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Sample records for qi

  1. [Getting qi and arrival of qi].

    Science.gov (United States)

    Liu, Nong-Yu

    2014-08-01

    In order to clarify the inter-relationship between getting qi and arrival of qi, the relevant theory in the Inner Canon of Yellow Emperor is re-considered, and then the relationship of the two concepts by combining with some opinions from scholars is compared and analyzed. Getting qi is the signal of acupuncture at an acupoint; also it is a sign of arrival of qi at an acupoint; what's more, it is the premise for reinforcing or reducing manipulation. The sensation of arrival of qi comes from both doctors and patients, characterized with explicit symptoms including "tight and swift", "sunken, sticky and tight", "light, loose and slow", "warm at the acupoint" or "cold at the acupoint" as well as implicit symptom including "qi moving along the meridians"; also there is the condition of qi regulation that is characterized with "paced and harmony" stomach qi. The arrival of qi could be divided into "qi moving to the needles" and "qi traveling to the diseases". The "qi moving to the needles" has similar meaning to getting qi. The "qi traveling to the diseases" is reflected as "qi arrival with efficacy" and characterized as an immediate effect or a delayed effect. There are differences between the concepts of getting qi and arrival of qi. Getting qi focuses on the importance of the doctor during acupuncture processes (differentiate the nature of qi, guard qi, manipulate qi), which also suggests the clinical significance of implicit getting qi. "Arrival of qi" emphasizes "qi arrival with efficacy", and indicates that during treatment the differences of the exterior or interior and deficit or surplus should be distinguished. For external and shallow diseases involving myofascia-related diseases, miu needling and shallow needling can achieve an immediate treatment effect; for deep, internal and deficient diseases, reinforcing or reducing manipulation should be used to achieve stomach qi, which has delayed effects but can be used as an indicator. It is believed that pulse

  2. YI LING QI

    Indian Academy of Sciences (India)

    Home; Journals; Bulletin of Materials Science. YI LING QI. Articles written in Bulletin of Materials Science. Volume 40 Issue 7 December 2017 pp 1329-1333. Synthesis and enhanced photocatalytic activity of g-C 3 N 4 hybridized CdS nanoparticles · QING YING LIU YI LING QI YI FAN ZHENG XU CHUN SONG · More Details ...

  3. Interprofessional QI Training Enhances Competency and QI Productivity Among Graduates: Findings From Nationwide Children's Hospital.

    Science.gov (United States)

    Bartman, Thomas; Heiser, Karen; Bethune, Andrew; Crandall, Wallace; McClead, Richard; Davis, J Terrance; Brilli, Richard J

    2018-02-01

    Significant resources are expended on quality improvement (QI) training courses. The authors sought to determine whether education provided in QI course training improves self-assessed QI content competence and QI-related productivity among course graduates. "Quality Improvement Essentials" is a four-month didactic and experiential course designed to prepare multidisciplinary professionals to participate in and lead QI efforts at Nationwide Children's Hospital (NCH). This study used a milestone-based self-assessment survey of graduates from 2012 to 2014 to gauge change in participants' self-assessed QI competency after course completion. Four competency domains were evaluated: QI knowledge; testing and implementing change using teams; data management and analysis; and spreading and sustaining science. Metrics for assessing individual QI productivity were presentation or publication of QI work outside NCH; local, regional, or national QI teaching; serving on a local, regional, or national QI committee; appointment as a QI leader; involvement in an internal or external QI collaborative; and leading a maintenance of certification Part IV project approved by NCH. Course participation more than doubled participants' self-assessed QI competence across all four domains. Gains continued after the course, increasing with time rather than degrading. Self-assessed competency increase was significantly associated with increased QI productivity. Self-assessed QI competence dramatically improved after participation in an educational course and continued to increase over time. Increased self-assessed QI competency correlated with increased individual QI productivity. Further studies are necessary to fully evaluate "return on investment" for this type of course.

  4. Thermography applied acupuncture and qi-gong

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    Qin, Yuwen; Ji, Hong-Wei; Chen, Jin-Long; Li, Hong-Qi

    1997-04-01

    Thermographic technique can be used to measure temperature distribution of body surface in real-time, non-contact and full-field, which has been successfully used in medical diagnosis, remote sensing, and NDT, etc. The authors have developed a thermographic experiment that can be applied to inspect the effect of action of acupuncture and qi-gong (a system of deep breathing exercises) by measuring the temperature of hand and arm. The observation is performed respectively by thermography for the dynamic changes of temperature of the arm and hand after acupuncture therapy and qi-gong therapy. Thermographic results show that the temperature on the collateral channels increases markedly. In the meantime, it can be seen that the above therapies of Chinese medicine can stimulate the channel collateral system. This also contributes a new basis to the effect of action of the therapies of Chinese medicine. The work shows that thermographic technique is a powerful tool for research in Chinese medicine. In this paper, some thermal images are obtained from the persons treated with acupuncture and qi- gong.

  5. Three Identities of the Catalan-Qi Numbers

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    Mansour Mahmoud

    2016-05-01

    Full Text Available In the paper, the authors find three new identities of the Catalan-Qi numbers and provide alternative proofs of two identities of the Catalan numbers. The three identities of the Catalan-Qi numbers generalize three identities of the Catalan numbers.

  6. Three Identities of the Catalan-Qi Numbers

    OpenAIRE

    Mansour Mahmoud; Feng Qi

    2016-01-01

    In the paper, the authors find three new identities of the Catalan-Qi numbers and provide alternative proofs of two identities of the Catalan numbers. The three identities of the Catalan-Qi numbers generalize three identities of the Catalan numbers.

  7. Qi Liu - Bulletin of Materials Science | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Home; Journals; Bulletin of Materials Science. QI LIU. Articles written in Bulletin of Materials Science. Volume 34 Issue 2 April 2011 pp 183-189. Study of structural transformations and phases formation upon calcination of Zn–Ni–Al hydrotalcite nanosheets · Zhanshuang Li Yanchao Song Jun Wang Qi Liu Piaoping Yang ...

  8. 78 FR 43857 - Order Relating to Yaming Nina Qi Hanson

    Science.gov (United States)

    2013-07-22

    ... Hanson shall not take any action or make or permit to be made any public statement, directly or... intention to initiate an administrative proceeding against Qi Hanson pursuant to Section 766.3 of the Export..., delivering, storing, disposing of, forwarding, transporting, financing, or otherwise servicing in any way...

  9. Artemisiae Argyi Folium and its geo-authentic crude drug qi ai

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    Diangang Liu

    2017-01-01

    Conclusion: The superior quality of qi ai compared with general AAF may be due to relatively higher contents of bioactive components. This study provides basic information for further study and utilization of AAF and qi ai.

  10. Parental use of the term "Hot Qi" to describe symptoms in their children in Hong Kong: a cross sectional survey "Hot Qi" in children

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    Chan Danny

    2006-01-01

    Full Text Available Abstract Background The Chinese term "Hot Qi" is often used by parents to describe symptoms in their children. The current study was carried out to estimate the prevalence of using the Chinese term "Hot Qi" to describe symptoms in children by their parents and the symptomatology of "Hot Qi". Method A cross sectional survey by face-to-face interview with a semi-structured questionnaire was carried out in a public hospital and a private clinic in Hong Kong. The parental use of the term "Hot Qi", the symptoms of "Hot Qi" and the remedies used for "Hot Qi" were asked. Results 1060 pairs of children and parents were interviewed. 903 (85.1% of parents claimed that they had employed the term "Hot Qi" to describe their children's symptoms. Age of children and place of birth of parents were the predictors of parents using the term "Hot Qi". Eye discharge (37.2%, sore throat (33.9%, halitosis(32.8%, constipation(31.0%, and irritable (21.2% were the top five symptoms of "Hot Qi" in children. The top five remedies for "Hot Qi" were the increased consumption of water (86.8%, fruit (72.5%, soup (70.5%, and the use of herbal beverages "five-flower- tea" (a combination of several flowers such as Chrysanthemum morifolii, Lonicera japonica, Bombax malabaricum, Sophora japonica, and Plumeria rubra (57.6% or selfheal fruit spike (Prunella vulgaris (42.4%. Conclusion "Hot Qi" is often used by Chinese parents to describe symptoms in their children in Hong Kong. Place of birth of parents and age of the children are main factors for parents to apply the term "Hot Qi" to describe symptoms of their children. The common symptoms of "Hot Qi" suggest infections or allergy.

  11. Tai Chi and Qi Gong for Health and Well-Being

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    Full Text Available ... Tai Chi and Qi Gong for Health and Well-Being Share: © Mariann Seriff The following video is intended ... Tai Chi and Qi Gong for Health and Well-Being Video › Tai Chi and Qi Gong for Health ...

  12. Tai Chi and Qi Gong for Health and Well-Being

    Science.gov (United States)

    ... Tai Chi and Qi Gong for Health and Well-Being Share: © Mariann Seriff The following video is intended ... Tai Chi and Qi Gong for Health and Well-Being Video › Tai Chi and Qi Gong for Health ...

  13. Tai Chi and Qi Gong for Health and Well-Being

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    Full Text Available ... Chi and Qi Gong for Health and Well-Being Share: © Mariann Seriff The following video is intended ... Chi and Qi Gong for Health and Well-Being Video › Tai Chi and Qi Gong for Health ...

  14. Acupuncture phenomenon of the Qi energy complete awakening

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    Viktor N. Skakov

    2013-11-01

    Full Text Available Aims The aim is to study the phenomenon of the Qi energy complete awakening using the acupuncture method and the reactions appearing during this process that lead to recovery of the body and of the cardiovascular system first of all. Materials and methods The study is based on the classical acupuncture method using the unique technique of effecting the points by I-Ching. Results The result is the body recovering the pathologic diseases the patient has been suffering for decades. Conclusion The new method for acupuncture is the Qi energy complete awakening based on structuring the Qi energy in the acupoints according to the figures of gua (trigrams and hexagrams in the Chinese Canon of Changes and can be used for the treatment of almost any kind of the disease including cardiovascular. The given method allows not only balancing the Yin and Yang energy in the human body but also launching the generalized recovery program concentrated in the deepest layers of the human genetic memory. The given method allows treating many diseases considered to be incurable by the official medicine.

  15. [Comparative analysis on the biological basis of blood stasis syndrome induced by qi-stagnation and qi-deficiency in patients with unstable angina pectoris].

    Science.gov (United States)

    Ren, Jian-xun; Liu, Jian-xun; Lin, Cheng-ren

    2010-04-01

    To comparatively analyse the objective characteristics of different syndrome types of qi-disturbance-induced blood stasis syndrome (QDBS) in the pathogenetic evolution of unstable angina coronary heart disease (UA-CHD). Seventy-eight patients with UA-CHD of QDBS were differentiated into 2 groups: 55 in the qi-deficiency-induced blood-stasis syndrome group (A) and 23 in the qi-stagnation-induced blood-stasis syndrome group (B). The comparative analysis on them was carried out through comparing their blood pressure, glucose and lipid metabolisms, coagulation function, thyroid function and inflammation reaction changes, etc. In the pathogenetic process of qi-disturbance induced blood stasis, the initiating age, levels of HbA1c, TSH, PT and APTT between the two groups were significantly different (P emotional stress is possibly the essence of qi-stagnation induced blood stasis syndrome.

  16. QiShenYiQi Pills, a Compound Chinese Medicine, Prevented Cisplatin Induced Acute Kidney Injury via Regulating Mitochondrial Function

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    Li Zhou

    2017-12-01

    Full Text Available Nephrotoxicity is a serious adverse effect of cisplatin chemotherapy that limits its clinical application, to deal with which no effective management is available so far. The present study was to investigate the potential protective effect of QiShenYiQi Pills (QSYQ, a compound Chinese medicine, against cisplatin induced nephrotoxicity in mice. Pretreatment with QSYQ significantly attenuated the cisplatin induced increase in plasma urea and creatinine, along with the histological damage, such as tubular necrosis, protein cast, and desquamation of epithelial cells, improved the renal microcirculation disturbance as indicated by renal blood flow, microvascular flow velocity, and the number of adherent leukocytes. Additionally, QSYQ prevented mitochondrial dysfunction by preventing the cisplatin induced downregulation of mitochondrial complex activity and the expression of NDUFA10, ATP5D, and Sirt3. Meanwhile, the cisplatin-increased renal thiobarbituric acid-reactive substances, caspase9, cleaved-caspase9, and cleaved-caspase3 were all diminished by QSYQ pretreatment. In summary, the pretreatment with QSYQ remarkably ameliorated the cisplatin induced nephrotoxicity in mice, possibly via the regulation of mitochondrial function, oxidative stress, and apoptosis.

  17. [Professor GAO Yuchun's experience on "sequential acupuncture leads to smooth movement of qi"].

    Science.gov (United States)

    Wang, Yanjun; Xing, Xiao; Cui, Linhua

    2016-01-01

    Professor GAO Yuchun is considered as the key successor of GAO's academic school of acupuncture and moxibustion in Yanzhao region. Professor GAO's clinical experience of, "sequential acupuncture" is introduced in details in this article. In Professor GAO's opinions, appropriate acupuncture sequence is the key to satisfactory clinical effects during treatment. Based on different acupoints, sequential acupuncture can achieve the aim of qi following needles and needles leading qi; based on different symptoms, sequential acupuncture can regulate qi movement; based on different body positions, sequential acupuncture can harmonize qi-blood and reinforcing deficiency and reducing excess. In all, according to the differences of disease condition and constitution, based on the accurate acupoint selection and appropriate manipulation, it is essential to capture the nature of diseases and make the order of acupuncture, which can achieve the aim of regulating qi movement and reinforcing deficiency and reducing excess.

  18. [Guiding-qi acupuncture for dry eye syndrome].

    Science.gov (United States)

    Xie, Wenzhang; Zeng, Liang; Tao, Ying; Zhou, Yingfan; Zhao, Ran; Huang, Xinyun; Hou, Wenguang; Zhang, Ren; Zong, Lei

    2018-02-12

    To observe the clinical efficacy differences between different needling methods for dry eye syndrome. Sixty patients of dry eye syndrome were randomly divided into an observation group and a control group, 30 cases (60 eyes) in each group. Shangjingming (Extra), Xiajingming (Extra), Tongziliao (GB 1), Cuanzhu (BL 2), Fengchi (GB 20), Hegu (LI 4), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3) were selected in the two groups. The control group was treated with conventional acupuncture, while the observation group was treated with guiding- qi acupuncture. Electroacupuncture (EA) was used at bilateral Tongziliao (GB1) and Cuanzhu (BL 2), 30 min per treatment. The treatment was given three times per week. Totally 1-month treatment (12 treatments) was given. The eye symptom score, breakup time of tear film (BUT), Schirmer Ⅰ test (SⅠT) and visual analogue scale (VAS) score were compared before and after treatment in the two groups. The clinical efficacy was compared between the two groups. Compared before treatment, the eye symptom score, BUT, SⅠT and VAS score were improved after treatment in the two groups (all P eye symptom score and SⅠT in the observation group were superior to those in the control group (both P 0.05). The total effective rate was 86.7% (52/60) in the observation group, which was superior to 73.3% (44/60) in the control group ( P dry eye syndrome, and the efficacy of guiding- qi acupuncture combined with EA is superior to that of conventional EA.

  19. Cardioprotective Effects of QiShenYiQi Dripping Pills on Transverse Aortic Constriction-Induced Heart Failure in Mice.

    Science.gov (United States)

    Ruan, Guoran; Ren, Haojin; Zhang, Chi; Zhu, Xiaogang; Xu, Chao; Wang, Liyue

    2018-01-01

    QiShenYiQi dripping pills (QSYQ), a traditional Chinese medicine, are commonly used to treat coronary heart disease, and QSYQ was recently approved as a complementary treatment for ischemic heart failure in China. However, only few studies reported on whether QSYQ exerts a protective effect on heart failure induced by pressure overload. In this study, we explored the role of QSYQ in a mouse model of heart failure induced by transverse aortic constriction (TAC). Twenty-eight C57BL/6J mice were divided into four groups: Sham + NS group, Sham + QSYQ group, TAC + NS group, and TAC + QSYQ group. QSYQ dissolved in normal saline (NS) was administered intragastrically (3.5 mg/100 g/day) in the Sham + QSYQ and TAC + QSYQ groups. In the Sham + NS and TAC + NS groups, NS was provided every day intragastrically. Eight weeks after TAC, echocardiography, and cardiac catheterization were performed to evaluate the cardiac function, and immunofluorescent staining with anti-actinin2 antibody was performed to determine the structure of the myocardial fibers. Moreover, TUNEL staining and Masson trichrome staining were employed to assess the effects of QSYQ on cardiac apoptosis and cardiac fibrosis. Western blots and real-time polymerase chain reaction (PCR) were used to measure the expression levels of vascular endothelial growth factor (VEGF) in the heart, and immunohistochemical staining with anti-CD31 antibody was performed to explore the role of QSYQ in cardiac angiogenesis. Results showed that TAC-induced cardiac dysfunction and disrupted structure of myocardial fibers significantly improved after QSYQ treatment. Moreover, QSYQ treatment also significantly improved cardiac apoptosis and cardiac fibrosis in TAC-induced heart failure, which was accompanied by an increase in VEGF expression levels and maintenance of microvessel density in the heart. In conclusion, QSYQ exerts a protective effect on TAC-induced heart failure, which could be attributed to enhanced cardiac angiogenesis

  20. Tai Chi and Qi Gong for Health and Well-Being

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  1. Logarithmically complete monotonicity of a function related to the Catalan-Qi function

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    Qi Feng

    2016-08-01

    Full Text Available In the paper, the authors find necessary and sufficient conditions such that a function related to the Catalan-Qi function, which is an alternative generalization of the Catalan numbers, is logarithmically complete monotonic.

  2. [Qi as a materialist concept on the level of medical philosophy].

    Science.gov (United States)

    Su, Zhan-Qing

    2005-03-01

    This paper has made a distinction between the materialist concept of qi on the medical philosophical level and its substantial existence, and illustrated the materiality and multiplicity of qi. Materiality refers to the objective reality, a summation of various things or phenomena related to human beings; while multiplicity refers to diversity of specific substances, each holding its individual essence. Based on two essential conceptions "xiang" and "xiangji", and combining the theories of traditional Chinese medicine and Western medicine, this paper has also made a preliminary study on the substantial existence of qi at macro- and micro-levels, and on physiological (normal) and pathological (abnormal) aspects. It is the author's argument that studies of the substantial existence of qi from different aspects, micro-dimension in particular, will push the syndrome differentiation of traditional Chinese medicine to a more subtle sphere.

  3. Tai Chi and Qi Gong for Health and Well-Being

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    Full Text Available ... tool that features tai chi and qi gong as an activity to enhance wellness. These exercise therapies ... care approaches used to promote a healthy lifestyle. As always, talk to your health care provider if ...

  4. Weaker cognitive control abilities of Pi (Spleen) qi-deficient individuals supported Chinese medicine diagnosis.

    Science.gov (United States)

    Lin, Hui-Yan; Zhao, Yan-Ping; Xu, Gui-Ping; Li, Yun-Si; Xie, Wei-Yun; Bai, Li-Hua; Jin, Hua

    2017-07-28

    To investigate whether Pi (Spleen) qi-deficiency affected psychological and neural responses in relevance to cognitive control. Pi qi-deficient and balanced participants were asked to perform the Stroop task, a classical cognitive control paradigm. In this paradigm, participants had to judge the color of the prompted word. The word's meaning indicated the color (the consistent condition) or not (the inconsistent condition), or were unrelated to the color (the neutral condition). Electroencephalograph (EEG) was recorded during the task. Event-related potential (ERP) results showed that Pi qi-deficient individuals failed to exhibit a normal Stroop effect as Balanced individuals did, such as the accuracy differences between the consistent and the inconsistent conditions as well as the N450 effect (P>0.05). Meanwhile, Pi qi-deficient individuals displayed larger P2 and P3 amplitudes than balanced individuals did during performing the cognitive control task (Pcognitive control aspect.

  5. [Discussion on needling sensation, arrival of qi and needling response (Deqi)].

    Science.gov (United States)

    Zhang, Fang; Wang, Hong-Du

    2012-12-01

    The current appointed teaching material of Science of Acupuncture and Moxibustion holds that there is no difference among the needling sensation, arrival of qi and needling response. However, the author has a different understanding. Therefore, Neijing (Internal Classic), its annotation, exposition and understandings of ancient and modern famous experts are cited to analyze their meanings. And the result indicates that the needling sensation is subjective feelings and perceived responses of doctors and patients. Arrival of qi is the healing process of the organ through activating the anti-pathogenic qi to expel the pathogens. The needling response is the final aim of acupuncture therapy. Thus, the meaning of needling sensation, arrival of qi, and needling response are different. And an accurate understanding can better guide acupuncture treatment.

  6. Feasibility of a virtual learning collaborative to implement an obesity QI project in 29 pediatric practices.

    Science.gov (United States)

    John, Tamara; Morton, Michaela; Weissman, Mark; O'Brien, Ellen; Hamburger, Ellen; Hancock, Yolandra; Moon, Rachel Y

    2014-04-01

    Quality improvement (QI) activities are required to maintain board certification in pediatrics. However, because of lack of training and resources, pediatricians may feel overwhelmed by the need to implement QI activities. Pediatricians also face challenges when caring for overweight and obese children. To create a virtual (online) QI learning collaborative through which pediatric practices could easily develop and implement a continuous QI process. Prospective cohort. Pediatric practices that were part of the Children's National Health Network were invited to participate, with the option to receive continuing medical education and maintenance of certification credits. s) Practices conducted baseline and monthly chart audits, participated in educational webinars and selected monthly practice changes, using Plan-Do-Study-Act cycles. Practices reported activities monthly and periodic feedback was provided to practices about their performance. s) Improvement in (i) body mass index (BMI) percentile documentation, (ii) appropriate nutritional and activity counseling and (iii) follow-up management for high-risk patients. Twenty-nine practices (120 providers) participated, and 24 practices completed all program activities. Monthly chart audits demonstrated continuous improvement in documentation of BMI, abnormal weight diagnosis, nutrition and activity screening and counseling, weight-related health messages and follow-up management of overweight and obese patients. Impact of QI activities on visit duration and practice efficiency was minimal. A virtual learning collaborative was successful in providing a framework for pediatricians to implement a continuous QI process and achieve practice improvements. This format can be utilized to address multiple health issues.

  7. THE ERUPTION OF THE CANDIDATE YOUNG STAR ASASSN-15QI

    Energy Technology Data Exchange (ETDEWEB)

    Herczeg, Gregory J.; Dong, Subo; Chen, Ping; Jose, Jessy; Gully-Santiago, Michael [Kavli Institute for Astronomy and Astrophysics, Peking University, Yi He Yuan Lu 5, Haidian Qu, 100871 Beijing (China); Shappee, Benjamin J. [Carnegie Observatories, 813 Santa Barbara Street, Pasadena, CA 91101 (United States); Hillenbrand, Lynne A. [Caltech, MC 105-24, 1200 E. California Boulevard, Pasadena, CA 91125 (United States); Kochanek, Christopher S.; Stanek, K. Z.; Holoien, Thomas W.-S. [Department of Astronomy, The Ohio State University, 140 West 18th Avenue, Columbus, OH 43210 (United States); Prieto, Jose L. [Núcleo de Astronomía de la Facultad de Ingeniería, Universidad Diego Portales, Av. Ejército 441, Santiago (Chile); Kaplan, Kyle [Department of Astronomy, The University of Texas at Austin, Austin, TX 78712 (United States); Mairs, Steve; Johnstone, Doug [Department of Physics and Astronomy, University of Victoria, Victoria, BC, V8P 1A1 (Canada); Zhu, Zhaohuan [Department of Astrophysical Sciences, 4 Ivy Lane, Peyton Hall, Princeton University, Princeton, NJ 08544 (United States); Smith, Martin C. [Key Laboratory for Research in Galaxies and Cosmology, Shanghai Astronomical Observatory, Chinese Academy of Sciences, 80 Nandan Road, Shanghai 200030 (China); Bersier, David [Astrophysics Research Institute, Liverpool Science Park, 146 Brownlow Hill, Liverpool L3 5RF (United Kingdom); Mulders, Gijs D. [Lunar and Planetary Laboratory, The University of Arizona, Tucson, AZ 85721 (United States); Filippenko, Alexei V. [Department of Astronomy, University of California, Berkeley, CA 94720-3411 (United States); Ayani, Kazuya, E-mail: gherczeg1@gmail.com [Bisei Astronomical Observatory, 1723-70 Okura, Bisei, Ibara, Okayama 714-1411 (Japan); and others

    2016-11-10

    Outbursts on young stars are usually interpreted as accretion bursts caused by instabilities in the disk or the star–disk connection. However, some protostellar outbursts may not fit into this framework. In this paper, we analyze optical and near-infrared spectra and photometry to characterize the 2015 outburst of the probable young star ASASSN-15qi. The ∼3.5 mag brightening in the V band was sudden, with an unresolved rise time of less than one day. The outburst decayed exponentially by 1 mag for 6 days and then gradually back to the pre-outburst level after 200 days. The outburst is dominated by emission from ∼10,000 K gas. An explosive release of energy accelerated matter from the star in all directions, seen in a spectacular cool, spherical wind with a maximum velocity of 1000 km s{sup −1}. The wind and hot gas both disappeared as the outburst faded and the source returned to its quiescent F-star spectrum. Nebulosity near the star brightened with a delay of 10–20 days. Fluorescent excitation of H{sub 2} is detected in emission from vibrational levels as high as v = 11, also with a possible time delay in flux increase. The mid-infrared spectral energy distribution does not indicate the presence of warm dust emission, though the optical photospheric absorption and CO overtone emission could be related to a gaseous disk. Archival photometry reveals a prior outburst in 1976. Although we speculate about possible causes for this outburst, none of the explanations are compelling.

  8. On the qi deficiency in traditional Chinese medicine.

    Science.gov (United States)

    Chiang, Hui-Chu; Chang, Hen-Hong; Huang, Po-Yu; Hsu, Mutsu

    2014-09-01

    Qi deficiency (QD), one of the most common disorders in Traditional Chinese medicine (TCM), is relevant to many disorders in obstetrics and gynecology. This study aimed to identify the common processes and criteria for diagnosing QD among contemporary proficient TCM practitioners. Steps of decision tree analysis and modified Delphi method were merged together into four-round postal questionnaires to collect qualitative and quantitative data. Open-ended questions and content analysis were used to explore the proficient TCM practitioners' cognitive activities used for diagnosis. The statements obtained from the qualitative responses were used to develop the items for subsequent questionnaires. Based on the TCM practitioners' responses, the diagnostic processes and criteria for making diagnosis were generated. Twenty-eight out of the 30 participants completed all four questionnaires from June 2007 to January 2010. The 11 diagnostic procedures identified in the returned first round of questionnaires were used as the alternatives to select and rank for all the steps to diagnose QD. After three more rounds of postal surveys, an algorithm with a five-stage diagnostic process as well as sets of decision criteria were identified. Although the priorities of procedures and descriptions of reasoning were varied, the content revealed the major themes in the model. The criteria to differentiate signs and symptoms (S/S) included five principles for correlating S/S with QD, and 17 S/S should be differentiated carefully. The results demonstrate that the TCM practitioners precisely diagnosed QD using a number of specific procedures and criteria that could be used as a reference to understand women complaining of S/S that could be similar to QD. Copyright © 2014. Published by Elsevier B.V.

  9. Qing-Qi Rickshaw : A Boon Or Bane For Public Transportation? A Study Of Road Traffic Injury Patterns Involving Qing-Qi Rickshaws In Karachi Pakistan.

    Science.gov (United States)

    Muzzammil, Muhammad; Minhas, Muhammad Saeed; Effendi, Jahanzeb; Jahanzeb, Syed; Mughal, Ayesha; Qadir, Abdul

    2017-01-01

    The three-wheeler Qing-qi and Compressed Natural Gas (CNG) auto-rickshaws were introduced in Karachi to meet the transportation demand of the growing population. These vehicles have directly or indirectly been implicated in a number of road traffic violations as well as road accidents. This study aims to describe the crash characteristics and injury patterns for Qing-qi rickshaw occupants and other road users hit by Qing-qi rickshaw in Karachi, Pakistan. An Observational/ Descriptive study was conducted at Accident & Emergency and Orthopaedic Surgery Department, Jinnah Post Graduate Medical Centre, Karachi Pakistan from July 2014 to June 2015.All patients who came with Qing-qi rickshaw accident in Accident & Emergency (A&E) of JPMC were included. Crash characteristics, details of injuries, injury severity parameters and outcome were documented in detailed interviews. Four hundred and eighty-six rickshaw related injuries were noted in road traffic accidents by Qing-gi rickshaw. Age range was 2-85 (43.5±58.68). 350 injured victims were males and 136 were females. By occupation most victims were laborers and daily wage workers (45%) and students (21%). Overloading of vehicle with more than two passengers was found in (28.5%). The most common cause of injury was collision with a moving vehicle (56%), followed by fall from rickshaw. The most common contributing factor was the overloading of rickshaw and roll over on turning (61%). Injury severity on arrival were mild (49%), moderate were (32%), and severe were (19%). Injuries related to head and neck (26%), face (14%), thorax and abdomen (5%), lower extremity and pelvic girdle (31%) and upper extremity (23%) were observed. Qing-qi rickshaw injuries are common and these vehicles are vulnerable to road traffic accidents. Occupants and road users are both at risk of injuries.

  10. Making cognitive decision support work: Facilitating adoption, knowledge and behavior change through QI.

    Science.gov (United States)

    Weir, Charlene; Brunker, Cherie; Butler, Jorie; Supiano, Mark A

    2017-07-01

    This paper evaluates the role of facilitation in the successful implementation of Computerized Decision Support (CDS). Facilitation processes include education, specialized computerized decision support, and work process reengineering. These techniques, as well as modeling and feedback enhance self-efficacy, which we propose is one of the factors that mediate the effectiveness of any CDS. In this study, outpatient clinics implemented quality improvement (QI) projects focused on improving geriatric care. Quality Improvement is the systematic process of improving quality through continuous measurement and targeted actions. The program, entitled "Advancing Geriatric Education through Quality Improvement" (AGE QI), consisted of a 6-month, QI based, intervention: (1) 2h didactic session, (2) 1h QI planning session, (3) computerized decision support design and implementation, (4) QI facilitation activities, (5) outcome feedback, and (6) 20h of CME. Specifically, we examined the impact of the QI based program on clinician's perceived self-efficacy in caring for older adults and the relationship of implementation support and facilitation on perceived success. The intervention was implemented at 3 institutions, 27 community healthcare system clinics, and 134 providers. This study reports the results of pre/post surveys for the forty-nine clinicians who completed the full CME program. Self-efficacy ratings for specific clinical behaviors related to care of older adults were assessed using a Likert based instrument. Self-ratings of efficacy improved across the following domains (depression, falls, end-of-life, functional status and medication management) and specifically in QI targeted domains and were associated with overall clinic improvements. Published by Elsevier Inc.

  11. Relationship between endogenous hydrogen sulfide and blood stasis syndrome based on the Qi-blood theory of Chinese medicine.

    Science.gov (United States)

    Li, Wei-wei; Guo, Hao; Wang, Xue-mei

    2013-09-01

    "Qi" and "blood" are two essential concepts in Chinese medicine (CM). As qi is intangible, the concept of qi is still controversial between CM and Western medicine. However, the endogenous hydrogen sulfide (H2S) and other gaseous signaling molecules provides a new approach for understanding the essence of qi in CM. Blood stasis syndrome is a common syndrome in CM. According to the CM theory, the incidence of blood stasis syndrome is closely correlated to the reckless movement of qi, as qi and blood are inseparable in regulating physiological functions. In recent years, more and more evidences suggest a close correlation between blood stasis syndrome and microcirculation dysfunction. In this paper, we discuss the relationship between endogenous H2S and blood stasis syndrome based on qi-blood theory of CM. We found that endogenous H2S maybe a material basis in concept of qi in CM, while dysfunctional microcirculation is the pathological basis of the blood stasis syndrome. As qi is closely associated with incidence and progression of blood stasis syndrome, endogenous H2S may play an important role in preventing and treating the blood stasis syndrome by improving the function of microcirculation.

  12. Qi Gong exercises and Feldenkrais method from the perspective of Gestalt concept and humanistic psychology.

    Science.gov (United States)

    Posadzki, Paul; Stöckl, Andrea; Mucha, Dariusz

    2010-07-01

    This study describes two similar approaches to human movement: Qi Gong exercises and the Feldenkrais method. These systems are investigated in terms of Gestalt concepts and humanistic psychology. Moshe Feldenkrais created the concept known as Awareness Through Movement. This concept assumes that by becoming more aware of one's movements, one functions at a higher level. In similar ways to those using the Feldenkrais method, individuals may become more aware of their own movements by performing Qi Gong exercises: A therapeutic modality that facilitates mind-body integration. Qi Gong exercises commonly lead to increased personal awareness accompained by enhanced quality, fluency and smoothness of movement. These two methods of movement therapies are explored in terms of their relations with Gestalt concept and humanistic psychology. (c) 2008. Published by Elsevier Ltd. All rights reserved.

  13. Some properties of the Catalan-Qi function related to the Catalan numbers.

    Science.gov (United States)

    Qi, Feng; Mahmoud, Mansour; Shi, Xiao-Ting; Liu, Fang-Fang

    2016-01-01

    In the paper, the authors find some properties of the Catalan numbers, the Catalan function, and the Catalan-Qi function which is a generalization of the Catalan numbers. Concretely speaking, the authors present a new expression, asymptotic expansions, integral representations, logarithmic convexity, complete monotonicity, minimality, logarithmically complete monotonicity, a generating function, and inequalities of the Catalan numbers, the Catalan function, and the Catalan-Qi function. As by-products, an exponential expansion and a double inequality for the ratio of two gamma functions are derived.

  14. Efficacy of integrative medicine in deficiency of both qi and yin in the rat model of type 2 diabetes

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    Jing Zhao

    2015-10-01

    Conclusions: A rat model of T2DM with both qi and yin deficiency was successfully replicated. CHF appeared to be more efficacious than IM and PIO in the rat model of qi and yin deficiency pattern of T2DM, though IM and PIO were each found to have their merits and drawbacks in attenuating T2DM indicators in the rat model.

  15. Education in Quality Improvement for Pediatric Practice: an online program to teach clinicians QI.

    Science.gov (United States)

    Bundy, David G; Morawski, Lori F; Lazorick, Suzanne; Bradbury, Scott; Kamachi, Karen; Suresh, Gautham K

    2014-01-01

    Education in Quality Improvement for Pediatric Practice (EQIPP) is an online program designed to improve evidence-based care delivery by teaching front-line clinicians quality improvement (QI) skills. Our objective was to evaluate EQIPP data to characterize 1) participant enrollment, use patterns, and demographics; 2) changes in performance in clinical QI measures from baseline to follow-up measurement; and 3) participant experience. We conducted an observational study of EQIPP participants utilizing 1 of 3 modules (asthma, immunizations, gastroesophageal reflux disease) from 2009 to 2013. Enrollment and use, demographic, and quality measure data were extracted directly from the EQIPP system; participant experience was assessed via an optional online survey. Study participants (n = 3501) were diverse in their gender, age, and race; most were board certified. Significant quality gaps were observed across many of the quality measures at baseline; sizable improvements were observed across most quality measures at follow-up. Participants were generally satisfied with their experience. The most influential module elements were collecting and analyzing data, creating and implementing aim statements and improvement plans, and completing "QI Basics." Online educational programs, such as EQIPP, hold promise for front-line clinicians to learn QI. The sustainability of the observed improvements in care processes and their linkage to improvements in health outcomes are unknown and are an essential topic for future study. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  16. Tai Chi and Qi Gong for Health and Well-Being

    Medline Plus

    Full Text Available ... The following video is intended to be an educational tool that features tai chi and qi gong as an activity to enhance wellness. These exercise therapies are generally considered safe, self-care approaches used to promote a healthy lifestyle. As always, talk to your health care provider if you are ...

  17. Effect of Qi Ming Granule on the choroidal circulation in diabetic patients

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    Ke-Jun Li

    2016-03-01

    Full Text Available AIM:To investigate the effect of a Chinese medicine(Qi Ming granuleon the retinal and choroidal circulation in diabetes patients. METHODS: According to the results of fundus fluorescein angiography(FFA, all the 45 diabetes patients were divided into no diabetic retinopathy(NDRgroup and nonproliferative diabetic retinopathy(NPDRgroup. All subjects were examined by FFA and indocyanine green angiography(ICGAat the same time. After taken Qi Ming granule for 3mo, all subjects were examined by the same method. FFA and ICGA were used to evaluate the retinal and choroidal circulation and their features. The key points were filling time for the retinal and choroidal circulation before and after treatments. The accuracy data was used to evaluate the effect.RESULTS: After taken Qi Ming granule for 3mo, there were significant decrease of the retina and the choroid filling time in NDR and NPDR groups. The occurrence rate of various abnormal angiographic features were significantly decreased. CONCLUSION: Qi Ming granule can accelerate the blood flow of retina and choroid, improve the blood circulation in diabetes patients, and delay the occurrence and development of diabetic retinopathy.

  18. Requirement of histidine 217 for ubiquinone reductase activity (Qi site) in the cytochrome bc1 complex.

    Science.gov (United States)

    Gray, K A; Dutton, P L; Daldal, F

    1994-01-25

    Folding models suggest that the highly conserved histidine 217 of the cytochrome b subunit from the cytochrome bc1 complex is close to the quinone reductase (Qi) site. This histidine (bH217) in the cytochrome b polypeptide of the photosynthetic bacterium Rhodobacter capsulatus has been replaced with three other residues, aspartate (D), arginine (R), and leucine (L). bH217D and bH217R are able to grow photoheterotrophically and contain active cytochrome bc1 complexes (60% of wild-type activity), whereas the bH217L mutant is photosynthetically incompetent and contains a cytochrome bc1 complex that has only 10% of the wild-type activity. Single-turnover flash-activated electron transfer experiments show that cytochrome bH is reduced via the Qo site with near native rates in the mutant strains but that electron transfer between cytochrome bH and quinone bound at the Qi site is greatly slowed. These results are consistent with redox midpoint potential (Em) measurements of the cytochrome b subunit hemes and the Qi site quinone. The Em values of cyt bL and bH are approximately the same in the mutants and wild type, although the mutant strains have a larger relative concentration of what may be the high-potential form of cytochrome bH, called cytochrome b150. However, the redox properties of the semiquinone at the Qi site are altered significantly. The Qi site semiquinone stability constant of bH217R is 10 times higher than in the wild type, while in the other two strains (bH217D and bH217L) the stability constant is much lower than in the wild type. Thus H217 appears to have major effects on the redox properties of the quinone bound at the Qi site. These data are incorporated into a suggestion that H217 forms part of the binding pocket of the Qi site in a manner reminiscent of the interaction between quinone bound at the Qb site and H190 of the L subunit of the bacterial photosynthetic reaction center.

  19. The Chinese Herb Yi-Qi-Huo-Xue Protects Cardiomyocyte Function in Diabetic Cardiomyopathy

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    Xiangsheng Wang

    2018-01-01

    Full Text Available Aims. To study the effect of the Chinese herb Yi-qi-huo-xue on cardiomyopathy in diabetic rats. Methods. Rats were fed a high fat and high glucose diet and injected with 50 ml/kg streptozotocin (STZ to induce diabetic cardiomyopathy (DCM, followed by treatment with Yi-qi-huo-xue for 4 weeks. We measured the rats’ heart weight index, observed the myocardial morphology using hematoxylin eosin (HE staining, and determined the content of collagen types I and III in the myocardium using enzyme-linked immunosorbent assay (ELISA. We determined Bcl-2, Bax, and P53 protein expression by Western blot analysis and the cardiomyocyte apoptosis rate via a flow cytometry assay. Results. Compared with the rats in the control group, the diabetic rats gained weight and had increased blood sugar levels, an enhanced heart weight index, and increased myocardial pathophysiological damage. There was a decrease in their Bcl-2 expression, and their Bax and P53 expression increased. The Bcl-2/Bax ratio was enhanced, and there was an increase in the content of collagen types I and III in the myocardium. After treatment with Yi-qi-huo-xue, all levels listed above returned to normal. Conclusion. The Chinese herb Yi-qi-huo-xue degraded the myocardial interstitial collagen types I and III to protect the myocardium of the diabetic rats, thus delaying the role of myocardial fibrosis. Yi-qi-huo-xue could play an important role in protecting the myocardium of DCM rats by enhancing the expression of the Bcl-2 protein, inhibiting the expression of the Bax and P53 proteins, increasing the ratio of Bcl-2/Bax, and inhibiting the apoptosis of cardiomyocytes.

  20. Brain areas involved in acupuncture needling sensation of de qi: a single-photon emission computed tomography (SPECT) study.

    Science.gov (United States)

    Chen, Jia-Rong; Li, Gan-Long; Zhang, Gui-Feng; Huang, Yong; Wang, Shu-Xia; Lu, Na

    2012-12-01

    De qi is a sensory response elicited by acupuncture stimulation. According to traditional Chinese medicine (TCM), de qi is essential for clinical efficacy. However, the understanding of the neurobiological basis of de qi is still limited. To investigate the relationship between brain activation and de qi by taking a single-photon emission computed tomography (SPECT) scan while applying acupuncture at TE5. A total of 24 volunteers were randomly divided into 4 groups, and received verum or sham acupuncture at true acupuncture point TE5 or a nearby sham point according to grouping. All subjects then received a (99m)Tc-ethylcysteinate dimer (ECD) SPECT scan. All six subjects in the verum acupuncture at true acupuncture point group experienced de qi sensation; in contrast, all six subjects in the sham acupuncture at the sham point group responded with nothing other than non-sensation. Compared to the scan results from subjects who experienced non-sensation, SPECT scans from subjects with de qi sensation demonstrated significant activated points mainly located in brodmann areas 6, 8, 19, 21, 28, 33, 35, 37, 47, the parahippocampal gyrus, lentiform nucleus, claustrum and red nucleus; deactivated points were seen in brodmann areas 9 and 25. Verum acupuncture at true acupuncture points is more likely to elicit de qi sensation. De qi sensations mainly resulted in brain area activations, but not deactivations. These brain areas are related to the curative effect of Te5. The acupuncture needle sensations of de qi and sharp pain are associated with different patterns of activations and deactivations in the brain.

  1. The Contribution of Different Components in QiShenYiQi Pills® to Its Potential to Modulate Energy Metabolism in Protection of Ischemic Myocardial Injury

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    Yuan-Chen Cui

    2018-04-01

    Full Text Available Ischemic heart diseases remain a challenge for clinicians. QiShenYiQi pills® (QSYQ has been reported to be curative during coronary heart diseases with modulation of energy metabolism as one of the underlying mechanisms. In this study, we detected the effect of QSYQ and its components on rat myocardial structure, mitochondrial respiratory chain complexes activity and energy metabolism, and heart function after 30 min of cardiac ischemia, with focusing on the contribution of each component to its potential to regulate energy metabolism. Results showed that treatment with QSYQ and all its five components protected myocardial structure from damage by ischemia. QSYQ also attenuated release of myocardial cTnI, and restored the production of ATP after cardiac ischemia. AS-IV and Rb1, but not Rg1, R1, and DLA, had similar effect as QSYQ in regulation of energy metabolism. These results indicate that QSYQ may prevent ischemia-induced cardiac injury via regulation of energy metabolism, to which each of its components contributes differently.

  2. Switched modified function projective synchronization of hyperchaotic Qi system with uncertain parameters

    Science.gov (United States)

    Sebastian Sudheer, K.; Sabir, M.

    2010-12-01

    This work is involved with switched modified function projective synchronization of two identical Qi hyperchaotic systems using adaptive control method. Switched synchronization of chaotic systems in which a state variable of the drive system synchronize with a different state variable of the response system is a promising type of synchronization as it provides greater security in secure communication. Modified function projective synchronization with the unpredictability of scaling functions can enhance security. Recently formulated hyperchaotic Qi system in the hyperchaotic mode has an extremely broad frequency bandwidth of high magnitudes, verifying its unusual random nature and indicating its great potential for some relevant engineering applications such as secure communications. By Lyapunove stability theory, the adaptive control law and the parameter update law are derived to make the state of two chaotic systems modified function projective synchronized. Synchronization under the effect of noise is also considered. Numerical simulations are presented to demonstrate the effectiveness of the proposed adaptive controllers.

  3. The Role of Rumination and Stressful Life Events in the Relationship between the Qi Stagnation Constitution and Depression in Women: A Moderated Mediation Model

    Science.gov (United States)

    Liu, Qiaosheng

    2017-01-01

    The qi stagnation constitution is associated with depression in traditional Chinese medicine. It is unclear how rumination and stressful life events affect the relationship between the qi stagnation constitution and depression. The Qi Stagnation Constitution Scale, Ruminative Response Scale, Center for Epidemiologic Studies Depression Scale, and Adolescent Self-Rating Life Events Checklist were used to assess this association in 1200 female college students. The results revealed that the qi stagnation constitution was positively associated with depression. Furthermore, rumination was a partial mediator of the relationship between the qi stagnation constitution and depression. In addition, stressful life events moderated the direct effect and mediating effect of the qi stagnation constitution on depression. These findings indicate that rumination and stressful life events may affect the relationship between the qi stagnation constitution and depression in women. PMID:28757889

  4. The Role of Rumination and Stressful Life Events in the Relationship between the Qi Stagnation Constitution and Depression in Women: A Moderated Mediation Model

    Directory of Open Access Journals (Sweden)

    Mingfan Liu

    2017-01-01

    Full Text Available The qi stagnation constitution is associated with depression in traditional Chinese medicine. It is unclear how rumination and stressful life events affect the relationship between the qi stagnation constitution and depression. The Qi Stagnation Constitution Scale, Ruminative Response Scale, Center for Epidemiologic Studies Depression Scale, and Adolescent Self-Rating Life Events Checklist were used to assess this association in 1200 female college students. The results revealed that the qi stagnation constitution was positively associated with depression. Furthermore, rumination was a partial mediator of the relationship between the qi stagnation constitution and depression. In addition, stressful life events moderated the direct effect and mediating effect of the qi stagnation constitution on depression. These findings indicate that rumination and stressful life events may affect the relationship between the qi stagnation constitution and depression in women.

  5. Bifurcation Analysis of the QI 3-D Four-Wing Chaotic System

    International Nuclear Information System (INIS)

    Sun, Y.; Qi, G.; Wang, Z.; Wyk, B.J. van

    2010-01-01

    This paper analyzes the pitchfork and Hopf bifurcations of a new 3-D four-wing quadratic autonomous system proposed by Qi et al. The center manifold technique is used to reduce the dimensions of this system. The pitchfork and Hopf bifurcations of the system are theoretically analyzed. The influence of system parameters on other bifurcations are also investigated. The theoretical analysis and simulations demonstrate the rich dynamics of the system. (authors)

  6. External Qi therapy to treat symptoms of Agent Orange Sequelae in Korean combat veterans of the Vietnam War.

    Science.gov (United States)

    Lee, Myeong Soo; Woo, Won-Hong; Lim, Hyun-Ja; Hong, Sung-Soo; Kim, Hye-Jung; Moon, Sun-Rock

    2004-01-01

    We investigated the efficacy of Qi therapy as a non-pharmacological treatment for various symptoms presented by Korean combat veterans of the Vietnam War with Agent Orange Sequelae. Nine subjects volunteered to receive 30 minutes of Qi therapy, twice per day for 7 days. There was marked improvement in 89% of the patients with impaired physical activity, 86% of those with psychological disorder, 78% of those with heavy drug use, and 67% of those with fatigue, indigestion and high blood glucose levels. This data suggests that Qi therapy combined with conventional treatment has positive effects in reducing and managing the pain, psychosomatic disorders, and substance abuse in patients with Agent Orange Sequelae. We cannot completely discount the possible influence of the placebo effect, and more objective, clinical measures are needed to study the long-term effects of Qi therapy.

  7. Traditional Chinese medicine formula Bi-Qi capsule alleviates rheumatoid arthritis-induced inflammation, synovial hyperplasia, and cartilage destruction in rats.

    Science.gov (United States)

    Wang, Kai; Zhang, Dongmei; Liu, Yan; Wang, Xuan; Zhao, Jiantong; Sun, Tingting; Jin, Tingting; Li, Baoli; Pathak, Janak L

    2018-03-14

    Traditional Chinese medicine (TCM) formula Bi-Qi capsule (Bi-Qi) is a commonly prescribed drug to treat rheumatoid arthritis (RA). However, the mechanism of Bi-Qi-mediated amelioration of RA pathogenesis is still a mystery. Collagen induced arthritis (CIA) in rats is an established model that shares many similarities with RA in humans. In this study we investigated the effect of Bi-Qi on the pathogenesis of CIA in rats. CIA was developed in Sprague-Dawley (S.D) rats (n = 60, female) and used as a model resembling RA in humans. Rats were treated with a high or moderate dose of Bi-Qi, or methotrexate (MTX). Effects of the treatment on local joint and systemic inflammation, synovial hyperplasia, cartilage destruction, and other main features in the pathogenesis of CIA were analyzed. Inflamed and swollen ankles and joints were observed in arthritic rats, while Bi-Qi or MTX treatment alleviated these symptoms. Only the Bi-Qi moderate dose decreased RA-induced serum levels of tumor necrosis factor-alpha (TNF-α). Both Bi-Qi and MTX reduced the interleukin (IL)-18 serum level. Protein levels of cartilage oligomeric matrix protein and osteopontin in serum, synovium, and cartilage were elevated in arthritic rats, while Bi-Qi alleviated these effects. Synovial hyperplasia, inflammatory cell infiltration in synovium and a high degree of cartilage degradation was observed in RA, and Bi-Qi or MTX alleviated this effect. Bi-Qi at the moderate dose was the most effective in mitigating CIA-related clinical complications. Our findings showed that Bi-Qi alleviates CIA-induced inflammation, synovial hyperplasia, cartilage destruction, and the other main features in the pathogenesis of CIA. This provides fundamental evidence for the anti-arthritic properties of Bi-Qi and corroborates the use of Bi-Qi TCM formula for the treatment of RA.

  8. Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.

    Science.gov (United States)

    Hempel, Susanne; Shekelle, Paul G; Liu, Jodi L; Sherwood Danz, Margie; Foy, Robbie; Lim, Yee-Wei; Motala, Aneesa; Rubenstein, Lisa V

    2015-12-01

    Valid, reliable critical appraisal tools advance quality improvement (QI) intervention impacts by helping stakeholders identify higher quality studies. QI approaches are diverse and differ from clinical interventions. Widely used critical appraisal instruments do not take unique QI features into account and existing QI tools (eg, Standards for QI Reporting Excellence) are intended for publication guidance rather than critical appraisal. This study developed and psychometrically tested a critical appraisal instrument, the QI Minimum Quality Criteria Set (QI-MQCS) for assessing QI-specific features of QI publications. Approaches to developing the tool and ensuring validity included a literature review, in-person and online survey expert panel input, and application to empirical examples. We investigated psychometric properties in a set of diverse QI publications (N=54) by analysing reliability measures and item endorsement rates and explored sources of disagreement between reviewers. The QI-MQCS includes 16 content domains to evaluate QI intervention publications: Organisational Motivation, Intervention Rationale, Intervention Description, Organisational Characteristics, Implementation, Study Design, Comparator Description, Data Sources, Timing, Adherence/Fidelity, Health Outcomes, Organisational Readiness, Penetration/Reach, Sustainability, Spread and Limitations. Median inter-rater agreement for QI-MQCS items was κ 0.57 (83% agreement). Item statistics indicated sufficient ability to differentiate between publications (median quality criteria met 67%). Internal consistency measures indicated coherence without excessive conceptual overlap (absolute mean interitem correlation=0.19). The critical appraisal instrument is accompanied by a user manual detailing What to consider, Where to look and How to rate. We developed a ready-to-use, valid and reliable critical appraisal instrument applicable to healthcare QI intervention publications, but recognise scope for

  9. Validation of the qi blood yin yang deficiency questionnaire on chronic fatigue.

    Science.gov (United States)

    Kim, Jihye; Ku, Boncho; Kim, Keun Ho

    2016-01-01

    Chronic fatigue (CF) reflects an imbalance of inter-organ functions or of the four essential physiological components qi, blood (xue), yin, and yang. CF can be subdivided into different patterns. However, there are no diagnostic methods for CF. This study aimed to clinically validate a pattern identification method by identifying correlations between CF and responses to the qi blood yin yang deficiency questionnaire (QBYY-Q). Participants were recruited between May and June 2014 through the Kyung Hee University Korean Medicine hospital website and via posters and comprised 129 CF patients diagnosed with the United States Centers for Disease Control and Prevention (1994) criteria. Participants who had organic diseases that explained the CF were excluded. A total of 159 participants were asked to complete the QBYY-Q, the fatigue severity scale, and the Chalder fatigue scale. The latter two questionnaires were used to assess convergent validity with the QBYY-Q. Among the 129 CF participants, 70 and 59 had chronic fatigue syndrome and idiopathic chronic fatigue, respectively. Two Korean medical doctors independently assessed participants' qi, blood, yin, and yang deficiency patterns using QBYY deficiency pattern identification guidelines. Based on the results of a preliminary study of the QBYY-Q, we selected 32 reliable items for symptoms corresponding to each deficiency pattern. The items were used to estimate internal consistency and construct validity. Multinomial logistic regression analysis was performed for scores on each deficiency pattern. The data were means and standard deviations or numbers of participants and proportions for continuous and categorical variables, respectively. A statistical significance level of P yin, and yang deficiency were 45.1, 58.0, 52.2, and 63.4 %, respectively. Each QBYY-Q deficiency score was positively associated with each corresponding deficiency pattern. Qi deficiency was used as a reference category. Odds ratios of blood, yin

  10. Impact of Qi-invigorating traditional Chinese medicines on intestinal flora: A basis for rational choice of prebiotics.

    Science.gov (United States)

    Wang, Xiao-Meng; Li, Xiao-Bo; Peng, Ying

    2017-04-01

    According to the theory of traditional Chinese medicine (TCM), Qi (vital energy) is regarded as a driving force of biological activities in human body, including both nutrient substances and organ functions. Qi-invigorating TCMs are widely used to treat various symptoms and disorders, such as fatigue, obesity, immunosuppression, intestinal flora imbalance, and gastrointestinal diseases, in which Qi is considered to be reduced or depleted. Interestingly, abundant clinical evidences suggest that these disorders are associated with the alternation of intestinal flora, which directly affects disease status. Herein we review the interaction between gut microbiota and Qi-invigorating TCMs under healthy and disease conditions and discuss the mechanisms of action and applications of Qi-invigorating TCMs in enhancing health status through microbial alternation. A better understanding of the role of Qi-invigorating TCMs in modulating microbial composition and the association between intestinal microbiota and diseases would help reveal the clinical consequences of microbiota alteration and explore opportunities to harness this symbiotic relationship to improve public health. Copyright © 2017 China Pharmaceutical University. Published by Elsevier B.V. All rights reserved.

  11. Cardioprotection against ischemia/reperfusion injury by QiShenYiQi Pill® via ameliorate of multiple mitochondrial dysfunctions

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    Chen JR

    2015-06-01

    Full Text Available Jing Rui Chen,1–3 Jing Wei,1–3 Ling Yan Wang,1–3 Yan Zhu,1–3 Lan Li,1–3 Mary Akinyi Olunga,1–3 Xiu Mei Gao,1–3 Guan Wei Fan1–31Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin, People’s Republic of China; 2Key Laboratory of Pharmacology of Traditional Chinese Medicine Formulae, Ministry of Education, 3Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of ChinaAim: To investigate the potential cardioprotective effects of QiShenYiQi Pill® (QSYQ on myocardial ischemia/reperfusion (I/R injury through antioxidative stress and mitochondrial protection.Methods and results: Sprague Dawley rats were pretreated with QSYQ or saline for 7 days and subjected to ischemia (30 minutes occlusion of the left anterior descending coronary artery and reperfusion (120 minutes. Cardiac functions were evaluated by echocardiogram and hemodynamics. Myocardial mitochondria were obtained to evaluate changes in mitochondrial structure and function, immediately after 120 minutes reperfusion. Pretreatment with QSYQ protected against I/R-induced myocardial structural injury and improved cardiac hemodynamics, as demonstrated by normalized serum creatine kinase and suppressed oxidative stress. Moreover, the impaired myocardial mitochondrial structure and function decreased level of ATP (accompanied by reduction of ATP5D and increase in the expression of cytochrome C. Myocardial fiber rupture, interstitial edema, and infiltrated leukocytes were all significantly ameliorated by pretreatment with QSYQ.Conclusion: Pretreatment of QSYQ in Sprague Dawley rats improves ventricular function and energy metabolism and reduces oxidative stress via ameliorating multiple mitochondrial dysfunctions during I/R injury.Keywords: QSYQ, ischemia/reperfusion injury, energy metabolism, mitochondria

  12. Influence of de qi on the immediate analgesic effect of SP6 acupuncture in patients with primary dysmenorrhoea and cold and dampness stagnation: a multicentre randomised controlled trial.

