization. We also present how we anticipate such datasets developing in the future, their benefits, and the challenges with using and disseminating such large amounts of data.

X-rays taken by radiologists. Influence on a continuous quality improvement process?

International Nuclear Information System (INIS)

Kurtz, C.; Freiburg Univ.; Czapp, W.; Trampe, I.; Leppek, R.; Klose, K.J.

2000-01-01

Purpose: To evaluate how the training of radiology residents in taking radiographs influences the work of radiographers and the established quality standards. Methods: A first year radiology resident was trained for 4 weeks in focusing and exposure techniques by radiographers. In a second period the resident took 582 radiograms, which were compared with those taken by technicians for error estimation on a daily basis. During a third period the radiographs were produced in a contest between the resident and a skilled radiographer. Errors were analysed by two independent experts according to established guidelines of the German Medical Association. Results: At the beginning of the second period the average error rate of the resident was 11.9% as compared to 8.9% in the technicians team, in the following month 9.2% versus 15.9%. In the third period no relevant difference in errors could be observed. Finally, unexpected quality improvements were implemented like an improved standardization of focusing and exposure techniques as well as dose reduction. Conclusions: Radiology residents easily learn focusing and exposure techniques and achieve comparable results as radiographers within a short period of time. The additionally achieved knowledge improves the technical process of taking radiographs. We recommend to include a two plane radiography training period in the curriculum of radiology residents. It reinforces the radiologist's role in continuous quality improvements of the diagnostic process. (orig.) [de

Impact of continuous quality improvement initiatives on clinical outcomes in peritoneal dialysis.

Science.gov (United States)

Yu, Yusheng; Zhou, Yan; Wang, Han; Zhou, Tingting; Li, Qing; Li, Taoyu; Wu, Yan; Liu, Zhihong

2014-06-01

We evaluated the role of a quality improvement initiative in improving clinical outcomes in peritoneal dialysis (PD). In a retrospective analysis of 6 years of data from a hospital registry, the period between 1 July 2005 and 30 June 2008 (control group) provided baseline data from before implementation of systemic outcomes monitoring, and the period between 1 July 2008 and 30 June 2011 [continuous quality improvement (CQI) group] represented the time when a CQI program was in place. Peritonitis incidence, patient and technique survival, cardiovascular status, causes of death, and drop-out were compared between the groups. In the 370 patients of the CQI group and the 249 patients of the control group, the predominant underlying kidney diseases were chronic glomerulonephritis and diabetic nephropathy. After implementation of the CQI initiative, the peritonitis rate declined to 1 episode in 77.25 patient-months from 1 episode in 22.86 patient-months. Ultrasound parameters of cardiac structure were generally unchanged in the CQI group, but significant increases in cardiothoracic ratio and interventricular septal thickness were observed in the control group (both p improve technique survival rates: 95.6%, 92.6%, and 92.6% in the CQI group compared with 89.6%, 79.2%, and 76.8% in the control group (p improve the quality of therapy and its outcomes. Copyright © 2014 International Society for Peritoneal Dialysis.

Potential of integrated continuous surveys and quality management to support monitoring, evaluation, and the scale-up of health interventions in developing countries.

Science.gov (United States)

Rowe, Alexander K

2009-06-01

Well-funded initiatives are challenging developing countries to increase health intervention coverage and show impact. Despite substantial resources, however, major obstacles include weak health systems, a lack of reasonably accurate monitoring data, and inadequate use of data for managing programs. This report discusses how integrated continuous surveys and quality management (I-Q), which are well-recognized approaches in wealthy countries, could support intervention scale-up, monitoring and evaluation, quality control for commodities, capacity building, and implementation research in low-resource settings. Integrated continuous surveys are similar to existing national cross-sectional surveys of households and health facilities, except data are collected over several years by permanent teams, and most results are reported monthly at the national, province, and district levels. Quality management involves conceptualizing work as processes, involving all workers in quality improvement, monitoring quality, and teams that improve quality with "plan-do-study-act" cycles. Implementing and evaluating I-Q in a low-income country would provide critical information on the value of this approach.

Quality management manual for production of high quality cassava flour

DEFF Research Database (Denmark)

Dziedzoave, Nanam Tay; Abass, Adebayo Busura; Amoa-Awua, Wisdom K.

The high quality cassava flour (HQCF) industry has just started to evolve in Africa and elsewhere. The sustainability of the growing industry, the profitability of small- and medium-scale enterprises (SMEs) that are active in the industry and good-health of consumers can best be guaranteed through...... the adoption of proper quality and food safety procedures. Cassava processing enterprises involved in the productionof HQCF must therefore be commited to the quality and food safety of the HQCF. They must have the right technology, appropriate processing machhinery, standard testing instruments...... and the necessary technical expertise. This quality manual was therefore developed to guide small- to medium-scale cassava in the design and implematation of Hazard Analysis Critical Control Point (HACCP) system and Good manufacturing Practices (GMP) plans for HQCF production. It describes the HQCF production...

Air quality continued to improve in 2014, but progress are still needed

International Nuclear Information System (INIS)

Le Moullec, Aurelie

2015-09-01

The improvement in air quality that began some years ago continued. Average concentrations of pollutants decreased and exceedance of thresholds for protection of health was observed in fewer areas. Progress was, notably, the result of efforts made to reduce emissions, something made more difficult by the number and variety of sources of pollution. These improvements were, however, fragile as they were partially dependent on weather conditions. 2014 was, thus, marked by an important episode of particulate pollution. In addition, the progress made was not sufficient to bring France into full compliance with European standards, as was also the case for other European countries. (author)

Complementary therapy use and quality of life in persons with high-grade gliomas.

Science.gov (United States)

Fox, Sherry; Laws, Edward R; Anderson, Frederick; Farace, Elana

2006-08-01

Studies have indicated that 30%-80% of cancer patients use complementary and alternative practices and products (CAPPs), but little is known about CAPPs use by persons with brain tumors. This secondary analysis of Glioma Outcomes Project data compared CAPPs users with nonusers, compared those who stopped using CAPPs with those who continued use, described frequency and patterns of CAPPs use, and compared the relationship of CAPPs use to self-reported quality of life (QOL) over time, in 186 persons with high-grade gliomas. CAPPs users at all three measurement points rated QOL higher, although not significantly higher, than nonusers. Study findings support further exploration of CAPPs use and its effects on key outcomes in persons with high-grade gliomas.

Furthering the quality agenda in Aboriginal community controlled health services: understanding the relationship between accreditation, continuous quality improvement and national key performance indicator reporting.

Science.gov (United States)

Sibthorpe, Beverly; Gardner, Karen; McAullay, Daniel

2016-01-01

A rapidly expanding interest in quality in the Aboriginal-community-controlled health sector has led to widespread uptake of accreditation using more than one set of standards, a proliferation of continuous quality improvement programs and the introduction of key performance indicators. As yet, there has been no overarching logic that shows how they relate to each other, with consequent confusion within and outside the sector. We map the three approaches to the Framework for Performance Assessment in Primary Health Care, demonstrating their key differences and complementarity. There needs to be greater attention in both policy and practice to the purposes and alignment of the three approaches if they are to embed a system-wide focus that supports quality improvement at the service level.

Potential and Prospects of Continuous Polyhydroxyalkanoate (PHA Production

Directory of Open Access Journals (Sweden)

Martin Koller

2015-05-01

Full Text Available Together with other so-called “bio-plastics”, Polyhydroxyalkanoates (PHAs are expected to soon replace established polymers on the plastic market. As a prerequisite, optimized process design is needed to make PHAs attractive in terms of costs and quality. Nowadays, large-scale PHA production relies on discontinuous fed-batch cultivation in huge bioreactors. Such processes presuppose numerous shortcomings such as nonproductive time for reactor revamping, irregular product quality, limited possibility for supply of certain carbon substrates, and, most of all, insufficient productivity. Therefore, single- and multistage continuous PHA biosynthesis is increasingly investigated for production of different types of microbial PHAs; this goes for rather crystalline, thermoplastic PHA homopolyesters as well as for highly flexible PHA copolyesters, and even blocky-structured PHAs consisting of alternating soft and hard segments. Apart from enhanced productivity and constant product quality, chemostat processes can be used to elucidate kinetics of cell growth and PHA formation under constant process conditions. Furthermore, continuous enrichment processes constitute a tool to isolate novel powerful PHA-producing microbial strains adapted to special environmental conditions. The article discusses challenges, potential and case studies for continuous PHA production, and shows up new strategies to further enhance such processes economically by developing unsterile open continuous processes combined with the application of inexpensive carbon feedstocks.

High-power, continuous-wave, single-frequency, all-periodically-poled, near-infrared source.

Science.gov (United States)

Devi, Kavita; Chaitanya Kumar, S; Ebrahim-Zadeh, M

2012-12-15

We report a high-power, single-frequency, continuous-wave (cw) source tunable across 775-807 nm in the near-infrared, based on internal second harmonic generation (SHG) of a cw singly-resonant optical parametric oscillator (OPO) pumped by a Yb-fiber laser. The compact, all-periodically-poled source employs a 48-mm-long, multigrating MgO doped periodically poled lithium niobate (MgO:PPLN) crystal for the OPO and a 30-mm-long, fan-out grating MgO-doped stoichiometric periodically poled lithium tantalate (MgO:sPPLT) crystal for intracavity SHG, providing as much as 3.7 W of near-infrared power at 793 nm, together with 4 W of idler power at 3232 nm, at an overall extraction efficiency of 28%. Further, the cw OPO is tunable across 3125-3396 nm in the idler, providing as much as 4.3 W at 3133 nm with >3.8  W over 77% of the tuning range together with >3  W of near-infrared power across 56% of SHG tuning range, in high-spatial beam-quality with M2<1.4. The SHG output has an instantaneous linewidth of 8.5 MHz and exhibits a passive power stability better than 3.5% rms over more than 1 min.

A story of success: continuous quality improvement in cystic fibrosis care in the USA.

Science.gov (United States)

Quon, Bradley S; Goss, Christopher H

2011-12-01

Continuous quality improvement (CQI) in healthcare can be described as a reiterative approach to improving processes to reduce unexpected variation in health outcomes. CQI represents one model to achieve quality improvement (QI) and has long been recognized as a key to success in the manufacturing industry with companies like Toyota leading the way. Healthcare, and specifically pulmonary, critical care and sleep medicine represent ideal settings for the application of CQI. This opinion piece will describe QI and CQI initiatives in the US Cystic fibrosis (CF) population. QI in CF care in the United States has been ongoing since inception of the US CF Foundation (CFF) in 1955. This effort has included work to improve the quality of clinical care provided at CF centers and work to improve clinical outcomes in CF. More recently, QI methods have been applied to the conduct of clinical research. The CF community has become a leader in the area of QI and has pointed out the opportunities for others to follow in the area of lung diseases.

Evaluation of a guided continuous quality improvement program in community pharmacies.

Science.gov (United States)

Chinthammit, Chanadda; Rupp, Michael T; Armstrong, Edward P; Modisett, Tara; Snead, Rebecca P; Warholak, Terri L

2017-01-01

The importance of creating and sustaining a strong culture of patient safety has been recognized as a critical component of safe medication use. This study aims to assess changes in attitudes toward patient safety culture and frequency of quality-related event (QRE) reporting after guided implementation of a continuous quality improvement (CQI) program in a panel of community pharmacies in the United States (U.S.). Twenty-one community pharmacies volunteered to participate in the project and were randomly assigned to intervention or control groups. Pharmacy staff in the intervention group received guided training to ensure full implementation of a CQI program while those in the control group partially implemented the program. Pharmacy staff in both groups completed retrospective pre-post safety culture questionnaires and reported medication errors and near misses that occurred in their practices. Rasch analysis was applied to assess questionnaire validity and reliability and to confirm if the ordinal level data approximated interval level measures. Paired t-tests and repeated measure analysis of covariance tests were subsequently used to compare observed changes in the attitudes of subjects and frequency of QREs reporting in intervention and control groups. Sixty-nine employees completed the questionnaire, a 43.9% response rate. Improvement in attitudes toward patient safety was statistically significant in the intervention group in six domains: staff, training, and skill ( p  = 0.017); patient counseling ( p  = 0.043); communication about mistakes ( p  continuous improvement ( p  < 0.001); and overall patient safety perceptions ( p  = 0.033). No significant differences were observed in QRE reporting rates between intervention and control groups. However, differences were observed in the types of QREs reported (e.g., incorrect safety cap) and the point in the prescription processing workflow where a QRE was detected (e.g., partner check station, and drug

Quality Assurance Strategy for Existing Homes: Final Quality Management Primer for High Performing Homes

Energy Technology Data Exchange (ETDEWEB)

Del Bianco, M.; Taggart, J.; Sikora, J.; Wood, A.

2012-12-01

This guide is designed to help Building America (BA) Teams understand quality management and its role in transitioning from conventional to high performance home building and remodeling. It explains what quality means, the value of quality management systems, the unique need for QMS when building high performing homes, and the first steps to a implementing a comprehensive QMS. This document provides a framework and context for BA teams when they encounter builders and remodelers.

Quality Assurance Strategy for Existing Homes. Final Quality Management Primer for High Performing Homes

Energy Technology Data Exchange (ETDEWEB)

Del Bianco, M. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Taggart, J. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Sikora, J. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Wood, A. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States)

2012-12-01

This guide is designed to help Building America (BA) teams understand quality management and its role in transitioning from conventional to high performance home building and remodeling. It explains what quality means, the value of quality management systems, the unique need for QMS when building high performing homes, and the first steps to a implementing a comprehensive QMS. This document provides a framework and context for BA teams when they encounter builders and remodelers.

Organizational learning and continuous quality improvement: examining the impact on nursing home performance.

Science.gov (United States)

Rondeau, Kent V; Wagar, Terry H

2002-01-01

Interest is growing in learning more about the ability of total quality management and continuous quality improvement (TQM/CQI) initiatives to contribute to the performance of healthcare organizations. A major factor in the successful implementation of TQM/CQI is the seminal contribution of an organization's culture. Many implementation efforts have not succeeded because of a corporate culture that failed to stress broader organizational learning. This may help to explain why some TQM/CQI programs have been unsuccessful in improving healthcare organization performance. Organizational performance variables and organizational learning orientation were assessed in a sample of 181 Canadian long-term care organizations that had implemented a formal TQM/CQI program. Categorical regression analysis shows that, in the absence of a strong corporAte culture that stresses organizational learning and employee development, few performance enhancements are reported. The results of the assessment suggest that a TQM/CQI program without the backing of a strong organizational learning culture may be insufficient to achieve augmented organizational performance.

75 FR 17529 - High-Voltage Continuous Mining Machine Standard for Underground Coal Mines

Science.gov (United States)

2010-04-06

... High-Voltage Continuous Mining Machine Standard for Underground Coal Mines AGENCY: Mine Safety and... of high-voltage continuous mining machines in underground coal mines. It also revises MSHA's design...-- Underground Coal Mines III. Section-by-Section Analysis A. Part 18--Electric Motor-Driven Mine Equipment and...

Quality management program according to the ISO 9001: 2000 for the high density research reactor fuel development project (CADRIP)

International Nuclear Information System (INIS)

Mazzini, M.; Mamberto, L.; Piazza, A.F.

2002-01-01

The Quality is recognized at world level as the most effective and competitive strategy for the economic survival and the prosperity of organizations. In such a sense it is used to speak of the quality globalization. To be able to be competitive and to satisfy the more and more demanding expectations of the customers, the organization should use systems every time more effective and efficient. Such systems should lead to a continuous improvement of the quality and a highest satisfaction of the customers and of all the involved sectors (personnel, collaborators, stakeholders, suppliers, society). To these effects the National Commission of Atomic Energy of the Argentine Republic (CNEA) there is elaborated, ace necessary methodological instrument to guide and assessment t the process of continuous improvement of all the activities of the organization, to Quality Management Program (PGC) from which the Quality Systems of the facilities, laboratories and projects depends. The Quality System of the Development of Nuclear Fuels of High Density Project (CADRIP) was develop in accordance of the requirements of the PGC and the ISO 9001:2000, IAEA 50-C/SG-Q and AR 3.6.1. of the Nuclear Regulatory Body standards. The work describes this quality system, the systematic identification and administration of the processes used for the organization and the interaction among them. (author)

Continuous improvement in pursuit of quality (presidential address to the Midland Institute Branch of the Institute of Mining Engineers)

Energy Technology Data Exchange (ETDEWEB)

Siddall, R G [British Coal Corporation (United Kingdom). South Yorkshire Group

1993-03-01

The author considers that quality must be a central element in the future strategy of the UK coal mining industry. This quality approach should be all embracing and extend beyond physical performance to include safety, effective use of capital, customer satisfaction, environmental pressures and overall image. The address discusses, the current position in British Coal; strategic planning; the need for continuous improvement; and productivity and production problems.

Advancing obstetric and neonatal care in a regional hospital in Ghana via continuous quality improvement.

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Srofenyoh, Emmanuel; Ivester, Thomas; Engmann, Cyril; Olufolabi, Adeyemi; Bookman, Laurel; Owen, Medge

2012-01-01

To reduce maternal and neonatal death at a large regional hospital through the use of quality improvement methodologies. In 2007, Kybele and the Ghana Health Service formed a partnership to analyze systems and patient care processes at a regional hospital in Accra, Ghana. A model encompassing continuous assessment, implementation, advocacy, outputs, and outcomes was designed. Key areas for improvement were grouped into "bundles" based on personnel, systems management, and service quality. Primary outcomes included maternal and perinatal mortality, and case fatality rates for hemorrhage and hypertensive disorders. Implementation and outcomes were evaluated tri-annually between 2007 and 2009. During the study period, there was a 34% decrease in maternal mortality despite a 36% increase in patient admission. Case fatality rates for pre-eclampsia and hemorrhage decreased from 3.1% to 1.1% (Pcontinuous quality improvement were developed and employed. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Influence of Continuing Medical Education on Rheumatologists' Performance on National Quality Measures for Rheumatoid Arthritis.

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Sapir, Tamar; Rusie, Erica; Greene, Laurence; Yazdany, Jinoos; Robbins, Mark L; Ruderman, Eric M; Carter, Jeffrey D; Patel, Barry; Moreo, Kathleen

2015-12-01

In recent years researchers have reported deficits in the quality of care provided to patients with rheumatoid arthritis (RA), including low rates of performance on quality measures. We sought to determine the influence of a quality improvement (QI) continuing education program on rheumatologists' performance on national quality measures for RA, along with other measures aligned with National Quality Strategy priorities. Performance was assessed through baseline and post-education chart audits. Twenty community-based rheumatologists across the United States were recruited to participate in the QI education program and chart audits. Charts were retrospectively audited before (n = 160 charts) and after (n = 160 charts) the rheumatologists participated in a series of accredited QI-focused educational activities that included private audit feedback, small-group webinars, and online- and mobile-accessible print and video activities. The charts were audited for patient demographics and the rheumatologists' documented performance on the 6 quality measures for RA included in the Physician Quality Reporting System (PQRS). In addition, charts were abstracted for documentation of patient counseling about medication benefits/risks and adherence, lifestyle modifications, and quality of life; assessment of RA medication side effects; and assessment of RA medication adherence. Mean rates of documented performance on 4 of the 6 PQRS measures for RA were significantly higher in the post-education versus baseline charts (absolute increases ranged from 9 to 24% of patient charts). In addition, after the intervention, significantly higher mean rates were observed for patient counseling about medications and quality of life, and for assessments of medication side effects and adherence (absolute increases ranged from 9 to 40% of patient charts). This pragmatic study provides preliminary evidence for the positive influence of QI-focused education in helping rheumatologists improve

Inequality in Preschool Quality? Community-Level Disparities in Access to High-Quality Learning Environments

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Bassok, Daphna; Galdo, Eva

2016-01-01

In recent years, unequal access to high-quality preschool has emerged as a growing public policy concern. Because of data limitations, it is notoriously difficult to measure disparities in access to early learning opportunities across communities and particularly challenging to quantify gaps in access to "high-quality" programs. Research…

A Multi-center Study on Improvement in Life Quality of Pediatric Patients with Asthma via Continuous Care.

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Cai, Ying; Cao, Junhua; Kan, Ruixue; Liu, Yuping; Zhao, Li; Hu, Ming; Zhang, Xuemei

2017-11-01

To analyze and summarize the effect of continuous care on the life quality and control of asthma of pediatric patients with asthma discharged from multiple hospitals. Retrospective analysis was carried out on 172 pediatric patients with asthma aged between 6 and 11 yr old randomly selected from those admitted to five hospitals between January 2014 and December 2015. Among these 172 patients, only 86 (intervention group) received the continuous care between January 2015 and December 2015, while the rest (control group) did not receive from January 2014 and December 2014. After the patients in the intervention group were discharged from the hospital, the ratio of practical forced expiratory volume in one second (FEV1) to the expected FEV1 at the 12 th month was (90.28±10.35)%, and the ratio of peak expiratory flow to the expected value was (84.24±3.43)%, respectively higher than those [(82.73±8.86)% and (75.80±4.67)%] in the control group. Regarding pediatric asthma quality of life questionnaire (PAQLQ) between the intervention group and the control group, the difference had statistical significance ( Z =-7.254, PContinuous care can improve the pediatric patient's pulmonary function and life quality, and effectively control the asthmatic symptoms.

Low-quality birds do not display high-quality signals: The cysteine-pheomelanin mechanism of honesty

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Galván, Ismael; Wakamatsu, Kazumasa; Camarero, Pablo R; Mateo, Rafael; Alonso-Alvarez, Carlos

2015-01-01

The mechanisms that make that the costs of producing high-quality signals are unaffordable to low-quality signalers are a current issue in animal communication. The size of the melanin-based bib of male house sparrows Passer domesticus honestly signals quality. We induced the development of new bibs while treating males with buthionine-sulfoximine (BSO), a substance that depletes the levels of the antioxidant glutathione (GSH) and the amino acid cysteine, two elements that switch melanogenesis from eumelanin to pheomelanin. Final bib size is negatively related to pheomelanin levels in the bib feathers. BSO reduced cysteine and GSH levels in all birds, but improved phenotypes (bibs larger than controls) were only expressed by high-quality birds (BSO birds with largest bibs initially). Negative associations between final bib size and cysteine levels in erythrocytes, and between pheomelanin and cysteine levels, were observed in high-quality birds only. These findings suggest that a mechanism uncoupling pheomelanin and cysteine levels may have evolved in low-quality birds to avoid producing bibs of size not corresponding to their quality and greater relative costs. Indeed, greater oxidative stress in cells was not observed in low-quality birds. This may represent the first mechanism maintaining signal honesty without producing greater relative costs on low-quality signalers. PMID:25330349

Continuous water quality monitoring for the hard clam industry in Florida, USA.

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Bergquist, Derk C; Heuberger, David; Sturmer, Leslie N; Baker, Shirley M

2009-01-01

In 2000, Florida's fast-growing hard clam aquaculture industry became eligible for federal agricultural crop insurance through the US Department of Agriculture, but the responsibility for identifying the cause of mortality remained with the grower. Here we describe the continuous water quality monitoring system used to monitor hard clam aquaculture areas in Florida and show examples of the data collected with the system. Systems recording temperature, salinity, dissolved oxygen, water depth, turbidity and chlorophyll at 30 min intervals were installed at 10 aquaculture lease areas along Florida's Gulf and Atlantic coasts. Six of these systems sent data in real-time to a public website, and all 10 systems provided data for web-accessible archives. The systems documented environmental conditions that could negatively impact clam survival and productivity and identified biologically relevant water quality differences among clam aquaculture areas. Both the real-time and archived data were used widely by clam growers and nursery managers to make management decisions and in filing crop loss insurance claims. While the systems were labor and time intensive, we recommend adjustments that could reduce costs and staff time requirements.

Influence of the washing program on the blood processing performance of a continuous autotransfusion device.

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Yoon, Chiyul; Noh, Seungwoo; Lee, Jung Chan; Ko, Sung Ho; Ahn, Wonsik; Kim, Hee Chan

2014-03-01

The continuous autotransfusion system has been widely used in surgical operations. It is known that if oil is added to blood, and this mixture is then processed by an autotransfusion device, the added oil is removed and reinfusion of fat is prevented by the device. However, there is no detailed report on the influence of the particular washing program selected on the levels of blood components including blood fat after continuous autotransfusion using such a system. Fresh bovine blood samples were processed by a commercial continuous autotransfusion device using the "emergency," "quality," and "high-quality" programs, applied in random order. Complete blood count (CBC) and serum chemistry were analyzed to determine how the blood processing performance of the device changes with the washing program applied. There was no significant difference in the CBC results obtained with the three washing programs. Although all of the blood lipids in the processed blood were decreased compared to those in the blood before processing, the levels of triglyceride, phospholipid, and total cholesterol after processing via the emergency program were significantly higher than those present after processing via the quality and high-quality programs. Although the continuous autotransfusion device provided consistent hematocrit quality, the levels of some blood lipid components showed significant differences among the washing programs.

Emblems of Quality in Higher Education. Developing and Sustaining High-Quality Programs.

Science.gov (United States)

Haworth, Jennifer Grant; Conrad, Clifton F.

This book proposes an "engagement" theory of program quality to evaluate and improve higher education programs at all degree levels. Based on interviews with 781 participants in a national study of Masters degree programs, it focuses on the interactive roles of students, faculty, and administrators in developing high-quality programs…

Indigenous health: effective and sustainable health services through continuous quality improvement.

Science.gov (United States)

Bailie, Ross S; Si, Damin; O'Donoghue, Lyn; Dowden, Michelle

2007-05-21

The Australian government's Healthy for Life program is supporting capacity development in Indigenous primary care using continuous quality improvement (CQI) techniques. An important influence on the Healthy for Life program has been the ABCD research project. The key features contributing to the success of the project are described. The ABCD research project: uses a CQI approach, with an ongoing cycle of gathering data on how well organisational systems are functioning, and developing and then implementing improvements; is guided by widely accepted principles of community-based research, which emphasise participation; and adheres to the principles and values of Indigenous health research and service delivery. The potential for improving health outcomes in Aboriginal and Torres Strait Islander communities using a CQI approach should be strengthened by clear clinical and managerial leadership, supporting service organisations at the community level, and applying participatory-action principles.

Continuous High Frequency Activity: A peculiar SEEG pattern related to specific brain regions

Science.gov (United States)

Melani, Federico; Zelmann, Rina; Mari, Francesco; Gotman, Jean

2015-01-01

Objective While visually marking the high frequency oscillations in the stereo-EEG of epileptic patients, we observed a continuous/semicontinuous activity in the ripple band (80–250 Hz), which we defined continuous High Frequency Activity (HFA). We aim to analyze in all brain regions the occurrence and significance of this particular pattern. Methods Twenty patients implanted in mesial temporal and neocortical areas were studied. One minute of slow-wave sleep was reviewed. The background was classified as continuous/semicontinuous, irregular, or sporadic based on the duration of the fast oscillations. Each channel was classified as inside/outside the seizure onset zone (SOZ) or a lesion. Results The continuous/semicontinuous HFA occurred in 54 of the 790 channels analyzed, with a clearly higher prevalence in hippocampus and occipital lobe. No correlation was found with the SOZ or lesions. In the occipital lobe the continuous/semicontinuous HFA was present independently of whether eyes were open or closed. Conclusions We describe what appears to be a new physiological High Frequency Activity, independent of epileptogenicity, present almost exclusively in the hippocampus and occipital cortex but independent of the alpha rhythm. Significance The continuous HFA may be an intrinsic characteristic of specific brain regions, reflecting a particular type of physiological neuronal activity. PMID:23768436

Long quantum channels for high-quality entanglement transfer

International Nuclear Information System (INIS)

Banchi, L; Apollaro, T J G; Cuccoli, A; Verrucchi, P; Vaia, R

2011-01-01

High-quality quantum-state and entanglement transfer can be achieved in an unmodulated spin bus operating in the ballistic regime, which occurs when the endpoint qubits A and B are nonperturbatively coupled to the chain by a suitable exchange interaction j 0 . Indeed, the transition amplitude characterizing the transfer quality exhibits a maximum for a finite optimal value j opt 0 (N), where N is the channel length. We show that j opt 0 (N) scales as N -1/6 for large N and that it ensures a high-quality entanglement transfer even in the limit of arbitrarily long channels, almost independently of the channel initialization. For instance, for any chain length the average quantum-state transmission fidelity exceeds 90% and decreases very little in a broad neighbourhood of j opt 0 (N). We emphasize that, taking the reverse point of view, should j 0 be experimentally constrained, high-quality transfer can still be obtained by adjusting the channel length to its optimal value. (paper)

Improving pediatric immunization rates: description of a resident-led clinical continuous quality improvement project.

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Jones, Kyle Bradford; Gren, Lisa H; Backman, Richard

2014-09-01

Increased emphasis is being placed on the continuous quality improvement (CQI) education of residents of all specialties. This article describes a resident-led continuous quality improvement (CQI) project, based on a novel curriculum, to improve the immunization rates of children under 2 years old at the Madsen Family Health Center (MHC). All third-year residents were trained in the FOCUS-PDSA CQI methodology through concurrent didactic lectures and experience leading the CQI team. The CQI team included clinical staff led by a third-year family medicine resident and mentored by a member of the family medicine faculty. Immunization records were distributed to provider-medical assistant teamlets daily for each pediatric patient scheduled in clinic as the intervention. Compliance with the intervention (process measure), as well as immunization rates at 2 and 5 months post-intervention (outcome measure), were monitored. Immunization records were printed on 84% of clinic days from October 24, 2011 to March 31, 2012. The percentage of patients immunized at baseline was 66%. The percentage immunized as of December 31, 2011 was 96% and was 91% as of March 31, 2012. An important educational experience was organized for third-year family medicine residents through learning CQI skills, leading a CQI team, and directing a CQI project to completion. Significant improvement in the percentage of patients under 2 years old immunized at the MHC was achieved by presenting provider-medical assistant teamlets with immunization records of all pediatric patients on the daily clinic schedule.

Efficient continuous-wave nonlinear frequency conversion in high-Q gallium nitride photonic crystal cavities on silicon

Directory of Open Access Journals (Sweden)

Mohamed Sabry Mohamed

2017-03-01

Full Text Available We report on nonlinear frequency conversion from the telecom range via second harmonic generation (SHG and third harmonic generation (THG in suspended gallium nitride slab photonic crystal (PhC cavities on silicon, under continuous-wave resonant excitation. Optimized two-dimensional PhC cavities with augmented far-field coupling have been characterized with quality factors as high as 4.4 × 104, approaching the computed theoretical values. The strong enhancement in light confinement has enabled efficient SHG, achieving a normalized conversion efficiency of 2.4 × 10−3 W−1, as well as simultaneous THG. SHG emission power of up to 0.74 nW has been detected without saturation. The results herein validate the suitability of gallium nitride for integrated nonlinear optical processing.

Identifying suitable substrates for high-quality graphene-based heterostructures

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Banszerus, L.; Janssen, H.; Otto, M.; Epping, A.; Taniguchi, T.; Watanabe, K.; Beschoten, B.; Neumaier, D.; Stampfer, C.

2017-06-01

We report on a scanning confocal Raman spectroscopy study investigating the strain-uniformity and the overall strain and doping of high-quality chemical vapour deposited (CVD) graphene-based heterostuctures on a large number of different substrate materials, including hexagonal boron nitride (hBN), transition metal dichalcogenides, silicon, different oxides and nitrides, as well as polymers. By applying a hBN-assisted, contamination free, dry transfer process for CVD graphene, high-quality heterostructures with low doping densities and low strain variations are assembled. The Raman spectra of these pristine heterostructures are sensitive to substrate-induced doping and strain variations and are thus used to probe the suitability of the substrate material for potential high-quality graphene devices. We find that the flatness of the substrate material is a key figure for gaining, or preserving high-quality graphene.

Continuous support for women during childbirth.

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Bohren, Meghan A; Hofmeyr, G Justus; Sakala, Carol; Fukuzawa, Rieko K; Cuthbert, Anna

2017-07-06

additional information from the trial authors. The quality of the evidence was assessed using the GRADE approach. We included a total of 27 trials, and 26 trials involving 15,858 women provided usable outcome data for analysis. These trials were conducted in 17 different countries: 13 trials were conducted in high-income settings; 13 trials in middle-income settings; and no studies in low-income settings. Women allocated to continuous support were more likely to have a spontaneous vaginal birth (average RR 1.08, 95% confidence interval (CI) 1.04 to 1.12; 21 trials, 14,369 women; low-quality evidence) and less likely to report negative ratings of or feelings about their childbirth experience (average RR 0.69, 95% CI 0.59 to 0.79; 11 trials, 11,133 women; low-quality evidence) and to use any intrapartum analgesia (average RR 0.90, 95% CI 0.84 to 0.96; 15 trials, 12,433 women). In addition, their labours were shorter (MD -0.69 hours, 95% CI -1.04 to -0.34; 13 trials, 5429 women; low-quality evidence), they were less likely to have a caesarean birth (average RR 0.75, 95% CI 0.64 to 0.88; 24 trials, 15,347 women; low-quality evidence) or instrumental vaginal birth (RR 0.90, 95% CI 0.85 to 0.96; 19 trials, 14,118 women), regional analgesia (average RR 0.93, 95% CI 0.88 to 0.99; 9 trials, 11,444 women), or a baby with a low five-minute Apgar score (RR 0.62, 95% CI 0.46 to 0.85; 14 trials, 12,615 women). Data from two trials for postpartum depression were not combined due to differences in women, hospitals and care providers included; both trials found fewer women developed depressive symptomatology if they had been supported in birth, although this may have been a chance result in one of the studies (low-quality evidence). There was no apparent impact on other intrapartum interventions, maternal or neonatal complications, such as admission to special care nursery (average RR 0.97, 95% CI 0.76 to 1.25; 7 trials, 8897 women; low-quality evidence), and exclusive or any breastfeeding

A Continuous Quality Improvement Project to Implement Infant-Driven Feeding as a Standard of Practice in the Newborn/Infant Intensive Care Unit.