    Science.gov (United States)

    Zhao, Min-Yi; Zhang, Peng; Li, Jing; Wang, Lin-Peng; Zhou, Wei; Wang, Yan-Xia; She, Yan-Fen; Ma, Liang-Xiao; Wang, Pei; Hu, Ni-Juan; Lin, Chi; Hu, Shang-Qin; Wu, Gui-Wen; Wang, Ya-Feng; Sun, Jun-Jun; Jiang, Si-Zhu; Zhu, Jiang

    2017-10-01

    The aim of this multicentre randomised controlled trial was to investigate the contribution of de qi to the immediate analgesic effect of acupuncture in patients with primary dysmenorrhoea and the specific traditional Chinese medicine diagnosis cold and dampness stagnation . Eighty-eight patients with primary dysmenorrhoea and cold and dampness stagnation were randomly assigned to de qi (n=43) or no de qi (n=45) groups and underwent 30 min of SP6 acupuncture. The de qi group received deep needling at SP6 with manipulation using thick needles; the no de qi group received shallow needling with no manipulation using thin needles. In both groups the pain scores and actual de qi sensation were evaluated using a visual analogue scale for pain (VAS-P) and the acupuncture de qi clinical assessment scale (ADCAS), respectively. Both groups showed reductions in VAS-P, with no signficant differences between groups. ADCAS scores showed 43/43 and 25/45 patients in de qi and no de qi groups, respectively, actually experienced de qi sensation. Independent of original group allocation, VAS-P reductions associated with actual de qi (n=68) were greater than those without (28.4±18.19 mm vs 14.6±12.28 mm, p=0.008). This study showed no significant difference in VAS-P scores in patients with primary dysmenorrhoea and cold and dampness stagnation immediately after SP6 acupuncture designed to induce or avoid de qi sensation. Both treatments significantly reduced VAS-P relative to baseline. Irrespective of group allocation, patients experiencing actual de qi sensation demonstrated larger reductions in pain score relative to those without, suggesting greater analgesic effects. Chinese Clinical Trial Registry (ChiCTR-TRC-13003086); Results. © 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.

  13. [Mechanism of tonifying Qi traditional Chinese medicines contained in Yiqi Qingwen Jiedu mixture against influenza immune inflammatory injury].

    Science.gov (United States)

    Xu, Hong-Ri; Wang, Cheng-Xiang; Wang, Lan; Zhou, Ping-An; Yin, Ren-Yi; Jiang, Liang-Duo; Wang, Hui-Fang

    2014-10-01

    To observe the impact of tonifying Qi traditional Chinese medicines contained in Yiqi Qingwen Jiedu mixture on mRNA expression of lung inflammatory cytokines and pulmonary pathological injury of mice infected by influenza virus, in order to discuss the mechanism of tonifying Qi traditional Chinese medicines against pulmonary immune inflammatory injury of infected mice. In different time phases after mice were infected with influenza virus FM1, the RT-PCR method was adopted to observe the impact of tonifying Qi traditional Chinese medicines contained in Yiqi Qingwen Jiedu mixture on five inflammatory cytokines TNF-α, IL-1, IL-6, IL-10 and IFN-γ, and the changes in pulmonary pathological injury of mice with viral pneumonia after intervention with tonifying qi traditional Chinese medicines. (1) Tonifying Qi traditional Chinese medicines significantly reduced the mRNA expression of TNF-α at 1-5 d and IL-1 mRNA expression at 7 d, may increase IL-1 mRNA expression in mouse lung at 3 d, significantly reduced IL-6 mRNA expression in mouse lung and increased IL-10 mRNA expression at 3-7 d, and significantly increased IFN-γ mRNA expression at 1 d. (2) Tonifying Qi traditional Chinese medicines could significantly inhibited and repaired pulmonary immune inflammatory injury of mice infected by FM1, which was most remarkable at 3-7 d after the infection with influenza virus FM1. Tonifying Qi traditional Chinese medicines contained in Yiqi Qingwen Jiedu mixture could resist pulmonary immune inflammatory injury and repair inflammatory injury by regulating the mRNA expression of imbalance inflammatory cytokines of organisms infected with influenza virus.

  14. The effectiveness of a multidisciplinary QI activity for accidental fall prevention: Staff compliance is critical

    Directory of Open Access Journals (Sweden)

    Ohde Sachiko

    2012-07-01

    Full Text Available Abstract Background Accidental falls among inpatients are a substantial cause of hospital injury. A number of successful experimental studies on fall prevention have shown the importance and efficacy of multifactorial intervention, though success rates vary. However, the importance of staff compliance with these effective, but often time-consuming, multifactorial interventions has not been fully investigated in a routine clinical setting. The purpose of this observational study was to describe the effectiveness of a multidisciplinary quality improvement (QI activity for accidental fall prevention, with particular focus on staff compliance in a non-experimental clinical setting. Methods This observational study was conducted from July 2004 through December 2010 at St. Luke’s International Hospital in Tokyo, Japan. The QI activity for in-patient falls prevention consisted of: 1 the fall risk assessment tool, 2 an intervention protocol to prevent in-patient falls, 3 specific environmental safety interventions, 4 staff education, and 5 multidisciplinary healthcare staff compliance monitoring and feedback mechanisms. Results The overall fall rate was 2.13 falls per 1000 patient days (350/164331 in 2004 versus 1.53 falls per 1000 patient days (263/172325 in 2010, representing a significant decrease (p = 0.039. In the first 6 months, compliance with use of the falling risk assessment tool at admission was 91.5% in 2007 (3998/4368, increasing to 97.6% in 2010 (10564/10828. The staff compliance rate of implementing an appropriate intervention plan was 85.9% in 2007, increasing to 95.3% in 2010. Conclusion In our study we observed a substantial decrease in patient fall rates and an increase of staff compliance with a newly implemented falls prevention program. A systematized QI approach that closely involves, encourages, and educates healthcare staff at multiple levels is effective.

  15. A QI Initiative to Reduce Hospitalization for Children With Isolated Skull Fractures.

    Science.gov (United States)

    Lyons, Todd W; Stack, Anne M; Monuteaux, Michael C; Parver, Stephanie L; Gordon, Catherine R; Gordon, Caroline D; Proctor, Mark R; Nigrovic, Lise E

    2016-06-01

    Although children with isolated skull fractures rarely require acute interventions, most are hospitalized. Our aim was to safely decrease the hospitalization rate for children with isolated skull fractures. We designed and executed this multifaceted quality improvement (QI) initiative between January 2008 and July 2015 to reduce hospitalization rates for children ≤21 years old with isolated skull fractures at a single tertiary care pediatric institution. We defined an isolated skull fracture as a skull fracture without intracranial injury. The QI intervention consisted of 2 steps: (1) development and implementation of an evidence-based guideline, and (2) dissemination of a provider survey designed to reinforce guideline awareness and adherence. Our primary outcome was hospitalization rate and our balancing measure was hospital readmission within 72 hours. We used standard statistical process control methodology to assess change over time. To assess for secular trends, we examined admission rates for children with an isolated skull fracture in the Pediatric Health Information System administrative database. We identified 321 children with an isolated skull fracture with a median age of 11 months (interquartile range 5-16 months). The baseline admission rate was 71% (179/249, 95% confidence interval, 66%-77%) and decreased to 46% (34/72, 95% confidence interval, 35%-60%) after implementation of our QI initiative. No child was readmitted after discharge. The admission rate in our secular trend control group remained unchanged at 78%. We safely reduced the hospitalization rate for children with isolated skull fractures without an increase in the readmissions. Copyright © 2016 by the American Academy of Pediatrics.

  16. The Effects of Yin, Yang and Qi in the Skin on Pain.

    Science.gov (United States)

    Adams, James David

    2016-01-29

    The most effective and safe treatment site for pain is in the skin. This chapter discusses the reasons to treat pain in the skin. Pain is sensed in the skin through transient receptor potential cation channels and other receptors. These receptors have endogenous agonists (yang) and antagonists (yin) that help the body control pain. Acupuncture works through modulation of these receptor activities (qi) in the skin; as do moxibustion and liniments. The treatment of pain in the skin has the potential to save many lives and improve pain therapy in most patients.

  17. The Effects of Yin, Yang and Qi in the Skin on Pain

    Directory of Open Access Journals (Sweden)

    James David Adams

    2016-01-01

    Full Text Available The most effective and safe treatment site for pain is in the skin. This chapter discusses the reasons to treat pain in the skin. Pain is sensed in the skin through transient receptor potential cation channels and other receptors. These receptors have endogenous agonists (yang and antagonists (yin that help the body control pain. Acupuncture works through modulation of these receptor activities (qi in the skin; as do moxibustion and liniments. The treatment of pain in the skin has the potential to save many lives and improve pain therapy in most patients.

  18. Protocol for the evaluation and validation of Qi Blood Yin Yang deficiency pattern questionnaire: prospective observational study.

    Science.gov (United States)

    Kim, Jihye; Kim, Keun Ho

    2015-12-01

    The aim of this study is to validate the pattern identification standard of qi, blood, yin, and yang deficiency patterns diagnosis. The current study will investigate the usefulness of the Qi Blood Yin Yang deficiency pattern questionnaire as a diagnostic tool for qi, blood, yin, and yang deficiencies by assessing the agreement between the scores and a gold standard established by assessors. This protocol is for a single center, prospective, observational study. A total of 248 eligible patients with unexplained chronic fatigue will be assigned to four groups in a 1:1:1:1 ratio as the qi deficiency group, blood deficiency group, yin deficiency group, and yang deficiency group. The primary outcome will be measured using the score of the Qi Blood Yin Yang deficiency pattern questionnaire and the secondary outcomes will be measured using the fatigue severity scale, Korean-translated chalder fatigue scale, computerized tongue image analysis system, and three types of pattern identification questionnaires (cold-heat, food accumulation, and seven emotions patterns). The safety of the clinical study will be assessed after measurements at every visit. All statistical analysis will be performed using the R Statistics program. Statistics experts will analyze the relationship between clinical data using the Pearson's Chi-squared test and independent t -test. This study will provide reference data and good evidence that are applicable to future studies. Furthermore, the results of the present study are useful to improve the care of patients with unexplained chronic fatigue and unexplained chronic fatigue-related disorders.

  19. Ensuring Support for Research and Quality Improvement (QI) Networks: Four Pillars of Sustainability-An Emerging Framework.

    Science.gov (United States)

    Holve, Erin

    2013-01-01

    Multi-institutional research and quality improvement (QI) projects using electronic clinical data (ECD) hold great promise for improving quality of care and patient outcomes but typically require significant infrastructure investments both to initiate and maintain the project over its duration. Consequently, it is important for these projects to think holistically about sustainability to ensure their long-term success. Four "pillars" of sustainability are discussed based on the experiences of EDM Forum grantees and other research and QI networks. These include trust and value, governance, management, and financial and administrative support. Two "foundational considerations," adaptive capacity and policy levers, are also discussed.

  20. Alteration of radiation-induced hematotoxicity by Bu-Zhong-Yi-Qi-Tang in mouse

    International Nuclear Information System (INIS)

    Jang, Jong Sik; Kim, Sung Ho

    2008-01-01

    The purpose of this study reported here was to investigate the ability of Bu-Zhong-Yi-Qi-Tang (BZYQT), known to elevate hematopoietic functions, to protect mice undergoing treatment with whole body single gamma-irradiation. BZYQT was given (25 mg/kg B.W.) intraperitoneally at 36 and 12 hours before irradiation and 30 minute and 24 hours after irradiation. Recovery of neutrophil and lymphocyte counts was significantly stimulated by extract of BZYQT. Stimulated recovery by the extract from the BZYQT was also observed in thrombocytes. However, the anti-radiation effect of erythrocyte, hemoglobin and hematocrit was not as significant as that of leukocyte. Further studies are needed to better characterize the protective nature of BZYQT extract and its ingredients

  1. Alteration of radiation-induced hematotoxicity by Bu-Zhong-Yi-Qi-Tang in mouse

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Jong Sik [Kyungpook National University, Daegu (Korea, Republic of); Kim, Sung Ho [Chonnam National University, Gwangju (Korea, Republic of)

    2008-09-15

    The purpose of this study reported here was to investigate the ability of Bu-Zhong-Yi-Qi-Tang (BZYQT), known to elevate hematopoietic functions, to protect mice undergoing treatment with whole body single gamma-irradiation. BZYQT was given (25 mg/kg B.W.) intraperitoneally at 36 and 12 hours before irradiation and 30 minute and 24 hours after irradiation. Recovery of neutrophil and lymphocyte counts was significantly stimulated by extract of BZYQT. Stimulated recovery by the extract from the BZYQT was also observed in thrombocytes. However, the anti-radiation effect of erythrocyte, hemoglobin and hematocrit was not as significant as that of leukocyte. Further studies are needed to better characterize the protective nature of BZYQT extract and its ingredients.

  2. [Analysis in pulmonary ventilatory function from 100 patients with ano-rectal diseases caused by deficiency of qi].

    Science.gov (United States)

    Wang, W

    1999-03-01

    To explore the pathogenesis of ano-rectal diseases caused by deficiency of Qi, which is correlated with obstruction of pulmonary ventilation. The pulmonary ventilatory function was measured in 100 patients with the internal piles, the interno-external hemorrhoid and prolapse of rectum, the prolapse of anus was the principal symptom of them. Data from the 100 patients showed that 67% of them were diagnosed with the obstruction of pulmonary ventilation, the ratio was far less in the health control group. FEV 1.0 (mean +/- s) (2011.65 +/- 875) ml, MMF (1.84 +/- 1.24) L/s and PEF (2.34 +/- 1.51) L/s in male patients, (1551.54 +/- 514) ml, (1.57 +/- 0.62) L/s and (1.85 +/- 0.92) L/s in female patients, but those values were higher in the control than in the patients. The statistical analysis was performed and the difference was significant between patients and the control group (P < 0.01). The patients with ano-rectal diseases caused by deficiency of Qi accompanied with obstruction of pulmonary ventilation in different degree and varied sorts, it confirmed that the pathogenesis of ano-rectal diseases caused by deficiency of Qi is related with "sinking of pectoral Qi".

  3. 78 FR 56264 - Big Bear Mining Corp., Four Rivers BioEnergy, Inc., Mainland Resources, Inc., QI Systems Inc...

    Science.gov (United States)

    2013-09-12

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Big Bear Mining Corp., Four Rivers BioEnergy, Inc., Mainland Resources, Inc., QI Systems Inc., South Texas Oil Co., and Synova Healthcare Group, Inc... that there is a lack of current and accurate information concerning the securities of Big Bear Mining...

  4. Craniometric examination of Longxian and Qi Li Cun archaeological sites to assess population continuity in ancient northern China.

    Science.gov (United States)

    Gibbon, Victoria E; Porter, Tarun A; Wu, Xiujie; Liu, Wu

    2016-10-01

    In this paper, population continuity and discontinuity in northern China are explored using craniometric analyses from two archaeological sites, Longxian (Warring States) and Qi Li Cun (Han Dynasty). Neither population has been previously studied. Artefactual evidence shows the individuals from Qi Li Cun were Xianbei, descendants from Mongolia. Longxian is from further south in the central plains at an earlier time, thus, we expect to observe variability between these groups. In total, 24 cranial measurements were obtained on 66 crania from these sites. Howells's cranial measurements on Anyang (42 crania) and Hainan (83 crania) Chinese samples were included for comparative purposes. Less variability is expected between Longxian and Howells's Chinese data due to geographic and temporal similarity. With closer geographic and temporal affinity with Anyang, the expectation is for Longxian and Anyang to be similar. Few statistical differences exist between Longxian and Qi Li Cun; this was supported by the similarity found through principal components analysis (PCA). Regardless of sex, canonical discriminant analysis shows clustering of Longxian and Qi Li Cun separate from those of Anyang and Hainan. Their similarity indicates the people from Longxian and Qi Li Cun likely share Mongolian ancestry. Our results, supported by other studies, suggest that despite temporal differences, Mongolians living in China during the Warring States and Han dynasty retained their cultural and genetic Mongolian identity. These data add valuable bioarchaeological information regarding the peopling of northern China during a crucial period of cultural and political change in the Early Bronze Age and Iron Age. Copyright © 2016 Elsevier GmbH. All rights reserved.

  5. Efficacy of an integrated continuing medical education (CME) and quality improvement (QI) program on radiation oncologist (RO) clinical practice

    International Nuclear Information System (INIS)

    Leong, Cheng Nang; Shakespeare, Thomas Philip; Mukherjee, Rahul K.; Back, Michael F.; Lee, Khai Mun; Lu, Jiade Jay; Wynne, Christopher J.; Lim, Keith; Tang, Johann; Zhang Xiaojian

    2006-01-01

    Purpose: There has been little radiation oncologist (RO)-specific research in continuing medical education (CME) or quality improvement (QI) program efficacy. Our aim was to evaluate a CME/QI program for changes in RO behavior, performance, and adherence to department protocols/studies over the first 12 months of the program. Methods and Materials: The CME/QI program combined chart audit with feedback (C-AWF), simulation review AWF (SR-AWF), reminder checklists, and targeted CME tutorials. Between April 2003 and March 2004, management of 75 patients was evaluated by chart audit with feedback (C-AWF) and 178 patients via simulation review audit (SR-AWF) using a validated instrument. Scores were presented, and case management was discussed with individualized educational feedback. RO behavior and performance was compared over the first year of the program. Results: Comparing the first and second 6 months, there was a significant improvement in mean behavior (12.7-13.6 of 14, p = 0.0005) and RO performance (7.6-7.9 of 8, p = 0.018) scores. Protocol/study adherence significantly improved from 90.3% to 96.6% (p = 0.005). A total of 50 actions were generated, including the identification of learning needs to direct CME tutorials, the systematic change of suboptimal RO practice, and the alteration of deficient management of 3% of patients audited during the program. Conclusion: An integrated CME/QI program combining C-AWF, SR-AWF, QI reminders, and targeted CME tutorials effectively improved targeted RO behavior and performance over a 12-month period. There was a corresponding increase in departmental protocol and study adherence

  6. Efficacy and Safety of the TCM Qi-Supplementing Therapy in Patients with Myasthenia Gravis: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Xi-qian Yang

    2017-01-01

    Full Text Available Background. The Traditional Chinese Medicine (TCM Qi-supplementing therapy has been used widely for treating myasthenia gravis (MG in China. The purpose of this meta-analysis was to evaluate the efficacy and safety of Qi-supplementing therapy as an adjunctive therapy in MG patients. Methods. Seven electronic databases were searched through June 2016. Randomized controlled trials (RCTs evaluating the add-on effect of Qi-supplementing therapy in MG patients were included. The outcome measures were the total effective rate, relapse rate, and adverse events. Results. Twenty-three RCTs involving 1,691 MG patients were included. The included studies were of low-to-moderate quality. Meta-analysis showed that Qi-supplementing therapy combined with Western medicine (WM significantly improved the total response rate and reduced the relapse risk during 6–24 months of follow-up. Subgroup analysis showed that Qi-supplementing therapy only affected the total response rate within the first 6 months of treatment. Moreover, the rate of adverse events was lower with the addition of Qi-supplementing therapy to WM than with WM only. Conclusions. Short-term Qi-supplementing therapy combined with WM appears to be superior to WM for improving the total response rate and reducing the relapse rate. However, more high-quality RCTs are warranted owing to methodological flaws of previous trials.

  7. [Health assessment of Qi'ao Island mangrove wetland ecosystem in Pearl River Estuary].

    Science.gov (United States)

    Wang, Shu-Gong; Zheng, Yao-Hui; Peng, Yi-Sheng; Chen, Gui-Zhu

    2010-02-01

    Based on the theories of wetland ecosystem health and by using "Pressure-State-Response" model, a health assessment indicator system for Qi' ao Island mangrove wetland ecosystem in Pearl River Estuary was built, and the assessment indices, assessment criteria, indices weighted values, assessment grades, and assessment methods were established to assess the health state of this ecosystem. In 2008, the overall health index of this ecosystem was 0.6580, health level was of grade II (healthy), and the pressure, state, and response indices were 0.3469, 0.8718, and 0.7754, respectively, suggesting that this ecosystem was good in state and response, but still had definite pressure. As a provincial nature reserve, this ecosystem was to be further improved in its health level. However, the research on the health assessment of mangrove wetland ecosystem was still young. Further studies should be made on the selection of assessment indices, long-term oriented monitoring of these indices, and quantification of the relations between ecosystem health level and ecosystem services.

  8. [metabonomics research on coronary heart disease patients of phlegm turbidity syndrome and qi deficiency syndrome].

    Science.gov (United States)

    Cheng, Peng; Chen, Ze-qi; Wang, Dong-sheng

    2015-02-01

    To study the correlation between Chinese medical types of coronary heart disease (CHD) [i.e., phlegm turbidity syndrome (PTS) and qi deficiency syndrome (QDS)] and their metabolites. Recruited were 65 CHD patients including 37 cases of PTS and 28 cases of QDS. Serum endogenous metabolites in the two syndrome types were determined by gas chromatograph-mass spectrometer-computer (GC/MS), and their differences between their metabolic profiles analyzed. More than 100 chromatographic peaks were totally scanned. Chromatograms obtained was matched with mass spectrum bank, and finally we got the category contribution value of 46 kinds of substances. Results of MCTree analysis showed patients of PTS and patients of QDS could be effectively distinguished. Compounds contributing to identify the two syndromes were sequenced as serine, valine, 2 hydroxy propionic acid. Comparison of metabolites showed contents of serine and 2 hydroxy propionic acid were higher in patients of PTS than in patients of QDS (Pmetabonomics of CHD TCM syndrome types could provide material bases for TCM syndrome differentiation of CHD, indicating that metabonomics technologies might become a new research method for TCM syndrome typing.

  9. On Chinese-English Translation of Tourist Attraction in Cross-cultural Perspective--Taking Qi Culture as An Example

    Institute of Scientific and Technical Information of China (English)

    张滕龙

    2014-01-01

    Tourist textsfeature vividness and distinctiveness and its translation is a typical cross-cultural activity.By applying cross-cultural consciousness to the tourist material's translation, foreigners can understand the cultural connotation easily. Therefore, cross-cultural consciousness plays an important role in the translation of tourist materials.This thesis, taking Qi culture as an exam-ple, explores some typical tourist attractions from perspectives of historical allusions and legend as well as traditional customs. The analysis of Qi cultural connotation concludes business culture, Pu culture and filial piety culture. So, in order to transmit the cul-tural information to foreign tourists accurately, it is necessary to apply inter-cultural consciousness to the translation of tourist texts.

  10. Ensuring Support for Research and Quality Improvement (QI) Networks: Four Pillars of Sustainability?An Emerging Framework

    OpenAIRE

    Holve, Erin

    2013-01-01

    Multi-institutional research and quality improvement (QI) projects using electronic clinical data (ECD) hold great promise for improving quality of care and patient outcomes but typically require significant infrastructure investments both to initiate and maintain the project over its duration. Consequently, it is important for these projects to think holistically about sustainability to ensure their long-term success. Four ?pillars? of sustainability are discussed based on the experiences of...

  11. VizieR Online Data Catalog: Follow-up of probable young star ASASSN-15qi (Herczeg+, 2016)

    Science.gov (United States)

    Herczeg, G. J.; Dong, S.; Shappee, B. J.; Chen, P.; Hillenbrand, L. A.; Jose, J.; Kochanek, C. S.; Prieto, J. L.; Stanek, K. Z.; Kaplan, K.; Holoien, T.-S.; Mairs, S.; Johnstone, D.; Gully-Santiago, M.; Zhu, Z.; Smith, M. C.; Bersier, D.; Mulders, G. D.; Filippenko, A. V.; Ayani, K.; Brimacombe, J.; Brown, J. S.; Connelley, M.; Harmanen, J.; Itoh, R.; Kawabata, K. S.; Maehara, H.; Takata, K.; Yuk, H.; Zheng, W.

    2017-02-01

    The outburst of ASASSN-15qi (2MASS J22560882+5831040) occurred on JD2457298 (2015 October 2; UTC dates are used herein). The All-Sky Automated Survey for Supernovae (ASAS-SN) is an all-sky V-band transient survey with a limiting magnitude of ~17. ASAS-SN photometry of ASASSN-15qi was obtained from two different telescopes on Haleakala, Hawaii with intervals of one to three days. ASAS-SN photometry is listed in Table 2. Archival photometry, ground-based optical photometry with Las Cumbres Observatory Global Telescope Network (LCOGT) 1m telescope at McDonald Observatory between 2015 October 23 and December 23 and at the Liverpool Telescope on 2016 April 26 and June 11, Swift/UVOT photometry on 2015 October 12 (ID 00034098001) and 2015 December 27 (ID 00034098002), NIR photometry with the NOTCam camera at the Nordic Optical Telescope (NOT) on 2015 December 22 and Spitzer/IRAC MIR photometry on 2006 December 29 (Program ID 30734, PI Donald Figer) and James Clerk Maxwell Telescope (JCMT) SCUBA2 submillimeter observations of ASASSN-15qi on 2015 November 5 and optical and NIR spectroscopy observations are also described in section 2. (1 data file).

  12. Impact of a national QI programme on reducing electronic health record notifications to clinicians.

    Science.gov (United States)

    Shah, Tina; Patel-Teague, Shilpa; Kroupa, Laura; Meyer, Ashley N D; Singh, Hardeep

    2018-03-05

    Emerging evidence suggests electronic health record (EHR)-related information overload is a risk to patient safety. In the US Department of Veterans Affairs (VA), EHR-based 'inbox' notifications originally intended for communicating important clinical information are now cited by 70% of primary care practitioners (PCPs) to be of unmanageable volume. We evaluated the impact of a national, multicomponent, quality improvement (QI) programme to reduce low-value EHR notifications. The programme involved three steps: (1) accessing daily PCP notification load data at all 148 facilities operated nationally by the VA; (2) standardising and restricting mandatory notification types at all facilities to a recommended list; and (3) hands-on training for all PCPs on customising and processing notifications more effectively. Designated leaders at each of VA's 18 regional networks led programme implementation using a nationally developed toolkit. Each network supervised technical requirements and data collection, ensuring consistency. Coaching calls and emails allowed the national team to address implementation challenges and monitor effects. We analysed notification load and mandatory notifications preintervention (March 2017) and immediately postintervention (June-July 2017) to assess programme impact. Median number of mandatory notification types at each facility decreased significantly from 15 (IQR: 13-19) to 10 (IQR: 10-11) preintervention to postintervention, respectively (Pmanage them. Nevertheless, our project suggests feasibility of using large-scale 'de-implementation' interventions to reduce unintended safety or efficiency consequences of well-intended electronic communication systems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. [Efficacy of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation].

    Science.gov (United States)

    Li, Jian-xin; Lu, Qing-ge

    2015-05-01

    To observe the clinical effectiveness of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation (PE). A total of 120 patients with secondary non-consolidated kidney qi PE were randomly assigned to groups A (aged [35.5 ± 5.4] yr), B (aged [36.2 ± 5.7] yr), and C (aged [35.2 ± 5.3] yr) in the ratio of 1:1:1 to receive Qilin Pills (once 6 g, bid), sertraline (once 50 mg, qd), and Qilin Pills plus sertraline, respectively, all for 4 weeks. The intravaginal ejaculatory latency time (IELT) and PE diagnostic tool (PEDT) scores were obtained before and after medication and at 1 month after drug withdrawal, and comparative analyses were made among the three groups of patients. The IELT was dramatically prolonged in groups A, B, and C after treatment ([3.23 ± 1.84], [3.87 ± 2.43], and [5.92 ± 3.11] min) and at 1 month after drug withdrawal ([1.85 ± 1.27], [1.52 ± 1.06], and [ 4.26 ± 1.88 ] min) as compared with the baseline ([0.88 ± 0.45], [0.84 ± 0.47], and [0.85 ± 0.50] min) (P Pills combined with sertraline has a definite efficacy in the treatment of secondary non-consolidated kidney qi PE and therefore deserves wide clinical application.

  14. [Effect of protein intervention on amino acid metabolism spectrum of Qi and Yin deficiency type 2 diabetic rats].

    Science.gov (United States)

    Ma, Li-Na; Mao, Xin-Min; Ma, Xiao-Li; Li, Lin-Lin; Wang, Ye; Tao, Yi-Cun; Wang, Jing-Wei; Guo, Jia-Jia; Lan, Yi

    2016-11-01

    To study the effect of plant protein and animal protein on amino acid metabolism spectrum of Qi and Yin deficiency type 2 diabetic rats. 110 male SD rats were randomly divided into blank group (n=10), diabetic model group (n=20), disease-symptoms group (n=80). The rats of blank group received ordinary feeding, while other groups were fed with high sugar and fat diets. During the whole process of feeding, rats of disease-symptoms group were given with Qingpi-Fuzi (15.75 g•kg⁻¹) once a day through oral administration. Five weeks later, the rats were given with a low dose of STZ (40 mg•kg⁻¹) by intraperitoneal injection to establish experimental diabetic models. Then the models were randomly divided into disease-symptoms group 1 (Qi and Yin deficiency diabetic group, 15.75 g•kg⁻¹), disease-symptoms group 2 (plant protein group, 0.5 g•kg⁻¹), disease-symptoms group 3 (animal protein group, 0.5 g•kg⁻¹), disease-symptoms group 4 (berberine group, 0.1 g•kg⁻¹). The drugs were given for 4 weeks by gavage administration. After 4 weeks of protein intervention, the abdominal aortic blood was collected and serum was isolated to analyze its free amino acid by using AQC pre-column derivatization HPLC and fluorescence detector. Four weeks after the protein intervention, plant protein, animal protein and berberine had no obvious effect on body weight and blood sugar in type 2 diabetic rats. As compared with animal protein group, histidine and proline(PYin deficiency type 2 diabetic SD rats. Symbolic differential compounds could be found through metabonomics technology, providing experimental basis for early warning of type 2 diabetes and diagnosis of Qi and Yin deficiency syndrome. Copyright© by the Chinese Pharmaceutical Association.

  15. Gene Expression Profiles of HIV/AIDS Patients with Qi-Yin Deficiency and Dampness-Heat Retention.

    Science.gov (United States)

    Liu, Sa; Chen, Yulong; Xie, Shiping; Xu, Qianlei; Chen, Jianshe; Wang, Changhai; Wang, Zhao; Ma, Suna; Wu, Xingwei; Zhang, Ning

    2016-11-01

    Traditional Chinese Medicine (TCM) applied in the clinic as a complementary and alternative therapy has helped improve immunity and reduce side effects and symptomatic treatment in patients with HIV/AIDS. However, the mechanisms of TCM syndromes are not clear. Transcriptomics enables the study of such TCM syndromes. This study compared the messenger RNA (mRNA) expressions of healthy persons and patients with HIV/AIDS who had two common TCM syndromes, qi-yin deficiency and dampness-heat retention, to find the difference in HIV/AIDS with TCM syndromes. Comparison with healthy persons identified 113 mRNAs-41 enhanced and 72 decreased-in the qi-yin deficiency group. Additionally, 76 mRNAs were found in the dampness-heat retention group: 14 increased and 62 decreased. Functional genetic analysis of the mRNAs indicated that two TCM syndromes were correlated with cell apoptosis, immunoinflammatory responses, and lymphocyte activation. Differentially expressed mRNAs in the qi-yin deficiency group were obviously associated with cellular activity, communication, protein localization, cellular ion homeostasis, and regulation of cell motion, whereas mRNAs in the dampness-heat retention group were associated with sequence-specific DNA binding, cellular response to stress, and hemopoietic or lymphoid organ development. These results suggest that the formation of different TCM syndromes in patients with HIV/AIDS were founded on biological transcriptomics, which reveal mechanisms of the formation of these syndromes in HIV/AIDS. Differentially expressed mRNAs in two TCM syndrome groups tended to normalize after TCM intervention, which indicates that TCM might remit symptoms by changing genetic expression.

  16. Clinical Observation on Insomnia Treated by Wei-Defensive Qi-Regulating and Brain-Strengthening Needling Technique

    Institute of Scientific and Technical Information of China (English)

    GAO Xi-yan; LI Xing-rui; MA Qiao-lin; ZHAO Xin-ji; SHAO Su-ju; WEI Yu-long; SUN Wei-xia; HANG Guo-qi

    2007-01-01

    In order to make a report on 90 cases of insomnia treated by the Wei-defensive qi-regulating and brain-strengthening needling technique,as a clinical subject of the multiple center,for assessing the preliminary standardized indications and operating methods and making an initial summary for writing the draft of the technique operation.Methods:By ratio of 1:1,the patients in conformity with the criteria were randomly divided into the experimental group and control group.In the experimental group,45 cases were treated with the Wei-defensive qi-regulating and brain-strengthening needling technique on Baihui (GV 20),Dazhui(GV 14),Shenmai(BL 62),Zhaohai(KI 6),plus ear points.In the control group,45 cases were treated with routine acupuncture on Sishencong(Ex-HN 1),Shenmen (HT 7),Sanyinjiao(SP 6),etc.The therapeutic effects in the two groups were observed and assessed in comparison.Results:The results showed cure in 15 cases.remarkable effect in 27 cases,effect in 42 cases,failure in 6 cases,and the total eriective rate in 94.4% in 90 cases of insomnia.In the three centers,the statistic management was performed based upon PSQI integral and showed significant difference(P<0.01),and no significant difference among various groups(P>0.01).Conclusion:The therapeutic effect in the treatment of insomnia by Wei-defensive qi-regulating and brain-strengthening needling technique is better than the control group and the therapeutic effect and methods in various centers are stable.without any deviation.

  17. [Correlation between spirit-qi acupuncture and lifting-thrusting twirling method for spirit in Huangdi Neijing].

    Science.gov (United States)

    Wang, Feng; Qin, Yuge; Qin, Yuheng; Li, Li; Li, Mei

    2016-03-01

    By analyzing the articles in Huangdi Neijing (Inner Canon of Yellow Emperor), combined with the verification of consciousness in vitro in clinic and modern science, it is found Huangdi Neijing has made special requirements of treating spirit for physicians using spirit-qi acupuncture. The physicians consciously use different methods to motivate the spirit of physician and patients, especially patients, to transform it to the physiological effect of patients, which could minimize the psychological factors that make negative influence on treatment; also the psychotherapy is considered as the most important principle of treating spirit. The reinforcing and reducing methods in later generations, mainly lifting-thrusting twirling method, unintentionally lead patients into a basic or strong status of treating spirit or keeping spirit during the process of achieving stimulation and needle sensation. To partially perform the special role of treating spirit for physicians in Huangdi Neijing on patients could cause the chages including patient-based using spirit to move qi. It not only inspires the body's natural resistance to disease and self-healing, but also motivates the self-protection mechanism of keeping spirit.

  18. Oral Astragalus (Huang qi) for preventing frequent episodes of acute respiratory tract infection in children.

    Science.gov (United States)

    Su, Guobin; Chen, Xiankun; Liu, Zhuangzhu; Yang, Lihong; Zhang, La; Stålsby Lundborg, Cecilia; Wen, Zehuai; Guo, Xinfeng; Qin, Xindong; Liang, Jueyao; Liu, Xusheng

    2016-12-01

    Acute respiratory tract infections (ARTIs) are common in children and can involve both upper and lower airways. Many children experience frequent ARTI episodes or recurrent respiratory tract infections (RRTIs) in early life, which creates challenges for paediatricians, primary care physicians, parents and carers of children.In China, Astragalus (Huang qi), alone or in combination with other herbs, is used by Traditional Chinese Medicine (TCM) practitioners in the form of a water extract, to reduce the risk of ARTIs; it is believed to stimulate the immune system. Better understanding of the therapeutic mechanisms of Astragalus may provide insights into ARTI prevention, and consequently reduced antibiotic use. To assess the effectiveness and safety of oral Astragalus for preventing frequent episodes of acute respiratory tract infections (ARTIs) in children in community settings. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 12, 2015), MEDLINE (Ovid) (1946 to 31 December 2015), Embase (Elsevier) (1974 to 31 December 2015), AMED (Ovid) (1985 to 31 December 2015), Chinese National Knowledge Infrastructure (CNKI) (1979 to 31 December 2015) and Chinese Scientific Journals full text database (CQVIP) (1989 to 31 December 2015), China Biology Medicine disc (CBM 1976 to 31 December 2015) and Wanfang Data Knowledge Service Platform (WanFang) (1998 to 31 December 2015). We included randomised controlled trials (RCTs) comparing oral Astragalus as a sole Chinese herbal preparation with placebo to prevent frequent episodes of ARTIs in children. We used standard Cochrane methodological procedures for this review. We assessed search results to identify relevant studies. We planned to extract data using standardised forms. Disagreements were to be resolved through discussion. Risk of bias was to be assessed using the Cochrane 'Risk of bias' tool. We planned to use mean difference (MD) or standardised mean difference (SMD) for continuous data and risk

  19. Theory of sinking of qi in treating chronic disease and its clinical application%从大气下陷论治慢性病经验举隅

    Institute of Scientific and Technical Information of China (English)

    范逸品

    2012-01-01

    Chronic diseases are usually occult in onset, complicated, recur repeatedly and long-term, treatment-resistant and so on. With the development of the society, environmental and social changes, chronic diseases has been the most dangerous threats to human health. This paper detailed the concept about qi and sinking of qi and pathogenesis, and holds that sinking of qi is closely related to chronic disease. Through the successful case in the treatment of sequela of myocarditis and progressive muscular dystrophy(PMD), we demonstrate the curative effect about theory of sinking of qi in treating chronic diseases, and analysis the advantages about therapy of invigorating qi and ascending qi collapse.%慢性病具有起病隐匿、病因复杂、反复发作、迁延难愈等特点.随着社会发展、环境因素及生活方式的变化,慢性病已逐渐成为威胁人类健康的首要原因.文章叙述了大气和大气下陷概念及病机特点,提出大气下陷与慢性病密切相关,以病毒性心肌炎后遗症与进行性肌营养不良治疗为例,证实了从大气下陷论治慢性病的疗效并分析了益气升陷法的优势作用.

  20. Courtship and mating of Scorpiops luridus Zhu Lourenço & Qi, 2005 (Scorpiones: Euscorpiidae from Xizang province, China

    Directory of Open Access Journals (Sweden)

    GB Jiao

    2010-01-01

    Full Text Available In the current work, the courtship and mating of Scorpiops luridus Zhu Lourenço & Qi, 2005 (Euscorpiidae from Xizang province (Tibet, China, were studied for the first time in the laboratory. Most of the mating behaviors in Scorpiops luridus are not remarkably different from those exhibited by other scorpions. However, for the first time a male pulling a female with its chelicerae to rapidly accomplish the sperm uptake was observed. Additionally, the sexual stinging behavior displayed by the male occurred in the initial stage, not during the promenade stage as previously described in several scorpion species. Through observation and analysis, we speculate that venom injection during sexual stinging is selective, possibly relying on the status shown by the stung scorpion (passive or aggressive. In order to clearly describe the process of courtship and mating, both sequences are represented in a flow chart, while the main behavior components of these processes were identified, analyzed and discussed.

  1. Treatment of Motor Neuron Disease with Qi-invigorating Herbs—— A Report of 31 Cases

    Institute of Scientific and Technical Information of China (English)

    覃小兰; 杨志敏; 何德平; 刘旭生; 陈红霞; 黄燕; 张文青

    2002-01-01

    @@ The motor neuron disease (MND) refers to a group of progressive diseases with unknown reasons, which attacks the cells of the anterior horn of the spinal cord, the motor nuclei of the brain stem cranial nerves and the pyramidal cells of the cerebral motor cortex. It is characterized in clinic by atrophy of the muscles, myasthenia and even death due to paralysis of the respiratory muscle. Currently, there is still no any effective cure for this illness. 50-70% of the victims will die in 3 to 5 years, and the survival time for those with brain stem injuries is no more than two years.1 Since 1996, the authors have treated 31 cases of motor neuron disease with large dosage of qi-invigorating drugs in accordance with Prof. Liu Mocai's experience, and obtained certain therapeutic effects. A report follows.

  2. [Experimental study on the treatment of serious soft tissue injuries with strengthening the spleen and replenishing qi].

    Science.gov (United States)

    Chen, Xun-wen; Zhu, Yong-zhan; Chen, Zhi-wei; Wu, Zheng-jie; He, Li-lei

    2008-09-01

    To study the effects of Chinese drugs based on strengthening the spleen and replenishing qi treatment rule on neoformative capillaries and fibroblast during the soft tissue repair after serious trauma in rats, so as to explore the biological basis of the TCM theory "the spleen dominate extremities and muscles" applied to the treatment of soft tissue injuries. The model rats were established by bleeding from femoral artery and lancing method, and the rats were randomly divided into the control group, strengthening the spleen group and activating blood and resolving stasis group. The samples were got from the tissue of the wounded area at the 5th, 10th and 15th days after oral administration of the traditional Chinese medicine. After fixation and section, the tissues were stained by CD31 and PCNA staining. The amount of the capillaries and fibroblasts in the tissue of the wounded area were observed through multi-purpose microscope (ZEISS Axioskop2). Quantitative analysis was carried out on Image-ProPlus image analyzer. The amount of the capillaries and fibroblasts in the wounded tissue in the strengthening the spleen group were larger than that in the control group at the 5th, 10th and 15th day. And the proliferation speed of capillaries and fibroblasts was faster than those in the control group or the activating blood and resolving stasis group. The Chinese drugs according to strengthening the spleen and replenishing qi treatment rule were effective to promote growth of the granulation tissue and facilitate healing of the wounded area. And it has better effect than the treatment of promoting blood circulation and removing stasis.

  3. The influence of intestine-based treatment using Xuan Bai Cheng Qi Tang on the concentration of trace elements in the main organs of COPD rats

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    Jiamin Yang

    2017-01-01

    Conclusion: This study showed that “treating from the intestine” using Xuan Bai Cheng Qi Tang and its modified formulae can regulate the concentration of trace elements in the main organs of COPD rats. This may be one of the mechanisms for intestine-based treatment for COPD.

  4. Woman Survival in Chinese Feudal Patrilineal Society: An Analysis of Song Lian's Destiny in Qi Qie Chenqun By Su Tong

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    Xuc Lin

    2009-05-01

    Full Text Available Article depicted woman’s difficulties in maintaining her life as well as her aggressiveness in the patrilineal society in Chinese feudal time. Article analyzed Song Lian’s bad fate. She was the main character of qi qie chenqun novel, written by Su Tong. Article analysis consisted of three parts. The first part described Song Lian’s background of life and her becoming a mistress. The second part indicated Song Lian’s attacking behavior to other woman because of defending her life. His third part analyzed some causes that made Song Lian did not survive in life. It can be concluded that the fact, Song Lian is able to be survive but she decides to be a mistress caused by both personal and o social reasons. Song Lian’s attacking other woman is caused by her anger representing her unsuccessful life. Principally, Song Lian’s failure in the feudal life is caused by her unsuccessful in becoming a respected woman. If she had been a respected woman, she would have also competed with other women in achieving a better life.      

  5. Effect of Da-Cheng-Qi Decoction on Pancreatitis-Associated Intestinal Dysmotility in Patients and in Rat Models

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    Jianlei Zhao

    2015-01-01

    Full Text Available The impairment of intestinal motility and related infectious complications are the predominant clinical phenomenon in patients with severe acute pancreatitis (SAP. We aimed to investigate the effects of Da-Cheng-Qi decoction (DCQD on the gastrointestinal injury in SAP patients and the potential mechanism involved in rats. DCQD was enema administered to 70 patients for 7 days in West China Hospital. Mortality and organ failure during admission were observed and blood samples for laboratory analysis were collected. We also experimentally examined plasma inflammatory cytokines in rat serum and carried the morphometric studies of the gut. Intestinal propulsion index and serum and tissue vasoactive intestinal peptide (VIP were also detected. Though DCQD did not affect the overall incidence of organ failure, it shortened the average time of paralytic intestinal obstruction and decreased the morbidity of infectious complications in patients with SAP. Compared with untreated rats, the DCQD lowered the levels of proinflammatory cytokine and decreased the mean pathological intestinal lesion scores. The VIP level in intestinal tissue or serum in DCQD group was obviously lowered and intestinal propulsion index was significantly improved. In conclusion, DCQD has good effect on pancreatitis-associated intestinal dysmotility in patients and in rat models.

  6. "Warming yang and invigorating qi" acupuncture alters acetylcholine receptor expression in the neuromuscular junction of rats with experimental autoimmune myasthenia gravis

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    Hai-peng Huang

    2016-01-01

    Full Text Available Myasthenia gravis is an autoimmune disorder in which antibodies have been shown to form against the nicotinic acetylcholine nicotinic postsynaptic receptors located at the neuromuscular junction. "Warming yang and invigorating qi" acupuncture treatment has been shown to reduce serum inflammatory cytokine expression and increase transforming growth factor beta expression in rats with experimental autoimmune myasthenia gravis. However, few studies have addressed the effects of this type of acupuncture on the acetylcholine receptors at the neuromuscular junction. Here, we used confocal laser scanning microscopy to examine the area and density of immunoreactivity for an antibody to the nicotinic acetylcholine receptor at the neuromuscular junction in the phrenic nerve of rats with experimental autoimmune myasthenia gravis following "warming yang and invigorating qi" acupuncture therapy. Needles were inserted at acupressure points Shousanli (LI10, Zusanli (ST36, Pishu (BL20, and Shenshu (BL23 once daily for 7 consecutive days. The treatment was repeated after 1 day of rest. We found that area and the integrated optical density of the immunoreactivity for the acetylcholine receptor at the neuromuscular junction of the phrenic nerve was significantly increased following acupuncture treatment. This outcome of the acupuncture therapy was similar to that of the cholinesterase inhibitor pyridostigmine bromide. These findings suggest that "warming yang and invigorating qi" acupuncture treatment increases acetylcholine receptor expression at the neuromuscular junction in a rat model of autoimmune myasthenia gravis.

  7. 6 June 2012 - Chinese Nanjing University President J.Chen in the ATLAS visitor centre with Member of the ATLAS Collaboration I. Wingerter and International Relations Office Adviser E. Tsesmelis. M. Qi, Nanjing University and ATLAS Collaboration, accompanies the delegation.

    CERN Multimedia

    Maximilien Brice

    2012-01-01

    6 June 2012 - Chinese Nanjing University President J.Chen in the ATLAS visitor centre with Member of the ATLAS Collaboration I. Wingerter and International Relations Office Adviser E. Tsesmelis. M. Qi, Nanjing University and ATLAS Collaboration, accompanies the delegation.

  8. [Retrospective analysis of risk factors in 900 patients with ischemic cerebral stroke of wind-phlegm collateral obstruction syndrome and qi deficiency blood stasis syndrome in Wuhan District].

    Science.gov (United States)

    Qiu, Xin; Wang, Kai-xin; Chen, Guo-hua

    2011-11-01

    To analyze the correlation between risk factors and ischemic cerebral stroke of wind-phlegm collateral obstruction syndrome and qi deficiency blood stasis syndrome. Totally 900 patients of the two syndrome types were recruited. Risk factors correlated to ischemic cerebral stroke such as gender, age, time of onset, site of infarction, tongue proper, tongue fur, pulse picture, hypertension, diabetes, past stroke history, hyperlipidemia, hematocrit, smoking, drinking, genetic factor, blood type, complications were analyzed using Chi-square test and non-conditional Logistic regression analysis. Statistical significance existed between the two syndrome types in age (X2 = 8.2392, P = 0.0413), hyperlipidemia (X2 = 4.8386, P = 0.0278), tongue proper (X2 = 7.9470, P = 0.0048), and tongue fur (X2 = 4.3298, P = 0.0375). Statistical significance existed between the two syndrome types in hyperlipidemia, tongue proper, and tongue fur, and their OR value was 0.699 (P = 0.0282), 0.332 (P =0.0071), and 0.667 (P = 0.0382) respectively. The OR value of the past stroke history was 3.226 (P = 0.0314), that of complications 0.203 (P = 0.0705), and that of anterior circulation infarction 0.214 (P = 0.0098). Among different ages groups, the constituent ratio of qi deficiency blood stasis syndrome was obviously higher than that of wind-phlegm collateral obstruction syndrome. Besides, patients of qi deficiency blood stasis syndrome were liable to suffer from hyperlipidemia, anterior circulation infarction, and complications. The age, blood lipid levels, site of infarction, complications are closely correlated with Chinese syndrome types of ischemic cerebral stroke, which can provide objective indices for typing ischemic cerebral stroke.

  9. Improving cachectic symptoms and immune strength of tumour-bearing mice in chemotherapy by a combination of Scutellaria baicalensis and Qing-Shu-Yi-Qi-Tang.

    Science.gov (United States)

    Wang, Hang; Chan, Yi-Lin; Li, Tsung-Lin; Wu, Chang-Jer

    2012-05-01

    Cancer cachexia is characterised by the loss of body mass and directly compromises immune response and the quality of life of cancer patients. In the present study, we set out to investigate the role of Chinese herbs as anticancer medicines and/or chemotherapeutic adjuvants to increase therapeutic efficacy and/or ameliorate given side-effects in animal model. Twelve kinds of herbs were chosen from the ingredients of major Chinese herbal medicines, and their effects on the antioxidant activity were investigated. To obtain the anticancer effects of 5-fluorouracil (5-FU) when consumed with minimal side-effects, we investigated the combination effect of Scutellaria baicalensis and Qing-Shu-Yi-Qi-Tang that may enhance the anticancer activity of 5-FU on subcutaneous tumour growth in C57BL/6 mice challenged with Lewis lung carcinoma cells. Qing-Shu-Yi-Qi-Tang, a multiple-component herbal extract, was shown to have high anti-oxidation activity, while S. baicalensis (Chinese skullcap) was demonstrated to have high tumour-growth inhibition activity. Thus, S. baicalensis and Qing-Shu-Yi-Qi-Tang were evaluated for their combinaton effects on the cancer-induced cachectic murine upon receiving 5-FU chemotherapy. As a result, tumour masses and losses of carcass and/or gastrocnemius muscle were found to be significantly decreased. This combination otherwise increased both Th1/Th2 ratio and NK cytotoxicity. In the mice receiving with or without 5-FU, the serum levels of monocyte chemoattractant protein-1 (MCP-1) increased by all means but otherwise decreased when the herbal combination was administrated. Additionally, the expressions of nuclear factor-kappa B (NF-κB) and muscle RING finger protein-1 (MuRF-1) decreased in the gastrocnemius muscle when the herbal combination was applied. Our results revealed that the combination of S. baicalensis and Qing-Shu-Yi-Qi-Tang is able to ameliorate cachectic symptoms and positively stimulate anti-tumour immunity while undergoing

  10. Assessment of Electromagnetic Interference with Active Cardiovascular Implantable Electronic Devices (CIEDs) Caused by the Qi A13 Design Wireless Charging Board.

    Science.gov (United States)

    Seckler, Tobias; Jagielski, Kai; Stunder, Dominik

    2015-05-27

    Electromagnetic interference is a concern for people wearing cardiovascular implantable electronic devices (CIEDs). The aim of this study was to assess the electromagnetic compatibility between CIEDs and the magnetic field of a common wireless charging technology. To do so the voltage induced in CIEDs by Qi A13 design magnetic fields were measured and compared with the performance limits set by ISO 14117. In order to carry this out a measuring circuit was developed which can be connected with unipolar or bipolar pacemaker leads. The measuring system was positioned at the four most common implantation sites in a torso phantom filled with physiological saline solution. The phantom was exposed by using Helmholtz coils from 5 µT to 27 µT with 111 kHz sine‑bursts or by using a Qi A13 design wireless charging board (Qi‑A13‑Board) in two operating modes "power transfer" and "pinging". With the Helmholtz coils the lowest magnetic flux density at which the performance limit was exceeded is 11 µT. With the Qi‑A13‑Board in power transfer mode 10.8% and in pinging mode 45.7% (2.2% at 10 cm distance) of the performance limit were reached at maximum. In neither of the scrutinized cases, did the voltage induced by the Qi‑A13‑Board exceed the performance limits.

  11. [Effects of Chinese herbal medicines for regulating liver qi on expression of 5-hydroxytryptamine 3B receptor in hypothalamic tissues of rats with anger emotion].

    Science.gov (United States)

    Ge, Qing-fang; Zhang, Hui-yun

    2011-08-01

    To explore the central mechanisms of anger emotion and the effects of Chinese herbal medicines for regulating liver qi on the anger emotion and the expression level of 5-hydroxytryptamine 3B receptor (5-HT3BR) in rat hypothalamus. Rat models of anger-in or anger-out emotions were prepared by the methods of resident intruder paradigm. There were five groups in this study: control, anger-in model, Jingqianshu Granule-treated anger-in, anger-out model and Jingqianping Granule-treated anger-out groups. The treatment groups were orally given Jingqianshu granules and Jingqianping granules respectively, and the model groups and the normal control group were given sterile water. Open-field test and sucrose preference test were used to evaluate behavioristics of the rats. Semi-quantitative reverse transcription-polymerase chain reaction and Western blot methods were used to detect the expression levels of 5-HT3BR mRNA and protein in the rat hypothalamus. The expression of 5-HT3BR in hypothalamus of anger-in model rats increased obviously (Pexpressions of 5-HT3BR in the treatment groups were significantly improved (Pexpression and the anger-out emotion can obviously reduce its expression. Chinese herbal medicines for regulating liver qi may treat anger emotion in rats by improving the hypothalamic 5-HT3BR protein and gene expression levels.

  12. Incidencia de Mindfulness y Qi Gong sobre el Estado de Salud, Bienestar Psicológico, Satisfacción Vital y Estrés Laboral

    Directory of Open Access Journals (Sweden)

    Luis Armando Oblitas Guadalupe

    2017-02-01

    Full Text Available El presente estudio se realizó a través de un abordaje metodológico pre-experimental con medidas de tipo pre-test y post-test. Participaron 52 trabajadores de la Universidad de la Costa (Barranquilla, Colombia, quienes asistieron por invitación al taller de ocho horas de mindfulness y qi gong para el mejoramiento de la salud, bienestar psicológico, satisfacción vital y reducción del estrés. Los instrumentos utilizados fueron el Cuestionario de Salud sf-11, Escala de Bienestar Psicológico (Ryff & Keyes, 1995, Escala de Satisfacción Vital (Cortés, 2013 y Escala Numérica de Estrés Laboral. La combinación de mindfulness y qi gong produjo una mejoría en el estado de salud de los trabajadores —salud general, energía, eficiencia, actividades domésticas y disminución del dolor—, cambios importantes en el bienestar psicológico —adaptación, confianza, claridad, apertura y autoestima—, y mejoramiento de la satisfacción vital —salud y productividad—. No se encontraron diferencias significativas en los niveles de estrés laboral.

  13. An extract of a formula used in the traditional chinese medicine (Buzhong Yi Qi Wan) alters the labeling of blood constituents with technetium-99m

    International Nuclear Information System (INIS)

    Giani, Tania Santos; Paoli, Severo de; Brandao-Neto, Jose; Medeiros, Aldo da Cunha; Presta, Giuseppe Antonio; Maiworm, Adalgisa Ieda; Santos Filho, Sebastiao David; Fonseca, Adenilson de Souza da; Bernardo-Filho, Mario

    2007-01-01

    Buzhong Yi Qi Wan (Buzhong) is a medicinal herb widely used in Traditional Chinese Medicine to treat the digestive and circulatory systems. Red blood cell and plasma proteins labeled with technetium-99m ( 99m Tc) are used in nuclear medicine. The aim of this work was to investigate the effects of an aqueous Buzhong extract on the labeling of blood constituents with 99m Tc. Heparinized blood (Wistar rats) was incubated in vitro with different Buzhong extract concentrations and 99m Tc-labeling was performed. Plasma (P) and blood cells (BC) were separated and soluble (SF-P, SF-BC) and insoluble (IF-P, IF-BC) fractions were isolated. The radioactivity on blood constituents was determined and the percentage of incorporated radioactivity (%ATI) was calculated. Buzhong extract at the highest concentrations used altered significantly (p 99 mTc. (author)

  14. Assessment of effects of a formula used in the traditional Chinese medicine (Buzhong Yi Qi Wan on the morphologic and osmotic fragility of red blood cells

    Directory of Open Access Journals (Sweden)

    Tania S. Giani

    Full Text Available Buzhong Yi Qi Wan (BYQW is a combination of some medicinal herbs widely used in traditional Chinese medicine to treat blood, spleen and stomach disorders. Morphometric analysis and osmotic fragility assay have been used to evaluate changes on membrane integrity of red blood cells. The aim of this work was to evaluate the effect of an aqueous BYQW extract on the morphology and osmotic fragility of red blood cells. Blood samples were treated with BYQW extract, quantitative/qualitative morphological analysis and osmotic fragility assay were carried out against control groups treated with saline. The data obtained indicated no modification on morphology but osmotic fragility assay suggested a significant (p<0.05 increasing of hemolysis in red blood cells isolated from blood treated with aqueous BYQW extract. In conclusion, the aqueous BYQW extract could affect the membrane integrity decreasing the osmotic resistance but without altering the shape of red blood cells.

  15. The cost-effectiveness analysis of JinQi Jiangtang tablets for the treatment on prediabetes: a randomized, double-blind, placebo-controlled, multicenter design.

    Science.gov (United States)

    Sun, Xiao; Guo, Liping; Shang, Hongcai; Ren, Ming; Wang, Yue; Huo, Da; Lei, Xiang; Wang, Hui; Zhai, Jingbo

    2015-11-03

    reduced the incidence of diabetes mellitus and enhanced reversion rate. compared with the control group (p 0.05); finally the compliance of participants between the two groups had no significant difference. The cost-effectiveness analysis outcomes:in the intervention period of 12 months,on the aspect of reversion rate, the treatment group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio;on the aspect of the incidence of diabetes, the control group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio; in the follow-up period of 24 months, on the aspect of reversion rate, the treatment group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio, on the aspect of the incidence of diabetes, the control group had better economic advantage by using cost-effectivenes ratio and the incremental cost-effectiveness ratio.At the same time, these outcomes remained the same by sensitivity analysis. Assuming that prices and resident incomes rose 5%, the sensitiveness analysis shows that the two group affected by the paremeters changed little. The importance and effectiveness of lifestyle education and JinQi Jiangtang tablets was proven. In both the intervention period and follow-up, JinQi Jiangtang tablets combined with lifestyle education had a greater cost advantage effect than the lifestyle education alone on the reversion rate; the lifestyle education had a greater cost advantage effect than the JinQi Jiangtang tablets combined with lifestyle education on the incidence of diabetes. Chinese Clinical Trials ChiCTR-TRC-09000401 ) , registered on 25 May 2009.

  16. Treatment of Goiter with Traditional Chinese Medicine Regimen Xing Qi Hua Ying Tang: A Clinical Study on 72 Patients with Multinodular and Diffuse Goiter.

    Science.gov (United States)

    Yang, Ming-Li; Lu, Bo

    2018-04-01

    The present work aimed to further explore the therapeutic potential of Xing Qi Hua Ying Tang (XQHYT) by conducting a systemic clinical study in patients with goiter. Seventy-two patients with either multinodular or diffuse goiter were enrolled and randomly assigned into treatment group receiving XQHYT (n = 36) and control group receiving Hai Zao Yu Hu Tang (n = 36). Traditional Chinese Medicine Hospital of Shanxi. Patients were diagnosed multinodular goiter or diffuse goiter resulting from Qi stagnation. All patients took the extract twice a day (100 mL each time) for two courses of treatment, of which a single course lasted for 3 months. Before the treatment was commenced and after the completion of the treatment, general body checks, thyroid function test, and goiter size examination were performed. Scoring of the clinical symptoms using Chinese medicine symptomatology was also done. The symptom score of the treatment group was significantly lower than that of the control group (treatment group, 8.26 ± 2.62; control group, 10.02 ± 2.62; p < 0.05). Substantial reduction in goiter size was seen in 82.3% of XQHYT-treated patients, whereas in the control group only 67.7% of patients exhibited constricted goiter. When assessed by both the Chinese medicine criteria and goiter size, the overall effective rate of the treatment group was 91.2%, whereas that of the control group was only 67.7%. The difference was statistically significant (p < 0.05). XQHYT did not affect the normal functions of liver, kidney, and heart. For both groups of patients, their levels of thyroid-stimulating hormone, free T4 and free T3 were normal before the treatment, and were not affected by the treatment. XQHYT was shown to be a promising therapeutic regimen for the treatment of goiter. The herbal regimen ameliorated clinical symptoms of patients that were accompanied with reduction in the size of goiter.

  17. Measurements of VOC fluxes by Eddy-covariance with a PTR-Qi-TOF-MS over a mature wheat crop near Paris: Evaluation of data quality and uncertainties.

    Science.gov (United States)

    Buysse, Pauline; Loubet, Benjamin; Ciuraru, Raluca; Lafouge, Florence; Zurfluh, Olivier; Gonzaga-Gomez, Lais; Fanucci, Olivier; Gueudet, Jean-Christophe; Decuq, Céline; Gros, Valérie; Sarda, Roland; Zannoni, Nora

    2017-04-01

    The quantification of volatile organic compounds (VOC) fluxes exchanged by terrestrial ecosystems is of large interest because of their influence on the chemistry and composition of the atmosphere including aerosols and oxidants. Latest developments in the techniques for detecting, identifying and measuring VOC fluxes have considerably improved the abilities to get reliable estimates. Among these, the eddy-covariance (EC) methodology constitutes the most direct approach, and relies on both well-established principles (Aubinet et al. 2000) and a sound continuously worldwide improving experience. The combination of the EC methodology with the latest proton-transfer-reaction mass spectrometer (PTR-MS) device, the PTR-Qi-TOF-MS, which allows the identification and quantification of more than 500 VOC at high frequency, now provides a very powerful and precise tool for an accurate quantification of VOC fluxes on various types of terrestrial ecosystems. The complexity of the whole methodology however demands that several data quality requirements are fulfilled. VOC fluxes were measured by EC with a PTR-Qi-TOF-MS (national instrument within the ANAEE-France framework) for one month and a half over a mature wheat crop near Paris (FR-GRI ICOS site). Most important emissions (by descending order) were observed from detected compounds with mass-over-charge (m/z) ratios of 33.033 (methanol), 45.033 (acetaldehyde), 93.033 (not identified yet), 59.049 (acetone), and 63.026 (dimethyl sulfide or DMS). Emissions from higher-mass compounds, which might be due to pesticide applications at the beginning of our observation period, were also detected. Some compounds were also seen to deposit (e.g. m/z 47.013, 71.085, 75.044, 83.05) while others exhibited bidirectional fluxes (e.g. m/z 57.07, 69.07). Before analyzing VOC flux responses to meteorological and crop development drivers, a data quality check was performed which included (i) uncertainty analysis of mass and concentration

  18. An extract of a formula used in the traditional chinese medicine (Buzhong Yi Qi Wan alters the labeling of blood constituents with technetium-99m

    Directory of Open Access Journals (Sweden)

    Tania Santos Giani

    2007-09-01

    Full Text Available Buzhong Yi Qi Wan (Buzhong is a medicinal herb widely used in Traditional Chinese Medicine to treat the digestive and circulatory systems. Red blood cell and plasma proteins labeled with technetium-99m (99mTc are used in nuclear medicine. The aim of this work was to investigate the effects of an aqueous Buzhong extract on the labeling of blood constituents with 99mTc. Heparinized blood (Wistar rats was incubated in vitro with different Buzhong extract concentrations and 99mTc-labeling was performed. Plasma (P and blood cells (BC were separated and soluble (SF-P, SF-BC and insoluble (IF-P, IF-BC fractions were isolated. The radioactivity on blood constituents was determined and the percentage of incorporated radioactivity (%ATI was calculated. Buzhong extract at the highest concentrations used altered significantly (pBuzhong Yi Qi Wan (Buzhong é uma fórmula utilizada na Medicina Tradicional Chinesa para tratamento de distúrbios nos sistemas digestório e circulatório. Constituintes sangüíneos marcados com tecnécio-99m (99mTc são usados na medicina nuclear. O objetivo deste estudo foi investigar os efeitos do extrato de Buzhong na marcação de constituintes sangüíneos com 99mTc. Amostras de sangue de ratos Wistar foram incubadas com diferentes concentrações do extrato de Buzhong e a marcação de constituintes sangüíneos com 99mTc foi realizado. Plasma e células sangüíneas foram separados, frações solúveis e insolúveis do plasma e das células sangüíneas foram isoladas. A radioatividade nos constituintes sangüíneos foi contada e as porcentagens de radioatividade incorporada (%ATI, determinada. Extrato de Buzhong nas maiores concentrações utilizadas altera significativamente (p<0.05 a %ATI nos constituintes sangüíneos. Substâncias presentes no extrato de Buzhong poderiam alterar a membrana celular e/ou gerar radicais livres, que têm propriedades oxidantes, modificando a marcação dos constituintes sangüíneos com

  19. Yi Qi Qing Re Gao-containing serum inhibits lipopolysaccharide-induced rat mesangial cell proliferation by suppressing the Wnt pathway and TGF-β1 expression.

    Science.gov (United States)

    Yang, Liping; Sun, Xueyan; Zhan, Yongli; Liu, Huijie; Wen, Yumin; Mao, Huimin; Dong, X I; Li, Ping

    2016-04-01

    The aim of the present study was to investigate the effect of Yi Qi Qing Re Gao-containing serum (YQ-S) on rat mesangial cell (MC) proliferation and to investigate the underlying mechanism. MCs were divided into the control, lipopolysaccharide (LPS)-stimulated, YQ-S and fosinopril-containing serum (For-S) groups, and cultured for 48 h. An MTT assay was used to evaluate the proliferation of MCs. In addition, reverse transcription-quantitative polymerase chain reaction and western blot analysis were conducted to detect the expression levels of Wnt4, β-catenin and transforming growth factor (TGF)-β1 in MCs. The results indicated that YQ-S inhibited LPS-induced MC proliferation. The Wnt4 and TGF-β1 mRNA expression levels were reduced in the YQ-S group (P<0.01 or P<0.05). Furthermore, the Wnt4, β-catenin and TGF-β1 protein expression levels were suppressed in the YQ-S group (P<0.01 or P<0.05). Therefore, YQ-S appears to inhibit MC proliferation, and its mechanism may involve the inhibition of the Wnt signaling pathway and downregulation of TGF-β1 expression.

  20. An extract of a formula used in the traditional chinese medicine (Buzhong Yi Qi Wan) alters the labeling of blood constituents with technetium-99m

    Energy Technology Data Exchange (ETDEWEB)

    Giani, Tania Santos; Paoli, Severo de; Brandao-Neto, Jose; Medeiros, Aldo da Cunha [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil). Centro de Ciencias da Saude. Programa de Pos-graduacao em Ciencias da Saude]. E-mail: tgiani@gmail.com; Presta, Giuseppe Antonio; Maiworm, Adalgisa Ieda; Santos Filho, Sebastiao David; Fonseca, Adenilson de Souza da [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. de Biologia Roberto Alcantara Gomes. Lab. de Radiofarmacia Experimental; Bernardo-Filho, Mario [Instituto Nacional de Cancer (INCa), Rio de Janeiro, RJ (Brazil). Centro de Pesquisa Basica

    2007-09-15

    Buzhong Yi Qi Wan (Buzhong) is a medicinal herb widely used in Traditional Chinese Medicine to treat the digestive and circulatory systems. Red blood cell and plasma proteins labeled with technetium-99m ({sup 99m}Tc) are used in nuclear medicine. The aim of this work was to investigate the effects of an aqueous Buzhong extract on the labeling of blood constituents with {sup 99m}Tc. Heparinized blood (Wistar rats) was incubated in vitro with different Buzhong extract concentrations and {sup 99m}Tc-labeling was performed. Plasma (P) and blood cells (BC) were separated and soluble (SF-P, SF-BC) and insoluble (IF-P, IF-BC) fractions were isolated. The radioactivity on blood constituents was determined and the percentage of incorporated radioactivity (%ATI) was calculated. Buzhong extract at the highest concentrations used altered significantly (p<0.05) the %ATI in blood constituents. Substances present in the Buzhong extract could alter the cellular membrane and/or generation of free radicals that have oxidant properties modifying the labeling of blood constituents with {sup 99}mTc. (author)

  1. Effects of Qi-Fang-Xi-Bi-Granules on Cartilage Morphology and C/ebpα Promoter Methylation in Rats with Knee Osteoarthritis

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    Xinxin Wang

    2018-01-01

    Full Text Available Objective. To investigate the effects of Qi-Fang-Xi-Bi-Granules (QFXBGs on cartilage morphology and methylation of C/ebpα (CCAAT/enhancer binding proteinα at the promoter region. Methods. Knee osteoarthritis (KOA modeling was performed in rats in accordance with Hulth’s method, and control group received sham operation. Eight weeks after KOA modeling, the rats in the KOA modeling group were further divided into 6 groups. Each group was given the appropriate drug. After 8 weeks, half of the rats were used for Micro-CT scan, HE staining, ABH/OG staining, immunohistochemistry, and TUNNEL staining of the knee joint tissue, and the other half were used to examine C/ebpα promoter methylation. Results. The three dose groups of QFXBGs all showed lower degrees of surface fissures and flaking, thicker cartilage layer, and restored chondrocyte and subchondral bone morphology, compared with the KOA model group. C/ebpα-22 promoter methylation levels in the high- and low-dose groups were significantly higher than that in the KOA modeling group (p<0.05, while C/ebpα-2 promoter methylation level in the medium-dose group was significantly higher than that in the KOA modeling group (p<0.05. Conclusions. QFXBGs may alleviate articular cartilage degeneration through promoting C/ebpα-2 or C/ebpα-22 methylation at specific promoter sites.

  2. Qi-Dong-Huo-Xue-Yin Inhibits Inflammation in Acute Lung Injury in Mice via Toll-Like Receptor 4/Caveolin-1 Signaling

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    Li-Ying Xu

    2018-01-01

    Full Text Available Acute lung injury (ALI is a critical illness with no current effective treatment. Caveolin-1 indirectly activates inflammation-associated signaling pathways by inhibiting endothelial nitric oxide synthase (eNOS. This induces an imbalance between pro- and anti-inflammatory cytokine levels, which are involved in the pathogenesis of ALI. The compound Chinese prescription Qi-Dong-Huo-Xue-Yin (QDHXY is efficacious for ALI treatment via an anti-inflammatory effect; however, the exact underlying mechanism is unknown. Therefore, we explored the protective effect of QDHXY against lipopolysaccharide- (LPS- induced ALI in mice. Histopathological changes in mouse lung tissues were studied. Furthermore, alterations in the serum levels of pro- and anti-inflammatory cytokines were investigated. The levels of tumor necrosis factor- (TNF-α, interleukin- (IL- 6, IL-1β, and interferon-γ-induced protein 10 in bronchoalveolar lavage fluid were measured. Additionally, the expression levels of myeloid differentiation factor 88 (MyD88, caveolin-1, and eNOS were assessed. QDHXY significantly reduced lung infiltration with inflammatory cells and the production of serum pro- and anti-inflammatory cytokines and inhibited the expression of TNF-α, IL-1β, caveolin-1, and MyD88 but not eNOS. These indicate that QDHXY significantly improved the balance between pro- and anti-inflammatory cytokine levels, possibly by inhibiting the caveolin-1 signaling pathway. Therefore, QDHXY may be a potential treatment for ALI.

  3. Management and Long-Term Outcome of Acute Coronary Syndrome Patients Presenting with Heart Failure in a Contemporary New Zealand Cohort (ANZACS-QI 4).

    Science.gov (United States)

    Kueh, Shaw Hua Anthony; Devlin, Gerry; Lee, Mildred; Doughty, Rob N; Kerr, Andrew J

    2016-08-01

    Acute heart failure (HF) associated with an acute coronary syndrome (ACS) predicts adverse outcome. There have been important recent improvements in ACS management. Our aim was to describe the management and outcomes in those with and without HF in a contemporary ACS cohort. Consecutive patients presenting with ACS between 2007 and 2011 were enrolled in the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry. Outcomes and medication dispensing were obtained using anonymised linkage to national data sets. A summary pharmacotherapy measure of "quadruple therapy" was defined as dispensing of at least one agent from each of the four evidence-based classes - anti-platelet, statin, angiotensin converting enzyme inhibitor/angiotensin receptor blocker and beta blocker. Of 3743 ACS patients 14% had acute HF. Acute heart failure patients were older (69.2±12.6 vs 62.3±12.8 years, pcoronary angiography (66% vs 86%, pAcute heart failure complicating ACS is associated with heightened risk of short-term and long-term mortality. One in three ACS patients with HF did not have coronary angiography and less than half received quadruple therapy a year after presentation. Copyright © 2016. Published by Elsevier B.V.

  4. A ginástica terapêutica e preventiva chinesa Lian Gong/Qi Gong como um dos instrumentos na prevenção e reabilitação da LER/DORT

    Directory of Open Access Journals (Sweden)

    Gutembergue Livramento

    Full Text Available Este ensaio traz elementos da medicina ocidental, da medicina tradicional chinesa e da sociologia do trabalho para reflexão sobre o Qi Gong - exercícios terapêuticos, um dos pilares da Medicina Tradicional Chinesa (MTC - como importante meio de prevenção da LER/DORT e recuperação da saúde. Considerando a natureza interdisciplinar e diversos níveis de prevenção, aborda aspectos sociológicos sobre as condições de trabalho frequentemente relacionadas com este tipo de adoecimento e categorias de trabalhadores mais acometidos. Focaliza aspectos médicos sobre a LER/DORT e as Síndromes de Bloqueio na MTC, estabelecendo canais de articulação e contribuição entre esses campos de conhecimento sobre a saúde humana. Ressalta o Qi Gong como importante prática terapêutica e preventiva na MTC e sua adequação à LER/DORT. No âmbito do Qi Gong, focaliza o Lian Gong Shi Ba Fa - Lian Gong em 18 Terapias, já amplamente experimentado na China e divulgado, inclusive no Brasil, para tratar e prevenir síndromes de dor em região cervical, ombros, membros superiores, membros inferiores e região lombar. À guisa de conclusão, são apresentadas algumas reflexões sobre a propriedade e a importância do Qi Gong na reabilitação e na prevenção da LER/DORT.

  5. Viabilidade da estimativa de QI a partir dos subtestes Vocabulário e Cubos da WAIS-III Viability of IQ estimates based on Vocabulary and Block Design WAIS-III subtests

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    Flávia Wagner

    2010-08-01

    Full Text Available Objetivou-se avaliar a viabilidade de estimar o Quociente de Inteligência (QI de adultos por meio de duas estratégias que utilizam uma forma curta constituída pelos subtestes Vocabulário e Cubos da Escala Wechsler de Inteligência para Adultos (WAIS-III. Participaram do estudo 77 homens e mulheres, com idade média de 39,1 anos (dp=13,4. Foi aplicada a WAIS-III e questionários para cumprir os critérios de inclusão dos participantes sem prejuízos neurológicos e psiquiátricos. Para avaliar a concordância entre as duas estratégias de estimar o QI, utilizou-se o método estatístico proposto por Bland e Altman. Como resultado, encontrou-se que as estimativas de QI geradas pelas duas estratégias apresentam concordância com a medida do QI realizada pela aplicação da escala completa apenas em alguns dos casos avaliados. Sugere-se cautela na utilização dessas estratégias para estimar o QI de adultos.The aim of this study was to evaluate the feasibility of estimating the Intelligence Quotient (IQ in adults based on two strategies that use Vocabulary and Block Design subtests of Wechsler Adult Intelligence Scale (WAIS-III. Seventy-seven men and women participated of the study, with mean age of 39.1 (sd=13.4. WAIS-III subtests were administered and questionnaires were used to verify inclusion criteria for participants without neurological or psychiatric impairments. A statistical method proposed by Bland and Altman was used to evaluate the agreement between both strategies to estimate IQ. Results suggest that IQ estimates derived from both strategies only agree with the IQ derived from the full battery in a few cases of the sample. Considering these findings, caution is suggested when using these strategies to estimate adults' IQ.

  6. [Effect of medicines for activating blood and reinforcing Qi on angiogenesis in infarcted myocardium edge area of acute myocardial infarction model in rats].

    Science.gov (United States)

    Zang, Wen-Hua; Yin, Shen-Hua; Tang, De-Cai; Li, Bing-Bing

    2014-03-01

    To study the effect of medicines for activating blood and reinforcing Qi on the number of new micro-vessels and the protein expressions of VEGF and bFGF in the infarcted myocardium edge area of acute myocardial infarction (AMI) model in rats. The AMI model of rats was established. After the successful model establishment, rats were randomly divided into the sham-operated group, the model group, the Danshen-Huangqi (1 : 2) group, the Danshen-Huangqi (1 : 1) group, the Chuanxiong-Huangqi (1 : 2) group, the Danshen group, the Chuanxiong group, the Chishao group and the Shexiang Baoxin pill group, with five rats in each group. Rats in each medicated group were orally administered with drugs as per 13.5 g x kg(-1) x d(-1) once everyday for three weeks. The immunohistochemical SP method was adopted to detect the expression of vWF in myocardial tissues, and count the number of micro-vessels (MVC). The protein expression of VEGF and bFGF in myocardial tissues were determined by Western blot. The new micro-vessels stained by vWF factor could be found in the infarcted myocardium edge area of the sham-operated group, the model group and all of medicated groups. The sham-operated group show unobvious new micro-vessels in myocardial tissues. A small amount of new micro-vessels could be seen in the infarcted myocardium edge area of the model group. Whereas a larger number of micro-vessels could be seen in the infarcted myocardium edge area of all of medicated groups. The differences between the sham-operated group and the model group had statistical significance (P effect in promoting angiogenesis. Their mechanism for promoting angiogenesis may be related to the improvement of the protein expressions of VEGF and bFGF, so as to increase the contents of VEGF and bFGF and promote the angiogenesis of new vessels.

  7. Tai Chi and Qi Gong

    Science.gov (United States)

    ... of Grants and Contracts General Award Mechanisms Small Business Research Grant Program (SBIR) Funding for: Natural Product Research ... tai chi and qigong in older adults. Western Journal of Nursing Research. 2009;31(2):245–279. Saeed SA, Antonacci ...

  8. Role of phosphatase and tensin homolog deleted on chromosome ten in a rat model of carbon tetrachloride-induced liver fibrosis and the effect of qi-tonifying and blood-activating prescription

    Directory of Open Access Journals (Sweden)

    NIU Xuemin

    2018-01-01

    Full Text Available Objective To investigate the role of phosphatase and tensin homology deleted on chromosome ten (PTEN in a rat model of carbon tetrachloride (CCl4-induced liver fibrosis and the molecular mechanism of action of qi-tonifying and blood-activating prescription in regulating PTEN and inhibiting liver fibrosis. Methods A total of 27 male Wistar rats were randomly divided into three groups, with 9 rats in each group. The rats in liver fibrosis group were treated with CCl4 to establish a model of liver fibrosis, and those in qi-tonifying and blood-activating prescription group were also treated with CCl4 to establish a model and then given a self-made qi-tonifying and blood-activating prescription containing Astragalus membranaceus, Salvia miltiorrhiza, and poria. The rats in the control group were given intraperitoneally injected olive oil. HE staining, Masson staining, and immunohistochemical staining of collagen type I alpha 1 (Col1A1 and collagen type Ⅳ (Col4 were performed to observe the degree of liver fibrosis and collagen deposition; qRT-PCR, immunohistochemistry, and Western blot were used to measure the expression of transforming growth factor-β1 (TGF-β1, PTEN, and downstream genes AKT, mTOR, and p70S6K. A one-way analysis of variance was used for comparison of continuous data between multiple groups and the least significant difference t-test was used for further comparison between any two groups. Results In the liver fibrosis group, liver pathology showed perisinusoidal fibrosis and fibrous tissue proliferation, collagen deposition, and formation of fibrous septum in the portal area; compared with the control group, the liver fibrosis group had significant increases in the mRNA and protein expression of TGF-β1, a significant reduction in the expression of PTEN, and significant increases in the mRNA and phosphorylated protein expression of AKT, mTOR, and p70S6K (all P<0.01. The qi-tonifying and blood-activating prescription group had a

  9. Shen-Qi-Jie-Yu-Fang exerts effects on a rat model of postpartum depression by regulating inflammatory cytokines and CD4+CD25+ regulatory T cells

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    Li JY

    2016-04-01

    Full Text Available Jingya Li,1,* Ruizhen Zhao,1,* Xiaoli Li,1 Wenjun Sun,1 Miao Qu,1 Qisheng Tang,1 Xinke Yang,1 Shujing Zhang2 1Third Affiliated Hospital, 2School of Basic Medical Sciences, Beijing University of Chinese Medicine, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Shen-Qi-Jie-Yu-Fang (SJF is composed of eight Chinese medicinal herbs. It is widely used in traditional Chinese medicine for treating postpartum depression (PPD. Previous studies have shown that SJF treats PPD through the neuroendocrine mechanism. Aim: To further investigate the effect of SJF on the immune system, including the inflammatory response system and CD4+CD25+ regulatory T (Treg cells. Materials and methods: Sprague Dawley rats were used to create an animal model of PPD by inducing hormone-simulated pregnancy followed by hormone withdrawal. After hormone withdrawal, the PPD rats were treated with SJF or fluoxetine for 1, 2, and 4 weeks. Levels of Treg cells in peripheral blood were measured by flow cytometry analysis. Serum interleukin (IL-1β and IL-6 were evaluated by enzyme-linked immunosorbent assay, and gene and protein expressions of IL-1RI, IL-6Rα, and gp130 in the hippocampus were observed by reverse-transcription polymerase chain reaction and Western blot. Results: Serum IL-1β in PPD rats increased at 2 weeks and declined from then on, while serum IL-6 increased at 1, 2, and 4 weeks. Both IL-1β and IL-6 were downregulated by SJF and fluoxetine. Changes in gene and protein expressions of IL-1RI and gp130 in PPD rats were consistent with changes in serum IL-1β, and were able to be regulated by SJF and fluoxetine. The levels of Treg cells were negatively correlated with serum IL-1β and IL-6, and were decreased in PPD rats. The levels of Treg cells were increased by SJF and fluoxetine. Conclusion: Dysfunction of proinflammatory cytokines and Tregs in different stages of PPD was attenuated by SJF and fluoxetine through

  10. Evaluation of an on-line methodology for measuring volatile organic compounds (VOC) fluxes by eddy-covariance with a PTR-TOF-Qi-MS

    Science.gov (United States)

    Loubet, Benjamin; Buysse, Pauline; Lafouge, Florence; Ciuraru, Raluca; Decuq, Céline; Zurfluh, Olivier

    2017-04-01

    Field scale flux measurements of volatile organic compounds (VOC) are essential for improving our knowledge of VOC emissions from ecosystems. Many VOCs are emitted from and deposited to ecosystems. Especially less known, are crops which represent more than 50% of French terrestrial surfaces. In this study, we evaluate a new on-line methodology for measuring VOC fluxes by Eddy Covariance with a PTR-Qi-TOF-MS. Measurements were performed at the ICOS FR-GRI site over a crop using a 30 m long high flow rate sampling line and an ultrasonic anemometer. A Labview program was specially designed for acquisition and on-line covariance calculation: Whole mass spectra ( 240000 channels) were acquired on-line at 10 Hz and stored in a temporary memory. Every 5 minutes, the spectra were mass-calibrated and normalized by the primary ion peak integral at 10 Hz. The mass spectra peaks were then retrieved from the 5-min averaged spectra by withdrawing the baseline, determining the resolution and using a multiple-peak detection algorithm. In order to optimize the peak detection algorithm for the covariance, we determined the covariances as the integrals of the peaks of the vertical-air-velocity-fluctuation weighed-averaged-spectra. In other terms, we calculate , were w is the vertical component of the air velocity, Sp is the spectra, t is time, lag is the decorrelation lag time and denotes an average. The lag time was determined as the decorrelation time between w and the primary ion (at mass 21.022) which integrates the contribution of all reactions of VOC and water with the primary ion. Our algorithm was evaluated by comparing the exchange velocity of water vapor measured by an open path absorption spectroscopy instrument and the water cluster measured with the PTRQi-TOF-MS. The influence of the algorithm parameters and lag determination is discussed. This study was supported by the ADEME-CORTEA COV3ER project (http://www6.inra.fr/cov3er).

  11. Lipidomics study of plasma phospholipid metabolism in early type 2 diabetes rats with ancient prescription Huang-Qi-San intervention by UPLC/Q-TOF-MS and correlation coefficient.

    Science.gov (United States)

    Wu, Xia; Zhu, Jian-Cheng; Zhang, Yu; Li, Wei-Min; Rong, Xiang-Lu; Feng, Yi-Fan

    2016-08-25

    Potential impact of lipid research has been increasingly realized both in disease treatment and prevention. An effective metabolomics approach based on ultra-performance liquid chromatography/quadrupole-time-of-flight mass spectrometry (UPLC/Q-TOF-MS) along with multivariate statistic analysis has been applied for investigating the dynamic change of plasma phospholipids compositions in early type 2 diabetic rats after the treatment of an ancient prescription of Chinese Medicine Huang-Qi-San. The exported UPLC/Q-TOF-MS data of plasma samples were subjected to SIMCA-P and processed by bioMark, mixOmics, Rcomdr packages with R software. A clear score plots of plasma sample groups, including normal control group (NC), model group (MC), positive medicine control group (Flu) and Huang-Qi-San group (HQS), were achieved by principal-components analysis (PCA), partial least-squares discriminant analysis (PLS-DA) and orthogonal partial least-squares discriminant analysis (OPLS-DA). Biomarkers were screened out using student T test, principal component regression (PCR), partial least-squares regression (PLS) and important variable method (variable influence on projection, VIP). Structures of metabolites were identified and metabolic pathways were deduced by correlation coefficient. The relationship between compounds was explained by the correlation coefficient diagram, and the metabolic differences between similar compounds were illustrated. Based on KEGG database, the biological significances of identified biomarkers were described. The correlation coefficient was firstly applied to identify the structure and deduce the metabolic pathways of phospholipids metabolites, and the study provided a new methodological cue for further understanding the molecular mechanisms of metabolites in the process of regulating Huang-Qi-San for treating early type 2 diabetes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. A ginástica terapêutica e preventiva chinesa Lian Gong/Qi Gong como um dos instrumentos na prevenção e reabilitação da LER/DORT

    OpenAIRE

    Livramento,Gutembergue; Franco,Tânia; Livramento,Alaíde

    2010-01-01

    Este ensaio traz elementos da medicina ocidental, da medicina tradicional chinesa e da sociologia do trabalho para reflexão sobre o Qi Gong - exercícios terapêuticos, um dos pilares da Medicina Tradicional Chinesa (MTC) - como importante meio de prevenção da LER/DORT e recuperação da saúde. Considerando a natureza interdisciplinar e diversos níveis de prevenção, aborda aspectos sociológicos sobre as condições de trabalho frequentemente relacionadas com este tipo de adoecimento e categorias de...

  13. To compare the efficacy of two kinds of Zhizhu pills in the treatment of functional dyspepsia of spleen-deficiency and qi-stagnation syndrome:a randomized group sequential comparative trial

    Science.gov (United States)

    2011-01-01

    Background In Traditional Chinese Medicine (TCM) theory, functional dyspepsia (FD) can be divided into different syndromes according to different clinical symptoms and signs, and the most common one is spleen-deficiency and qi-stagnation syndrome that can be treated by Chinese traditional patent medicine ---- two kinds of Zhizhu pills, between which the primary difference in ingredients is that one contains immature orange fruit of Citrus aurantium L.(IFCA) and the other contains that of Citrus sinensis Osbeck (IFCS). The trial's objective was to compare the efficacy of two kinds of Zhizhu pills on symptom changes in patients with FD of spleen-deficiency and qi-stagnation syndrome. Methods A randomized, group sequential, double-blinded, multicenter trial was conducted in patients with FD of spleen-deficiency and qi-stagnation syndrome at 3 hospitals in Beijing between June 2003 and May 2005. Participants were randomly allocated into two groups (IFCA group and IFCS group) in a 1:1 ratio, and respectively took one of the two kinds of Zhizhu pills orally, 6 g each time, 3 times a day, for 4 weeks. Statistical analysis was performed with use of a group sequential method, the triangular test (TT). Results A total of 163 patients were randomized, and 3 patients were excluded from analysis because of early dropouts, leaving 160 patients (IFCA group: n = 82; IFCS group: n = 78) for statistical analysis. Three interim analyses were done after 62, 116, and 160 patients had completed their 4-week treatment, respectively. At the third interim analysis, the sample path crossed the upper boundary and the trial was stopped, the cure-markedly effective rates were 45% for IFCS group and 67% for IFCA group, respectively, the one-sided p-value was 0.0036, the median unbiased estimate of the odds ratio (OR) for the benefit of IFCA relative to IFCS was 2.91 with 95%CI: 1.40 to 6.06. No adverse events were observed in the two groups. Conclusions Zhizhu pills containing IFCA was superior

  14. 辛弃疾的“事功派”思想及在稼轩词中的体现%Xin Qi-ji’s Utilitarianism Ethics Thought And influence on Jiaxuan Ci-poems

    Institute of Scientific and Technical Information of China (English)

    宋学达

    2013-01-01

    事功派哲学家陈亮与辛弃疾私交甚厚,其哲学思想必然会对辛弃疾产生影响,而历来对辛弃疾的研究中,似乎很少关注其思想哲学的相关问题。本文旨在论证辛弃疾的哲学思想乃是以陈亮为代表的事功派哲学一脉,并探讨事功派哲学对稼轩词艺术特质及词史地位所产生的深刻影响。%Chen Liang, the philosopher of Utilitarianism Ethics Thought, has a good relationship with Xin Qi-ji. So his philosophical thoughts certainly would have an influence on Xin Qiji. But in the past, on the study of Xin Qi-ji, we can seldom found researches concerning his thought of philosophy. This dissertation is aimed to argue that Xin's philosophical thoughts is a brunch of Chen’s Utilitarianism Ethics Thought and the latter had great influence on Jiaxuan Ci-Poems, including its artistic particularities and the status in Ci-poetry history.

  15. [Effects of Chinese herbal compound for supplementing qi and activating blood circulation on actin, Cx43 expressions and gap junctional intercellular communication functions of myocardial cells in patients with Coxsackie virus B 3 viral myocarditis].

    Science.gov (United States)

    Zhang, Ming-xue; He, Wei; Gu, Ping

    2010-08-01

    To observe the effect of Chinese herbal compound for supplementing qi and activating blood circulation (CHC) on the gap junctional intercellular communication (GJIC) function of myocardial cells in patients with Coxsackie virus B 3 (CVB3) viral myocarditis. Expressions of actin and connexin43 (Cx43) in myocardial cells of patients arranged in three groups (the normal control group, the viral infected group and the CHC treated group) were detected by immunohistochemical method; the fluorescence photobleaching recovery rate of cells was detected by laser scanning confocal microscope. As compared with the viral infected group, the expressions of actin and Cx43 were increased and the GJIC function was improved in the CHC treated group. CHC could antagonize viral injury on skeleton protein, and repair the structure of gap junction channel to improve the GJIC function of myocardial cells after being attacked by CVB3.

  16. Simultaneous Qualitative and Quantitative Analysis of Multiple Chemical Constituents in YiQiFuMai Injection by Ultra-Fast Liquid Chromatography Coupled with Ion Trap Time-of-Flight Mass Spectrometry

    Directory of Open Access Journals (Sweden)

    Chunhua Liu

    2016-05-01

    Full Text Available YiQiFuMai injection (YQFM is a modern lyophilized powder preparation derived from the traditional Chinese medicine Sheng-mai san (SMS used for treating cardiovascular diseases, such as chronic heart failure. However, its chemical composition has not been fully elucidated, particularly for the preparation derived from Ophiopogon japonicus. This study aimed to establish a systematic and reliable method to quickly and simultaneously analyze the chemical constituents in YQFM by ultra-fast liquid chromatography coupled with ion trap time-of-flight mass spectrometry (UFLC-IT-TOF/MS. Sixty-five compounds in YQFM were tentatively identified by comparison with reference substances or literature data. Furthermore, twenty-one compounds, including three ophiopogonins, fifteen ginsenosides and three lignans were quantified by UFLC-IT-TOF/MS. Notably, this is the first determination of steroidal saponins from O. japonicus in YQFM. The relative standard deviations (RSDs of intra- and inter-day precision, reproducibility and stability were <4.9% and all analytes showed good linearity (R2 ≥ 0.9952 and acceptable recovery of 91.8%–104.2% (RSD ≤ 5.4%, indicating that the methods were reliable. These methods were successfully applied to quantitative analysis of ten batches of YQFM. The developed approach can provide useful and comprehensive information for quality control, further mechanistic studies in vivo and clinical application of YQFM.

  17. The first ever Cochrane event in Russia and Russian speaking countries - Cochrane Russia Launch - Evidence-based medicine: Achievements and barriers (QiQUM 2015) International Conference, Kazan, December 7-8, 2015.

    Science.gov (United States)

    Ziganshina, Liliya Eugenevna; Jørgensen, Karsten Juhl

    2016-01-01

    Kazan hosted Russia's second International Conference QiQUM 2015 on Cochrane evidence for health policy, which was entirely independent of the pharmaceutical or other health industry, bringing together 259 participants from 11 countries and 13 regions of the Russian Federation. The Conference was greeted and endorsed by world leaders in Evidence-based medicine, health and pharmaceutical information, policy and regulation, and the World Health Organization. Participants discussed the professional and social problems arising from biased health information, unethical pharmaceutical promotion, misleading reporting of clinical trials with consequent flaws in health care delivery and the role of Cochrane evidence for informed decisions and better health. The first in history Cochrane workshop, facilitated jointly by experts from Cochrane and the WHO, with 40 participants from Kazakhstan, Kyrgyzstan, Tajikistan and Russia introduced the concept of Cochrane systematic review and the Use of Cochrane evidence in WHO policy setting. Websites document conference materials and provide interface for future collaboration: http://kpfu.ru/biology-medicine/struktura-instituta/kafedry/kfikf/konferenciya/mezhdunarodnaya-konferenciya-39dokazatelnaya.html and http://russia.cochrane.org/news/international-conference.

  18. Determination of blood concentrations of main active compounds in Zi-Cao-Cheng-Qi decoction and their total plasma protein binding rates based on hollow fiber liquid phase microextraction coupled with high performance liquid chromatography.

    Science.gov (United States)

    Li, Miaomiao; Chen, Xuan; Hu, Shuang; Wang, Runqin; Peng, Xiaoli; Bai, Xiaohong

    2018-01-01

    Oil-in-salt hollow fiber liquid phase microextraction coupled with high performance liquid chromatography ultraviolet detection (HPLC-UV) was developed for determination of the blood concentrations of the main active compounds, hesperidin, honokiol, shikonin, magnolol, emodin and β,β'-dimethylacrylshikonin, after oral administration of Zi-Cao-Cheng-Qi decoction (ZCCQD) and their total plasma protein binding rates. In the procedure, a hollow fiber segment was immersed in organic solvent to fill the solvent in the fiber lumen and wall pore, and then the fiber was immersed into sodium chloride solution to cover a thin salt membrane on the fiber wall pore filling organic solvent. Various factors affecting the procedure, such as extraction solvent, sample phase pH, stirring rate, extraction time, NaCl concentration and fiber immersion time in the NaCl solution, were optimized. Under the optimum conditions, good linearities (r 2 ≥0.9905), low limits of detection (0.7-2.5ng/mL) or quantitation (1.2-12ng/mL), satisfactory precision (2.6%-12.8%) and accuracy (81.0%-114.2%) of this method, were observed. The results showed that, after oral administration of a 25g/kg dose, (1) the blood concentrations (at 0.5h) of hesperidin, honokiol, shikonin, magnolol, emodin and β,β'-dimethylacrylshikonin were 0.45, 0.40, 0.48, 0.74, 0.11 and 1.11μg/mL, respectively; (2) the total plasma protein binding rates of the six active compounds were 42.0% (hesperidin), 71.8% (honokiol), 64.6% (shikonin), 77.7% (magnolol), 75.3% (emodin) and 75.7% (β,β'-dimethylacrylshikonin), respectively. The proposed procedure coupled with HPLC shows obvious advantages, such as low solvent consumption, simple operation, high sensitivity and strong purifying and can be used for the determination of both the blood concentrations and total plasma protein binding rates of active compounds in traditional Chinese medicine. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Measurements of VOC fluxes by dynamic plant and soil chambers in wheat and maize crop near Paris with a PTR-Qi-TOF-MS: Quantification and response to environmental and physiological drivers.

    Science.gov (United States)

    Gonzaga-Gomez, Lais; Boissard, Christophe; Ciuraru, Raluca; Lafouge, Florence; Zurfluh, Olivier; Buysse, Pauline; Decuq, Céline; Fanucci, Olivier; Gueudet, Jean-Christophe; Gros, Valérie; Sarda, Roland; Zannoni, Nora; Loubet, Benjamin

    2017-04-01

    Volatile organic compounds (VOC) play an important role in the chemistry of the atmosphere as precursors of secondary pollutants such as ozone and organic aerosols. A large variety of VOC are exchanged between plants (BVOC) and the atmosphere. Their fluxes are strongly dependent on environmental factors (temperature, light, biotic and abiotic stress) and vary greatly among plant species. Only few studies focused on BVOC emissions by agricultural plants and were mostly carried in North America. However, agricultural lands occupy 51% of the total country area in France, with wheat being one of the most important crop. We used a PTR-Qi-TOF-MS (national instrument within the ANAEE-France framework) and dynamic chambers to measure BVOC emissions from plant and soil compartments of a wheat and a maize crop near Paris (FR-GRI ICOS site). More than 700 masses were detected thanks to the resolution and sensitivity of this new instrument. We analyze the emission response to light, temperature and stomatal aperture in order to explain the mechanisms of BVOC exchanges by wheat plants. We investigate the emission differences between soil and plant compartment, and between wheat and maize crops. Acetone (m/z 59.049) was the predominant volatile compound in the emissions from wheat. Both methanol (m/z 33.033) and acetaldehyde (m/z 45.033) were also quite abundantly emitted but were less than half the acetone emissions. Other masses detected in relative importance in this study were m/z 63.026 (possible DMS), m/z 93.033 (not identified), m/z 69.069 (isoprene), m/z 57.069 (not identified), m/z 83.085 (possible green leaf volatiles), m/z 73.064 (methyl ethyl ketone). Their emissions were around 7 times smaller than the emissions of acetone. On the other hand we observed a deposition for, mainly, m/z 75.044 (hydroxyacetone) and m/z 61.028 (acetic acid). Methanol presented both positive and negative fluxes witch could indicate either emission or absorption of this compound by the

  20. 角调音乐疗法结合柴胡加龙骨牡蛎汤加减治疗气郁质失眠48例临床观察%Clinical Observation on 48 Cases of Insomnia of Qi Stagnation Type Treated by Jue Tone(角调)Music Combined with Chaihu Jia Longgu Muli Tang(柴胡加龙骨牡蛎汤)

    Institute of Scientific and Technical Information of China (English)

    张莺; 沈叶静; 胡炜; 涂毅萍; 韩德雄

    2017-01-01

    Objective To evaluate the efficacy of Jue Tone music combined with Chaihu Jia Longgu Muli Tang (柴胡加龙骨牡蛎汤,CLMT) in treating insomnia of Qi stagnation type.Methods Totally 139 patients with insomnia of Qi stagnation type were randomized into comprehensive group (48 cases),Chinese medicine group (46 cases) and western medicine group (45 cases).The comprehensive group was treated by Jue Tone music combined with oral modified CLMT,Chinese medicine group was given oral modified CLMT alone,and western medicine group was administered with oral zolpidem tablets.All these three groups were given emotional counseling and health guidance at the same time.The clinical efficacy was evaluated after 4-week treatment with Constitution in Chinese Medicine Questionnaire (CCMQ) and Pittsburgh Sleep Quality Index (PSQI).The treatment safety was also evaluated at the same time.Results The total effective rate in the comprehensive group (95.83%) was higher than that in Chinese medicine group (82.61%) and western medicine group (80.00%) (P <0.05 or P <0.01).Compared with those before treatment,after treatment CCMQ and PSQI scores in the comprehensive group and Chinese medicine group significantly decreased,and the PSQI score of western medicine group also decreased (P < 0.05).CCMQ and PSQI scores in the comprehensive group were lower than those in Chinese medicine group and western medicine group (P < 0.05 or P <0.01).After treatment,the CCMQ score in Chinese medicine group was also lower than that in western medicine group (P < 0.05),but there was no significant difference in PSQI score between the two groups (P > 0.05).No adverse events occurred in each group.Conclusion Jue Tone music combined with oral modified CLMT could improve Qi stagnation status and sleep quality of the patients with insomnia of Qi stagnation type with good safety.%目的 评价角调音乐疗法结合柴胡加龙骨牡蛎汤加减治疗气郁质失眠的疗效.方法 将139例

  1. Tai Chi and Qi Gong for Health and Well-Being

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  2. San luo xuan mo xing ji qi liang hua fen zhi fang fa yan tao

    NARCIS (Netherlands)

    Ye, Y.; Leydesdorff, L.; Wu, Y.

    2014-01-01

    A discussed study on the Triple Helix with its quantitative analysis method. With brief introduction to background and progress of Triple-Helix(TH) researches, it is clarified that TH quantitative methodology focuses on the indicator of synergy (T) as reduction of uncertainty that can be shaped

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  4. Innovation Implementation in the Context of Hospital QI: Lessons Learned and Strategies for Success

    Science.gov (United States)

    Rangachari, Pavani

    2018-01-01

    In 1999, the Institute of Medicine reported that 98,000 people die each year due to medical errors. In the following years, the focus on hospital quality was intensified nationally, with policymakers providing evidence-based practice guidelines for improving health care quality. However, these innovations (evidence-based guidelines) that were being produced at policy levels were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of health care. Circa 2009, nearly a decade after the release of the IOM report, the health care organizational literature began referring to this challenge as “innovation implementation failure” in health care organizations (HCOs), ie, failure to implement an evidence-based practice that is new to a HCO. This stream of literature drew upon management research to explain why innovation implementation failure occurs in HCOs and what could be done to prevent it. This paper conducts an integrative review of the literature on “innovation implementation” in hospitals and health systems over the last decade, since the spotlight was cast on “innovation implementation failure” in HCOs. The review reveals that while some studies have retrospectively sought to identify the key drivers of innovation implementation, through surveys and interviews of practitioners (the “what”), other studies have prospectively sought to understand how innovation implementation occurs in hospitals and health systems (the “how”). Both make distinctive contributions to identifying strategies for success in innovation implementation. While retrospective studies have helped identify the key drivers of innovation implementation, prospective studies have shed light on how these drivers could be attained, thereby helping to develop context-sensitive management strategies for success. The literature has called for more prospective research on the implementation and sustainability of health care innovations. This paper summarizes the lessons learned from the literature, discusses the relevance of management research on innovation implementation in HCOs, and identifies future research avenues. PMID:29546884

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  6. Occurrence of spleen qi deficiency as defined by Chinese medicine in Parkinson disease

    Directory of Open Access Journals (Sweden)

    Ka-Kit Chua

    2017-01-01

    Conclusions: DSQ is 2.5 times higher in PD participants than in the non-PD participants. More PD participants had DSQ in the advanced H&Y stages. A larger study is needed to validate these results on the prevalence of DSQ in persons with PD.

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  2. Innovation Implementation in the Context of Hospital QI: Lessons Learned and Strategies for Success.

    Science.gov (United States)

    Rangachari, Pavani

    2018-01-01

    In 1999, the Institute of Medicine reported that 98,000 people die each year due to medical errors. In the following years, the focus on hospital quality was intensified nationally, with policymakers providing evidence-based practice guidelines for improving health care quality. However, these innovations (evidence-based guidelines) that were being produced at policy levels were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of health care. Circa 2009, nearly a decade after the release of the IOM report, the health care organizational literature began referring to this challenge as "innovation implementation failure" in health care organizations (HCOs), ie, failure to implement an evidence-based practice that is new to a HCO. This stream of literature drew upon management research to explain why innovation implementation failure occurs in HCOs and what could be done to prevent it. This paper conducts an integrative review of the literature on "innovation implementation" in hospitals and health systems over the last decade, since the spotlight was cast on "innovation implementation failure" in HCOs. The review reveals that while some studies have retrospectively sought to identify the key drivers of innovation implementation, through surveys and interviews of practitioners (the "what"), other studies have prospectively sought to understand how innovation implementation occurs in hospitals and health systems (the "how"). Both make distinctive contributions to identifying strategies for success in innovation implementation. While retrospective studies have helped identify the key drivers of innovation implementation, prospective studies have shed light on how these drivers could be attained, thereby helping to develop context-sensitive management strategies for success. The literature has called for more prospective research on the implementation and sustainability of health care innovations. This paper summarizes the lessons learned from the literature, discusses the relevance of management research on innovation implementation in HCOs, and identifies future research avenues.

  3. Tai Chi and Qi Gong for Health and Well-Being

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  6. QTL analysis of kernel soluble sugar content in supersweet corn | Qi ...

    African Journals Online (AJOL)

    sweet corn population consisting of 208 F2 individuals from the cross Ji557 (sh2) × Ji165 (sh2). Density of the linkage groups varied from 2.2 cM to 65.3 cM, with an average of 13.0 2 cM between two adjacent markers. The map covered 1470.9 cM ...

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  9. Progress in approximation theory and applicable complex analysis in memory of Q.I. Rahman

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    Mohapatra, Ram; Qazi, Mohammed; Schmeisser, Gerhard

    2017-01-01

    Current and historical research methods in approximation theory are presented in this book beginning with the 1800s and following the evolution of approximation theory via the refinement and extension of classical methods and ending with recent techniques and methodologies. Graduate students, postdocs, and researchers in mathematics, specifically those working in the theory of functions, approximation theory, geometric function theory, and optimization will find new insights as well as a guide to advanced topics. The chapters in this book are grouped into four themes; the first, polynomials (Chapters 1 –8), includes inequalities for polynomials and rational functions, orthogonal polynomials, and location of zeros. The second, inequalities and extremal problems are discussed in Chapters 9 –13. The third, approximation of functions, involves the approximants being polynomials, rational functions, and other types of functions and are covered in Chapters 14 –19. The last theme, quadrature, cubature and appl...

  10. SU-E-QI-12: Morphometry Based Measurements of the Structural Response to Whole Brain Radiation

    International Nuclear Information System (INIS)

    Fuentes, D; Castillo, R; Castillo, E; Guerrero, T

    2014-01-01

    Purpose: Although state of the art radiation therapy techniques for treating intracranial malignancies have eliminated acute brain injury, cognitive impairment occurs in 50–90% of patients who survive >6mo post irradiation. Quantitative characterization of therapy response is needed to facilitate therapeutic strategies to minimize radiation induced cognitive impairment [1]. Deformation based morphometry techniques [2, 3] are presented as a quantitative imaging biomarker of therapy response in patients receiving whole brain radiation for treating medulloblastoma. Methods: Post-irradiation magnetic resonance imaging (MRI) data sets were retrospectively analyzed in N=15 patients, >60 MR image datasets. As seen in Fig 1(a), volume changes at multiple time points post-irradiation were quantitatively measured in the cerebrum and ventricles with respect to pre-irradiation MRI. A high resolution image Template, was registered to the pre-irradiation MRI of each patient to create a brain atlas for the cerebrum, cerebellum, and ventricles. Skull stripped images for each patient were registered to the initial pre-treatment scan. Average volume changes in the labeled regions were measured using the determinant of the displacement field Jacobian. Results: Longitudinal measurements, Fig 1(b-c), show a negative correlation p=.06, of the cerebral volume change with the time interval from irradiation. A corresponding positive correlation, p=.01, between ventricular volume change and time interval from irradiation is seen. One sample t-test for correlations were computed using a Spearman method. An average decrease in cerebral volume, p=.08, and increase in ventricular volume, p<.001, was observed. The radiation dose was seen directly proportional to the induced volume changes in the cerebrum, r=−.44, p<.001, Fig 1(d). Conclusion: Results indicate that morphometric monitoring of brain tissue volume changes may potentially be used to quantitatively assess toxicity and response to radiation and may provide insight in developing new therapeutic approaches and monitoring efficacy

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  18. SU-E-QI-12: Morphometry Based Measurements of the Structural Response to Whole Brain Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Fuentes, D; Castillo, R; Castillo, E; Guerrero, T [UT MD Anderson Cancer Center, Houston, TX (United States)

    2014-06-15

    Purpose: Although state of the art radiation therapy techniques for treating intracranial malignancies have eliminated acute brain injury, cognitive impairment occurs in 50–90% of patients who survive >6mo post irradiation. Quantitative characterization of therapy response is needed to facilitate therapeutic strategies to minimize radiation induced cognitive impairment [1]. Deformation based morphometry techniques [2, 3] are presented as a quantitative imaging biomarker of therapy response in patients receiving whole brain radiation for treating medulloblastoma. Methods: Post-irradiation magnetic resonance imaging (MRI) data sets were retrospectively analyzed in N=15 patients, >60 MR image datasets. As seen in Fig 1(a), volume changes at multiple time points post-irradiation were quantitatively measured in the cerebrum and ventricles with respect to pre-irradiation MRI. A high resolution image Template, was registered to the pre-irradiation MRI of each patient to create a brain atlas for the cerebrum, cerebellum, and ventricles. Skull stripped images for each patient were registered to the initial pre-treatment scan. Average volume changes in the labeled regions were measured using the determinant of the displacement field Jacobian. Results: Longitudinal measurements, Fig 1(b-c), show a negative correlation p=.06, of the cerebral volume change with the time interval from irradiation. A corresponding positive correlation, p=.01, between ventricular volume change and time interval from irradiation is seen. One sample t-test for correlations were computed using a Spearman method. An average decrease in cerebral volume, p=.08, and increase in ventricular volume, p<.001, was observed. The radiation dose was seen directly proportional to the induced volume changes in the cerebrum, r=−.44, p<.001, Fig 1(d). Conclusion: Results indicate that morphometric monitoring of brain tissue volume changes may potentially be used to quantitatively assess toxicity and response to radiation and may provide insight in developing new therapeutic approaches and monitoring efficacy.

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  3. SU-E-QI-08: Fourier Properties of Cone Beam CT Projection

    International Nuclear Information System (INIS)

    Bai, T; Yan, H; Jia, X; Jiang, Steve B.; Mou, X

    2014-01-01

    Purpose: To explore the Fourier properties of cone beam CT (CBCT) projections and apply the property to directly estimate noise level of CBCT projections without any prior information. Methods: By utilizing the property of Bessel function, we derivate the Fourier properties of the CBCT projections for an arbitrary point object. It is found that there exists a double-wedge shaped region in the Fourier space where the intensity is approximately zero. We further derivate the Fourier properties of independent noise added to CBCT projections. The expectation of the square of the module in any point of the Fourier space is constant and the value approximately equals to noise energy. We further validate the theory in numerical simulations for both a delta function object and a NCAT phantom with different levels of noise added. Results: Our simulation confirmed the existence of the double-wedge shaped region in Fourier domain for the x-ray projection image. The boundary locations of this region agree well with theoretical predictions. In the experiments of estimating noise level, the mean relative error between the theory estimation and the ground truth values is 2.697%. Conclusion: A novel theory on the Fourier properties of CBCT projections has been discovered. Accurate noise level estimation can be achieved by applying this theory directly to the measured CBCT projections. This work was supported in part by NIH(1R01CA154747-01), NSFC((No. 61172163), Research Fund for the Doctoral Program of Higher Education of China (No. 20110201110011) and China Scholarship Council

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  13. Screening bioactive quality control markers of QiShenYiQi dripping pills based on the relationship between the ultra-high performance liquid chromatography fingerprint and vascular protective activity.

    Science.gov (United States)

    Zhuo, Limeng; Peng, Jingjing; Zhao, Yunli; Li, Dongxiang; Xie, Xiuman; Tong, Ling; Yu, Zhiguo

    2017-10-01

    Traditional Chinese medicine consists of complex phytochemical constituents. Selecting appropriate analytical markers of traditional Chinese medicine is a critical step in quality control. Currently, the combination of fingerprinting and efficacy evaluation is considered as a useful method for screening active ingredients in complex mixtures. This study was designed to develop an orthogonal partial least squares model for screening bioactive quality control markers of QishenYiqi dripping pills based on the fingerprint-efficacy relationship. First, the chemical fingerprints of 49 batches of QishenYiqi dripping pill samples were established by ultra-high performance liquid chromatography coupled with a photodiode array detector. Second, ultra-high performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry was exploited to systematically investigate the 36 copossessing fingerprint components in QishenYiqi dripping pills. The vascular protective activity of QishenYiqi dripping pills was determined by using a cell counting kit-8 assay. Finally, fingerprint-efficacy relationship was established by orthogonal partial least squares model. The results indicated that ten components exhibited strong correlation with vascular protective activity, and these were preliminarily screened as quality control markers. The present study provided a novel idea for the study of the pharmacodynamic material basis and quality evaluation of QishenYiqi dripping pills. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Pacemaker Use in New Zealand - Data From the New Zealand Implanted Cardiac Device Registry (ANZACS-QI 15).