Science.gov (United States)

Chrupcala, Kimberly A; Edwards, Taryn M; Spatz, Diane L

2015-01-01

To increase the number of neonates who were fed according to cues prior to discharge and potentially decrease length of stay. Continuous quality improvement. Eighty-five bed level IV neonatal intensive care unit. Surgical and nonsurgical neonates of all gestational ages. Neonates younger than 32 weeks gestation, who required intubation, continuous positive airway pressure (CPAP), high flow nasal cannula (HFNC), or did not have suck or gag reflexes were excluded as potential candidates for infant-driven feeding. The project was conducted over a 13-month period using the following methods: (a) baseline data collection, (b) designation of Infant Driven Feeding (IDF) Champions, (c) creation of a multidisciplinary team, (d) creation of electronic health record documentation, (e) initial staff education, (f) monthly team meetings, (g) reeducation throughout the duration of the project, and (h) patient-family education. Baseline data were collected on 20 neonates with a mean gestational age of 36 0/7(th) weeks and a mean total length of stay (LOS) of 43 days. Postimplementation data were collected on 150 neonates with a mean gestational age of 36 1/7(th) weeks and a mean total LOS of 36.4 days. A potential decrease in the mean total LOS of stay by 6.63 days was achieved during this continuous quality improvement (CQI) project. Neonates who are fed according to cues can become successful oral feeders and can be safely discharged home regardless of gestational age or diagnosis. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Continuous production of fenofibrate solid lipid nanoparticles by hot-melt extrusion technology: a systematic study based on a quality by design approach.

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Patil, Hemlata; Feng, Xin; Ye, Xingyou; Majumdar, Soumyajit; Repka, Michael A

2015-01-01

This contribution describes a continuous process for the production of solid lipid nanoparticles (SLN) as drug-carrier systems via hot-melt extrusion (HME). Presently, HME technology has not been used for the manufacturing of SLN. Generally, SLN are prepared as a batch process, which is time consuming and may result in variability of end-product quality attributes. In this study, using Quality by Design (QbD) principles, we were able to achieve continuous production of SLN by combining two processes: HME technology for melt-emulsification and high-pressure homogenization (HPH) for size reduction. Fenofibrate (FBT), a poorly water-soluble model drug, was incorporated into SLN using HME-HPH methods. The developed novel platform demonstrated better process control and size reduction compared to the conventional process of hot homogenization (batch process). Varying the process parameters enabled the production of SLN below 200 nm. The dissolution profile of the FBT SLN prepared by the novel HME-HPH method was faster than that of the crude FBT and a micronized marketed FBT formulation. At the end of a 5-h in vitro dissolution study, a SLN formulation released 92-93% of drug, whereas drug release was approximately 65 and 45% for the marketed micronized formulation and crude drug, respectively. Also, pharmacokinetic study results demonstrated a statistical increase in Cmax, Tmax, and AUC0-24 h in the rate of drug absorption from SLN formulations as compared to the crude drug and marketed micronized formulation. In summary, the present study demonstrated the potential use of hot-melt extrusion technology for continuous and large-scale production of SLN.

Continuous improvement concepts as a link between quality assurance and implementation of cleaner production: Case study in the generic pharmaceutical industry

Directory of Open Access Journals (Sweden)

Boltić Zorana

2016-01-01

Full Text Available The subject and the research objective presented in this article is establishing of the relationship between quality assurance and implementation of cleaner production in the generic pharmaceutical industry through the comprehensive concept of continuous improvement. This is mostly related to application of Lean and Six Sigma tools and techniques for process improvement and their link to other known concepts used in the industrial environment, especially manufacturing of generic pharmaceutical products from which two representative case studies were selected for comparative analysis, also considering relevant regulatory requirements in the field of quality management, as well as appropriate quality standards. Although the methodology discussed in this conceptual and practice oriented article is strongly related to chemical engineering, the focus is mainly on process industry, i.e. production systems, rather than any specific technological process itself. The scope of this research is an engineering approach to evaluation of the production systems in terms of continuous improvement concepts application, considering both quality aspects and efficiency of such systems. [Projekat Ministarstva nauke Republike Srbije, br. TR 34009

Conjugated Polymers Via Direct Arylation Polymerization in Continuous Flow: Minimizing the Cost and Batch-to-Batch Variations for High-Throughput Energy Conversion.

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Gobalasingham, Nemal S; Carlé, Jon E; Krebs, Frederik C; Thompson, Barry C; Bundgaard, Eva; Helgesen, Martin

2017-11-01

Continuous flow methods are utilized in conjunction with direct arylation polymerization (DArP) for the scaled synthesis of the roll-to-roll compatible polymer, poly[(2,5-bis(2-hexyldecyloxy)phenylene)-alt-(4,7-di(thiophen-2-yl)-benzo[c][1,2,5]thiadiazole)] (PPDTBT). PPDTBT is based on simple, inexpensive, and scalable monomers using thienyl-flanked benzothiadiazole as the acceptor, which is the first β-unprotected substrate to be used in continuous flow via DArP, enabling critical evaluation of the suitability of this emerging synthetic method for minimizing defects and for the scaled synthesis of high-performance materials. To demonstrate the usefulness of the method, DArP-prepared PPDTBT via continuous flow synthesis is employed for the preparation of indium tin oxide (ITO)-free and flexible roll-coated solar cells to achieve a power conversion efficiency of 3.5% for 1 cm 2 devices, which is comparable to the performance of PPDTBT polymerized through Stille cross coupling. These efforts demonstrate the distinct advantages of the continuous flow protocol with DArP avoiding use of toxic tin chemicals, reducing the associated costs of polymer upscaling, and minimizing batch-to-batch variations for high-quality material. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Total quality approach at ABB Atom Nuclear Fuel - winner of the Swedish quality award 1994

International Nuclear Information System (INIS)

Moorlin, K.; Olsson, S.

1995-01-01

ABB Atom Nuclear Fuel Division received the Swedish Quality Award 1994. The company has since many years a reputation for high product quality and a well implemented quality assurance system. Since some years a total quality approach is applied. For ABB Atom, total quality means continuous improvement of all business processes keeping the customer in focus. This paper elaborates on the improvement tools used at the ABB Atom Nuclear Fuel Division and gives some detailed information of the experience. (author) 6 figs

[Audit and feedback, and continuous quality improvement strategies to improve the quality of care for type 2 diabetes: a systematic review of literature].

Science.gov (United States)

Vecchi, Simona; Agabiti, Nera; Mitrova, Susanna; Cacciani, Laura; Amato, Laura; Davoli, Marina; Bargagli, Anna Maria

2016-01-01

we analysed evidence on effective interventions to improve the quality of care and management in patients with diabetes type 2. This review focuses particularly on audit and feedback intervention, targeted to healthcare providers, and continuous quality improvement (CQI) involving health professionals and health care systems, respectively. we searched The Cochrane Library, PubMed, and EMBASE (search period: January 2005-December 2015) to identify systematic reviews (SR) and randomized controlled trials (RCTs) considering patients' outcomes and process measures as quality indicators in diabetes care. Selection of studies and data extraction were carried out independently by two reviewers. Methodological quality of individual studies was assessed using the checklist «Assessment of methodological quality of systematic review» (AMSTAR) and the Cochrane's tool, respectively. We produced summaries of results for each study design. the search process resulted in 810 citations. One SR and 7 RCTs that compared any intervention in which audit and feedback and CQI was a component vs. other interventions were selected. The SR found that audit and feedback activity was associated with improvements of glycaemic (mean difference: 0.26; 95%CI 0.08;0.44) and cholesterol control (mean difference: 0.03; 95%CI -0.04;0.10). CQI interventions were not associated with an improvement of quality of diabetes care. The RCTs considered in this review compared a broad range of interventions including feedback as unique activity or as part of more complex strategies. The methodological quality was generally poor in all the included trials. the available evidence suggests that audit and feedback and CQI improve quality of care in diabetic patients, although the effect is small and heterogeneous among process and outcomes indicators.

Methods and Conditions for Achieving Continuous Improvement of Processes

OpenAIRE

Florica BADEA; Catalina RADU; Ana-Maria GRIGORE

2010-01-01

In the early twentieth century, the Taylor model improved, in a spectacular maner the efficiency of the production processes. This allowed obtaining high productivity by low-skilled workers, but used in large number in the execution of production. Currently this model is questioned by experts and was replaced by the concept of "continuous improvement". The first signs of change date from the '80s, with the apparition of quality circles and groups of operators on quality issues, principles whi...

Continuous quality improvement intervention for adolescent and young adult HIV testing services in Kenya improves HIV knowledge.

Science.gov (United States)

Wagner, Anjuli D; Mugo, Cyrus; Bluemer-Miroite, Shay; Mutiti, Peter M; Wamalwa, Dalton C; Bukusi, David; Neary, Jillian; Njuguna, Irene N; O'Malley, Gabrielle; John-Stewart, Grace C; Slyker, Jennifer A; Kohler, Pamela K

2017-07-01

To determine whether continuous quality improvement (CQI) improves quality of HIV testing services for adolescents and young adults (AYA). CQI was introduced at two HIV testing settings: Youth Centre and Voluntary Counseling and Testing (VCT) Center, at a national referral hospital in Nairobi, Kenya. Primary outcomes were AYA satisfaction with HIV testing services, intent to return, and accurate HIV prevention and transmission knowledge. Healthcare worker (HCW) satisfaction assessed staff morale. T tests and interrupted time series analysis using Prais-Winsten regression and generalized estimating equations accounting for temporal trends and autocorrelation were conducted. There were 172 AYA (Youth Centre = 109, VCT = 63) during 6 baseline weeks and 702 (Youth Centre = 454, VCT = 248) during 24 intervention weeks. CQI was associated with an immediate increase in the proportion of AYA with accurate knowledge of HIV transmission at Youth Centre: 18 vs. 63% [adjusted risk difference (aRD) 0.42,95% confidence interval (CI) 0.21 to 0.63], and a trend at VCT: 38 vs. 72% (aRD 0.30, 95% CI -0.04 to 0.63). CQI was associated with an increase in the proportion of AYA with accurate HIV prevention knowledge in VCT: 46 vs. 61% (aRD 0.39, 95% CI 0.02-0.76), but not Youth Centre (P = 0.759). In VCT, CQI showed a trend towards increased intent to retest (4.0 vs. 4.3; aRD 0.78, 95% CI -0.11 to 1.67), but not at Youth Centre (P = 0.19). CQI was not associated with changes in AYA satisfaction, which was high during baseline and intervention at both clinics (P = 0.384, P = 0.755). HCW satisfaction remained high during intervention and baseline (P = 0.746). CQI improved AYA knowledge and did not negatively impact HCW satisfaction. Quality improvement interventions may be useful to improve adolescent-friendly service delivery.

Ninth Annual NASA/Contractors Conference on Quality and Productivity. World Class Excellence: The Journey Continues. Conference presentations

Science.gov (United States)

Templeton, Geoffrey B. (Editor); Stewart, Lynne M. (Editor)

1992-01-01

The topics covered include the following: The George M. Low Trophy; total quality assessment and measurement; using award criteria to improve organizational effectiveness; results--keeping an eye on the bottom line; capturing customer satisfaction; moving from management to leadership; leadership versus management; transforming the management team; leadership success stories; success stories in the quest for excellence; small business successes; education success stories; government success stories; tools and techniques for total quality management (TQM) integration; planning and organizing for TQM integration; successful stories for implementing system level TQM/CI tools; assessing TQM results; establishing an environment for continuous improvement at NASA; empowerment; synergism of partnering; and partnerships in education.

High quality data: An evaluation of AIM data quality and data quality procedures

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The goal of every monitoring program is to collect high-quality data which can then be used to provide information to decision makers. The Bureau of Land Management (BLM) Assessment, Inventory, and Monitoring (AIM) program is one such data set which provides rangeland status, condition, and trend in...

Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare

Science.gov (United States)

Schwartz, Robert; Cohen, Joanna; Manson, Heather; Scott, Fran

2017-01-01

Context: Evidence of the effect of continuous quality improvement (CQI) in public health and valid tools to judge that such effects are not fully formed. Objective: The objective was to adapt and apply Shortell et al.'s (1998) four dimensions of CQI in an examination of a public health accountability and performance management initiative in Ontario, Canada. Methods: In total, 24 semi-structured, in-depth interviews were conducted with informants from public health units and the Ministry of Health and Long-Term Care. A web survey of public health managers in the province was also carried out. Results: A mix of facilitators and barriers was identified. Leadership and organizational cultures, conducive to CQI success were evident. However, limitations in performance measurement and managerial discretion were key barriers. Conclusion: The four dimensions of CQI provided insight into both facilitators and barriers of CQI adoption in public health. Future research should compare the outcomes of public health CQI initiatives to the framework's stated facilitators and barriers. PMID:28277203

Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare.

Science.gov (United States)

Price, Alex; Schwartz, Robert; Cohen, Joanna; Manson, Heather; Scott, Fran

2017-02-01

Evidence of the effect of continuous quality improvement (CQI) in public health and valid tools to judge that such effects are not fully formed. The objective was to adapt and apply Shortell et al.'s (1998) four dimensions of CQI in an examination of a public health accountability and performance management initiative in Ontario, Canada. In total, 24 semi-structured, in-depth interviews were conducted with informants from public health units and the Ministry of Health and Long-Term Care. A web survey of public health managers in the province was also carried out. A mix of facilitators and barriers was identified. Leadership and organizational cultures, conducive to CQI success were evident. However, limitations in performance measurement and managerial discretion were key barriers. The four dimensions of CQI provided insight into both facilitators and barriers of CQI adoption in public health. Future research should compare the outcomes of public health CQI initiatives to the framework's stated facilitators and barriers. Copyright © 2017 Longwoods Publishing.

Health-related quality of life in children with high-functioning autism.

Science.gov (United States)

Potvin, Marie-Christine; Snider, Laurie; Prelock, Patricia A; Wood-Dauphinee, Sharon; Kehayia, Eva

2015-01-01

The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of life of children. A cross-sectional study of children with high-functioning autism (n = 30) and peers (n = 31) was conducted using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales. Children with high-functioning autism had significantly poorer health-related quality of life than peers whether reported by themselves (p children and parental scores suggested variance in points of view. This study specifically investigated health-related quality of life in children with high-functioning autism as compared to a sample of peers, from the child's perspective. It strengthens earlier findings that children with high-functioning autism experience poorer health-related quality of life than those without this disorder and points to the importance of clinicians working with families to identify areas in a child's life that promote or hinder their sense of well-being. © The Author(s) 2013.

A modified Continuous Quality Improvement approach to improve culturally and socially inclusive care within rural health services.

Science.gov (United States)

Mitchell, Olivia; Malatzky, Christina; Bourke, Lisa; Farmer, Jane

2018-03-23

The sickest Australians are often those belonging to non-privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically diverse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature. The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations. This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness. The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care. The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on-the-ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated. © 2018 National Rural Health Alliance Ltd.

Indicators for continuous quality improvement for otitis media in primary health care for Aboriginal and Torres Strait Islander children.

Science.gov (United States)

Sibthorpe, Beverly; Agostino, Jason; Coates, Harvey; Weeks, Sharon; Lehmann, Deborah; Wood, Marianne; Lannigan, Francis; McAullay, Daniel

2017-04-01

Otitis media is a common, generally self-limiting childhood illness that can progress to severe disease and have lifelong sequelae, including hearing loss and developmental delays. Severe disease is disproportionately prevalent among Aboriginal and Torres Strait Islander children. Primary health care is at the frontline of appropriate prevention and treatment. Continuous quality improvement in the prevention and management of important causes of morbidity in client populations is accepted best practice in primary health care and now a requirement of Australian Government funding to services providing care for Aboriginal and Torres Strait Islander children. To date, there have been no indicators for continuous quality improvement in the prevention and management of otitis media and its sequelae in primary health care. Through an expert group consensus process, seven evidence-based indicators, potentially extractable from electronic health records, have been developed. The development process and indicators are described.

Image Quality in High-resolution and High-cadence Solar Imaging

Science.gov (United States)

Denker, C.; Dineva, E.; Balthasar, H.; Verma, M.; Kuckein, C.; Diercke, A.; González Manrique, S. J.

2018-03-01

Broad-band imaging and even imaging with a moderate bandpass (about 1 nm) provides a photon-rich environment, where frame selection (lucky imaging) becomes a helpful tool in image restoration, allowing us to perform a cost-benefit analysis on how to design observing sequences for imaging with high spatial resolution in combination with real-time correction provided by an adaptive optics (AO) system. This study presents high-cadence (160 Hz) G-band and blue continuum image sequences obtained with the High-resolution Fast Imager (HiFI) at the 1.5-meter GREGOR solar telescope, where the speckle-masking technique is used to restore images with nearly diffraction-limited resolution. The HiFI employs two synchronized large-format and high-cadence sCMOS detectors. The median filter gradient similarity (MFGS) image-quality metric is applied, among others, to AO-corrected image sequences of a pore and a small sunspot observed on 2017 June 4 and 5. A small region of interest, which was selected for fast-imaging performance, covered these contrast-rich features and their neighborhood, which were part of Active Region NOAA 12661. Modifications of the MFGS algorithm uncover the field- and structure-dependency of this image-quality metric. However, MFGS still remains a good choice for determining image quality without a priori knowledge, which is an important characteristic when classifying the huge number of high-resolution images contained in data archives. In addition, this investigation demonstrates that a fast cadence and millisecond exposure times are still insufficient to reach the coherence time of daytime seeing. Nonetheless, the analysis shows that data acquisition rates exceeding 50 Hz are required to capture a substantial fraction of the best seeing moments, significantly boosting the performance of post-facto image restoration.

Post-examination interpretation of objective test data: monitoring and improving the quality of high-stakes examinations--a commentary on two AMEE Guides.

Science.gov (United States)

Tavakol, Mohsen; Dennick, Reg

2012-01-01

As great emphasis is rightly placed upon the importance of assessment to judge the quality of our future healthcare professionals, it is appropriate not only to choose the most appropriate assessment method, but to continually monitor the quality of the tests themselves, in a hope that we may continually improve the process. This article stresses the importance of quality control mechanisms in the exam cycle and briefly outlines some of the key psychometric concepts including reliability measures, factor analysis, generalisability theory and item response theory. The importance of such analyses for the standard setting procedures is emphasised. This article also accompanies two new AMEE Guides in Medical Education (Tavakol M, Dennick R. Post-examination Analysis of Objective Tests: AMEE Guide No. 54 and Tavakol M, Dennick R. 2012. Post examination analysis of objective test data: Monitoring and improving the quality of high stakes examinations: AMEE Guide No. 66) which provide the reader with practical examples of analysis and interpretation, in order to help develop valid and reliable tests.

U.S. Geological Survey continuous monitoring workshop—Workshop summary report

Science.gov (United States)

Sullivan, Daniel J.; Joiner, John K.; Caslow, Kerry A.; Landers, Mark N.; Pellerin, Brian A.; Rasmussen, Patrick P.; Sheets, Rodney A.

2018-04-20

Executive SummaryThe collection of high-frequency (in other words, “continuous”) water data has been made easier over the years because of advances in technologies to measure, transmit, store, and query large, temporally dense datasets. Commercially available, in-situ sensors and data-collection platforms—together with new techniques for data analysis—provide an opportunity to monitor water quantity and quality at time scales during which meaningful changes occur. The U.S. Geological Survey (USGS) Continuous Monitoring Workshop was held to build stronger collaboration within the Water Mission Area on the collection, interpretation, and application of continuous monitoring data; share technical approaches for the collection and management of continuous data that improves consistency and efficiency across the USGS; and explore techniques and tools for the interpretation of continuous monitoring data, which increases the value to cooperators and the public. The workshop was organized into three major themes: Collecting Continuous Data, Understanding and Using Continuous Data, and Observing and Delivering Continuous Data in the Future. Presentations each day covered a variety of related topics, with a special session at the end of each day designed to bring discussion and problem solving to the forefront.The workshop brought together more than 70 USGS scientists and managers from across the Water Mission Area and Water Science Centers. Tools to manage, assure, control quality, and explore large streams of continuous water data are being developed by the USGS and other organizations and will be critical to making full use of these high-frequency data for research and monitoring. Disseminating continuous monitoring data and findings relevant to critical cooperator and societal issues is central to advancing the USGS networks and mission. Several important outcomes emerged from the presentations and breakout sessions.

Identifying continuous quality improvement publications: what makes an improvement intervention 'CQI'?

Science.gov (United States)

O'Neill, Sean M; Hempel, Susanne; Lim, Yee-Wei; Danz, Marjorie S; Foy, Robbie; Suttorp, Marika J; Shekelle, Paul G; Rubenstein, Lisa V

2011-12-01

The term continuous quality improvement (CQI) is often used to refer to a method for improving care, but no consensus statement exists on the definition of CQI. Evidence reviews are critical for advancing science, and depend on reliable definitions for article selection. As a preliminary step towards improving CQI evidence reviews, this study aimed to use expert panel methods to identify key CQI definitional features and develop and test a screening instrument for reliably identifying articles with the key features. We used a previously published method to identify 106 articles meeting the general definition of a quality improvement intervention (QII) from 9427 electronically identified articles from PubMed. Two raters then applied a six-item CQI screen to the 106 articles. Per cent agreement ranged from 55.7% to 75.5% for the six items, and reviewer-adjusted intra-class correlation ranged from 0.43 to 0.62. 'Feedback of systematically collected data' was the most common feature (64%), followed by being at least 'somewhat' adapted to local conditions (61%), feedback at meetings involving participant leaders (46%), using an iterative development process (40%), being at least 'somewhat' data driven (34%), and using a recognised change method (28%). All six features were present in 14.2% of QII articles. We conclude that CQI features can be extracted from QII articles with reasonable reliability, but only a small proportion of QII articles include all features. Further consensus development is needed to support meaningful use of the term CQI for scientific communication.

Wound Care Center of Excellence: A Process for Continuous Monitoring and Improvement of Wound Care Quality.

Science.gov (United States)

Howell, Raelina S; Kohan, Lauren S; Woods, Jon S; Criscitelli, Theresa; Gillette, Brian M; Donovan, Virginia; Gorenstein, Scott

2018-05-01

To provide information about a study using a new process for continuous monitoring to improve chronic wound care quality.This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.After completing this continuing education activity, you should be better able to:1. Recognize problems associated with chronic wound care.2. Identify methods used in this project to improve care.3. Illustrate the findings from this and similar projects and implications for providing improved wound care.Patients with chronic wounds require complex care because of comorbidities that can affect healing. Therefore, the goal of this project was to develop a system of reviewing all hospitalized patients seen by the study authors' wound care service on a weekly basis to decrease readmissions, morbidity, and mortality. Weekly multidisciplinary conferences were conducted to evaluate patient data and systematically assess for adherence to wound care protocols, as well as to create and modify patient care plans. This review of pathology and the performance of root-cause analyses often led to improved patient care.

Legislation should support optimal breastfeeding practices and access to low-cost, high-quality complementary foods: Indonesia provides a case study.

Science.gov (United States)

Soekarjo, Damayanti; Zehner, Elizabeth

2011-10-01

It is important to support women to exclusively breastfeed for 6 months and continue breastfeeding for 24 months and beyond. It is also necessary to provide the poor with access to affordable ways to improve the quality of complementary foods. Currently, many countries do not have the legal and policy environment necessary to support exclusive and continued breastfeeding. Legislative and policy changes are also necessary for introducing complementary food supplements, allowing them to be marketed to those who need them, and ensuring that marketing remains appropriate and in full compliance with the International Code of Marketing of Breastmilk Substitutes. This paper aims to illustrate the above with examples from Indonesia and to identify legislative requirements for supporting breastfeeding and enabling appropriate access to high-quality complementary food supplements for children 6-24 months of age. Requirements include improved information, training, monitoring and enforcement systems for the International Code of Marketing of Breastmilk Substitutes; implementation and monitoring of the Baby-Friendly Hospital Initiative; establishment of a registration category for complementary food supplements to enhance availability of high-quality, low-cost fortified products to help improve young child feeding; clear identification and marketing of these products as complementary food supplements for 6-24-month-olds so as to promote proper use and not interfere with breastfeeding. © 2011 Blackwell Publishing Ltd.

A guide to calculating habitat-quality metrics to inform conservation of highly mobile species

Science.gov (United States)

Bieri, Joanna A.; Sample, Christine; Thogmartin, Wayne E.; Diffendorfer, James E.; Earl, Julia E.; Erickson, Richard A.; Federico, Paula; Flockhart, D. T. Tyler; Nicol, Sam; Semmens, Darius J.; Skraber, T.; Wiederholt, Ruscena; Mattsson, Brady J.

2018-01-01

Many metrics exist for quantifying the relative value of habitats and pathways used by highly mobile species. Properly selecting and applying such metrics requires substantial background in mathematics and understanding the relevant management arena. To address this multidimensional challenge, we demonstrate and compare three measurements of habitat quality: graph-, occupancy-, and demographic-based metrics. Each metric provides insights into system dynamics, at the expense of increasing amounts and complexity of data and models. Our descriptions and comparisons of diverse habitat-quality metrics provide means for practitioners to overcome the modeling challenges associated with management or conservation of such highly mobile species. Whereas previous guidance for applying habitat-quality metrics has been scattered in diversified tracks of literature, we have brought this information together into an approachable format including accessible descriptions and a modeling case study for a typical example that conservation professionals can adapt for their own decision contexts and focal populations.Considerations for Resource ManagersManagement objectives, proposed actions, data availability and quality, and model assumptions are all relevant considerations when applying and interpreting habitat-quality metrics.Graph-based metrics answer questions related to habitat centrality and connectivity, are suitable for populations with any movement pattern, quantify basic spatial and temporal patterns of occupancy and movement, and require the least data.Occupancy-based metrics answer questions about likelihood of persistence or colonization, are suitable for populations that undergo localized extinctions, quantify spatial and temporal patterns of occupancy and movement, and require a moderate amount of data.Demographic-based metrics answer questions about relative or absolute population size, are suitable for populations with any movement pattern, quantify demographic

Real-World Solutions for Developing High-Quality PHP Frameworks and Applications

CERN Document Server

Bergmann, Sebastian

2011-01-01

Learn to develop high-quality applications and frameworks in PHP Packed with in-depth information and step-by-step guidance, this book escorts you through the process of creating, maintaining and extending sustainable software of high quality with PHP. World-renowned PHP experts present real-world case studies for developing high-quality applications and frameworks in PHP that can easily be adapted to changing business requirements. . They offer different approaches to solving  typical development and quality assurance problems that every developer needs to know and master.Details the process

Experiences in the continuous improvement of quality assurance of the dosimetry services of SLDC-MD-ININ

International Nuclear Information System (INIS)

Tovar M, V. M.; Vergara M, F.; Perez M, V.; Anaya M, R.; Cejudo A, J.; Alvarez R, J. T.; Arenas O, A.; Cruz F, C.

2010-09-01

From 2003 the Secondary Laboratory of Dosimetric Calibration (SLDC) of Metrology Department of Ionizing Radiations (MD), has complemented the Quality Manual of National Institute of Nuclear Research (ININ) according to the standard ISO 9001: 2000. However, due to that the National Center of Metrology of Mexico delegates its functions in the dosimetry and activity area for the field of the ionizing radiations to the ININ: one of the requirements so that the ININ has been designated as -Declared Institute- before the International Office of Weights and Measurements, it is to demonstrate before the Inter-American System of Metrology that the quality system of the SLDC fulfills the standard ISO/IEC 17025: 2005, satisfied this requirement the Inter-American System of Metrology in their meeting of evaluation of quality systems, Ottawa (2007) grants a certification document to the SLDC that guarantees their capacities of calibration measurements for dosimetry services. Concretely, inside the standard activities ISO 9000 with respect to the point 8 on measurement, analysis and improvement the Management of Quality Assurance of ININ carries out at year two interns auditing and every month is given continuation to the non conformities detected in the procedures that support the services of the SLDC for dosimetry with purposes of radiological protection and clinical dosimetry. (Author)

Multi-stage high cell continuous fermentation for high productivity and titer.

Science.gov (United States)

Chang, Ho Nam; Kim, Nag-Jong; Kang, Jongwon; Jeong, Chang Moon; Choi, Jin-dal-rae; Fei, Qiang; Kim, Byoung Jin; Kwon, Sunhoon; Lee, Sang Yup; Kim, Jungbae

2011-05-01

We carried out the first simulation on multi-stage continuous high cell density culture (MSC-HCDC) to show that the MSC-HCDC can achieve batch/fed-batch product titer with much higher productivity to the fed-batch productivity using published fermentation kinetics of lactic acid, penicillin and ethanol. The system under consideration consists of n-serially connected continuous stirred-tank reactors (CSTRs) with either hollow fiber cell recycling or cell immobilization for high cell-density culture. In each CSTR substrate supply and product removal are possible. Penicillin production is severely limited by glucose metabolite repression that requires multi-CSTR glucose feeding. An 8-stage C-HCDC lactic acid fermentation resulted in 212.9 g/L of titer and 10.6 g/L/h of productivity, corresponding to 101 and 429% of the comparable lactic acid fed-batch, respectively. The penicillin production model predicted 149% (0.085 g/L/h) of productivity in 8-stage C-HCDC with 40 g/L of cell density and 289% of productivity (0.165 g/L/h) in 7-stage C-HCDC with 60 g/L of cell density compared with referring batch cultivations. A 2-stage C-HCDC ethanol experimental run showed 107% titer and 257% productivity of the batch system having 88.8 g/L of titer and 3.7 g/L/h of productivity. MSC-HCDC can give much higher productivity than batch/fed-batch system, and yield a several percentage higher titer as well. The productivity ratio of MSC-HCDC over batch/fed-batch system is given as a multiplication of system dilution rate of MSC-HCDC and cycle time of batch/fed-batch system. We suggest MSC-HCDC as a new production platform for various fermentation products including monoclonal antibody.

Applications of optical sensors for high-frequency water-quality monitoring and research

Science.gov (United States)

Pellerin, Brian

2015-01-01

The recent commercial availability of in-situ optical sensors, together with new techniques for data collection and analysis, provides the opportunity to monitor a wide range of water-quality constituents over time scales during which environmental conditions actually change. Traditional approaches for data collection (daily to monthly discrete samples) are often limited by high sample collection, processing, and analytical costs, difficult site access, and logistical challenges, particularly for long-term sampling at a large number of sites. Optical sensors that continuously measure constituents in the environment by absorbance or fluorescence properties (Figure 1) have had a long history of use in oceanography for measuring highly resolved concentrations and fluxes of organic matter, nutrients, and algal material. However, much of the work using commercially-available optical sensors in rivers and streams has taken place in only the last few years. Figure 1. [NOT SHOWN] Optical sensor technology is now sufficiently developed to warrant broader application for research and monitoring in coastal and freshwater systems, and the United States Geological Survey (a U.S. science agency) is now using these sensors in a variety of research and monitoring programs to better understand water quality in-situ and in real-time. Examples are numerous and range from the applications of nitrate sensors for calculating loads to estuaries susceptible to hypoxia (Pellerin et al., 2014) to the use of fluorometers to estimate methymercury fluxes (Bergamaschi et al., 2011) and disinfection byproduct formation (Carpenter et al., 2013). Transmitting these data in real-time provides information that can be used for early trend detection, help identify monitoring gaps critical for water management, and provide science-based decision support across a range of issues related to water quality, freshwater ecosystems, and human health. Despite the value of these sensors, collecting data that

TECHNICAL SUPPORT AS A BASIS OF HIGH AVAILABILITY LEVEL AND IT SYSTEM SERVICE QUALITY

Directory of Open Access Journals (Sweden)

Dejan Vidojevic

2007-06-01

Full Text Available This work presents the development and implementation methodology of technical support in IT1system operation. Methodology is developed and applied in realistic system (Information system of the Tax administration - DIS 2003, which is technically very complex and highly distributed. The results of IT system availability assessment and identification of the critical components are input parameters in the process of establishing of the technical support. The importance of technical support for achieving optimal IT system availability and IT service quality is assessed according to its operation during one year. The history of technical support system operation is a basis for further continuous improvement.

Blueprint for action: steps toward a high-quality, high-value maternity care system.

Science.gov (United States)

Angood, Peter B; Armstrong, Elizabeth Mitchell; Ashton, Diane; Burstin, Helen; Corry, Maureen P; Delbanco, Suzanne F; Fildes, Barbara; Fox, Daniel M; Gluck, Paul A; Gullo, Sue Leavitt; Howes, Joanne; Jolivet, R Rima; Laube, Douglas W; Lynne, Donna; Main, Elliott; Markus, Anne Rossier; Mayberry, Linda; Mitchell, Lynn V; Ness, Debra L; Nuzum, Rachel; Quinlan, Jeffrey D; Sakala, Carol; Salganicoff, Alina

2010-01-01

Childbirth Connection hosted a 90th Anniversary national policy symposium, Transforming Maternity Care: A High Value Proposition, on April 3, 2009, in Washington, DC. Over 100 leaders from across the range of stakeholder perspectives were actively engaged in the symposium work to improve the quality and value of U.S. maternity care through broad system improvement. A multi-disciplinary symposium steering committee guided the strategy from its inception and contributed to every phase of the project. The "Blueprint for Action: Steps Toward a High Quality, High Value Maternity Care System", issued by the Transforming Maternity Care Symposium Steering Committee, answers the fundamental question, "Who needs to do what, to, for, and with whom to improve the quality of maternity care over the next five years?" Five stakeholder workgroups collaborated to propose actionable strategies in 11 critical focus areas for moving expeditiously toward the realization of the long term "2020 Vision for a High Quality, High Value Maternity Care System", also published in this issue. Following the symposium these workgroup reports and recommendations were synthesized into the current blueprint. For each critical focus area, the "Blueprint for Action" presents a brief problem statement, a set of system goals for improvement in that area, and major recommendations with proposed action steps to achieve them. This process created a clear sightline to action that if enacted could improve the structure, process, experiences of care, and outcomes of the maternity care system in ways that when anchored in the culture can indeed transform maternity care. Copyright 2010 Jacobs Institute of Women

Hearing the voices of women in war through continuous quality improvement.

Science.gov (United States)

Farrell, M; Farrell, J D

1998-04-01

During the war in Bosnia-Herzegovina (BIH), the infrastructure of the health care system was destroyed and health officials, health care providers, and women experienced the war from their own perspectives. Using the principles of continuous quality improvement (CQI), these perspectives were honored and served as the basis for an international training program to hear the voices of women in war and the concerns of those who cared for them. With the results of a comprehensive national survey of all partners, the World Health Organization's European Regional Office held a five-day workshop that used CQI methods. The facilitators and 18 nurses, midwives, and physicians from six cantons developed interventions to address the women's needs, as detailed from the women's stories and from the professional perspectives of governmental authorities and health providers. The effort illustrates the ways in which the principles and tools of CQI can be used to capture the needs of the users of the services with those responsible for restructuring the health service and those with overall responsibility for the health of woman throughout the country.

Benchmarking: a method for continuous quality improvement in health.

Science.gov (United States)

Ettorchi-Tardy, Amina; Levif, Marie; Michel, Philippe

2012-05-01

Benchmarking, a management approach for implementing best practices at best cost, is a recent concept in the healthcare system. The objectives of this paper are to better understand the concept and its evolution in the healthcare sector, to propose an operational definition, and to describe some French and international experiences of benchmarking in the healthcare sector. To this end, we reviewed the literature on this approach's emergence in the industrial sector, its evolution, its fields of application and examples of how it has been used in the healthcare sector. Benchmarking is often thought to consist simply of comparing indicators and is not perceived in its entirety, that is, as a tool based on voluntary and active collaboration among several organizations to create a spirit of competition and to apply best practices. The key feature of benchmarking is its integration within a comprehensive and participatory policy of continuous quality improvement (CQI). Conditions for successful benchmarking focus essentially on careful preparation of the process, monitoring of the relevant indicators, staff involvement and inter-organizational visits. Compared to methods previously implemented in France (CQI and collaborative projects), benchmarking has specific features that set it apart as a healthcare innovation. This is especially true for healthcare or medical-social organizations, as the principle of inter-organizational visiting is not part of their culture. Thus, this approach will need to be assessed for feasibility and acceptability before it is more widely promoted.

Continuous quality improvement using intelligent infusion pump data analysis.

Science.gov (United States)

Breland, Burnis D

2010-09-01

The use of continuous quality-improvement (CQI) processes in the implementation of intelligent infusion pumps in a community teaching hospital is described. After the decision was made to implement intelligent i.v. infusion pumps in a 413-bed, community teaching hospital, drug libraries for use in the safety software had to be created. Before drug libraries could be created, it was necessary to determine the epidemiology of medication use in various clinical care areas. Standardization of medication administration was performed through the CQI process, using practical knowledge of clinicians at the bedside and evidence-based drug safety parameters in the scientific literature. Post-implementation, CQI allowed refinement of clinically important safety limits while minimizing inappropriate, meaningless soft limit alerts on a few select agents. Assigning individual clinical care areas (CCAs) to individual patient care units facilitated customization of drug libraries and identification of specific CCA compliance concerns. Between June 2007 and June 2008, there were seven library updates. These involved drug additions and deletions, customization of individual CCAs, and alterations of limits. Overall compliance with safety software use rose over time, from 33% in November 2006 to over 98% in December 2009. Many potentially clinically significant dosing errors were intercepted by the safety software, prompting edits by end users. Only 4-6% of soft limit alerts resulted in edits. Compliance rates for use of infusion pump safety software varied among CCAs over time. Education, auditing, and refinement of drug libraries led to improved compliance in most CCAs.

Robust Trajectory Design in Highly Perturbed Environments Leveraging Continuation Methods, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — Research is proposed to investigate continuation methods to improve the robustness of trajectory design algorithms for spacecraft in highly perturbed dynamical...

Adoption and impact of high quality bambara flour (HQBF ...

African Journals Online (AJOL)

Adoption and impact of high quality bambara flour (HQBF) technology in the ... consumer acceptability/quality of products, credit, availability of raw materials, and ... as a result of 12.5 per cent increase in demand for bambara-based products.

Development of a high-quality cut-off wall using electrophoresis

International Nuclear Information System (INIS)

Kawachi, T.; Murahashi, H.

1991-01-01

Techniques to build a high-quality cut-off wall have been developed for storage facilities of low-level radioactive waste (LLW) as an emergency measures to prevent leakages. The cut-off wall is highly impermeable, nucleid-adsorptive and have long-term durability. Electrophoresis is used to form impermeable membrane of bentonite as main features of the cut-off wall. First of all, laboratory tests have been conducted to study ways of building barriers on site and to collect data on the barriers properties. Afterwards, on-site construction tests of a high-quality cut-off wall have been carried out. In this paper, we describe the process and results on the studies of the high-quality cut-off wall using electrophoresis

In-house quality audit and benefits of some quality control procedures in the quality assurance of TL dosimetry system at NRPB

International Nuclear Information System (INIS)

Dutt, J.C.

1993-01-01

A number of Quality Control (QC) procedures have been introduced into the running and operation of the NRPB personal monitoring services. Those described here apply to the whole-body TL dosimetry system. These QC procedures comprise Quality Assurance (QA) of incoming raw materials and equipment, reader stabilisation, daily, routine and periodic QA checks on all phases of the service. In-house quality audit, periodic internal and external 'blind QA checks' on the dosimetry system as a whole have assured the continuing high quality and reliability of the NRPB TL dosimetry service for assessing body and skin doses of radiation workers from external photon and beta radiations. (author)

Timing of high-quality child care and cognitive, language, and preacademic development.

Science.gov (United States)

Li, Weilin; Farkas, George; Duncan, Greg J; Burchinal, Margaret R; Vandell, Deborah Lowe

2013-08-01

The effects of high- versus low-quality child care during 2 developmental periods (infant-toddlerhood and preschool) were examined using data from the National Institute of Child Health and Human Development Study of Early Child Care. Propensity score matching was used to account for differences in families who used different combinations of child care quality during the 2 developmental periods. Findings indicated that cognitive, language, and preacademic skills prior to school entry were highest among children who experienced high-quality care in both the infant-toddler and preschool periods, somewhat lower among children who experienced high-quality child care during only 1 of these periods, and lowest among children who experienced low-quality care during both periods. Irrespective of the care received during infancy-toddlerhood, high-quality preschool care was related to better language and preacademic outcomes at the end of the preschool period; high-quality infant-toddler care, irrespective of preschool care, was related to better memory skills at the end of the preschool period. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Health-Related Quality of Life in Children with High-Functioning Autism

Science.gov (United States)

Potvin, Marie-Christine; Snider, Laurie; Prelock, Patricia A.; Wood-Dauphinee, Sharon; Kehayia, Eva

2015-01-01

The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of…

High quality digital holographic reconstruction on analog film

Science.gov (United States)

Nelsen, B.; Hartmann, P.

2017-05-01

High quality real-time digital holographic reconstruction, i.e. at 30 Hz frame rates, has been at the forefront of research and has been hailed as the holy grail of display systems. While these efforts have produced a fascinating array of computer algorithms and technology, many applications of reconstructing high quality digital holograms do not require such high frame rates. In fact, applications such as 3D holographic lithography even require a stationary mask. Typical devices used for digital hologram reconstruction are based on spatial-light-modulator technology and this technology is great for reconstructing arbitrary holograms on the fly; however, it lacks the high spatial resolution achievable by its analog counterpart, holographic film. Analog holographic film is therefore the method of choice for reconstructing highquality static holograms. The challenge lies in taking a static, high-quality digitally calculated hologram and effectively writing it to holographic film. We have developed a theoretical system based on a tunable phase plate, an intensity adjustable high-coherence laser and a slip-stick based piezo rotation stage to effectively produce a digitally calculated hologram on analog film. The configuration reproduces the individual components, both the amplitude and phase, of the hologram in the Fourier domain. These Fourier components are then individually written on the holographic film after interfering with a reference beam. The system is analogous to writing angularly multiplexed plane waves with individual component phase control.

The potential of Arachis pintoi biomass to improve quality of soil continuously used for cassava cropping

OpenAIRE

N. Muddarisna; S. Prijono

2014-01-01

A field experiment that was aimed to elucidate the effects of application of Arachis pintoi biomass and animal dung on quality of soil continuously used for cassava cropping was conducted at Jatikerto Village, Kromengan District of Malang Regency. Eight treatments tested were 100% NPK inorganic fertilizer, 100 kg N Arachis pintoi/ha, (3) 100 kg N chicken dung / ha, 100 kg N cow dung /ha, 100 kg N goat dung /ha, 100 kg N Arachis pintoi + chicken dung /ha, 100 kg N Arachis pintoi + cow dung /h...

Provider-Payer Partnerships as an Engine for Continuous Quality Improvement.

Science.gov (United States)

Balfour, Margaret E; Zinn, Tylar E; Cason, Karena; Fox, Jerimya; Morales, Myra; Berdeja, Cesar; Gray, Jay

2018-03-01

The authors describe a quality improvement approach in which a crisis center and a payer collaborate to improve care. Each crisis visit is considered as a potentially missed opportunity for community stabilization. Daily data on crisis visits are sent to the payer for a more up-to-date analysis of trends than is possible with financial claims data, which may lag behind services provided by up to 90 days. Using these trend data, the two organizations collaborate to identify patterns that lead to opportunities for improvement and develop multiple rapid-cycle projects for better management of services, resulting in significant decreases in readmissions and in the number of high utilizers.

[Dexmedetomidine combined with ropivacaine for continuous femoral nerve block improved postoperative sleep quality in elderly patients after total knee arthroplasty].

Science.gov (United States)

Wang, X L; Wang, J; Mu, D L; Wang, D X

2018-03-13

Objective: To investigate the effect of dexmedetomidine adding to ropivacaine for continuous femoral nerve block on the improvement of postoperative sleep quality in elderly patients after total knee arthroplasty. Methods: One hundred and sixty patients aged 60 years or older in Jishuitan Hospital scheduled for single total knee arthroplasty between Nov. 2016 and Jun. 2017 were recruited. All patients received spinal anesthesia and were randomized to receive either combined ropivacaine and dexmedetomidine (0.2% ropivacaine 250 ml and 5 μg/kg dexmedetomidine, at a rate of 5 ml/h or 0.1 μg·kg -1 ·h -1 dexmedetomidine, dexmedetomidine group) or only ropivacaine (0.2% ropivacaine, at a rate of 5 ml/h, controlled group) for continuous femoral nerve block as postoperative analgesia after surgery. The severity of postoperative pain was assessed with numeric rating scale at 4, 24, and 48 hours after surgery both at rest and with movement. Subjective sleep quality and delirium were evaluated daily during the first 3 days postoperatively. Results: The subjective sleep quality scores were 2(1-4), 2(1-4) and 4(2-8), 4(2-7) in dexmedetomidine group and controlled group respectively on the 1st and 2nd days after surgery. The scores of dexmedetomidine group were much better than those of controlled group ( Z =-4.597, -4.183, both P quality, postoperative analgesia, and reduce delirium in the elderly after total knee arthroplasty.

Quality-assurance and data-management plan for water-quality activities in the Kansas Water Science Center, 2014

Science.gov (United States)

Rasmussen, Teresa J.; Bennett, Trudy J.; Foster, Guy M.; Graham, Jennifer L.; Putnam, James E.

2014-01-01

As the Nation’s largest water, earth, and biological science and civilian mapping information agency, the U.S. Geological Survey is relied on to collect high-quality data, and produce factual and impartial interpretive reports. This quality-assurance and data-management plan provides guidance for water-quality activities conducted by the Kansas Water Science Center. Policies and procedures are documented for activities related to planning, collecting, storing, documenting, tracking, verifying, approving, archiving, and disseminating water-quality data. The policies and procedures described in this plan complement quality-assurance plans for continuous water-quality monitoring, surface-water, and groundwater activities in Kansas.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes.

Science.gov (United States)

McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

2018-01-01

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

Factors Influencing Older Worker Quality of Life and Intent to Continue to Work

Science.gov (United States)

Spokus, Diane

2008-01-01

High turnover has been a major problem in healthcare organizations. The purpose of this study was to examine the relationship among job characteristics, social support, and organizational characteristics on quality of the working life. Subsequently, the intent was to examine how those factors collectively influence turnover intention. A…

Report on 'electricity quality'. Diagnosis and propositions related to the continuity of electric power supply - October 2010

International Nuclear Information System (INIS)

2010-10-01

As public electric power distribution networks have been facing a significant increase of annual supply outage mean duration since several years, different stakeholders, notably authorities, are concerned by this degradation, even though final consumers are globally satisfied. This report thus addresses this issue. A first part proposes a precise analysis of electricity quality degradation: degradation of supply continuity has been noticed during the last decade, France stands at a good rank in Europe regarding this issue, and consumer expectations regarding quality are difficult to identify. The report outlines that many actors contribute to the definition of the electricity quality level: the French Parliament, the French government, and standardization bodies. It describes how licensing authorities and distribution network operators are acting for supply quality in public distribution networks. The report however outlines that stakeholders have different motivations regarding supply quality. The next chapter shows that actions have already been undertaken and results have already been obtained by ERDF regarding electricity quality. It also outlines that use prices are the main sources of financing expenses aimed at improving supply quality. In the next chapter, the report outlines that, within an uncertain context, perspectives of improvement of supply quality have to be discussed within the frame of the wider context of grid evolution, and also in terms of transparency

High-power UV-LED degradation: Continuous and cycled working condition influence

Science.gov (United States)

Arques-Orobon, F. J.; Nuñez, N.; Vazquez, M.; Segura-Antunez, C.; González-Posadas, V.

2015-09-01

High-power (HP) UV-LEDs can replace UV lamps for real-time fluoro-sensing applications by allowing portable and autonomous systems. However, HP UV-LEDs are not a mature technology, and there are still open issues regarding their performance evolution over time. This paper presents a reliability study of 3 W UV-LEDs, with special focus on LED degradation for two working conditions: continuous and cycled (30 s ON and 30 s OFF). Accelerated life tests are developed to evaluate the influence of temperature and electrical working conditions in high-power LEDs degradation, being the predominant failure mechanism the degradation of the package. An analysis that includes dynamic thermal and optical HP UV-LED measurements has been performed. Static thermal and stress simulation analysis with the finite element method (FEM) identifies the causes of package degradation. Accelerated life test results prove that HP UV-LEDs working in cycled condition have a better performance than those working in continuous condition.

Prediction of bread-making quality using size exclusion high ...

African Journals Online (AJOL)

Variation in the distribution of protein molecular weight in wheat (Triticum aestivum), influences breadmaking quality of wheat cultivars, resulting in either poor or good bread. The objective of this study was to predict breadmaking quality of wheat cultivars using size exclusion high performance liquid chromatography.

Exome sequencing generates high quality data in non-target regions

Directory of Open Access Journals (Sweden)

Guo Yan

2012-05-01

Full Text Available Abstract Background Exome sequencing using next-generation sequencing technologies is a cost efficient approach to selectively sequencing coding regions of human genome for detection of disease variants. A significant amount of DNA fragments from the capture process fall outside target regions, and sequence data for positions outside target regions have been mostly ignored after alignment. Result We performed whole exome sequencing on 22 subjects using Agilent SureSelect capture reagent and 6 subjects using Illumina TrueSeq capture reagent. We also downloaded sequencing data for 6 subjects from the 1000 Genomes Project Pilot 3 study. Using these data, we examined the quality of SNPs detected outside target regions by computing consistency rate with genotypes obtained from SNP chips or the Hapmap database, transition-transversion (Ti/Tv ratio, and percentage of SNPs inside dbSNP. For all three platforms, we obtained high-quality SNPs outside target regions, and some far from target regions. In our Agilent SureSelect data, we obtained 84,049 high-quality SNPs outside target regions compared to 65,231 SNPs inside target regions (a 129% increase. For our Illumina TrueSeq data, we obtained 222,171 high-quality SNPs outside target regions compared to 95,818 SNPs inside target regions (a 232% increase. For the data from the 1000 Genomes Project, we obtained 7,139 high-quality SNPs outside target regions compared to 1,548 SNPs inside target regions (a 461% increase. Conclusions These results demonstrate that a significant amount of high quality genotypes outside target regions can be obtained from exome sequencing data. These data should not be ignored in genetic epidemiology studies.

Practical Approaches to Quality Improvement for Radiologists.

Science.gov (United States)

Kelly, Aine Marie; Cronin, Paul

2015-10-01

Continuous quality improvement is a fundamental attribute of high-performing health care systems. Quality improvement is an essential component of health care, with the current emphasis on adding value. It is also a regulatory requirement, with reimbursements increasingly being linked to practice performance metrics. Practice quality improvement efforts must be demonstrated for credentialing purposes and for certification of radiologists in practice. Continuous quality improvement must occur for radiologists to remain competitive in an increasingly diverse health care market. This review provides an introduction to the main approaches available to undertake practice quality improvement, which will be useful for busy radiologists. Quality improvement plays multiple roles in radiology services, including ensuring and improving patient safety, providing a framework for implementing and improving processes to increase efficiency and reduce waste, analyzing and depicting performance data, monitoring performance and implementing change, enabling personnel assessment and development through continued education, and optimizing customer service and patient outcomes. The quality improvement approaches and underlying principles overlap, which is not surprising given that they all align with good patient care. The application of these principles to radiology practices not only benefits patients but also enhances practice performance through promotion of teamwork and achievement of goals. © RSNA, 2015.

Key factors for a high-quality VR experience

Science.gov (United States)

Champel, Mary-Luc; Doré, Renaud; Mollet, Nicolas

2017-09-01

For many years, Virtual Reality has been presented as a promising technology that could deliver a truly new experience to users. The media and entertainment industry is now investigating the possibility to offer a video-based VR 360 experience. Nevertheless, there is a substantial risk that VR 360 could have the same fate as 3DTV if it cannot offer more than just being the next fad. The present paper aims at presenting the various quality factors required for a high-quality VR experience. More specifically, this paper will focus on the main three VR quality pillars: visual, audio and immersion.

Continuous water-quality and suspended-sediment transport monitoring in the San Francisco Bay, California, water years 2014–15

Science.gov (United States)

Buchanan, Paul A.; Downing-Kunz, Maureen; Schoellhamer, David H.; Livsey, Daniel N.

2018-03-08

The U.S. Geological Survey (USGS) monitors water quality and suspended-sediment transport in the San Francisco Bay (bay) as part of a multi-agency effort to address management, water supply, and ecological concerns. The San Francisco Bay area is home to millions of people, and the bay teems both with resident and with migratory wildlife, plants, and fish. Freshwater mixes with salt water in the bay, which is subject both to riverine influences (floods, droughts, managed reservoir releases and freshwater diversions) and to marine influences (tides, waves, effects of salt water). To understand this environment, the USGS, along with its partners (see “Acknowledgements”), has been monitoring the bay’s waters continuously since 1988. Several water-quality variables are of particular importance to State and Federal resource managers and are monitored at key locations throughout the bay (fig. 1). Salinity, which indicates the relative mixing of fresh and ocean waters in the bay, is derived from specific conductance measurements. Water temperature, along with salinity, affects the density of water, which controls gravity-driven circulation patterns and stratification in the water column. Turbidity, a measure of light scattered from suspended particles in the water, is used to estimate suspended-sediment concentration (SSC). Suspended sediment affects the bay in multiple ways: attenuation of sunlight in the water column, affecting phytoplankton growth; deposition on tidal marsh and intertidal mudflats, which can help sustain these habitats as sea level rises; deposition in ports and shipping channels, which can necessitate dredging; and often, adsorption of contaminants, affecting their distribution and concentrations in the environment. Dissolved oxygen concentration, essential to a healthy ecosystem and a fundamental indicator of water quality, is affected by water temperature, salinity, ecosystem metabolism, tidal currents, and wind. Tidal currents in the bay

Sleep quality and its relationship with quality of life among high-risk pregnant women (gestational diabetes and hypertension).

Science.gov (United States)

Saadati, Fatemeh; Sehhatiei Shafaei, Fahimeh; Mirghafourvand, Mozhgan

2018-01-01

Sleep is one of the most basic human requirements. This research aims at determining the status of sleep quality and its relationship with quality of life among high-risk pregnant women in Tabriz, Iran, in 2015. This research was a sectional study done on 364 qualified women in 28-36 weeks of pregnancy suffering from mild preeclampsia and gestational diabetes. The sampling was done as convenience. Personal-social-midwifery questionnaire, Pittsburg sleep quality, and quality of life in pregnancy (QOL-ORAV) were used for gathering data. Multivariate linear regression model was used for determining the relationship between sleep quality and its subsets with quality of life and controlling confounders. In the current study, the prevalence of sleep disturbance was 96.4%. Mean (SD) of the total score of sleep quality was 10.1 (4.1) and the total score of quality of life was 61.7 (17.3). According to Pearson's correlation test, there was statistically significant relationship between quality of life and sleep quality and all its subsets except sleep duration and use of sleep medication (p quality of life. The findings of current research show that sleep quality is low among high-risk pregnant women and quality of life is medium. So, it is necessary that required training is given by health cares for improving sleep quality and quality of life to mothers.

How to Sustain Change and Support Continuous Quality Improvement.

Science.gov (United States)

Silver, Samuel A; McQuillan, Rory; Harel, Ziv; Weizman, Adam V; Thomas, Alison; Nesrallah, Gihad; Bell, Chaim M; Chan, Christopher T; Chertow, Glenn M

2016-05-06

To achieve sustainable change, quality improvement initiatives must become the new way of working rather than something added on to routine clinical care. However, most organizational change is not maintained. In this next article in this Moving Points in Nephrology feature on quality improvement, we provide health care professionals with strategies to sustain and support quality improvement. Threats to sustainability may be identified both at the beginning of a project and when it is ready for implementation. The National Health Service Sustainability Model is reviewed as one example to help identify issues that affect long-term success of quality improvement projects. Tools to help sustain improvement include process control boards, performance boards, standard work, and improvement huddles. Process control and performance boards are methods to communicate improvement results to staff and leadership. Standard work is a written or visual outline of current best practices for a task and provides a framework to ensure that changes that have improved patient care are consistently and reliably applied to every patient encounter. Improvement huddles are short, regular meetings among staff to anticipate problems, review performance, and support a culture of improvement. Many of these tools rely on principles of visual management, which are systems transparent and simple so that every staff member can rapidly distinguish normal from abnormal working conditions. Even when quality improvement methods are properly applied, the success of a project still depends on contextual factors. Context refers to aspects of the local setting in which the project operates. Context affects resources, leadership support, data infrastructure, team motivation, and team performance. For these reasons, the same project may thrive in a supportive context and fail in a different context. To demonstrate the practical applications of these quality improvement principles, these principles are

Identifying continuous quality improvement publications: what makes an improvement intervention ‘CQI’?

Science.gov (United States)

Hempel, Susanne; Lim, Yee-Wei; Danz, Marjorie S; Foy, Robbie; Suttorp, Marika J; Shekelle, Paul G; Rubenstein, Lisa V

2011-01-01

Background The term continuous quality improvement (CQI) is often used to refer to a method for improving care, but no consensus statement exists on the definition of CQI. Evidence reviews are critical for advancing science, and depend on reliable definitions for article selection. Methods As a preliminary step towards improving CQI evidence reviews, this study aimed to use expert panel methods to identify key CQI definitional features and develop and test a screening instrument for reliably identifying articles with the key features. We used a previously published method to identify 106 articles meeting the general definition of a quality improvement intervention (QII) from 9427 electronically identified articles from PubMed. Two raters then applied a six-item CQI screen to the 106 articles. Results Per cent agreement ranged from 55.7% to 75.5% for the six items, and reviewer-adjusted intra-class correlation ranged from 0.43 to 0.62. ‘Feedback of systematically collected data’ was the most common feature (64%), followed by being at least ‘somewhat’ adapted to local conditions (61%), feedback at meetings involving participant leaders (46%), using an iterative development process (40%), being at least ‘somewhat’ data driven (34%), and using a recognised change method (28%). All six features were present in 14.2% of QII articles. Conclusions We conclude that CQI features can be extracted from QII articles with reasonable reliability, but only a small proportion of QII articles include all features. Further consensus development is needed to support meaningful use of the term CQI for scientific communication. PMID:21727199

CONTINUOUS AND SEMICONTINUOUS REACTION SYSTEMS FOR HIGH-SOLIDS ENZYMATIC HYDROLYSIS OF LIGNOCELLULOSICS

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A. González Quiroga

2015-12-01

Full Text Available Abstract An attractive operation strategy for the enzymatic hydrolysis of lignocellulosics results from dividing the process into three stages with complementary goals: continuous enzyme adsorption at low-solids loading (5% w/w with recycling of the liquid phase; continuous liquefaction at high-solids content (up to 20% w/w; and, finally, continuous or semicontinuous hydrolysis with supplementation of fresh enzymes. This paper presents a detailed modeling and simulation framework for the aforementioned operation strategies. The limiting micromixing situations of macrofluid and microfluid are used to predict conversions. The adsorption and liquefaction stages are modeled as a continuous stirred tank and a plug flow reactor, respectively. Two alternatives for the third stage are studied: a train of five cascading stirred tanks and a battery of batch reactors in parallel. Simulation results show that glucose concentrations greater than 100 g L-1 could be reached with both of the alternatives for the third stage.

Next Generation High Quality Videoconferencing Service for the LHC

CERN Multimedia

CERN. Geneva

2012-01-01

In recent times, we have witnessed an explosion of video initiatives in the industry worldwide. Several advancements in video technology are currently improving the way we interact and collaborate. These advancements are forcing tendencies and overall experiences: any device in any network can be used to collaborate, in most cases with an overall high quality. To cope with this technology progresses, CERN IT Department has taken the leading role to establish strategies and directions to improve the user experience in remote dispersed meetings and remote collaboration at large in the worldwide LHC communities. Due to the high rate of dispersion in the LHC user communities, these are critically dependent of videoconferencing technology, with a need of robustness and high quality for the best possible user experience. We will present an analysis of the factors that influenced the technical and strategic choices to improve the reliability, efficiency and overall quality of the LHC remote sessions. In particular, ...

Expanding Educators' Contributions to Continuous Quality Improvement of American Board of Medical Specialties Maintenance of Certification.

Science.gov (United States)

Nora, Lois Margaret; Pouwels, Mellie Villahermosa; Irons, Mira

2016-01-01

The American Board of Medical Specialties board certification has transformed into a career-long process of learning, assessment, and performance improvement through its Program for Maintenance of Certification (MOC). Medical educators across many medical professional organizations, specialty societies, and other institutions have played important roles in shaping MOC and tailoring its overarching framework to the needs of different specialties. This Commentary addresses potential barriers to engagement in work related to MOC for medical school (MS) and academic health center (AHC) educators and identifies reasons for, and ways to accomplish, greater involvement in this work. The authors present ways that medical and other health professions educators in these settings can contribute to the continuous improvement of the MOC program including developing educational and assessment activities, engaging in debate about MOC, linking MOC with institutional quality improvement activities, and pursuing MOC-related scholarship. MS- and AHC-based educators have much to offer this still-young and continually improving program, and their engagement is sought, necessary, and welcomed.

Optimization of nitridation conditions for high quality inter-polysilicon dielectric layers

NARCIS (Netherlands)

Klootwijk, J.H.; Bergveld, H.J.; van Kranenburg, H.; Woerlee, P.H.; Wallinga, Hans

1996-01-01

Nitridation of deposited high temperature oxides (HTO) was studied to form high quality inter-polysilicon dielectric layers for embedded non volatile memories. Good quality dielectric layers were obtained earlier by using an optimized deposition of polysilicon and by performing a post-dielectric

Continuous high-yield production of vertically aligned carbon nanotubes on 2D and 3D substrates.

Science.gov (United States)

Guzmán de Villoria, Roberto; Hart, A John; Wardle, Brian L

2011-06-28

Vertically aligned carbon nanotubes (VACNTs) have certain advantages over bulk CNT powders and randomly oriented CNT mats for applications in flexible electronic devices, filtration membranes, biosensors and multifunctional aerospace materials. Here, a machine and a process to synthesize VACNTs in a continuous manner are presented showing uniform growth on 2D and 3D substrates, including alumina fibers, silicon wafer pieces, and stainless steel foils. Aligned multiwalled carbon nanotubes (MWNT) are synthesized at substrate feed rates of up to 6.8 cm/min, and the CNTs reach up to 60 μm in length depending on residence time in the reactor. In addition to the aligned morphology indicative of high yield growth, transmission electron microscopy and Raman spectroscopy reveal that the CNTs are of comparable quality to CNTs grown via a similar batch process. A significant reduction in time, reaction products, gases, and energy is demonstrated relative to batch processing, paving the way for industrial production of VACNTs.

Rough case-based reasoning system for continues casting

Science.gov (United States)

Su, Wenbin; Lei, Zhufeng

2018-04-01

The continuous casting occupies a pivotal position in the iron and steel industry. The rough set theory and the CBR (case based reasoning, CBR) were combined in the research and implementation for the quality assurance of continuous casting billet to improve the efficiency and accuracy in determining the processing parameters. According to the continuous casting case, the object-oriented method was applied to express the continuous casting cases. The weights of the attributes were calculated by the algorithm which was based on the rough set theory and the retrieval mechanism for the continuous casting cases was designed. Some cases were adopted to test the retrieval mechanism, by analyzing the results, the law of the influence of the retrieval attributes on determining the processing parameters was revealed. A comprehensive evaluation model was established by using the attribute recognition theory. According to the features of the defects, different methods were adopted to describe the quality condition of the continuous casting billet. By using the system, the knowledge was not only inherited but also applied to adjust the processing parameters through the case based reasoning method as to assure the quality of the continuous casting and improve the intelligent level of the continuous casting.

Barriers and facilitators to implementing continuous quality improvement programs in colonoscopy services: a mixed methods systematic review.

Science.gov (United States)

Candas, Bernard; Jobin, Gilles; Dubé, Catherine; Tousignant, Mario; Abdeljelil, Anis Ben; Grenier, Sonya; Gagnon, Marie-Pierre

2016-02-01

Continuous quality improvement (CQI) programs may result in quality of care and outcome improvement. However, the implementation of such programs has proven to be very challenging. This mixed methods systematic review identifies barriers and facilitators pertaining to the implementation of CQI programs in colonoscopy services and how they relate to endoscopists, nurses, managers, and patients. We developed a search strategy adapted to 15 databases. Studies had to report on the implementation of a CQI intervention and identified barriers or facilitators relating to any of the four groups of actors directly concerned by the provision of colonoscopies. The quality of the selected studies was assessed and findings were extracted, categorized, and synthesized using a generic extraction grid customized through an iterative process. We extracted 99 findings from the 15 selected publications. Although involving all actors is the most cited factor, the literature mainly focuses on the facilitators and barriers associated with the endoscopists' perspective. The most reported facilitators to CQI implementation are perception of feasibility, adoption of a formative approach, training and education, confidentiality, and assessing a limited number of quality indicators. Receptive attitudes, a sense of ownership and perceptions of positive impacts also facilitate the implementation. Finally, an organizational environment conducive to quality improvement has to be inclusive of all user groups, explicitly supportive, and provide appropriate resources. Our findings corroborate the current models of adoption of innovations. However, a significant knowledge gap remains with respect to barriers and facilitators pertaining to nurses, patients, and managers.

Final report: High current capacity high temperature superconducting film based tape for high field magnets

International Nuclear Information System (INIS)

Ying Xin

2000-01-01

The primary goal of the program was to establish the process parameters for the continuous deposition of high quality, superconducting YBCO films on one meter lengths of buffered RABiTS tape using MOCVD and to characterize the potential utility of the resulting tapes in high field magnet applications

Producing high-quality slash pine seeds

Science.gov (United States)

James Barnett; Sue Varela

2003-01-01

Slash pine is a desirable species. It serves many purposes and is well adapted to poorly drained flatwoods and seasonally flooded areas along the lower Coastal Plain of the Southeastern US. The use of high-quality seeds has been shown to produce uniform seedlings for outplanting, which is key to silvicultural success along the Coastal Plain and elsewhere. We present...