    Science.gov (United States)

    Larsen, P D; Kerr, A J; Hood, M; Harding, S A; Hooks, D; Heaven, D; Lever, N A; Sinclair, S; Boddington, D; Tang, E W; Swampillai, J; Stiles, M K

    2017-03-01

    The New Zealand Cardiac Implanted Device Registry (Device) has recently been developed under the auspices of the New Zealand Branch of the Cardiac Society of Australia and New Zealand. This study describes the initial Device registry cohort of patients receiving a new pacemaker, their indications for pacing and their perioperative complications. The Device Registry was used to audit patients receiving a first pacemaker between 1 st January 2014 and 1 st June 2015. We examined 1611 patients undergoing first pacemaker implantation. Patients were predominantly male (59%), and had a median age of 70 years. The most common symptom for pacemaker implantation was syncope (39%), followed by dizziness (30%) and dyspnoea (12%). The most common aetiology for a pacemaker was a conduction tissue disorder (35%), followed by sinus node dysfunction (22%). Atrioventricular (AV) block was the most common ECG abnormality, present in 44%. Dual chamber pacemakers were most common (62%), followed by single chamber ventricular pacemakers (34%), and cardiac resynchronisation therapy - pacemakers (CRT-P) (2%). Complications within 24hours of the implant procedure were reported in 64 patients (3.9%), none of which were fatal. The most common complication was the need for reoperation to manipulate a lead, occurring in 23 patients (1.4%). This is the first description of data entered into the Device registry. Patients receiving a pacemaker were younger than in European registries, and there was a low use of CRT-P devices compared to international rates. Complications rates were low and compare favourably to available international data. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  15. SU-E-QI-14: Quantitative Variogram Detection of Mild, Unilateral Disease in Elastase-Treated Rats

    Energy Technology Data Exchange (ETDEWEB)

    Jacob, R [Pacific Northwest National Laboraory, Richland, WA (United States); Carson, J [Texas Advanced Computing Center, Austin, TX (United States)

    2014-06-15

    Purpose: Determining the presence of mild or early disease in the lungs can be challenging and subjective. We present a rapid and objective method for evaluating lung damage in a rat model of unilateral mild emphysema based on a new approach to heterogeneity assessment. We combined octree decomposition (used in three-dimensional (3D) computer graphics) with variograms (used in geostatistics to assess spatial relationships) to evaluate 3D computed tomography (CT) lung images for disease. Methods: Male, Sprague-Dawley rats (232 ± 7 g) were intratracheally dosed with 50 U/kg of elastase dissolved in 200 μL of saline to a single lobe (n=6) or with saline only (n=5). After four weeks, 3D micro-CT images were acquired at end expiration on mechanically ventilated rats using prospective gating. Images were masked, and lungs were decomposed to homogeneous blocks of 2×2×2, 4×4×4, and 8×8×8 voxels using octree decomposition. The spatial variance – the square of the difference of signal intensity – between all pairs of the 8×8×8 blocks was calculated. Variograms – graphs of distance vs. variance - were made, and data were fit to a power law and the exponent determined. The mean HU values, coefficient of variation (CoV), and the emphysema index (EI) were calculated and compared to the variograms. Results: The variogram analysis showed that significant differences between groups existed (p<0.01), whereas the mean HU (p=0.07), CoV (p=0.24), and EI (p=0.08) did not. Calculation time for the variogram for a typical 1000 block decomposition was ∼6 seconds, and octree decomposition took ∼2 minutes. Decomposing the images prior to variogram calculation resulted in a ∼700x decrease in time as compared to other published approaches. Conclusions: Our results suggest that the approach combining octree decomposition and variogram analysis may be a rapid, non-subjective, and sensitive imaging-based biomarker for quantitative characterization of lung disease.

  16. SU-E-QI-13: Predictable Models for Radio-Sensitizing Agent Kinetics: Application to Stereotactic Synchrotron Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Obeid, L; Schmitt, M; Esteve, F; Adam, J [Grenoble Institut des Neurosciences, La Tronche, RHONE-ALPES (France)

    2014-06-15

    Purpose: Iodine-enhanced radiotherapy is an innovative treatment combining the selective accumulation of an iodinated contrast agent in brain tumors with irradiations using monochromatic medium energy x-rays. The radiation dose enhancement depends on the time course of iodine in the tumors. A prolonged CT scanning (∼30 min) is required to follow-up iodine kinetics for recruited patients. This protocol could lead to substantial radiation dose to the patient. A novel method is proposed to reduce the acquisition time. Methods: 12 patients received an intravenous bolus of iodinated contrast agent, followed by a steady-state infusion to ensure stable intra-tumoral amounts of iodine during the treatment. Absolute iodine concentrations (IC) were derived from 40 multi-slice dynamic conventional CT images of the brain. The impulse response function (IRF) to the bolus was estimated using the adiabatic approximation of the Johnson and Wilson's model. The arterial input function (AIF) of the steady-state infusion was fitted with several models: Gamma, Gamma with recirculation and hybrid. Estimated IC were calculated by convolving the IRF with the modeled AIF and were compared to the measured data. Results: The gamma variate function was not relevant to model the AIF due to high differences with the measured AIF. The hybrid and the gamma with recirculation models provided differences below 8% during the whole acquisition time. The absolute difference between the measured and the estimated IC was lower than 0.5 mg/ml, which corresponds to 5% of dose enhancement error. Conclusion: The proposed method allows a good estimation of the iodine time course with reduced scanning delays (3 instead of 30 min) and dose to the patient. The results suggest that the dose errors may stay within the radiotherapy standards.

  17. SU-E-QI-06: Design and Initial Validation of a Precise Capillary Phantom to Test Perfusion Systems

    Energy Technology Data Exchange (ETDEWEB)

    Wood, R; Iacobucci, G; Khobragade, P; Ying, L; Snyder, K; Wack, D; Rudin, S; Ionita, C [University at Buffalo, Buffalo, NY (United States)

    2014-06-15

    Purpose: To design a precise perfusion phantom mimicking capillaries of the brain vasculature which could be used to test various perfusion protocols and algorithms which generate perfusion maps. Methods: A perfusion phantom was designed in Solidworks and built using additive manufacturing. The phantom was an overall cylindrical shape of diameter and height 20mm and containing capillaries of 200μm or 300μm which were parallel and in contact making up the inside volume where flow was allowed. We created a flow loop using a peristaltic pump and contrast agent was injected manually. Digital Subtraction Angiographic images and low contrast images with cone beam CT were acquired after the contrast was injected. These images were analyzed by our own code in LabVIEW software and Time-Density Curve, MTT and TTP was calculated. Results: Perfused area was visible in the cone beam CT images; however, individual capillaries were not distinguishable. The Time-Density Curve acquired was accurate, sensitive and repeatable. The parameters MTT, and TTP offered by the phantom were very sensitive to slight changes in the TDC shape. Conclusion: We have created a robust calibrating model for evaluation of existing perfusion data analysis systems. This approach is extremely sensitive to changes in the flow due to the high temporal resolution and could be used as a golden standard to assist developers in calibrating and testing of imaging perfusion systems and software algorithms. Supported by NIH Grant: 2R01EB002873 and an equipment grant from Toshiba Medical Systems Corporation.

  18. 'Huang Qi Elixir' for proteinuria in patients with diabetic nephropathy: a study protocol for a randomized controlled pilot trial.

    Science.gov (United States)

    Tu, Xiang; Liu, Fang; Jordan, James B; Ye, Xue Feng; Fu, Ping; Wang, Fei; Zhong, Sen

    2013-07-18

    Diabetic nephropathy (DN) is the major complication of diabetes; proteinuria is the hall mark of DN. Currently, the treatment for proteinuria is mainly limited to angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs). According to Traditional Chinese Medicine (TCM) theory, Chinese medicinals 'securing essence and tonifying the kidney' may be appropriate for proteinuria. The most promising Chinese medicinals and formulae are introduced in the present study to form a potent formula for DN proteinuria. To make oral administration convenient, the formula will be processed in the form of granules. A randomized, multi-center pilot trial will be conducted. Forty eight participants with DN will be randomly assigned to one of four treatment groups: 1. A granule group, at 10 grams, three times daily (G10 group, n = 12); 2. A granule group, at 20 grams, three times daily (G20 group, n = 12); 3. A decoction group (D group, n = 12); and 4. An irbesartan group (Aprovel group, n = 12).The following outcome measures will be used: the percentage change of the albumin-to-creatinine ratio; and the changes in serum creatinine, glomerular filtration rate, fasting plasma glucose and hemoglobulin from baseline to the end of the trial. It is notable that most published clinical trials which assessed the efficacy of TCM on DN were of poor methodology and, therefore, their results have been invalidated. It is necessary to carry out well-designed clinical trials to provide sound evidence. The present trial is a study with potentially great value, for it will provide the parameters for future randomized, placebo-controlled, clinical trials with large sample sizes. The trial is registered on the Chinese Clinical Trial Registry: ChiCTR-TRC-12002718 (http://www.chictr.org/cn/proj/show.aspx?proj=3820).

  19. SU-E-QI-06: Design and Initial Validation of a Precise Capillary Phantom to Test Perfusion Systems

    International Nuclear Information System (INIS)

    Wood, R; Iacobucci, G; Khobragade, P; Ying, L; Snyder, K; Wack, D; Rudin, S; Ionita, C

    2014-01-01

    Purpose: To design a precise perfusion phantom mimicking capillaries of the brain vasculature which could be used to test various perfusion protocols and algorithms which generate perfusion maps. Methods: A perfusion phantom was designed in Solidworks and built using additive manufacturing. The phantom was an overall cylindrical shape of diameter and height 20mm and containing capillaries of 200μm or 300μm which were parallel and in contact making up the inside volume where flow was allowed. We created a flow loop using a peristaltic pump and contrast agent was injected manually. Digital Subtraction Angiographic images and low contrast images with cone beam CT were acquired after the contrast was injected. These images were analyzed by our own code in LabVIEW software and Time-Density Curve, MTT and TTP was calculated. Results: Perfused area was visible in the cone beam CT images; however, individual capillaries were not distinguishable. The Time-Density Curve acquired was accurate, sensitive and repeatable. The parameters MTT, and TTP offered by the phantom were very sensitive to slight changes in the TDC shape. Conclusion: We have created a robust calibrating model for evaluation of existing perfusion data analysis systems. This approach is extremely sensitive to changes in the flow due to the high temporal resolution and could be used as a golden standard to assist developers in calibrating and testing of imaging perfusion systems and software algorithms. Supported by NIH Grant: 2R01EB002873 and an equipment grant from Toshiba Medical Systems Corporation

  20. Acupuncture Treatment of Insomnia by Regulating the Defensive-qi and Strengthening the Brain and the Spinal Cord

    Institute of Scientific and Technical Information of China (English)

    GAO Xi-yan; REN Shan; WANG Pei-yu; WANG Xin-zhong

    2010-01-01

    @@ Insomnia is a commonly encountered disease as the result of insufficient sleeping time and poor sleeping quality, which make people unable to get rid of fatigue, and restore physical strength and energy.In milder cases, it is manifested by difficulty in falling asleep, unsound sleep, sometimes sleeping and sometimes waking, or inability to fall asleep again after waking; while in severe cases, the patient would have sleeplessness all night.

  1. Technology Education and Technology Teacher Education in Taiwan, R.O.C. = Zhong Hua Min Guo Ke Ji Jiao Yu Ji qi shi zi Jiao Yu.

    Science.gov (United States)

    Lee, Lung-Sheng Steven; Wang, Cheng-Pin Peter; Wang, Yen-chao; Shih, Neng-Mu; Yeh, Chung-ching

    Technology education in Taiwan begins with craft work at the elementary school level, and the most important point is the practical application. All junior high school students are required to take the Living Technology course. Content includes technology and life, information and communication, construction and manufacturing, and energy and…

  2. SU-E-QI-21: Iodinated Contrast Agent Time Course In Human Brain Metastasis: A Study For Stereotactic Synchrotron Radiotherapy Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Obeid, L; Esteve, F; Adam, J [Grenoble Institut des Neurosciences, La Tronche, Isere (France); Tessier, A; Balosso, J [Centre Hospitalier Universitaire, La Tronche, Isere (France)

    2014-06-15

    Purpose: Synchrotron stereotactic radiotherapy (SSRT) is an innovative treatment combining the selective accumulation of heavy elements in tumors with stereotactic irradiations using monochromatic medium energy x-rays from a synchrotron source. Phase I/II clinical trials on brain metastasis are underway using venous infusion of iodinated contrast agents. The radiation dose enhancement depends on the amount of iodine in the tumor and its time course. In the present study, the reproducibility of iodine concentrations between the CT planning scan day (Day 0) and the treatment day (Day 10) was assessed in order to predict dose errors. Methods: For each of days 0 and 10, three patients received a biphasic intravenous injection of iodinated contrast agent (40 ml, 4 ml/s, followed by 160 ml, 0.5 ml/s) in order to ensure stable intra-tumoral amounts of iodine during the treatment. Two volumetric CT scans (before and after iodine injection) and a multi-slice dynamic CT of the brain were performed using conventional radiotherapy CT (Day 0) or quantitative synchrotron radiation CT (Day 10). A 3D rigid registration was processed between images. The absolute and relative differences of absolute iodine concentrations and their corresponding dose errors were evaluated in the GTV and PTV used for treatment planning. Results: The differences in iodine concentrations remained within the standard deviation limits. The 3D absolute differences followed a normal distribution centered at zero mg/ml with a variance (∼1 mg/ml) which is related to the image noise. Conclusion: The results suggest that dose errors depend only on the image noise. This study shows that stable amounts of iodine are achievable in brain metastasis for SSRT treatment in a 10 days interval.

  3. Regulation of non-classical immune parameters in immune thrombocytopenic purpura mice by a spleen-invigorating, qi-replenishing and blood-containing formula

    Directory of Open Access Journals (Sweden)

    Tiantian Li

    2015-04-01

    Conclusions: The SQBF had a similar effect to prednisone with regards to enhancing peripheral blood platelet counts in ITP mice. Furthermore, it decreased β-EP levels and increased VIP and SIgA, and protected the thymus. This shows that, on base of the brain-gut axis functions, some non-classical immune vascular active factors or neurotransmitters are also involved in immune responses, and also have relationship with the onset of ITP and bleeding and/or hemostasis. It needs further study to determine whether a change in these active factors is related to immediate hemostasis.

  4. Análise da assimetria funcional hemisférica de crianças com epilepsia parcial e QI normal pelo desempenho nos subtestes do WISC

    OpenAIRE

    Muszkat,Mauro; Vincenzo,Neyde Santacchi de; Masuko,Alice; Reami,Denilce O.; Campos,Carlos J. Reis de

    1991-01-01

    Foram avaliadas 26 crianças, sem deficiência mental, com média de idade de 9±2 anos, com epilepsia parcial sem lesão cerebral evidenciável à TCC e com atividade paroxistica no EEG intercrítico localizada apenas em um hemisfério cerebral. Essas crianças foram submetidas à Escala de Inteligência Wechsler para Crianças (WISC) e à análise dos vários subtestes verbais e execução em relação à localização hemisférica da descarga no EEG. Os dados foram comparados ao desempenho no WISC de um grupo de ...

  5. Comment on “Band gaps structure and semi-Dirac point of two-dimensional function photonic crystals” by Si-Qi Zhang et al.

    Science.gov (United States)

    Zhang, Hai-Feng

    2018-01-01

    Not Available Project supported by the Special Grade of the Financial Support from the China Postdoctoral Science Foundation (Grant No. 2016T90455), the China Postdoctoral Science Foundation (Grant No. 2015M581790), and the Chinese Jiangsu Planned Projects for Postdoctoral Research Funds, China (Grant No. 1501016A).

  6. SU-E-QI-03: Compartment Modeling of Dynamic Brain PET - The Effect of Scatter and Random Corrections On Parameter Errors

    International Nuclear Information System (INIS)

    Häggström, I; Karlsson, M; Larsson, A; Schmidtlein, C

    2014-01-01

    Purpose: To investigate the effects of corrections for random and scattered coincidences on kinetic parameters in brain tumors, by using ten Monte Carlo (MC) simulated dynamic FLT-PET brain scans. Methods: The GATE MC software was used to simulate ten repetitions of a 1 hour dynamic FLT-PET scan of a voxelized head phantom. The phantom comprised six normal head tissues, plus inserted regions for blood and tumor tissue. Different time-activity-curves (TACs) for all eight tissue types were used in the simulation and were generated in Matlab using a 2-tissue model with preset parameter values (K1,k2,k3,k4,Va,Ki). The PET data was reconstructed into 28 frames by both ordered-subset expectation maximization (OSEM) and 3D filtered back-projection (3DFBP). Five image sets were reconstructed, all with normalization and different additional corrections C (A=attenuation, R=random, S=scatter): Trues (AC), trues+randoms (ARC), trues+scatters (ASC), total counts (ARSC) and total counts (AC). Corrections for randoms and scatters were based on real random and scatter sinograms that were back-projected, blurred and then forward projected and scaled to match the real counts. Weighted non-linearleast- squares fitting of TACs from the blood and tumor regions was used to obtain parameter estimates. Results: The bias was not significantly different for trues (AC), trues+randoms (ARC), trues+scatters (ASC) and total counts (ARSC) for either 3DFBP or OSEM (p<0.05). Total counts with only AC stood out however, with an up to 160% larger bias. In general, there was no difference in bias found between 3DFBP and OSEM, except in parameter Va and Ki. Conclusion: According to our results, the methodology of correcting the PET data for randoms and scatters performed well for the dynamic images where frames have much lower counts compared to static images. Generally, no bias was introduced by the corrections and their importance was emphasized since omitting them increased bias extensively

  7. Reply to Cen LiXiang, Li XinQi, and Yan YiJing: No adiabatic conditional geometrical phase shift

    OpenAIRE

    Xiangbin, Wang

    2002-01-01

    Much long before the appearing time of the Comment by Cen, Li, and Yan,, the main issue addresed there by Cen et al had been resolved already. The information offered by the Comment is selective and misleading.

  8. Quality Improvement Cycles that Reduced Waiting Times at ...

    African Journals Online (AJOL)

    It was decided to undertake quality improvement (QI) cycles to analyse and improve the situation, using waiting time as a measure of improvement. Methods: A QI team was chosen to conduct two QI cycles. The allocated time for QI cycle 1 was from May to August 2006 and for QI cycle 2 from September to December 2006.

  9. 78 FR 13342 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-02-27

    .... Officers: Keith Phillips, Vice President (QI), Glenn Henderson, President. Application Type: New NVO & OFF.... Officers: Paul Pellitieri, President (QI), Virginia Pellitieri, Vice President. Application Type: New NVO...

  10. Pediatrics Residents' Confidence and Performance Following a Longitudinal Quality Improvement Curriculum.

    Science.gov (United States)

    Courtlandt, Cheryl; Noonan, Laura; Koricke, Maureen Walsh; Zeskind, Philip Sanford; Mabus, Sarah; Feld, Leonard

    2016-02-01

    Quality improvement (QI) training is an integral part of residents' education. Understanding the educational value of a QI curriculum facilitates understanding of its impact. The purpose of this study was to evaluate the effects of a longitudinal QI curriculum on pediatrics residents' confidence and competence in the acquisition and application of QI knowledge and skills. Three successive cohorts of pediatrics residents (N = 36) participated in a longitudinal curriculum designed to increase resident confidence in QI knowledge and skills. Key components were a succession of progressive experiential projects, QI coaching, and resident team membership culminating in leadership of the project. Residents completed precurricular and postcurricular surveys and demonstrated QI competence by performance on the pediatric QI assessment scenario. Residents participating in the Center for Advancing Pediatric Excellence QI curriculum showed significant increases in pre-post measures of confidence in QI knowledge and skills. Coaching and team leadership were ranked by resident participants as having the most educational value among curriculum components. A pediatric QI assessment scenario, which correlated with resident-perceived confidence in acquisition of QI skills but not QI knowledge, is a tool available to test pediatrics residents' QI knowledge. A 3-year longitudinal, multimodal, experiential QI curriculum increased pediatrics residents' confidence in QI knowledge and skills, was feasible with faculty support, and was well-accepted by residents.

  11. Comparison of practice based research network based quality improvement technical assistance and evaluation to other ongoing quality improvement efforts for changes in agency culture.

    Science.gov (United States)

    Livingood, William C; Peden, Angela H; Shah, Gulzar H; Marshall, Nandi A; Gonzalez, Ketty M; Toal, Russell B; Alexander, Dayna S; Wright, Alesha R; Woodhouse, Lynn D

    2015-07-31

    Public health agencies in the USA are increasingly challenged to adopt Quality Improvement (QI) strategies to enhance performance. Many of the functional and structural barriers to effective use of QI can be found in the organizational culture of public health agencies. The purpose of this study was to assess the impact of public health practice based research network (PBRN) evaluation and technical assistance for QI interventions on the organizational culture of public health agencies in Georgia, USA. An online survey of key informants in Georgia's districts and county health departments was used to compare perceptions of characteristics of organizational QI culture between PBRN supported QI districts and non-PBRN supported districts before and after the QI interventions. The primary outcomes of concern were number and percentage of reported increases in characteristics of QI culture as measured by key informant responses to items assessing organizational QI practices from a validated instrument on QI Collaboratives. Survey results were analyzed using Multi-level Mixed Effects Logistic Model, which accounts for clustering/nesting. Increases in QI organizational culture were consistent for all 10- items on a QI organizational culture survey related to: leadership support, use of data, on-going QI, and team collaboration. Statistically significant odds ratios were calculated for differences in increased QI organizational culture between PBRN-QI supported districts compared to Non-PBRN supported districts for 5 of the 10 items, after adjusting for District clustering of county health departments. Agency culture, considered by many QI experts as the main goal of QI, is different than use of specific QI methods, such as Plan-Do-Study-Act (PDSA) cycles or root-cause analyses. The specific use of a QI method does not necessarily reflect culture change. Attempts to measure QI culture are newly emerging. This study documented significant improvements in characteristics of

  12. Pharmacist leadership in ICU quality improvement: coordinating spontaneous awakening and breathing trials.

    Science.gov (United States)

    Stollings, Joanna L; Foss, Julie J; Ely, E Wesley; Ambrose, Anna M; Rice, Todd W; Girard, Timothy D; Wheeler, Arthur P

    2015-08-01

    Coordinating efforts across disciplines in the intensive care unit is a key component of quality improvement (QI) efforts. Spontaneous awakening trials (SATs) and spontaneous breathing trials (SBTs) are considered key components of guidelines, yet unfortunately are often not done or coordinated properly. To determine if a pharmacist-driven awakening and breathing coordination (ABC) QI program would improve compliance (ie, process measures) as compared with the previous protocol, which did not involve pharmacists. The QI program included pharmacist-led education, daily discussion on rounds, and weekly performance reports to staff. Using a pre-QI versus during-QI versus post-QI intervention design, we compared data from 500 control ventilator-days (pre-QI period) versus 580 prospective ventilator-days (during-QI period). We then evaluated the sustainability of the QI program in 216 ventilator-days in the post-QI period. SAT safety screens were performed on only 20% pre-QI patient-days versus 97% of during-QI patient-days (P improved process measures compliance, comparing the pre-QI versus during-QI rates of screening, performing, and coordinating SAT and SBTs, and these results were sustained in the 8-month follow-up period post-QI program. © The Author(s) 2015.

  13. Educational system factors that engage resident physicians in an integrated quality improvement curriculum at a VA hospital: a realist evaluation.

    Science.gov (United States)

    Ogrinc, Greg; Ercolano, Ellyn; Cohen, Emily S; Harwood, Beth; Baum, Karyn; van Aalst, Robertus; Jones, Anne C; Davies, Louise

    2014-10-01

    Learning about quality improvement (QI) in resident physician training is often relegated to elective or noncore clinical activities. The authors integrated teaching, learning, and doing QI into the routine clinical work of inpatient internal medicine teams at a Veterans Affairs (VA) hospital. This study describes the design factors that facilitated and inhibited the integration of a QI curriculum-including real QI work-into the routine work of inpatient internal medicine teams. A realist evaluation framework used three data sources: field notes from QI faculty; semistructured interviews with resident physicians; and a group interview with QI faculty and staff. From April 2011 to July 2012, resident physician teams at the White River Junction VA Medical Center used the Model for Improvement for their QI work and analyzed data using statistical process control charts. Three domains affected the delivery of the QI curriculum and engagement of residents in QI work: setting, learner, and teacher. The constant presence of the QI material on a public space in the team workroom was a facilitating mechanism in the setting. Explicit sign-out of QI work to the next resident team formalized the handoff in the learner domain. QI teachers who were respected clinical leaders with QI expertise provided role modeling and local system knowledge. Integrating QI teaching into the routine clinical and educational systems of an inpatient service is challenging. Identifiable, concrete strategies in the setting, learner, and teacher domains helped integrate QI into the clinical and educational systems.

  14. Community Sourced Knowledge: Solving the Maintenance Problem

    Science.gov (United States)

    2012-05-01

    The end-user doesn’t need further assistance. KPI – Key Performance Indicator KPI -1 = Relayed solution to the end-user. KPI -2 = Trouble ticket is...created for the end-user and escalated for further review. KPI -3 = Trouble ticket is created for the end-user. KPI -4 = End of Call. Start of Process...14i KPI -1 KPI -2 KPI -3 KPI -4 QI-2QI-3 QI-4 QI-5 QI-6 Does the analyst understand the end- user’s rqst. Yes No 7 QI-1 Inform KMT. Legend KMT

  15. Strategies for addressing barriers to publishing pediatric quality improvement research.

    Science.gov (United States)

    Van Cleave, Jeanne; Dougherty, Denise; Perrin, James M

    2011-09-01

    Advancing the science of quality improvement (QI) requires dissemination of the results of QI. However, the results of few QI interventions reach publication. To identify barriers to publishing results of pediatric QI research and provide practical strategies that QI researchers can use to enhance publishability of their work. We reviewed and summarized a workshop conducted at the Pediatric Academic Societies 2007 meeting in Toronto, Ontario, Canada, on conducting and publishing QI research. We also interviewed 7 experts (QI researchers, administrators, journal editors, and health services researchers who have reviewed QI manuscripts) about common reasons that QI research fails to reach publication. We also reviewed recently published pediatric QI articles to find specific examples of tactics to enhance publishability, as identified in interviews and the workshop. We found barriers at all stages of the QI process, from identifying an appropriate quality issue to address to drafting the manuscript. Strategies for overcoming these barriers included collaborating with research methodologists, creating incentives to publish, choosing a study design to include a control group, increasing sample size through research networks, and choosing appropriate process and clinical quality measures. Several well-conducted, successfully published QI studies in pediatrics offer guidance to other researchers in implementing these strategies in their own work. Specific, feasible approaches can be used to improve opportunities for publication in pediatric, QI, and general medical journals.

  16. Team dynamics within quality improvement teams: a scoping review.

    Science.gov (United States)

    Rowland, Paula; Lising, Dean; Sinclair, Lynne; Baker, G Ross

    2018-03-31

    This scoping review examines what is known about the processes of quality improvement (QI) teams, particularly related to how teams impact outcomes. The aim is to provide research-informed guidance for QI leaders and to inform future research questions. Databases searched included: MedLINE, EMBASE, CINAHL, Web of Science and SCOPUS. Eligible publications were written in English, published between 1999 and 2016. Articles were included in the review if they examined processes of the QI team, were related to healthcare QI and were primary research studies. Studies were excluded if they had insufficient detail regarding QI team processes. Descriptive detail extracted included: authors, geographical region and health sector. The Integrated (Health Care) Team Effectiveness Model was used to synthesize findings of studies along domains of team effectiveness: task design, team process, psychosocial traits and organizational context. Over two stages of searching, 4813 citations were reviewed. Of those, 48 full-text articles are included in the synthesis. This review demonstrates that QI teams are not immune from dysfunction. Further, a dysfunctional QI team is not likely to influence practice. However, a functional QI team alone is unlikely to create change. A positive QI team dynamic may be a necessary but insufficient condition for implementing QI strategies. Areas for further research include: interactions between QI teams and clinical microsystems, understanding the role of interprofessional representation on QI teams and exploring interactions between QI team task, composition and process.

  17. A multi-state assessment of employer-sponsored quality improvement education for early-career registered nurses.

    Science.gov (United States)

    Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida K; Seltzer, Joanna R

    2013-01-01

    Increasing participation of registered nurses (RNs) in quality improvement (QI) is a promising strategy to close the health care quality chasm. For RNs to participate effectively in hospital QI, they must have adequate QI knowledge and skills. This descriptive study assessed employer-sponsored QI education and RNs' preparedness across a wide range of QI steps and processes. RNs from 15 U.S. states who were employed in hospitals and were initially licensed to practice in 2007 to 2008 were surveyed. Fewer than one third of respondents reported being very prepared across all measured QI topics. More than half reported receiving zero hours of training in these same topics in the last year. Lack of educational offerings on the topic was the top reason respondents gave for not obtaining QI training. The QI education offered by employers to RNs could be substantially improved. Nurse educators play a critical role in making these improvements. Copyright 2013, SLACK Incorporated.

  18. 78 FR 30921 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-05-23

    .... (NVO & OFF), 2500 Wilcrest Drive, Suite 300, Houston, TX 77042, Officers: Myrian T. Morales, Vice..., FL 33178, Officer: Jose R. Gantus, President (QI), Application Type: QI Change XL Worldwide Corp...

  19. A national study of nurse leadership and supports for quality improvement in rural hospitals.

    Science.gov (United States)

    Paez, Kathryn; Schur, Claudia; Zhao, Lan; Lucado, Jennifer

    2013-01-01

    This study assessed the perceptions and actions of rural hospital nurse executives with regard to patient safety and quality improvement (QI). A national sample of rural hospital nurse executives (n = 300) completed a survey measuring 4 domains related to patient safety and QI: (a) patient "Safety Culture," (b) adequacy of QI "Resources," (c) "Barriers" related to QI, and (d) "Nurse Leader Engagement" in activities supporting QI. Perceptions of Safety Culture were strong but 47% of the Resources needed to carry out QI were inadequate, 29% of Barriers were moderate to major, and 25% of Nurse Leader Engagement activities were performed infrequently. Nurse Leader Engagement in quality-related activities was less frequent among nurses in isolated and small rural town hospitals compared with large rural city hospitals. To further QI, rural nurse executives may need to use their communications and actions to raise the visibility of QI.

  20. 78 FR 38336 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-06-26

    ..., President (QI), Stephen B. Schwark, Treasurer, Application Type: License Transfer to EFL Container Lines...., Suite K, Mobile, AL 36609, Officers: Thomas (Mac) H. McPhillips IV, Assistant Vice President (QI), Oscar...

  1. 78 FR 10173 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-02-13

    ... Road, Scituate, MA 02066, Officers: Stephen J. Zambo, Member (QI), Stephen A. Zambo, Member... 60007, Officers: Joshua H. Chau, President (QI), Bessie S. Chau, Secretary, Application Type: New NVO...

  2. Sustaining a quality improvement culture in local health departments applying for accreditation.

    Science.gov (United States)

    Verma, Pooja; Moran, John W

    2014-01-01

    This article focuses on local health departments (LHDs) that are advanced in accreditation and quality improvement (QI) efforts and the barriers and facilitators associated with sustaining improvements and building an organizational culture of QI. To understand the barriers and facilitators associated with building and sustaining progress toward a QI culture in LHDs. Quantitative data from a self-reporting survey and qualitative data from telephone interviews. Twenty-two LHDs across the United States responded to the survey. Ten of the 22 LHD respondents participated in telephone interviews. QI lead staff at LHDs that are advanced in accreditation preparation and QI. Self-reported LHD survey ratings against indicators for a QI culture, and the identified barriers and facilitators around sustaining QI initiatives. Of the 6 domains of a QI culture measured in the survey, the percentages of respondents that scored themselves highly to at least 1 indicator in each domain are as follows: leadership commitment (100%); employee empowerment (100%); teamwork and collaboration (100%); continuous process improvement (86%); customer focus (72%); and QI infrastructure (64%). Qualitative data from 10 telephone interviews revealed that key barriers to sustaining progress around QI included staff turnover, budget cuts, and major crises or events that arise as priority. Key facilitators included leadership commitment, accreditation, and dedication of resources and staff time to QI. When engaging in QI, LHDs should consider investing efforts in gaining leadership support and dedicating staff time early in the QI journey to ensure that QI efforts and initiatives are sustained. Local health departments interested in developing a QI culture should also consider pursuing accreditation, as it provides a structured framework for continuous improvement. They should also actively develop QI knowledge and skills among all staff members to minimize the negative impact of staff turnover.

  3. Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

    Science.gov (United States)

    Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie

    2017-01-01

    Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  4. Embedding organisational quality improvement through middle manager ownership.

    Science.gov (United States)

    Balding, Cathy

    2005-01-01

    To strengthen the middle manager role in a hospital quality improvement (QI) program, with a view to increasing and sustaining organisational QI implementation. Case study based action research project, combining pre- and post-action quantitative and qualitative data collection, relating to a QI program intervention in an Australian metropolitan specialist teaching hospital. A model for enhancing the middle manager role in QI was developed and then implemented as the action over a 12-month period. Middle manager understanding and ownership of the QI program and organisational QI implementation significantly increased, although their perceived enjoyment of being involved in QI decreased. This case-study based action research project was limited to one organisation of a specific type - a large specialist metropolitan teaching hospital. The composition of the middle manager group, therefore, is necessarily limited to particular specialties. It is acknowledged that findings from case study and action research methodologies are limited in their generalisability, but assist in the development of knowledge and principles that can be adapted to different settings. This QI implementation model can increase levels of organisational QI implementation by effecting a positive change in middle manager attitude to and involvement in QI. There are many theories regarding the importance of the middle manager role in QI, but little empirical research into exactly what this role may be and how it may be strengthened. This research adds to the knowledge base, and provides clear steps for achieving increased staff involvement and QI implementation.

  5. 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).

  6. Quality improvement cycles that reduced waiting times at Tshwane ...

    African Journals Online (AJOL)

    improvement. QI in medical practices is a method for continuously finding better ways to provide better care and service.11 The QI cycle is a recognised tool for analysing and improving the efficiency and quality of healthcare services.12 QI is a team effort, requiring knowledge, skills, experience and perspective of each team ...

  7. 78 FR 78956 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-12-27

    ... & OFF), 1515 Kona Drive, Compton, CA 90220, Officers: Won Rok (aka Steve) Choi, CFO (QI), Myeong H. Kim..., El Monte, CA 91731, Officers: Lynn H. Tran, Secretary (QI), Zheng Feng, CFO, Application Type: New.... 25th Street, Suite 107D, Miami, FL 33182, Officers: Sergio I. Lotero, President (QI), Stephen A. Blass...

  8. 78 FR 75345 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-12-11

    .... Romero, President (QI). Application Type: New NVO & OFF License. F.H.L. Logistics, Inc. (NVO & OFF), 1354.... Officers: Arif H. Butt, General Manager (QI), Unni Krishnan Nair, President. Application Type: New NVO...: Stephen F. Crooks, Vice President (QI), Scott Kelly, President. Application Type: Adding NVO Service...

  9. MO-E-12A-01: Quantitative Imaging: Techniques, Applications, and Challenges

    International Nuclear Information System (INIS)

    Jackson, E; Jeraj, R; McNitt-Gray, M; Cao, Y

    2014-01-01

    The first symposium in the Quantitative Imaging Track focused on the introduction of quantitative imaging (QI) by illustrating the potential of QI in diagnostic and therapeutic applications in research and patient care, highlighting key challenges in implementation of such QI applications, and reviewing QI efforts of selected national and international agencies and organizations, including the FDA, NCI, NIST, and RSNA. This second QI symposium will focus more specifically on the techniques, applications, and challenges of QI. The first talk of the session will focus on modalityagnostic challenges of QI, beginning with challenges of the development and implementation of QI applications in single-center, single-vendor settings and progressing to the challenges encountered in the most general setting of multi-center, multi-vendor settings. The subsequent three talks will focus on specific QI challenges and opportunities in the modalityspecific settings of CT, PET/CT, and MR. Each talk will provide information on modality-specific QI techniques, applications, and challenges, including current efforts focused on solutions to such challenges. Learning Objectives: Understand key general challenges of QI application development and implementation, regardless of modality. Understand selected QI techniques and applications in CT, PET/CT, and MR. Understand challenges, and potential solutions for such challenges, for the applications presented for each modality

  10. Quality Improvement in Athletic Health Care.

    Science.gov (United States)

    Lopes Sauers, Andrea D; Sauers, Eric L; Valier, Alison R Snyder

    2017-11-01

      Quality improvement (QI) is a health care concept that ensures patients receive high-quality (safe, timely, effective, efficient, equitable, patient-centered) and affordable care. Despite its importance, the application of QI in athletic health care has been limited.   To describe the need for and define QI in health care, to describe how to measure quality in health care, and to present a QI case in athletic training.   As the athletic training profession continues to grow, a widespread engagement in QI efforts is necessary to establish the value of athletic training services for the patients that we serve. A review of the importance of QI in health care, historical perspectives of QI, tools to drive QI efforts, and examples of common QI initiatives is presented to assist clinicians in better understanding the value of QI for advancing athletic health care and the profession. Clinical and Research Advantages:  By engaging clinicians in strategies to measure outcomes and improve their patient care services, QI practice can help athletic trainers provide high-quality and affordable care to patients.

  11. Quality Improvement in Otolaryngology Residency: Survey of Program Directors.

    Science.gov (United States)

    Bowe, Sarah N

    2016-02-01

    The Clinical Learning Environment Review focuses on the responsibility of the sponsoring institution for quality and patient safety. Very little information is known regarding the status of quality improvement (QI) education during otolaryngology training. The purpose of this survey is to evaluate the extent of resident and faculty participation in QI and identify opportunities for both resident curriculum and faculty development. Cross-sectional survey A 15-item survey was distributed to all 106 otolaryngology program directors. The survey was developed after an informal review of the literature regarding education in QI and patient safety. Questions were directed at the format and content of the QI curriculum, as well as barriers to implementation. There was a 39% response rate. Ninety percent of responding program directors considered education in QI important or very important to a resident's future success. Only 23% of responding programs contained an educational curriculum in QI, and only 33% monitored residents' individual outcome measures. Barriers to implementation of a QI program included inadequate number of faculty with expertise in QI (75%) and competing resident educational demands (90%). Every program director considered morbidity and mortality conferences as an integral component in QI education. Program directors recognize the importance of QI in otolaryngology practice. Unfortunately, this survey identifies a distinct lack of resources in support of these educational goals. The results highlight the need to generate a comprehensive and stepwise approach to QI for faculty development and resident instruction. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  12. Documentation of quality improvement exposure by internal medicine residency applicants.

    Science.gov (United States)

    Kolade, Victor O; Sethi, Anuradha

    2016-01-01

    Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. To document the reporting of QI training or experience in residency applications. Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.

  13. Key Characteristics of Rehabilitation Quality Improvement Publications: Scoping Review From 2010 to 2016.

    Science.gov (United States)

    Jesus, Tiago S; Papadimitriou, Christina; Pinho, Cátia S; Hoenig, Helen

    2017-09-28

    To characterize the peer-reviewed quality improvement (QI) literature in rehabilitation. Five electronic databases were searched for English-language articles from 2010 to 2016. Keywords for QI and safety management were searched for in combination with keywords for rehabilitation content and journals. Secondary searches (eg, references-list scanning) were also performed. Two reviewers independently selected articles using working definitions of rehabilitation and QI study types; of 1016 references, 112 full texts were assessed for eligibility. Reported study characteristics including study focus, study setting, use of inferential statistics, stated limitations, and use of improvement cycles and theoretical models were extracted by 1 reviewer, with a second reviewer consulted whenever inferences or interpretation were involved. Fifty-nine empirical rehabilitation QI studies were found: 43 reporting on local QI activities, 7 reporting on QI effectiveness research, 8 reporting on QI facilitators or barriers, and 1 systematic review of a specific topic. The number of publications had significant yearly growth between 2010 and 2016 (P=.03). Among the 43 reports on local QI activities, 23.3% did not explicitly report any study limitations; 39.5% did not used inferential statistics to measure the QI impact; 95.3% did not cite/mention the appropriate reporting guidelines; only 18.6% reported multiple QI cycles; just over 50% reported using a model to guide the QI activity; and only 7% reported the use of a particular theoretical model. Study sites and focuses were diverse; however, nearly a third (30.2%) examined early mobilization in intensive care units. The number of empirical, peer-reviewed rehabilitation QI publications is growing but remains a tiny fraction of rehabilitation research publications. Rehabilitation QI studies could be strengthened by greater use of extant models and theory to guide the QI work, consistent reporting of study limitations, and use of

  14. Quality Improvement and Performance Management Benefits of Public Health Accreditation: National Evaluation Findings.

    Science.gov (United States)

    Siegfried, Alexa; Heffernan, Megan; Kennedy, Mallory; Meit, Michael

    To identify the quality improvement (QI) and performance management benefits reported by public health departments as a result of participating in the national, voluntary program for public health accreditation implemented by the Public Health Accreditation Board (PHAB). We gathered quantitative data via Web-based surveys of all applicant and accredited public health departments when they completed 3 different milestones in the PHAB accreditation process. Leadership from 324 unique state, local, and tribal public health departments in the United States. Public health departments that have achieved PHAB accreditation reported the following QI and performance management benefits: improved awareness and focus on QI efforts; increased QI training among staff; perceived increases in QI knowledge among staff; implemented new QI strategies; implemented strategies to evaluate effectiveness and quality; used information from QI processes to inform decision making; and perceived achievement of a QI culture. The reported implementation of QI strategies and use of information from QI processes to inform decision making was greater among recently accredited health departments than among health departments that had registered their intent to apply but not yet undergone the PHAB accreditation process. Respondents from health departments that had been accredited for 1 year reported higher levels of staff QI training and perceived increases in QI knowledge than those that were recently accredited. PHAB accreditation has stimulated QI and performance management activities within public health departments. Health departments that pursue PHAB accreditation are likely to report immediate increases in QI and performance management activities as a result of undergoing the PHAB accreditation process, and these benefits are likely to be reported at a higher level, even 1 year after the accreditation decision.

  15. Healthcare quality improvement work: a professional employee perspective.

    Science.gov (United States)

    Gadolin, Christian; Andersson, Thomas

    2017-06-12

    Purpose The purpose of this paper is to describe and analyze conditions that influence how employees engage in healthcare quality improvement (QI) work. Design/methodology/approach Qualitative case study based on interviews ( n=27) and observations ( n=10). Findings The main conditions that influence how employees engage in healthcare QI work are professions, work structures and working relationships. These conditions can both prevent and facilitate healthcare QI. Professions and work structures may cement existing institutional logics and thus prevent employees from engaging in healthcare QI work. However, attempts to align QI with professional logics, together with work structures that empower employees, can make these conditions increase employee engagement, which can be accomplished through positive working relationships that foster institutional work, which bridge different competing institutional logics, making it possible to overcome barriers that professions and work structures may constitute. Practical implications Understanding the conditions that influence how employees engage in healthcare QI work will make initiatives more likely to succeed. Originality/value Healthcare QI has mainly been studied from an implementer perspective, and employees have either been neglected or seen as passive resisters. Weak employee perspectives make healthcare QI research incomplete. In our research, healthcare QI work is studied closely at the actor level to understand healthcare QI from an employee perspective.

  16. The Model for Understanding Success in Quality (MUSIQ): building a theory of context in healthcare quality improvement.

    Science.gov (United States)

    Kaplan, Heather C; Provost, Lloyd P; Froehle, Craig M; Margolis, Peter A

    2012-01-01

    BACKGROUND Quality improvement (QI) efforts have become widespread in healthcare, however there is significant variability in their success. Differences in context are thought to be responsible for some of the variability seen. To develop a conceptual model that can be used by organisations and QI researchers to understand and optimise contextual factors affecting the success of a QI project. 10 QI experts were provided with the results of a systematic literature review and then participated in two rounds of opinion gathering to identify and define important contextual factors. The experts subsequently met in person to identify relationships among factors and to begin to build the model. The Model for Understanding Success in Quality (MUSIQ) is organised based on the level of the healthcare system and identifies 25 contextual factors likely to influence QI success. Contextual factors within microsystems and those related to the QI team are hypothesised to directly shape QI success, whereas factors within the organisation and external environment are believed to influence success indirectly. The MUSIQ framework has the potential to guide the application of QI methods in healthcare and focus research. The specificity of MUSIQ and the explicit delineation of relationships among factors allows a deeper understanding of the mechanism of action by which context influences QI success. MUSIQ also provides a foundation to support further studies to test and refine the theory and advance the field of QI science.

  17. An analysis of the suitability of public spaces to physical activity practice in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Vieira, Marcelo Carvalho; Sperandei, Sandro; Reis, Arianne; da Silva, Cláudia Gonçalves Thaumaturgo

    2013-09-01

    To assess the physical characteristics of public spaces designed for sport/physical activity/leisure in Rio de Janeiro, Brazil, and their relationship to the socioeconomic indicators. Public spaces (n = 38) spread across the city were evaluated between December 2011 and January 2012 using the Physical Activity Resource Assessment (PARA) instrument. Based on PARA results, a Quality Indicator (QI) was prepared and the sample was grouped into "High QI" and "Low QI" using a k-means clustering algorithm. The association between QI and the local Social Development Index (SDI) was tested using a Chi-square test. The average QI was 13.6 ± 4.91 and the median was equal to 13 points. The High QI group, composed of sites with a QI above median, reached 17.9 ± 2.35 points, while the Low QI group reached 9.3 ± 2.16 points. Pearson's Chi-square tests identified a significant association between QI and SDI when the value of SDI 0.7 was used as a criterion for separation (χ(2) = 17.84, p public spaces usually had a lower QI. Policies to encourage physical activity need to focus attention on the built environment also, particularly in socially vulnerable areas. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Quality Improvement Practices in Academic Emergency Medicine: Perspectives from the Chairs

    Directory of Open Access Journals (Sweden)

    DelliFraine, Jami L

    2010-12-01

    Full Text Available Objective: To assess academic emergency medicine (EM chairs’ perceptions of quality improvement (QI training programs.Methods: A voluntary anonymous 20 item survey was distributed to a sample of academic chairs of EM through the Association of Academic Chairs of Emergency Medicine. Data was collected to assess the percentage of academic emergency physicians who had received QI training, the type of training they received, their perception of the impact of this training on behavior, practice and outcomes, and any perceived barriers to implementing QI programs in the emergency department.Results: The response rate to the survey was 69% (N = 59. 59.3% of respondents report that their hospital has a formal QI program for physicians. Chairs received training in a variety of QI programs. The type of QI program used by respondents was perceived as having no impact on goals achieved by QI (χ2 = 12.382; p = 0.260, but there was a statistically significant (χ2 = 14.383; p = 0.006 relationship between whether or not goals were achieved and academic EM chairs’ perceptions about return on investment for QI training. Only 22% of chairs responded that they have already made changes as a result of the QI training. 78.8% of EM chairs responded that quality programs could have a significant positive impact on their practice and the healthcare industry. Chairs perceived that QI programs had the most potential value in the areas of understanding and reducing medical errors and improving patient flow and throughput. Other areas of potential value of QI include improving specific clinical indicators and standardizing physician care.Conclusion: Academic EM chairs perceived that QI programs were an effective way to drive needed improvements. The results suggest that there is a high level of interest in QI but a low level of adoption of training and implementation.[West J Emerg Med. 2010; 11(5:479-485.

  19. A scoping review of online repositories of quality improvement projects, interventions and initiatives in healthcare.

    Science.gov (United States)

    Bytautas, Jessica P; Gheihman, Galina; Dobrow, Mark J

    2017-04-01

    Quality improvement (QI) is becoming an important focal point for health systems. There is increasing interest among health system stakeholders to learn from and share experiences on the use of QI methods and approaches in their work. Yet there are few easily accessible, online repositories dedicated to documenting QI activity. We conducted a scoping review of publicly available, web-based QI repositories to (i) identify current approaches to sharing information on QI practices; (ii) categorise these approaches based on hosting, scope and size, content acquisition and eligibility, content format and search, and evaluation and engagement characteristics; and (iii) review evaluations of the design, usefulness and impact of their online QI practice repositories. The search strategy consisted of traditional database and grey literature searches, as well as expert consultation, with the ultimate aim of identifying and describing QI repositories of practices undertaken in a healthcare context. We identified 13 QI repositories and found substantial variation across the five categories. The QI repositories used different terminology (eg, practices vs case studies) and approaches to content acquisition, and varied in terms of primary areas of focus. All provided some means for organising content according to categories or themes and most provided at least rudimentary keyword search functionality. Notably, none of the QI repositories included evaluations of their impact. With growing interest in sharing and spreading best practices and increasing reliance on QI as a key contributor to health system performance, the role of QI repositories is likely to expand. Designing future QI repositories based on knowledge of the range and type of features available is an important starting point for improving their usefulness and impact. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. 圖書館事業專欄/面向數位化及日益多樣化的館藏建設與服務:上海圖書館的經驗與策略/張奇 | Toward Digitization and Increasingly Diverse Collections and Services: Strategy and Experiences of the Shanghai Library / Zhang Qi

    Directory of Open Access Journals (Sweden)

    張奇

    2007-10-01

    Full Text Available

    As an indispensable part of society, libraries are experiencing the changes, enjoying the progress, and hoping to benefit from the promises of digitalization. With consolidation of collections from many local libraries, The Shanghai Library must continue to provide traditional services and explore and implement appropriate development opportunities offered by 21st century technology. The Shanghai Library is the second largest library in China, with a total collection of 50.95 million titles. Since its establishment in 1952, the Library has grown rapidly through some historic mergers. In 1958 the city government combined four municipal libraries (Municipal Historical Document Library, Municipal Periodicals Library, Municipal Science and Technology Library, and the Shanghai Library with some other collections including the Bibliotheca Xujiahui and SMC (Shanghai Municipal Council Library. In 1995, the Institute of Scientific and Technical Information of Shanghai (known as ISTIS, one of the country’s leading information institutions, was merged with the Shanghai Library, resulting in the first combination of a library and an information institution in the country. This was an epoch-making event in Chinese librarianship. The merger between library and information institute has provided a significant opportunity for the Shanghai Library to redefine itself as a center of information resources, an information clearinghouse, a knowledge repository, a school of life-long

    頁次:95-98

  1. Educational gaps and solutions for early-career nurse managers' education and participation in quality improvement.

    Science.gov (United States)

    Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida; Jun, Jin

    2015-04-01

    The objective of this study was to examine early-career frontline nurse managers' (FLNMs') reported educational preparedness and participation in quality improvement (QI). Frontline nurse managers are vitally important for leading QI. However, it is not well known if they have adequate knowledge and skills to lead this important function. We examined cross-sectional survey data from 42 FLNMs using descriptive statistics. About 30% of FLNMs reported being very prepared across 12 measured QI skills by schools or employers and 35% reported participating in a specific clinical effort to improve patient care on their unit more than once a month. More than 50% reported having good organizational support for QI, but only about 30% reported being rewarded for their contributions to QI. Our study highlights opportunities for development in QI for FLNMs and offers some solutions for nurse executives that can bridge the educational gaps.

  2. Vitrification and Devitrification of Rigid Amorphous Fraction of PET during Quasi-isothermal Cooling and Heating

    Science.gov (United States)

    Cebe, Peggy; Chen, Huipeng

    2009-03-01

    Poly(ethylene terephthalate), PET, was studied by quasi-isothermal (QI) Temperature Modulated Differential Scanning Calorimetry (TMDSC). For the first time, both the temperature dependent crystalline fraction and rigid amorphous fraction (RAF) were quantitatively analyzed during QI cooling and reheating. Specific reversing heat capacity measurements show that most RAF vitrifies step by step during QI cooling after completion of crystallization. Upon subsequent QI reheating, the RAF devitrifies also step by step and only a small RAF of 0.04 remains at 470K, while melting starts above 473K. To obtain the exact temperature of the start of melting, heat capacity measurements were made using subsequent standard DSC heating, after QI cooling. By combining this method with the QI results, the temperature dependent phase fractions were obtained during standard DSC heating. We conclude that RAF completely devitrifies before the temperature reaches the crystal melting endotherm under the conditions used in this work.

  3. Just-in-Time Training: A Novel Approach to Quality Improvement Education.

    Science.gov (United States)

    Knutson, Allison; Park, Nesha D; Smith, Denise; Tracy, Kelly; Reed, Danielle J W; Olsen, Steven L

    2015-01-01

    Just-in-time training (JITT) is accepted in medical education as a training method for newer concepts or seldom-performed procedures. Providing JITT to a large nursing staff may be an effective method to teach quality improvement (QI) initiatives. We sought to determine if JITT could increase knowledge of a specific nutrition QI initiative. Members of the nutrition QI team interviewed staff using the Frontline Contextual Inquiry to assess knowledge regarding the specific QI project. The inquiry was completed pre- and post-JITT. A JITT educational cart was created, which allowed trainers to bring the educational information to the bedside for a short, small group educational session. The results demonstrated a marked improvement in the knowledge of the frontline staff regarding our Vermont Oxford Network involvement and the specifics of the nutrition QI project. Just-in-time training can be a valuable and effective method to disseminate QI principles to a large audience of staff members.

  4. Epidemiological Distribution and Subtype Analysis of Premenstrual Dysphoric Disorder Syndromes and Symptoms Based on TCM Theories

    Directory of Open Access Journals (Sweden)

    Mingqi Qiao

    2017-01-01

    Full Text Available We performed an epidemiological investigation of subjects with premenstrual dysphoric disorder (PMDD to identify the clinical distribution of the major syndromes and symptoms. The pathogenesis of PMDD mainly involves the dysfunction of liver conveyance and dispersion. Excessive liver conveyance and dispersion are associated with liver-qi invasion syndrome, while insufficient liver conveyance and dispersion are expressed as liver-qi depression syndrome. Additionally, a nonconditional logistic regression was performed to analyze the symptomatic features of liver-qi invasion and liver-qi depression. As a result of this analysis, two subtypes of PMDD are proposed, namely, excessive liver conveyance and dispersion (liver-qi invasion syndrome and insufficient liver conveyance and dispersion (liver-qi depression syndrome. Our findings provide an epidemiological foundation for the clinical diagnosis and treatment of PMDD based on the identification of different types.

  5. Can first-year medical students acquire quality improvement knowledge prior to substantial clinical exposure? A mixed-methods evaluation of a pre-clerkship curriculum that uses education as the context for learning.

    Science.gov (United States)

    Brown, Allison; Nidumolu, Aditya; Stanhope, Alexandra; Koh, Justin; Greenway, Matthew; Grierson, Lawrence

    2018-03-19

    Quality Improvement (QI) training for health professionals is essential to strengthen health systems. However, QI training during medical school is constrained by students' lack of contextual understanding of the health system and an already saturated medical curriculum. The Program for Improvement in Medical Education (PRIME), an extracurricular offered at the Michael G. DeGroote School of Medicineat McMaster University (Hamilton, Canada), addresses these obstacles by having first-year medical students engage in QI by identifying opportunities for improvement within their own education. A sequential explanatory mixed-methods approach, which combines insights derived from quantitative instruments and qualitative interview methods, was used to examine the impact of PRIME on first-year medical students and the use of QI in the context of education. The study reveals that participation in PRIME increases both knowledge of, and comfort with, fundamental QI concepts, even when applied to clinical scenarios. Participants felt that education provided a meaningful context to learn QI at this stage of their training, and were motivated to participate in future QI projects to drive real-world improvements in the health system. Early exposure to QI principles that uses medical education as the context may be an effective intervention to foster QI competencies at an early stage and ultimately promote engagement in clinical QI. Moreover, PRIME also provides a mechanism to drive improvements in medical education. Future research is warranted to better understand the impact of education as a context for later engagement in clinical QI applications as well as the potential for QI methods to be translated directly into education. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. The Mechanism Research of Qishen Yiqi Formula by Module-Network Analysis

    OpenAIRE

    Zheng, Shichao; Zhang, Yanling; Qiao, Yanjiang

    2015-01-01

    Qishen Yiqi formula (QSYQ) has the effect of tonifying Qi and promoting blood circulation, which is widely used to treat the cardiovascular diseases with Qi deficiency and blood stasis syndrome. However, the mechanism of QSYQ to tonify Qi and promote blood circulation is rarely reported at molecular or systems level. This study aimed to elucidate the mechanism of QSYQ based on the protein interaction network (PIN) analysis. The targets’ information of the active components was obtained from C...

  7. Developing a taxonomy for the science of improvement in public health.

    Science.gov (United States)

    Riley, William; Lownik, Beth; Halverson, Paul; Parrotta, Carmen; Godsall, Jonathan R; Gyllstrom, Elizabeth; Gearin, Kimberly J; Mays, Glen

    2012-11-01

    Quality improvement (QI) methods have been used for almost a decade in public health departments to increase effectiveness and efficiency. Although results are rapidly accumulating, the evidence for the science of improvement is shallow and limited. To advance the use and effectiveness of QI in public health, it is important to develop a science of improvement using practice-based research to build an evidence base for QI projects. This purpose of this study is to advance the science of improvement in public health departments with 3 objectives: (1) establish a taxonomy of QI projects in public health, (2) categorize QI projects undertaken in health departments using the taxonomy, and (3) create an opportunity modes and effects analysis. This study is a qualitative analysis of archival data from 2 separate large databases consisting of 51 QI projects undertaken in public health departments over the last 5 years. The study involves 2 separate QI collaboratives. One includes Minnesota health departments; the other is a national collaborative. We propose a standardized case definition, common metrics, and a taxonomy of QI projects to begin building the evidence base for QI in public health and to advance the science of continuous quality improvement. All projects created an aim statement and used metrics while 53% used a specific QI model with an average of 3.25 QI techniques per project. Approximately 40% of the projects incorporated a process control methodology, and 60% of the projects identified the process from beginning to end, while 11 of 12 PHAB (Public Health Accreditation Board) domains were included. The findings provide a baseline for QI taxonomy to operationalize a science of improvement for public health departments.