Short-Run Contexts and Imperfect Testing for Continuous Sampling Plans

Directory of Open Access Journals (Sweden)

Mirella Rodriguez

2018-04-01

Full Text Available Continuous sampling plans are used to ensure a high level of quality for items produced in long-run contexts. The basic idea of these plans is to alternate between 100% inspection and a reduced rate of inspection frequency. Any inspected item that is found to be defective is replaced with a non-defective item. Because not all items are inspected, some defective items will escape to the customer. Analytical formulas have been developed that measure both the customer perceived quality and also the level of inspection effort. The analysis of continuous sampling plans does not apply to short-run contexts, where only a finite-size batch of items is to be produced. In this paper, a simulation algorithm is designed and implemented to analyze the customer perceived quality and the level of inspection effort for short-run contexts. A parameter representing the effectiveness of the test used during inspection is introduced to the analysis, and an analytical approximation is discussed. An application of the simulation algorithm that helped answer questions for the U.S. Navy is discussed.

Main Directions in Ensuring Business Continuity for Information and Telecommunication Systems of High Availability

Directory of Open Access Journals (Sweden)

Boris Mikhailovich Egorov

2014-12-01

Full Text Available Enterprise Continuity Program, Information and Telecommunication System of Bank of Russia The results of the analysis of the main directions to ensure business continuity for the information and telecommunication systems of high availability in relation to expansion of the problems range, their intellectualization and the modern IT implementation are given.

Breeding and maintaining high-quality insects

DEFF Research Database (Denmark)

Jensen, Kim; Kristensen, Torsten Nygård; Heckmann, Lars-Henrik

2017-01-01

Insects have a large potential for sustainably enhancing global food and feed production, and commercial insect production is a rising industry of high economic value. Insects suitable for production typically have fast growth, short generation time, efficient nutrient utilization, high...... reproductive potential, and thrive at high density. Insects may cost-efficiently convert agricultural and industrial food by-products into valuable protein once the technology is finetuned. However, since insect mass production is a new industry, the technology needed to efficiently farm these animals is still...... in a starting phase. Here, we discuss the challenges and precautions that need to be considered when breeding and maintaining high-quality insect populations for food and feed. This involves techniques typically used in domestic animal breeding programs including maintaining genetically healthy populations...

High Quality Virtual Reality for Architectural Exhibitions

DEFF Research Database (Denmark)

Kreutzberg, Anette

2016-01-01

This paper will summarise the findings from creating and implementing a visually high quality Virtual Reality (VR) experiment as part of an international architecture exhibition. It was the aim to represent the architectural spatial qualities as well as the atmosphere created from combining natural...... and artificial lighting in a prominent not yet built project. The outcome is twofold: Findings concerning the integration of VR in an exhibition space and findings concerning the experience of the virtual space itself. In the exhibition, an important aspect was the unmanned exhibition space, requiring the VR...... experience to be self-explanatory. Observations of different visitor reactions to the unmanned VR experience compared with visitor reactions at guided tours with personal instructions are evaluated. Data on perception of realism, spatial quality and light in the VR model were collected with qualitative...

Information management for aged care provision in Australia: development of an aged care minimum dataset and strategies to improve quality and continuity of care.

Science.gov (United States)

Davis, Jenny; Morgans, Amee; Burgess, Stephen

2016-04-01

Efficient information systems support the provision of multi-disciplinary aged care and a variety of organisational purposes, including quality, funding, communication and continuity of care. Agreed minimum data sets enable accurate communication across multiple care settings. However, in aged care multiple and poorly integrated data collection frameworks are commonly used for client assessment, government reporting and funding purposes. To determine key information needs in aged care settings to improve information quality, information transfer, safety, quality and continuity of care to meet the complex needs of aged care clients. Modified Delphi methods involving five stages were employed by one aged care provider in Victoria, Australia, to establish stakeholder consensus for a derived minimum data set and address barriers to data quality. Eleven different aged care programs were identified; with five related data dictionaries, three minimum data sets, five program standards or quality frameworks. The remaining data collection frameworks related to diseases classification, funding, service activity reporting, and statistical standards and classifications. A total of 170 different data items collected across seven internal information systems were consolidated to a derived set of 60 core data items and aligned with nationally consistent data collection frameworks. Barriers to data quality related to inconsistencies in data items, staff knowledge, workflow, system access and configuration. The development an internal aged care minimum data set highlighted the critical role of primary data quality in the upstream and downstream use of client information; and presents a platform to build national consistency across the sector.

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

Science.gov (United States)

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

2014-09-01

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

Continuous Distributed Top-k Monitoring over High-Speed Rail Data Stream in Cloud Computing Environment

Directory of Open Access Journals (Sweden)

Hanning Wang

2013-01-01

Full Text Available In the environment of cloud computing, real-time mass data about high-speed rail which is based on the intense monitoring of large scale perceived equipment provides strong support for the safety and maintenance of high-speed rail. In this paper, we focus on the Top-k algorithm of continuous distribution based on Multisource distributed data stream for high-speed rail monitoring. Specifically, we formalized Top-k monitoring model of high-speed rail and proposed DTMR that is the Top-k monitoring algorithm with random, continuous, or strictly monotone aggregation functions. The DTMR was proved to be valid by lots of experiments.

Quality Market: Design and Field Study of Prediction Market for Software Quality Control

Science.gov (United States)

Krishnamurthy, Janaki

2010-01-01

Given the increasing competition in the software industry and the critical consequences of software errors, it has become important for companies to achieve high levels of software quality. While cost reduction and timeliness of projects continue to be important measures, software companies are placing increasing attention on identifying the user…

Continuous-Energy Data Checks

Energy Technology Data Exchange (ETDEWEB)

Haeck, Wim [Radioprotection and Nuclear Safety Institute, Fontenay-aux-Roses (France); Conlin, Jeremy Lloyd [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); McCartney, Austin Paul [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Parsons, Donald Kent [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-05-25

The purpose of this report is to provide an overview of all Quality Assurance tests that have to be performed on a nuclear data set to be transformed into an ACE formatted nuclear data file. The ACE file is capable of containing different types of data such as continuous energy neutron data, thermal scattering data, etc. Within this report, we will limit ourselves to continuous energy neutron data.

[Quality management in health care - continuous improvement of processes and outcomes].

Science.gov (United States)

Vagts, Dierk A; Martin, Jörg; Dahmen, Klaus

2008-02-01

What is quality, what is quality management? Who is responsible for quality management in a hospital? Which tools, communication instruments and which instruments for feed back are necessary for institutions to control its tasks in a multi-disciplinary environment? Are there various requirements concerning quality management systems in different hospitals or departments? Which tools of quality management are used in German anaesthesia and intensive care departments? This paper gives an introduction to quality management systems in hospitals and an overview of current models in anaesthesia and intensive care medicine.

Course on Radiological Protection and Quality Assurance in Radiology. Tele-education course: A Possible Solution to continued Postgraduate training

International Nuclear Information System (INIS)

Alcaraz, M.; Chico, P.; Saura Iniesta, A.; Armero, D.; Vicente, V.

2004-01-01

The creation of an interdepartmental project subsidised by the Spanish Ministry of Education has made it possible to create a series of specific didactic materials on Radiological Protection and Quality Assurance in Medical Radiodiagnostic Practices, leading to the publication of a specific manual and practical notebook. As a result, this material now constitutes the working basis for those professionals exposed to ionising radiation who are following the first continuous tele-education training course in Spanish via the Internet on this subject. Interactive multimedia training and tele-education may become one of the alternatives that allow health science professionals to receive continuous training, if adequate content and aims have been established during undergraduate training. (Author) 18 refs

Health-related quality of life in young adults with symptoms of constipation continuing from childhood into adulthood

Directory of Open Access Journals (Sweden)

Bongers Marloes EJ

2009-03-01

Full Text Available Abstract Background Children with functional constipation report impaired Health-related Quality of Life (HRQoL in relation to physical complaints and long duration of symptoms. In about one third of children with constipation, symptoms continue into adulthood. Knowledge on HRQoL in adults with constipation persisting from childhood is lacking. Objectives To assess HRQoL in adults with constipation from early childhood in comparison to that of their peers. Furthermore to gain insight into the specific social consequences related to continuing symptoms of constipation and/or fecal incontinence at adult age. Methods One HRQoL questionnaire and one self-developed questionnaire focusing on specific consequences of symptoms of constipation continuing into adulthood were administrated to 182 adults with a history of childhood constipation. Successful clinical outcome was defined as a defecation frequency three or more times per week with less than two episodes of fecal incontinence per month, irrespective of laxative use. HRQoL of both adults with unsuccessful and successful clinical outcome were compared to a control group of 361 peers from the general Dutch population. Results No differences in HRQoL were found between the whole study population and healthy peers, nor between adults with successful clinical outcome (n = 139 and the control group. Adults with an unsuccessful clinical outcome (n = 43 reported significantly lower HRQoL compared to the control group with respect to scores on bodily pain (mean ± SD 77.4 ± 19.6 versus 85.7 ± 19.5, p = 0.01 and general health (67.6 ± 18.8 versus 74.0 ± 18.1, p = 0.04. Adults with an unsuccessful clinical outcome reported difficulties with social contact and intimacy (20% and 12.5%, respectively, related to their current symptoms. Current therapy in these adults was more often self-administered treatment (e.g. diet modifications (60.4% than laxatives (20.9%. Conclusion Overall, young adults with

Continuous Quality Improvement in a University Setting: The Case of the Department of Vocational and Technical Education at the University of Minnesota.

Science.gov (United States)

Copa, George H.

1993-01-01

Discusses the application of continuous quality improvement principles in the Department of Vocational and Technical Education at the University of Minnesota. Reviews the processes that the department incorporated to implement this program and lists future steps and categories of action. (Author)

High-efficient and high-content cytotoxic recording via dynamic and continuous cell-based impedance biosensor technology.

Science.gov (United States)

Hu, Ning; Fang, Jiaru; Zou, Ling; Wan, Hao; Pan, Yuxiang; Su, Kaiqi; Zhang, Xi; Wang, Ping

2016-10-01

Cell-based bioassays were effective method to assess the compound toxicity by cell viability, and the traditional label-based methods missed much information of cell growth due to endpoint detection, while the higher throughputs were demanded to obtain dynamic information. Cell-based biosensor methods can dynamically and continuously monitor with cell viability, however, the dynamic information was often ignored or seldom utilized in the toxin and drug assessment. Here, we reported a high-efficient and high-content cytotoxic recording method via dynamic and continuous cell-based impedance biosensor technology. The dynamic cell viability, inhibition ratio and growth rate were derived from the dynamic response curves from the cell-based impedance biosensor. The results showed that the biosensors has the dose-dependent manners to diarrhetic shellfish toxin, okadiac acid based on the analysis of the dynamic cell viability and cell growth status. Moreover, the throughputs of dynamic cytotoxicity were compared between cell-based biosensor methods and label-based endpoint methods. This cell-based impedance biosensor can provide a flexible, cost and label-efficient platform of cell viability assessment in the shellfish toxin screening fields.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

Directory of Open Access Journals (Sweden)

Janya McCalman

2018-03-01

Full Text Available Continuous quality improvement (CQI processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

Science.gov (United States)

McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

2018-01-01

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271

Paths to continuous improvement of a CRM strategy

Directory of Open Access Journals (Sweden)

Lluís G. Renart

2008-07-01

Full Text Available The concept of relationship marketing has led to a paradigm change in marketing. Over the last few decades, numerous studies have analyzed the impact of customer relationship management (CRM programs on customer satisfaction and loyalty. Quite a few CRM programs have been found to have little or no impact. Having already published several articles and cases on the subject, in this paper we set out to answer the following question: assuming a company already has a reasonably successful CRM strategy in place, how can it continuously adapt and improve that strategy? Our recommendation is that such companies implement a continuous improvement process at four different but complementary levels: first, review and reinforce the company’s mission, culture and values; second, reconsider and, if necessary, redesign the CRM strategy; third, manage the various relationship-building activities more effectively; and lastly, review and, if necessary, improve the quality of material and human resources, program execution and process governance. A systematic review of these four levels or “paths” of improvement should help generate and maintain high quality relationships over time.

Comparison of reduced sugar high quality chocolates sweetened with stevioside and crude stevia 'green' extract.

Science.gov (United States)

Torri, Luisa; Frati, Alessandra; Ninfali, Paolino; Mantegna, Stefano; Cravotto, Giancarlo; Morini, Gabriella

2017-06-01

The demand for zero and reduced-sugar food products containing cocoa is expanding continuously. The present study was designed to evaluate the feasibility of producing high-quality chocolate sweetened with a crude extract of Stevia rebaudiana (Bertoni) prepared by a green microwave-assisted water-steam extraction procedure. Seven approximately isosweet chocolate formulations were developed, mixing cocoa paste, sucrose, commercial stevioside, crude green extract and maltitol in different proportions. All samples were analyzed for the determination of polyphenol and flavonoid content, antioxidant activity, and sensory acceptability. The use of a crude stevia extract allowed low-sugar, high-quality chocolates to be obtained that were also acceptable by consumers and had a significant increased antioxidant activity. Moreover, consumers' segmentation revealed a cluster of consumers showing the same overall liking for the sample with 50% sucrose replaced by the stevia crude extract as that obtained with the commercial stevioside and the control sample (without sucrose replacement). The results provide information that can contribute to promoting the development of sweet food products, with advantages in terms of an improved nutritional value (reduced sugar content and increased antioxidant activity) and a reduced impact of the production process on the environment. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Search for continuous and single day emission from ultra-high-energy sources

International Nuclear Information System (INIS)

Chen, Mei-Li.

1993-01-01

Data from the CYGNUS experiment has been used to search the northern sky for point sources of continuous ultra-high-energy gamma radiation and to examine 51 candidate sources on a daily basis to search for episodic emission. In this paper, we make use of our most recent data to update our previously published results from these searches. The data sample is approximately twice as large as the published data set for continuous emission, and contains an additional year for the daily search. The latest results, up to the time of the conference, will be presented at the meeting

Speaking the right language: the scientific method as a framework for a continuous quality improvement program within academic medical research compliance units.

Science.gov (United States)

Nolte, Kurt B; Stewart, Douglas M; O'Hair, Kevin C; Gannon, William L; Briggs, Michael S; Barron, A Marie; Pointer, Judy; Larson, Richard S

2008-10-01

The authors developed a novel continuous quality improvement (CQI) process for academic biomedical research compliance administration. A challenge in developing a quality improvement program in a nonbusiness environment is that the terminology and processes are often foreign. Rather than training staff in an existing quality improvement process, the authors opted to develop a novel process based on the scientific method--a paradigm familiar to all team members. The CQI process included our research compliance units. Unit leaders identified problems in compliance administration where a resolution would have a positive impact and which could be resolved or improved with current resources. They then generated testable hypotheses about a change to standard practice expected to improve the problem, and they developed methods and metrics to assess the impact of the change. The CQI process was managed in a "peer review" environment. The program included processes to reduce the incidence of infections in animal colonies, decrease research protocol-approval times, improve compliance and protection of animal and human research subjects, and improve research protocol quality. This novel CQI approach is well suited to the needs and the unique processes of research compliance administration. Using the scientific method as the improvement paradigm fostered acceptance of the project by unit leaders and facilitated the development of specific improvement projects. These quality initiatives will allow us to improve support for investigators while ensuring that compliance standards continue to be met. We believe that our CQI process can readily be used in other academically based offices of research.

Study of continuous-wave domain fluorescence diffuse optical tomography for quality control on agricultural produce

Energy Technology Data Exchange (ETDEWEB)

Nadhira, Vebi, E-mail: vebi@tf.itb.ac.id; Kurniadi, Deddy, E-mail: vebi@tf.itb.ac.id; Juliastuti, E., E-mail: vebi@tf.itb.ac.id; Sutiswan, Adeline, E-mail: vebi@tf.itb.ac.id [Instrumentation and Control Research Group, Faculty of Industrial Technology, Institute Technology of Bandung, Ganesha 10 40132 Bandung (Indonesia)

2014-03-24

The importance of monitoring the quality of vegetables and fruits is prosperity by giving a competitive advantage for producer and providing a more healthy food for consumer. Diffuse Optical Tomography (DOT) is offering the possibility to detect the internal defects of the agricultural produce quality. Fluorescence diffuse optical tomography (FDOT) is the development of DOT, offering the possibilities to improve spatial resolution and to contrast image. The purpose of this research is to compare FDOT and DOT in forward analysis with continuous wave approach. The scattering and absorbing parameters of potatoes are used to represent the real condition. The object was illuminated by the NIR source from some positions on the boundary of object. A set of NIR detector are placed on the peripheral position of the object to measure the intensity of propagated or emitted light. In the simulation, we varied a condition of object then we analyzed the sensitivity of forward problem. The result of this study shows that FDOT has a better sensitivity than DOT and a better potential to monitor internal defects of agricultural produce because of the contrast value between optical and fluorescence properties of agricultural produce normal tissue and defects.

Processing of high-temperature simulated waste glass in a continuous ceramic melter

International Nuclear Information System (INIS)

Barnes, S.M.; Brouns, R.A.; Hanson, M.S.

1980-01-01

Recent operations have demonstrated that high-melting-point glasses and glass-ceramics can be successfully processed in joule-heated, ceramic-lined melters with minor modifications to the existing technology. Over 500 kg of simulated waste glasses have been processed at temperatures up to 1410 0 C. The processability of the two high-temperature waste forms tested is similar to existing borosilicate waste glasses. High-temperature waste glass formulations produced in the bench-scale melter exhibit quality comparing favorably to standard waste glass formulations

40 CFR 130.5 - Continuing planning process.

Science.gov (United States)

2010-07-01

... QUALITY PLANNING AND MANAGEMENT § 130.5 Continuing planning process. (a) General. Each State shall establish and maintain a continuing planning process (CPP) as described under section 303(e)(3)(A)-(H) of... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Continuing planning process. 130.5...

ESSD: Real World Issues and Challenges of High-Quality Data Publication

Science.gov (United States)

Pfeiffenberger, Hans; Carlson, David

2013-04-01

The Copernicus data publication journal Earth System Science Data (ESSD) represents an important and unique (and by no means final!) step forward in the larger world of data publication. Working with authors, reviewers, editors and data centres, ESSD has successfully produced many high-quality data publications across a wide variety of scientific disciplines, for individual data sets, multiple data sets as the product of scientific consortia and in special issues coordinated with other science journals. The ESSD success also exposes issues and challenges for present and future data publication, particularly around the topic and implementation of persistent identifiers. • As ESSD encourages redundant data sets across multiple data centres for access and archive purposes, how will DOIs be employed to accurately point to those distributed or replicated data? How can authenticity and integrity be verified? • How can or should object identifiers be employed in pointing from raw to quality-controlled and finally derived data processing levels; how can we designate or distinguish among these, particularly as those terms vary substantially among, for example, geophysical and ecological communities? Likewise, how to distinguish an auto-generated data product (e.g a species identification from GBIF) from a high-effort expertly reviewed data product (e.g. an ESSD publication)? • For a growing number of ESSD data publications with expected annual or periodic revisions and updates, how should data journals' and the repositories' use of persistent identifiers best record the subsequent versions, extensions or corrections? • As published data sets become a valued part of high profile science, with attendant deadlines, announcements and publicity, do the various DOI policies and minting practices among cooperating publishers, data centres and journals represent a help or a hindrance? These questions evolve directly from increasing interest in and activity by ESSD and, as

Impact of continuous glucose monitoring on quality of life, treatment satisfaction, and use of medical care resources

DEFF Research Database (Denmark)

Hommel, E; Olsen, B; Battelino, T

2014-01-01

To investigate the impact of continuous glucose monitoring (CGM) on health-related quality of life (HRQOL), treatment satisfaction (TS) medical resource use, and indirect costs in the SWITCH study. SWITCH was a multicentre, randomized, crossover study. Patients with type 1 diabetes (n = 153) using...... longer during the sensor-On arm. Regarding indirect costs, children with >70 % sensor usage missed fewer school days, compared with the sensor-Off arm (P = 0.0046) but there was no significant difference in the adults days of work off. The addition of CGM to CSII resulted in better metabolic control...

Sustained participation in annual continuous quality improvement activities improves quality of care for Aboriginal and Torres Strait Islander children.

Science.gov (United States)

McAullay, Daniel; McAuley, Kimberley; Bailie, Ross; Mathews, Veronica; Jacoby, Peter; Gardner, Karen; Sibthorpe, Beverly; Strobel, Natalie; Edmond, Karen

2018-02-01

To determine whether participation in the continuous quality improvement (CQI) Audit and Best Practice for Chronic Disease programme improved care and outcomes for Indigenous children. Data were collected from 59 Australian primary health-care centres providing services to Indigenous people and participating in the programme (February 2008 and December 2013). Indigenous children aged less than 2 years and centres that completed three or more consecutive annual audits within the 6-year study period were included. Crude and adjusted logistic generalised estimating equation models were used to examine the effect of year of audit on the delivery of care. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Outcomes were related to age-relevant health issues, including prevention and early intervention. These included administrative, health check, anticipatory guidance and specific health issues. During the audit period, there were 2360 files from 59 centres. Those that had a recall recorded, improved from 84 to 95% (OR 2.44, 95% CI 1.44-4.11). Hearing assessments improved from 52 to 89% (OR 1.37, 95% CI 1.22-1.54). Improvement in anticipatory guidance, treatment and follow-up of medical conditions was almost universal. We documented significant improvements in quality of care of Indigenous children. Outcomes and their corresponding treatment and follow-ups improved over time. This appears to be related to services participating in annual CQI activities. However, these services may be more committed to CQI than others and therefore possibly better performing. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement.

Science.gov (United States)

Dorrington, Melanie S; Herceg, Ana; Douglas, Kirsty; Tongs, Julie; Bookallil, Marianne

2015-01-01

This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.

Perseverative Cognition as an Explanatory Mechanism in the Relation Between Job Demands and Sleep Quality.

Science.gov (United States)

Van Laethem, Michelle; Beckers, Debby G J; Geurts, Sabine A E; Garefelt, Johanna; Magnusson Hanson, Linda L; Leineweber, Constanze

2018-04-01

The aim of this longitudinal three-wave study was to examine (i) reciprocal associations among job demands, work-related perseverative cognition (PC), and sleep quality; (ii) PC as a mediator in-between job demands and sleep quality; and (iii) continuous high job demands in relation to sleep quality and work-related PC over time. A representative sample of the Swedish working population was approached in 2010, 2012, and 2014, and 2316 respondents were included in this longitudinal full-panel survey study. Structural equation modelling was performed to analyse the temporal relations between job demands, work-related PC, and sleep quality. Additionally, a subsample (N = 1149) consisting of individuals who reported the same level of exposure to job demands during all three waves (i.e. stable high, stable moderate, or stable low job demands) was examined in relation to PC and sleep quality over time. Analyses showed that job demands, PC, and poor sleep quality were positively and reciprocally related. Work-related PC mediated the normal and reversed, direct across-wave relations between job demands and sleep quality. Individuals with continuous high job demands reported significantly lower sleep quality and higher work-related PC, compared to individuals with continuous moderate/low job demands. This study substantiated reciprocal relations between job demands, work-related PC, and sleep quality and supported work-related PC as an underlying mechanism of the reciprocal job demands-sleep relationship. Moreover, this study showed that chronically high job demands are a risk factor for low sleep quality.

EXPERT-ANALITICAL MONITORING OF LEARNING PROCESS QUALITY IN HIGH SCHOOL

Directory of Open Access Journals (Sweden)

T. M. Korotun

2010-10-01

Full Text Available The technological model is proposed for monitoring process of learning process quality in high school compliant with current European and home standards. The mathematical methods are elaborated for diverse activities as to learning process objects quality determination unified support. They self-consistently combine: automatic expert evaluation with Bayesian net and Value tree models; Delphi technique enhancement; best practices for education quality assessment. Quality estimates’ consistency index is introduced for their choice and acceptability analysis. Its permanent increasing over monitoring stages is guaranteed. The tools for these stages’ automatic support are described.

Combined microfluidization and ultrasonication: a synergistic protocol for high-efficient processing of SWCNT dispersions with high quality

Energy Technology Data Exchange (ETDEWEB)

Luo, Sida, E-mail: s.luo@buaa.edu.cn [Beihang University, School of Mechanical Engineering and Automation (China); Liu, Tao, E-mail: tliu@fsu.edu [Florida State University, High-Performance Materials Institute (United States); Wang, Yong; Li, Liuhe [Beihang University, School of Mechanical Engineering and Automation (China); Wang, Guantao; Luo, Yun [China University of Geosciences, Center of Safety Research, School of Engineering and Technology (China)

2016-08-15

High-efficient and large-scale production of high-quality CNT dispersions is necessary for meeting the future needs to develop various CNT-based electronic devices. Herein, we have designed novel processing protocols by combining conventional ultrasonication process with a new microfluidization technique to produce high-quality SWCNT dispersions with improved processing efficiency. To judge the quality of SWCNT dispersions, one critical factor is the degree of exfoliation, which could be quantified by both geometrical dimension of the exfoliated nanotubes and percentage of individual tubes in a given dispersion. In this paper, the synergistic effect of the combined protocols was systematically investigated through evaluating SWCNT dispersions with newly developed characterization techniques, namely preparative ultracentrifuge method (PUM) and simultaneous Raman scattering and photoluminescence spectroscopy (SRSPL). The results of both techniques draw similar conclusions that as compared with either of the processes operated separately, a low-pass microfluidization followed by a reasonable duration of ultrasonication could substantially improve the processing efficiency to produce high-quality SWCNT dispersions with averaged particle length and diameter as small as ~600 and ~2 nm, respectively.Graphical abstract.

Technical Note: Continuity of MIPAS-ENVISAT operational ozone data quality from full- to reduced-spectral-resolution operation mode

Directory of Open Access Journals (Sweden)

S. Ceccherini

2008-04-01

Full Text Available MIPAS (Michelson Interferometer for Passive Atmospheric Sounding is operating on the ENVIronmental SATellite (ENVISAT since March 2002. After two years of nearly continuous limb scanning measurements, at the end of March 2004, the instrument was stopped due to problems with the mirror drive of the interferometer. Operations with reduced maximum path difference, corresponding to both a reduced-spectral-resolution and a shorter measurement time, were resumed on January 2005. In order to exploit the reduction in measurement time, the measurement scenario was changed adopting a finer vertical limb scanning. The change of spectral resolution and of measurement scenario entailed an update of the data processing strategy. The aim of this paper is the assessment of the differences in the quality of the MIPAS ozone data acquired before and after the stop of the operations. Two sets of MIPAS ozone profiles acquired in 2003–2004 (full-resolution measurements and in 2005–2006 (reduced-resolution measurements are compared with collocated ozone profiles obtained by GOMOS (Global Ozone Monitoring by Occultation of Stars, itself also onboard ENVISAT. The continuity of the GOMOS data quality allows to assess a possible discontinuity of the MIPAS performances. The relative bias and precision of MIPAS ozone profiles with respect to the GOMOS ones have been compared for the measurements acquired before and after the stop of the MIPAS operations. The results of the comparison show that, in general, the quality of the MIPAS ozone profiles retrieved from reduced-resolution measurements is comparable or better than that obtained from the full-resolution dataset. The only significant change in MIPAS performances is observed at pressures around 2 unit{hPa}, where the relative bias of the instruments increases by a factor of 2 from the 2003–2004 to 2005–2006 measurements.

High-quality graphene grown on polycrystalline PtRh{sub 20} alloy foils by low pressure chemical vapor deposition and its electrical transport properties

Energy Technology Data Exchange (ETDEWEB)

Yang, He; Shen, Chengmin, E-mail: cmshen@iphy.ac.cn; Tian, Yuan; Bao, Lihong; Chen, Peng; Yang, Rong; Yang, Tianzhong; Li, Junjie; Gu, Changzhi; Gao, Hong-Jun [Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing 100190 (China)

2016-02-08

High-quality continuous uniform monolayer graphene was grown on polycrystalline PtRh{sub 20} alloy foils by low pressure chemical vapor deposition. The morphology of graphene was investigated by Raman spectroscopy, scanning electron microscopy, and atomic force microscopy. Analysis results confirm that high quality single-layer graphene was fabricated on PtRh{sub 20} foil at 1050 °C using a lower flux of methane under low pressure. Graphene films were transferred onto the SiO{sub 2}/Si substrate by the bubbling transfer method. The mobility of a test field effect transistor made of the graphene grown on PtRh{sub 20} was measured and reckoned at room temperature, showing that the carrier mobility was about 4000 cm{sup 2} V{sup −1} s{sup −1}. The results indicate that desired quality of single-layer graphene grown on PtRh{sub 20} foils can be obtained by tuning reaction conditions.

Examination of Operation Quality for High-frequent Railway Operation

DEFF Research Database (Denmark)

Landex, Alex; Kaas, Anders H.

2009-01-01

take the first train in their direction. The article examines four different approaches to examine operation quality for high-frequent operation that are based on the experiences of the passengers. These approaches are the service frequency of the operation, travel time extension, a combination......The examination of operation quality for high-frequent operation requires other approaches than the typical evaluation of punctuality (trains on time) and reliability (operated trains). This is because passengers in high-frequent railway systems do not necessarily notice train delays as they just...... of the service frequency and travel time approaches, and passenger delays. The service frequency and travel time approaches are simple measurements with low complexity and complement each other. Therefore, the article recommends combining the service frequency and travel time approaches to get a more accurate...

The efficacy of a continuous quality improvement (CQI) method in a radiological department: comparison with non-CQI control material

International Nuclear Information System (INIS)

Laurila, J.; Standertskjoeld-Nordenstam, C.G.; Suramo, I.; Tolppanen, E.M.; Tervonen, O.; Korhola, O.; Brommels, M.

2000-01-01

To study the efficacy of continuous quality improvement (CQI) compared to ordinary management in an on-duty radiology department. Because of complaints regarding delivery of on-duty radiological services, an improvement was initiated simultaneously at two hospitals, at the HUCH (Helsinki University Central Hospital) utilising the CQI-method, and at the OUH (Oulu University Hospital) with a traditional management process. For the CQI project, a team was formed to evaluate the process with flow-charts, cause and effect diagrams, Pareto analysis and control charts. Interventions to improve the process were based on the results of these analyses. The team at the HUCH implemented the following changes: A radiologist was added to the evening shift between 15:00 - 22:00 and a radiographer was moved from the morning shift to 15:00 - 22:00. A clear improvement was achieved in the turn-around time, but in the follow-up some of the gains were lost. Only minimal changes were achieved at the OUH, where the intervention was based on traditional management processes. CQI was an effective method for improving the quality of performance of a radiology department compared with ordinary management methods, but some of this improvement may be subsequently lost without a continuous measurement system

Logistic and linear regression model documentation for statistical relations between continuous real-time and discrete water-quality constituents in the Kansas River, Kansas, July 2012 through June 2015

Science.gov (United States)

Foster, Guy M.; Graham, Jennifer L.

2016-04-06

The Kansas River is a primary source of drinking water for about 800,000 people in northeastern Kansas. Source-water supplies are treated by a combination of chemical and physical processes to remove contaminants before distribution. Advanced notification of changing water-quality conditions and cyanobacteria and associated toxin and taste-and-odor compounds provides drinking-water treatment facilities time to develop and implement adequate treatment strategies. The U.S. Geological Survey (USGS), in cooperation with the Kansas Water Office (funded in part through the Kansas State Water Plan Fund), and the City of Lawrence, the City of Topeka, the City of Olathe, and Johnson County Water One, began a study in July 2012 to develop statistical models at two Kansas River sites located upstream from drinking-water intakes. Continuous water-quality monitors have been operated and discrete-water quality samples have been collected on the Kansas River at Wamego (USGS site number 06887500) and De Soto (USGS site number 06892350) since July 2012. Continuous and discrete water-quality data collected during July 2012 through June 2015 were used to develop statistical models for constituents of interest at the Wamego and De Soto sites. Logistic models to continuously estimate the probability of occurrence above selected thresholds were developed for cyanobacteria, microcystin, and geosmin. Linear regression models to continuously estimate constituent concentrations were developed for major ions, dissolved solids, alkalinity, nutrients (nitrogen and phosphorus species), suspended sediment, indicator bacteria (Escherichia coli, fecal coliform, and enterococci), and actinomycetes bacteria. These models will be used to provide real-time estimates of the probability that cyanobacteria and associated compounds exceed thresholds and of the concentrations of other water-quality constituents in the Kansas River. The models documented in this report are useful for characterizing changes

Continuous quality improvement in daily clinical practice: a proof of concept study.

Directory of Open Access Journals (Sweden)

Jonathan A Lorch

Full Text Available Continuous Quality Improvement (CQI is an iterative process of: planning to improve a product or process, plan implementation, analyzing and comparing results against those expected, and corrective action on differences between actual and expected results. It is little used in clinical medicine. Anemia, a complex problem in End Stage Renal Disease patients, served to test the ability of an unique electronic medical record (EMR optimized for daily care to empower CQI in practice. We used data collected during daily care, stored in the EMR, and organized to display temporal relationships between clinical, laboratory, and therapeutic events. Our aims were optimal hemoglobin with minimum epoetin, and maintaining stable hemoglobin and epoetin. The study was done on 250 patients treated by maintenance hemodialysis (HD, receiving epoetin prior to February 1, 2010 and followed to July 31, 2011. Repleting iron, ensuring iron sufficiency, slow epoetin reduction, and decision support tools enabling data display over long periods in patient-centered reports were key elements. Epoetin dose, adjusted 6-8 weekly, was based on current clinical conditions and past responses. Hemoglobin increased by months 1-2; epoetin decreased from month 4. By months 16-18, epoetin had decreased 42% to 9,720 units/week while hemoglobin increased 8% to 123.6 g/L. Hemoglobin and epoetin were stable from month 7 onward. New epoetin orders decreased 83%. Transferrin saturation increased after the study start. Individual patient hemoglobin variation decreased by 23%, range by 27%. Mortality, 11.78 per 100 patient years, was 42% less than United States dialysis patient mortality. Allowable epoetin charges decreased by $15.33 per treatment and were $22.88 less than current Medicare allowance. The study validates the hypothesis that an EMR optimized for daily patient care can empower CQI in clinical medicine and serve to monitor medical care quality and cost.

High quality graphene synthesized by atmospheric pressure CVD on copper foil

OpenAIRE

Trinsoutrot, Pierre; Rabot, Caroline; Vergnes, Hugues; Delamoreanu, Alexandru; Zenasni, Aziz; Caussat, Brigitte

2013-01-01

International audience; Graphene was synthesized at 1000 °C by Atmospheric Pressure Chemical Vapor Deposition on copper foil from methane diluted in argon and hydrogen. The influence of the main synthesis parameters was studied on 2 × 2 cm2 foils in order to obtain continuous monolayer graphenewithout crystalline defect. The uniformity, crystal quality and number of layers of graphenewere analyzed by Raman spectroscopy and Scanning Electronic Microscopy. First, an increase of the annealing pr...

40 CFR Table 9 to Subpart Eeee of... - Continuous Compliance With Operating Limits-High Throughput Transfer Racks

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Continuous Compliance With Operating Limits-High Throughput Transfer Racks 9 Table 9 to Subpart EEEE of Part 63 Protection of Environment...—Continuous Compliance With Operating Limits—High Throughput Transfer Racks As stated in §§ 63.2378(a) and (b...

Does accelerometer feedback on high-quality chest compression improve survival rate? An in-hospital cardiac arrest simulation.

Science.gov (United States)

Jung, Min Hee; Oh, Je Hyeok; Kim, Chan Woong; Kim, Sung Eun; Lee, Dong Hoon; Chang, Wen Joen

2015-08-01

We investigated whether visual feedback from an accelerometer device facilitated high-quality chest compressions during an in-hospital cardiac arrest simulation using a manikin. Thirty health care providers participated in an in-hospital cardiac arrest simulation with 1 minute of continuous chest compressions. Chest compressions were performed on a manikin lying on a bed according to visual feedback from an accelerometer feedback device. The manikin and accelerometer recorded chest compression data simultaneously. The simulated patient was deemed to have survived when the chest compression data satisfied all of the preset high-quality chest compression criteria (depth ≥51 mm, rate >100 per minute, and ≥95% full recoil). Survival rates were calculated from the feedback device and manikin data. The survival rate according to the feedback device data was 80%; however, the manikin data indicated a significantly lower survival rate (46.7%; P = .015). The difference between the accelerometer and manikin survival rates was not significant for participants with a body mass index greater than or equal to 20 kg/m(2) (93.3 vs 73.3%, respectively; P = .330); however, the difference in survival rate was significant in participants with body mass index less than 20 kg/m(2) (66.7 vs 20.0%, respectively; P = .025). The use of accelerometer feedback devices to facilitate high-quality chest compression may not be appropriate for lightweight rescuers because of the potential for compression depth overestimation. Clinical Research Information Service (KCT0001449). Copyright © 2015 Elsevier Inc. All rights reserved.

Malaysian private general practitioners’ views and experiences on continuous professional development: A qualitative study

Directory of Open Access Journals (Sweden)

Norlehan Abdul Samad

2014-08-01

Full Text Available Continuous professional development (CPD is an important aspect of a medical practitioner’s career. Aiming to be at par with other developed countries for high quality of professional practice, Malaysia is planning to implement compulsory CPD for the doctors.

Kaizen - continuous improvement of high voltage products; Kaizen - kontinuierliche Verbesserung bei Hochspannungsprodukten

Energy Technology Data Exchange (ETDEWEB)

Schwarz, M. [ABB Calor Emag Schaltanlagen AG, Hanau-Grossauheim (Germany); Goessmann, T. [ABB Calor Emag Schaltanlagen AG, Mannheim (Germany)

1999-07-12

In the actual global competition only the company can survive who cares for the continuous improvement of all business activities. The ABB Calor Emag Schaltanlagen AG at his production site in Hanau-Grossauheim has installed a specific improvement programm called KVP what is based on the ideas of Kaizen. Aim is the improvement of processes, mainly in production, concerning quality, dates, costs and environment by activating all colleagues. (orig.) [Deutsch] Im heutigen globalen Wettbewerb kann sich nur der behaupten, der sich kontinuierlich in allen Unternehmensbereichen weiterentwickelt. Die ABB Calor Emag Schaltanlagen AG hat in ihrem Werk Hanau-Grossauheim nach den Ideen des Kaizen ein werkspezifisches Programm zur kontinuierlichen Verbesserung der Prozesse in der Fertigung eingefuehrt. Ziel ist die stetige Verbesserung von Fertigungsparametern, wie Qualitaet, Termine, Kosten und Umwelt unter Einbeziehung aller Mitarbeiter. (orig.)

Continuous and pulsed laser high power beam combiner for additive manufacturing applications

Science.gov (United States)

Bassignana, Marta; Califano, Alessio; Pescarmona, Francesco; Braglia, Andrea; Perrone, Guido

2018-02-01

Laser-based additive manufacturing (AM) from metal powders is emerging as the new industrial revolution, although current fabrication approaches still require long mechanical post-processing to improve the final surface quality and meet the design tolerances. To overcome this limitation, the next generation machines are expected to complement laser AM with laser ablation (LA) to implement surface finishing and micro texturing already during the device growth process. With this aim, a new beam combiner to allow the real-time interchange of additive and subtractive processes using the same scanner head has been designed. Extensive tests have been carried out using a 6 kW continuous-wave laser similar to that used for the metal powder fusion and a nanosecond 100W pulsed source similar to that used for laser ablation.

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

Science.gov (United States)

Seemann, Tine Lindberg; Nybo, Mads

2016-10-15

An observational study was conducted using a structured observation scheme to assess compliance with the local phlebotomy guideline, to identify necessary focus items, and to investigate whether adherence to the phlebotomy guideline improved. The questionnaire from the EFLM Working Group for the Preanalytical Phase was adapted to local procedures. A pilot study of three months duration was conducted. Based on this, corrective actions were implemented and a follow-up study was conducted. All phlebotomists at the Department of Clinical Biochemistry and Pharmacology were observed. Three blood collections by each phlebotomist were observed at each session conducted at the phlebotomy ward and the hospital wards, respectively. Error frequencies were calculated for the phlebotomy ward and the hospital wards and for the two study phases. A total of 126 blood drawings by 39 phlebotomists were observed in the pilot study, while 84 blood drawings by 34 phlebotomists were observed in the follow-up study. In the pilot study, the three major error items were hand hygiene (42% error), mixing of samples (22%), and order of draw (21%). Minor significant differences were found between the two settings. After focus on the major aspects, the follow-up study showed significant improvement for all three items at both settings (P < 0.01, P < 0.01, and P = 0.01, respectively). Continuous quality control of the phlebotomy procedure revealed a number of items not conducted in compliance with the local phlebotomy guideline. It supported significant improvements in the adherence to the recommended phlebotomy procedures and facilitated documentation of the phlebotomy quality.

Insomnia in epilepsy is associated with continuing seizures and worse quality of life.

Science.gov (United States)

Quigg, Mark; Gharai, Sean; Ruland, Jeff; Schroeder, Catherine; Hodges, Matthew; Ingersoll, Karen S; Thorndike, Frances P; Yan, Guofen; Ritterband, Lee M

2016-05-01

To evaluate how insomnia is associated with seizure control and quality of life in patients with epilepsy. Consecutive patients with epilepsy attending clinical visits were surveyed with the Insomnia Severity Index (ISI). Patients had to be treated with at least one anticonvulsant and could not have had documented psychogenic pseudoseizure. The presence or absence of seizures and quality of life (QOLIE-P-10) within the past 4 weeks was recorded. Other variables included demographic and clinical data, sleep-wake timing, the Hörne-Östberg Morningness-Eveningness Questionnaire (MEQ), sleepiness (Epworth Sleepiness Scale (ESS), and mood (Center for Epidemiologic Studies Depression Scale, CES-D). 207 patients completed surveys. 43% had clinically significant insomnia, and 51% had at least mild insomnia. 58% were seizure free. Mean ISI scores were significantly worse for those with continuing seizures, and more severe ISI scores correlated strongly with worse QOL. Younger age, shorter duration of epilepsy, use of sedative/hypnotics, medical and sleep comorbidities, delayed sleep timing and chronotype, excessive sleepiness, and depression were all associated with more severe insomnia. Those with unexpected health care visits over the most recent 4 weeks had worse insomnia. After adjustment for these covariates, more severe insomnia remained significantly associated with lack of seizure freedom and with worse QOL. Insomnia is common in epilepsy, and is associated with short term poor seizure control and worse QOL. Future studies must evaluate cause-and-effect relationships. Assessment of insomnia may be important in the comprehensive care of epilepsy and may influence control of epileptic seizures. Copyright © 2016 Elsevier B.V. All rights reserved.

Endorectal high dose rate brachytherapy quality assurance

International Nuclear Information System (INIS)

Devic, S.; Vuong, T.; Evans, M.; Podgorsak, E.

2008-01-01

We describe our quality assurance method for preoperative high dose rate (HDR) brachytherapy of endorectal tumours. Reproduction of the treatment planning dose distribution on a daily basis is crucial for treatment success. Due to the cylindrical symmetry, two types of adjustments are necessary: applicator rotation and dose distribution shift along the applicator axis. (author)

Internal factors influencing the knowledge continuity ensuring

Directory of Open Access Journals (Sweden)

Hana Urbancová

2012-01-01

Full Text Available The aim of the systematic ensuring of knowledge continuity is the continuity of an organisation’s development, the quality of managerial positions and the continuity of decision-making. By ensuring knowledge continuity, organisations may gain a performance-enhancing factor. The objective of the article is to identify the level of impact of decisive internal factors determining knowledge continuity ensuring and contributing to the efficiency of the organisations. Knowledge continuity ensuring as an internal force, however, can together with the right employees, help adapt more quickly to external conditions that organisations can hardly control. Monitoring and ensuring knowledge continuity can contribute to a higher quality of processes in general, in particular processes exploiting knowledge, and thus help improve the level of management. The first part of the article presents theoretical views on the aspects of knowledge continuity ensuring in organisations while the second part analyses the findings of the surveys carried out among managers in organisations in the Czech Republic. Based on the summary of the outcomes obtained it is possible to say that internal factors influence knowledge continuity ensuring in organisations, however, the level of impact of individual factors is determined by their size. The findings regarding the impact of each of the factors show that the most significant barriers to knowledge continuity ensuring are those associated with the human factor.

Keeping the "continuous" in continuous quality improvement: exploring perceived outcomes of CQI program use in community pharmacy.

Science.gov (United States)

Boyle, Todd A; Bishop, Andrea C; Duggan, Kellie; Reid, Carolyn; Mahaffey, Thomas; MacKinnon, Neil J; Mahaffey, Amelia

2014-01-01

Given the significant potential of continuous quality improvement (CQI) programs in enhancing overall levels of patient safety, community pharmacies in North America are under increasing pressure to have a formal and documented CQI program in place. However, while such initiatives may seem great on paper, in practice the outcomes of such programs to community pharmacy practice remain unclear. To explore the perceived outcomes identified by community pharmacies that adopted and actively used a standardized (i.e., common across pharmacies) CQI program for at least 1 year and to develop a framework for how such outcomes were achieved. A multi-site study of SafetyNET-Rx, a standardized and technologically sophisticated (e.g., online reporting of medication errors to a national database) CQI program, involving community pharmacies in Nova Scotia, Canada, was performed. During the summer and fall of 2011, 22 interviews were conducted with the CQI facilitators in 12 Nova Scotia community pharmacies; equally split between independent/banners and corporate chains. Of the CQI facilitators, 14 were pharmacists, while the remaining eight were pharmacy technicians. Thematic analysis following the procedures presented by Braun and Clarke was adopted to identify and explore the major outcomes. Results of the thematic analysis highlighted a number of perceived outcomes from the use of a standardized CQI program in community pharmacies, specifically: (1) perceived reduction in the number of medication errors that were occurring in the pharmacy, (2) increased awareness/confidence of individual actions related to dispensing, (3) increased understanding of the dispensing and related processes/workflow, (4) increased openness to talking about medication errors among pharmacy staff, and (5) quality and safety becoming more entrenched in the workflow (e.g., staff is more aware of their roles and responsibilities in patient safety and confident that the dispensing processes are safe and

Integrated continuous processing of proteins expressed as inclusion bodies: GCSF as a case study.

Science.gov (United States)

Kateja, Nikhil; Agarwal, Harshit; Hebbi, Vishwanath; Rathore, Anurag S

2017-07-01

Affordability of biopharmaceuticals continues to be a challenge, particularly in developing economies. This has fuelled advancements in manufacturing that can offer higher productivity and better economics without sacrificing product quality in the form of an integrated continuous manufacturing platform. While platform processes for monoclonal antibodies have existed for more than a decade, development of an integrated continuous manufacturing process for bacterial proteins has received relatively scant attention. In this study, we propose an end-to-end integrated continuous downstream process (from inclusion bodies to unformulated drug substance) for a therapeutic protein expressed in Escherichia coli as inclusion body. The final process consisted of a continuous refolding in a coiled flow inverter reactor directly coupled to a three-column periodic counter-current chromatography for capture of the product followed by a three-column con-current chromatography for polishing. The continuous bioprocessing train was run uninterrupted for 26 h to demonstrate its capability and the resulting output was analyzed for the various critical quality attributes, namely product purity (>99%), high molecular weight impurities (<0.5%), host cell proteins (<100 ppm), and host cell DNA (<10 ppb). All attributes were found to be consistent over the period of operation. The developed assembly offers smaller facility footprint, higher productivity, fewer hold steps, and significantly higher equipment and resin utilization. The complexities of process integration in the context of continuous processing have been highlighted. We hope that the study presented here will promote development of highly efficient, universal, end-to-end, fully continuous platforms for manufacturing of biotherapeutics. © 2016 American Institute of Chemical Engineers Biotechnol. Prog., 33:998-1009, 2017. © 2016 American Institute of Chemical Engineers.

Assessment of long-term quality of life of esophageal carcinoma patients treated with continuous accelerated hyperfractionated and late-course accelerated hyperfractionated radiotherapy

International Nuclear Information System (INIS)

Wang Yang; He Shaoqin; Shi Xuehui; Jiang Kaida; Yao Weiqiang; Wang Ying

2002-01-01

Objective: To compare the long-term quality of life in esophageal carcinoma patients treated with continuous accelerated hyperfractionated (CAHF) and late-course accelerated hyperfractionated (LCAF) radiotherapy. Methods: Subjective and Objective Management Analysis (SOMA) scale, Symptom Checklist 90 (SCL-90) and Life Satisfaction Index A (LSIA) questionnaire were mailed to the long survivors in both CAHF and LCAF groups to assess the long-term quality of life including symptoms, psychological status and life satisfaction. Results: There was no significant difference between the two groups in the score of quality of life such as late radiation reaction, SCL-90 and LSI-A. Conclusions: 1. It is reasonable to assess the quality of life with these scales for esophageal carcinoma patients treated with radiotherapy, 2. Preliminary results demonstrate that there is no significant difference in long-term quality of life between the CAHF and LCAF radiotherapy groups, 3. Methods of evaluating the long-term quality of life for esophageal carcinoma patients treated with radiotherapy needs further investigation, preferably involving more patients and setting on control arm

Continuous, flexible, and high-strength superconducting Nb3Ge and Nb3Sn filaments

International Nuclear Information System (INIS)

Ahmad, I.; Heffernan, W.J.

1976-01-01

Fabrication of continuous, flexible, and high-strength (1600 MN/m 2 ) composite filaments of Nb 3 Ge (T/subc/ 18 0 K) and Nb 3 Sn is reported, involving chemical vapor deposition of these compounds on Nb-coated high-strength W--1% ThO 2 filaments

Monitoring urban air quality using a high-density network of low-cost sensor nodes in Oslo, Norway.

Science.gov (United States)

Castell, Nuria; Schneider, Philipp; Vogt, Matthias; Dauge, Franck R.; Lahoz, William; Bartonova, Alena

2017-04-01

Urban air quality represents a major public health burden and is a long-standing concern to citizens. Air pollution is associated with a range of diseases, symptoms and conditions that impair health and quality of life. In Oslo, traffic, especially exhaust from heavy-duty and private diesel vehicles and dust resuspension from studded tyres, together with wood burning in winter, are the main sources of pollution. Norway, as part of the European Economic Area, is obliged to comply with the European air quality regulations and ensure clean air. Despite this, Oslo has exceeded both the NO2 and PM10 thresholds for health protection defined in the Directive 2008/50/EC. The air quality in the Oslo area is continuously monitored in 12 compliance monitoring stations. These stations provide reliable and accurate data but their density is too low to provide a detailed spatial distribution of air quality. The emergence of low-cost nodes enables observations at high spatial resolution, providing the opportunity to enhance existing monitoring systems. However, the data generated by these nodes is significantly less accurate and precise than the data provided by reference equipment. We have conducted an evaluation of low-cost nodes to monitor NO2 and PM10, comparing the data collected with low-cost nodes against CEN (European Standardization Organization) reference analysers. During January and March 2016, a network of 24 nodes was deployed in Oslo. During January, high NO2 levels were observed for several days in a row coinciding with the formation of a thermal inversion. During March, we observed an episode with high PM10 levels due to road dust resuspension. Our results show that there is a major technical challenge associated with current commercial low-cost sensors, regarding the sensor robustness and measurement repeatability. Despite this, low-cost sensor nodes are able to reproduce the NO2 and PM10 variability. The data from the sensors was employed to generate detailed

[E-Learning--an important contribution to general medical training and continuing education?].

Science.gov (United States)

Ruf, D; Berner, M M; Kriston, L; Härter, M

2008-09-01

There is increasing activity in the development of e-learning modules for general medical training and continuing education. One of the central advantages of e-learning is flexibility regarding time and place of its use. The quality of the available e-learning opportunities varies quite considerably. For users it is often not easy to assess the quality of e-learning modules or to find offers of high quality. This could be a reason for the fact that despite the huge number of e-learning modules still only few students and physicians are using them. This is although e-learning has proven to be as effective as and even more efficient than learning in the classroom or with paper-based materials. This article summarizes the different models of e-learning, how and where to find offers of high quality, advantages of using e-learning, and the effectiveness and efficiency of such offers. In addition problems of e-learning and possibilities to overcome these problems are shown.

Continual improvement plan

Science.gov (United States)

1994-01-01

NASA's approach to continual improvement (CI) is a systems-oriented, agency-wide approach that builds on the past accomplishments of NASA Headquarters and its field installations and helps achieve NASA's vision, mission, and values. The NASA of the future will fully use the principles of continual improvement in every aspect of its operations. This NASA CI plan defines a systematic approach and a model for continual improvement throughout NASA, stressing systems integration and optimization. It demonstrates NASA's constancy of purpose for improvement - a consistent vision of NASA as a worldwide leader in top-quality science, technology, and management practices. The CI plan provides the rationale, structures, methods, and steps, and it defines NASA's short term (1-year) objectives for improvement. The CI plan presents the deployment strategies necessary for cascading the goals and objectives throughout the agency. It also provides guidance on implementing continual improvement with participation from top leadership and all levels of employees.

A global reference database from very high resolution commercial satellite data and methodology for application to Landsat derived 30 m continuous field tree cover data

Science.gov (United States)

Pengra, Bruce; Long, Jordan; Dahal, Devendra; Stehman, Stephen V.; Loveland, Thomas R.

2015-01-01

The methodology for selection, creation, and application of a global remote sensing validation dataset using high resolution commercial satellite data is presented. High resolution data are obtained for a stratified random sample of 500 primary sampling units (5 km  ×  5 km sample blocks), where the stratification based on Köppen climate classes is used to distribute the sample globally among biomes. The high resolution data are classified to categorical land cover maps using an analyst mediated classification workflow. Our initial application of these data is to evaluate a global 30 m Landsat-derived, continuous field tree cover product. For this application, the categorical reference classification produced at 2 m resolution is converted to percent tree cover per 30 m pixel (secondary sampling unit)for comparison to Landsat-derived estimates of tree cover. We provide example results (based on a subsample of 25 sample blocks in South America) illustrating basic analyses of agreement that can be produced from these reference data. Commercial high resolution data availability and data quality are shown to provide a viable means of validating continuous field tree cover. When completed, the reference classifications for the full sample of 500 blocks will be released for public use.

Early quality of life outcomes in patients with prostate cancer managed by high-dose-rate brachytherapy as monotherapy

International Nuclear Information System (INIS)

Komiya, Akira; Fujiuchi, Yasuyoshi; Ito, Takatoshi

2013-01-01

The purpose of this study was to evaluate the early quality of life outcomes in prostate cancer patients managed by high-dose-rate brachytherapy as monotherapy. A total of 51 patients with cT1c-T3aN0M0 prostate cancer treated between July 2007 and January 2010 were included in this study. The average age was 69?years, and the average initial serum prostate-specific antigen was 10.98?ng/mL. A total of 25, 18 and eight patients were considered to be low, intermediate and high risk, respectively. All patients received one implant of Ir-192 and seven fractions of 6.5?Gy within 3.5?days for a total prescribed dose of 45.5?Gy. For high-risk prostate cancer, neoadjuvant androgen deprivation therapy was carried out for at least 6?months, and continued after high-dose-rate brachytherapy. Quality of life outcomes were measured by using the International Prostate Symptom Score, the Functional Assessment of Cancer Therapy-Prostate and the International Index of Erectile Function Questionnaire. The oncological outcome was assessed by serum prostate-specific antigen and diagnostic imaging. Adverse events were also recorded. The Functional Assessment of Cancer Therapy-Prostate scores decreased for a few months after high-dose-rate brachytherapy, and recovered to pretreatment condition thereafter. The International Prostate Symptom Score significantly increased 2?weeks after treatment for each of its items and their sum, and it returned to baseline after 12?weeks. Sexual function decreased at 2 and 4?weeks, and recovered after 12?weeks. Severe complications were rare. Within a median follow up of 17.2?months, two patients showed a prostate-specific antigen recurrence. High-dose-rate brachytherapy for prostate cancer is a feasible treatment modality with acceptable toxicity and only a limited impact on the quality of life. (author)

Mesoporous Bragg reflectors: block-copolymer self-assembly leads to building blocks with well defined continuous pores and high control over optical properties

KAUST Repository

Guldin, S.

2011-08-19

Mesoporous distributed Bragg re ectors (MDBRs) exhibit porosity on the sub-optical length scale. This makes them ideally suited as sensing platforms in biology and chemistry as well as for light management in optoelectronic devices. Here we present a new fast forward route for the fabrication of MDBRs which relies on the self-assembling properties of the block copolymer poly(isoprene-block -ethylene oxide) (PI-b -PEO) in combination with sol-gel chemistry. The interplay between structure directing organic host and co-assembled inorganic guest allows the ne tuning of refractive index in the outcome material. The refractive index dierence between the high and low porosity layer can be as high as 0.4, with the optical interfaces being well dened. Following a 30 min annealing protocol after each layer deposition enables the fast and reliable stacking of MDBRs which exhibit a continuous TiO2 network with large accessible pores and high optical quality.

Continuous water-quality and suspended-sediment transport monitoring in the San Francisco Bay, California, water years 2011–13

Science.gov (United States)

Buchanan, Paul A.; Downing-Kunz, Maureen; Schoellhamer, David H.; Shellenbarger, Gregory; Weidich, Kurt

2014-01-01

The U.S. Geological Survey (USGS) monitors water quality and suspended-sediment transport in the San Francisco Bay. The San Francisco Bay area is home to millions of people, and the bay teems with both resident and migratory wildlife, plants, and fish. Fresh water mixes with salt water in the bay, which is subject both to riverine and marine (tides, waves, influx of salt water) influences. To understand this environment, the USGS, along with its partners, has been monitoring the bay’s waters continuously since 1988. Several water-quality variables are of particular importance to State and Federal resource managers and are monitored at key locations throughout the bay. Salinity, which indicates the relative mixing of fresh and ocean waters in the bay, is derived from specific conductance measurements. Water temperature, along with salinity, affects the density of water, which causes gravity driven circulation patterns and stratification in the water column. Turbidity is measured using light-scattering from suspended solids in water, and is used as a surrogate for suspended-sediment concentration (SSC). Suspended sediment often carries adsorbed contaminants; attenuates sunlight in the water column; deposits on tidal marsh and intertidal mudflats, which can help sustain these habitats as sea level rises; and deposits in ports and shipping channels, which can necessitate dredging. Dissolved oxygen, which is essential to a healthy ecosystem, is a fundamental indicator of water quality, and its concentration is affected by water temperature, salinity, ecosystem metabolism, tidal currents, and wind. Tidal currents in the bay reverse four times a day, and wind direction and intensity typically change on a daily cycle: consequently, salinity, water temperature, suspendedsediment concentration, and dissolvedoxygen concentration vary spatially and temporally throughout the bay, and continuous measurements are needed to observe these changes. The purpose of this fact sheet

Measurement quality assurance

International Nuclear Information System (INIS)

Eisenhower, E.H.

1988-01-01

The quality of a radiation protection program can be no better than the quality of the measurements made to support it. In many cases, that quality is unknown and is merely implied on the basis of a calibration of a measuring instrument. If that calibration is inappropriate or is performed improperly, the measurement result will be inaccurate and misleading. Assurance of measurement quality can be achieved if appropriate procedures are followed, including periodic quality control actions that demonstrate adequate performance. Several national measurement quality assurance (MQA) programs are operational or under development in specific areas. They employ secondary standards laboratories that provide a high-quality link between the National Bureau of Standards and measurements made at the field use level. The procedures followed by these secondary laboratories to achieve MQA will be described, as well as plans for similar future programs. A growing general national interest in quality assurance, combined with strong specific motivations for MQA in the area of ionizing radiation, will provide continued demand for appropriate national programs. Such programs must, however, employ procedures that are cost effective and must be developed with participation by all affected parties

The Barriers to High-Quality Inpatient Pain Management: A Qualitative Study.

Science.gov (United States)

Lin, Richard J; Reid, M Carrington; Liu, Lydia L; Chused, Amy E; Evans, Arthur T

2015-09-01

The current literature suggests deficiencies in the quality of acute pain management among general medical inpatients. The aim of this qualitative study is to identify potential barriers to high-quality acute pain management among general medical inpatients at an urban academic medical center during a 2-year period. Data are collected using retrospective chart reviews, survey questionnaires, and semistructured, open-ended interviews of 40 general medical inpatients who have experienced pain during their hospitalization. Our results confirm high prevalence and disabling impacts of pain and significant patient- and provider-related barriers to high-quality acute pain management. We also identify unique system-related barriers such as time delay and pain management culture. Efforts to improve the pain management experience of general medical inpatients will need to address all these barriers. © The Author(s) 2014.

High Resolution Air Quality Forecasts in the Western Mediterranean area within the MACC, MACC-II and MACC-III European projects

Energy Technology Data Exchange (ETDEWEB)

Cansado, A.; Martinez, I.; Morales, T.

2015-07-01

The European Earth observation programme Copernicus, formerly known as GMES (Global Monitoring for Environment and Security) is establishing a core global and regional environmental atmospheric service as a component of the Europes Copernicus/GMES initiative through successive R and D projects led by ECMWF (European Center for Medium-range Weather Forecasting) and funded by the 6th and 7th European Framework Programme for Research and Horizon 2020 Programme: GEMS, MACC, MACC-II and MACC-III. AEMET (Spanish State Meteorological Agency) has participated in the projects MACC and MACC-II and continues participating in MACC-III (http://atmosphere.copernicus.eu). AEMET has contributed to those projects by generating highresolution (0.05 degrees) daily air-quality forecasts for the Western Mediterranean up to 48 hours aiming to analyse the dependence of the quality of forecasts on resolution. We monitor the evolution of different chemical species such as NO{sub 2}, O{sub 3}, CO y SO{sub 2} at surface and different vertical levels using the global model MOCAGE and the MACC Regional Ensemble forecasts as chemical boundary conditions. We will show different case-studies, where the considered chemical species present high values and will show a validation of the air-quality by comparing to some of the available air-quality observations (EMEP/GAW, regional -autonomous communities- and local -city councils- air-quality monitoring networks) over the forecast domain. The aim of our participation in these projects is helping to improve the understanding of the processes involved in the air-quality forecast in the Mediterranean where special factors such as highly populated areas together with an intense solar radiation make air-quality forecasting particularly challenging. (Author)

High Resolution Air Quality Forecasts in the Western Mediterranean area within the MACC, MACC-II and MACC-III European projects

Energy Technology Data Exchange (ETDEWEB)

Cansado, A.; Martinez, I.; Morales, T.

2015-07-01

The European Earth observation programme Copernicus, formerly known as GMES (Global Monitoring for Environment and Security) is establishing a core global and regional environmental atmospheric service as a component of the Europe’s Copernicus/GMES initiative through successive R&D projects led by ECMWF (European Center for Medium-range Weather Forecasting) and funded by the 6th and 7th European Framework Programme for Research and Horizon 2020 Programme: GEMS, MACC, MACC-II and MACC-III. AEMET (Spanish State Meteorological Agency) has participated in the projects MACC and MACC-II and continues participating in MACC-III (http://atmosphere.copernicus.eu). AEMET has contributed to those projects by generating highresolution (0.05 degrees) daily air-quality forecasts for the Western Mediterranean up to 48 hours aiming to analyse the dependence of the quality of forecasts on resolution. We monitor the evolution of different chemical species such as NO2, O3, CO y SO2 at surface and different vertical levels using the global model MOCAGE and the MACC Regional Ensemble forecasts as chemical boundary conditions. We will show different case-studies, where the considered chemical species present high values and will show a validation of the air-quality by comparing to some of the available air-quality observations (EMEP/GAW, regional -autonomous communities- and local -city councils- air-quality monitoring networks) over the forecast domain. The aim of our participation in these projects is helping to improve the understanding of the processes involved in the air-quality forecast in the Mediterranean where special factors such as highly populated areas together with an intense solar radiation make air-quality forecasting particularly challenging. (Author)

When high-volume PCI operators in high-volume hospitals move to lower volume hospitals-Do they still maintain high volume and quality of outcomes?

Science.gov (United States)

Lu, Tsung-Hsueh; Li, Sheng-Tun; Liang, Fu-Wen; Lee, Jo-Chi; Yin, Wei-Hsian

2017-10-31

The aim of this quasi-experimental study was to examine whether high-volume percutaneous coronary intervention (PCI) operators still maintain high volume and quality of outcomes when they moved to lower volume hospitals. Systematic reviews have indicated that high-volume PCI operators and hospitals have higher quality outcomes. However, little is known on whether high PCI volume and high quality outcomes are mainly due to operator characteristics (i.e., skill and experience) and is portable across organizations or whether it is due to hospital characteristics (i.e., equipment, team, and management system) and is less portable. We used Taiwan National Health Insurance claims data 2000-2012 to identify 98 high-volume PCI operators, 10 of whom moved from one hospital to another during the study period. We compared the PCI volume, risk-adjusted mortality ratio, and major adverse cardiovascular event (MACE) ratio before and after moving. Of the 10 high-volume operators who moved, 6 moved from high- to moderate- or low-volume hospitals, with median annual PCI volumes (interquartile range) of 130 (117-165) in prior hospitals and 54 (46-84) in subsequent hospitals (the hospital the operator moved to), and the remaining 4 moved from high to high-volume hospitals, with median annual PCI volumes (interquartile range) of 151 (133-162) in prior hospitals and 193 (178-239) in subsequent hospitals. No significant differences were observed in the risk-adjusted mortality ratios and MACE ratios between high-volume operators and matched controls before and after moving. High-volume operators cannot maintain high volume when they moved from high to moderate or low-volume hospitals; however, the quality of care is maintained. High PCI volume and high-quality outcomes are less portable and more hospital bound. © 2017 Wiley Periodicals, Inc.

Long distance high power optical laser fiber break detection and continuity monitoring systems and methods

Science.gov (United States)

Rinzler, Charles C.; Gray, William C.; Faircloth, Brian O.; Zediker, Mark S.

2016-02-23

A monitoring and detection system for use on high power laser systems, long distance high power laser systems and tools for performing high power laser operations. In particular, the monitoring and detection systems provide break detection and continuity protection for performing high power laser operations on, and in, remote and difficult to access locations.

Better Data Quality for Better Healthcare Research Results - A Case Study.

Science.gov (United States)

Hart, Robert; Kuo, Mu-Hsing

2017-01-01

Electronic Health Records (EHRs) have been identified as a key tool to collect data for healthcare research. However, EHR data must be of sufficient quality to support quality research results. Island Health, BC, Canada has invested and continues to invest in the development of solutions to address the quality of its EHR data and support high quality healthcare studies. This paper examines Island Health's data quality engine, its development and its successful implementation.