  8. The Educational Toolbox: Kick Start Your Educational Program in Quality Improvement.

    Science.gov (United States)

    Hoffman, Rebecca L; Medbery, Rachel L; Vandermeer, Thomas J; Morris, Jon B; Kelz, Rachel R

    2015-01-01

    To disseminate materials and learning from the proceedings of the Association of Program Directors 2014 Annual Meeting workshop on the integration of quality improvement (QI) education into the existing educational infrastructure. Modern surgical practice demands an understanding of QI methodology. Yet, today׳s surgeons are not formally educated in QI methodology. Therefore, it is hard to follow the historical mantra of "see one, do one, teach one" in the quality realm. Participants were given a brief introduction to QI approaches. A number of concrete examples of how to incorporate QI education into training programs were presented, followed by a small group session focused on the identification of barriers to incorporation. Participants were provided with a worksheet to help navigate the initial incorporation of QI education in 3 steps. Participants were representative of all types of training programs, with differing levels of existing QI integration. Barriers to QI education included lack of resident interest/buy-in, concerns over the availability of educational resources (i.e., limited time to devote to QI), and a limited QI knowledge among surgical educators. The 3 steps to kick starting the educational process included (1) choosing a specific method of QI education, (2) incorporation via barrier, infrastructure, and stakeholder identification, and (3) implementation and ongoing assessment. Recent changes in the delivery of surgical care along with the new accreditation system have necessitated the development of QI education programs for use in surgical education. To continue to make surgery safer and ensure optimal patient outcomes, surgical educators must teach each resident to adopt quality science methodology in a meaningful way. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. Increased Adoption of Quality Improvement Interventions to Implement Evidence-Based Practices for Pressure Ulcer Prevention in U.S. Academic Medical Centers.

    Science.gov (United States)

    Padula, William V; Mishra, Manish K; Makic, Mary Beth F; Wald, Heidi L; Campbell, Jonathan D; Nair, Kavita V; Valuck, Robert J

    2015-12-01

    In 2008, the U.S. Centers for Medicare and Medicaid Services enacted a nonpayment policy for stage III and IV hospital-acquired pressure ulcers (HAPUs), which incentivized hospitals to improve prevention efforts. In response, hospitals looked for ways to support implementation of evidence-based practices for HAPU prevention, such as adoption of quality improvement (QI) interventions. The objective of this study was to quantify adoption patterns of QI interventions for supporting evidence-based practices for HAPU prevention. This study surveyed wound care specialists working at hospitals within the University HealthSystem Consortium. A questionnaire was used to retrospectively describe QI adoption patterns according to 25 HAPU-specific QI interventions into four domains: leadership, staff, information technology (IT), and performance and improvement. Respondents indicated QI interventions implemented between 2007 and 2012 to the nearest quarter and year. Descriptive statistics defined patterns of QI adoption. A t-test and statistical process control chart established statistically significant increase in adoption following nonpayment policy enactment in October 2008. Increase are described in terms of scope (number of QI domains employed) and scale (number of QI interventions within domains). Fifty-three of the 55 hospitals surveyed reported implementing QI interventions for HAPU prevention. Leadership interventions were most frequent, increasing in scope from 40% to 63% between 2008 and 2012; "annual programs to promote pressure ulcer prevention" showed the greatest increase in scale. Staff interventions increased in scope from 32% to 53%; "frequent consult driven huddles" showed the greatest increase in scale. IT interventions increased in scope from 31% to 55%. Performance and improvement interventions increased in scope from 18% to 40%, with "new skin care products . . ." increasing the most. Academic medical centers increased adoption of QI interventions

  10. 75 FR 80499 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2010-12-22

    ... Individual), Jeffrey Cullen, President. Application Type: QI Change. Cala Distribution, LLC (NVO), 2705 NW..., (Qualifying Individual), William S. Askew, Manager. Application Type: New NVO License. Encar Trading, Corp...

  11. The Relation between Structure and Quantum Interference in Single Molecule Junctions

    DEFF Research Database (Denmark)

    Markussen, Troels; Stadler, Robert; Thygesen, Kristian Sommer

    2010-01-01

    Quantum interference (QI) of electron pathways has recently attracted increased interest as an enabling tool for single-molecule electronic devices. Although various molecular systems have been shown to exhibit QI effects and a number of methods have been proposed for its analysis, simple...... guidelines linking the molecular structure to QI effects in the phase-coherent transport regime have until now been lacking. In the present work we demonstrate that QI in aromatic molecules is intimately related to the topology of the molecule’s π system and establish a simple graphical scheme to predict...

  12. 75 FR 32780 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2010-06-09

    .../Secretary, (Qualifying Individual), Bengt R. Anderson, President, Application Type: QI Change. Cargomar... Corp. (OFF & NVO), 6301 E. 10th Avenue, Hialeah, FL 33013, Officers: Marjorie E. Morales, Operation...

  13. What infusion flow should be used for mid-dilution hemodiafiltration?

    Science.gov (United States)

    Maduell, Francisco; Arias, Marta; Fontseré, Néstor; Vera, Manel; Masso, Elisabeth; Garro, Julia; Barros, Xoana; Martina, Maria N; Elena, Montserrat; Bergadá, Eduardo; Cases, Aleix; Bedini, Jose Luis; Campistol, Josep M

    2010-01-01

    There is still no consensus on the optimal infusion flow (Qi) in mid-dilution hemodiafiltration. The aim of this study was to compare mid-dilution with varying Qi. Prospective study in 25 patients who underwent seven hemodialysis sessions with a Qi of 0, 50, 100, 150, 200, 250 and 300 ml/min. All sessions were well tolerated except Qi 300 ml/min. No significant differences in urea, creatinine, alpha(1)-microglobulin or alpha(1)-acid glycoprotein reduction ratios were observed. beta(2)-Microglobulin, myoglobin and prolactin reduction ratios were higher with Qi 150, 200, 250 and 300 ml/min in comparison with Qi of 0, 50 and 100 ml/min. There were no differences in the removal of small or larger molecules when Qi was 150 ml/min or higher. Optimal Qi in mid-dilution appears to be in the range of 150-250 ml/min since good clinical outcomes, similar efficiency and no technical complications up to a Qi of 250 ml/min were observed.

  14. Integrating Quality Improvement and Continuing Professional Development: A Model From the Mental Health Care System.

    Science.gov (United States)

    Sockalingam, Sanjeev; Tehrani, Hedieh; Lin, Elizabeth; Lieff, Susan; Harris, Ilene; Soklaridis, Sophie

    2016-04-01

    To explore the perspectives of leaders in psychiatry and continuing professional development (CPD) regarding the relationship, opportunities, and challenges in integrating quality improvement (QI) and CPD. In 2013-2014, the authors interviewed 18 participants in Canada: 10 psychiatrists-in-chief, 6 CPD leaders in psychiatry, and 2 individuals with experience integrating these domains in psychiatry who were identified through snowball sampling. Questions were designed to identify participants' perspectives about the definition, relationship, and integration of QI and CPD in psychiatry. Interviews were recorded and transcribed. An iterative, inductive method was used to thematically analyze the transcripts. To ensure the rigor of the analysis, the authors performed member checking and sampling until theoretical saturation was achieved. Participants defined QI as a concept measured at the individual, hospital, and health care system levels and CPD as a concept measured predominantly at the individual and hospital levels. Four themes related to the relationship between QI and CPD were identified: challenges with QI training, adoption of QI into the mental health care system, implementation of QI in CPD, and practice improvement outcomes. Despite participants describing QI and CPD as mutually beneficial, they expressed uncertainty about the appropriateness of aligning these domains within a mental health care context because of the identified challenges. This study identified challenges with aligning QI and CPD in psychiatry and yielded a framework to inform future integration efforts. Further research is needed to determine the generalizability of this framework to other specialties and health care professions.

  15. Impact of a competency based curriculum on quality improvement among internal medicine residents.

    Science.gov (United States)

    Fok, Mark C; Wong, Roger Y

    2014-11-28

    Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among internal medicine residents. This was a prospective, cohort study over four years (2007-2011) using pre-post curriculum comparison design in an internal medicine residency program in Canada. Overall 175 post-graduate year one internal medicine residents participated. A two-phase, competency based curriculum on QI was developed with didactic workshops and longitudinal, team-based QI projects. The main outcome measures included self-assessment, objective assessment using the Quality Improvement Knowledge Assessment Tool (QIKAT) scores to assess QI knowledge, and performance-based assessment via presentation of longitudinal QI projects. Overall 175 residents participated, with a response rate of 160/175 (91%) post-curriculum and 114/175 (65%) after conducting their longitudinal QI project. Residents' self-reported confidence in making changes to improve health increased and was sustained at twelve months post-curriculum. Self-assessment scores of QI skills improved significantly from pre-curriculum (53.4 to 69.2 percent post-curriculum [p-value 0.002]) and scores were sustained at twelve months after conducting their longitudinal QI projects (53.4 to 72.2 percent [p-value 0.005]). Objective scores using the QIKAT increased post-curriculum from 8.3 to 10.1 out of 15 (p-value for difference value for difference from pre-curriculum based assessment occurred via presentation of all projects at the annual QI Project Podium Presentation Day. The competency based curriculum on QI improved residents' QI knowledge and skills during residency training. Importantly, residents perceived that their QI knowledge improved after the curriculum and this also correlated to improved QIKAT

  16. Capacity and readiness for quality improvement among home and community-based service providers.

    Science.gov (United States)

    Abrahamson, Kathleen; Myers, Jaclyn; Arling, Greg; Davila, Heather; Mueller, Christine; Abery, Brian; Cai, Yun

    2016-01-01

    The objective of this study was to explore home and community-based service (HCBS) providers' perspectives of organizational readiness for quality improvement (QI). Data were obtained from a survey of participants (N = 56) in a state-sponsored HCBS QI initiative. Quality improvement challenges included lack of time and resources, staff apprehension or resistance, resistance from consumers and families, and project sustainability. Support from leadership was viewed as an important factor in participating organizations' decision to engage in QI. Internal resources available to support QI varied widely between participating organizations, with differences observed between smaller and larger agencies, as well as between provider types and populations served.

  17. Validation of a method for assessing resident physicians' quality improvement proposals.

    Science.gov (United States)

    Leenstra, James L; Beckman, Thomas J; Reed, Darcy A; Mundell, William C; Thomas, Kris G; Krajicek, Bryan J; Cha, Stephen S; Kolars, Joseph C; McDonald, Furman S

    2007-09-01

    Residency programs involve trainees in quality improvement (QI) projects to evaluate competency in systems-based practice and practice-based learning and improvement. Valid approaches to assess QI proposals are lacking. We developed an instrument for assessing resident QI proposals--the Quality Improvement Proposal Assessment Tool (QIPAT-7)-and determined its validity and reliability. QIPAT-7 content was initially obtained from a national panel of QI experts. Through an iterative process, the instrument was refined, pilot-tested, and revised. Seven raters used the instrument to assess 45 resident QI proposals. Principal factor analysis was used to explore the dimensionality of instrument scores. Cronbach's alpha and intraclass correlations were calculated to determine internal consistency and interrater reliability, respectively. QIPAT-7 items comprised a single factor (eigenvalue = 3.4) suggesting a single assessment dimension. Interrater reliability for each item (range 0.79 to 0.93) and internal consistency reliability among the items (Cronbach's alpha = 0.87) were high. This method for assessing resident physician QI proposals is supported by content and internal structure validity evidence. QIPAT-7 is a useful tool for assessing resident QI proposals. Future research should determine the reliability of QIPAT-7 scores in other residency and fellowship training programs. Correlations should also be made between assessment scores and criteria for QI proposal success such as implementation of QI proposals, resident scholarly productivity, and improved patient outcomes.

  18. Dicty_cDB: SSK783 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available KLTLIIIAVVVLLLVVIIVPIVLKFT*i nlkkgkttliyifqnskn*kkkkkl*lkiink***pkkkketnnnxxxiink***pkkkk etnnx**qiinnnnk*qi...NIKLTLIIIAVVVLLLVVIIVPIVLKFT*i nlkkgkttliyifqnskn*kkkkkl*lkiink***pkkkketnnnxxxiink***pkkkk etnnx**qiinnnnk*

  19. Dicty_cDB: VSF280 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available slated Amino Acid sequence qi*KHCIKLTFIKKK--- ---SNSKVVVIWING*hhlkfvillmvligksiemvvlllliviviqlplislilqlelv q...lf pvefksipliaitlghidttsadatgtnvyqqtrvdvqainvtx Frame B: snlktly*infy*kk--- ---SNSKVVVIWING*hhlkfvillmvligksiem

  20. MO-C-12A-01: Quantitative Imaging Initiatives: Why, Who, What, and How?

    International Nuclear Information System (INIS)

    Sullivan, D; Jackson, E; Clarke, L; Petrick, N; Russek, S

    2014-01-01

    Over the past decade, there has been an increasing focus on quantitative imaging (QI), which, according to one definition, is “the extraction of quantifiable features from medical images for the assessment of normal or the severity, degree of change, or status of a disease, injury, or chronic condition relative to normal” ( www.rsna.org/QIBA ). To achieve the goals of QI requires the development and standardization of data acquisition, data analysis, and data display techniques, as well as appropriate reporting structures. As such, successful implementation of QI relies heavily on expertise from the fields of medical physics, radiology, statistics, and informatics as well as collaboration from vendors of imaging acquisition, analysis, and reporting systems. When successfully implemented, QI techniques will provide image-derived metrics with known bias and variance that can be validated with anatomically and physiologically relevant measures, including treatment response, and the heterogeneity of that response, and outcome. Such non-invasive measures can then be used effectively in clinical and translational research as well as patient care. In addition to modality-specific QI efforts implemented by individual scientific organizations, national and international organizations, including the NCI, RSNA, FDA, and NIST, appreciating the tremendous potential of QI but also understanding the associated challenges, have become increasingly involved. This symposium session will focus on 1) introducing QI and illustrating why it is important, even though challenging, in both research and clinical applications, and 2) providing overviews of QI efforts from national and international organizations, including the RSNA, NCI, FDA, and NIST. Learning Objectives: Understand the importance and potential of QI in research and clinical applications. Understand key challenges of QI and current barriers to implementation. Understand the current QI efforts of several national and

  1. MO-C-12A-01: Quantitative Imaging Initiatives: Why, Who, What, and How?

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, D [Duke University, Durham, NC (United States); Jackson, E; Clarke, L; Petrick, N; Russek, S [University of Wisconsin, Madison, WI (United States)

    2014-06-15

    Over the past decade, there has been an increasing focus on quantitative imaging (QI), which, according to one definition, is “the extraction of quantifiable features from medical images for the assessment of normal or the severity, degree of change, or status of a disease, injury, or chronic condition relative to normal” ( www.rsna.org/QIBA ). To achieve the goals of QI requires the development and standardization of data acquisition, data analysis, and data display techniques, as well as appropriate reporting structures. As such, successful implementation of QI relies heavily on expertise from the fields of medical physics, radiology, statistics, and informatics as well as collaboration from vendors of imaging acquisition, analysis, and reporting systems. When successfully implemented, QI techniques will provide image-derived metrics with known bias and variance that can be validated with anatomically and physiologically relevant measures, including treatment response, and the heterogeneity of that response, and outcome. Such non-invasive measures can then be used effectively in clinical and translational research as well as patient care. In addition to modality-specific QI efforts implemented by individual scientific organizations, national and international organizations, including the NCI, RSNA, FDA, and NIST, appreciating the tremendous potential of QI but also understanding the associated challenges, have become increasingly involved. This symposium session will focus on 1) introducing QI and illustrating why it is important, even though challenging, in both research and clinical applications, and 2) providing overviews of QI efforts from national and international organizations, including the RSNA, NCI, FDA, and NIST. Learning Objectives: Understand the importance and potential of QI in research and clinical applications. Understand key challenges of QI and current barriers to implementation. Understand the current QI efforts of several national and

  2. Importance of Performance Measurement and MCH Epidemiology Leadership to Quality Improvement Initiatives at the National, State and Local Levels.

    Science.gov (United States)

    Rankin, Kristin M; Gavin, Loretta; Moran, John W; Kroelinger, Charlan D; Vladutiu, Catherine J; Goodman, David A; Sappenfield, William M

    2016-11-01

    Purpose In recognition of the importance of performance measurement and MCH epidemiology leadership to quality improvement (QI) efforts, a plenary session dedicated to this topic was presented at the 2014 CityMatCH Leadership and MCH Epidemiology Conference. This paper summarizes the session and provides two applications of performance measurement to QI in MCH. Description Performance measures addressing processes of care are ubiquitous in the current health system landscape and the MCH community is increasingly applying QI processes, such as Plan-Do-Study-Act (PDSA) cycles, to improve the effectiveness and efficiency of systems impacting MCH populations. QI is maximally effective when well-defined performance measures are used to monitor change. Assessment MCH epidemiologists provide leadership to QI initiatives by identifying population-based outcomes that would benefit from QI, defining and implementing performance measures, assessing and improving data quality and timeliness, reporting variability in measures throughout PDSA cycles, evaluating QI initiative impact, and translating findings to stakeholders. MCH epidemiologists can also ensure that QI initiatives are aligned with MCH priorities at the local, state and federal levels. Two examples of this work, one highlighting use of a contraceptive service performance measure and another describing QI for peripartum hemorrhage prevention, demonstrate MCH epidemiologists' contributions throughout. Challenges remain in applying QI to complex community and systems-level interventions, including those aimed at improving access to quality care. Conclusion MCH epidemiologists provide leadership to QI initiatives by ensuring they are data-informed and supportive of a common MCH agenda, thereby optimizing the potential to improve MCH outcomes.

  3. Successfully reducing newborn asphyxia in the labour unit in a large academic medical centre

    DEFF Research Database (Denmark)

    Hollesen, Rikke von Benzon; Johansen, Rie Laurine Rosenthal; Rørbye, Christina

    2018-01-01

    with a peer when using an oxytocin infusion and the use of a checklist before vacuum extractions. CONCLUSION: This QI project illustrates how aspects of patient safety, such as the prevention of asphyxia, can be improved using QI methods to more reliably implement best practice, even in high...

  4. Relative importance of pasture size and grazing continuity for the long-term conservation of Europena dung beetles

    Czech Academy of Sciences Publication Activity Database

    Buse, J.; Šlachta, M.; Sládeček, František Xaver Jiří; Pung, M.; Wagner, T.; Entling, M. H.

    2015-01-01

    Roč. 187, JUL 01 (2015), s. 112-119 ISSN 0006-3207 Grant - others:GA MZe(CZ) QI111C034 Program:QI Institutional support: RVO:60077344 Keywords : habitat area * habitat continuity * geotrupidae Subject RIV: EH - Ecology, Behaviour Impact factor: 3.985, year: 2015 http://www.sciencedirect.com/science/article/pii/S0006320715001561

  5. 75 FR 21329 - Medicaid Program; State Allotments for Payment of Medicare Part B Premiums for Qualifying...

    Science.gov (United States)

    2010-04-23

    ... includes payment for premiums for Medicare Part B. Section 4732 of the Balanced Budget Act of 1997 (BBA... formula for determining State allotments. However, since certain States projected a deficit in their... minimize the impact on States with FY QI allotments that might be greater than their QI expenditures for...

  6. RN-to-BSN Students' Quality Improvement Knowledge, Skills, Confidence, and Systems Thinking.

    Science.gov (United States)

    Trent, Peggy; Dolansky, Mary A; DeBrew, Jacqueline Kayler; Petty, Gayle M

    2017-12-01

    Little evidence demonstrates that RN-to-baccalaureate nursing (BSN) graduates have met The Essentials of Baccalaureate Education for Professional Nursing Practice-specifically, evidence of the graduates' organizational and systems leadership related to quality care and patient safety. This BSN Essentials reflects the QSEN quality improvement (QI) competency. The purpose of this pilot study was to develop and test an assessment strategy to measure RN-to BSN students' QI competence and their perception of QI knowledge and skills. Students (N = 59) from six RN-to-BSN programs participated in a Qualtrics survey e-mailed during the last semester of their program. The majority of students (60%) reported that they did not experience QI content in their program. Scores on QI knowledge, skills, and systems thinking were low, yet the students self-reported that they were confident in their ability to perform QI. This pilot study provides an assessment strategy to measure students' competence related to QI. Nursing education has an opportunity to integrate and measure QI competence to ensure that nurses have the knowledge and skills to continually improve patient care. [J Nurs Educ. 2017;56(12):737-740.]. Copyright 2017, SLACK Incorporated.

  7. Castle Gardens Nursing Home, Drumgoold, Enniscorthy, Wexford.

    LENUS (Irish Health Repository)

    White, Mark

    2014-05-14

    Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to \\'engage\\' and \\'empower\\' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the \\'engagement\\' of the clinical teams who participate and vice-versa.

  8. An Evaluation of the Technical Adequacy of a Revised Measure of Quality Indicators of Transition

    Science.gov (United States)

    Morningstar, Mary E.; Lee, Hyunjoo; Lattin, Dana L.; Murray, Angela K.

    2016-01-01

    This study confirmed the reliability and validity of the Quality Indicators of Exemplary Transition Programs Needs Assessment-2 (QI-2). Quality transition program indicators were identified through a systematic synthesis of transition research, policies, and program evaluation measures. To verify reliability and validity of the QI-2, we…

  9. Chemical constituents of Cyperus rotundus L. and their inhibitory ...

    African Journals Online (AJOL)

    Background: Xiang Fu (Cyperus rotundus L) enters the liver, spleen and triple warmer meridians, and has qi stagnation-removing, qi circulation-promoting, menstruation-regulating and pain-relieving effects. Besides, it can improve ovarian function, and has hypolipidemic, hypoglycemic and neuroprotective actions.

  10. Training Psychiatry Residents in Quality Improvement: An Integrated, Year-Long Curriculum

    Science.gov (United States)

    Arbuckle, Melissa R.; Weinberg, Michael; Cabaniss, Deborah L.; Kistler; Susan C.; Isaacs, Abby J.; Sederer, Lloyd I.; Essock, Susan M.

    2013-01-01

    Objective: The authors describe a curriculum for psychiatry residents in Quality Improvement (QI) methodology. Methods: All PGY3 residents (N=12) participated in a QI curriculum that included a year-long group project. Knowledge and attitudes were assessed before and after the curriculum, using a modified Quality Improvement Knowledge Assessment…

  11. Methods for Estimation of Radiation Risk in Epidemiological Studies Accounting for Classical and Berkson Errors in Doses

    KAUST Repository

    Kukush, Alexander; Shklyar, Sergiy; Masiuk, Sergii; Likhtarov, Illya; Kovgan, Lina; Carroll, Raymond J; Bouville, Andre

    2011-01-01

    thyroid dose of a person i is expressed as Dimes=fiQi(mes)/Mi(mes). Here, Qi(mes) is the measured content of radioiodine in the thyroid gland of person i at time t(mes), Mi(mes) is the estimate of the thyroid mass, and f(i) is the normalizing multiplier

  12. 77 FR 65887 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2012-10-31

    ..., Washington, DC 20573, by telephone at (202) 523-5843 or by email at [email protected] . ACM Logistics & Consulting... Type: New OFF License; Highland Project Logistics, Inc. (NVO & OFF), 35 Constitution Drive, Suite A.... Bonner, Special Manager (QI), Martine L. Plunkett, Manager, Application Type: Additional QI; Radiant...

  13. 78 FR 14792 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-03-07

    ...: Mohamed Y. Ali, Manager (QI); Abdul S. Mohamed, Member. Application Type: Add Trade Name Compass Logistics... Ugueto, Secretary. Application Type: New NVO & OFF License American Forwarding & Logistics, LLC (NVO & OFF), 1919 NW 19th Street, Unit 624, Ft. Lauderdale, FL 33311. Officers: Gabriele Awada, Manager (QI...

  14. Simultaneous estimation of QTL parameters for mapping multiple traits

    Indian Academy of Sciences (India)

    LIANG TONG

    2018-03-13

    XM ji ) denotes the conditional probability of the QTL genotype. X. ∗ ji (QiQi, Qiqi or ... random error of the ith trait value of the jth subject, with mean zero and ..... to adjust the conditional probabilities in table 1 when conducting ...

  15. The impact of a large-scale quality improvement programme on work engagement: Preliminary results from a national cross-sectional-survey of the 'Productive Ward'

    LENUS (Irish Health Repository)

    White, Mark

    2014-05-14

    Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to \\'engage\\' and \\'empower\\' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the \\'engagement\\' of the clinical teams who participate and vice-versa.

  16. Investigation of the sequential validity of quality improvement team ...

    African Journals Online (AJOL)

    Background: Self-assessment is widely used in the health care improvement collaboratives quality improvement (QI) teams' to assess their own performance. There is mixed evidence on the validity of this approach. This study investigated sequential validity of self-assessments in a QI HIV collaborative in Tanzania.

  17. A Longitudinal, Experiential Quality Improvement Curriculum Meeting ACGME Competencies for Geriatrics Fellows: Lessons Learned

    Science.gov (United States)

    Callahan, Kathryn E.; Rogers, Matthew T.; Lovato, James F.; Fernandez, Helen M.

    2013-01-01

    Quality improvement (QI) initiatives are critical in the care of older adults who are more vulnerable to substandard care. QI education meets aspects of core Accreditation Council of Graduate Medical Education competencies and prepares learners for the rising focus on performance measurement in health care. The authors developed, implemented, and…

  18. Quality improvement primer part 1: Preparing for a quality improvement project in the emergency department.

    Science.gov (United States)

    Chartier, Lucas B; Cheng, Amy H Y; Stang, Antonia S; Vaillancourt, Samuel

    2018-01-01

    Emergency medicine (EM) providers work in a fast-paced and often hectic environment that has a high risk for patient safety incidents and gaps in the quality of care. These challenges have resulted in opportunities for frontline EM providers to play a role in quality improvement (QI) projects. QI has developed into a mature field with methodologies that can dramatically improve the odds of having a successful project with a sustainable impact. However, this expertise is not yet commonly taught during professional training. In this first of three articles meant as a QI primer for EM clinicians, we will introduce QI methodology and strategic planning using a fictional case study as an example. We will review how to identify a QI problem, define components of an effective problem statement, and identify stakeholders and core change team members. We will also describe three techniques used to perform root cause analyses-Ishikawa diagrams, Pareto charts and process mapping-and how they relate to preparing for a QI project. The next two papers in this series will focus on the execution of the QI project itself using rapid-cycle testing and on the evaluation and sustainability of QI projects.

  19. Journal of Genetics | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Genetics. SHUWU QI. Articles written in Journal of Genetics. Volume 96 Issue 4 September 2017 pp 695-700 RESEARCH NOTE. Clinical and genetic characterization of six cases with complete androgen insensitivity syndrome in China · JING HE SHUWU QI HUIJUN ZHANG JINGJING GUO ...

  20. Quality improvement education incorporated as an integral part of critical care fellows training at the Mayo Clinic.

    Science.gov (United States)

    Kashani, Kianoush B; Ramar, Kannan; Farmer, J Christopher; Lim, Kaiser G; Moreno-Franco, Pablo; Morgenthaler, Timothy I; Dankbar, Gene C; Hale, Curt W

    2014-10-01

    The Accreditation Council for Graduate Medical Education emphasizes quality improvement (QI) education in residency/fellowship training programs. The Mayo Clinic Combined Critical Care Fellowship (CCF) program conducted a pilot QI education program to incorporate QI training as a required curriculum for the 2010-2011 academic year. CCF collaborated with the Mayo Quality Academy to customize and teach the existing Mayo Quality Fellows curriculum to the CCF fellows with the help of two quality coaches over five months starting July 2010. All fellows were to achieve Bronze and Silver certification prior to graduation. Silver required passing four written exams and submitting a health care QI project. Five projects were selected on the basis of the Impact-Effort Prioritization matrix, and DMAIC (Define, Measure, Analyze, Improve, and Control) methodology was used to complete the projects. The primary outcome was to assess learners' satisfaction, knowledge, and skill transfer. All 20 fellows were Bronze certified, and 14 (70%) were Silver certified by the time of graduation. All five QI projects were completed and showed positive impacts on patient safety and care. Surveys showed improved learner satisfaction. Graduates felt the QI training improved their QI skills and employment and career advancement. The QI curriculum had appropriate content and teaching pace and did not significantly displace other important clinical core curriculum topics. The pilot was successfully implemented in the CCF program and now is in the fourth academic year as an established and integral part of the fellowship core curriculum.

  1. 78 FR 23252 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-04-18

    .... Logistics, Inc. dba BE Logistics dba Belogistics dba Core Logistics (NVO), 12911 Simms Avenue, Hawthorn, CA... (QI), Kevin L. Miller, Secretary, Application Type: QI Change Triple Eagle Logistics Inc. dba Triple Eagle Logistic Canada Inc. (NVO & OFF), 17890 Castleton Street, Suite 367, City of Industry, CA 91748...

  2. 75 FR 66099 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2010-10-27

    ... Logistics, Inc. (NVO), 17890 Castleton Street, Suite 398, City of Industry, CA 91748, Officers: Jennifer X... (Qualifying Individual), Application Type: QI Change. Concert Group Logistics, Inc. (NVO & OFF), 1430 Branding... Individual), Daniel Para, CEO, Application Type: QI Change. De Well Logistics LLC dba De Well Logistics, dba...

  3. 78 FR 68444 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-11-14

    ... (America), Ltd. (NVO & OFF), 21061 S. Western Avenue, Suite 300, Torrance, CA 90501-1122, Officers: Mary M..., Officers: Kimberly A. Whisler Wagner, Member Manager (QI), Kara M. Norkus, Member Manager, Application Type..., Iselin, NJ 08830, Officers: Richard Kenyon, President (QI), Fernando Valenzuela, Global President...

  4. 75 FR 60124 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2010-09-29

    ... Individual), Sharlene Chesnes, EVP/COB/EVP/Secretary, Application Type: QI Change IAL Container Line (USA..., Vice President (Qualifying Individual), Arjun Menon, Director, Application Type: QI Change LTA Import & Export, Inc. (NVO & OFF), 14331 SW 120th Street, 203, Miami, FL 33186, Officers: Eric E. Diaz, Director...

  5. 78 FR 48435 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-08-08

    ..., Washington, DC 20573, by telephone at (202) 523-5843 or by email at [email protected] . A & J Cargo Logistics Inc... (QI), Application Type: Add Trade Name Arabia Cargo and OFF Service. CMX Global Logistics, LLC (NVO... Transport Co., Ltd. (NVO), 13101 Moore Street, Cerritos, CA 90703, Officers: Ki Hyeon Lee, CFO (QI), Seong...

  6. 77 FR 76483 - Ocean Transportation Intermediary License Applicants The Commission gives notice that the...

    Science.gov (United States)

    2012-12-28

    ... Transport Co., PAC International Logistics Company, & Book Express Network. Stealth Logistics LLC (NVO & OFF.... Application Type: QI Change. Efrinsa Global Logistics Inc. (NVO & OFF), 8441 NW 68th Street, Miami, FL 33166... (QI), Sheila E. Lawrence, President. Application Type: New OFF License. MMC Logistics, LLC (OFF), 2853...

  7. 78 FR 28845 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-05-16

    ..., President, Application Type: QI Change Contract Logistics, LLC (NVO), 4911 North Portland Avenue, Suite 200..., Application Type: Add Trade Name Smart Lines Worldwide Feiliks Global Logistics Corporation (NVO), 176-20 S..., Director, Application Type: QI Change Intermodal Tank Transport (USA), Inc. (NVO), 2537 S. Gessner, Suite...

  8. 78 FR 50054 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-08-16

    ...), Ross V. Stemmler, President, Application Type: QI Change. Dawson Logistics, Inc. (OFF), 2220 South... (QI), Chad Earwood, President, Application Type: Add NVO Service. Fesco Integrated Transport North...), Ugochukwu O. Ene, President, Application Type: New NVO & OFF License. Icon Logistics Services LLC (OFF...

  9. [Profound meaning of acupuncture taboos in Internal Classic based on the fault of reinforcing and reducing technique by mind conduction of acupuncture therapy].

    Science.gov (United States)

    Qin, Yuge; Wang, Feng; Qin, Yuheng; Li, Li; Li, Mei

    2016-05-01

    By analyzing the acupuncture taboos in Neijing (Internal Classic) on clinical application of mind conduction of acupuncture therapy in going against the actual situation, astronomy and others, it is found that the relevant acupuncture taboo implies many subtle mysteries of human body, qi, mind and astronomy, which have not been discovered yet in modern science and are very significant in qi protection. In Neijing, the acupuncture physicians have been highly required in the mind treatment, in which, accurately regulating qi circulation is the target in the treatment. The mind conduction is used for qi circulation to accomplish accurately the reinforcing or reducing in the deficiency or excess condition. All of the taboos are provided to normalize the accuracy of reinforcing and reducing technique of acupuncture therapy and avoid the damage of qi in human body. Hence, those taboos must be obeyed so as to prevent from serious consequence and ensure the safety of this acupuncture therapy.

  10. The Association of Organizational Culture and Quality Improvement Implementation With Neonatal Outcomes in the NICU.

    Science.gov (United States)

    Mahl, Sukhy; Lee, Shoo K; Baker, G Ross; Cronin, Catherine M G; Stevens, Bonnie; Ye, Xiang Y

    2015-01-01

    Studies of adult patient populations suggest that organizational culture is associated with quality improvement (QI) implementation, as well as patient outcomes. However, very little research on organizational culture has been performed in neonatal patient populations. This combined cross-sectional survey and retrospective cohort study assessed employee perceptions of organizational culture and QI implementation within 18 Canadian neonatal intensive care units. The associations between these data and neonatal outcomes in extremely preterm infants (born at culture and QI implementation varied according to occupation and age. Higher hierarchical culture was associated with increased survival without major morbidities (odds ratio, 1.04; 95% confidence interval, 1.01-1.06), as were higher QI implementation scores (odds ratio range, 1.20-1.36 by culture type). Our data suggest that organizational culture, particularly hierarchical culture, and level of QI implementation may play a role in neonatal outcomes. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  11. Developing an Interdisciplinary, Team-Based Quality Improvement Leadership Training Program for Clinicians: The Partners Clinical Process Improvement Leadership Program.

    Science.gov (United States)

    Rao, Sandhya K; Carballo, Victoria; Cummings, Brian M; Millham, Frederick; Jacobson, Joseph O

    Although there has been tremendous progress in quality improvement (QI) education for students and trainees in recent years, much less has been published regarding the training of active clinicians in QI. The Partners Clinical Process Improvement Leadership Program (CPIP) is a 6-day experiential program. Interdisciplinary teams complete a QI project framed by didactic sessions, interactive exercises, case-based problem sessions, and a final presentation. A total of 239 teams composed of 516 individuals have graduated CPIP. On completion, participant satisfaction scores average 4.52 (scale 1-5) and self-reported understanding of QI concepts improved. At 6 months after graduation, 66% of survey respondents reported sustained QI activity. Three opportunities to improve the program have been identified: (1) increasing faculty participation through online and tiered course offerings, (2) integrating the faculty-focused program with the trainee curriculum, and (3) developing a postgraduate curriculum to address the challenges of sustained improvement.

  12. Call to action: Better care, better health, and greater value in college health.

    Science.gov (United States)

    Ciotoli, Carlo; Smith, Allison J; Keeling, Richard P

    2018-03-05

    It is time for action by leaders across higher education to strengthen quality improvement (QI) in college health, in pursuit of better care, better health, and increased value - goals closely linked to students' learning and success. The size and importance of the college student population; the connections between wellbeing, and therefore QI, and student success; the need for improved standards and greater accountability; and the positive contributions of QI to employee satisfaction and professionalism all warrant a widespread commitment to building greater capacity and capability for QI in college health. This report aims to inspire, motivate, and challenge college health professionals and their colleagues, campus leaders, and national entities to take both immediate and sustainable steps to bring QI to the forefront of college health practice - and, by doing so, to elevate care, health, and value of college health as a key pathway to advancing student success.

  13. A retrospective evaluation of the Perfecting Patient Care University training program for health care organizations.

    Science.gov (United States)

    Morganti, Kristy Gonzalez; Lovejoy, Susan; Beckjord, Ellen Burke; Haviland, Amelia M; Haas, Ann C; Farley, Donna O

    2014-01-01

    This study evaluated how the Perfecting Patient Care (PPC) University, a quality improvement (QI) training program for health care leaders and clinicians, affected the ability of organizations to improve the health care they provide. This training program teaches improvement methods based on Lean concepts and principles of the Toyota Production System and is offered in several formats. A retrospective evaluation was performed that gathered data on training, other process factors, and outcomes after staff completed the PPC training. A majority of respondents reported gaining QI competencies and cultural achievements from the training. Organizations had high average scores for the success measures of "outcomes improved" and "sustainable monitoring" but lower scores for diffusion of QI efforts. Total training dosage was significantly associated with the measures of QI success. This evaluation provides evidence that organizations gained the PPC competencies and cultural achievements and that training dosage is a driver of QI success.

  14. Project JOINTS: what factors affect bundle adoption in a voluntary quality improvement campaign?

    Science.gov (United States)

    Khodyakov, Dmitry; Ridgely, M Susan; Huang, Christina; DeBartolo, Katherine O; Sorbero, Melony E; Schneider, Eric C

    2015-01-01

    Diffusion and adoption of effective evidence-based clinical practices can be slow, especially if complex changes are required to implement new practices. To examine how hospital adherence to quality improvement (QI) methods and hospital engagement with a large-scale QI campaign could facilitate the adoption of an enhanced prevention bundle designed to reduce surgical site infection (SSI) rates after orthopaedic surgery (hip and knee arthroplasty). We conducted telephone interviews with hospital QI leaders from 73 of the 109 hospitals (67% response rate) in five states that participated in Project JOINTS (Joining Organizations IN Tackling SSIs), a QI campaign run by Institute for Healthcare Improvement (IHI). Using QI methods grounded in the IHI Model for Improvement, this campaign encouraged hospitals to implement an enhanced SSI prevention bundle. Hospital QI leaders reported on their hospital's adherence to the Project JOINTS QI methods; their level of engagement with Project JOINTS activities; and adoption of the SSI prevention bundle components. Interview data were analysed quantitatively and qualitatively. Both adherence to the QI methods and hospital engagement were positively associated with complete bundle adoption. Hospital engagement, especially the use of project materials and tools, was also positively associated with the initiation of and improved adherence to individual bundle components. Our findings suggest that greater adherence to the QI methods and active hospital engagement in a QI campaign facilitate adoption of evidence-based patient safety bundles in orthopaedic practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomized controlled trial.

    Science.gov (United States)

    Xu, Sha-bei; Huang, Bo; Zhang, Chen-yan; Du, Peng; Yuan, Qi; Bi, Gui-juan; Zhang, Gui-bin; Xie, Min-jie; Luo, Xiang; Huang, Guang-ying; Wang, Wei

    2013-04-02

    The traditional Chinese theory of acupuncture emphasizes that the intensity of acupuncture must reach a threshold to generate de qi, which is necessary to achieve the best therapeutic effect. De qi is an internal compound sensation of soreness, tingling, fullness, aching, cool, warmth and heaviness, and a radiating sensation at and around the acupoints. However, the notion that de qi must be achieved for maximum benefit has not been confirmed by modern scientific evidence. We performed a prospective multicentre randomized controlled trial involving patients with Bell palsy. Patients were randomly assigned to the de qi (n = 167) or control (n = 171) group. Both groups received acupuncture: in the de qi group, the needles were manipulated manually until de qi was reached, whereas in the control group, the needles were inserted without any manipulation. All patients received prednisone as a basic treatment. The primary outcome was facial nerve function at month 6. We also assessed disability and quality of life 6 months after randomization. After 6 months, patients in the de qi group had better facial function (adjusted odds ratio [OR] 4.16, 95% confidence interval [CI] 2.23-7.78), better disability assessment (differences of least squares means 9.80, 95% CI 6.29-13.30) and better quality of life (differences of least squares means 29.86, 95% CI 22.33-37.38). Logistic regression analysis showed a positive effect of the de qi score on facial-nerve function (adjusted OR 1.07, 95% CI 1.04-1.09). Among patients with Bell palsy, acupuncture with strong stimulation that elicited de qi had a greater therapeutic effect, and stronger intensity of de qi was associated with the better therapeutic effects. Clinicaltrials.gov no. NCT00685789.

  16. Mixed-Methods Assessment of Trauma and Acute Care Surgical Quality Improvement Programs in Peru.

    Science.gov (United States)

    LaGrone, Lacey N; Fuhs, Amy K; Egoavil, Eduardo Huaman; Rodriguez Castro, Manuel J A; Valderrama, Roberto; Isquith-Dicker, Leah N; Herrera-Matta, Jaime; Mock, Charles N

    2017-04-01

    Evidence for the positive impact of quality improvement (QI) programs on morbidity, mortality, patient satisfaction, and cost is strong. Data regarding the status of QI programs in low- and middle-income countries, as well as in-depth examination of barriers and facilitators to their implementation, are limited. This cross-sectional, descriptive study employed a mixed-methods design, including distribution of an anonymous quantitative survey and individual interviews with healthcare providers who participate in the care of the injured at ten large hospitals in Lima, Peru. Key areas identified for improvement in morbidity and mortality (M&M) conferences were the standardization of case selection, incorporation of evidence from the medical literature into case presentation and discussion, case documentation, and the development of a clear plan for case follow-up. The key barriers to QI program implementation were a lack of prioritization of QI, lack of sufficient human and administrative resources, lack of political support, and lack of education on QI practices. A national program that makes QI a required part of all health providers' professional training and responsibilities would effectively address a majority of identified barriers to QI programs in Peru. Specifically, the presence of basic QI elements, such as M&M conferences, should be required at hospitals that train pre-graduate physicians. Alternatively, short of this national-level organization, efforts that capitalize on local examples through apprenticeships between institutions or integration of QI into continuing medical education would be expected to build on the facilitators for QI programs that exist in Peru.

  17. Effectiveness of a quality improvement curriculum for medical students

    Directory of Open Access Journals (Sweden)

    Kimberly M. Tartaglia

    2015-05-01

    Full Text Available Introduction: As health systems find ways to improve quality of care, medical training programs are finding opportunities to prepare learners on principles of quality improvement (QI. The impact of QI curricula for medical students as measured by student learning is not well delineated. The aim of this study is to evaluate the effectiveness of a QI curriculum for senior medical students as measured by student knowledge and skills. Methods: This study was an observational study that involved a self-assessment and post-test Quality Improvement Knowledge Application Tool (QIKAT for intervention and control students. A QI curriculum consisting of online modules, live discussions, independent readings and reflective writing, and participation in a mentored QI project was offered to fourth-year medical students completing an honor's elective (intervention group. Senior medical students who received the standard QI curriculum only were recruited as controls. Results: A total of 22 intervention students and 12 control students completed the self-assessment and QIKAT. At baseline, there was no difference between groups in self-reported prior exposure to QI principles. Students in the intervention group reported more comfort with their skills in QI overall and in 9 of the 12 domains (p<0.05. Additionally, intervention students performed better in each of the three case scenarios (p<0.01. Discussion: A brief QI curriculum for senior medical students results in improved comfort and knowledge with QI principles. The strengths of our curriculum include effective use of classroom time and faculty mentorship with reliance on pre-existing online modules and written resources. Additionally, the curriculum is easily expandable to larger groups of students and transferable to other institutions.

  18. Do relationships exist between the scope and intensity of quality improvement activities and hospital operation performance? A 10-year observation in Taiwan.

    Science.gov (United States)

    Chung, Kuo-Piao; Yu, Tsung-Hsien

    2015-08-14

    The relationship between the scope and intensity of quality improvement (QI) activities and hospital performance remains unclear. This study investigated the relationship between performance, external environment, and the scope and intensity of QI activities in hospitals. The study used a longitudinal observation. Data regarding the scope and intensity of QI activities were collected using a questionnaire survey among the administrative deputy superintendents / directors of quality management center in 139 hospitals. Hospital performance indicators were abstracted from the 2000-2009 national hospitals profiles. We adopted year 2000 as the baseline, and divided the study period into three 3-year periods. The Generalized Estimating Equations (GEE) model was used for the statistical analysis. Seventy-two hospitals responded to the survey, giving a response rate of 52%. The results showed a significant increase in the scope and intensity of QI activities between 2000 and 2009. The results also showed that the scope and intensity of a hospital's QI activities were associated with the scope and intensity of its competitors' QI activities in the previous period and its own prior performance. The scope of QI activities in the previous period was not significantly related to the selected hospital performance measures. However, the intensity of QI activities in the previous period showed a significant and positive relationship with the number of inpatients and the turnover of beds. The study demonstrates that the intensity of QI activities is associated with the external environment and the hospital's own performance in the previous period. Furthermore, some performance measures are associated with the intensity of the QI activities in the previous period.

  19. Assessing the Organizational Characteristics Influencing Quality Improvement Implementation in Saudi Hospitals.

    Science.gov (United States)

    Shamsuddin Alaraki, Mohammad

    The health care system in Saudi Arabia has serious problems with quality and safety that can be reduced through systematic quality improvement (QI) activities. Despite the use of different QI models to improve health care in Saudi hospitals during the last 2 decades, consistent improvements have not yet been achieved and the results are still far below expectations. This may reflect a problem in introducing and implementing the QI models in the local contexts. The objective of this study is to assess the extent of QI implementation in Saudi hospitals and to identify the organizational characteristics that make Saudi hospitals particularly challenging for QI. Understanding these characteristics can inform efforts to improve them and may lead to more successful implementation. A mixed-methods approach was conducted using 2 data collection tools: questionnaires and interviews. The quantitative phase (questionnaires) aimed to uncover the current level of QI implementation in Saudi hospital as measured by 7 critical dimensions adapted from the literature. The qualitative phase (interviews) aimed to understand the organizational characteristics that impede or underpin QI in Saudi hospitals. The QI implementation was found to be significantly poor across the 7 dimensions with average score ranging between 22.80 ± 0.57 and 2.11 ± 0.69 on a 5-point Likert scale and with P value of less than .05. We also found that the current level of QI implementation helped Saudi hospitals neither to improve "customer satisfaction" nor to achieve measurable improvements in "quality results" scoring significantly low at 2.11 ± 0.69 with P value of .000 and 2.47 ± 0.57 with P value of .000, respectively. Our study confirms the presence of a multitude of organizational barriers that impede QI in Saudi hospitals. These are related to organizational culture, human resources management, processes and systems, and structure. These 4 were found to have the strongest impact on QI in Saudi

  20. The science of quality improvement implementation: developing capacity to make a difference.

    Science.gov (United States)

    Alexander, Jeffrey A; Hearld, Larry R

    2011-12-01

    Quality improvement (QI) holds promise to improve quality of care; however, organizations often struggle with its implementation. It has been recommended that practitioners, managers, and researchers attempt to increase systematic understanding of the structure, practices, and context of organizations that facilitate or impede the implementation of QI innovations. To critically review the empirical research on QI implementation in health care organizations. A literature review of 107 studies that examined the implementation of QI innovations in health care organizations. Studies were classified into 4 groups based on the types of predictors that were assumed to affect implementation (content of QI innovation, organizational processes, internal context, and external context). Internal context and organizational processes were the most frequently studied categories. External context and organizational process categories exhibited the highest rate of positive effects on QI implementation. The review revealed several important gaps in the QI implementation literature. Studies often lacked clear conceptual frameworks to guide the research, which may hinder efforts to compare relationships across studies. Studies also tended to adopt designs that were narrowly focused on independent effects of predictors and did not include holistic frameworks to capture interactions among the many factors involved in implementation. Other design limitations included the use of cross-sectional designs, single-source data collection, and potential selection bias among study participants.

  1. Addressing Opioid-Associated Constipation Using Quality Oncology Practice Initiative Scores and Plan-Do-Study-Act Cycles.

    Science.gov (United States)

    Kaur, Varinder; Haider, Sajjad; Sasapu, Appalanaidu; Mehta, Paulette; Arnaoutakis, Konstantinos; Makhoul, Issam

    2017-01-01

    Using the Quality Oncology Practice Initiative, an affiliate program of ASCO, we outlined opioid-associated constipation (OAC) as a subject in need of quality improvement (QI) in our fellowship program at the University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System. We initiated a fellow-led QI project to advance the quality of patient care and provide a valuable avenue for QI training of young physicians. Fellows organized meetings with all stakeholders, addressed the scope of the problem, and devised strategies for OAC management. Monthly meetings were organized using Plan-Do-Study-Act principles. Mandatory check boxes were inserted into our electronic medical record templates to remind all physicians to identify patients on opioid medications and assess and address OAC. Final chart audit and patient satisfaction surveys were performed 6 months after project initiation. Assessment of OAC improved from 52% at baseline to 92% ( P < .003). This improvement corresponded with high patient satisfaction scores, with 90% of surveyed patients reporting adequate management of their constipation. In this QI initiative, we showed that participation in ASCO's Quality Oncology Practice Initiative helps identify areas in need of QI, and such fellow-led QI projects can serve as models for QI training of young physicians.

  2. The effect of the SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines on reporting standards in the quality improvement literature: a before-and-after study.

    Science.gov (United States)

    Howell, Victoria; Schwartz, Amanda Eva; O'Leary, James Daniel; Mc Donnell, Conor

    2015-06-01

    The SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines were developed to improve the reporting of quality improvement (QI) projects. The effect of the guidelines on the completeness of reporting in the QI literature is unknown. Our primary objective was to determine if the completeness of reporting in the QI literature has been improved[OUP_CE13] since the introduction of the SQUIRE guidelines. We performed a before-and-after evaluation of QI articles selected from four prominent journals of healthcare quality. Twenty-five articles published in each of two time periods (2006-2008 and 2010-2011) were confirmed to be QI projects using a standardised definition and were independently evaluated by two investigators as an interim evaluation of a planned larger sample. Articles were assessed using 50 statements of the SQUIRE guidelines, and the overall change in the completeness of reporting between the two groups was determined. The value of pimprovement observed in the completeness of reporting of QI projects after the publication of the SQUIRE guidelines, and the study was stopped early. There is potential for improvement in reporting standards, particularly for those guideline items or statements specific to QI projects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. Does lean muddy the quality improvement waters? A qualitative study of how a hospital management team understands lean in the context of quality improvement.

    Science.gov (United States)

    Savage, Carl; Parke, Louise; von Knorring, Mia; Mazzocato, Pamela

    2016-10-19

    Health care has experimented with many different quality improvement (QI) approaches with greater variation in name than content. This has been dubbed pseudoinnovation. However, it could also be that the subtleties and differences are not clearly understood. To explore this further, the purpose of this study was to explore how hospital managers perceive lean in the context of QI. We used a qualitative study design with semi-structured interviews to explore twelve top managers' perceptions of the relationship between lean and quality improvement (QI) at a university-affiliated hospital. Managers described that QI and lean shared the same overall purpose: focus on patient needs and improve efficiency and effectiveness. Employee involvement was emphasized in both strategies, as well as the support offered by managers of staff initiatives. QI was perceived as a strategy that could support structural changes at the organizational level whereas lean was seen as applicable at the operational level. Moreover, lean carried a negative connotation, lacked the credibility of QI, and was perceived as a management fad. Aspects of QI and lean were misunderstood. In a context where lean remains an abstract term, and staff associate lean with automotive applications and cost reduction, it may be fruitful for managers to invest time and resources to develop a strategy for continual improvement and utilize vocabulary that resonates with health care staff. This could reduce the risk that improvement efforts are rejected out of hand.

  4. Effect of material strength on the relationship between the principal Hugoniot and quasi-isentrope of beryllium and 6061-T6 aluminum below 35 GPa

    International Nuclear Information System (INIS)

    Moss, W.C.

    1985-01-01

    Quasi-isentropic (QI) compression can be achieved by loading a specimen with a low strain rate, long rise time uniaxial strain wave. Recent experimental data show that the quasi-isentrope of 6061-T6 aluminum lies a few percent above the principal Hugoniot, that is, at a given specific volume, the QI stress exceeds the principal Hugoniot stress. It has been suggested that this effect is due to material strength. Using Hugoniot data, shock-reshock, and shock-unload data for beryllium and 6061-T6 aluminum, we have constructed the quasi-isentropes as functions of specific volume. Our results show that the QI stress exceeds the principal Hugoniot stress above a Hugoniot stress of 8.4 GPa in beryllium, and between Hugoniot stresses of 3.8 and 21.4 GPa in aluminum. The effect is due to strength and implies that the QI yield strength can be large. Our calculations show that the QI yield strength is 0.9 GPa in aluminum at a QI stress of 9 GPa, and 5.2 GPa in beryllium at a QI stress of 35 GPa

  5. Promoting mobility and reducing length of stay in hospitalized general medicine patients: A quality-improvement project.

    Science.gov (United States)

    Hoyer, Erik H; Friedman, Michael; Lavezza, Annette; Wagner-Kosmakos, Kathleen; Lewis-Cherry, Robin; Skolnik, Judy L; Byers, Sherrie P; Atanelov, Levan; Colantuoni, Elizabeth; Brotman, Daniel J; Needham, Dale M

    2016-05-01

    To determine whether a multidisciplinary mobility promotion quality-improvement (QI) project would increase patient mobility and reduce hospital length of stay (LOS). Implemented using a structured QI model, the project took place between March 1, 2013 and March 1, 2014 on 2 general medicine units in a large academic medical center. There were 3352 patients admitted during the QI project period. The Johns Hopkins Highest Level of Mobility (JH-HLM) scale, an 8-point ordinal scale ranging from bed rest (score = 1) to ambulating ≥250 feet (score = 8), was used to quantify mobility. Changes in JH-HLM scores were compared for the first 4 months of the project (ramp-up phase) versus 4 months after project completion (post-QI phase) using generalized estimating equations. We compared the relative change in median LOS for the project months versus 12 months prior among the QI units, using multivariable linear regression analysis adjusting for 7 demographic and clinically relevant variables. Comparing the ramp-up versus post-QI phases, patients reaching JH-HLM's ambulation status increased from 43% to 70% (P mobility scores between admission and discharge increased from 32% to 45% (P 7 days), were associated with a significantly greater adjusted median reduction in LOS of 1.11 (95% CI: -1.53 to -0.65, P mobility was not associated with an increase in injurious falls compared to 12 months prior on the QI units (P = 0.73). Active prevention of a decline in physical function that commonly occurs during hospitalization may be achieved with a structured QI approach. In an adult medicine population, our QI project was associated with improved mobility, and this may have contributed to a reduction in LOS, particularly for more complex patients with longer expected hospital stay. Journal of Hospital Medicine 2016. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  6. Evaluating the state of quality-improvement science through evidence synthesis: insights from the closing the quality gap series.

    Science.gov (United States)

    McDonald, Kathryn M; Schultz, Ellen M; Chang, Christine

    2013-01-01

    The Closing the Quality Gap series from the Agency for Healthcare Research and Quality summarizes evidence for eight high-priority health care topics: outcomes used in disability research, bundled payment programs, public reporting initiatives, health care disparities, palliative care, the patient-centered medical home, prevention of health care-associated infections, and medication adherence. To distill evidence from this series and provide insight into the "state of the science" of quality improvement (QI). We provided common guidance for topic development and qualitatively synthesized evidence from the series topic reports to identify cross-topic themes, challenges, and evidence gaps as related to QI practice and science. Among topics that examined effectiveness of QI interventions, we found improvement in some outcomes but not others. Implementation context and potential harms from QI activities were not widely evaluated or reported, although market factors appeared important for incentive-based QI strategies. Patient-focused and systems-focused strategies were generally more effective than clinician-focused strategies, although the latter approach improved clinician adherence to infection prevention strategies. Audit and feedback appeared better for targeting professionals and organizations, but not patients. Topic reviewers observed heterogeneity in outcomes used for QI evaluations, weaknesses in study design, and incomplete reporting. Synthesizing evidence across topics provided insight into the state of the QI field for practitioners and researchers. To facilitate future evidence synthesis, consensus is needed around a smaller set of outcomes for use in QI evaluations and a framework and lexicon to describe QI interventions more broadly, in alignment with needs of decision makers responsible for improving quality.

  7. Quality of care achievements of the Prostate Cancer Outcomes Registry-Victoria.

    Science.gov (United States)

    Sampurno, Fanny; Earnest, Arul; Kumari, Patabendi B; Millar, Jeremy L; Davis, Ian D; Murphy, Declan G; Frydenberg, Mark; Kearns, Paul A; Evans, Sue M

    2016-05-02

    To analyse the performance of the quality of prostate cancer (CaP) care over a 5-year period with reference to three quality indicators (QIs) reported by the Prostate Cancer Outcomes Registry-Victoria (PCOR-Vic):QI-1: Alignment with the modified Prostate Cancer Research International Active Surveillance (PRIAS) protocol guideline;QI-2: Timeliness of CaP care for men with high risk and locally advanced disease;QI-3: Positive surgical margins (PSMs) for organ-confined pathological T2 disease. Between 1 January 2009 and 31 December 2013, 4708 men diagnosed with CaP who met the QI-1, QI-2 or QI-3 inclusion criteria were recruited from Victorian hospitals.Outcome measures and statistical analysis: Trend analysis was conducted to monitor performance according to QI-1, QI-2 and QI-3. We used the autoregressive integrated moving average (ARIMA) model to account for any inherent autocorrelation in the data when analysing the monthly incidence of each indicator. Differences in the annual figures for the indicators across years were also analysed by aggregating data by year and applying the ARIMA model. There was a downward trend over the 5 years in the percentage of men with low risk disease who underwent active treatment (45% to 34%; P = 0.024), an upward trend in the percentage of those with high risk and locally advanced disease who received active treatment within 12 months of diagnosis (88% to 93%; P = 0.181), and a decline in PSM rate in men with pathological T2 disease after radical prostatectomy (21% to 12%; P = 0.036). Limitations of the study include the fact that the improvement in the QIs was detected using PCOR-Vic as a single population, but there may be institutional variations in quality improvement. Over 2009-2013, the performance of the Victorian health system improved according to the three processes of care indicators reported by the PCOR-Vic.