A System for Continual Quality Improvement of Normal Tissue Delineation for Radiation Therapy Treatment Planning

Energy Technology Data Exchange (ETDEWEB)

Breunig, Jennifer; Hernandez, Sophy; Lin, Jeffrey; Alsager, Stacy; Dumstorf, Christine; Price, Jennifer; Steber, Jennifer; Garza, Richard; Nagda, Suneel; Melian, Edward; Emami, Bahman [Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois (United States); Roeske, John C., E-mail: jroeske@lumc.edu [Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois (United States)

2012-08-01

Purpose: To implement the 'plan-do-check-act' (PDCA) cycle for the continual quality improvement of normal tissue contours used for radiation therapy treatment planning. Methods and Materials: The CT scans of patients treated for tumors of the brain, head and neck, thorax, pancreas and prostate were selected for this study. For each scan, a radiation oncologist and a diagnostic radiologist, outlined the normal tissues ('gold' contours) using Radiation Therapy Oncology Group (RTOG) guidelines. A total of 30 organs were delineated. Independently, 5 board-certified dosimetrists and 1 trainee then outlined the same organs. Metrics used to compare the agreement between the dosimetrists' contours and the gold contours included the Dice Similarity Coefficient (DSC), and a penalty function using distance to agreement. Based on these scores, dosimetrists were re-trained on those organs in which they did not receive a passing score, and they were subsequently re-tested. Results: Passing scores were achieved on 19 of 30 organs evaluated. These scores were correlated to organ volume. For organ volumes <8 cc, the average DSC was 0.61 vs organ volumes {>=}8 cc, for which the average DSC was 0.91 (P=.005). Normal tissues that had the lowest scores included the lenses, optic nerves, chiasm, cochlea, and esophagus. Of the 11 organs that were considered for re-testing, 10 showed improvement in the average score, and statistically significant improvement was noted in more than half of these organs after education and re-assessment. Conclusions: The results of this study indicate the feasibility of applying the PDCA cycle to assess competence in the delineation of individual organs, and to identify areas for improvement. With testing, guidance, and re-evaluation, contouring consistency can be obtained across multiple dosimetrists. Our expectation is that continual quality improvement using the PDCA approach will ensure more accurate treatments and dose

A System for Continual Quality Improvement of Normal Tissue Delineation for Radiation Therapy Treatment Planning

International Nuclear Information System (INIS)

Breunig, Jennifer; Hernandez, Sophy; Lin, Jeffrey; Alsager, Stacy; Dumstorf, Christine; Price, Jennifer; Steber, Jennifer; Garza, Richard; Nagda, Suneel; Melian, Edward; Emami, Bahman; Roeske, John C.

2012-01-01

Purpose: To implement the “plan-do-check-act” (PDCA) cycle for the continual quality improvement of normal tissue contours used for radiation therapy treatment planning. Methods and Materials: The CT scans of patients treated for tumors of the brain, head and neck, thorax, pancreas and prostate were selected for this study. For each scan, a radiation oncologist and a diagnostic radiologist, outlined the normal tissues (“gold” contours) using Radiation Therapy Oncology Group (RTOG) guidelines. A total of 30 organs were delineated. Independently, 5 board-certified dosimetrists and 1 trainee then outlined the same organs. Metrics used to compare the agreement between the dosimetrists' contours and the gold contours included the Dice Similarity Coefficient (DSC), and a penalty function using distance to agreement. Based on these scores, dosimetrists were re-trained on those organs in which they did not receive a passing score, and they were subsequently re-tested. Results: Passing scores were achieved on 19 of 30 organs evaluated. These scores were correlated to organ volume. For organ volumes <8 cc, the average DSC was 0.61 vs organ volumes ≥8 cc, for which the average DSC was 0.91 (P=.005). Normal tissues that had the lowest scores included the lenses, optic nerves, chiasm, cochlea, and esophagus. Of the 11 organs that were considered for re-testing, 10 showed improvement in the average score, and statistically significant improvement was noted in more than half of these organs after education and re-assessment. Conclusions: The results of this study indicate the feasibility of applying the PDCA cycle to assess competence in the delineation of individual organs, and to identify areas for improvement. With testing, guidance, and re-evaluation, contouring consistency can be obtained across multiple dosimetrists. Our expectation is that continual quality improvement using the PDCA approach will ensure more accurate treatments and dose assessment in

Characteristics of primary care practices associated with high quality of care.

Science.gov (United States)

Beaulieu, Marie-Dominique; Haggerty, Jeannie; Tousignant, Pierre; Barnsley, Janet; Hogg, William; Geneau, Robert; Hudon, Éveline; Duplain, Réjean; Denis, Jean-Louis; Bonin, Lucie; Del Grande, Claudio; Dragieva, Natalyia

2013-09-03

No primary practice care model has been shown to be superior in achieving high-quality primary care. We aimed to identify the organizational characteristics of primary care practices that provide high-quality primary care. We performed a cross-sectional observational study involving a stratified random sample of 37 primary care practices from 3 regions of Quebec. We recruited 1457 patients who had 1 of 2 chronic care conditions or 1 of 6 episodic care conditions. The main outcome was the overall technical quality score. We measured organizational characteristics by use of a validated questionnaire and the Team Climate Inventory. Statistical analyses were based on multilevel regression modelling. The following characteristics were strongly associated with overall technical quality of care score: physician remuneration method (27.0; 95% confidence interval [CI] 19.0-35.0), extent of sharing of administrative resources (7.6; 95% CI 0.8-14.4), presence of allied health professionals (15.3; 95% CI 5.4-25.2) and/or specialist physicians (19.6; 95% CI 8.3-30.9), the presence of mechanisms for maintaining or evaluating competence (7.7; 95% CI 3.0-12.4) and average organizational access to the practice (4.9; 95% CI 2.6-7.2). The number of physicians (1.2; 95% CI 0.6-1.8) and the average Team Climate Inventory score (1.3; 95% CI 0.1-2.5) were modestly associated with high-quality care. We identified a common set of organizational characteristics associated with high-quality primary care. Many of these characteristics are amenable to change through practice-level organizational changes.

High-efficiency Gaussian key reconciliation in continuous variable quantum key distribution

Science.gov (United States)

Bai, ZengLiang; Wang, XuYang; Yang, ShenShen; Li, YongMin

2016-01-01

Efficient reconciliation is a crucial step in continuous variable quantum key distribution. The progressive-edge-growth (PEG) algorithm is an efficient method to construct relatively short block length low-density parity-check (LDPC) codes. The qua-sicyclic construction method can extend short block length codes and further eliminate the shortest cycle. In this paper, by combining the PEG algorithm and qua-si-cyclic construction method, we design long block length irregular LDPC codes with high error-correcting capacity. Based on these LDPC codes, we achieve high-efficiency Gaussian key reconciliation with slice recon-ciliation based on multilevel coding/multistage decoding with an efficiency of 93.7%.

Evaluating the Quantity and Quality of Continuing medical education Programs from the Viewpoint of General Medical Practitioners, Ilam Province

Directory of Open Access Journals (Sweden)

Mohsen Fatahi

2015-07-01

Full Text Available Background and purpose: The purpose of this research was to evaluate the quantity and quality of continuing medical education programs from the viewpoint of general medical practitioners in Ilam province.Methods: The research method was descriptive survey and the statistic sample was a group of 61 general medical practitioners who have been working in Ilam during 2010-2011 and were chosen by simple random sampling method. The data collection tool was a questionnaire with 50 items and reliability coefficient obtained using Cronbach's alpha which was 88%.Results: The findings showed that there is a meaningful/significant relationship between CME (Continuing Medical Education/retraining programs and improving GPs (General Practitioner clinical skills with reliability of 99% and this relationship is direct and positive (r=0.502. It means that increasing the quality and quantity of these programs has positive effect on improving general practitioners’ clinical skills. There was no meaningful/significant relationship between the method of teaching and GPs satisfaction (r=0.160. It means most of these practitioners were not satisfied with using training equipment, teaching methods, teachers' knowledge and manners. Also, there was no meaningful/significant relationship between teaching times and educational materials and GPs satisfaction (r=0.73 .It shows that the rate of GPs satisfaction from teaching times and educational materials is very low and there is little coherence between them. But there was a meaningful/significant relationship between GPs job requirements and educational materials with reliability of 95% (r=0.326. It means presenting suitable teaching materials and content related to GPs jobs requirements led to increase GPs desire to attend educational classes .There was no meaningful/significant relationship between time dedicated to each topic and improving GPs skills (r=0.096. So, findings indicate that there is no coincidence between

Exploration of process parameters for continuous hydrolysis of canola oil, camelina oil and algal oil

KAUST Repository

Wang, Weicheng

2012-07-01

Thermal hydrolysis of triglycerides to form free fatty acid (FFA) is a well-established industry practice. Recently, this process has been employed as a first step in the production of biofuels from lipids. To that end, batch and continuous hydrolysis of various feedstocks has been examined at the laboratory scale. Canola, the primary feedstock in this paper, camelina and algal oils were converted to high quality FFA. For the different reaction temperatures, the continuous hydrolysis system was found to provide better yields than the laboratory batch system. In addition, CFD simulation with ANSYS-CFX was used to model the performance and reactant/product separation in the continuous, counter-flow reactor. The effects of reaction temperature, water-to-oil ratio (ratio of water and oil volumetric inflow rate), and preheating of the reactants were examined experimentally. Optimization of these parameters has resulted in an improved, continuous process with high mass yields (89-93%, for reactor temperature of 260°C and water-to-oil ratio of 4:1) and energy efficiency (76%, for reactor temperature of 250°C and water-to-oil ratio of 2:1). Based on the product quality and energy efficiency considerations, the reactor temperature of 260°C and water-to-oil ratio of 4:1 have provided the optimal condition for the lab scale continuous hydrolysis reaction. © 2012 Elsevier B.V.

Exploration of process parameters for continuous hydrolysis of canola oil, camelina oil and algal oil

KAUST Repository

Wang, Weicheng; Turner, Timothy L.; Stikeleather, Larry F.; Roberts, William L.

2012-01-01

Thermal hydrolysis of triglycerides to form free fatty acid (FFA) is a well-established industry practice. Recently, this process has been employed as a first step in the production of biofuels from lipids. To that end, batch and continuous hydrolysis of various feedstocks has been examined at the laboratory scale. Canola, the primary feedstock in this paper, camelina and algal oils were converted to high quality FFA. For the different reaction temperatures, the continuous hydrolysis system was found to provide better yields than the laboratory batch system. In addition, CFD simulation with ANSYS-CFX was used to model the performance and reactant/product separation in the continuous, counter-flow reactor. The effects of reaction temperature, water-to-oil ratio (ratio of water and oil volumetric inflow rate), and preheating of the reactants were examined experimentally. Optimization of these parameters has resulted in an improved, continuous process with high mass yields (89-93%, for reactor temperature of 260°C and water-to-oil ratio of 4:1) and energy efficiency (76%, for reactor temperature of 250°C and water-to-oil ratio of 2:1). Based on the product quality and energy efficiency considerations, the reactor temperature of 260°C and water-to-oil ratio of 4:1 have provided the optimal condition for the lab scale continuous hydrolysis reaction. © 2012 Elsevier B.V.

Comparison of affective responses during and after low volume high-intensity interval exercise, continuous moderate- and continuous high-intensity exercise in active, untrained, healthy males.

Science.gov (United States)

Niven, Ailsa; Thow, Jacqueline; Holroyd, Jack; Turner, Anthony P; Phillips, Shaun M

2018-09-01

This study compared affective responses to low volume high-intensity interval exercise (HIIE), moderate-intensity continuous exercise (MICE) and high-intensity continuous exercise (HICE). Twelve untrained males ([Formula: see text] 48.2 ± 6.7 ml·kg -1 ·min -1 ) completed MICE (30 min cycle at 85% of ventilatory threshold (VT)), HICE (cycle at 105% of VT matched with MICE for total work), and HIIE (10 x 6 s cycle sprints with 60 s recovery). Affective valence and perceived activation were measured before exercise, post warm-up, every 20% of exercise time, and 1, 5, 10, and 15 min post-exercise. Affective valence during exercise declined by 1.75 ± 2.42, 1.17 ± 1.99, and 0.42 ± 1.38 units in HICE, HIIE, and MICE, respectively, but was not statistically influenced by trial (P = 0.35), time (P = 0.06), or interaction effect (P = 0.08). Affective valence during HICE and HIIE was consistently less positive than MICE. Affective valence post-exercise was not statistically influenced by trial (P = 0.10) and at 5 min post-exercise exceeded end-exercise values (P = 0.048). Circumplex profiles showed no negative affect in any trial. Affective responses to low volume HIIE are similar to HICE but remain positive and rebound rapidly, suggesting it may be a potential alternative exercise prescription.

Accuracy of Continuous Glucose Monitoring (CGM) during Continuous and High-Intensity Interval Exercise in Patients with Type 1 Diabetes Mellitus.

Science.gov (United States)

Moser, Othmar; Mader, Julia K; Tschakert, Gerhard; Mueller, Alexander; Groeschl, Werner; Pieber, Thomas R; Koehler, Gerd; Messerschmidt, Janin; Hofmann, Peter

2016-08-10

Continuous exercise (CON) and high-intensity interval exercise (HIIE) can be safely performed with type 1 diabetes mellitus (T1DM). Additionally, continuous glucose monitoring (CGM) systems may serve as a tool to reduce the risk of exercise-induced hypoglycemia. It is unclear if CGM is accurate during CON and HIIE at different mean workloads. Seven T1DM patients performed CON and HIIE at 5% below (L) and above (M) the first lactate turn point (LTP₁), and 5% below the second lactate turn point (LTP₂) (H) on a cycle ergometer. Glucose was measured via CGM and in capillary blood (BG). Differences were found in comparison of CGM vs. BG in three out of the six tests (p exercise-induced hypoglycemia, but usual BG control should be performed during intense exercise.

Quality assurance and reliability

International Nuclear Information System (INIS)

Normand, J.; Charon, M.

1975-01-01

Concern for obtaining high-quality products which will function properly when required to do so is nothing new - it is one manifestation of a conscientious attitude to work. However, the complexity and cost of equipment and the consequences of even temporary immobilization are such that it has become necessary to make special arrangements for obtaining high-quality products and examining what one has obtained. Each unit within an enterprise must examine its own work or arrange for it to be examined; a unit whose specific task is quality assurance is responsible for overall checking, but does not relieve other units of their responsibility. Quality assurance is a form of mutual assistance within an enterprise, designed to remove the causes of faults as far as possible. It begins very early in a project and continues through the ordering stage, construction, start-up trials and operation. Quality and hence reliability are the direct result of what is done at all stages of a project. They depend on constant attention to detail, for even a minor piece of poor workmanship can, in the case of an essential item of equipment, give rise to serious operational difficulties

Continuous Software Quality analysis for the ATLAS experiment

CERN Document Server

Washbrook, Andrew; The ATLAS collaboration

2017-01-01

The regular application of software quality tools in large collaborative projects is required to reduce code defects to an acceptable level. If left unchecked the accumulation of defects invariably results in performance degradation at scale and problems with the long-term maintainability of the code. Although software quality tools are effective for identification there remains a non-trivial sociological challenge to resolve defects in a timely manner. This is a ongoing concern for the ATLAS software which has evolved over many years to meet the demands of Monte Carlo simulation, detector reconstruction and data analysis. At present over 3.8 million lines of C++ code (and close to 6 million total lines of code) are maintained by a community of hundreds of developers worldwide. It is therefore preferable to address code defects before they are introduced into a widely used software release. Recent wholesale changes to the ATLAS software infrastructure have provided an ideal opportunity to apply software quali...

High-temperature vitrification of Hanford residual-liquid waste in a continuous melter

International Nuclear Information System (INIS)

Barnes, S.M.

1980-04-01

Over 270 kg of high-temperature borosilicate glass have been produced in a series of three short-term tests in the High-Temperature Ceramic Melter vitrification system at PNL. The glass produced was formulated to vitrify simulated Hanford residual-liquid waste. The tests were designed to (1) demonstrate the feasibility of utilizing high-temperature, continuous-vitrification technology for the immobilization of the residual-liquid waste, (2) test the airlift draining technique utilized by the high-temperature melter, (3) compare glass produced in this process to residual-liquid glass produced under laboratory conditions, (4) investigate cesium volatility from the melter during waste processing, and (5) determine the maximum residual-liquid glass production rate in the high-temperature melter. The three tests with the residual-liquid composition confirmed the viability of the continuous-melting vitrification technique for the immobilization of this waste. The airlift draining technique was demonstrated in these tests and the glass produced from the melter was shown to be less porous than the laboratory-produced glass. The final glass produced from the second test was compared to a glass of the same composition produced under laboratory conditions. The comparative tests found the glasses to be indistinguishable, as the small differences in the test results fell within the precision range of the characterization testing equipment. The cesium volatility was examined in the final test. This examination showed that 0.44 wt % of the cesium (assumed to be cesium oxide) was volatilized, which translates to a volatilization rate of 115 mg/cm 2 -h

Isolation of high quality RNA from pistachio (Pistacia vera L.) and other woody plants high in secondary metabolites.

Science.gov (United States)

Moazzam Jazi, Maryam; Rajaei, Saideh; Seyedi, Seyed Mahdi

2015-10-01

The quality and quantity of RNA are critical for successful downstream transcriptome-based studies such as microarrays and RNA sequencing (RNA-Seq). RNA isolation from woody plants, such as Pistacia vera, with very high amounts of polyphenols and polysaccharides is an enormous challenge. Here, we describe a highly efficient protocol that overcomes the limitations posed by poor quality and low yield of isolated RNA from pistachio and various recalcitrant woody plants. The key factors that resulted in a yield of 150 μg of high quality RNA per 200 mg of plant tissue include the elimination of phenol from the extraction buffer, raising the concentration of β-mercaptoethanol, long time incubation at 65 °C, and nucleic acid precipitation with optimized volume of NaCl and isopropyl alcohol. Also, the A260/A280 and A260/A230 of extracted RNA were about 1.9-2.1and 2.2-2.3, respectively, revealing the high purity. Since the isolated RNA passed highly stringent quality control standards for sensitive reactions, including RNA sequencing and real-time PCR, it can be considered as a reliable and cost-effective method for RNA extraction from woody plants.

Quack: A quality assurance tool for high throughput sequence data.

Science.gov (United States)

Thrash, Adam; Arick, Mark; Peterson, Daniel G

2018-05-01

The quality of data generated by high-throughput DNA sequencing tools must be rapidly assessed in order to determine how useful the data may be in making biological discoveries; higher quality data leads to more confident results and conclusions. Due to the ever-increasing size of data sets and the importance of rapid quality assessment, tools that analyze sequencing data should quickly produce easily interpretable graphics. Quack addresses these issues by generating information-dense visualizations from FASTQ files at a speed far surpassing other publicly available quality assurance tools in a manner independent of sequencing technology. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Global perspective on continuing professional development

Directory of Open Access Journals (Sweden)

Lawrence T. Sherman

2018-05-01

Full Text Available Healthcare professionals worldwide participate in continuing professional development (CPD to remain competent in practice, and to ensure they provide high-quality care to patients. Globally, CPD systems have evolved at different rates resulting in significant variation in structure, requirements, and oversight. In some countries, CPD has moved from single profession educational designs and formal didactic methods of delivery to educational models that are innovative, dynamic, and learnercentric. In other countries, CPD is a neglected part of the healthcare education continuum. This article provides a global perspective on the evolution of CPD over the past 20 years, and identifies opportunities for the future.

MODERN CONCEPTS OF THE SIX SIGMA METHODOLOGY FOR IMPROVING THE QUALITY

Directory of Open Access Journals (Sweden)

MARGARITA JANESKA

2018-02-01

Full Text Available Product quality is generally accepted as being crucial in today’s industrial business. The traditional aspects of product quality are connected to product design (translating customer demands into attractive features and technical specifications and to the design and specification of high performance production processes with low defect rates. Quality management is the general expression for all actions leading to quality. Quality management is focused on improving customer satisfaction through continuous improvement of processes including the removal of uncertain activities, and continuous improvement of the quality of processes, products and services. The quality management includes four key processes, such as quality planning, quality assurance, quality control and quality costs. The main accent in this paper will be on quality control and the application of one of the quality control tools in order to improve it. Six Sigma is different from other quality improvement concepts in that its framework is comprised of many principles, tools and techniques, which, together with experience, are all integrated and translated into best practices. Bearing in mind that the goal of every company is to work effectively and effectively in the long run, this paper focuses on Six Sigma as a way to continuously improve quality. Namely, this paper emphasizes the key features of the quality of products / services, the Need for the application of Six Sigma for quality assurance, and also a detailed list of tools and techniques that can be used during the implementation of Six Sigma.

High- but not low-intensity light leads to oxidative stress and quality loss of cold-stored baby leaf spinach.

Science.gov (United States)

Glowacz, Marcin; Mogren, Lars M; Reade, John P H; Cobb, Andrew H; Monaghan, James M

2015-07-01

Quality management in the fresh produce industry is an important issue. Spinach is exposed to various adverse conditions (temperature, light, etc.) within the supply chain. The present experiments were conducted to investigate the effect of light conditions (dark, low-intensity light (LL) and high-intensity light (HL)) and photoperiod (6 h HL and 18 h dark) on the quality changes of cold-stored spinach. HL exposure resulted in oxidative stress, causing tissue damage and quality loss as evidenced by increased membrane damage and water loss. The content of total ascorbic acid was reduced under HL conditions. On the other hand, storage of spinach under LL conditions gave promising results, as nutritional quality was not reduced, while texture maintenance was improved. No significant differences, with the exception of nutritional quality, were found between spinach leaves stored under continuous (24 h) low-intensity light (30-35 µmol m(-2) s(-1)) and their counterparts stored under the same light integral over 6 h (130-140 µmol m(-2) s(-1)). LL extended the shelf-life of spinach. The amount of light received by the leaves was the key factor affecting produce quality. Light intensity, however, has to be low enough not to cause excess oxidative stress and lead to accelerated senescence. © 2014 Society of Chemical Industry.

Applications of continuous water quality monitoring techniques for more efficient water quality research and water resources management

NARCIS (Netherlands)

Rozemeijer, J.C.; Velde, Y. van der; Broers, H.P.; Geer, F. van

2013-01-01

Understanding and taking account of dynamics in water quality is essential for adequate water quality policy and management. In conventional regional surface water and upper groundwater quality monitoring, measurement frequencies are too low to capture the short-term dynamic behavior of solute

Practice Change From Intermittent Medication Boluses to Bolusing From a Continuous Infusion in Pediatric Critical Care: A Quality Improvement Project.

Science.gov (United States)

Hochstetler, Jessica L; Thompson, A Jill; Ball, Natalie M; Evans, Melissa C; Frame, Shaun C; Haney, A Lauren; Little, Amelia K; O'Donnell, Jaime L; Rickett, Bryna M; Mack, Elizabeth H

2018-04-12

To determine whether implementing a guideline to bolus medications from continuous infusions in PICUs affects nursing satisfaction, patient safety, central line entries, medication utilization, or cost. This is a pre- and postimplementation quality improvement study. An 11-bed ICU and 14-bed cardiac ICU in a university-affiliated children's hospital. Patients less than 18 years old admitted to the PICU or pediatric cardiac ICU receiving a continuous infusion of dexmedetomidine, midazolam, fentanyl, morphine, vecuronium, or cisatracurium from May 2015 to May 2016, excluding November 2015 (washout period), were eligible for inclusion. Change in practice from administering bolus doses from an automated dispensing machine to administering bolus medications from continuous infusion in PICUs. Timing studies were conducted pre- and post implementation in 29 and 26 occurrences, respectively. The median time from the decision to give a bolus until it began infusing decreased by 169 seconds (p 0.05). Annualized cost avoidance was $124,160. Implementation of bolus medications from continuous infusion in PICUs significantly decreased time to begin a bolus dose and increased nursing satisfaction. The practice change also improved medication utilization without negatively impacting patient safety.

[Quality of sleep and academic performance in high school students].

Science.gov (United States)

Bugueño, Maithe; Curihual, Carolina; Olivares, Paulina; Wallace, Josefa; López-AlegrÍa, Fanny; Rivera-López, Gonzalo; Oyanedel, Juan Carlos

2017-09-01

Sleeping and studying are the day-to-day activities of a teenager attending school. To determine the quality of sleep and its relationship to the academic performance among students attending morning and afternoon shifts in a public high school. Students of the first and second year of high school answered an interview about socio-demographic background, academic performance, student activities and subjective sleep quality; they were evaluated using the Pittsburgh Sleep Quality Index (PSQI). The interview was answered by 322 first year students aged 15 ± 5 years attending the morning shift and 364 second year students, aged 16 ± 0.5 years, attending the afternoon shift. The components: sleep latency, habitual sleep efficiency, sleep disturbance, drug use and daytime dysfunction were similar and classified as good in both school shifts. The components subjective sleep quality and duration of sleep had higher scores among students of the morning shift. The mean grades during the first semester of the students attending morning and afternoon shifts were 5.9 and 5.8, respectively (of a scale from 1 to 7). Among students of both shifts, the PSQI scale was associated inversely and significantly with academic performance. A bad sleep quality influences academic performance in these students.

The potential of Arachis pintoi biomass to improve quality of soil continuously used for cassava cropping

Directory of Open Access Journals (Sweden)

N. Muddarisna

2014-01-01

Full Text Available A field experiment that was aimed to elucidate the effects of application of Arachis pintoi biomass and animal dung on quality of soil continuously used for cassava cropping was conducted at Jatikerto Village, Kromengan District of Malang Regency. Eight treatments tested were 100% NPK inorganic fertilizer, 100 kg N Arachis pintoi/ha, (3 100 kg N chicken dung/ ha, 100 kg N cow dung /ha, 100 kg N goat dung /ha, 100 kg N Arachis pintoi + chicken dung /ha, 100 kg N Arachis pintoi + cow dung /ha, and 100 kg N Arachis pintoi + goat dung /ha. Monitoring quality of top soil (0-20 cm was carried out at planting time and 3 months after planting. Soil samples were collected and analyzed for chemical and physical properties. Yield of cassava was measured at 6 months after planting. Results of this study showed that application of organic fertilizer in forms of green manure (Arachis pintoi biomass, and animal dung significantly improved physical and chemical properties of soil. Application of 50% NPK combined with organic manures did not significantly gave different tuber yield with that of 100% NPK.

extraction of high quality dna from polysaccharides-secreting ...

African Journals Online (AJOL)

cistvr

A DNA extraction method using CTAB was used for the isolation of genomic DNA from ten. Xanthomonas campestris pathovars, ten isolates of Xanthomonas albilineans and one isolate of. Pseudomonas rubrisubalbicans. High quality DNA was obtained that was ideal for molecular analy- ses. Extracellular polysaccharides ...

Managing quality inside a high-technology project organization

OpenAIRE

Jokinen, T. (Tauno)

2004-01-01

Abstract This action research addresses the deployment of Total Quality Management (TQM) principles in a high-technology new product development organisation. During the period of study, the organisation grew fast. High-technology product development and hypergrowth provided a unique combination of extreme conditions for the study. The existing concepts of TQM are presented as an organised map enabling strategic analysis for an implementation plan. The history of TQM dates back to the ...

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

Science.gov (United States)

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

2014-11-01

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

The association between continuity of care in the community and health outcomes: a population-based study

Directory of Open Access Journals (Sweden)

Dreiher Jacob

2012-05-01

Full Text Available Abstract Background The study goal was to assess indices of continuity of care in the primary care setting and their association with health outcomes and healthcare services utilization, given the reported importance of continuity regarding quality of care and healthcare utilization. Methods The study included a random sample of enrollees from Clalit Health Services 19 years-of-age or older who visited their primary care clinic at least three times in 2009. Indices of continuity of care were computed, including the Usual Provider Index (UPC, Modified Modified Continuity Index (MMCI, Continuity of Care Index (COC, and Sequential Continuity (SECON. Quality measures of preventive medicine and healthcare services utilization and their costs were assessed as outcomes. Results 1,713 randomly sampled patients were included in the study (mean age: 48.9 ± 19.2, 42% males. Continuity of care indices were: UPC: 0.75; MMCI: 0.81; COC: 0.67; SECON: 0.70. After controlling for patient characteristics in a multivariate analysis, a statistically significant association was found between higher values of UPC, COC, and SECON and a decrease in the number and cost of ED visits. Higher MMCI values were associated with a greater number and higher costs of medical consultation visits. Continuity of care indices were associated with BMI measurements, and inversely associated with blood pressure measurements. No association was found with other quality indicators, e.g., screening tests for cancer. Conclusions Several continuity of care indices were associated with decreased number and costs of ED visits. There were both positive and negative associations of continuity of care indices with different aspects of healthcare utilization. The relatively small effects of continuity might be due to the consistently high levels of continuity in Clalit Health Services.

High quality transportation fuels from renewable feedstock

Energy Technology Data Exchange (ETDEWEB)

Lindfors, Lars Peter

2010-09-15

Hydrotreating of vegetable oils is novel process for producing high quality renewable diesel. Hydrotreated vegetable oils (HVO) are paraffinic hydrocarbons. They are free of aromatics, have high cetane numbers and reduce emissions. HVO can be used as component or as such. HVO processes can also be modified to produce jet fuel. GHG savings by HVO use are significant compared to fossil fuels. HVO is already in commercial production. Neste Oil is producing its NExBTL diesel in two plants. Production of renewable fuels will be limited by availability of sustainable feedstock. Therefore R and D efforts are made to expand feedstock base further.

Using Small Tests of Change to Improve PMTCT Services in Northern Nigeria: Experiences From Implementation of a Continuous Quality Improvement and Breakthrough Series Program.

Science.gov (United States)

Osibo, Bamidele; Oronsaye, Frank; Alo, Oluwafemi D; Phillips, Abimbola; Becquet, Renaud; Shaffer, Nathan; Ogirima, Francis; Imarhiagbe, Collins; Ameh, Bernice; Ezebuka, Obioma; Sodzi-Tettey, Sodzi; Obi, Adaobi; Afolabi, Olusegun T; Inedu, Abutu; Anyaike, Chukwuma; Oyeledun, Bolanle

2017-06-01

Continuous Quality Improvement (CQI) is a process where health teams systematically collect and regularly reflect on local data to inform decisions and modify local practices and so improve delivery of services. We implemented a cluster randomized trial to examine the effects of CQI interventions on Prevention of Mother-to-Child Transmission (PMTCT) services. Here, we report our experiences and challenges establishing CQI in 2 high HIV prevalence states in northern Nigeria. Facility-based teams were trained to implement CQI activities, including structured assessments, developing change packages, and participation in periodic collaborative learning sessions. Locally evolved solutions (change ideas) were tested and measured using process data and intermediate process indicators were agreed including overall time spent accessing services, client satisfaction, and quality of data. Health workers actively participated in clinic activities and in the collaborative learning sessions. During the study, the mean difference in time spent accessing services during clinic visits increased by 40 minutes (SD = 93.4) in the control arm and decreased by 44 minutes (SD = 73.7) in the intervention arm. No significant difference was recorded in the mean client satisfaction assessment score by study arm. The quality of data was assessed using a standardized tool scored out of 100; compared with baseline data, quality at the end of study had improved at intervention sites by 6 points (95% CI: 2.0 to 10.1). Health workers were receptive to CQI process. A compendium of "change ideas" compiled into a single change package can be used to improve health care delivery.

Improving high quality, equitable maternal health services in Malawi ...

International Development Research Centre (IDRC) Digital Library (Canada)

Improving high quality, equitable maternal health services in Malawi (IMCHA) ... In response, the Ministry of Health implemented a Standards-Based Management and Recognition for Reproductive Health initiative to improve ... Total funding.

High throughput electrospinning of high-quality nanofibers via an aluminum disk spinneret

Science.gov (United States)

Zheng, Guokuo

In this work, a simple and efficient needleless high throughput electrospinning process using an aluminum disk spinneret with 24 holes is described. Electrospun mats produced by this setup consisted of fine fibers (nano-sized) of the highest quality while the productivity (yield) was many times that obtained from conventional single-needle electrospinning. The goal was to produce scaled-up amounts of the same or better quality nanofibers under variable concentration, voltage, and the working distance than those produced with the single needle lab setting. The fiber mats produced were either polymer or ceramic (such as molybdenum trioxide nanofibers). Through experimentation the optimum process conditions were defined to be: 24 kilovolt, a distance to collector of 15cm. More diluted solutions resulted in smaller diameter fibers. Comparing the morphologies of the nanofibers of MoO3 produced by both the traditional and the high throughput set up it was found that they were very similar. Moreover, the nanofibers production rate is nearly 10 times than that of traditional needle electrospinning. Thus, the high throughput process has the potential to become an industrial nanomanufacturing process and the materials processed by it may be used as filtration devices, in tissue engineering, and as sensors.

Coupling of high-quality-factor optical resonators

International Nuclear Information System (INIS)

Salzenstein, Patrice; Henriet, Rémi; Coillet, Aurélien; Chembo, Yanne K; Mortier, Michel; Sérier-Brault, Hélène; Rasoloniaina, Alphonse; Dumeige, Yannick; Féron, Patrice

2013-01-01

We improve theoretically and experimentally the problem of the coupling between a high Q-factor resonator and its external coupler. We have observed oscillations of ringing induced by the sweeping of the excitation frequency of an active microsphere. Thanks to this approach, the quality factor of an optical resonator was measured and we obtained Q = 5.8 × 10 8 . (paper)

High-picture quality industrial CT scanner

International Nuclear Information System (INIS)

Shoji, Takao; Nishide, Akihiko; Fujii, Masashi.

1989-01-01

Industrial X-ray-CT-scanners, which provide cross-sectional images of a tested sample without destroying it, are attracting attention as a new nondestructive inspection device. In 1982, Toshiba commenced the development of industrial CT scanners, and introduced the 'TOSCANER' -3000 and-4000 series. Now, the state of the art 'TOSCANER'-20000 series of CT systems has been developed incorporating the latest computer tomography and image processing technology, such as the T9506 image processor. One of the advantages of this system is its applicability to a wide range of X-ray energy . The 'TOSCANER'-20000 series can be utilized for inspecting castings and other materials with relatively low-transparency to X-rays, as well as ceramics, composite materials and other materials with high X-ray transparency. A further feature of the new system is its high-picture quality, with a high-spatial resolution resulting from a pixel size of 0.2x0.2(mm). (author)

Crystal and Particle Engineering Strategies for Improving Powder Compression and Flow Properties to Enable Continuous Tablet Manufacturing by Direct Compression.

Science.gov (United States)

Chattoraj, Sayantan; Sun, Changquan Calvin

2018-04-01

Continuous manufacturing of tablets has many advantages, including batch size flexibility, demand-adaptive scale up or scale down, consistent product quality, small operational foot print, and increased manufacturing efficiency. Simplicity makes direct compression the most suitable process for continuous tablet manufacturing. However, deficiencies in powder flow and compression of active pharmaceutical ingredients (APIs) limit the range of drug loading that can routinely be considered for direct compression. For the widespread adoption of continuous direct compression, effective API engineering strategies to address power flow and compression problems are needed. Appropriate implementation of these strategies would facilitate the design of high-quality robust drug products, as stipulated by the Quality-by-Design framework. Here, several crystal and particle engineering strategies for improving powder flow and compression properties are summarized. The focus is on the underlying materials science, which is the foundation for effective API engineering to enable successful continuous manufacturing by the direct compression process. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Computer-aided control of high-quality cast iron

Directory of Open Access Journals (Sweden)

S. Pietrowski

2008-04-01

Full Text Available The study discusses the possibility of control of the high-quality grey cast iron and ductile iron using the author’s genuine computer programs. The programs have been developed with the help of algorithms based on statistical relationships that are said to exist between the characteristic parameters of DTA curves and properties, like Rp0,2, Rm, A5 and HB. It has been proved that the spheroidisation and inoculation treatment of cast iron changes in an important way the characteristic parameters of DTA curves, thus enabling a control of these operations as regards their correctness and effectiveness, along with the related changes in microstructure and mechanical properties of cast iron. Moreover, some examples of statistical relationships existing between the typical properties of ductile iron and its control process were given for cases of the melts consistent and inconsistent with the adopted technology.A test stand for control of the high-quality cast iron and respective melts has been schematically depicted.

Effect of high hydrostatic pressure on overall quality parameters of watermelon juice.

Science.gov (United States)

Liu, Y; Zhao, X Y; Zou, L; Hu, X S

2013-06-01

High hydrostatic pressure as a kind of non-thermal processing might maintain the quality of thermo-sensitive watermelon juice. So, the effect of high hydrostatic pressure treatment on enzymes and quality of watermelon juice was investigated. After high hydrostatic pressure treatment, the activities of polyphenol oxidase, peroxidase, and pectin methylesterase of juice decreased significantly with the pressure (P  0.05). No significant difference was observed in lycopene and total phenolics after high hydrostatic pressure treatment when compared to the control (P > 0.05). Cloudiness and viscosity increased with pressure (P  0.05). a*- and b*-value both unchanged after high hydrostatic pressure treatment (P > 0.05) while L*-value increased but the values had no significant difference among treated juices. Browning degree after high hydrostatic pressure treatment decreased with increase in pressure and treatment time (P hydrostatic pressure had little effect on color of juice. The results of this study demonstrated the efficacy of high hydrostatic pressure in inactivating enzymes and maintaining the quality of watermelon juice.

High quality ceramic coatings sprayed by high efficiency hypersonic plasma spraying gun

International Nuclear Information System (INIS)

Zhu Sheng; Xu Binshi; Yao JiuKun

2005-01-01

This paper introduced the structure of the high efficiency hypersonic plasma spraying gun and the effects of hypersonic plasma jet on the sprayed particles. The optimised spraying process parameters for several ceramic powders such as Al 2 O 3 , Cr 2 O 3 , ZrO 2 , Cr 3 C 2 and Co-WC were listed. The properties and microstructure of the sprayed ceramic coatings were investigated. Nano Al 2 O 3 -TiO 2 ceramic coating sprayed by using the high efficiency hypersonic plasma spraying was also studied. Compared with the conventional air plasma spraying, high efficiency hypersonic plasma spraying improves greatly the ceramic coatings quality but at low cost. (orig.)

High quality electron beams from a laser wakefield accelerator

Energy Technology Data Exchange (ETDEWEB)

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

2010-12-15

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

Continuous, Highly Flexible, and Transparent Graphene Films by Chemical Vapor Deposition for Organic Photovoltaics

KAUST Repository

Gomez De Arco, Lewis; Zhang, Yi; Schlenker, Cody W.; Ryu, Koungmin; Thompson, Mark E.; Zhou, Chongwu

2010-01-01

We report the implementation of continuous, highly flexible, and transparent graphene films obtained by chemical vapor deposition (CVD) as transparent conductive electrodes (TCE) in organic photovoltaic cells. Graphene films were synthesized by CVD

Isolation of high-quality total RNA from leaves of Myrciaria dubia "CAMU CAMU".

Science.gov (United States)

Gómez, Juan Carlos Castro; Reátegui, Alina Del Carmen Egoavil; Flores, Julián Torres; Saavedra, Roberson Ramírez; Ruiz, Marianela Cobos; Correa, Sixto Alfredo Imán

2013-01-01

Myrciaria dubia is a main source of vitamin C for people in the Amazon region. Molecular studies of M. dubia require high-quality total RNA from different tissues. So far, no protocols have been reported for total RNA isolation from leaves of this species. The objective of this research was to develop protocols for extracting high-quality total RNA from leaves of M. dubia. Total RNA was purified following two modified protocols developed for leaves of other species (by Zeng and Yang, and by Reid et al.) and one modified protocol developed for fruits of the studied species (by Silva). Quantity and quality of purified total RNA were assessed by spectrophotometric and electrophoretic analysis. Additionally, quality of total RNA was evaluated with reverse-transcription polymerase chain reaction (RT-PCR). With these three modified protocols we were able to isolate high-quality RNA (A260nm/A280nm >1.9 and A260nm/A230nm >2.0). Highest yield was produced with the Zeng and Yang modified protocol (384±46µg ARN/g fresh weight). Furthermore, electrophoretic analysis showed the integrity of isolated RNA and the absence of DNA. Another proof of the high quality of our purified RNA was the successful cDNA synthesis and amplification of a segment of the M. dubia actin 1 gene. We report three modified protocols for isolation total RNA from leaves of M. dubia. The modified protocols are easy, rapid, low in cost, and effective for high-quality and quantity total RNA isolation suitable for cDNA synthesis and polymerase chain reaction.

40 CFR 75.21 - Quality assurance and quality control requirements.

Science.gov (United States)

2010-07-01

... quality assurance audit or any other audit, the system is out-of-control. The owner or operator shall... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Quality assurance and quality control... assurance and quality control requirements. (a) Continuous emission monitoring systems. The owner or...

Enabling Continuous Quality Improvement in Practice: The Role and Contribution of Facilitation.

Science.gov (United States)

Harvey, Gillian; Lynch, Elizabeth

2017-01-01

Facilitating the implementation of continuous quality improvement (CQI) is a complex undertaking. Numerous contextual factors at a local, organizational, and health system level can influence the trajectory and ultimate success of an improvement program. Some of these contextual factors are amenable to modification, others less so. As part of planning and implementing healthcare improvement, it is important to assess and build an understanding of contextual factors that might present barriers to or enablers of implementation. On the basis of this initial diagnosis, it should then be possible to design and implement the improvement intervention in a way that is responsive to contextual barriers and enablers, often described as "tailoring" the implementation approach. Having individuals in the active role of facilitators is proposed as an effective way of delivering a context-sensitive, tailored approach to implementing CQI. This paper presents an overview of the facilitator role in implementing CQI. Drawing on empirical evidence from the use of facilitator roles in healthcare, the type of skills and knowledge required will be considered, along with the type of facilitation strategies that can be employed in the implementation process. Evidence from both case studies and systematic reviews of facilitation will be reviewed and key lessons for developing and studying the role in the future identified.

Clinical audit as a tool of continuous improvement of quality in radiology

International Nuclear Information System (INIS)

Horvathova, M.; Nikodemova, D.; Prikazska, M.

2008-01-01

Medical diagnosis and treatment including X -rays, nuclear medicine and radiotherapy , are the largest man-made sources of radiation exposure. The medical use of ionising radiation continues to expand, and is moving towards more complex procedures entailing higher exposures. Directive 97/43/EURATOM, on health protection of individuals against the dangers of ionizing radiation in relation to medical exposures acknowledged that medical practices using ionizing radiation are developing rapidly and that they are from a radiation protection point of view of regulatory concern. Our contribution summarizes the main recommendations of the Guidelines and the major problems of implementation of Clinical audits in Slovakia, which are: Incomplete national legislation for clinical audit; Methods of financing; Lack of formal framework of auditing; Poor understanding of the purpose and contents of clinical audits; Lack of criteria for the standards of good practices; Difficulty to employ sufficient number of auditors; Insufficient time available for auditors; Lack of specific training of auditors; Need of technological modernization of radiology equipment to meet quality standards. The need for harmonization of clinical audits has been recognized by all countries which replied to the questionnaire, including Slovakia and therefore it should be implemented in radiation protection regulations of Health ministry. (authors)

Clinical audit as a tool of continuous improvement of quality in radiology

International Nuclear Information System (INIS)

Horvathova, M.; Nikodemova, D.; Prikazska, M.

2009-01-01

Medical diagnosis and treatment including X -rays, nuclear medicine and radiotherapy , are the largest man-made sources of radiation exposure. The medical use of ionising radiation continues to expand, and is moving towards more complex procedures entailing higher exposures. Directive 97/43/EURATOM, on health protection of individuals against the dangers of ionizing radiation in relation to medical exposures acknowledged that medical practices using ionizing radiation are developing rapidly and that they are from a radiation protection point of view of regulatory concern. Our contribution summarizes the main recommendations of the Guidelines and the major problems of implementation of Clinical audits in Slovakia, which are: Incomplete national legislation for clinical audit; Methods of financing; Lack of formal framework of auditing; Poor understanding of the purpose and contents of clinical audits; Lack of criteria for the standards of good practices; Difficulty to employ sufficient number of auditors; Insufficient time available for auditors; Lack of specific training of auditors; Need of technological modernization of radiology equipment to meet quality standards. The need for harmonization of clinical audits has been recognized by all countries which replied to the questionnaire, including Slovakia and therefore it should be implemented in radiation protection regulations of Health ministry. (authors)

Continuous Innovation and Business Development in High-tech SME Clusters: A Change Point Analysis and Assessment Approach

DEFF Research Database (Denmark)

Müller, Sabine; Neergaard, Helle; Ulhøi, John Parm

The aim of this paper is to  propose an integrated methodological approach to study  complex  and  longitudinal  processes  such  as  continuous  innovation  and business development in high-tech SME clusters. It draws from four existing and  well-recognised approaches for studying events...... is especially helpful for studies which focus on continuous innovation and  business development in high-tech SME clusters as these  studies  could  benefit  tremendously  from  more qualitative  approaches, which  facilitate  in-depth  understanding  continuous  and  changing  processes. Therefore, major...

The program of continuous improvements in factory in Juzbado

International Nuclear Information System (INIS)

Prieto, M.

2015-01-01

This articles describes the historical development of the continuous improvement program at Juzbado Factory, since its beginning to nowadays. The evolution throughout the ideas of Total Quality, ISO, EFQM, Six Sigma, and so on, leading to the present situation in which all these tools and methodologies live together is shown. all this has led to a philosophy and business culture focused on safety, quality and continuous improvement. (Author)

Negative Binomial charts for monitoring high-quality processes

NARCIS (Netherlands)

Albers, Willem/Wim

Good control charts for high quality processes are often based on the number of successes between failures. Geometric charts are simplest in this respect, but slow in recognizing moderately increased failure rates p. Improvement can be achieved by waiting until r > 1 failures have occurred, i.e. by

High quality mask storage in an advanced Logic-Fab

Science.gov (United States)

Jähnert, Carmen; Fritsche, Silvio

2012-02-01

High efficient mask logistics as well as safe and high quality mask storage are essential requirements within an advanced lithography area of a modern logic waferfab. Fast operational availability of the required masks at the exposure tool with excellent mask condition requires a safe mask handling, safeguarding of high mask quality over the whole mask usage time without any quality degradation and an intelligent mask logistics. One big challenge is the prevention of haze on high advanced phase shift masks used in a high volume production line for some thousands of 248nm or 193nm exposures. In 2008 Infineon Dresden qualified a customer specific developed semi-bare mask storage system from DMSDynamic Micro Systems in combination with a high advanced mask handling and an interconnected complex logistic system. This high-capacity mask storage system DMS M1900.22 for more than 3000 masks with fully automated mask and box handling as well as full-blown XCDA purge has been developed and adapted to the Infineon Lithotoollandscape using Nikon and SMIF reticle cases. Advanced features for ESD safety and mask security, mask tracking via RFID and interactions with the exposure tools were developed and implemented. The stocker is remote controlled by the iCADA-RSM system, ordering of the requested mask directly from the affected exposure tool allows fast access. This paper discusses the advantages and challenges for this approach as well as the practical experience gained during the implementation of the new system which improves the fab performance with respect to mask quality, security and throughput. Especially the realization of an extremely low and stable humidity level in addition with a well controlled air flow at each mask surface, preventing masks from haze degradation and particle contamination, turns out to be a notable technical achievement. The longterm stability of haze critical masks has been improved significantly. Relevant environmental parameters like

Effective quality auditing

International Nuclear Information System (INIS)

Sivertsen, Terje

2004-01-01

The present report focuses on how to improve the effectiveness of quality audits and organization-wide quality management. It discusses several concepts related to internal quality auditing, includes guidelines on how to establish auditing as a key process of the organization, and exemplifies its application in the management of quality, strategy, and change. The report follows a line of research documented previously in the reports 'Continuous Improvement of Software Quality' (HWR-584) and 'ISO 9000 Quality Systems for Software Development' (HWR-629). In particular, the concepts of measurement programmes and process improvement cycles, discussed in HWR-584, form the basis for the approach advocated in the present report to the continual improvement of the internal quality audit process. Internal auditing is an important ingredient in ISO 9000 quality systems, and continual improvement of this process is consistent with the process-oriented view of the 2000 revision of the ISO 9000 family (HWR-629). The overall aim of the research is to provide utilities and their system vendors with better tools for quality management in digital I and C projects. The research results are expected to provide guidance to the choice of software engineering practices to obtain a system fulfilling safety requirements at an acceptable cost. For licensing authorities, the results are intended to make the review process more efficient through the use of appropriate measures (metrics), and to be of help in establishing requirements to software quality assurance in digital I and C projects. (Author)

IMPACT OF RESILIENCE, ICT SUPPORT AND QUALITY OF STUDENT'S LIFE ON QUALITY OF HIGH EDUCATION PROCESS

Directory of Open Access Journals (Sweden)

Zorica Lazic

2016-12-01

Full Text Available Answers to the questions of how and in what way the quality of life of students, resilience and ICT support affects the quality of high education we will get through this work where main objective is to define a network of processes and process management ensuring more quality and more innovative managing and service provision, therefore satisfying the needs of service users - in this case the students of the university. To collect the relevant data in the thematic analysis of this paper, the method of interviewing by questionnaires was applied. The sample survey was conducted among undergraduate students, teachers and staff of the Teacher Training Faculty in Uzice.

Water-Quality Data

Science.gov (United States)

... Water Quality? [1.7MB PDF] Past featured science... Water Quality Data Today's Water Conditions Get continuous real- ... list of USGS water-quality data resources . USGS Water Science Areas Water Resources Groundwater Surface Water Water ...

Aligning business processes and information systems new approaches to continuous quality engineering

CERN Document Server

Heinrich, Robert

2014-01-01

Business processes and information systems mutually affect each other in non-trivial ways. Frequently, processes are designed without taking the systems' impact into account, and vice versa. Missing alignment at design-time results in quality problems at run-time. Robert Heinrich gives examples from research and practice for an integrated design of process and system quality. A quality reference-model characterizes process quality and a process notation is extended to operationalize the model. Simulation is a powerful means to predict the mutual quality impact, to compare design alternatives,

A continuous high-throughput bioparticle sorter based on 3D traveling-wave dielectrophoresis.

Science.gov (United States)

Cheng, I-Fang; Froude, Victoria E; Zhu, Yingxi; Chang, Hsueh-Chia; Chang, Hsien-Chang

2009-11-21

We present a high throughput (maximum flow rate approximately 10 microl/min or linear velocity approximately 3 mm/s) continuous bio-particle sorter based on 3D traveling-wave dielectrophoresis (twDEP) at an optimum AC frequency of 500 kHz. The high throughput sorting is achieved with a sustained twDEP particle force normal to the continuous through-flow, which is applied over the entire chip by a single 3D electrode array. The design allows continuous fractionation of micron-sized particles into different downstream sub-channels based on differences in their twDEP mobility on both sides of the cross-over. Conventional DEP is integrated upstream to focus the particles into a single levitated queue to allow twDEP sorting by mobility difference and to minimize sedimentation and field-induced lysis. The 3D electrode array design minimizes the offsetting effect of nDEP (negative DEP with particle force towards regions with weak fields) on twDEP such that both forces increase monotonically with voltage to further increase the throughput. Effective focusing and separation of red blood cells from debris-filled heterogeneous samples are demonstrated, as well as size-based separation of poly-dispersed liposome suspensions into two distinct bands at 2.3 to 4.6 microm and 1.5 to 2.7 microm, at the highest throughput recorded in hand-held chips of 6 microl/min.

Continuous Process for Low-Cost, High-Quality YSZ Powder

Energy Technology Data Exchange (ETDEWEB)

Scott L. Swartz; Michael Beachy; Matthew M. Seabaugh

2006-03-31

This report describes results obtained by NexTech Materials, Ltd. in a project funded by DOE under the auspices of the Solid-State Energy Conversion Alliance (SECA). The project focused on development of YSZ electrolyte powder synthesis technology that could be ''tailored'' to the process-specific needs of different solid oxide fuel cell (SOFC) designs being developed by SECA's industry teams. The work in the project involved bench-scale processing work aimed at establishing a homogeneous precipitation process for producing YSZ electrolyte powder, scaleup of the process to 20-kilogram batch sizes, and evaluation of the YSZ powder products produced by the process. The developed process involved the steps of: (a) preparation of an aqueous hydrous oxide slurry via coprecipitation; (b) washing of residual salts from the precipitated hydroxide slurry followed by drying; (c) calcination of the dried powder to crystallize the YSZ powder and achieve desired surface area; and (d) milling of the calcined powder to targeted particle size. YSZ powders thus prepared were subjected to a comprehensive set of characterization and performance tests, including particle size distribution and surface area analyses, sintering performance studies, and ionic conductivity measurements. A number of different YSZ powder formulations were established, all of which had desirable performance attributes relative to commercially available YSZ powders. Powder characterization and performance metrics that were established at the onset of the project were met or exceeded. A manufacturing cost analysis was performed, and a manufactured cost of $27/kg was estimated based on this analysis. The analysis also allowed an identification of process refinements that would lead to even lower cost.

Learning Disabilities and Achieving High-Quality Education Standards

Science.gov (United States)

Gartland, Debi; Strosnider, Roberta

2017-01-01

This is an official document of the National Joint Committee on Learning Disabilities (NJCLD), of which Council for Learning Disabilities is a long-standing, active member. With this position paper, NJCLD advocates for the implementation of high-quality education standards (HQES) for students with learning disabilities (LD) and outlines the…

CCD Astrophotography High-Quality Imaging from the Suburbs

CERN Document Server

Stuart, Adam

2006-01-01

This is a reference book for amateur astronomers who have become interested in CCD imaging. Those glorious astronomical images found in astronomy magazines might seem out of reach to newcomers to CCD imaging, but this is not the case. Great pictures are attainable with modest equipment. Adam Stuart’s many beautiful images, reproduced in this book, attest to the quality of – initially – a beginner’s efforts. Chilled-chip astronomical CCD-cameras and software are also wonderful tools for cutting through seemingly impenetrable light-pollution. CCD Astrophotography from the Suburbs describes one man’s successful approach to the problem of getting high-quality astronomical images under some of the most light-polluted conditions. Here is a complete and thoroughly tested program that will help every CCD-beginner to work towards digital imaging of the highest quality. It is equally useful to astronomers who have perfect observing conditions, as to those who have to observe from light-polluted city skies.

Theoretical-Experimental study on the electroslag remelting technology of high quality steels

International Nuclear Information System (INIS)

Robles P, E.F.

1993-01-01

This is a theoretical-experimental laboratory study on the Electroslag Remelting Technology (ESRT) of high quality steels. The objective of this study was to analyze the problems that this technology entails and thus facilitate its industrial application in Mexico. The study was carried out using a 1 Kg. capacity furnace, the behavior of different fluxes on the remelting of 1018 AISI carbon steel was established and a slag 70F/15/15 was selected for the remelting of H-13 AISI hot work tool steel. From the experimental results it was possible to establish a flux manufacture route, the electrode conditioning necessary for the experiments, and the critical points of the process. It was demonstrated that the crucible and electrode advance system are the more critical points in the furnace manufacture, that the start up is fundamental for the remelting continuity and that the CaF 2 base slags are more recommendable for special steels refining. It has been proven that it is possible to experiment with little laboratory electroslag furnaces. (Author)

Implementing a Continuous Quality Improvement Program in a High-Volume Clinical Echocardiography Laboratory: Improving Care for Patients With Aortic Stenosis.

Science.gov (United States)

Samad, Zainab; Minter, Stephanie; Armour, Alicia; Tinnemore, Amanda; Sivak, Joseph A; Sedberry, Brenda; Strub, Karen; Horan, Seanna M; Harrison, J Kevin; Kisslo, Joseph; Douglas, Pamela S; Velazquez, Eric J

2016-03-01

The management of aortic stenosis rests on accurate echocardiographic diagnosis. Hence, it was chosen as a test case to examine the utility of continuous quality improvement (CQI) approaches to increase echocardiographic data accuracy and reliability. A novel, multistep CQI program was designed and prospectively used to investigate whether it could minimize the difference in aortic valve mean gradients reported by echocardiography when compared with cardiac catheterization. The Duke Echo Laboratory compiled a multidisciplinary CQI team including 4 senior sonographers and MD faculty to develop a mapped CQI process that incorporated Intersocietal Accreditation Commission standards. Quarterly, the CQI team reviewed all moderate- or greater-severity aortic stenosis echocardiography studies with concomitant catheterization data, and deidentified individual and group results were shared at meetings attended by cardiologists and sonographers. After review of 2011 data, the CQI team proposed specific amendments implemented over 2012: the use of nontraditional imaging and Doppler windows as well as evaluation of aortic gradients by a second sonographer. The primary outcome measure was agreement between catheterization- and echocardiography-derived mean gradients calculated by using the coverage probability index with a prespecified acceptable echocardiography-catheterization difference of <10 mm Hg in mean gradient. Between January 2011 and January 2014, 2093 echocardiograms reported moderate or greater aortic stenosis. Among cases with available catheterization data pre- and post-CQI, the coverage probability index increased from 54% to 70% (P=0.03; 98 cases, year 2011; 70 cases, year 2013). The proportion of patients referred for invasive valve hemodynamics decreased from 47% pre-CQI to 19% post-CQI (P<0.001). A laboratory practice pattern that was amenable to reform was identified, and a multistep modification was designed and implemented that produced clinically

The influence of knowledge management implementation toward the quality of high schools

Directory of Open Access Journals (Sweden)

Hilda Ainissyifa

2012-09-01

Full Text Available The purpose of this study is to analyze the influence of knowledge management implementation toward the quality of high schools. This study was conducted among five high schools under an education foundation. The analysis models used in the study were correlation analysis and t-test. The respondents were used as the profession references are 86 teachers. The result of the study shows that knowledge management implementation has a positive and significant influence toward the quality of high schools.

Boiling curve in high quality flow boiling

International Nuclear Information System (INIS)

Shiralkar, B.S.; Hein, R.A.; Yadigaroglu, G.

1980-01-01

The post dry-out heat transfer regime of the flow boiling curve was investigated experimentally for high pressure water at high qualities. The test section was a short round tube located downstream of a hot patch created by a temperature controlled segment of tubing. Results from the experiment showed that the distance from the dryout point has a significant effect on the downstream temperatures and there was no unique boiling curve. The heat transfer coefficients measured sufficiently downstream of the dryout point could be correlated using the Heineman correlation for superheated steam, indicating that the droplet deposition effects could be neglected in this region

Impact of continuous in-home rehabilitation on quality of life and activities of daily living in elderly clients over 1 year.

Science.gov (United States)

Imanishi, Miyuki; Tomohisa, Hisao; Higaki, Kazuo

2017-11-01

To verify the effect of in-home rehabilitation on quality of life and activities of daily living in elderly clients. In this non-randomized controlled intervention trial, elderly participants were separated into a rehabilitation or a non-rehabilitation group (n = 100 each). The non-rehabilitation group received basic in-home nursing care, including assistance with cooking, cleaning, toileting, meals and medication. The rehabilitation group received a physical treatment program provided by a licensed professional once a week and basic nursing care in the home. For each group, quality of life and activities of daily living were assessed approximately every 3 months over a 1-year period. Quality of life was evaluated using the Philadelphia Geriatric Center Morale Scale, and activities of daily living were evaluated based on the Functional Independence Measure. The rehabilitation group showed statistically significant improvements in both quality of life and activities of daily living. In contrast, the non-rehabilitation group, although showing slight improvement in quality of life at 9 months, showed almost no effects at the other time-points and no significant changes in activities of daily living over the course of the study. The results of the present study suggest that long-term continuous in-home rehabilitation might improve quality of life and activities of daily living in elderly clients. Geriatr Gerontol Int 2017; 17: 1866-1872. © 2017 Japan Geriatrics Society.

Risk reduction and TQM: A corporate culture of continuous improvement

International Nuclear Information System (INIS)

Nau, D.C.

1992-01-01

A company supplying products and services to the nuclear industry that implements a cultural commitment to continuous improvement, in addition to providing higher quality products and services, also represents a significant reduction in operational risk to that industry. The implementation of a culture of total quality management (TQM), initiated by Sorrento Electronics (SE) in 1989, involves total commitment to the basic TQM principles: continuous improvement, people performing the work are the best sources of how to do it better, and employees must be empowered to make the improvements. What this means to the nuclear industry is a significant reduction in operational risk through: (1) products based on simpler, standardized, proven designs with established operational track records, enhancing confidence that they will perform as expected; (2) the highest confidence that products and supporting documentation are delivered with zero defects; (3) critical power plant schedules can be supported through the shortest possible equipment delivery times; (4) highly motivated employees with extremely positive attitudes, working together in cross-functional teams, virtually eliminate the possibility of deliberate product tampering or sabotage

CBE growth of high-quality ZnO epitaxial layers

Energy Technology Data Exchange (ETDEWEB)

El-Shaer, A.; Bakin, A.; Mofor, A.C.; Kreye, M.; Waag, A. [Institute of Semiconductor Technology, Technical University Braunschweig, Hans-Sommer-Strasse 66, 38106 Braunschweig (Germany); Blaesing, J.; Krost, A. [Institute of Experimental Physics, Otto-von-Guericke-University Magdeburg (Germany); Stoimenos, J. [Physics Department, Aristotele University, Univ. Campus, 54006 Thessaloniki (Greece); Pecz, B. [Research Institute for Technical Physics and Materials Science, Hungarian Academy of Sciences, P.O. Box 49, 1525 Budapest (Hungary); Heuken, M. [Aixtron AG, Kackertstr. 15-17, 52072 Aachen (Germany)

2006-03-15

Further improvements on the recently reported novel approach to zinc oxide Chemical Beam Epitaxy (CBE) are presented. Hydrogen peroxide is employed as a very efficient novel oxidant. ZnO layers with a thickness from 100 nm to 600 nm were grown on c-sapphire using a MgO buffer. PL-mapping as well as conductivity mapping shows a good uniformity across the 2 inch ZnO-on-sapphire epiwafers. The measured surface roughness for the best layers is as low as 0.26 nm. HRXRD measurements of the obtained ZnO layers show excellent quality of the single crystalline ZnO. The FWHM of the HRXRD (0002) rocking curves measured for the 2 inch ZnO-on-sapphire wafers is as low as 27 arcsec with a very high lateral homogeneity across the whole wafer. Plane view HRTEM observations reveal the very good quality of the ZnO films. The results indicate that CBE is a suitable technique to fabricate ZnO of very high structural quality, which can eventually be used as an alternative to bulk ZnO substrates. (copyright 2006 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

High quality factor GaAs microcavity with buried bullseye defects

DEFF Research Database (Denmark)

Winkler, K.; Gregersen, Niels; Hayrynen, T.

2018-01-01

The development of high quality factor solid-state microcavities with low mode volumes has paved the way towards on-chip cavity quantum electrodynamics experiments and the development of high-performance nanophotonic devices. Here, we report on the implementation of a new kind of solid...

Low-cost high-quality crystalline germanium based flexible devices

KAUST Repository

Nassar, Joanna M.

2014-06-16

High performance flexible electronics promise innovative future technology for various interactive applications for the pursuit of low-cost, light-weight, and multi-functional devices. Thus, here we show a complementary metal oxide semiconductor (CMOS) compatible fabrication of flexible metal-oxide-semiconductor capacitors (MOSCAPs) with high-κ/metal gate stack, using a physical vapor deposition (PVD) cost-effective technique to obtain a high-quality Ge channel. We report outstanding bending radius ~1.25 mm and semi-transparency of 30%.

Low-cost high-quality crystalline germanium based flexible devices

KAUST Repository

Nassar, Joanna M.; Hussain, Aftab M.; Rojas, Jhonathan Prieto; Hussain, Muhammad Mustafa

2014-01-01

High performance flexible electronics promise innovative future technology for various interactive applications for the pursuit of low-cost, light-weight, and multi-functional devices. Thus, here we show a complementary metal oxide semiconductor (CMOS) compatible fabrication of flexible metal-oxide-semiconductor capacitors (MOSCAPs) with high-κ/metal gate stack, using a physical vapor deposition (PVD) cost-effective technique to obtain a high-quality Ge channel. We report outstanding bending radius ~1.25 mm and semi-transparency of 30%.

High-quality GaN epitaxially grown on Si substrate with serpentine channels

Science.gov (United States)

Wei, Tiantian; Zong, Hua; Jiang, Shengxiang; Yang, Yue; Liao, Hui; Xie, Yahong; Wang, Wenjie; Li, Junze; Tang, Jun; Hu, Xiaodong

2018-06-01

A novel serpentine-channeled mask was introduced to Si substrate for low-dislocation GaN epitaxial growth and the fully coalesced GaN film on the masked Si substrate was achieved for the first time. Compared with the epitaxial lateral overgrowth (ELOG) growth method, this innovative mask only requires one-step epitaxial growth of GaN which has only one high-dislocation region per mask opening. This new growth method can effectively reduce dislocation density, thus improving the quality of GaN significantly. High-quality GaN with low dislocation density ∼2.4 × 107 cm-2 was obtained, which accounted for about eighty percent of the GaN film in area. This innovative technique is promising for the growth of high-quality GaN templates and the subsequent fabrication of high-performance GaN-based devices like transistors, laser diodes (LDs), and light-emitting diodes (LEDs) on Si substrate.

Study on quality assurance for high-level radioactive waste disposal project

International Nuclear Information System (INIS)

Takada, Susumu

2005-01-01

The U.S. Department of Energy (DOE) has developed comparatively detailed quality assurance requirements for the high-level radioactive waste disposal systems. Quality assurance is recognized as a key issue for confidence building and smooth implementation of the HLW program in Japan, and Japan is at an initial phase of repository development. Then the quality assurance requirements at site research and site selection, site characterization, and site suitability analysis used in the Yucca Mountain project were examined in detail and comprehensive descriptions were developed using flow charts. Additionally, the applicability to the Japan high-level radioactive waste disposal project was studied. The examination and study were performed for the following QA requirements: The requirements that have the relative importance at site research and site selection, site characterization, and site suitability analysis (such as planning and performing scientific investigations, sample control, data control, model development and use, technical report review, software control, and control of the electric management of data). The requirements that have the relative importance at the whole repository phases (such as quality assurance program, document control, and control of quality assurance records). (author)

Geophysical insights on the GIA process provided by high-quality constraints from peripheral regions: An outlook on perspectives from North America and from the Mediterranean basin

Science.gov (United States)

Roy, K.; Peltier, W. R.