  8. Is the implementation of quality improvement methods in hospitals subject to the neighbourhood effect?

    Science.gov (United States)

    Yu, Tsung-Hsien; Chung, Kuo-Piao

    2014-06-01

    Quality improvement (QI) methods have been fashionable in hospitals for decades. Previous studies have discussed the relationships between the implementation of QI methods and various external and internal factors, but there has been no examination to date of whether the neighbourhood effect influences such implementation. The aim of this study was to use a multilevel model to investigate whether and how the neighbourhood effect influences the implementation of QI methods in the hospital setting in Taiwan. This is a retrospective questionnaire-based survey. All medical centres, regional hospitals and district teaching hospitals in Taiwan. Directors or persons in charge of implementing QI methods in hospitals. None. The breadth and depth of QI method implementation. Seventy-two of the 139 hospitals contacted returned the questionnaire, yielding a 52% response rate. The breadth and depth of QI method implementation increased over the 10-year study period, particularly between 2004 and 2006. The breadth and depth of the QI methods implemented in the participating hospitals were significantly associated with the average breadth and depth of those implemented by their competitors in the same medical area during the previous period. In addition, time was positively associated with the breadth and depth of QI method implementation. In summary, the findings of this study show that hospitals' QI implementation status is influenced by that of their neighbours. Hence, the neighbourhood effect is an important factor in understanding hospital behaviour. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  9. What is needed to implement a web-based audit and feedback intervention with outreach visits to improve care quality: A concept mapping study among cardiac rehabilitation teams.

    Science.gov (United States)

    van Engen-Verheul, Mariëtte M; Peek, Niels; Haafkens, Joke A; Joukes, Erik; Vromen, Tom; Jaspers, Monique W M; de Keizer, Nicolette F

    2017-01-01

    Evidence on successful quality improvement (QI) in health care requires quantitative information from randomized clinical trials (RCTs) on the effectiveness of QI interventions, but also qualitative information from professionals to understand factors influencing QI implementation. Using a structured qualitative approach, concept mapping, this study determines factors identified by cardiac rehabilitation (CR) teams on what is needed to successfully implement a web-based audit and feedback (A&F) intervention with outreach visits to improve the quality of CR care. Participants included 49 CR professionals from 18 Dutch CR centres who had worked with the A&F system during a RCT. In three focus group sessions participants formulated statements on factors needed to implement QI successfully. Subsequently, participants rated all statements for importance and feasibility and grouped them thematically. Multi dimensional scaling was used to produce a final concept map. Forty-two unique statements were formulated and grouped into five thematic clusters in the concept map. The cluster with the highest importance was QI team commitment, followed by organisational readiness, presence of an adequate A&F system, access to an external quality assessor, and future use and functionalities of the A&F system. Concept mapping appeared efficient and useful to understand contextual factors influencing QI implementation as perceived by healthcare teams. While presence of a web-based A&F system and external quality assessor were seen as instrumental for gaining insight into performance and formulating QI actions, QI team commitment and organisational readiness were perceived as essential to actually implement and carry out these actions. These two sociotechnical factors should be taken into account when implementing and evaluating the success of QI implementations in future research. Copyright © 2016. Published by Elsevier Ireland Ltd.

  10. Ins-Robust Primitive Words

    OpenAIRE

    Srivastava, Amit Kumar; Kapoor, Kalpesh

    2017-01-01

    Let Q be the set of primitive words over a finite alphabet with at least two symbols. We characterize a class of primitive words, Q_I, referred to as ins-robust primitive words, which remain primitive on insertion of any letter from the alphabet and present some properties that characterizes words in the set Q_I. It is shown that the language Q_I is dense. We prove that the language of primitive words that are not ins-robust is not context-free. We also present a linear time algorithm to reco...

  11. Quality improvement tools and processes.

    Science.gov (United States)

    Lau, Catherine Y

    2015-04-01

    The Model for Improvement and the Plan-Do-Study-Act cycle is a popular quality improvement (QI) tool for health care providers to successfully lead QI projects and redesign care processes. This tool has several distinct components that must be addressed in sequence to organize and critically evaluate improvement activities. Unlike other health sciences clinical research, QI projects and research are based on dynamic hypotheses that develop into observable, serial tests of change with continuous collection and feedback of performance data to stakeholders. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Identifying quality improvement intervention publications - A comparison of electronic search strategies

    Directory of Open Access Journals (Sweden)

    Rubenstein Lisa V

    2011-08-01

    Full Text Available Abstract Background The evidence base for quality improvement (QI interventions is expanding rapidly. The diversity of the initiatives and the inconsistency in labeling these as QI interventions makes it challenging for researchers, policymakers, and QI practitioners to access the literature systematically and to identify relevant publications. Methods We evaluated search strategies developed for MEDLINE (Ovid and PubMed based on free text words, Medical subject headings (MeSH, QI intervention components, continuous quality improvement (CQI methods, and combinations of the strategies. Three sets of pertinent QI intervention publications were used for validation. Two independent expert reviewers screened publications for relevance. We compared the yield, recall rate, and precision of the search strategies for the identification of QI publications and for a subset of empirical studies on effects of QI interventions. Results The search yields ranged from 2,221 to 216,167 publications. Mean recall rates for reference publications ranged from 5% to 53% for strategies with yields of 50,000 publications or fewer. The 'best case' strategy, a simple text word search with high face validity ('quality' AND 'improv*' AND 'intervention*' identified 44%, 24%, and 62% of influential intervention articles selected by Agency for Healthcare Research and Quality (AHRQ experts, a set of exemplar articles provided by members of the Standards for Quality Improvement Reporting Excellence (SQUIRE group, and a sample from the Cochrane Effective Practice and Organization of Care Group (EPOC register of studies, respectively. We applied the search strategy to a PubMed search for articles published in 10 pertinent journals in a three-year period which retrieved 183 publications. Among these, 67% were deemed relevant to QI by at least one of two independent raters. Forty percent were classified as empirical studies reporting on a QI intervention. Conclusions The presented

  13. Evaluation of the expression of internal control transcripts by real ...

    African Journals Online (AJOL)

    Evaluation of the expression of internal control transcripts by real-time RT-PCR analysis during tomato flower abscission. Song Gao, Tao Xu, Mingfang Qi, Yufeng Liu, Hong Li, Shuangshuang Lv, Jinhong Li, Tianlai Li ...

  14. 75 FR 52343 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2010-08-25

    ... Company, Inc. (NVO & OFF), 4529 Angeles Crest Highway, Suite 300, La Canada, CA 91011, Officers: Ernest V..., Application Type: QI Change. BestOcean Worldwide Logistics, Inc. (OFF & NVO), 1300 Valley Vista Drive, Suite...

  15. Vajame arengut toetavat kooli / Raivo Juurak

    Index Scriptorium Estoniae

    Juurak, Raivo, 1949-

    2012-01-01

    Suurbritannia haridusprogrammist, kus õpilase arengut koolis maksimaalselt toetakse. Canterbury ülikooli haridusteaduskonna programmi „Kvaliteet õppe toetamisel” ehk QiSS (Quality in Study Support) direktori Linda Leith'i intervjuu põhjal

  16. Dicty_cDB: AFN327 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available TTATAATTTTATTGT AAAGGTTAA sequence update 2009. 4. 3 Translated Amino Acid sequence ifiif*itiiqtiiflilkiivillilvkiiknamak...ftieqisfhviki*mlifili s*i*nptk*qi*liknf*iqvkmnfnfqkql*fyckg* Frame C: ifiif*itiiqtiiflilkiivillilvkiiknama

  17. 76 FR 67188 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2011-10-31

    ... Liability Company, dba GlobalForwarding.com dba Forwardingservices.com dba Containerquote.com dba Global.../CEO/CFO, Application Type: QI Change. Unicorn Shipping, Inc. (NVO & OFF), 1225 W. 190th Street, Suite...

  18. Scientific Results of Yoga for Health and Well-Being

    Medline Plus

    Full Text Available ... series entitled The Science of Mind and Body Therapies . The first video, Tai Chi and Qi Gong ... We encourage you to discuss any decisions about treatment or care with your health care provider. The ...

  19. A procurement decision model for a video rental store — A case study

    African Journals Online (AJOL)

    eral; hence the video rental store owner (the decision maker) is required to procure new ... process by presenting a point of departure from which procurement decisions may be made. .... M = number of titles available for purchase,. Qi.

  20. 78 FR 20106 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-04-03

    ... M. Tsai, President (QI). Application Type: New NVO License. American International Shipping Company... Type: New NVO License. Nippon Concept America, LLC (OFF), 2203 Timberloch Place, Suite 218D, The...

  1. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... Teledermatology Compliance HIT Webinars Media relations toolkit Affinity partner programs NP/PA laws AAD Fellow Logo Quality ...

  2. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... Teledermatology Compliance HIT Webinars Media relations toolkit Affinity partner programs NP/PA laws AAD Fellow Logo Quality ...

  3. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... Teledermatology Compliance HIT Webinars Media relations toolkit Affinity partner programs NP/PA laws AAD Fellow Logo Quality ...

  4. Research Article Special Issue

    African Journals Online (AJOL)

    2017-08-08

    Aug 8, 2017 ... souces and Food Industry, Universiti Sultan Zainal Abidin, Besut. 22200 Besut ... QI) based on Interim National Water Quality Standards, Malaysia (IN sampling was ..... pH indicates contamination and acidification. Besides ...

  5. Building bridges : engaging medical residents in quality improvement and medical leadership

    NARCIS (Netherlands)

    Voogt, Judith J; van Rensen, Elizabeth L J; van der Schaaf, Marieke F; Noordegraaf, Mirko; Schneider, Margriet Me

    2017-01-01

    OBJECTIVE: To develop an educational intervention that targets residents' beliefs and attitudes to quality Improvement (QI) and leadership in order to demonstrate proactive behaviour. DESIGN: Theory-driven, mixed methods study including document analysis, interviews, observations and open-ended

  6. Wei et al., Afr J Tradit Complement Altern Med. (2015) 12(5):127 ...

    African Journals Online (AJOL)

    Proff.Adewunmi

    AstragalosideIV was the active composition of Radix Astragali. ..... Radix Astragali has been used for the treatment of night sweats, deficiency of qi (e.g., fatigue, weakness, and loss of appetite) and diarrhea. ... Cancer Metastasis Rev.

  7. Liu et al., Afr J Tradit Complement Altern Med. (2016) 13(1):157-168 ...

    African Journals Online (AJOL)

    acer

    included studies was evaluated and a meta-analysis was performed using the ... Conclusion: Compared to a regular treatment with western medicine alone, the ..... kidney qi increases, she starts losing her baby teeth and hair grows longer;.

  8. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... sunscreen that contains insect repellent, as sunscreen must be applied liberally and often while insect repellant should ...

  9. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... continue through adulthood, and the side effects can be more than cosmetic. Repeated nail biting can make ...

  10. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... are still studying the causes, which appear to be complex. The most effective way to treat and ...

  11. 77 FR 64991 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2012-10-24

    ..., Manager/Member. Application Type: New NVO & OFF License. Hospitality Logistics International LLC (NVO...), 11690 NW. 105th Street, Law 4W, Miami, FL 33178. Officers: Chris Merritt, Vice President (QI), John H...

  12. FILTWAM - A Framework for Online Game-based Communication Skills Training

    NARCIS (Netherlands)

    Bahreini, Kiavash; Nadolski, Rob; Qi, Wen; Westera, Wim

    2013-01-01

    Bahreini, K., Nadolski, R., Qi, W., & Westera, W. (2012, October). FILTWAM - A Framework for Online Game-based Communication Skills Training. Poster presented at reaseach day in Pretoria building at the Open University of the Netherlands, Heerlen, The Netherlands.

  13. Accelerating Best Care in Pennsylvania: adapting a large academic system's quality improvement process to rural community hospitals.

    Science.gov (United States)

    Haydar, Ziad; Gunderson, Julie; Ballard, David J; Skoufalos, Alexis; Berman, Bettina; Nash, David B

    2008-01-01

    Industrial quality improvement (QI) methods such as continuous quality improvement (CQI) may help bridge the gap between evidence-based "best care" and the quality of care provided. In 2006, Baylor Health Care System collaborated with Jefferson Medical College of Thomas Jefferson University to conduct a QI demonstration project in select Pennsylvania hospitals using CQI techniques developed by Baylor. The training was provided over a 6-month period and focused on methods for rapid-cycle improvement; data system design; data management; tools to improve patient outcomes, processes of care, and cost-effectiveness; use of clinical guidelines and protocols; leadership skills; and customer service skills. Participants successfully implemented a variety of QI projects. QI education programs developed and pioneered within large health care systems can be adapted and applied successfully to other settings, providing needed tools to smaller rural and community hospitals that lack the necessary resources to establish such programs independently.

  14. 76 FR 10593 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2011-02-25

    ... Individual), Steven L. Leturno, Director, Application Type: QI Change. Combined Freight System, Inc. (NVO...), 148-08 Guy R. Brewer Blvd., Jamaica, NY 11434, Officers: Wei Hu, Vice President, (Qualifying...

  15. Physician Perceptions of Performance Feedback in a Quality Improvement Activity.

    Science.gov (United States)

    Eden, Aimee R; Hansen, Elizabeth; Hagen, Michael D; Peterson, Lars E

    2017-10-01

    Physician performance and peer comparison feedback can affect physician care quality and patient outcomes. This study aimed to understand family physician perspectives of the value of performance feedback in quality improvement (QI) activities. This study analyzed American Board of Family Medicine open-ended survey data collected between 2004 and 2014 from physicians who completed a QI module that provided pre- and post-QI project individual performance data and peer comparisons. Physicians made 3480 comments in response to a question about this performance feedback, which were generally positive in nature (86%). Main themes that emerged were importance of accurate feedback data, enhanced detail in the content of feedback, and ability to customize peer comparison groups to compare performance to peers with similar patient populations or practice characteristics. Meaningful and tailored performance feedback may be an important tool for physicians to improve their care quality and should be considered an integral part of QI project design.

  16. Fibromyalgia: A Puzzling and Painful Condition | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... your doctor. Exercise. Research has shown that regular exercise is one of the most effective treatments for fibromyalgia. Try a complementary health approach. Practices such as tai chi, qi gong, ...

  17. Focusing on Fibromyalgia : A Puzzling and Painful Condition

    Science.gov (United States)

    ... your doctor. Exercise . Research has shown that regular exercise is one of the most effective treatments for fibromyalgia. Try a complementary health approach . Practices such as tai chi, qi gong, ...

  18. Defining and Assessing Quality Improvement Outcomes: A Framework for Public Health

    Science.gov (United States)

    Nawaz, Saira; Thomas, Craig; Young, Andrea

    2015-01-01

    We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention’s National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI’s impact on the practice of public health. PMID:25689185

  19. Scientific Results of Yoga for Health and Well-Being

    Medline Plus

    Full Text Available ... SBIR) Funding for: Natural Product Research Mind and Body Research Pain Research All Grant Information Training About ... video series entitled The Science of Mind and Body Therapies . The first video, Tai Chi and Qi ...

  20. Quality Index Method (QIM) scheme developed for farmed Atlantic salmon ( Salmo salar )

    DEFF Research Database (Denmark)

    Sveinsdóttir, K.; Hyldig, Grethe; Martinsdóttir, E.

    2003-01-01

    The aim of the study was to develop 'Quality Index Method (QIM) scheme for raw, farmed Atlantic salmon (Salmo salar) and to evaluate the scheme. in a shelf life study. QIM is based on the evaluation of key parameters in the deterioration of seafood's. Demerit points are assigned to selected...... parameters according to their importance and a Quality Index (QI) is established by cumulating the resulting scores. The maximum storage time in ice was determined with Quantitative Descriptive Analysis (QDA) of the salmon after cooking and found to be 20-21 days. This was used as a reference to enable...... prediction of the remaining storage time of raw salmon in ice with QIM. The calculated QI evolved linearly with storage time in ice (QI=0.82x (days in ice)+0.18, R-2=0.97). Individual salmon varied in QI within each storage day. However, the multivariate analysis (PLS1) demonstrated that storage time could...

  1. 77 FR 70162 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2012-11-23

    ...), 900 Center Park Drive, Suite F, Charlotte, NC 28217, Officers: Paul L. Carter, Vice President (QI...), Application Type: New NVO License. Transport Partner (USA), Inc. (NVO & OFF), 2006 Cherry Hill Lane...

  2. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... from outside organizations Health Volunteers Overseas Grant Honorary International Society Meeting Travel Grant Lila and Murray Gruber ... Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative Conference Skin Care ...

  3. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... from outside organizations Health Volunteers Overseas Grant Honorary International Society Meeting Travel Grant Lila and Murray Gruber ... Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative Conference Skin Care ...

  4. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... from outside organizations Health Volunteers Overseas Grant Honorary International Society Meeting Travel Grant Lila and Murray Gruber ... Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative Conference Skin Care ...

  5. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... a Difference Award Native American Health Service Resident Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project ... Overseas International resources Native American Health Services Resident Rotation Shade Structure Program SPOTme® Skin Cancer Screening Program ...

  6. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... a Difference Award Native American Health Service Resident Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project ... Overseas International resources Native American Health Services Resident Rotation Shade Structure Program SPOTme® Skin Cancer Screening Program ...

  7. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... a Difference Award Native American Health Service Resident Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project ... Overseas International resources Native American Health Services Resident Rotation Shade Structure Program SPOTme® Skin Cancer Screening Program ...

  8. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and activities Video library Find a dermatologist Why ...

  9. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and activities Video library Find a dermatologist Why ...

  10. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and activities Video library Find a dermatologist Why ...

  11. 75 FR 28250 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2010-05-20

    ... Type: Add NVO Service and QI Change. Best Container Express, Inc. (NVO), 17238 S. Main Street, Gardena...). Peixin Li, President. Application Type: Add OFF Services. Project Rail, LLC dba Vectora Transportation...

  12. 76 FR 12962 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2011-03-09

    ... L. Li, President, Application Type: QI Change. EP-Team, Inc. dba EP-Team (NVO & OFF), 3700 Forums... Maritime Services USA (NVO), 425 West Main Street, Alhambra, CA 91801. Officers: Hans P. Hofmann, Assistant...

  13. Process Evaluation of a Quality Improvement Project to Decrease Hospital Readmissions From Skilled Nursing Facilities.

    Science.gov (United States)

    Meehan, Thomas P; Qazi, Daniel J; Van Hoof, Thomas J; Ho, Shih-Yieh; Eckenrode, Sheila; Spenard, Ann; Pandolfi, Michelle; Johnson, Florence; Quetti, Deborah

    2015-08-01

    To describe and evaluate the impact of quality improvement (QI) support provided to skilled nursing facilities (SNFs) by a Quality Improvement Organization (QIO). Retrospective, mixed-method, process evaluation of a QI project intended to decrease preventable hospital readmissions from SNFs. Five SNFs in Connecticut. SNF Administrators, Directors of Nursing, Assistant Directors of Nursing, Admissions Coordinators, Registered Nurses, Certified Nursing Assistants, Receptionists, QIO Quality Improvement Consultant. QIO staff provided training and technical assistance to SNF administrative and clinical staff to establish or enhance QI infrastructure and implement an established set of QI tools [Interventions to Reduce Acute Care Transfers (INTERACT) tools]. Baseline SNF demographic, staffing, and hospital readmission data; baseline and follow-up SNF QI structure (QI Committee), processes (general and use of INTERACT tools), and outcome (30-day all-cause hospital readmission rates); details of QIO-provided training and technical assistance; QIO-perceived barriers to quality improvement; SNF leadership-perceived barriers, accomplishments, and suggestions for improvement of QIO support. Success occurred in establishing QI Committees and targeting preventable hospital readmissions, as well as implementing INTERACT tools in all SNFs; however, hospital readmission rates decreased in only 2 facilities. QIO staff and SNF leaders noted the ongoing challenge of engaging already busy SNF staff and leadership in QI activities. SNF leaders reported that they appreciated the training and technical assistance that their institutions received, although most noted that additional support was needed to bring about improvement in readmission rates. This process evaluation documented mixed clinical results but successfully identified opportunities to improve recruitment of and provision of technical support to participating SNFs. Recommendations are offered for others who wish to conduct

  14. Partnering health disparities research with quality improvement science in pediatrics.

    Science.gov (United States)

    Lion, K Casey; Raphael, Jean L

    2015-02-01

    Disparities in pediatric health care quality are well described in the literature, yet practical approaches to decreasing them remain elusive. Quality improvement (QI) approaches are appealing for addressing disparities because they offer a set of strategies by which to target modifiable aspects of care delivery and a method for tailoring or changing an intervention over time based on data monitoring. However, few examples in the literature exist of QI interventions successfully decreasing disparities, particularly in pediatrics, due to well-described challenges in developing, implementing, and studying QI with vulnerable populations or in underresourced settings. In addition, QI interventions aimed at improving quality overall may not improve disparities, and in some cases, may worsen them if there is greater uptake or effectiveness of the intervention among the population with better outcomes at baseline. In this article, the authors review some of the challenges faced by researchers and frontline clinicians seeking to use QI to address health disparities and propose an agenda for moving the field forward. Specifically, they propose that those designing and implementing disparities-focused QI interventions reconsider comparator groups, use more rigorous evaluation methods, carefully consider the evidence for particular interventions and the context in which they were developed, directly engage the social determinants of health, and leverage community resources to build collaborative networks and engage community members. Ultimately, new partnerships between communities, providers serving vulnerable populations, and QI researchers will be required for QI interventions to achieve their potential related to health care disparity reduction. Copyright © 2015 by the American Academy of Pediatrics.

  15. Applying ethnography to the study of context in healthcare quality and safety.

    Science.gov (United States)

    Leslie, Myles; Paradis, Elise; Gropper, Michael A; Reeves, Scott; Kitto, Simon

    2014-02-01

    Translating and scaling healthcare quality improvement (QI) and patient safety interventions remains a significant challenge. Context has been identified as a major factor in this. QI and patient safety research have begun to focus on context, with ethnography seen as a promising methodology for understanding the professional, organisational and cultural aspects of context. While ethnography is used to investigate the context of a variety of QI and safety interventions, the challenges inherent in effectively importing a qualitative methodology and its social science practitioners into this work have been largely unexamined. We explain ethnography as a research practice grounded in theory and dependent on observations gathered and interpreted in particular ways. We then review the approach of health services literature to evaluating this sort of qualitative research. Although the study of context is an interest shared by both social scientists and healthcare QI and safety researchers, we identify three key points at which those 'exporting' ethnography as a methodology and those 'importing' it to deal with QI and safety challenges may diverge. We describe perspectival divergences on the methodology's mission, form and scale. At the level of mission we demonstrate how ethnography has been adapted to a 'describe and feed back' role in the service of QI. At the level of form, we show how the long-term embedded observation at the heart of ethnography can be adapted only so far to accommodate QI interests if both data quality and ethical standards are to be upheld. Finally, at the level of scale, we demonstrate one ethnographic study design that balances breadth of exposure with depth of experience in its observations and so generates a particular type of scalable findings. The effective export of ethnography into QI and safety research requires discussion and negotiation between social scientific and health services research perspectives, as well as creative approaches

  16. Early-career registered nurses' participation in hospital quality improvement activities.

    Science.gov (United States)

    Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida K; Bernstein, Ilya

    2013-01-01

    We surveyed 2 cohorts of early-career registered nurses from 15 states in the US, 2 years apart, to compare their reported participation in hospital quality improvement (QI) activities. We anticipated differences between the 2 cohorts because of the growth of several initiatives for engaging nurses in QI. There were no differences between the 2 cohorts across 14 measured activities, except for their reported use of appropriate strategies to improve hand-washing compliance to reduce nosocomial infection rates.

  17. Building Perinatal Case Manager Capacity Using Quality Improvement

    OpenAIRE

    Fitzgerald, Elaine

    2015-01-01

    Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote a...

  18. SLAP: Specification logic of actions with probability

    CSIR Research Space (South Africa)

    Rens, G

    2014-06-01

    Full Text Available )|. Let W (Γ)# = (w1, w2, . . . , wn) be an ordering of the worlds in W (Γ). With each world wk ∈ W (Γ)#, we associate a rational variable prk ∈ Q[0,1]. One can generate ci,1pr1 + ci,2pr2 + · · ·+ ci,nprn = qi, for a formula (x, [α]qiϕi) ∈ Γ and ci,1pr1...

  19. Exploration of contextual factors in a successful quality improvement collaborative in English ambulance services: cross‐sectional survey

    Science.gov (United States)

    Phung, Viet‐Hai; Essam, Nadya; Asghar, Zahid; Spaight, Anne

    2015-01-01

    Abstract Rationale, aims and objectives Clinical leadership and organizational culture are important contextual factors for quality improvement (QI) but the relationship between these and with organizational change is complex and poorly understood. We aimed to explore the relationship between clinical leadership, culture of innovation and clinical engagement in QI within a national ambulance QI Collaborative (QIC). Methods We used a self‐administered online questionnaire survey sent to front‐line clinicians in all 12 English ambulance services. We conducted a cross‐sectional analysis of quantitative data and qualitative analysis of free‐text responses. Results There were 2743 (12% of 22 117) responses from 11 of the 12 participating ambulance services. In the 3% of responders that were directly involved with the QIC, leadership behaviour was significantly higher than for those not directly involved. QIC involvement made no significant difference to responders' perceptions of the culture of innovation in their organization, which was generally considered poor. Although uptake of QI methods was low overall, QIC members were significantly more likely to use QI methods, which were also significantly associated with leadership behaviour. Conclusions Despite a limited organizational culture of innovation, clinical leadership and use of QI methods in ambulance services generally, the QIC achieved its aims to significantly improve pre‐hospital care for acute myocardial infarction and stroke. We postulate that this was mediated through an improvement subculture, linked to the QIC, which facilitated large‐scale improvement by stimulating leadership and QI methods. Further research is needed to understand success factors for QI in complex health care environments. PMID:26303398

  20. Patterns of Energy Imbalance of the Meridians in Patients with Temporomandibular Dysfunction.

    Science.gov (United States)

    Rasera Zotelli, Vera L; Grillo, Cássia M; Bressiani Gil, Maria L; Wada, Ronaldo S; Sato, Jorge E; de Sousa, Maria da Luz R

    2018-02-01

    Temporomandibular dysfunction (TMD) is a set of changes that affects the muscles of mastication, temporomandibular joint, teeth, and associated periodontal and orofacial structures. According to Traditional Chinese Medicine, the imbalance of energy (Qi) circulating in the acupuncture meridians is always the primary etiologic cause of any physical manifestation. The aim of this study was to describe the patterns of Qi imbalance in patients with TMD by means of an objective measurement. The clinical study was conducted at the Piracicaba Dental School (FOP/Unicamp), in Piracicaba-SP, Brazil. We evaluated 40 adult volunteers with TMD. The Qi measurement was carried out by the researcher using the Ryodoraku method using 24 points representing the 12 acupuncture meridians: LU9 (Taiyuan), PC7 (Daling), HT7 (Shemen), SI5 (Yanggu), TE4 (Yangchi), LI5 (Yangxi), SP3 (Taibai), LR3 (Taichong), KI3 (Taixi), BL64 (Jinggu), GB40 (Qiuxu), and ST42 (Chongyang). The average total Qi of 40 volunteers (21.7 μA ± 1.5), was below the normal range (40-60 μA) and was classified as deficiency of Qi (empty). The coupled meridians that showed the highest Qi imbalance were the kidney (29.4 μA ± 2.8) and bladder (13.8 μA ± 1). The Qi planes with greatest imbalance were the Shao Yang and Shao Yin. In conclusion, volunteers with TMD presented a pattern of Qi deficiency, and the most prevalent imbalance patterns identified were in the kidney and bladder coupled meridians and in the energetic planes Shao Yin (heart/kidney) and Shao Yang (triple energizer/gall bladder). Copyright © 2017. Published by Elsevier B.V.

  1. Patterns of Energy Imbalance of the Meridians in Patients with Temporomandibular Dysfunction

    Directory of Open Access Journals (Sweden)

    Vera L. Rasera Zotelli

    2018-02-01

    Full Text Available Temporomandibular dysfunction (TMD is a set of changes that affects the muscles of mastication, temporomandibular joint, teeth, and associated periodontal and orofacial structures. According to Traditional Chinese Medicine, the imbalance of energy (Qi circulating in the acupuncture meridians is always the primary etiologic cause of any physical manifestation. The aim of this study was to describe the patterns of Qi imbalance in patients with TMD by means of an objective measurement. The clinical study was conducted at the Piracicaba Dental School (FOP/Unicamp, in Piracicaba-SP, Brazil. We evaluated 40 adult volunteers with TMD. The Qi measurement was carried out by the researcher using the Ryodoraku method using 24 points representing the 12 acupuncture meridians: LU9 (Taiyuan, PC7 (Daling, HT7 (Shemen, SI5 (Yanggu, TE4 (Yangchi, LI5 (Yangxi, SP3 (Taibai, LR3 (Taichong, KI3 (Taixi, BL64 (Jinggu, GB40 (Qiuxu, and ST42 (Chongyang. The average total Qi of 40 volunteers (21.7 μA ± 1.5, was below the normal range (40–60 μA and was classified as deficiency of Qi (empty. The coupled meridians that showed the highest Qi imbalance were the kidney (29.4 μA ± 2.8 and bladder (13.8 μA ± 1. The Qi planes with greatest imbalance were the Shao Yang and Shao Yin. In conclusion, volunteers with TMD presented a pattern of Qi deficiency, and the most prevalent imbalance patterns identified were in the kidney and bladder coupled meridians and in the energetic planes Shao Yin (heart/kidney and Shao Yang (triple energizer/gall bladder.

  2. Computerized follow-up of discrepancies in image interpretation between emergency and radiology departments

    OpenAIRE

    Siegel, Eliot; Groleau, Georgina; Reiner, Bruce; Stair, Thomas

    1998-01-01

    Radiographs are ordered and interpreted for immediate clinical decisions 24 hours a day by emergency physicians (EP’s). The Joint Commission for Accreditation of Health Care Organizations requires that all these images be reviewed by radiologists and that there be some mechanism for quality improvement (QI) for discrepant readings. There must be a log of discrepancies and documentation of follow up activities, but this alone does not guarantee effective Q.I. Radiologists reviewing images from...

  3. Hierarchical and Complex System Entropy Clustering Analysis Based Validation for Traditional Chinese Medicine Syndrome Patterns of Chronic Atrophic Gastritis.

    Science.gov (United States)

    Zhang, Yin; Liu, Yue; Li, Yannan; Zhao, Xia; Zhuo, Lin; Zhou, Ajian; Zhang, Li; Su, Zeqi; Chen, Cen; Du, Shiyu; Liu, Daming; Ding, Xia

    2018-03-22

    Chronic atrophic gastritis (CAG) is the precancerous stage of gastric carcinoma. Traditional Chinese Medicine (TCM) has been widely used in treating CAG. This study aimed to reveal core pathogenesis of CAG by validating the TCM syndrome patterns and provide evidence for optimization of treatment strategies. This is a cross-sectional study conducted in 4 hospitals in China. Hierarchical clustering analysis (HCA) and complex system entropy clustering analysis (CSECA) were performed, respectively, to achieve syndrome pattern validation. Based on HCA, 15 common factors were assigned to 6 syndrome patterns: liver depression and spleen deficiency and blood stasis in the stomach collateral, internal harassment of phlegm-heat and blood stasis in the stomach collateral, phlegm-turbidity internal obstruction, spleen yang deficiency, internal harassment of phlegm-heat and spleen deficiency, and spleen qi deficiency. By CSECA, 22 common factors were assigned to 7 syndrome patterns: qi deficiency, qi stagnation, blood stasis, phlegm turbidity, heat, yang deficiency, and yin deficiency. Combination of qi deficiency, qi stagnation, blood stasis, phlegm turbidity, heat, yang deficiency, and yin deficiency may play a crucial role in CAG pathogenesis. In accord with this, treatment strategies by TCM herbal prescriptions should be targeted to regulating qi, activating blood, resolving turbidity, clearing heat, removing toxin, nourishing yin, and warming yang. Further explorations are needed to verify and expand the current conclusions.

  4. Application of quality improvement analytic methodology in emergency medicine research: A comparative evaluation.

    Science.gov (United States)

    Harries, Bruce; Filiatrault, Lyne; Abu-Laban, Riyad B

    2018-05-30

    Quality improvement (QI) analytic methodology is rarely encountered in the emergency medicine literature. We sought to comparatively apply QI design and analysis techniques to an existing data set, and discuss these techniques as an alternative to standard research methodology for evaluating a change in a process of care. We used data from a previously published randomized controlled trial on triage-nurse initiated radiography using the Ottawa ankle rules (OAR). QI analytic tools were applied to the data set from this study and evaluated comparatively against the original standard research methodology. The original study concluded that triage nurse-initiated radiographs led to a statistically significant decrease in mean emergency department length of stay. Using QI analytic methodology, we applied control charts and interpreted the results using established methods that preserved the time sequence of the data. This analysis found a compelling signal of a positive treatment effect that would have been identified after the enrolment of 58% of the original study sample, and in the 6th month of this 11-month study. Our comparative analysis demonstrates some of the potential benefits of QI analytic methodology. We found that had this approach been used in the original study, insights regarding the benefits of nurse-initiated radiography using the OAR would have been achieved earlier, and thus potentially at a lower cost. In situations where the overarching aim is to accelerate implementation of practice improvement to benefit future patients, we believe that increased consideration should be given to the use of QI analytic methodology.

  5. Hospital accreditation: staff experiences and perceptions.

    Science.gov (United States)

    Bogh, Søren Bie; Blom, Ane; Raben, Ditte Caroline; Braithwaite, Jeffrey; Thude, Bettina; Hollnagel, Erik; Plessen, Christian von

    2018-06-11

    Purpose The purpose of this paper is to understand how staff at various levels perceive and understand hospital accreditation generally and in relation to quality improvement (QI) specifically. Design/methodology/approach In a newly accredited Danish hospital, the authors conducted semi-structured interviews to capture broad ranging experiences. Medical doctors, nurses, a quality coordinator and a quality department employee participated. Interviews were audio recorded and subjected to framework analysis. Findings Staff reported that The Danish Healthcare Quality Programme affected management priorities: office time and working on documentation, which reduced time with patients and on improvement activities. Organisational structures were improved during preparation for accreditation. Staff perceived that the hospital was better prepared for new QI initiatives after accreditation; staff found disease specific requirements unnecessary. Other areas benefited from accreditation. Interviewees expected that organisational changes, owing to accreditation, would be sustained and that the QI focus would continue. Practical implications Accreditation is a critical and complete hospital review, including areas that often are neglected. Accreditation dominates hospital agendas during preparation and surveyor visits, potentially reducing patient care and other QI initiatives. Improvements are less likely to occur in areas that other QI initiatives addressed. Yet, accreditation creates organisational foundations for future QI initiatives. Originality/value The authors study contributes new insights into how hospital staff at different organisational levels perceive and understand accreditation.

  6. Competition in collaborative clothing: a qualitative case study of influences on collaborative quality improvement in the ICU.

    Science.gov (United States)

    Dainty, Katie N; Scales, Damon C; Sinuff, Tasnim; Zwarenstein, Merrick

    2013-04-01

    Multiorganisational quality improvement (QI) collaborative networks are promoted for improving quality within healthcare. Recently, several large-scale QI initiatives have been conducted in the intensive care unit (ICU) environment with successful quantitative results. However, the mechanisms through which such networks lead to QI success remain uncertain. We aim to understand ICU staff perspectives on collaborative QI based on involvement in a multiorganisational improvement network and hypothesise about theoretical constructs that might explain the effect of collaboration in such networks. Qualitative study using a modified grounded theory approach. Key informant interviews were conducted with staff from 12 community hospital ICUs that participated in a cluster randomized control trial (RCT) of a QI intervention using a collaborative approach between 2006 and 2008. Data analysis followed the standard procedure for grounded theory using constant comparative methodology. The collaborative network was perceived to promote increased intrateam cooperation over interorganisational cooperation, but friendly competition with other ICUs appeared to be a prominent driver of behaviour change. Bedsides, clinicians reported that belonging to a collaborative network provided recognition for the high-quality patient care that they already provided. However, the existing communication structure was perceived to be ineffective for staff engagement since it was based on a hierarchical approach to knowledge transfer and project awareness. QI collaborative networks may promote behaviour change by improving intrateam communication, fostering competition with other institutions, and increasing recognition for providing high-quality care. Other commonly held assumptions about their potential impact, for instance, increasing interorganisational legitimisation, communication and collaboration, may be less important.

  7. Progress of Shenqi Fuzheng Injection as Adjuvant Therapy for Malignant Tumors

    Directory of Open Access Journals (Sweden)

    Jing WANG

    2017-09-01

    Full Text Available Tumor is a kind of common and frequently-occurring disease that severely impaires human lives and health. As is proposed in Required Readings for Medical Professions, “Accumulation of virus causes insuffcient healthy qi, and then results in invasion of evil qi into the body”. Tumor is caused by interaction of exogenous evil qi and pathogenic products in the body such as phlegm and blood stasis on the basis of healthy qi defciency and disharmony of viscera. Therefore, the condition of healthy qi is not only the key of the occurrence of tumor, but a decisive factor of the development and prognosis of the disease. At present, the main therapeutic approaches for malignant tumors are radiotherapy and chemotherapy. However, during the disease process, the healthy qi gradually decreases due to the consumption of malignant tumors and the injury caused by radiotherapy and chemotherapy. In recent years, taking advantages of traditional Chinese drugs such as Shenqi Fuzheng Injection in combination with radiotherapy or chemotherapy is an important approach for many clinical physicians to improve therapeutic effects and alleviate toxic and side effects induced by radiotherapy and chemotherapy. This study mainly reviewed the progress of mechanisms and application of Shenqi Fuzhen Injection in malignant tumors in recent years.

  8. Development of a Multi-Domain Assessment Tool for Quality Improvement Projects.

    Science.gov (United States)

    Rosenbluth, Glenn; Burman, Natalie J; Ranji, Sumant R; Boscardin, Christy K

    2017-08-01

    Improving the quality of health care and education has become a mandate at all levels within the medical profession. While several published quality improvement (QI) assessment tools exist, all have limitations in addressing the range of QI projects undertaken by learners in undergraduate medical education, graduate medical education, and continuing medical education. We developed and validated a tool to assess QI projects with learner engagement across the educational continuum. After reviewing existing tools, we interviewed local faculty who taught QI to understand how learners were engaged and what these faculty wanted in an ideal assessment tool. We then developed a list of competencies associated with QI, established items linked to these competencies, revised the items using an iterative process, and collected validity evidence for the tool. The resulting Multi-Domain Assessment of Quality Improvement Projects (MAQIP) rating tool contains 9 items, with criteria that may be completely fulfilled, partially fulfilled, or not fulfilled. Interrater reliability was 0.77. Untrained local faculty were able to use the tool with minimal guidance. The MAQIP is a 9-item, user-friendly tool that can be used to assess QI projects at various stages and to provide formative and summative feedback to learners at all levels.

  9. Quantitative Reasoning in Environmental Science: Rasch Measurement to Support QR Assessment

    Directory of Open Access Journals (Sweden)

    Robert L. Mayes

    2015-07-01

    Full Text Available The ability of middle and high school students to reason quantitatively within the context of environmental science was investigated. A quantitative reasoning (QR learning progression, with associated QR assessments in the content areas of biodiversity, water, and carbon, was developed based on three QR progress variables: quantification act, quantitative interpretation, and quantitative modeling. Diagnostic instruments were developed specifically for the progress variable quantitative interpretation (QI, each consisting of 96 Likert-scale items. Each content version of the instrument focused on three scale levels (macro scale, micro scale, and landscape scale and four elements of QI identified in prior research (trend, translation, prediction, and revision. The QI assessments were completed by 362, 6th to 12th grade students in three U.S. states. Rasch (1960/1980 measurement was used to determine item and person measures for the QI instruments, both to examine validity and reliability characteristics of the instrument administration and inform the evolution of the learning progression. Rasch methods allowed identification of several QI instrument revisions, including modification of specific items, reducing number of items to avoid cognitive fatigue, reconsidering proposed item difficulty levels, and reducing Likert scale to 4 levels. Rasch diagnostics also indicated favorable levels of instrument reliability and appropriate targeting of item abilities to student abilities for the majority of participants. A revised QI instrument is available for STEM researchers and educators.

  10. One size does not fit all: a qualitative content analysis of the importance of existing quality improvement capacity in the implementation of Releasing Time to Care: the Productive Ward™ in Saskatchewan, Canada.

    Science.gov (United States)

    Hamilton, Jessica; Verrall, Tanya; Maben, Jill; Griffiths, Peter; Avis, Kyla; Baker, G Ross; Teare, Gary

    2014-12-19

    Releasing Time to Care: The Productive Ward™ (RTC) is a method for conducting continuous quality improvement (QI). The Saskatchewan Ministry of Health mandated its implementation in Saskatchewan, Canada between 2008 and 2012. Subsequently, a research team was developed to evaluate its impact on the nursing unit environment. We sought to explore the influence of the unit's existing QI capacity on their ability to engage with RTC as a program for continuous QI. We conducted interviews with staff from 8 nursing units and asked them to speak about their experience doing RTC. Using qualitative content analysis, and guided by the Organizing for Quality framework, we describe the existing QI capacity and impact of RTC on the unit environment. The results focus on 2 units chosen to highlight extreme variation in existing QI capacity. Unit B was characterized by a strong existing environment. RTC was implemented in an environment with a motivated manager and collaborative culture. Aided by the structural support provided by the organization, the QI capacity on this unit was strengthened through RTC. Staff recognized the potential of using the RTC processes to support QI work. Staff on unit E did not have the same experience with RTC. Like unit B, they had similar structural supports provided by their organization but they did not have the same existing cultural or political environment to facilitate the implementation of RTC. They did not have internal motivation and felt they were only doing RTC because they had to. Though they had some success with RTC activities, the staff did not have the same understanding of the methods that RTC could provide for continuous QI work. RTC has the potential to be a strong tool for engaging units to do QI. This occurs best when RTC is implemented in a supporting environment. One size does not fit all and administrative bodies must consider the unique context of each environment prior to implementing large-scale QI projects. Use of an

  11. Establishing a portfolio of quality-improvement projects in pediatric surgery through advanced improvement leadership systems.

    Science.gov (United States)

    Gerrein, Betsy T; Williams, Christina E; Von Allmen, Daniel

    2013-01-01

    Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children's Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution's strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division's efficiency and effectiveness in pursing the QI mission that is integral at our hospital.

  12. Postgraduate Education in Quality Improvement Methods: Initial Results of the Fellows' Applied Quality Training (FAQT) Curriculum.

    Science.gov (United States)

    Winchester, David E; Burkart, Thomas A; Choi, Calvin Y; McKillop, Matthew S; Beyth, Rebecca J; Dahm, Phillipp

    2016-06-01

    Training in quality improvement (QI) is a pillar of the next accreditation system of the Accreditation Committee on Graduate Medical Education and a growing expectation of physicians for maintenance of certification. Despite this, many postgraduate medical trainees are not receiving training in QI methods. We created the Fellows Applied Quality Training (FAQT) curriculum for cardiology fellows using both didactic and applied components with the goal of increasing confidence to participate in future QI projects. Fellows completed didactic training from the Institute for Healthcare Improvement's Open School and then designed and completed a project to improve quality of care or patient safety. Self-assessments were completed by the fellows before, during, and after the first year of the curriculum. The primary outcome for our curriculum was the median score reported by the fellows regarding their self-confidence to complete QI activities. Self-assessments were completed by 23 fellows. The majority of fellows (15 of 23, 65.2%) reported no prior formal QI training. Median score on baseline self-assessment was 3.0 (range, 1.85-4), which was significantly increased to 3.27 (range, 2.23-4; P = 0.004) on the final assessment. The distribution of scores reported by the fellows indicates that 30% were slightly confident at conducting QI activities on their own, which was reduced to 5% after completing the FAQT curriculum. An interim assessment was conducted after the fellows completed didactic training only; median scores were not different from the baseline (mean, 3.0; P = 0.51). After completion of the FAQT, cardiology fellows reported higher self-confidence to complete QI activities. The increase in self-confidence seemed to be limited to the applied component of the curriculum, with no significant change after the didactic component.

  13. Methods for the guideline-based development of quality indicators--a systematic review

    Science.gov (United States)

    2012-01-01

    Background Quality indicators (QIs) are used in many healthcare settings to measure, compare, and improve quality of care. For the efficient development of high-quality QIs, rigorous, approved, and evidence-based development methods are needed. Clinical practice guidelines are a suitable source to derive QIs from, but no gold standard for guideline-based QI development exists. This review aims to identify, describe, and compare methodological approaches to guideline-based QI development. Methods We systematically searched medical literature databases (Medline, EMBASE, and CINAHL) and grey literature. Two researchers selected publications reporting methodological approaches to guideline-based QI development. In order to describe and compare methodological approaches used in these publications, we extracted detailed information on common steps of guideline-based QI development (topic selection, guideline selection, extraction of recommendations, QI selection, practice test, and implementation) to predesigned extraction tables. Results From 8,697 hits in the database search and several grey literature documents, we selected 48 relevant references. The studies were of heterogeneous type and quality. We found no randomized controlled trial or other studies comparing the ability of different methodological approaches to guideline-based development to generate high-quality QIs. The relevant publications featured a wide variety of methodological approaches to guideline-based QI development, especially regarding guideline selection and extraction of recommendations. Only a few studies reported patient involvement. Conclusions Further research is needed to determine which elements of the methodological approaches identified, described, and compared in this review are best suited to constitute a gold standard for guideline-based QI development. For this research, we provide a comprehensive groundwork. PMID:22436067

  14. Developing a Benchmarking Process in Perfusion: A Report of the Perfusion Downunder Collaboration

    Science.gov (United States)

    Baker, Robert A.; Newland, Richard F.; Fenton, Carmel; McDonald, Michael; Willcox, Timothy W.; Merry, Alan F.

    2012-01-01

    Abstract: Improving and understanding clinical practice is an appropriate goal for the perfusion community. The Perfusion Downunder Collaboration has established a multi-center perfusion focused database aimed at achieving these goals through the development of quantitative quality indicators for clinical improvement through benchmarking. Data were collected using the Perfusion Downunder Collaboration database from procedures performed in eight Australian and New Zealand cardiac centers between March 2007 and February 2011. At the Perfusion Downunder Meeting in 2010, it was agreed by consensus, to report quality indicators (QI) for glucose level, arterial outlet temperature, and pCO2 management during cardiopulmonary bypass. The values chosen for each QI were: blood glucose ≥4 mmol/L and ≤10 mmol/L; arterial outlet temperature ≤37°C; and arterial blood gas pCO2 ≥ 35 and ≤45 mmHg. The QI data were used to derive benchmarks using the Achievable Benchmark of Care (ABC™) methodology to identify the incidence of QIs at the best performing centers. Five thousand four hundred and sixty-five procedures were evaluated to derive QI and benchmark data. The incidence of the blood glucose QI ranged from 37–96% of procedures, with a benchmark value of 90%. The arterial outlet temperature QI occurred in 16–98% of procedures with the benchmark of 94%; while the arterial pCO2 QI occurred in 21–91%, with the benchmark value of 80%. We have derived QIs and benchmark calculations for the management of several key aspects of cardiopulmonary bypass to provide a platform for improving the quality of perfusion practice. PMID:22730861

  15. Establishing a Portfolio of Quality-Improvement Projects in Pediatric Surgery through Advanced Improvement Leadership Systems

    Science.gov (United States)

    Gerrein, Betsy T; Williams, Christina E; von Allmen, Daniel

    2013-01-01

    Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children’s Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution’s strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division’s efficiency and effectiveness in pursing the QI mission that is integral at our hospital. PMID:24361020

  16. Exploring the role of communications in quality improvement: A case study of the 1000 Lives Campaign in NHS Wales.

    Science.gov (United States)

    Cooper, Andrew; Gray, Jonathon; Willson, Alan; Lines, Chris; McCannon, Joe; McHardy, Karina

    2015-03-01

    Effective communication is critical to successful large-scale change. Yet, in our experience, communications strategies are not formally incorporated into quality improvement (QI) frameworks. The 1000 Lives Campaign ('Campaign') was a large-scale national QI collaborative that aimed to save an additional 1000 lives and prevent 50 000 episodes of harm in Welsh health care over a 2-year period. We use the Campaign as a case study to describe the development, application, and impact of a communications strategy embedded in a large-scale QI initiative. A comprehensive communications strategy guided communications work during the Campaign. The main aims of the communications strategy were to engage the hearts and minds of frontline National Health Service (NHS) staff in the Campaign and promote their awareness and understanding of specific QI interventions and the wider patient safety agenda. We used qualitative and quantitative measures to monitor communications outputs and assess how the communications strategy influenced awareness and knowledge of frontline NHS staff. The communications strategy facilitated clear and consistent framing of Campaign messages and allowed dissemination of information related to the range of QI interventions. It reaffirmed the aim and value of the Campaign to frontline staff, thereby promoting sustained engagement with Campaign activities. The communications strategy also built the profile of the Campaign both internally with NHS organizations across Wales and externally with the media, and played a pivotal role in improving awareness and understanding of the patient safety agenda. Ultimately, outcomes from the communications strategy could not be separated from overall Campaign outcomes. Systematic and structured communications can support and enhance QI initiatives. From our experience, we developed a 'communications bundle' consisting of six core components. We recommend that communications bundles be incorporated into existing QI

  17. Clinical and Educational Outcomes of an Integrated Inpatient Quality Improvement Curriculum for Internal Medicine Residents.

    Science.gov (United States)

    Ogrinc, Greg; Cohen, Emily S; van Aalst, Robertus; Harwood, Beth; Ercolano, Ellyn; Baum, Karyn D; Pattison, Adam J; Jones, Anne C; Davies, Louise; West, Al

    2016-10-01

    Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. We sought to determine the clinical and educational impact of an integrated QI curriculum. This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum. QI project effectiveness was assessed using statistical process control. Learning outcomes were assessed with the Quality Improvement Knowledge Application Tool-Revised (QIKAT-R) and through self-efficacy, interprofessional care attitudes, and satisfaction of learners. Free text responses by residents and a focus group of nurses who worked with the residents provided information about the acceptability of the intervention. The QI projects improved many clinical processes and outcomes, but not all led to improvements. Educational outcome response rates were 65% (68 of 105) at baseline, 50% (18 of 36) for the early intervention group at midpoint, 67% (24 of 36) for the control group at midpoint, and 53% (42 of 80) for the late intervention group. Composite QIKAT-R scores (range, 0-27) increased from 13.3 at baseline to 15.3 at end point ( P  < .01), as did the self-efficacy composite score ( P  < .05). Satisfaction with the curriculum was rated highly by all participants. Learning and participating in hands-on QI can be integrated into the usual inpatient work of resident physicians.

  18. Integrated clinical and quality improvement coaching in Son La Province, Vietnam: a model of building public sector capacity for sustainable HIV care delivery.

    Science.gov (United States)

    Cosimi, Lisa A; Dam, Huong V; Nguyen, Thai Q; Ho, Huyen T; Do, Phuong T; Duc, Duat N; Nguyen, Huong T; Gardner, Bridget; Libman, Howard; Pollack, Todd; Hirschhorn, Lisa R

    2015-07-17

    The global scale-up of antiretroviral therapy included extensive training and onsite support to build the capacity of HIV health care workers. However, traditional efforts aimed at strengthening knowledge and skills often are not successful at improving gaps in the key health systems required for sustaining high quality care. We trained and mentored existing staff of the Son La provincial health department and provincial HIV clinic to work as a provincial coaching team (PCT) to provide integrated coaching in clinical HIV skills and quality improvement (QI) to the HIV clinics in the province. Nine core indicators were measured through chart extraction by clinic and provincial staff at baseline and at 6 month intervals thereafter. Coaching from the team to each of the clinics, in both QI and clinical skills, was guided by results of performance measurements, gap analyses, and resulting QI plans. After 18 months, the PCT had successfully spread QI activities, and was independently providing regular coaching to the provincial general hospital clinic and six of the eight district clinics in the province. The frequency and type of coaching was determined by performance measurement results. Clinics completed a mean of five QI projects. Quality of HIV care was improved throughout all clinics with significant increases in seven of the indicators. Overall both the PCT activities and clinic performance were sustained after integration of the model into the Vietnam National QI Program. We successfully built capacity of a team of public sector health care workers to provide integrated coaching in both clinical skills and QI across a province. The PCT is a feasible and effective model to spread and sustain quality activities and improve HIV care services in a decentralized rural setting.

  19. Quality improvement and accreditation readiness in state public health agencies.

    Science.gov (United States)

    Madamala, Kusuma; Sellers, Katie; Beitsch, Leslie M; Pearsol, Jim; Jarris, Paul

    2012-01-01

    There were 3 specific objectives of this study. The first objective was to examine the progress of state/territorial health assessment, health improvement planning, performance management, and quality improvement (QI) activities at state/territorial health agencies and compare findings to the 2007 findings when available. A second objective was to examine respondent interest and readiness for national voluntary accreditation. A final objective was to explore organizational factors (eg, leadership and capacity) that may influence QI or accreditation readiness. Cross-sectional study. State and Territorial Public Health Agencies. Survey respondents were organizational leaders at State and Territorial Public Health Agencies. Sixty-seven percent of respondents reported having a formal performance management process in place. Approximately 77% of respondents reported a QI process in place. Seventy-three percent of respondents agreed or strongly agreed that they would seek accreditation and 36% agreed or strongly agreed that they would seek accreditation in the first 2 years of the program. In terms of accreditation prerequisites, a strategic plan was most frequently developed, followed by a state/territorial health assessment and health improvement plan, respectively. Advancements in the practice and applied research of QI in state public health agencies are necessary steps for improving performance. In particular, strengthening the measurement of the QI construct is essential for meaningfully assessing current practice patterns and informing future programming and policy decisions. Continued QI training and technical assistance to agency staff and leadership is also critical. Accreditation may be the pivotal factor to strengthen both QI practice and research. Respondent interest in seeking accreditation may indicate the perceived value of accreditation to the agency.

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

    Directory of Open Access Journals (Sweden)

    Roy Jason

    2003-11-01

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

  1. Enhancing system-wide implementation of opioid prescribing guidelines in primary care: protocol for a stepped-wedge quality improvement project.

    Science.gov (United States)

    Zgierska, Aleksandra E; Vidaver, Regina M; Smith, Paul; Ales, Mary W; Nisbet, Kate; Boss, Deanne; Tuan, Wen-Jan; Hahn, David L

    2018-06-05

    Systematic implementation of guidelines for opioid therapy management in chronic non-cancer pain can reduce opioid-related harms. However, implementation of guideline-recommended practices in routine care is subpar. The goal of this quality improvement (QI) project is to assess whether a clinic-tailored QI intervention improves the implementation of a health system-wide, guideline-driven policy on opioid prescribing in primary care. This manuscript describes the protocol for this QI project. A health system with 28 primary care clinics caring for approximately 294,000 primary care patients developed and implemented a guideline-driven policy on long-term opioid therapy in adults with opioid-treated chronic non-cancer pain (estimated N = 3980). The policy provided multiple recommendations, including the universal use of treatment agreements, urine drug testing, depression and opioid misuse risk screening, and standardized documentation of the chronic pain diagnosis and treatment plan. The project team drew upon existing guidelines, feedback from end-users, experts and health system leadership to develop a robust QI intervention, targeting clinic-level implementation of policy-directed practices. The resulting multi-pronged QI intervention included clinic-wide and individual clinician-level educational interventions. The QI intervention will augment the health system's "routine rollout" method, consisting of a single educational presentation to clinicians in group settings and a separate presentation for staff. A stepped-wedge design will enable 9 primary care clinics to receive the intervention and assessment of within-clinic and between-clinic changes in adherence to the policy items measured by clinic-level electronic health record-based measures and process measures of the experience with the intervention. Developing methods for a health system-tailored QI intervention required a multi-step process to incorporate end-user feedback and account for the needs of

  2. Quality and safety training in primary care: making an impact.

    Science.gov (United States)

    Byrne, John M; Hall, Susan; Baz, Sam; Kessler, Todd; Roman, Maher; Patuszynski, Mark; Thakkar, Kruti; Kashner, T Michael

    2012-12-01

    Preparing residents for future practice, knowledge, and skills in quality improvement and safety (QI/S) is a requisite element of graduate medical education. Despite many challenges, residency programs must consider new curricular innovations to meet the requirements. We report the effectiveness of a primary care QI/S curriculum and the role of the chief resident in quality and patient safety in facilitating it. Through the Veterans Administration Graduate Medical Education Enhancement Program, we added a position for a chief resident in quality and patient safety, and 4 full-time equivalent internal medicine residents, to develop the Primary Care Interprofessional Patient-Centered Quality Care Training Curriculum. The curriculum includes a first-or second-year, 1-month block rotation that serves as a foundational experience in QI/S and interprofessional care. The responsibilities of the chief resident in quality and patient safety included organizing and teaching the QI/S curriculum and mentoring resident projects. Evaluation included prerotation and postrotation surveys of self-assessed QI/S knowledge, abilities, skills, beliefs, and commitment (KASBC); an end-of-the-year KASBC; prerotation and postrotation knowledge test; and postrotation and faculty surveys. Comparisons of prerotation and postrotation KASBC indicated significant self-assessed improvements in 4 of 5 KASBC domains: knowledge (P < .001), ability (P < .001), skills (P < .001), and belief (P < .03), which were sustained on the end-of-the-year survey. The knowledge test demonstrated increased QI/S knowledge (P  =  .002). Results of the postrotation survey indicate strong satisfaction with the curriculum, with 76% (25 of 33) and 70% (23 of 33) of the residents rating the quality and safety curricula as always or usually educational. Most faculty members acknowledged that the chief resident in quality and patient safety enhanced both faculty and resident QI/S interest and

  3. Development of a core set of quality indicators for paediatric primary care practices in Europe, COSI-PPC-EU.

    Science.gov (United States)

    Ewald, Dominik A; Huss, Gottfried; Auras, Silke; Caceres, Juan Ruiz-Canela; Hadjipanayis, Adamos; Geraedts, Max

    2018-06-01

    Paediatric ambulatory healthcare systems in Europe are, because of historical reasons, diverse and show strikingly different outcomes. All across Europe, the benchmarking of structures, processes and outcomes could reveal opportunities for improving Paediatric Primary Care (PPC). The aim of this study was to develop a set of Quality Indicators (QIs) to assess and monitor PPC in Europe. In a three-step process, we used the available external evidence and European expert consensus in a modified RAND/UCLA Appropriateness Method (RAM) to develop an indicator set. (1) A broad literature and online research of published QI and guidelines yielded an inventory of 1516 QI. (2) A collaborative panel of paediatric senior experts from the European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) from 15 European countries participated in a first consensus process to reduce the initial indicator inventory by eliminating not PPC-focused indicators and duplicates. (3) In a second consensus process, the panel rated the QI regarding validity and feasibility. The final QI set "COSI-PPC-EU" consists of 42 indicators in five categories of PPC: (A) health promotion/prevention/screening (13 QI), (B) acute care (9 QI), (C) chronic care (8 QI), (D) practice management (3 QI) and (E) patient safety (9 QI). COSI-PPC-EU represents a consented set of a limited number of valid quality indicators for the application in paediatric primary care in different healthcare systems throughout Europe. What is Known: • Paediatric ambulatory healthcare systems in Europe are diverse and show strikingly different outcomes. • There are known gaps in quality performance measures of paediatric primary care in Europe. Pre-existing sets of quality indicators are predominantly limited to national populations, specific diseases and hospital care. What is New: • A set of 42 quality indicators for primary paediatric care in Europe was developed in a multi

  4. Interventions designed using quality improvement methods reduce the incidence of serious airway events and airway cardiac arrests during pediatric anesthesia.