2017-12-01

Our understanding of the Earth-Ice-Ocean interactions that have accompanied the large glaciation-deglaciation process characteristic of the last half of the Pleistocene has benefited significantly from the development of high-quality models of the Glacial Isostatic Adjustment (GIA) process. These models provide fundamental insight on the large changes in sea level and land ice cover over this time period, as well as key constraints on the viscosity structure of the Earth's interior. Their development has benefited from the recent availability of high-quality constraints from regions of forebulge collapse. In particular, over North America, the joint use of high-quality sea level data from the U.S. East coast, together with the vast network of precise space-geodetic observations of crustal motion existing over most of the interior of the continent, has led to the latest ICE-7G_NA (VM7) model (Roy & Peltier, GJI, 2017). In this paper, exciting opportunities provided by such high-quality observations related to the GIA process will be discussed, not only in the context of the continuing effort to refine global models of this phenomenon, but also in terms of the fundamental insight they may provide on outstanding issues in high-pressure geophysics, paleoclimatology or hydrogeology. Specific examples where such high-quality observations can be used (either separately, or using a combination of independent sources) will be presented, focusing particularly on constraints from the North American continent and from the Mediterranean basin. This work will demonstrate that, given the high-quality of currently available constraints on the GIA process, considerable further geophysical insight can be obtained based upon the use of spherically-symmetric models of the viscosity structure of the planet.

75 FR 20918 - High-Voltage Continuous Mining Machine Standard for Underground Coal Mines

Science.gov (United States)

2010-04-22

... DEPARTMENT OF LABOR Mine Safety and Health Administration 30 CFR Parts 18 and 75 RIN 1219-AB34 High-Voltage Continuous Mining Machine Standard for Underground Coal Mines Correction In rule document 2010-7309 beginning on page 17529 in the issue of Tuesday, April 6, 2010, make the following correction...

Effect of high-oxygen and high-carbon-dioxide atmospheres on strawberry flavor and other quality traits.

Science.gov (United States)

Pérez, A G; Sanz, C

2001-05-01

The effect of high-oxygen atmospheres on strawberry flavor was studied. Strawberry fruits (Fragariax ananassa Duch. cv. Camarosa) were stored at 8 degrees C in four different atmospheres: air, 5% O(2)/20% CO(2), 80% O(2)/20% CO(2), and 90% O(2)/10% CO(2). Changes in several quality parameters were evaluated. Atmospheres combining high O(2) and high CO(2) were the most effective in preventing fungal growth and enhancing strawberry firmness. Other quality parameters such as color, titrable acidity, sugars and organic acids distribution, off-flavor development, and aroma were only mildly affected by superatmospheric O(2) levels. After one week of storage, unexpected high contents of off-flavor related compounds were found in the 80% O(2)/20% CO(2) and 90% O(2)/10% CO(2) atmospheres. Evidence of an altered ester biosynthesis was also found in fruits stored under these high-O(2) atmospheres. Data obtained suggest that stress induced by high CO(2) and stress induced by high O(2) have an additive effect on strawberry flavor alteration.

Discontinuous and Continuous Indoor Air Quality Monitoring in Homes with Fireplaces or Wood Stoves as Heating System.

Science.gov (United States)

de Gennaro, Gianluigi; Dambruoso, Paolo Rosario; Di Gilio, Alessia; Di Palma, Valerio; Marzocca, Annalisa; Tutino, Maria

2015-12-24

Around 50% of the world's population, particularly in developing countries, uses biomass as one of the most common fuels. Biomass combustion releases a considerable amount of various incomplete combustion products, including particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs). The paper presents the results of Indoor Air Quality (IAQ) measurements in six houses equipped with wood burning stoves or fireplaces as heating systems. The houses were monitored for 48-h periods in order to collect PM10 samples and measure PAH concentrations. The average, the maximum and the lowest values of the 12-h PM10 concentration were 68.6 μg/m³, 350.7 μg/m³ and 16.8 μg/m³ respectively. The average benzo[a]pyrene 12-h concentration was 9.4 ng/m³, while the maximum and the minimum values were 24.0 ng/m³ and 1.5 ng/m³, respectively. Continuous monitoring of PM10, PAHs, Ultra Fine Particle (UFP) and Total Volatile Organic Compounds (TVOC) was performed in order to study the progress of pollution phenomena due to biomass burning, their trends and contributions to IAQ. The results show a great heterogeneity of impacts on IAQ in terms of magnitude and behavior of the considered pollutants' concentrations. This variability is determined by not only different combustion technologies or biomass quality, but overall by different ignition mode, feeding and flame management, which can also be different for the same house. Moreover, room dimensions and ventilation were significant factors for pollution dispersion. The increase of PM10, UFP and PAH concentrations, during lighting, was always detected and relevant. Continuous monitoring allowed singling out contributions of other domestic sources of considered pollutants such as cooking and cigarettes. Cooking contribution produced an impact on IAQ in same cases higher than that of the biomass heating system.

Discontinuous and Continuous Indoor Air Quality Monitoring in Homes with Fireplaces or Wood Stoves as Heating System

Directory of Open Access Journals (Sweden)

Gianluigi de Gennaro

2015-12-01

Full Text Available Around 50% of the world’s population, particularly in developing countries, uses biomass as one of the most common fuels. Biomass combustion releases a considerable amount of various incomplete combustion products, including particulate matter (PM and polycyclic aromatic hydrocarbons (PAHs. The paper presents the results of Indoor Air Quality (IAQ measurements in six houses equipped with wood burning stoves or fireplaces as heating systems. The houses were monitored for 48-h periods in order to collect PM10 samples and measure PAH concentrations. The average, the maximum and the lowest values of the 12-h PM10 concentration were 68.6 μg/m3, 350.7 μg/m3 and 16.8 μg/m3 respectively. The average benzo[a]pyrene 12-h concentration was 9.4 ng/m3, while the maximum and the minimum values were 24.0 ng/m3 and 1.5 ng/m3, respectively. Continuous monitoring of PM10, PAHs, Ultra Fine Particle (UFP and Total Volatile Organic Compounds (TVOC was performed in order to study the progress of pollution phenomena due to biomass burning, their trends and contributions to IAQ. The results show a great heterogeneity of impacts on IAQ in terms of magnitude and behavior of the considered pollutants’ concentrations. This variability is determined by not only different combustion technologies or biomass quality, but overall by different ignition mode, feeding and flame management, which can also be different for the same house. Moreover, room dimensions and ventilation were significant factors for pollution dispersion. The increase of PM10, UFP and PAH concentrations, during lighting, was always detected and relevant. Continuous monitoring allowed singling out contributions of other domestic sources of considered pollutants such as cooking and cigarettes. Cooking contribution produced an impact on IAQ in same cases higher than that of the biomass heating system.

Quality assurance system for sitting high risk facilities; Sistema de aseguramiento de la calidad para el emplazamiento de obras de alto riesgo

Energy Technology Data Exchange (ETDEWEB)

Rodriguez, Aymee; Peralta, Jose L.; Fernandez, Manuel [Centro de Tecnologia Nuclear, San Jose de las Lajas (Cuba)

1999-11-01

The paper shows how we have conceived and designed the quality assurance system for the site selection process of an area for sitting the facility of high risk in correspondence with the approved methodology. The results obtained in the implementation of the system have permitted the satisfactory performance of each one the expected stage, defining the most favorable sectors in order to continue the studies of the repository site for the disposal of low and intermedium. (author) 7 refs., 1 tab.

A safe inexpensive method to isolate high quality plant and fungal ...

African Journals Online (AJOL)

STORAGESEVER

2008-08-18

Aug 18, 2008 ... quality DNA from plant and fungal species. This method uses potassium acetate to remove proteins and polysaccharides in an SDS extraction buffer. Further DNA purification is achieved using a low salt. CTAB treatment. This SDS/CTAB protocol was used to isolate high quality genomic DNA subject to.

Continuous quality improvement in substance abuse treatment facilities: How much does it cost?

Science.gov (United States)

Hunt, Priscillia; Hunter, Sarah B; Levan, Deborah

2017-06-01

Continuous quality improvement (CQI) has grown in the U.S. since the 1970s, yet little is known about the costs to implement CQI in substance abuse treatment facilities. This paper is part of a larger group randomized control trial in a large urban county evaluating the impact of Plan-Study-Do-Act (PDSA)-CQI designed for community service organizations (Hunter, Ober, Paddock, Hunt, & Levan, 2014). Operated by one umbrella organization, each of the eight facilities of the study, four residential and four outpatient substance abuse treatment facilities, selected their own CQI Actions, including administrative- and clinical care-related Actions. Using an activity-based costing approach, we collected labor and supplies and equipment costs directly attributable to CQI Actions over a 12-month trial period. Our study finds implementation of CQI and meeting costs of this trial per facility were approximately $2000 to $10,500 per year ($4500 on average), or $10 to $60 per admitted client. We provide a description of the sources of variation in these costs, including differing intensity of the CQI Actions selected, which should help decision makers plan use of PDSA-CQI. Copyright © 2017. Published by Elsevier Inc.

Analysis of non-conformity in continuous quality improvement in a Hospital Radiopharmacy Unit.

Science.gov (United States)

Martinez, T; Contreras, J F

To perform an analysis of non-conformities (NC) registered between 2012 and 2015, as a part of the review process of the Quality Management System of our Radiopharmacy Unit. Non-conformities registered in the Radiopharmacy Unit in the period 2012-2015 are analyzed and sorted by their impact on the process (critical, major, and minor), cause/origin of the non-conformity, and nature of radiopharmaceutical (PET vs. SPECT). A decrease in the NC of 20% per year is observed, especially in PET radiopharmaceuticals. Non-conformities in SPECT make up about 62-84% of the total of the NC, mainly related to the high number of doses prepared and not administered, which is about 1.5-3% in the ratio of non-administered/administered per year. Analysis of the NC can be considered as a useful indicator in assessment of quality assurance, and in our particular case, the decrease in the registration of NC indicates effectiveness in the corrective and preventive actions implemented. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Evaluation of service quality in family planning clinics in Lusaka, Zambia.

Science.gov (United States)

Hancock, Nancy L; Vwalika, Bellington; Sitali, Elizabeth Siyama; Mbwili-Muleya, Clara; Chi, Benjamin H; Stuart, Gretchen S

2015-10-01

To determine the quality of contraceptive services in family planning clinics in Lusaka, Zambia, using a standardized approach. We utilized the Quick Investigation of Quality, a cross-sectional survey tool consisting of a facility assessment, client-provider observation and client exit interview, in public-sector family planning clinics. Data were collected on availability of seven contraceptive methods, information given to clients, interpersonal relations between providers and clients, providers' technical competence and mechanisms for continuity and follow-up. Data were collected from five client-provider observations and client exit interviews in each of six public-sector family planning clinics. All clinics had at least two contraceptive methods continuously available for the preceding 6 months. Most providers asked clients about concerns with their contraceptive method (80%) and told clients when to return to the clinic (87%). Most clients reported that the provider advised what to do if a problem develops (93%), described possible side effects (89%), explained how to use the method effectively (85%) and told them when to come for follow-up (83%). Clients were satisfied with services received (93%). This application of the Quick Investigation of Quality showed that the participating family planning clinics in Lusaka, Zambia, were prepared to offer high-quality services with the available commodities and that clients were satisfied with the received services. Despite the subjective client satisfaction, quality improvement efforts are needed to increase contraceptive availability. Although clients perceived the quality of care received to be high, family planning service quality could be improved to continuously offer the full spectrum of contraceptive options. The Quick Investigation of Quality was easily implemented in Lusaka, Zambia, and this simple approach could be utilized in a variety of settings as a modality for quality improvement. Copyright © 2015

Some Operational Aspects Relating to Quality Management and Total Quality Management

OpenAIRE

Sorin GRESOI; Aurelian DIACONU

2013-01-01

The work pass in review a few basic concepts found in quality management focusing on operational aspects of quality assurance in production activity and continue with issues regarding total quality strategy, the vector of competitiveness on the market.

Wellbeing Understanding in High Quality Healthcare Informatics and Telepractice.

Science.gov (United States)

Fiorini, Rodolfo A; De Giacomo, Piero; L'Abate, Luciano

2016-01-01

The proper use of healthcare informatics technology and multidimensional conceptual clarity are fundamental to create and boost outstanding clinical and telepractice results. Avoiding even terminology ambiguities is mandatory for high quality of care service. For instance, well-being or wellbeing is a different way to write the same concept only, or there is a good deal of ambiguity around the meanings of these terms the way they are written. In personal health, healthcare and healthcare informatics, this kind of ambiguity and lack of conceptual clarity has been called out repeatedly over the past 50 years. It is time to get the right, terse scenario. We present a brief review to develop and achieve ultimate wellbeing understanding for practical high quality healthcare informatics and telepractice application. This article presents an innovative point of view on deeper wellbeing understanding towards its increased clinical effective application.

Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour.

Science.gov (United States)

Alfirevic, Zarko; Devane, Declan; Gyte, Gillian Ml; Cuthbert, Anna

2017-02-03

Cardiotocography (CTG) records changes in the fetal heart rate and their temporal relationship to uterine contractions. The aim is to identify babies who may be short of oxygen (hypoxic) to guide additional assessments of fetal wellbeing, or determine if the baby needs to be delivered by caesarean section or instrumental vaginal birth. This is an update of a review previously published in 2013, 2006 and 2001. To evaluate the effectiveness and safety of continuous cardiotocography when used as a method to monitor fetal wellbeing during labour. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (30 November 2016) and reference lists of retrieved studies. Randomised and quasi-randomised controlled trials involving a comparison of continuous cardiotocography (with and without fetal blood sampling) with no fetal monitoring, intermittent auscultation intermittent cardiotocography. Two review authors independently assessed study eligibility, quality and extracted data from included studies. Data were checked for accuracy. We included 13 trials involving over 37,000 women. No new studies were included in this update.One trial (4044 women) compared continuous CTG with intermittent CTG, all other trials compared continuous CTG with intermittent auscultation. No data were found comparing no fetal monitoring with continuous CTG. Overall, methodological quality was mixed. All included studies were at high risk of performance bias, unclear or high risk of detection bias, and unclear risk of reporting bias. Only two trials were assessed at high methodological quality.Compared with intermittent auscultation, continuous cardiotocography showed no significant improvement in overall perinatal death rate (risk ratio (RR) 0.86, 95% confidence interval (CI) 0.59 to 1.23, N = 33,513, 11 trials, low quality evidence), but was associated with halving neonatal seizure rates (RR 0.50, 95% CI 0.31 to 0.80, N = 32,386, 9 trials, moderate quality evidence). There was no

Construction of High-Quality Camel Immune Antibody Libraries.

Science.gov (United States)

Romão, Ema; Poignavent, Vianney; Vincke, Cécile; Ritzenthaler, Christophe; Muyldermans, Serge; Monsion, Baptiste

2018-01-01

Single-domain antibodies libraries of heavy-chain only immunoglobulins from camelids or shark are enriched for high-affinity antigen-specific binders by a short in vivo immunization. Thus, potent binders are readily retrieved from relatively small-sized libraries of 10 7 -10 8 individual transformants, mostly after phage display and panning on a purified target. However, the remaining drawback of this strategy arises from the need to generate a dedicated library, for nearly every envisaged target. Therefore, all the procedures that shorten and facilitate the construction of an immune library of best possible quality are definitely a step forward. In this chapter, we provide the protocol to generate a high-quality immune VHH library using the Golden Gate Cloning strategy employing an adapted phage display vector where a lethal ccdB gene has to be substituted by the VHH gene. With this procedure, the construction of the library can be shortened to less than a week starting from bleeding the animal. Our libraries exceed 10 8 individual transformants and close to 100% of the clones harbor a phage display vector having an insert with the length of a VHH gene. These libraries are also more economic to make than previous standard approaches using classical restriction enzymes and ligations. The quality of the Nanobodies that are retrieved from immune libraries obtained by Golden Gate Cloning is identical to those from immune libraries made according to the classical procedure.

Prolonged continuous exposure to high fine particulate matter associated with cardiovascular and respiratory disease mortality in Beijing, China

Science.gov (United States)

Wang, Jinfeng; Yin, Qian; Tong, Shilu; Ren, Zhoupeng; Hu, Maogui; Zhang, Hongrui

2017-11-01

Although many studies examined the effects of fine particulate matter (PM2.5) on the deaths of cardiovascular disease (CVD) and respiratory disease (RD), few research has paid attention to the effects of prolonged continuous exposure to high PM2.5 pollution. This study estimated the excess risks (ER) of CVD and RD mortalities associated with prolonged continuous exposure to high PM2.5 pollution for the whole population and specific subsociodemographic groups in Beijing, which is the capital city of China with over 20 million residents and having severe PM2.5 pollution problems. Our results suggested that when high PM2.5 pollution occurred continuously, at various thresholds and durations, the adverse effects on CVD and RD mortalities varied significantly. The CVD mortality risks in association with prolonged continuous high PM2.5 pollution exposure were more serious for single individuals (including unmarried, divorced, and widowed), illiterate and outdoor workers than for other specific subsociodemographic groups. When the daily PM2.5 concentration higher than 105 μg/m3 consecutively occurs, at the ninth day, the ERs of CVD death for single individuals, illiterate and outdoor workers groups reached to 45% (95% CI: 22, 71), 51% (95% CI: 28, 79) and 53% (95% CI: 29, 82) respectively. On the other hand, prolonged continuous high PM2.5 pollution level appeared to contribute a higher proportion of RD deaths among illiterate and outdoor workers, but less significant for the other specific subsociodemographic groups. When the duration with daily PM2.5 pollution higher than 115 μg/m3 reached to six days, the ERs for outdoor workers and illiterate attributed to prolonged continuous PM2.5 pollution exposure increased 36% (95% CI: 5, 76) and 49% (95% CI: 16, 91) respectively.

Air Quality Standards for Particulate Matter (PM) at high altitude cities

International Nuclear Information System (INIS)

Bravo Alvarez, H.; Sosa Echeverria, R.; Sanchez Alvarez, P.; Krupa, S.

2013-01-01

The Air Quality Standards for Particulate Matter (PM) at high altitude urban areas in different countries, must consider the pressure and temperature due to the effect that these parameters have on the breath volume. This paper shows the importance to correct Air Quality Standards for PM considering pressure and temperature at different altitudes. Specific factors were suggested to convert the information concerning PM, from local to standard conditions, and adjust the Air Quality Standards for different high altitudes cities. The correction factors ranged from: 1.03 for Santiago de Chile to 1.47 for El Alto Bolivia. Other cities in this study include: Mexico City, México; La Paz, Bolivia; Bogota, Cali and Medellin, Colombia; Quito, Ecuador and Cuzco, Peru. If these corrections are not considered, the atmospheric concentrations will be underestimated. - Highlights: ► AQS for particulate matter concentrations adjusted by pressure and temperature. ► Particulate matter concentrations can be underestimated in high altitude Cities. ► Particulate matter concentrations must be compared under the same conditions. - In order to compare high altitude atmospheric PM concentrations with AQS, one must consider T and P of the sampling site.

Providing high-quality care in primary care settings: how to make trade-offs.

Science.gov (United States)

Beaulieu, Marie-Dominique; Geneau, Robert; Del Grande, Claudio; Denis, Jean-Louis; Hudon, Eveline; Haggerty, Jeannie L; Bonin, Lucie; Duplain, Réjean; Goudreau, Johanne; Hogg, William

2014-05-01

To gain a deeper understanding of how primary care (PC) practices belonging to different models manage resources to provide high-quality care. Multiple-case study embedded in a cross-sectional study of a random sample of 37 practices. Three regions of Quebec. Health care professionals and staff of 5 PC practices. Five cases showing above-average results on quality-of-care indicators were purposefully selected to contrast on region, practice size, and PC model. Data were collected using an organizational questionnaire; the Team Climate Inventory, which was completed by health care professionals and staff; and 33 individual interviews. Detailed case histories were written and thematic analysis was performed. The core common feature of these practices was their ongoing effort to make trade-offs to deliver services that met their vision of high-quality care. These compromises involved the same 3 areas, but to varying degrees depending on clinic characteristics: developing a shared vision of high-quality care; aligning resource use with that vision; and balancing professional aspirations and population needs. The leadership of the physician lead was crucial. The external environment was perceived as a source of pressure and dilemmas rather than as a source of support in these matters. Irrespective of their models, PC practices' pursuit of high-quality care is based on a vision in which accessibility is a key component, balanced by appropriate management of available resources and of external environment expectations. Current PC reforms often create tensions rather than support PC practices in their pursuit of high-quality care. Copyright© the College of Family Physicians of Canada.

Alternative indicators for monitoring the quality of a continuous intervention program on antibiotic prescribing during changing healthcare conditions.

Science.gov (United States)

Bantar, C; Franco, D; Heft, C; Vesco, E; Arango, C; Izaguirre, M; Alcázar, G; Boleas, M; Oliva, M E

2005-06-01

We recently published on the impact of a four-phase hospital-wide intervention program designed to optimize the quality of antibiotic use, where a multidisciplinary team (MDT) could modify prescription at the last phase. Because health care quality was changing during the last 5 years (late 1999 to early 2004), we developed certain indicators to monitor the quality of our intervention over time. Different periods were defined as baseline (pre-intervention), initial intervention-active control, pre-crisis control, crisis control, post-crisis control and end of crisis control. Major indicators were rates of prescription modification by the MDT; prescription for an uncertain infection and a novel index formula (RIcarb) to estimate the rationale for carbapenem use. We assessed 2115 antimicrobial prescriptions. Modification of prescription rate was 30% at the beginning and decreased thereafter up to stable levels. Rate of prescriptions ordered for cases of both uncertain infection and unknown source of infection decreased significantly after intervention (i.e. from baseline to active control). In contrast, a doubling of culture-directed prescriptions was observed between these periods. RIcarb values lower and higher than 60% (modal, cut-off) were assumed as carbapenem overuse and underuse, respectively. Overuse was observed at the pre-intervention, while pronounced underuse was shown during the crisis (RIcarb, 45% and 87%, respectively). The present study demonstrates that certain indicators, other than the widely adopted impact outcomes, are a suitable tool for monitoring the quality of a continuous, long-term, active intervention on antimicrobial prescribing practice, especially when applied in a changing healthcare setting.

Stainless steel fabrication for high quality requirements in the nuclear industry

International Nuclear Information System (INIS)

Wareing, A.J.

1990-01-01

In this paper the author explains the welding procedures and practices adopted within the nuclear industry to achieve the high quality and standards of welds required. The changeover to mechanised welding, orbital TIG welding and synergic MIG welding, has resulted in consistent achievement of high quality standards as well as optimising the productivity. However, the use of mechanised welding machines does require the welder operating them to be fully trained and qualified. The formally organised training courses are described and the cost savings and production rates achieved by utilising the mechanised method are discussed. (author)

Comparison of continuous with step and shoot acquisition in SPECT scanning

International Nuclear Information System (INIS)

McCarthy, L.; Cotterill, T.; Chu, J.M.G.

1998-01-01

Full text: Following the recent advent of continuous acquisition for performing SPECT scanning, it was decided to compare the commonly used Step and Shoot mode of acquisition with the new continuous acquisition mode. The aim of the study is to assess any difference in resolution from the resulting images acquired using the two modes of acquisition. Sequential series of studies were performed on a SPECT phantom using both modes of acquisition. Separate sets of data were collected for both high resolution parallel hole and ultra high resolution fan beam collimators. Clinical data was collected on patients undergoing routine gallium, 99m Tc-MDP bone and 99m Tc-HMPAO brain studies. Separate sequential acquisition in both modes were collected for each patient. The sequence of collection was also alternated. Reconstruction was performed utilising the same parameters for each acquisition. The reconstructed data were assessed visually by blinded observers to detect differences in resolution and image quality. No significant difference in the studies collected by either acquisition modes were detected. The time saved by continuous acquisition could be an advantage

Improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach.

Science.gov (United States)

Ralph, Anna P; Fittock, Marea; Schultz, Rosalie; Thompson, Dale; Dowden, Michelle; Clemens, Tom; Parnaby, Matthew G; Clark, Michele; McDonald, Malcolm I; Edwards, Keith N; Carapetis, Jonathan R; Bailie, Ross S

2013-12-18

Rheumatic heart disease (RHD) remains a major health concern for Aboriginal Australians. A key component of RHD control is prevention of recurrent acute rheumatic fever (ARF) using long-term secondary prophylaxis with intramuscular benzathine penicillin (BPG). This is the most important and cost-effective step in RHD control. However, there are significant challenges to effective implementation of secondary prophylaxis programs. This project aimed to increase understanding and improve quality of RHD care through development and implementation of a continuous quality improvement (CQI) strategy. We used a CQI strategy to promote implementation of national best-practice ARF/RHD management guidelines at primary health care level in Indigenous communities of the Northern Territory (NT), Australia, 2008-2010. Participatory action research methods were employed to identify system barriers to delivery of high quality care. This entailed facilitated discussion with primary care staff aided by a system assessment tool (SAT). Participants were encouraged to develop and implement strategies to overcome identified barriers, including better record-keeping, triage systems and strategies for patient follow-up. To assess performance, clinical records were audited at baseline, then annually for two years. Key performance indicators included proportion of people receiving adequate secondary prophylaxis (≥80% of scheduled 4-weekly penicillin injections) and quality of documentation. Six health centres participated, servicing approximately 154 people with ARF/RHD. Improvements occurred in indicators of service delivery including proportion of people receiving ≥40% of their scheduled BPG (increasing from 81/116 [70%] at baseline to 84/103 [82%] in year three, p = 0.04), proportion of people reviewed by a doctor within the past two years (112/154 [73%] and 134/156 [86%], p = 0.003), and proportion of people who received influenza vaccination (57/154 [37%] to 86/156 [55%], p�

The future of pharmaceutical quality and the path to get there.

Science.gov (United States)

Yu, Lawrence X; Kopcha, Michael

2017-08-07

While six sigma quality has long been achieved in other industries, it is rarely seen in the pharmaceutical sector. However, consumers and patients deserve six sigma quality pharmaceuticals with minimal risks of shortages or recalls. We propose that the future of pharmaceutical quality is six sigma, meaning that no more than 3.4 defects occur per million opportunities. We discuss the path to get there, including economic drivers, performance-based regulation, Quality by Design, advanced manufacturing technologies, and continuous improvement and operational excellence. This article outlines an ambitious goal and is intended to be thought-provoking in spite of the challenging path to get there. This goal is envisioned because it is in the best interest of patients and consumers and is realizable with continued advances and investments in science and technology. The fundamental destination of pharmaceutical quality has been long envisioned: a maximally efficient, agile, flexible pharmaceutical manufacturing sector that reliably produces high quality drugs without extensive regulatory oversight. Published by Elsevier B.V.

Continuous emission monitoring systems for power plants. The state-of-the-art

International Nuclear Information System (INIS)

Bamberger, J.A.

1988-01-01

Continuous monitoring of power plant emissions is performed to improve combustion and control equipment efficiency, and in response to various government agency requirements. This paper focuses upon recent developments in Continuous Emission Monitoring (CEM) and Systems (CEMS) for power plants. Topics presented include the perspective of the U.S. Environmental Protection Agency and the states: Continuous Monitoring of Power Plant Emissions - An EPA Perspective; Pennsylvania's Proposed Continuous Emission Monitoring System Data Telemetry Requirements for Municipal, Hospital and Infectious Waste Incinerators; the importance of quality assurance; Continuous Emission Monitoring and Quality Assurance Requirements for New Power Plants; Highlights of Pennsylvania's Continuous Emission Monitoring System Quality Assurance Program; improved system specifications and data acquisition methods; Improved Specifications for Continuous Emission Monitoring; A Microcomputer-Based Data Acquisition System for CEMS; CEMS applications; Expanded Use of CEMS in Acid Rain Control Programs: Opinions of Users, Control Agencies and Vendors; and an innovative measurement technique to assess electrostatic precipitator performance; The Assessment of Pulverized Coal Fly Ash Collection in Electrostatic Precipitators Using an Instrumental Assessment Technique

Quality indicators of continuous renal replacement therapy (CRRT) care in critically ill patients: a systematic review.

Science.gov (United States)

Rewa, Oleksa G; Villeneuve, Pierre-Marc; Lachance, Philippe; Eurich, Dean T; Stelfox, Henry T; Gibney, R T Noel; Hartling, Lisa; Featherstone, Robin; Bagshaw, Sean M

2017-06-01

Renal replacement therapy is increasingly utilized in the intensive care unit (ICU), of which continuous renal replacement therapy (CRRT) is most common. Despite CRRT being a relatively invasive and resource intensive technology, there remains wide practice variation in its application. This systematic review appraised the evidence for quality indicators (QIs) of CRRT care in critically ill patients. A comprehensive search strategy was developed and performed in five citation databases (Medline, Embase, CINAHL, Cochrane Library, and PubMed) and select grey literature sources. Two reviewers independently screened, selected, and extracted data using standardized forms. Each retrieved citation was appraised for quality using the Newcastle-Ottawa Scale (NOS) and Cochrane risk of bias tool. Data were summarized narratively. Our search yielded 8374 citations, of which 133 fulfilled eligibility. This included 97 cohort studies, 24 randomized controlled trials, 10 case-control studies, and 2 retrospective medical audits. The quality of retrieved studies was generally good. In total, 18 QIs were identified that were mentioned in 238 instances. Identified QIs were classified as related to structure (n = 4, 22.2 %), care processes (n = 9, 50.0 %), and outcomes (n = 5, 27.8 %). The most commonly mentioned QIs focused on filter lifespan (n = 98), small solute clearance (n = 46), bleeding (n = 30), delivered dose (n = 19), and treatment interruption (n = 5). Across studies, the definitions used for QIs evaluating similar constructs varied considerably. When identified, QIs were most commonly described as important (n = 144, 48.3 %), scientifically acceptable (n = 32, 10.7 %), and useable and/or feasible (n = 17, 5.7 %) by their primary study authors. We identified numerous potential QIs of CRRT care, characterized by heterogeneous definitions, varying quality of derivation, and limited evaluation. Further study is needed to prioritize a concise

Continuous integration and quality control for scientific software

Science.gov (United States)

Neidhardt, A.; Ettl, M.; Brisken, W.; Dassing, R.

2013-08-01

Modern software has to be stable, portable, fast and reliable. This is going to be also more and more important for scientific software. But this requires a sophisticated way to inspect, check and evaluate the quality of source code with a suitable, automated infrastructure. A centralized server with a software repository and a version control system is one essential part, to manage the code basis and to control the different development versions. While each project can be compiled separately, the whole code basis can also be compiled with one central “Makefile”. This is used to create automated, nightly builds. Additionally all sources are inspected automatically with static code analysis and inspection tools, which check well-none error situations, memory and resource leaks, performance issues, or style issues. In combination with an automatic documentation generator it is possible to create the developer documentation directly from the code and the inline comments. All reports and generated information are presented as HTML page on a Web server. Because this environment increased the stability and quality of the software of the Geodetic Observatory Wettzell tremendously, it is now also available for scientific communities. One regular customer is already the developer group of the DiFX software correlator project.

Pulse versus continuous peracetic acid applications: effects on Rainbow trout performance, biofilm formation and water quality

Science.gov (United States)

Peracetic acid (PAA) products are being introduced to aquaculture as sustainable disinfectants. Two strategies are used to apply PAA: short term high dose (1-2 mg L-1 PAA) periodic pulse applications or continuous low dose (< 0.2 mg L-1 PAA) applications. In the present study, these strategies and a...

Occupational Analysis: A Continuous Improvement Approach

National Research Council Canada - National Science Library

Duffy, Tom

1998-01-01

.... In doing so, the Air Force has implemented "Quality Air Force (QAF)" (AF Handbook 90-502). QAF is a leadership commitment that inspires trust, teamwork, and continuous improvement everywhere in the Air Force...

Evaluation of Measurements Collected with Multi-Parameter Continuous Water-Quality Monitors in Selected Illinois Streams, 2001-03

Science.gov (United States)

Groschen, George E.; King, Robin B.

2005-01-01

Eight streams, representing a wide range of environmental and water-quality conditions across Illinois, were monitored from July 2001 to October 2003 for five water-quality parameters as part of a pilot study by the U.S. Geological Survey (USGS) in cooperation with the Illinois Environmental Protection Agency (IEPA). Continuous recording multi-parameter water-quality monitors were installed to collect data on water temperature, dissolved-oxygen concentrations, specific conductivity, pH, and turbidity. The monitors were near USGS streamflow-gaging stations where stage and streamflow are continuously recorded. During the study period, the data collected for these five parameters generally met the data-quality objectives established by the USGS and IEPA at all eight stations. A similar pilot study during this period for measurement of chlorophyll concentrations failed to achieve the data-quality objectives. Of all the sensors used, the temperature sensors provided the most accurate and reliable measurements (generally within ?5 percent of a calibrated thermometer reading). Signal adjustments and calibration of all other sensors are dependent upon an accurate and precise temperature measurement. The dissolved-oxygen sensors were the next most reliable during the study and were responsive to changing conditions and accurate at all eight stations. Specific conductivity was the third most accurate and reliable measurement collected from the multi-parameter monitors. Specific conductivity at the eight stations varied widely-from less than 40 microsiemens (?S) at Rayse Creek near Waltonville to greater than 3,500 ?S at Salt Creek at Western Springs. In individual streams, specific conductivity often changed quickly (greater than 25 percent in less than 3 hours) and the sensors generally provided good to excellent record of these variations at all stations. The widest range of specific-conductivity measurements was in Salt Creek at Western Springs in the Greater Chicago