    Science.gov (United States)

    Spaeth, James P; Kreeger, Renee; Varughese, Anna M; Wittkugel, Eric

    2016-02-01

    Although serious complications during pediatric anesthesia are less common than they were 20 years ago, serious airway events continue to occur. Based on Quality Improvement (QI) data from our institution, a QI project was designed to reduce the incidence of serious airway events and airway cardiac arrests. A quality improvement team consisting of members of the Department of Anesthesia was formed and QI data from previous years were analyzed. The QI team developed a Smart Aim, Key Driver Diagram, and specific Interventions that focused on the accessibility of emergency drugs, the use of nondepolarizing muscle relaxants for endotracheal intubation in children 2 years and younger, and the presence of anesthesia providers until emergence from anesthesia in high-risk patients. The percentage of cases where muscle relaxants were utilized in children 2 years and younger for endotracheal intubation and where atropine and succinylcholine were readily available increased at both our base and outpatient facilities. Over the 2.5-year study period, the incidence of serious airway events and airway cardiac arrests was reduced by 44% and 59%, respectively compared to the previous 2-year period. We utilized QI methodology to design and implement a project which led to greater standardization of clinical practice within a large pediatric anesthesia group. Based on an understanding of system issues impacting our clinical practice, we designed and tested interventions that led to a significant reduction in the incidence of serious airway events and airway cardiac arrests. © 2015 John Wiley & Sons Ltd.

  5. Innovative model of delivering quality improvement education for trainees – a pilot project

    Directory of Open Access Journals (Sweden)

    Kannan Ramar

    2015-09-01

    Full Text Available Background: After incorporating quality improvement (QI education as a required curriculum for our trainees in 2010, a need arose to readdress our didactic sessions as they were too long, difficult to schedule, and resulting in a drop in attendance. A ‘flipped classroom’ (FC model to deliver QI education was touted to be an effective delivery method as it allows the trainees to view didactic materials on videos, on their own time, and uses the classroom to clarify concepts and employ learned tools on case-based scenarios including workshops. Methods: The Mayo Quality Academy prepared 29 videos that incorporated the previously delivered 17 weekly didactic sessions, for a total duration of 135 min. The half-day session clarified questions related to the videos, followed by case examples and a hands-on workshop on how to perform and utilize a few commonly used QI tools and methods. Results: Seven trainees participated. There was a significant improvement in knowledge as measured by pre- and post-FC model test results [improvement by 40.34% (SD 16.34, p<0.001]. The survey results were overall positive about the FC model with all trainees strongly agreeing that we should continue with this model to deliver QI education. Conclusions: The pilot project of using the FC model to deliver QI education was successful in a small sample of trainees.

  6. A novel approach to leveraging electronic health record data to enhance pediatric surgical quality improvement bundle process compliance.

    Science.gov (United States)

    Fisher, Jason C; Godfried, David H; Lighter-Fisher, Jennifer; Pratko, Joseph; Sheldon, Mary Ellen; Diago, Thelma; Kuenzler, Keith A; Tomita, Sandra S; Ginsburg, Howard B

    2016-06-01

    Quality improvement (QI) bundles have been widely adopted to reduce surgical site infections (SSI). Improvement science suggests when organizations achieve high-reliability to QI processes, outcomes dramatically improve. However, measuring QI process compliance is poorly supported by electronic health record (EHR) systems. We developed a custom EHR tool to facilitate capture of process data for SSI prevention with the aim of increasing bundle compliance and reducing adverse events. Ten SSI prevention bundle processes were linked to EHR data elements that were then aggregated into a snapshot display superimposed on weekly case-log reports. The data aggregation and user interface facilitated efficient review of all SSI bundle elements, providing an exact bundle compliance rate without random sampling or chart review. Nine months after implementation of our custom EHR tool, we observed centerline shifts in median SSI bundle compliance (46% to 72%). Additionally, as predicted by high reliability principles, we began to see a trend toward improvement in SSI rates (1.68 to 0.87 per 100 operations), but a discrete centerline shift was not detected. Simple informatics solutions can facilitate extraction of QI process data from the EHR without relying on adjunctive systems. Analyses of these data may drive reductions in adverse events. Pediatric surgical departments should consider leveraging the EHR to enhance bundle compliance as they implement QI strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. 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.

  8. Improving the Quality of Care for Patients Diagnosed With Glioma During the Perioperative Period

    Science.gov (United States)

    Riblet, Natalie B.V.; Schlosser, Evelyn M.; Homa, Karen; Snide, Jennifer A.; Jarvis, Lesley A.; Simmons, Nathan E.; Sargent, David H.; Mason, Linda P.; Cooney, Tobi J.; Kennedy, Nancy L.; Fadul, Camilo E.

    2014-01-01

    Purpose: Although there is agreement on the oncologic management of patients with glioma, few guidelines exist to standardize other aspects of care, including supportive care. Methods: A quality improvement (QI) project was chartered to improve the care provided to patients with glioma. A multidisciplinary team was convened and identified 10 best-practice measures. Using a plan-do-study-act framework, the team brainstormed and implemented various improvement interventions between June 2011 and October 2012. Statistical process control charts were used to evaluate progress. A dashboard of quality measures was generated to allow for ongoing measurement and reporting. Results: The retrospective assessment phase consisted of 43 patients with diagnosis of glioma. A manual medical record review for these patients showed that compliance with 10 best-practice measures ranged from 23% to 100%. Several factors contributed to less-than-ideal process performance, including poor communication among disciplines and lack of familiarity with the larger system of care. After implementing improvement interventions, performance was measured in 96 consecutive patients with glioma. The proportion of patients who met criteria for 10 practice measures significantly improved (pre-QI work, 63%; post-QI work, 85%; P = .003). The largest improvement was observed in the measure assessing for preoperative notification of the neuro-oncology program (pre-QI work, 39%; post-QI work, 97%; P sustaining process improvements. PMID:25294392

  9. Translation of an Action Learning Collaborative Model Into a Community-Based Intervention to Promote Physical Activity and Healthy Eating.

    Science.gov (United States)

    Schifferdecker, Karen E; Adachi-Mejia, Anna M; Butcher, Rebecca L; O'Connor, Sharon; Li, Zhigang; Bazos, Dorothy A

    2016-01-01

    Action Learning Collaboratives (ALCs), whereby teams apply quality improvement (QI) tools and methods, have successfully improved patient care delivery and outcomes. We adapted and tested the ALC model as a community-based obesity prevention intervention focused on physical activity and healthy eating. The intervention used QI tools (e.g., progress monitoring) and team-based activities and was implemented in three communities through nine monthly meetings. To assess process and outcomes, we used a longitudinal repeated-measures and mixed-methods triangulation approach with a quasi-experimental design including objective measures at three time points. Most of the 97 participants were female (85.4%), White (93.8%), and non-Hispanic/Latino (95.9%). Average age was 52 years; 28.0% had annual household income of $20,000 or less; and mean body mass index was 35. Through mixed-effects models, we found some physical activity outcomes improved. Other outcomes did not significantly change. Although participants favorably viewed the QI tools, components of the QI process such as sharing goals and data on progress in teams and during meetings were limited. Participants' requests for more education or activities around physical activity and healthy eating, rather than progress monitoring and data sharing required for QI activities, challenged ALC model implementation. An ALC model for community-based obesity prevention may be more effective when applied to preexisting teams in community-based organizations. © 2015 Society for Public Health Education.

  10. Research and quality improvement experience and knowledge: a nursing survey.

    Science.gov (United States)

    Fox, Jolene; Bagley, Lisa; Day, Suzanne; Holleran, Renee; Handrahan, Diana

    2011-07-01

    To assess nursing staff's background and research and quality improvement (QI) experience. In this corporation, participation in research and QI is encouraged, but little is known about nurses' experiences. A web-based survey was distributed. Nursing staffs from an academic/teaching medical centre and other intra-corporation non-academic facilities were compared. Respondents included: 148 (52.9%) medical centre and 132 (47.1%) non-medical centre subjects. Medical centre respondents had a higher proportion previously engaged in research, currently engaged in research and previously engaged in QI. Productivity (grant, published and presented) was low for both groups but statistically lower for the non-medical centre group. Medical centre employees used research resources more often than the non-medical centre. Time was the most frequently mentioned barrier to participation in research and QI initiatives. A moderate proportion of respondents had research and QI experience, yet productivity and use of resources was low. Nurses at non-academically focused facilities were in most need of assistance. Familiarizing nurses with resources and providing protected time may increase productivity. Developing an infrastructure to support nursing research is a worthy goal. Information about interest and experience of nurses can aid management in determining how to focus financial resources. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  11. What's in It for Me? Maintenance of Certification as an Incentive for Faculty Supervision of Resident Quality Improvement Projects.

    Science.gov (United States)

    Rosenbluth, Glenn; Tabas, Jeffrey A; Baron, Robert B

    2016-01-01

    Residents are required to engage in quality improvement (QI) activities, which requires faculty engagement. Because of increasing program requirements and clinical demands, faculty may be resistant to taking on additional teaching and supervisory responsibilities without incentives. The authors sought to create an authentic benefit for University of California, San Francisco (UCSF) Pediatrics Residency Training Program faculty who supervise pediatrics residents' QI projects by offering maintenance of certification (MOC) Part 4 (Performance in Practice) credit. The authors identified MOC as an ideal framework to both more actively engage faculty who were supervising QI projects and provide incentives for doing so. To this end, in 2011, the authors designed an MOC portfolio program which included faculty development, active supervision of residents, and QI projects designed to improve patient care. The UCSF Pediatrics Residency Training Program's Portfolio Sponsor application was approved by the American Board of Pediatrics (ABP) in 2012, and faculty whose projects were included in the application were granted MOC Part 4 credit. As of December 2013, six faculty had received MOC Part 4 credit for their supervision of residents' QI projects. Based largely on the success of this program, UCSF has transitioned to the MOC portfolio program administered through the American Board of Medical Specialties, which allows the organization to offer MOC Part 4 credit from multiple specialty boards including the ABP. This may require refinements to screening, over sight, and reporting structures to ensure the MOC standards are met. Ongoing faculty development will be essential.

  12. Survey on risk perception of radiation following an incident involving a stuck 60Co source in Henan Province, China

    International Nuclear Information System (INIS)

    Lei, C.; Sun, Q.; Cheng, X.; Zhang, Q.; Fu, Y.; Chu, C.; Zhao, Y.; Qin, W.; Su, X.

    2012-01-01

    In July 2009, an incident involving a stuck Co-60 source led hundreds of thousands of people to escape Qi County, Henan Province, China, although no medical or environmental consequences were related to the incident. To investigate knowledge about radiation, public risk-perception of radiation, and evaluation of the official response, a survey was conducted in Qi and Hui County (control). Face-to-face questionnaire interviews were conducted among three groups with different educational backgrounds. In total, 1340 valid questionnaires were collected from people interviewed. Knowledge about radiation was low in all groups in both counties, although knowledge in Qi County was higher than that in Hui County (control). More than 40 % respondents supported construction of nuclear power plants (NPPs) in China, while only a few supported constructing NPPs in their vicinity. The main reasons for the mass escape following the incident were assumed to be lack of knowledge about radiation, misinformation, the government's failure to disclose information in time and imitation of group behaviour. Over 60 % in Group I and II trusted the local government. About 64 % disapproved the response of the Qi County government. After the incident, the population in Qi County still knows little about radiation. Although people trust the government, they are dissatisfied with the response of the local government regarding the incident. (authors)

  13. Are Evidence-based Practices Associated With Effective Prevention of Hospital-acquired Pressure Ulcers in US Academic Medical Centers?

    Science.gov (United States)

    Padula, William V; Gibbons, Robert D; Valuck, Robert J; Makic, Mary B F; Mishra, Manish K; Pronovost, Peter J; Meltzer, David O

    2016-05-01

    In 2008, the Centers for Medicare and Medicaid Services (CMS) established nonpayment policies resulting from costliness of hospital-acquired pressure ulcers (HAPUs) to hospitals. This prompted hospitals to adopt quality improvement (QI) interventions that increase use of evidence-based practices (EBPs) for HAPU prevention. To evaluate the longitudinal impact of CMS policy and QI adoption on HAPU rates. We characterized longitudinal adoption of 25 QI interventions that support EBPs through hospital leadership, staff, information technology, and performance and improvement. Quarterly counts of HAPU incidence and inpatient characteristics were collected from 55 University HealthSystem Consortium hospitals between 2007 and 2012. Mixed-effects regression models tested the longitudinal association of CMS policy, HAPU coding, and QI on HAPU rates. The models assumed level-2 random intercepts and random effects for CMS policy and EBP implementation to account for between-hospital variability in HAPU incidence. Controlling for all 25 QI interventions, specific updates to EBPs for HAPU prevention had a significant, though modest reduction on HAPU rates (-1.86 cases/quarter; P=0.002) and the effect of CMS nonpayment policy on HAPU prevention was much greater (-11.32 cases/quarter; P<0.001). HAPU rates were significantly lower after changes in CMS reimbursement. Reductions are associated with hospital-wide implementation of EBPs for HAPU prevention. Given that administrative data were used, it remains unknown whether these improvements were due to changes in coding or improved quality of care.

  14. Residency Training: Quality improvement projects in neurology residency and fellowship: applying DMAIC methodology.

    Science.gov (United States)

    Kassardjian, Charles D; Williamson, Michelle L; van Buskirk, Dorothy J; Ernste, Floranne C; Hunderfund, Andrea N Leep

    2015-07-14

    Teaching quality improvement (QI) is a priority for residency and fellowship training programs. However, many medical trainees have had little exposure to QI methods. The purpose of this study is to review a rigorous and simple QI methodology (define, measure, analyze, improve, and control [DMAIC]) and demonstrate its use in a fellow-driven QI project aimed at reducing the number of delayed and canceled muscle biopsies at our institution. DMAIC was utilized. The project aim was to reduce the number of delayed muscle biopsies to 10% or less within 24 months. Baseline data were collected for 12 months. These data were analyzed to identify root causes for muscle biopsy delays and cancellations. Interventions were developed to address the most common root causes. Performance was then remeasured for 9 months. Baseline data were collected on 97 of 120 muscle biopsies during 2013. Twenty biopsies (20.6%) were delayed. The most common causes were scheduling too many tests on the same day and lack of fasting. Interventions aimed at patient education and biopsy scheduling were implemented. The effect was to reduce the number of delayed biopsies to 6.6% (6/91) over the next 9 months. Familiarity with QI methodologies such as DMAIC is helpful to ensure valid results and conclusions. Utilizing DMAIC, we were able to implement simple changes and significantly reduce the number of delayed muscle biopsies at our institution. © 2015 American Academy of Neurology.

  15. Engaging Australian physicians in evidence-based medicine: a representative national survey.

    Science.gov (United States)

    Toulkidis, V; Donnelly, N J; Ward, J E

    2005-01-01

    To assess Australian adult physicians' views about evidence-based medicine (EBM) and quality improvement (QI). Cross-sectional postal survey of two hundred and forty-four randomly selected Australian physicians (78.5% response rate). Physicians' views about the promotion of EBM and QI and their impact on patient care, strategies to support better clinical practice and self-reported understanding of EBM terms. Sixty-eight per cent (95% confidence interval (CI): 62-74%) of physicians had a positive view of the current promotion of EBM in Australia. Significantly fewer (45%; 95% CI: 38-51%) were so positive about QI (P evidence, significantly fewer (21%; 95% CI: 17-27%) agreed they had sufficient time to do so (P Australian physicians have positive views of EBM, QI appears less well regarded. Initiatives to improve quality and safety that incorporate principles and language of EBM will likely be received better by physicians than isolated QI. Further enhancement of EBM requires concomitant attention to physician training, workplace infrastructure and supportive professional development.

  16. Organization Complexity and Primary Care Providers' Perceptions of Quality Improvement Culture Within the Veterans Health Administration.

    Science.gov (United States)

    Korom-Djakovic, Danijela; Canamucio, Anne; Lempa, Michele; Yano, Elizabeth M; Long, Judith A

    2016-01-01

    This study examined how aspects of quality improvement (QI) culture changed during the introduction of the Veterans Health Administration (VHA) patient-centered medical home initiative and how they were influenced by existing organizational factors, including VHA facility complexity and practice location. A voluntary survey, measuring primary care providers' (PCPs') perspectives on QI culture at their primary care clinics, was administered in 2010 and 2012. Participants were 320 PCPs from hospital- and community-based primary care practices in Pennsylvania, West Virginia, Delaware, New Jersey, New York, and Ohio. PCPs in community-based outpatient clinics reported an improvement in established processes for QI, and communication and cooperation from 2010 to 2012. However, their peers in hospital-based clinics did not report any significant improvements in QI culture. In both years, compared with high-complexity facilities, medium- and low-complexity facilities had better scores on the scales assessing established processes for QI, and communication and cooperation. © The Author(s) 2014.

  17. [Brief discussion on acupuncture technique "controlling Qihai to regulate blood pressure" proposed by academician SHI Xuemin].

    Science.gov (United States)

    Yu, Liang; Xu, Xifa; Liu, Jian; Fan, Xiaonong

    2017-08-12

    According to Qihai theory, academician SHI Xuemin established the acupuncture technique "controlling Qihai to regulate blood pressure" which focused on Renying (ST 9), and achieved favorable effects in clinical application. In this paper, based on the Qihai theory, from aspects of Yuan qi , Zong qi , Ying qi and Wei qi and relations among qi , blood and veins in TCM, and cardiac output, sympathetic nerve activity and blood vessels in modern medicine, the understanding on hypertension was explained. As a result, both TCM and modern medicine had consistency in the understanding of hypertension, reflecting the scientificity and practicability of this acupuncture technique. Besides, according to Qihai theory and "wind leading to vertigo" theory, academician SHI Xuemin brought forward the key pathogenesis of hypertension was "dysfunction of Qihai ", and the acupoint selected Renying (ST 9), Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3). At the same time, the operation specification of each acupoint was mainly discussed, and the references of acupoint selection was explained based on TCM theory and modern clinical research.

  18. An Empirical Study of Critical Soft Factors for Quality Improvement in The Electrical and Electronics Firms in Malaysia

    Directory of Open Access Journals (Sweden)

    Muhammad Madi Abdullah

    2009-03-01

    Full Text Available Soft factors are important aspect that sustains the organizations in their efforts towards continuous quality improvement (QI and customer satisfaction. The conventional wisdom states that quality improvement in organizations increases profits and productivity. Therefore, the aim of the paper is to examine the influence of critical soft factors (CSF on quality improvement (QI. For that purpose, this study examine: (i the relationship between the CSF and QI and (ii to what extent the six CSF explain QI. The study used survey data from 255 electrical and electronics (E&E firms in Malaysia. The individual managers representing the each firm made the unit of analysis of the study. The finding reveals that QI was significantly influenced by the following soft factors: management commitment, customer focus, employee involvement, training & education, and reward & recognition. Supplier relationship was not a significant predictor of quality improvement. Finally, this study has empirically shown that quality improvement will increase when the organizations emphasize more on soft factors.Keywords: Critical soft factors, quality improvement, Electrical and Electronics firms

  19. Organizational coherence in health care organizations: conceptual guidance to facilitate quality improvement and organizational change.

    Science.gov (United States)

    McAlearney, Ann Scheck; Terris, Darcey; Hardacre, Jeanne; Spurgeon, Peter; Brown, Claire; Baumgart, Andre; Nyström, Monica E

    2014-01-01

    We sought to improve our understanding of how health care quality improvement (QI) methods and innovations could be efficiently and effectively translated between settings to reduce persistent gaps in health care quality both within and across countries. We aimed to examine whether we could identify a core set of organizational cultural attributes, independent of context and setting, which might be associated with success in implementing and sustaining QI systems in health care organizations. We convened an international group of investigators to explore the issues of organizational culture and QI in different health care contexts and settings. This group met in person 3 times and held a series of conference calls to discuss emerging ideas over 2 years. Investigators also conducted pilot studies in their home countries to examine the applicability of our conceptual model. We suggest that organizational coherence may be a critical element of QI efforts in health care organizations and propose that there are 3 key components of organizational coherence: (1) people, (2) processes, and (3) perspectives. Our work suggests that the concept of organizational coherence embraces both culture and context and can thus help guide both researchers and practitioners in efforts to enhance health care QI efforts, regardless of organizational type, location, or context.

  20. Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.

    Science.gov (United States)

    Padula, William V; Makic, Mary Beth F; Mishra, Manish K; Campbell, Jonathan D; Nair, Kavita V; Wald, Heidi L; Valuck, Robert J

    2015-06-01

    Prevention of pressure ulcers, one of the hospital-acquired conditions (HACs) targeted by the 2008 nonpayment policy of the Centers for Medicare & Medicaid Services (CMS), is a critical issue. This study was conducted to determine the comparative effectiveness of quality improvement (QI) interventions associated with reduced hospital-acquired pressure ulcer (HAPU) rates. In an quasi-experimental design, interrupted time series analyses were conducted to determine the correlation between HAPU incidence rates and adoption of QI interventions. Among University HealthSystem Consortium hospitals, 55 academic medical centers were surveyed from September 2007 through February 2012 for adoption patterns of QI interventions for pressure ulcer prevention, and hospital-level data for 5,208 pressure ulcer cases were analyzed. Between- and within-hospital reduction significance was tested with t-tests post-CMS policy intervention. Fifty-three (96%) of the 55 hospitals used QI interventions for pressure ulcer prevention. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates by greater than 1 case per 1,000 patient discharges per quarter: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition. The greatest reductions in rates occurred earlier in the adoption process (pprevention protocol for pressure ulcers. Hospitals can not only use these findings from this study as part of a QI bundle for preventing HAPUs.

  1. [Discussion on relationship between "living alone with closed windows and doors" and depression].

    Science.gov (United States)

    Liu, Fengfeng; Li, Rui

    2018-03-12

    "Living alone with closed windows and doors"was mentioned in the pathological manifestations of stomach meridian of foot- yangming in Neijing ( The Inner Canon of Huangdi ), which is similar to the symptoms of depression. Currently the treatment of depression is mostly based on"spirit being stored in five organs"theory, and little attention is paid on stomach meridian of foot- yangming . From the pathological manifestations of"living alone with closed windows and doors"in stomach meridian of foot- yangming , the relationship between stomach meridian and depression is discussed from ying-yang and qi -blood. In addition, the close relationship between the stomach meridian and qi -blood, qi movement of five organs, heart and brain is discussed to explore the mechanism of treating depression. In conclusion, the literature and modern research regarding treating depression from stomach meridian are summarized, hoping to provide more clinical methods for the treatment of depression.

  2. Quantum entanglement in electron optics generation, characterization, and applications

    CERN Document Server

    Chandra, Naresh

    2013-01-01

    This monograph forms an interdisciplinary study in atomic, molecular, and quantum information (QI) science. Here a reader will find that applications of the tools developed in QI provide new physical insights into electron optics as well as properties of atoms & molecules which, in turn, are useful in studying QI both at fundamental and applied levels. In particular, this book investigates entanglement properties of flying electronic qubits generated in some of the well known processes capable of taking place in an atom or a molecule following the absorption of a photon. Here, one can generate Coulombic or fine-structure entanglement of electronic qubits. The properties of these entanglements differ not only from each other, but also from those when spin of an inner-shell photoelectron is entangled with the polarization of the subsequent fluorescence. Spins of an outer-shell electron and of a residual photoion can have free or bound entanglement in a laboratory.

  3. Prediction of quantum interference in molecular junctions using a parabolic diagram: Understanding the origin of Fano and anti-resonances

    DEFF Research Database (Denmark)

    Nozaki, Daijiro; Avdoshenko, Stanislav M.; Sevincli, Haldun

    2013-01-01

    Recently the interest in quantum interference (QI) phenomena in molecular devices (molecular junctions) has been growing due to the unique features observed in the transmission spectra. In order to design single molecular devices exploiting QI effects as desired, it is necessary to provide simple...... rules for predicting the appearance of QI effects such as anti-resonances or Fano line shapes and for controlling them. In this study, we derive a transmission function of a generic molecular junction with a side group (T-shaped molecular junction) using a minimal toy model. We developed a simple method...... to predict the appearance of quantum interference, Fano resonances or anti- resonances, and its position in the conductance spectrum by introducing a simple graphical representation (parabolic model). Using it we can easily visualize the relation between the key electronic parameters and the positions...

  4. Preventing falls in assisted living: Results of a quality improvement pilot study.

    Science.gov (United States)

    Zimmerman, Sheryl; Greene, Angela; Sloane, Philip D; Mitchell, Madeline; Giuliani, Carol; Nyrop, Kirsten; Walsh, Edith

    Residents of assisted living (AL) communities are at high risk for falls, which result in negative outcomes and high health care costs. Adapting effective falls prevention programs for AL quality improvement (QI) has the potential to reduce falls, improve resident quality of life, and reduce costs. This project tested the feasibility and outcomes of an evidence-based multi-component QI program, the Assisted Living Falls Prevention and Monitoring Program (AL-FPMP). Resident posture and gait improved, likely due to exercise and/or physical therapy. Effective falls prevention QI programs can be implemented in AL, and are advised to (1) establish and maintain a falls team to create a culture focused on the reduction of falls risk; (2) teach staff to assess residents using the Morse Falls Scale to increase their awareness of residents' falls risk and improvement; and (3) modify existing exercise programs to address balance and lower body strength. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Hyper-chaos encryption using convolutional masking and model free unmasking

    International Nuclear Information System (INIS)

    Qi Guo-Yuan; Matondo Sandra Bazebo

    2014-01-01

    In this paper, during the masking process the encrypted message is convolved and embedded into a Qi hyper-chaotic system characterizing a high disorder degree. The masking scheme was tested using both Qi hyper-chaos and Lorenz chaos and indicated that Qi hyper-chaos based masking can resist attacks of the filtering and power spectrum analysis, while the Lorenz based scheme fails for high amplitude data. To unmask the message at the receiving end, two methods are proposed. In the first method, a model-free synchronizer, i.e. a multivariable higher-order differential feedback controller between the transmitter and receiver is employed to de-convolve the message embedded in the receiving signal. In the second method, no synchronization is required since the message is de-convolved using the information of the estimated derivative. (general)

  6. Self-reported quality care for knee osteoarthritis

    DEFF Research Database (Denmark)

    Østerås, N; Jordan, K P; Clausen, B

    2015-01-01

    OBJECTIVES: To assess and compare patient perceived quality of osteoarthritis (OA) management in primary healthcare in Denmark, Norway, Portugal and the UK. METHODS: Participants consulting with clinical signs and symptoms of knee OA were identified in 30 general practices and invited to complete...... a cross-sectional survey including quality indicators (QI) for OA care. A QI was considered as eligible if the participant had checked 'Yes' or 'No', and as achieved if the participant had checked 'Yes' to the indicator. The median percentage (with IQR and range) of eligible QIs achieved by country...... was determined and compared in negative binominal regression analysis. Achievement of individual QIs by country was determined and compared using logistic regression analyses. RESULTS: A total of 354 participants self-reported QI achievement. The median percentage of eligible QIs achieved (checked 'Yes') was 48...

  7. Through Their Eyes: Lessons Learned Using Participatory Methods in Health Care Quality Improvement Projects.

    Science.gov (United States)

    Balbale, Salva N; Locatelli, Sara M; LaVela, Sherri L

    2016-08-01

    In this methodological article, we examine participatory methods in depth to demonstrate how these methods can be adopted for quality improvement (QI) projects in health care. We draw on existing literature and our QI initiatives in the Department of Veterans Affairs to discuss the application of photovoice and guided tours in QI efforts. We highlight lessons learned and several benefits of using participatory methods in this area. Using participatory methods, evaluators can engage patients, providers, and other stakeholders as partners to enhance care. Participant involvement helps yield actionable data that can be translated into improved care practices. Use of these methods also helps generate key insights to inform improvements that truly resonate with stakeholders. Using participatory methods is a valuable strategy to harness participant engagement and drive improvements that address individual needs. In applying these innovative methodologies, evaluators can transcend traditional approaches to uniquely support evaluations and improvements in health care. © The Author(s) 2015.

  8. [Theoretic basis on the same therapeutic program for different degenerative brain diseases in terms of the Governor Vessel: Alzheimer's disease and Parkinson's disease].

    Science.gov (United States)

    Wu, Junyan; Wang, Jie; Zhang, Junlong

    2015-05-01

    Through the consultation of TCM ancient classical theory, the relationship of kidney essence, marrow and brain is analyzed. It is discovered that the degenerative brain diseases, represented by Alzheimer's disease (AD) and Parkinson's disease (PD) share the same etiological basis as "kidney essence deficiency and brain marrow emptiness" and have the mutual pathological outcomes as yang qi declining. The Governor Vessel gathers yang qi of the whole body and maintains the normal functional activity of zangfu organs in the human body through the storage, regulation and invigoration of yang qi. It is viewed that the theory of the Governor Vessel is applied to treat the different degenerative brain diseases, which provides the theoretic support and practice guide for the thought of TCM as the same therapeutic program for the different diseases. As a result, the degenerative brain diseases can be retarded and the approach is provided to the effective prevention and treatment of degenerative diseases in central nerve system:

  9. A parabolic model to control quantum interference in T-shaped molecular junctions

    DEFF Research Database (Denmark)

    Nozaki, Daijiro; Sevincli, Haldun; Avdoshenko, Stanislav M.

    2013-01-01

    Quantum interference (QI) effects in molecular devices have drawn increasing attention over the past years due to their unique features observed in the conductance spectrum. For the further development of single molecular devices exploiting QI effects, it is of great theoretical and practical...... interest to develop simple methods controlling the emergence and the positions of QI effects like anti-resonances or Fano line shapes in conductance spectra. In this work, starting from a well-known generic molecular junction with a side group (T-shaped molecule), we propose a simple graphical method...... to visualize the conditions for the appearance of quantum interference, Fano resonances or anti-resonances, in the conductance spectrum. By introducing a simple graphical representation (parabolic diagram), we can easily visualize the relation between the electronic parameters and the positions of normal...

  10. Using Economic Evaluation to Illustrate Value of Care for Improving Patient Safety and Quality: Choosing the Right Method.

    Science.gov (United States)

    Padula, William V; Lee, Ken K H; Pronovost, Peter J

    2017-08-03

    To scale and sustain successful quality improvement (QI) interventions, it is recommended for health system leaders to calculate the economic and financial sustainability of the intervention. Many methods of economic evaluation exist, and the type of method depends on the audience: providers, researchers, and hospital executives. This is a primer to introduce cost-effectiveness analysis, budget impact analysis, and return on investment calculation as 3 distinct methods for each stakeholder needing a measurement of the value of QI at the health system level. Using cases for the QI of hospital-acquired condition rates (e.g., pressure injuries), this primer proceeds stepwise through each method beginning from the same starting point of constructing a model so that the repetition of steps is minimized and thereby capturing the attention of all intended audiences.

  11. Study on stability of DMS meridian detector.

    Science.gov (United States)

    Yang, Ning; Huang, Li; Yuan, Jiamin; Zhang, Zhifang; Yang, Zhimin

    2016-05-01

    The stability of meridian detector was the basis to study meridian through conductance method. Ancient documents mentioned that the human body's blood could change with the time and meridians. When qi and blood came, the qi and blood would be full of that place; when qi and blood gone, the local skin shining could fade and recess. It liked the tidal fluctuation, then caused the corresponding acupuncture points conductance value changes. Modern studies had reported that meridian detector instrument the skin area of twelve meridians acupuncture points could change along with time within 24 hours. In this circumstance, whether the conductance values changes in human acupuncture points had statistical significance was vital important. DMS meridian detector instruction was adopt to measure the twelve meridian jingyuan acupuncture point in order to analyze the acupuncture point conductance value changes within one day.

  12. Applying the Advancing Excellence in America's Nursing Homes Circle of Success to improving and sustaining quality.

    Science.gov (United States)

    Bakerjian, Debra; Zisberg, Anna

    2013-01-01

    Looking forward to the Quality Assurance Performance Improvement (QAPI) program to be implemented and required in 2014, and as nursing home staff provide care for residents with increasingly complex health issues, knowledge of how to implement quality improvement (QI) is imperative. The nursing home administrator and director of nursing (DON) provide overall leadership, but it is the primary responsibility of the DON and other registered nurse staff to implement and manage the day to day QI process. This article describes potential roles of nursing leaders and key components of a QI project using a pressure ulcer case study exemplar to illustrate a quality improvement process. The authors suggest specific methods that RN leaders can employ using the Advancing Excellence Campaign Circle of Success as an organizing framework along with evidence-based resources. Nursing home leaders could use this article as a guideline for implementing any clinical quality improvement process. Copyright © 2013 Mosby, Inc. All rights reserved.

  13. Optimized Shielding and Fabrication Techniques for TiN and Al Microwave Resonators

    Science.gov (United States)

    Kreikebaum, John Mark; Kim, Eunseong; Livingston, William; Dove, Allison; Calusine, Gregory; Hover, David; Rosenberg, Danna; Oliver, William; Siddiqi, Irfan

    We present a systematic study of the effects of shielding and packaging on the internal quality factor (Qi) of Al and TiN microwave resonators designed for use in qubit readout. Surprisingly, Qi =1.3x106 TiN samples investigated at 100 mK exhibited no significant changes in linewidth when operated without magnetic shielding and in an open cryo-package. In contrast, Al resonators showed systematic improvement in Qi with each successive shield. Measurements were performed in an adiabatic demagnetization refrigerator, where typical ambient fields of 0.2 mT are present at the sample stage. We discuss the effect of 100 mK and 500 mK Cu radiation shields and cryoperm magnetic shielding on resonator Q as a function of temperature and input power in samples prepared with a variety of surface treatments, fabrication recipes, and embedding circuits. This research was supported by the ARO and IARPA.

  14. Vocabulário e memória de trabalho predizem desempenho em leitura de crianças

    OpenAIRE

    Piccolo, Luciane da Rosa; Salles, Jerusa Fumagalli

    2013-01-01

    Resumo: Este trabalho investiga a relação entre leitura (palavras e texto), memória de trabalho, quociente de inteligência (QI) e vocabulário em crianças (2ª-5ª séries) de escolas públicas. Analisou-se também qual dessas habilidades melhor contribui para explicar o desempenho em leitura. Realizaram-se análises com e sem crianças com QI abaixo da média. Primeiro, avaliaram-se 57 crianças (9-11 anos) em QI, vocabulário, leitura de palavras isoladas, compreensão de leitura textual e quatro taref...

  15. Kalanchoe pinnata inhibits mast cell activation and prevents allergic airway disease.

    Science.gov (United States)

    Cruz, E A; Reuter, S; Martin, H; Dehzad, N; Muzitano, M F; Costa, S S; Rossi-Bergmann, B; Buhl, R; Stassen, M; Taube, C

    2012-01-15

    Aqueous extract of Kalanchoe pinnata (Kp) have been found effective in models to reduce acute anaphylactic reactions. In the present study, we investigate the effect of Kp and the flavonoid quercetin (QE) and quercitrin (QI) on mast cell activation in vitro and in a model of allergic airway disease in vivo. Treatment with Kp and QE in vitro inhibited degranulation and cytokine production of bone marrow-derived mast cells following IgE/FcɛRI crosslinking, whereas treatment with QI had no effect. Similarly, in vivo treatment with Kp and QE decreased development of airway hyperresponsiveness, airway inflammation, goblet cell metaplasia and production of IL-5, IL-13 and TNF. In contrast, treatment with QI had no effect on these parameters. These findings demonstrate that treatment with Kp or QE is effective in treatment of allergic airway disease, providing new insights to the immunomodulatory functions of this plant. Copyright © 2011 Elsevier GmbH. All rights reserved.

  16. On the synchronization of identical and non-identical 4-D chaotic systems using arrow form matrix

    International Nuclear Information System (INIS)

    Hammami, S.; Ben Saad, K.; Benrejeb, M.

    2009-01-01

    Using the Borne and Gentina practical criterion associated with the Benrejeb canonical arrow form matrix, to derive the stability property of dynamic complex systems, a new strategy of control is formulated for chaos synchronization of two identical Lorenz Stenflo systems and two new four-dimensional chaotic systems, namely the Qi chaotic systems. The designed controller ensures that the state variables of both controlled chaotic slave Lorenz Stenflo and Qi systems globally synchronizes with the state variables of the master systems, respectively. It is also shown that Qi system globally synchronizes with Lorenz Stenflo system under the afforded generalized strategy of control. Numerical simulations are carried out to assess the performance of the proposed contributions in the important field of chaotic synchronization.

  17. Using an online quiz-based reinforcement system to teach healthcare quality and patient safety and care transitions at the University of California.

    Science.gov (United States)

    Shaikh, Ulfat; Afsar-Manesh, Nasim; Amin, Alpesh N; Clay, Brian; Ranji, Sumant R

    2017-10-01

    Implementing quality improvement (QI) education during clinical training is challenging due to time constraints and inadequate faculty development in these areas. Quiz-based reinforcement systems show promise in fostering active engagement, collaboration, healthy competition and real-time formative feedback, although further research on their effectiveness is required. An online quiz-based reinforcement system to increase resident and faculty knowledge in QI, patient safety and care transitions. Experts in QI and educational assessment at the 5 University of California medical campuses developed a course comprised of 3 quizzes on Introduction to QI, Patient Safety and Care Transitions. Each quiz contained 20 questions and utilized an online educational quiz-based reinforcement system that leveraged spaced learning. Approximately 500 learners completed the course (completion rate 66-86%). Knowledge acquisition scores for all quizzes increased after completion: Introduction to QI (35-73%), Patient Safety (58-95%), and Care Transitions (66-90%). Learners reported that the quiz-based system was an effective teaching modality and preferred this type of education to classroom-based lectures. Suggestions for improvement included reducing frequency of presentation of questions and utilizing more questions that test learners on application of knowledge instead of knowledge acquisition. A multi-campus online quiz-based reinforcement system to train residents in QI, patient safety and care transitions was feasible, acceptable, and increased knowledge. The course may be best utilized to supplement classroom-based and experiential curricula, along with increased attention to optimizing frequency of presentation of questions and enhancing application skills. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  18. Developing a caries risk registry to support caries risk assessment and management for children: A quality improvement initiative.

    Science.gov (United States)

    Ruff, Jesley C; Herndon, Jill Boylston; Horton, Roger A; Lynch, Julie; Mathwig, Dawn C; Leonard, Audra; Aravamudhan, Krishna

    2017-10-27

    Health registries are commonly used in medicine to support public health activities and are increasingly used in quality improvement (QI) initiatives. Illustrations of dental registries and their QI applications are lacking. Within dentistry, caries risk assessment implementation and documentation are vital to optimal patient care. The purpose of this article is to describe the processes used to develop a caries risk assessment registry as a QI initiative to support clinical caries risk assessment, caries prevention, and disease management for children. Developmental steps reflected Agency for Healthcare Research and Quality recommendations for planning QI registries and included engaging "champions," defining the project, identifying registry features, defining performance dashboard indicators, and pilot testing with participant feedback. We followed Standards for Quality Improvement Reporting Excellence guidelines. Registry eligibility is patients aged 0-17 years. QI tools include prompts to register eligible patients; decision support tools grounded in evidence-based guidelines; and performance dashboard reports delivered at the provider and aggregated levels at regular intervals. The registry was successfully piloted in two practices with documented caries risk assessment increasing from 57 percent to 92 percent and positive feedback regarding the potential to improve dental practice patient centeredness, patient engagement and education, and quality of care. The caries risk assessment registry demonstrates how dental registries may be used in QI efforts to promote joint patient and provider engagement, foster shared decision making, and systematically collect patient information to generate timely and actionable data to improve care quality and patient outcomes at the individual and population levels. © 2017 American Association of Public Health Dentistry.

  19. Characteristics of Quality Improvement Champions in Nursing Homes: A Systematic Review With Implications for Evidence-Based Practice.

    Science.gov (United States)

    Woo, Kyungmi; Milworm, Gvira; Dowding, Dawn

    2017-12-01

    Improving care quality while reducing cost has always been a focus of nursing homes. Certified nursing assistants comprise the largest proportion of the workforce in nursing homes and have the potential to contribute to the quality of care provided. Quality improvement (QI) initiatives using certified nursing assistants as champions have the potential to improve job satisfaction, which has been associated with care quality. To identify the role, use and preparation of champions in a nursing home setting as a way of informing future QI strategies in nursing homes. A systematic literature review. Medical Subject Headings and text words for "quality improvement" were combined with those for "champion*" to search Medline, CINAHL, Joanna Briggs Institute, MedLine In-Process, and other Nonindexed Citations. After duplicates were removed, a total of 337 potential articles were identified for further review. After full text review, seven articles from five original studies met inclusion criteria and were included in the synthesis. Various types of QI initiatives and implementation strategies were used together with champions. Champions were identified by study authors as one of the single most effective strategies employed in all studies. The majority of studies described the champion role as that of a leader, who fosters and reinforces changes for improvement. Although all the included studies suggested that implementing nurse or aid champions in their QI initiatives were important facilitators of success, how the champions were selected and trained in their role is either missing or not described in any detail in the studies included in the review. Utilizing certified nursing assistants as QI champions can increase participation in QI projects and has the potential to improve job satisfaction and contribute to improve quality of care and improved patient outcomes in nursing homes. © 2017 Sigma Theta Tau International.

  20. A large-scale longitudinal study indicating the importance of perceived effectiveness, organizational and management support for innovative culture.

    Science.gov (United States)

    Cramm, Jane M; Strating, Mathilde M H; Bal, Roland; Nieboer, Anna P

    2013-04-01

    Teams participating in QI collaboratives reportedly enhance innovative culture in long-term care, but we currently lack empirical evidence of the ability of such teams to enhance (determinants of) innovative culture over time. The objectives of our study are therefore to explore innovative cultures in QI teams over time and identify its determinants. The study included QI teams participating between 2006 and 2011 in a national Dutch quality program (Care for Better), using an adapted version of the Breakthrough Method. Each QI team member received a questionnaire by mail within one week after the second (2-3 months post-implementation of the collaborative = T0) and final conference (12 months post-implementation = T1). A total of 859 (out of 1161) respondents filled in the questionnaire at T0 and 541 at T1 (47% response). A total of 307 team members filled in the questionnaire at both T0 and T1. We measured innovative culture, respondent characteristics (age, gender, education), perceived team effectiveness, organizational support, and management support. Two-tailed paired t-tests showed that innovative culture was slightly but significantly lower at T1 compared to T0 (12 months and 2-3 months after the start of the collaborative, respectively). Univariate analyses revealed that perceived effectiveness, organizational and management support were significantly related to innovative culture at T1 (all at p ≤ 0.001). Multilevel analyses showed that perceived effectiveness, organizational support, and management support predicted innovative culture. Our QI teams were not able to improve innovative culture over time, but their innovative culture scores were higher than non-participant professionals. QI interventions require organizational and management support to enhance innovative culture in long-term care settings. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Improving Tanzanian childbirth service quality.

    Science.gov (United States)

    Jaribu, Jennie; Penfold, Suzanne; Green, Cathy; Manzi, Fatuma; Schellenberg, Joanna

    2018-04-16

    Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

  2. 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.

  3. Use of a structured template to facilitate practice-based learning and improvement projects.

    Science.gov (United States)

    McClain, Elizabeth K; Babbott, Stewart F; Tsue, Terance T; Girod, Douglas A; Clements, Debora; Gilmer, Lisa; Persons, Diane; Unruh, Greg

    2012-06-01

    The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to meet and demonstrate outcomes across 6 competencies. Measuring residents' competency in practice-based learning and improvement (PBLI) is particularly challenging. We developed an educational tool to meet ACGME requirements for PBLI. The PBLI template helped programs document quality improvement (QI) projects and supported increased scholarly activity surrounding PBLI learning. We reviewed program requirements for 43 residency and fellowship programs and identified specific PBLI requirements for QI activities. We also examined ACGME Program Information Form responses on PBLI core competency questions surrounding QI projects for program sites visited in 2008-2009. Data were integrated by a multidisciplinary committee to develop a peer-protected PBLI template guiding programs through process, documentation, and evaluation of QI projects. All steps were reviewed and approved through our GME Committee structure. An electronic template, companion checklist, and evaluation form were developed using identified project characteristics to guide programs through the PBLI process and facilitate documentation and evaluation of the process. During a 24 month period, 27 programs have completed PBLI projects, and 15 have reviewed the template with their education committees, but have not initiated projects using the template. The development of the tool generated program leaders' support because the tool enhanced the ability to meet program-specific objectives. The peer-protected status of this document for confidentiality and from discovery has been beneficial for program usage. The document aggregates data on PBLI and QI initiatives, offers opportunities to increase scholarship in QI, and meets the ACGME goal of linking measures to outcomes important to meeting accreditation requirements at the program and institutional level.

  4. On equal constituent quark masses in different heavy quarkonia potential models

    International Nuclear Information System (INIS)

    Lewin, K.; Motz, G.

    1989-01-01

    In a representative number of more or less QCD-motivated QQ-bar potentials the simultaneous transformations of potentials V' j (r)=V i (r)-V i (r 0 ), m' Qi +1/2V j (r 0 ) (i -model index) introduce approximately equal constituent quark masses m' Qi ≅m Q (Q=b,c) for all considered models. The known model independence of m bi -m ci is explained and the influence of the transformation on data reproduction is studied. 16 refs.; 4 figs.; 1 tab

  5. Factors influencing the long-term sustainment of quality improvements made in addiction treatment facilities: a qualitative study

    Directory of Open Access Journals (Sweden)

    Scott P. Stumbo

    2017-11-01

    Full Text Available Abstract Background A greater understanding of the factors that influence long-term sustainment of quality improvement (QI initiatives is needed to promote organizational ability to sustain QI practices over time, help improve future interventions, and increase the value of QI investments. Methods We approached 83 of 201 executive sponsors or change leaders at addiction treatment organizations that participated in the 2007–2009 NIATx200 QI intervention. We completed semi-structured interviews with 33 individuals between November 2015 and April 2016. NIATx200 goals were to decrease wait time, increase admissions and improve retention in treatment. Interviews sought to understand factors that either facilitated or impeded long-term sustainment of organizational QI practices made during the intervention. We used thematic analysis to organize the data and group patterns of responses. We assessed available quantitative outcome data and intervention engagement data to corroborate qualitative results. Results We used narrative analysis to group four important themes related to long-term sustainment of QI practices: (1 finding alignment between business- and client-centered practices; (2 staff engagement early in QI process added legitimacy which facilitated sustainment; (3 commitment to integrating data into monitoring practices and the identification of a data champion; and (4 adequate organizational human resources devoted to sustainment. We found four corollary factors among agencies which did not sustain practices: (1 lack of evidence of impact on business practices led to discontinuation; (2 disengaged staff and lack of organizational capacity during implementation period led to lack of sustainment; (3 no data integration into overall business practices and no identified data champion; and (4 high staff turnover. In addition, we found that many agencies’ current use of NIATx methods and tools suggested a legacy effect that might improve

  6. Beyond coverage: improving the quality of antenatal care delivery through integrated mentorship and quality improvement at health centers in rural Rwanda.

    Science.gov (United States)

    Manzi, Anatole; Nyirazinyoye, Laetitia; Ntaganira, Joseph; Magge, Hema; Bigirimana, Evariste; Mukanzabikeshimana, Leoncie; Hirschhorn, Lisa R; Hedt-Gauthier, Bethany

    2018-02-23

    Inadequate antenatal care (ANC) can lead to missed diagnosis of danger signs or delayed referral to emergency obstetrical care, contributing to maternal mortality. In developing countries, ANC quality is often limited by skill and knowledge gaps of the health workforce. In 2011, the Mentorship, Enhanced Supervision for Healthcare and Quality Improvement (MESH-QI) program was implemented to strengthen providers' ANC performance at 21 rural health centers in Rwanda. We evaluated the effect of MESH-QI on the completeness of danger sign assessments. Completeness of danger sign assessments was measured by expert nurse mentors using standardized observation checklists. Checklists completed from October 2010 to May 2011 (n = 330) were used as baseline measurement and checklists completed between February and November 2012 (12-15 months after the start of MESH-QI implementation) were used for follow-up. We used a mixed-effects linear regression model to assess the effect of the MESH-QI intervention on the danger sign assessment score, controlling for potential confounders and the clustering of effect at the health center level. Complete assessment of all danger signs improved from 2.1% at baseline to 84.2% after MESH-QI (p ANC screening items. After controlling for potential confounders, the improvement in danger sign assessment score was significant. However, the effect of the MESH-QI was different by intervention district and type of observed ANC visit. In Southern Kayonza District, the increase in the danger sign assessment score was 6.28 (95% CI: 5.59, 6.98) for non-first ANC visits and 5.39 (95% CI: 4.62, 6.15) for first ANC visits. In Kirehe District, the increase in danger sign assessment score was 4.20 (95% CI: 3.59, 4.80) for non-first ANC visits and 3.30 (95% CI: 2.80, 3.81) for first ANC visits. Assessment of critical danger signs improved under MESH-QI, even when controlling for nurse-mentees' education level and previous training in focused ANC. MESH-QI

  7. Using Statistical Process Control to Drive Improvement in Neonatal Care: A Practical Introduction to Control Charts.

    Science.gov (United States)

    Gupta, Munish; Kaplan, Heather C

    2017-09-01

    Quality improvement (QI) is based on measuring performance over time, and variation in data measured over time must be understood to guide change and make optimal improvements. Common cause variation is natural variation owing to factors inherent to any process; special cause variation is unnatural variation owing to external factors. Statistical process control methods, and particularly control charts, are robust tools for understanding data over time and identifying common and special cause variation. This review provides a practical introduction to the use of control charts in health care QI, with a focus on neonatology. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Postherpetic Neuralgia: Practical Experiences Return to Traditional Chinese Medicine

    Directory of Open Access Journals (Sweden)

    Majid Avijgan

    2017-06-01

    In traditional medicine (TM, PHN is mostly due to incomplete heat and damp clearing in liver and spleen meridians, qi and toxic pathogens stagnation, accumulation of yin (blood stagnation in microcapillary, internal fire, and heat and obstruction of meridians. Acupuncture works based on the eradication of wind, clearing of heat, and destroying of damp by regulating qi and blood movement. In clinics, several methods of TM are used to relief PHN, such as simultaneous needling, surrounding needling, acupuncture, electro acupuncture, moxibustion, wet cupping or hijamat, and herbal medicine. In this review, we discussed all these methods and their role in reducing PHN and pain.

  9. Factors influencing the long-term sustainment of quality improvements made in addiction treatment facilities: a qualitative study.

    Science.gov (United States)

    Stumbo, Scott P; Ford, James H; Green, Carla A

    2017-11-01

    A greater understanding of the factors that influence long-term sustainment of quality improvement (QI) initiatives is needed to promote organizational ability to sustain QI practices over time, help improve future interventions, and increase the value of QI investments. We approached 83 of 201 executive sponsors or change leaders at addiction treatment organizations that participated in the 2007-2009 NIATx200 QI intervention. We completed semi-structured interviews with 33 individuals between November 2015 and April 2016. NIATx200 goals were to decrease wait time, increase admissions and improve retention in treatment. Interviews sought to understand factors that either facilitated or impeded long-term sustainment of organizational QI practices made during the intervention. We used thematic analysis to organize the data and group patterns of responses. We assessed available quantitative outcome data and intervention engagement data to corroborate qualitative results. We used narrative analysis to group four important themes related to long-term sustainment of QI practices: (1) finding alignment between business- and client-centered practices; (2) staff engagement early in QI process added legitimacy which facilitated sustainment; (3) commitment to integrating data into monitoring practices and the identification of a data champion; and (4) adequate organizational human resources devoted to sustainment. We found four corollary factors among agencies which did not sustain practices: (1) lack of evidence of impact on business practices led to discontinuation; (2) disengaged staff and lack of organizational capacity during implementation period led to lack of sustainment; (3) no data integration into overall business practices and no identified data champion; and (4) high staff turnover. In addition, we found that many agencies' current use of NIATx methods and tools suggested a legacy effect that might improve quality elsewhere, even absent overall sustainment of

  10. Shugan Jieyu Yin for Treatment of Senile Depression--A Clinical Report of 84 Cases

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ TCM holds that depression is, in most cases,resulted from injuries of the seven emotions and/or from stagnation of qi. The principle of treatment should be mainly to relieve the depressed liver and to regulate the flow of qi, supplemented by nourishing the blood and the liver, eliminating heat and irritability, promoting blood circulation by removing blood stasis, tranquilizing the mind, and dredging the collaterals to stop pain. Since 1995, we have treated 84 cases of senile depression with the prescription of Shugan Jieyu Yin (舒肝解郁饮Decoction for Relieving the Depressed Liver), and obtained satisfactory therapeutic results. A report follows.

  11. Evaluating the effectiveness of a tailored multifaceted performance feedback intervention to improve the quality of care: protocol for a cluster randomized trial in intensive care

    Directory of Open Access Journals (Sweden)

    Westert Gert P

    2011-10-01

    Full Text Available Abstract Background Feedback is potentially effective in improving the quality of care. However, merely sending reports is no guarantee that performance data are used as input for systematic quality improvement (QI. Therefore, we developed a multifaceted intervention tailored to prospectively analyzed barriers to using indicators: the Information Feedback on Quality Indicators (InFoQI program. This program aims to promote the use of performance indicator data as input for local systematic QI. We will conduct a study to assess the impact of the InFoQI program on patient outcome and organizational process measures of care, and to gain insight into barriers and success factors that affected the program's impact. The study will be executed in the context of intensive care. This paper presents the study's protocol. Methods/design We will conduct a cluster randomized controlled trial with intensive care units (ICUs in the Netherlands. We will include ICUs that submit indicator data to the Dutch National Intensive Care Evaluation (NICE quality registry and that agree to allocate at least one intensivist and one ICU nurse for implementation of the intervention. Eligible ICUs (clusters will be randomized to receive basic NICE registry feedback (control arm or to participate in the InFoQI program (intervention arm. The InFoQI program consists of comprehensive feedback, establishing a local, multidisciplinary QI team, and educational outreach visits. The primary outcome measures will be length of ICU stay and the proportion of shifts with a bed occupancy rate above 80%. We will also conduct a process evaluation involving ICUs in the intervention arm to investigate their actual exposure to and experiences with the InFoQI program. Discussion The results of this study will inform those involved in providing ICU care on the feasibility of a tailored multifaceted performance feedback intervention and its ability to accelerate systematic and local quality

  12. Chlorine isotopic geochemistry of salt lakes in the Qaidam Basin, China

    Digital Repository Service at National Institute of Oceanography (India)

    Liu, W.G.; Xiao, Y.K.; Wang, Q.Z.; Qi, H.P.; Wang, Y.H.; Zhou, Y.M.; Shirodkar, P.V.

    *Cl+ ion. Int. J. Mass Spectrom. Ion Process., 116: crysatallization of saline minerals in salt lake. J. Salt Lake 183-192. Sci., 2: 35-40 (in Chinese). Xiao, Y.K., Sun, D.P., Wang, Y.H., Qi, H.P. and Jin, L., 1992. Boron isotopic compositions of brine..., sediments, and source water in Da Qaidam Lake, Qinghai, China. Geochim. Cos- mochim. Acta, 56: 1.561-1568. Xiao, Y.K., Jin, L., Liu. W.G., Qi, H.P., Wang, W.H. and Sun, D.P., 1994a. The isotopic compositions of chlorine in Da Qaidam Lake. Chin. Sci...

  13. Average Likelihood Methods of Classification of Code Division Multiple Access (CDMA)

    Science.gov (United States)

    2016-05-01

    subject to code matrices that follows the structure given by (113). [⃗ yR y⃗I ] = √ Es 2L [ GR1 −GI1 GI2 GR2 ] [ QR −QI QI QR ] [⃗ bR b⃗I ] + [⃗ nR n⃗I... QR ] [⃗ b+ b⃗− ] + [⃗ n+ n⃗− ] (115) The average likelihood for type 4 CDMA (116) is a special case of type 1 CDMA with twice the code length and...AVERAGE LIKELIHOOD METHODS OF CLASSIFICATION OF CODE DIVISION MULTIPLE ACCESS (CDMA) MAY 2016 FINAL TECHNICAL REPORT APPROVED FOR PUBLIC RELEASE

  14. QING YING LIU

    Indian Academy of Sciences (India)

    Home; Journals; Bulletin of Materials Science. QING YING LIU. Articles written in Bulletin of Materials Science. Volume 40 Issue 7 December 2017 pp 1329-1333. Synthesis and enhanced photocatalytic activity of g-C 3 N 4 hybridized CdS nanoparticles · QING YING LIU YI LING QI YI FAN ZHENG XU CHUN SONG.

  15. Evaluation of effectiveness in a novel wound healing ointment ...

    African Journals Online (AJOL)

    Evaluation of effectiveness in a novel wound healing ointment-crocodile oil burn ointment. Hua-Liang Li, Yi-Tao Deng, Zi-Ran Zhang, Qi-Rui Fu, Ya-Hui Zheng, Xing-Mei Cao, Jing Nie, Li-Wen Fu, Li-Ping Chen, You-Xiong Xiong, Dong-Yan Shen, Qing-Xi Chen ...

  16. Selected Terms in Traditional Chinese Medicine and Their Interpretations (XV)

    Institute of Scientific and Technical Information of China (English)

    谢竹藩

    2001-01-01

    @@Febrifugation (清热) (清热) [qing re] or Heat-Clearing Method (清法) [qing fa] One of the principal therapeutic methods by administering medicines cool or cold in nature to treat interior heat. Clearing heat and removing toxin (清热解毒)(清热解毒) [qing re jie du]: a therapeutic method for acute infectious diseases and pyogenic inflammations caused by toxic heat. Clearing Qi heat (清气分热) (清气分热) [qing qi fen re]: a therapeutic method of treating acute febrile disease at the Qi stage, also abbreviated as "clearing the Qi" (清气) (清气) [qing qi]. Clearing Ying heat (清营分热) (清营分热) [qing ying fen re]: a therapeutic method of treating acute febrile disease at the Ying stage, also abbreviated as "clearing the Ying" (清营) (清营) [qing ying]. Clearing Heart fire (清心火) [qing xin huo]: a method to treat exuberant Heart fire, also known as "clearing the Heart" (清心) [qing xin]. Clearing Lung heat (清肺热) (清肺热) [qing fei re]: a method to treat excessive heat in the Lung, also known as "clearing the Lung" (清肺) [qing fei].

  17. Author Details

    African Journals Online (AJOL)

    Qi, Qing. Vol 29, No 2 (2017) - Articles Psychological health among Chinese college students: a rural/urban comparison. Abstract. ISSN: 1728-0583. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use ...

  18. Into Space

    Institute of Scientific and Technical Information of China (English)

    YIN PUMIN

    2010-01-01

    @@ China plans to launch an unmanned space module,Tiangong 1,in 2011,said Qi Faren,the chief designer of China's Shenzhou spacecraft,at the sidelines of the annual plenary session of the National Committee of the Chinese People's Political Consultative Conference(CPPCC),the country's top political advisory body,on March 3.

  19. Digitální model reliéfu jako podklad pro návrh vodohospodářských opatření v pozemkových úpravách

    Czech Academy of Sciences Publication Activity Database

    Mayer, Z.; Zemek, František

    2015-01-01

    Roč. 2015, č. 3 (2015), s. 5-10 ISSN 1211-0760 R&D Projects: GA MZe QI111C034 Institutional support: RVO:67179843 Keywords : digital terrain model * GIS * airborne laser scanning * LiDAR * landscaping projects Subject RIV: DJ - Water Pollution ; Quality

  20. Creation and Implementation of an Environmental Scan to Assess Cancer Genetics Services at Three Oncology Care Settings.

    Science.gov (United States)

    Bednar, Erica M; Walsh, Michael T; Baker, Ellen; Muse, Kimberly I; Oakley, Holly D; Krukenberg, Rebekah C; Dresbold, Cara S; Jenkinson, Sandra B; Eppolito, Amanda L; Teed, Kelly B; Klein, Molly H; Morman, Nichole A; Bowdish, Elizabeth C; Russ, Pauline; Wise, Emaline E; Cooper, Julia N; Method, Michael W; Henson, John W; Grainger, Andrew V; Arun, Banu K; Lu, Karen H

    2018-05-16

    An environmental scan (ES) is an efficient mixed-methods approach to collect and interpret relevant data for strategic planning and project design. To date, the ES has not been used nor evaluated in the clinical cancer genetics setting. We created and implemented an ES to inform the design of a quality improvement (QI) project to increase the rates of adherence to national guidelines for cancer genetic counseling and genetic testing at three unique oncology care settings (OCS). The ES collected qualitative and quantitative data from reviews of internal processes, past QI efforts, the literature, and each OCS. The ES used a data collection form and semi-structured interviews to aid in data collection. The ES was completed within 6 months, and sufficient data were captured to identify opportunities and threats to the QI project's success, as well as potential barriers to, and facilitators of guideline-based cancer genetics services at each OCS. Previously unreported barriers were identified, including inefficient genetic counseling appointment scheduling processes and the inability to track referrals, genetics appointments, and genetic test results within electronic medical record systems. The ES was a valuable process for QI project planning at three OCS and may be used to evaluate genetics services in other settings.

  1. TACOM LCMC IB and DMSMS Mitigation

    Science.gov (United States)

    2011-09-26

    Sources I Gosed II Opened ~ I AAC flag: Vii6d AI CAGE codes (CONUS): 3 3 CAGE codes (OCONUS): 0 0 ---- Total: 3 3 Single or no CAGE code...v In box - I’lL- I Qi) chambers:... I ~ Microsoft - I I~ AADO SER.- t@) ~ i_ .... gose I I Used On Reference/Part Numbers I~ 26SEP11

  2. Quantile index for gradual and abrupt change detection from CFB boiler sensor data in online settings

    NARCIS (Netherlands)

    Maslov, A.; Pechenizkiy, M.; Kärkkäinen, T.; Tähtinen, M.

    2012-01-01

    In this paper we consider the problem of online detection of gradual and abrupt changes in sensor data having high levels of noise and outliers. We propose a simple heuristic method based on the Quantile Index (QI) and study how robust this method is for detecting both gradual and abrupt changes

  3. Impact of a Metabolic Screening Bundle on Rates of Screening for Metabolic Syndrome in a Psychiatry Resident Outpatient Clinic

    Science.gov (United States)

    Wiechers, Ilse R.; Viron, Mark; Stoklosa, Joseph; Freudenreich, Oliver; Henderson, David C.; Weiss, Anthony

    2012-01-01

    Objective: Although it is widely acknowledged that second-generation antipsychotics are associated with cardiometabolic side effects, rates of metabolic screening have remained low. The authors created a quality-improvement (QI) intervention in an academic medical center outpatient psychiatry resident clinic with the aim of improving rates of…

  4. Investigation of cerebral cortical functional areas of the acupoints in zusanli and xiajuxu by fMRI

    International Nuclear Information System (INIS)

    Gong Honghan; Xiao Xiangzuo; Qiu Chunmei; Wang Liya; Ji Yuqiang; Wang Min; Wang Minjun; Wang Jinghua; Zeng Xianjun; Wang Yongzheng

    2003-01-01

    Objective: To study the functional areas of Zusanli (ST36) and Xiajuxu (ST39) in the cerebral cortex with fMRI and acupuncture stimulation. Material and Methods: 64 healthy Volunteers were divided into two groups. Acupuncture stimulation was induced to both of them by manipulating acupuncture needle at the acupuncture point at right ST36 and then ST39 respectively. FMRI was performed in the experimental group during state of the reaction to the acupuncture ('De-Qi') and in the control group during state of no reaction. Functional responses were investigated by students group t-test analysis. Results: Chi-square test showed that there was no significant difference (P>0.05) in ROI in state of 'De-Qi' and in state of no reaction. In state of 'De-Qi', acupuncture mainly resulted in activating bilateral cingulate cortex, insula, upper wall of lateral sulcus and bilateral postcentral gyrus. However, in state of no reaction, acupuncture mainly resulted in activating left postcentral gyrus. Significant difference of between ROI in state of 'De-Qi' and no reaction (P<0.01) at each acupoint was shown. Conclusion: Treatment of gastroenteric disease by acupuncturing ST36 and ST39 has its scientific basis. There are close relations between the central neural system (CNS) and the acupoints. It may be that the acupuncture stimulates the corresponding functional areas in cerebral cortex via the CNS at first, thereby treating disorders of organs

  5. Storage compounds, ABA and fumarase in Fagus sylvatica embryos during stratification

    Czech Academy of Sciences Publication Activity Database

    Eliášová, Kateřina; Pešek, Bedřich; Vondráková, Zuzana

    2015-01-01

    Roč. 74, 10 March (2015), s. 25-33 ISSN 1641-1307 R&D Projects: GA MZe QI102A256 Institutional support: RVO:61389030 Keywords : Embryonic axis * Fagus sylvatica * Seed dormancy Subject RIV: EF - Botanics Impact factor: 0.643, year: 2015

  6. Proceedings – Mathematical Sciences | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    -Convex Functions · Feng Qi Bo-Yan Xi ... Stability of a Simple Levi–Civitá Functional Equation on Non-Unital Commutative Semigroups · Jaeyoung Chung Heather Hunt .... On Quadratic Variation of Martingales · Rajeeva L Karandikar B V Rao.

  7. Browse Title Index

    African Journals Online (AJOL)

    Items 351 - 400 of 1250 ... Vol 9, No 4 (2012), Aromatherapy as an Adjuvant Treatment in Cancer Care – A Descriptive Systematic Review, Abstract PDF. K Boehm, A Büssing, T Ostermann. Vol 10, No 3 (2013), Arteriovenous fistula failure due to two straight shunts formation at draining vein, Abstract PDF. Y Tong, W Qi, M Sun.

  8. Metallo–organic compound-based plasma enhanced CVD of ZrO2 ...

    Indian Academy of Sciences (India)

    Unknown

    require a passivation barrier (oxynitride or nitride) to prevent interfacial layer growth (Ngai et al 2000). Zirconium dioxide (ZrO2) is one of the few high-k dielectrics predicted to be thermodynamically stable in contact with silicon (Qi et al 1999). ZrO2 was also characterized for low electrical conductivity and chemical inertness ...

  9. Adjusting Quality index Log Values to Represent Local and Regional Commercial Sawlog Product Values

    Science.gov (United States)

    Orris D. McCauley; Joseph J. Mendel; Joseph J. Mendel

    1969-01-01

    The primary purpose of this paper is not only to report the results of a comparative analysis as to how well the Q.I. method predicts log product values when compared to commercial sawmill log output values, but also to develop a methodology which will facilitate the comparison and provide the adjustments needed by the sawmill operator.

  10. Britain at CERN, from 12 to 14 November 2002: le stand de PPARC

    CERN Multimedia

    Patrice Loïez

    2002-01-01

    Photo 01: Nathan Hill (from Qi3, the company appointed as UK Technology Transfer Co-ordinator for CERN), Basil Eastwood (UK Ambassador to Switzerland), Nigel Griffiths (UK Parliamentary Under-Secretary of State for Small Business) and Luciano Maiani (CERN Director-General) at the PPARC stand.

  11. Development and Implementation of a Quality Improvement Process for Echocardiographic Laboratory Accreditation.

    Science.gov (United States)

    Gilliland, Yvonne E; Lavie, Carl J; Ahmad, Homaa; Bernal, Jose A; Cash, Michael E; Dinshaw, Homeyar; Milani, Richard V; Shah, Sangeeta; Bienvenu, Lisa; White, Christopher J

    2016-03-01

    We describe our process for quality improvement (QI) for a 3-year accreditation cycle in echocardiography by the Intersocietal Accreditation Commission (IAC) for a large group practice. Echocardiographic laboratory accreditation by the IAC was introduced in 1996, which is not required but could impact reimbursement. To ensure high-quality patient care and community recognition as a facility committed to providing high-quality echocardiographic services, we applied for IAC accreditation in 2010. Currently, there is little published data regarding the IAC process to meet echocardiography standards. We describe our approach for developing a multicampus QI process for echocardiographic laboratory accreditation during the 3-year cycle of accreditation by the IAC. We developed a quarterly review assessing (1) the variability of the interpretations, (2) the quality of the examinations, (3) a correlation of echocardiographic studies with other imaging modalities, (4) the timely completion of reports, (5) procedure volume, (6) maintenance of Continuing Medical Education credits by faculty, and (7) meeting Appropriate Use Criteria. We developed and implemented a multicampus process for QI during the 3-year accreditation cycle by the IAC for Echocardiography. We documented both the process and the achievement of those metrics by the Echocardiography Laboratories at the Ochsner Medical Institutions. We found the QI process using IAC standards to be a continuous educational experience for our Echocardiography Laboratory physicians and staff. We offer our process as an example and guide for other echocardiography laboratories who wish to apply for such accreditation or reaccreditation. © 2016, Wiley Periodicals, Inc.

  12. State landscape in public health planning and quality improvement: results of the ASTHO survey.

    Science.gov (United States)

    Madamala, Kusuma; Sellers, Katie; Pearsol, Jim; Dickey, Michael; Jarris, Paul E

    2010-01-01

    Limited data exist on state public health agencies and their use of planning and quality improvement (QI) initiatives. Using the 2007 Association of State and Territorial Health Officials (ASTHO) State Public Health Survey, this article describes how state public health agencies perform tasks related to planning, performance management (PM), and QI. While 82 percent of respondents report having a QI process in place, only 9.8 percent have it fully implemented departmentwide. Seventy-six percent reported having a PM process in place, with 16 percent (n = 8) having it fully implemented departmentwide. A state health improvement plan was used by 80.4 percent of respondents, with 56.9 percent of respondents completing the plan more than 3 years ago. More than two-thirds (68.2%) of the respondents developed the plan by using results of their state health assessment. Analysis of state health department level planning, PM, and QI initiatives can inform states' efforts to ready themselves to meet the proposed national voluntary accreditation standards of the Public Health Accreditation Board.

  13. (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…

  14. 78 FR 5810 - AHRQ Standing Workgroup for Quality Indicator Measure Specification

    Science.gov (United States)

    2013-01-28

    ... collaboratively publish peer-reviewed journal articles or reports based on workgroup activities. However, this is..., quality alliances, medical or specialty societies, measure developers, accrediting organizations, and... topics include: (1) Strategic areas for AHRQ QI program development for the upcoming year, (2) measure...

  15. Li and Zhang., Afr J Tradit Complement Altern Med. (2016) 13(3):75 ...

    African Journals Online (AJOL)

    imbalance of Yin and Yang is the fundamental element leading to diseases. Qi is defined as the most ... All of the dryness symptoms are attributed to insufficiency of body fluid. Lack of tears .... Medsurg nursing : official journal of the Academy of.

  16. Effect of the relative time of emergence on the growth allometry of Galium aparine in competition with Triticum aestivum

    Czech Academy of Sciences Publication Activity Database

    Klem, Karel; Rajsnerová, Petra; Novotná, Kateřina; Urban, Otmar; Marek, Michal V.

    2014-01-01

    Roč. 14, č. 4 (2014), s. 262-270 ISSN 1444-6162 R&D Projects: GA MZe QI111A133; GA TA ČR TA02010780 Institutional support: RVO:67179843 Keywords : cleaver * competition * growth allometry * relative time of emergence * wheat Subject RIV: GC - Agronomy Impact factor: 0.537, year: 2014

  17. Findings of VA/DoD CPG on CAM Therapies for PTSD

    Science.gov (United States)

    2011-01-26

    no intervention? • Body-mind • Meditation (e.g., zen) • Herbal, food supplements • Energy (e.g., Reiki ) • Tai Chi • Acupuncture 2011 MHS Conference...Qi Gung, Reiki , Johrei) • Improvement in comorbid conditions, BUT not RCTs in PTSD – Acupuncture 2011 MHS Conference Complementary and Alternative

  18. miR-200a-3p promotes β-Amyloid-induced neuronal apoptosis ...

    Indian Academy of Sciences (India)

    Qi-Shun Zhang

    2017-07-20

    Jul 20, 2017 ... through down-regulation of SIRT1 in Alzheimer's disease. QI-SHUN ... purpose of this study was to examine whether miR-200a-3p regulated ... miR-29b-1 can modulate b-site amyloid precursor protein- ... multiple important cellular processes, including cell meta- .... Institutes of Health, Bethesda, MD, USA).

  19. Changes in vertical distribution of spectral reflectance within Spring barley canopy as an indicator of nitrogen nutrition, canopy structure and yield parametrs

    Czech Academy of Sciences Publication Activity Database

    Klem, Karel; Rajsnerová, Petra; Novotná, Kateřina; Míša, P.; Křen, J.

    2014-01-01

    Roč. 60, č. 2 (2014), s. 50-59 ISSN 0551-3677 R&D Projects: GA MZe QI111A133; GA TA ČR TA02010780 Institutional support: RVO:67179843 Keywords : Hordeum vulgare * spectral reflectance * vertical gradient * vegetation indices * nitrogen * grain yield * protein content Subject RIV: GC - Agronomy

  20. Successful management of a set of preterm, low birth weight ...

    African Journals Online (AJOL)

    Case report: We report a case of successful management of preterm, low birth weight quadruplets (QI, QII, QIII, and QIV) delivered at 32 weeks by Caesarean section to a 30 year old primiparous mother. QIII and QIV developed septicaemia with conjugated bilirubinaemia and were managed with intravenous antibiotics, and ...

  1. Anti-hepatitis B viral activity of Phyllanthus niruri L (Phyllanthaceae ...

    African Journals Online (AJOL)

    Yong Li, Xin Li, Jia-Kun Wang, Yan Kuang and Ming-Xiu Qi*. Centers for Disease .... sarkosyl, 7 % 2-mercaptoethanol, 4 M guanidine ..... AK, Gane E, Hou JL, Jafri W, Jia J, Kim JH, Lai CL, Lee. HC, Lim SG, Liu CJ ... Shin MS, Kang EH, Lee YI.

  2. Cyclic guanosine monophosphate does not inhibit gonadotropin-induced activation of mitogen-activated protein kinase 3/1 in pig cumulus-oocyte complexes

    Czech Academy of Sciences Publication Activity Database

    Blaha, Milan; Němcová, Lucie; Procházka, Radek

    2015-01-01

    Roč. 13, č. 1 (2015) ISSN 1477-7827 R&D Projects: GA ČR GAP502/11/0593; GA MZe QI101A166 Institutional support: RVO:67985904 Keywords : pig * oocyte * cGMP Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 2.147, year: 2015

  3. The Mechanism Research of Qishen Yiqi Formula by Module-Network Analysis

    Directory of Open Access Journals (Sweden)

    Shichao Zheng

    2015-01-01

    Full Text Available Qishen Yiqi formula (QSYQ has the effect of tonifying Qi and promoting blood circulation, which is widely used to treat the cardiovascular diseases with Qi deficiency and blood stasis syndrome. However, the mechanism of QSYQ to tonify Qi and promote blood circulation is rarely reported at molecular or systems level. This study aimed to elucidate the mechanism of QSYQ based on the protein interaction network (PIN analysis. The targets’ information of the active components was obtained from ChEMBL and STITCH databases and was further used to search against protein-protein interactions by String database. Next, the PINs of QSYQ were constructed by Cytoscape and were analyzed by gene ontology enrichment analysis based on Markov Cluster algorithm. Finally, based on the topological parameters, the properties of scale-free, small world, and modularity of the QSYQ’s PINs were analyzed. And based on function modules, the mechanism of QSYQ was elucidated. The results indicated that Qi-tonifying efficacy of QSYQ may be partly attributed to the regulation of amino acid metabolism, carbohydrate metabolism, lipid metabolism, and cAMP metabolism, while QSYQ improves the blood stasis through the regulation of blood coagulation and cardiac muscle contraction. Meanwhile, the “synergy” of formula compatibility was also illuminated.

  4. Annual Training: Leader’s Safety Guide

    Science.gov (United States)

    1991-10-01

    QiSTsreUTFOH STATEMENT X; DISTIUaimON AUTHORIZED TOL’S GOVSRNMES’T ÄGSNCES »ND ’(WATE INDIVIDUALS OR ENTERPRISES E.UÖ3SLE TO OBTAIN ESPORT ...Statistics show that— • In World War II, one out of every five American soldiers killed died as a result of an accident. • In Korea , more than half

  5. Antinociceptive and anti-inflammatory properties of methanol fruit ...

    African Journals Online (AJOL)

    Purpose: To investigate the anti-inflammatory and antinociceptive properties of crude methanol fruit extract of Quercus incana (QI), as well as its acute toxicity and phytochemical profile. Methods: Two animal models were used: Wistar rats for carrageenan-induced paw inflammation and Swiss albino mice for acetic ...

  6. Curling Edges: A Problem that Has Plagued Scrolls for Millennia

    Science.gov (United States)

    Chou, Ming-Han; Shen, Wei-Chao; Wang, Yi-Ping; Hung, Sun-Hsin; Hong, Tzay-Ming

    2014-01-01

    Qi-Wa refers to the up curl on the lengths of hand scrolls and hanging scrolls, which has troubled Chinese artisans and emperors for as long as the art of painting and calligraphy has existed. This warp is unwelcome not only for aesthetic reasons, but its potential damage to the fiber and ink. Although it is generally treated as a part of the cockling and curling due to moisture, consistency of paste, and defects from the mounting procedures, we demonstrate that the spontaneous extrinsic curvature incurred from the storage is in fact more essential to understanding and curing Qi-Wa. In contrast to the former factors whose effects are less predictable, the plastic deformation and strain distribution on a membrane are a well-defined mechanical problem. We study this phenomenon by experiments, theoretical models, and molecular dynamics simulation, and obtain consistent scaling relations for the Qi-Wa height. This knowledge enables us to propose modifications on the traditional mounting techniques that are tested on real mounted paper to be effective at mitigating Qi-Wa. By experimenting on polymer-based films, we demonstrate the possible relevance of our study to the modern development of flexible electronic paper.

  7. Edge curling that has plagued scrolls for millenniums

    Science.gov (United States)

    Chou, Ming-Han; Shen, Wei-Chao; Wang, Yi-Ping; Hung, Sun-Hsin; Hong, Tzay-Ming; Department of Registration and Conservation, National Palace Museum Collaboration; Department of Physics, National Tsing Hua University Team

    2014-03-01

    Qi-Wa refers to the up curl on the lengths of handscrolls and hanging scrolls, which has troubled Chinese artisans and emperors for as long as the art of painting and calligraphy exists. This warp is unwelcome not only for aesthetic reasons, but its potential damage to the fiber and ink. Although it is generally treated as a part of the cockling and curling due to moisture, consistency of paste, and defects from the mounting procedures, we demonstrate that the spontaneous extrinsic curvature incurred from the storage is in fact more essential to understanding and curing Qi-Wa. In contrast to the former factors whose effects are less predictable, the plastic deformation and strain distribution on a membrane are a well-defined mechanical problem. We study this phenomenon by experiments, theoretical models, and Molecular Dynamics Simulation, and obtain consistent scaling relations for the Qi-Wa height. This knowledge enables us to propose modifications on the traditional mounting techniques, that are tested on real mounted paper to be effective at mitigating Qi-Wa. By experimenting on polymer-based films, we demonstrate possible relevance of our study to the modern development of flexible electronic paper.

  8. A Qualitative Evaluation of Web-Based Cancer Care Quality Improvement Toolkit Use in the Veterans Health Administration.

    Science.gov (United States)

    Bowman, Candice; Luck, Jeff; Gale, Randall C; Smith, Nina; York, Laura S; Asch, Steven

    2015-01-01

    Disease severity, complexity, and patient burden highlight cancer care as a target for quality improvement (QI) interventions. The Veterans Health Administration (VHA) implemented a series of disease-specific online cancer care QI toolkits. To describe characteristics of the toolkits, target users, and VHA cancer care facilities that influenced toolkit access and use and assess whether such resources were beneficial for users. Deductive content analysis of detailed notes from 94 telephone interviews with individuals from 48 VHA facilities. We evaluated toolkit access and use across cancer types, participation in learning collaboratives, and affiliation with VHA cancer care facilities. The presence of champions was identified as a strong facilitator of toolkit use, and learning collaboratives were important for spreading information about toolkit availability. Identified barriers included lack of personnel and financial resources and complicated approval processes to support tool use. Online cancer care toolkits are well received across cancer specialties and provider types. Clinicians, administrators, and QI staff may benefit from the availability of toolkits as they become more reliant on rapid access to strategies that support comprehensive delivery of evidence-based care. Toolkits should be considered as a complement to other QI approaches.

  9. Zebrafish Functional Genetics Approach to the Pathogenesis of Well-Differentiated Liposarcoma

    Science.gov (United States)

    2015-12-01

    Roderick JE, LaBelle JL, Bird G, Mathieu R, Bodaar K, Colon D, Pyati U, Stevenson KE, Qi J, Harris M, Silverman LB, Sallan SE, Bradner JL, Neuberg DS...pathogenesis of high-risk T-cell acute lymphoblastic leukemia. Our approach combines human cancer genomics with functional genetics, biochemistry and

  10. Quadrupole interactions of Au in Be and lattice location studies

    International Nuclear Information System (INIS)

    Perscheid, B.; Gayer, H.W.; Krien, K.; Freitag, K.

    1978-01-01

    The Moessbauer nucleus 197 Au is used as probe for quadrupole interaction (QI) studies in Be metal. The 77 keV Moessbauer level is populated by the β - decay of 197 Pt and the EC decay of 197 Hg. This fact enabled samples prepared in different ways to be studied. (Auth.)

  11. Evidence Based Practice: Valuable and Successful Examples from ...

    African Journals Online (AJOL)

    While research is needed and necessary, promoting the value of evidence-based practice (EBP), quality improvement (QI) and project evaluation (PE) initiatives could rapidly and economically further the development of nursing and midwifery disciplines globally, perhaps especially in resource constrained settings.

  12. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... Mohs AUC MyDermPath+ Psoriasis Patient education resources Practice Management Center Coding and reimbursement Coding MACRA Fee schedule ...

  13. Bug bites and stings: When to see a dermatologist

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... Mohs AUC MyDermPath+ Psoriasis Patient education resources Practice Management Center Coding and reimbursement Coding MACRA Fee schedule ...

  14. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... Mohs AUC MyDermPath+ Psoriasis Patient education resources Practice Management Center Coding and reimbursement Coding MACRA Fee schedule ...

  15. Shape, size and temperature dependency of thermal expansion ...

    Indian Academy of Sciences (India)

    M GOYAL

    2018-05-19

    May 19, 2018 ... Oriental J. Chem.32(4), 2193 (2016), is extended in the present study using Qi and Wang model [Mater. Chem. Phys. ... Nanomaterials; shape factor; size effect; thermal expansion; equation of state. ... als are different from that of their bulk material. ..... and 1c along with the present calculated results. It is.

  16. A nationwide quality improvement project to accelerate Ghana's progress toward Millennium Development Goal Four: design and implementation progress.

    Science.gov (United States)

    Twum-Danso, Nana A Y; Akanlu, George B; Osafo, Enoch; Sodzi-Tettey, Sodzi; Boadu, Richard O; Atinbire, Solomon; Adondiwo, Ane; Amenga-Etego, Isaac; Ashagbley, Francis; Boadu, Eric A; Dasoberi, Ireneous; Kanyoke, Ernest; Yabang, Elma; Essegbey, Ivan T; Adjei, George A; Buckle, Gilbert B; Awoonor-Williams, J Koku; Nang-Beifubah, Alexis; Twumasi, Akwasi; McCannon, C Joseph; Barker, Pierre M

    2012-12-01

    The gap between evidence-based guidelines and practice of care is reflected, in low- and middle-income countries, by high rates of maternal and child mortality and limited effectiveness of large-scale programing to decrease those rates. We designed a phased, rapid, national scale-up quality improvement (QI) intervention to accelerate the achievement of Millennium Development Goal Four in Ghana. Our intervention promoted systems thinking, active participation of managers and frontline providers, generation and testing of local change ideas using iterative learning from transparent district and local data, local ownership and sustainability. After 50 months of implementation, we have completed two prototype learning phases and have begun regional spread phases to all health facilities in all 38 districts of the three northernmost regions and all 29 Catholic hospitals in the remaining regions of the country. To accelerate the spread of improvement, we developed 'change packages' of rigorously tested process changes along the continuum of care from pregnancy to age 5 in both inpatient and outpatient settings. The primary successes for the project so far include broad and deep adoption of QI by local stakeholders for improving system performance, widespread capacitation of leaders, managers and frontline providers in QI methods, incorporation of local ideas into change packages and successful scale-up to approximately 25% of the country's districts in 3 years. Implementation challenges include variable leadership uptake and commitment at the district level, delays due to recruiting and scheduling barriers, weak data systems and repeated QI training due to high staff turnover.

  17. Integral Representations of the Catalan Numbers and Their Applications

    Directory of Open Access Journals (Sweden)

    Feng Qi

    2017-08-01

    Full Text Available In the paper, the authors survey integral representations of the Catalan numbers and the Catalan–Qi function, discuss equivalent relations between these integral representations, supply alternative and new proofs of several integral representations, collect applications of some integral representations, and present sums of several power series whose coefficients involve the Catalan numbers.

  18. Gaps in Addressing Cardiovascular Risk in Rheumatoid Arthritis: Assessing Performance Using Cardiovascular Quality Indicators.

    Science.gov (United States)

    Barber, Claire E H; Esdaile, John M; Martin, Liam O; Faris, Peter; Barnabe, Cheryl; Guo, Selynne; Lopatina, Elena; Marshall, Deborah A

    2016-11-01

    Cardiovascular disease (CVD) is a major comorbidity for patients with rheumatoid arthritis (RA). This study sought to determine the performance of 11 recently developed CVD quality indicators (QI) for RA in clinical practice. Medical charts for patients with RA (early disease or biologic-treated) followed at 1 center were retrospectively reviewed. A systematic assessment of adherence to 11 QI over a 2-year period was completed. Performance on the QI was reported as a percentage pass rate. There were 170 charts reviewed (107 early disease and 63 biologic-treated). The most frequent CVD risk factors present at diagnosis (early disease) and biologic start (biologic-treated) included hypertension (26%), obesity (25%), smoking (21%), and dyslipidemia (15%). Performance on the CVD QI was highly variable. Areas of low performance (risk assessment, communication to the primary care physician (PCP) that patients with RA were at increased risk of CVD, body mass index documentation and counseling if overweight, communication to a PCP about an elevated blood pressure, and discussion of risks and benefits of antiinflammatories in patients at CVD risk. Rates of diabetes screening and lipid screening were 67% and 69%, respectively. The area of highest performance was observed for documentation of intent to taper corticosteroids (98%-100% for yrs 1 and 2, respectively). Gaps in CVD risk management were found and highlight the need for quality improvements. Key targets for improvement include coordination of CVD care between rheumatology and primary care, and communication of increased CVD risk in RA.

  19. Santa Claus Coming to Town

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    More Chinese are embracing the Christmas holiday season,providing a vital boost to the country’s economy A Beijing netizen using the online screen name Da Qi and a group of his Web friends had big plans to celebrate the holiday season-an

  20. Leveraging Trainees to Improve Quality and Safety at the Point of Care: Three Models for Engagement.

    Science.gov (United States)

    Johnson Faherty, Laura; Mate, Kedar S; Moses, James M

    2016-04-01

    Trainees, as frontline providers who are acutely aware of quality improvement (QI) opportunities and patient safety (PS) issues, are key partners in achieving institutional quality and safety goals. However, as academic medical centers accelerate their initiatives to prioritize QI and PS, trainees have not always been engaged in these efforts. This article describes the development of an organizing framework with three suggested models of varying scopes and time horizons to effectively involve trainees in the quality and safety work of their training institutions. The proposed models, which were developed through a literature review, expert interviews with key stakeholders, and iterative testing, are (1) short-term, team-based, rapid-cycle initiatives; (2) medium-term, unit-based initiatives; and (3) long-term, health-system-wide initiatives. For each, the authors describe the objective, scope, duration, role of faculty leaders, steps for implementation in the clinical setting, pros and cons, and examples in the clinical setting. There are many barriers to designing the ideal training environments that fully engage trainees in QI/PS efforts, including lack of protected time for faculty mentors, time restrictions due to rotation-based training, and structural challenges. However, one of the most promising strategies for overcoming these barriers is integrating QI/PS principles into routine clinical care. These models provide opportunities for trainees to successfully learn and apply quality and safety principles to routine clinical care at the team, unit, and system level.

  1. Quality index tables for some eastern hardwood species

    Science.gov (United States)

    Joseph J. Mendel; William H. Smith; William H. Smith

    1970-01-01

    This paper briefly reviews the quality-index concept, presents log-quality index tables for a selected group of eastern hardwood tree species, and explains how timber operators can use Q.I. for evaluating the lumber that can be sawed from logs and trees.

  2. Diffusion of a quality improvement programme among allied health professionals.

    NARCIS (Netherlands)

    Sluijs, E.M.; Dekker, J.

    1999-01-01

    Objective: To assess the diffusion of a quality improvement (QI) programme among allied health professions in The Netherlands. Design: Descriptive study, based on a questionnaire distributed to allied health professionals; response rate, 63%. Settings and participants: All subsectors in health care

  3. 78 FR 35634 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-06-13

    ..., Washington, DC 20573, by telephone at (202) 523-5843 or by email at [email protected] . China Interocean Transport.... Taleon, Sole Proprietor (QI). Application Type: New NVO & OFF License. Dulce Auto Import & Export, Inc...), Parque de Granada No. 71, P.H. 504, Huixquilucan, Estado de Mexico 52785 Mexico. Officers: Moises S. Leon...

  4. A quality improvement approach to reducing use of meperidine.

    Science.gov (United States)

    Gordon, D B; Jones, H D; Goshman, L M; Foley, D K; Bland, S E

    2000-12-01

    In 1991 the University of Wisconsin Hospital and Clinics formed a pain management QI team whose goal was to improve pain management through education, outcome monitoring, and the development of programs intended to improve clinical practice. Longitudinal monitoring mechanisms were established to audit medical records and survey patients to examine both staff practice patterns and patient outcomes. The QI team targeted use of meperidine, one of the most widely used opioid analgesics for the treatment of moderate to severe pain, which is now discouraged as a first-line agent for most painful conditions. A QI process was implemented using a traditional plan-do-check-act (PDCA) model, resulting in a successful and sustained reduction of inappropriate meperidine use. A cause-and-effect diagram helped highlight the multiple factors contributing to the drug's overuse and was used to prioritize targets for action. A flow chart helped to uncover some of the interrelationships between the myths about meperidine and the resultant customary prescribing and administration practices. While most of the strategies were implemented in 1996 (formulary guideline release, change in stock supply and physician orders, staff education and feedback), a significant impact in practice was not seen until late 1997. Ongoing tracking and feedback loops were established to ensure continued low use of meperidine. Use of a QI approach in pain management has been shown to affect the visibility of pain as a clinical priority, enhance interdisciplinary collaboration, facilitate the implementation of clinical guidelines at the bedside, and improve the quality of care for patients.

  5. Chronic Pain and Complementary Health Approaches

    Science.gov (United States)

    ... qi gong, and yoga, are generally safe for healthy people if they’re performed appropriately. People with medical conditions and pregnant women may need to modify or avoid some mind and body practices. Like other forms of exercise, mind and ...

  6. Relationship between two blood stasis syndromes and inflammatory factors in patients with acute coronary syndrome.

    Science.gov (United States)

    Ma, Cai-Yun; Liu, Jing-Hua; Liu, Jian-Xun; Shi, Da-Zhuo; Xu, Zhen-Ye; Wang, Shao-Ping; Jia, Min; Zhao, Fu-Hai; Jiang, Yue-Rong; Ma, Qin; Peng, Hong-Yu; Lu, Yuan; Zheng, Ze; Ren, Feng-Xue

    2017-11-01

    To investigate the relationship between inflammatory factors and two Chinese medicine (CM) syndrome types of qi stagnation and blood stasis (QSBS) and qi deficiency and blood stasis (QDBS) in patients with acute coronary syndrome (ACS). Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups: 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1 (ICAM-1), chitinase-3-like protein 1 (YKL-40) and lipoprotein-associated phospholipase A2 (Lp-PLA2). Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference (P>0.05); ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS (Psyndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.

  7. Control Charts in Healthcare Quality Improvement A Systematic Review on Adherence to Methodological Criteria

    NARCIS (Netherlands)

    Koetsier, A.; van der Veer, S. N.; Jager, K. J.; Peek, N.; de Keizer, N. F.

    2012-01-01

    Objectives: Use of Shewhart control charts in quality improvement (QI) initiatives is increasing. These charts are typically used in one or more phases of the Plan Do Study Act (PDSA) cycle to monitor summaries of process and outcome data, abstracted from clinical information systems, over time. We

  8. Influence of UV and Ozonised Water Treatment on Trans-resveratrol Content in Berry Skins and Juices of Franc and Green Veltliner Grapes

    Czech Academy of Sciences Publication Activity Database

    Landfeld, A.; Tříska, Jan; Balík, J.; Strohalm, J.; Novotná, P.; Vrchotová, Naděžda; Totušek, J.; Lefnerová, D.; Híc, P.; Tománková, E.; Halama, R.; Houška, M.

    2015-01-01

    Roč. 33, č. 3 (2015), s. 267-276 ISSN 1212-1800 R&D Projects: GA MZe QI91B094 Institutional support: RVO:67179843 Keywords : grape juices * stilbens content * UV irradiation * ozonisation Subject RIV: GM - Food Processing Impact factor: 0.728, year: 2015

  9. Dicty_cDB: SHK664 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available *r*psl*rlysls*rg*rlkiitskrnrclk*ihqky*igr*it* rgrkeskin*rdsft*nlfhlkrkiksktfinh*rsfn*ikitnftkfy*yvnlifr*ff k...QI**ccy *tkigsn*ryh**ft*r*psl*rlysls*rg*rlkiitskrnrclk*ihqky*igr*it* rgrkeskin*rdsft*nlfhlkrkiksktfinh*rsfn*

  10. Fulltext PDF

    Indian Academy of Sciences (India)

    Floating bodies, immersed bod- ies. Floating and Immersed Bodies. The problems given below are based on the article on p.28. The readers are invited to send the solutions. The first correct answer for each problem with clear explanation will be published. QI. A sphere of radius R and density psis immersed in liquid of.

  11. A son in heaven, but no father on earth: A note in the margin of a ...

    African Journals Online (AJOL)

    Test

    2011-06-07

    Jun 7, 2011 ... for biblical studies in multi- and interdisciplinary research. As a consequence ... to John W. Miller's (1997) Jesus at Thirty, 'My uneasiness with ..... plausible way of involving (the) parents in the saying is suggested by Collins ... the mother 'puts' her baby in the river, in a basket (2:3 e[qhken aujth;n [i.e. qi bin].

  12. Quality improvement "201": context-relevant quality improvement leadership training for the busy clinician-educator.

    Science.gov (United States)

    Stille, Christopher J; Savageau, Judith A; McBride, Jeanne; Alper, Eric J

    2012-01-01

    Development of quality improvement (QI) skills and leadership for busy clinician-educators in academic medical centers is increasingly necessary, although it is challenging given limited resources. In response, the authors developed the Quality Scholars program for primary care teaching faculty. They conducted a needs assessment, evaluated existing internal and national resources, and developed a 9-month, 20-session project-based curriculum that combines didactic and hands-on techniques with facilitated project discussion. They also conducted pre-post tests of knowledge and attitudes, and evaluations of each session, scholars' projects, and program sustainability and costs. In all, 10 scholars from all 3 generalist disciplines comprised the first class. A wide spectrum of previous experiences enhanced collaboration. QI knowledge increased slightly, and reported self-readiness to lead QI projects increased markedly. Protected time for project work and group discussion of QI topics was seen as essential. All 10 scholars completed projects and presented results. Institutional leadership agreed to sustain the program using institutional funds.

  13. 77 FR 60434 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2012-10-03

    ..., Washington, DC 20573, by telephone at (202) 523-5843 or by email at [email protected] . AAB Logistics, LLC (NVO... Logistics, Inc. (NVO & OFF), 4666 Faries Parkway, Decatur, IL 62526, Officers: Mark D. Schweitzer, Vice... (NVO & OFF), 2705 NW 109th Avenue, Miami, FL 33172, Officers: Pedro Salcedo, Manager (QI), Daniel S...

  14. 78 FR 55698 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-09-11

    ...), Karla Costilla, Member/Manager, Application Type: New NVO & OFF License. ICAT Logistics, Inc. (OFF..., Washington, DC 20573, by telephone at (202) 523-5843 or by email at [email protected] . Abaco Logistics Corporation..., CFO, Application Type: QI Change & Add OFF Service. American General Logistics, Inc. (NVO), 626 N...

  15. 77 FR 23719 - Ocean Transportation Intermediary License; Applicants

    Science.gov (United States)

    2012-04-20

    ... Logistics, Inc. (NVO & OFF), 180 Champion Way, Northlake, IL 60164. Officers: David F. Gross, CEO (Qualifying Individual), Lance A. Lucibello, Vice President. Application Type: QI Change. CMA CGM Logistics... Fafoutis, General Manager (Qualifying Individual), Frank J. Baragona, Director. Application Type: New NVO...

  16. 78 FR 48435 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-08-08

    ... Change. Ever Line Logistics Inc. (NVO & OFF), 147-35 Farmers Blvd., Suite 208, Jamaica, NY 11434, Officer: Caihong Yang, President (QI), Application Type: Name Change to Bona Logistics US Inc. Global Container.... Bote, Member/Manager, Edgar T. Bote, Member/Manager, Application Type: New NVO License. National Air...

  17. 78 FR 66713 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-11-06

    ..., Washington, DC 20573, by telephone at (202) 523-5843 or by email at [email protected] . Action One Logistics, Inc..., Operating Manager (QI), Joseph Lam, Member, Application Type: New NVO License. Altex US, LLC (NVO & OFF), 1... President, Application Type: New NVO & OFF License. Andes Logistics USA LLC (NVO & OFF) 7500 NW 25 Street, 7...

  18. 77 FR 74186 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2012-12-13

    ... Logistics, Inc. (NVO & OFF), 7685 NW. 80th Terrace, Medley, FL 33166, Officers: Hugo E. Martinez, Secretary... & OFF), 1834 Harden Blvd., Lakeland, FL 33803, Officers: Steven C. Pniewski, Manager (QI), Manuel R. Echevarria, President, Application Type: New NVO & OFF License, Global Wide Logistics, Inc. (NVO), 1937 Davis...

  19. 78 FR 18592 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-03-27

    ...), Veronica Alcestte, Manager, Application Type: New NVO & OFF License Worldcraft Logistics LLC (NVO & OFF.... Salvat, Vice President, Application Type: Add NVO Service Bayshore Logistics & Services, LLC (NVO & OFF), 909 Westfield Avenue, Elizabeth, NJ 07208, Officers: Raquel Velez, Operating Manager (QI), Jose Moreno...

  20. 78 FR 63475 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-10-24

    ... dba Fachel Shipping & Logistics (NVO & OFF), 6331 Belair Road, Baltimore, MD 21206, Officers: Chinyere W. Osasuyi, Chief Executive Manager (QI), Famous I. Osasuyi, Chief Executive Member. Application... Change. Perimeter International dba Perimeter Logistics (NVO & OFF), 2700 Story Road, Suite 150, Irving...

  1. 78 FR 43202 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-07-19

    .... Alsea Global Logistics, LLC dba Alsea Global Logistics (NVO & OFF), 4836 SE Powell Blvd., Portland, OR... NVO & OFF License. Atlant Consulting Inc. dba Avro Logistics (NVO & OFF), 3626 Geary Blvd., Suite 206..., Officers: Paul Selvage, Member (QI), Steven Periman, Member/Manager, Application Type: Add Trade Name Blu...

  2. 76 FR 14395 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2011-03-16

    ..., Manager/President. Application Type: QI Change. Geoffrey Au dba ABC Logistics Company (NVO), 2250 Gellert... at (202) 523-5843 or by e-mail at [email protected] . Arkman Logistics Inc. (NVO), 1001 Fargo Avenue, Elk... Type: New NVO & OFF License. BCargo Logistics, S.A. de C.V. (NVO), Av. Revolucion 725-A, Col. Jardin...

  3. 76 FR 62407 - Ocean Transportation Intermediary License; Applicants

    Science.gov (United States)

    2011-10-07

    ... & Product Logistics Manager (Qualifying Individual), Thomas B. Crowley, Director, Application Type: QI... at (202) 523-5843 or by e-mail at [email protected] . Alltransport International Logistics, Inc. (NVO), 63... Individual), Application Type: New NVO License. American Global Logistics LLC dba AGL (NVO & OFF), 3399...

  4. Study on the effects of Jinqi hypoglycemic table on serum P-sel, TNF-α and HbAlc levels in patients with type two diabetes mellitus

    International Nuclear Information System (INIS)

    Qi Falian; Xu Jun; Wang Bin; Chen Yingjian; Yin Qiuxia; Ke Bingshen

    2007-01-01

    Objective: To study the effects of Huang Qi and Huang Lian on serum P-selectin, tumor necrosis factor-α (TNF-α), glucose and glycosylated hemoglobin (HbAlc) levels in patients with type two diabetes mellitus (DM). Methods: Sixty DM2 patients were divided randomly into 2 equal numbered groups: one group were treated with routine hypoglycemic medicine, in other group, Jinqi hypoglycemic tablets were added besides western medicine. Fasting blood glucose, two hour postprandial glucose, HbAlc, P-SLT and TNF-α levels were measured detected before and after three months' treatment. Results: There were no significant differences between the plasma glucose, HbAlc, P-SLT and TNF-α levels (P>0.05) in the JinQi group and western medicine group before treatment. Fasting plasma glucose and postprandial glucose were decreased after treatment in both groups. HbAlc, P-SLT and TNF-α levels were significantly decreased after treatment (P<0.05, P<0.01, P<0.01) in JinQi group. Conclusion: On the basis of treatment with western medicine, additional Huang Lian and Huang Qi could further decrease HbAlc, P-SLT and TNF-α levels, stabilize blood glucose and provide better therapeutic results in patients with type 2 diabetes mellitus. (authors)

  5. Chen et al., Afr J Tradit Complement Altern Med. (2011) 8(4):467-476

    African Journals Online (AJOL)

    AJTCAM

    Keywords: Shen-qi-di-huang decoction, proteinuria, nephrin, adriamycin nephropathy. Introduction. Proteinuria is a clinical signature of podocyte injury resulting in many renal diseases. The slit diaphragm (SD) which connects neighboring foot processes of podocytes represents a critical structure of protein filtration (Tarabra ...

  6. 奥运场馆溶入校园

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Beijing,the host city of the 2008 Olympic Games,plans to build more Olympicvenues in universities in order to avoid wasting resources after the Games."In view of the post-Games utilization,we have decided to build more venues oncampus,”said Liu Qi,president of the Beijing Organizing Committee for the 2008Olympic Games(BOCOG).

  7. Model for the low-temperature magnetic phases observed in doped YBa2Cu3O6+x

    DEFF Research Database (Denmark)

    Andersen, N.H.; Uimin, G.

    1997-01-01

    A classical statistical model for the antiferromagnetic ordering of the Cu spins in the CuO2 planes of reduced YBa2Cu3O6+x-type materials is presented. The magnetic phases considered are the experimentally observed high-temperature antiferromagnetic (AFI) phase with ordering vector Q(I)=(1/2 1/2 0...

  8. Monitoring kvality popelů ze spalování biomasy (1. část – živiny)

    Czech Academy of Sciences Publication Activity Database

    Ochecová, P.; Tlustoš, P.; Száková, J.; Perná, Ivana; Hanzlíček, Tomáš; Habart, J.

    -, č. 4 (2012), s. 204-209 ISSN 1804-0195 R&D Projects: GA MZe QI102A207 Institutional support: RVO:67985891 Keywords : ash * biomass * nutrients * pH * economics Subject RIV: DM - Solid Waste and Recycling http://www.wasteforum.cz/cisla/WF_4_2012.pdf#page=46

  9. Signaling pathways regulating FSH- and amphiregulin-induced meiotic resumption and cumulus cell expansion in the pig

    Czech Academy of Sciences Publication Activity Database

    Procházka, Radek; Blaha, Milan; Němcová, Lucie

    2012-01-01

    Roč. 144, č. 5 (2012), 535-546 ISSN 1470-1626 R&D Projects: GA ČR GAP502/11/0593; GA MZe QI101A166 Institutional support: RVO:67985904 Keywords : epidermal growth factor * activated protein kinase * in vitro maturation Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 3.555, year: 2012

  10. Investigating the interactions of the enantiomers of phenylglycine ...

    Indian Academy of Sciences (India)

    In this study, molecular dynamics simulation has been used to investigate the interactions of both chiral forms of ... about two orders of magnitude less than that in free water. Keywords. ... acids, peptides, drugs, and proteins with the surfaces of inorganic .... and energy parameters, qi and qj are the atomic point charges ...

  11. Monitoring kvality popelů ze spalování biomasy (2. část – rizikové prvky, PAU)

    Czech Academy of Sciences Publication Activity Database

    Ochecová, P.; Tlustoš, P.; Száková, J.; Perná, Ivana; Hanzlíček, Tomáš

    -, č. 2 (2013), s. 67-75 ISSN 1804-0195 R&D Projects: GA MZe QI102A207 Institutional support: RVO:67985891 Keywords : ash * biomass * trace elements * loss on ignition * polycyclic aromatic hydrocarbons Subject RIV: DM - Solid Waste and Recycling http://www.wasteforum.cz/cisla/WF_2_2013.pdf#page=21

  12. WAN-MING LIU

    Indian Academy of Sciences (India)

    Home; Journals; Sadhana. WAN-MING LIU. Articles written in Sadhana. Volume 41 Issue 7 July 2016 pp 713-719. Integrated fleet assignment and aircraft routing based on delay propagation · WAN-MING LIU XING-HUI ZHU YAN-LONG QI · More Details Abstract Fulltext PDF. Airlines' expensive resources, especially aircraft ...

  13. FILTWAM - A Framework for Online Game-based Communication Skills Training - Using Webcams and Microphones for Enhancing Learner Support

    NARCIS (Netherlands)

    Bahreini, Kiavash; Nadolski, Rob; Qi, Wen; Westera, Wim

    2012-01-01

    Bahreini, K., Nadolski, R., Qi, W., & Westera, W. (2012). FILTWAM - A Framework for Online Game-based Communication Skills Training - Using Webcams and Microphones for Enhancing Learner Support. In P. Felicia (Ed.), The 6th European Conference on Games Based Learning - ECGBL 2012 (pp. 39-48). Cork,

  14. 78 FR 17205 - Ocean Transportation Intermediary License Applicants

    Science.gov (United States)

    2013-03-20

    .... Sicilia, Member, Application Type: New NVO & OFF License. Brookfield Relocation Inc. (OFF), Two Corporate... Schwartz, President, Application Type: QI Change. Covenant Global Logistics Inc (NVO & OFF), 440 Benmar..., President, Application Type: Add Trade Name CGL Shipping. EXL Logistics, Inc. (NVO), 1444 NW 82nd Avenue...

  15. Interdisciplinary medical, nursing, and administrator education in practice: the Johns Hopkins experience.

    Science.gov (United States)

    Walrath, Jo M; Muganlinskaya, Nailya; Shepherd, Megan; Awad, Michael; Reuland, Charles; Makary, Martin A; Kravet, Steven

    2006-08-01

    Reforming graduate medical, nursing and health administrators' education to include the core competencies of interdisciplinary teamwork and quality improvement (QI) techniques is a key strategy to improve quality in hospital settings. Practicing clinicians are best positioned in these settings to understand systems issues and craft potential solutions. The authors describe how, in ten months during 2004 and 2005 the school of medicine, the school of nursing, and an administrative residency program, all at Johns Hopkins University, implemented and evaluated the Achieving Competency Today II Program (ACT II), a structured and interdisciplinary approach to learning QI that was piloted at various sites around the United States. Six teams of learners participated, each consisting of a medical, nursing, and administrative resident. The importance of interdisciplinary participation in planning QI projects, the value of the patient's perspective on systems issues, and the value of a system's perspective in crafting solutions to issues all proved to be valuable lessons. Challenges were encountered throughout the program, such as (1) participants' difficulties in balancing competing academic, personal and clinical responsibilities, (2) difficulties in achieving the intended goals of a broad curriculum, (3) barriers to openly discussing interdisciplinary team process and dynamics, and (4) the need to develop faculty expertise in systems thinking and QI. In spite of these challenges steps have been identified to further enhance and develop interdisciplinary education within this academic setting.

  16. Caring, learning, improving quality and doing research: Different ...

    African Journals Online (AJOL)

    The aim of this article is to describe the similarities between the consultation process, the quality improvement (QI) process, action- and problem-based learning and participatory action research (PAR). We feel this understanding adds value to our work in enabling personal development as practitioners, fostering teamwork ...

  17. Quantum Illumination-Based Target Detection and Discrimination

    Science.gov (United States)

    2014-06-30

    photodiode with an estimated quantum efficiency of 85% and an ultralow-noise transimpedance amplifier . Compared with to our initial QI measurements...demonstrated high signal-to-noise ratio (SNR) quantum-illumination target detection in a lossy, noisy environment using an optical parametric amplifier ...Research Triangle Park, NC 27709-2211 quantum communication, target detection, entanglement, parametric downconversion, optical parametric amplifiers

  18. Healthline | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... This is the second installment in NCCAM's The Science of Mind and Body Therapies video series. The first video, Tai Chi and Qi Gong for Health and Well-Being, was released in September 2010. Two New Topics Added to NIHSeniorHealth What You Need to ...

  19. [Analysis on medication regularity of modern traditional Chinese medicines in treating melancholia based on data mining technology].

    Science.gov (United States)

    Zhao, Yan-qing; Teng, Jing; Yang, Hong-jun

    2015-05-01

    To analyze the prescription and medication regularities of traditional Chinese medicines in the treatment of melancholia in the Chinese journal full text database (CNKI), Wanfang Data knowledge service platform, VIP, Chinese biomedical literature database (CBM) in based on the traditional Chinese medicine inheritance support platform software, in order to provide reference for further mining traditional Chinese medicines for the treatment of melancholia and new drug development. The traditional Chinese medicine inheritance support platform software V2.0 was used to establish the prescription database of traditional Chinese medicines for treating melancholia. The software integrated data mining method was adopted to analyze four Qis, five flavors, meridian distribution, frequency statistics, syndrome distribution, composition regularity and new prescriptions. Totally 358 prescriptions for treating melancholia were analyzed to determine the frequency of prescription drugs, commonly used drug pairs and combinations and develop 22 new prescriptions. According to this study, prescriptions for treating depression collected in modern literature databases mainly have the effects in soothing liver and resolving melancholia, strengthening spleen and eliminating phlegm, activating and replenishing blood, regulating liver qi, tonifying spleen qi, clearing heat and purging heat, soothing the mind, nourishing yin and tonifying kidney, with neutral drug property and sweet or bitter flavor, and follow the melancholia treatment principle of "regulating qi and opening the mind, regulating qi and empathy".

  20. Determination of Plant-Available Nutrients in Two Wood Ashes: the Influence of Combustion Conditions

    Czech Academy of Sciences Publication Activity Database

    Perná, Ivana; Ochecová, P.; Száková, J.; Hanzlíček, Tomáš; Tlustoš, P.

    2016-01-01

    Roč. 47, 13/14 (2016), 1664-1674 ISSN 0010-3624 R&D Projects: GA MZe QI102A207 Institutional support: RVO:67985891 Keywords : combustion condition * crystal phases * fertilizer * plant-available nutrients * wood ash Subject RIV: DM - Solid Waste and Recycling Impact factor: 0.589, year: 2016